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Sample records for patient history intake

  1. Comparison of anamnestic history, alcohol intake and smoking, nutritional status, and liver dysfunction between thorotrast patients who developed primary liver cancer and those who did not

    Energy Technology Data Exchange (ETDEWEB)

    Kiyosawa, K.; Imai, H.; Sodeyama, T.; Franca, S.T.; Yousuf, M.; Furuta, S.; Fujisawa, K.; Kido, C. (Shinshu Univ. School of Medicine, Matsumoto (Japan))

    1989-08-01

    In order to clarify the differences in past history, nutritional condition and, consumption of alcohol and tobacco, and liver dysfunction between the thorotrast patients who developed primary liver cancer and those who did not, 103 persons who had no primary liver cancer in January 1980 were studied. All subjects were military men who had undergone angiography with thorotrast between 1943 and 1946. Twenty persons developed hepatocellular carcinoma and 16 developed intrahepatic bile duct carcinoma by April 1987, whereas 67 are still alive without any cancer. There was no difference in age or period after thorotrast infusion between those two groups of patients in January 1980. A difference in history of hepatitis and/or jaundice and presence of hepatic dysfunction was found between the subjects who developed primary liver cancers and those who did not. These findings suggest that an anamnestic history of hepatitis and liver dysfunction are risks for development of thorotrast-induced liver cancer. On the basis of the above findings, early detection of liver dysfunction offers a possibility of early diagnosis of primary liver cancer.

  2. Food intake in patients on hemodialysis

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    Inaiana Marques Filizola Vaz

    2014-12-01

    Full Text Available Objective: To evaluate the intake of energy and nutrients by individuals on hemodialysis, following especific recommendations for this population and according to Food Guide for the Brazilian Population. Methods: A cross-sectional study, 118 adult patients, considered stable from, ten dialysis centers in Goiânia, Goiás. Dietary intake was estimated by six 24-hour recalls, and classified as adequate or inadequate, according to specific recommendations for individuals undergoing dialysis and that recommended for a healthy diet. A descriptive analysis was performed. Results: Average dietary intake of 2022.40 ± 283.70 kcal/day; 31.18 kcal/kg/day; 55.03 ± 4.20% carbohydrate; 30.23 ± 3.71% lipid, 1.18 ± 0.23 g protein/kg/day. Important prevalences of inadequacy were observed for the intake of calories (39.0%, protein (39.0% and other nutrients such as retinol (94.9%, saturated fat (87.3%, cholesterol (61,9%, iron (61.0%, potassium (60.2% and zinc (45.0%. Patients had a low intake of fruit food group (1.22 ± 0.89 servings and vegetables (1.76 ± 1.01 servings, dairy products (0.57 ± 0.43 servings and high intake of food group of oils and fats (3.45 ± 0.95 servings, sugars and sweets (1.55 ± 0.77 servings. Conclusion: Observed food consumption imbalance, characterized by excess of oils and fats, especially saturated oils and cholesterol, sugars and sweets, parallel to low intake of fruits and vegetables and dairy products. A considerable percentage of patients did not intake the minimum recommended of calories, protein, retinol, iron, zinc and potassium.

  3. Assessment of Daily Food and Nutrient Intake in Japanese Type 2 Diabetes Mellitus Patients Using Dietary Reference Intakes

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    Naoto Nakamura

    2013-06-01

    Full Text Available Medical nutrition therapy for the management of diabetes plays an important role in preventing diabetes complications and managing metabolic control. However, little is known about actual eating habits of individuals with type 2 diabetic mellitus (T2DM, especially in Japan. Therefore, we sought to (1 assess the dietary intake of individuals with T2DM, and (2 characterize their intake relative to national recommendations. This cross-sectional study involved 149 patients (77 males and 72 females aged 40–79 years with T2DM recruited at a Kyoto hospital. Dietary intake was assessed using a validated self-administered diet history questionnaire. Under-consumption, adequacy, and over-consumption, of nutrients were compared to the age- and sex-based standards of the Japanese Dietary Reference Intakes. Among the results, most notable are (1 the inadequacy of diets in men with respect to intake of vitamins and minerals, likely owing to low intake of vegetables and fruits; (2 excess contributions of fat intake to total energy in both sexes; and (3 excess consumption of sweets and beverages relative to the national average. The prevalence of diabetes complications may be increasing because of a major gap between the typical dietary intake of individuals with T2DM and dietary recommendation.

  4. Food intake in three groups of cancer patients. A prospective study during cancer treatment.

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    Hulshof, K F; Gooskens, A C; Wedel, M; Bruning, P F

    1987-02-01

    The dietary intake of 105 adult Dutch Caucasian patients (28 women with endometrial or cervical cancer, 50 men with bladder or prostate cancer and 14 men and 13 women with malignant lymphoma) was studied for 19 weeks. Energy and nutrient intakes of all patients were assessed by a dietary history with cross-check over 2 months prior to treatment and by seven 48-h dietary records filled in just before, during and after cancer therapy. No differences were observed between the results obtained with the dietary history and the first 48-h diary. In females treated with abdominal irradiation the mean daily intake of fat, dietary fibre, iron and thiamin decreased during therapy. In men treated with radiotherapy the intake of vegetable protein, polysaccharides, dietary fibre and thiamin also decreased during treatment. This may be partly explained by the observation that many of these patients had spontaneously chosen a 'constipating diet' because of diarrhoea. As compared with the Dutch Recommended Dietary Allowance only the iron intake of the women gave rise to some concern. In our study we did not observe marked changes in dietary intake and nutritional status. In females who underwent irradiation therapy especially, the dietary intake increased after a period of intensive treatment. This demonstrates that food intake of these groups of cancer patients is not consistently reduced by chemotherapy or even abdominal radiotherapy.

  5. Reorganization of a hospital catering system increases food intake in patients with inadequate intake

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    Freil, M; Nielsen, MA; Blitz, B;

    2006-01-01

    , increases the energy and protein intake of the patients. Design: Observational study comparing the food intake before and twice after the implementation of the new system, the first time by specially trained staff and the second time by ordinary staff members, following training. The amount of food served......, eaten and wasted was measured, and energy and protein intake calculated. Results: The quartile of patients with the lowest energy intake consumed on average 128 kJ per patient [(95% confidence interval (CI) 79-178 kJ] with the old system; with the new system they consumed 560 kJ per patient (95% CI 489....... Conclusions: Reorganization of a hospital catering system can increase energy and protein intake and reduce waste substantially....

  6. Reorganization of a hospital catering system increases food intake in patients with inadequate intake

    DEFF Research Database (Denmark)

    Freil, M.; Nielsen, M. A.; Biltz, C.;

    2006-01-01

    the energy and protein intake of the patients. Design: Observational study comparing the food intake before and twice after the implementation of the new system, the first time by specially trained staff and the second time by ordinary staff members, following training. The amount of food served, eaten...... and wasted was measured, and energy and protein intake calculated. Results: The quartile of patients with the lowest energy intake consumed on average 128 kJ per patient [(95% confidence interval (CI) 79-178 kJ] with the old system; with the new system they consumed 560 kJ per patient (95% CI 489-631 k......: Reorganization of a hospital catering system can increase energy and protein intake and reduce waste substantially. Keywords: hospital food; nutritional risk; undernutrition...

  7. Caffeine intake by patients with autosomal dominant polycystic kidney disease

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    Vendramini, L.C.; Nishiura, J.L.; Baxmann, A.C.; Heilberg, I.P. [Disciplina de Nefrologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP (Brazil)

    2012-07-20

    Because caffeine may induce cyst and kidney enlargement in autosomal dominant polycystic kidney disease (ADPKD), we evaluated caffeine intake and renal volume using renal ultrasound in ADPKD patients. Caffeine intake was estimated by the average of 24-h dietary recalls obtained on 3 nonconsecutive days in 102 ADPKD patients (68 females, 34 males; 39 ± 12 years) and compared to that of 102 healthy volunteers (74 females, 28 males; 38 ± 14 years). The awareness of the need for caffeine restriction was assessed. Clinical and laboratory data were obtained from the medical records of the patients. Mean caffeine intake was significantly lower in ADPKD patients versus controls (86 vs 134 mg/day), and 63% of the ADPKD patients had been previously aware of caffeine restriction. Caffeine intake did not correlate with renal volume in ADPKD patients. There were no significant differences between the renal volumes of patients in the highest and lowest tertiles of caffeine consumption. Finally, age-adjusted multiple linear regression revealed that renal volume was associated with hypertension, chronic kidney disease stage 3 and the time since diagnosis, but not with caffeine intake. The present small cross-sectional study indicated a low level of caffeine consumption by ADPKD patients when compared to healthy volunteers, which was most likely due to prior awareness of the need for caffeine restriction. Within the range of caffeine intake observed by ADPKD patients in this study (0-471 mg/day), the renal volume was not directly associated with caffeine intake.

  8. Caffeine intake by patients with autosomal dominant polycystic kidney disease

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    L.C. Vendramini

    2012-09-01

    Full Text Available Because caffeine may induce cyst and kidney enlargement in autosomal dominant polycystic kidney disease (ADPKD, we evaluated caffeine intake and renal volume using renal ultrasound in ADPKD patients. Caffeine intake was estimated by the average of 24-h dietary recalls obtained on 3 nonconsecutive days in 102 ADPKD patients (68 females, 34 males; 39 ± 12 years and compared to that of 102 healthy volunteers (74 females, 28 males; 38 ± 14 years. The awareness of the need for caffeine restriction was assessed. Clinical and laboratory data were obtained from the medical records of the patients. Mean caffeine intake was significantly lower in ADPKD patients versus controls (86 vs 134 mg/day, and 63% of the ADPKD patients had been previously aware of caffeine restriction. Caffeine intake did not correlate with renal volume in ADPKD patients. There were no significant differences between the renal volumes of patients in the highest and lowest tertiles of caffeine consumption. Finally, age-adjusted multiple linear regression revealed that renal volume was associated with hypertension, chronic kidney disease stage 3 and the time since diagnosis, but not with caffeine intake. The present small cross-sectional study indicated a low level of caffeine consumption by ADPKD patients when compared to healthy volunteers, which was most likely due to prior awareness of the need for caffeine restriction. Within the range of caffeine intake observed by ADPKD patients in this study (0-471 mg/day, the renal volume was not directly associated with caffeine intake.

  9. Evaluation of Food Intake in Ulcerative Colitis Patients

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    Z Faghfoori

    2010-04-01

    Full Text Available Introduction: Ulcerative colitis (UC is a chronic inflammatory disorder of the colon of unknown cause that is associated with important nutrition deficiencies such as protein-energy malnutrition, vitamin and mineral deficiencies. Because no study has been carried out to date in Iran, the aim of this pilot study was the assessment of dietary intake of these patients. Methods: In this pilot study, 41 UC patients whose disease severity was mild or moderate were selected. Data about diet restrictions were collected via a questionnaire and dietary intake was assessed 3 times during a 2 month period with 30 days interval and 3-day food-recall (9days in general. Results: Subjects were 26 men and 15 women and 65.9% patients avoided completely or limited milk intake. Dietary limitation about fruits and vegetables was 24.4 and 43.9 percent, respectively and legumes intake was 58.5%. Mean calorie intake in 41 patients was 2125.14±60.83 calories/day and in two groups, calcium and fiber intake was significantly less than the standard dietary recommendation. Conclusion: Dietary intake examination showed some deficiencies such as calcium and iron deficiency and fiber intake was low because the intake of fruits, vegetables and legumes was limited.

  10. Dietary intakes and some biochemical markers in hemodialysis patients

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    Emine Yassibas

    2016-03-01

    Full Text Available Purpose: Intake of energy and some nutrients is frequently inadequate in dialysis patients because of eating and appetite disorders due to uremic syndrome. Inadequate energy and protein intake cause to malnutrition. Anthropometric measurements, biochemical markers and dietary intake records have great importance in determining the nutritional status of hemodialysis (HD patients. Therefore this study was planned to determination of daily energy, nutrient intake and some biochemical markers of adult hemodialysis patients. Method and Material:  A hundred and thirty six (male = 73, female = 63 clinically stable HD patients were enrolled in this study. All patients were taken 24-hour dietary recall. The daily energy and nutrient intakes of patients were calculated by food consumption records and anthropometric measurements were taken. Results: The mean age was found 45.5±13.51 years. The ratio of patients with body mass index (BMI below 18.5 kg/m2 was 7.4% and 25 kg/m2 or upper was 16.9%. Blood hemoglobin, hematocrit, albumin and total protein levels were below the normal levels. The daily dietary energy and protein intakes were found under the recommended level in the study period. A significant positive correlation was found between daily protein intake and serum albumin levels (r=0.210, p=0.014, daily protein intake and serum total protein levels (r=0.201, p=0.019, daily energy intake and serum total protein levels (r=0.178, p=0.039. Conclusions: HD patients often have low protein and energy intakes and most of them suffer from malnutrition. Therefore nutritional status of patients should be evaluated and periodically nutrition education should be given for improving eating habits and increasing dietary compliance is recommended.

  11. Multi-modal intervention improved oral intake in hospitalized patients

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    Holst, M; Beermann, T; Mortensen, M N;

    2015-01-01

    BACKGROUND: Good nutritional practice (GNP) includes screening, nutrition plan and monitoring, and is mandatory for targeted treatment of malnourished patients in hospital. AIMS: To optimize energy- and protein-intake in patients at nutritional risk and to improve GNP in a hospital setting. METHODS......: A 12-months observational multi-modal intervention study was done, using the top-down and bottom-up principle. All hospitalized patients (>3 days) were included. Setting: A university hospital with 758 beds and all specialities. Measurements: Record audit of GNP, energy- and protein-intake by 24-h......, age, BMI or previous weight loss before and after the intervention. Result-indicators: Energy intake improved from 52% to 68% (p protein intake from 33% to 52% (p 75% of requirements). Intake of less than 50% of requirements decreased with 50%. Process-indicators: Screening...

  12. Food intakes and preferences of hospitalised geriatric patients

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    Wan Chik Wan Chak; Chee Kan; Shahar Suzana

    2002-01-01

    Abstract Background A cross sectional survey was carried out on 120 hospitalised geriatric patients aged 60 and above in Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur to investigate their nutrient intakes and food preferences. Methods Food intakes were recorded using a one day weighed method and diet recall. Food preferences were determined using a five point hedonic score. Food wastages and factors affecting dietary adequacy were also investigated. Results The findings indicated that...

  13. Stress history increases alcohol intake in relapse: Relation to phosphodiesterase 10A

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    Logrip, Marian L.; Zorrilla, Eric P.

    2012-01-01

    Stressful experiences in humans can result in elevated alcohol drinking, as exemplified in many individuals with post-traumatic stress disorder. However, how stress history, rather than acute stressors, influences alcohol intake remains uncertain. To model the protracted effects of past stress, male Wistar rats were subjected to light-cued footshock stress (Stress History) or light cues alone (Control) prior to their acquisition of alcohol self-administration (1-h sessions, fixed ratio1–3, 10...

  14. Food intakes and preferences of hospitalised geriatric patients

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    Wan Chik Wan Chak

    2002-08-01

    Full Text Available Abstract Background A cross sectional survey was carried out on 120 hospitalised geriatric patients aged 60 and above in Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur to investigate their nutrient intakes and food preferences. Methods Food intakes were recorded using a one day weighed method and diet recall. Food preferences were determined using a five point hedonic score. Food wastages and factors affecting dietary adequacy were also investigated. Results The findings indicated that the mean intakes of energy and all nutrients investigated except for vitamin C and fluid were below the individual requirement for energy, protein and fluid, and the Malaysian Recommendation of Dietary Allowances (RDA for calcium, iron, vitamin A, thiamin, riboflavin, niacin and acid ascorbic. In general, subjects preferred vegetables, fruits and beans to red meat, milk and dairy products. There was a trend of women to have a higher percentage for food wastage. Females, diabetic patients, subjects who did not take snacks and subjects who were taking hospital food only, were more likely to consume an inadequate diet (p Conclusions Food service system in hospital should consider the food preferences among geriatric patients in order to improve the nutrient intake. In addition, the preparation of food most likely to be rejected such as meat, milk and dairy products need some improvements to increase the acceptance of these foods among geriatric patients. This is important because these foods are good sources of energy, protein and micronutrients that can promote recovery from disease or illness.

  15. Effect of sow history features on growth and feed intake in grow-finish pigs

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    Sell-Kubiak, E.B.; Knol, E.F.; Bijma, P

    2012-01-01

    The sow provides a specific environment to her offspring during gestation and lactation. Certain features in the early life of the sow (sow history features) may affect her ability to deliver and feed a healthy litter. In genetic analyses of grow-finish traits, these effects are estimated as common litter or permanent sow effects. The objective of this research was to identify sow history features that affect the growth rate (GR) and feed intake (FI) of her offspring during the grow-finish st...

  16. Innovations in Calculating Precise Nutrient Intake of Hospitalized Patients

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    Sheila Cox Sullivan

    2016-07-01

    Full Text Available Obtaining a detailed assessment of a hospitalized patient’s nutrient intake is often critically important to ensuring the patient’s successful recovery. However, this process is often laborious and prone to error. Inaccurate nutrient intake assessments result in the inability of the healthcare team to recognize patients with developing nutritional deficits that contribute to delayed recovery and prolonged lengths of stay. This paper describes an innovative, easy to use system designed to increase the precision of calorie count reports by using a combination of photography, direct observation, and a specially developed computer program. Although the system was designed specifically for use in a Department of Veterans Affairs Hospital, it has the potential to be adapted for use in other hospital environments.

  17. Impact of dietary fiber intake on glycemic control, cardiovascular risk factors and chronic kidney disease in Japanese patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry

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    FUJII, Hiroki; Iwase, Masanori; Ohkuma, Toshiaki; Ogata-Kaizu, Shinako; Ide, Hitoshi; Kikuchi, Yohei; Idewaki, Yasuhiro; Joudai, Tamaki; Hirakawa, Yoichiro; UCHIDA, Kazuhiro; Sasaki, Satoshi; Nakamura, Udai; Kitazono, Takanari

    2013-01-01

    Background Dietary fiber is beneficial for the treatment of type 2 diabetes mellitus, although it is consumed differently in ethnic foods around the world. We investigated the association between dietary fiber intake and obesity, glycemic control, cardiovascular risk factors and chronic kidney disease in Japanese type 2 diabetic patients. Methods A total of 4,399 patients were assessed for dietary fiber intake using a brief self-administered diet history questionnaire. The associations betwee...

