Phase I/II clinical and pharmacokinetic study evaluating a fully human monoclonal antibody against EGFr (HuMax-EGFr) in patients with advanced squamous cell carcinoma of the head and neck

DEFF Research Database (Denmark)

Bastholt, Lars; Specht, Lena; Jensen, Kenneth

2007-01-01

PURPOSE: To assess safety, tolerability, pharmacokinetics and clinical activity of HuMax-EGFr in patients with SCCHN. PATIENTS AND METHODS: Twenty-eight patients with SCCHN were enrolled. The study comprised a single-dose escalation part for assessment of safety issues followed by a repeat dose e...

Mycobacterium genavense infection in AIDS: imaging findings in eight patients

International Nuclear Information System (INIS)

Monill, J.M.; Franquet, T.; Martinez-Noguera, A.; Villalba, J.; Sambeat, M.A.

2001-01-01

This retrospective study included eight HIV-positive patients with a M. genavense infection. Seven of these patients had a CT scan of the abdomen and a US examination, whereas one patient with pulmonary symptoms had conventional chest radiographs and thin-section CT scan of the thorax. Multiple large retroperitoneal and mesenteric lymph nodes were demonstrated in seven patients; low-attenuation centers within enlarged nodes were identified in two patients. On CT scans two cases showed circumferential wall thickening of the proximal small bowel with a deep ulceration in one of these patients. Additional findings included focal lesions in the liver (n = 1), spleen (n = 2), splenomegaly (n = 6), and hepatomegaly (n = 4). The CT scans from the thoracic examination demonstrated multiple diffuse nodular infiltrates in both lungs. M. genavense infection should be considered in the differential diagnosis of AIDS patients with CD4 counts below 100 cells/mm 3 presenting with abdominal lymphadenopathy, multinodular or homogeneous hepatosplenic enlargement and circumferential thickening of the small bowel wall. (orig.)

Comparison of transvagianl ultrasonography with hysterosonography as a screening method in patients with abnormal uterine bleeding

International Nuclear Information System (INIS)

Ryu, Jeong Ah; Kim, Bo Hyun; Lee, Jong Mee; Kim, Soo Ah; Lee, Sang Hoon

2004-01-01

To assess the utility of hysterosonography (HS) as a screening method in patients with abnormal uterine bleeding. We retrospectively reviewed transvaginal ultrasonography (TVS) and HS for 105 patients whose diagnosis was confirmed pathologically. All 105 patients were initially evaluated on the same day with both TVS and HS. On TVS and HS examination. endometrial cavitary lesions were classified as diffuse hyperplasis, endometrial polyp, endometrial cancer, uterine synechia and submucosal leiomyoma. Hysteroscopy with biopsy (n=35), curettage (n=60) or hysterectomy (n=10) was performed, and the results of TVS and HS examination were correlated with the pathological findings. The sensitivity and specificity were 79.0% and 45.8% for TVS, and 95.1% and 83.3% for HS, respectively. The positive and negative predictive values were 83.0% and 39.3% for TVS, and 95.1% and 83.3% for HS, respectively. Twenty-seven showed a discrepancy between the TVS and HS, and eight cases showed a discrepancy between HS and the pathologic diagnosis. TVS is a sensitive method to evaluate the endometrial cavitary lesions, but it often does not provide the physician with sufficient diagnostic information. With its higher sensitivities, specificities and positive and negative predictive values, HS can be better used than TVS in evaluating those patients with abnormal uterine bleeding

Comparison of transvagianl ultrasonography with hysterosonography as a screening method in patients with abnormal uterine bleeding

Energy Technology Data Exchange (ETDEWEB)

Ryu, Jeong Ah; Kim, Bo Hyun; Lee, Jong Mee; Kim, Soo Ah [Sungkyunkwan University, Seoul (Korea, Republic of); Lee, Sang Hoon [University of Ulsan College of Medicine, Seoul (Korea, Republic of)

2004-03-15

To assess the utility of hysterosonography (HS) as a screening method in patients with abnormal uterine bleeding. We retrospectively reviewed transvaginal ultrasonography (TVS) and HS for 105 patients whose diagnosis was confirmed pathologically. All 105 patients were initially evaluated on the same day with both TVS and HS. On TVS and HS examination. endometrial cavitary lesions were classified as diffuse hyperplasis, endometrial polyp, endometrial cancer, uterine synechia and submucosal leiomyoma. Hysteroscopy with biopsy (n=35), curettage (n=60) or hysterectomy (n=10) was performed, and the results of TVS and HS examination were correlated with the pathological findings. The sensitivity and specificity were 79.0% and 45.8% for TVS, and 95.1% and 83.3% for HS, respectively. The positive and negative predictive values were 83.0% and 39.3% for TVS, and 95.1% and 83.3% for HS, respectively. Twenty-seven showed a discrepancy between the TVS and HS, and eight cases showed a discrepancy between HS and the pathologic diagnosis. TVS is a sensitive method to evaluate the endometrial cavitary lesions, but it often does not provide the physician with sufficient diagnostic information. With its higher sensitivities, specificities and positive and negative predictive values, HS can be better used than TVS in evaluating those patients with abnormal uterine bleeding.

Therapeutic effects of diaphragmatic plication for acquired unilateral non-malignant diaphragm paralysis in twenty patients

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Reza Bagheri

2013-12-01

Full Text Available Background: Acquired paralysis of the diaphragm is a condition caused by trauma, surgical injuries, (lung cancer surgery, esophageal surgery, cardiac surgery, thoracic surgery, and is sometimes of an unknown etiology. It can lead to dyspnea and can affect ventilatory function and patients activity. Diaphragmatic plication is a treatment method which decreases inconsistent function of diaphragm. The aim of this study is to evaluate the outcome of diaphragmatic plication in patients with acquired unilateral non-malignant diaphragmatic paralysis. Methods: From 1991 to 2011, 20 patients with acquired unilateral diaphragmatic paralysis who underwent surgery enrolled in our study in Ghaem Hospital Mashhad University of Medical Science. Patients were evaluated in terms of age, sex, BMI, clinical symptoms, dyspnea score (DS, etiology of paralysis, diagnostic methods, respiratory function tests and complication of surgery. Some tests including dyspnea score were carried out again six months after surgery. We evaluated patients with SPSS version 11.5 and Paired t-test or nonparametric equivalent. Results: Twenty patients enrolled in our study. 14 were male and 6 were female. The mean age was 58 years and the average time interval between diagnosis to surgical treatment was 38.3 months. Acquired diaphragmatic paralysis was mostly caused by trauma (in 11 patients and almost occurred on the left side (in 15 patients. Diagnostic methods included chest x-ray, CT scan, ultrasonography and sniff. Test prior to surgery the average FVC was 41.4±7 percent and the average FEV1 was 52.4±6 percent and after surgery they were 80.1±8.6 percent and 74.4±1 percent respectively. The average increase in FEV1 and FVC 63.4±4, 61.1±7.8. Performing surgery also leads to a noticeable improvement in dyspnea score in our study. Conclusion: In patients with acquired unilateral non-malignant diaphragm paralysis diaphragmatic plication is highly recommended due to the

Mycobacterium genavense infection in AIDS: imaging findings in eight patients

Energy Technology Data Exchange (ETDEWEB)

Monill, J.M.; Franquet, T.; Martinez-Noguera, A.; Villalba, J. [Dept. of Radiology, Univ. Autonoma de Barcelona (Spain); Sambeat, M.A. [Dept. of Infectious Diseases, Univ. Autonoma de Barcelona (Spain)

2001-02-01

This retrospective study included eight HIV-positive patients with a M. genavense infection. Seven of these patients had a CT scan of the abdomen and a US examination, whereas one patient with pulmonary symptoms had conventional chest radiographs and thin-section CT scan of the thorax. Multiple large retroperitoneal and mesenteric lymph nodes were demonstrated in seven patients; low-attenuation centers within enlarged nodes were identified in two patients. On CT scans two cases showed circumferential wall thickening of the proximal small bowel with a deep ulceration in one of these patients. Additional findings included focal lesions in the liver (n = 1), spleen (n = 2), splenomegaly (n = 6), and hepatomegaly (n = 4). The CT scans from the thoracic examination demonstrated multiple diffuse nodular infiltrates in both lungs. M. genavense infection should be considered in the differential diagnosis of AIDS patients with CD4 counts below 100 cells/mm{sup 3} presenting with abdominal lymphadenopathy, multinodular or homogeneous hepatosplenic enlargement and circumferential thickening of the small bowel wall. (orig.)

Effects of Biologic Agents in Patients with Rheumatoid Arthritis and Amyloidosis Treated with Hemodialysis

OpenAIRE

Kuroda, Takeshi; Tanabe, Naohito; Nozawa, Yukiko; Sato, Hiroe; Nakatsue, Takeshi; Kobayashi, Daisuke; Wada, Yoko; Saeki, Takako; Nakano, Masaaki; Narita, Ichiei

2016-01-01

Objective Our objective was to examine the safety and effects of therapy with biologics on the prognosis of rheumatoid arthritis (RA) patients with reactive amyloid A (AA) amyloidosis on hemodialysis (HD). Methods Twenty-eight patients with an established diagnosis of reactive AA amyloidosis participated in the study. The survival was calculated from the date of HD initiation until the time of death, or up to end of June 2015 for the patients who were still alive. HD initiation was according ...

Effects of Art Therapy Using Color on Purpose in Life in Patients with Stroke and Their Caregivers

OpenAIRE

Kim, Mi Kyoung; Kang, Sung Don

2012-01-01

Purpose Patients with stroke suffer from physical disabilities, followed by mental instability. Their caregivers also suffer from mental instability. The present study attempted to address the degree and the change of the level of Purpose in Life (PIL) in patients with stroke and caregivers by applying art therapy using colors. Materials and Methods Twenty-eight stroke patients with a good functional recovery or a moderate disability and their 28 caregivers were selected and evaluated. The pe...

Radiotherapy of patients with germ cell tumor

International Nuclear Information System (INIS)

Inomata, Taisuke; Maeda, Tomoho; Yoshida, Shoji; Ogawa, Yasuhiro; Hamada, Fumio; Imajo, Yoshinari; Gose, Kyuhei; Fujiwara, Kiyoshi.

1986-01-01

Twenty-one patients with germ cell tumor who received radiotherapy were discussed. There were eight patients with germinoma, two patients with malignant teratoma, three patients with pineocytoma (out of category of germ cell tumor today) and eight unverified patients. Irradiated dose was mostly from 50 Gy to 60 Gy and local irradiation was performed after whole brain irradiation in many cases. The effect of radiotherapy was not so good in patients with malignant teratoma. On the contrary, it was relatively good in patients with germinoma and five out of eight patients are alive with no symptoms of recurrence. Six out of eight unverified patients are also alive. Among them, several patients with germinoma are considered to be included. Germinoma occupies many cases of germ cell tumor and has a good response to radiotherapy. Against spinal cord metastasis and late recurrence, additional therapy, such as chemotherapy, seems to be useful to improve cure ratio. (author)

Twenty-four-hour ambulatory blood pressure monitoring in very elderly patients

Science.gov (United States)

Cappelleri, Claudia; Janoschka, Alin; Berli, Reto; Kohler, Sibylle; Braun-Dullaeus, Ruediger C.; Heuss, Ludwig T.; Wolfrum, Mathias

2017-01-01

Abstract Elevated blood pressure (BP) is frequently diagnosed in very elderly hospitalized patients. Accurate diagnosis of hypertension is challenging in the hospital environment, due to the “white coat effect,” and both overtreatment and undertreatment can adversely affect clinical outcome. Twenty-four-hour ambulatory blood pressure monitoring (ABPM) has the potential to avoid the “white coat effect” and accurately guide the management of hypertension. However, effects of the hospital environment on ABPM are unknown in the very elderly. We set out to enroll 45 patients, age ≥70 years, with elevated conventional BP during hospitalization in this observational study. It was prespecified by protocol to assess initially the difference between 24-hour BP during hospital-admission and home follow-up. Subsequent analysis should investigate the change in anxiety (Hospital Anxiety and Depression Scale-A [HADS-A]) after discharge, the correlation with change in 24-hour BP after discharge, and the prevalence of orthostatic hypertension. Thirty-one patients were included in the final analysis (age 83.5 ± 4.4 years; 71% female). Twenty-four-hour BP decreased significantly after hospital discharge (systolic from 133.5 ± 15.6 to 126.2 ± 14.4 mm Hg [millimeter of mercury], P = .008; diastolic from 71.0 ± 9.0 to 68.3 ± 8.6 mm Hg, P = .046). Anxiety level (HADS-A) decreased significantly after discharge, from 7.5 (interquartile range [IQR]: 4.0–13.8) to 5.0 (IQR: 4.0–8.0, P = .012). The change in anxiety was a predictor of change in systolic BP after discharge (F[1,20] = 5.9, P = .025). Sixty-one percent of the patients had significant orthostatic hypotension during hospital stay. In conclusion, 24-hour BP in very elderly patients is lower in the home environment than during hospitalization. This phenomenon seems to be directly linked to a lower anxiety-level at home. Reassessing hypertension at home may decrease the

Thyrotropin Secretion in Mild and Severe Primary Hypothyroidism Is Distinguished by Amplified Burst Mass and Basal Secretion with Increased Spikiness and Approximate Entropy

NARCIS (Netherlands)

Roelfsema, Ferdinand; Pereira, Alberto M.; Adriaanse, Ria; Endert, Erik; Fliers, Eric; Romijn, Johannes A.; Veldhuis, Johannes D.

2010-01-01

Context: Twenty-four-hour TSH secretion profiles in primary hypothyroidism have been analyzed with methods no longer in use. The insights afforded by earlier methods are limited. Objective: We studied TSH secretion in patients with primary hypothyroidism (eight patients with severe and eight

How to Boost the Breast Tumor Bed? A Multidisciplinary Approach in Eight Steps

International Nuclear Information System (INIS)

Kirova, Youlia M.; Fournier-Bidoz, Nathalie; Servois, Vincent; Laki, Fatima; Pollet, Guillaume A.; Salmon, Remy; Thomas, Alexandra; Dendale, Remi; Bollet, Marc A.; Campana, Francois M.D.; Fourquet, Alain

2008-01-01

Purpose: To describe a new procedure for breast radiotherapy that will improve tumor bed localization and radiotherapy treatment using a multidisciplinary approach. Patients and Methods: This pilot study was conducted by departments of radiation oncology, surgery, and radiology. A new procedure has been implemented, summarized as eight steps: from pre-surgery contrast CT to surgery, tumor bed planning target volume (PTV) determination, and finally breast and tumor bed irradiation. Results: Twenty patients presenting with T1N0M0 tumors were enrolled in the study. All patients underwent lumpectomy with the placement of surgical clips in the tumor bed region. During surgery, 1 to 5 clips were placed in the lumpectomy cavity before the plastic procedure. All patients underwent pre- and postoperative CT scans in the treatment position. The two sets of images were registered with a match-point registration. All volumes were contoured and the results evaluated. The PTV included the clips region, the gross tumor volume, and the surgical scar, with an overall margin of 5-10 mm in all directions, corresponding to localization and setup uncertainties. For each patient the boost PTV was discussed and compared with our standard forward-planned PTV. Conclusions: We demonstrate the feasibility of a tumor bed localization and treatment procedure that seems adaptable to routine practice. Our study shows the advantages of a multidisciplinary approach for tumor bed localization and treatment. The use of more than 1 clip associated with pre- to postoperative CT image registration allows better definition of the PTV boost volume

Correlation of diagnostic imaging and autopsy findings of eight patients with acquired immune deficiency syndrome

International Nuclear Information System (INIS)

Li Hongjun; Zhang Yuzhong; Cheng Jingliang

2009-01-01

Objective: To investigate the imaging findings with pathologic correlation in patients with acquired immune deficiency syndrome (AIDS). Methods: Imaging findings, autopsy and pathological data were retrospectively analyzed in eight patients with AIDS. Routine CT scanning of different body parts was performed during their hospitalization. CT scanning was performed from the skull to the pelvis immediately following their death. After routine formalin fixing, 7 cadavers were cross sectioned for autopsy in freezing state and 1 for gross autopsy. Tissues were obtained from each sections and organs for pathological examinations. Results: The autopsy data showed parasitic infections (5 cases), bacterial infections (3 cases), fungal infections (2 cases), virus infections (2 cases), lymphoma (1 case) and cerebrovascular diseases (1 case)in eight patients with AIDS. The CT scanning demonstrated symmetrical ground glass liked shadows with pulmonary hilus as the center in 5 cases of pulmonary PCP infection; pulmonary patchy shadows, scattering distribution of nodular shadows, extensive military nodular shadows with even distribution and tuberculous pleurisy; cloudy shadows for 2 cases of fungi infection with multiple foci of chronic inflammation; pulmonary net-like parenchymal changes for 2 cases of pulmonary CMV infection; thickened intestinal wall and narrowed intestinal lumen for 1 case of intestinal tumor; low density shadows of brain tissue for 1 case of CMV encephalitis and MRI findings of high T 1 and high T 2 signals as well as MRA findings of broken vascular channels in liquefied areas of brain tissues; patchy low density areas inside a cyst of brain for one case of brain toxoplasmosis infection; multiple small patchy low density areas in cerebral basal ganglia for one case of brain cryptococcus infection. Conclusions: In AIDS patients, infection and tumor may occur in various organs resulting in complex symptoms, which makes it more complicated and difficult to make

Congenital duodenal diaphragm in eight children

International Nuclear Information System (INIS)

Nawaz, Akhtar; Matta, Hilal; Jacobsz, Alic; Al-Salem, Ahmad H.; Trad, Omar

2004-01-01

Congenital duodenal obstruction (CDO) is common and usually easy to diagnose cause of intestinal obstruction in the newborn, except when the cause of the obstruction is duodenal diaphragm. We describe our experience with eight children who had intrinsic duodenal obstruction secondary to a duodenal diaphragm. The medical record of 22 children with the diagnosis of congenital intrinsic duodenal were reviewed for age, sex, gestation, birth weight, clinical features, associated anomalies, method of diagnosis, treatment and outcome. Operative findings and procedures were obtained from the operative notes. Eight of 22 children (36.4%) had congenital duodenal diaphragm (CDD). In all children, the diagnosis was made from the plain abdominal X-ray, which showed the classic double-bubble appearence, and barium meal, which showed duodenal obstruction. Four patients had associated anomalies, including two with Down's syndrome intraoperatively, five patients were found to have duodenal diaphragm with a central hole, while the other three had complete duodenal diaphragms. Postoperatively, all patients did well. Six required total parenteral nutrition. The 100% survival rate among these children is comparable to that in Western countries, and can be attributed to the lack of major associated abnormalities, good perioperative management, and the availability of total parenteral nutrition. (author)

Eight-term cyclic phosphites as coke deposit inhibitors and a method for producing them

Energy Technology Data Exchange (ETDEWEB)

Vershinin, P.V.; Chebotareva, E.G.; Kadyrova, V.Kh.; Kirpichnikov, P.A.; Pozdnev, V.V.; Vershinin, Yu.P.; Zharkova, V.M.

1982-01-01

It is proposed that a eight-term cyclic phosphite formula be used where R = methyl, R' = tertiary-butyl or alpha-methylcyclohexyl, R'' = tertiary-butyl, R''' = hydrogen, methyl, tertiary-butyle, bromine, X = methylene and sulfur as coke deposit inhibitors in the pyrolysis of petroleum raw materials. A method for producing the eight-term cyclic phosphite formula is proposed where a cyclic chlorophosphite formula interacts with a phenol formula in a medium of polar aprotic solvent using a base at 80-100 degrees.

Imaging and quantification of anomaly volume using an eight-electrode 'hemiarray' EIT reconstruction method.

Science.gov (United States)

Sadleir, R J; Zhang, S U; Tucker, A S; Oh, Sungho

2008-08-01

Electrical impedance tomography (EIT) is particularly well-suited to applications where its portability, rapid acquisition speed and sensitivity give it a practical advantage over other monitoring or imaging systems. An EIT system's patient interface can potentially be adapted to match the target environment, and thereby increase its utility. It may thus be appropriate to use different electrode positions from those conventionally used in EIT in these cases. One application that may require this is the use of EIT on emergency medicine patients; in particular those who have suffered blunt abdominal trauma. In patients who have suffered major trauma, it is desirable to minimize the risk of spinal cord injury by avoiding lifting them. To adapt EIT to this requirement, we devised and evaluated a new electrode topology (the 'hemiarray') which comprises a set of eight electrodes placed only on the subject's anterior surface. Images were obtained using a two-dimensional sensitivity matrix and weighted singular value decomposition reconstruction. The hemiarray method's ability to quantify bleeding was evaluated by comparing its performance with conventional 2D reconstruction methods using data gathered from a saline phantom. We found that without applying corrections to reconstructed images it was possible to estimate blood volume in a two-dimensional hemiarray case with an uncertainty of around 27 ml. In an approximately 3D hemiarray case, volume prediction was possible with a maximum uncertainty of around 38 ml in the centre of the electrode plane. After application of a QI normalizing filter, average uncertainties in a two-dimensional hemiarray case were reduced to about 15 ml. Uncertainties in the approximate 3D case were reduced to about 30 ml.

Effects of Twenty-four Move Shadow Boxing Combined with psychosomatic relaxation on Depression and Anxiety in Patients with Type-2 Diabetes.

Science.gov (United States)

Zheng, Yingying; Zhou, Yiyi; Lai, Qiujia

2015-06-01

The aim of the current study was to observe the effects of Twenty-four Move Shadow Boxing combined with psychosomatic relaxation on depression and anxiety in patients with Type-2 Diabetes. One hundred and twenty (120) patients with Type-2 Diabetes and depressive/anxious symptoms were divided into intervention group (60 cases) and control group (60 cases) according to the minimum distribution principle of unbalanced indicators. Twenty-four Move Shadow Boxing group used this intervention combined with psychosomatic relaxation. Control group underwent conventional treatment. All the patients in the two groups completed the Self-rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) before and after treatment. Among the 52 people included in the statistical analysis, the recovery rate was 13.3%. The differences between depression and anxiety scores in the intervention group before and after treatment were statistically significant (PBoxing and psychosomatic relaxation has a beneficial auxiliary therapeutic effect on depression and anxiety accompanying Type-2 Diabetes.

The effects of Transcutaneous Electrical Nerve Stimulation on postural control in patients with chronic low back pain

OpenAIRE

Rojhani-Shirazi, Z; Rezaeian, T

2015-01-01

Objective: The effects of transcutaneous electrical nerve stimulation (TENS) on postural control in patients with low back pain which is not well known. This study aimed to evaluate the effects of TENS on postural control in chronic low back pain. Methods: This study was an experimental research design. Twenty-eight patients with chronic LBP (25-45 Y/ O) participated and by using a random allocation, were divided to samples who participated in this study. The mean center of pressure (COP) vel...

Hereditary Transthyretin Amyloidosis in Eight Chinese Families

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Ling-Chao Meng

2015-01-01

Full Text Available Background: Mutations of transthyretin (TTR cause the most common type of autosomal-dominant hereditary systemic amyloidosis, which occurs worldwide. To date, more and more mutations in the TTR gene have been reported. Some variations in the clinical presentation are often observed in patients with the same mutation or the patients in the same family. The purpose of this study was to find out the clinicopathologic and genetic features of Chinese patients with hereditary TTR amyloidosis. Methods: Clinical and necessary examination materials were collected from nine patients of eight families with hereditary TTR amyloidosis at Peking University First Hospital from January 2007 to November 2014. Sural nerve biopsies were taken for eight patients and skin biopsies were taken in the calf/upper arm for two patients, for light and electron microscopy examination. The TTR genes from the nine patients were analyzed. Results: The onset age varied from 23 to 68 years. The main manifestations were paresthesia, proximal and/or distal weakness, autonomic dysfunction, cardiomyopathy, vitreous opacity, hearing loss, and glossohypertrophia. Nerve biopsy demonstrated severe loss of myelinated fibers in seven cases and amyloid deposits in three. One patient had skin amyloid deposits which were revealed from electron microscopic examination. Genetic analysis showed six kinds of mutations of TTR gene, including Val30Met, Phe33Leu, Ala36Pro, Val30Ala, Phe33Val, and Glu42Gly in exon 2. Conclusions: Since the pathological examinations of sural nerve were negative for amyloid deposition in most patients, the screening for TTR mutations should be performed in all the adult patients, who are clinically suspected with hereditary TTR amyloidosis.

Osteonecrosis in patients with malignant lymphoma: a review of twenty-five cases

International Nuclear Information System (INIS)

Engel, I.A.; Straus, D.J.; Lacher, M.; Lane, J.; Smith, J.

1981-01-01

A retrospective study of 25 patients with malignant lymphoma who had osteonecrosis of either the femoral or humeral head(s) was undertaken. The common factor present among all patients was the administration of intermittent steroid-containing combination chemotherapy. Seventeen Hodgkin's disease patients received chemotherapy predominantly consisting of an alkylating agent, vincristine, procarbazine, and moderate amounts of prednisone. The non-Hodgkin's lymphoma patients were on various moderate dosage steroid-containing protocols, except three who received prolonged high-dose steroid-containing chemotherapy regimens. Sixteen of the 17 Hodgkin's disease patients and five of the eight non-Hodgkin's lymphoma patients received radiotherapy to the bones that subsequently developed osteonecrosis. Two of the three non-Hodgkin's lymphoma patients who were not irradiated were treated with high-dose steroid-containing chemotherapy regimens. Symptoms developed in patients 12 months to 32 months after completion of chemotherapy and radiotherapy, respectively. Osteonecrosis was a long-term complication of treatment between 1970 and 1979 and occurred in 1.6% of the Hodgkin's disease and 0.12% of the non-Hodgkin's lymphoma patients treated. The authors conclude that the patients at highest risk for this complication are those who receive both radiotherapy to the affected bone(s) and intermittent steroid-containing multiple drug chemotherapy

Efficacy of intraarterial chemoinfusion therapy for locally advanced breast cancer patients: a retrospective analysis of 28 cases

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Zhang W

2013-06-01

Full Text Available Wei Zhang,1,* Rong Liu,1,* Yingying Wang,1 Sheng Qian,1 Jianhua Wang,1 Zhiping Yan,1 Hongwei Zhang21Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China; 2Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China*These authors contributed equally to this workObjective: The objective of this study was to evaluate the outcome of image-guided delivery of intraarterially infused chemotherapeutic drugs for patients with locally advanced breast cancer.Methods: Twenty-eight patients with pathologically proven, locally advanced breast cancer received intraarterial chemoinfusion therapy (chemoinfusion with docetaxel 75 mg/m2 and epirubicin 50 mg/m2. Digital subtraction angiography was performed to determine tumor arterial blood supply and to guide chemotherapy infusion. Patients were evaluated for complete remission (CR and partial remission (PR.Results: Twenty-eight patients received a total of 64 intraarterial chemoinfusions, 20 patients (71.4% received two infusions, and eight patients (28.6% received three infusions. One patient (3.6% had CR and 23 (82.1% had PR. The total effectiveness rate (CR and PR was 85.7% (24/28. All stage 3 patients underwent Phase II surgical resection after chemoinfusion, and the surgical resection participation rate was 100% (26/26. The mean time from the first chemoinfusion to surgery was 2 ± 1.2 months. Two patients with stage 4 cancer died of distant metastasis and cachexia, and the remaining 26 patients were still alive.Conclusion: Intraarterial chemoinfusion is a safe and effective therapy, achieving down-staging in a relatively short period for locally advanced breast cancer.Keywords: advanced breast cancer, intraarterial infusion, chemotherapy, therapeutic effect

Evaluation of the Adhesive Properties of the Cornea by Means of Optical Coherence Tomography in Patients with Meibomian Gland Dysfunction and Lacrimal Tear Deficiency

OpenAIRE

Napoli, Pietro Emanuele; Coronella, Franco; Satta, Giovanni Maria; Galantuomo, Maria Silvana; Fossarello, Maurizio

2014-01-01

Objective The aim was to determine the influence of meibomian gland dysfunction (MGD) and aqueous tear deficiency dry eye (ADDE) on the adhesive properties of the central cornea by means of optical coherence tomography (OCT), and to investigate the relationship between corneal adhesiveness and classical tear tests, as well as the reliability of results, in these lacrimal functional unit disorders. Design Prospective, case-control study. Methods Twenty-eight patients with MGD and 27 patients w...

Cardiac abnormalities in the acquired immunodeficiency syndrome. A prospective study with a clinical-pathological correlation in twenty-one adult patients

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Herdy Gesmar Volga Haddad

1999-01-01

Full Text Available OBJECTIVE - To evaluate the cardiac abnormalities and their evolution during the course of the acquired immunodeficiency syndrome, as well as to correlate clinical and pathological data. METHODS - Twenty-one patients, admitted to the hospital with the diagnosis of acquired immunodeficiency syndrome, were prospectively studied and followed until their death. Age ranged from 19 to 42 years (17 males. ECG and echocardiogram were also obtained every six months. After death, macro- and microscopic examinations were also performed. RESULTS - The most frequent causes of referral to the hospital were: diarrhea or repeated pneumonias, tuberculosis, toxoplasmosis or Kaposi sarcoma. The most frequent findings were acute or chronic pericarditis (42% and dilated cardiomyopathy (19%. Four patients died of cardiac problems: infective endocarditis, pericarditis with pericardial effusion, bacterial myocarditis and infection by Toxoplasma gondii. CONCLUSION - Severe cardiac abnormalities were the cause of death in some patients. In the majority of the patients, a good correlation existed between clinical and anatomical-pathological data. Cardiac evaluation was important to detect early manifestations and treat them accordingly, even in asymptomatic patients.

Pulmonary involvement in patients with Guillain–Barré syndrome in subacute phase

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Meeka Khanna

2017-01-01

Full Text Available Objectives: To evaluate the pulmonary function in Guillain–Barre syndrome (GBS patients in subacute phase and find clinical correlates of pulmonary dysfunction. Methods: This was a single-center, prospective, cross-sectional, hospital-based study in GBS patients performed in Department of Neurological Rehabilitation at a tertiary care institute. Clinical examination for pulmonary function was done by measuring chest expansion. The pulmonary function tests were carried out by Spirometry kit Microquark Cosmed, Italy. Fatigue was assessed by Fatigue Severity Scale, disability status by Hughes Disability Scale (HDS, and muscle weakness by Medical Research Council sum scores. Statistical Analysis: Statistical analysis was performed by Stata 11. The significance of P value was adjudged against an alpha of 0.05. Results: Twenty-eight patients were included with 17 (61% men and mean age of 31 years. Median duration of symptoms was 16.5 days. There were 10 (36% demyelinating and 18 (64% axonal variants. Twenty-six (93% patients scored more than 2 on HDS. All study participants reported fatigue. Twenty-two (78.6% patients had chest expansion of <2.5 cm. Spirometry showed restrictive pulmonary dysfunction in 23 (79% patients. Significant correlation was found between abnormal pulmonary function test and chest expansion (P = 0.003. Conclusion: Pulmonary dysfunction in GBS is common even during subacute phase. It needs to be identified and managed appropriately for better clinical outcome.

Pulmonary Involvement in Patients with Guillain–Barré Syndrome in Subacute Phase

Science.gov (United States)

Khanna, Meeka; Rawat, Nidhi; Gupta, Anupam; Nagappa, Madhu; Taly, Arun B.; Rukmani, M. R.; Sathyaprabha, T. N.; Haldar, Partha

2017-01-01

Objectives: To evaluate the pulmonary function in Guillain–Barre syndrome (GBS) patients in subacute phase and find clinical correlates of pulmonary dysfunction. Methods: This was a single-center, prospective, cross-sectional, hospital-based study in GBS patients performed in Department of Neurological Rehabilitation at a tertiary care institute. Clinical examination for pulmonary function was done by measuring chest expansion. The pulmonary function tests were carried out by Spirometry kit Microquark Cosmed, Italy. Fatigue was assessed by Fatigue Severity Scale, disability status by Hughes Disability Scale (HDS), and muscle weakness by Medical Research Council sum scores. Statistical Analysis: Statistical analysis was performed by Stata 11. The significance of P value was adjudged against an alpha of 0.05. Results: Twenty-eight patients were included with 17 (61%) men and mean age of 31 years. Median duration of symptoms was 16.5 days. There were 10 (36%) demyelinating and 18 (64%) axonal variants. Twenty-six (93%) patients scored more than 2 on HDS. All study participants reported fatigue. Twenty-two (78.6%) patients had chest expansion of <2.5 cm. Spirometry showed restrictive pulmonary dysfunction in 23 (79%) patients. Significant correlation was found between abnormal pulmonary function test and chest expansion (P = 0.003). Conclusion: Pulmonary dysfunction in GBS is common even during subacute phase. It needs to be identified and managed appropriately for better clinical outcome. PMID:28694622

The effect of eight weeks endurance training and high-fat diet on appetite-regulating hormones in rat plasma

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Rouhollah Haghshenas

2014-04-01

Full Text Available Objective(s:Consumption of high-fat foods is one of the major causes of obesity. Physical exercise is a strategy used to counteract obesity. The aim of this study was to investigate the effect of eight weeks endurance training and high-fat diet (HFD on appetite-regulating hormones in rat plasma. Materials and Methods:Twenty eight male Wistar rats were randomly divided into four groups: Control group with standard diet (CSD, endurance training with a standard diet (ESD, control group with high-fat diet (CHFD and endurance training with high-fat diet (EHFD. Twenty-four hr after the last training session, the blood samples were obtained and analyzed for hormones levels. Results: The significant increased weight gain and food intake and decreased plasma nesfatin-1 and PYY3-36 levels were observed in CHFD group, while exercise under the HFD antagonized these effects. There were no significant changes in ghrelin, insulin and leptin levels in different groups. Conclusion: These results suggest that exercise can prevent fattening effect of HFD. Probably, performing exercise makes a reduction of food intake and weight gain in rat via the increase in nesfatin-1 and PYY levels. However, further studies are necessary to understand the exact mechanisms involved in this field.

Hibernoma: MRI features in eight consecutive cases

International Nuclear Information System (INIS)

Lee, J.C.; Gupta, A.; Saifuddin, A.; Flanagan, A.; Skinner, J.A.; Briggs, T.W.R.; Cannon, S.R.

2006-01-01

Aim: To describe the preoperative magnetic resonance imaging findings of eight histologically-proven cases of hibernoma. Materials and methods: The site, size, and signal characteristics of eight consecutive hibernomas were retrospectively assessed on T1-weighted spin-echo and short T1 inversion recovery (STIR)/fat-saturated T2-weighted fast spin echo magnetic resonance images. Four patients also had gadolinium-enhanced fat-saturated T1-weighted spin echo imaging. Patient age and sex, and duration of symptoms were recorded. Results: Three female and five male patients with an average age 36 years (range 16-53 years) were included. Seven lesions occurred in the thigh, four in the anterior compartment and three in the posterior compartment. One lesion occurred superficial to the scapula. All cases demonstrated common magnetic resonance imaging findings of a well-defined, heterogeneous mass, slightly or clearly hypo-intense to subcutaneous fat on T1-weighted spin-echo images, with prominent thin low signal bands throughout the tumour. The lesions failed to fully suppress on STIR or fat-saturated T2-weighted images. Only one of the four contrast-enhanced studies demonstrated increased vascularity in the tumour. Conclusion: The MRI findings of a lesion that is diffusely slightly hypointense to surrounding subcutaneous fat, should prompt the operator to consider hibernoma in the differential diagnosis

Recent developments and applications of multi-configuration Hartree-Fock methods. NRCC proceedings No. 10

Energy Technology Data Exchange (ETDEWEB)

Dupuis, M. (ed.)

1981-02-01

Twenty-seven papers are included in four sessions titled: generalized Fock operator methods, annihilation of single excitations methods, second-order MCSCF methods, and applications of MCHF methods. Separate abstracts were prepared for eight papers; one of the remaining had been previously abstracted. (DLC)

Recent developments and applications of multi-configuration Hartree-Fock methods. NRCC proceedings No. 10

International Nuclear Information System (INIS)

Dupuis, M.

1981-02-01

Twenty-seven papers are included in four sessions titled: generalized Fock operator methods, annihilation of single excitations methods, second-order MCSCF methods, and applications of MCHF methods. Separate abstracts were prepared for eight papers; one of the remaining had been previously abstracted

Chemotherapy in locally advanced nasopharyngeal carcinoma: An individual patient data meta-analysis of eight randomized trials and 1753 patients

International Nuclear Information System (INIS)

Baujat, Bertrand; Audry, Helene; Bourhis, Jean; Chan, Anthony T.C.; Onat, Haluk; Chua, Daniel T.T.; Kwong, Dora L.W.; Al-Sarraf, Muhyi; Chi, K.-H.; Hareyama, Masato; Leung, Sing F.; Thephamongkhol, Kullathorn; Pignon, Jean-Pierre

2006-01-01

Objectives: To study the effect of adding chemotherapy to radiotherapy (RT) on overall survival and event-free survival for patients with nasopharyngeal carcinoma. Methods and Materials: This meta-analysis used updated individual patient data from randomized trials comparing chemotherapy plus RT with RT alone in locally advanced nasopharyngeal carcinoma. The log-rank test, stratified by trial, was used for comparisons, and the hazard ratios of death and failure were calculated. Results: Eight trials with 1753 patients were included. One trial with a 2 x 2 design was counted twice in the analysis. The analysis included 11 comparisons using the data from 1975 patients. The median follow-up was 6 years. The pooled hazard ratio of death was 0.82 (95% confidence interval, 0.71-0.94; p = 0.006), corresponding to an absolute survival benefit of 6% at 5 years from the addition of chemotherapy (from 56% to 62%). The pooled hazard ratio of tumor failure or death was 0.76 (95% confidence interval, 0.67-0.86; p < 0.0001), corresponding to an absolute event-free survival benefit of 10% at 5 years from the addition of chemotherapy (from 42% to 52%). A significant interaction was observed between the timing of chemotherapy and overall survival (p = 0.005), explaining the heterogeneity observed in the treatment effect (p = 0.03), with the highest benefit resulting from concomitant chemotherapy. Conclusion: Chemotherapy led to a small, but significant, benefit for overall survival and event-free survival. This benefit was essentially observed when chemotherapy was administered concomitantly with RT

Eight previously unidentified mutations found in the OA1 ocular albinism gene

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Dufier Jean-Louis

2006-04-01

Full Text Available Abstract Background Ocular albinism type 1 (OA1 is an X-linked ocular disorder characterized by a severe reduction in visual acuity, nystagmus, hypopigmentation of the retinal pigmented epithelium, foveal hypoplasia, macromelanosomes in pigmented skin and eye cells, and misrouting of the optical tracts. This disease is primarily caused by mutations in the OA1 gene. Methods The ophthalmologic phenotype of the patients and their family members was characterized. We screened for mutations in the OA1 gene by direct sequencing of the nine PCR-amplified exons, and for genomic deletions by PCR-amplification of large DNA fragments. Results We sequenced the nine exons of the OA1 gene in 72 individuals and found ten different mutations in seven unrelated families and three sporadic cases. The ten mutations include an amino acid substitution and a premature stop codon previously reported by our team, and eight previously unidentified mutations: three amino acid substitutions, a duplication, a deletion, an insertion and two splice-site mutations. The use of a novel Taq polymerase enabled us to amplify large genomic fragments covering the OA1 gene. and to detect very likely six distinct large deletions. Furthermore, we were able to confirm that there was no deletion in twenty one patients where no mutation had been found. Conclusion The identified mutations affect highly conserved amino acids, cause frameshifts or alternative splicing, thus affecting folding of the OA1 G protein coupled receptor, interactions of OA1 with its G protein and/or binding with its ligand.

Irrigation quality of ground water of twenty villages in Lahore district

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M.S. Ali

2009-05-01

Full Text Available study was conducted in twenty villages of Lahore district to assess the suitability of ground water for irrigation. Three water samples were collected from each of twenty villages and were analyzed for electrical conductivity (EC, sodium adsorption ratio (SAR, residual sodium carbonate (RSC and chloride concentration. Out of total 60 water samples, 7 (11.7% were fit, 7 (11.7% were marginally fit, and remaining 46 (76.6% were unfit for irrigation. Twenty eight samples (46.6% had electrical conductivity higher than permissible limit (i.e. >1250 µS cm-1, 19 samples (31.6% were found with high SAR (i.e. >10 (m mol L-10. 5, 44 samples (73.3% had high RSC (i.e. >2.5 me L-1 and 10 samples (16.6% were found unfit for irrigation due to high concentration of chloride (i.e. >3.9 me L-1. It can be inferred from data that quality of available ground water in most ofthe villages is not suitable for sustainable crop production and soil health.

Poor Efficiency of Eight-Plates in the Treatment of Lower Limb Discrepancy.

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Gaumétou, Elodie; Mallet, Cindy; Souchet, Philippe; Mazda, Keyvan; Ilharreborde, Brice

2016-01-01

Among the numerous existing epiphysiodesis procedures, the eight-plate-guided growth technique, initially described for angular deformities correction, has progressively gained popularity among pediatric orthopaedic surgeons to treat lower limb discrepancy (LLD). The goal of this study was to assess the efficacy of eight-plates in LLD. All children treated for LLD with eight-plates were prospectively included and followed until skeletal maturity. Efficacy of the epiphysiodesis was calculated 6 and 18 months postoperatively and at latest follow-up, according to a method previously validated for percutaneous epiphysiodesis using transphyseal screws (PETS). Radiologic measurements were performed using 3-dimensional low-dose stereoradiography. Intraoperative and postoperative complications were reported. Thirty-two patients were included (average age at surgery, 12.5 y). For femoral epiphysiodesis, efficacy was only 23% at 6 months and 68% at latest follow-up. The procedure was even less efficient on the proximal tibia, with only 42% of the expected growth arrest at latest examination. Eight patients (20%) experienced plate-related pain during follow-up, and 5 physes (12.5%) required unplanned revision surgery. Results of the current series show that the eight-plate technique procedure was associated with few perioperative complications, but the growth arrest observed at follow-up was unpredictable and lower than that achieved with PETS in previous reports. Eight-plate procedures cannot be considered as an efficient epiphysiodesis technique in comparison with standard technique. Level IV.

Refractive errors in patients attending a private hospital in Jos, Nigeria

African Journals Online (AJOL)

2013-05-02

May 2, 2013 ... of 6/9 or less and showed improvement in distance vision of one or more ... ninety eight patients were seen at the hospital for various eye problems. ... Two hundred twenty one (36.8%) of patients with refractive error were ... Other risk factors are ..... Myopia profile in Copenhagen medical students 1996‑98.

Left ventricular filling pressure estimation at rest and during exercise in patients with severe aortic valve stenosis: comparison of echocardiographic and invasive measurements

DEFF Research Database (Denmark)

Dalsgaard, Morten; Kjaergaard, Jesper; Pecini, Redi

2009-01-01

BACKGROUND: The Doppler index of left ventricular (LV) filling (E/e') is recognized as a noninvasive measure for LV filling pressure at rest but has also been suggested as a reliable measure of exercise-induced changes. The aim of this study was to investigate changes in LV filling pressure......, measured invasively as pulmonary capillary wedge pressure (PCWP), at rest and during exercise to describe the relation with E/e' in patients with severe aortic stenosis. METHODS: Twenty-eight patients with an aortic valve areas

Calreticulin mutation analysis in non-mutated Janus kinase 2 essential thrombocythemia patients in Chiang Mai University: analysis of three methods and clinical correlations.

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Rattarittamrong, Ekarat; Tantiworawit, Adisak; Kumpunya, Noppamas; Wongtagan, Ornkamon; Tongphung, Ratchanoo; Phusua, Arunee; Chai-Adisaksopha, Chatree; Hantrakool, Sasinee; Rattanathammethee, Thanawat; Norasetthada, Lalita; Charoenkwan, Pimlak; Lekawanvijit, Suree

2018-03-09

The primary objective was to determine the prevalence of calreticulin (CALR) mutation in patients with non-JAK2V617F mutated essential thrombocythemia (ET). The secondary objectives were to evaluate the accuracy of CALR mutation analysis by high-resolution melting (HRM) analysis and real-time polymerase chain reaction (PCR) compared with DNA sequencing and to compare clinical characteristics of CALR mutated and JAK2V617F mutated ET. This was a prospective cohort study involving ET patients registered at Chiang Mai University in the period September 2015-September 2017 who were aged more than 2 years, and did not harbor JAK2V617F mutation. The presence of CALR mutation was established by DNA sequencing, HRM, and real-time PCR for type 1 and type 2 mutation. Clinical data were compared with that from ET patients with mutated JAK2V617F. Twenty-eight patients were enrolled onto the study. CALR mutations were found in 10 patients (35.7%). Three patients had type 1 mutation, 5 patients had type 2 mutation, 1 patient had type 18 mutation, and 1 patients had novel mutations (c.1093 C-G, c.1098_1131 del, c.1135 G-A). HRM could differentiate between the types of mutation in complete agreement with DNA sequencing. Patients with a CALR mutation showed a significantly greater male predominance and had a higher platelet count when compared with 42 JAK2V617F patients. The prevalence of CALR mutation in JAK2V617F-negative ET in this study is 35.7%. HRM is an effective method of detecting CALR mutation and is a more advantageous method of screening for CALR mutation.

[Evaluation on programs regarding the community-based management of hypertension and type 2 diabetes mellitus patients in eight provinces, China].

Science.gov (United States)

Li, Yuan; Ren, Duofu; Ding, Pingfei; Zhang, Qin; Zhang, Juan; Shi, Wenhui; Wu, Jing; Shi, Xiaoming; Liang, Xiaofeng

2014-01-01

To understand the situation and efficacy of community-based management programs on hypertension and type 2 diabetes mellitus patients in primary health service centers. In eight provinces being selected, a stratified multistage random sampling method was used to survey 5 116 cases of hypertension patients and 3 586 cases of type 2 diabetes mellitus patients aged over 35 years who had been under the management program for over 1 year. Face-to-face questionnaire interview and physical and biochemical examination were applied to collect related information, blood pressure and situation of glucose control. The rates of management on hypertension patients and type 2 diabetes mellitus patients were 23.6% (urban:17.1%, rural:28.1%, χ² = 27 195.33, P hypertension patients and the rate on fasting glucose control on type 2 diabetes mellitus patients were 50.3% (urban:62.0%, rural:36.6%, χ² = 329.31, P hypertension patients and type 2 diabetes mellitus patients were 83.0% (urban:84.7% , rural: 80.7% , χ² = 13.42, P hypertension and type 2 diabetes mellitus patients in primary health service centers. Further improvement was expected on rates regarding management, standardized management and control on both blood pressure and glucose.

Chiropractic management of patients post-disc arthroplasty: eight case reports

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Descarreaux Martin

2010-04-01

Full Text Available Abstract Background When conservative therapies for low back pain (LBP are not effective, elective surgery may be proposed to these patients. Over the last 20 years, a new technology, disc replacement, has become increasingly popular because it is believed to maintain or restore the integrity of spinal movement and minimize the side-effects compared to fusion. Although disc replacement may relieve a patient from pain and related disability, soreness and stiffness of the lumbopelvic region seem to be common aftermaths of the surgery. This prospective case series was undertaken to identify and describe potential adverse events of lumbar spinal manipulation, a common therapy for low back pain, in a group of patients with symptoms after disc prostheses. Cases presentation Eight patients who underwent lumbar spine total disc replacement were referred by an orthopaedic surgeon for chiropractic treatments. These patients had 1 or 2 total lumbar disc replacements and were considered stable according to the surgical protocol but presented persistent, post-surgical, non-specific LBP or pelvic pain. They were treated with lumbar spine side posture manipulations only and received 8 to 10 chiropractic treatments based on the clinical evolution and the chiropractor's judgment. Outcome measures included benign, self-limiting, and serious adverse events after low back spinal manipulative therapy. The Oswestry Disability Index, a pain scale and the fear avoidance belief questionnaire were administered to respectively assess disability, pain and fear avoidance belief about work and physical activity. This prospective case series comprised 8 patients who all had at least 1 total disc replacement at the L4/L5 or L5/S1 level and described persistent post-surgical LBP interfering with their daily activities. Commonly-reported side-effects of a benign nature included increased pain and/or stiffness of short duration in nearly half of the chiropractic treatment period

Role of Twenty-Four-Hour Ambulatory Blood Pressure Monitoring in Children on Dialysis

Science.gov (United States)

Sutherland, Scott M.; Begin, Brandy; Salsbery, Kari; McCabe, Lonisa; Potter, Donald; Alexander, Steven R.; Wong, Cynthia J.

2011-01-01

Summary Background and objectives Pre- or postdialysis BP recordings are imprecise, can be biased, and have poor test–retest reliability in children on dialysis. We aimed to examine the possible differences between pre- and postdialysis BP levels and 24-hour ambulatory BP monitoring (ABPM) in diagnosis of hypertension (HTN). Design, setting, participants, & measurements Twenty-four children on dialysis had 24-hour ABPM in the interdialytic period, and values were compared with average pre- and postdialysis systolic BP (SBP) and diastolic BP (DBP) recordings that week. Each patient had an echocardiogram to determine presence of left ventricular hypertrophy (LVH). Results By ABPM, 8% of patients had white coat HTN and 12% had masked HTN. There was no significant difference in diagnosis of systolic HTN based on ABPM daytime SBP mean or load and postdialysis SBP. However, only 15% of patients had diastolic HTN based on postdialysis measures, whereas 46% of patients had significantly elevated daytime DBP loads and 71% had high nighttime DBP loads on ABPM. Forty-eight percent of patients were SBP nondippers. Children with LVH had higher daytime and nighttime SBP loads, significantly higher daytime and nighttime DBP loads, and lesser degree of nocturnal dipping of SBP compared with those who did not. Conclusion ABPM is more informative than pre- and postdialysis BPs and improves the predictability of BP as a risk factor for target organ damage. Diagnosis and treatment monitoring of HTN among pediatric dialysis patients is enhanced with addition of ABPM. PMID:21273374

Comparison of eight degree-days estimation methods in four agroecological regions in Colombia

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Daniel Rodríguez Caicedo

2012-01-01

Full Text Available Eight methods were used to estimate degree-days in four Colombian localities. Four methods have been previously proposed in literature: Simple Sine, Double Sine, Simple Triangle, and Double Triangle methods. The other four methods are proposed in this research: Simple Logistic, Double Logistic, Simple Normal, and Double Normal. The estimation of the degree-days through hourly temperature values was used as the reference standard method, and the four localities from where the temperature values were taken were the municipalities of Cajicá (Cundinamarca, Santa Elena (Antioquia, Carepa (Urabá Antioqueño, and Ciudad Bolivar (Zona cafetera Antioqueña. Degree-days obtained by all methods under study were compared through linear regression to those obtained by the reference standard method. There were differences in the correlation of each method to the reference when compared within each region and among regions. The Simple Logistic and Double Logistic methods showed the best performance with acceptable R² values and considerably lower bias than the other methods. The poorest fit was found in Cajicá, where the average R² was 0.571. For the regions of Santa Elena and Carepa, the average R² was 0.756 and 0.733. The best fit was found in Ciudad Bolivar, with an average R² of 0.826.

Bile Duct Hamartomas: US, CT and MR Findings in Eight Patients, Focusing on the US Findings

International Nuclear Information System (INIS)

Ahn, Jae Hong; Kim, Min Jeong; Kim, Pyo Nyun; Ha, Hyun Kwon; Lee, Moon Gyu; Han, Heon; Kim, Sam Soo; Jang, Kyung Mi

2005-01-01

To describe the US, CT and MR findings in eight patients with bile duct hamartomas. Bile duct hamartomas were diagnosed in eight patients (5 men and 3 women; age range, 41-69 years; mean age, 56 years) by liver biopsy. The US, CT and MR findings were retrospectively reviewed. Ultrasonographic ally, the bile duct hamartomas presented diffuse inhomogeneous and coarse echo texture with focal lesions, including bright spotty echoes or small hyperechoic nodules (n=7), hypoechoic nodules (n=7) and comet-tail echo (n=3) in seven patients. 16 of the 39 definable hypoechoic nodules that ranged in size from 5 mm to 16mm showed posterior enhancement. CT revealed innumerable hypodense nodules measuring 2-5 mm (n=3), 2-13 mm (n=1), 2-15 mm (n=2) and 2-18 mm (n=1) in seven patients. They were usually irregular in shape and showed no enhancement, but became more apparent after the administration of intravenous contrast medium. The innumerable hypodense nodules on enhanced CT scans were uniformly (n=5) or non uniformly (n=2) distributed throughout the liver. In four patients, MR images showed multiple small cyst-like lesions 2-13 mm in diameter. These small cyst like lesions were much more apparent on T2-weighted images or MR cholangiography. The diagnosis was made by either core-needle or wedge biopsy. In one patient, a small single lesion on the liver surface was not visible on the imaging studies. Pathologic examination revealed multiple bile duct hamartomas of varying size or microhamartomas. Although the bile duct hamartomas on CT and MR presented as numerous intrahepatic, small cyst-like lesions, they on US showed variable findings consisting of inhomogeneous and coarse echo texture with focal lesions, including bright spotty echoes or small hyperechoic nodules, hypoechoic nodules, and comet-tail echoes

Eight new genomes and synthetic controls increase the accessibility of rapid melt-MAMA SNP typing of Coxiella burnetii.

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Edvin Karlsson

Full Text Available The case rate of Q fever in Europe has increased dramatically in recent years, mainly because of an epidemic in the Netherlands in 2009. Consequently, there is a need for more extensive genetic characterization of the disease agent Coxiella burnetii in order to better understand the epidemiology and spread of this disease. Genome reference data are essential for this purpose, but only thirteen genome sequences are currently available. Current methods for typing C. burnetii are criticized for having problems in comparing results across laboratories, require the use of genomic control DNA, and/or rely on markers in highly variable regions. We developed in this work a method for single nucleotide polymorphism (SNP typing of C. burnetii isolates and tissue samples based on new assays targeting ten phylogenetically stable synonymous canonical SNPs (canSNPs. These canSNPs represent previously known phylogenetic branches and were here identified from sequence comparisons of twenty-one C. burnetii genomes, eight of which were sequenced in this work. Importantly, synthetic control templates were developed, to make the method useful to laboratories lacking genomic control DNA. An analysis of twenty-one C. burnetii genomes confirmed that the species exhibits high sequence identity. Most of its SNPs (7,493/7,559 shared by >1 genome follow a clonal inheritance pattern and are therefore stable phylogenetic typing markers. The assays were validated using twenty-six genetically diverse C. burnetii isolates and three tissue samples from small ruminants infected during the epidemic in the Netherlands. Each sample was assigned to a clade. Synthetic controls (vector and PCR amplified gave identical results compared to the corresponding genomic controls and are viable alternatives to genomic DNA. The results from the described method indicate that it could be useful for cheap and rapid disease source tracking at non-specialized laboratories, which requires accurate

Altered Interhemispheric Functional Coordination in Chronic Tinnitus Patients

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Yu-Chen Chen

2015-01-01

Full Text Available Purpose. Recent studies suggest that tinnitus may be due in part to aberrant callosal structure and interhemispheric interaction. To explore this hypothesis we use a novel method, voxel-mirrored homotopic connectivity (VMHC, to examine the resting-state interhemispheric functional connectivity and its relationships with clinical characteristics in chronic tinnitus patients. Materials and Methods. Twenty-eight chronic tinnitus patients with normal hearing thresholds and 30 age-, sex-, education-, and hearing threshold-matched healthy controls were included in this study and underwent the resting-state fMRI scanning. We computed the VMHC to analyze the interhemispheric functional coordination between homotopic points of the brain in both groups. Results. Compared to the controls, tinnitus patients showed significantly increased VMHC in the middle temporal gyrus, middle frontal gyrus, and superior occipital gyrus. In tinnitus patients, a positive correlation was found between tinnitus duration and VMHC of the uncus. Moreover, correlations between VMHC changes and tinnitus distress were observed in the transverse temporal gyrus, superior temporal pole, precentral gyrus, and calcarine cortex. Conclusions. These results show altered interhemispheric functional connectivity linked with specific tinnitus characteristics in chronic tinnitus patients, which may be implicated in the neuropathophysiology of tinnitus.

The Oesophageal Involvement of Pemphigus Vulgaris Patients and Comparison with Skin Findings

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Sıla Şeremet

2008-10-01

Full Text Available Background and Design: The pemphigus family includes a number of disease which feature intraepidermal blisters with acantholysis. Pemphigus vulgaris(PV is the most common form of pemphigus, affects the skin and mucous membranes. Although oral mucosa is the most commonly affected site, all stratified squamous epithelium can be involved like pharynx, larynx, oesophagus, conjunctiva, vaginal, penile, and anal mucosa. We planned our study aiming to find frequency of oesophagus involvement in PV patients and to compare them immunohistopathologically with skin findings.Material and Method: Twenty three female and seven male patients, who were admitted to The Health Ministry Vakıf Gureba Education and Research Hospital, Dermatology Clinic, in between January 2004 and March 2005, and were accepted as PV according to clinical and immunohistopathological findings. Mucosal biopsies were taken by oesophagoscopy from patients in the same time with skin biopsies for DIF examination. Antibody titers in serum was detected by indirect immunofluorescein method.Results: DIF was positive in twenty eight patients while two patients had negative results. During oesophagoscopy, macroscopically nine patients (%30 had esophageal lesions supporting pemphigus vulgaris.When a relationship were examined between dysphagia with endoscopic pemphigus vulgaris findings, skin involvement, oral mucosal involvement, genital mucosal involvement, skin DIF positivity, oesophagus DIF positivity, IIF positivity, no meaningful difference was found istatistically. In our study, four patients had endoscopic findings and nineteen patients had positive DIF results although they did not have gastrointestinal symptoms. When relationship between oesophageal DIF positivity and skin DIF positivity was examined, there was a positive correlation meaningfully. Conclusion: According to our article we believe that upper GI endoscopy is a useful and neccessary diagnostic method in pemphigus vulgaris

Driving safety after brain damage: follow-up of twenty-two patients with matched controls.

Science.gov (United States)

Katz, R T; Golden, R S; Butter, J; Tepper, D; Rothke, S; Holmes, J; Sahgal, V

1990-02-01

Driving after brain damage is a vital issue, considering the large number of patients who suffer from cerebrovascular and traumatic encephalopathy. The ability to operate a motor vehicle is an integral part of independence for most adults and so should be preserved whenever possible. The physician may estimate a patient's ability to drive safely based on his own examination, the evaluation of a neuropsychologist, and a comprehensive driving evaluation--testing, driving simulation, behind-the-wheel observation--with a driving specialist. This study sought to evaluate the ability of brain-damaged individuals to operate a motor vehicle safely at follow-up. These patients had been evaluated (by a physician, a neuropsychologist, and a driving specialist) and were judged able to operate a motor vehicle safely after their cognitive insult. Twenty-two brain-damaged patients who were evaluated at our institution were successfully followed up to five years (mean interval of 2.67 years). Patients were interviewed by telephone. Their driving safely was compared with a control group consisting of a close friend or spouse of each patient. Statistical analysis revealed no difference between patient and control groups in the type of driving, the incidence of speeding tickets, near accidents, and accidents, and the cost of vehicle damage when accidents occurred. The patient group was further divided into those who had, and those who had not experienced driving difficulties so that initial neuropsychologic testing could be compared. No significant differences were noted in any aspect of the neuropsychologic test battery. We conclude that selected brain-damaged patients who have passed a comprehensive driving assessment as outlined were as fit to drive as were their normal matched controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Development and application of a HPLC method for eight sunscreen agents in suncare products.