  18. Sensitivity to calcium intake in calcium stone forming patients.

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    Heilberg, I P; Martini, L A; Draibe, S A; Ajzen, H; Ramos, O L; Schor, N

    1996-01-01

    The absorptive or renal origin of hypercalciuria can be discriminated using an acute oral calcium load test (ACLT). Of 86 patients with calcium oxalate kidney stones, 28 (23%) were found to be hypercalciuric (HCa) and 58 (67%) normocalciuric (NCa) on their customary free diet, containing 542 +/- 29 mg/day (mean +/- SE) of calcium. Since the apparently normal 24-hour calcium excretion of many calcium stone formers (CSF) may be due to a combination of high calcium absorption with moderately low calcium intake, all patients were investigated by ACLT. Of 28 HCa patients, 13 (46%) were classified as absorptive (AH) and 15 (54%) as renal hypercalciuria (RH). Of the 58 NCa patients, 38 (65%) presented features of intestinal hyperabsorption and were therefore designated as AH-like, and 20 (35%) as RH-like. To further elucidate the role of dietary calcium in these CSF, a chronic calcium load test (CCLT), consisting of 1 g/day of oral Ca for 7 days, was designed. A positive response to the CCLT was considered to occur when urinary calcium (uCa) was > or = 4 mg/ kg/24 h on the 7th day. Among NCa patients, 29% of AH-like subjects responded to the CCLT and 71% did not; 50% of RH-like subjects also responded and 50% did not. In HCa patients, 85% of AH and 67% of RH subjects maintained uCa > or = 4 mg/kg/24 h after the CCLT and 15% of AH and 23% of RH subjects did not. However, a significant additional increase in mean uCa was not observed among HCa patients. All patients were submitted to a second evaluation of fasting calciuria (Ca/Cr). A modification of this parameter was noticed in 89% of RH-like and 78% of RH patients. In conclusion, these data suggest the presence of subpopulations of patients sensitive or not to calcium intake, regardless of whether the acute response to a calcium overload test suggested AH or RH. The CCLT disclosed dietary hypercalciuria in 21/58 (36%) of previously NCa patients. In these NCa patients, the ACLT may be replaced by the CCLT. The distinction

  19. Dietary fat and antioxidant vitamin intake in patients of neurodegenerative disease in a rural region of Jalisco, Mexico

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    Navarro-Meza, Mónica; Gabriel-Ortiz, Genaro; Pacheco-Moisés, Fermín P.; Cruz-Ramos, José A.; López-Espinoza, Antonio

    2014-01-01

    Objective To evaluate and compare the intake of lipids and (A, E, and C) vitamins in patients with and without possible neurodegenerative diseases. Methods Twenty adults with possible Alzheimer's disease or Parkinson's disease and 41 control subjects (50–89 years old) from a rural region were studied. Dietary intake was evaluated with the analysis of macronutrients and micronutrients conducted by a food frequency questionnaire and 24 hours dietary record. Analyses were adjusted for age, sex, body mass index, and energy intake. Through interrogation and use of medical record form of health secretary we obtained information about the sociodemographic characteristics. Multivariate analysis of variance to allow for covariated adjustment was used. Results Patients had a lower energy intake, vitamin C (P = 0.016), fruits (P < 0.001), vegetables (P = 0.037), and oils and fat (P = 0.002), than the controls. Interestingly, the C vitamin intake in patients was still higher than the recommended. Patients had a higher consumption of cereals (P = 0.017), high-animal fat diet (P = 0.024), and whole milk (P < 0.001); 2.4% of the controls smoke and 5% are alcohol consumers. Eighty-five percent of patients and 78% of the controls do not have physical activity. Family history of subjects in this study indicated chronic diseases. Conclusion The subjects included in this study had a high intake of C vitamin, this is due to the consumption of fruits and vegetables. However, patients with possible Alzheimer's or Parkinson's disease had a lower intake of fruits and vegetables, which could be due to type of food to which they have access. PMID:24257159

  20. Intake of antioxidants in patients with rheumatoid arthritis

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    Bruna Nolasco Siqueira Silva

    2014-12-01

    Full Text Available Objective: to investigate dietary intake of antioxidants in patients with rheumatoid arthritis. Methods: this is a cross-sectional case series study with 53 women accompanied at the Rheumatology Outpatient Clinic, Hospital das Clínicas/UFPE, from January to October 2012. Demographic and anthropometric parameters (weight, height, body mass index, weight change were collected by means of a form. The assessment of food consumption was conducted using a semi-quantitative food frequency survey, analyzed according to a food composition table. Database construction and statistical analysis were performed using Excel and SPSS version 18.0, using chi-squared test, Anova, and Student’s t-test, at a confidence level of 5%. Results: the sample was composed of 53 women with a mean age of 54.51 ± 4.24 years and BMI of 25.97 ± 5.94 kg/m². In the sociodemographic variables, statistically significant differences in origin, occupation, and income were observed. Daily consumption showed significance for vitamins A, C, and zinc. In adults, vitamins A and C were in accordance with recommendations, while in the elderly a low intake of vitamin E and selenium was observed. The relation between vitamin E and origin was significant. Conclusion: the sample was composed of 53 women with a mean age of 54.51 ± 4.24 years and BMI of 25.97 ± 5.94 kg/m². In the sociodemographic variables, statistically significant differences in origin, occupation, and income were observed. Daily consumption showed significance for vitamins A, C, and zinc. In adults, vitamins A and C were in accordance with recommendations, while in the elderly a low intake of vitamin E and selenium was observed. The relation between vitamin E and origin was significant.

  1. Energy intake of Swedish overweight and obese children is underestimated using a diet history interview.

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    Waling, Maria U; Larsson, Christel L

    2009-03-01

    Estimating energy intake (EI) of a child by using a diet history interview (DHI) method may be a challenge because of difficulty for the child to remember what has been eaten as well as to report portion sizes. The aim of this research was to validate reported EI from a DHI in children classified as overweight or obese by comparing the reported EI to total energy expenditure (TEE) measured by 2 objective measures. Eighty-five 10.5- +/- 1.1-y-old overweight and obese children, with help from 1 or 2 parents, reported their EI 2 wk retrospectively in a DHI. Reported EI was compared with TEE, as measured by SenseWear armband (n = 85) and the doubly-labeled water (DLW) method (n = 21), during the same period as the DHI. Reported EI was underestimated by 14% when validated against both the armband and DLW method. Underestimation did not differ between boys and girls. However, the EI of obese children was underestimated by 22%, which is twice the rate as for the overweight children (95% CI: 0.55, 3.08). Underestimated EI was negatively correlated with BMI (r = -0.38; P = BMI and higher age when using a DHI method. The findings show the importance of validating dietary intake of children in general and in overweight and obese children in particular.

  2. Dietary intake in head and neck irradiated patients with permanent dry mouth symptoms

    International Nuclear Information System (INIS)

    Radiotherapy of the head and neck region, which includes the major and minor salivary glands in the radiation field, usually leads to temporary or permanent xerostomia. This may affect eating and increase the risk of inadequate intake of energy and nutrients. The aim of the present study was to investigate the effects of radiotherapy-induced xerostomia on energy and nutrient intake in individuals treated for malignancies in the head and neck region. The dietary intake of 24 patients with a low chewing stimulated whole saliva flow rate (1.0 ml/min) was recorded for 7 days. The average daily energy intake was nearly 300 kcal lower in the irradiated patients with dry mouth symptoms than in the control group. The mean intake in the former group was 1925 kcal per day whereas the control group had an intake of 2219 kcal per day. Irradiated patients with dry mouth symptoms had significantly lower mean intakes of vitamin A, β-carotene, vitamin E, vitamin B6, folacine, iron and zinc than those in the control group. There was also a lower intake of vitamin C, but this was not statistically significant. The intake of vitamins A and C exceeded or reached the levels recommended in the Swedish Nutritional recommendations, but the average intakes of fibre, iron, β-carotene, vitamin E, zinc, selenium, and iron did not reach recommended levels, in neither the experimental nor the control group. (Author)

  3. Adequacy of nutritional intake in a Canadian population of patients with Crohn's disease.

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    Aghdassi, Elaheh; Wendland, Barbara E; Stapleton, Melanie; Raman, Maitreyi; Allard, Johane P

    2007-09-01

    Crohn's disease is frequently associated with nutritional deficiencies, often a result of disease activity and poor oral intake. This study investigated the adequacy of dietary intake, based on the Canadian Dietary Reference Intake, in ambulatory patients with Crohn's disease and a normal body mass index (BMI; calculated as kg/m(2)). This was a cross-sectional study of 74 patients with mean age of 35.7+/-1.4 years and BMI of 23.05+/-0.45. All patients completed a 7-day food record and a diary for the Crohn's Disease Activity Index. Mean Crohn's Disease Activity Index was 138.99+/-11.38. Energy and protein intakes were within the recommended levels of intake, but total carbohydrates, fat, and saturated fat intake exceeded the recommended levels of <55%, <35%, and <10% in 39.2%, 27%, and 59.5% of the patients, respectively. Micronutrient intakes were suboptimal most notably for folate, vitamins C, E, and calcium. There were no substantial differences between patients with active and inactive disease in terms of failure to meet the Dietary Reference Intake. In conclusion, in this population sample, a large number of ambulatory patients with Crohn's disease have suboptimal dietary patterns despite a normal BMI and inactive disease. Dietary counseling and supplementation may be warranted in this patient population. PMID:17761234

  4. [Calcium intake and glucose and lipids concetrations in overweight and obese patients].

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    Pachocka, Lucyna M; Nowak, Agnieszka; Targosz, Urszula; Kłosiewicz-Latoszek, Longina; Stolarska, Irena

    2007-01-01

    Well-balanced diet is one of the determinants of the health and wellbeing. Inadequate nutrients' intake can promote disease development. The purpose of this study was to assess the intake of calcium, phosphorus and protein and relation between calcium intake and lipids and glucose serum concentration in patients with obesity. The studied group consisted of 57 subjects, aged 21-63 years. Dietary assessment was based on 3-d dietary record. Serum lipids concentrations were assessed by enzymatic methods, serum calcium concentrations were assessed by Vitros 250. The mean calcium intake in men was 588.8 mg/d, in women 549.3 mg/d. Calcium intake was statistically significant correlated with glucose concentration in women and men, but not with lipids concentrations. Dietary calcium intake in studied group was below the RDA. Calcium intake could be one of determinants of glucose concentration in obese persons.

  5. Association of Processed Meat Intake with Hypertension Risk in Hemodialysis Patients: A Cross-Sectional Study.

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    Pei-Yu Wu

    Full Text Available In this cross-sectional study, we hypothesized that hemodialysis patients consuming greater processed meat is associated with hypertension risk, which can be partly explained by the high sodium content in processed meat. From September 2013 to May 2014, one hundred and four patients requiring chronic hemodialysis treatment were recruited from hemodialysis centers. Data on systolic blood pressure and diastolic blood pressure before receiving dialysis, and 3-day dietary records of the recruited patients were collected. HD patients with systolic and diastolic blood pressures greater than140 mmHg and higher than 90 mmHg, respectively, were considered hypertension risk. Protein foods were divided into 4 categories: red meat, white meat, soybeans, and processed meat (e.g., sausage and ham. In a model adjusted for energy intake and hypertension history, additional servings of processed meats was positively associated to systolic blood pressure >140 mmHg (odds ratio [95% confidence interval]: 2.1 [1.0-4.3], and diastolic blood pressure > 90 mmHg (odds ratio: 2.5 [1.2-5.5]. After adjustment for dietary sodium contents or body mass index (BMI, most associations were substantially attenuated and were no longer significant. In systolic blood pressure greater than140 mmHg, one serving per day of red meats (β = -1.22, P < .05 and white meats (β = -0. 75, P = .05 was associated with a reduced risk compared with one serving per day of processed meats. Similarly, compared with one serving per day of processed meat, a reduced risk of diastolic blood pressure higher than 90 mmHg was associated with one serving per day of red meat (β = -1. 59, P < .05, white meat (β = -0. 62, P < .05. Thus, in these hemodialysis patients, intake of processed meat is significantly positively associated with higher blood pressure risk, and both sodium contents in processed meat and BMI significantly contributes to this association.

  6. Effect of sow history features on growth and feed intake in grow-finish pigs.

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    Sell-Kubiak, E; Knol, E F; Bijma, P

    2012-01-01

    The sow provides a specific environment to her offspring during gestation and lactation. Certain features in the early life of the sow (sow history features) may affect her ability to deliver and feed a healthy litter. In genetic analyses of grow-finish traits, these effects are estimated as common litter or permanent sow effects. The objective of this research was to identify sow history features that affect the growth rate (GR) and feed intake (FI) of her offspring during the grow-finish stage. Data from 17,743 grow-finish pigs, coming from 604 sires and 681 crossbred sows, were recorded between May 2001 and February 2010 at the experimental farm of the Institute for Pig Genetics (Beilen, the Netherlands). The grow-finish stage was divided into 2 phases (phase 1: 26 to 75 kg; phase 2: 75 to 115 kg). The sow history features were birth litter size, birth year and season, birth farm, weaning age, age of transfer to the experimental farm, and age at first insemination. The sow features were added to the basic model one at a time to study their effect on the grow-finish traits of the pigs. Subsequently, significant sow features (P sow, the GR of her offspring decreased by 1 g/d and the FI decreased by 4 g/d. Every extra day to the first insemination increased the GR of grow-finish pigs by 0.1 g/d. The heritability estimates for GR and FI (only in phase 2 of the grow-finish stage) decreased after adding the sow features to the model. No differences were found in estimates of the common litter effects between the basic model and the model with all significant sow features. The estimates of the permanent sow effect changed for FI from 0.03 (basic model) to 0.00 (model with sow features), and for FI in phase 1, the permanent sow effect decreased from 0.03 (basic model) to 0.01 (model with sow features). In conclusion, selected sow features do affect the grow-finish traits of the pigs, but their estimates are small and explain only a small proportion of the differences in

  7. Validation of The Fluid Intake Appraisal Inventory for patients on haemodialysis in Denmark

    DEFF Research Database (Denmark)

    Pahus, Jytte; Ludvigsen, Mette Spliid; Lindberg, Magnus

    2016-01-01

    Background Many haemodialysis patients have problems limiting their fluid intake, which might be influenced by their self-efficacy (SE). Thus interventions to improve patients’ SE could lead to an improvement in their managing of fluid allowance. The Fluid Intake Appraisal Inventory (FIAI...

  8. Bereaved relatives' perspectives of the patient's oral intake towards the end of life: a qualitative study.

    NARCIS (Netherlands)

    Raijmakers, N.J.H.; Clark, J.B.; Zuylen, L. van; Allan, S.G.; Heide, A. van der

    2013-01-01

    Background: Patients approaching death often have a decreasing oral intake, which can be distressing for relatives. Little is known about the relatives' experiences with and perceptions of oral intake at the end of life. Aim:This study aims to contribute to a more thorough understanding of relatives

  9. Effects of Nutritional Intervention on Vitamins and Minerals Intake at Overweight and Obese Patients

    OpenAIRE

    Mihaela Posea; Andreea Dragomir; Emilia Rusu; Raluca Nan; Ramona Dragut; Horatiu Popescu; Florentina Stoicescu; Ileana Teodoru; Anca Hancu; Marilena Stoian; Gabriela Radulian

    2015-01-01

    Background and Aims- To evaluate the impact of nutritional intervention on vitamins and minerals from intake food and anthropometric parameters at overweight and obese patients. Material and methods- To a sample of 40 overweight and obese patients we evaluated the nutritional content of food intake (kilocalories, macro and micronutrients). We also measured anthropometric parameters like weight, body mass index, body fat, percent of body fat, abdominal circumference and arterial tension. Resul...

  10. A Study on the Dietary Intake and the Nutritional Status among the Pancreatic Cancer Surgical Patients

    Science.gov (United States)

    Park, Joon Seong; Yoon, Dong Sup; Kim, Woo Jeong; Chung, Hae-yun

    2016-01-01

    The adequate dietary intake is important to maintain the nutritional status of the patients after pancreatic cancer surgery. This prospective study was designed to investigate the dietary intake and the nutritional status of the patients who had pancreatic cancer surgery. Thirty-one patients (15 men, 16 women) were enrolled and measured body weight, body mass index (BMI), nutritional risk index (NRI), and Malnutrition Universal Screening Tool (MUST). Actual oral intake with nutritional impact symptoms recorded on the clinical research foam at every meal and medical information were collected from electronic medical charts. The rates of malnutrition at admission were 45.1% (14/31) and 28.9% (9/31) by NRI and MUST method, respectively, but those were increased to 87% (27/31) and 86.6% (26/31) after operation on discharge. The median values of daily intake of energy, carbohydrates, fat, and protein were 588.1 kcal, 96.0 g, 11.8 g, and 27.0 g, respectively. Most patients (n = 20, 64.5%) experienced two or more symptoms such as anorexia, abdominal bloating and early satiety. There were negative correlations between C-reactive protein (CRP) levels and the intake of total energy, protein, fat, and zinc. The rates of malnutrition were increased sharply after surgery and the dietary intake also influenced the inflammatory indicators. The results suggested that need of considering special therapeutic diets for the patients who received pancreatic surgery. PMID:27812517

  11. Dietary Vitamin K Intake Is Associated with Cognition and Behaviour among Geriatric Patients: The CLIP Study.

    Science.gov (United States)

    Chouet, Justine; Ferland, Guylaine; Féart, Catherine; Rolland, Yves; Presse, Nancy; Boucher, Kariane; Barberger-Gateau, Pascale; Beauchet, Olivier; Annweiler, Cedric

    2015-08-12

    Our objective was to determine whether dietary vitamin K intake was associated with cognition and behavior among older adults. 192 consecutive participants ≥65 years, recruited in the cross-sectional CLIP (Cognition and LIPophilic vitamins) study, were separated into two groups according to the tertiles of dietary phylloquinone intake (i.e., lowest third below 207 µg/day versus the other two thirds combined). Daily dietary phylloquinone intake was estimated from 50-item interviewer-administered food frequency questionnaire. Cognition was assessed with Mini-Mental State Examination (MMSE); behaviour with Frontotemporal Behavioral Rating Scale (FBRS). Age, gender, social problems, education, body mass index (BMI), comorbidities, history of stroke, use vitamin K antagonists, inadequate fatty fish intake, serum thyroid-stimulating hormone (TSH), vitamin B12, albumin, and estimated glomerular filtration rate were used as confounders. Compared to participants in the lowest third of dietary phylloquinone intake (n = 64), those with higher intake had higher (i.e., better) mean MMSE score (22.0 ± 5.7 versus 19.9 ± 6.2, p = 0.024) and lower (i.e., better) FBRS score (1.5 ± 1.2 versus 1.9 ± 1.3, p = 0.042). In multivariate linear regressions, log dietary phylloquinone intake was positively associated with MMSE score (adjusted β = 1.66, p = 0.013) and inversely associated with FBRS score (adjusted β = -0.33, p = 0.037). Specifically, log dietary phylloquinone intake correlated negatively with FBRS subscore of physical neglect (r = -0.24, p = 0.001). Higher dietary phylloquinone intake was associated with better cognition and behavior among older adults.