Science.gov (United States)

Peruchi, L M; Rath, S

2012-06-01

This work describes the development, validation and application of a simple and fast high-performance liquid chromatography-with diode array dectection (HPLC-DAD) method for the determination of eight sunscreen agents: benzophenone-3, octocrylene, ethylhexyl methoxycinnamate, ethylhexyl salicylate, homosalate (used in two isomeric forms), butyl methoxydibenzoylmethane, 4-methylbenzylidene camphor and ethylhexyl dimethyl PABA in sunscreen formulations. The separation of the eight sunscreen compounds was achieved using an ACE C18 column (250 × 4.6 mm, 5 μm), with a column temperature 20°C, and a mobile phase of 88 : 12 (v/v) methanol-water with isocratic elution. Column temperature strongly influences the retention time and resolution of the compounds. The flow rate was 1.0 mL min(-1) and quantitation was performed by external calibration at the maximum wavelength of each compound. The sample preparation was simple and consisted basically of sample dilution with methanol, centrifugation and filtration in syringe filters before quantitation. Total run time was 18 min. The method was validated according to the parameters: linear range, linearity, selectivity, intra-day and inter-day precision and accuracy. Ten samples of sunscreen emulsions commercially available in Brazil (SPF 30) from different manufacturers were analysed using the proposed method. The number of the sunscreen agents varied between one and five in a single sample. The concentrations of all compounds were in the range of 0.9-10% (w/w) and were in accordance with the current Brazilian legislation. © 2012 The Authors. ICS © 2012 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

Twenty-two patients with Sotos' syndrome

International Nuclear Information System (INIS)

Miyake, Shota; Tada, Hiroshi; Hayashi, Michiko; Iwamoto, Hiroko; Fukushima, Yoshimitsu; Kuroki, Yoshikazu

1985-01-01

A retrospective study of 22 patients with Sotos' syndrome (17 boys and 5 girls) seen in the past 14 years was made respecting the age of the patients at the first visit, the age of the patients' parents at birth, neonatal abnormalities, neonatal physical characteristics, facial expression characteristics of this syndrome, growth index, and CT findings. CT showed ventricular dilation in all patients (moderate or extreme dilation in 87%, and the association of structure abnormality in the median part in many patients), subdural edema in 4 and arachnoid cyst in 2. (Namekawa, K.)

Unsedation colonoscopy can be not that painful: Evaluation of the effect of "Lamaze method of colonoscopy".

Science.gov (United States)

Yu, Shao-Ping; Lin, Xiao-Dong; Wu, Guang-Yao; Li, Song-Hu; Wen, Zong-Quan; Cen, Xiao-Hong; Huang, Xian-Guang; Huang, Mei-Ting

2015-10-25

To evaluate the pain relieving effect of intervention with "Lamaze method of colonoscopy" in the process of colonoscopy. Five hundred and eighty-five patients underwent colonoscopy were randomly divided into three groups, Lamaze group, anesthetic group and control group. Two hundred and twenty-four patients of Lamaze group, the "Lamaze method of colonoscopy" were practiced in the process of colonoscopy. The Lamaze method of colonoscopy is modified from the Lamaze method of childbirth, which helped patients to relieve pain through effective breathing control. One hundred and seventy-eight patients in anesthetic group accepted sedation colonoscopy. For 183 patients in control group, colonoscopy was performed without any intervention. The satisfactory of colon cleaning, intestinal lesions, intubation time, success ratio, pain grading and complications were recorded. All data were statistically analyzed. There were no significant differences at base line of the three groups (P > 0.05). Anesthetic group shows advantage in intubation time than the other two groups (P advantage in intubation time than that in control group (P > 0.05). The anesthetic group showed an apparent advantage in relieving pain (P promotion in clinical practice.

Acellular porcine small intestinal submucosa graft for cervicovaginal reconstruction in eight patients with malformation of the uterine cervix.

Science.gov (United States)

Ding, Jing-Xin; Chen, Xiao-Jun; Zhang, Xu-Yin; Zhang, Ying; Hua, Ke-Qin

2014-04-01

Can surgical reconstruction of the cervix and vagina in patients be achieved using an acellular porcine small intestinal submucosa (SIS) graft? Our experiences of combined laparoscopic and vaginal cervicovaginal reconstruction using an SIS graft in eight patients were positive, with successful reconstruction and no complications, cervical stenosis or vaginal stenosis. In patients with agenesis and dysgenesis of the uterine cervix and vagina, surgical reconstruction of the internal genitalia is a challenging problem for gynecologists. Hysterectomy with the creation of an artificial vagina was the treatment of choice in the 1990s. Recently, conservative management has been gradually adopted to avoid extirpation of the uterus, including the canalization techniques, the uterovaginal anastomosis and the reconstruction of cervical and vaginal agenesis with some autologous tissues. This prospective observational study from January 2012 to March 2013 included 8 patients aged 10-18 years with malformation of the cervix (1 with cervical agenesis, 1 with a cervical body consisting of a fibrous band and 6 with obstruction of the cervical os) and vagina (4 with complete vaginal aplasia and 4 with a 1-3 cm long vaginal pouch) diagnosed by physical examination and magnetic resonance imaging. Eight patients underwent combined laparoscopic and vaginal cervicovaginal reconstruction using an SIS graft during the end of menstruation. A T-shaped intrauterine device connected with a 14-French Foley catheter was inserted into the uterine cavity to keep the newly created cervix patent, and then a permanent lower uterine cerclage was placed. Patients were assessed post-operatively at 1, 2, 4, 6, 12 and 15 months, and data on menstruation and the morphology of the neovagina and cervix were recorded. The mean ± SD age of the patients was 14.5 ± 2.8 (10-18) years. All patients had a history of cyclic abdominal pain, and the average delay in diagnosis was 4.5 ± 4.0 (0-12) months. One

Radiation exposure estimation from patient treated by I-131

International Nuclear Information System (INIS)

Lahfi, Y.; Anjak, O.

2012-09-01

Radioactive iodine is the main radiopharmaceutical substance in the nuclear medicine field which used in diagnosis and treatment of patients suffering from thyroid cancer; thus it can be considered as the main source of the public and patient relative exposure. In this study, 192 patients were selected randomly and their radiation dose rate was measured at different levels of the patient's body (thyroid, knee, bladder) after one, twenty four and forty eight hours from availing the prescript quantity of the I-131. The collected data may serve in estimating the worker and public exposure related to the patient treated by I-131. (authors)

Multidisciplinary management of Paget-Schroetter syndrome. A case series of eight patients.

Science.gov (United States)

Rosa Salazar, Vladimir; Otálora Valderrama, Sonia Del Pilar; Hernández Contreras, María Encarnación; García Pérez, Bartolomé; Arroyo Tristán, Andrés Del Amor; García Méndez, María Del Mar

2015-08-01

Paget-Schroetter syndrome (PSS) in the context of upper extremity deep venous thrombosis (DVT) is an uncommon but potentially very serious condition affecting young, healthy adults, in which secondary post-thrombotic syndrome (PTS) can be a complication with major implications. The best treatment option remains controversial, with current guidelines recommending anticoagulation for at least 3 months. However, an incidence of PTS of approximately 50% after 6 months, 30% after 1 year and 25% after 2 years has been found using this therapeutic approach. Consequently, specialized units recommend local thrombolysis and early decompressive surgery. We describe a series of eight cases treated in this way. None of the patients showed signs of complications, and an early return to regular activities with no PTS was observed in 90% of cases. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

Vesico-vaginal fistula repair: experience with first twenty-three ...

African Journals Online (AJOL)

Vesico-vaginal fistula repair: experience with first twenty-three patients seen at a tertiary hospital in north-central Nigeria. Stephen D. Ngwan, Bassey E. Edem, Ajen S. Anzaku, Barnabas A. Eke, Mohammed A. Shittu, Solomon A. Obekpa ...

Infective endocarditis in patients on haemodialysis - possible strategies for prevention.

Science.gov (United States)

Oun, Hadi A; Price, Andrew J; Traynor, Jamie P

2016-05-01

Infective endocarditis is an important cause of morbidity and mortality in patients receiving haemodialysis for established renal failure. We carried out a prospective audit of patients developing infective endocarditis in a single renal unit. From 1 January 2000 to 31 December 2013, we collected data on all cases of endocarditis occurring in patients receiving haemodialysis at Monklands Hospital, Airdrie. Twenty-nine patients developed endocarditis during our audit period. Twenty-three (79.3%) of the patients had pre-existing cardiac valve abnormalities such as regurgitation or calcification. Staphylococcus aureus was the most common microorganism cultured from the blood of 22 patients (75.9%). MRSA bacteraemia was identified in eight of these patients and all eight patients died during that first presentation. Different strategies were introduced within the unit during the audit period aiming to reduce the rate of bacteraemia. Since 2011, a successful strategy has been introduced under the auspices of the Scottish Patient Safety Programme. This led to our Staph aureus bacteraemia rate related to non-tunnelled venous catheters going from an average of 15 days between episodes to having had no episodes between 2 December 2011 and the end of the study period (760 days). This also appears to have had a positive impact on reducing the rate of endocarditis. Infective endocarditis remains a devastating consequence of bacteraemia in patients receiving haemodialysis. An effective strategy aimed at reducing the rate of bacteraemia appears to have a similar effect on the rate of endocarditis. © The Author(s) 2016.

Twenty-eight Days to a Climax community: A Succession Laboratory Using Periphyton

Science.gov (United States)

Denicola, D. M.

2005-05-01

Succession in benthic algal communities (periphyton) occurs in a relatively short time scale because of the rapid reproductive rates of algae. To examine primary succession of periphyton in a lake and stream, unglazed tiles are placed in the respective habitats and sampled on days 4, 8, 16 and 28. Students count the preserved samples at 400X and identify taxa to genera based on customized picture keys (does not require a high degree of instructor expertise). Genera also are categorized according to algal growth forms, based on the size, shape, motility and attachment mechanism. After pooling the class data, students present the change in community structure, contrast succession between the lake and stream, and hypothesize which mechanisms may apply (facilitation, inhibition, tolerance). Successional sequences also are examined to see whether they agree with published growth form models for periphyton succession in lotic and lentic habitats. The laboratory uses the more intuitive method of repeated measures to study succession as an alternative to the often infeasible chronosequence method traditionally done for terrestrial communities. Additional outcomes include, reinforcement of the concept of species guilds (growth forms), an introduction into the use of empirical models, and an increased awareness of microorganism communities.

Mucocutaneous disorders in Hiv positive patients

Directory of Open Access Journals (Sweden)

Kar H

1996-01-01

Full Text Available Twenty eight HIV positive patients were included in this study. They were evaluated for their mucocutaneous disorders, sexually transmitted diseases and other systemic disorders between 1994-95 in the department of Dermatology and STD Dr R M L Hospital of New Delhi. The heterosexual contact with commercial sex workers (CSWs was the most common route of HIV transmission. Chancroid, syphilis and genital warts were common STDs found in HIV positive patients. Oral thrush (67.9% was the commonest mucocutaneous disorder found in these patients followed by herpes zoster (25% and seborrhoeic dermatitis (21.4%. There was no unusual clinical presentation seen in mucocutaneous disorders and STDs.

Long-term followup of rheumatoid arthritis patients treated with total lymphoid irradiation

International Nuclear Information System (INIS)

Tanay, A.; Field, E.H.; Hoppe, R.T.; Strober, S.

1987-01-01

Total lymphoid irradiation was administered to 32 patients with intractable rheumatoid arthritis. Twenty-four patients showed at least a 25% improvement in 3 of 4 disease activity parameters, which persisted during the followup period of up to 48 months. Eight of the 32 patients required adjunctive immunosuppressive drug therapy to maintain improvement. Four patients died after total lymphoid irradiation; the causes of death were acute myocardial infarction (1 patient), pulmonary embolism (1 patient), and rheumatoid lung disease complicated by respiratory infection (2 patients). After therapy, patients exhibited a prolonged reduction in the number and function of circulating T helper cells

Twenty-One at TREC-8: using Language Technology for Information Retrieval

NARCIS (Netherlands)

Kraaij, Wessel; Pohlmann, Renée; Hiemstra, Djoerd; Voorhees, E.M; Harman, D.K.

2000-01-01

This paper describes the official runs of the Twenty-One group for TREC-8. The Twenty-One group participated in the Ad-hoc, CLIR, Adaptive Filtering and SDR tracks. The main focus of our experiments is the development and evaluation of retrieval methods that are motivated by natural language

Young patients with colorectal cancer have poor survival in the first twenty months after operation and predictable survival in the medium and long-term: Analysis of survival and prognostic markers

Directory of Open Access Journals (Sweden)

Wickramarachchi RE

2010-09-01

Full Text Available Abstract Objectives This study compares clinico-pathological features in young (50 years with colorectal cancer, survival in the young and the influence of pre-operative clinical and histological factors on survival. Materials and methods A twelve year prospective database of colorectal cancer was analysed. Fifty-three young patients were compared with forty seven consecutive older patients over fifty years old. An analysis of survival was undertaken in young patients using Kaplan Meier graphs, non parametric methods, Cox's Proportional Hazard Ratios and Weibull Hazard models. Results Young patients comprised 13.4 percent of 397 with colorectal cancer. Duration of symptoms and presentation in the young was similar to older patients (median, range; young patients; 6 months, 2 weeks to 2 years, older patients; 4 months, 4 weeks to 3 years, p > 0.05. In both groups, the majority presented without bowel obstruction (young - 81%, older - 94%. Cancer proximal to the splenic flexure was present more in young than in older patients. Synchronous cancers were found exclusively in the young. Mucinous tumours were seen in 16% of young and 4% of older patients (p Conclusion If patients, who are less than 40 years old with colorectal cancer, survive twenty months after operation, the prognosis improves and their survival becomes predictable.

The Reliability and Validity of the Rosenberg Self-Esteem Scale with Japanese Patients After Stroke

OpenAIRE

篠原, 純子; 児玉, 和紀; 迫田, 勝則; 金久, 重子; 百本, 文子

2002-01-01

The reliability and validity of the Rosenberg Self-Esteem Scale with Japanese patients after stroke was examined. Subjects were outpatients between 6 months and 3 years post stroke of cerebral infarction. Two kinds of Self-Esteem were examined. One was that of the present time. The other was that of the past time (Respondents recalled their Self-Esteem before having a stroke). The respondents were 38 people who consisted of 26 males and 12 females. Twenty-eight of thirty-eight respondents ans...

Eight to ten years follow-up after carotid endarterectomy

DEFF Research Database (Denmark)

Knudsen Rathenborg, Lisbet; Sillesen, H; Schroeder, T

1990-01-01

Follow-up information was obtained on 185 patients who consecutively underwent carotid endarterectomy eight to ten years previously. Doppler ultrasound examination was performed in 59 patients who were still alive and living within 100 miles of the hospital. Using lifetable analysis, the annual r...

[Magnetic resonance in AIDS-related encephalopathy].

Science.gov (United States)

Gualdi, G F; Di Biasi, C; D'Agostino, A; Trasimeni, G; Melone, A

1995-12-01

Fifty-eight patients with AIDS disease were studied with MR imaging in the aim of detecting the grade of brain involvement. The examinations were performed with a 1.5 Tesla magnet. Thirty-seven showed white matter lesion (63.5%), twenty-five patients showed cerebral atrophy (43%), in eight patients the MR appearance was consistent with toxoplasmosis infection (13.5%), two patients showed a linfoma (3.4%) and two patients micrococcosis (3.4%). Seventeen out of the thirty-seven patients with white matter disease showed focal well circumscribed lesion (46%), while twenty showed diffuse involvement. Between the twenty-five patients with cerebral atrophy, twelve showed a prevalence of the cortical involvement and eight a subcortical atrophy. In five patients a concomitant, cortical and subcortical atrophy was found. Between the eight patients with neurotoxolesion and two of them a widespread encephalitis picture. The MR appearance of the two limphomas was that of periventricular, space occupying, masses. In two patients with micrococcis a nodular aspect of leptomeningeal lesions was found.

Global Aphasia As A Predictor Of Mortality In The Acute Phase Of A First Stroke [afasia Global Prediz Mortalidade Na Fase Aguda De Um Primeiro Acidente Vascular Cerebral Isquêmico

OpenAIRE

de Oliveira F.F.; Damasceno B.P.

2011-01-01

OBJECTIVE: To establish whether vascular aphasic syndromes can predict stroke outcomes. METHOD: Thirty-seven adults were evaluated for speech and language within 72 hours after a single first-ever ischemic brain lesion, in blind association to CT and/or MR. RESULTS: Speech or language disabilities were found in seven (87.5%) of the eight deceased patients and twenty-six (89.7%) of the twenty-nine survivors. Global aphasia was identified in eleven patients, all with left hemisphere lesions (ni...

The Twenty Statement Test in Teacher Development

Directory of Open Access Journals (Sweden)

Ahmet Aypay

2011-10-01

Full Text Available The purpose of this study is to describe teacher characteristics using Twenty Statements Test (TST. Study group includes a total of thirty-five individuals, including teachers, guidance and counselors and research assistants. The study used a qualitative approach on teacher identity. TST is one of the qualitative methods that were used to determine individual self-conceptualization. Study group were requested to write twenty statements that describe themselves responding to the question “Who I am?” in a free format. The findings indicated that teachers were overwhelmingly in group c (reflective. No differences were found in terms of gender and profession. Only few significant differences have been found based on marital status. The utility of TST in teacher training and development was discussed.

The Twenty Statement Test in Teacher Development

Directory of Open Access Journals (Sweden)

Ahmet Aypay

2011-04-01

Full Text Available The purpose of this study is to describe teacher characteristics using Twenty Statements Test (TST. Study group includes a total of thirty-five individuals, including teachers, guidance and counselors and research assistants. The study used a qualitative approach on teacher identity. TST is one of the qualitative methods that were used to determine individual self-conceptualization. Study group were requested to write twenty statements that describe themselves responding to the question “Who I am?” in a free format. The findings indicated that teachers were overwhelmingly in group c (reflective. No differences were found in terms of gender and profession. Only few significant differences have been found based on marital status. The utility of TST in teacher training and development was discussed

Twenty-First Century Literacy: A Matter of Scale from Micro to Mega

Science.gov (United States)

Brown, Abbie; Slagter van Tryon, Patricia J.

2010-01-01

Twenty-first century technologies require educators to look for new ways to teach literacy skills. Current communication methods are combinations of traditional and newer, network-driven forms. This article describes the changes twenty-first century technologies cause in the perception of time, size, distance, audience, and available data, and…

Respiratory mechanics by least squares fitting in mechanically ventilated patients: application on flow-limited COPD patients.

Science.gov (United States)

Volta, Carlo A; Marangoni, Elisabetta; Alvisi, Valentina; Capuzzo, Maurizia; Ragazzi, Riccardo; Pavanelli, Lina; Alvisi, Raffaele

2002-01-01

Although computerized methods of analyzing respiratory system mechanics such as the least squares fitting method have been used in various patient populations, no conclusive data are available in patients with chronic obstructive pulmonary disease (COPD), probably because they may develop expiratory flow limitation (EFL). This suggests that respiratory mechanics be determined only during inspiration. Eight-bed multidisciplinary ICU of a teaching hospital. Eight non-flow-limited postvascular surgery patients and eight flow-limited COPD patients. Patients were sedated, paralyzed for diagnostic purposes, and ventilated in volume control ventilation with constant inspiratory flow rate. Data on resistance, compliance, and dynamic intrinsic positive end-expiratory pressure (PEEPi,dyn) obtained by applying the least squares fitting method during inspiration, expiration, and the overall breathing cycle were compared with those obtained by the traditional method (constant flow, end-inspiratory occlusion method). Our results indicate that (a) the presence of EFL markedly decreases the precision of resistance and compliance values measured by the LSF method, (b) the determination of respiratory variables during inspiration allows the calculation of respiratory mechanics in flow limited COPD patients, and (c) the LSF method is able to detect the presence of PEEPi,dyn if only inspiratory data are used.

Post-mortem cytogenomic investigations in patients with congenital malformations.

Science.gov (United States)

Dias, Alexandre Torchio; Zanardo, Évelin Aline; Dutra, Roberta Lelis; Piazzon, Flavia Balbo; Novo-Filho, Gil Monteiro; Montenegro, Marilia Moreira; Nascimento, Amom Mendes; Rocha, Mariana; Madia, Fabricia Andreia Rosa; Costa, Thais Virgínia Moura Machado; Milani, Cintia; Schultz, Regina; Gonçalves, Fernanda Toledo; Fridman, Cintia; Yamamoto, Guilherme Lopes; Bertola, Débora Romeo; Kim, Chong Ae; Kulikowski, Leslie Domenici

2016-08-01

Congenital anomalies are the second highest cause of infant deaths, and, in most cases, diagnosis is a challenge. In this study, we characterize patterns of DNA copy number aberrations in different samples of post-mortem tissues from patients with congenital malformations. Twenty-eight patients undergoing autopsy were cytogenomically evaluated using several methods, specifically, Multiplex Ligation-dependent Probe Amplification (MLPA), microsatellite marker analysis with a MiniFiler kit, FISH, a cytogenomic array technique and bidirectional Sanger sequencing, which were performed on samples of different tissues (brain, heart, liver, skin and diaphragm) preserved in RNAlater, in formaldehyde or by paraffin-embedding. The results identified 13 patients with pathogenic copy number variations (CNVs). Of these, eight presented aneuploidies involving chromosomes 13, 18, 21, X and Y (two presented inter- and intra-tissue mosaicism). In addition, other abnormalities were found, including duplication of the TYMS gene (18p11.32); deletion of the CHL1 gene (3p26.3); deletion of the HIC1 gene (17p13.3); and deletion of the TOM1L2 gene (17p11.2). One patient had a pathogenic missense mutation of g.8535C>G (c.746C>G) in exon 7 of the FGFR3 gene consistent with Thanatophoric Dysplasia type I. Cytogenomic techniques were reliable for the analysis of autopsy material and allowed the identification of inter- and intra-tissue mosaicism and a better understanding of the pathogenesis of congenital malformations. Copyright © 2016 Elsevier Inc. All rights reserved.

Five-year experience of critical incidents associated with patient-controlled analgesia in an Irish University Hospital.

LENUS (Irish Health Repository)

Ahmad, I

2012-02-01

BACKGROUND: Patient-controlled analgesia (PCA) is a common and effective means of managing post-operative pain. We sought to identify factors that may lead to critical incidents (CIs) in patient safety when using PCA in our institution. METHODS: An observational study of prospectively collected data of patients who received PCA from 2002 to 2006 was performed. All CIs were documented and analysed by staff members of the acute pain service (APS). Cause analysis of CIs was undertaken to determine if measures can be instituted to prevent recurrence of similar events. RESULTS: Over eight thousand patients (8,240) received PCA. Twenty-seven CIs were identified. Eighteen were due to programming errors. Other CIs included co-administration of opioids and oversedation. CONCLUSION: In our institution, the largest contributory factor to CIs with PCAs was programming error. Strategies to minimize this problem include better education and surveillance.

Caring touch as a bodily anchor for patients after sustaining a motor vehicle accident with minor or no physical injuries - a mixed methods study.

Science.gov (United States)

Airosa, Fanny; Arman, Maria; Sundberg, Tobias; Öhlén, Gunnar; Falkenberg, Torkel

2016-03-22

Patients who sustain a motor vehicle accident may experience long-term distress, even if they are uninjured or only slightly injured. There is a risk of neglecting patients with minor or no physical injuries, which might impact future health problems. The aim of this study was to explore patients' subjective experiences and perspectives on pain and other factors of importance after an early nursing intervention consisting of "caring touch" (tactile massage and healing touch) for patients subjected to a motor vehicle accident with minor or no physical injuries. A mixed method approach was used. The qualitative outcomes were themes derived from individual interviews. The quantitative outcomes were measured by visual analogue scale for pain (VAS, 0-100), sense of coherence (SOC), post-traumatic stress (IES-R) and health status (EQ-5D index and EQ-5D self-rated health). Forty-one patients of in total 124 eligible patients accepted the invitation to participate in the study. Twenty-seven patients completed follow-up after 6 months whereby they had received up to eight treatments with either tactile massage or healing touch. Patients reported that caring touch may assist in trauma recovery by functioning as a physical "anchor" on the patient's way of suffering, facilitating the transition of patients from feeling as though their body is "turned off" to becoming "awake". By caring touch the patients enjoyed a compassionate care and experience moments of pain alleviation. The VAS pain ratings significantly decreased both immediately after the caring touch treatment sessions and over the follow-up period. The median scores for VAS (p touch intervention is associated with patients' report of decreased pain and improved wellbeing up to 6 months after the accident. ClinicalTrials.gov Id: NCT02610205 . Date 25 November 2015.

Comparison of clinical outcome parameters, the Patient Benefit Index (PBI-k) and patient satisfaction after ablative fractional laser treatment of peri-orbital rhytides.

Science.gov (United States)

Karsai, Syrus; Raulin, Christian

2010-03-01

Laser treatment of facial rhytides has evolved as a major modality of aesthetic surgery. Published results, while generally encouraging, feature highly diverse evaluation methods, which makes an evidence-based assessment of treatment efficacy and safety all but impossible. To compare the results of different instruments of measurement. Twenty-eight patients were enrolled and completed the entire study. They received a single ablative fractional treatment of the peri-orbital region. The evaluation included the Fitzpatrick wrinkle score, the profilometric measurement of wrinkle depth and the Patient Benefit Index (both before and 3 months after treatment) as well as the assessment of patient satisfaction (1, 3, 6 days and 3 months after treatment). All assessment instruments showed a significant, albeit moderate, improvement. The agreement between assessment methods was poor. Despite claiming to assess basically the same parameter, the Fitzpatrick wrinkle score and profilometry differed significantly, and neither assessment instrument showed any appreciable correlation with any other. The outcome assessment of rhytide therapy-regardless of the method used-shows substantial room for improvement. Strict methodological precautions ought to be applied for 'objective' evaluation methods like photographic scoring and profilometry. Subjective methods of assessment are essential and might serve as a main outcome parameter. Finally, critical reappraisal of published treatment results seems warranted to review the quality of their methodology.

Automated patient and medication payment method for clinical trials

Directory of Open Access Journals (Sweden)

Yawn BP

2013-01-01

Full Text Available Barbara P Yawn,1 Suzanne Madison,1 Susan Bertram,1 Wilson D Pace,2 Anne Fuhlbrigge,3 Elliot Israel,3 Dawn Littlefield,1 Margary Kurland,1 Michael E Wechsler41Olmsted Medical Center, Department of Research, Rochester, MN, 2UCDHSC, Department of Family Medicine, University of Colorado Health Science Centre, Aurora, CO, 3Brigham and Women's Hospital, Pulmonary and Critical Care Division, Boston, MA, 4National Jewish Medical Center, Division of Pulmonology, Denver, CO, USABackground: Published reports and studies related to patient compensation for clinical trials focus primarily on the ethical issues related to appropriate amounts to reimburse for patient's time and risk burden. Little has been published regarding the method of payment for patient participation. As clinical trials move into widely dispersed community practices and more complex designs, the method of payment also becomes more complex. Here we review the decision process and payment method selected for a primary care-based randomized clinical trial of asthma management in Black Americans.Methods: The method selected is a credit card system designed specifically for clinical trials that allows both fixed and variable real-time payments. We operationalized the study design by providing each patient with two cards, one for reimbursement for study visits and one for payment of medication costs directly to the pharmacies.Results: Of the 1015 patients enrolled, only two refused use of the ClinCard, requesting cash payments for visits and only rarely a weekend or fill-in pharmacist refused to use the card system for payment directly to the pharmacy. Overall, the system has been well accepted by patients and local study teams. The ClinCard administrative system facilitates the fiscal accounting and medication adherence record-keeping by the central teams. Monthly fees are modest, and all 12 study institutional review boards approved use of the system without concern for patient

Technetium-labeled HM-PAO studies in patients with cerebrovascular disease

International Nuclear Information System (INIS)

Smith, F.W.; Sharp, P.F.; Gemmell, H.; Evans, N.T.; MacDonald, A.F.

1986-01-01

Technetium-labeled hexamethyl-propyleneamineoxime (HM-PAO) is a promising radiopharmaceutical for the demonstration of cerebral blood flow. Twenty-four patients who had experienced either acute stroke (AS) or transient ischemic attack (TIA) were studied by x-ray CT and SPECT using technetium-labeled HM-PAO total of 26 studies. HM-PAO has a cerebral distribution similar to that of iodoamphetamine, but labeling with technetium allows good SPECT imaging on demand in any nuclear medicine department. In ten of the 16 patients who had experienced AS, findings on HM-PAO and CT studies correlated well. In six patients reduced cortical perfusion was detected on HM-PAO imaging, but only small infarcts in the internal capsule were seen on CT. In four of the eight patients who had experienced TIA, neither study revealed any abnormality. In the remaining four, areas of cortical underperfusion were seen on HM-PAO imaging, whereas the CT examination was normal. The findings in this study suggest that HM-PAO imaging is a more sensitive method for demonstrating the extent of cerebral underperfusion in cases of cerebrovascular accident

The social context and the need of information from patients with epilepsy: evaluating a tertiary referral service

Directory of Open Access Journals (Sweden)

Priscila Freitas-Lima

2015-04-01

Full Text Available Objective Characterize the social profile and the need of information from patients with refractory epilepsy. Method A semi-structured questionnaire was applied to 103 patients to investigate sociodemographic aspects, pharmacotherapy and any doubts about epilepsy. Results Patients were highly dependent on having a free and accessible supply of antiepileptic drugs. Sixty-eight percent of the population was unemployed, and 26% confirmed receiving social security benefits due to epilepsy. Twenty-nine percent of the population reached high school. Eighty-five percent of the patients had at least one doubt about epilepsy; treatment and epilepsy aspects in general were the main topics. Conclusion : As observed in developed countries, patients with refractory epilepsy from a developing country also have high rates of unemployment and low educational levels. The results raise a concern about the need of information about epilepsy by patients and their families, urging the necessity to invest in strategies to solve this deficiency in knowledge.

NRS-2002 for pre-treatment nutritional risk screening and nutritional status assessment in head and neck cancer patients.

Science.gov (United States)

Orell-Kotikangas, Helena; Österlund, Pia; Saarilahti, Kauko; Ravasco, Paula; Schwab, Ursula; Mäkitie, Antti A

2015-06-01

The aim of this study was to assess the value of nutritional risk screening-2002 (NRS-2002) as a nutritional risk screening and status assessment method and to compare it with nutritional status assessed by subjective and objective methods in the screening of head and neck cancer patients. Sixty-five consecutive patients (50 male), with a median age of 61 years (range, 33-77), with head and neck squamous cell carcinoma (HNSCC) were enrolled prior to cancer therapy. Nutritional status was assessed by NRS-2002, patient-generated subjective global assessment (PG-SGA), handgrip strength (HGS) and mid-arm muscle area (MAMA). Twenty-eight percent of patients were at nutritional risk based on NRS-2002, and 34 % were malnourished according to PG-SGA, while 43 % had low HGS. NRS-2002 cut-off score of ≥3 compared with the nutritional status according to PG-SGA showed 77 % specificity and 98 % sensitivity (K = 0.78). NRS-2002 was able to predict malnutrition (PG-SGA BC) both in men (p nutrition screening in head and neck cancer patients prior to oncological treatment.

Comparative Effectiveness of Low-Volume Time-Efficient Resistance Training Versus Endurance Training in Patients With Heart Failure

DEFF Research Database (Denmark)

Munch, Gregers Winding; Birgitte Rosenmeier, Jaya; Petersen, Morten

2018-01-01

-related quality of life in lower New York Heart Association-stage HF patients, despite less time required as well as lower energy expenditure during TRE than during AMC. Therefore, TRE might represent a time-efficient exercise modality for improving adherence to exercise in patients with class I-II HF.......PURPOSE: Cardiorespiratory fitness is positively related to heart failure (HF) prognosis, but lack of time and low energy are barriers for adherence to exercise. We, therefore, compared the effect of low-volume time-based resistance exercise training (TRE) with aerobic moderate-intensity cycling...... (AMC) on maximal and submaximal exercise capacity, health-related quality of life, and vascular function. METHODS: Twenty-eight HF patients (New York Heart Association class I-II) performed AMC (n = 14) or TRE (n = 14). Maximal and submaximal exercise capacity, health-related quality of life...

Oral health of pediatric AIDS patients: a hospital-based study.

Science.gov (United States)

Valdez, I H; Pizzo, P A; Atkinson, J C

1994-01-01

The prevalence of acquired immunodeficiency syndrome (AIDS) is steadily increasing among American children. The dental needs of these patients are significant. This study evaluated the oral health of forty children being treated for HIV-infection at the National Institutes of Health (NIH). Eight of twenty-two patients in primary dentition (36 percent) had baby bottle tooth decay (BBTD). These cases required extensive dental restoration usually under general anesthesia. Tooth development was delayed in 31 percent of patients. Candidiasis was the most common soft tissue abnormality, found in 35 percent of children. Preventive and therapeutic dental programs should be instituted to meet the special needs of pediatric AIDS patients.

A Comparative Study of Potential Evapotranspiration Estimation by Eight Methods with FAO Penman–Monteith Method in Southwestern China

Directory of Open Access Journals (Sweden)

Dengxiao Lang

2017-09-01

Full Text Available Potential evapotranspiration (PET is crucial for water resources assessment. In this regard, the FAO (Food and Agriculture Organization–Penman–Monteith method (PM is commonly recognized as a standard method for PET estimation. However, due to requirement of detailed meteorological data, the application of PM is often constrained in many regions. Under such circumstances, an alternative method with similar efficiency to that of PM needs to be identified. In this study, three radiation-based methods, Makkink (Mak, Abtew (Abt, and Priestley–Taylor (PT, and five temperature-based methods, Hargreaves–Samani (HS, Thornthwaite (Tho, Hamon (Ham, Linacre (Lin, and Blaney–Criddle (BC, were compared with PM at yearly and seasonal scale, using long-term (50 years data from 90 meteorology stations in southwest China. Indicators, viz. (videlicet Nash–Sutcliffe efficiency (NSE, relative error (Re, normalized root mean squared error (NRMSE, and coefficient of determination (R2 were used to evaluate the performance of PET estimations by the above-mentioned eight methods. The results showed that the performance of the methods in PET estimation varied among regions; HS, PT, and Abt overestimated PET, while others underestimated. In Sichuan basin, Mak, Abt and HS yielded similar estimations to that of PM, while, in Yun-Gui plateau, Abt, Mak, HS, and PT showed better performances. Mak performed the best in the east Tibetan Plateau at yearly and seasonal scale, while HS showed a good performance in summer and autumn. In the arid river valley, HS, Mak, and Abt performed better than the others. On the other hand, Tho, Ham, Lin, and BC could not be used to estimate PET in some regions. In general, radiation-based methods for PET estimation performed better than temperature-based methods among the selected methods in the study area. Among the radiation-based methods, Mak performed the best, while HS showed the best performance among the temperature

Uranium analysis by neutron induced fissionography method using solid state nuclear track detectors

International Nuclear Information System (INIS)

Akyuez, T.; Tretyakova, S. P.; Guezel, T.; Akyuz, S.

1999-01-01

In this study total twenty samples (eight reference materials and twelve sediment samples) were analysed for their uranium content which is in the range of 1-17 μg/g, by neutron induced fissionography (NIF) method using solid state nuclear track detectors (SSNTDs) in comparison with the results of neutron activation analysis (NAA), delayed neutron counting (DNC) technique or fluorometric method. It is found that NIF method using SSNTDs is very sensitive for analysis of uranium

Uranium analysis by neutron induced fissionography method using solid state nuclear track detectors

CERN Document Server

Akyuez, T; Guezel, T; Akyuz, S

1999-01-01

In this study total twenty samples (eight reference materials and twelve sediment samples) were analysed for their uranium content which is in the range of 1-17 mu g/g, by neutron induced fissionography (NIF) method using solid state nuclear track detectors (SSNTDs) in comparison with the results of neutron activation analysis (NAA), delayed neutron counting (DNC) technique or fluorometric method. It is found that NIF method using SSNTDs is very sensitive for analysis of uranium.

Method for simultaneous analysis of eight analogues of vitamin D using liquid chromatography tandem mass spectrometry

Directory of Open Access Journals (Sweden)

Shah Iltaf

2012-10-01

Full Text Available Abstract Background Despite considerable global investigation over several decades, the roles of vitamin D in health and disease development remains convoluted. One recognised issue is the difficulty of accurately measuring the active forms of vitamin D. Advances made include some new methods addressing the potential interference by excluding epimers and isobars. However, there is no evidence that epimers are without function. Therefore, the aim of this study was to develop and validate, for the first time, a new assay to simultaneously measure levels of six forms of vitamin D along with two epimers. The assay was applied to multilevel certified reference material (CRM and 25 pooled human sera samples, obtained from the Vitamin D External Quality Assessment Scheme (DEQAS, to demonstrate its efficiency. Results The assay is capable of simultaneously measuring eight vitamin D analogues over the calibration ranges and LODs (in nmol/L of: 1α25(OH2D2 [0.015-1; 0.01], 1α25(OH2D3 [0.1-100; 0.01], 25OHD3 [0.5-100, 0.025], 3-epi-25OHD3 [0.1-100, 0.05], 25OHD2 [0.5-100, 0.025], 3-epi-25OHD2 [0.1-100, 0.05], vitamin D3 [0.5-100, 0.05] and vitamin D2 [0.5-100, 0.05], using stanozolol-d3 as internal standard. Certified reference material and external quality control samples (DEQAS were analysed to meet the standards outlined by National Institute of Standards and Technology (NIST. Validation steps included recovery and both precision and accuracy under inter- and intra-day variation limit of detection, and analysis of each analyte over a linear range. All validation parameters were in line with acceptable Food and Drug Administration (FDA guidelines. All eight analogues were quantified with the 25OHD levels being commensurate with DEQAS data. Conclusions This report details the application of a new LC-MS/MS based assay for the efficient analysis of eight analogues of vitamin D over a range of samples, which is a significant advance over the existing

Influence of Formal Education on Cognitive Reserve in Patients with Multiple Sclerosis.

Science.gov (United States)

Luerding, Ralf; Gebel, Sophie; Gebel, Eva-Maria; Schwab-Malek, Susanne; Weissert, Robert

2016-01-01

The concept of cognitive reserve (CR) and its influence on cognitive impairment has attracted increasing interest. One hundred twenty-eight patients with multiple sclerosis (MS) from Southern Germany were evaluated during the years 2000 to 2012. Twenty-seven neuropsychological (NP) tests were applied regarding basic cognitive functions, attention, executive functions, visual perception and construction, memory and learning, problem solving, and language. By this retrospective approach, a comprehensive NP profile of the investigated individuals was established. An effect of timespan of formal education on CR was observed. Enrichment by reading, physical activities, and challenging vocational practices had more profound effects in patients who had undergone a shorter educational period compared to a longer educational period. In summary, our study demonstrates that the advantage of longer formal education periods, compared to shorter formal education periods, can be counterbalanced by high frequencies of reading, physical activities, and challenging vocational practices in patients with MS.

Cold Therapy in Migraine Patients: Open-label, Non-controlled, Pilot Study

Directory of Open Access Journals (Sweden)

Serap Ucler

2006-01-01

Full Text Available Some patients with headache report that they have frequently used physical therapies such as application of cold to relieve their headache. There are only a few reported studies related to cold therapies in patients with migraine. In this study, we investigated the effect of cold application on migraine patients. Twenty-eight migraine patients were included. Cold therapy was administered to them by gel cap. Patients used this cap during their two migraine attacks. Before and after the cold therapy, headache severity was recorded by using visual analogue scale (VAS. Patients used this cap for 25 min in each application. They recorded their VAS score just after the therapy and 25 min, 1 h, 2 h and 3 h later. Two patients could not use this therapy due to side effects (one due to cold intolerance and one due to vertigo in both applications. Therefore, therapeutic efficacy was evaluated in 26 patients. Twenty-five minutes after treatment of the first attack, VAS score was decreased from 7.89 ± 1.93 to 5.54 ± 2.96 (P < 0.01. Twenty-five minutes after treatment of the second attack, VAS score was decreased from 7.7 ± 1.8 to 5.4 ± 3.55 (P < 0.01. Cold application alone may be effective in some patients suffering from migraine attacks. Its combination with conventional drugs should be investigated in future studies.

Simultaneous quantification of twenty Amadori products in soy sauce using liquid chromatography-tandem mass spectrometry.

Science.gov (United States)

Katayama, Hiroshi; Tatemichi, Yuki; Nakajima, Ayako

2017-08-01

A liquid chromatography-tandem mass spectrometry method using a pentafluorophenylpropyl-bonded silica column was developed to simultaneously quantify twenty Amadori products (APs), including N-(1-Deoxy-d-fructosyl-1-yl)-l-isoleucine (Fru-Ile) and N-(1-Deoxy-d-fructosyl-1-yl)-l-leucine (Fru-Leu), in soy sauce, without the need for an ion-pairing reagent or sample derivatization. The method was applied to six types of soy sauce, to determine the total AP levels and the levels of individual APs. The level of total APs widely varied between the eight samples, from 358mg/L to 24347mg/L. The concentrations of N-ε-(1-deoxy-d-fructosyl-1-yl)-l-lysine (Fru-Lys) and N-(1-deoxy-d-fructosyl-1-yl)-l-pyroglutamic acid (Fru-pGlu) were the highest among the APs and the level of Fru-pGlu was similar to that of Fru-Lys. Furthermore, fermentation periods of up to six months greatly influenced AP levels in soy sauce but the levels remained constant thereafter. Thermal treatment of soy sauce had little effect on AP levels. Copyright © 2017. Published by Elsevier Ltd.

Ultrasonographic differentiation between Kikuchi's disease and lymphoma in patients with cervical lymphadenopathy

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Lo, Wu-Chia [Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan (China); Chang, Wen-Cheng [Department of Pediatrics, Far Eastern Memorial Hospital, Taipei, Taiwan (China); Lin, Yu-Chin [Department of Medical Oncology and Hematology, Far Eastern Memorial Hospital, Taipei, Taiwan (China); Hsu, Yao-Peng [Department of Anatomic Pathology, Far Eastern Memorial Hospital, Taipei, Taiwan (China); Liao, Li-Jen, E-mail: liaolj@ntu.edu.tw [Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan (China); Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan (China)

2012-08-15

Purpose: Kikuchi's disease, or histiocytic necrotizing lymphadenitis, is a self-limited necrotizing lymphadenitis. Clinically, it resembles lymphoma. We want to compare the sonographic features between Kikuchi's disease and lymphoma in patients with cervical lymphadenopathy. Materials and methods: The study protocol was approved by the institutional review board. Two hundred and twenty six cervical lymph nodes (137 nodes from 21 Kikuchi's disease patients and 89 nodes from 20 malignant lymphoma patients) were examined. The demographic and ultrasonographic characteristics of lymph nodes were collected and analyzed. Results: The Kikuchi's disease patients (mean age, 24.2 years; range, 8-57 years) were younger than those with lymphoma (mean age, 54 years; range, 13-81 years). There was no difference in laterality of nodes (p = 0.19). The nodal distribution demonstrated most enlarged neck lymph nodes located at level II, III and V. The ranges of short-axis and long-axis length were 6.5 {+-} 2.3 mm (mean {+-} SD) versus 13.4 {+-} 5.1 mm and 13.4 {+-} 5.0 mm versus 21.2 {+-} 9.2 mm for Kikuchi's disease versus lymphoma (p < 0.01), respectively. The S/R ratio of Kikuchi's disease nodes was 0.5 {+-} 0.2 compared to 0.7 {+-} 0.2 in lymphoma nodes (p < 0.01). Eighty-seven of 137 nodes (63.5%) of Kikuchi's disease, and eight of 89 nodes (9%) of malignant lymphoma had signs of cortical widening (p < 0.01). Seventy-six nodes (55.5%) of Kikuchi's disease and twenty-eight nodes (31.5%) of malignant lymphoma were matted (p < 0.01). Forty-five of 89 nodes among lymphoma and twenty-four among 137 of Kikuchi's disease had features of micronodular reticular echotexture (p < 0.01). All nodes exhibited hypoechogenicity except one lymphomatous node demonstrated isoechogenicity, and there was no difference in sharpness of border and presence of echogenic hilum between the two diseases (p > 0.05). Conclusion: Analysis of basic ultrasonographic

Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups

DEFF Research Database (Denmark)

Janssen, M F; Pickard, A Simon; Golicki, Dominik

2012-01-01

PURPOSE: The aim of this study was to assess the measurement properties of the 5-level classification system of the EQ-5D (5L), in comparison with the 3-level EQ-5D (3L). METHODS: Participants (n = 3,919) from six countries, including eight patient groups with chronic conditions (cardiovascular...... of the 3-level system which improves upon the measurement properties, reducing the ceiling while improving discriminatory power and establishing convergent and known-groups validity.......), redistribution properties, ceiling, discriminatory power, convergent validity, and known-groups validity. RESULTS: Missing values were on average 0.8 % for 5L and 1.3 % for 3L. In total, 2.9 % of responses were inconsistent between 5L and 3L. Redistribution from 3L to 5L using EQ dimension-specific rating scales...

RAPID KNEE-EXTENSIONS TO INCREASE QUADRICEPS MUSCLE ACTIVITY IN PATIENTS WITH TOTAL KNEE ARTHROPLASTY

DEFF Research Database (Denmark)

Husted, Rasmus Skov; Wilquin, Lousia; Jakobsen, Thomas Linding

2017-01-01

rapid knee-extensions were associated with greater voluntary quadriceps muscle activity during an experimental strength training session, compared to that elicited using slow knee-extensions. STUDY DESIGN: A randomized cross-over study. METHODS: Twenty-four patients (age 66.5) 4-8 weeks post total knee...... agonist muscle activity, especially if the exercise is conducted using rapid muscle contractions. PURPOSE: The purpose of this study was to examine if patients with total knee arthroplasty could perform rapid knee-extensions using a 10 RM load four to eight weeks after surgery, and the degree to which...... arthroplasty randomly performed one set of five rapid, and one set of five slow knee-extensions with the operated leg, using a load of their 10 repetition maximum, while surface electromyography recordings were obtained from the vastus medialis and lateralis of the quadriceps muscle. RESULTS: Data from 23...

Rapid knee-extensions to increase quadriceps muscle activity in patients with total knee arthroplasty

DEFF Research Database (Denmark)

Husted, Rasmus Skov; Wilquin, Lousia; Jakobsen, Thomas Linding

2017-01-01

rapid knee-extensions were associated with greater voluntary quadriceps muscle activity during an experimental strength training session, compared to that elicited using slow knee-extensions. STUDY DESIGN: A randomized cross-over study. METHODS: Twenty-four patients (age 66.5) 4-8 weeks post total knee...... agonist muscle activity, especially if the exercise is conducted using rapid muscle contractions. PURPOSE: The purpose of this study was to examine if patients with total knee arthroplasty could perform rapid knee-extensions using a 10 RM load four to eight weeks after surgery, and the degree to which...... arthroplasty randomly performed one set of five rapid, and one set of five slow knee-extensions with the operated leg, using a load of their 10 repetition maximum, while surface electromyography recordings were obtained from the vastus medialis and lateralis of the quadriceps muscle. RESULTS: Data from 23...

Perlappendiceal inflammatory masses: CT-directed management and clinical outcome in 70 patients

International Nuclear Information System (INIS)

Jeffrey, R.B. Jr.; Tolentino, C.S.; Federle, M.P.

1987-01-01

The clinical outcome was reviewed in 70 patients with CT evidence of periappendiceal inflammatory masses. Thirty-two patients had either phlegmons or small abscesses (less than 3 cm). These patients were initially treated with antibiotic therapy alone, with resolution of the inflammatory process in 28 of the patients (88%). Twenty-eight patients underwent percutaneous abscess drainage of periappendiceal abscesses that was successful in 26 patients (93%). Although 13 patients (46%) had low-output fistulas communicating with the cecum, 12 of 13 closed with 2 weeks of drainage. Ten patients had early surgical drainage for extensive, poorly defined abscesses. Based on CT, a rational approach can be chosen to reduce morbidity and optimize clinical outcome

Desensitization with oxaliplatin in patients intolerant of carboplatin desensitization.

Science.gov (United States)

Rose, Peter G; Metz, Carol; Link, Nicolas

2014-11-01

The tolerance and efficacy of oxaliplatin desensitization in patients who were intolerant of carboplatin desensitization were determined. We retrospectively reviewed the Gynecologic Oncology patients who received carboplatin or oxaliplatin from December 2007 until August 2014. The number of treatments and number of patients of carboplatin standard infusions, carboplatin desensitizations, and oxaliplatin desensitizations were determined. Carboplatin infusions (2294) were administered to 281 patients. Twenty-eight (10%) of these patients developed carboplatin hypersensitivity and were treated with 205 carboplatin desensitizations. Nine (29%) patients were subsequently treated with 61 oxaliplatin desensitizations due to intolerance of carboplatin desensitization. Nine of the 10 patients tolerated this infusion well. Four of 9 evaluable patients had an objective response, 2 complete and 2 partial. Oxaliplatin desensitization seems well tolerated and effective in most patients who are intolerant of carboplatin desensitization.

Twenty-first century learning in schools: A case study of New Technology High School in Napa, California.

Science.gov (United States)

Pearlman, Bob

2006-01-01

The most pertinent question concerning teaching and learning in the twenty-first century is not what knowledge and skills students need--that laundry list was identified over a decade ago--but rather how to foster twenty-first century learning. What curricula, experiences, assessments, environments, and technology best support twenty-first century learning? New Technology High School (NTHS) in Napa, California, is one example of a successful twenty-first century school. In this chapter, the author describes the components of this exemplary high school, illustrating an environment that will cultivate twenty-first century student learning. New Technology High School began by defining eight learning outcomes, aligned with the standards of the Partnership for 21st Century Skills; to graduate, students demonstrate mastery of these outcomes through an online portfolio. To help students achieve the outcomes, NTHS employs project- and problem-based learning. Whereas in traditional classrooms students work alone on short-term assignments that do not lend themselves to deep understanding, the project-based learning approach has students working in teams on long-term, in-depth, rigorous projects. Students' work is supported by the school's workplace-like environment and effectiv use of technology. Meaningful assessment is essential to project-based learning; students receive continuous feedback, helping them become self-directed learners. In fact, NTHS uses outcome-based grading through which students constantly know how they are performing on the twenty-first century outcomes. Research has shown that NTHS graduates are better prepared for postsecondary education, careers, and citizenship than their peers from other schools. To facilitate twenty-first century learning, all schools need to rethink their approach to teaching and learning. New Technology High School is one way to do so.

Pulmonary Involvement in Patients with Guillain-Barré Syndrome in Subacute Phase.

Science.gov (United States)

Khanna, Meeka; Rawat, Nidhi; Gupta, Anupam; Nagappa, Madhu; Taly, Arun B; Rukmani, M R; Sathyaprabha, T N; Haldar, Partha

2017-01-01

To evaluate the pulmonary function in Guillain-Barre syndrome (GBS) patients in subacute phase and find clinical correlates of pulmonary dysfunction. This was a single-center, prospective, cross-sectional, hospital-based study in GBS patients performed in Department of Neurological Rehabilitation at a tertiary care institute. Clinical examination for pulmonary function was done by measuring chest expansion. The pulmonary function tests were carried out by Spirometry kit Microquark Cosmed, Italy. Fatigue was assessed by Fatigue Severity Scale, disability status by Hughes Disability Scale (HDS), and muscle weakness by Medical Research Council sum scores. Statistical analysis was performed by Stata 11. The significance of P value was adjudged against an alpha of 0.05. Twenty-eight patients were included with 17 (61%) men and mean age of 31 years. Median duration of symptoms was 16.5 days. There were 10 (36%) demyelinating and 18 (64%) axonal variants. Twenty-six (93%) patients scored more than 2 on HDS. All study participants reported fatigue. Twenty-two (78.6%) patients had chest expansion of <2.5 cm. Spirometry showed restrictive pulmonary dysfunction in 23 (79%) patients. Significant correlation was found between abnormal pulmonary function test and chest expansion ( P = 0.003). Pulmonary dysfunction in GBS is common even during subacute phase. It needs to be identified and managed appropriately for better clinical outcome.

Techniques of preoxygenation in patients with ineffective face mask seal

Directory of Open Access Journals (Sweden)

Pankaj Kundra

2013-01-01

Full Text Available Background: Ineffective face mask seal is the most common cause for suboptimal pre-oxygenation. Room air entrainment can be more with vital capacity (VC breaths when the mask is not a tight fit. Aims: This study was designed to compare 5 min tidal volume (TV breathing and eight VC breaths in patients with ineffective face mask seal. Methods: Twenty eight ASA I adults with ineffective face mask seal were randomized to breathe 100% oxygen at normal TV for 5 min (Group TV and eight VC breaths (Group VC in a cross over manner through circle system at 10 L/min. End tidal oxygen concentration (EtO 2 and arterial blood gas analysis was performed to evaluate oxygenation with each technique. Statistical Analysis: Data were analysed using SPSS statistical software, version 16. Friedman′s two-way analysis of variance by ranks was used for non-parametric data. Results: Significant increase in EtO 2 (median 90 and PaO 2 (228.85 was seen in group TV when compared to group VC (EtO 2 median 85, PaO 2 147.65, P<0.05. Mean total ventilation volume in 1 min in group VC was 9.4±3.3 L/min and more than fresh gas flow (10 L/min in seven patients. In group TV, the fresh gas flow (50 L/5 min was sufficient at normal TV (mean total ventilation in 5 min 36.7±6.3 L/min. Conclusions: TV breathing for 5 min provides better pre-oxygenation in patients with ineffective mask seal with fresh gas flow of 10 L/min delivered through a circle system.

Indications for admission, treatment and improved outcome of paediatric haematology/oncology patients admitted to a tertiary paediatric ICU.

LENUS (Irish Health Repository)

Owens, C

2012-02-01

BACKGROUND: Overall survival in paediatric cancer has improved significantly over the past 20 years. Treatment strategies have been intensified, and supportive care has made substantial advances. Historically, paediatric oncology patients admitted to an intensive care unit (ICU) have had extremely poor outcomes. METHODS: We conducted a retrospective cohort study over a 3-year period in a single centre to evaluate the outcomes for this particularly vulnerable group of patients admitted to a paediatric ICU. RESULTS: Fifty-five patients were admitted a total of 66 times to the ICU during the study period. The mortality rate of this group was 23% compared with an overall ICU mortality rate of 5%. 11\\/15 patients who died had an underlying haematological malignancy. Twenty-eight percent of children with organism-identified sepsis died. CONCLUSIONS: While mortality rates for paediatric oncology patients admitted to a ICU have improved, they are still substantial. Those with a haematological malignancy or admitted with sepsis are most at risk.

Isolation and characterization of eight polymorphic microsatellites for the spotted spiny lobster, Panulirus guttatus

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Nathan Truelove

2016-01-01

Full Text Available Microsatellite sequences were isolated from enriched genomic libraries of the spotted spiny lobster, Panulirus guttatus using 454 pyrosequencing. Twenty-nine previously developed polymerase chain reaction primer pairs of Panulirus argus microsatellite loci were also tested for cross-species amplification in Panulirus guttatus. In total, eight consistently amplifying, and polymorphic loci were characterized for 57 individuals collected in the Florida Keys and Bermuda. The number of alleles per locus ranged from 8 to 20 and observed heterozygosities ranged from 0.409 to 0.958. Significant deviations from Hardy–Weinberg equilibrium were found in one locus from Florida and three loci from Bermuda. Quality control testing indicated that all loci were easy to score, highly polymorphic and showed no evidence of linkage disequilibrium. Null alleles were detected in three loci with moderate frequencies ranging from (20% to 22%. These eight microsatellites provide novel molecular markers for future conservation genetics research of P. guttatus.

Storyline and Associations Pyramid as Methods of Creativity Enhancement: Comparison of Effectiveness in 5-Year-Old Children

Science.gov (United States)

Smogorzewska, Joanna

2012-01-01

This article presents the results of a study comparing the originality, the length, the number of neologisms and the syntactic complexity of fairy tales created with "Storyline" and "Associations Pyramid." Both methods were developed to enhance children's language abilities and their creative thinking. One hundred twenty eight 5-year-old children…

Treatment and retreatment with omalizumab in chronic spontaneous urticaria: Real life experience with twenty-five patients.

Science.gov (United States)

Türk, Murat; Yılmaz, İnsu; Bahçecioğlu, Sakine Nazik

2018-01-01

Previous data have shown the high efficacy of omalizumab in chronic spontaneous urticaria (CSU). However, factors that may be effective on the response to therapy, relapse rates after drug discontinuation, and efficacy of retreatment remain unclear. This study aimed to determine the efficacy of omalizumab in CSU refractory to conventional therapy, to identify possible factors affecting treatment response and relapse, and also to evaluate the efficacy of retreatment on relapsed disease. The data of CSU patients treated with 300 mg/month omalizumab for at least 3 months were retrospectively analyzed. In order to evaluate the efficacy of treatment and retreatment, baseline and follow-up concomitant medication score (CMS) and urticaria activity score (UAS) were calculated. Possible factors affecting treatment response and relapse were identified. Twenty-five patients were included. The median duration of omalizumab therapy was 6 (6-12) months. Of the patients with baseline UAS 6 (5.5-6) and CMS 13 (10-15), 8 (32%) had complete response (UAS = 0) and 2 (8%) were non-responders after 3 months of therapy. None of the complete responders were positive for IgG-anti-TPO. After discontinuation of omalizumab therapy, 11 (61%) patients experienced relapse and 10 of them received retreatment with omalizumab. Half of the patients had complete response, and half had partial response (UAS = 1-4) after retreatment. No treatment related adverse events were documented. Omalizumab has high efficacy in both the treatment and retreatment of CSU; however, relapse rates after discontinuation are high. Autoimmune markers may be helpful in predicting treatment response and relapse. Copyright © 2017 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

For CERN's Golden Jubilee, the Canton of Geneva, supported by the Pays de Gex local authorities, lit up eight points around the LHC ring.

CERN Multimedia

Patrice Loiez

2004-01-01

On the date of CERN's fiftieth anniversary, 29 September 2004, the Organization's Host State authorities gave the Laboratory a gift of light. As night fell, twenty-four powerful floodlights blazed into the night sky from the eight access points to the future LHC. (View from Mourex, France)

Re-irradiation after salvage mastectomy for local recurrence after a conservative treatment: a retrospective analysis of twenty patients (Nancy: 1988-2001)

International Nuclear Information System (INIS)

Racadot, S.; Marchal, C.; Charra-Brunaud, C.; Peiffert, D.; Bey, P.; Verhaeghe, J.L.

2003-01-01

Purpose. - To retrospectively assess the efficacy of post-mastectomy re-irradiation for local relapse of breast cancer. Patients and methods. - Twenty patients, initially treated by conservative surgery and radiotherapy (50 Gy in 25 fractions over 5 weeks) were treated from 1998 to 2001 for a local relapse by salvage mastectomy and re-irradiation (either electron or photon beams). Mean age was 53 years (31-71). Reasons for re-irradiation were that the local relapses were inflammatory (4 pts), multifocal (5 pts), cutaneous (5 pts), involved the nipple (3 pts) or because the surgical margins (either muscle or skin) were involved (3 pts). The median dose of re-irradiation was 45 Gy (33-65) in 15 fractions over 33 days. Mean follow-up was 48 months (5-97). Results. - Fifteen patients remained free of a second local recurrence and 10 were still alive, without metastasis. Neither the dose of re-irradiation nor the irradiated surfaces were prognostic factors of local control (P = 0.877 and P = 0.424). Five patients developed radiation-induced pneumonitis without functional respiratory impairment. The incidence of pneumonitis seemed to be related to the biological dose of re-irradiation (P = 0.037). Other late complications occurred such as pigmentation changes (12 pts), telangiectasia (8 pts), chondritis (2 pts), parietal fibrosis (7 pts), rib fractures (4 pts), severe pain (11 pts) and lymphedema (2 pts). The increase in biological equivalent dose was highly statistically linked with the occurrence of disabling pain (P = 0.0123). Conclusion. - Parietal re-irradiation achieves good and lasting local control with an acceptable rate of acute complications but with a risk of disabling late sequelae such as severe pain. (author)

[Management of patients with bronchial asthma received general anesthesia and surgical intervention].

Science.gov (United States)

To, Masako; Tajima, Makoto; Ogawa, Cyuhei; Otomo, Mamoru; Suzuki, Naohito; Sano, Yasuyuki

2002-01-01

Stimulation to bronchial mucosa is one of the major risk factor of asthma attack. When patients receive surgical intervention and general anesthesia, they are always exposed to stimulation to bronchial mucosa. Prevention method of bronchial asthma attack during surgical intervention is not established yet. We investigated that clinical course of patients with bronchial asthma who received general anesthesia and surgical intervention. Seventy-six patients with bronchial asthma were received general anesthesia and surgical intervention from 1993 to 1998. Twenty-four patients were mild asthmatic patients, 39 were moderate asthmatic patients and 13 were severe asthmatic patients. Preoperative treatment for preventing asthma attack was as follows; Eight patients were given intravenous infusion of aminophylline before operation. Fifty-two patients were given intravenous infusion of aminophylline and hydrocortisone before operation. Three patients were given intravenous infusion of hydrocortisone for consecutive 3 days before operation. Thirteen patients were given no treatment for preventing asthma attack. One patient was suffered from asthma attack during operation. She was given no preventing treatment for asthma attack before operation. Three patients were suffered from asthma attack after operation. No wound dehiscence was observed in all patients. To prevent asthma attack during operation, intravenous infusion of steroid before operation is recommended, when patients with asthma receive general anesthesia and surgical intervention.