  12. Association Between Usual Vitamin K Intake and Anticoagulation in Patients Under Warfarin Therapy.

    Science.gov (United States)

    Park, Ji Na; Lee, Ji Sun; Noh, Min Young; Sung, Mi-Kyung

    2015-10-01

    This study aimed to explore the correlation between usual vitamin K intake and response to anticoagulant therapy among patients under warfarin therapy. We conducted a retrospective survey of patients (n = 50) on continuous warfarin therapy. Clinical information and laboratory parameters were sourced from medical records. Anticoagulant effect was evaluated by using the percent time in therapeutic range (TTR) and the coefficient of variation (CV) of International normalized ratio (INR). Dietary vitamin K intake was assessed using a semi-quantitative food frequency questionnaire that has been developed for the purpose of assessing dietary intake of vitamin K. A total of 50 patients aged between 21 and 87 years were included in the study. The mean vitamin K intake was 262.8 ± 165.2 µg/day. Study subjects were divided into tertiles according to their usual vitamin K intake. The proportion of men was significantly higher in second and third tertile than first tertile (p = 0.028). The mean percent TTR was 38.4 ± 28.4% and CV of INR was 31.8 ± 11.8%. Long-term warfarin therapy group (≥ 3 years) had a higher percentage of TTR as compared to the control group (vitamin K intake and percent TTR (p > 0.05). In conclusion, no significant association was observed between usual vitamin K intake and anticoagulant effects. Further studies are required to consider inter-individual variability of vitamin K intake. Development of assessment tools to measure inter-individual variability of vitamin K intake might be helpful.

  13. Dietary intake of nutrients and its correlation with fatigue in multiple sclerosis patients.

    Directory of Open Access Journals (Sweden)

    Sama Bitarafan

    2014-03-01

    Full Text Available The role of nutrition in the progression of multiple sclerosis (MS and related complications such as fatigue has been reported by several studies. The aim of this study is the assessment of nutritional status and its relationship with fatigue in multiple sclerosis patients.This is a cross-sectional study, in which 101 relapsing-remitting MS patients were enrolled. The fatigue status was determined using the validated Persian version of of the Modified Fatigue Impact Scale (MFIS. Dietary intake was assessed using a 3-day food record questionnaire and compared to dietary reference intake (DRI values. Association between variables was determined using Pearson Correlation Coefficient.In the preset study, 25 men and 76 women (total = 101 were enrolled. Analysis of dietary intake showed that daily intake of vitamin D, folate, calcium, and magnesium were significantly lower than DRI in all of patients. In men, zinc intake was significantly lower than DRI; while, in women, iron was significantly below the DRI level. After adjusting for energy, MFIS and its physical subscale were highly correlated with intake of folate and magnesium.Our findings support that lower magnesium and folate diets are correlated with higher fatigue scores in MS patients.

  14. Effects of Nutritional Intervention on Vitamins and Minerals Intake at Overweight and Obese Patients

    Directory of Open Access Journals (Sweden)

    Mihaela Posea

    2015-03-01

    Full Text Available Background and Aims- To evaluate the impact of nutritional intervention on vitamins and minerals from intake food and anthropometric parameters at overweight and obese patients. Material and methods- To a sample of 40 overweight and obese patients we evaluated the nutritional content of food intake (kilocalories, macro and micronutrients. We also measured anthropometric parameters like weight, body mass index, body fat, percent of body fat, abdominal circumference and arterial tension. Results- After the nutritional intervention, overweight and obese patients had significantly lower level of intake carbohydrates (P=.018, lipids (P=.002, B1 vitamin (P<.001, B3 vitamin (P=.02 and E vitamin (P=.016. There is a significantly increased level of proteins (P<.001. Regarding the minerals, we found that the intake levels of following‘s decreased: sodium (P<.001, magnesium (P=.006, zinc (P=.035, copper (P=.002, manganese (P<.001. Phosphorus is the only mineral of which the intake level increased significantly (P<.001. All the anthropometric parameters decreased significantly: weight (P<.001, body mass index (P<.001, body fat (P<.001, percent of body fat (P<.001, abdominal circumference (P<0.001, systolic arterial tension (P<.001, diastolic arterial tension (P=.002. Conclusions- All the patients had imbalanced intake of vitamins and minerals both before and after intervention. There is a significant improved on anthropometric measures after nutritional intervention. We need to promote healthy lifestyle changes to prevent the risks associated with obesity.

  15. Evaluation of dietary habits and nutritional content of food intake in overweight and obese patients

    Directory of Open Access Journals (Sweden)

    Posea Mihaela

    2014-03-01

    Full Text Available Background and Aims To document the nutritional content of food intake in overweight and obese people, in order to change dietary habits for acquiring the normal weight. Material and methods We assessed the nutritional content of food intake (kilocalories, vitamins and minerals in a sample of 124 overweight and obese people and 33 subjects with normal weight. We also measured abdominal circumference, percent of body fat and resting metabolic rate. Results Overweight and obese patients, compared to normal weight, have a significant increased intake of vitamin A (p=0.002, vitamin B1 (p=0.037, vitamin B5 (p=0.047, vitamin C (p=0.029 and vitamin D (p=0.015, sodium (p=0.036, iron (p=0.032 and selenium (p=0.007. The percent of body fat in obese persons is increased (p=0.00001 and very close to abnormal in patients with no weight problems. An increased food intake, above the calculated resting metabolic rate, is associated with a slower metabolism and a rapid resting metabolic rate is often associated with food intake below resting metabolic rate (p=0.002. Conclusions All subjects had imbalanced intake of vitamins and minerals. The normal weight group didn’t achieve the dietary recommendations for vitamins and minerals and we found that these subjects had risk factors for cardiac diseases like increased abdominal circumference, body fat and sodium intake.

  16. Sodium Intake, Dietary Knowledge, and Illness Perceptions of Controlled and Uncontrolled Rural Hypertensive Patients

    Directory of Open Access Journals (Sweden)

    Aziz Kamran

    2014-01-01

    Full Text Available Introduction and Objectives. Nutritional knowledge of the patients is important in dietary adherence. This study aimed to determine the relationship between illness perceptions and nutritional knowledge with the amounts of sodium intake among rural hypertensive patients. Methods. In a cross-sectional study, 671 hypertensive patients were selected in a multistage random sampling from the rural areas of Ardabil city, Iran, in 2013. Data were collected using a questionnaire consisting of four sections and were analyzed using Pearson correlation and multiple linear regressions by SPSS-18. Results. The mean of sodium intake in the uncontrolled hypertensive patients was 3599±258 mg/day and significantly greater than controlled group (2654±540 mg/day (P<0.001. Knowledge and illness perceptions could predict 47.2% of the variation in sodium intake of uncontrolled group. A significant negative relationship was found between knowledge and illness perceptions of uncontrolled hypertensive patients with dietary sodium intake (r=-0.66, P<0.001 and r=-0.65, P<0.001, resp.. Conclusion. Considering the fact that patients’ nutritional knowledge and illness perceptions could highly predict their sodium intake, the importance of paying more attention to improve patients’ information and perceptions about hypertension is undeniable, especially among the uncontrolled hypertensive patients.

  17. Hepatic Steatosis, Carbohydrate Intake, and Food Quotient in Patients with NAFLD

    Directory of Open Access Journals (Sweden)

    Concepcion Gonzalez

    2013-01-01

    Full Text Available Is steatosis related to the spontaneous carbohydrate intake in patients with NAFLD? We performed dietary records for 24 patients with NAFLD, 3 months after their liver biopsy was performed and before the deliverance of a dietary advice. The food quotient, indicator of the proportion of calories from carbohydrates, was calculated as (1.00×%  calories from carbohydrates/100 + (0.70×%  calories from lipids/100 + (0.81×%  calories from proteins/100. The associations between diet variables and steatosis% on the hepatic biopsies were tested by regression analysis, and diet variables were compared according to the presence of fibrosis. The subjects displayed a large range of steatosis, 50.5% ± 25.5 [10–90], correlated with their energy intake (1993 ± 597 kcal/d, , and food quotient (0.85 ± 0.02, , , which remained significant with both variables by a multivariate regression analysis (, . For the 17/24 patients with a hepatic fibrosis, the energy intake was lower (fibrosis: 1863 ± 503 versus others: 2382 ± 733 kcal/d, , and their food quotients did not differ from patients without fibrosis. Hepatic steatosis was related to the energy and carbohydrate intakes in our patients; the role of dietary carbohydrates was detectable in the range of usual carbohydrate intake: 32% to 58% calories.

  18. Functional oral intake and time to reach unrestricted dieting for patients with traumatic brain injury

    DEFF Research Database (Denmark)

    Hansen, Trine S; Engberg, Aase W; Larsen, Klaus

    2008-01-01

    OBJECTIVES: To investigate the status of functional oral intake for patients with severe traumatic brain injury (TBI) and time to return to unrestricted dieting; and to investigate whether severity of brain injury is a predictor for unrestricted dieting. DESIGN: Observational retrospective cohort...... planning rehabilitation, giving information to patients and relatives, and designing efficacy studies of facial oral tract therapy, which are highly recommended....

  19. The impact of exercise on body composition and nutritional intake in patients with heart failure.

    Science.gov (United States)

    Oka, Roberta K; Sanders, Mark G

    2005-01-01

    Little is known about the nutritional status of heart failure patients and the potential synergistic effects between nutritional intake and exercise. This small, randomized trial examined the effects of a 3-month exercise program on body composition and nutritional intake in 31 men (17 exercisers; 14 controls), aged 30-76 years (mean, 56 years) with stable class II-III heart failure. Baseline and 3-month evaluations included body mass index, body fat mass by triceps skinfold thickness, dietary intake by food frequency questionnaire, and the 6-minute walk test. Exercise consisted of walking 3 d/wk and resistance exercises 2 d/wk for 40-60 minutes. Dietary recommendations were consistent with the American Heart Association/American College of Cardiology heart failure guidelines. Exercisers decreased body weight (p=0.001), body mass index (p=0.0001), and triceps skinfold thickness (p=0.03) and improved 6-minute walk test (p=0.01) compared with controls. Exercisers also demonstrated trends toward decreased total caloric and cholesterol intake and a three-fold higher carbohydrate, fiber, and beta carotene intake vs. controls. In this study population, protein, fiber, and magnesium intake were below recommended daily allowance. After exercise, body mass index was reduced, accompanied by dietary modifications including greater intake of foods with higher moisture content. Further study is needed to investigate the interaction among diet, exercise, and weight.

  20. History of Abuse and Neglect in Patients with Schizophrenia Who Have a History of Violence

    Science.gov (United States)

    Bennouna-Greene, Mehdi; Bennouna-Greene, Valerie; Berna, Fabrice; Defranoux, Luc

    2011-01-01

    Objective: To determine the prevalence of five forms of abuse/neglect during childhood and adolescence in a group of schizophrenic patients with a history of violence. Methods: Twenty-eight patients hospitalized in a highly secured psychiatric unit were included. Abuse and neglect during patients' growth were evaluated with the childhood trauma…

  1. Dietary zinc intake of vegetarian and nonvegetarian patients with anorexia nervosa.

    Science.gov (United States)

    Bakan, R; Birmingham, C L; Aeberhardt, L; Goldner, E M

    1993-03-01

    Anorexia nervosa (AN) and zinc deficiency, found most frequently in young females, have a number of symptoms in common. These include weight loss, alterations in taste and appetite, depression, and amenorrhea. Approximately half of anorexia nervosa patients (ANs) are vegetarian (VANs), a practice that may increase their risk for zinc deficiency. This study compared the dietary intake of zinc and related nutrients in 9 outpatient VANs with that of 11 outpatient nonvegetarian patients with anorexia nervosa (NVANs). VANs reported significantly lower (p zinc, fat, and protein, and a significantly higher (p zinc intake should be routinely assessed in VANs and that zinc supplementation of their diets may be indicated. PMID:8477292

  2. Obesity coexists with malnutrition?: adequacy of food consumption by severely obese patients to dietary reference intake recommendations

    Directory of Open Access Journals (Sweden)

    Jaqueline Driemeyer Correia Horvath

    2014-02-01

    Full Text Available To assess the adequacy of food intake in severely obese patients and describe their main nutritional deficiencies on the basis of Dietary Reference Intakes (DRIs. Patients on a waiting list for bariatric surgery were sequentially recruited from March 2010 to November 2011. All subjects underwent nutritional status assessment (anthropometry, dietary recall and semi-structured interview, socioeconomic evaluation (Brazilian Association of Research Companies criteria and laboratory testing (glucose/hormone/lipid panel. A total of 77 patients were assessed, 50 of whom (76.6% were female. Mean age was 44.48±12.55 years. The most common comorbidities were hypertension (72.4%, binge eating disorder (47.4%, type 2 diabetes mellitus (32.9%, sleep apnea (30.3% and dyslipidemia (18.4%. Macronutrient intake was largely adequate, in view of the high calorie intake. However, some micronutrient deficiencies were present. Only 19.5% of patients had an adequate intake of potassium, 26.0% of calcium, and 66.2% of iron. All subjects consumed more than the minimum recommended intake of sodium, with 98.7% reaching the upper limit. B-complex vitamin intake was satisfactory (adequate in >80% of subjects, but lipid-soluble vitamin (A, D, E intake often fell short of the RDI. The diet of severely obese patients is unbalanced, with high calorie intake paralleled by insufficient micronutrient intake. When these patients are assessed and managed, qualitative dietary changes should be considered in addition to routine caloric restriction.

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

    Directory of Open Access Journals (Sweden)

    Kentaro Wakamatsu

    2015-01-01

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

  4. Dietary Intake in Body Mass Index Differences in Community-Based Japanese Patients with Schizophrenia

    OpenAIRE

    Haruyuki Ito; Takako Kumagai; Midori Kimura; Shotaro Koike; Takeshi Shimizu

    2015-01-01

    Background: Patients with schizophrenia reportedly have a high prevalence of obesity. One of the reasons is a poor choice of diet. The goal of this study was to clarify characteristics of the dietary intake across the strata of the body mass index (BMI) and to compare the general population and patients with schizophrenia in Japan. Methods: This is a cross-sectional study of 51 patients with schizophrenia residing in rural areas in 2011. Anthropometric indices (of height, weight, body mass in...

  5. Assessing Sexual Abuse/Attack Histories with Bariatric Surgery Patients

    Science.gov (United States)

    Mahony, David

    2010-01-01

    This study assessed sexual abuse/attack histories in 537 bariatric surgery patients using the PsyBari. The prevalence rates found were lower (15.5%, 19.3% of women, 5.2% of men) than other studies that used bariatric surgery patients but consistent with studies that used nonbariatric obese subjects. Furthermore, bariatric surgery patients who…

  6. Effect of sow history features on growth and feed intake in grow-finish pigs

    NARCIS (Netherlands)

    Sell-Kubiak, E.B.; Knol, E.F.; Bijma, P.

    2012-01-01

    The sow provides a specific environment to her offspring during gestation and lactation. Certain features in the early life of the sow (sow history features) may affect her ability to deliver and feed a healthy litter. In genetic analyses of grow-finish traits, these effects are estimated as common

  7. Comparison of amino acid oxidation and urea metabolism in haemodialysis patients during fasting and meal intake

    NARCIS (Netherlands)

    Veeneman, JM; Kingma, HA; Stellaard, F; de Jong, PE; Reijngoud, DJ; Huisman, RM

    2004-01-01

    Background. The PNA (protein equivalent of nitrogen appearance) is used to calculate protein intake from urea kinetics. One of the essential assumptions in the calculation of PNA is that urea accumulation in haemodialysis (HD) patients is equivalent to amino acid oxidation. However, urea is hydrolys

  8. Dietary intake and physical activity in a Canadian population sample of male patients with HIV infection and metabolic abnormalities.

    Science.gov (United States)

    Arendt, Bianca Maria; Aghdassi, Elaheh; Mohammed, Saira Saddia; Fung, Lillia Yan; Jalali, Pegah; Salit, Irving Elliot; Allard, Johane Pierette

    2008-01-01

    Objective was to assess dietary intake and physical activity in a Canadian population sample of male patients with HIV and metabolic abnormalities and to compare the data to Canadian recommendations. Sixty-five HIV-infected men with at least one feature associated with the metabolic syndrome (insulin resistance, dyslipidemia, central obesity, or lipodystrophy) were enrolled. Results from 7-day food records and activity logs were compared to the Dietary Reference Intakes and recommendations of Canada's Physical Activity Guide, respectively. Anthropometric data were also measured. Fifty-two percent of the subjects were overweight, another 15% were obese. However, energy intake (mean+/-SEM) (2153+/-99 kcal/d) was lower than the estimated requirement (2854+/-62 kcal/d; p<0.0001), and 84.5% of the patients reached the recommended minimum of 60 min of mild or 30 min of moderate daily exercise. Intake was adequate for protein, but high for fat and cholesterol in 40% of patients. No patient reached the recommendation for fiber. Intake from diet alone was suboptimal for most micronutrients. Prevalence was highest for low vitamin E (91% of patients) and magnesium (68%) intake, and high sodium intake (72%). In summary, a large proportion of HIV patients with metabolic abnormalities were overweight or obese. However, this was not associated with high energy intake, or reduced physical activity. High fat, low fiber and inadequate micronutrient intakes were prevalent. PMID:18288980

  9. Assessment of habitual energy and macronutrient intake in adults: comparison of a seven day food record with a dietary history interview

    DEFF Research Database (Denmark)

    Høidrup, S.; Andreasen, A. H.; Osler, M.;

    2002-01-01

    Objective: To examine the quantitative agreement between a 7 day food record and a diet history interview when these are conducted under the same conditions and to evaluate whether the two methods assess habitual diet intake differently among subgroups of age and body mass index (BMI). Design......: Cross-sectional study. Setting: Population study, Denmark. Subjects: A total of 175 men and 173 women aged 30-60 y, selected randomly from a larger population sample of Danish adults. Interventions: All subjects had habitual diet intake assessed by a diet history interview and completed a 7 day food...

  10. Tailored information increases patient/physician discussion of colon cancer risk and testing: The Cancer Risk Intake System trial.

    Science.gov (United States)

    Skinner, Celette Sugg; Gupta, Samir; Bishop, Wendy Pechero; Ahn, Chul; Tiro, Jasmin A; Halm, Ethan A; Farrell, David; Marks, Emily; Morrow, Jay; Julka, Manjula; McCallister, Katharine; Sanders, Joanne M; Rawl, Susan M

    2016-12-01

    Assess whether receipt of tailored printouts generated by the Cancer Risk Intake System (CRIS) - a touch-screen computer program that collects data from patients and generates printouts for patients and physicians - results in more reported patient-provider discussions about colorectal cancer (CRC) risk and screening than receipt of non-tailored information. Cluster-randomized trial, randomized by physician, with data collected via CRIS prior to visit and 2-week follow-up telephone survey among 623 patients. Patients aged 25-75 with upcoming primary-care visits and eligible for, but currently non-adherent to CRC screening guidelines. Patient-reported discussions with providers about CRC risk and testing. Tailored recipients were more likely to report patient-physician discussions about personal and familial risk, stool testing, and colonoscopy (all p cancer (+ 10%); family history (+ 15%); stool testing (+ 9%); and colonoscopy (+ 8%) (all p < 0.05). CRIS is a promising strategy for facilitating discussions about testing in primary-care settings. PMID:27413654

  11. Tailored information increases patient/physician discussion of colon cancer risk and testing: The Cancer Risk Intake System trial.

    Science.gov (United States)

    Skinner, Celette Sugg; Gupta, Samir; Bishop, Wendy Pechero; Ahn, Chul; Tiro, Jasmin A; Halm, Ethan A; Farrell, David; Marks, Emily; Morrow, Jay; Julka, Manjula; McCallister, Katharine; Sanders, Joanne M; Rawl, Susan M

    2016-12-01

    Assess whether receipt of tailored printouts generated by the Cancer Risk Intake System (CRIS) - a touch-screen computer program that collects data from patients and generates printouts for patients and physicians - results in more reported patient-provider discussions about colorectal cancer (CRC) risk and screening than receipt of non-tailored information. Cluster-randomized trial, randomized by physician, with data collected via CRIS prior to visit and 2-week follow-up telephone survey among 623 patients. Patients aged 25-75 with upcoming primary-care visits and eligible for, but currently non-adherent to CRC screening guidelines. Patient-reported discussions with providers about CRC risk and testing. Tailored recipients were more likely to report patient-physician discussions about personal and familial risk, stool testing, and colonoscopy (all p < 0.05). Tailored recipients were more likely to report discussions of: chances of getting cancer (+ 10%); family history (+ 15%); stool testing (+ 9%); and colonoscopy (+ 8%) (all p < 0.05). CRIS is a promising strategy for facilitating discussions about testing in primary-care settings.

  12. Study of fruit and vegetable intake in breast cancer patients in the city of Sabzevar

    Science.gov (United States)

    Kooshki, Akram; Moghaddam, Manidgeh Yousefi; Akbarzadeh, Roya

    2016-01-01

    Introduction Diet is one of the most important modifiable risk factors for prevention and control of chronic diseases, including breast cancer. This study aimed to determine the fruit and vegetable intake in women with cancer breast in Sabzevar. Methods This cross-sectional study was conducted on 125 women with breast cancer in Sabzevar in 2011. Census sampling was done on volunteers in a visiting home and suspected women referred to the mammography, ultrasound, and radiology clinic in the Sabzevar center for breast cancer. Demographic and semi quantitative food questionnaires of 160 foods were completed for each of the patients by trained interviewers. Data were analyzed using the software Nutritionist IV. Descriptive statistics, one-sample t-test, and Chi-square test were used, employing the SPSS version 16. Results In this study, 125 women were assessed with breast cancer. The highest risk with breast cancer was 35.5% in women 40 to 49 years old. The results of this study showed that patients with breast cancer had minimum daily recommended intake (3.06 ± 2.3 serving of fruits and 2.09 ± 1.81 serving of vegetables in days). One sample t-test showed that the mean intake of fruits and vegetables was not a significant deference with daily recommended intake (p>0.05). The chi-square test showed that patients with minimum daily recommended intake of fruits and vegetables were at high risk for breast cancer in comparison with those who received the highest amount (p=0.001). Conclusion This study supports evidence that high vegetable and fruit intake is associated with lower breast cancer risk.

  13. Perceived Barriers and Support Strategies for Reducing Sodium Intake in Patients with Chronic Kidney Disease : a Qualitative Study

    NARCIS (Netherlands)

    Meuleman, Yvette; ten Brinke, Lucia; Kwakernaak, Arjan J.; Vogt, Liffert; Rotmans, Joris I.; Bos, Willem Jan W.; van der Boog, Paul J. M.; Navis, Gerjan; van Montfrans, Gert A.; Hoekstra, Tiny; Dekker, Friedo W.; van Dijk, Sandra

    2015-01-01

    Reducing sodium intake can prevent cardiovascular complications and further decline of kidney function in patients with chronic kidney disease. However, the vast majority of patients fail to reach an adequate sodium intake, and little is known about why they do not succeed. This study aims to identi

  14. Evaluation of fiber intake in diabetes 2 patients of an asistencial center of Rosario city

    OpenAIRE

    María Elisa Zapata; Ana María Hoet; Daniela Simonini

    2013-01-01

    Introduction: a diet high in fiber has associated with better glycaemic control in diabetes 2 patients, being the soluble fraction of the most effective in the control of blood sugar levels. The aim of the study is determine the amount of total, soluble and insoluble dietary fiber intake by patients with type 2 diabetes who attended a medical centre for diabetics in Rosario.Material and methods: descriptive, observational, cross-sectional study was conducted. It was determined a sample of 60 ...

  15. Evaluation of dysphagia risk, nutritional status and caloric intake in elderly patients with Alzheimer's

    Directory of Open Access Journals (Sweden)

    Vanessa Fernanda Goes

    2014-04-01

    Full Text Available OBJECTIVE: to evaluate the risk of dysphagia and its relationship with the stage of Alzheimer's Disease, as well as the relationship between the risk of dysphagia and nutritional status and caloric intake in elderly people with Alzheimer's disease.METHODS: the sample consisted of 30 subjects of both genders with probable Alzheimer's disease. The stage of the disease, nutritional status, energy intake, and risk of dysphagia were assessed.RESULTS: it was found that increased risk of dysphagia is associated with the advance in the stages of Alzheimer's disease and that even patients in the early stages of disease have a slight risk of developing dysphagia. No association was found between nutritional status and the risk of dysphagia. High levels of inadequate intake of micronutrients were also verified in the patients.CONCLUSION: an association between dysphagia and the development of Alzheimer's disease was found. The results indicate the need to monitor the presence of dysphagia and the micronutrient intake in patients with Alzheimer's disease.

  16. Estimation of milk, dairy products and calcium intake in nutrition of the celiac patients

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    Ines Panjkota Krbavčić

    2007-10-01

    Full Text Available Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate a protein called gluten, which is found in wheat, rye, barley and possibly oats. The smallest amount of gluten in food damages the small intestine of these patients. In Croatia there is no data about nutrition and dietary habits of people with celiac disease. In celiac disease there is one and only cure: a gluten-free diet. Milk and dairy products are major source of calcium, and this population, because of malapsorptive syndrome is especially sensitive and predisposed for osteoporosis and osteopenya. Therefore, the purpose of this research was to establish milk, dairy products and calcium intake in celiac patients nutrition. Milk and dairy products was determined by using 3-day-dietary record (3DD combined with food frequency questionnaire (FFQ in 15 celiac patients. Energy share of milk and dairy products were 11,82 % kJ, twice less than recommendation. Average daily intake of calcium was also below the recommendation (62,64 % DRI, and 67 % of examinees did not achieve neither 2/3 of daily recommendation intake (DRI for calcium. From milk and dairy group examinees use milk and pudding the most, yoghurt and fruit yoghurt less. It is necessary to increase intake of calcium from milk and dairy products group because they are the best source of this nutrient.

  17. The Natural History of Nursing Home Patients.

    Science.gov (United States)

    Lewis, Mary Ann; And Others

    1985-01-01

    Former nursing home residents (N=197) were followed for 2 years after discharge. Four subgroups of patients were identified on the basis of different patterns of survival and use of health care resources: those who returned home, died in nursing homes, transferred to hospitals, or transferred to other nursing homes. (NRB)

  18. Sodium intake prediction with health promotion model constructs in rural hypertensive patients

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    Aziz Kamran

    2015-01-01

    Full Text Available Background: Hypertension is the most common cause of cardiovascular disease, and the growing epidemic is a serious warning to pay more attention to this disease. The aims of this study were to examine the relationships between the health promotion model (HPM constructs and sodium intake, and to determine the predictive power of the HPM constructs as the possible mediators of sodium intake in rural Iranian hypertensive patients. Materials and Methods: This cross-sectional study was conducted on 671 hypertensive patients in Ardabil, Iran in 2013. The data were obtained during a 25-40 min face-to-face conversation by validated and reliable instruments. The nutritional data were assessed with Nutritionist version 4 (N4 software. Descriptive statistics, Spearman′s correlations were calculated using SPSS Statistics version 18.0. Structural equation modeling was conducted using AMOS version 18. Results: Sodium intake was negatively correlated with perceived benefits (r = -0.707; P < 0.01, perceived self-efficacy (r = -0.719; P < 0.01, situational influences (r = -0.590; P < 0.01, interpersonal influences (r = -0.637; P < 0.01, commitment to action (r = -0.605; P < 0.01, affects related behavior (r = -0.499; P < 0.01, and positively associated with the perceived barriers score (r = 0.563; P < 0.01. The structural equation modeling showed that the model explained 63.0% of the variation in sodium intake. Conclusions: HPM constructs were significantly associated with sodium intake and dietary perceptions based on HPM constructs can predict acceptable rate of the variation of sodium intake. Therefore, we suggest using this model constructs to improve the effectiveness of nutritional interventions.

  19. NUTRITIONAL STATUS AND DIETARY INTAKE IN NON-CIRRHOTIC ADULT CHRONIC HEPATITIS C PATIENTS

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    Catarina B A GOTTSCHALL

    2015-09-01

    Full Text Available BackgroundThe hepatitis C virus is one of the main causes of liver disease worldwide and may develop nutritional deficiencies.ObjectiveThe objective of this study was to assess and compare different nutritional status methods of adult patients with chronic hepatitis C virus, and to describe inadequacies in dietary intake.MethodsA cross-sectional study was conducted with adult outpatients with hepatitis C virus at a Brazilian hospital. Nutritional assessment included the 24-hour dietary recall, anthropometry (body weight, height, body mass index, triceps skinfold, mid-upper arm circumference, mid-arm muscle circumference, mid-upper arm muscle area, adductor policis muscle, Subjective Global Assessment, Royal Free Hospital Global Assessment and handgrip strength.ResultsA total of 94 outpatients (ages 30 to 76 years, was included, 46 were men. The prevalence of malnutrition as measured by the different methods was 6.4% (body mass index; 60.6% (handgrip strength, and 53.2% (Royal Free Hospital Global Assessment. There was correlation between mid-upper arm circumference and mid-arm muscle circumference (r=0.821, mid-upper arm circumference and triceps skinfold (r=0.575 and mid-upper arm circumference and mid-upper arm muscle area (r=0.781. Energy and protein intakes were below recommended levels in 49 (52.1% and 44 (46.8% of patients, respectively. Inadequate calcium, potassium, zinc and vitamin C intakes occurred in 92.6%, 97.9%, 63.8% and 60.6% of patients. There was an association between dietary energy and protein intake with Royal Free Hospital Global Assessment (P<0.001 and a tendency for them to be associated with handgrip strength (P=0.076 and P=0.054.ConclusionMalnutrition is frequently in hepatitis C virus patients. They have high prevalence of inadequate energy, protein and micronutrients intake, even in the absence of cirrhosis.

  20. Does Preoperative Carbohydrate Intake Reduces Postoperative Stress Response in Patients Undergoing Valve Replacement Surgeries

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    Hoda Shokri

    2015-01-01

    Full Text Available Background Cardiac surgery is a stress that causes insulin resistance leading to increased insulin requirements. The aim of our study was to evaluate whether preoperative oral intake of carbohydrate rich drinks could improve outcomes and reduce stress response post valve replacement cardiac surgeries. Methods Our prospective study included 20 ASA 1-3 patients undergoing valve replacement cardiac surgeries.10 patients were fasted after midnight while the other 10 patients received 600 ml of carbohydrate bevering in the evening before the procedure and 150 ml of the drink 2 hours before operation. The following was monitored in all patients: hemodynamics after induction of anesthesia till 24 hours postoperative, insulin resistance (exogenous insulin requirement to keep blood sugar below or equal to 10 mmol/l was used as marker, postoperative discomfort using visual analogue scales, and length of ICU stay. Results Preoperative intake of carbohydrate rich drinks significantly reduced the length of ICU stay (p=0.019 due to reduced postoperative inotropic support requirements and time of mechanical ventilation. Significant reduction in postoperative discomfort and reduced stress response .No significant difference in postoperative level of insulin sensitivity between the two groups. Conclusion Our study showed that although preoperative carbohydrate intake does not reduce insulin resistance postoperatively, it significantly improved other aspects of clinical outcome, in terms of reduced ICU stay, reduced postoperative stress and patient discomfort.

  1. Comparison of fat intake between patients with stroke and normal population

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    Leila Darvishi

    2013-01-01

    Full Text Available Background: Stroke happens when blood flow to parts of brain stops. Stroke is sometimes called "brain attack." Risk factor is something that increases the chance of getting a disease. Some risk factors for stroke cannot be changed, but some can be altered. The chance of stroke is higher in people who live an unhealthy lifestyle by: Being overweight as a result of over-eating, eating too much fat, smoking, etc., Therefore, we compared the fat intake between patients with stroke and normal population. Materials and Methods: Sixty nine patients with stroke (46 men and 23 women as cases and 60 subjects (30 men and 30 women as controls during April 2009 and May 2010 from Alzzahra hospital, Isfahan, Iran were evaluated. Dietary intakes were collected using a food frequency questionnaire (FFQ through their close relatives such as spouse, daughter or mother. Also, anthropometry measurements such as weight, height and waist extracted from their medical files, however, body mass index (BMI and waist to hip ratio (WHR were calculated. Result: The intake of saturated fatty acids (SFA and monounsaturated fatty acids (MUFA both in men and women with stroke were significantly higher than controls (P = 0.04 and P = 0.03 for men and P = 0.05 and P = 0.02 for women, respectively. Also, the mean intake of hydrogenated fats, butter, cream, mayonnaise sauce and nuts were higher in men with stroke with respect in control group; while, women with stroke consumed more hydrogenated fats, vegetable oils, cream and mayonnaise sauce than controls. Conclusion : Increased fat intake was observed in patients with stroke compared with normal population.

  2. Evaluation of an Innovative Method for Calculating Energy Intake of Hospitalized Patients

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    Sheila Cox Sullivan

    2016-09-01

    Full Text Available The purpose of this study was to evaluate a multi-component method for capturing nutrient intake, which used observation, photography, and an innovative computer program. To assess reliability and accuracy, multiple responsible employees (REs independently conducted nutrient intake assessments on simulated meals; each RE’s results relating to energy intake were compared to those from the other REs and to those obtained by pre- and post-meal weighing of the food items. System efficiency was assessed by having REs perform independent assessments on the same set of simulated meals using either the new or traditional hospital method for which the REs had to document each food item served and then find the items in a computer database–steps that were automated in the new method. Interrater reliability for energy intake estimated on clinic wards was excellent (intraclass correlation coefficient = 0.975, 95% CI 0.958 to 0.992 and there was a high level of agreement between the REs’ estimates and the true values determined by food weighing; per the method of Bland and Altman the mean difference between the two types of estimates was 0.3 kcal (95% CI, −8.1 to 8.7 kcal with limits of agreement of −79.5 kcal to 80.1 kcal. Compared to the traditional method, energy intake assessments could be completed using the multi-component method in less than a third of the time. These results indicate the multi-component method is an accurate, reliable, and efficient method of obtaining energy intake assessments for hospitalized patients.

  3. Positive effect of protein-supplemented hospital food on protein intake in patients at nutritional risk

    DEFF Research Database (Denmark)

    Munk, T; Beck, A M; Holst, M;

    2014-01-01

    the protein-supplemented food service concept. The control group (CG) received the standard hospital menu. Primary outcome comprised the number of patients achieving ≥75% of energy and protein requirements. Secondary outcomes comprised mean energy and protein intake, body weight, handgrip strength and length......BACKGROUND: New evidence indicates that increased dietary protein ingestion promotes health and recovery from illness, and also maintains functionality in older adults. The present study aimed to investigate whether a novel food service concept with protein-supplementation would increase protein...... and energy intake in hospitalised patients at nutritional risk. METHODS: A single-blinded randomised controlled trial was conducted. Eighty-four participants at nutritional risk, recruited from the departments of Oncology, Orthopaedics and Urology, were included. The intervention group (IG) received...

  4. Energy expenditure and substrate metabolism in patients with cirrhosis of the liver: effects of the pattern of food intake.

    OpenAIRE

    Verboeket-van de Venne, W P; Westerterp, K. R.; B. Van Hoek; G. R. Swart

    1995-01-01

    Patients with liver cirrhosis are often undernourished. In healthy subjects, the pattern of food intake is one of the variables that can influence energy balance and substrate metabolism. The short term (two day) effect of the pattern of food intake in patients with cirrhosis and controls was compared. In a respiration chamber, eight patients with cirrhosis of the liver and 23 controls were fed to estimated energy balance in two meals daily ('gorging' pattern) and four to seven meals daily ('...

  5. Low Recent Protein Intake Predicts Cancer-Related Fatigue and Increased Mortality in Patients with Advanced Tumor Disease Undergoing Chemotherapy.

    Science.gov (United States)

    Stobäus, Nicole; Müller, Manfred J; Küpferling, Susanne; Schulzke, Jörg-Dieter; Norman, Kristina

    2015-01-01

    Cancer patients, in general, suffer from anorexia hence diminished nutritional intake. In a prospective observational study, we investigated the impact of recent energy and protein intake on cancer-related fatigue and 6-month mortality in patients undergoing chemotherapy. Recent protein and energy intake was assessed by 24-h recall in 285 patients. Cancer-related fatigue was determined by Brief Fatigue Inventory, and fat free mass index (FFMI) was assessed with bioelectrical impedance analysis. Symptoms with the validated German version of European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (30 questions) and 6-month mortality was documented. Risk factors of cancer-related fatigue and predictors of mortality were investigated with logistic regression analysis and stepwise Cox regression analysis, respectively. Low protein intake (protein intake emerged as the strongest contributor to cancer-related fatigue followed by nausea/vomiting, insomnia, and age. Reduced protein intake, male sex, number of comorbidities, and FFMI were identified as significant predictors for increased 6-month mortality. In conclusion, a low recent protein intake assessed by 24-h recall is associated with a more than twofold higher risk of cancer-related fatigue and 6-month mortality. Every effort should be taken to assess and guarantee proper nutritional intake in patients undergoing chemotherapy.