Nutritional survey of neoplasm patients receiving radiotherapy

International Nuclear Information System (INIS)

Li Xinli; Zhu Shengtao

2001-01-01

Objective: In order to know the nutriture of neoplasm patients receiving radiotherapy and give nutritional guidance properly, the authors make the following survey. Methods: A dietary survey of twenty-four-hour retrospective method was used; The patients' activity was recorded and their twenty-four hours caloric consumption was calculated. Results: Of all the patients, the intake of protein is more than recommended, percentage of calorific proportion is about 15%-19% of gross caloric. A larger portion of patients' caloric intake, especially female patients, is lower than caloric consumption. Among all the patients, the intake of vegetables is not enough; The consumption of milk and milky products is lower; it is common and serious that neoplasm patients receiving radiotherapy have vitamine and mineral's scarcity. Conclusions: Nutriture of neoplasm patients is not optimistic, it is imperative to improve their nutriture

Wegner′s granulomatosis developing for the first time in a patient eight years after starting maintenance hemodialysis

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Ahmad Ramadan Ali

2015-01-01

Full Text Available Wegener′s granulomatosis is a serious autoimmune disorder characterized by necrotizing small-vessel vasculitis. It is a multisystem disease that primarily affects the lung and kidneys. Previous studies indicated few relapses of vasculitis after hemodialysis due to uremic immunosuppression. Our case report describes an end-stage renal failure patient who had developed non-caseating lung granulomata with giant cell formation and fibrinoid necrosis of arterial media that is consistent with Wegner′s granulomatosis for the first time and eight years after initiation of maintenance hemodialysis. We believe that such a phenomenon has rarely been reported.

Dynamic CE-MRA for endoleak classification after endovascular aneurysm repair.

NARCIS (Netherlands)

Laan, M.J. van der; Bakker, C.J.; Blankensteijn, J.D.; Bartels, L.W.

2006-01-01

AIM: To evaluate the value of dynamic contrast enhanced magnetic resonance angiography (CE-MRA) for classification of endoleaks after endovascular aneurysm repair (EVAR). MATERIALS AND METHODS: Twenty-eight patients, between 2 days and 54 months after EVAR, were evaluated with CTA, MRI and dynamic

Dynamic CE=MRA for endoleak classification after endovascular aneurysm repair

NARCIS (Netherlands)

van der Laan, MJ; Bakker, CJG; Blankensteijn, JD; Bartels, LW

Aim. To evaluate the value of dynamic contrast enhanced magnetic resonance angiography (CE-MRA)for classification of endoleaks after endovascular aneurysm repair (EVAR). Materials and methods. Twenty-eight patients, between 2 days and 54 months after EVAR, were evaluated with CTA, MRI and dynamic

Early twenty-first-century droughts during the warmest climate

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Felix Kogan

2016-01-01

Full Text Available The first 13 years of the twenty-first century have begun with a series of widespread, long and intensive droughts around the world. Extreme and severe-to-extreme intensity droughts covered 2%–6% and 7%–16% of the world land, respectively, affecting environment, economies and humans. These droughts reduced agricultural production, leading to food shortages, human health deterioration, poverty, regional disturbances, population migration and death. This feature article is a travelogue of the twenty-first-century global and regional droughts during the warmest years of the past 100 years. These droughts were identified and monitored with the National Oceanic and Atmospheric Administration operational space technology, called vegetation health (VH, which has the longest period of observation and provides good data quality. The VH method was used for assessment of vegetation condition or health, including drought early detection and monitoring. The VH method is based on operational satellites data estimating both land surface greenness (NDVI and thermal conditions. The twenty-first-century droughts in the USA, Russia, Australia and Horn of Africa were intensive, long, covered large areas and caused huge losses in agricultural production, which affected food security and led to food riots in some countries. This research also investigates drought dynamics presenting no definite conclusion about drought intensification or/and expansion during the time of the warmest globe.

Ontogeny of methionine utilization and splanchnic uptake in critically ill children

Science.gov (United States)

To determine the rates of methionine splanchnic uptake and utilization in critically ill pediatric patients, we used two kinetic models: the plasma methionine enrichment,and the "intracellular" homocysteine enrichment. Twenty-four patients, eight infants, eight children, and eight adolescents, were ...

Colonic production of butyrate in patients with previous colonic cancer during long-term treatment with dietary fibre (Plantago ovata seeds)

DEFF Research Database (Denmark)

Nordgaard, I; Hove, H; Clausen, M R

1996-01-01

BACKGROUND: Butyrate has antineoplastic properties against colorectal cancer cells and is the preferred oxidative substrate for colonocytes. Like acetate and propionate (short-chain fatty acids; SCFAs), butyrate is produced by colonic fermentation of dietary fibre. METHODS: Twenty patients resected...... for colorectal cancer were treated with 20 g/day of the fibre Plantago ovata seeds for 3 months, which increased the intake of fibre by 17.9 +/- 0.8 g/day, from basal levels of 19.2 +/- 1.7 g/day; 17 patients completed the study. Faecal samples were obtained on eight occasions, twice before treatment......, and monthly three times during and three time after treatment. RESULTS: One month of fibre therapy increased faecal concentrations of butyrate by 42 +/- 12% (from 13.2 +/- 1.2 to 19.3 +/- 3.0 mmol/l; P

Transurethral resection of the prostate for patients with grade III urinary symptoms following transperineal implantation of the prostate

International Nuclear Information System (INIS)

Potters, L; Waldbaum, R; Bosworth, J; Ashley, R

1996-01-01

PURPOSE/OBJECTIVE: Patients (Pts) undergoing a I-125 or Pd-103 transperineal implant of the prostate (TPIP) experience urethritis of a varying degree. Most pts with mild to moderate symptoms can be treated with alpha blocking agents. Few pts will experience urethritis that does not respond to medical management, or persists beyond three half life's of the isotope. These pts will have significant quality of life complaints related to their symptoms. The purpose of this study is to present our results of Transurethral resection of the prostate (TURP) for patients with grade III urethritis. MATERIALS AND METHODS: Between November 1992 and January 1996, 378 patients underwent TPIP for clinically localized cancer. Treatment consisted of either a Pd-103 or I-125 implant either alone or in combination with external beam radiation and/or hormones. All the implants used a peripheral loading and urethral sparing technique. All pts were followed after the implant and assessed by DRE, PSA, and symptoms. The grading of urinary symptoms was as follows: Grade I-successful relief with pyridium or an equivalent medication, Grade II-pts requiring various doses of alpha blockers, Grade III-pts with persistent symptoms despite medical management. RESULTS: Of the 378 pts undergoing implant, 358 had sufficient follow-up to be included in this review. Forty two pts (12%) received hormone downsizing prior to implantation. Two hundred and two (56%) underwent a Pd-103 implant and 156 (44%) a I-125 implant; 15 underwent EBRT plus I-125 and 27 with EBRT and Pd-103. One hundred and fifty five (43%) pts experienced grade I urethritis during the first three half life's of the implant, while 116 (32%) experienced grade II urethritis. Twenty eight pts (8%) experienced grade III urethritis that persisted beyond three half life's of the implant. All grade III pts were offered TURP and 26 elected to undergo this procedure. Of the twenty six pts undergoing TURP, 100% experienced relief of their

Treatment of Acute Uncomplicated Gonococcal Urethritis in Males by Rosoxacin

Directory of Open Access Journals (Sweden)

A N Tiwari

1986-01-01

Full Text Available Twenty eight male patients with acute gonococcal, urethritis were treated, with rosoxacin 300 mg capsule, (Eradacil as a single- dose oral therapy. Twenty six patients were cured, while two patients did not improve. Four patients developed post-gonococcal urethritis (PGU.

Outlook: The Next Twenty Years

Energy Technology Data Exchange (ETDEWEB)

Murayama, Hitoshi

2003-12-07

I present an outlook for the next twenty years in particle physics. I start with the big questions in our field, broken down into four categories: horizontal, vertical, heaven, and hell. Then I discuss how we attack the bigquestions in each category during the next twenty years. I argue for a synergy between many different approaches taken in our field.

[Acid-base status in patients treated with peritoneal dialysis].

Science.gov (United States)

Katalinić, Lea; Blaslov, Kristina; Pasini, Eva; Kes, Petar; Bašić-Jukić, Nikolina

2014-04-01

When compared to hemodialysis, peritoneal dialysis is very simple yet low cost method of renal replacement therapy. Series of studies have shown its superiority in preserving residual renal function, postponing uremic complications, maintaining the acid-base balance and achieving better post-transplant outcome in patients treated with this method. Despite obvious advantages, its role in the treatment of chronic kidney disease is still not as important as it should be. Metabolic acidosis is an inevitable complication associated with progressive loss of kidney function. Its impact on mineral and muscle metabolism, residual renal function, allograft function and anemia is very complex but can be successfully managed. The aim of our study was to evaluate the efficiency in preserving the acid-base balance in patients undergoing peritoneal dialysis at Zagreb University Hospital Center. Twenty-eight patients were enrolled in the study. The mean time spent on the treatment was 32.39 ± 43.43 months. Only lactate-buffered peritoneal dialysis fluids were used in the treatment. Acid-base balance was completely maintained in 73.07% of patients; 11.54% of patients were found in the state of mild metabolic acidosis, and the same percentage of patients were in the state of mild metabolic alkalosis. In one patient, mixed alkalosis with respiratory and metabolic component was present. The results of this study showed that acid-base balance could be maintained successfully in patients undergoing peritoneal dialysis, even only with lactate-buffered solutions included in the treatment, although they were continuously proclaimed as inferior in comparison with bicarbonate-buffered ones. In well educated and informed patients who carefully use this method, accompanied by the attentive and thorough care of their physicians, this method can provide quality continuous replacement of lost renal function as well as better quality of life.

Paclitaxel with Cisplatin as Salvage Treatment for Patients with Previously Treated Advanced Transitional Cell Carcinoma of the Urothelial Tract

Directory of Open Access Journals (Sweden)

Ji Eun Uhm

2007-01-01

Full Text Available BACKGROUND: This study was performed to evaluate the safety and efficacy of paclitaxel with cisplatin as salvage therapy in patients previously treated with gemcitabine and cisplatin (G/C for advanced transitional cell carcinoma (TCC of the urothelial tract. METHODS: Twenty-eight patients with metastatic or locally advanced TCC who had received prior G/C chemotherapy were enrolled. All patients received paclitaxel (175 mg/m2 and cisplatin (60 mg/m2 every 3 weeks for eight cycles or until disease progression. RESULTS: The median age was 61 years (range, 43–83 years, and the median Eastern Cooperative Oncology Group performance status was 1 (range, 0–2. The overall response rate was 36% [95% confidence interval (95% CI = 18–54], with three complete responses and seven partial responses. The median time to progression was 6.2 months (95% CI = 3.9–8.5, and the median overall survival was 10.3 months (95% CI = 6.1–14.1. The most common Grade 3/4 nonhematologic and hematologic toxicities were emesis (10 of 28 patients; 36% and neutropenia (5 of 110 cycles; 5%. CONCLUSIONS: Salvage chemotherapy with paclitaxel and cisplatin displayed promising results with tolerable toxicity profiles in patients with metastatic or locally advanced TCC who had been pretreated with G/C.

Results of the new nitinol self-expandable stents for distal biliary structures

NARCIS (Netherlands)

Smits, M.; Huibregtse, K.; Tytgat, G.

1995-01-01

The nitinol stent is a self-expandable spiral stent made of nickel-titanium alloy. We performed a pilot study to evaluate the method of stent insertion and stent efficacy. Twenty-eight patients with irresectable malignancy had nitinol stents inserted for obstructive jaundice due to distal biliary

Twenty-four-hour ambulatory blood pressure monitoring for clinical evaluation of hypertensive patients in primary care: which groups would most benefit?

Science.gov (United States)

Grezzana, Guilherme B; Stein, Airton T; Pellanda, Lucia C

2017-04-01

Arterial hypertension is an important risk factor for cardiovascular outcomes. Blood pressure (BP) control levels remain largely out of target among primary healthcare (PHC) patients. Twenty-four-hour ambulatory blood pressure monitoring (ABPM) may contribute toward the identification of cardiovascular risk groups. To assess concordance between conventional office BP measurements and 24-h ABPM of hypertension control in cardiovascular risk groups of PHC hypertensive patients. A cross-sectional study with 569 hypertensive patients was carried out. The evaluation of BP was performed by a PHC doctor, and the 24-h ABPM was performed by a different and blinded provider. The therapeutic targets for BP followed the guidance of The Eighth Joint National Committee, the Brazilian guideline, and the 2013 European Society of Hypertension. Considering the hypertension control therapeutic targets, the guidelines were not similar and were used to evaluate differences in BP value concordances compared with BP standard measurements. After a multivariate logistic regression analysis, a conventional BP was used in comparison with ABPM in different cardiovascular risk groups of hypertensive patients. According to the ABPM by European Society of Hypertension guideline, the subgroup of inactive patients (P=0.006), with altered glycemia (P=0.015) and over 30 mg/dl albuminuria (P=0.001), presented discordance among methods. When a conventional BP measurement in comparison with the ABPM results according to the Brazilian ABPM guideline was used, the discordance occurred significantly in inactive (P=0.001) and microalbuminuria more than 30 mg/dl (P=0.022) subgroups. However, in this comparison, a concordance between high-density lipoprotein more than 60 mg/dl (P=0.015) and obesity (P=0.035) subgroups occurred. Uncontrolled glucose levels, a sedentary lifestyle, and the presence of microalbuminuria correspond to some cardiovascular risk groups that would particularly benefit from 24-h

[Simultaneous determination of eight kinds of conjunct bile acids in human bile by R-HPLC].

Science.gov (United States)

Dai, Z; Tan, G; Qian, K; Chen, X

1997-01-01

A method for the simultaneous determination of eight kinds of conjunct bile acids in human bile was developed by HPLC. They were separated on a YWG-C18 (3 microns) column at 30 degrees C, with methanol/water (65/35, V/V, pH3.0) as mobile phase, and detection wavelength at UV 210 nm. The linear ranges were 50-1,000 microns.ml-1, the recoveries were 91.2%-108.6%. The biles of 30 cases with cholelithiasis cholecystolithiasis and 20 cases without gallstone were detected by HPLC. The results showed that the constitution of bile acids was different between patients with cholelithiasis cholecystolithiasis and patients without gallstone.

Gait pattern recognition in cerebral palsy patients using neural network modelling

International Nuclear Information System (INIS)

Muhammad, J.; Gibbs, S.; Abboud, R.; Anand, S.

2015-01-01

Interpretation of gait data obtained from modern 3D gait analysis is a challenging and time consuming task. The aim of this study was to create neural network models which can recognise the gait patterns from pre- and post-treatment and the normal ones. Neural network is a method which works on the principle of learning from experience and then uses the obtained knowledge to predict the unknown. Methods: Twenty-eight patients with cerebral palsy were recruited as subjects whose gait was analysed in pre- and post-treatment. A group of twenty-six normal subjects also participated in this study as control group. All subjects gait was analysed using Vicon Nexus to obtain the gait parameters and kinetic and kinematic parameters of hip, knee and ankle joints in three planes of both limbs. The gait data was used as input to create neural network models. A total of approximately 300 trials were split into 70% and 30% to train and test the models, respectively. Different models were built using different parameters. The gait was categorised as three patterns, i.e., normal, pre- and post-treatments. Result: The results showed that the models using all parameters or using the joint angles and moments could predict the gait patterns with approximately 95% accuracy. Some of the models e.g., the models using joint power and moments, had lower rate in recognition of gait patterns with approximately 70-90% successful ratio. Conclusion: Neural network model can be used in clinical practice to recognise the gait pattern for cerebral palsy patients. (author)

Mixed chimerism following hematopoietic stem cell transplantation in pediatric thalassemia major patients: a single center experience

Directory of Open Access Journals (Sweden)

Elif Ünal İnce

2010-03-01

Full Text Available Objective: Stable mixed chimerism (MC may result in cure for thalassemia major patients following hematopoietic stem cell transplantation (HSCT, but rejection can occur. Twenty-eight HSCTs for thalassemia major were reviewed retrospectively to evaluate the clinical course of MC with possible risk factors and predictors of outcome, with a median follow-up of 1669 days (811-3576 days. Materials and Methods: Chimerism was detected by fluorescence in situ hybridization (FISH or multiplex polymerase chain reaction depending on the sex match between the donor and the recipient. Results: Primary rejection, stable MC and full donor chimerism was detected in 3.6%, 17.8% and 78.6% of patients, respectively. Clinically, 4/5 patients with stable MC had thalassemia trait with donor chimerism as low as 14%. One patient was started on pRBC transfusions at 2.5 years postHSCT. Conclusion: Stable MC can result in cure for thalassemia major patients. The clinical picture remains as the best guide for intervention until a more reliable predictor is available.

Can Dynamic Susceptibility Contrast Magnetic Resonance Imaging Replace Single-Photon Emission Computed Tomography in the Diagnosis of Patients with Alzheimer's Disease? A Pilot Study

International Nuclear Information System (INIS)

Cavallin, L.; Danielsson, R.; Oeksengard, A.R.; Wahlund, L.O.; Julin, P.; Frank, A.; Engman, E.L.; Svensson, L.; Kristoffersen Wiberg, M.

2006-01-01

Purpose: To compare single-photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI) in a cohort of patients examined for suspected dementia, including patients with no objective cognitive impairment (control group), mild cognitive impairment (MCI), and Alzheimer's disease (AD). Material and Methods: Twenty-four patients, eight with AD, 10 with MCI, and six controls were investigated with SPECT using 99m Tc-hexamethylpropyleneamine oxime (HMPAO) and dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) with gadobutrol. Three observers performed a visual interpretation of the SPECT and MR images using a four-point visual scale. Results: SPECT was superior to DSC-MRI in differentiating normal from pathological. All three observers showed statistically significant results in discriminating between the control group, AD, and MCI by SPECT, with a P value of 0.0006, 0.04, and 0.01 for each observer. The statistical results were not significant for MR (P values 0.8, 0.1, and 0.2, respectively). Conclusion: DSC-MRI could not replace SPECT in the diagnosis of patients with Alzheimer's disease. Several patient- and method-related improvements should be made before this method can be recommended for clinical practice

Development of SPME-LC-MS method for screening of eight beta-blockers and bronchodilators in plasma and urine samples.

Science.gov (United States)

Goryński, Krzysztof; Kiedrowicz, Alicja; Bojko, Barbara

2016-08-05

The current work describes the development and validation of a simple, efficient, and fast method using solid phase microextraction coupled to liquid chromatography-tandem mass spectrometry (SPME-LC-MS/MS) for the concomitant measurement of eight beta-blockers and bronchodilators in plasma and urine. The presented assay enables quantitative determination of acebutolol, atenolol, fenoterol, nadolol, pindolol, procaterol, sotalol, and timolol. In this work, samples were prepared on a high-throughput platform using the 96-well plate format of the thin film solid phase microextraction (TFME) system, and a biocompatible extraction phase made of hydrophilic-lipophilic balance particles. Analytes were separated on a pentafluorophenyl column (100mm×2.1mm, 3μm) by gradient elution using an UPLC Nexera coupled with an LCMS-8060 mass spectrometer. The mobile phase consisted of water-acetonitrile (0.1% formic acid) at a flow rate of 0.4mLmin(-1). The linearity of the method was checked within therapeutic blood-plasma concentrations, and shown to adequately reflect typically expected concentrations of future study samples. Post-extraction addition experiments showed that the matrix effect ranged in plasma from 98% for procaterol to 115% for nadolol, and in urine, from 85% for nadolol and pindolol to 119% for atenolol. The method was successfully validated using Food and Drug Administration (FDA) guidelines, and met all acceptance criteria for bioanalytical assays at five concentration levels for all selected drugs. The final protocol can be successfully applied for monitoring concentrations of the selected drugs in both plasma and urine matrices obtained from patients or athletes. Copyright © 2016 Elsevier B.V. All rights reserved.

Primary radiotherapy of prolactinomas. Eight- to 15-year follow-up

Energy Technology Data Exchange (ETDEWEB)

Mehta, A.E.; Reyes, F.I.; Faiman, C.

1987-07-01

Eight women with amenorrhea, galactorrhea, and hyperprolactinemia, of whom six had macroadenomas and two had microadenomas, were treated with conventional (cobalt-60) external radiotherapy, and their progress was monitored for eight to 15 years. Normoprolactinemia was established in five of these patients after two to 13 years (median, nine years). A recurrence was treated surgically in one patient, and stable prolactin values and roentgenographic features have been maintained in two patients. Hypopituitarism has developed in only one patient to date, and no other complications of radiotherapy have been observed. These findings, together with the few previous reports on the long-term effects of radiotherapy on macroprolactinomas, have been compared with the long-term results following surgery or dopamine agonist therapy. The normalization of prolactin values is considerably delayed following radiotherapy compared with the other two therapeutic modalities. However, radiotherapy affords permanent normalization without recurrence in a larger percentage of patients than does surgery and avoids the considerable ongoing cost and inconvenience of daily drug ingestion. The long-term development of hypopituitarism appears to be an acceptably small risk of radiotherapy. Thus, conventional radiotherapy is an attractive treatment option, particularly for macroprolactinomas; adjunctive bromocriptine can be used while awaiting the longer-term benefits of radiotherapy.

Primary radiotherapy of prolactinomas. Eight- to 15-year follow-up

International Nuclear Information System (INIS)

Mehta, A.E.; Reyes, F.I.; Faiman, C.

1987-01-01

Eight women with amenorrhea, galactorrhea, and hyperprolactinemia, of whom six had macroadenomas and two had microadenomas, were treated with conventional (cobalt-60) external radiotherapy, and their progress was monitored for eight to 15 years. Normoprolactinemia was established in five of these patients after two to 13 years (median, nine years). A recurrence was treated surgically in one patient, and stable prolactin values and roentgenographic features have been maintained in two patients. Hypopituitarism has developed in only one patient to date, and no other complications of radiotherapy have been observed. These findings, together with the few previous reports on the long-term effects of radiotherapy on macroprolactinomas, have been compared with the long-term results following surgery or dopamine agonist therapy. The normalization of prolactin values is considerably delayed following radiotherapy compared with the other two therapeutic modalities. However, radiotherapy affords permanent normalization without recurrence in a larger percentage of patients than does surgery and avoids the considerable ongoing cost and inconvenience of daily drug ingestion. The long-term development of hypopituitarism appears to be an acceptably small risk of radiotherapy. Thus, conventional radiotherapy is an attractive treatment option, particularly for macroprolactinomas; adjunctive bromocriptine can be used while awaiting the longer-term benefits of radiotherapy

Twenty Practices of an Entrepreneurial University

DEFF Research Database (Denmark)

Gjerding, Allan Næs; Wilderom, Celeste P.M.; Cameron, Shona P.B.

2006-01-01

studies twenty organisational practices against which a University's entrepreneurship can be measured. These twenty practices or factors in effect formed the basis for an entrepreneurship audit. During a series of interviews, the extent to which the universities are seen as entrepreneurial...

Use of multiple methods to determine factors affecting quality of care of patients with diabetes.

Science.gov (United States)

Khunti, K

1999-10-01

The process of care of patients with diabetes is complex; however, GPs are playing a greater role in its management. Despite the research evidence, the quality of care of patients with diabetes is variable. In order to improve care, information is required on the obstacles faced by practices in improving care. Qualitative and quantitative methods can be used for formation of hypotheses and the development of survey procedures. However, to date few examples exist in general practice research on the use of multiple methods using both quantitative and qualitative techniques for hypothesis generation. We aimed to determine information on all factors that may be associated with delivery of care to patients with diabetes. Factors for consideration on delivery of diabetes care were generated by multiple qualitative methods including brainstorming with health professionals and patients, a focus group and interviews with key informants which included GPs and practice nurses. Audit data showing variations in care of patients with diabetes were used to stimulate the brainstorming session. A systematic literature search focusing on quality of care of patients with diabetes in primary care was also conducted. Fifty-four potential factors were identified by multiple methods. Twenty (37.0%) were practice-related factors, 14 (25.9%) were patient-related factors and 20 (37.0%) were organizational factors. A combination of brainstorming and the literature review identified 51 (94.4%) factors. Patients did not identify factors in addition to those identified by other methods. The complexity of delivery of care to patients with diabetes is reflected in the large number of potential factors identified in this study. This study shows the feasibility of using multiple methods for hypothesis generation. Each evaluation method provided unique data which could not otherwise be easily obtained. This study highlights a way of combining various traditional methods in an attempt to overcome the

[Quality of life of post-colostomy patients].

Science.gov (United States)

Bartha, I; Hajdu, J; Bokor, L; Kanyári, Z; Damjanovich, L

1995-09-10

The psychosomatic care of patients after surgical treatment must comprise the analysis of quality of life with colostomy. Five different parameters were assessed of 100 colostomy patients. Sixty-one percent of our patients had skin irritation problems. Twenty-eight patients applied regular irrigation. Seventy-two percent of these had daily motions, 20% had bidaily, the remaining 8% had irregular bowel movements. Seventeen percent of the nonirrigating patients observed very irritating fecal discharge around the stoma. Embarrassing noises concomittant with bowel movements were observed by 42% and 45% struggled with bad odors. Irrigating patients had hardly any of these problems. For 65% of the patients the idea of having a colostoma meant the greatest psychological burden before the operation. The stress situation culminated in the immediate postoperative period in 10%. Forty percent of those asked were seriously worried about the reaction of their social environment. In 65% a significant decrease of social relations could be observed. Sixteen percent reported an increased social activity after colostomy had been performed. Sixty percent admitted considering the option of suicide at least once. Thirty-five percent revealed to have any kind of sexual problems after colostomy. Eight of our 100 colostomy patients experienced serious adverse reactions from their family members. In eighty percent of the cases family members showed great sympathy although they acted naively. The quality of life of colostomy patients may be best taken care of by qualified stomatherapists, out-patient proctology departments and the ileo-colostomy movement (ILCO).

Technetium-99m sestamibi single-photon emission tomography detects subclinical myocardial perfusion abnormalities in patients with systemic lupus erythematosus

Energy Technology Data Exchange (ETDEWEB)

Schillaci, O. [Nuclear Medicine, University of l`Aquila (Italy); Lagana, B.; Gentile, R.; Tubani, L.; Baratta, L. [Department of Clinical Medicine, University ``La Sapienza``, Rome (Italy); Danieli, R.; Scopinaro, F. [Section of Nuclear Medicine, Department of Experimental Medicine and Pathology, University ``La Sapienza``, Rome (Italy)

1999-07-01

In patients with systemic lupus erythematosus, involvement of the cardiovascular system is the third leading cause of death. However, although autopsy studies have demonstrated a high incidence of abnormalities in both the myocardium and coronary vessels, clinical manifestations have been reported in only a small percentage of cases. The aim of this study was to evaluate myocardial perfusion in asymptomatic lupus patients using technetium-99m sestamibi single-photon emission tomography (SPET). Twenty-eight patients without overt cardiac involvement and risk factors were studied with {sup 99m}Tc-sestamibi SPET at rest and after dipyridamole infusion. Perfusion abnormalities were detected in 18 cases: six had persistent defects, three had reversible defects, seven had both persistent and reversible defects, and two showed rest defects which normalized on dipyridamole images (``reverse redistribution pattern``). Coronary angiography was performed in eight patients with positive {sup 99m}Tc-sestamibi SPET, and showed normal epicardial vessels in all the cases. These results indicate that {sup 99m}Tc-sestamibi SPET reveals a high prevalence (18 out of 28 patients in this study, i.e. 64%) of myocardial perfusion abnormalities in asymptomatic lupus patients, probably due to the primary immunological damage of this autoimmune disease. In conclusion, rest/dipyridamole {sup 99m}Tc-sestamibi SPET can be a useful non-invasive method to identify subclinical myocardial involvement in systemic lupus erythematosus, and patients potentially at risk of later cardiac events. (orig.) With 2 figs., 2 tabs., 21 refs.

Technetium-99m sestamibi single-photon emission tomography detects subclinical myocardial perfusion abnormalities in patients with systemic lupus erythematosus

International Nuclear Information System (INIS)

Schillaci, O.; Lagana, B.; Gentile, R.; Tubani, L.; Baratta, L.; Danieli, R.; Scopinaro, F.

1999-01-01

In patients with systemic lupus erythematosus, involvement of the cardiovascular system is the third leading cause of death. However, although autopsy studies have demonstrated a high incidence of abnormalities in both the myocardium and coronary vessels, clinical manifestations have been reported in only a small percentage of cases. The aim of this study was to evaluate myocardial perfusion in asymptomatic lupus patients using technetium-99m sestamibi single-photon emission tomography (SPET). Twenty-eight patients without overt cardiac involvement and risk factors were studied with 99m Tc-sestamibi SPET at rest and after dipyridamole infusion. Perfusion abnormalities were detected in 18 cases: six had persistent defects, three had reversible defects, seven had both persistent and reversible defects, and two showed rest defects which normalized on dipyridamole images (''reverse redistribution pattern''). Coronary angiography was performed in eight patients with positive 99m Tc-sestamibi SPET, and showed normal epicardial vessels in all the cases. These results indicate that 99m Tc-sestamibi SPET reveals a high prevalence (18 out of 28 patients in this study, i.e. 64%) of myocardial perfusion abnormalities in asymptomatic lupus patients, probably due to the primary immunological damage of this autoimmune disease. In conclusion, rest/dipyridamole 99m Tc-sestamibi SPET can be a useful non-invasive method to identify subclinical myocardial involvement in systemic lupus erythematosus, and patients potentially at risk of later cardiac events. (orig.)

Clinical and cost effectiveness of eight disinfection methods for terminal disinfection of hospital isolation rooms contaminated with Clostridium difficile 027.

Science.gov (United States)

Doan, L; Forrest, H; Fakis, A; Craig, J; Claxton, L; Khare, M

2012-10-01

Clostridium difficile spores can survive in the environment for months or years, and contaminated environmental surfaces are important sources of nosocomial C. difficile transmission. To compare the clinical and cost effectiveness of eight C. difficile environmental disinfection methods for the terminal cleaning of hospital rooms contaminated with C. difficile spores. This was a novel randomized prospective study undertaken in three phases. Each empty hospital room was disinfected, then contaminated with C. difficile spores and disinfected with one of eight disinfection products: hydrogen peroxide vapour (HPV; Bioquell Q10) 350-700 parts per million (ppm); dry ozone at 25 ppm (Meditrox); 1000 ppm chlorine-releasing agent (Actichlor Plus); microfibre cloths (Vermop) used in combination with and without a chlorine-releasing agent; high temperature over heated dry atomized steam cleaning (Polti steam) in combination with a sanitizing solution (HPMed); steam cleaning (Osprey steam); and peracetic acid wipes (Clinell). Swabs were inoculated on to C. difficile-selective agar and colony counts were performed pre and post disinfection for each method. A cost-effectiveness analysis was also undertaken comparing all methods to the current method of 1000 ppm chlorine-releasing agent (Actichlor Plus). Products were ranked according to the log(10) reduction in colony count from contamination phase to disinfection. The three statistically significant most effective products were hydrogen peroxide (2.303); 1000 ppm chlorine-releasing agent (2.223) and peracetic acid wipes (2.134). The cheaper traditional method of using a chlorine-releasing agent for disinfection was as effective as modern methods. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Antimicrobial susceptibility pattern of Aeromonas hydrophila among ...

African Journals Online (AJOL)

A total of one hundred and twenty eight (128) stool samples were collected from patients attending Ahmadu Bello University Teaching Hospital Zaria and Aminu Kano Teaching Hospital Kano, and screened for the presence of Aeromonas hydrophila infection. Out of the one hundred and twenty eight samples analyzed 4 ...

A Chemical Eight Group Separation Method for Routine Use in Gamma Spectrometric Analysis. II. Detailed analytical schema

Energy Technology Data Exchange (ETDEWEB)

Samsahl, K

1961-06-15

A detailed ion-exchange procedure for the separation of chemical elements in eight groups suitable for subsequent gamma spectrometric analysis is described. The method has been in use for gamma spectrometry of some inorganic - but mostly organic - samples for one year. The separation time for inorganic samples, is usually about 1.5 hours and for organic samples as least 2 hours. One man can separate and count three samples per day. In comparative measurements of short-lived isotopes in biological material 10-12 elements can be analysed thus making possible 30 - 35 determinations per day for one man.

Predictors of weight loss in young adults who are over-weight or obese and have psychosocial problems

DEFF Research Database (Denmark)

Lous, Jørgen; Freund, Kirsten S.

2016-01-01

BACKGROUND: The aim of this study is in a general practice trial setting to identify predictive factors for weight loss after 1 year among young adults who are over-weight or obese and who have several psychosocial problems. METHODS: Twenty-eight general practitioners recruited 495 patients aged 20...

Role of rectal myomectomy in refractory chronic constipation ...

African Journals Online (AJOL)

Background: To assess the role of diagnostic and therapeutic value of anorectal myectomy in cases of chronic refractory constipation. Materials and Methods: Twenty-eight patients 11 months to 9 years of age presenting with chronic constipation, with contrast enema showing dilated rectum and sigmoid colon were included ...

MRI bone oedema scores are higher in the arthritis mutilans form of psoriatic arthritis and correlate with high radiographic scores for joint damage

DEFF Research Database (Denmark)

Tan, Yu M; Østergaard, Mikkel; Doyle, Anthony

2009-01-01

INTRODUCTION: The aim of this study was to investigate the magnetic resonance imaging (MRI) features of bone disease in the arthritis mutilans (AM) form of psoriatic arthritis (PsA). METHODS: Twenty-eight patients with erosive PsA were enrolled (median disease duration of 14 years). Using x-rays ...

Effects of patient safety auditing in hospital care: results of a mixed-method evaluation (part 1).

Science.gov (United States)

Hanskamp-Sebregts, Mirelle; Zegers, Marieke; Westert, Gert P; Boeijen, Wilma; Teerenstra, Steven; van Gurp, Petra J; Wollersheim, Hub

2018-06-15

To evaluate the effectiveness of internal auditing in hospital care focussed on improving patient safety. A before-and-after mixed-method evaluation study was carried out in eight departments of a university medical center in the Netherlands. Internal auditing and feedback focussed on improving patient safety. The effect of internal auditing was assessed 15 months after the audit, using linear mixed models, on the patient, professional, team and departmental levels. The measurement methods were patient record review on adverse events (AEs), surveys regarding patient experiences, safety culture and team climate, analysis of administrative hospital data (standardized mortality rate, SMR) and safety walk rounds (SWRs) to observe frontline care processes on safety. The AE rate decreased from 36.1% to 31.3% and the preventable AE rate from 5.5% to 3.6%; however, the differences before and after auditing were not statistically significant. The patient-reported experience measures regarding patient safety improved slightly over time (P audit. The SWRs showed that medication safety and information security were improved (P auditing was associated with improved patient experiences and observed safety on wards. No effects were found on adverse outcomes, safety culture and team climate 15 months after the internal audit.

Can Dynamic Susceptibility Contrast Magnetic Resonance Imaging Replace Single-Photon Emission Computed Tomography in the Diagnosis of Patients with Alzheimer's Disease? A Pilot Study

Energy Technology Data Exchange (ETDEWEB)

Cavallin, L.; Danielsson, R.; Oeksengard, A.R.; Wahlund, L.O.; Julin, P.; Frank, A.; Engman, E.L.; Svensson, L.; Kristoffersen Wiberg, M. [Karolinska Univ. Hospital, Stockholm (Sweden). Div. of Radiology

2006-11-15

Purpose: To compare single-photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI) in a cohort of patients examined for suspected dementia, including patients with no objective cognitive impairment (control group), mild cognitive impairment (MCI), and Alzheimer's disease (AD). Material and Methods: Twenty-four patients, eight with AD, 10 with MCI, and six controls were investigated with SPECT using {sup 99m}Tc-hexamethylpropyleneamine oxime (HMPAO) and dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) with gadobutrol. Three observers performed a visual interpretation of the SPECT and MR images using a four-point visual scale. Results: SPECT was superior to DSC-MRI in differentiating normal from pathological. All three observers showed statistically significant results in discriminating between the control group, AD, and MCI by SPECT, with a P value of 0.0006, 0.04, and 0.01 for each observer. The statistical results were not significant for MR (P values 0.8, 0.1, and 0.2, respectively). Conclusion: DSC-MRI could not replace SPECT in the diagnosis of patients with Alzheimer's disease. Several patient- and method-related improvements should be made before this method can be recommended for clinical practice.

Visuospatial and verbal memory in chronic pain patients: an explorative study.

Science.gov (United States)

Busch, Hillevi; Montgomery, William; Melin, Bo; Lundberg, Ulf

2006-09-01

Cognitive bias, such as selective memory for pain-related information, is frequently observed in chronic pain patients and is assessed mostly using verbal material. Beside word lists, the current study used photographs of people presenting pain behaviors to assess memory bias in chronic pain patients. Chronic pain patients were hypothesized to show better recall of pain-related words and pictures as compared to pain-free controls. Twenty-eight female chronic neck patients and 28 pain-free female controls completed two computerized pictorial memory games and two word recall tasks. Patients and controls performed equally well in the neutral pictorial memory game. In the pain-related game, patients performed significantly worse than controls. No significant differences were found in the word recall task. The result is discussed in terms of cognitive avoidance.

Nurses' perception of knowledge, attitudes and reported practice towards patients with eating disorders: A concurrent mixed-methods study.

Science.gov (United States)

Seah, Xin Yi; Tham, Xiang Cong; Kamaruzaman, Netty Ryanie; Yobas, Piyanee Klainin

2018-02-01

Eating disorders are complex disorders requiring specialised care, thus knowledge and attitudes are crucial for management. This study aims to examine nurses' knowledge, attitudes, reported practice, and perceptions towards patients with eating disorders in Singapore. A concurrent mixed-methods study was carried out in Southeast Asia's only psychiatric unit with eating disorders programme. Twenty nurses were recruited using census sampling. Quantitative data were analysed with descriptive and inferential statistics, while qualitative data were analysed with content and thematic analysis. Certain personal factors were associated with nurses' levels of perceived knowledge. Different attitudes towards managing these patients were identified during interview sessions. Copyright © 2017 Elsevier Inc. All rights reserved.

Eight-week aerobic training effects on Apelin-13 and insulin resistance in overweight men

Directory of Open Access Journals (Sweden)

Rahman Soori

2017-06-01

Full Text Available Background & aims: Obesity as a pandemic disease is the high accumulation of adipose tissue which secrets different hormones such as apelin. Apelin as an adipocytokine increases in obesity. Aerobic training induced apelin responses are not clarify well. So, we aimed to determine the effect of eight weeks aerobic training on Apelin-13 and insulin resistance in overweight men. Methods: Current study was quasi-experiment design. Twenty-six overweight men with BMI between 27-30 kg/m2 were randomly enrolled in the present study following public call announcement and match to inclusion criteria. They accidently divided into submaximal-aerobic and control groups. The submaximal-aerobic group carried out exercise training for 24 continuous sessions (with 50-70% of maximum heart rate and 3 sessions/per-week for eight weeks. The anthropometrical, VO2max and blood sampling assessments performed and later assessments were completed 24 hours after last training period. Then, whole of data were analyzed by Stata software at P0.05. In addition, there were direct and significant relationship between anthropometrical indices and HbA1c with Apelin-13 (p<0.05. Conclusions: Obesity increases the possibility of metabolic diseases and insulin resistance. In the current study we represented that the internal factors of exercise, such as intensity, had meaningful effects on anthropometric features of overweight individuals but it was not enough for exercise induced-apelin-13 and insulin resistance changes.  According to this record, longer and higher intense exercise compare with the current study's protocol were recommended to beneficially decrease and control the incidence and catch the type II diabetes and cardiovascular diseases.

The summer institute in clinical dental research methods: still going and growing after twenty years.

Science.gov (United States)

Derouen, Timothy A; Wiesenbach, Carol

2012-11-01

The first Summer Institute in Clinical Dental Research Methods, a faculty development program at the University of Washington, was offered in the summer of 1992 for sixteen participants. The primary objective of the program was to give clinical faculty members in dentistry an introduction to and an understanding of the fundamental principles and methods used in good clinical research. In the twentieth offering of the institute in 2011, there were thirty-five participants, and over the twenty institutes, there has been a cumulative total of 463 participants who have come from thirty U.S. states as well as forty-three countries outside the United States. The curriculum has expanded from the initial offering of biostatistics, clinical epidemiology, behavioral research methods, and ethics in clinical research to now include clinical trials, grantsmanship, data analysis, an elective in molecular biology, and a team project that provides participants with hands-on experience in research proposal development as members of an interdisciplinary team. Enrollment has doubled since the first year, yet exit evaluations of the program content have remained consistently high (rated as very good to excellent). One of the indicators of program quality is that at least 50 percent of recent participants indicated that they attended because the program was recommended by colleagues who had attended. There seems to be an ever-increasing pool of dental faculty members who are eager to learn more about clinical research methodology through the institute despite the intensive demands of full-time participation in a six-week program.

Nurses`knowledge of and attitude towards exercise as a treatment method for hypertensive patients

Directory of Open Access Journals (Sweden)

L. Grobler

2005-01-01

Full Text Available Aerobic exercise is used in treating hypertension. Eventhough physiotherapists are the first choice in presenting exercise treatment, few are available to do so in primary health clinics. Nurses arepatients’ first contact and may be able to fulfil this role. Nurses’knowledge and attitude towards exercise as a treatment method for hypertensive patients was determined. This descriptive study included all nurses (n=67 working in 23 Bloemfontein clinics. Forty-three nursescompleted structured questionnaires that determined their knowledge of exercise as a treatment method. All nurses prescribed medication forhypertensive patients. Most nurses prescribed weight control (72.1%, diet control (76.7%, patient education (74.4%, and life-style modification (72.1%. Most (83.7% nurses were aware of exercise as a treatment method for hypertension. Only seven nurses, prescribing a brisk walk, recommended the correct type of exercise. The nurses’attitude towards exercise as a treatment method was determined using focus group interviews (n=16. Nurses reflected a positive attitude towards exercise with 198 positive responses. Nurses could express more than one opinion, all of which were recorded. Twenty responses reflected little or no knowledge, and four responses reflected an unsure/neutral attitude towards exercise. Ten responses reflected disinterest in prescribing exercise. Nurses do not have adequate knowledge to enable them to confidently prescribe exercise to patients. The need for more information was mentioned and some nurses were willing to present exercise classes. A training program, containing pertinent information, so that nurses can prescribe exercise for hypertension, needs to be developed.

Comparison of a PCR-Based Method with Culture and Direct Examination for Diagnosis of Acanthamoeba keratitis

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S Farnia

2009-05-01

Full Text Available "nBackground: The aim was to compare three different methods (direct examination, culture and PCR meth­ods for the diagnosis of Acanthamoeba keratitis (AK in corneal scrapes."nMethods: Twenty eight corneal scrapes and contact lenses were collected from keratitis patients and re­ferred to the De­partment of Medical Parasitology and Mycology, School of Public Health, Tehran Univer­sity of Medical Sci­ences. Corneal scrapes were divided in three parts for direct examination, culture on non-nutrient agar and PCR analysis. PCR analysis was also performed using a 18S rRNA gene primer pair (DF3 region. DF3 (Diagnostic frag­ment 3 is a region of the nuclear small subunit ribosomal RNA gene which is specific for detecting Acan­thamoeba strains."nResults:  Acanthamoeba was the causative agent of keratitis in 50% of the patients. Direct smear of all pre­pared corneal scrapes in AK patients was negative and culture was positive in only 14.3% of the isolates. PCR analysis was positive in 71.4% of AK patients. These three methods were negative in corneal scrapes of non-AK patients. The sensitivity and specificity of PCR technique for the detection of Acanthamoeba sp. were calculated as 71.4% and 100%, respectively."nConclusion: According to high sensitivity and specificity of PCR-based method, this study confirmed that PCR using 18S rRNA gene primers (DF3 region is more useful for detecting AK cases compare to culture and direct microscopy methods.

Menstrual Concerns and Intrauterine Contraception Among Adolescent Bariatric Surgery Patients

Science.gov (United States)

Miller, Rachel J.; Inge, Thomas H.

2011-01-01

Abstract Objective Adolescent obesity has dramatically increased in recent decades, and along with that so have other medical comorbidities, such as hypertension, diabetes, hyperlipidemia, nonalcoholic steatohepatitis, polycystic ovary syndrome (PCOS), and pseudotumor cerebri. Obesity and related comorbidites may be contraindications to hormonal contraception, making contraception counseling of morbidly obese adolescents more challenging. Obese adolescent females seeking bariatric surgery need effective contraception in the postoperative period. This study is designed to determine the acceptance rate of the levonorgestrel-releasing intrauterine device (IUD) and describe common menstrual problems in obese adolescent bariatric surgery patients. Methods This is a historic cohort study of adolescent females who underwent bariatric surgery over a 2-year period at a tertiary referral center for pediatric obesity. Data were systematically abstracted. The percent of patients with menstrual problems and the acceptance rate for the levonorgestrel-releasing IUD were determined. Results Twenty-five adolescents met inclusion criteria. The mean age was 17.4 years (standard deviation [SD] 2.6), and the mean body mass index (BMI) was 51.4 (SD 6.3) kg/m2. Eighty-four percent were white. Twenty-eight percent had menorrhagia, 32% had oligomenorrhea, 40% had dysmenorrhea, and 36% had PCOS. Ninety-two percent (23 of 25) underwent IUD placement. Conclusions There was a high prevalence of menstrual problems among this sample of severely obese adolescent females. The majority accepted the IUD, indicating it is a viable option among this population. PMID:21413894

Real-life radiation burden to relatives of patients treated with iodine-131: a study in eight centres in Flanders (Belgium)

International Nuclear Information System (INIS)

Monsieurs, M.; Thierens, H.; Dierckx, R.A.; Casier, K.; Simons, M.; Baere, E. de; Ridder, L. de; Saedeleer, C. de; Winter, H. de; Lippens, M.; Imschoot, S. van; Wulfrank, D.

1998-01-01

In view of the EURATOM 96/29 regulations, a prospective multicentre study was performed to evaluate the present guidelines given to relatives of patients treated with iodine-131 for both thyroid carcinoma and thyrotoxicosis, based on the real-life radiation burden. This study comprised 166 measurements carried out on a group of 94 relatives of 65 patients. All relatives wore a thermoluminescent dosemeter (TLD) on the wrist for 7 days. Sixty-one relatives agreed to wear another TLD for an additional 7 days. TLD were placed on nine patients' bedside tables. The eight participating centres were arbitrarily divided into three groups according to the period of time they advised their patients to sleep separately. Groups I, II and III respectively advised their patients to sleep separately for 0, 7-10 and 14-21 days. The median dose received by in-living relatives of thyroid carcinoma patients during the 14 days following hospital discharge was 281 μSv (doses to infinity not calculated); the median dose to infinity received by in-living relatives of ambulatory treated thyrotoxicosis patients was 596 μSv, as compared with 802 μSv for in-living relatives of hospitalised thyrotoxicosis patients. In general the children of patients received a significantly (P 131 I, while still following the ALARA principle. (orig.)

Novel Selectivity-Based Forensic Toxicological Validation of a Paper Spray Mass Spectrometry Method for the Quantitative Determination of Eight Amphetamines in Whole Blood

NARCIS (Netherlands)

Teunissen, Sebastiaan F.; Fedick, Patrick W.; Berendsen, Bjorn J.A.; Nielen, Michel W.F.; Eberlin, Marcos N.; Graham Cooks, R.; Asten, van Arian C.

2017-01-01

Paper spray tandem mass spectrometry is used to identify and quantify eight individual amphetamines in whole blood in 1.3 min. The method has been optimized and fully validated according to forensic toxicology guidelines, for the quantification of amphetamine, methamphetamine,

The Effect of an Eight-Week Period of Aerobic Exercise on Plasma Concentration of Ghrelin and Growth Hormone in Young Women

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Rashidlamir

2011-12-01

Full Text Available Introduction: Ghrelin is a peptide which is secreted from human stomach. It has an important role in the secretion of growth hormone, energy balance, obesity, food intake behavior, and some cardiovascular functions. The purpose of this study was to assess the effects of an eight-week of aerobic exercise on plasma concentration of ghrelin and GH in non-athletic young women. Methods: Twenty young non-athletic women with mean age of 22±2/1 years and mean BMI of 21±1/07 Kg/m2 voluntarily entered the study and they were randomly divided into control and experimental groups. Experimental group conducted an aerobic exercise program three sessions each week and 60 minutes in each session with 70-80% of maximum heart rate for 8 weeks. Control group didn’t exercise. Blood samples were taken 48 hours before the first and after the last session of exercise. Plasma concentrations of ghrelin and growth hormone were measured by ELISA and radioimmunoassay methods, respectively. Data was analyzed by independent samples T test and Pearson correlation test by SPSS(version16. Results: The eight-week period of aerobic exercise caused a significant increase in plasma concentration of ghrelin and a significant decrease in plasma concentration of GH. Conclusion: It can be concluded from the study that exercise-induced increase in plasma ghrelin in response to negative energy balance didn’t stimulate GH secretion, so other mechanisms may be effective in this regard.

The Management of Keloids by Radiotherapy in Nigeria | Ketiku ...

African Journals Online (AJOL)

A new method of treatment of keloid was compared with an old technique in five hundred and twenty eight Nigerian patients with 617 keloid lesions seen at the Department of Radiation Biology and Radiotherapy, Lagos University Teaching Hospital, between 1969 and 1981. The etiological factors were identified. A total of ...

Magnetic resonance imaging at 3.0 tesla detects more lesions in acute optic neuritis than at 1.5 tesla

DEFF Research Database (Denmark)

Nielsen, Kirsten; Rostrup, Egill; Frederiksen, Jette L

2006-01-01

OBJECTIVE:: We sought to assess whether magnetic resonance imaging (MRI) at 3.0 T detects more brain lesions in acute optic neuritis (ON) than MRI at 1.5 T. MATERIALS AND METHODS:: Twenty-eight patients with acute ON were scanned at both field-strengths using fast-fluid-attenuated inversion recov...

Twenty-four-hour esophageal pH monitoring in children and adolescents with chronic and/or recurrent rhinosinusitis

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V.R.S.G. Monteiro

2005-02-01

Full Text Available Gastroesophageal reflux (GER disorder was studied in children and adolescents with chronic and/or recurrent rhinosinusitis not associated with bronchial asthma. Ten children with a clinical and radiological diagnosis of chronic and/or recurrent rhinosinusitis, consecutively attended at the Pediatric Otolaryngology Outpatient Clinic, Federal University of São Paulo, were evaluated. Prolonged esophageal pH monitoring was used to investigate GER disorder. The mean age of the ten patients evaluated (eight males was 7.4 ± 2.4 years. Two patients presented vomiting as a clinical manifestation and one patient presented retrosternal pain with a burning sensation. Twenty-four-hour esophageal pH monitoring was performed using the Sandhill apparatus. An antimony probe electrode was placed in the lower third of the esophagus, confirmed by fluoroscopy and later by a chest X-ray. The parameters analyzed by esophageal pH monitoring included: total percent time of the presence of acid esophageal pH, i.e., pH below 4 (<4.2%; total number of acid episodes (<50 episodes; number of reflux episodes longer than 5 min (3 or less, and duration of the longest reflux episode (<9.2 min. One patient (1/10, 10% presented a 24-h esophageal pH profile compatible with GER disorder. This data suggest that an association between chronic rhinosinusitis not associated with bronchial asthma and GER disorder may exist in children and adolescents, especially in those with compatible GER disorder symptoms. In these cases, 24-h esophageal pH monitoring should be performed before indicating surgery, since the present data suggest that 10% of chronic rhinosinusitis surgeries can be eliminated.

Capital in the Twenty-First Century

DEFF Research Database (Denmark)

Hansen, Per H.

2014-01-01

Review essay on: Capital in the Twenty-First Century. By Thomas Piketty . Translated by Arthur Goldhammer . Cambridge, Mass.: The Belknap Press of Harvard University Press, 2014. viii + 685 pp......Review essay on: Capital in the Twenty-First Century. By Thomas Piketty . Translated by Arthur Goldhammer . Cambridge, Mass.: The Belknap Press of Harvard University Press, 2014. viii + 685 pp...

Altered balance in the autonomic nervous system in schizophrenic patients

DEFF Research Database (Denmark)

Nielsen, B M; Mehlsen, J; Behnke, K

1988-01-01

.05). Heart-rate response to inspiration was greater in non-medicated schizophrenics compared to normal subjects (P less than 0.05), whereas no difference was found between medicated and non-medicated schizophrenics. The results show that the balance in the autonomic nervous system is altered in schizophrenic...... patients with a hyperexcitability in both the sympathetic and the parasympathetic division. Our study has thus indicated a dysfunction in the autonomic nervous system per se and the previous interpretations of attentional orienting responses in schizophrenia is questioned. Medication with neuroleptics......The aim of the present study was to evaluate the autonomic nervous function in schizophrenic patients. Twenty-eight patients (29 +/- 6 years) diagnosed as schizophrenics and in stable medication were included, together with ten schizophrenic patients (25 +/- 5 years) who were unmedicated. Eleven...

Viral Hepatitis A in 108 Adult Patients During an Eight-Year Observation at a Single Center in Poland.

Science.gov (United States)

Bura, Maciej; Michalak, Michał; Chojnicki, Michał K; Kowala-Piaskowska, Arleta; Mozer-Lisewska, Iwona

2015-01-01

Hepatitis A is related to significant morbidity and occasional mortality. Based on data from the Polish National Institute of Hygiene, from 2000 to 2013 a mean of 213 hepatitis A cases were reported yearly. The aim of the study was to assess selected data in adults hospitalized for symptomatic hepatitis A during an eight-year period in a single center in the Wielkopolska Region of Poland. All the hepatitis A patients hospitalized in the center from 2005 to 2013 were analyzed retrospectively. Data were extracted from the medical records of these individuals. The disease was confirmed by anti-HAV IgM testing. In total, 108 patients (71 men and 37 women), aged 18-65 years, were identified. All but 1 patient recovered (99.1%) and in 6 cases (5.6%) a relapse occurred. Risk factors for hepatitis A were identified in 56 patients (52%), with travel abroad being the most common one (32 patients); 19 cases were secondary and 5 patients were men who have sex with men. One hepatitis A outbreak was noted in the region during the study period. Acalculous cholecystitis was found in 33.3% of the patients who underwent abdominal ultrasound. This tended to be more common among older individuals (47.8% in patients over 40 vs. 22.6% in patients aged 18-40, p=0.0521). Patients with this finding had significantly higher mean peak ALT in comparison to those with no gallbladder abnormalities. Although hepatitis A in adults is typically a benign, self-limited disease, it can occasionally have a fatal course. In a significant proportion of patients with an evident risk factor for hepatitis A, the possibility of active prophylaxis was not used. Hepatitis A should be regarded as a sexually transmitted infection. Acalculous cholecystitis is a frequent finding among adults with symptomatic hepatitis A.

Genetic disorders of vitamin B12 metabolism: eight complementation groups – eight genes

Science.gov (United States)

Froese, D. Sean; Gravel, Roy A.

2010-01-01

Vitamin B12 (cobalamin, Cbl) is an essential nutrient in human metabolism. Genetic diseases of vitamin B12 utilisation constitute an important fraction of inherited newborn disease. Functionally, B12 is the cofactor for methionine synthase and methylmalonyl CoA mutase. To function as a cofactor, B12 must be metabolised through a complex pathway that modifies its structure and takes it through subcellular compartments of the cell. Through the study of inherited disorders of vitamin B12 utilisation, the genes for eight complementation groups have been identified, leading to the determination of the general structure of vitamin B12 processing and providing methods for carrier testing, prenatal diagnosis and approaches to treatment. PMID:21114891

Barriers and facilitators to reducing frequent laboratory testing for patients who are stable on warfarin: a mixed methods study of de-implementation in five anticoagulation clinics.

Science.gov (United States)

Barnes, Geoffrey D; Misirliyan, Sevan; Kaatz, Scott; Jackson, Elizabeth A; Haymart, Brian; Kline-Rogers, Eva; Kozlowski, Jay; Krol, Gregory; Froehlich, James B; Sales, Anne

2017-07-14

Patients on chronic warfarin therapy require regular laboratory monitoring to safely manage warfarin. Recent studies have challenged the need for routine monthly blood draws in the most stable warfarin-treated patients, suggesting the safety of less frequent laboratory testing (up to every 12 weeks). De-implementation efforts aim to reduce the use of low-value clinical practices. To explore barriers and facilitators of a de-implementation effort to reduce the use of frequent laboratory tests for patients with stable warfarin management in nurse/pharmacist-run anticoagulation clinics, we performed a mixed-methods study conducted within a state-wide collaborative quality improvement collaborative. Using a mixed-methods approach, we conducted post-implementation semi-structured interviews with a total of eight anticoagulation nurse or pharmacist staff members at five participating clinic sites to assess barriers and facilitators to de-implementing frequent international normalized ratio (INR) laboratory testing among patients with stable warfarin control. Interview guides were based on the Tailored Implementation for Chronic Disease (TICD) framework. Informed by interview themes, a survey was developed and administered to all anticoagulation clinical staff (n = 62) about their self-reported utilization of less frequent INR testing and specific barriers to de-implementing the standard (more frequent) INR testing practice. From the interviews, four themes emerged congruent with TICD domains: (1) staff overestimating their actual use of less frequent INR testing (individual health professional factors), (2) barriers to appropriate patient engagement (incentives and resources), (3) broad support for an electronic medical record flag to identify potentially eligible patients (incentives and resources), and (4) the importance of personalized nurse/pharmacist feedback (individual health professional factors). In the survey (65% response rate), staff report offering less

Value of ultrasound in the determination of drainage methods in patients with tuberculous pleural effusion

International Nuclear Information System (INIS)

Kang, Eun Young; Suh, Bo Kyoung; Shim, Jae Jeong

1997-01-01

To evaluate the utility of ultrasonography (US) as a guide in deciding drainage methods and as a prognostic factor in the prediction of pleural fibrosis, and to compare the effects of drainage methods in patients with tuberculous pleural effusions. In 51 patients with tuberculous pleural effusion, US patterns of pleural effusion were classified according to degree of septa into three groups, as follows : anechoic (n=5), linear septa (n=15), and honeycomb septa (n=31). US-guided drainage methods, including thoracentesis (n=17), percutaneous catheter insertion (n=12), catheter insertion with urokinase instillation (n=22) were employed. Therapeutic effects were evaluated with follow-up chest radiographs after 3 and 6 months. Three months after the procedure, 43 of 51 effusions had drained effectively. US guided drainage failed in eight patients including two of six with linear septated effusion treated with thoracentesis, four of seven with honeycomb septated effusion treated with thoracentesis, and two of six with honeycomb septated effusion treated with catheter drainage. There was no drainage failure in patients with anechoic effusions and in patients with urokinase instillation. Late effects were assessed in 39 patients after 6 months. Follow-up radiographs available in 39 patients demonstrated pleural fibrosis with intercostal space narrowing in 7 patients with honeycomb septated effusion, 3 patients with linear septated effusion, and none of the patients with anechoic effusions. The pattern of septa seen on US could be a useful factor for determining drainage methods and predicting late results in tuberculous pleural effusion. Percutaneous catheter drainage with urokinase instillation was a good drainage modality for patients with septated pleural effusions. Pleural fibrosis is more frequently induced by septated pleural effusion than by anechoic pleural effusion

Value of ultrasound in the determination of drainage methods in patients with tuberculous pleural effusion

Energy Technology Data Exchange (ETDEWEB)

Kang, Eun Young; Suh, Bo Kyoung; Shim, Jae Jeong [Korea Univ. College of Medicine, Seoul (Korea, Republic of)

1997-01-01

To evaluate the utility of ultrasonography (US) as a guide in deciding drainage methods and as a prognostic factor in the prediction of pleural fibrosis, and to compare the effects of drainage methods in patients with tuberculous pleural effusions. In 51 patients with tuberculous pleural effusion, US patterns of pleural effusion were classified according to degree of septa into three groups, as follows : anechoic (n=5), linear septa (n=15), and honeycomb septa (n=31). US-guided drainage methods, including thoracentesis (n=17), percutaneous catheter insertion (n=12), catheter insertion with urokinase instillation (n=22) were employed. Therapeutic effects were evaluated with follow-up chest radiographs after 3 and 6 months. Three months after the procedure, 43 of 51 effusions had drained effectively. US guided drainage failed in eight patients including two of six with linear septated effusion treated with thoracentesis, four of seven with honeycomb septated effusion treated with thoracentesis, and two of six with honeycomb septated effusion treated with catheter drainage. There was no drainage failure in patients with anechoic effusions and in patients with urokinase instillation. Late effects were assessed in 39 patients after 6 months. Follow-up radiographs available in 39 patients demonstrated pleural fibrosis with intercostal space narrowing in 7 patients with honeycomb septated effusion, 3 patients with linear septated effusion, and none of the patients with anechoic effusions. The pattern of septa seen on US could be a useful factor for determining drainage methods and predicting late results in tuberculous pleural effusion. Percutaneous catheter drainage with urokinase instillation was a good drainage modality for patients with septated pleural effusions. Pleural fibrosis is more frequently induced by septated pleural effusion than by anechoic pleural effusion.