  6. Oxidative stress and nutritional intakes in lung patients with bronchiolitis obliterans syndrome.

    Science.gov (United States)

    Madill, J; Aghdassi, E; Arendt, B M; Gutierrez, C; Singer, L; Chow, C-W; Keshavjee, S; Allard, J P

    2009-11-01

    Survival after lung transplantation is limited by bronchiolitis obliterans syndrome (BOS). Oxidative stress (OxS) can be associated with BOS due to chronic inflammation. The type of fat and antioxidant intakes may also contribute to OxS. Our aim was to compare OxS and nutritional intakes in non-BOS versus various stages of BOS. Fifty-eight lung recipients with versus without BOS were prospectively classified as: non-BOS; BOS Op-1 (mild), and BOS 2-3 (severe). We measured nutritional intake and plasma vitamins A, C, and E. Among a subgroup of 37 patients, OxS was assessed by measuring lipid peroxidation (LPO micromol/L MDA) and oxidized glutathione (GSSG) in bronchoalveolar lavage BAL fluid (BALF). One-way analysis of variance was used to compare groups. Results are reported as mean values +/- standard errors of the mean. There was no significant difference in demographic features on time posttransplant among groups. Although there were comparable cell counts in BALF, severe BOS patients showed significantly higher BALF LPO concentrations when compared with milder stage of BOS or with non-BOS (P = .001, for both). Severe BOS recipients also displayed higher BALF GSSG concentrations compared to milder stage of BOS (P = .001) or non-BOS (P = .007). In conclusion, patients with severe BOS were more oxidatively stressed compared with mild and non-BOS recipients. PMID:19917398

  7. The association of functional oral intake and pneumonia in patients with severe traumatic brain injury

    DEFF Research Database (Denmark)

    Hansen, T.S.; Larsen, K.; Engberg, Anders

    2008-01-01

    OBJECTIVES: To investigate the incidence and onset time of pneumonia for patients with severe traumatic brain injury (TBI) in the early phase of rehabilitation and to identify parameters associated with the risk of pneumonia. DESIGN: Observational retrospective cohort study. SETTING: Subacute...... MEASURE: Pneumonia. RESULTS: Twenty-seven percent of the patients admitted to the brain injury unit were in treatment for pneumonia; pneumonia developed in 12% of the patients during rehabilitation; the condition occurred within 19 days of admission in all but 1 patient. Of these patients, 81% received...... nothing by mouth. Three factors identified patients at highest risk of pneumonia: Glasgow Coma Scale score less than 9 (1 day after cessation of sedation); Rancho Los Amigos Scale score less than 3 (on admission); and no oral intake on admission. Having a tracheotomy tube and/or feeding tube was also...

  8. Effect of calcium intake on urinary oxalate excretion in calcium stone-forming patients

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    Nishiura J.L.

    2002-01-01

    Full Text Available Dietary calcium lowers the risk of nephrolithiasis due to a decreased absorption of dietary oxalate that is bound by intestinal calcium. The aim of the present study was to evaluate oxaluria in normocalciuric and hypercalciuric lithiasic patients under different calcium intake. Fifty patients (26 females and 24 males, 41 ± 10 years old, whose 4-day dietary records revealed a regular low calcium intake (<=500 mg/day, received an oral calcium load (1 g/day for 7 days. A 24-h urine was obtained before and after load and according to the calciuria under both diets, patients were considered as normocalciuric (NC, N = 15, diet-dependent hypercalciuric (DDHC, N = 9 or diet-independent hypercalciuric (DIHC, N = 26. On regular diet, mean oxaluria was 30 ± 14 mg/24 h for all patients. The 7-day calcium load induced a significant decrease in mean oxaluria compared to the regular diet in NC and DIHC (20 ± 12 vs 26 ± 7 and 27 ± 18 vs 32 ± 15 mg/24 h, respectively, P<0.05 but not in DDHC patients (22 ± 10 vs 23 ± 5 mg/24 h. The lack of an oxalate decrease among DDHC patients after the calcium load might have been due to higher calcium absorption under higher calcium supply, with a consequent lower amount of calcium left in the intestine to bind with oxalate. These data suggest that a long-lasting regular calcium consumption <500 mg was not associated with high oxaluria and that a subpopulation of hypercalciuric patients who presented a higher intestinal calcium absorption (DDHC tended to hyperabsorb oxalate as well, so that oxaluria did not change under different calcium intake.

  9. Intake of ruminant trans-fatty acids, assessed by diet history interview, and changes in measured body size, shape and composition

    DEFF Research Database (Denmark)

    Hansen, Camilla P; Heitmann, Berit L; Sørensen, Thorkild Ia;

    2016-01-01

    OBJECTIVE: Studies have suggested that total intake of trans-fatty acids (TFA) is positively associated with changes in body weight and waist circumference, whereas intake of TFA from ruminant dairy and meat products (R-TFA) has not been associated with weight gain. However, these previous studies...... composition (body fat percentage). DESIGN: A 6-year follow-up study. Information on dietary intake was collected through diet history interviews, and anthropometric and bioelectrical impedance measurements were obtained by trained technicians at baseline (1987-1988) and at follow-up (1993-1994). Multiple...... was 1.3 g/d (5th, 95th percentile: 0.4, 2.7 g/d) or 0.6% of the total energy intake (5th, 95th percentile: 0.2, 1.1%). No significant associations were observed between R-TFA intake and changes in body weight, waist and hip circumference or body fat percentage. CONCLUSIONS: R-TFA intake within the range...

  10. Prevalence of family history in patients with reflex syncope

    DEFF Research Database (Denmark)

    Holmegard, Haya N; Benn, Marianne; Kaijer, Michelle Nymann;

    2013-01-01

    Reflex syncope is defined by a rapid transient loss of consciousness caused by global cerebral hypoperfusion resulting from vasodilatation and/or bradycardia attributable to inappropriate cardiovascular reflexes. A hereditary component has been suggested, but prevalence of family history may differ...... among subtypes of reflex syncope, as these have different autonomic responses and pathogeneses may be diverse. The present study aimed to assess the prevalence of a positive family history of syncope and cardiovascular characteristics in patients with cardioinhibitory and vasodepressor reflex syncope....... Patients (n=74) were classified into subtypes of reflex syncope - cardioinhibition/asystole (Vasovagal Syncope International Study subtypes II-B [VASIS II-B], n=38) or vasodepressor (VASIS III, n=36) - using the head-up tilt test. Family history was obtained by questionnaires supplemented by interview...

  11. Mycobacterium sherrisii Lung Infection in a Brazilian Patient with Silicosis and a History of Pulmonary Tuberculosis

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    Carolina de Oliveira Abrão

    2015-01-01

    Full Text Available Nontuberculous mycobacteria (NTM diseases became relevant with the emergence and spread of HIV and are also related to lung infection in non-HIV individuals with structural lung diseases. Mycobacterium sherrisii is a NTM first characterized in 2004. Only a few cases have been reported. The aim of this case report is to describe the first detailed case of infection with M. sherrisii in a patient with silicosis and history of pulmonary tuberculosis. A 50-year-old HIV-negative white male, previous smoker, with silicosis and a history of treated pulmonary tuberculosis developed a worsening of cough and expectoration pattern, and two sputum samples were positive for acid-fast bacilli. Presumptive treatment for pulmonary tuberculosis was initiated with rifampin, isoniazid, pyrazinamide, and ethambutol, but, at month 5 of treatment, despite correct medication intake and slight improvement of symptoms, sputum bacilloscopy remained positive. Sputum cultures were positive Mycobacterium sherrisii. Treatment regimen was altered to streptomycin (for 2 months, ethambutol, clarithromycin, rifabutin, and trimethoprim-sulfamethoxazole. M. sherrisii should be considered a possible etiological agent of lung infections in patients with pneumoconiosis and history of tuberculosis.

  12. A simple dietary assessment tool to monitor food intake of hospitalized adult patients

    Science.gov (United States)

    Budiningsari, Dwi; Shahar, Suzana; Manaf, Zahara Abdul; Susetyowati, Susetyowati

    2016-01-01

    Background/objectives Monitoring food intake of patients during hospitalization using simple methods and minimal training is an ongoing problem in hospitals. Therefore, there is a need to develop and validate a simple, easy to use, and quick tool that enables staff to estimate dietary intake. Thus, this study aimed to develop and validate the Pictorial Dietary Assessment Tool (PDAT). Subjects and methods A total of 37 health care staff members consisting of dietitians, nurses, and serving assistants estimated 130 breakfast and lunch meals consumed by 67 patients using PDAT. PDAT was developed based on the hospital menu that consists of staple food (rice or porridge), animal source protein (chicken, meat, eggs, and fish), and non-animal source protein (tau fu and tempeh), with a total of six pictorials of food at each meal time. Weighed food intake was used as a gold standard to validate PDAT. Agreement between methods was analyzed using correlations, paired t-test, Bland–Altman plots, kappa statistics, and McNemar’s test. Sensitivity, specificity, and area under the curve of receiver operating characteristic were calculated to identify whether patients who had an inadequate food intake were categorized as at risk by the PDAT, based on the food weighing method. Agreement between different backgrounds of health care staff was calculated by intraclass correlation coefficient and analysis of variance test. Results There was a significant correlation between the weighing food method and PDAT for energy (r=0.919, P0.05). The PDAT and food weighing method showed a satisfactory agreement beyond chance (k) (0.81 for staple food and animal source protein; 0.735 for non-animal source protein). Intraclass correlation coefficient ranged between 0.91 and 0.96 among respondents. There were no differences in energy, protein, carbohydrate, and fat intake estimated among health care staff (P=0.967; P=0.951; P=0.888; P=0.847, respectively). Conclusion In conclusion, PDAT provides

  13. Obesity coexists with malnutrition?: adequacy of food consumption by severely obese patients to dietary reference intake recommendations

    OpenAIRE

    Jaqueline Driemeyer Correia Horvath; Mariana Laitano Dias de Castro; Natália Kops; Natasha Kruger Malinoski; Rogério Friedman

    2014-01-01

    To assess the adequacy of food intake in severely obese patients and describe their main nutritional deficiencies on the basis of Dietary Reference Intakes (DRIs). Patients on a waiting list for bariatric surgery were sequentially recruited from March 2010 to November 2011. All subjects underwent nutritional status assessment (anthropometry, dietary recall and semi-structured interview), socioeconomic evaluation (Brazilian Association of Research Companies criteria) and laboratory testing (gl...

  14. A simple dietary assessment tool to monitor food intake of hospitalized adult patients

    Directory of Open Access Journals (Sweden)

    Budiningsari D

    2016-07-01

    Full Text Available Dwi Budiningsari,1,2 Suzana Shahar,1 Zahara Abdul Manaf,1 Susetyowati Susetyowati2 1Dietetic Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; 2Department of Health Nutrition, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia Background/objectives: Monitoring food intake of patients during hospitalization using simple methods and minimal training is an ongoing problem in hospitals. Therefore, there is a need to develop and validate a simple, easy to use, and quick tool that enables staff to estimate dietary intake. Thus, this study aimed to develop and validate the Pictorial Dietary Assessment Tool (PDAT.Subjects and methods: A total of 37 health care staff members consisting of dietitians, nurses, and serving assistants estimated 130 breakfast and lunch meals consumed by 67 patients using PDAT. PDAT was developed based on the hospital menu that consists of staple food (rice or porridge, animal source protein (chicken, meat, eggs, and fish, and non-animal source protein (tau fu and tempeh, with a total of six pictorials of food at each meal time. Weighed food intake was used as a gold standard to validate PDAT. Agreement between methods was analyzed using correlations, paired t-test, Bland–Altman plots, kappa statistics, and McNemar’s test. Sensitivity, specificity, and area under the curve of receiver operating characteristic were calculated to identify whether patients who had an inadequate food intake were categorized as at risk by the PDAT, based on the food weighing method. Agreement between different backgrounds of health care staff was calculated by intraclass correlation coefficient and analysis of variance test.Results: There was a significant correlation between the weighing food method and PDAT for energy (r=0.919, P<0.05, protein (r=0.843, P<0.05, carbohydrate (r=0.912, P<0.05, and fat (r=0.952; P<0.05. Nutrient intakes as assessed using

  15. Functional oral intake and time to reach unrestricted dieting for patients with traumatic brain injury

    DEFF Research Database (Denmark)

    Hansen, T.S.; Engberg, Anders; Larsen, K.

    2008-01-01

    OBJECTIVES: To investigate the status of functional oral intake for patients with severe traumatic brain injury (TBI) and time to return to unrestricted dieting; and to investigate whether severity of brain injury is a predictor for unrestricted dieting. DESIGN: Observational retrospective cohort...... study. SETTING: Subacute rehabilitation department, university hospital. PARTICIPANTS: Patients age 16 to 65 years (N=173) with severe TBI (posttraumatic amnesia from 7d to >6 mo) admitted over a 5-year period. Patients are transferred to the brain injury unit as soon as they ventilate spontaneously...... planning rehabilitation, giving information to patients and relatives, and designing efficacy studies of facial oral tract therapy, which are highly recommended Udgivelsesdato: 2008/8...

  16. First Quantification of Calcium Intake from Calcium-Dense Dairy Products in Dutch Fracture Patients (The Delft Cohort Study

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    Peter van den Berg

    2014-06-01

    Full Text Available Recommendations for daily calcium intake from dairy products are variable and based on local consensus. To investigate whether patients with a recent fracture complied with these recommendations, we quantified the daily dairy calcium intake including milk, milk drinks, pudding, yoghurt, and cheese in a Dutch cohort of fracture patients and compared outcomes with recent data of a healthy U.S. cohort (80% Caucasians. An observational study analyzed dairy calcium intakes of 1526 female and 372 male Dutch fracture patients older than 50. On average, participants reported three dairy servings per day, independently of age, gender or population density. Median calcium intake from dairy was 790 mg/day in females and males. Based on dairy products alone, 11.3% of women and 14.2% of men complied with Dutch recommendations for calcium intake (adults ≤ 70 years: 1100 mg/day and >70 years: 1200 mg/day. After including 450 mg calcium from basic nutrition, compliance raised to 60.5% and 59.1%, respectively, compared to 53.2% in the U.S. cohort. Daily dairy calcium intake is not associated with femoral neck bone mineral density (BMD T-scores or WHO Fracture Assessment Tool (FRAX risk scores for major fracture or hip fracture. However, when sub analyzing the male cohort, these associations were weakly negative. The prevalence of maternal hip fracture was a factor for current fracture risks, both in women and men. While daily dairy calcium intake of Dutch fracture patients was well below the recommended dietary intake, it was comparable to intakes in a healthy U.S. cohort. This questions recommendations for adding more additional dairy products to preserve adult skeletal health, particularly when sufficient additional calcium is derived from adequate non-dairy nutrition.

  17. The effect of dietary intake changes on nutritional status in acute leukaemia patients after first induction chemotherapy.

    Science.gov (United States)

    Malihi, Z; Kandiah, M; Chan, Y M; Esfandbod, M; Vakili, M; Hosseinzadeh, M; Zarif Yeganeh, M

    2015-07-01

    This study aimed to evaluate how changes in dietary intake among acute lymphoblastic and acute myeloid leukaemia (ALL and AML) patients affect nutritional status after the first induction chemotherapy. Dietary intake was assessed using 24-h recall and a 136-item food frequency questionnaire. Nutritional status was assessed by Patients Subjective Global Assessment questionnaire before starting induction therapy and again after 1 month. All newly diagnosed acute leukaemia patients aged 15 years old and older who attended three referral hospitals for initiation of their induction chemotherapy were included in the sample selection provided that they gave informed consent. A total of 30 AML and 33 ALL patients participated in the study. Dietary intake and nutritional status worsened after the chemotherapy treatment. Dietary intake in terms of macronutrients, micronutrients, food variety and diet diversity score changed significantly after the induction chemotherapy. No significant relationship was found between the changes in dietary indices and nutritional status. Chemotherapy-related side effects as an additional factor to cancer itself could affect dietary intake of leukaemia patients. The effectiveness of an early assessment of nutritional status and dietary intake should be further investigated in order to deter further deterioration.

  18. Association Between Protein Intake and Mortality in Hypertensive Patients Without Chronic Kidney Disease in the OLD-HTA Cohort.

    Science.gov (United States)

    Courand, Pierre-Yves; Lesiuk, Chloé; Milon, Hugues; Defforges, Alice; Fouque, Denis; Harbaoui, Brahim; Lantelme, Pierre

    2016-06-01

    Protein intake may have some benefits on reducing blood pressure and cardiovascular events, but their effects are still debated. The objective of this study was to test the prognostic value of protein intake assessed by 24-hour urinary urea in a cohort of hypertensive patients with preserved renal function. A total of 1128 hypertensive patients were followed according to tertile of protein intake adjusted for ideal body weight: 0.93 g/kg. Baseline characteristics (mean±standard deviation) were age 45.1±13.2 years, systolic/diastolic blood pressure 185±32/107±20 mm Hg, and estimated glomerular filtration rate 82±32 mL/min. After 10 years of follow-up, 289 deaths occurred, 202 of which were of cardiovascular cause. After adjustment for major cardiovascular risk factors, patients in the second and third tertiles of protein intake had a decreased risk of all-cause death (hazard ratio [95% confidence interval], 0.71 [0.56-0.91]) and cardiovascular death (0.72 [0.54-0.96]), but not of stroke death (0.72 [0.41-1.28]) in comparison to patients in the low protein intake tertile. Normal-high protein intake was associated with a better outcome in a subset of the population: younger patients, low salt intake, without aortic atherosclerosis, or previous cardiovascular events (Pinteractionprotein intake >0.7 g/kg ideal body weight, particularly those at low risk, had lower all-cause and cardiovascular mortality rates. Physicians may encourage hyper tensive patients to have normal or high protein diet in addition to low salt consumption, moderate alcohol consumption, and regular physical activity.

  19. The art of history-taking in a headache patient

    Directory of Open Access Journals (Sweden)

    K Ravishankar

    2012-01-01

    Full Text Available Headache is a common complaint that makes up for approximately 25% of any neurologists outpatient practice. Yet, it is often underdiagnosed and undertreated. Ninety percent of headaches seen in practice are due to a primary headache disorder where there are no confirmatory tests, and neuroimaging studies, if done, are normal. In this situation, a good headache history allows the physician to recognize a pattern that in turn leads to the correct diagnosis. A comprehensive history needs time, interest, focus and establishment of rapport with the patient. When to ask what question to elicit which information, is an art that is acquired by practice and improves with experience. This review discusses the art of history-taking in headache patients across different settings. The nuances of headache history-taking are discussed in detail, particularly the questions related to the time, severity, location and frequency of the headache syndrome in general and the episode in particular. An emphasis is made on the recognition of red flags that help in the identification of secondary headaches.

  20. Clinical Characteristics in Patients with Liver Cirrhosis Induced by HBV Infection and Combined with Mild Alcohol Intake

    Institute of Scientific and Technical Information of China (English)

    Ha-lida Xiaerfuhazi; Hai-lin Ma; Xiu-jiang Shi; Xiao-tang Fan; Xi-ernayi Abuduheilili; Fang-ping He

    2014-01-01

    Objective To investigate the differences of clinical and biochemical characteristics between patients with liver cirrhosis induced by HBV infection combined with and without mild alcohol intake. Methods Data of patients with liver cirrhosis who were hospitalized in the First Hospital Afifliated to Xinjiang Medical University were retrospectively analyzed. Patients were divided into three groups: patients with liver cirrhosis induced by HBV infection and combined with mild alcohol intake, patients with HBV-related cirrhosis, and patients with alcohol-related cirrhosis. Biochemical detections including liver function, fasting lipid proifles, lipoprotein, kidney function, glucose, uric acid and regular blood tests were carried out and results were compared among three groups. Data were analyzed through STATA software and co-variant analysis. Results Total of 2 350 patients with liver cirrhosis were included, 732 patients had cirrhosis induced by HBV infection combined with mild alcohol intake, 1 316 patients had HBV-related liver cirrhosis, 302 patients had alcohol-related cirrhosis. The highest mean level of white cell count, mean corpuscular volume,γ-glutamyltranspeptidase and uric acid were observed in HBV infection combined with mild alcohol intake group. Multivariate regression analysis revealed that HBV infection, excessive alcohol intake, male and age were risk factors for hepatocellular carcinoma (HCC) in patients with liver cirrhosis. Conclusions HBV infection combined with mild alcoholic-related liver cirrhosis group showed the highest oxidative stress compared with alcoholic liver cirrhosis group, which suggested that mild alcohol intake may increase the incidence of liver cirrhosis in HBV infected patients and may not increase the incidence of HCC.

  1. Visualization of patient prescription history data in emergency care.

    Science.gov (United States)

    Ozturk, Selcuk; Kayaalp, Mehmet; McDonald, Clement J

    2014-01-01

    Interpreting patient's medication history from long textual data can be unwieldy especially in emergency care. We developed a real-time software application that converts one-year-long patient prescription history data into a visually appealing and information-rich timeline chart. The chart can be digested by healthcare providers quickly; hence, it could be an invaluable clinical tool when the rapid response time is crucial as in stroke or severe trauma cases. Furthermore, the visual clarity of the displayed information may help providers minimize medication errors. The tool has been deployed at the emergency department of a trauma center. Due to its popularity, we developed another version of this tool. It provides more granular drug dispensation information, which clinical pharmacists find very useful in their routine medication-reconciliation efforts.

  2. Nutritional Intake, Physical Activity and Quality of Life in COPD Patients.

    Science.gov (United States)

    Chambaneau, A; Filaire, M; Jubert, L; Bremond, M; Filaire, E

    2016-08-01

    In this study, we aimed to document the level of physical activity (PA), quality of life, depression status and nutritional data of 20 individuals with chronic obstructive pulmonary disease (COPD) (mean age 65.0±7.0 years) admitted in hospital for pulmonary rehabilitation and compare these data to those obtained in 20 similarly aged healthy individuals. Nutritional data were collected using a 3-day diet record. COPD patients engaged in significantly less PA than healthy individuals and achieved a significant higher score of Beck Depression Inventory (BDI) than the control group. Their Fat Free Mass Index (FFMI) was significantly lower when compared to the control group (pVitamins B6, B9, B12, Vitamin E, β carotene and omega 3 than controls. Moreover, patients with low FFMI reported significantly lower mean intake of energy, carbohydrate, vitamin E and vitamin B6 than patients with normal FFMI. Because oxidative stress and inflammation are features of many lung diseases, nutrients with anti-oxidant and anti-inflammatory properties could be useful in prevention or treatment. Further work is needed to explore the possible relationship between the intake of B group vitamins, Vitamin E, n-3PUFAS and the development and progression of lung disease. PMID:27286177

  3. Low nutrient intake among adult women and patients with severe tuberculosis disease in Uganda: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Mupere Ezekiel

    2012-12-01

    Full Text Available Abstract Background Information regarding dietary nutrient intake during tuberculosis disease is lacking. We established the relationship between disease severity or wasting during pulmonary tuberculosis and nutrient intake. Methods In a cross-sectional study of 131 adults with or without pulmonary tuberculosis were screened for human immune-deficiency virus (HIV, wasting, disease severity using 13 item validated clinical TBscore, and 24-hour dietary intake recall. Results Of the 131 participants, 61 were males and 70 females. Overall men and women had similar age. In average 24-hour nutrient intake, the following nutrients: energy, protein, total fat, carbohydrate, calcium, vitamin A, and folate were low among patients with severe tuberculosis disease. Patients with moderate-to-severe clinical TBscore had lower average energy intake than patients with mild TBscores (6.11 vs. 9.27 MJ, respectively (p Conclusions Findings suggest that severity of pulmonary tuberculosis and female gender had reduced nutrient intake. Early tuberculosis diagnosis and nutritional support may be important in management of tuberculosis patients.

  4. [Protestant clergymen among Hahnemann's clientele. Patient histories in letters].

    Science.gov (United States)

    Kreher, Simone; Schlott, Melanie; Schlott, Thilo

    2016-01-01

    As part of the research project, developments in the history of science and in the regional and ecclesiastic history of the late feudal petty state of Köthen-Anhalt have been assessed and numerous documents of the Nagel and Mühlenbein family histories examined that place the transcribed patient letters of the two Protestant clergymen within the context of the Hahnemann Archives. These findings complement and extend previous insights into Hahnemann's Köthen clientele, especially when it comes to the structure and milieu of the local clerical elite. Inspired by the interpretive methods of sequential textual analysis, form and content of the letters of the two clergymen and their relatives were also investigated as methodically structured lines of communication. The body of sources published here presents--embedded in the body-image (of sickness and health) prevalent at the time--the medical cultures of educated patients as well as the increasingly professionalized medical practices of Samuel Hahnemann in a flourishing urban doctor's surgery. The correspondence between the pastors Albert Wilhelm Gotthilf Nagel (1796-1835) and August Carl Ludwig Georg Mühlenbein (1797-1866), presented here in a standard edition, has been investigated at Fulda University as part of the project 'Homöopathisches Medicinieren zwischen alltäglicher Lebensführung und professioneller Praxis' ('Homeopathic medicine between everyday use and professional practice'). Of the altogether 78 transcribed documents, 53 are letters written by either of the two pastors, 16 are patient journals by Samuel Hahnemann, 9 letters by the pastors' wives and Mühlenbein's mother. The two series of letters, originally composed between 1831 and 1833 in old German cursive script, can now be used as sources for research into the history of homeopathy. PMID:27263219

  5. Evaluation of fiber intake in diabetes 2 patients of an asistencial center of Rosario city

    Directory of Open Access Journals (Sweden)

    María Elisa Zapata

    2013-09-01

    Full Text Available Introduction: a diet high in fiber has associated with better glycaemic control in diabetes 2 patients, being the soluble fraction of the most effective in the control of blood sugar levels. The aim of the study is determine the amount of total, soluble and insoluble dietary fiber intake by patients with type 2 diabetes who attended a medical centre for diabetics in Rosario.Material and methods: descriptive, observational, cross-sectional study was conducted. It was determined a sample of 60 adults with a diagnosis of diabetes type 2 >6 months, 18 to 70 years old, with no disease or intestinal disorders. A semiquantitative food frequency questionnaire of foods source of dietary fiber, and a photo album was used to identify the portion size. Descriptive statistical analysis was performed and Chi-square and ANOVA test was used to evaluate the association.Results: the average consumption of total fiber was 18,8±5,9 g/d, 14, 8±4,6 g/d corresponded to insoluble fiber and 4,0±1,5 g/d to soluble fiber. Fruits and vegetables contributed 82% of soluble fiber. Most patients (62% had a consumption of fiber total less than the recommendation of the ADA, and 60% presented an inadequate relationship between intake of soluble and insoluble fiber.Conclusions: it is necessary to increase the contribution of total dietary fiber, especially the soluble fraction in diabetes 2 patients, because there are evidences that supports its benefits.

  6. History of Nutrition: The Long Road Leading to the Dietary Reference Intakes for the United States and Canada.

    Science.gov (United States)

    Murphy, Suzanne P; Yates, Allison A; Atkinson, Stephanie A; Barr, Susan I; Dwyer, Johanna

    2016-01-01

    The Dietary Reference Intakes (DRIs) are reference values to guide the planning and assessing of nutrient intakes in the United States and Canada. The DRI framework was conceptualized in 1994, and the first reports were issued from 1997–2004, based on work by expert panels and subcommittees under the guidance of the Food and Nutrition Board of the Institute of Medicine. Numerous conventions, challenges, and controversies were encountered during the process of defining and setting the DRIs, including the definition of the framework, the use of chronic disease endpoints, lack of data on requirements for children and youth, and methods for addressing nonessential bioactive substances with potential health benefits. DRIs may be used to plan and assess the nutrient intakes of both individuals and population groups, but the new paradigm particularly improved methods used for groups. It is now possible to estimate both the prevalence of inadequate intake and the prevalence of potentially excessive intake within a group. The DRIs have served as a potent influence on national nutrition policies, including those related to dietary guidance, food labeling, nutrition monitoring, food assistance programs, and military nutrition standards. Because of this important impact on nutrition policy, the DRIs must be based on the best possible and most up-to-date science. Unfortunately, no updates to specific DRIs are currently planned. Despite the long and challenging road that led to the current DRIs, it must not finish in a dead end. Monetary resources and political will are crucial to maintaining and continuously updating the DRIs.

  7. Relationship between daily dietary fructose intake, body composition and biochemical parameters patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Sabriye Arslan

    2016-05-01

    Conclusion: Further studies are needed to develop more specific suggestions regarding fructose intake and to better understand the relationship between fructose intakes, body composition and biochemical parameters in individuals with type 2 diabetes.

  8. Usefulness of dietary enrichment on energy and protein intake in elderly patients at risk of malnutrition discharged to home

    Directory of Open Access Journals (Sweden)

    Joan Trabal

    2014-02-01

    Full Text Available Introduction: Malnutrition is a cause for concern among many admitted elderly patients, being common at hospital admission and discharge. Objectives: The objective of this study was to assess if diet enrichment with small servings of energy and protein dense foods, improves energy and nutrient intake in elderly patients at risk of malnutrition discharged to home. Methods: This was a retrospective case series study in elderly patients at risk of malnutrition treated with diet enrichment. There was a data review of dietary and health records of elderly patients discharged to home. Forty-one patients, mean age of 83 ± 5 years, met the inclusion criteria; 13 patients had been lost after 4 weeks of treatment and a total of 24 patients after 12 weeks. Records contained food intake data assessed at baseline, and after 4 and 12 weeks of treatment. Mini Nutritional Assessment, anthropometric measurements, routine biochemical parameters and the Barthel Index were assessed at baseline and after 12 weeks. Results: Compared to baseline, patients significantly improved their energy and protein intake after 4 weeks of treatment, fulfilling the mean nutritional requirements. The improvement in energy and protein intake was still manifest at week 12. After 12 weeks of dietary enrichment, a significant weight gain was observed (4.1%, p = 0.011, as well. No significant changes were detected in functional status. Conclusions: Using small servings of energy and protein dense foods to enrich meals seems a feasible nutritional treatment to increase energy and protein intake and meet nutritional goals among elderly patients discharged to home.

  9. History of Nutrition: The Long Road Leading to the Dietary Reference Intakes for the United States and Canada.

    Science.gov (United States)

    Murphy, Suzanne P; Yates, Allison A; Atkinson, Stephanie A; Barr, Susan I; Dwyer, Johanna

    2016-01-01

    The Dietary Reference Intakes (DRIs) are reference values to guide the planning and assessing of nutrient intakes in the United States and Canada. The DRI framework was conceptualized in 1994, and the first reports were issued from 1997–2004, based on work by expert panels and subcommittees under the guidance of the Food and Nutrition Board of the Institute of Medicine. Numerous conventions, challenges, and controversies were encountered during the process of defining and setting the DRIs, including the definition of the framework, the use of chronic disease endpoints, lack of data on requirements for children and youth, and methods for addressing nonessential bioactive substances with potential health benefits. DRIs may be used to plan and assess the nutrient intakes of both individuals and population groups, but the new paradigm particularly improved methods used for groups. It is now possible to estimate both the prevalence of inadequate intake and the prevalence of potentially excessive intake within a group. The DRIs have served as a potent influence on national nutrition policies, including those related to dietary guidance, food labeling, nutrition monitoring, food assistance programs, and military nutrition standards. Because of this important impact on nutrition policy, the DRIs must be based on the best possible and most up-to-date science. Unfortunately, no updates to specific DRIs are currently planned. Despite the long and challenging road that led to the current DRIs, it must not finish in a dead end. Monetary resources and political will are crucial to maintaining and continuously updating the DRIs. PMID:27180379

  10. Intake of Nutrients, Fiber, and Sugar in Patients with Nonalcoholic Fatty Liver Disease in Comparison to Healthy Individuals

    Science.gov (United States)

    Zolfaghari, Hamid; Askari, Gholamreza; Siassi, Fereydoun; Feizi, Awat; Sotoudeh, Gity

    2016-01-01

    Background: Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the world. Although some studies have been conducted about dietary intakes of these patients, but the results are inconsistent. The aim of this study was to survey all macronutrients and micronutrients included in dietary intake of these patients for better understanding the factors influencing this disease. Methods: The present study is a case-control conducted in Isfahan city, Iran. The cases were recently diagnosed patients with NAFLD who identified by ultrasonography. The case (159) and control (158) individuals were matched in age and gender. Data of general characteristics and physical activity of individuals were collected through questionnaire. Dietary intake was also collected using 24 h dietary recall questionnaire. Results: Waistline and body mass index for the case group were more than the control group (P acids and sugar in patients with NAFLD was more than healthy individuals (P folic acid, Vitamin D, zinc, and potassium in healthy individuals was more than patients with NAFLD (P source is associated with NAFLD. Increasing saturated fatty acids and sugar and decreasing fiber, folic acid, Vitamin D, zinc, and potassium intake might play a role in the progression of this disease. PMID:27625763

  11. [The effect of dietotherapy and supplementary calcium intake on phosphorus-calcium homeostasis in hypertensive patients].

    Science.gov (United States)

    Gladkevich, A V; Samsonov, M A; Spirichev, V B

    1990-01-01

    A total of 25 patients with essential hypertension received a hyponatrium, hypocaloric antisclerotic diet providing 800 mg Ca and 1100 mg P/day, during 18-20 days. As a result of the dietotherapy, Ca concentration in the patients' blood serum rose from 9.9 +/- 0.2 to 10.4 +/- 0.1 mg/100 ml (p = 0.02), total cholesterol level was lowered from 6.58 +/- 0.43 to 5.42 +/- 0.3 mmol/l (p less than 0.05), Na+ and K+ distribution between the blood plasma and red blood cells was improved, and the arterial blood pressure was normalized in all the patients investigated. It dropped from 162 +/- 3.8/102 +/- 1.8 mm Hg before the treatment to 129 +/- 2.1/83.4 +/- 2.2 mm Hg after the treatment. Additional intake of 850 mg Ca/day, as CaCO3, decreased parathormone level in the blood serum from 0.40 +/- 0.03 to 0.23 ng/ml (p less than 0.01), intensified the hypolipidemic effect of the ration, and did not influence the degree of arterial blood pressure reduction under the action of this ration. Optimization of Ca consumption plays an important role in the combined dietotherapy of essential hypertension. PMID:2378097

  12. Plant Protein Intake Is Associated with Fibroblast Growth Factor 23 and Serum Bicarbonate in Patients with CKD: The Chronic Renal Insufficiency Cohort Study

    Science.gov (United States)

    Scialla, Julia J.; Appel, Lawrence J; Wolf, Myles; Yang, Wei; Zhang, Xiaoming; Sozio, Stephen M.; Miller, Edgar R.; Bazzano, Lydia A.; Cuevas, Magdalena; Glenn, Melanie J.; Lustigova, Eva; Kallem, Radhakrishna R.; Porter, Anna C.; Townsend, Raymond R.; Weir, Matthew R.; Anderson, Cheryl A.M.

    2012-01-01

    Background Protein from plant, as opposed to animal, sources may be preferred in chronic kidney disease (CKD), due to lower bioavailability of phosphate and lower nonvolatile acid load. Study Design Observational cross-sectional study. Setting & Participants 2938 participants with chronic kidney disease and information on dietary intake at the baseline visit in the Chronic Renal Insufficiency Cohort Study. Predictors Percentage of total protein from plant sources (% plant protein) was determined by scoring individual food items from the National Cancer Institute Diet History Questionnaire (DHQ). Outcomes Metabolic parameters, including serum phosphate, bicarbonate (HCO3), potassium, and albumin, plasma fibroblast growth factor 23 (FGF23), and parathyroid hormone (PTH), and hemoglobin. Measurements We modeled the association between % plant protein and metabolic parameters using linear regression. Models were adjusted for age, sex, race, diabetes, body mass index, eGFR, income, smoking, total energy intake, total protein intake, 24 hour urinary sodium, use of angiotensin converting enzyme inhibitors/angiotensin receptor blockers and use of diuretics. Results Higher % plant protein was associated with lower FGF23 (p=0.05) and higher HCO3 (p=0.01), but not with serum phosphate or PTH (p=0.9 and 0.5, respectively). Higher % plant protein was not associated with higher serum potassium (p=0.2), lower serum albumin (p=0.2) or lower hemoglobin (p=0.3). The associations of % plant protein with FGF23 and HCO3 did not differ by diabetes status, sex, race, CKD stage (2/3 vs. 4/5) or total protein intake (≤ 0.8 g/kg/d vs. >0.8 g/kg/d) (p-interaction > 0.10 for each). Limitations Cross-sectional study; Determination of % plant protein using the DHQ has not been validated. Conclusions Consumption of a higher percentage of protein from plant sources may lower FGF23 and raise HCO3 in patients with CKD. PMID:22480598

  13. Application of Information Visualization Techniques in Representing Patients' Temporal Personal History Data

    Science.gov (United States)

    Noah, Shahrul Azman; Yaakob, Suraya; Shahar, Suzana

    The anthropometries and nutrients records of patients are usually vast in quantity, complex and exhibit temporal features. Therefore, the information acceptance among users will become blur and give cognitive burden if such data is not displayed using effective techniques. The aim of this study is to apply, use and evaluate Information Visualization (IV) techniques for displaying the Personal History Data (PHD) of patients for dietitians during counseling sessions. Since PHD values change consistently with the counseling session, our implementation mainly focused on quantitative temporal data such as Body Mass Index (BMI), blood pressure and blood glucose readings. This data is mapped into orientation circle type of visual representation, whereas data about medicinal and supplement intake are mapped into timeline segment which is based on the thickness of lines as well as the colors. A usability testing has been conducted among dietitians at Faculty of Allied Health Sciences, UKM. The result of the testing has shown that the use of visual representations capable of summarising complex data which ease the dietitian task of checking the PHD.