Novel four-wing and eight-wing attractors using coupled chaotic Lorenz systems

International Nuclear Information System (INIS)

Grassi, Giuseppe

2008-01-01

This paper presents the problem of generating four-wing (eight-wing) chaotic attractors. The adopted method consists in suitably coupling two (three) identical Lorenz systems. In analogy with the original Lorenz system, where the two wings of the butterfly attractor are located around the two equilibria with the unstable pair of complex-conjugate eigenvalues, this paper shows that the four wings (eight wings) of these novel attractors are located around the four (eight) equilibria with two (three) pairs of unstable complex-conjugate eigenvalues. (general)

Neurobrucellosis: Clinical and laboratory findings in 22 patients

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Rasoolinejad M

1999-09-01

Full Text Available Brucellosis is a multisystem disease with diverse clinical presentations and involvement of the nervous system is considered to 5 to be 10% in adult patients and 1% in children. The presentations of neurobrucellosis includes meningoencephalitis, subarachnoid haemorrhage, myelitis, radiculoneuritis, intracerebral and epidural abscess, psychosis and vascular syndrome. Twenty-two patients with neurobrucellosis are described. Ten patients had meningoencephalitis, seven patients had meningitis, three patients had polyradiculopathy and one patient presented with spinal epidural abscess and one patient had brain abscess. Results of an agglutination test for Brucella in serum were positive for all patients (>1:160; eight of 15 patients had positive agglutination test in CSF. Five patients had positive blood cultures, 3 patients had positive bone marrow cultures and 2 of 15 patients had positive CSF cultures. All of cultures were Brucella Mellitensis. Antimicrobial treatment included concurrent administration of Doxycycline, Rifampin and Trimethoprim-Sulfametoxazole. Four patients received Dexamethason concurrently. In conclusion, nervous system involvement is a serious manifestation of brucellosis. As brucellosis is an endemic disease in Iran we suggest that brucellosis be investigated with neurological symptoms and signs.

[Value of visual nystagmography in diagnosis of the patients with vertebrobasilar transient ischemic vertigo].

Science.gov (United States)

Guo, Ying; Zhou, Huifang

2007-07-01

To study the changes of visual nystagmography(VNG) in patients with vertebrobasilar transient ischemic vertigo(VBTIV), explore their clinical value in diagnosis of the patients with VBTIV. Thirty-eight patients who complained vertigo and imbalance with VBTIV were selected as experimental group for testing of visual nystagmography (VNG). Twenty normal persons were chosen as control group. The result was analyzed. In the experimental group, there was one case that had spontaneous nystagmus and 29 cases (76.3%) with positional nystagmus. The positional nystagmus intension in those patients was (4.08+/-3.18) degrees/s, which was much higher as compared with the control group( P VNG be used as important diagnostic test for patients with VBTIV and might be helpful for the location diagnosis of VBTIV.

Value of magnetic resonance imaging (MRI) for the assessment of ventricular and anastomosis function in patients with extra- or intracardial total cavopulmonary connection (TCPC)-modified Fontan-operation

International Nuclear Information System (INIS)

Gutberlet, M.; Hosten, N.; Oellinger, H.; Ehrenstein, T.; Felix, R.; Abdul-Khaliq, H.; Rechter, S.; Vogel, M.; Vojtovic, P.; Alexi-Meshkishvili, V.; Hetzer, R.

1999-01-01

Purpose: To evaluate different MR methods (ventricle and flow measurements) for the postoperative follow-up of hemodynamics in patients with extra- or intracardial TCPC. Materials and Methods: Twenty-eight consecutive patients (14 female, 14 male) within the ages of two to thirty-eight years were examined using a 1.5 T Gyroscan ACS-NT scanner (Philips, Best, Netherlands). 7 patients had an extracardial (eTCPC), and 21 an intracardial (iTCPC) tunnel. The calculation of the ventricular function and muscle mass was performed using 'multislice-multiphase' technique by summing up the enddiastolic and endsystolic areas; the flow measurements were evaluated by phase shift velocity mapping in the superior vena cava (SVC), inferior vena cava (IVC), right (RPA) and left (LPA) pulmonary artery. Besides peak and mean velocity, the mean and maximal flow volumes (ml/min) were calculated. Results: Ejection fraction (EF) of the functionally single ventricle was within the normal range (mean 57%) in 22/28 patients while mean muscle mass was elevated in the group with eTCPC (mean 121 g/m 2 ). The mean flow volumes and the peak velocities in all vessels were higher in the group with iTCPC as compared to the one with eTCPC. Clinically relevant retrograde flows in the IVC were only found in the group with iTCPC (7/21), as well as a significant predominant flow distribution towards the RPA (p [de

A Rare Pontine Neuro-ophthalmic Syndrome: Eight-and-a-Half Syndrome

Directory of Open Access Journals (Sweden)

Esra Eruyar

2017-06-01

Full Text Available One-and-a half syndrome is seen in paramedian pontine lesions, and may also co-exist with cranial nerve paralysis. This clinical situation is called eight-and-a-half syndrome when facial nerve paralysis also accompanies this manifestation. A man aged 38 years was admitted with symptoms of sudden-onset binocular diplopia and dizziness. The patient had no known co-morbidities. Cranial magnetic resonance imaging showed a small-sized infarct in the left paramedian pontine tegmentum posterior area. In his neuro-ophthalmologic examination, total paresis of left eye horizontal movements, mild lateral deviation, and monocular nystagmus during abduction of the right eye were observed. The patient also had peripheral facial paralysis on the left side; therefore, no signs of motor deficit of his extremities were examined. Eight-and-a-half syndrome is a rare disorder that is seen in localized-small pons lesions, mostly accompanied by infarcts. This clinical manifestation is called eight-and-a-half syndrome and arises within lesions in both the parapontine reticular formation and the medial longitudinal fasciculus in the inferior pons tegmentum where horizontal eye movements are controlled, and facial axons adjacent to the nucleus of the sixth nerve. We wanted to present this case to emphasize this rare situation

Outcomes of Patients with Intestinal Failure after the Development and Implementation of a Multidisciplinary Team

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Sabrina Furtado

2016-01-01

Full Text Available Aim. A multidisciplinary team was created in our institution to manage patients with intestinal failure (INFANT: INtestinal Failure Advanced Nutrition Team. We aimed to evaluate the impact of the implementation of the team on the outcomes of this patient population. Methods. Retrospective chart review of patients with intestinal failure over a 6-year period was performed. Outcomes of patients followed up by INFANT (2010–2012 were compared to a historical cohort (2007–2009. Results. Twenty-eight patients with intestinal failure were followed up by INFANT while the historical cohort was formed by 27 patients. There was no difference between the groups regarding remaining length of small and large bowel, presence of ICV, or number of infants who reached full enteral feeds. Patients followed up by INFANT took longer to attain full enteral feeds and had longer duration of PN, probably reflecting more complex cases. Overall mortality (14.8%/7.1% was lower than other centers, probably illustrating our population of “early” intestinal failure patients. Conclusions. Our data demonstrates that the creation and implementation of a multidisciplinary program in a tertiary center without an intestinal and liver transplant program can lead to improvement in many aspects of their care.

Is Ureter Visualization Possible on Tc-99m DMSA Scintigraphy with Vesicoureteral Reflux Patients?

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Hasan Atilgan

2014-12-01

Full Text Available Aim: Ureter or pelvicalyceal system is not be vizualized with 99mTechnetium- dimercaptosuccinic acid (99mTc-DMSA which is accumulated by renal cortex normally. In this study the cases whose ureters are visible were reviewed with 99mTc-DMSA scintigraphy. Material and Method: 18 patients (5 females, 13 males with median age 3.5 years (min 2 months-max 18 years were included in this study. Twenty ureters and/or pelvis of 18 patients were visible in 99mTc-DMSA scintigraphy. In two patients%u2019s both ureters were visible. Vesicoureteral reflux (VUR grade, 99mTc-DMSA uptake, renal size, status of pelvicalyceal system, urea, creatinine levels were evaluated in all patients. Results: Three of the visible ureters were actually due to pelvicaliectasis. These pelvicaliectasic patients were excluded from the study. In the evaluation of the remaining 17 ureters of patients, congenital megaureter was present in three patients. Grade 3 VUR was detected in three patients, grade 4 was in three patients. VUR is seen as grade five in eight kidneys of seven patients because one of these patients has bilateral vizualized ureter. Discussion: In patients with congenital megaureter and VUR, ureters can be visible with 99mTc-DMSA scintigraphy and further imaging modalities are recommended for these patients.

Operation for ensidig recurrensparese

DEFF Research Database (Denmark)

Melchiors, Jacob; Rasmussen, Niels

2009-01-01

INTRODUCTION: Medialisation surgery for unilateral recurrent nerve paralysis has been performed for the past 100 years to improve voice quality. The aim of this paper is to describe our surgical methods and evaluate the results using subjective and objective parameters with an emphasis on acoustic...... voice analysis. MATERIAL AND METHODS: Retrospective cohort study of 42 consecutively operated patients from 1996 to 2006. Twenty-eight patients were treated with a hydroxyapatite prosthesis, which was inserted into the larynx (VoCom), nine patients had a silicone bead oil injected into the paretic vocal...

Evaluation of eight enzyme immunoassays for detection of immunoglobulin G against Helicobacter pylori

NARCIS (Netherlands)

Thijs, JC; Kleibeuker, JH; vanZwet, AA; Berrelkamp, RJP; Meijer, B.C

Eight commercial enzyme-linked immunosorbent assays (ELISAs) were used to test sera taken from 102 patients in whom Helicobacter pylori infection status had been determined by means of biopsy culture, PCR, histology, and urease production and by C-13 urea breath test. By those means, 61 patients had

Implementation of Activity Sensor Equipment in the Homes of Chronic Obstructive Pulmonary Disease Patients.

Science.gov (United States)

Tillis, William; Bond, William F; Svendsen, Jessica; Guither, Sheila

2017-11-01

Telemedicine care models for managing advanced chronic obstructive pulmonary disease (COPD) may benefit from the addition of motion sensing, spirometry, and tablet-based symptom diary tracking. We conducted a feasibility study of telemedicine in the home setting using multiple activity sensor monitoring equipment. Deployment and monitoring were supported by home health nurses with technical advice from the equipment makers as needed. Data analytics for motion sensing was provided by the research sponsor, but was not used for care decisions. On study intake, a health risk assessment, Quality of Life (SF-36) survey, and the St. George Respiratory Questionnaire were administered to assess patients' self-perception of quality of life, activities of daily life function, and difficulty living with COPD. Twenty-eight patients were enrolled and data were gathered for a minimum of 6 months and maximum of 9 months. The researchers demonstrated that augmentation of traditional telemedicine methods with motion sensing, spirometry, and symptom diaries appears feasible. The technical, process, logistics barriers, and solutions required for system deployment are described. The researchers demonstrated that augmentation of traditional telemedicine methods with motion sensing, spirometry, and symptom diaries appears feasible. Further exploration will be needed to determine the value of this information in preventing outcomes relevant to patients.

Acute Superior Mesenteric Venous Thrombosis: Transcatheter Thrombolysis and Aspiration Thrombectomy Therapy by Combined Route of Superior Mesenteric Vein and Artery in Eight Patients

International Nuclear Information System (INIS)

Yang, Shuofei; Liu, Baochen; Ding, Weiwei; He, Changsheng; Wu, Xingjiang; Li, Jieshou

2015-01-01

PurposeTo assess the feasibility, effectiveness, and safety of catheter-directed thrombolysis and aspiration thrombectomy therapy by combined route of superior mesenteric vein and artery (SMV+SMA) for acute superior mesenteric venous thrombosis (ASMVT).MethodsThis retrospective study reviewed eight ASMVT patients with transcatheter direct thrombolysis and aspiration thrombectomy therapy via SMV and indirect thrombolysis via SMA during a period of 14 months. The demographics, etiology, risk factors, therapeutic effect, complications, mortality, and follow-up of the study population were assessed. Anatomic and imaging classification of location and extent of thrombus at diagnosis and degree of thrombus lysis were described.ResultsTechnical success was achieved with substantial improvement in symptoms and thrombus resolution after thrombolytic therapy in all patients. The local urokinase infusion by SMA and SMV was performed for 5–7 (6.13 ± 0.83) and 7–15 (12 ± 2.51) days. Anticoagulation was performed catheter-directed and then orally throughout hospitalization and after discharge. Four patients required delayed localized bowel resection after thrombolytic therapy with no death. Thrombolytic therapy was not interrupted despite minor bleeding at the puncture site in two patients and sepsis in another two postoperatively. Nearly complete removal of thrombus was demonstrated by contrast-enhanced CT scan and portography before discharge. Patients were discharged in 10–27 (19.25 ± 4.89) days after admission. No recurrence developed during the follow-up of 10–13 (12.13 ± 0.99) months.ConclusionsCatheter-directed thrombolytic and aspiration therapy via SMV+SMA is beneficial for ASMVT in avoiding patient death, efficient resolving thrombus, rapid improving symptoms, reversing extensive intestinal ischemia, averting bowel resection, or localizing infarcted bowel segment and preventing short bowel syndrome

Acute Superior Mesenteric Venous Thrombosis: Transcatheter Thrombolysis and Aspiration Thrombectomy Therapy by Combined Route of Superior Mesenteric Vein and Artery in Eight Patients

Energy Technology Data Exchange (ETDEWEB)

Yang, Shuofei, E-mail: yangshuofei@gmail.com; Liu, Baochen, E-mail: 306446264@qq.com; Ding, Weiwei, E-mail: dingwei-nju@hotmail.com; He, Changsheng, E-mail: hechsh@163.com; Wu, Xingjiang, E-mail: wuxingjiang@sohu.com; Li, Jieshou, E-mail: lijieshou2013@sohu.com [Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University (China)

2015-02-15

PurposeTo assess the feasibility, effectiveness, and safety of catheter-directed thrombolysis and aspiration thrombectomy therapy by combined route of superior mesenteric vein and artery (SMV+SMA) for acute superior mesenteric venous thrombosis (ASMVT).MethodsThis retrospective study reviewed eight ASMVT patients with transcatheter direct thrombolysis and aspiration thrombectomy therapy via SMV and indirect thrombolysis via SMA during a period of 14 months. The demographics, etiology, risk factors, therapeutic effect, complications, mortality, and follow-up of the study population were assessed. Anatomic and imaging classification of location and extent of thrombus at diagnosis and degree of thrombus lysis were described.ResultsTechnical success was achieved with substantial improvement in symptoms and thrombus resolution after thrombolytic therapy in all patients. The local urokinase infusion by SMA and SMV was performed for 5–7 (6.13 ± 0.83) and 7–15 (12 ± 2.51) days. Anticoagulation was performed catheter-directed and then orally throughout hospitalization and after discharge. Four patients required delayed localized bowel resection after thrombolytic therapy with no death. Thrombolytic therapy was not interrupted despite minor bleeding at the puncture site in two patients and sepsis in another two postoperatively. Nearly complete removal of thrombus was demonstrated by contrast-enhanced CT scan and portography before discharge. Patients were discharged in 10–27 (19.25 ± 4.89) days after admission. No recurrence developed during the follow-up of 10–13 (12.13 ± 0.99) months.ConclusionsCatheter-directed thrombolytic and aspiration therapy via SMV+SMA is beneficial for ASMVT in avoiding patient death, efficient resolving thrombus, rapid improving symptoms, reversing extensive intestinal ischemia, averting bowel resection, or localizing infarcted bowel segment and preventing short bowel syndrome.

Prostatic cancer - A retrospective study of 50 patients

International Nuclear Information System (INIS)

Hussain, I.; Khattak, A.M.; Shah, S.H.

2005-01-01

This Objective of this study was to see histologic typing of prostate cancer and its relation to patient's age, as no curative therapy exists for the advanced stages. This is a retrospective study of 50 patients suffering from prostatic adenocarcinoma and admitted at Basic Medical Sciences Institute, Jinnah Postgraduate Medical Center Karachi. A total of fifty patients between ages of 50-80 years diagnosed during the period of 1990-2001 suffering from prostate cancer were included in this study. The result showed that maximum number of tumours were in age group ranging from 61-70 years, (58% of total cases). Sixteen were (32%) well-differentiated tumours, twenty-eight (56%), moderately differentiated tumours and six (12%) were labelled as undifferentiated tumours. It was concluded that the majority of tumors were moderately differentiated tumours. Early diagnosis is useful for patients; because high grade tumours have bad prognostic markers. (author)

A prospective study of percutaneous vertebroplasty in patients with myeloma and spinal metastases

International Nuclear Information System (INIS)

Chew, C.; Ritchie, M.; O’Dwyer, P.J.; Edwards, R.

2011-01-01

Aim: To assess patient outcome in a consecutive series of patients with myeloma and spinal metastases who underwent percutaneous vertebroplasty. Materials and methods: Data were gathered prospectively on all patients undergoing percutaneous vertebroplasty between June 2001 and June 2010. Outcome measures included visual analogue pain scores (VAS) and Roland–Morris Questionnaire (RMQ) in patients treated since 2005 as well as complications and long-term outcome in all patients. Results: One hundred and twenty-eight patients underwent percutaneous vertebroplasty for myeloma (n = 41) or spinal metastases (n = 87) over a 9 year period. VAS scores fell from 7.75 ± 1.88 pre-vertebroplasty to 4.77 ± 2.69 post-vertebroplasty (p = 0.001). RDQ scores improved from 18.55 ± 4.79 to 13.5 ± 6.96 (p = 0.001). Complications were recorded in three patients: cement extension to vena cava (n = 1), local haematoma (n = 1), and loss of sensation over T1 dermatome (n = 1). The Kaplan–Meier estimate of 5 year survival post-vertebroplasty was 40% for patients with myeloma and 25% for those with metastases. Conclusion: This large prospective study demonstrates percutaneous vertebroplasty reduces pain and improves disability in patients from intractable pain from myeloma or spinal metastases and now forms an important part of the multimodality treatment for these patients.

Parieto-occipital encephalomalacia in children; clinical and electrophysiological features of twenty-seven cases.

Science.gov (United States)

Karaoğlu, Pakize; Polat, Ayşe İpek; Yiş, Uluç; Hız, Semra

2015-01-01

Brain injuries occurring at a particular time may cause damages in well-defined regions of brain. Perinatal hypoxic ischemic encephalopathy and hypoglycemia are some of the most common types of brain injuries. Neonatal hypoglycemia can cause abnormal myelination in parietal and occipital lobes resulting in parieto-occipital encephalomalacia. There is a small number of studies about clinical and electroencephalographic (EEG) features of children with parieto-occipital encephalomalacia. They might have important neurologic sequelae such as cortical visual loss, seizures, and psychomotor retardation. We aimed to evaluate the causes of parieto-occipital encephalomalacia and evaluate the clinical and electrophysiological features of children with parieto-occipital encephalomalacia. We evaluated clinical features and EEGs of 27 children with parieto-occipital encephalomalacia. Descriptive statistics were used. Hospitalization during the neonatal period was the most common cause (88.9%) of parieto-occipital brain injury. Eleven patients (40.7%) had a history of neonatal hypoglycemia. Twenty-three patients (85.2%) had epilepsy and nine of the epileptic patients (39%) had refractory seizures. Most of the patients had bilateral (50%) epileptic discharges originating from temporal, parietal, and occipital lobes (56.2%). However, some patients had frontal sharp waves and some had continuous spike and wave discharges during sleep. Visual abnormalities were evident in 15 (55.6%) patients. Twenty-two (81.5%) had psychomotor retardation. Fine motor skills, social contact and language development were impaired more than gross motor skills. In our study, most of the patients with parieto-occipital encephalomalacia had an eventful perinatal history. Epilepsy, psychomotor retardation, and visual problems were common neurologic complications.

Hemibalismo: relato de oito casos Hemiballism: report of eight cases

Directory of Open Access Journals (Sweden)

PATRÍCIA CORAL

2000-09-01

Full Text Available Relatamos oito casos de hemibalismo: seis em pacientes com diabetes mellitus; um em paciente com encefalomalácia pós trauma crânio-encefálico; e um em paciente com granuloma fúngico (criptococo subtalâmico associado a SIDA. Entre os pacientes com diabetes mellitus, três apresentavam hiperglicemia não cetótica, dois dos quais com hemorragias nos gânglios da base, e três acidente vascular encefálico isquêmico. Em 75% dos casos ocorria também hemicoréia, com acometimento predominante do dimídio direito. Do total de pacientes seis apresentaram boa resposta clínica ao tratamento farmacológico com neurolépticos. Dois pacientes foram submetidos a talamotomia estereotáxica, um dos quais apresentou remissão completa do hemibalismo. Em nossa série de oito pacientes com hemibalismo houve predominância da associação com diabetes mellitus e acidente vascular encefálico, e boa evolução clínica.We report eight cases of hemiballism. Six patients had diabetes mellitus, one patient presented with porencephaly after cranial trauma and one patient had a HIV-associated fungic granuloma (cryptococcus. In the diabetic group three patients had non-ketotic hyperglycemia; two of them with striatal hemorrhage, and the remaining three presented with an ischemic stroke. Hemichorea occurred in 75% of our patients, predominantly in the right side of the body. Six patients had good improvement with treatment with haloperidol and two patients had to undergo a thalamotomy, one of them with good results. In our series of eight patients with hemiballismus we observed an association with diabetes mellitus and stroke, and good clinical improvement.

Educational outcomes associated with early immersion of second-year student pharmacists into direct patient care roles in health-system practice.

Science.gov (United States)

Sanders, Kimberly A; McLaughlin, Jacqueline E; Waldron, Kayla M; Willoughby, Ian; Pinelli, Nicole R

2018-02-01

To assess the educational impact of engaging second professional year student pharmacists in active, direct patient care experiences in health system practice. Student pharmacists in their second professional year completed a redesigned, skill-based four-week introductory pharmacy practice experience in health system practice. The immersion consisted of experiences in both operational and clinical pharmacy environments. Students were assessed with skill development checklist assessments. Pre-post surveys were also collected. Data were analyzed using a mixed methods approach. Twenty-eight student pharmacists were included; of those, 26 completed both surveys (92.9% response rate). Survey results revealed significant increases in 81.8% of operational and 100% of clinical self-efficacy statements (psystem practice while identifying additional areas for emphasized learning. Student pharmacists engaged in early, hands-on, direct patient care experiences enhanced their skill development in operational and clinical pharmacy practice. Copyright © 2017 Elsevier Inc. All rights reserved.

Sialendoscopy for Patients with Radioiodine-Induced Sialadenitis and Xerostomia.

Science.gov (United States)

Bhayani, Mihir K; Acharya, Varun; Kongkiatkamon, Suchada; Farah, Sally; Roberts, Dianna B; Sterba, Jennifer; Chambers, Mark S; Lai, Stephen Y

2015-07-01

We examined outcomes in patients treated for radioactive iodine-induced sialadenitis (RAIS) and xerostomia with sialendoscopy. Data was prospectively collected for all patients undergoing sialendoscopy for RAIS from a single institution. Interventional details and intraoperative findings were recorded. Qualitative data were obtained through patient examination, telephone interviews, and use of a standard quality of life questionnaire, Xerostomia Questionnaire. Quantitative data were obtained from patients who underwent sialometry. Twenty-six patients (24 women and 2 men; median age, 43 years; age range, 19-57 years) underwent interventional sialendoscopy after conservative management of symptoms proved unsuccessful. Sialadenitis was present in 25 patients and xerostomia in 22 patients. Mucus plugging in the duct of the gland was the most common finding (22 patients) followed by stenosis (18 patients), inflammation (eight patients), and erythema (eight patients). Median follow-up time was 23.4±12.1 months. Sixteen patients (64%) reported complete resolution; seven (28%), partial resolution; one (4%), no change in symptoms; and one (4%), regression in RAIS-related symptoms. Patients subjectively noted the following regarding their xerostomia symptoms: seven (31.8%) had complete resolution; 10 (45.5%), partial resolution; four (18.2%), no change; and one (4.5%), regression. Statistical analysis of the available sialometry data revealed a statistically significant difference in saliva production at 6 months following sialendoscopy for unstimulated saliva production (p=0.028). Sialendoscopy is an effective treatment option for the management of RAIS and xerostomia refractory to conservative therapy and medical management. Patients in our cohort report durable improvement in symptoms after intervention.

The value of FDG-PET in patients with painful total knee arthroplasty

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Stumpe, Katrin D.M.; Schulthess, Gustav K. von; Strobel, Klaus [University Hospital, Department of Medical Radiology, Division of Nuclear Medicine, Zurich (Switzerland); Romero, Jose [Orthopaedic University Hospital Balgrist, Orthopaedic Surgery, Zurich (Switzerland); Center for Joint Diseases at Hirslanden Clinic, EndoClinic Zurich, Zurich (Switzerland); Ziegler, Oliver [Orthopaedic University Hospital Balgrist, Orthopaedic Surgery, Zurich (Switzerland); Ortho Zentrum Rosenheim, Rosenheim (Germany); Kamel, Ehab M. [University Hospital, Department of Medical Radiology, Division of Nuclear Medicine, Zurich (Switzerland); Centre Hospitalier Universitaire Vaudois (CHUV), Division of Nuclear Medicine, Lausanne (Switzerland); Hodler, Juerg [Orthopaedic University Hospital Balgrist, Department of Radiology, Zurich (Switzerland)

2006-10-15

The purpose of this study was to evaluate{sup 18}F-fluorodeoxyglucose (FDG) uptake in patients with painful total knee arthroplasty and to relate FDG uptake to the location of soft tissue pain. Twenty-eight patients with painful total knee arthroplasty had a clinical examination, standard radiographs, CT measurement of rotation of the femoral component and FDG-PET (18 PET/CT, 10 PET). The diagnosis of infection was based on microbiological examinations of surgical specimens (n=12) or clinical follow-up for at least 6 months (n=16),{sup 99m}Tc-labelled monoclonal antibody scintigraphy and joint aspiration. Twenty-seven of 28 patients presented with diffuse synovial FDG uptake. Additional focal extrasynovial FDG uptake was observed in 19 knees. Twenty-four of the 28 patients had a diagnosis of internal femoral malrotation. The remaining four patients showed no rotation (0 ) and 3 , 4 and 7 of external rotation, respectively. Three patients presented with the additional diagnosis of an infected total knee replacement. Pain was described as diffuse (n=10) or focal (n=18). In two knees a relationship between pain location and FDG uptake was observed. Of ten patients with a severe internal femoral component rotation (>6 ), seven had focal uptake, four in the femoral periosteum and three in the tibial periosteum. The difference between knees with severe malrotation and the remaining knees was not significant (p=1.000, Fisher's Exact Test). Diffuse synovial and focal extrasynovial FDG-PET uptake is commonly found in patients with malrotation of the femoral component and is not related to pain location. The information provided by FDG-PET does not contribute to the diagnosis and management of individual patients with persistent pain after total knee replacement. (orig.)

The value of FDG-PET in patients with painful total knee arthroplasty

International Nuclear Information System (INIS)

Stumpe, Katrin D.M.; Schulthess, Gustav K. von; Strobel, Klaus; Romero, Jose; Ziegler, Oliver; Kamel, Ehab M.; Hodler, Juerg

2006-01-01

The purpose of this study was to evaluate 18 F-fluorodeoxyglucose (FDG) uptake in patients with painful total knee arthroplasty and to relate FDG uptake to the location of soft tissue pain. Twenty-eight patients with painful total knee arthroplasty had a clinical examination, standard radiographs, CT measurement of rotation of the femoral component and FDG-PET (18 PET/CT, 10 PET). The diagnosis of infection was based on microbiological examinations of surgical specimens (n=12) or clinical follow-up for at least 6 months (n=16), 99m Tc-labelled monoclonal antibody scintigraphy and joint aspiration. Twenty-seven of 28 patients presented with diffuse synovial FDG uptake. Additional focal extrasynovial FDG uptake was observed in 19 knees. Twenty-four of the 28 patients had a diagnosis of internal femoral malrotation. The remaining four patients showed no rotation (0 ) and 3 , 4 and 7 of external rotation, respectively. Three patients presented with the additional diagnosis of an infected total knee replacement. Pain was described as diffuse (n=10) or focal (n=18). In two knees a relationship between pain location and FDG uptake was observed. Of ten patients with a severe internal femoral component rotation (>6 ), seven had focal uptake, four in the femoral periosteum and three in the tibial periosteum. The difference between knees with severe malrotation and the remaining knees was not significant (p=1.000, Fisher's Exact Test). Diffuse synovial and focal extrasynovial FDG-PET uptake is commonly found in patients with malrotation of the femoral component and is not related to pain location. The information provided by FDG-PET does not contribute to the diagnosis and management of individual patients with persistent pain after total knee replacement. (orig.)

The pharmacokinetics of a B-domain truncated recombinant factor VIII, turoctocog alfa (NovoEight®), in patients with hemophilia A.

Science.gov (United States)

Jiménez-Yuste, V; Lejniece, S; Klamroth, R; Suzuki, T; Santagostino, E; Karim, F A; Saugstrup, T; Møss, J

2015-03-01

Turoctocog alfa (NovoEight(®)) is a human recombinant coagulation factor VIII (rFVIII) for the treatment of patients with hemophilia A. To evaluate the pharmacokinetics of turoctocog alfa in all age groups across clinical trials. Data from previously treated patients with severe hemophilia A (FVIII activity level of ≤ 1%) with no history of FVIII inhibitors, in a non-bleeding state, were included. The pharmacokinetics were assessed following a wash-out period and a subsequent single intravenous 50 IU kg(-1) dose of turoctocog alfa. Blood was sampled during a 48-h period postdose. Standard pharmacokinetic (PK) parameters were estimated on the basis of plasma FVIII activity vs. time (PK profiles) with non-compartmental methods. Furthermore, a population PK analysis was conducted. Data from 76 patients (aged 1-60 years) enrolled globally across six clinical trials were included, totaling 105 turoctocog alfa PK profiles. Single-dose PK results 3-6 months after the first dose of turoctocog alfa were comparable with the results obtained after the first dose. Similar PK characteristics were shown for different lots and strengths of the drug product. Overall, area under the plasma concentration (activity) curve from administration to infinity (AUC) and t1(/2) tended to increase with increasing age, with lower AUC and shorter t(1/2) being seen in children than in adolescents and adults. The PK profiles of turoctocog alfa and other commercially available plasma-derived FVIII and rFVIII products were similar in all age groups. The PK characteristics of turoctocog alfa have been thoroughly studied, and shown to be consistent over time, reproducible between different lots and strengths of drug product, and similar to those observed for other FVIII products. © 2014 International Society on Thrombosis and Haemostasis.

Therapeutic impact of [18F]fluoride positron-emission tomography/computed tomography on patients with unclear foot pain

International Nuclear Information System (INIS)

Fischer, Dorothee Rita; Hesselmann, Rolf; Johayem, Anass; Hany, Thomas F.; Schulthess, Gustav K. von; Strobel, Klaus; Maquieira, Gerardo J.; Espinosa, Norman; Zanetti, Marco

2010-01-01

To evaluate the therapeutic impact of [ 18 F]fluoride positron-emission tomography/computed tomography ([ 18 F]fluoride PET/CT) imaging on patients with unclear foot pain. Twenty-eight patients were prospectively included in this study. Therapeutic management was defined by two experienced dedicated foot surgeons before and after [ 18 F]fluoride PET/CT imaging. Twenty-six patients underwent cross-sectional imaging [CT, magnetic resonance (MR)] prior to PET/CT. A retrospective analysis of the magnetic resonance imaging (MRI) diagnoses was performed when a therapy change occurred after PET/CT imaging. In 13/28 (46%) patients therapeutic management was changed due to PET/CT results. Management changes occurred in patients with the following diagnoses: os trigonum syndrome; sinus tarsi syndrome; os tibiale externum syndrome; osteoarthritis of several joints; non-consolidated fragments; calcaneo-navicular coalition; plantar fasciitis; insertional tendinopathy; suggestion of periostitis; neoarticulations between metatarsal bones. Os trigonum, os tibiale externum, subtalar osteoarthritis and plantar fasciitis were only seen to be active on PET/CT images but not on MR images. [ 18 F]fluoride PET/CT has a substantial therapeutic impact on management in patients with unclear foot pain. (orig.)

Radiology and the Internet: A systematic review of patient information resources

Energy Technology Data Exchange (ETDEWEB)

Smart, James M; Burling, David

2001-11-01

AIM: To determine whether the internet is a useful resource for patients seeking information on radiological procedures. MATERIALS AND METHODS: A systematic search of the world wide web was performed by means of four general search engines (AltaVista, Yahoo{exclamation_point}, Infoseek and Excite). Twenty-eight suitable patient-directed websites on arteriography were identified for analysis. The value of this material was measured by establishing inclusion or exclusion of a number of factors relating to the procedure. Readability of the materials was evaluated using the Flesch reading ease score. RESULTS: Advice on preparation was included in 21 (75%) sites. Contraindications were found in 16 (57%) sites, risks in 6 (21%) and aftercare in 25 (89%). Result availability was discussed in 15 (54%) sites, with links to other radiology sites in 13 (46%). Visual aids were used in 6 (21%) sites and a contact address found in 27 (96%). Mean Flesch reading ease score was 57, with 46% of sites below the preferred minimum of 60. CONCLUSIONS: Few sites provide the range of information a patient needs before arriving for a procedure. In addition, the readability of the material on these sites is frequently set at a level incomprehensible to patients with lower levels of literacy. Smart, J.M. and Burling, D. (2001)

Radiology and the Internet: A systematic review of patient information resources

International Nuclear Information System (INIS)

Smart, James M.; Burling, David

2001-01-01

AIM: To determine whether the internet is a useful resource for patients seeking information on radiological procedures. MATERIALS AND METHODS: A systematic search of the world wide web was performed by means of four general search engines (AltaVista, Yahoo!, Infoseek and Excite). Twenty-eight suitable patient-directed websites on arteriography were identified for analysis. The value of this material was measured by establishing inclusion or exclusion of a number of factors relating to the procedure. Readability of the materials was evaluated using the Flesch reading ease score. RESULTS: Advice on preparation was included in 21 (75%) sites. Contraindications were found in 16 (57%) sites, risks in 6 (21%) and aftercare in 25 (89%). Result availability was discussed in 15 (54%) sites, with links to other radiology sites in 13 (46%). Visual aids were used in 6 (21%) sites and a contact address found in 27 (96%). Mean Flesch reading ease score was 57, with 46% of sites below the preferred minimum of 60. CONCLUSIONS: Few sites provide the range of information a patient needs before arriving for a procedure. In addition, the readability of the material on these sites is frequently set at a level incomprehensible to patients with lower levels of literacy. Smart, J.M. and Burling, D. (2001)

Exclusive curietherapy by permanent iodine-125 implants: selection of patients and results after eight years; Curietherapie exclusive par implants permanents d'iode-125: selection des patients et resultats a huit ans

Energy Technology Data Exchange (ETDEWEB)

Boutenbat, G.; Peiffert, D.; Bernier, V.; Moreau, J.L.; Boudran, G.; Noel, A.; Marchesi, V.; Huget, S. [Centre Alexis Vautrin, 54 - Vandoeuvre-Les-Nancy (France); Moreau, J.L. [Cabinet prive d' urologie, 54 - Nancy (France); Boudran, G. [Centre Hospitalier Universitaire de Brabois, 54 - Vandoeuvre-Les-Nancy (France)

2010-10-15

The authors report a retrospective study which assesses the results obtained over eight years and the toxicity of an exclusive curietherapy by permanent iodine-125 implants performed at the Nancy centre of struggle against cancer. More than five hundred patients have been treated between December 1999 and December 2007, a first group comprising patients suffering from a low risk cancer and a second group suffering from a medium risk cancer. The authors discuss the survival rates, the existence of side effects, and rectal toxicity results. Short communication

Diagnosis of eight groups of xeroderma pigmentosum by genetic complementation using recombinant adenovirus vectors.

Science.gov (United States)

Yamashita, Toshiharu; Okura, Masae; Ishii-Osai, Yasue; Hida, Tokimasa

2016-10-01

Because patients with xeroderma pigmentosum (XP) must avoid ultraviolet (UV) light from an early age, an early diagnosis of this disorder is essential. XP is composed of seven genetic complementation groups, XP-A to -G, and a variant type (XP-V). To establish an easy and accurate diagnosis of the eight disease groups, we constructed recombinant adenoviruses that expressed one of the XP cDNA. When fibroblasts derived from patients with XP-A, -B, -C, -D, -F or -G were infected with the adenovirus expressing XPA, XPB, XPC, XPD, XPF or XPG, respectively, and UV-C at 5-20 J/m 2 was irradiated, cell viability was clearly recovered by the corresponding recombinant adenoviruses. In contrast, XP-E and XP-V cells were not significantly sensitive to UV irradiation and were barely complemented by the matched recombinant adenoviruses. However, co-infection of Ad-XPA with Ad-XPE increased survival rate of XP-E cells after UV-C exposure. When XP-V cell strains, including one derived from a Japanese patient, were infected with Ad-XPV, exposed to UV-B and cultured with 1 mmol/L of caffeine, flow cytometry detected a characteristic decrease in the S phase in all the XP-V cell strains. From these results, the eight groups of XP could be differentiated by utilizing a set of recombinant adenoviruses, indicating that our procedure provides a convenient and correct diagnostic method for all the XP groups including XP-E and XP-V. © 2016 Japanese Dermatological Association.

Clinical analysis of 28 patients with deep neck infection

International Nuclear Information System (INIS)

Takeda, Shoichiro; Kobayashi, Taisuke; Nakamura, Koshiro

2008-01-01

Although the number of patients with deep neck infection has been decreasing with the development of antibiotics, this condition sometimes shows a poor prognosis. Early diagnosis and appropriate treatment are important for good results. In this study, 28 patients (21 males, 7 females) with deep neck infection treated between April 1991 and March 2004 at Department of Otolaryngology, Ehime Prefectural Central Hospital were investigated retrospectively. Twenty-seven of those patients resulted in good recovery, while one patient died the day after admission because of disseminated intravascular coagulation (DIC). Surgical drainage was performed for 19 of 28 patients and tracheostomy or postoperative endotracheal intubation was performed in eight patients. The average interval between admission and surgery was 1.2 days, which was shorter than that in other previous reports. Early diagnosis using CT with enhancement and surgical drainage are important in order to prevent progression of abscess into the mediastinum, which is sometimes fatal. Tracheostomy or postoperative endotracheal intubation is necessary when upper aiway stenosis is occurs. (author)

Reduced GABA levels correlate with cognitive impairment in patients with relapsing-remitting multiple sclerosis

International Nuclear Information System (INIS)

Cao, Guanmei; Gao, Fei; Gong, Tao; Wang, Guangbin; Zhao, Bin; Edden, Richard A.E.; Li, Hao; Chen, Weibo; Liu, Xiaohui

2018-01-01

To investigate if brain gamma-aminobutyric acid (GABA) levels in patients with relapsing-remitting multiple sclerosis (RRMS) are abnormal compared with healthy controls, and their relationship to cognitive function in RRMS. Twenty-eight RRMS patients and twenty-six healthy controls underwent magnetic resonance spectroscopy (MRS) at 3-T to detect GABA signals from posterior cingulate cortex (PCC), medial prefrontal cortex (mPFC) and left hippocampus using the 'MEGAPoint Resolved Spectroscopy Sequence' (MEGA-PRESS) technique. All subjects also underwent a cognitive assessment. In RRMS patients, GABA+ were lower in the PCC (p = 0.036) and left hippocampus (p = 0.039) compared with controls, decreased GABA+ in the PCC and left hippocampus were associated with specific cognitive functions (r = -0.452, p = 0.016 and r = 0.451, p = 0.016 respectively); GABA+ in the mPFC were not significantly decreased or related to any cognitive scores (p > 0.05). This study demonstrates that abnormalities of the GABAergic system may be present in the pathogenesis of RRMS and suggests a potential link between regional GABA levels and cognitive impairment in patients with RRMS. (orig.)

Reduced GABA levels correlate with cognitive impairment in patients with relapsing-remitting multiple sclerosis

Energy Technology Data Exchange (ETDEWEB)

Cao, Guanmei; Gao, Fei; Gong, Tao; Wang, Guangbin; Zhao, Bin [Shandong University, Shandong Medical Imaging Research Institute, Jinan (China); Edden, Richard A.E. [The Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Kennedy Krieger Institute, FM Kirby Center for Functional Brain Imaging, Baltimore, MD (United States); Li, Hao [Air Force General Hospital PLA, Beijing (China); Chen, Weibo [Philips Healthcare, Shanghai (China); Liu, Xiaohui [Shandong Provincial Hospital Affiliated to Shandong University, Department of Neurology, Jinan (China)

2018-03-15

To investigate if brain gamma-aminobutyric acid (GABA) levels in patients with relapsing-remitting multiple sclerosis (RRMS) are abnormal compared with healthy controls, and their relationship to cognitive function in RRMS. Twenty-eight RRMS patients and twenty-six healthy controls underwent magnetic resonance spectroscopy (MRS) at 3-T to detect GABA signals from posterior cingulate cortex (PCC), medial prefrontal cortex (mPFC) and left hippocampus using the 'MEGAPoint Resolved Spectroscopy Sequence' (MEGA-PRESS) technique. All subjects also underwent a cognitive assessment. In RRMS patients, GABA+ were lower in the PCC (p = 0.036) and left hippocampus (p = 0.039) compared with controls, decreased GABA+ in the PCC and left hippocampus were associated with specific cognitive functions (r = -0.452, p = 0.016 and r = 0.451, p = 0.016 respectively); GABA+ in the mPFC were not significantly decreased or related to any cognitive scores (p > 0.05). This study demonstrates that abnormalities of the GABAergic system may be present in the pathogenesis of RRMS and suggests a potential link between regional GABA levels and cognitive impairment in patients with RRMS. (orig.)

Remission and rheumatoid arthritis: Data on patients receiving usual care in twenty-four countries

DEFF Research Database (Denmark)

Sokka, Tuulikki; Hetland, Merete Lund; Mäkinen, Heidi

2008-01-01

and lowest remission rates was >/=15% in 10 countries, 5-14% in 7 countries, and definition of remission, male sex, higher education, shorter disease duration, smaller number of comorbidities, and regular......OBJECTIVE: To compare the performance of different definitions of remission in a large multinational cross-sectional cohort of patients with rheumatoid arthritis (RA). METHODS: The Questionnaires in Standard Monitoring of Patients with RA (QUEST-RA) database, which (as of January 2008) included 5......,848 patients receiving usual care at 67 sites in 24 countries, was used for this study. Patients were clinically assessed by rheumatologists and completed a 4-page self-report questionnaire. The database was analyzed according to the following definitions of remission: American College of Rheumatology (ACR...

Remission and rheumatoid arthritis: Data on patients receiving usual care in twenty-four countries

DEFF Research Database (Denmark)

Sokka, Tuulikki; Hetland, Merete Lund; Mäkinen, Heidi

2008-01-01

and lowest remission rates was >/=15% in 10 countries, 5-14% in 7 countries, and generally low remission rates [definition of remission, male sex, higher education, shorter disease duration, smaller number of comorbidities, and regular......OBJECTIVE: To compare the performance of different definitions of remission in a large multinational cross-sectional cohort of patients with rheumatoid arthritis (RA). METHODS: The Questionnaires in Standard Monitoring of Patients with RA (QUEST-RA) database, which (as of January 2008) included 5......,848 patients receiving usual care at 67 sites in 24 countries, was used for this study. Patients were clinically assessed by rheumatologists and completed a 4-page self-report questionnaire. The database was analyzed according to the following definitions of remission: American College of Rheumatology (ACR...

Are Indian patients with juvenile-onset ankylosing spondylitis taller than reference population ?

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Pulukool Sandhya

2015-01-01

Full Text Available Background & objectives: Paucity of growth retardation has been observed by us in patients with juvenile-onset ankylosing spondylitis (JAS in a tertiary care health centre in south India. We, therefore, undertook this pilot study to assess and compare anthropometry of patients with JAS who were 15 yr and older with that of adult onset ankylosing spondylitis (AAS and matching Indian reference population. Methods: Consecutive male patients (December 2009- October 2012 with JAS and AAS fulfilling Modified New York Criteria were selected after applying inclusion and exclusion criteria. Demography and anthropometry were noted. Height of both patient groups as well as their parents and siblings were compared with that of the reference population. Mid-parental height and delta height were derived. Those with delta height of >8.5 cm were compared with the remaining. Multivariate logistic regression was done for variables that were found to be significant by chi-square in bivariate analysis. Similar analysis was done for BMI also. Results: There was no significant difference in anthropometric variables between JAS and AAS groups. Twenty eight of the 30 (93.33% JAS patients were taller as compared to the reference population. Twenty six (86.67% AAS patients were taller than the reference population. The mean heights of JAS (170.67 ± 6.94 cm and AAS (168.2 ± 5.94 cm patients were significantly higher than the reference value of 163.11 cm; both p0 <0.001. Logistic regression revealed that tallness in JAS was associated positively with hypermobility (OR=23.46,95%CI 1.2-447.2, p0 =0.036. No significant association was detected for height in AAS and for BMI in both JAS and AAS groups. Interpretation & conclusions: No growth retardation was seen in patients with JAS in our study. Majority of patients with JAS and AAS were taller than reference population. The difference between mean height of JAS and AAS was not significant. Larger studies involving different

Clinical Characteristics of Dry Eye Patients With Chronic Pain Syndromes

NARCIS (Netherlands)

Vehof, Jelle; Smitt-Kamminga, Nicole Sillevis; Kozareva, Diana; Nibourg, Simone A.; Hammond, Christopher J.

PURPOSE: To investigate clinical characteristics of dry eye disease (DED) patients with a chronic pain syndrome. DESIGN: Cross-sectional. study. METHODS: Four hundred twenty-five patients of a tertiary care DED patient cohort in the Netherlands were included. Chronic pain syndromes irritable bowel

Frequency of metabolic syndrome in patients with type-2 diabetes

International Nuclear Information System (INIS)

Ahmed, N.; Ahmad, T.; Hussain, S.J.; Javed, M.

2010-01-01

Background: Diabetes, Hypertension, Obesity and Ischaemic Heart Disease have become a problem of public health magnitude with substantial economic burden both in the developed as well as the developing countries. Obesity is quite frequent in Type 2 diabetics and also plays a central role in causing Metabolic Syndrome (MetS). Metabolic Syndrome significantly increases the incidence of cardiovascular complications. This study was done to determine the frequency of MetS in our Type 2 diabetic patients as most of the components of MetS can be modified and identifying/managing these at an early stage might be of considerable help in reducing cardiovascular complications. Methods: This cross-sectional study was done in Medical B and Medical A wards of Ayub Teaching Hospital, Abbottabad from Nov, 08 to April, 09. Type 2 Diabetic patients aged above 40 years who gave informed consent were included in the study. Data was collected through a structured proforma. Frequency of Metabolic Syndrome was estimated according to the IDF consensus worldwide definition of the MetS. Results: Of the 100 patients enrolled in this study 56 were females and 44 were males with a mean age of 59.9 years. Out of these 100 participants seventy six (76%) were diagnosed to have metabolic syndrome. Of the 56 females, forty eight (85.71%) were having metabolic syndrome while twenty eight (63.63%) of the 44 male participants were having the syndrome. The difference was statistically significant (p<0.05). Conclusion: Frequency of MetS was found to be significantly high in this study with female preponderance. All the components, except Hypertension were more frequent in females. Diabetic patients with metabolic syndrome need more aggressive approach in management so as to decrease the incidence of cardiovascular complications. (author)

Relative mRNA expression of prostate-derived E-twenty-six factor and E-twenty-six variant 4 transcription factors, and of uridine phosphorylase-1 and thymidine phosphorylase enzymes, in benign and malignant prostatic tissue

Science.gov (United States)

CAVAZZOLA, LUCIANE ROSTIROLA; CARVALHAL, GUSTAVO FRANCO; DEVES, CANDIDA; RENCK, DAIANA; ALMEIDA, RICARDO; SANTOS, DIóGENES SANTIAGO

2015-01-01

Prostate cancer is the most frequent urological tumor, and the second most common cancer diagnosed in men. Incidence and mortality are variable and appear to depend on behavioral factors and genetic predisposition. The prostate-derived E-twenty-six factor (PDEF) and E-twenty-six variant 4 (ETV4) transcription factors, and the thymidine phosphorylase (TP) and uridine phosphorylase-1 (UP-1) enzymes, are reported to be components of the pathways leading to tumorigenesis and/or metastasis in a number of tumors. The present study aimed to analyze the mRNA expression levels of these proteins in prostatic cancerous and benign tissue, and their association with clinical and pathological variables. Using quantitative reverse transcription polymerase chain reaction, the mRNA expression levels of PDEF, ETV4, TP and UP-1 were studied in 52 tissue samples (31 of benign prostatic hyperplasia and 21 of prostate adenocarcinomas) obtained from patients treated by transurethral resection of the prostate or by radical prostatectomy. Relative expression was assessed using the ∆-CT method. Data was analyzed using Spearman's tests for correlation. Pbenign and malignant prostatic tissues. Further studies are necessary to define the role of these proteins as therapeutic targets in prostate cancer. PMID:26137165

Single agent vinorelbine in pediatric patients with progressive optic pathway glioma.

Science.gov (United States)

Cappellano, Andrea Maria; Petrilli, Antonio Sergio; da Silva, Nasjla Saba; Silva, Frederico Adolfo; Paiva, Priscila Mendes; Cavalheiro, Sergio; Bouffet, Eric

2015-01-01

The management of progressive unresectable low-grade glioma remains controversial. Treatment options have included radiotherapy, and more recently chemotherapy, usually following an initial period of observation. Within this context, we evaluated vinorelbine, a semi-synthetic vinca alkaloid that has shown evidence of activity against glioma. From July 2007 an institutional protocol with vinorelbine (30 mg/m(2) days 0, 8, 22) for a total of 18 cycles, has been conducted at IOP/GRAACC/UNIFESP for children with optic pathway glioma (OPG). The main objectives were clinical and radiological response, as well as toxicity profile. Twenty-three patients with progressive OPG with a mean age of 69 months (4-179) were enrolled. Three patients had a diagnosis of neurofibromatosis type 1. Twenty-two patients were assessable for response with an overall objective response rate of 63 %, with eight patients showing stable disease. The most important toxicity was hematologic (grade III/IV neutropenia) observed in four patients. Gastrointestinal toxicity (grade I/II vomiting) was observed in seven patients and only 1 patient showed grade I peripheral neuropathy. The median progression-free survival (PFS) was 33 months (6.9-69) with a 3 and 5 year PFS of 64 ± 19 and 37 ± 20 %, respectively, for an overall 3 and 5 year-survival of 95 ± 10 %. This study suggests that vinorelbine may be an interesting option for pediatric low-grade gliomas, showing low toxicity profile and providing a good quality of life for patients with such chronic disease.

Risk factors for early treatment discontinuation in patients with obsessive-compulsive disorder

Directory of Open Access Journals (Sweden)

Juliana Belo Diniz

2011-01-01

Full Text Available INTRODUCTION: In obsessive-compulsive disorder, early treatment discontinuation can hamper the effectiveness of first-line treatments. OBJECTIVE: This study aimed to investigate the clinical correlates of early treatment discontinuation among obsessive-compulsive disorder patients. METHODS: A group of patients who stopped taking selective serotonin reuptake inhibitors (SSRIs or stopped participating in cognitive behavioral therapy before completion of the first twelve weeks (total n = 41; n = 16 for cognitive behavioral therapy and n = 25 for SSRIs were compared with a paired sample of compliant patients (n = 41. Demographic and clinical characteristics were obtained at baseline using structured clinical interviews. Chisquare and Mann-Whitney tests were used when indicated. Variables presenting a p value <0.15 for the difference between groups were selected for inclusion in a logistic regression analysis that used an interaction model with treatment dropout as the response variable. RESULTS: Agoraphobia was only present in one (2.4% patient who completed the twelve-week therapy, whereas it was present in six (15.0% patients who dropped out (p = 0.044. Social phobia was present in eight (19.5% patients who completed the twelve-week therapy and eighteen (45% patients who dropped out (p = 0.014. Generalized anxiety disorder was present in eight (19.5% patients who completed the twelve-week therapy and twenty (50% dropouts (p = 0.004, and somatization disorder was not present in any of the patients who completed the twelveweek therapy; however, it was present in six (15% dropouts (p = 0.010. According to the logistic regression model, treatment modality (p = 0.05, agoraphobia, the Brown Assessment of Beliefs Scale scores (p = 0.03 and the Beck Anxiety Inventory (p = 0.02 scores were significantly associated with the probability of treatment discontinuation irrespective of interactions with other variables. DISCUSSION AND CONCLUSION: Early treatment

Patients with carcinoid syndrome exhibit symptoms of aggressive impulse dysregulation

NARCIS (Netherlands)

Russo, S; Boon, JC; Kema, IP; Willemse, PHB; den Boer, JA; Korf, J; de Vries, EGE

2004-01-01

Objective: Carcinoid tumors can produce excessive amounts of biogenic amines, notably serotonin. We assessed psychiatric symptoms in carcinoid patients and peripheral metabolism of tryptophan, the precursor of serotonin. Methods: Twenty consecutive patients with carcinoid syndrome underwent a

Comparison of eight methods for the extraction of Bacillus atrophaeus spore DNA from eleven common interferents and a common swab.

Directory of Open Access Journals (Sweden)

Helen L Rose

Full Text Available Eight DNA extraction products or methods (Applied Biosystems PrepFiler Forensic DNA Extraction Kit; Bio-Rad Instagene Only, Bio-Rad Instagene & Spin Column Purification; EpiCentre MasterPure DNA & RNA Kit; FujiFilm QuickGene Mini80; Idaho Technologies 1-2-3 Q-Flow Kit; MoBio UltraClean Microbial DNA Isolation Kit; Sigma Extract-N-Amp Plant and Seed Kit were adapted to facilitate extraction of DNA under BSL3 containment conditions. DNA was extracted from 12 common interferents or sample types, spiked with spores of Bacillus atropheaus. Resulting extracts were tested by real-time PCR. No one method was the best, in terms of DNA extraction, across all sample types. Statistical analysis indicated that the PrepFiler method was the best method from six dry powders (baking, biological washing, milk, plain flour, filler and talcum and one solid (Underarm deodorant, the UltraClean method was the best from four liquids (aftershave, cola, nutrient broth, vinegar, and the MasterPure method was the best from the swab sample type. The best overall method, in terms of DNA extraction, across all sample types evaluated was the UltraClean method.

Understanding reasons for and outcomes of patients lost to follow-up in antiretroviral therapy programs in Africa through a sampling-based approach.

Science.gov (United States)

Geng, Elvin H; Bangsberg, David R; Musinguzi, Nicolas; Emenyonu, Nneka; Bwana, Mwebesa Bosco; Yiannoutsos, Constantin T; Glidden, David V; Deeks, Steven G; Martin, Jeffrey N

2010-03-01

Losses to follow-up after initiation of antiretroviral therapy (ART) are common in Africa and are a considerable obstacle to understanding the effectiveness of nascent treatment programs. We sought to characterize, through a sampling-based approach, reasons for and outcomes of patients who become lost to follow-up. Cohort study. We searched for and interviewed a representative sample of lost patients or close informants in the community to determine reasons for and outcomes among lost patients. Three thousand six hundred twenty-eight HIV-infected adults initiated ART between January 1, 2004 and September 30, 2007 in Mbarara, Uganda. Eight hundred twenty-nine became lost to follow-up (cumulative incidence at 1, 2, and 3 years of 16%, 30%, and 39%). We sought a representative sample of 128 lost patients in the community and ascertained vital status in 111 (87%). Top reasons for loss included lack of transportation or money and work/child care responsibilities. Among the 111 lost patients who had their vital status ascertained through tracking, 32 deaths occurred (cumulative 1-year incidence 36%); mortality was highest shortly after the last clinic visit. Lower pre-ART CD4 T-cell count, older age, low blood pressure, and a central nervous system syndrome at the last clinic visit predicted deaths. Of patients directly interviewed, 83% were in care at another clinic and 71% were still using ART. Sociostructural factors are the primary reasons for loss to follow-up. Outcomes among the lost are heterogeneous: both deaths and transfers to other clinics were common. Tracking a sample of lost patients is an efficient means for programs to understand site-specific reasons for and outcomes among patients lost to follow-up.

Semi-lethal high temperature and heat tolerance of eight Camellia species

OpenAIRE

He, XY; Ye, H; Ma, JL; Zhang, RQ; Chen, GC; Xia, YY

2012-01-01

Annual leaf segments of eight Camellia species were used to study the heat tolerance by an electrical conductivity method, in combination with a Logistic equation to ascertain the semi-lethal high temperature by fitting the cell injury rate curve. Te relationship between the processing temperature and the cell injury rate in Camellia showed a typical "S" shaped curve, following the Logistic model. Te correlation coeficient was above 0.95. Te semi-lethal high temperature LT50 of the eight Came...

Irisin is Associated with Urotensin II and Protein Energy Wasting in Hemodialysis Patients

Directory of Open Access Journals (Sweden)

Wan-Yu He

2016-02-01

Full Text Available Aims/Introduction: Irisin is a newly identified myokine which can promote energy expenditure. Urotensin II (UII is identified as the most potent mammalian vasoconstrictor to date. Previous studies showed that UII can aggravate insulin resistance while irisin alleviate insulin resistance. Through this study, it is our aim to elucidate if UII can induce insulin resistance and also have an association with the irisin level in hemodialysis (HD patients. Materials and Methods: One hundred and twenty-eight patients on maintenance hemodialysis treatment and forty healthy subjects were enrolled in this study. Blood irisin concentrations and UII concentrations were measured by ELISA and RIA respectively. The body composition was analyzed by bioelectrical impedance. Results: The serum irisin levels and UII levels were both significantly lower in HD patients in comparison to that of the healthy subjects. The serum irisin levels were lower in HD patients with protein energy wasting than those of the patients without protein energy wasting. The independent determinants of circulating Ln (irisin (the natural logarithm of irisin were UII lean body mass and patients with protein energy wasting. Conclusions: Our results are the first to provide the clinical evidence of the association among irisin, UII, and protein energy wasting. Our results hint that UII and protein energy wasting might inhibit the release or synthesis of irisin from skeletal muscles in HD patients.

[Changes of twenty-four-hour profile blood pressure and its correction of patients with arterial hypertension on the background of combined antihypertensive therapy application].

Science.gov (United States)

Solomennchuk, T M; Slaba, N A; Prots'ko, V V; Bedzaĭ, A O

2014-01-01

The aim of this research was the study of efficiency and endurance antihypertensive therapy on the basis of fixed combination of enalapril and hydrochlorothiazide (HCTZ) and enalapril and HCTZ in combination with amlodipine according to the twenty-four-hour (? day-and-night) monitoring of blood pressure (? 24H BPM) of patients with arterial hypertension (AH) 2-3 severity. The study included 33 patients with 2-3 grade of hypertension (average age--54,40 ± 3.45 years). All patients performed ? 24H BPM before treatment and after 12 weeks of therapy. The combination of enalapril and HCTZ allowed to achieve target levels of blood pressure in 79% of patients, amlodipine additional purpose--in 86% of patients. We found that this therapy has a corrective effect on daily blood pressure profile, significantly reducing the load pressure and blood pressure variability. During treatment with the combination of enalapril and HCTZ combination of enalapril, HCTZ with amlodipine optimal daily profile of blood pressure after 12 weeks of reaching respectively 63.1% and 71.4% of patients. The treatment with combination of enalapril and HCTZ and adding of amlodipine is characterized by good endurance and high adherence to treatment.