  14. The influence of high versus low sodium intake on blood pressure and haemodynamics in patients with morbid obesity

    DEFF Research Database (Denmark)

    Bonfils, Peter K; Taskiran, Mustafa; Damgaard, Morten;

    2013-01-01

    fluid compartments and haemodynamic responses (at rest and during exercise) after 5 days of a low-sodium diet (90 mmol/day) and 5 days of a high-sodium diet (250 mmol/day) in 12 morbidly obese, hypertensive patients; 12 morbidly obese, normotensive patients and 12 nonobese controls. RESULTS: High sodium...... intake as compared to low sodium intake was associated with an increase in plasma volume (obese, hypertensive patients: 5 ± 4%; obese, normotensive patients: 10 ± 11%; nonobese controls: 7 ± 6%), cardiac output (CO) (obese, hypertensive patients: 17 ± 12%; obese, normotensive patients: 20 ± 16%; nonobese...... controls: 13 ± 14%) and stroke volume (SV) (obese, hypertensive patients: 27 ± 26%; obese, normotensive patients: 27 ± 24%; nonobese controls: 18 ± 27%) in all three groups with no differences between the groups. Despite an increase in CO during high salt intake, 24-h blood pressure (BP) was unchanged...

  15. Pre-hospital dietary intake correlates with muscle mass at the time of fracture in older hip fractured patients

    Directory of Open Access Journals (Sweden)

    Riccardo eCalvani

    2014-11-01

    Full Text Available Background. Failure to meet an adequate dietary intake is involved in the pathogenesis of sarcopenia and osteoporosis, which in turn increase the risk for falls and fractures, respectively. Older people with hip fracture are often protein-malnourished at hospitalization. Whether low protein-energy intake is associated with muscle atrophy in hip fractured patients is presently unknown. This information is necessary for the development of novel strategies to manage this especially vulnerable patient population. The aim of this study was therefore to explore the relationship between dietary intake and muscle mass in older hip fractured patients.Methods. Analyses were conducted in hip fractured elderly admitted to an orthopedic and trauma surgery ward (University Hospital. Muscle mass was estimated by bioelectrical impedance analysis within 24 h from admission. Dietary information was collected via 24-h dietary recall and nutrient intakes calculated by a nutrition software.Results. Among 62 hip fractured patients (mean age 84.6±7.6 years, 84% women, the average energy intake was 929.2±170.3 Kcal/day, with higher values reported by men (1.046.8±231.4 Kcal/day relative to women (906.5±148.3 Kcal/day; p=0.01. Absolute and normalized protein intake was 50.0±13.5 g/day and 0.88±0.27 g/kg (body weight/day, respectively, with no gender differences. A positive correlation was determined between total energy intake and muscle mass (r=0.384; p=0.003. Similarly, protein and leucine consumption was positively correlated with muscle mass (r=0.367 and 0.311, respectively; p=0.005 for both.Conclusions. A low intake of calories, protein and leucine is associated with reduced muscle mass in hip fractured elderly. Given the relevance of sarcopenia as a risk factor for adverse outcomes in this patient population, our findings highlight the importance of a comprehensive dietary assessment for the detection of nutritional deficits predisposing to or aggravating

  16. The daily gluten intake in relatives of patients with coeliac disease compared with that of the general Dutch population

    NARCIS (Netherlands)

    vanOverbeek, FM; UilDieterman, IGA; Mol, IW; KohlerBrands, L; Heymans, HSA; Mulder, CJJ

    1997-01-01

    Background: It has been suggested that the amount of gluten intake in populations offers an explanation for differences in the epidemiology of coeliac disease. Investigations into first-degree relatives of coeliac disease patients have often shown that relatives exhibit intermediate features of coel

  17. Preoperative protein and energy intake and postoperative complications in well-nourished, non-hospitalized elderly cardiac surgery patients

    NARCIS (Netherlands)

    L.M.W. van Venrooij; P.A.M. van Leeuwen; R. de Vos; M.M.M.J. Borgmeijer-Hoelen; B.A.J.M. de Mol

    2009-01-01

    Background & aims: Little is known about the impact of preoperative protein or energy intake in relation to the occurrence of postoperative complications in patients who are not undernourished but cannot keep up their daily protein or energy requirements prior to cardiac surgery. Therefore, a prospe

  18. Relating protein intake to nutritional status in haemodialysis patients : How to normalize the protein equivalent of total nitrogen appearance (PNA)?

    NARCIS (Netherlands)

    Kloppenburg, Wybe; Stegeman, CA; de Jong, PE; Huisman, RM

    1999-01-01

    Background. The protein equivalent of total nitrogen appearance (PNA) is assumed to be a reliable estimate of dietary protein intake in haemodialysis patients. Protein requirements are related to body size. In order to standardize PNA to individual differences in body size, PNA is normalized to vari

  19. Appropriate physical activity and dietary intake achieve optimal metabolic control in older type 2 diabetes patients

    OpenAIRE

    Huang, Jui‐Hua; Cheng, Fu‐Chou; Tsai, Leih‐Ching; Lee, Ning‐Yuean; Lu, Yi‐Fa

    2013-01-01

    Abstract Aims/Introduction The aim of the present study was to investigate an appropriate level of physical activity and optimal dietary intake in older type 2 diabetes patients. Materials and Methods The cross‐sectional study enrolled 210 older type 2 diabetes patients. Participants were interviewed to obtain information on physical activity, 24‐h dietary recall and typical weekly dietary patterns. Anthropometric measurements, and biochemical analysis of blood and urine were determined. Resu...

  20. The Metabolic Effects of Oats Intake in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Hou, Qingtao; Li, Yun; Li, Ling; Cheng, Gaiping; Sun, Xin; Li, Sheyu; Tian, Haoming

    2015-12-01

    The present study aimed to comprehensively assess if oats intake is beneficial for diabetic patients. The literature search was conducted in PubMed database up to 23 August 2015. Fourteen controlled trials and two uncontrolled observational studies were included. Compared with the controls, oats intake significantly reduced the concentrations of glycosylated hemoglobin A1c (HbA1c) (MD, -0.42%; 95% CI, -0.61% to -0.23%), fasting blood glucose (FBG) (MD, -0.39 mmol/L; 95% CI, -0.58 to -0.19 mmol/L), total cholesterol (TC) (MD, -0.49 mmol/L; 95% CI, -0.86 to -0.12 mmol/L), low-density lipoprotein cholesterol (LDL-C) (MD, -0.29 mmol/L; 95% CI, -0.48 to -0.09 mmol/L). Oatmeal significantly reduced the acute postprandial glucose and insulin responses compared with the control meal. The present study has revealed a beneficial effect of oats intake on glucose control and lipid profiles in type 2 diabetic patients. Further investigations of oats intake in patients with type 1 diabetes and the safety of oats consumption are required. PMID:26690472

  1. The Metabolic Effects of Oats Intake in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Hou, Qingtao; Li, Yun; Li, Ling; Cheng, Gaiping; Sun, Xin; Li, Sheyu; Tian, Haoming

    2015-12-01

    The present study aimed to comprehensively assess if oats intake is beneficial for diabetic patients. The literature search was conducted in PubMed database up to 23 August 2015. Fourteen controlled trials and two uncontrolled observational studies were included. Compared with the controls, oats intake significantly reduced the concentrations of glycosylated hemoglobin A1c (HbA1c) (MD, -0.42%; 95% CI, -0.61% to -0.23%), fasting blood glucose (FBG) (MD, -0.39 mmol/L; 95% CI, -0.58 to -0.19 mmol/L), total cholesterol (TC) (MD, -0.49 mmol/L; 95% CI, -0.86 to -0.12 mmol/L), low-density lipoprotein cholesterol (LDL-C) (MD, -0.29 mmol/L; 95% CI, -0.48 to -0.09 mmol/L). Oatmeal significantly reduced the acute postprandial glucose and insulin responses compared with the control meal. The present study has revealed a beneficial effect of oats intake on glucose control and lipid profiles in type 2 diabetic patients. Further investigations of oats intake in patients with type 1 diabetes and the safety of oats consumption are required.

  2. The Metabolic Effects of Oats Intake in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Qingtao Hou

    2015-12-01

    Full Text Available The present study aimed to comprehensively assess if oats intake is beneficial for diabetic patients. The literature search was conducted in PubMed database up to 23 August 2015. Fourteen controlled trials and two uncontrolled observational studies were included. Compared with the controls, oats intake significantly reduced the concentrations of glycosylated hemoglobin A1c (HbA1c (MD, −0.42%; 95% CI, −0.61% to −0.23%, fasting blood glucose (FBG (MD, −0.39 mmol/L; 95% CI, −0.58 to −0.19 mmol/L, total cholesterol (TC (MD, −0.49 mmol/L; 95% CI, −0.86 to −0.12 mmol/L, low-density lipoprotein cholesterol (LDL-C (MD, −0.29 mmol/L; 95% CI, −0.48 to −0.09 mmol/L. Oatmeal significantly reduced the acute postprandial glucose and insulin responses compared with the control meal. The present study has revealed a beneficial effect of oats intake on glucose control and lipid profiles in type 2 diabetic patients. Further investigations of oats intake in patients with type 1 diabetes and the safety of oats consumption are required.

  3. A history of arterial hypertension does not affect mortality in patients hospitalised with congestive heart failure

    DEFF Research Database (Denmark)

    Gustafsson, F; Torp-Pedersen, C; Seibaek, M;

    2006-01-01

    OBJECTIVES: To evaluate the importance of a history of hypertension on long-term mortality in a large cohort of patients hospitalised with congestive heart failure (CHF). DESIGN: Retrospective analysis of 5491 consecutive patients, of whom 24% had a history of hypertension. 60% of the patients had...

  4. Assessing Nutrient Intake and Nutrient Status of HIV Seropositive Patients Attending Clinic at Chulaimbo Sub-District Hospital, Kenya

    Directory of Open Access Journals (Sweden)

    Agatha Christine Onyango

    2012-01-01

    Full Text Available Background. Nutritional status is an important determinant of HIV outcomes. Objective. To assess the nutrient intake and nutrient status of HIV seropositive patients attending an AIDS outpatient clinic, to improve the nutritional management of HIV-infected patients. Design. Prospective cohort study. Setting. Comprehensive care clinic in Chulaimbo Sub-District Hospital, Kenya. Subjects. 497 HIV sero-positive adults attending the clinic. Main Outcome Measures. Evaluation of nutrient intake using 24-hour recall, food frequency checklist, and nutrient status using biochemical assessment indicators (haemoglobin, creatinine, serum glutamate pyruvate (SGPT and mean corpuscular volume (MCV. Results. Among the 497 patients recruited (M : F sex ratio: 1.4, mean age: 39 years ± 10.5 y, Generally there was inadequate nutrient intake reported among the HIV patients, except iron (10.49 ± 3.49 mg. All the biochemical assessment indicators were within normal range except for haemoglobin 11.2 g/dL (11.4 ± 2.60 male and 11.2 ± 4.25 female. Conclusions. Given its high frequency, malnutrition should be prevented, detected, monitored, and treated from the early stages of HIV infection among patients attending AIDS clinics in order to improve survival and quality of life.

  5. Dietary fortificant iron intake is negatively associated with quality of life in patients with mildly active inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Powell Jonathan J

    2013-01-01

    Full Text Available Abstract Background Iron deficiency anaemia and oral iron supplementation have been associated negatively with quality of life, and with adverse effects, respectively, in subjects with inflammatory bowel disease (IBD. Hence, the risk-benefit ratio of oral iron is not understood in this patient group. The present case–control study investigated whether dietary iron intake impacts on quality of life in IBD patients. Methods Quality of life, habitual dietary iron intakes and iron requirements were assessed in 29 patients with inactive or mildly active IBD as well as in 28 healthy control subjects. Results As expected, quality of life was worse in IBD patients as a whole in comparison to healthy controls according to EuroQol score and EuroQol VAS percentage (6.9 ± 1.6 vs 5.3 ± 0.6; pvs 88 ± 12%; p=0.004 respectively. For IBD subjects, 21/29 were iron deplete based upon serum iron responses to oral iron but, overall, were non-anaemic with mean haemoglobin of 13.3 ± 1.5 g/dL, and there was no difference in their quality of life compared to 8/29 iron replete subjects (Hb 14.0 ± 0.8 g/dL. Interestingly, total dietary iron intake was significantly negatively associated with quality of life in IBD patients, specifically for non-haem iron and, more specifically, for fortificant iron. Moreover, for total non-haem iron the negative association disappeared when fortificant iron values were subtracted. Finally, further sub-analysis indicated that the negative association between (fortificant dietary iron intake and quality of life in IBD patients is driven by findings in patients with mildly active disease rather than in patients with quiescent disease. Conclusions Iron deficiency per se (i.e. without concomitant anaemia does not appear to further affect quality of life in IBD patients with inactive or mildly active disease. However, in this preliminary study, dietary iron intake, particularly fortificant iron, appears to be significantly negatively

  6. Correlation of magnesium intake with metabolic parameters, depression and physical activity in elderly type 2 diabetes patients: a cross-sectional study

    OpenAIRE

    Huang Jui-Hua; Lu Yi-Fa; Cheng Fu-Chou; Lee John; Tsai Leih-Ching

    2012-01-01

    Abstract Background Type 2 diabetes mellitus is a major global public health problem in the worldwide and is increasing in aging populations. Magnesium intake may be one of the most important factors for diabetes prevention and management. Low magnesium intake may exacerbate metabolic abnormalities. In this study, the relationships of magnesium intake with metabolic parameters, depression and physical activity in elderly patients with type 2 diabetes were investigated. Methods This cross-sect...

  7. Correlation of magnesium intake with metabolic parameters, depression and physical activity in elderly type 2 diabetes patients: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Huang Jui-Hua

    2012-06-01

    Full Text Available Abstract Background Type 2 diabetes mellitus is a major global public health problem in the worldwide and is increasing in aging populations. Magnesium intake may be one of the most important factors for diabetes prevention and management. Low magnesium intake may exacerbate metabolic abnormalities. In this study, the relationships of magnesium intake with metabolic parameters, depression and physical activity in elderly patients with type 2 diabetes were investigated. Methods This cross-sectional study involved 210 type 2 diabetes patients aged 65 years and above. Participants were interviewed to obtain information on lifestyle and 24-hour dietary recall. Assessment of depression was based on DSM-IV criteria. Clinical variables measured included anthropometric measurements, blood pressure, and biochemical determinations of blood and urine samples. Linear regression was applied to determine the relationships of magnesium intake with nutritional variables and metabolic parameters. Results Among all patients, 88.6% had magnesium intake which was less than the dietary reference intake, and 37.1% had hypomagnesaemia. Metabolic syndromes and depression were associated with lower magnesium intake (p  0.05. A positive relationship was found between magnesium intake and HDL-cholesterol (p = 0.005. Magnesium intake was inversely correlated with triglyceride, waist circumference, body fat percent and body mass index (p p for trend = 0005. Waist circumference, body fat percentage, and body mass index were significantly lower with increase quartile of magnesium intake (p for trend p for trend  Conclusions The majority of elderly type 2 diabetes who have low magnesium intake may compound this deficiency with metabolic abnormalities and depression. Future studies should determine the effects of increased magnesium intake or magnesium supplementation on metabolic control and depression in elderly people with type 2 diabetes.

  8. Validation of The Fluid Intake Appraisal Inventory; a self-efficacy scale for managing fluid allowance among patients on haemodialysis in Denmark

    DEFF Research Database (Denmark)

    Pahus, Jytte; Ludvigsen, Mette Spliid; Lindberg, Magnus

    2015-01-01

    Background Many haemodialysis patients have problems limiting their fluid intake, and this might be influenced by their self-efficacy (SE). Thus interventions to improve patients’ SE might lead to an improvement in their managing of fluid allowance. The Fluid Intake Appraisal Inventory (FIAI...

  9. Stress-induced enhancement of ethanol intake in C57BL/6J mice with a history of chronic ethanol exposure: Involvement of kappa opioid receptors

    Directory of Open Access Journals (Sweden)

    Rachel Ivy Anderson

    2016-02-01

    Full Text Available Our laboratory has previously demonstrated that daily forced swim stress (FSS prior to ethanol drinking sessions facilitates enhanced ethanol consumption in mice with a history of chronic intermittent ethanol (CIE vapor exposure without altering ethanol intake in air-exposed controls. Because both stress and chronic ethanol exposure have been shown to activate the dynorphin/kappa opioid receptor (KOR system, the present study was designed to explore a potential role for KORs in modulating stress effects on ethanol consumption in the CIE model of dependence and relapse drinking. After stable baseline ethanol intake was established in adult male C57BL/6J mice, subjects received chronic intermittent exposure (16 hr/day x 4 days/week to ethanol vapor (CIE group or air (CTL group. Weekly cycles of inhalation exposure were alternated with 5-day limited access drinking tests (1 hour access to 15% ethanol. Experiment 1 compared effects of daily FSS and KOR activation on ethanol consumption. CIE and CTL mice were either exposed to FSS (10 min, the KOR agonist U50,488 (5 mg/kg, or a vehicle injection (non-stressed condition prior to each daily drinking session during test weeks. FSS selectively increased drinking in CIE mice. U50,488 mimicked this effect in CIE mice, but also increased drinking in CTL mice. Experiment 2 assessed effects of KOR blockade on stress-induced drinking in CIE and CTL mice. Stressed and non-stressed mice were administered the short-acting KOR antagonist LY2444296 (0 or 5 mg/kg 30 min prior to each drinking session during test weeks. FSS selectively increased ethanol consumption in CIE mice, an effect that was abolished by LY2444296 pretreatment. In Experiment 3, CIE and CTL mice were administered one of four doses of U50,488 (0,1.25, 2.5, 5.0 mg/kg one hour prior to each daily drinking test (in lieu of FSS. All doses of U50,488 increased ethanol consumption in both CIE and CTL mice. The U50,488-induced increase in drinking was

  10. Dietary calcium intake in a cohort of elderly patients already in drug therapy for osteoporosis. Is it possible and how to modify the eating habits before calcium supplementation?