High-Dose Statin Pretreatment Decreases Periprocedural Myocardial Infarction and Cardiovascular Events in Patients Undergoing Elective Percutaneous Coronary Intervention: A Meta-Analysis of Twenty-Four Randomized Controlled Trials

Science.gov (United States)

Wang, Le; Peng, Pingan; Zhang, Ou; Xu, Xiaohan; Yang, Shiwei; Zhao, Yingxin; Zhou, Yujie

2014-01-01

Background Evidence suggests that high-dose statin pretreatment may reduce the risk of periprocedural myocardial infarction (PMI) and major adverse cardiac events (MACE) for certain patients; however, previous analyses have not considered patients with a history of statin maintenance treatment. In this meta-analysis of randomized controlled trials (RCTs), we reevaluated the efficacy of short-term high-dose statin pretreatment to prevent PMI and MACE in an expanded set of patients undergoing elective percutaneous coronary intervention. Methods We searched the PubMed/Medline database for RCTs that compared high-dose statin pretreatment with no statin or low-dose statin pretreatment as a prevention of PMI and MACE. We evaluated the incidence of PMI and MACE, including death, spontaneous myocardial infarction, and target vessel revascularization at the longest follow-up for each study for subgroups stratified by disease classification and prior low-dose statin treatment. Results Twenty-four RCTs with a total of 5,526 patients were identified. High-dose statin pretreatment was associated with 59% relative reduction in PMI (odds ratio [OR]: 0.41; 95% confidence interval [CI]: 0.34–0.49; Pstatin pretreatment on MACE was significant for statin-naive patients (OR: 0.69; 95% CI: 0.50–0.95; P = 0.02) and prior low dose statin-treated patients (OR: 0.28; 95% CI: 0.12–0.65; P = 0.003); and for patients with acute coronary syndrome (OR: 0.52; 95% CI: 0.34–0.79; P = 0.003), but not for patients with stable angina (OR: 0.71; 95% CI 0.45–1.10; P = 0.12). Long-term effects on survival were less obvious. Conclusions High-dose statin pretreatment can result in a significant reduction in PMI and MACE for patients undergoing elective PCI. The positive effect of high-dose statin pretreatment on PMI and MACE is significant for statin-naïve patients and patients with prior treatment. The positive effect of high-dose statin pretreatment on MACE is significant for

Thyroid malignomas after irradiation of the neck (eight own observations)

Energy Technology Data Exchange (ETDEWEB)

Schulte, G A; Hering, K

1981-01-01

Eight cases of thyroid neoplasias are presented the anamnesis of which shows an irradiation in the head-neck region. After a short survey of the existing literature, the authors discuss the influence of the dose, the relatively long latent time and the different tissular tumor types (carcinomas and sarcomas in dependence on the age of the patient at the time of irradiation.

Eight years' experience with an IVF surrogate gestational pregnancy programme.

Science.gov (United States)

Raziel, Arieh; Schachter, Morey; Strassburger, Deborah; Komarovsky, Dafna; Ron-El, Raphael; Friedler, Shevach

2005-08-01

The aim of this study was to retrospectively audit eight years' experience of an IVF surrogate gestational programme and to compare the outcome of surrogacy due to absence of the uterus with surrogacy indicated for repeated IVF failure and recurrent abortions. A total of 60 cycles of IVF surrogate pregnancy were initiated in 19 treated couples. Absence of the uterus was the indication for surrogacy in 10 cases: Rokitansky syndrome (eight cases) and post-hysterectomy (two cases) designated as group A. The indications in the remaining nine patients (group B) were: IVF implantation failure (three cases), habitual abortions (four cases) and deteriorating maternal diseases (two cases). IVF performance and subsequent pregnancy outcome of groups A and B were compared. There was no difference in ovarian stimulation parameters and in IVF performance between the groups A and B. The overall pregnancy rate per transfer was 10/60 (17%). The pregnancy rates per patient and per transfer were 7/10 (70%) and 7/35 (20%) in group A compared with 3/9 (33%) and 3/25 (12%) in group B. A median number of three treatment cycles were needed to achieve pregnancy. In conclusion, the existence or absence of the uterus in the commissioning mothers is irrelevant for their IVF performance and conception rates. In patients who conceived after more than three IVF cycles, an additional 'oocyte factor' might be present.

Accelerators for the twenty-first century a review

CERN Document Server

Wilson, Edmund J N

1990-01-01

The development of the synchrotron, and later the storage ring, was based upon the electrical technology at the turn of this century, aided by the microwave radar techniques of World War II. This method of acceleration seems to have reached its limit. Even superconductivity is not likely to lead to devices that will satisfy physics needs into the twenty-first century. Unless a new principle for accelerating elementary particles is discovered soon, it is difficult to imagine that high-energy physics will continue to reach out to higher energies and luminosities.

Effects of auditing patient safety in hospital care: design of a mixed-method evaluation

Science.gov (United States)

2013-01-01

Background Auditing of patient safety aims at early detection of risks of adverse events and is intended to encourage the continuous improvement of patient safety. The auditing should be an independent, objective assurance and consulting system. Auditing helps an organisation accomplish its objectives by bringing a systematic, disciplined approach to evaluating and improving the effectiveness of risk management, control, and governance. Audits are broadly conducted in hospitals, but little is known about their effects on the behaviour of healthcare professionals and patient safety outcomes. This study was initiated to evaluate the effects of patient safety auditing in hospital care and to explore the processes and mechanisms underlying these effects. Methods and design Our study aims to evaluate an audit system to monitor and improve patient safety in a hospital setting. We are using a mixed-method evaluation with a before-and-after study design in eight departments of one university hospital in the period October 2011–July 2014. We measure several outcomes 3 months before the audit and 15 months after the audit. The primary outcomes are adverse events and complications. The secondary outcomes are experiences of patients, the standardised mortality ratio, prolonged hospital stay, patient safety culture, and team climate. We use medical record reviews, questionnaires, hospital administrative data, and observations to assess the outcomes. A process evaluation will be used to find out which components of internal auditing determine the effects. Discussion We report a study protocol of an effect and process evaluation to determine whether auditing improves patient safety in hospital care. Because auditing is a complex intervention targeted on several levels, we are using a combination of methods to collect qualitative and quantitative data about patient safety at the patient, professional, and department levels. This study is relevant for hospitals that want to

Temporal lobe epilepsy: analysis of patients with dual pathology.

Science.gov (United States)

Salanova, V; Markand, O; Worth, R

2004-02-01

To determine the frequency and types of dual pathology in patients with temporal lobe epilepsy (TLE) and to analyze the clinical manifestations and surgical outcome. A total of 240 patients with TLE underwent temporal resections following a comprehensive pre-surgical evaluation. Thirty-seven (15.4%) of these had hippocampal sclerosis (HS) or temporal lobe gliosis in association with another lesion (dual pathology). Eighteen of 37 patients with dual pathology had heterotopia of the temporal lobe, nine had cortical dysplasia, four had cavernous angiomas or arteriovenous malformations, one had a dysembryoplastic neuroepithelial tumor, one had a contusion and four patients had cerebral infarctions in childhood. 68.5% had abnormal head magnetic resonance imagings, 91.3% had abnormal positron emission tomography scans, and 96% had abnormal ictal SPECT. The intracarotid amobarbital procedure (IAP) showed impaired memory of the epileptogenic side in 72% of the patients. Twenty patients had left and 17 had right-sided en bloc temporal resections, including the lesion and mesial temporal structures. Twenty-six (70.2%) became seizure-free, eight (21.6%) had rare seizures, two (5.4%) had worthwhile seizure reduction and one (2.7%) had no improvement (range of follow-up 1-16 years, mean = 7.4 years). 15.4% had dual pathology. The dual pathology was almost exclusively seen in patients whose lesions were congenital, or occurred early in life, suggesting that the hippocampus is more vulnerable and more readily develops HS in early childhood. Resections, including the lateral and mesial temporal structures led to a favorable outcome with no mortality and little morbidity.

Treatment Results of Ovarian Dysqerminoma

International Nuclear Information System (INIS)

Chung, Eun Ji; Suh, Chang Ok; Seong, Jin Sil; Keum, Ki Chang; Kim, Gwi Eon

1996-01-01

Purpose : We tried to evaluate the clinical characteristics, the treatment methods, the results of treatments, and the patterns of failure in ovarian dysgerminoma retrospectively. According to the results we would like to suggest the proper management guideline of stage la ovarian dysgerminoma patients who want to maintain fertility. Methods and Materials : Between 1975 and 1990, 34 patients with ovarian dysgerminoma were treated at the Yonsei University Hospital. The case records of these patients have been reviewed for presenting symptoms, treatment methods, local control, and survival following treatment. Excluded from analysis were five patients with mixed ovarian germ cell tumors and gonadoblastomas (46,XY). Treatment results of the twenty nine patients were analysed by each treatment modality. Twenty one patients were treated with surgery and postoperative adjuvant radiotherapy(group 1). The other eight patients were treated with operation alone (group 2). The median age of twenty-nine patients was 23 years with a range of 8 to 39 years. Presenting symptoms were abdominal mass(20), pelvic discomfort or pain(5) et al. Radiotherapy was performed by 10MV LINAC or Co-60 teletherapy unit. The total radiation dose of the whole abdomen was 20-25 Gy/3 weeks, 1-1.5 Gy/fraction with a boost to the whole pelvis 10-15 Gy / 1-2 weeks1.8-2.0 Gy/fraction. Advanced stage disease (stage II or stage III) patients received prophylactic mediastinal and supraclavicular irradiation to a dose of 16-26 Gy. Median duration of follow-up of living patients was 80 months (range : 13-201 months). Results : All of the twenty one patients of group 1 were alive without disease (100%). Among the eight patients who were not treated with radiotherapy (group 2), six patients developed local recurrence. Four patients referred with recurrent disease were treated with salvage radiotherapy. Three of four patients were salvaged and one patient who had recurrent intra-abdominal disease died of

Frequency of different grades of retinopathy in type-2 diabetes mellitus patients at Military Hospital Rawalpindi

International Nuclear Information System (INIS)

Khan, A.U.; Yasmeen, R.; Habib, M.

2012-01-01

To analyse the various types of retinopathy in individuals with type 2 DM. Design: Descriptive study. Place and duration of study: Military Hospital Rawalpindi from January 2010 to July 2010 Methods: One hundred and fifty patients with type 2 DM were studied into for different types of retinopathy, based on history, clinical examination (ophthalmological) and laboratory investigations. Results: Out of 150 patients who fulfilled the criteria for study, 93(62%) were male and 57(38%) were female patients, frequency of retinopathy was 28.67%. The duration of diabetes ranged from 5 to 30 years. The frequency of retinopathy was higher in males as compared to females. The mean age of the patients was 51.10 +- 8.33 years with range 36-77 years. Proliferative retinopathy was seen more in those diabetic patients whose duration of disease was more than 10 years. They also showed poor glycaemic control in the form of raised blood glucose and HbA1C levels. Conclusion: About twenty eight percent of our diabetic patients are suffering from diabetic retinopathy. This can be controlled by early detection and effective treatment both in terms of strict glycemic control and laser photocoagulation, thus decreasing the morbidity and mortality due to this chronic disease. (author)

Identification of eight novel SDHB, SDHC, SDHD germline variants in Danish pheochromocytoma/paraganglioma patients

DEFF Research Database (Denmark)

Bennedbæk, Marc; Rossing, Maria; Rasmussen, Åse K

2016-01-01

patients. METHODS: Mutational screening was performed by Sanger sequencing or next-generation sequencing. The frequencies of variants of unknown clinical significance, e.g. intronic, missense, and synonymous variants, were determined using the Exome Aggregation Consortium database, while the significance...

Management of eight labor and delivery patients dependent on buprenorphine (Subutex™: A retrospective chart review [version 2; referees: 2 approved

Directory of Open Access Journals (Sweden)

Solina Tith

2018-02-01

Full Text Available Background: Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by “The American College of Obstetrics and Gynecology” as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial μ-opioid agonists’ unique pharmacology, including its long half time and high affinity to the μ-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia. We reviewed our management and outcomes in this medically complex population. Methods: An Institutional Review Board (IRB approved retrospective chart review was conducted of women admitted to the University of Washington Medical Center Labor and Delivery unit from July 2012 to November 2013 using buprenorphine. All deliveries, including intrauterine fetal demise, were included. Results: Eight women were admitted during this period to our L&D floor on buprenorphine. All required peri-partum anesthetic management either for labor and/or cesarean delivery management. Analgesic management included dilaudid or fentanyl PCA and/or continued epidural infusion, and in one instance ketamine infusion, while the pre-admission buprenorphine regimen was continued. Five babies were viable, two women experienced intrauterine fetal death at 22 and 36 weeks gestational age (GSA, respectively, and one neonate died shortly after delivery due to a congenital diaphragmatic hernia. Conclusions: This case series illuminates the medical complexity of parturients using buprenorphine. Different treatment modalities in the absence of evidence-based guidelines included additional opioid administration and continued epidural analgesia. The management of post-cesarean pain in patients on partial μ-opioid agonists remains complex and variable, and evidence-based guidelines could be useful for clinicians to direct care.

Trends in CPAP adherence over twenty years of data collection: a flattened curve.

Science.gov (United States)

Rotenberg, Brian W; Murariu, Dorian; Pang, Kenny P

2016-08-19

Obstructive sleep apnea (OSA) is a common disorder, and continuous airway positive pressure (CPAP) is considered to be the gold standard of therapy. CPAP however is known to have problems with adherence, with many patients eventually abandoning the device. The purpose of this paper is to assess secular trends in CPAP adherence over the long term to see if there have been meaningful improvements in adherence in light of the multiple interventions proposed to do so. A comprehensive systematic literature review was conducted using the Medline-Ovid, Embase, and Pubmed databases, searching for data regarding CPAP adherence over a twenty year timeframe (1994-2015). Data was assessed for quality and then extracted. The main outcome measure was reported CPAP non-adherence. Secondary outcomes included changes in CPAP non-adherence when comparing short versus long-term, and changes in terms of behavioral counseling. Eighty-two papers met study inclusion/exclusion criteria. The overall CPAP non-adherence rate based on a 7-h/night sleep time that was reported in studies conducted over the twenty year time frame was 34.1 %. There was no significant improvement over the time frame. Behavioral intervention improved adherence rates by ~1 h per night on average. The rate of CPAP adherence remains persistently low over twenty years worth of reported data. No clinically significant improvement in CPAP adherence was seen even in recent years despite efforts toward behavioral intervention and patient coaching. This low rate of adherence is problematic, and calls into question the concept of CPAP as gold-standard of therapy for OSA.

Effects of auditing patient safety in hospital care: design of a mixed-method evaluation.

Science.gov (United States)

Hanskamp-Sebregts, Mirelle; Zegers, Marieke; Boeijen, Wilma; Westert, Gert P; van Gurp, Petra J; Wollersheim, Hub

2013-06-22

Auditing of patient safety aims at early detection of risks of adverse events and is intended to encourage the continuous improvement of patient safety. The auditing should be an independent, objective assurance and consulting system. Auditing helps an organisation accomplish its objectives by bringing a systematic, disciplined approach to evaluating and improving the effectiveness of risk management, control, and governance. Audits are broadly conducted in hospitals, but little is known about their effects on the behaviour of healthcare professionals and patient safety outcomes. This study was initiated to evaluate the effects of patient safety auditing in hospital care and to explore the processes and mechanisms underlying these effects. Our study aims to evaluate an audit system to monitor and improve patient safety in a hospital setting. We are using a mixed-method evaluation with a before-and-after study design in eight departments of one university hospital in the period October 2011-July 2014. We measure several outcomes 3 months before the audit and 15 months after the audit. The primary outcomes are adverse events and complications. The secondary outcomes are experiences of patients, the standardised mortality ratio, prolonged hospital stay, patient safety culture, and team climate. We use medical record reviews, questionnaires, hospital administrative data, and observations to assess the outcomes. A process evaluation will be used to find out which components of internal auditing determine the effects. We report a study protocol of an effect and process evaluation to determine whether auditing improves patient safety in hospital care. Because auditing is a complex intervention targeted on several levels, we are using a combination of methods to collect qualitative and quantitative data about patient safety at the patient, professional, and department levels. This study is relevant for hospitals that want to early detect unsafe care and improve patient

Correlation of interdental and interradicular bone loss in patients ...

African Journals Online (AJOL)

Objective: The aim of this study was to investigate the correlation between interdental and interradicular bone loss and clinical parameters in patients with chronic periodontitis. Materials and Methods: One hundred-twenty intraoral periapical radiographs of first molars were obtained from patients with chronic periodontitis ...

[Eight Cases of Esophagus and Tracheobronchial Stenting for Advanced Esophageal Cancer].

Science.gov (United States)

Nakahara, Yujiro; Takachi, Ko; Tsujimura, Naoto; Wakasugi, Masaki; Hirota, Masaki; Matsumoto, Takashi; Takemoto, Hiroyoshi; Nishioka, Kiyonori; Oshima, Satoshi

2017-11-01

Malignant stricture and fistula of the esophagus and tracheobronchus adversely affect the quality of life(QOL)in patients with advanced esophageal cancer. Stenting is one ofthe therapies available for these patients. We investigated the outcomes ofesophagus and tracheobronchial stenting in our institution. Eight patients with advanced esophageal cancer underwent double stenting from 2010 to 2016. Among them, 4 patients underwent double stenting as planned. One patient underwent an emergency tracheal stenting because ofstenosis ofthe trachea caused by esophageal stenting. Three patients underwent tracheobronchial stenting later on because ofan increase in the tumor size after esophageal stenting. Dysphagia score was improved in 5(67.5%)out ofthe 8 patients. Respiratory symptoms were improved in all patients, and 4 patients(50.0%) were discharged. The median survival time after esophageal stenting was 70.5 days. Esophagus and tracheobronchial stenting for advanced esophageal cancer was useful for the improvement of the QOL.

Implant overdentures: dental students' performance in fabrication, denture quality, and patient satisfaction.

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Aragon, Cecilia E; Cornacchio, Angelica Lee Petrina; Ibarra, Lilia Marcela; Saad, Muhammed N; Zibrowski, Elaine

2010-09-01

The purpose of this study was to evaluate dental students' performance when fabricating a mandibular two-implant overdenture (OD) as compared to conventional dentures (CD) and to determine if these prostheses were successful. Twenty students and twenty patients were divided into two groups: complete denture group (CDG) and maxillary denture and two-implant OD group (ODG). Students' progress was evaluated at each appointment as they were given a clinical assessment score (CAS), which varied from 1 (unacceptable, needs to repeat procedure) to 4 (acceptable, no errors). The success of the prosthesis was evaluated by the patients using a visual analog scale (VAS) and an expert (a prosthodontist) using a denture quality assessment (DQA) form. Performance for both groups was not statistically different across all eight appointments (CDG 3.16 versus ODG 3.25; p=0.46). Patients with ODs reported greater stability with their dentures (p=0.048) and greater ability to chew than patients with CDs (p=0.03). There were no differences between the groups in terms of expert appraisal (ODG 71.1 versus CDG 67.5; p=0.59). The performance of dental students when fabricating a two-implant OD is thus not different from that of a CD. Students can successfully fabricate a two-implant OD as perceived by both patients and prosthodontists.

Prevalence of Autonomic Dysreflexia in Patients with Spinal Cord Injury above T6

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Eun Sun Lee

2017-01-01

Full Text Available Objective. To investigate the prevalence of autonomic dysreflexia (AD using ambulatory blood pressure monitoring (ABPM and the autonomic dysfunction following spinal cord injury (ADFSCI questionnaire in patients with spinal cord injury (SCI above T6. Methods. Twenty-eight patients diagnosed with SCI above T6 were enrolled. ABPM and ADFSCI were utilized to assess AD. Using ABPM, systolic blood pressure (SBP, diastolic blood pressure, and heart rate (HR were measured at 30-minute intervals. AD was defined as SBP 20 mmHg higher than basal SBP, and the number of AD events was counted. The ADFSCI questionnaire evaluates the severity and frequency of the AD symptoms. Results. According to the ABPM, AD occurred in 26 patients and AD events occurred 5.8±4.7 times. Average daytime and nighttime SBP were 119.9±18.8 mmHg and 123.8±21.2 mmHg, respectively, and the nighttime mean SBP appeared to be 4 mmHg higher than daytime mean SBP. These findings suggest the loss of nocturnal BP dipping in SCI patients. ADFSCI results revealed that 16 of the patients evaluated were symptomatic while 12 were asymptomatic. Conclusion. AD following SCI above T6 was highly prevalent and several patients seemed asymptomatic. These results suggest the necessity of proper diagnostic and therapeutic interventions for managing AD.

Qualitative analysis of patient-centered decision attributes associated with initiating hepatitis C treatment.

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Zuchowski, Jessica L; Hamilton, Alison B; Pyne, Jeffrey M; Clark, Jack A; Naik, Aanand D; Smith, Donna L; Kanwal, Fasiha

2015-10-01

In this era of a constantly changing landscape of antiviral treatment options for chronic viral hepatitis C (CHC), shared clinical decision-making addresses the need to engage patients in complex treatment decisions. However, little is known about the decision attributes that CHC patients consider when making treatment decisions. We identify key patient-centered decision attributes, and explore relationships among these attributes, to help inform the development of a future CHC shared decision-making aid. Semi-structured qualitative interviews with CHC patients at four Veterans Health Administration (VHA) hospitals, in three comparison groups: contemplating CHC treatment at the time of data collection (Group 1), recently declined CHC treatment (Group 2), or recently started CHC treatment (Group 3). Participant descriptions of decision attributes were analyzed for the entire sample as well as by patient group and by gender. Twenty-nine Veteran patients participated (21 males, eight females): 12 were contemplating treatment, nine had recently declined treatment, and eight had recently started treatment. Patients on average described eight (range 5-13) decision attributes. The attributes most frequently reported overall were: physical side effects (83%); treatment efficacy (79%), new treatment drugs in development (55%); psychological side effects (55%); and condition of the liver (52%), with some variation based on group and gender. Personal life circumstance attributes (such as availability of family support and the burden of financial responsibilities) influencing treatment decisions were also noted by all participants. Multiple decision attributes were interrelated in highly complex ways. Participants considered numerous attributes in their CHC treatment decisions. A better understanding of these attributes that influence patient decision-making is crucial in order to inform patient-centered clinical approaches to care (such as shared decision-making augmented

Prevalence of Toxoplasma gondii and Toxocara canis among Patients with Uveitis.

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Lim, Su Jin; Lee, Sang Eun; Kim, Sun Hyun; Hong, Sung-Hee; You, Yong Sung; Kwon, Oh Woong; Kim, Hyeun Seung

2015-04-01

To investigate the prevalence of Toxoplasma gondii and Toxocara canis in patients with uveitis. Patients with uveitis were examined. Serum antibodies to T. gondii and T. canis were tested by using the enzyme-linked immunosorbent assay. Polymerase chain reaction (PCR) was done using blood and aqueous humor (AH). Ninety-eight patients were enrolled. Mean age was 43.5 ± 13.2 years. Six patients were seropositive for T. gondii with the following pattern: anterior uveitis, 1; posterior uveitis with retinitis, 2; pan uveitis, 2. One patient had a positive PCR result for T. gondii in AH, who showed panuveitis. Twenty-three patients were positive to serum IgG for T. canis with the following clinical manifestation: granuloma, 6; pigmented scar, 3; vitritis, 6--but none were PCR positive. T. gondii and T. canis are still important causes of uveitis. Ocular toxocariasis is not an uncommon cause of uveitis, even in adults.

A mixed-methods needs assessment of adult diabetes mellitus (type II) and hypertension care in Toledo, Belize.

Science.gov (United States)

Dekker, Annette M; Amick, Ashley E; Scholcoff, Cecilia; Doobay-Persaud, Ashti

2017-02-28

Non-communicable diseases, including diabetes mellitus and hypertension, continue to disproportionately burden low- and middle-income countries. However, little research has been done to establish current practices and management of chronic disease in these settings. The objective of this study was to examine current clinical management and identify potential gaps in care of patients with diabetes mellitus and hypertension in the district of Toledo, Belize. The study used a mixed methodology to assess current practices and identify gaps in diabetes mellitus and hypertension care. One hundred and twenty charts of the general clinic population were reviewed to establish disease epidemiology. One hundred and seventy-eight diabetic and hypertensive charts were reviewed to assess current practices. Twenty providers completed questionnaires regarding diabetes mellitus and hypertension management. Twenty-five individuals with diabetes mellitus and/or hypertension answered a questionnaire and in-depth interview. The prevalence of diabetes mellitus and hypertension was 12%. Approximately 51% (n = 43) of patients with hypertension were at blood pressure goal and 26% (n = 21) diabetic patients were at glycemic goal based on current guidelines. Of the patients with uncontrolled diabetes, 49% (n = 29) were on two oral agents and only 10% (n = 6) were on insulin. Providers stated that barriers to appropriate management include concerns prescribing insulin and patient health literacy. Patients demonstrated a general understanding of the concept of chronic illness, however lacked specific knowledge regarding disease processes and self-management strategies. This study provides an initial overview of diabetes mellitus and hypertension management in a diverse patient population in rural Belize. Results indicate areas for future investigation and possible intervention, including barriers to insulin use and opportunities for lifestyle-specific disease education for

Musical dual-task training in patients with mild-to-moderate dementia: a randomized controlled trial

Science.gov (United States)

Chen, Yu-Ling; Pei, Yu-Cheng

2018-01-01

Background/aims Dual-task training may improve dual-task gait performance, balance, and cognition in older adults with and without cognitive impairment. Although music has been widely utilized in dementia management, there are no existing protocols for music-based dual-task training. This randomized controlled study developed a Musical Dual-Task Training (MDTT) protocol that patients with dementia can use to practice walking and making music simultaneously, to enhance attention control in patients during dual-tasking. Methods Twenty-eight adults diagnosed with mild-to-moderate dementia were assigned to the MDTT (n=15) or control groups (n=13). The MDTT group received MDTT, while the control group participated in non-musical cognitive and walking activities. The effects of MDTT were evaluated through the primary outcome of attention control, and secondary outcomes of dual-task performance, balance, falls efficacy, and agitation. Results The MDTT group showed a significant improvement in attention control, while the control group did not (Pmusic therapy intervention that demands a high level of cognitive processing, enhances attention control, falls efficacy, and helps alleviate agitation in patients with mild-to-moderate dementia. PMID:29881275

[Prognostic impact of anthracyclines in the treatment of aggressive lymphoma in patients over 70 years].

Science.gov (United States)

Ancochea, Águeda; Salar, Antonio; García-Pallarols, Francesc; Gimeno, Eva; Fernández-Rodriguez, Conchi; Sánchez-González, Blanca

2015-06-22

The optimal treatment of aggressive non-Hodgkin lymphoma (NHL) in elderly patients remains controversial. We aimed to evaluate the impact of age and use of anthracyclines. Retrospective analysis of patients with aggressive NHL aged over 70 years old. One hundred and twenty-eight patients with a median age of 76 years (70-91). Eighty-eight percent received chemotherapy, and 72% received anthracyclines. The overall response rate was 70%, 51% with a complete response (CR)/uncertain complete response and 19% with a partial response (PR). Overall survival (OS) was 28 months (95% confidence interval 18-78). In the diffuse large B-cell lymphoma group, progression-free survival (PFS) and OS were significantly better in patients who achieved CR versus PR. The use of anthracyclines was associated with CR, the international prognostic index (IPI) was associated with both survival and response, and age showed no association. In patients aged ≥ 70 years with aggressive lymphoma who received chemotherapy, the IPI but not age and the use of anthracyclines showed a prognostic impact. Therefore, in elderly patients with aggressive lymphomas, the use of anthracyclines should be considered and therapeutic decisions should not be based on age exclusively. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Perinatal occipital lobe injury in children: analysis of twenty-one cases.

Science.gov (United States)

Wang, San-Mei; Yang, Chang-Shuan; Hou, Yu; Ma, Xiu-Wei; Feng, Zhi-Chun; Liao, Yu-Zhen

2012-12-01

This study used magnetic resonance imaging to analyze causes and clinical courses of pediatric occipital lobe injury. Patients undergoing magnetic resonance imaging for suspected bilateral occipital lobe injury at our Neurodevelopmental Department between July 2007 and June 2011 were included. We evaluated magnetic resonance imaging characteristics, clinical courses, electroencephalogram monitoring, and Denver Development Screen Test scores. Twenty-one infants were examined. Of these, 10 had been born preterm. Thirteen patients demonstrated hypoglycemia. Perinatal period hypoglycemia comprised the most common cause (71.4%) of occipital brain injury. Visual abnormalities were evident in 18 patients. Seventeen (80.9%) patients manifested epilepsy. Infantile spasms were observed in 13 cases (76.5%). According to Denver Development Screen Test assessment, 17 patients demonstrated delayed motor development. Motor function and language improved in 10 patients after effective control of their seizures. Hypoglycemia constitutes the most common cause of occipital injury in infants. Visual impairment, startle episodes, infantile spasms, and motor developmental delay comprise the most common complications, whereas language function is usually spared. Copyright © 2012 Elsevier Inc. All rights reserved.

Fluorescence In Situ Hybridization and Immunohistochemistry as Diagnostic Methods for ALK Positive Non-Small Cell Lung Cancer Patients

Science.gov (United States)

Martinez, Pablo; Hernández-Losa, Javier; Cedrés, Susana; Castellví, Josep; Martinez-Marti, Alex; Tallada, Natalia; Murtra-Garrell, Nuria; Navarro-Mendivill, Alejandro; Rodriguez-Freixinos, Victor; Canela, Mercedes; Ramon y Cajal, Santiago; Felip, Enriqueta

2013-01-01

Background Anaplastic Lymphoma Kinase (ALK) positivity represents a novel molecular target in a subset of Non-Small Cell Lung Cancers (NSCLC). We explore Fluorescence in situ Hybridization (FISH) and Immunohistochemistry (IHC) as diagnostic methods for ALK positive patients and to describe its prevalence and outcomes in a population of NSCLC patients. Methods NSCLC patients previously screened for Epidermal Growth Factor Receptor (EGFR) at our institution were selected. ALK positive patients were identified by FISH and the value of IHC (D5F3) was explored. Results ninety-nine patients were identified. Median age was 61.5 years (range 35–83), all were caucasians, eighty percent were adenocarcinomas, fifty-one percent were male and thirty-eight percent were current smokers. Seven (7.1%) patients were ALK positive by FISH, thirteen (13.1%) were EGFR mutant, and 65 (65.6%) were negative/Wild Type (WT) for both ALK and EGFR. ALK positivity and EGFR mutations were mutually exclusive. ALK positive patients tend to be younger than EGFR mutated or wt patients. ALK positive patients were predominantly never smokers (71.4%) and adenocarcinoma (71.4%). ALK positive and EGFR mutant patients have a better outcome than negative/WT. All patients with ALK FISH negative tumours were negative for ALK IHC. Out of 6 patients positive for ALK FISH with more tissue available, 5 were positive for ALK IHC and 1 negative. Conclusions ALK positive patients represent 7.1% of a population of selected NSCLC. ALK positive patients have different clinical features and a better outcome than EGFR WT and ALK negative patients. IHC is a promising method for detecting ALK positive NSCLC patients. PMID:23359795

Impact of Different Obesity Assessment Methods after Acute Coronary Syndromes

Directory of Open Access Journals (Sweden)

Caroline N. M. Nunes

2014-07-01

Full Text Available Background: Abdominal obesity is an important cardiovascular risk factor. Therefore, identifying the best method for measuring waist circumference (WC is a priority. Objective: To evaluate the eight methods of measuring WC in patients with acute coronary syndrome (ACS as a predictor of cardiovascular complications during hospitalization. Methods: Prospective study of patients with ACS. The measurement of WC was performed by eight known methods: midpoint between the last rib and the iliac crest (1, point of minimum circumference (2; immediately above the iliac crest (3, umbilicus (4, one inch above the umbilicus (5, one centimeter above the umbilicus (6, smallest rib and (7 the point of greatest circumference around the waist (8. Complications included: angina, arrhythmia, heart failure, cardiogenic shock, hypotension, pericarditis and death. Logistic regression tests were used for predictive factors. Results: A total of 55 patients were evaluated. During the hospitalization period, which corresponded on average to seven days, 37 (67% patients had complications, with the exception of death, which was not observed in any of the cases. Of these complications, the only one that was associated with WC was angina, and with every cm of WC increase, the risk for angina increased from 7.5 to 9.9%, depending on the measurement site. It is noteworthy the fact that there was no difference between the different methods of measuring WC as a predictor of angina. Conclusion: The eight methods of measuring WC are also predictors of recurrent angina after acute coronary syndromes.

Deliberate ingestion of foreign bodies by institutionalised psychiatric hospital patients and prison inmates.

LENUS (Irish Health Repository)

O'Sullivan, S T

2012-02-03

Deliberate and recurrent foreign body ingestion is a common problem among institutionalised patients. We review our experience with 36 cases of deliberate foreign body ingestion by prisoners or psychiatric patients, thirty of whom were institutionalised at the time of ingestion. Symptoms were frequently severe in the prison inmate group but, in contrast, psychiatric patients presented with few, if any, symptoms. A majority of objects pass spontaneously or remain in situ without complication. Twenty-four patients were discharged following initial evaluation and without specific treatment. Eight of these were reviewed electively and discharged within one week. Twelve patients were admitted for observation, seven of whom were discharged within 48 hrs. Upper gastrointestinal endoscopy was performed in four patients and an intragastric foreign body identified in two cases. Laparotomy was performed in two cases for unresolving mechanical intestinal obstruction. Management should be conservative when possible, with surgery indicated only for complications.

Metastatic melanoma patients treated with dendritic cell vaccination, Interleukin-2 and metronomic cyclophosphamide

DEFF Research Database (Denmark)

Ellebaek, Eva; Engell-Noerregaard, Lotte; Iversen, Trine Zeeberg

2012-01-01

Dendritic cells (DC) are the most potent antigen presenting cells and have proven effective in stimulation of specific immune responses in vivo. Competing immune inhibition could limit the clinical efficacy of DC vaccination. In this phase II trial, metronomic Cyclophosphamide and a Cox-2 inhibitor...... have been added to a DC vaccine with the intend to dampen immunosuppressive mechanisms. Twenty-eight patients with progressive metastatic melanoma were treated with autologous DCs pulsed with survivin, hTERT, and p53-derived peptides (HLA-A2(+)) or tumor lysate (HLA-A2(-)). Concomitantly the patients...... were treated with IL-2, Cyclophosphamide, and Celecoxib. The treatment was safe and tolerable. Sixteen patients (57 %) achieved stable disease (SD) at 1st evaluation and 8 patients had prolonged SD (7-13.7 months). The median OS was 9.4 months. Patients with SD had an OS of 10.5 months while patients...

Incidence and risk factors of refeeding syndrome in head and neck cancer patients

DEFF Research Database (Denmark)

Rasmussen, Stine Ostenfeldt; Kristensen, Marianne Boll; Wessel, Irene

2016-01-01

This study aimed to determine the incidence rates of refeeding phenomena (defined as a decline in p-phosphate) and refeeding syndrome (RFS; defined as development of clinical symptoms in addition to a decline in p-phosphate) in head and neck cancer patients, and to identify risk factors. Fifty......-four head and neck cancer patients referred for surgery were included. Forty-six potential risk factors were registered at the baseline, and p-phosphate was measured at Days 2, 4, and 7. Eleven patients (20%) developed RFS, and twenty-eight (52%) developed refeeding phenomena. At baseline, these patients...... presented a higher prevalence of head and neck pain, eating difficulties, higher p-phosphate levels, lower p-transferrin levels, and, in men, lower b-hemoglobin levels. Patients who developed symptoms had a decline in p-phosphate ≥0.22 mmol/l. At baseline, these patients had higher p-phosphate levels...

Multiple sclerosis patients lacking oligoclonal bands in the cerebrospinal fluid have less global and regional brain atrophy.

Science.gov (United States)

Ferreira, Daniel; Voevodskaya, Olga; Imrell, Kerstin; Stawiarz, Leszek; Spulber, Gabriela; Wahlund, Lars-Olof; Hillert, Jan; Westman, Eric; Karrenbauer, Virginija Danylaité

2014-09-15

To investigate whether multiple sclerosis (MS) patients with and without cerebrospinal fluid (CSF) oligoclonal immunoglobulin G bands (OCB) differ in brain atrophy. Twenty-eight OCB-negative and thirty-five OCB-positive patients were included. Larger volumes of total CSF and white matter (WM) lesions; smaller gray matter (GM) volume in the basal ganglia, diencephalon, cerebellum, and hippocampus; and smaller WM volume in corpus callosum, periventricular-deep WM, brainstem, and cerebellum, were observed in OCB-positives. OCB-negative patients, known to differ genetically from OCB-positives, are characterized by less global and regional brain atrophy. This finding supports the notion that OCB-negative MS patients may represent a clinically relevant MS subgroup. Copyright © 2014 Elsevier B.V. All rights reserved.

Aspartate aminotransferase-to-platelet ratio index for fibrosis and cirrhosis prediction in chronic hepatitis C patients

Directory of Open Access Journals (Sweden)

Roberto Gomes da Silva Junior

Full Text Available In chronic hepatitis C (CHC, liver biopsy is the gold standard method for assessing liver histology, however it is invasive and can have complications. Non-invasive markers have been proposed and aspartate aminotransferase (AST-to-platelet ratio index (APRI has been shown as an easy and inexpensive marker of liver fibrosis. This study evaluated the diagnostic performance of APRI for significant fibrosis and cirrhosis prediction in CHC patients. This study included treatment-naive CHC patients who had undergone liver biopsy from January 2000 to August 2006. All histological slides were reviewed according to the METAVIR system. APRI was calculated based on laboratory results performed within four months from the biopsy. Twenty-eight (56% patients had significant fibrosis (F2-F4 and 13 (26% had cirrhosis (F4. The area under ROC curves of APRI for predicting significant fibrosis and cirrhosis were 0.92 (0.83-1.00 and 0.92 (0.85-1.00, respectively. Using cut-off values recommended by prior studies, significant fibrosis could be identified, in accordance with liver biopsy, in 44% and cirrhosis in 66% of patients. APRI could identify significant fibrosis and cirrhosis at a high degree of accuracy in studied patients.

Soybean allergen detection methods--a comparison study

DEFF Research Database (Denmark)

Pedersen, M. Højgaard; Holzhauser, T.; Bisson, C.

2008-01-01

Soybean containing products are widely consumed, thus reliable methods for detection of soy in foods are needed in order to make appropriate risk assessment studies to adequately protect soy allergic patients. Six methods were compared using eight food products with a declared content of soy...

Science Teacher Education in the Twenty-First Century: a Pedagogical Framework for Technology-Integrated Social Constructivism

Science.gov (United States)

Barak, Miri

2017-04-01

Changes in our global world have shifted the skill demands from acquisition of structured knowledge to mastery of skills, often referred to as twenty-first century competencies. Given these changes, a sequential explanatory mixed methods study was undertaken to (a) examine predominant instructional methods and technologies used by teacher educators, (b) identify attributes for learning and teaching in the twenty-first century, and (c) develop a pedagogical framework for promoting meaningful usage of advanced technologies. Quantitative and qualitative data were collected via an online survey, personal interviews, and written reflections with science teacher educators and student teachers. Findings indicated that teacher educators do not provide sufficient models for the promotion of reform-based practice via web 2.0 environments, such as Wikis, blogs, social networks, or other cloud technologies. Findings also indicated four attributes for teaching and learning in the twenty-first century: (a) adapting to frequent changes and uncertain situations, (b) collaborating and communicating in decentralized environments, (c) generating data and managing information, and (d) releasing control by encouraging exploration. Guided by social constructivist paradigms and twenty-first century teaching attributes, this study suggests a pedagogical framework for fostering meaningful usage of advanced technologies in science teacher education courses.

[An evaluation of eight cases of intraosseous lipoma].

Science.gov (United States)

Sahin, Yilmaz; Dabak, Nevzat; Selçuk, M Bekir; Bariş, Y Sancar

2007-01-01

We retrospectively evaluated patients with intraosseous lipoma. The study included eight patients (5 males, 3 females; mean age 39 years; range 23 to 60 years) who were treated between 1997 and 2005 for intraosseous lipoma. Localizations of the lipomas were the calcaneus in six patients, proximal humerus in one patient, and proximal femur in one patient. The presenting complaints were heel pain in patients with calcaneal involvement, and shoulder pain associated with proximal humeral involvement. In one patient, detection of intraosseous lipoma in the left proximal femur was incidental during examination for right hip pain. According to the Milgram classification, five of the intraosseous lipomas were stage 1, while two calcaneal lesions and one femoral lesion were stage 2. Treatment consisted of excisional biopsy, curettage, and allografting under regional or general anesthesia. The diagnosis was confirmed histopathologically in all cases. The mean follow-up period was 28 months (range 9 to 110 months). Complaints of heel pain and shoulder pain resolved within four and five months, respectively. No infection or skin necrosis occurred at the wound site. No neurovascular complications developed during or after surgery. Radiological consolidation of the implanted bone allografts were complete by a mean of three months (range 2 to 4 months). No pathological fractures or recurrences were encountered. Treatment of intraosseous lipomas with curettage and grafting is effective in relieving pain and preventing possible pathological fractures.

Growth response of eight tropical turfgrass species to salinity

African Journals Online (AJOL)

PRECIOUS

2009-11-02

Nov 2, 2009 ... MATERIALS AND METHODS. The experiment was conducted in the glasshouse of Faculty of. Agriculture at Universiti Putra Malaysia under sand culture system. Eight turfgrass (Table 1) species were planted in plastic pot filled with a mix of 9 washed river sand: 1 peat moss (v/v). The soil was sandy with pH ...

Thymus irradiation for myasthenia gravis

International Nuclear Information System (INIS)

Currier, R.D.; Routh, A.; Hickman, B.T.; Douglas, M.A.

1983-01-01

Twenty-eight patients with progressive myasthenia gravis without thymoma received treatment of 3000 rads (30 Gy) to the anterior mediastinum, and a followup was conducted for five to 18 years. Twenty-four patients had generalized myasthenia, and four had ocular myasthenia gravis. Twenty patients with generalized myasthenia survived the several month post-treatment period and improved, but four died during that period. The improvement lasted a median of 1.5 years, and older patients had longer remissions than younger patients. The four patients who had ocular myasthenia did not change after treatment. Mediastinal irradiation produces a temporary remission in generalized myasthenia

Thymus irradiation for myasthenia gravis

Energy Technology Data Exchange (ETDEWEB)

Currier, R.D.; Routh, A.; Hickman, B.T.; Douglas, M.A.

1983-01-01

Twenty-eight patients with progressive myasthenia gravis without thymoma received treatment of 3000 rads (30 Gy) to the anterior mediastinum, and a followup was conducted for five to 18 years. Twenty-four patients had generalized myasthenia, and four had ocular myasthenia gravis. Twenty patients with generalized myasthenia survived the several month post-treatment period and improved, but four died during that period. The improvement lasted a median of 1.5 years, and older patients had longer remissions than younger patients. The four patients who had ocular myasthenia did not change after treatment. Mediastinal irradiation produces a temporary remission in generalized myasthenia.

Methods of patient warming during abdominal surgery.

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Li Shao

Full Text Available BACKGROUND: Keeping abdominal surgery patients warm is common and warming methods are needed in power outages during natural disasters. We aimed to evaluate the efficacy of low-cost, low-power warming methods for maintaining normothermia in abdominal surgery patients. METHODS: Patients (n = 160 scheduled for elective abdominal surgery were included in this prospective clinical study. Five warming methods were applied: heated blood transfusion/fluid infusion vs. unheated; wrapping patients vs. not wrapping; applying moist dressings, heated or not; surgical field rinse heated or not; and applying heating blankets or not. Patients' nasopharyngeal and rectal temperatures were recorded to evaluate warming efficacy. Significant differences were found in mean temperatures of warmed patients compared to those not warmed. RESULTS: When we compared temperatures of abdominal surgery patient groups receiving three specific warming methods with temperatures of control groups not receiving these methods, significant differences were revealed in temperatures maintained during the surgeries between the warmed groups and controls. DISCUSSION: The value of maintaining normothermia in patients undergoing abdominal surgery under general anesthesia is accepted. Three effective economical and practically applicable warming methods are combined body wrapping and heating blanket; combined body wrapping, heated moist dressings, and heating blanket; combined body wrapping, heated moist dressings, and warmed surgical rinse fluid, with or without heating blanket. These methods are practically applicable when low-cost method is indeed needed.

Comparison of clinical practice education in dental hygiene schools in eight countries

DEFF Research Database (Denmark)

Inukai, Junko; Sakurai, Miwa; Nakagaki, Haruo

2012-01-01

OBJECTIVES: The profession of dental hygienist is one of the few in which the primary function of the practitioner is to prevent oral disease and to promote the well-being of patients. The aim of this study was to investigate clinical training conditions in schools of dental hygiene in eight coun...... are trained to perform local anaesthesia and to fill and extract deciduous teeth although the country does not have a specific qualification system. CONCLUSIONS: The contents of clinical training and education in schools of dental hygiene differ greatly among countries....... countries (the USA, Canada, the UK, Sweden, Denmark, Thailand, South Korea and Japan). METHODS: In 2006, we sent out a questionnaire in which we asked dental hygiene schools about how they educate dental hygiene students. RESULTS: The techniques taught to students in schools in Western industrialised...

Evaluation of the polymerase chain reaction in the diagnosis of cutaneous leishmaniasis due to Leishmania major: a comparison with direct microscopy of smears and sections from lesions

DEFF Research Database (Denmark)

Andresen, K; Gaafar, A; El-Hassan, A M

1996-01-01

We have compared the sensitivity of the polymerase chain reaction (PCR) as a diagnostic tool against conventional microscopical diagnostic techniques in patients with cutaneous leishmaniasis from the Sudan. Twenty-eight patients were diagnosed according to clinical criteria followed by microscopi......We have compared the sensitivity of the polymerase chain reaction (PCR) as a diagnostic tool against conventional microscopical diagnostic techniques in patients with cutaneous leishmaniasis from the Sudan. Twenty-eight patients were diagnosed according to clinical criteria followed......%, respectively. The PCR should be considered as a valuable and sensitive diagnostic tool in the diagnosis of cutaneous leishmaniasis; it has the added advantage of identification of the species of Leishmania causing the lesion....

Intraperitoneal fluid collection after laparoscopic appendectomy. Sonographic analysis in asymptomatic patients.

Science.gov (United States)

Sales, J P; Adrien, C; Blery, M; Gayral, F

1995-07-01

The aim of this prospective study was to evaluate the frequency of postoperative fluid collection after laparoscopic appendectomy in patients with normal postoperative development. Twenty-eight patients were included. The surgical technique, histological data, and postoperative development during the first postoperative month were recorded. A sonographic analysis was performed on the 5th postoperative day by a radiologist who was not aware of the histological and surgical data. Ten cases of fluid collection were found (37%). The frequency was higher in cases of suppurated appendicitis and significantly higher with associated periappendicitis. Peritoneal irrigation or retrocecal dissection did not influence the occurrence of fluid collection. Postoperative serous fluid collection occurs with a high frequency after laparoscopic appendectomies, and one must be careful in interpreting sonographic analyses in looking for deep abscesses in patients with difficult postoperative development.

The impact of an oral hygiene education module on patient practices and nursing documentation.

Science.gov (United States)

Coke, Lola; Otten, Karine; Staffileno, Beth; Minarich, Laura; Nowiszewski, Candice

2015-02-01

Oral hygiene is inconsistent among patients with cancer and is a national patient care issue. To promote comfort and nutritional status, oral hygiene for patients with cancer is important. The purpose of this study was to develop an evidence-based oral hygiene educational module (EM) for nursing and patient care technician (PCT) staff to promote consistent oral hygiene patient education; evaluate patient understanding of oral hygiene practices post-EM; and determine staff documentation frequency of oral hygiene care. Pre- and post-EM data were collected using a developed oral hygiene assessment tool; nursing documentation data were collected by chart review. Post-EM data were collected eight weeks post-EM. Data were analyzed using frequencies and the Mann-Whitney U test. Twenty-two patient documentation pairs were collected. Compared to pre-EM, admission teaching, patient education, and patient oral hygiene practices improved post-EM. Post-EM oral hygiene documentation and PCT teaching increased.

Image diagnosis of parathyroid glands in patients with secondary hyperparathyroidism

International Nuclear Information System (INIS)

Kuriyama, Keiko; Kozuka, Takahiro; Morimoto, Shizuo; Ikezoe, Junpei; Arisawa, Jun; Akira, Masanori; Koide, Takuo; Oka, Toshitsugu; Sone, Shusuke.

1986-01-01

Ultrasonography (US) and computed tomography (CT) of the neck were performed in 12 patients with chronic renal failure and secondary hyperparathyroidism. Twenty-eight of 44 excised parathyroid glands were visualized by US preoperatively (64 %). By CT, 20 parathyroid glands were detected (45 %). US was superior to CT for demonstrating parathyroid glands weighing between 500 and 1500 mg. There was no difference between US and CT for demonstrating parathyroid glands weighing more than 1500 mg and less than 500 mg. For definite diagnosis of secondary hyperparathyroidism and preoperative localization, US is modality of choice initially, and then CT can be employed to search for mediastinal parathyroid gland. (author)

Impact of Different Obesity Assessment Methods after Acute Coronary Syndromes

Energy Technology Data Exchange (ETDEWEB)

Nunes, Caroline N. M.; Minicucci, Marcos F.; Farah, Elaine; Fusco, Daniéliso; Azevedo, Paula S.; Paiva, Sergio A. R.; Zornoff, Leonardo A. M., E-mail: lzornoff@cardiol.br [Faculdade de Medicina de Botucatu, Botucatu, SP (Brazil)

2014-07-15

Abdominal obesity is an important cardiovascular risk factor. Therefore, identifying the best method for measuring waist circumference (WC) is a priority. To evaluate the eight methods of measuring WC in patients with acute coronary syndrome (ACS) as a predictor of cardiovascular complications during hospitalization. Prospective study of patients with ACS. The measurement of WC was performed by eight known methods: midpoint between the last rib and the iliac crest (1), point of minimum circumference (2); immediately above the iliac crest (3), umbilicus (4), one inch above the umbilicus (5), one centimeter above the umbilicus (6), smallest rib and (7) the point of greatest circumference around the waist (8). Complications included: angina, arrhythmia, heart failure, cardiogenic shock, hypotension, pericarditis and death. Logistic regression tests were used for predictive factors. A total of 55 patients were evaluated. During the hospitalization period, which corresponded on average to seven days, 37 (67%) patients had complications, with the exception of death, which was not observed in any of the cases. Of these complications, the only one that was associated with WC was angina, and with every cm of WC increase, the risk for angina increased from 7.5 to 9.9%, depending on the measurement site. It is noteworthy the fact that there was no difference between the different methods of measuring WC as a predictor of angina. The eight methods of measuring WC are also predictors of recurrent angina after acute coronary syndromes.

Impact of Different Obesity Assessment Methods after Acute Coronary Syndromes

International Nuclear Information System (INIS)

Nunes, Caroline N. M.; Minicucci, Marcos F.; Farah, Elaine; Fusco, Daniéliso; Azevedo, Paula S.; Paiva, Sergio A. R.; Zornoff, Leonardo A. M.

2014-01-01

Abdominal obesity is an important cardiovascular risk factor. Therefore, identifying the best method for measuring waist circumference (WC) is a priority. To evaluate the eight methods of measuring WC in patients with acute coronary syndrome (ACS) as a predictor of cardiovascular complications during hospitalization. Prospective study of patients with ACS. The measurement of WC was performed by eight known methods: midpoint between the last rib and the iliac crest (1), point of minimum circumference (2); immediately above the iliac crest (3), umbilicus (4), one inch above the umbilicus (5), one centimeter above the umbilicus (6), smallest rib and (7) the point of greatest circumference around the waist (8). Complications included: angina, arrhythmia, heart failure, cardiogenic shock, hypotension, pericarditis and death. Logistic regression tests were used for predictive factors. A total of 55 patients were evaluated. During the hospitalization period, which corresponded on average to seven days, 37 (67%) patients had complications, with the exception of death, which was not observed in any of the cases. Of these complications, the only one that was associated with WC was angina, and with every cm of WC increase, the risk for angina increased from 7.5 to 9.9%, depending on the measurement site. It is noteworthy the fact that there was no difference between the different methods of measuring WC as a predictor of angina. The eight methods of measuring WC are also predictors of recurrent angina after acute coronary syndromes

Radiation-induced sarcoma following radiotherapy for breast cancer: report of eight cases and review of the literature

International Nuclear Information System (INIS)

Kirova, Y.M.; Feuilhade, F.; Calitchi, E.; Otmezguine, Y.; Belembaogo, E.; Le Bourgeois, J.P.

1998-01-01

Retrospective analysis of eight new cases of radiation-induced sarcomas following radiotherapy for breast carcinoma and literature review. Eleven patients presenting with radiation-induced sarcoma after radiotherapy for breast cancer have been treated between 1983 and 1997 at Henri Mondor University Hospital (France). Eight of these patients respected the criteria established by Cahan et al. The others had Stewart-Treves Syndrome and were thus excluded from the analysis. Only one of the eight patients had received chemotherapy. All of the patients at the time of diagnosis of radiation-induced sarcoma were free of breast cancer recurrence. Radiation-induced sarcoma appeared with a latency period of 5 to 18 years (mean: 10.3 years). Patients' ages ranged from 39 to 88 years (mean: 57.6 years) at the time of diagnosis of sarcoma. Three sarcomas occurred in the treated breast, two in the chest wall, one in the pre-clavicular area and two in the axillary region. There were two angiosarcomas, three fibrosarcomas, one osteosarcoma, one malignant fibrous histiocytoma (MFH), and one undifferentiated sarcoma. All patients have received treatment for their sarcoma: all of them underwent surgery, one patient combined radiotherapy and chemotherapy, and three patients chemotherapy. Two patients were alive and free from disease. Six patients died (5-34 months); all six had local and/or metastatic recurrence. Radiotherapy can induce malignancies after a latent period of several years. Radiation-induced sarcomas are associated with poor overall prognosis. The treatment in most of the cases is late and ineffective, therefore careful follow-up is needed. There are still many uncertainties and questions about radiation-induced sarcomas. (authors)

Twenty-four-week effects of liraglutide on body composition, adherence to appetite, and lipid profile in overweight and obese patients with type 2 diabetes mellitus

Directory of Open Access Journals (Sweden)

Rondanelli M

2016-03-01

Full Text Available Mariangela Rondanelli,1 Simone Perna,1 Paolo Astrone,2 Annalisa Grugnetti,2 Sebastiano Bruno Solerte,2 Davide Guido3,4 1Endocrinology and Nutrition Unit, Section of Human Nutrition, Department of Public Health, Experimental and Forensic Medicine, Agency for Elderly People Services, Santa Margherita Hospital, University of Pavia, Pavia, Italy; 2Section of Geriatrics and Gerontology, Department of Internal Medicine, Agency for Elderly People Services, Santa Margherita Hospital, University of Pavia, Pavia, Italy; 3Medical and Genomics Statistics Unit, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; 4Biostatistics and Clinical Epidemiology Unit, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy Background: Liraglutide has well-known effects on glucose patterns. However, its several other metabolic properties are still controversial. Given this background, the aims of the present study are to evaluate the effects of 24-week liraglutide treatment on body composition, appetite, and lipid profile in overweight and obese type 2 diabetes mellitus (T2DM patients. Methods: A cohort study was carried out on overweight and obese T2DM patients with glycosylated hemoglobin A1c equal to 6% (42 mmol/mol-10% (86 mmol/mol, under a 3-month treatment (at least with maximal dose of metformin as stable regime, by adding liraglutide at doses up to 3 mg/d. Body composition markers were measured by dual-energy X-ray densitometry at baseline and after 24 weeks of liraglutide treatment. Glucose control was monitored by glucose, glycosylated hemoglobin A1c, insulin, and homeostasis model assessment. Finally, the appetite sensation and plasma lipids were also evaluated. Results: Twenty-eight subjects (male/female: 16/12, mean age: 58.75±9.33 years, body mass index: 34.13±5.46 kg/m2 were evaluated. Accounting for the adjustment for age, sex, and duration of diabetes, we noted significant

Advanced soft computing diagnosis method for tumour grading.

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Papageorgiou, E I; Spyridonos, P P; Stylios, C D; Ravazoula, P; Groumpos, P P; Nikiforidis, G N

2006-01-01

To develop an advanced diagnostic method for urinary bladder tumour grading. A novel soft computing modelling methodology based on the augmentation of fuzzy cognitive maps (FCMs) with the unsupervised active Hebbian learning (AHL) algorithm is applied. One hundred and twenty-eight cases of urinary bladder cancer were retrieved from the archives of the Department of Histopathology, University Hospital of Patras, Greece. All tumours had been characterized according to the classical World Health Organization (WHO) grading system. To design the FCM model for tumour grading, three experts histopathologists defined the main histopathological features (concepts) and their impact on grade characterization. The resulted FCM model consisted of nine concepts. Eight concepts represented the main histopathological features for tumour grading. The ninth concept represented the tumour grade. To increase the classification ability of the FCM model, the AHL algorithm was applied to adjust the weights of the FCM. The proposed FCM grading model achieved a classification accuracy of 72.5%, 74.42% and 95.55% for tumours of grades I, II and III, respectively. An advanced computerized method to support tumour grade diagnosis decision was proposed and developed. The novelty of the method is based on employing the soft computing method of FCMs to represent specialized knowledge on histopathology and on augmenting FCMs ability using an unsupervised learning algorithm, the AHL. The proposed method performs with reasonably high accuracy compared to other existing methods and at the same time meets the physicians' requirements for transparency and explicability.

Molecular epidemiology of MRSA in 13 ICUs from eight European countries.

Science.gov (United States)

Hetem, D J; Derde, L P G; Empel, J; Mroczkowska, A; Orczykowska-Kotyna, M; Kozińska, A; Hryniewicz, W; Goossens, H; Bonten, M J M

2016-01-01

The European epidemiology of MRSA is changing with the emergence of community-associated MRSA (CA-MRSA) and livestock-associated MRSA (LA-MRSA). In this study, we investigated the molecular epidemiology of MRSA during 2 years in 13 ICUs in France, Greece, Italy, Latvia, Luxemburg, Portugal, Slovenia and Spain. Surveillance cultures for MRSA from nose and wounds were obtained on admission and twice weekly from all patients admitted to an ICU for ≥3 days. The first MRSA isolate per patient was genotyped in a central laboratory by MLST, spa typing, agr typing and SCCmec (sub)typing. Risk factors for patients with an unknown history of MRSA colonization were identified. Overall, 14 390 ICU patients were screened, of whom 8519 stayed in an ICU for ≥3 days. Overall MRSA admission prevalence was 3.9% and ranged from 1.0% to 7.0% for individual ICUs. Overall MRSA acquisition rate was 2.5/1000 patient days at risk and ranged from 0.2 to 8/1000 patient days at risk per ICU. In total, 557 putative MRSA isolates were submitted to the central laboratory for typing, of which 511 (92%) were confirmed as MRSA. Each country had a distinct epidemiology, with ST8-IVc (UK-EMRSA-2/-6, USA500) being most prevalent, especially in France and Spain, and detected in ICUs in five of eight countries. Seventeen (3%) and three (70 years and hospitalization within 1 year prior to ICU admission. The molecular epidemiology of MRSA in 13 European ICUs in eight countries was homogeneous within, but heterogeneous between, countries. CA-MRSA and LA-MRSA genotypes and Panton-Valentine leucocidin-producing isolates were detected sporadically. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Psychological distress screening in cancer patients: psychometric properties of tools available in Italy.

Science.gov (United States)

Muzzatti, Barbara; Annunziata, Maria Antonietta

2012-01-01

The main national and international organisms recommend continuous monitoring of psychological distress in cancer patients throughout the disease trajectory. The reasons for this concern are the high prevalence of psychological distress in cancer patients and its association with a worse quality of life, poor adherence to treatment, and stronger assistance needs. Most screening tools for psychological distress were developed in English-speaking countries. To be fit for use in different cultural contexts (like the Italian), they need to undergo accurate translation and specific validation. In the present work we summarized the validation studies for psychological distress screening tools available in Italian that are most widely employed internationally, with the aim of helping clinicians choose the adequate instrument. With knowledge of the properties of the corresponding Italian versions, researchers would be better able to identify the instruments that deserve further investigation. We carried out a systematic review of the literature. Results. Twenty-nine studies of eight different instruments (five relating to psychological distress, three to its depressive component) were identified. Ten of these studies involved cancer patients and 19 referred to the general population or to non-cancer, non-psychiatric subjects. For seven of the eight tools, data on concurrent and discriminant validity were available. For five instruments data on criterion validity were available, for four there were data on construct validity, and for one tool divergent and cross-cultural validity data were provided. For six of the eight tools the literature provided data on reliability (mostly about internal consistency). Since none of the eight instruments for which we found validation studies relative to the Italian context had undergone a complete and organic validation process, their use in the clinical context must be cautious. Italian researchers should be proactive and make a valid

Prediction of 5-year overall survival in cervical cancer patients treated with radical hysterectomy using computational intelligence methods.

Science.gov (United States)

Obrzut, Bogdan; Kusy, Maciej; Semczuk, Andrzej; Obrzut, Marzanna; Kluska, Jacek

2017-12-12

Computational intelligence methods, including non-linear classification algorithms, can be used in medical research and practice as a decision making tool. This study aimed to evaluate the usefulness of artificial intelligence models for 5-year overall survival prediction in patients with cervical cancer treated by radical hysterectomy. The data set was collected from 102 patients with cervical cancer FIGO stage IA2-IIB, that underwent primary surgical treatment. Twenty-three demographic, tumor-related parameters and selected perioperative data of each patient were collected. The simulations involved six computational intelligence methods: the probabilistic neural network (PNN), multilayer perceptron network, gene expression programming classifier, support vector machines algorithm, radial basis function neural network and k-Means algorithm. The prediction ability of the models was determined based on the accuracy, sensitivity, specificity, as well as the area under the receiver operating characteristic curve. The results of the computational intelligence methods were compared with the results of linear regression analysis as a reference model. The best results were obtained by the PNN model. This neural network provided very high prediction ability with an accuracy of 0.892 and sensitivity of 0.975. The area under the receiver operating characteristics curve of PNN was also high, 0.818. The outcomes obtained by other classifiers were markedly worse. The PNN model is an effective tool for predicting 5-year overall survival in cervical cancer patients treated with radical hysterectomy.

Assessment of myocardial viability in patients with myocardial infarction using twenty-four hour thallium-201 late redistribution imaging

International Nuclear Information System (INIS)

Yang Xiangjun; He Yongming; Zhang Bin; Wu Yiwei; Hui Jie; Jiang Tingbo; Song Jianping; Liu Zhihua; Jiang Wenping

2006-01-01

Rest thallium-201 ( 201 Tl) myocardial perfusion imaging has been widely used for evaluation of myocardial ischemia/viability after myocardial infarction, but the ideal timing for imaging after injection to maximally estimate viability is not well established. Thirty-six patients with myocardial infarction underwent the initial, 3 h, and 24 h redistribution imaging after intravenous injection of 148-185 MBq 201 Tl. The initial and 3 h images, the initial and 24 h images, and the 3 and 24 h images were compared double-blinded. Out of the 184 abnormal segments based on the initial imaging, 56 (30%) segments improved by at least 1 grade on the 3 h imaging while 78 (42%) segments improved by at least 1 grade on the 24 h imaging. The 24 h late imaging detected more viable myocardium than the 3 h imaging did, with a significant difference (χ 2 =5.680, p=0.017). There were 158 abnormal segments on the 3 h imaging, with average 28% (44) segments improved by at least 1 grade on the 24 h imaging. There were 128 initial abnormal segments with no improvement on the 3 h imaging. Out of these segments, the 24 h late redistribution imaging detected additional redistribution in 26 segments, taking up 20%. Twenty-four hour late 201 Tl imaging will demonstrated additional redistribution in patients who have incompletely reversible defects on early redistribution imaging at 3 h. (author)

Weight and height prediction of immobilized patients

OpenAIRE

Rabito,Estela Iraci; Vannucchi,Gabriela Bergamini; Suen,Vivian Marques Miguel; Castilho Neto,Laércio Lopes; Marchini,Júlio Sérgio

2006-01-01

OBJECTIVE: To confirm the adequacy of the formula suggested in the literature and/or to develop appropriate equations for the Brazilian population of immobilized patients based on simple anthropometric measurements. METHODS: Hospitalized patients were submitted to anthropometry and methods to estimate weight and height of bedridden patients were developed by multiple linear regression. RESULTS: Three hundred sixty eight persons were evaluated at two hospital centers and five weight-predicting...

Heart rhythm at the time of death documented by an implantable loop recorder

DEFF Research Database (Denmark)

Gang, Uffe Jakob Ortved; Jøns, Christian; Jørgensen, Rikke Mørch

2009-01-01

Aims The aims of this study were to describe arrhythmias documented with an implantable loop recorder (ILR) in post-acute myocardial infarction (AMI) patients with left ventricular dysfunction at the time of death and to establish the correlation to mode of death. Methods and results Post......-mortem ILR device interrogations were analysed from patients dying in the CARISMA study. Mode of death was classified by a modified CAST classification. Twenty-six patients died with an implanted ILR. Of these, 16 had an electrocardiogram recorded at the time of death. Ventricular tachycardia (VT......)/ventricular fibrillation (VF) was terminal rhythm in eight patients and bradyarrhythmias were observed in another eight patients. Of the deaths with peri-mortem recordings, seven were classified as sudden cardiac death (SCD). In six of these, VF was documented at the time of death. Six monitored deaths were classified...

Clinical course teaching in transport of critically ill patients: Small group methods

Directory of Open Access Journals (Sweden)

Mohammad Taghi Beigmohammadi

2016-10-01

Full Text Available Critically ill patient transfer is potentially risky and may be lead to morbidity and mortality. Physicians' skill is very important for safe transport. We want to evaluate the effect of clinical course teaching on the promotion of physicians' abilities in the transport of critically ill patients. In an interventional study, 320 interns, male and female, were taught about patient transfer in two groups include in one day clinical course as the small group system (n=160 and other group the lecture base learning (n=160. In the clinical course, each participant under observation of an anesthesiologist in the operation room and ICU was acquainted with mask ventilation, intubation and learned to work with a defibrillator, infusion pump, portable ventilator and pulse oximeter. In lecture group, the anesthesiologist explained the topics by video and dummy. At the end of education course, the interns’ abilities were evaluated based on checklist method and scored by the project colleague in all educational items. Three hundred twenty interns, 122 males, and 198 females; were enrolled, two groups. The clinical course training caused improvements in the interns’ knowledge and abilities in intubation and use of the defibrillator and portable ventilator vs.lecture group significantly (P<0.005. The males were better than females in laryngoscopy, but the progress of the females was significantly better than males (P=0.003. The rate of adverse events was reduced significantly after clinical course teaching (P=0.041 Clinical course teaching could promote interns' clinical competencies in the transport of critically ill patients.

Tenodesis of the long head of the biceps brachii for chronic bicipital tendinitis. Long-term results.

Science.gov (United States)

Becker, D A; Cofield, R H

1989-03-01

Fifty-four shoulders in fifty-one patients were followed for an average of thirteen years (range, two to twenty-three years) after surgical tenodesis of the long head of the biceps brachii for the treatment of chronic tendinitis. At an average of six months postoperatively, in all but three shoulders (forty-eight patients) some benefit was evident. However, after a longer follow-up, a satisfactory result was achieved in only twenty-eight shoulders (approximately 50 per cent). About one-third of the shoulders continued to be pain-free, and in eight shoulders (15 per cent) an additional operation was performed. Tenodesis of the long head of the biceps tendon, therefore, was not an effective treatment for tendinitis over the long term.

Twenty-Nail Transverse Melanonychia Induced by Hydroxyurea: Case Report and Review of the Literature.

Science.gov (United States)

Osemwota, Osamuede; Uhlemann, John; Rubin, Adam

2017-08-01

Twenty-nail transverse melanonychia from hydroxyurea is a rare phenomenon, only reported four times previously. Here we describe a 51-year-old female who presented with 20-nail transverse melanonychia 3 months after initiating hydroxyurea therapy. Transverse melanonychia is a benign process but can cause patients significant distress, and thus is an entity with which dermatologists should recognize. We then review the cutaneous manifestations, differential diagnosis, and clinical considerations when evaluating patients with transverse melanonychia from hydroxyurea or other causes. J Drugs Dermatol. 2017;16(8):814-815..

Overexpression of CFH gene in pterygiumv patients

African Journals Online (AJOL)

Purpose: To investigate the expression of complement factors in pterygium tissues compared to normal conjunctival samples, using next-generation RNA sequencing. Methods: Twenty pterygium and 20 healthy conjunctival samples were obtained from 19 patients who consented to pterygium excision and conjunctival ...

Eight equation model for arbitrary shaped pipe conveying fluid

International Nuclear Information System (INIS)

Gale, J.; Tiselj, I.

2006-01-01

Linear eight-equation system for two-way coupling of single-phase fluid transient and arbitrary shaped one-dimensional pipeline movement is described and discussed. The governing phenomenon described with this system is also known as Fluid-Structure Interaction. Standard Skalak's four-equation model for axial coupling was improved with additional four Timoshenko's beam equations for description of flexural displacements and rotations. In addition to the conventional eight-equation system that enables coupling of straight sections, the applied mathematical model was improved for description of the arbitrary shaped pipeline located in two-dimensional plane. The applied model was solved with second-order accurate numerical method that is based on Godounov's characteristic upwind schemes. The model was successfully used for simulation of the rod impact induced transient and conventional instantaneous valve closure induced transient in the tank-pipe-valve system. (author)

Reconstruction of the maxillary midline papilla following a combined orthodontic-periodontic treatment in adult periodontal patients.

Science.gov (United States)

Cardaropoli, Daniele; Re, Stefania; Corrente, Giuseppe; Abundo, Roberto

2004-02-01

The aim of the present study was to evaluate the role of a combined orthodontic-periodontic treatment in determining the reconstruction of midline papilla lost following periodontitis. Twenty-eight patients, with infrabony defect and extrusion of one maxillary central incisor, were treated. At baseline, all patients presented opening of the interdental diastema and loss of the papilla. At 7-10 days after open-flap surgery, the intrusive movement started. For each patient, probing pocket depth (PPD), clinical attachment level (CAL) and papilla presence index (PI) were assessed at baseline, end of treatment and after 1 year. PI was also evaluated independently in patients with narrow or wide periodontal biotype (NPB-WPB). All parameters showed statistical improvement between the initial and final measurements, and showed no changes at follow-up time. The mean residual PPD was 2.50 mm, with a decrease of 4.29 mm, while the mean CAL gain was 5.93 mm. Twenty-three out of 28 patients improved the PI score at the end of therapy. No statistical difference was recorded in PI values between groups NPB and WPB. The presented clinical protocol resulted in the improvement of all parameters examined. At the end of orthodontic treatment, a predictable reconstruction of the interdental papilla was reported, both in patients with thin or wide gingiva. Copyright Blackwell Munksgaard, 2004.

A study on the evaluation of pneumothorax by imaging methods in patients presenting to the emergency department for blunt thoracic trauma.

Science.gov (United States)

Kaya, Şeyhmus; Çevik, Arif Alper; Acar, Nurdan; Döner, Egemen; Sivrikoz, Cumhur; Özkan, Ragıp

2015-09-01

Pneumothorax (PNX) is the collection of air between parietal and visceral pleura, and collapsed lung develops as a complication of the trapped air. PNX is likely to develop spontaneously in people with risk factors. However, it is mostly seen with blunt or penetrating trauma. Diagnosis is generally confirmed by chest radiography [posteroanterior chest radiography (PACR)]. Chest ultrasound (US) is also a promising technique for the detection of PNX in trauma patients. There is not much literature on the evaluation of blunt thoracic trauma (BTT) and pneumothorax (PNX) in the emergency department (ED). The aim of this study was to investigate the effectiveness of chest US for the diagnosis of PNX in patients presenting to ED with BTT. This study was carried out for a period of nine months in the ED of a university hospital. The chest US of patients was performed by emergency physicians trained in the field. The results were compared with anteroposterior chest radiography and/or CT scan of the chest. The APCR and chest CT results were evaluated by a radiology specialist blind to US findings. The evaluation of the radiology specialist was taken as the gold standard for diagnosis by imaging methods. Clinical follow-up was taken into consideration for the diagnosis of PNX in patients on whom CT scan was not performed. Chest US was performed on all two hundred and twelve patients (144 female and 68 male patients; mean age 45.8) who participated in this study. The supine APCR was performed on two hundred and ten (99%) patients and chest CT was performed on one hundred and twenty (56.6%). Out of the twenty-five (11.8%) diagnosed cases of PNX, 22 (88%) were diagnosed by chest US and 8 were diagnosed by APCR. For the detection of PNX, compared to clinical follow-up and chest CT, the sensitivity of chest US was 88%, specificity 99.5%, positive predictive value 95.7% and negative predictive value 98.4%. Chest US has not superseded supine and standing chest radiography for PNX

Operative treatment of radiation-induced fistulae

International Nuclear Information System (INIS)

Balslev, I.; Harling, H.

1987-01-01

Out of 136 patients with radiation-induced intestinal complications, 45 had fistulae. Twenty-eight patients had rectovaginal fistulae while the remainder had a total of 13 different types of fistulae. Thirty-seven patients were treated operatively and eight were treated conservatively. Thirty-three patients were submitted to operation for rectal fistulae. Of these, 28 were treated by defunctioning colostomy, three were treated by Hartmann's method and resection and primary anastomosis was carried out in two patients. In the course of the period of observation, 35% of the patients developed new radiation damage. The frequency in the basic material without fistulae was 21% (0.05< p<0.10). Following establishment of defunctioning colostomy on account of rectovaginal fistulae in 25 patients, eight patients developed new fistulae, Significantly more patients with fistulae died of recurrence as compared with patients with other lesions (p<0.01). Defunctioning colostomy in the treatment of rectal fistula is a reasonable form of treatment in elderly patients and in case of recurrence. Younger patients should be assessed in a special department in view of the possibility of a sphincter-preserving procedure following resection of the rectum and restorative anastomosis. (author)

Operative treatment of radiation-induced fistulae

Energy Technology Data Exchange (ETDEWEB)

Balslev, I.; Harling, H.

1987-01-01

Out of 136 patients with radiation-induced intestinal complications, 45 had fistulae. Twenty-eight patients had rectovaginal fistulae while the remainder had a total of 13 different types of fistulae. Thirty-seven patients were treated operatively and eight were treated conservatively. Thirty-three patients were submitted to operation for rectal fistulae. Of these, 28 were treated by defunctioning colostomy, three were treated by Hartmann's method and resection and primary anastomosis was carried out in two patients. In the course of the period of observation, 35% of the patients developed new radiation damage. The frequency in the basic material without fistulae was 21% (0.05patients, eight patients developed new fistulae, Significantly more patients with fistulae died of recurrence as compared with patients with other lesions (p<0.01). Defunctioning colostomy in the treatment of rectal fistula is a reasonable form of treatment in elderly patients and in case of recurrence. Younger patients should be assessed in a special department in view of the possibility of a sphincter-preserving procedure following resection of the rectum and restorative anastomosis. 11 refs.

Visual Literacy: Does It Enhance Leadership Abilities Required for the Twenty-First Century?

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Bintz, Carol

2016-01-01

The twenty-first century hosts a well-established global economy, where leaders are required to have increasingly complex skills that include creativity, innovation, vision, relatability, critical thinking and well-honed communications methods. The experience gained by learning to be visually literate includes the ability to see, observe, analyze,…

Glycemic control paradox: Poor glycemic control associated with higher one-year and eight-year risks of all-cause hospitalization but lower one-year risk of hypoglycemia in patients with type 2 diabetes.

Science.gov (United States)

Li, Tsai-Chung; Kardia, Sharon L R; Li, Chia-Ing; Chen, Ching-Chu; Liu, Chiu-Shong; Yang, Sing-Yu; Muo, Chin-Shin; Peyser, Patricia A; Lin, Cheng-Chieh

2015-09-01

The relationship between glycemic control and adverse outcomes found in a population with diabetes has seldom been evaluated in patients with type 2 diabetes. We explored the association between hemoglobin A1c (HbA1c) and hospitalization risks within one-year and eight-year follow-up periods. We conducted a retrospective cohort study on 57,061 patients with type 2 diabetes from National Diabetes Case Management Program during 2002-2004 in Taiwan. HbA1c at baseline and in-hospital mortality, all-cause and cause-specific hospitalization over one year and eight years were analyzed. After multivariate adjustment, one-year risk was higher for cases with HbA1c level risk of hypoglycemia hospitalization (0.81, 95% CI: 0.74-0.88). For eight-year risk, subjects with HbA1c level risks of all-cause and diabetes-related hospitalization (1.04, 1.03-1.05, and 1.15, 1.14-1.17, respectively). Higher HbA1c level correlated with lower one-year risk due to hypoglycemia hospitalization but increased one-year and eight-year risks due to all-cause and diabetes-specific hospitalization among Chinese people with type 2 diabetes in Taiwan. Future study must ascertain how to meet HbA1c targets and improve outcome without risk to this population. Copyright © 2015 Elsevier Inc. All rights reserved.

Combined milrinone and enteral metoprolol therapy in patients with septic myocardial depression

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Schmittinger, Christian A; Dünser, Martin W; Haller, Maria; Ulmer, Hanno; Luckner, Günter; Torgersen, Christian; Jochberger, Stefan; Hasibeder, Walter R

2008-01-01

Introduction The multifactorial etiology of septic cardiomyopathy is not fully elucidated. Recently, high catecholamine levels have been suggested to contribute to impaired myocardial function. Methods This retrospective analysis summarizes our preliminary clinical experience with the combined use of milrinone and enteral metoprolol therapy in 40 patients with septic shock and cardiac depression. Patients with other causes of shock or cardiac failure, patients with beta-blocker therapy initiated more than 48 hours after shock onset, and patients with pre-existent decompensated congestive heart failure were excluded. In all study patients, beta blockers were initiated only after stabilization of cardiovascular function (17.7 ± 15.5 hours after shock onset or intensive care unit admission) in order to decrease the heart rate to less than 95 beats per minute (bpm). Hemodynamic data and laboratory parameters were extracted from medical charts and documented before and 6, 12, 24, 48, 72, and 96 hours after the first metoprolol dosage. Adverse cardiovascular events were documented. Descriptive statistical methods and a linear mixed-effects model were used for statistical analysis. Results Heart rate control (65 to 95 bpm) was achieved in 97.5% of patients (n = 39) within 12.2 ± 12.4 hours. Heart rate, central venous pressure, and norepinephrine, arginine vasopressin, and milrinone dosages decreased (all P milrinone dosages were increased in nine (22.5%) and six (15%) patients, respectively. pH increased (P < 0.001) whereas arterial lactate (P < 0.001), serum C-reactive protein (P = 0.001), and creatinine (P = 0.02) levels decreased during the observation period. Twenty-eight-day mortality was 33%. Conclusion Low doses of enteral metoprolol in combination with phosphodiesterase inhibitors are feasible in patients with septic shock and cardiac depression but no overt heart failure. Future prospective controlled trials on the use of beta blockers for septic cardiomyopathy

Primary pulmonary cryptococcosis: evaluation of CT characteristics in 26 immunocompetent Chinese patients

Energy Technology Data Exchange (ETDEWEB)

Qu, Yanjuan; Liu, Guobing; Ghimire, Prasanna; Liao, Meiyan; Xu, Liying [Dept. of Radiology, Zhongnan Hospital of Wuhan Univ., Wuhan (China)], E-mail: leometeor123@gmail.com; Shi, Heshui [Dept. of Radiology, Union Hospital affiliated to Tongji Medical College of Huazhong Univ. of Science and Technology, Wuhan (China); Yang, Guifang [Dept. of Pathology, Zhongnan Hospital of Wuhan Univ., Wuhan (China); Wang, Guanliang [Dept. of Radiology, Taizhou Hospital of Zhejiang Province, Taizhou (China)

2012-07-15

Background. Discrepancies still exist in the diagnosis of primary pulmonary cryptococcosis in immunocompetent patients. Purpose. To describe and evaluate radiological manifestations of pulmonary cryptococcosis in immunocompetent patients. Material and Methods. Twenty-six histopathologically confirmed cases of pulmonary cryptococcosis were analyzed for clinical, pathological, and CT characteristics. Necessary statistical tests for differences in CT presentations and correlation analysis between clinical and CT characteristics were performed. Results. The patients' ages ranged from 24 to 79 years, with 20 men and six women. Eighteen patients were symptomatic, with cough as the most common symptom (n = 14, 53.8%). Nodules (n = 21, 80.8%) were the most common CT findings. Eight cases presented with solitary and nine with multiple nodules, while 13 cases presented with irregular and 19 with ill-defined nodules. The halo sign was demonstrated, encompassing nodules in 14 of the 21 patients. Lesions were mainly localized in the lower lobes of the lungs (n = 15, 57.7%) with peripheral distribution (n = 18, 69.2%). Ground-glass opacities (GGOs) were more easily detected in older patients (66.7%, P <0.01). No significant differences in CT abnormalities were found between male and female patients. Conclusion. Primary pulmonary cryptococcosis in immunocompetent patients exhibits certain CT characteristics. The typical presentation includes multiple nodules with the halo sign scattered in the peripheral field in the lower lobes of the bilateral lungs. This could contribute to diagnosis of the disease entity. However, vigilance should be exercised when facing GGOs, with or without nodules, in older patients.

Anismus in patients with normal and slow transit constipation.

Science.gov (United States)

Miller, R; Duthie, G S; Bartolo, D C; Roe, A M; Locke-Edmunds, J; Mortensen, N J

1991-06-01

This study examined differences in anorectal function, with particular reference to anismus, which might explain why some patients with intractable constipation have slow and others have normal whole gut transit times. Twenty-four patients were studied; 13 with slow transit (all female, median age 32 years, range 16-52 years) and 11 with normal transit (eight women, three men, median age 37 years, range 21-60 years). Videoproctography with synchronous sphincteric electromyography and anorectal manometry was performed. There were no differences between the two groups, suggesting that slow transit constipation is not secondary to any abnormality in anorectal function and may therefore be a primary disorder of colonic motility. There was no correlation between electromyographic evidence of anismus (pelvic floor contraction on defaecation) and the ability of the patient to evacute the rectum or symptoms of obstructed defaecation. Electromyography findings alone can be misleading and should be related to proctographic evidence of incomplete rectal evacuation before functional anismus can be said to be present.

Twenty-eight years of wilderness campsite monitoring in Yosemite National Park

Science.gov (United States)

Laurel Boyers; Mark Fincher; Jan van Wagtendonk

2000-01-01

The research, resource management and wilderness staffs in Yosemite National Park recently completed the third 10-year cycle of a wilderness campsite impact monitoring program. Initial results indicate an overall improvement in conditions due to a strong restoration program, decreased use and increased visitor education. Lessons learned point to the necessity for ample...

Patients with advanced and metastatic renal cell carcinoma treated with targeted therapy in the Czech Republic: twenty cancer centres, six agents, one database.

Science.gov (United States)

Poprach, Alexandr; Bortlíček, Zbyněk; Büchler, Tomáš; Melichar, Bohuslav; Lakomý, Radek; Vyzula, Rostislav; Brabec, Petr; Svoboda, Marek; Dušek, Ladislav; Gregor, Jakub

2012-12-01

The incidence and mortality of renal cell carcinoma (RCC) in the Czech Republic are among the highest in the world. Several targeted agents have been recently approved for the treatment of advanced/metastatic RCC. Presentation of a national clinical database for monitoring and assessment of patients with advanced/metastatic RCC treated with targeted therapy. The RenIS (RENal Information System, http://renis.registry.cz ) registry is a non-interventional post-registration database of epidemiological and clinical data of patients with RCC treated with targeted therapies in the Czech Republic. Twenty cancer centres eligible for targeted therapy administration participate in the project. As of November 2011, six agents were approved and reimbursed from public health insurance, including bevacizumab, everolimus, pazopanib, sorafenib, sunitinib, and temsirolimus. As of 10 October 2011, 1,541 patients with valid records were entered into the database. Comparison with population-based data from the Czech National Cancer Registry revealed that RCC patients treated with targeted therapy are significantly younger (median age at diagnosis 59 vs. 66 years). Most RenIS registry patients were treated with sorafenib and sunitinib, many patients sequentially with both agents. Over 10 % of patients were also treated with everolimus in the second or third line. Progression-free survival times achieved were comparable to phase III clinical trials. The RenIS registry has become an important tool and source of information for the management of cancer care and clinical practice, providing comprehensive data on monitoring and assessment of RCC targeted therapy on a national level.

Stability of medicines after repackaging into multicompartment compliance aids: eight criteria for detection of visual alteration.

Science.gov (United States)

Albert, Valerie; Lanz, Michael; Imanidis, Georgios; Hersberger, Kurt E; Arnet, Isabelle

2017-01-01

Multicompartment compliance aids (MCA) are widely used by patients. They support the management of medication and reduce unintentional nonadherence. MCA are filled with medicines unpacked from their original packaging. Swiss pharmacists currently provide MCA for 1-2 weeks, although little and controversial information exists on the stability of repackaged medicines. We aimed to validate the usefulness of a simple screening method capable of detecting visual stability problems with repackaged medicines. We selected eight criteria for solid formulations from The International Pharmacopoeia : (1) rough surface, (2) chipping, (3) cracking, (4) capping, (5) mottling, (6) discoloration, (7) swelling, and (8) crushing. A selection of 24 critical medicines was repackaged in three different MCA (Pharmis ® , SureMed™, and self-produced blister) and stored at room temperature for 4 weeks. Pharmis ® was additionally stored at accelerated conditions. Appearance was scored weekly. Six alterations (rough surface, cracking, mottling, discoloration, swelling, and crushing) were observed at accelerated conditions. No alteration was observed at room temperature, except for the chipping of tablets that had been stuck to cold seal glue. The eight criteria can detect alterations of the appearance of oral solid medicines repackaged in MCA. In the absence of specific guidelines, they can serve as a simple screening method in community pharmacies for identifying medicines unsuitable for repackaging.

Psychosocial functioning in patients with treatment-resistant depression after group cognitive behavioral therapy

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Kunisato Yoshihiko

2010-03-01

Full Text Available Abstract Background Although patients with Treatment Resistant Depression (TRD often have impaired social functioning, few studies have investigated the effectiveness of psychosocial treatment for these patients. We examined whether adding group cognitive behavioral therapy (group-CBT to medication would improve both the depressive symptoms and the social functioning of patient with mild TRD, and whether any improvements would be maintained over one year. Methods Forty-three patients with TRD were treated with 12 weekly sessions of group-CBT. Patients were assessed with the Global Assessment of Functioning scale (GAF, the 36-item Short-Form Health Survey (SF-36, the Hamilton Rating Scale for Depression (HRSD, the Dysfunctional Attitudes Scale (DAS, and the Automatic Thought Questionnaire-Revised (ATQ-R at baseline, at the termination of treatment, and at the 12-month follow-up. Results Thirty-eight patients completed treatment; five dropped out. For the patients who completed treatment, post-treatment scores on the GAF and SF-36 were significantly higher than baseline scores. Scores on the HRSD, DAS, and ATQ-R were significantly lower after the treatment. Thus patients improved on all measurements of psychosocial functioning and mood symptoms. Twenty patients participated in the 12-month follow-up. Their improvements for psychosocial functioning, depressive symptoms, and dysfunctional cognitions were sustained at 12 months following the completion of group-CBT. Conclusions These findings suggest a positive effect that the addition of cognitive behavioural group therapy to medication on depressive symptoms and social functioning of mildly depressed patients, showing treatment resistance.

Why do patients drop out during radiation therapy?

International Nuclear Information System (INIS)

Huh, Seung Jae; Ahn, Yong Chan; Kim, Dae Yong; Shin, Kyung Hwan; Lee, Kyu Chan; Chong, Won A; Kim, Hyun Joo; Wu, Hong Gyun

1998-01-01

This study is to see how much proportion of the patients receiving radiation therapy drop out during radiation therapy and to analyze the reason for the incomplete treatment. The base population of this study was 1,100 patients with registration numbers 901 through 2,000 at Department of Radiation Oncology, Samsung Medical Center, Seoul, Korea. Authors investigated the incidence of incomplete radiation therapy, which was defined as less than 95% of initially planned radiation dose, and the reasons for incomplete radiation therapy. One hundred and twenty eight patients (12%) did not complete the planned radiation therapy. The performance status of the incompletely treated patients was generally poorer than that of the base population, and the aim of radiation therapy was more commonly palliative. The most common reason for not completing the planned treatment was the patients' refusal of further radiation therapy because of the distrust of radiation therapy and/or the poor economic status. Careful case selection for radiation therapy with consideration of the socioeconomic status of the patients in addition to the clinical indication would be necessary for the reduction of incomplete treatment, especially in the palliative setting

Clinical Characteristics of Multiple Colorectal Adenoma Patients Without Germline APC or MYH Mutations

NARCIS (Netherlands)

Tieu, Alan H; Edelstein, Daniel; Axilbund, Jennifer; Romans, Katharine E; Brosens, Lodewijk; Wiley, Elizabeth; Hylind, Linda; Giardiello, Francis M

BACKGROUND: Patients with multiple colorectal adenomas (MCRA) without genetic cause are increasingly being diagnosed. The characteristics and natural history of this condition are not well studied. MATERIALS AND METHODS: Twenty-seven patients with MCRA, with cumulatively 10 to 99 colorectal adenomas

Neuro image in neuroectodermal disorders. Part III: angiomatous and melanotic syndromes

International Nuclear Information System (INIS)

Marti-Bonmati, L.; Menor, F.; Poyatos, C.; Cortina, H.; Esteban, M.J.; Vilar, J.

1994-01-01

Twenty-eight consecutive patients affected by these rare angiomatous melanotic neuroectodermal disorders are assessed. The diagnostics value and clinical correlation of neuroimaging methods, both CT and MR, are established. Patients with Sturge-Weber syndrome (15 cases), Klippel-Trenaunay syndrome (1 case), Rendu-Osler disease (3 cases), multiple hemangiomatosis (4 cases), von Hippel-Lindau syndrome (3 cases), neuro cutaneous melanosis (1 case) and hypo melanosis of Ito (1 case) are included. In vascular phacomatosis, neuroimaging methods usually contribute to the positive diagnosis. In melanotic disorders, the neuroradiological findings most often are unspecific and do not contribute to the diagnosis of the disease

Mental rotation evoked potentials P500 in patients with major depressive disorder

Institute of Scientific and Technical Information of China (English)

陈玖

2013-01-01

Objective To explore the difference on mental rotation ability between major depressive disorders and healthy subjects.Methods Twenty-three patients with major depressive disorders and 24 healthy subjects

Augmentation of light therapy in difficult-to-treat depressed patients: an open-label trial in both unipolar and bipolar patients

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Camardese, Giovanni; Leone, Beniamino; Serrani, Riccardo; Walstra, Coco; Di Nicola, Marco; Della Marca, Giacomo; Bria, Pietro; Janiri, Luigi

2015-01-01

Objectives We investigated the clinical benefits of bright light therapy (BLT) as an adjunct treatment to ongoing psychopharmacotherapy, both in unipolar and bipolar difficult-to-treat depressed (DTD) outpatients. Methods In an open-label study, 31 depressed outpatients (16 unipolar and 15 bipolar) were included to undergo 3 weeks of BLT. Twenty-five completed the treatment and 5-week follow-up. Main outcome measures Clinical outcomes were evaluated by the Hamilton Depression Rating Scale (HDRS). The Snaith–Hamilton Pleasure Scale and the Depression Retardation Rating Scale were used to assess changes in anhedonia and psychomotor retardation, respectively. Results The adjunctive BLT seemed to influence the course of the depressive episode, and a statistically significant reduction in HDRS scores was reported since the first week of therapy. The treatment was well-tolerated, and no patients presented clinical signs of (hypo)manic switch during the overall treatment period. At the end of the study (after 5 weeks from BLT discontinuation), nine patients (36%, eight unipolar and one bipolar) still showed a treatment response. BLT augmentation also led to a significant improvement of psychomotor retardation. Conclusion BLT combined with the ongoing pharmacological treatment offers a simple approach, and it might be effective in rapidly ameliorating depressive core symptoms of vulnerable DTD outpatients. These preliminary results need to be confirmed in placebo-controlled, randomized, double-blind clinical trial on larger samples. PMID:26396517

Fatigue as experienced by patients with rheumatoid arthritis (RA): a qualitative study.

NARCIS (Netherlands)

Repping-Wuts, J.W.J.; Uitterhoeve, R.J.; Riel, P.L.C.M. van; Achterberg, T. van

2008-01-01

OBJECTIVE: Interest in fatigue research has grown since the finding that fatigue is, besides pain, the symptom most frequently reported by patients with rheumatoid arthritis (RA). The aim of this study was to explore the experience of fatigue from the patients' perspective. METHODS: Twenty-nine

The Frontier Framework (and its eight Frontier Archetypes): A new conceptual approach to representing staff and patient well-being in health systems.

Science.gov (United States)

Baines, Darrin L

2018-05-04

This paper proposes a new conceptual framework for jointly analysing the production of staff and patient welfare in health systems. Research to date has identified a direct link between staff and patient well-being. However, until now, no one has produced a unified framework for analysing them concurrently. In response, this paper introduces the "Frontier Framework". The new conceptual framework is applicable to all health systems regardless of their structure or financing. To demonstrate the benefits of its use, an empirical example of the Frontier Framework is constructed using data from the UK's National Health Service. This paper also introduces eight "Frontier Archetypes", which represent common patterns of welfare generation observable in health organisations involved in programmes of change. These archetypes may be used in planning, monitoring or creating narratives about organisational journeys. Copyright © 2018 The Author. Published by Elsevier Ltd.. All rights reserved.

Disturbed spontaneous brain activity pattern in patients with primary angle-closure glaucoma using amplitude of low-frequency fluctuation: a fMRI study

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Huang X

2015-07-01

Full Text Available Xin Huang,1,* Yu-Lin Zhong,1,* Xian-Jun Zeng,2 Fuqing Zhou,2 Xin-Hua Liu,1 Pei-Hong Hu,1 Chong-Gang Pei,1 Yi Shao,1 Xi-Jian Dai21Department of Ophthalmology, 2Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People’s Republic of China*These authors contributed equally to this workObjective: The aim of this study is to use amplitude of low-frequency fluctuation (ALFF as a method to explore the local features of spontaneous brain activity in patients with primary angle -closure glaucoma (PACG and ALFFs relationship with the behavioral performances.Methods: A total of twenty one patients with PACG (eight males and 13 females, and twenty one healthy subjects (nine males and twelve females closely matched in age, sex, and education, each underwent a resting-state functional magnetic resonance imaging scan. The ALFF method was used to assess the local features of spontaneous brain activity. The correlation analysis was used to explore the relationships between the observed mean ALFF signal values of the different areas in PACG patients and the thickness of the retinal nerve fiber layer (RNFL. Results: Compared with the healthy subjects, patients with PACG had significant lower ALFF areas in the left precentral gyrus, bilateral middle frontal gyrus, bilateral superior frontal gyrus, right precuneus, and right angular gyrus, and higher areas in the right precentral gyrus. In the PACG group, there were significant negative correlations between the mean ALFF signal value of the right middle frontal gyrus and the left mean RNFL thickness (r=-0.487, P=0.033, and between the mean ALFF signal value of the left middle frontal gyrus and the right mean RNFL thickness (r=-0.504, P=0.020. Conclusion: PACG mainly involved in the dysfunction in the frontal lobe, which may reflect the underlying pathologic mechanism of PACG.Keywords: angle-closure glaucoma, amplitude of low-frequency fluctuation, functional

Patient-controlled analgesia with remifentanil versus alternative parenteral methods for pain management in labour

DEFF Research Database (Denmark)

Weibel, Stephanie; Jelting, Yvonne; Afshari, Arash

2017-01-01

trial sequential analysis. We included total zero event trials and used a constant continuity correction of 0.01 (ccc 0.01) for meta-analysis. We applied the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach to assess the quality of evidence. MAIN RESULTS: Twenty RCTs......) (all study arms included zero events, two trials, low-quality evidence). In one trial of remifentanil (PCA) versus another opioid (IM) three out of 18 women in the remifentanil and none out of 18 in the control group had a respiratory depression (very low-quality evidence).There is no evidence...... opioid (IV) and compared to remifentanil (PCA, different regimen) both with zero events in all study arms (one trial, very-low quality evidence). In one trial of remifentanil (PCA) versus another opioid (PCA) none out of nine newborns in the remifentanil and three out of eight in the opioid (PCA) group...

Changes of Serum Intercellular Adhesion Molecule – 1, Vascular Adhesion Molecule-1 and C – Reactive Protein in Middle-Aged Men with Heart Failure after Eight Weeks of Aerobic Exercise

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Hoda Haghir

2017-03-01

Full Text Available Introduction: The evidence has shown that expansion of cardiovascular disease has inflammation base, and general inflammation (systemic plays a pivotal role in the development of atherosclerosis. The purpose of this research was evaluation of changes in intercellular adhesion molecule – 1, vascular adhesion molecule-1 and C – reactive protein in middle-aged men with heart failure after eight weeks of aerobic exercise. Methods: Twenty four middle-aged men with heart failure were selected as volunteers, and were divided into two groups; the aerobic training and the control groups. Aerobic training program was eight weeks, three times per week with the intensity of 40%-70% maximum heart rate. Fasting blood samples were taken from all subjects before and after eight weeks of aerobic exercise. . Data were analyzed by paired sample t-test and independent sample t-test at a significance levels of P<0.05. Results: In the aerobic training group, comparison within groups showed, serum levels of ICAM-1, VCAM-1 and CRP (respectively P=0.001, P=0.001 and P=0.001 were significantly reduced. There was a significant reduction in comparison between groups only for VCAM-1 (P=0.001 and CRP (P=0.002. Conclusion: Aerobic exercise with reducing levels of inflammatory markers ICAM-1 and CRP may play an important role in the prevention and control of cardiovascular diseases in middle-aged men with heart failure.

Skin Sparing Mastectomy and Immediate Breast Reconstruction (SSMIR for early breast cancer: Eight years single institution experience

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Bobin Jean

2008-04-01

Full Text Available Abstract Background Skin Sparing Mastectomy (SSM and immediate breast reconstruction has become increasingly popular as an effective treatment for patients with breast carcinoma. The aim of this study was to evaluate the clinical outcome of skin sparing mastectomy in early breast cancer at a single population-based institution. Methods Records of ninety-five consecutive patients with operable breast cancer who had skin-sparing mastectomy and immediate breast reconstructions between 1995 and 2003 were reviewed. Patient and tumor characteristic, type of reconstruction, postoperative complications, aesthetic results and incidence of recurrence were analyzed. Results Mean age of the patients was 51.6(range 33–72 years. The AJCC pathologic stages were 0 (n = 51, 53.7%, I (n = 20, 21.1%, and II (n = 2, 2.1%. Twenty of the patients had recurrent disease (21.1%. The immediate breast reconstructions were performed with autologus tissue including latissimus dorsi musculocutaneous flap in 63 (66.3% patients and transverse rectus abdominis myocutaneous (TRAM flap in 4 (4.2% patients. Implants were used in 28 (29.4% patients. The average hospital stay was 7.7 days. Flap complication occurred in seven (10.4% patients resulting in four (6% re-operations and there were no delay in accomplishing postoperative adjuvant therapy. At a median follow-up of 69 months (range 48 to 144, local recurrence was seen in one patient (1.1% and systemic recurrence was seen in two patients (2.1%. Conclusion Skin sparing mastectomy and immediate breast reconstruction for early breast cancer is associated with low morbidity and low rate of local recurrence.

The sensitivity of patch test in patients with psoriasis

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Yavuz Yeşilova

2010-09-01

Full Text Available Objectives: Allergic diseases play an important role in the natural course of psoriasis. Atopic sensitization and con-tact dermatitis are common in patients with psoriasis. Since the symptoms are prolonged in patients who are resistant to therapy and exposure to itchy and external factors are common among these patients, the effects of contact aller-gens on triggering psoriasis are investigated. Contact allergens have an important role in activation and remission of psoriasis. We aimed to investigate contact sensitization rates in patients with psoriasis in the study.Material and Methods: Contact sensitization was investigated with the application of European standard series in twenty patients with psoriasis, twenty patients with contact dermatitis, and twenty healthy persons. Results: Among the whole study cases, positivity rate of patch test against one allergen at least was 25%. rate of patch test was 25% in patients with psoriasis, 35% in patients with contact dermatitis, and 15% in healthy persons. There were no significant differences between the groups according to sensitization to one or more allergens (p>0.05. There were no significant difference in clinical subgroup of psoriatic patients according to contact sensitiza-tion (p>0.05. The allergens in patients with psoriasis on patch test were as the followings: phenyldiamine, potassium dichromat, nickel, and cobalt.Conclusion: We think that the patch test has a major role in the diagnosis and elimination of allergens in patients with the chronic and resistant diseases and palmoplantar and flexural psoriasis.

Clinical Features Indicating Nigrostriatal Dopaminergic Degeneration in Drug-Induced Parkinsonism

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Seung Ha Lee

2017-01-01

Full Text Available Objective Patients with drug-induced parkinsonism (DIP may have nigrostriatal dopaminergic degeneration. We studied the clinical features that may indicate nigrostriatal dopaminergic degeneration in patients with DIP. Methods Forty-one DIP patients were classified into normal and abnormal [18F] FP-CIT scan groups. Differences in 32 clinical features and drug withdrawal effects were studied. Results Twenty-eight patients had normal (Group I and 13 patients had abnormal (Group II scans. Eight patients of Group I, but none of Group II, had taken calcium channel blockers (p = 0.040. Three patients of Group I and six of Group II had hyposmia (p = 0.018. After drug withdrawal, Group I showed greater improvement in Unified Parkinson’s Disease Rating Scale total motor scores and subscores for bradykinesia and tremors than Group II. Only hyposmia was an independent factor associated with abnormal scans, but it had suboptimal sensitivity. Conclusion None of the clinical features were practical indicators of nigrostriatal dopaminergic degeneration in patients with DIP.

Managing the twenty-first century reference department challenges and prospects

CERN Document Server

Katz, Linda S

2014-01-01

Learn the skills needed to update and manage a reference department that efficiently meets the needs of clients today?and tomorrow! Managing the Twenty-First Century Reference Department: Challenges and Prospects provides librarians with the knowledge and skills they need to manage an effective reference service. Full of useful and practical ideas, this book presents successful methods for recruiting and retaining capable reference department staff and management, training new employees and adapting current services to an evolving field. Expert practitioners address the changing role of the r

The social context and the need of information from patients with epilepsy: evaluating a tertiary referral service.

Science.gov (United States)

Freitas-Lima, Priscila; Monteiro, Edna Almeida; Macedo, Lígia Ribeiro Horta; Funayama, Sandra Souza; Ferreira, Flávia Isaura Santi; Matias Júnior, Ivair; Angelis, Geisa; Nogueira, Adriana Maria Arantes; Alexandre, Veriano; Velasco, Tonicarlo Rodrigues; Pinheiro-Martins, Ana Paula; Sakamoto, Américo Ceiki

2015-04-01

Characterize the social profile and the need of information from patients with refractory epilepsy. A semi-structured questionnaire was applied to 103 patients to investigate sociodemographic aspects, pharmacotherapy and any doubts about epilepsy. Patients were highly dependent on having a free and accessible supply of antiepileptic drugs. Sixty-eight percent of the population was unemployed, and 26% confirmed receiving social security benefits due to epilepsy. Twenty-nine percent of the population reached high school. Eighty-five percent of the patients had at least one doubt about epilepsy; treatment and epilepsy aspects in general were the main topics. As observed in developed countries, patients with refractory epilepsy from a developing country also have high rates of unemployment and low educational levels. The results raise a concern about the need of information about epilepsy by patients and their families, urging the necessity to invest in strategies to solve this deficiency in knowledge.

The Talar Body Prosthesis: Results at Ten to Thirty-six Years of Follow-up.

Science.gov (United States)

Harnroongroj, Thos; Harnroongroj, Thossart

2014-07-16

Satisfactory results of implantation of the talar body prosthesis were reported in 1997, although some complications associated with the initial design were noted. The present study evaluated outcomes of treatment with a modified talar body prosthesis. Of the thirty-six talar body prostheses implanted with use of a transmalleolar surgical approach from 1974 to 2011, thirty-three were available for follow-up at ten to thirty-six years or had failed prior to that time. The indication for implantation had been osteonecrosis in twenty-three patients, a comminuted talar fracture in eight, and a talar body tumor in two. Twenty-eight of the thirty-three prostheses were still in place at the time of final follow-up and five had failed prior to five years. The duration of follow-up was ten to twenty years in eight patients, twenty to thirty years in eleven, and thirty to thirty-six years in nine. The AOFAS (American Orthopaedic Foot & Ankle Society) ankle-hindfoot score did not differ significantly among these three groups. Patients over sixty-five years of age with underlying disease that impeded walking ability had lower AOFAS scores. Early prosthesis failure occurred as a result of size mismatch in two patients, tumor recurrence in one, infection in one, and osteonecrosis of the talar head and neck in one. These failures, which occurred at eight to fifty-seven months, were treated with tibiotalar arthrodesis in three patients, prosthesis revision in one, and below-the-knee amputation in one. Although early prosthesis failure may occur, survival of the talar body prosthesis can provide satisfactory ankle and foot function. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Evaluation of continuous ambulatory peritoneal dialysis fluid C-reactive protein in patients with peritonitis.

Science.gov (United States)

Ramanathan, Kumaresan; Padmanabhan, Giri; Vijayaraghavan, Bhooma

2016-05-01

Severe peritonitis causing death is one of the most devastating complications of peritoneal dialysis (PD). Since the predictive value of C-reactive protein (CRP) in PD fluid has not been assessed, the objective of the present study is to evaluate its predictive value and clinical correlation in patients on PD with peritonitis. One hundred and twenty patients on continuous ambulatory PD (CAPD) were enrolled and their serum and fluid CRP (Fl. CRP) were evaluated at the start of CAPD. All patients who developed peritonitis were further evaluated for serum and fluid CRP. The patients were categorized into four groups, namely: normal patients (control group), patients with peritonitis, patients with peritonitis leading to catheter removal, and death due to peritonitis. Sixty-five patients developed peritonitis of whom, catheter removal was performed in eight patients. Five patients died due to peritonitis-related complications. Fl. CRP showed a significant difference among the three groups, unlike S. CRP. Estimation of CRP in the peritoneal fluid may be a useful marker to monitor the onset of peritonitis.

Eight-year follow-up of patients with myasthenia gravis after thymectomy.

Science.gov (United States)

Yu, S; Li, F; Chen, B; Lin, J; Yang, M; Fu, X; Li, J; Bu, B

2015-02-01

To depict the long-term outcome of patients with myasthenia gravis after thymectomy in combination with immunotherapy, and the factors that may potentially affect the outcome. The 306 patients with myasthenia gravis who underwent extended thymectomy from January 1984 to December 2011 at Tongji Hospital were retrospectively evaluated. The patients consisted of 174 cases with thymoma and 132 cases without thymoma. Pharmaceutical treatment was tailored for each case during follow-up. Nine patients with thymomatous myasthenia gravis died during the perioperative period, and 297 patients were followed for 8.6 years. By their latest visits, 241 patients (81.1%) gained satisfactory efficacy, 24 cases died (8.1%), and 32 cases (10.8%) remained unchanged or deteriorated. Favorable factors for satisfactory efficacy included the presence of ocular myasthenia gravis before operation, no presence of thymoma, and lack of concomitant diseases. It is interesting to mention that, patients with non-thymomatous myasthenia gravis obtained significantly higher rates of complete stable remission and clinical remission than the patients with thymomatous myasthenia gravis. Extended thymectomy combined with immunotherapy is a preferred treatment with a satisfactory long-term remission rate. Patients with non-thymomatous myasthenia gravis have a much more promising prognosis than the patients with thymomatous myasthenia gravis. However, appropriate caution must be taken to discontinue pharmaceutical therapy as relapse remains a major concern after a patient who has already undergone thymectomy becomes symptom-free. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Teen use of a patient portal: a qualitative study of parent and teen attitudes.

Science.gov (United States)

Bergman, David A; Brown, Nancy L; Wilson, Sandra

2008-01-01

We conducted a qualitative study of the attitudes of teens and parents toward the use of a patient portal. We conducted two teen and two parent focus groups, one teen electronic bulletin board, and one parent electronic bulletin board. Videotapes and transcripts from the groups were independently analyzed by two reviewers for significant themes, which were then validated by two other members of the research team. Twenty-eight teens and 23 parents participated in the groups. Significant themes included issues about teens' control of their own healthcare; enthusiasm about the use of a patient portal to access their providers, seek health information, and make appointments; and concerns about confidentiality. In summary, there was considerable support among teens and parents for a patient portal as well as concerns about confidentiality. The teen portal affords an opportunity to negotiate issues of confidentiality.

New approach to imaging HIV-positive patients with pyrexia of undetermined origin

International Nuclear Information System (INIS)

Buscombe, J.; Miller, R.; Lui, D.; Ell, P.J.

1990-01-01

This paper established if imaging with Tc-99m human immunoglobulin (HIG) in addition to Ga-67 citrate increased the diagnostic sensitivity in patients who have pyrexia of unknown origin (PUO) and who have tested positive for human immunodeficiency virus (HIV). The authors studied 18 HIV-positive patients with PUO for 3 or more weeks. Imaging was performed 4 and 20 hours after administration of 200 MBq of Tc-99m HIG and 24, 48, and (if indicated) 72 hours after administration of 300 MBq of Ga-67. Anterior whole body and relevant spot view were obtained for both agents. Twenty-four sites of infection were confirmed microbiologically in 12 patients. Ga-67 scan results were positive in 22 of these sites, and Tc-99m HIG results were positive in 13; the nine Ga-positive sites that were Tc-negative were intrathoracic (one Pneumocystis carinii, eight Mycobacterium intracellulare)

Clinical and molecular epidemiological study of xeroderma pigmentosum in China: A case series of 19 patients.

Science.gov (United States)

Zhou, Eray Yihui; Wang, Huijun; Lin, Zhimiao; Xu, Guiwen; Ma, Zhihong; Zhao, Jiahui; Feng, Cheng; Duo, Lina; Yin, Jinghua; Yang, Yong

2017-01-01

Xeroderma pigmentosum (XP) is a rare genetic disorder which is divided into eight complementation groups: XP-A to XP-G and XP-V. Some XP patients demonstrate severe cutaneous and neurological manifestations, management of which requires timely diagnosis and intervention. We performed clinical evaluation and genetic analysis on 19 patients, the largest cohort of XP to date in China. Twenty-three mutations from six groups were identified, 16 of which were novel. All patients developed marked freckle-like pigmentation on sun-exposed sites while patients with XP-A, XP-D, XP-F and XP-G showed acute sunburn reactions. Only XP-A patients displayed progressive neurological degeneration. A relatively larger proportion of XP-A and XP-C were found in Chinese XP patients. One XP case and two carriers were prenatally determined. This study extended the mutation spectrum of XP in China and may aid in the diagnosis and treatment of Chinese XP patients. © 2016 Japanese Dermatological Association.

Momentary relationship between cortisol secretion and symptoms in patients with fibromyalgia.

Science.gov (United States)

McLean, Samuel A; Williams, David A; Harris, Richard E; Kop, Willem J; Groner, Kimberly H; Ambrose, Kirsten; Lyden, Angela K; Gracely, Richard H; Crofford, Leslie J; Geisser, Michael E; Sen, Ananda; Biswas, Pinaki; Clauw, Daniel J

2005-11-01

To compare the momentary association between salivary cortisol levels and pain, fatigue, and stress symptoms in patients with fibromyalgia (FM), and to compare diurnal cycles of cortisol secretion in patients with FM and healthy control subjects in a naturalistic environment. Twenty-eight patients with FM and 27 healthy control subjects completed assessments on salivary cortisol levels and pain, fatigue, and stress symptoms, 5 times a day for 2 consecutive days, while engaging in usual daily activities. Only those participants who adhered to the protocol (assessed via activity monitor) were included in the final analyses. Twenty FM patients and 16 healthy control subjects adhered to the protocol. There were no significant differences in cortisol levels or diurnal cortisol variation between FM patients and healthy controls. Among women with FM, a strong relationship between cortisol level and current pain symptoms was observed at the waking time point (t = 3.35, P = 0.008) and 1 hour after waking (t = 2.97, P = 0.011), but not at the later 3 time points. This association was not due to differences in age, number of symptoms of depression, or self-reported history of physical or sexual abuse. Cortisol levels alone explained 38% and 14% of the variation in pain at the waking and 1 hour time points, respectively. No relationship was observed between cortisol level and fatigue or stress symptoms at any of the 5 time points. Among women with FM, pain symptoms early in the day are associated with variations in function of the hypothalamic-pituitary-adrenal axis.

UK National Survey of Practice Patterns of Fluid Volume Management in Haemodialysis Patients: A Need for Evidence.

Science.gov (United States)

Dasgupta, Indranil; Farrington, Ken; Davies, Simon J; Davenport, Andrew; Mitra, Sandip

2016-01-01

Fluid management in haemodialysis (HD) affects patient experience, morbidity and mortality. Standards for best practice are lacking. A national survey of the United Kingdom was undertaken to define prevalent practice. An online questionnaire was distributed to all UK renal centres. Forty-five of 74 centres (173 dialysis units), serving 62% (n = 14,697) of UK HD population responded. Seventy-eight per cent had no agreed policy for managing fluid balance in patients on HD; 44% did not assess fluid status routinely. Clinical assessment was the norm; 27% used bio-impedance-based device. To achieve a target-weight, 53% reduced weight as far as tolerated. Twenty-two per cent measured residual renal function (RRF). Ninety-one per cent had no policy for fluid overload. Sixty-four per cent restricted salt and water. Ninety-three per cent used diuretics in patients with RRF. Thirty-eight per cent felt management was adequate; 77% felt there was a need for better evidence. Ninety-one per cent would participate in a study addressing this. There is an urgent need for establishing an evidence base on the optimal approaches to fluid management. © 2016 S. Karger AG, Basel.

Twenty-year mortality of adult patients with primary immune thrombocytopenia

DEFF Research Database (Denmark)

Frederiksen, Henrik; dybdal, Merete Lund; Nørgaard, Mette

2014-01-01

Studies have reported a 1·3- to 2·2-fold higher mortality rate among patients with primary immune thrombocytopenia (ITP) compared to the general population. However, long-term mortality estimates as well as cause-specific mortality data are sparse. In our population-based cohort of adult patients...

Reduced Baroreflex Sensitivity in Cluster Headache Patients

DEFF Research Database (Denmark)

Barloese, Mads C J; Mehlsen, Jesper; Brinth, Louise

2015-01-01

by baroreflex sensitivity (BRS) in CH patients. METHODS: Twenty-six active CH patients and an equal number of age-, sex-, and BMI-matched controls underwent head-up tilt table test and BRS was determined by the sequence method. RESULTS: Compared with controls, patients exhibited a blunted reactivity of RR...... patients who had not (n = 13, 16.0 ms/mmHg, P = .1523). In the tilted position, the drop in SBP at the carotid sinuses was higher in patients who had recently suffered an attack. Despite this, they exhibited a less marked shortening of RR intervals when compared with patients who had been attack free...... of the autonomic nervous system or in the central relay of impulses from the baroreceptors....

Results of Entecavir treatment in patients with chronic hepatitis B

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Şükran Köse

2013-12-01

Full Text Available Objective: This study was designed to determine the efficacy and safety of Entecavir (ETV after 96 weeks treatment in patients with chronic viral hepatitis B (CHB. Methods: Thirty-eight patients were included into the study. The criteria for starting ETV treatment were as follows: elevated ALT levels >upper limit of normal (ULN two times, with HBV-DNA levels ≥5 log10 copies/ml (≥20000 IU/mL, in HBe Ag positive patients, ≥4log10 copies/ml (≥2000IU/mL in HBe Ag negative patients and liver damage was confirmed by histopathology (Knodell HAI ≥4 or fibrosis ≥1. Patients were followed up every 12 weeks by virological and biochemical tests. Results: Twenty-four of 38 patients (63.2% were male. Mean age of patients were 38.6 years, 14 of them were HBeAg positive (36.8%. At baseline, median ALT level was detected as 106.7 IU/ml, median HBV DNA levels were 4.8 x 107 copy/ml, and mean Knodell HAI score was nine. Eleven of 14 HBe Ag positive patients (78.6% were treatment-naïve. No resistance mutation was determined during treatment. Biochemical responses (BR at 48 th and 96th week were 100% and virologic response (VR were 57.1%, and 50%, respectively. Serological response (SR at 48th and 96 th weeks were 35.7% and 42.8% respectively. Fifteen (62.5% of 24 HBe Ag negative patients were treatment-naïve; two patients were detected to have lamivudine resistance mutation. At 48 th and 96 th week, BR was 95.8%, and 100%, respectively; and VR were 83.3% both. Conclusion:In our study, virologic response was significantly high after two years of therapy with Entecavir in HBe Ag negative patients. J Microbiol Infect Dis 2013;3(4: 176-180

Evaluation of semisolid agar method for antifungal susceptibility test of T. rubrum

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Sultana Razia

2016-08-01

Full Text Available Background: With increasing fungal disease many newer antifungal drugs are available with different spectrum of activ­ity. Antifungal susceptibility test will help clinicians for selection of effective drug and thereby treatment of patient. Objective: The study was undertaken to perform a simple screening drug susceptibility test of T. rnbrum by Semi Solid Agar Antifungal Susceptibility (SAAS Method: Perfonnance of susceptibility method was assessed by comparing the MICs of three commonly prescribed antifungal agents namely- tluconazole (FCZ, itraconazole (ITZ and terbinafine (TER to the CLSI (Clinical and Laboratory Standard Institute recommended M-38, a broth microdilution method. Results: In SAAS method, among twenty nine T. rubrum, twenty five (86.2% were susceptible (MIC range 0.5-64 µg/ml to Fluconazole (FCZ and four (13.7% were resistant (MIC value >64 µg/ml. In broth microdilution method, among twenty nine T. rubrum, twenty six (89.6% were susceptible (MIC range 0.3-64 µg/ml to FCZ and three (10.3% were resistant (MIC value >64 µg/ml. In case of both ITZ and TER, all were susceptible (MIC range 0.3-64 µg/ml to both methods. The SAAS method demonstrated the susceptibility pattern of T. rubrum against FCZ, ITZ and TER usually within 72 to 96 hours after organism isolation and results were concordance with the results of CLSI broth microdilution method. Conclusion: Though it is a newer method with proper standardization of the test method, SAAS method is simple and easily applicable screening method for susceptibility testing of antifungal agents against dermatophytes in any microbiology laboratories.

Gastrointestinal motor function in patients with portal hypertension

DEFF Research Database (Denmark)

Madsen, Jan Lysgård; Brinch, K; Hansen, Erik Feldager

2000-01-01

BACKGROUND: Existing data on gastric emptying and small-intestinal transit rates in portal-hypertensive patients are scarce and contradictory, and so far, the motor function of the colon has not been assessed in these patients. In this study we evaluated the propulsive effect of all main segments...... of the gastrointestinal tract in patients with well-characterized portal hypertension. METHODS: Eight patients with a postsinusoidal hepatic pressure gradient of at least 13 mmHg and eight age- and sex-matched healthy controls participated in the study. Gastric emptying, small-intestinal transit, and colonic transit...... the test meal between patients and controls. CONCLUSIONS: These data suggest that the colonic transit is often accelerated in patients with portal hypertension, whereas the motor function of the stomach and the small intestine is unaffected....

Genetic analysis of the pedigrees and molecular defects of the GH-receptor gene in the Israeli cohort of patients with Laron syndrome.

Science.gov (United States)

Shevah, Orit; Laron, Zvi

2006-08-01

Out of the 63 patients with Laron Syndrome ( LS) followed in our clinic we were able to perform a genetic analysis on 43 patients belonging to 28 families. Twenty-seven patients were Jews, eight were Arabs, one was Druze, and six were Caucasians from countries other then Israel. Consanguinity was found in 11 families. Molecular analysis of the growth hormone receptor gene was performed in 32 patients and 32 family members. From the study of the pedigrees, as well as the GH receptor gene analysis, we confirmed an earlier report from our group that LS is a recessively inherited disease. One patient with a classical phenotype of LS had a non-classical pattern of inheritance: R43X heterozygosity together with a heterozygous polymorphism G168G; a condition which needs further exploration.

Use of neuromuscular electrostimulation in the treatment of dysphagia in patients with multiple sclerosis

NARCIS (Netherlands)

Bogaardt, Hans; van Dam, Danielle; Wever, Nienke M.; Bruggeman, Caroline E.; Koops, Johan; Fokkens, Wytske J.

2009-01-01

OBJECTIVES: We explored the possible effects of neuromuscular electrostimulation on the swallowing function of patients with multiple sclerosis and swallowing problems. METHODS: Twenty-five patients (average age, 53.1 years; SD, 9.8 years) with multiple sclerosis and swallowing problems were treated

European Registry of Carotid Artery Stenting: results from a prospective registry of eight high volume EUROPEAN institutions.

Science.gov (United States)

Stabile, Eugenio; Garg, Pallav; Cremonesi, Alberto; Bosiers, Marc; Reimers, Bernhard; Setacci, Carlo; Cao, Piergiorgio; Schmidt, Andrej; Sievert, Horst; Peeters, Patrick; Nikas, Dimitry; Werner, Martin; de Donato, Gianmarco; Parlani, Giambattista; Castriota, Fausto; Hornung, Marius; Mauri, Laura; Rubino, Paolo

2012-08-01

Carotid endarterectomy (CEA) is the standard revascularization therapy to prevent stroke in patients with carotid artery disease. Carotid artery stenting (CAS) could be considered a potential alternative in patients at high surgical risk. Recent clinical trials have challenged this concept due a relatively high incidence of post-CAS adverse events, which occurred in low volume centers. The aim of this study was to evaluate the outcomes associated with neuroprotected CAS in selected high volume centers. From January 2007 to December 2007, 1,611 patients underwent neuroprotected CAS in eight European Centers. For each patients, clinical, procedural, and one month follow-up data from all patients have been collected. An independent clinical events committee adjudicated the events. Overall in hospital death was 0.06% (one patient), whereas in-hospital stroke was 0.49% (eight patients). Between hospital discharge and 30 days three additional patients died (0.18%) and 10 patients experienced a stroke (0.67%). Overall 30 days mortality was 0.24% (four patients) and stroke incidence 1.12% (18 patients). The 30 day stroke/death rate was 1.36%. CAS is a reasonable alternative to CEA to treat carotid artery atherosclerosis in well-experienced high volume centers. These data suggest that future prospective trials comparing CAS and CEA outcomes should include only centers highly experienced in both treatment modalities. Copyright © 2012 Wiley Periodicals, Inc.

Radioimmunotherapy of indolent non-Hodgkin's lymphoma with Yttrium-90 labeled anti-CD20 monoclonal antibody therapy does not preclude subsequent chemotherapy or autologous hematologic stem cell transplantation therapy in most patients

International Nuclear Information System (INIS)

Wiseman, G.A.; Witzig, T.E.; Ansell, S.M.; Ristow, K.M.

2002-01-01

Introduction: Yttrium-90 (Y-90) labeled anti-CD20 monoclonal antibody (ibritumomab tiuxetan or Zevalin TM ) is a novel therapy for patients with relapsed CD20+ B-cell non-Hodgkin's lymphoma (NHL). Patients treated with Zevalin radioimmunotherapy (RIT) are limited from higher doses due to transient and reversible platelet and neutrophil suppression. Patients with indolent NHL who relapse or are refractory to chemotherapy have a 70-80% overall response rate and a 20-30% complete response rate when treated with Zevalin RIT. Therefore additional treatment is required in a minority of patients shortly after Zevalin therapy and in many others at relapse. Relapsed patients are generally treated with chemotherapy alone or high dose chemotherapy followed by autologous transplantation. We wanted to evaluate the ability of patients to tolerate subsequent therapy given at relapse following Zevalin RIT. Methods: We had 58 patients who relapsed after receiving Zevalin RIT and later received additional therapy. The clinical records and lab results were reviewed and compared with a matched control group of patients treated prior to Zevalin availability who received chemotherapy without prior Zevalin RIT. Results: The toxicity in 58 patients treated with Zevalin RIT and subsequent therapy was not significantly different from the control group who did not receive Zevalin RIT. Patients had a median of two subsequent therapies (range, 1-7) after Zevalin. Twenty eight percent required blood cell growth factor support with subsequent chemotherapy and 2 patients required reductions from the standard chemotherapy doses due to prolonged myelosuppression. Eight patients subsequently had successful autologous hematologic stem cell transplant with cells collected after Zevalin. Thirteen of the 58 patients (28%) treated with standard dose chemotherapy were hospitalized for neutropenic fever or thrombocytopenia. Conclusions: Chemotherapy or high dose chemotherapy with autologous transplantation

Monitoring delays in diagnosis of pulmonary tuberculosis in eight cities in Colombia

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David A. Rodríguez

Full Text Available ABSTRACT Objective To measure time between onset of tuberculosis (TB symptoms and start of treatment, and to identify factors associated with delay in eight Colombian cities. Methods Operational research with a retrospective analytical cohort design was conducted in 2014 using routinely collected data about new smear-positive pulmonary TB patients from eight cities in Colombia (Barranquilla, Bogotá, Bucaramanga, Cali, Cúcuta, Medellín, Pereira, and Villavicencio. Date of symptom onset was sourced from TB surveillance databases. Data on all other variables came from National TB Program (NTP registers. Results There were 2 545 new cases of smear-positive pulmonary TB, but a plausible date of symptom onset was available for only 1 456 (57%. Median number of days between symptom onset and treatment start was 51 days (interquartile range: 27–101. A total of 72% of patients had a delay (> 30 days between symptom onset and treatment start, and 28% had a 3+ bacillary load at diagnosis. Based on multiple logistic regression, three factors were significantly associated with delay: being uninsured (odds ratio (OR: 1.30; 95% confidence interval (CI: 1.01–1.68 and having an unknown HIV status (OR: 1.81; CI: 1.04–3.17, which increased risk, and coming from a neighborhood with NTP-employed community health workers, which decreased risk (OR: 0.56; CI: 0.34–0.90. Conclusions Delays still prevent timely TB diagnosis and treatment in Colombia. As the country aims for TB elimination, delays must be reduced, especially in cities and vulnerable neighborhoods, to stop community transmission. The NTP should focus not only on the number of cases detected but also on how long it takes to detect them. To monitor interventions designed to reduce delays, additional dates in the process should be recorded routinely. In addition, reliability and completeness of data are crucial for monitoring.

[Effect of 2 methods of occlusion adjustment on occlusal balance and muscles of mastication in patient with implant restoration].

Science.gov (United States)

Wang, Rong; Xu, Xin

2015-12-01

To compare the effect of 2 methods of occlusion adjustment on occlusal balance and muscles of mastication in patients with dental implant restoration. Twenty patients, each with a single edentulous posterior dentition with no distal dentition were selected, and divided into 2 groups. Patients in group A underwent original occlusion adjustment method and patients in group B underwent occlusal plane reduction technique. Ankylos implants were implanted in the edentulous space in each patient and restored with fixed prosthodontics single unit crown. Occlusion was adjusted in each restoration accordingly. Electromyograms were conducted to determine the effect of adjustment methods on occlusion and muscles of mastication 3 months and 6 months after initial restoration and adjustment. Data was collected and measurements for balanced occlusal measuring standards were obtained, including central occlusion force (COF), asymmetry index of molar occlusal force(AMOF). Balanced muscles of mastication measuring standards were also obtained including measurements from electromyogram for the muscles of mastication and the anterior bundle of the temporalis muscle at the mandibular rest position, average electromyogram measurements of the anterior bundle of the temporalis muscle at the intercuspal position(ICP), Astot, masseter muscle asymmetry index, and anterior temporalis asymmetry index (ASTA). Statistical analysis was performed using Student 's t test with SPSS 18.0 software package. Three months after occlusion adjustment, parameters of the original occlusion adjustment method were significantly different between group A and group B in balanced occlusal measuring standards and balanced muscles of mastication measuring standards. Six months after occlusion adjustment, parameters of the original occlusion adjustment methods were significantly different between group A and group B in balanced muscles of mastication measuring standards, but was no significant difference in balanced

Prognosen for den kritisk iskaemiske underekstremitet som ikke kan revaskulariseres karkirurgisk

DEFF Research Database (Denmark)

Sørensen, S; Lorentzen, J E; Schroeder, T V

1993-01-01

were rest pain in 24 cases and gangrenous ulceration in ten. During a follow-up of eight to twenty-eight months five (15%) patients improved significantly, and complained only of claudication. Three patients, suffering rest pain, were unchanged at nine months follow-up, and 25 (74%) patients had...... that of an age- and sex-matched Danish population. The group of patients who preserved their limb could not be identified by either ankle- and toe-pressure measurements or clinical evaluation....

The occurrence of graft-versus-host disease is the major predictive factor for response to donor lymphocyte infusions in multiple myeloma

NARCIS (Netherlands)

Lokhorst, Henk M.; Wu, Kalung; Verdonck, Leo F.; Laterveer, Laurens L.; van de Donk, Niels W. C. J.; van Oers, Marinus H. J.; Cornelissen, Jan J.; Schattenberg, Anton V.

2004-01-01

The graft-versus-myeloma (GVM) effect of donor lymphocyte infusions (DLIs) is well established. We now report the outcome of DLI in 54 patients with relapsed myeloma following allogeneic transplantation. Twenty-eight patients (52%) responded, 19 patients (35%) with a partial response and 9 patients

Design and Methods for a Pilot Study of a Phone-Delivered, Mindfulness-Based Intervention in Patients with Implantable Cardioverter Defibrillators

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Elena Salmoirago-Blotcher

2012-01-01

Full Text Available Background. Meditation practices are associated with a reduction in adrenergic activity that may benefit patients with severe cardiac arrhythmias. This paper describes the design and methods of a pilot study testing the feasibility of a phone-delivered mindfulness-based intervention (MBI for treatment of anxiety in patients with implantable cardioverter defibrillators (ICDs. Design and Methods. Consecutive, clinically stable outpatients (n=52 will be screened for study eligibility within a month of an ICD-related procedure or ICD shock and will be randomly assigned to MBI or to usual care. MBI patients will receive eight weekly individual phone sessions based on two mindfulness practices (awareness of breath and body scan plus home practice with a CD for 20 minutes daily. Patients assigned to usual care will be offered the standard care planned by the hospital. Assessments will occur at baseline and at the completion of the intervention (between 9 and 12 weeks after randomization. The primary study outcome is feasibility; secondary outcomes include anxiety, mindfulness, and number of administered shocks during the intervention period. Conclusions. If proven feasible and effective, phone-delivered mindfulness-based interventions could improve psychological distress in ICD outpatients with serious cardiovascular conditions.

Maxillary sinusitis - a comparative study of different imaging diagnosis methods

International Nuclear Information System (INIS)

Hueb, Marcelo Miguel; Borges, Fabiano de Almeida; Pulcinelli, Emilte; Souza, Wandir Ferreira; Borges, Luiz Marcondes

1999-01-01

We conducted prospective study comparing different methods (plain X-rays, computed tomography and ultrasonography mode-A) for the initial diagnosis of maxillary sinusitis. Twenty patients (40 maxillary sinuses) with a clinical history suggestive of sinusitis included in this study. The results were classified as abnormal or normal, using computed tomography as gold standard. The sensitivity for ultrasonography and plain X-rays was 84.6% and 69.2%, respectively. The specificity of both methods was 92.6%. This study suggests that ultrasonography can be used as a good follow-up method for patients with maxillary. sinusitis. (author)

Nested PCR Assay for Eight Pathogens: A Rapid Tool for Diagnosis of Bacterial Meningitis.

Science.gov (United States)

Bhagchandani, Sharda P; Kubade, Sushant; Nikhare, Priyanka P; Manke, Sonali; Chandak, Nitin H; Kabra, Dinesh; Baheti, Neeraj N; Agrawal, Vijay S; Sarda, Pankaj; Mahajan, Parikshit; Ganjre, Ashish; Purohit, Hemant J; Singh, Lokendra; Taori, Girdhar M; Daginawala, Hatim F; Kashyap, Rajpal S

2016-02-01

Bacterial meningitis is a dreadful infectious disease with a high mortality and morbidity if remained undiagnosed. Traditional diagnostic methods for bacterial meningitis pose a challenge in accurate identification of pathogen, making prognosis difficult. The present study is therefore aimed to design and evaluate a specific and sensitive nested 16S rDNA genus-based polymerase chain reaction (PCR) assay using clinical cerebrospinal fluid (CSF) for rapid diagnosis of eight pathogens causing the disease. The present work was dedicated to development of an in-house genus specific 16S rDNA nested PCR covering pathogens of eight genera responsible for causing bacterial meningitis using newly designed as well as literature based primers for respective genus. A total 150 suspected meningitis CSF obtained from the patients admitted to Central India Institute of Medical Sciences (CIIMS), India during the period from August 2011 to May 2014, were used to evaluate clinical sensitivity and clinical specificity of optimized PCR assays. The analytical sensitivity and specificity of our newly designed genus-specific 16S rDNA PCR were found to be ≥92%. With such a high sensitivity and specificity, our in-house nested PCR was able to give 100% sensitivity in clinically confirmed positive cases and 100% specificity in clinically confirmed negative cases indicating its applicability in clinical diagnosis. Our in-house nested PCR system therefore can diagnose the accurate pathogen causing bacterial meningitis and therefore be useful in selecting a specific treatment line to minimize morbidity. Results are obtained within 24 h and high sensitivity makes this nested PCR assay a rapid and accurate diagnostic tool compared to traditional culture-based methods.

Healthcare professionals’ views of feedback on patient safety culture assessment.

OpenAIRE

Zwijnenberg, N.C.; Hendriks, M.; Hoogervorst-Schilp, J.; Wagner, C.

2016-01-01

Background: By assessing patient safety culture, healthcare providers can identify areas for improvement in patient safety culture. To achieve this, these assessment outcomes have to be relevant and presented clearly. The aim of our study was to explore healthcare professionals’ views on the feedback of a patient safety culture assessment. Methods: Twenty four hospitals participated in a patient safety culture assessment in 2012. Hospital departments received feedback in a report and on a web...

[Separation and determination of eight plant hormones by reversed-phase high performance liquid chromatography].

Science.gov (United States)

Fang, N; Hou, S; Shao, X; He, Y; Zhao, G

1998-09-01

In this paper, reversed-phase high performance liquid chromatographic technique was used for the separation and determination of eight plant hormones. Methanol-water-acetic acid system was chosen as the mobile phase. The effects of different separation conditions, such as the methanol and acetic acid concentrations in mobile phase, on the retention behaviours of eight plant hormones in this system were studied. The general trends in retention behaviours could be correlated to the methanol concentration in mobile phase. The experimental results showed that the optimum separation was achieved with following gradient elution condition: 0-3 minutes, 70% (water percentage in mobile phase), 3-13 minutes, 70%-20%, 13-48 minutes, 20%. Benzene was added to be as the internal standard. Under this experimental condition, the eight plant hormones could be separated completely and detected quantitatively at 260 nm within 16 minutes. The calibration curves for the eight compounds gave linearity over a wide range. The correlation coefficients of each components were r(ZT) = 0.9971, r(GAs) = 0.9999, r(K) = 0.9997, r(BA) = 0.9995, r(IAA) = 0.9998, r(IPA) = 0.9982, r(IBA) = 0.9995 and r(NAA) = 0.9995. The method is rapid, simple and efficient. It is a suitable method for the accurate determination of gibberellic acid (GA) and alpha-naphthaleneacetic acid (alpha-NAA) in products for agricultural use.

A Case: Eight-and-A-Half Syndrome

Directory of Open Access Journals (Sweden)

Cennet Nalan Kuş

2007-12-01

Full Text Available Scientific BACKGROUND: The combination of clinical one-and-a-half syndrome together with cranial nerve VII palsy is known to as eight-and-a-half syndrome. It localized the pathology to the pons. OBJECTIVE: To report a case having clinical and radiologic findings typical of eight-and-a-half syndrome. CASE: 65 year old man with hypertension presented with sudden onset of binocular diplopia left facial weakness. Magnetic resonance imaging demostrated a small lesion in the left paramedian pontine tegmentum. CONCLUSION: To our knowledge, this is the first report of a case of eight-and-a-half syndrome in Turkish literature

The comparison between two different methods of radiotherapy in palliation and survival of patients with esophageal cancer

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Keshvary M

2001-10-01

Full Text Available Esophageal cancer is one of the most common malignancies in our country. Patients often seek medical advice in advanced and inoperable stages or with cervical esophageal cancer, in which operation is accompanied by sever morbidity. In this conditions many of them cannot tolerate chemo-radiation, or refuse it. Therefore radiotherapy is applied as a single modality in palliation of many patients with esophageal cancer. One of the palliative radio therapeutic methods is application of 5000 CGY in 20 fractions (Long Course; but considering the great number of our patients and limited capacity of radiotherapy centers, as well as emphasis of literature on palliation with 4000 CGY in 13 fractions (short course, we decided to compare these two methods (which are both used in our departments. In this retrospective analytic study, the files of 283 patients with esophageal cancer referred to cancer institute of Imam Khomeini Hospital from 1989-1999 were studied. Patients were between 27-97 years old (mean age=58.3 and most of them were male (53.7 percent. The mean length of lesion was 8.5 cm. The most common site of lesion was middle third at esophagus (48.1 percent and the most common pathology was squamous cell carcinoma (99.6 percent. Fifty-four percent of patients were hot tea drinkers habitually. From the mentioned variables, only length of lesion had significant relationship with overall survival (P=0.04. Thirty-eight of 283 patients were excluded from analytic study because of incomplete follow-up. The number of patients had been treated by long course (5000 CGY in 20 fractions was 137 and the remainder (108 patients by short course (4000 CGY in 13 fractions. No significant difference was seen statistically between these two groups in overall and dysphagia-free survival (Kaplan-Meyer test. Also total dosage of spinal cord is lower in the short course. Thus regarding to less required time in short course and comparable palliation and survival between

Wilson's disease: an analysis of 28 Brazilian children

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Rodolpho Truffa Kleine

2012-01-01

Full Text Available OBJECTIVES: Clinical-laboratory and evolutionary analysis of twenty-eight patients with Wilson's disease. METHODS: Twenty-eight children (twelve females and sixteen males with Wilson's disease were evaluated retrospectively between 1987 and 2009, with a follow-up of 72 months (1 - 240 months. The clinical, laboratory, and histologic features at diagnosis were recorded at the end of the study. RESULTS: The median age at diagnosis was 11 years (2 - 18 years. Twelve patients were asymptomatic, seven had hepatitis symptoms, five had raised aminotransferase levels, three had hepatomegaly associated with neurological disorders, one had fulminant hepatitis with hemolytic anemia, and six patients presented with a Kayser-Fleischer ring. A histological analysis revealed that six children had chronic hepatitis, seven had cirrhosis, two had steatosis, one had portal fibrosis, and one had massive necrosis. The treatment consisted of D-penicillamine associated with pyridoxine for 26 patients. Adverse effects were observed in the other two patients: one presented with uncontrollable vomiting and the other demonstrated elastosis perforans serpiginosa. At the end of the study, all 26 treated patients were asymptomatic. Twenty-four of the patients were treated with D-penicillamine and pyridoxine, and two were treated with trientine and zinc sulfate. A liver transplant was performed in one patient with fulminant hepatitis, but the final patient died 48 hours after admission to the intensive care unit. CONCLUSIONS: Family screenings associated with early treatment are important in preventing Wilson's disease symptoms and potentially fatal disease progression. The study suggests that Wilson's disease must be ruled out in children older than two years presenting with abnormal levels of hepatic enzymes because of the heterogeneity of symptoms and the encouraging treatment results obtained so far.

Technetium-99m methylene diphosphonate scintimammography for evaluation of palpable breast masses

International Nuclear Information System (INIS)

Shah, S.; Khan, M.M.; Khan, A.U.; Khan, S.M.; Khan, A.A.

2002-01-01

Objective:To evaluate technetium-99m methylene diphosphonate (/sup 99m/Tc-MDP) as a noninvasive tumor-localizing agent in patients with palpable breast masses and to differentiate malignant from benign breast lesions. Design: It was an observational and experimental study. Place and Duration of Study: the study was conducted at the Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar during a six-month period (June to November, 1995). Subjects and Methods: 99m Tc-MDP scintimammography (SMM) was performed in thirty patients with palpable breast masses (Group A). Ten patients with no palpable breast abnormality (Group B) also underwent /sup 99m/Tc-MDP breast study; they served as controls. Upright anterior, lateral and oblique lateral images of the breasts were acquired 10-30 minutes after intravenous injection of 740 MBq of /sup 99m/Tc-MDP. This was performed during routine bone scanning. SMM was followed by surgical and /or needle biopsy. Results: breast cancer was histologically diagnosed in twenty two (73%), and benign disease found in eight patients (27%). Of the twenty two breast carcinomas, twenty (91%) were detected using /sup 99m/Tc-MDP SMM, while no uptake was seen in two (9%). Of the eight patients with pathologically proven benign breast lesions, seven (88%) either did not show any uptake or showed faint bilateral accumulation. Focal /sup 99m/Tc-MDP uptake was observed in one fibroadenoma. Conclusion: The study showed that SMM with /sup 99m/Tc-MDP is positive in a high percentage of patients with carcinoma of the breast and may differentiate malignant from benign masses. (author)

Display methods of electronic patient record screens: patient privacy concerns.

Science.gov (United States)

Niimi, Yukari; Ota, Katsumasa

2013-01-01

To provide adequate care, medical professionals have to collect not only medical information but also information that may be related to private aspects of the patient's life. With patients' increasing awareness of information privacy, healthcare providers have to pay attention to the patients' right of privacy. This study aimed to clarify the requirements of the display method of electronic patient record (EPR) screens in consideration of both patients' information privacy concerns and health professionals' information needs. For this purpose, semi-structured group interviews were conducted of 78 medical professionals. They pointed out that partial concealment of information to meet patients' requests for privacy could result in challenges in (1) safety in healthcare, (2) information sharing, (3) collaboration, (4) hospital management, and (5) communication. They believed that EPRs should (1) meet the requirements of the therapeutic process, (2) have restricted access, (3) provide convenient access to necessary information, and (4) facilitate interprofessional collaboration. This study provides direction for the development of display methods that balance the sharing of vital information and protection of patient privacy.

Parasite detection in patients with post kala-azar dermal leishmaniasis in India: a comparison between molecular and immunological methods

Science.gov (United States)

Salotra, P; Sreenivas, G; Beena, K R; Mukherjee, A; Ramesh, V

2003-01-01

Aims: To evaluate the sensitivity and specificity of serological, immunohistochemical, and molecular methods in the diagnosis of post kala-azar dermal leishmaniasis (PKDL). Methods: Twenty five patients with confirmed PKDL and 25 controls were included in the study. G2D10, a monoclonal antibody against Leishmania, was used for the immunohistochemical (IHC) staining of lesion sections to visualise anti-Leishmania donovani antibodies. The diagnostic usefulness of IHC was compared with enzyme linked immunosorbent assay (ELISA) with a recombinant (rk39) antigen, and a species specific polymerase chain reaction (PCR) assay, amplifying a kinetoplast minicircle DNA sequence. Results: IHC detected 22 of 25 PKDL cases, giving a sensitivity of 88%. The diagnostic sensitivity of both the ELISA and PCR tests was higher (96%). All of the 25 controls examined were negative in PCR, indicating 100% specificity of the test, whereas ELISA showed 96% specificity. Conclusions: IHC with G2D10 significantly enhances the sensitivity of detection of PKDL over routine haematoxylin and eosin staining. ELISA with a recombinant antigen is an economical and practical assay. PCR is the most sensitive and specific diagnostic method for PKDL. The tests described would facilitate the recognition of patients with PKDL, enabling timely treatment, which would contribute greatly to the control of kala-azar. PMID:14600129

Sonographic and Clinical Features of Upper Extremity Deep Venous Thrombosis in Critical Care Patients

Directory of Open Access Journals (Sweden)

Michael Blaivas

2012-01-01

Full Text Available Background-Aim. Upper extremity deep vein thrombosis (UEDVT is an increasingly recognized problem in the critically ill. We sought to identify the prevalence of and risk factors for UEDVT, and to characterize sonographically detected thrombi in the critical care setting. Patients and Methods. Three hundred and twenty patients receiving a subclavian or internal jugular central venous catheter (CVC were included. When an UEDVT was detected, therapeutic anticoagulation was started. Additionally, a standardized ultrasound scan was performed to detect the extent of the thrombus. Images were interpreted offline by two independent readers. Results. Thirty-six (11.25% patients had UEDVT and a complete scan was performed. One (2.7% of these patients died, and 2 had pulmonary embolism (5.5%. Risk factors associated with UEDVT were presence of CVC [(odds ratio (OR 2.716, P=0.007], malignancy (OR 1.483, P=0.036, total parenteral nutrition (OR 1.399, P=0.035, hypercoagulable state (OR 1.284, P=0.045, and obesity (OR 1.191, P=0.049. Eight thrombi were chronic, and 28 were acute. We describe a new sonographic sign which characterized acute thrombosis: a double hyperechoic line at the interface between the thrombus and the venous wall; but its clinical significance remains to be defined. Conclusion. Presence of CVC was a strong predictor for the development of UEDVT in a cohort of critical care patients; however, the rate of subsequent PE and related mortality was low.

Proceedings: Twenty years of energy policy: Looking toward the twenty-first century

International Nuclear Information System (INIS)

1992-01-01

In 1973, immediately following the Arab Oil Embargo, the Energy Resources Center, University of Illinois at Chicago initiated an innovative annual public service program called the Illinois Energy Conference. The objective was to provide a public forum each year to address an energy or environmental issue critical to the state, region and nation. Twenty years have passed since that inaugural program, and during that period we have covered a broad spectrum of issues including energy conservation nuclear power, Illinois coal, energy policy options, natural gas, alternative fuels, new energy technologies, utility deregulation and the National Energy Strategy

Proceedings: Twenty years of energy policy: Looking toward the twenty-first century

Energy Technology Data Exchange (ETDEWEB)

1992-12-31

In 1973, immediately following the Arab Oil Embargo, the Energy Resources Center, University of Illinois at Chicago initiated an innovative annual public service program called the Illinois Energy Conference. The objective was to provide a public forum each year to address an energy or environmental issue critical to the state, region and nation. Twenty years have passed since that inaugural program, and during that period we have covered a broad spectrum of issues including energy conservation nuclear power, Illinois coal, energy policy options, natural gas, alternative fuels, new energy technologies, utility deregulation and the National Energy Strategy.

Computed Tomography (CT) Perfusion as an Early Predictive Marker for Treatment Response to Neoadjuvant Chemotherapy in Gastroesophageal Junction Cancer and Gastric Cancer - A Prospective Study

DEFF Research Database (Denmark)

Lundsgaard Hansen, Martin; Fallentin, Eva; Lauridsen, Carsten

2014-01-01

OBJECTIVES: To evaluate whether early reductions in CT perfusion parameters predict response to pre-operative chemotherapy prior to surgery for gastroesophageal junction (GEJ) and gastric cancer. MATERIALS AND METHODS: Twenty-eight patients with adenocarcinoma of the gastro-esophageal junction (GEJ......-operative chemotherapy in GEJ and gastric cancer. As a single diagnostic test, CT Perfusion only has moderate sensitivity and specificity in response assessment of pre-operative chemotherapy making it insufficient for clinical decision purposes....

Infective endocarditis not related to intravenous drug abuse in HIV-1-infected patients: report of eight cases and review of the literature.

Science.gov (United States)

Losa, J E; Miro, J M; Del Rio, A; Moreno-Camacho, A; Garcia, F; Claramonte, X; Marco, F; Mestres, C A; Azqueta, M; Gatell, J M

2003-01-01

To add to the limited information on infective endocarditis (IE) not related to intravenous drug abuse (IVDA) in HIV-1-infected patients. We have reviewed the characteristics of eight cases of IE in non-IVDA HIV-1 infected patients diagnosed in our institution between 1979 and 1999 as well as cases in the literature. All our patients were male, and the mean age was 44 years (range 29-64). HIV-1 risk factors were: homosexuality in five, heterosexuality in two, and the use of blood products in one. HIV stage C was found in six cases, and the median (range) CD4 cell count was 22/microL (4-274 cells/microL). IE was caused by Enterococcus faecalis in three cases, staphylococci in two cases, and Salmonella enteritidis, viridans group streptococci and Coxiella burnetii in one case each. Three patients acquired IE while in the hospital. All IE cases involved a native valve, and underlying valve disease was found in three patients. The aortic valve was the most frequently affected (five cases). Two patients underwent surgery, with a good outcome, and one patient died. Fourteen cases of IE not related to IVDA in HIV-1-infected patients were found in the literature review. The most common causative agents were Salmonella spp. and fungi (four cases each). Two patients had prosthetic valve IE, and the mitral valve was the most frequently affected (10 cases). The remaining clinical characteristics and the outcome were similar to those in the present series. IE not related to IVDA is rare in HIV-1-infected patients. In more than half of the cases, IE develops in patients with advanced HIV-1 disease. A wide etiologic range is found, reflecting different clinical and environmental conditions. None of the patients who underwent surgery died, and the overall mortality rate was not higher than in non-HIV-1-infected patients with IE.

Why the American public supports twenty-first century learning.

Science.gov (United States)

Sacconaghi, Michele

2006-01-01

Aware that constituent support is essential to any educational endeavor, the AOL Time Warner Foundation (now the Time Warner Foundation), in conjunction with two respected national research firms, measured Americans' attitudes toward the implementation of twenty-first century skills. The foundation's national research survey was intended to explore public perceptions of the need for changes in the educational system, in school and after school, with respect to the teaching of twenty-first century skills. The author summarizes the findings of the survey, which were released by the foundation in June 2003. One thousand adults were surveyed by telephone, including African Americans, Latinos, teachers, and business executives. In general, the survey found that Americans believe today's students need a "basics-plus" education, meaning communication, technology, and critical thinking skills in addition to the traditional basics of reading, writing, and math. In fact, 92 percent of respondents stated that students today need different skills from those of ten to twenty years ago. Also, after-school programs were found to be an appropriate vehicle to teach these skills. Furthermore, the survey explored how well the public perceives schools to be preparing youth for the workforce and postsecondary education, which twenty-first century skills are seen as being taught effectively, and the level of need for after-school and summer programs. The survey results provide conclusive evidence of national support for basics-plus education. Thus, a clear opportunity exists to build momentum for a new model of education for the twenty-first century.

Value of exercise thallium-201 imaging in patients with diagnostic and nondiagnostic exercise electrocardiograms

International Nuclear Information System (INIS)

Iskandrian, A.S.; Segal, B.L.

1981-01-01

The role of exercise imaging with thallium-201 in the evaluation of patients suspected of having coronary artery disease was studied in 194 patients undergoing diagnostic coronary arteriography. Ninety-eight patients had 70 percent or more narrowing of one or more coronary vessels and 96 patients had either no or insignificant coronary artery disease. One hundren twenty-three of the 194 patients had conclusive treadmill exercise electrocardiograms (either positive or negative), and 71 had inconclusive exercise electrocardiograms. The specificity of exercise imaging (97 percent) was higher than that of exercise electrocardiograms (86 percent, p less than 0.02). The specificity of both tests combined was not significantly different from that of exercise electrocardiograms alone. The sensitivity (79 percent) and specificity (95 percent) of exercise imaging were not significantly different in patients with inconclusive exercise electrocardiograms when compared with those in patients whose exercise electrocardiograms were conclusive. These data indicate that exercise imaging is sensitive and specific in diagnosing coronary artery disease in the presence of diagnostic as well as nondiagnostic exercise electrocardiograms and that propranolol therapy does not affect the results

A preliminary psychometric evaluation of the eight-item cognitive load scale.

Science.gov (United States)

Pignatiello, Grant A; Tsivitse, Emily; Hickman, Ronald L

2018-04-01

The aim of this article is to report the psychometric properties of the eight-item cognitive load scale. According to cognitive load theory, the formatting and delivery of healthcare education influences the degree to which patients and/or family members can engage their working memory systems for learning. However, despite its relevance, cognitive load has not yet been evaluated among surrogate decision makers exposed to electronic decision support for healthcare decisions. To date, no psychometric analyses of instruments evaluating cognitive load have been reported within healthcare settings. A convenience sample of 62 surrogate decision makers for critically ill patients were exposed to one of two healthcare decision support interventions were recruited from four intensive care units at a tertiary medical center in Northeast Ohio. Participants were administered a battery of psychosocial instruments and the eight-item cognitive load scale (CLS). The CLS demonstrated a bidimensional factor structure with acceptable discriminant validity and internal consistency reliability (Cronbach's α = 0.75 and 0.89). The CLS is a psychometrically sound instrument that may be used in the evaluation of decision support among surrogate decision makers of the critically ill. The authors recommend application of the cognitive load scale in the evaluation and development of healthcare education and interventions. Copyright © 2018 Elsevier Inc. All rights reserved.

Eight channel fast scalar

Energy Technology Data Exchange (ETDEWEB)

Waddoup, W D; Stubbs, R J [Durham Univ. (UK)

1977-11-01

An eight channel 64-bit scaler has been constructed with a static CMOS memory. Scaling frequencies are independently variable, at each channel, as are the number of bits/channel. The scaler, when used in conjunction with a multichannel charge to time converter results in a very flexible, gated multichannel ADC.

Clinical Evaluation of Small Diameter Straumann Implants in Partially Edentulous Patients: A 5-Year Retrospective Study

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S. OZER

2011-06-01

Full Text Available Objective: The aim of the present study was to retrospectively evaluate small-diameter (3.3 mm Straumann® dental implants placed in the maxilla or the mandible over a period of 5 years in function.Materials and Methods: Twenty- eight partially edentulous patients received a total of 48 implants over a 5-year period. After the standard healing period (3 to 6 months, the implants were restored with single-tooth prostheses or fixed partial dentures. All patients were followed according to a strict maintenance program with regular recalls. The cumulative survival rates of implants were analyzed and prosthetic complications were assessed.Results: After 5 years of function, one single 10-mm-long implant in the maxillary premolar region was lost because of recurrent peri-implant infection in a female patient. Two single 10-mm-long maxillary implants placed in the posterior region were lost due to body fracture. The cumulative 5-year survival rate of the implants was 93.75 %. The most common prosthetic complication was loosening of the occlusal screw.Conclusion: Within the limited observation period and the number of patients included in this study, it may be concluded that the use of small-diameter implants appears to be predictable if clinical guidelines are followed and appropriate prosthetic restorations are provided. However, it should be noted that fatigue fracture may occur.

Twenty lectures on thermodynamics

CERN Document Server

Buchdahl, H A

2013-01-01

Twenty Lectures on Thermodynamics is a course of lectures, parts of which the author has given various times over the last few years. The book gives the readers a bird's eye view of phenomenological and statistical thermodynamics. The book covers many areas in thermodynamics such as states and transition; adiabatic isolation; irreversibility; the first, second, third and Zeroth laws of thermodynamics; entropy and entropy law; the idea of the application of thermodynamics; pseudo-states; the quantum-static al canonical and grand canonical ensembles; and semi-classical gaseous systems. The text

Clinical Experience and Evaluation of Patient Treatment Verification With a Transit Dosimeter

Energy Technology Data Exchange (ETDEWEB)

Ricketts, Kate, E-mail: k.ricketts@ucl.ac.uk [Division of Surgery and Interventional Sciences, University College London, London (United Kingdom); Department of Radiotherapy Physics, Royal Berkshire NHS Foundation Trust, Reading (United Kingdom); Navarro, Clara; Lane, Katherine; Blowfield, Claire; Cotten, Gary; Tomala, Dee; Lord, Christine; Jones, Joanne; Adeyemi, Abiodun [Department of Radiotherapy Physics, Royal Berkshire NHS Foundation Trust, Reading (United Kingdom)

2016-08-01

Purpose: To prospectively evaluate a protocol for transit dosimetry on a patient population undergoing intensity modulated radiation therapy (IMRT) and to assess the issues in clinical implementation of electronic portal imaging devices (EPIDs) for treatment verification. Methods and Materials: Fifty-eight patients were enrolled in the study. Amorphous silicon EPIDs were calibrated for dose and used to acquire images of delivered fields. Measured EPID dose maps were back-projected using the planning computed tomographic (CT) images to calculate dose at prespecified points within the patient and compared with treatment planning system dose offline using point dose difference and point γ analysis. The deviation of the results was used to inform future action levels. Results: Two hundred twenty-five transit images were analyzed, composed of breast, prostate, and head and neck IMRT fields. Patient measurements demonstrated the potential of the dose verification protocol to model dose well under complex conditions: 83.8% of all delivered beams achieved the initial set tolerance level of Δ{sub D} of 0 ± 5 cGy or %Δ{sub D} of 0% ± 5%. Importantly, the protocol was also sensitive to anatomic changes and spotted that 3 patients from 20 measured prostate patients had undergone anatomic change in comparison with the planning CT. Patient data suggested an EPID-reconstructed versus treatment planning system dose difference action level of 0% ± 7% for breast fields. Asymmetric action levels were more appropriate for inversed IMRT fields, using absolute dose difference (−2 ± 5 cGy) or summed field percentage dose difference (−6% ± 7%). Conclusions: The in vivo dose verification method was easy to use and simple to implement, and it could detect patient anatomic changes that impacted dose delivery. The system required no extra dose to the patient or treatment time delay and so could be used throughout the course of treatment to identify and limit

Is Bjerkandera adusta Important to fungus-associated chronic cough as an allergen? Eight cases' reports.

Science.gov (United States)

Ogawa, Haruhiko; Fujimura, Masaki; Takeuchi, Yasuo; Makimura, Koichi

2009-10-01

Recently, we have reported a new clinical disease concept called fungus-associated chronic cough (FACC), which entailed the following manifestations: (1) chronic cough; (2) the presence of environmental fungi, particularly basidiomycetous (BM) fungi, in the sputum; and (3) good clinical response to antifungal drugs. To clarify the relationship between the exposure to environmental fungi and the development of cough attacks, we reviewed the clinical records of patients with FACC and performed a molecular biological analysis of the BM fungi. We successfully selected 8 patients with chronic cough, wherein a sputum culture yielded B. adusta beforehand; moreover, we conducted allergological tests such as the immediate-type skin test, a serological test, bronchoprovocation test, and lymphocyte stimulation test (LST), using the antigenic solution of B. adusta. The efficacy of individualized therapy and the clinical manifestations in the eight patients were examined. All the eight patients were diagnosed with FACC. Although three patients who did not show a positive reaction to the bronchoprovocation test or LST showed excellent clinical response to anti-fungal drugs; other 5 patients who showed a positive reaction to the bronchoprovocation test and/or LST seemed to be more intractable because of taking a longer time for complete remission and more frequent recurrence of cough. It was suggested that so-called allergic fungal cough (AFC), which is characterized by sensitization to B. adusta, may be included in a part of chronic intractable cough.

Our experience with Syrian refugee patients at the child and adolescent psychiatry clinic in Gaziantep, Turkey.

Science.gov (United States)

Karadag, Mehmet; Gokcen, Cem; Dandil, Funda; Calisgan, Baran

2018-06-01

Reporting from Turkey's frontier with the civil war in Syria, we examined the demographic characteristics, psychiatric diagnoses and treatments for the Syrian refugee patients who have presented to Gaziantep University, Child and Adolescent Psychiatry Clinic through 2016 and the first half of 2017 retrospectively, having aimed to understand the special characteristics and needs of this novel patient group. Within a year and a half, we evaluated 51 children and adolescents and 25 (51%) had come from refugee camps, where primary healthcare services are available. Twenty-eight patients (54.9%) had special educational needs. Among our patients, there were only 15 (29.4%) girls. After our experience with refugee patients, we conclude that the role of primary healthcare services in reaching psychiatric treatment should be investigated for child refugees that special educational needs of Syrian refugees in Turkey needs urgent attention and that more research is needed to establish whether gender may be a factor in negligence of internalising symptoms by refugee families.

Self-reported medical, medication and laboratory error in eight countries: risk factors for chronically ill adults.

Science.gov (United States)

Scobie, Andrea

2011-04-01

To identify risk factors associated with self-reported medical, medication and laboratory error in eight countries. The Commonwealth Fund's 2008 International Health Policy Survey of chronically ill patients in eight countries. None. A multi-country telephone survey was conducted between 3 March and 30 May 2008 with patients in Australia, Canada, France, Germany, the Netherlands, New Zealand, the UK and the USA who self-reported being chronically ill. A bivariate analysis was performed to determine significant explanatory variables of medical, medication and laboratory error (P error: age 65 and under, education level of some college or less, presence of two or more chronic conditions, high prescription drug use (four+ drugs), four or more doctors seen within 2 years, a care coordination problem, poor doctor-patient communication and use of an emergency department. Risk factors with the greatest ability to predict experiencing an error encompassed issues with coordination of care and provider knowledge of a patient's medical history. The identification of these risk factors could help policymakers and organizations to proactively reduce the likelihood of error through greater examination of system- and organization-level practices.

Eight-channel video broadcast feed service using free-space optical wireless technology at the Sydney 2000 Olympic Games

Science.gov (United States)

Szajowski, Paul F.; Rigas, A. J.; Robinson, J. W.; Nykolak, Gerald; Paulson, Bruce D.; Tourgee, G. E.; Auborn, James J.

2001-02-01

12 Terrestrial 1550 nm WDM free-space optical communication systems have been demonstrated to provide a viable means to transport data, voice and video channels for point-to-point applications without the use of optical fiber. Key features of free-space optical transmission systems are their ability to utilize present day telecommunication components such as: laser diode transmitters, high-power optical amplifiers operating within the 1550 nm optical transmission window and high-sensitivity optical receivers designed for multi-Giga- bit data rates. In this paper, we report on details of the world's first field test, demonstrating real time video transmission of eight uncompressed standard-definition (SD) video channels operating at an aggregate data rate of 1.485 Gb/s over a 0.89 km terrestrial free-space link. This data link was used in support of the 2000 Olympic games held recently in Sydney, Australia. Results from this eight- channel SD terrestrial free-space laser communications systems are presented. The transmission system operated error-free continuously from September 14, 2000 until October 1, 2000, twenty-four hours a day, throughout the coverage of the games. Modeling results predict that free- space SD video transmission systems can be designed and operated over significant link distances under nominal visibility conditions.

Dual-source CT coronary angiography in patients with premature heart-beats: initial experience

International Nuclear Information System (INIS)

Wang Yining; Zhang Zhuhua; Kong Lingyan; Song Lan; Mu Wenbin; Wang Yun; Jin Zhengyu

2008-01-01

Objective: To evaluate the feasibility of dual-source computed tomography (DSCT) coronary angiography in a population with premature heart-beats. Methods: Seventy patients with suspected coronary artery disease and premature heart-beats were routinely imaged on a DSCT scanner (Somatom Definition, Siemens AG, Germany). The images were reconstmcted before and after ECG editing. Two readers independently assessed image quality of all coronary segments using a four-point grading scale from excellent (1) to non-assessable (4). The results of the two groups were compared with a paired t-test, and a P value of less than 0.05 was considered significant. Results: The mean heart rate during examination ranged from 49 to 111 bpm[ mean(70.7±12.4) bpm]. Twenty-eight of 70 patients with relatively small variability of the heart rate [(41.0±18.4) bpm] got diagnostic image quality without ECG editing. In other 42 patients with larger variability of the heart rate [(71.4±28.7) bpm], the mean image quality scores were 2.09±1.27 and 1.50±0.79 before and after ECG editing, there was a significant difference (t= 13.764, P 2 =121.846, P<0.01). Finally, the diagnostic image accounted 98.0% (1014/1035) in all segments of 70 patients. Conclusion: DSCT can provide diagnostic images for patients with premature heart-beats. The image quality in patients with larger variability of the heart rate can be significantly improved through ECG editing. (authors)

Varicella-zoster virus immunity in dermatological patients on systemic immunosuppressant treatment.

LENUS (Irish Health Repository)

Hackett, C B

2012-02-01

BACKGROUND: Primary varicella infection is caused by varicella-zoster virus (VZV). It is a common childhood infection, which is usually benign but can occasionally cause morbidity and mortality. In immunosuppressed adults, atypical presentation and disseminated disease can occur with significant morbidity and mortality. A VZV vaccine is available. OBJECTIVES: This study was designed to measure the prevalence of immunity to VZV and to determine the predictive value of a self-reported history of varicella infection in a population of dermatological patients receiving systemic immunosuppressant therapy. We sought to assess the need for routine serological testing for varicella-zoster immunity in this cohort. METHODS: Serological testing for VZV immunity was done on 228 patients receiving systemic immunosuppressive treatment for a dermatological condition. Information regarding a history of previous primary VZV infection was obtained from each patient. RESULTS: Two hundred and twenty-eight patients had VZV serology performed. The mean age of the patients was 49.6 years. The prevalence of VZV seropositivity in this cohort was 98.7%. One hundred and two patients (44.7%) reported having a definite history of primary VZV. The sensitivity of a self-reported history of VZV infection was 45.3% with a specificity of 100%. The positive and negative predictive values of a self-reported history of VZV for serologically confirmed immunity were 100% and 2.3%, respectively. CONCLUSIONS: The prevalence of VZV IgG antibodies in our cohort of Irish dermatology patients receiving immunosuppressive therapy is 98.7%. A recalled history of varicella infection is a good predictor of serological immunity. This study has shown that there are VZV-susceptible individuals within our cohort. These patients did not have a clear history of previous infection. We recommend serological testing of patients without a clear history of infection prior to the commencement of immunosuppressive therapy and

Amiodarone-induced hypothyroidism. A common complication of prolonged therapy: a report of eight cases

International Nuclear Information System (INIS)

Hawthorne, G.C.; Campbell, N.P.; Geddes, J.S.; Ferguson, W.R.; Postlethwaite, W.; Sheridan, B.; Atkinson, A.B.

1985-01-01

Amiodarone is a widely used antiarrhythmic drug, which contains 75 mg of iodide per 200 mg of active substance. Eight patients receiving long-term amiodarone therapy became hypothyroid. Seven of these patients had no previous history of thyroid dysfunction or goiter. Antithyroid antibodies were absent, and standard perchlorate discharge tests were positive in seven patients when hypothyroidism was diagnosed. In one patient, amiodarone therapy was withdrawn; over the next nine months, the hypothyroidism resolved, and results of the perchlorate discharge test reverted to normal. The authors conclude that amiodarone-induced hypothyroidism is similar to previously described iodide-induced hypothyroidism. It may develop in the absence of a previous history of thyroid disease, and all patients receiving long-term amiodarone therapy should therefore be regularly monitored for hypothyroidism

Hippotherapy in Adult Patients with Chronic Brain Disorders: A Pilot Study

OpenAIRE

Sunwoo, Hyuk; Chang, Won Hyuk; Kwon, Jeong-Yi; Kim, Tae-Won; Lee, Ji-Young; Kim, Yun-Hee

2012-01-01

Objective To investigate the effects of hippotherapy for adult patients with brain disorders. Method Eight chronic brain disorder patients (7 males, mean age 42.4?16.6 years) were recruited. The mean duration from injury was 7.9?7.7 years. The diagnoses were stroke (n=5), traumatic brain disorder (n=2), and cerebral palsy (n=1). Hippotherapy sessions were conducted twice a week for eight consecutive weeks in an indoor riding arena. Each hippotherapy session lasted 30 minutes. All participants...

Healthcare professionals? views on feedback of a patient safety culture assessment

OpenAIRE

Zwijnenberg, Nicolien C.; Hendriks, Michelle; Hoogervorst-Schilp, Janneke; Wagner, Cordula

2016-01-01

Background By assessing patient safety culture, healthcare providers can identify areas for improvement in patient safety culture. To achieve this, these assessment outcomes have to be relevant and presented clearly. The aim of our study was to explore healthcare professionals? views on the feedback of a patient safety culture assessment. Methods Twenty four hospitals participated in a patient safety culture assessment in 2012. Hospital departments received feedback in a report and on a websi...

Efficacy and Toxicity of Intrathecal Liposomal Cytarabine in First-line Therapy of Childhood Acute Lymphoblastic Leukemia

DEFF Research Database (Denmark)

Levinsen, Mette; Harila-Saari, Arja; Grell, Kathrine

2016-01-01

We investigated efficacy and toxicity of replacing conventional triple (cytarabine, methotrexate, and hydrocortisone) intrathecal therapy (TIT) with liposomal cytarabine during maintenance therapy among 40 acute lymphoblastic leukemia patients. Twenty-eight of 29 patients in the TIT arm received...

Quality of life in patients diagnosed with primary hepatocellular carcinoma: hepatic arterial infusion of Cisplatin versus 90-Yttrium microspheres (Therasphere).

Science.gov (United States)

Steel, Jennifer; Baum, Andrew; Carr, Brian

2004-02-01

The aims of the study were to test the difference in health-related quality (HRQL) of life and survival in patients diagnosed with primary hepatocellular carcionma (HCC) and treated with either hepatic arterial infusion (HAI) of Cisplatin or 90-Yttrium microspheres (Therasphere). The design of the study was a non-randomized parallel cohort study. Twenty-eight patients participated in the present study. HRQL was assessed by administration of the Functional Assessment of Cancer Therapy-Hepatobiliary. Survival was measured using Kaplan Meier methods. The results of present study suggest treatment with Therasphere) had an advantage in regard to HRQL and survival when compared to Cisplatin. At 3-month follow-up, patients who were treated with Therasphere had a higher level of functional well-being as well as overall quality of life when compared to patients treated with Cisplatin. At 6-month follow-up patients (treated with Therasphere) continued to have better functional well-being when compared to patients being treated with HAI of Cisplatin. At 6-month follow-up, survival was found to be similar for patients treated with Therasphere when compared to patients being treated with Cisplatin. Preliminary data suggest that treatment with Therasphere has a modest advantage in regard to HRQL when compared patients treated with HAI of Cisplatin. Future research with Therasphere, that includes a larger sample size and longer follow-up, is necessary to make definitive conclusions regarding the efficacy and effect on HRQL. Copyright 2003 John Wiley & Sons, Ltd.

Virtual endoscopy using spiral CT in patients with carcinomas of the hypopharynx and larynx

International Nuclear Information System (INIS)

Song, Sang Gook; Seo, Jeong Jin; Chung, Tae Woong; Kim, Hyeong Kil; Jeong, Gwang Woo; Jeong, Yong Yeon; Kang, Heoung Keun; Cho, Jae Sik

2000-01-01

To compare the usefulness of virtual endoscopy using spiral CT with that of laryngoscopy in the detection and evaluation of laryngeal and pharyngeal carcinomas. Twenty-four patients with pathologically proven laryngeal and pharyngeal carcinomas underwent laryngoscopy and virtual endoscopy using spiral CT. Eleven of the carcinomas were supraglottic, five were glottic, and eight were hypopharyngeal. Source images obtained by spiral CT were transmitted to an independent workstation and virtual endoscopic images were obtained using Navigator software. These were graded according to their quality (good, fair, bad), and were interpreted by two radiologists who were blinded to the conventional endoscopic findings. These latter were subsequently compared with the virtual endoscopic findings in terms of similarity to laryngoscopic examination and detectability of lesions. The overall image quality of virtual endoscopy was good in 16 cases (67%), fair in eight (33%), and bad in no case. Among the 11 supraglottic carcinomas, image quality was good in seven cases (64%), and fair in four (36%). In four of the five glottic carcinomas (80%) quality was good, and in one case (20%) it was fair, while among the eight hypopharyngeal carcinomas, quality was good in five cases (63%), and fair in three (37%). Overall, detection of the lesion was possible in 23 cases (96%). Due to the small size of the lesion, the one case of glottic carcinoma was not detected. Virtual endoscopy using spiral CT is a safe and noninvasive method, and also successfully detects laryngeal and pharyngeal lesions, with good image quality. For the evaluation of laryngeal and hypopharyngeal carcinoma, its use ma complement that of axial CT. (author)

Prospective evaluation of bone and leukocyte scintigraphy for diagnosis of chronic osteomyelitis in patients with coexistent soft-tissue pathology

International Nuclear Information System (INIS)

Jacobson, A.F.; Harley, J.D.; Lipsky, B.A.; Pecoraro, R.E.

1989-01-01

This paper reports on a study involving twenty-four patients with soft-tissue infections or wounds and radiographic abnormalities in contiguous bones possibly representing osteomyelitis who underwent three-phase T c -99 m methylene diphosphonate (MDP) bone scanning, followed by In-111 leukocyte scintigraphy (22 patients) and bone biopsy (21 patients). Chronic osteomyelitis was confirmed in 12 patients by means of biopsy cultures and in one by means of histologic findings following amputation. Four patterns of leukocyte uptake in bone were identified: definitely increased, possibly increased, normal, and decreased. The prevalence of osteomyelitis for these four leukocyte scan patterns was as follows: 89% (eight of nine patients), 40% (two of five), 20% (one of five), and 67% (two of three), respectively. A definite increase in bone uptake of In-111-labeled leukocytes usually reflects osteomyelitis, but bone biopsy may be necessary to establish the diagnosis when other scan patterns are present

Synthesis of all eight stereoisomeric 6-deoxy-l-hexopyranosyl donors - trends in using stereoselective reductions or mitsunobu epimerizations

DEFF Research Database (Denmark)

Frihed, Tobias; Pedersen, Christian Marcus; Bols, Mikael

2014-01-01

The synthesis of all eight rare but biologically important 6deoxy-L-hexoses as their thioglycoside glycosyl donors starting from the commercially available L-rhamnose or L-fucose is reported. The synthesis of all eight 6-deoxy-L-hexoses was accomplished using a variety of epimerization methods, w...

Uricosuric effect of losartan in patients with renal transplants

DEFF Research Database (Denmark)

Kamper, A L; Nielsen, A H

2001-01-01

BACKGROUND: The aim of the study was to evaluate the uricosuric effect of the angiotensin II receptor antagonist, losartan, in hypertensive patients with renal transplants who are treated with cyclosporin A (CsA). METHODS: Twenty-six patients with stable renal function and hypertension, 16 men......-daily administration of 50 mg of losartan in hypertensive CsA-treated patients with renal transplants caused a 17% increase in FE(uric acid) and an 8% fall in plasma uric acid....

Thyroid Radiation Dose to Patients from Diagnostic Radiology Procedures over Eight Decades: 1930-2010.

Science.gov (United States)

Chang, Lienard A; Miller, Donald L; Lee, Choonsik; Melo, Dunstana R; Villoing, Daphnée; Drozdovitch, Vladimir; Thierry-Chef, Isabelle; Winters, Sarah J; Labrake, Michael; Myers, Charles F; Lim, Hyeyeun; Kitahara, Cari M; Linet, Martha S; Simon, Steven L

2017-12-01

considerable uncertainties associated with the presented doses, particularly for characterizing exposures of individual identified patients. Nonetheless, the tabulations provide the only comprehensive report on the estimation of typical radiation doses to the thyroid gland from medical diagnostic procedures over eight decades (1930-2010). These data can serve as a resource for epidemiologic studies that evaluate the late health effects of radiation exposure associated with diagnostic radiologic examinations.

Arginase activity in peripheral blood of patients with intestinal schistosomiasis, Wonji, Central Ethiopia.

Science.gov (United States)

Getaneh, A; Tamrat, A; Tadesse, K

2015-07-01

Morbidity and mortality caused by schistosomiasis usually results from immunopathology. But the underlying mechanisms are not yet clearly understood. Th2-type immune response is thought to be dominant during chronic schistosomiasis, and upregulation of arginase-I is one component of this milieu. A cohort study was conducted to assess arginase activity in peripheral blood of humans with intestinal schistosomiasis in Wonji-Shoa Sugar Estate, Central Ethiopia. Laboratory-confirmed 30 Schistosoma mansoni-infected patients and 18 apparently healthy controls were recruited. Faecal egg count was carried out by Kato-Katz technique. Plasma and peripheral blood mononuclear cells (PBMCs) were isolated from whole blood. Activity of arginase in plasma and PBMC lysates was measured, and results were compared with that of controls. Twenty-one of 30 patients had light infection, whereas moderate and heavy intensity infections were observed in eight and only one patient(s), respectively. A significant increase in both PBMC (patients: 59.96 + 82.99, controls: 25.44 + 24.6 mU/mg protein, P intestinal schistosomiasis. © 2015 John Wiley & Sons Ltd.

Patient compliance with extended low molecular weight heparin injections following hip and knee arthroplasty.

Science.gov (United States)

Deakin, Dan E; Mishreki, Andrew; Aslam, Nadim; Docker, Charles

2010-01-01

The use of extended duration thromboprophylaxis following hip and knee arthroplasty is becoming widespread. The aim of our study was to determine patient compliance with extended duration thromboprophylaxis using low molecular weight (LMWH) injections following hip and knee arthroplasty. 42 consecutive patients undergoing hip and knee arthroplasty were prospectively contacted during their fifth post operative week. A fully anonymised questionnaire was completed by each patient. All patients responded. One was excluded having been prescribed warfarin for pre existing atrial fibrillation. Twenty nine (71%) patients were discharged with the intention of self administering LMWH injections. Eight (20%) and four (9%) patients were discharged with the intention of administration by a relative or district nurse respectively. No patient required the person administering the injections to be changed after discharge from hospital. 90% (n=37) of patients reported not missing any doses. 10% (n=2) of patients missed one dose and 10% (n=2) missed two doses. Patient compliance with extended duration thromboprophylaxis using LMWH injections is extremely high. Oral thromboprophylaxis may be useful in the minority of patients requiring daily visits by a nurse to administer injections.

Gastrointestinal motor function in patients with portal hypertension

DEFF Research Database (Denmark)

Madsen, Jan Lysgård; Brinch, K; Hansen, Erik Feldager

2000-01-01

BACKGROUND: Existing data on gastric emptying and small-intestinal transit rates in portal-hypertensive patients are scarce and contradictory, and so far, the motor function of the colon has not been assessed in these patients. In this study we evaluated the propulsive effect of all main segments...... of the gastrointestinal tract in patients with well-characterized portal hypertension. METHODS: Eight patients with a postsinusoidal hepatic pressure gradient of at least 13 mmHg and eight age- and sex-matched healthy controls participated in the study. Gastric emptying, small-intestinal transit, and colonic transit...... rates were evaluated in all subjects by means of a gamma camera technique. The technique was also used to measure the frequency of antral contractions. RESULTS: No difference was observed in gastric mean emptying time or small-intestinal mean transit time of liquid and solid markers between patients...

Study of the Cooldown and Warmup for the Eight Sectors of the Large Hadron Collider

CERN Document Server

Liu, L; Tavian, L

2004-01-01

The LHC cryogenic system is based on a five-point feed scheme with eight refrigerators serving the eight sectors of the LHC machine. The paper presents the simplified flow scheme of the eight sectors and the mathematical methods including the program flowchart and the boundary conditions to simulate the cooldown and warmup of these sectors. The methods take into account the effect of the pressure drop across the valves as well as the pressure evolution in the different headers of the cryogenic distribution line. The simulated pressure and temperature profiles of headers of the LHC sector during the cooldown and warmup are given and the temperature evolutions of entire processes of cooldown and warmup are presented. As a conclusion, the functions of the input temperature for the normal and fast cooldown and warmup, the cooldown and warmup time of each sector and the distributions of mass flow rates in each sector are summarized. The results indicate that it is possible to cool down any of the LHC sector within...

Utility of 99mTc dextran scintigraphy in diabetic patients with suspected osteomyelitis of the foot

International Nuclear Information System (INIS)

Sarikaya, A.; Aygit, A.C.; Pekindil, G.

2003-01-01

Osteomyelitis of the foot is a frequent complication of diabetes mellitus and its diagnosis is often difficult. The goal of this study was to demonstrate the utility of 99m Tc dextran scintigraphy in suspected diabetic foot infections. Twenty-six patients (20 males, 6 females, age range 18-80 years) with diabetes mellitus who had a total of 36 foot ulcers or necrosis were studied. All the patients underwent both three phase bone scan and 99m Tc dextran scintigraphy. Final diagnosis was based upon either pathologic examination or clinical follow-up at least four months. On bone scan increased uptake was seen in 55 sites, and among these there were 11 lesions of proven osteomyelitis. There were 11 true-positive, 0 false negative, 0 true negative and 44 false positive results for bone scan. The sensitivity, specificity and accuracy of bone scan were 100%, 0% and 20%, respectively. With regard to 99m Tc dextran scan, nine lesions produced true-positive results with two lesions indicating false negatives resulting in a sensitivity of 82%. Thirty-six true negative and eight false positive results produced a specificity of 82%, and an accuracy 82% from 99m Tc dextran studies was obtained. Eight false-positive results were possibly due to neuroarthropathy, pressure points and deep penetrating ulcers. A patient with one false-negative result had angiopathy while other had neither neuropathy nor angiopathy. According to these results, 99m Tc dextran scintigraphy seems to be a sensitive and specific diagnostic method, and because of its advantages over other radiopharmaceuticals (shorter preparation time, highly stability in vivo/in vitro, early diagnostic imaging and low cost), it may be a radiopharmaceutical of choice for diagnosing in diabetic foot infections. (author)

Patient-specific quantification of image quality: An automated method for measuring spatial resolution in clinical CT images

Energy Technology Data Exchange (ETDEWEB)

Sanders, Jeremiah, E-mail: jeremiah.sanders@duke.edu [Medical Physics Graduate Program, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Clinical Imaging Physics Group, Duke University, Durham, North Carolina 27710 (United States); Hurwitz, Lynne [Department of Radiology, Duke University, Durham, North Carolina 27710 (United States); Samei, Ehsan [Medical Physics Graduate Program, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Clinical Imaging Physics Group, Duke University, Durham, North Carolina 27710 and Departments of Physics, Biomedical Engineering, Electrical and Computer Engineering, Duke University, Durham, North Carolina 27710 (United States)

2016-10-15

Purpose: To develop and validate an automated technique for evaluating the spatial resolution characteristics of clinical computed tomography (CT) images. Methods: Twenty one chest and abdominopelvic clinical CT datasets were examined in this study. An algorithm was developed to extract a CT resolution index (RI) analogous to the modulation transfer function from clinical CT images by measuring the edge-spread function (ESF) across the patient’s skin. A polygon mesh of the air-skin boundary was created. The faces of the mesh were then used to measure the ESF across the air-skin interface. The ESF was differentiated to obtain the line-spread function (LSF), and the LSF was Fourier transformed to obtain the RI. The algorithm’s ability to detect the radial dependence of the RI was investigated. RIs measured with the proposed method were compared with a conventional phantom-based method across two reconstruction algorithms (FBP and iterative) using the spatial frequency at 50% RI, f{sub 50}, as the metric for comparison. Three reconstruction kernels were investigated for each reconstruction algorithm. Finally, an observer study was conducted to determine if observers could visually perceive the differences in the measured blurriness of images reconstructed with a given reconstruction method. Results: RI measurements performed with the proposed technique exhibited the expected dependencies on the image reconstruction. The measured f{sub 50} values increased with harder kernels for both FBP and iterative reconstruction. Furthermore, the proposed algorithm was able to detect the radial dependence of the RI. Patient-specific measurements of the RI were comparable to the phantom-based technique, but the patient data exhibited a large spread in the measured f{sub 50}, indicating that some datasets were blurrier than others even when the projection data were reconstructed with the same reconstruction algorithm and kernel. Results from the observer study substantiated this

Evaluation of 14 patients performed radiotherapy due to Kaposi sarcoma

Directory of Open Access Journals (Sweden)

Fatma Teke

2015-09-01

Full Text Available Methods: The patients undergoing radiotherapy (RT because of the KS between the years 2005-2012 in Radiation Oncology Department of Dicle University Hospital were included. All patients underwent RT with different dose-fractionation schemes to increase quality of life and to palliate the symptoms. Patients with lesions in multiple regions underwent RT in the same or different dates. Responses to radiotherapy were recorded as complete or partial response. Results: Fourteen patients received radiotherapy because of f KS were evaluated retrospectively. Twenty two different regions of 14 patients underwent RT . Only one patient (4.5% was performed RT to glans penis as a third region while performed to the two regions in six patients (27.3%. At irradiations, 6 MV and 10 MV photon energies with 6 MeV, 9 MeV and 12 MeV electron energy were used. Water phantom or bolus material was used to obtain a homogeneous dose distribution in the photon irradiation. RT dose administered to a total of 22 different regional was median 800 cGy (Range: 800-3000 cGy. Median number of RT fractions was 1 (Range: 1-10. When treatment response were evaluated stable disease was present in the 4 (18.1% regions. Partial response was achieved in eight (36.4% regions, complete response in 10 (45.5%. RT-related common lymphedema in the feet and legs was observed in the four (57.3% regions in the acute period. Complication of pain was present in two (28.7% regions. Conclusion: RT is an appropriate and effective treatment regimen in the palliative treatment of KS lesions. Excellent response rates of skin lesions may be obtained by RT. Lesions and symptoms such as itching may be lost after RT. Side effects such as edema and pain may be relieved by supportive treatment.

Striatal D_2/3 Binding Potential Values in Drug-Naïve First-Episode Schizophrenia Patients Correlate With Treatment Outcome

DEFF Research Database (Denmark)

Wulff, Sanne; Pinborg, Lars Hageman; Svarer, Claus

2015-01-01

potential (BP(p)) values and treatment outcome in a cohort of antipsychotic-naïve first-episode schizophrenia patients. Additionally, we wished to investigate associations between striatal dopamine D(2/3) receptor blockade and alterations of negative symptoms as well as functioning and subjective well......-being. Twenty-eight antipsychotic-naïve schizophrenia patients and 26 controls were included in the study. Single-photon emission computed tomography (SPECT) with [(123)I]iodobenzamide ([(123)I]-IBZM) was used to examine striatal D(2/3) receptor BP(p). Patients were examined before and after 6 weeks...... of treatment with the D(2/3) receptor antagonist amisulpride. There was a significant negative correlation between striatal D(2/3) receptor BP(p) at baseline and improvement of positive symptoms in the total group of patients. Comparing patients responding to treatment to nonresponders further showed...

Growth retardation due to idiopathic growth hormone deficiencies: MR findings in 24 patients

International Nuclear Information System (INIS)

Ochi, M.; Morikawa, M.; Yoshimoto, M.; Kinoshita, E.; Hayashi, K.

1992-01-01

In this study we evaluated the pituitary-hypothalamic abnormalities of ''idiopathic growth hormone (GH) deficiency'' as demonstrated by MR imaging. Twenty-four patients were examined with a 1.5-T unit using spin echo T-1 weighted images. The patients were divided into two groups according to MR findings: those with ectopic posterior pituitary glands (12 patients), and those with normal posterior pituitary glands (12 patients). Ten patients in the former group and four in the latter group had small anterior pituitary glands. All patients in the former group but only four in the latter group had severe GH deficiencies. Multiple hormone deficiencies were found in eight patients in the former group, but in only two in the latter group. It is speculated that perinatal abnormalities can cause posterior pituitary ectopia and that there is a close correlation between breech delivery and the male disadvantage of posterior pituitary ectopia. Half of our patients with ''idiopathic GH deficiency'' had ectopic posterior pituitaries. GH deficiency with posterior pituitary ectopia should no longer be considered idiopathic because organic lesions can now be identified during life. (orig./GD)

Esthetic Evaluation of Anterior Single-Tooth Implants with Different Abutment Designs - Patients' Satisfaction Compared to Dentists' Observations

NARCIS (Netherlands)

Patil, Ratnadeep; Gresnigt, Marco M M; Mahesh, Kavita; Dilbaghi, Anjali; Cune, Marco S

Purpose: To correlate patients' satisfaction and dentists' observations regarding two abutment designs used for single crowns in the esthetic zone: a divergent one (control) and a curved one (experimental), with special emphasis on muco-gingival esthetics. Materials and Methods: Twenty-six patients

Establishing the R&D Agenda for Twenty-First Century Learning

Science.gov (United States)

Kay, Ken; Honey, Margaret

2006-01-01

Much ink has flowed over the past few years describing the need to incorporate twenty-first century skills into K-12 education. Preparing students to succeed as citizens, thinkers, and workers--the bedrock of any educational system--in this environment means arming them with more than a list of facts and important dates. Infusing twenty-first…

Correlation between Serum Aldosterone Level and Hearing Condition of Elderly Patients Referred to Otolaryngology Services of Hamadan, Western Iran

Directory of Open Access Journals (Sweden)

Dr. Farhad Farahani

2010-06-01

Full Text Available Background and Aim: Recently, more attention was paid to the direct protective effect of aldosterone against hearing impairment in elderly patients. The aim of this study was determination of possible correlation between serum aldosterone level and hearing condition of elderly patients that referred to the Otolaryngology services of Hamadan in 2005-2006.Methods: In this case control study 54 (27 males,27 females persons above 60 years old were evaluated. They contained twenty eight cases with normal hearing and 26 cases with presbycusis. Persons with any abnormal biochemical finding or history of conditions that predispose them to the sensorineural hearing loss (SNHL were excluded. In both groups serum level of sodium, potassium and aldosterone were measured and hearing condition evaluated by puretone, speech and immitance audiometry.Results: Statistical relationship between serum aldostrone level and hearing condition, sex, configuration of audiogram and speech discrimination score (SDS were not significant. In addition, no significant relationship between sodium and potassium levels with hearing condition was found (p>0.05.Conclusion: This study could not confirm protective effect of aldostrone against presbycusis. This discrepancy may originate from epidemiologic differences, laboratory errors or small sample size.

Asthma in Patients Climbing to High and Extreme Altitudes in the Tibetan Everest Region

NARCIS (Netherlands)

Huismans, Henrike K.; Douma, W. Rob; Kerstjens, Huib A. M.; Renkema, Tineke E. J.

Objectives: The aim of this study was to investigate the behavior of asthma in patients traveling to high and extreme altitudes. Methods: Twenty-four Dutch patients with mild asthma did a trekking at high and extreme altitudes (up to 6410 m = 21030 ft) in the Tibetan Everest region. Asthma symptoms,

Evaluation of a practical expert defined approach to patient population segmentation: a case study in Singapore

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Lian Leng Low

2017-11-01

Full Text Available Abstract Background Segmenting the population into groups that are relatively homogeneous in healthcare characteristics or needs is crucial to facilitate integrated care and resource planning. We aimed to evaluate the feasibility of segmenting the population into discrete, non-overlapping groups using a practical expert and literature driven approach. We hypothesized that this approach is feasible utilizing the electronic health record (EHR in SingHealth. Methods In addition to well-defined segments of “Mostly healthy”, “Serious acute illness but curable” and “End of life” segments that are also present in the Ministry of Health Singapore framework, patients with chronic diseases were segmented into “Stable chronic disease”, “Complex chronic diseases without frequent hospital admissions”, and “Complex chronic diseases with frequent hospital admissions”. Using the electronic health record (EHR, we applied this framework to all adult patients who had a healthcare encounter in the Singapore Health Services Regional Health System in 2012. ICD-9, 10 and polyclinic codes were used to define chronic diseases with a comprehensive look-back period of 5 years. Outcomes (hospital admissions, emergency attendances, specialist outpatient clinic attendances and mortality were analyzed for years 2012 to 2015. Results Eight hundred twenty five thousand eight hundred seventy four patients were included in this study with the majority being healthy without chronic diseases. The most common chronic disease was hypertension. Patients with “complex chronic disease” with frequent hospital admissions segment represented 0.6% of the eligible population, but accounted for the highest hospital admissions (4.33 ± 2.12 admissions; p < 0.001 and emergency attendances (ED (3.21 ± 3.16 ED visits; p < 0.001 per patient, and a high mortality rate (16%. Patients with metastatic disease accounted for the highest specialist outpatient

Osteopoikilosis: A Sign Mimicking Skeletal Metastases in a Cancer Patient

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Hamid Nasrolahi

2011-01-01

Full Text Available Osteopoikilosis is a rare benign osteosclerotic bone disorder that may be misdiagnosed as skeletal metastases. Here we describe a case of coincidental breast cancer and osteopoikilosis mimicking skeletal metastases. A 41-year-old woman underwent right modified radical mastectomy in April 2007. Twenty-eight months after initial treatment,the patient complained of bilateral knee and foot pain. Plain X-rays of the feet and knees showed multiple well-defined osteosclerotic lesions. According to the radiographic appearance, the most likely differential diagnoses included skeletal metastases from breast cancer and osteopoikilosis. A whole-body bone scintigraphy showed no increase in uptake by the sclerotic lesions, and serum lactic dehydrogenase, carcinoembryonic antigen, alkaline phosphatase and cancer antigen 15-3 were not elevated. We therefore diagnosed the patient’s skeletal lesions as osteopoikilosis. This case and ourliterature review suggest that the radiographic appearance of osteopoikilosis may mimic or mask skeletal metastases, potentially leading to misdiagnosis in patients with cancer.

Evaluation of iopentol (Imagopaque trademark 350) in CT enhancement. A multi-centre monitoring trial assessing adverse events and diagnostic information - results from 1823 patients in France

International Nuclear Information System (INIS)

Oxaal, M.; Lambrechts, M.; Bunouf, P.; Menuet, J.F.

1997-01-01

Objectives: To evaluate the safety and efficacy of iopentol 350 mg I/ml (Imagopaque trademark /Ivepaque trademark , Nycomed Imaging As, Oslo, Norway), a monomeric non-ionic contrast medium for computed tomography, in a large population. To identify predictive factors for patient safety. Materials and methods: One thousand eight hundred and twenty-three (1,823) patients form 48 centres in France were included during a 5-month period. Safety was evaluated by registering adverse events (AEs) reported by the patients, and data were analysed using a multiple factor model. Results: Only 2.6% of the patients experienced AEs other than discomfort. There were no serious AEs. Overall, AEs were more frequent in patients under 50 years of age, in women, and in patients who received contrast medium as a single bolus. Contrast enhancement was considered adequate or better in 98.9% of the patients. A large variation in discomfort (local warmth/chill or pain) frequency was seen between centres, ranging from 0% to 81%. This result implies that factors other than the CM influence the incidence of discomfort. Conclusions: This first study in a large population shows that iopentol 350 mg I/ml is well tolerated and provides CT images of excellent, good or adequate quality in the vast majority of patients. Age, sex and injection procedure were shown to be independent predictors in the AE survey. (orig.)

Evaluation of Brain and Cervical MRI Abnormality Rates in Patients With Systemic Lupus Erythematosus With or Without Neurological Manifestations

International Nuclear Information System (INIS)

Harirchian, Mohammad Hossein; Saberi, Hazhir; Najafizadeh, Seyed Reza; Hashemi, Seyed Ali

2011-01-01

Central nervous system (CNS) involvement has been observed in 14-80% of patients with systemic lupus erythematosus (SLE). Magnetic resonance imaging (MRI) is an appropriate method for evaluating CNS involvement in these patients. Clinical manifestations and MRI findings of CNS lupus should be differentiated from other mimicking diseases such as multiple sclerosis (MS). The aim of this study was to evaluate the prevalence and extent of brain and cervical cord MRI lesions of lupus patients. The relationship between neurological signs and symptoms and MRI findings were evaluated as well. Fifty SLE patients who had been referred to the rheumatology clinic of our hospital within 2009 were included in a cross sectional study. All patients fulfilled the revised 1981 American College of Rheumatology (ACR) criteria for SLE. We evaluated the neurological signs and symptoms and brain and cervical MRI findings in these patients. Forty-one patients (82%) were female and nine (18%) were male. The mean age was 30.1 ± 9.3 years. Twenty eight (56%) patients had an abnormal brain MRI. No one showed any abnormality in the cervical MRI. The lesions in 20 patients were similar to demyelinative plaques. Seventeen patients with abnormal brain MRI were neurologically asymptomatic. There was only a significant relationship between neurological motor manifestations and brain MRI abnormal findings. Unlike the brain, cervical MRI abnormality and especially asymptomatic cord involvement in MRI is quite rare in SLE patients. This finding may be helpful to differentiate SLE from other CNS disorders such as MS

Hypopigmented mycosis fungoides in a twenty-year-old Saudi woman with fair skin

Directory of Open Access Journals (Sweden)

Al-Ratrout J

2006-01-01

Full Text Available The hypopigmented variant of mycosis fungoides (MF is charactrized by the presence of hypopigmented patches as the sole manifestation of the disease. This variant is usually observed in the dark skin of African or Asian individuals particularly children, but nevertheless is an uncommonly reported presentation of the disease. The incidence of hypopigmented MF in Caucasian patients and others of fair skin color is rare. We describe hypopigmented lesions arising in a twenty-year-old Saudi woman with type IV skin color. The diagnosis of mycosis fungoides stage IA was made based on the clinico-radiological and histological features. The patient responded well to PUVA therapy and is currently clear of lesions. MF should be considered in the differential diagnosis of hypopigmented macular lesions in patients of any skin color and age. Multiple skin biopsies must be performed on different occasions so as not to miss the diagnosis; and long term follow up is recommended since recurrence is common and occasional cases behave aggressively.

The next twenty years - IAEA's role

International Nuclear Information System (INIS)

Tape, G.F.

1977-01-01

The twentieth anniversary of an institution is an appropriate time to look back and to ask what has been achieved. It is also an appropriate time to look ahead and to ask what should be the mission for the future. How can the strengths of the International Atomic Energy Agency (IAEA) be best utilized, what new opportunities should be seized upon, and what challenges should the IAEA be prepared to meet in the next twenty years? Forward planning is a very necessary activity in today's world. There are so many demands on national or institutional resources that careful analysis of options is necessary to establish priorities and ultimately to provide for implementation. But such planning must be done carefully with full appreciation for the validity and sensitivity of the input assumptions and data. Furthermore, today's plan, while setting goals and directions, cannot be so inflexible that it cannot be responsive to ever-changing political, economic and technical constraints or opportunities. Thus in looking ahead, the plan must contain provisions for flexibility to provide for further modifications in the light of ever-changing knowledge, attitudes, and world conditions. The experience of the past five years in the energy field, and especially in nuclear energy, underscores this need. In looking ahead for the next twenty years, we are attempting to describe the International Atomic Energy Agency and its role through the twentieth century. In doing so, we are automatically laying the base for the Agency's work going into the twenty-first century. In short, we are trying to visualize a programme that can serve the coming generation and, in doing so, creating a base from which the needs of the succeeding generation can be met. This is a large order and the crystal ball is less than clear. (author)

Disparities in sexually transmitted disease rates across the "eight Americas".

Science.gov (United States)

Chesson, Harrell W; Kent, Charlotte K; Owusu-Edusei, Kwame; Leichliter, Jami S; Aral, Sevgi O

2012-06-01

The purpose of this study was to examine rates of 3 bacterial sexually transmitted diseases (STDs; syphilis, gonorrhea, and chlamydia) in 8 subpopulations (known as the "eight Americas") defined by race and a small number of county-level sociodemographic and geographical characteristics. The eight Americas are (1) Asians and Pacific Islanders in specific counties; (2) Northland low-income rural white; (3) Middle America; (4) Low-income whites in Appalachia and Mississippi Valley; (5) Western Native American; (6) Black middle America; (7) Southern low-income rural black; and (8) High-risk urban black. A list of the counties comprising each of the eight Americas was obtained from the corresponding author of the original eight Americas project, which examined disparities in mortality rates across the eight Americas. Using county-level STD surveillance data, we calculated syphilis, gonorrhea, and chlamydia rates (new cases per 100,000) for each of the eight Americas. Reported STD rates varied substantially across the eight Americas. STD rates were generally lowest in Americas 1 and 2 and highest in Americas 6, 7, and 8. Although disparities in STDs across the eight Americas are generally similar to the well-established disparities in STDs across race/ethnicity, the grouping of counties into the eight Americas does offer additional insight into disparities in STDs in the United States. The high STD rates we found for black Middle America are consistent with the assertion that sexual networks and social factors are important drivers of racial disparities in STDs.

Regional migratory osteoporosis in the knee: MRI findings in 22 patients and review of the literature

International Nuclear Information System (INIS)

Karantanas, Apostolos H.; Nikolakopoulos, Ioannis; Korompilias, Anastasios V.; Apostolaki, Eleni; Skoulikaris, Nicolaos; Eracleous, Eleni

2008-01-01

Objective: Acute non-traumatic bone marrow edema (BME) in the knee is a common clinical problem. The aim of the present study is to present the MR imaging findings of the uncommon transient migratory pattern of this syndrome. Materials and methods: Twenty-two patients (21 men, 1 woman, age range 35-73 years, mean 49.4 ± 7.6) who presented with pain in the knee joint (ranging from 2 weeks to 6 months) and BME in the MR imaging examination, were included in the study. In all cases, the knee joint BME was either preceded or followed by another site of BME in the same or another joint. All patients were studied with plain X-rays and MR imaging at presentation and with MR imaging after resolution of symptoms. Results: The eight patients with initial involvement in the knee showed migration either intra-articularly (5), or/and in the contralateral knee (2) and only 1 case showed migration to the ipsilateral hip joint. In two patients the BME shifted from the hip first to the foot and then to the knee. The median migration period was 4 months for the second involvement in all patients and 3 months for the third involvement (10 patients). Conclusions: The present study reports the largest series of patients with regional migratory osteoporosis involving the knee. In most of the cases, shifting of BME remains in the joint or moves to the contralateral knee. In only one case the BME shifted from the knee elsewhere. All lesions were transient

NMR-based metabolic study of fruits of Physalis peruviana L. grown in eight different Peruvian ecosystems.

Science.gov (United States)

Maruenda, Helena; Cabrera, Rodrigo; Cañari-Chumpitaz, Cristhian; Lopez, Juan M; Toubiana, David

2018-10-01

The berry of Physalis peruviana L. (Solanaceae) represents an important socio-economical commodity for Latin America. The absence of a clear phenotype renders it difficult to trace its place of origin. In this study, Cape gooseberries from eight different regions within the Peruvian Andes were profiled for their metabolism implementing a NMR platform. Twenty-four compounds could be unequivocally identified and sixteen quantified. One-way ANOVA and post-hoc Tukey test revealed that all of the quantified metabolites changed significantly among regions: Bambamarca I showed the most accumulated significant differences. The coefficient of variation demonstrated high phenotypic plasticity for amino acids, while sugars displayed low phenotypic plasticity. Correlation analysis highlighted the closely coordinated behavior of the amino acid profile. Finally, PLS-DA revealed a clear separation among the regions based on their metabolic profiles, accentuating the discriminatory capacity of NMR in establishing significant phytochemical differences between producing regions of the fruit of P. peruviana L. Copyright © 2018 Elsevier Ltd. All rights reserved.

Safety and Efficacy of Liraglutide in Patients With Type 2 Diabetes and End-Stage Renal Disease

DEFF Research Database (Denmark)

Idorn, Thomas; Knop, Filip K; Jørgensen, Morten B

2016-01-01

OBJECTIVE: To evaluate parameters related to safety and efficacy of liraglutide in patients with type 2 diabetes and dialysis-dependent end-stage renal disease (ESRD). RESEARCH DESIGN AND METHODS: Twenty-four patients with type 2 diabetes and ESRD and 23 control subjects with type 2 diabetes...

Statin and fibrate associed myopathy: study of eight patients Miopatia associada a estatina e fibrato: estudo de oito pacientes

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Alzira A. Siqueira Carvalho

2004-06-01

Full Text Available Lipid-lowering drugs have been occasionally associated with neuromuscular symptoms and muscle biopsy changes. We reported the clinical course and the muscle biopsy in eight patients with hyperlipoproteinemia, treated with lipid -lowering drugs (statins/fibrates. Five patients had myalgias while; in two cases there was proximal muscle weakness. All patients became asymptomatic after the withdrawal of the drug, although creatine kinase remained elevated. We performed muscle biopsy in six cases from three months to two years after suspension of the drug. We found variation in fibers diameters in all cases, with necrosis of fibers in five cases, inflammatory infiltration in one case, the presence of vacuolated fiber in one patient and ragged-red fibers in three subjects. We concluded that although the muscle biopsy findings were not specific, the prolonged use of statins and or fibrates might induce a chronic myopathy even in the absence of symptoms.As drogas redutoras de colesterol são ocasionalmente associadas a sintomas neuromusculares e alterações morfológicas observadas na biopsia muscular. Relatamos o curso clínico e achado da biopsia muscular em oito pacientes com hiperlipoproteinemia tratados com drogas redutoras de colesterol (estatinas/fibratos. Cinco pacientes tiveram mialgia e em dois havia fraqueza muscular proximal. Todos os pacientes ficaram assintomáticos após retirada da medicação embora a creatinoquinase permanecesse elevada. Analisamos a biopsia muscular em seis casos realizados entre três meses e dois anos após a suspensão da droga. Encontramos variação no calibre das fibras em todos os casos com necrose de fibras em cinco, infiltrado inflamatório em um caso, presença de vacúolos em um e "ragged red fiber" em três deles. Concluímos que, embora os achados da biopsia muscular não fossem específicos, o uso prolongado de estatinas e/ou fibratos pode induzir a uma miopatia crônica até mesmo na ausência de

Guillain-Barre Syndrome – rehabilitation outcome, residual deficits and requirement of lower limb orthosis for locomotion at 1 year follow-up.

Science.gov (United States)

Gupta, Anupam; Taly, Arun B; Srivastava, Abhishek; Murali, Thyloth

2010-01-01

To analyse long-term functional recovery, deficits and requirement of lower limb orthosis (LLO) for locomotion in patients with Guillain-Barre Syndrome (GBS). Prospective longitudinal follow-up study. Neurological Rehabilitation unit of university hospital. Sixty-nine patients of GBS admitted for inpatient rehabilitation. Thirty-five patients (M:F, 19:16) reporting after 1 year follow-up (50.72%) were included in study (between September 2005 and July 2009). Their residual deficits and requirement of LLO were recorded and analysed. Age ranged from 4 to 65 year (29.74 ± 15.75). Twenty-seven patients had typical GBS and eight patients had acute motor axonal neuropathy variant. Twenty-eight patients (80%) had neuropathic pain needing medication with 11 required more than one drug. Twenty-one patients (60%) had foot drop and advised ankle-foot orthosis-AFO (20 bilateral AFO). Thirty patients (85.71%) needed assistive devices also for locomotion at discharge. After 1 year, foot drop was still present in 12 patients (34.28%) using orthosis. Modified Barthel Index scores, Modified Rankin Scale and Hughes Disability Scale were used to assess functional disabilities. Significant recovery was observed at the time of discharge and after 1 year (p < 0.001 each). Patients with GBS continue to show significant functional recovery for long period. They have residual deficits even after 1 year with requirement of orthosis in large number of patients.

Assessment of functional status in children with brain tumors

International Nuclear Information System (INIS)

Sugita, Yasuo; Kobayashi, Seiichi; Uegaki, Masami; Katayama, Masahiko; Miyagi, Jun; Iryo, Osamu; Shigemori, Minoru; Kuramoto, Shinken; Ootsubo, Masaaki

1987-01-01

Thirty children treated for brain tumors between 1978 - 1985 at Kurume university hospital were evaluated for alternation in intellectual, emotional, and social function. They were 15 males and 15 females, aged 3 to 16 years, on the averaged 1.7 years after treatment. Twenty-eight children had no neurological deficits and 2 children had slight neurological deficits. It was possible for twenty-eight children to be evaluated for intelligence quotient by Wechsler Intelligence Scale for Children-revised and Tanaka-Binet. The median score and standard deviation of intelligence quotient (IQ) test in children with brain tumors were as follows; verbal IQ: 84 ± 16, performance IQ: 77 ± 20, full scale IQ: 80 ± 20. There children with brain tumors obtained significant low IQ scores than children (t-test, P < 0.01). Twenty-one (72 %) children showed subnormal IQ scores (IQ < 90) and 7 children showed normal IQ scores (IQ ≥ 90). Concerning social and emotional function, twelve children (45.7 %) showed abnormal behaviour. The median scores and standard deviation of IQ scores in cranial irradiated patients were as follows; verbal IQ: 79 ± 13, performance IQ: 71 ± 15, full scale IQ: 71 ± 14. Especially, ten of twelve cranial irradiated patients showed subnormal IQ scores. Also, cranial irradiated patients obtained significant low IQ scores than non-cranial irradiated patients (t-test, P < 0.05). Serial evaluation of three cranial irradiated patients revealed further deterioration without recurrence of tumor and hydrocephalus. The results are discussed to: (1) the effects and mechanism of cranial irradiation on cognitive development: (2) the relationship between cognitive dysfunction and irradiation methods. The effects and mechanism of cranial irradiation on cognitive dysfunction is considered to be not only injury of cortex but also injury of fiber tracts. Also, cognitive dysfunction is apt to be related to age of irradiated patients. (J.P.N.)

Assessment of functional status in children with brain tumors

Energy Technology Data Exchange (ETDEWEB)

Sugita, Yasuo; Kobayashi, Seiichi; Uegaki, Masami; Katayama, Masahiko; Miyagi, Jun; Iryo, Osamu; Shigemori, Minoru; Kuramoto, Shinken; Ootsubo, Masaaki

1987-06-01

Thirty children treated for brain tumors between 1978 - 1985 at Kurume university hospital were evaluated for alternation in intellectual, emotional, and social function. They were 15 males and 15 females, aged 3 to 16 years, on the averaged 1.7 years after treatment. Twenty-eight children had no neurological deficits and 2 children had slight neurological deficits. It was possible for twenty-eight children to be evaluated for intelligence quotient by Wechsler Intelligence Scale for Children-revised and Tanaka-Binet. The median score and standard deviation of intelligence quotient (IQ) test in children with brain tumors were as follows; verbal IQ: 84 +- 16, performance IQ: 77 +- 20, full scale IQ: 80 +- 20. There children with brain tumors obtained significant low IQ scores than children (t-test, P < 0.01). Twenty-one (72 %) children showed subnormal IQ scores (IQ < 90) and 7 children showed normal IQ scores (IQ greater than or equal to 90). Concerning social and emotional function, twelve children (45.7 %) showed abnormal behaviour. The median scores and standard deviation of IQ scores in cranial irradiated patients were as follows; verbal IQ: 79 +- 13, performance IQ: 71 +- 15, full scale IQ: 71 +- 14. Especially, ten of twelve cranial irradiated patients showed subnormal IQ scores. Also, cranial irradiated patients obtained significant low IQ scores than non-cranial irradiated patients (t-test, P < 0.05). Serial evaluation of three cranial irradiated patients revealed further deterioration without recurrence of tumor and hydrocephalus. The results are discussed to: (1) the effects and mechanism of cranial irradiation on cognitive development: (2) the relationship between cognitive dysfunction and irradiation methods. The effects and mechanism of cranial irradiation on cognitive dysfunction is considered to be not only injury of cortex but also injury of fiber tracts. Also, cognitive dysfunction is apt to be related to age of irradiated patients. (J.P.N.).

Muscle strength and functional performance in patients at high risk of knee osteoarthritis: a follow-up study

DEFF Research Database (Denmark)

Thorlund, Jonas Bloch; Aagaard, Per; Roos, Ewa M.

2012-01-01

PURPOSE: To investigate whether changes from 2 to 4 years post arthroscopic partial meniscectomy (APM) in mechanical muscle function and objectively measured function differ between the operated and contra-lateral leg of APM patients or compared with controls. METHODS: Twenty-two patients (age 46...

Miglustat therapy in the French cohort of paediatric patients with Niemann-Pick disease type C

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Héron Bénédicte

2012-06-01

Full Text Available Abstract Background Niemann-Pick disease type C (NP-C is a rare neurovisceral lysosomal lipid storage disease characterized by progressive neurological deterioration. Published data on the use of miglustat in paediatric patients in clinical practice settings are limited. We report findings from a prospective open-label study in the French paediatric NP-C cohort. Methods Data on all paediatric NP-C patients treated with miglustat in France between October 2006 and December 2010 were compiled. All patients had a confirmed diagnosis of NP-C, and received miglustat therapy according to manufacturer’s recommendations. Pre-treatment and follow-up assessments were conducted according to a standardized protocol. Results Twenty children were enrolled; 19 had NPC1 gene mutations and 1 had NPC2 gene mutations. The median age at diagnosis was 1.5 years, and the median age at miglustat initiation was 6.0 years. Eight NPC1 patients had the early-infantile, eight had the late-infantile, and three had the juvenile-onset forms of NP-C. A history of hepatosplenomegaly and/or other cholestatic symptoms was recorded in all 8 early-infantile onset patients, 3/8 late-infantile patients, and 1/3 juvenile onset patients. Brain imaging indicated white matter abnormalities in most patients. The median (range duration of miglustat therapy was 1.3 (0.6–2.3 years in early-infantile, 1.0 (0.8–5.0 year in late-infantile, and 1.0 (0.6–2.5 year in juvenile onset patients. NP-C disability scale scores indicated either stabilization or improvement of neurological manifestations in 1/8, 6/8, and 1/3 NPC1 patients in these subgroups, respectively. There were no correlations between brain imaging findings and disease course. Mild-to-moderate gastrointestinal disturbances were frequent during the first 3 months of miglustat therapy, but were easily managed with dietary modifications and/or anti-propulsive medication. Conclusions Miglustat can improve or stabilize neurological

Health food store recommendations: implications for breast cancer patients

International Nuclear Information System (INIS)

Mills, Edward; Ernst, Edzard; Singh, Rana; Ross, Cory; Wilson, Kumanan

2003-01-01

Many breast cancer patients use complementary and alternative medicine (CAM). We aimed to determine what advice health food store employees present to individuals seeking treatment options for breast cancer. Eight data gatherers asked employees of all retail health food stores in a major Canadian city, what they recommended for a patient with breast cancer. The data gatherers inquired about product safety, potential drug interactions, costs and efficacy. They also enquired about employee training related to the products. Thirty-four stores were examined. A total of 33 different products were recommended, none of which are supported by sufficient evidence of efficacy. The average cost of the products they recommended was $58.09 (CAD) (minimum $5.28, median $32.99, maximum $600) per month. Twenty-three employees (68%) did not ask whether the patient took prescription medications. Fifteen employees (44%) recommended visiting a healthcare professional (naturopaths (9), physicians (5), nutritionists (1). Three employees (8.8%) discussed potential adverse effects of the products. Eight employees (23.5%) discussed the potential for drug interactions. Two employees (5.9%) suggested a possible cure with the products and one employee (2.9%) suggested discontinuing Tamoxifen. Four employees (11.8%) recommended lifestyle changes and three employees (8.8%) recommended books for further reading on the products. This study draws attention to the heterogeneity of advice provided by natural health food stores to individuals seeking treatments for breast cancer, and the safety and cost implications of some of the products recommended. Physicians should enquire carefully about the use of natural health food products by patients with breast cancer. Regulators need to consider regulations to protect vulnerable patients from incurring significant costs in their purchasing of natural health food products lacking evidence of benefit and of questionable safety

Emotion Regulation in Patients with Psoriasis: Correlates of Disability, Clinical Dimensions, and Psychopathology Symptoms.

Science.gov (United States)

Almeida, Vera; Taveira, Sofia; Teixeira, Maribel; Almeida, Isabel; Rocha, José; Teixeira, Ana

2017-08-01

There are known connections between emotions and psoriasis; however, we have not established a clear pathway for this association. This study aimed to explore correlates of difficulties in emotional regulation in patients with psoriasis and predict the influence of emotional regulation in psoriasis disability. Two hundred and twenty eight participants completed the Difficulties in Emotion Regulation Scale, Self-administered Psoriasis Area and Severity Index, Psoriasis Disability Index, and Brief Symptom Inventory. Spearman's correlation and a hierarchical stepwise multiple regression were carried out to analyse associations. Results indicated that patients with the most recent diagnoses experienced greater difficulty in acting in accordance with goals (r = .16, p psoriasis severity (r = .15, p psoriasis disability (β = .34). The results highlighted the relationship between emotional regulation difficulty, disease characteristics, and psychological variables in psoriasis disability emphasizing the importance of including a broader approach in clinical management of psoriatic patients.

Surveillance of colorectal cancer: effectiveness of early detection of intraluminal recurrences on prognosis and survival of patients treated for cure.

Science.gov (United States)

Barillari, P; Ramacciato, G; Manetti, G; Bovino, A; Sammartino, P; Stipa, V

1996-04-01

The authors evaluate the effectiveness of routine colonoscopy and marker evaluation in diagnosis of intraluminal recurrent cancer. Chart review was conducted on 481 patients who underwent curative resection for colorectal cancer between 1980 and 1990. Clinical visits were scheduled and carcinoembryonic antigen evaluation was performed every three months, and colonoscopy was performed preoperatively, 12 to 15 months after surgical treatment, and then with intervals of 12 to 24 months or when symptoms appeared. About 10 percent of patients developed intraluminal recurrences. More than one-half of metachronous lesions arose within the first 24 months, and median time to diagnosis was 25 months. Patients with left-sited tumors in the advanced stage had a higher risk of developing recurrent intraluminal disease. Twenty-nine patients underwent a second surgical operation, of which 17 cases were radical. In this group, the five-year survival was 70.6 percent, although no nonradically treated or nonresected patients survived longer than 31 months. Twenty-two patients were asymptomatic at time of diagnosis of recurrence, and of these, 12 patients underwent radical operation; on the other hand, of the 24 symptomatic patients, only 5 were treated radically. Carcinoembryonic antigen was the first sign of recurrence in eight cases. Colonoscopy must be performed within the first 12 to 15 months after operation, whereas an interval of 24 months between examinations seems sufficient to guarantee early detection of metachronous lesions. Serial tumor marker evaluation is of help in earlier diagnosis of local recurrences. Asymptomatic patients more frequently undergo another operation for cure and thus have a better survival rate.

Percutaneous tracheostomy in patients with cervical spine fractures--feasible and safe.

Science.gov (United States)

Ben Nun, Alon; Orlovsky, Michael; Best, Lael Anson

2006-08-01

The aim of this study is to evaluate the short and long-term results of percutaneous tracheostomy in patients with documented cervical spine fracture. Between June 2000 and September 2005, 38 consecutive percutaneous tracheostomy procedures were performed on multi-trauma patients with cervical spine fracture. Modified Griggs technique was employed at the bedside in the general intensive care department. Staff thoracic surgeons and anesthesiologists performed all procedures. Demographics, anatomical conditions, presence of co-morbidities and complication rates were recorded. The average operative time was 10 min (6-15). Two patients had minor complications. One patients had minor bleeding (50 cc) and one had mild cellulitis. Nine patients had severe paraparesis or paraplegia prior to the PCT procedure and 29 were without neurological damage. There was no PCT related neurological deterioration. Twenty-eight patients were discharged from the hospital, 21 were decannulated. The average follow-up period was 18 months (1-48). There was no delayed, procedure related, complication. These results demonstrate that percutaneous tracheostomy is feasible and safe in patients with cervical spine fracture with minimal short and long-term morbidity. We believe that percutaneous tracheostomy is the procedure of choice for patients with cervical spine fracture who need prolonged ventilatory support.

Nutritional support in patients with colorectal cancer during chemotherapy: does it work?

Science.gov (United States)

Dobrila-Dintinjana, Renata; Trivanovic, Dragan; Zelić, Marko; Radić, Mladen; Dintinjana, Marijan; Petranović, Duška; Toni, Valković; Vukelic, Jelena; Matijasic, Nusa

2013-05-01

Early intervention with nutritional supplementation has been shown to halt malnutrition and may improve outcome in some patients with colorectal cancer. The aim of this study was to investigate whether dietary counseling, oral nutrition and megestrol acetate during chemotherapy affected nutritional status and survival in patients with advanced disease. Six hundred and twenty-eight patients with colorectal advanced disease were included in the study from January 2000 through December 2009 and divided into one of two groups. Group I consisted of 315 patients who were monitored prospectively and were given nutritional support. Group II included 313 patients without nutritional counseling and support. After the completion of chemotherapy all patients were evaluated (BMI, NST, Appetite Loss Scale and ECOG). After the completion of chemotherapy, there were lower proportions of patients in Group I with a BMI=5, loss of appetite and decreased weight gain. Nutritional counseling and supplemental feeding temporarily halted weight loss and improved appetite. This improvement may have implications for patient survival. Patients with early nutritional support lived 19.1 months while patients in the control group had a survival of 12.4 months (p=0.022). This study demonstrated that concurrent individualized dietary counseling and nutritional support are effective in improving nutritional status thereby lessening chemotherapy-induced morbidity.

Laboratory validation of an in-home method for assessing circadian phase using dim light melatonin onset (DLMO).

Science.gov (United States)

Pullman, Rebecca E; Roepke, Stephanie E; Duffy, Jeanne F

2012-06-01

To determine whether an accurate circadian phase assessment could be obtained from saliva samples collected by patients in their home. Twenty-four individuals with a complaint of sleep initiation or sleep maintenance difficulty were studied for two evenings. Each participant received instructions for collecting eight hourly saliva samples in dim light at home. On the following evening they spent 9h in a laboratory room with controlled dim (light where hourly saliva samples were collected. Circadian phase of dim light melatonin onset (DLMO) was determined using both an absolute threshold (3 pg ml(-1)) and a relative threshold (two standard deviations above the mean of three baseline values). Neither threshold method worked well for one participant who was a "low-secretor". In four cases the participants' in-lab melatonin levels rose much earlier or were much higher than their at-home levels, and one participant appeared to take the at home samples out of order. Overall, the at-home and in-lab DLMO values were significantly correlated using both methods, and differed on average by 37 (± 19)min using the absolute threshold and by 54 (± 36)min using the relative threshold. The at-home assessment procedure was able to determine an accurate DLMO using an absolute threshold in 62.5% of the participants. Thus, an at-home procedure for assessing circadian phase could be practical for evaluating patients for circadian rhythm sleep disorders. Copyright © 2012 Elsevier B.V. All rights reserved.

Comparison of cognitive flexibility and planning ability in patients with obsessive compulsive disorder, patients with obsessive compulsive personality disorder, and healthy controls

OpenAIRE

PAAST, Negin; KHOSRAVI, Zohreh; MEMARI, Amir Hossein; SHAYESTEHFAR, Monir; ARBABI, Mohammad

2016-01-01

Background Cognitive functioning in individuals with Obsessive Compulsive Disorder (OCD) and with Obsessive Compulsive Personality Disorder (OCPD) has not been adequately studied. Aim Examine the cognitive flexibility and planning ability of individuals with OCD and OCPD. Methods Twenty patients with OCD and 25 patients with OCPD who had not taken medication in the previous two weeks were identified in an outpatient psychology clinic in Tehran, and 25 healthy control subjects were identified ...

Normal Health-Related Quality of Life and Ability to Work Twenty-nine Years After in Situ Arthrodesis for High-Grade Isthmic Spondylolisthesis.

Science.gov (United States)

Joelson, Anders; Hedlund, Rune; Frennered, Karin

2014-06-18

The purpose of this mixed prospective and retrospective case series was to evaluate the long-term health-related quality of life and physical disability after in situ arthrodesis for high-grade isthmic spondylolisthesis. Thirty-five of forty consecutive patients who had in situ spinal arthrodesis for high-grade isthmic spondylolisthesis at a mean age of fifteen years (range, nine to twenty-five years) completed validated questionnaires (Short Form-36 [SF-36], EuroQol-5 Dimensions [EQ-5D], Zung depression scale, Oswestry disability index [ODI], Million score, and back and leg pain visual analog scale [VAS]) and underwent physical examination twenty-nine years (range, twenty-three to thirty-five years) after surgery. The mean age at the time of follow-up was forty-three years (range, thirty-seven to fifty-one years). In the absence of a formal control group, the scores on the SF-36 and EQ-5D were compared with Swedish normative data. The proportion of patients at work was compared with an age-matched control group derived from official statistics of Sweden. The Million score at the long-term follow-up was compared with the corresponding results at the mid-term follow-up of the same patients at a mean age of twenty-two years. The scores on the SF-36 and EQ-5D were similar to the scores of the general Swedish population. The mean Zung depression scale score was 30 (range, 20 to 52), the mean ODI score was 10 (range, 0 to 34), the mean back pain VAS score was 13 (range, 0 to 72), and the mean leg pain VAS score was 9 (range, 0 to 60). The Million score averaged 28 (range, 0 to 109) and was slightly worsened compared with the score of 19 (range, 0 to 94) at the mid-term follow-up (p = 0.034). The proportion of patients at work was the same as that for the age-matched general Swedish population. Our study shows good outcomes in health-related quality of life, disability, pain, and ability to work at up to twenty-nine years after in situ lumbar spine arthrodesis for high

Transnasal gastroskopi

DEFF Research Database (Denmark)

Christensen, M; Achiam, Michael Patrick; Trap, R

2000-01-01

difficulties. Sixty-eight percent of the procedures were unsedated, 55% of the patients did not experience gag-reflexes. The procedure was described by most patients as "slightly uncomfortable". Twenty-five percent had uncomplicated epistaxis. Pulse rate and saturation levels were stable. Transnasal...

Retroperitoneal Fibrosis: A Retrospective Clinical Data Analysis of 30 Patients in a 10-year Period

Directory of Open Access Journals (Sweden)

Hai-Jiang Zhou

2015-01-01

Full Text Available Background: Retroperitoneal fibrosis (RPF is an uncommon disease that is characterized by development of fibrosclerotic tissues involving retroperitoneal structures. This study aimed to investigate the clinical features of 30 patients with RPF in a single center in Beijing in a 10-year period. Methods: We retrospectively analyzed clinical data on demographic characteristics, clinical manifestations, laboratory findings, radiological findings, modalities of treatments, outcomes and prognosis of 30 patients with RPF. Patients were treated in Beijing Chao-Yang Hospital between January 2003 and December 2013. Results: The mean age of patients with RPF was 56.7 ± 14.4 years. Twenty-three patients were men and seven patients were women. Acute phase reactants were elevated in most patients. Rheumatic factor was positive in 4/25 (16.0% patients, and antinuclear antibody was positive in 6/22 (27.3% patients. Elevation of IgG4 was observed in 9/22 (40.9% patients. The most common type was I + III (n = 13, followed by I + II + III (n = 12. Five patients undertook an 18 F-fluoro-deoxy-D-glucose positron emission tomography examination and increased uptake was detected in four patients. Eight patients received combination therapy with glucocorticoids and tamoxifen. Surgical intervention treatments included intraureteral double-J stent implantation (n = 26, percutaneous nephrostomy (n = 2, open ureterolysis and intraperitonealization of the ureters (n = 5 and laparoscopic ureterolysis and intraperitonealization of the ureters (n = 5. Three patients underwent hemodialysis because of renal failure. Conclusions: Clinical characteristics of RPF patients in our study are similar to those previously reported. Steroids and immunosuppressive therapy combined with ureterolysis could be a viable choice of treatment for RPF. More prospective, multi-center studies with a longer follow-up are warranted.

Percutaneous treatment of hepatocellular carcinoma in patients with cirrhosis: A comparison of the safety of cryoablation and radiofrequency ablation

International Nuclear Information System (INIS)

Dunne, Ruth M.; Shyn, Paul B.; Sung, Jeffrey C.; Tatli, Servet; Morrison, Paul R.; Catalano, Paul J.; Silverman, Stuart G.

2014-01-01

Purpose: To compare the safety of image-guided percutaneous cryoablation and radiofrequency ablation in the treatment of hepatocellular carcinoma in patients with cirrhosis. Materials and methods: This retrospective HIPAA-compliant study received institutional review board approval. Forty-two adult patients with cirrhosis underwent image-guided percutaneous ablation of hepatocellular carcinoma from 2003 to 2011. Twenty-five patients underwent 33 cryoablation procedures to treat 39 tumors, and 22 underwent 30 radiofrequency ablation procedures to treat 39 tumors. Five patients underwent both cryoablation and radiofrequency ablation procedures. Complication rates and severity per procedure were compared between the ablation groups. Potential confounding patient, procedure, and tumor-related variables were also compared. Statistical analyses included Kruskal–Wallis, Wilcoxon rank sum, and Fisher's exact tests. Two-sided P-values <0.05 were considered significant. Results: The overall complication rates, 13 (39.4%) of 33 cryoablation procedures versus eight (26.7%) of 30 radiofrequency ablation procedures and severe/fatal complication rates, two (6.1%) of 33 cryoablation procedures versus one (3.3%) of 30 radiofrequency ablation procedures, were not significantly different between the ablation groups (both P = 0.26). Severe complications included pneumothoraces requiring chest tube insertion during two cryoablation procedures. One death occurred within 90 days of a radiofrequency ablation procedure; all other complications were managed successfully. Conclusion: No significant difference was seen in the overall safety of image-guided percutaneous cryoablation and radiofrequency ablation in the treatment of hepatocellular carcinoma in patients with cirrhosis

Utility of computed axial tomography angiography in anatomic evaluation of pediatric patients with congenital heart diseases

International Nuclear Information System (INIS)

Mosquera, Walter A; Reyes P, Rafael; Aguilera N, Favio M; Breton, Cesar A; Buitrago, Danuby A; Suarez J Ramiro; Castillo, Victor

2007-01-01

Although echocardiogram and cardiac catheterization are used as first option tools for congenital heart diseases diagnosis, computed tomography angiography is a minimally invasive exam that through two to three dimensional images in real time gives an adequate approach to patients having this type of pathologies that require a rapid and precise evaluation of its extra cardiac anatomy. Objective: describe the institutional experience from August 2005 to August 2006 in the use of angiography by tomography as a complementary diagnostic method in the evaluation of pediatric patients with congenital heart diseases. Method: serial descriptive study. 58 pediatric patients with clinical and echocardiographic diagnosis of congenital heart diseases were evaluated through the General Electric Multislice Light peed/16 scanner. Results: 58 patients with history of congenital heart disease were evaluated through CT angiography. Mean age was 2.4 ± 4.03 years. Twenty (33.8%) had diagnosis of pulmonary atresia, four (6.7%) had tricuspid atresia, eight (13.5%,) had double-outlet right ventricle, seven (11.8%) had tetralogy of Fallot, nine (15.2%) had alterations of the aortic arch, seven (11.8%) had coarctation of the aorta two (3.3%) had interrupted aortic arch, six (10.3%) had persistent ductus arteriosus, four (6.7%) had anomalous venous drainage and three (5.1 %) had transposition of the great arteries. High quality images that allowed assessing the precise vascular anatomy were obtained. Conclusions: computed tomography angiography turned out to be a useful tool in the diagnostic approach of congenital heart diseases, because it allowed a tridimensional anatomic reconstruction. New studies that may permit the assessment of sensitivity, specificity and concordance level of this technique with other invasive diagnostic methods available for the diagnosis of this type of diseases, are required

Switch from Immediate-release Pramipexole to Extended-release Pramipexole: The Safety and Efficacy Characteristics of Sixty-eight Patients

Directory of Open Access Journals (Sweden)

Müge Kuzu

2016-09-01

Full Text Available Objective: To evaluate the safety and efficacy of switching from immediate-release pramipexole (pex to extended-release pramipexole (pex-ER. Materials and Methods: Pex-ER became available in Turkey about a year ago, since then we documented satisfactory information on patients (26 women; 38% who were switched from pex to pex-ER. We recorded pre- and post-switch pex and levodopa, equivalent doses of other anti-parkinsonian medication, and analyzed the frequency and nature of reported adverse effects. Results: The mean age of the patients was 63.3 years (range, 44-88 years, and the mean disease duration was 7.1 years (range, 1-27 years. The other drugs were levodopa (57 patients, 82.6%, entacapone (24 patients, 34.58%, rasagiline (20 patients, 29%, amantadine (18 patients, 26.1%, and apomorphine (six patients, 8.7%. Switch from pex to pex-ER was uneventful in 62 (91.2% patients. Adverse events were reported in six (8.8% patients: ankle swelling (two patients, nausea (one patient, dyskinesia (one patient, hypersexuality (one patient, and psychosis (one patient. Problems resolved with further medication change in two patients. Four patients preferred to return to pex. Conclusion: The great majority of patients (91.2% switched from three times daily pex to once daily pex-ER uneventfully. A slight increase in pex daily dose, which was tailored according to patients’ symptomatic needs, resulted in an increase in post-switch levodopa equivalent doses. Our experience is compatible with previously reported studies.

Music for Hemodialysis patients

DEFF Research Database (Denmark)

Gross, B; Ketema Wassie, F; Agnholt, Hanne

Music for hemodialysis patients Background Patients starting a new regimen of dialysis often experience anxiety and other psychological disturbances. They struggle with the unknown situation, feelings of uncertainty and on top of that, a high level of sophisticated technological equipment. Music...... is known from literature to influence and dampen anxiety and tension and has been used for millennia in the treatment of illness. Here we report a study on the influence of music on patients undergoing dialysis and whether music has a potential for lowering discomfort in patients during first-time dialysis.......   Purpose To investigate whether music can reduce feelings of anxiety, tension and restlessness in patients new to dialysis treatment and make them more relaxed during the treatment.   Method Twenty patients aged 42-84 were selected for participation in the study, which took place over two separate dialysis...

Application of a uniform anatomic grading system to measure disease severity in eight emergency general surgical illnesses.

Science.gov (United States)

Crandall, Marie L; Agarwal, Suresh; Muskat, Peter; Ross, Steven; Savage, Stephanie; Schuster, Kevin; Tominaga, Gail T; Shafi, Shahid

2014-11-01

Emergent general surgical diseases encompass a broad spectrum of anatomy and pathophysiology, creating challenges for outcomes assessment, research, and surgical training. The goal of this study was to measure anatomic disease severity for eight emergent general surgical diseases using the uniform grading system of the American Association for the Surgery of Trauma (AAST). The Committee on Patient Assessment and Outcomes of AAST applied the previously developed uniform grading system to eight emergent general surgical diseases using a consensus of experts. It was then reviewed and approved by the Board of Managers of AAST. Severity grades for eight commonly encountered emergent general surgical conditions were created: breast abscess, esophageal perforation, infectious colitis, pelvic inflammatory disease, perirectal abscess, pleural space infections, soft tissue infections, and surgical site infections. The range of grades from I through V, reflect progression from mild disease, limited to within the organ itself, to widespread severe disease. This article provides a uniform grading system for measuring anatomic severity of eight emergent general surgical diseases. Consistent adoption of these grades could improve standardization for quality assurance, outcomes research, and surgical training.

An evaluation of patients' experienced usability of a diabetes mHealth system using a multi-method approach.

Science.gov (United States)

Georgsson, Mattias; Staggers, Nancy

2016-02-01

mHealth systems are becoming more common to aid patients in their diabetes self-management, but recent studies indicate a need for thorough evaluation of patients' experienced usability. Current evaluations lack a multi-method design for data collection and structured methods for data analyses. The purpose of this study was to provide a feasibility test of a multi-method approach for both data collection and data analyses for patients' experienced usability of a mHealth system for diabetes type 2 self-management. A random sample of 10 users was selected from a larger clinical trial. Data collection methods included user testing with eight representative tasks and Think Aloud protocol, a semi-structured interview and a questionnaire on patients' experiences using the system. The Framework Analysis (FA) method and Usability Problem Taxonomy (UPT) were used to structure, code and analyze the results. A usability severity rating was assigned after classification. The combined methods resulted in a total of 117 problems condensed into 19 usability issues with an average severity rating of 2.47 or serious. The usability test detected 50% of the initial usability problems, followed by the post-interview at 29%. The usability test found 18 of 19 consolidated usability problems while the questionnaire uncovered one unique issue. Patients experienced most usability problems (8) in the Glucose Readings View when performing complex tasks such as adding, deleting, and exporting glucose measurements. The severity ratings were the highest for the Glucose Diary View, Glucose Readings View, and Blood Pressure View with an average severity rating of 3 (serious). Most of the issues were classified under the artifact component of the UPT and primary categories of Visualness (7) and Manipulation (6). In the UPT task component, most issues were in the primary category Task-mapping (12). Multiple data collection methods yielded a more comprehensive set of usability issues. Usability

Performance of an open-source heart sound segmentation algorithm on eight independent databases.

Science.gov (United States)

Liu, Chengyu; Springer, David; Clifford, Gari D

2017-08-01

Heart sound segmentation is a prerequisite step for the automatic analysis of heart sound signals, facilitating the subsequent identification and classification of pathological events. Recently, hidden Markov model-based algorithms have received increased interest due to their robustness in processing noisy recordings. In this study we aim to evaluate the performance of the recently published logistic regression based hidden semi-Markov model (HSMM) heart sound segmentation method, by using a wider variety of independently acquired data of varying quality. Firstly, we constructed a systematic evaluation scheme based on a new collection of heart sound databases, which we assembled for the PhysioNet/CinC Challenge 2016. This collection includes a total of more than 120 000 s of heart sounds recorded from 1297 subjects (including both healthy subjects and cardiovascular patients) and comprises eight independent heart sound databases sourced from multiple independent research groups around the world. Then, the HSMM-based segmentation method was evaluated using the assembled eight databases. The common evaluation metrics of sensitivity, specificity, accuracy, as well as the [Formula: see text] measure were used. In addition, the effect of varying the tolerance window for determining a correct segmentation was evaluated. The results confirm the high accuracy of the HSMM-based algorithm on a separate test dataset comprised of 102 306 heart sounds. An average [Formula: see text] score of 98.5% for segmenting S1 and systole intervals and 97.2% for segmenting S2 and diastole intervals were observed. The [Formula: see text] score was shown to increases with an increases in the tolerance window size, as expected. The high segmentation accuracy of the HSMM-based algorithm on a large database confirmed the algorithm's effectiveness. The described evaluation framework, combined with the largest collection of open access heart sound data, provides essential resources for

Ratings of Essentialism for Eight Religious Identities.

Science.gov (United States)

Toosi, Negin R; Ambady, Nalini

2011-01-01

As a social identity, religion is unique because it contains a spectrum of choice. In some religious communities, individuals are considered members by virtue of having parents of that background, and religion, culture, and ethnicity are closely intertwined. Other faith communities actively invite people of other backgrounds to join, expecting individuals to choose the religion that best fits their personal beliefs. These various methods of identification influence beliefs about the essentialist nature of religious identity. Essentialism is when social groups are considered to have deep, immutable, and inherent defining properties. In this study, college students (N=55) provided ratings of essentialism for eight religious identities: Atheist, Buddhist, Catholic, Hindu, Jewish, Muslim, Protestant, and Spiritual-but-not-religious. Significant differences in essentialism were found between the target groups. Results and implications for intergroup relations are discussed.

Synthesis of all eight L-glycopyranosyl donors using C-H activation

DEFF Research Database (Denmark)

Frihed, Tobias; Pedersen, Christian Marcus; Bols, Mikael

2014-01-01

by an intramolecular C-H activation of the methyl group in g-position; both steps were catalyzed by iridium. The following Fleming-Tamao oxidation and acetylation gave the suitably protected L-hexoses. This is the first general method for the preparation of all eight L-hexoses as their thioglycosyl donors ready...... for glycosylation and the first example of an iridium-catalyzed C(sp3)-H activation on sulfide-containing compounds....

Simultaneous comparison and assessment of eight remotely sensed maps of Philippine forests

Science.gov (United States)

Estoque, Ronald C.; Pontius, Robert G.; Murayama, Yuji; Hou, Hao; Thapa, Rajesh B.; Lasco, Rodel D.; Villar, Merlito A.

2018-05-01

This article compares and assesses eight remotely sensed maps of Philippine forest cover in the year 2010. We examined eight Forest versus Non-Forest maps reclassified from eight land cover products: the Philippine Land Cover, the Climate Change Initiative (CCI) Land Cover, the Landsat Vegetation Continuous Fields (VCF), the MODIS VCF, the MODIS Land Cover Type product (MCD12Q1), the Global Tree Canopy Cover, the ALOS-PALSAR Forest/Non-Forest Map, and the GlobeLand30. The reference data consisted of 9852 randomly distributed sample points interpreted from Google Earth. We created methods to assess the maps and their combinations. Results show that the percentage of the Philippines covered by forest ranges among the maps from a low of 23% for the Philippine Land Cover to a high of 67% for GlobeLand30. Landsat VCF estimates 36% forest cover, which is closest to the 37% estimate based on the reference data. The eight maps plus the reference data agree unanimously on 30% of the sample points, of which 11% are attributable to forest and 19% to non-forest. The overall disagreement between the reference data and Philippine Land Cover is 21%, which is the least among the eight Forest versus Non-Forest maps. About half of the 9852 points have a nested structure such that the forest in a given dataset is a subset of the forest in the datasets that have more forest than the given dataset. The variation among the maps regarding forest quantity and allocation relates to the combined effects of the various definitions of forest and classification errors. Scientists and policy makers must consider these insights when producing future forest cover maps and when establishing benchmarks for forest cover monitoring.

Study of the Cooldown and Warmup for the Eight Sectors of the Large Hadron Collider

Science.gov (United States)