    Directory of Open Access Journals (Sweden)

    Ciro Manzo

    2015-08-01

    Full Text Available Inadequate intake of calcium via the diet is very common in patients taking drugs for osteoporosis. We have evaluated 302 consecutive elderly patients (68.6 median age attending our Rheumatological and Orthopedic Outpatient Clinics using a questionnaire for evaluation of dietary calcium intake. Two hundred and forty of these had a questionnaire score 7 in 205/240 after an average period of 3-6 months. In the 35 patients in which this was not possible, the exact knowledge of calcium dietary intake (poor or absent has allowed a tailored calcium supplementation.

  11. Dose assessment of medical staff taking care of patients treated with 131I due to the intake of 131I

    International Nuclear Information System (INIS)

    Aim: Legislation requires that patient receiving 131I in activities greater than 550MBq have to be hospitalized in special closed department. Medical staff taking care of these patients can be exposed to external irradiation and internal contamination with 131I. The aim of this study was to assess the annual effective dose of medical staff taking care of patients treated with 131I due to the occupational intake of 131I. Material - Medical Staff: 6 nurses took care of 6 patients (placed into two rooms) treated with 131I in activities between 550 and 1100 MBq. 131I was normally delivered to patients once per week. After patients received 131I nurses were in contact with patients in average 4 hours per day, 4 days per week. Methods: Direct Method - whole body counting (WBC) of staff was performed daily after they finished their work and indirect method - determination of air 131I concentration in patient's rooms (AC) were used to assess the intake of 131I by staff. Measurements were done in winter period.Results and Dose Assessment: Results of measurements of medical staff and determination of 131I air concentration are presented. Average daily 131I intake of staff assessed from WBC results was 315 Bq; average daily 131I air concentration for first four days was 35 Bq/m3. Assessment of annual effective dose due to the internal contamination (realistic approach): - Direct method: 315 Bq/day x 208 days/year x 7,6 Sv/Bq x 10-9 = 0,498 mSv/year. - Indirect method: 35 Bq/m3 x 1,5 m3/hour x 832 hours/year x 7,6 Sv/Bq x 10-9 = 0,332 mSv/year. Conclusion: Medical staff taking care of patients treated with 131I received effective dose less than 0,5 mSv/year due to the intake of 131I. In the some time period they received 1,65 to 2,24 mSv due to the exposure to the external radiation coming from patients treated with 131I

  12. Natural history of hepatitis C in HIV-negative patients with congenital coagulation disorders

    NARCIS (Netherlands)

    Haagsma, EB; Kok, T; Schirm, J; Smid, WM; van der Meer, J

    1999-01-01

    Background/Aims: Knowledge of the natural history of hepatitis C is useful for counselling patients and planning treatment, More data are needed from unselected patient groups without concomitant disease, The aim of this study was to describe the natural history of hepatitis C, two decades after inf

  13. Improvement of functional constipation with kiwifruit intake in a Mediterranean patient population: An open, non-randomized pilot study

    Directory of Open Access Journals (Sweden)

    Oriol Cunillera

    2015-07-01

    Full Text Available Introduction: Kiwifruit consumption has shown to improve functional constipation in healthy elderly population, according to studies in New Zealand and China. The aim of this study was to evaluate the effect of kiwifruit intake on functional constipation in a Mediterranean patient population characterized by its distinctive nutritional habits.Material and Methods: An open, non-controlled and non-randomized longitudinal study was conducted in 46 patients with constipation (Rome III criteria. Patients monitored for five weeks: weeks 1 and 2 no kiwifruit and weeks 3-5 three kiwifruit per day (Green kiwifruit, Actinidia deliciosa var Hayward. Bristol Scale, volume of stools, and ease of defecation was self- reported daily. The evolution of the categorical variables was tested using the Bhapkar test; functional data methodology was used for continuous variables, and Generalized Estimating Equation (GEE models were adjusted.Results: The percentage of patients with ≥3 stools per week increased from 82.61% (95% CI: 69–91.2 at week 1 to 97.78% (95% CI: 87.4–99.9 at week 2 of kiwifruit intake, with 76.09% (95% CI: 61.9–86.2 responding during the first week. The reporting of stable ideal stools increased from 17.39% (95% CI: 8.8–31 at week 2 to 33.33% (95% CI: 21.3–48 at week 5. According to GEE models, the number of depositions increased significantly (p-values<0.001 in 0.398 daily units at week 1 the first week of intake, up to 0.593 daily units at week 5; significant improvements on facility in evacuation and volume of evacuation were found from the firstweek of intake (all p-values<0.001.Conclusions: The intake of three kiwifruits per day significantly improves the quality of evacuation (number of depositions, volume, consistency and ease in a Mediterranean patient population suffering from functional constipation.

  14. Timing of food intake is associated with weight loss evolution in severe obese patients after bariatric surgery

    OpenAIRE

    Ruíz-Lozano, T.; Vidal i Cortada, Josep; de Hollanda, A.; Scheer, F.A.J.L.; Garaulet, M.; Izquierdo Pulido, María Luz

    2016-01-01

    Background Recent research has demonstrated a relationship between the timing of food intake and weight loss in humans. However, whether the meal timing can be associated with weight loss in patients treated with bariatric surgery is unknown. Objective To evaluate the role of food-timing in the evolution of weight loss in a sample of 270 patients that underwent bariatric surgery with a follow-up of 6 years. Methods Participants (79% women; age [mean ± SD]: 52 ± 11 years; BMI: 46.5 ± 6.0 kg/m2...

  15. CLINICAL HISTORY AND OUTCOME OF 59 PATIENTS WITH IDIOPATHIC HYPERPROLACTINEMIA

    NARCIS (Netherlands)

    SLUIJMER, AV; LAPPOHN, RE

    1992-01-01

    Objective: To investigate the clinical course of hyperprolactinemia without demonstrable cause. Design: Prospective study of all patients with idiopathic hyperprolactinemia first seen between 1974 and 1985. Setting: Outpatient Department of University Hospital. Patients: Fifty-nine patients followed

  16. Dietary intake of micronutrients in first-degree healthy, diabetic and IGT relatives of type II diabetic patients

    Directory of Open Access Journals (Sweden)

    Hosein Khosravi-Broojeni

    2008-01-01

    Full Text Available Introduction: To evaluate the dietary content of micronutrients in first-degree relatives of type II diabetic patients, with respect to the influence of dietary composition on the development of diabetes. Methods and Materials: 210 first-degree relatives of type II diabetic patients were divided into 2 groups (normal and IGT+ diabetic, according to the results of OGTT. 3-Day food recall questionnaire was completed by skilled nutritionists from all subjects. The participants’ intake of calorie, magnesium, zinc, calcium, phosphorus, chromium and vitamins B1, B6, C and E was calculated and the results were compared between 2 groups. Results: The mean of age and BMI were 48.9  5.2, 43.6  6.7 years (P=0.373 and 29.3  0.7, 28.7  0.8 kg/m2 in impaired and normal groups, respectively. No significant difference was observed in energy, magnesium, zinc, calcium, phosphorus, chromium and vitamins B1, B6, C and E intake between 2 groups. Conclusion: Although the micronutrient intake between studied groups didn’t differ significantly, the dietary content of chromium, magnesium, zinc and vitamin E was less than recommended daily allowance values. This finding can be taken into consideration with respect to the influence of some micronutrients, including magnesium and chromium, on glucose tolerance and insulin resistance.

  17. Influence of metformin intake on the risk of bladder cancer in type 2 diabetes patients

    NARCIS (Netherlands)

    Goossens, Maria E; Buntinx, Frank; Zeegers, Maurice P; Driessen, J H M; De Bruin, Marie L; de Vries, Frank

    2015-01-01

    OBJECTIVE: The aim of this study is to look at the influence of metformin intake and duration, on urinary bladder cancer (UBC) risk, with sulfonylurea (SU) only users as control using a new-user design (inception cohort). METHODS: We conducted a retrospective cohort study using data from the UK Clin

  18. Evaluation of Salt Intake, Urinary Sodium Excretion and Their Relationship to Overhydration in Chronic Kidney Disease Patients.

    Science.gov (United States)

    Hallvass, Andrea E C; Claro, Lígia Maria; Gonçalves, Simone; Olandoski, Márcia; Nerbass, Fabiana Baggio; Aita, Carlos Alberto Mayora; de Moraes, Thyago Proença; Pecoits-Filho, Roberto

    2015-01-01

    The purpose of this study was to estimate sodium intake in a group of patients with chronic kidney disease (CKD) and to correlate the results with the urinary excretion values of sodium and signs of fluid overload. We included patients with CKD in different stages. Urinary sodium was measured in 24 h urine samples. Body composition monitor (BCM) was used to estimate the hydration status. Sixty patients (38 ± 15 ml/min of GFR) presented 4.14 ± 1.71 g/24 h of urinary sodium excretion. Overhydration was detected in 50% of the patients by the BCM. There was a positive correlation between the measured sodium excretion values and BCM, ICW, ECW and TBW. In conclusion, markers of overhydration evaluated by BCM were positively correlated with urinary sodium excretion.

  19. Value of history-taking in syncope patients: in whom to suspect long QT syndrome?

    NARCIS (Netherlands)

    N. Colman; A. Bakker; M. Linzer; J.B. Reitsma; W. Wieling; A.A.M. Wilde

    2009-01-01

    Long QT syndrome (LQTS), a potentially fatal disorder, has to be distinguished from non-fatal conditions. Our aim was to investigate whether history-taking can be used in identifying patients likely to have LQTS. We compared the characteristics of a group of LQTS patients with syncope patients prese

  20. [Nightmares in patients with Alzheimer's disease caused by donepezil. Therapeutic effect depends on the time of intake].

    Science.gov (United States)

    Singer, M; Romero, B; Koenig, E; Förstl, H; Brunner, H

    2005-09-01

    Dementia of the Alzheimer type (DAT) has been linked to losses of cholinergic function in the brain. The acetylcholinesterase inhibitors donepezil, rivastigmine and galantamine improve cognitive performance in manifest dementia. These substances, however, also influence the quality of sleep, and particularly the quality and amount of dreams. We therefore investigated the influence of the time point of donepezil intake on the occurrence of nightmares. We observed a clear-cut relationship between the occurrence of nightmares and an evening dose of donepezil in eight patients with DAT. None of these patients reported nightmares when donepezil was taken in the morning. We suggest that the activation of the visual association cortex during REM sleep is enhanced by donepezil, a mechanism most likely facilitating the development of nightmares in patients with DAT. PMID:15630600

  1. Family History of Alzheimer's Disease and Cortical Thickness in Patients With Dementia.

    Science.gov (United States)

    Ganske, Steffi; Haussmann, Robert; Gruschwitz, Antonia; Werner, Annett; Osterrath, Antje; Baumgaertel, Johanna; Lange, Jan; Donix, Katharina L; Linn, Jennifer; Donix, Markus

    2016-08-01

    A first-degree family history of Alzheimer's disease reflects genetic risks for the neurodegenerative disorder. Recent imaging data suggest localized effects of genetic risks on brain structure in healthy people. It is unknown whether this association can also be found in patients who already have dementia. Our aim was to investigate whether family history risk modulates regional medial temporal lobe cortical thickness in patients with Alzheimer's disease. We performed high-resolution magnetic resonance imaging and cortical unfolding data analysis on 54 patients and 53 nondemented individuals. A first-degree family history of Alzheimer's disease was associated with left hemispheric cortical thinning in the subiculum among patients and controls. The contribution of Alzheimer's disease family history to regional brain anatomy changes independent of cognitive impairment may reflect genetic risks that modulate onset and clinical course of the disease. PMID:27303063

  2. Platelet function in patients with a history of unexplained recurrent miscarriage who subsequently miscarry again.

    LENUS (Irish Health Repository)

    Dempsey, Mark Anthony

    2015-05-01

    This study was designed to evaluate platelet aggregation in pregnant women with a history of unexplained recurrent miscarriage (RM) and to compare platelet function in such patients who go on to have either another subsequent miscarriage or a successful pregnancy.

  3. Twelve Tips for Better Communication with Patients During History-Taking

    Directory of Open Access Journals (Sweden)

    Aminur Rahman

    2007-01-01

    Full Text Available Eliciting proper history from a patient is of paramount importance to establish an accurate diagnosis and management in medical practice. Good communication skill is a prerequisite for an effective physician patient relationship. A systematic search of medical literature has been made to formulate a guideline for better communication during history taking. The guideline emphasizes on both physical environment and emotional encounter and the key points are expressed as tips on relevant issues.

  4. Twelve Tips for Better Communication with Patients During History-Taking

    OpenAIRE

    Aminur Rahman; Saria Tasnim

    2007-01-01

    Eliciting proper history from a patient is of paramount importance to establish an accurate diagnosis and management in medical practice. Good communication skill is a prerequisite for an effective physician patient relationship. A systematic search of medical literature has been made to formulate a guideline for better communication during history taking. The guideline emphasizes on both physical environment and emotional encounter and the key points are expressed as tips on relevant issues.

  5. Family History and Functional Outcome in Korean Stroke Patients: A Preliminary Study

    OpenAIRE

    Park, Hee Jung; Kim, Tae Uk; Hyun, Jung Keun; Kim, Jung Yoon

    2015-01-01

    Objective To investigate the association of family history of stroke with functional outcomes in stroke patients in Korea. Methods A case-control study was conducted. A total of 170 patients who were admitted to a rehabilitation unit were included. Risk factors for stroke such as age, sex, diabetes mellitus, hypertension, atrial fibrillation, smoking, high blood cholesterol and homocysteine level, obesity, and family history of stroke were taken into account. Stroke subtypes were the followin...

  6. Weight history of patients with newly diagnosed Type 2 diabetes

    DEFF Research Database (Denmark)

    Olivarius, N de Fine; Richelsen, B; Siersma, V;

    2008-01-01

    newly diagnosed with diabetes aged > or = 40 years. Patients' weight at diagnosis was measured by the doctor, while patients recalled their weight approximately 1, 5 and 10 years prior to diagnosis and at age 20 years. RESULTS: Median weight gain from age 20 years to diabetes diagnosis at median age 65...

  7. Ethics and Undertreatment of Pain in Patients with a History of Drug Abuse.

    Science.gov (United States)

    da Cunha, Brooke Faria

    2015-01-01

    Patients with substance abuse history make up 14% of inpatient admissions to acute care units, where it has been reported a great deal of patient pain is unrelieved (Substance Abuse and Mental Health Service Administration [SAMHSA], 2009. Definitions of substance abuse terms including tolerance, dependence, addiction, and pseudoaddiction are essential to a nurse's understanding of pain medication administration in patients with substance abuse history. Pain management is one of the nurse's main responsibilities, and using the principles of autonomy, beneficence, nonmaleficence, and justice can guide the nurse to making appropriate pain management decisions for and with these patients. Nursing implications and resources for more information are discussed.

  8. Nutritional status and food intake of Brazilian patients at various stages of Alzheimer’s disease: A crosssectional study

    Directory of Open Access Journals (Sweden)

    Vanessa Fernanda Goes

    2014-04-01

    Full Text Available Alzheimer’s disease (AD is characterized by disorders that can impair the nutrition of the patient and lead to weight loss and nutritional deficits during the course of the disease. The aim of this study was to assess the nutritional status and food intake of Brazilian patients with Alzheimer’s disease at 3 different stages of the disease. The sample consisted of 30 subjects of both genders, mean age 77 years, with probable AD. Subjects were assessed by collecting anthropometric data, the Mini Nutritional Assessment (MNA, serum albumin content, Mini Mental State Examination and 24-hour records of food and drink. Although a steady decrease in average weight was observed as the disease progressed (CDR1: 70.8±15.9 kg; CDR2: 61.4±15.7 kg; CDR3: 56.1± 8.4 kg, the differences were not significant. MNA and serum albumin both fell during the progression of the disease (p = 0.042; p = 0.047, respectively and, at the severe stage, half the patients were found to be undernourished and the other half at risk of undernutrition. According to their body mass index, 23.3% of patients were overweight. The nutritional value of the food consumed was similar across the stages of AD. In conclusion, the majority of Brazilian patients with AD in this study exhibited cognitive decline and malnutrition. However, food intake was similar among the stages of the disease, thus having no direct association with the progression of AD.

  9. Visual pathway abnormalities were found in most multiple sclerosis patients despite history of previous optic neuritis

    Directory of Open Access Journals (Sweden)

    Stella Maris Costa Castro

    2013-07-01

    Full Text Available Objective It was to investigate visual field (VF abnormalities in a group of multiple sclerosis (MS patients in the remission phase and the presence of magnetic resonance imaging (MRI lesions in the optic radiations. Methods VF was assessed in 60 participants (age range 20-51 years: 35 relapsing-remitting MS patients [20 optic neuritis (+, 15 optic neuritis (-] and 25 controls. MRI (3-Tesla was obtained in all patients. Results Visual parameters were abnormal in MS patients as compared to controls. The majority of VF defects were diffuse. All patients except one had posterior visual pathways lesions. No significant difference in lesion number, length and distribution was noted between patients with and without history of optic neuritis. One patient presented homonymous hemianopsia. Conclusion Posterior visual pathway abnormalities were found in most MS patients despite history of previous optic neuritis.

  10. Evaluation of computer-based medical histories taken by patients at home

    Science.gov (United States)

    Kowaloff, Hollis B; Davis, Roger B; Delbanco, Tom; Locke, Steven E; Safran, Charles; Bleich, Howard L

    2012-01-01

    The authors developed a computer-based general medical history to be taken by patients in their homes over the internet before their first visit with their primary care doctor, and asked six doctors and their participating patients to assess this history and its effect on their subsequent visit. Forty patients began the history; 32 completed the history and post-history assessment questionnaire and were for the most part positive in their assessment; and 23 continued on to complete their post-visit assessment questionnaire and were for the most part positive about the helpfulness of the history and its summary at the time of their visit with the doctor. The doctors in turn strongly favored the immediate, routine use of two modules of the history—the family and social histories—for all their new patients. The doctors suggested further that the summaries of the other modules of the history be revised and shortened to make it easier for them to focus on clinical issues in the order of their preference. PMID:22237866

  11. Opposite Cannabis-Cognition Associations in Psychotic Patients Depending on Family History

    Science.gov (United States)

    González-Pinto, Ana; González-Ortega, Itxaso; Alberich, Susana; Ruiz de Azúa, Sonia; Bernardo, Miguel; Bioque, Miquel; Cabrera, Bibiana; Corripio, Iluminada; Arango, Celso; Lobo, Antonio; Sánchez-Torres, Ana M.; Cuesta, Manuel J.

    2016-01-01

    The objective of this study is to investigate cognitive performance in a first-episode psychosis sample, when stratifying the interaction by cannabis use and familial or non-familial psychosis. Hierarchical-regression models were used to analyse this association in a sample of 268 first-episode psychosis patients and 237 controls. We found that cannabis use was associated with worse working memory, regardless of family history. However, cannabis use was clearly associated with worse cognitive performance in patients with no family history of psychosis, in cognitive domains including verbal memory, executive function and global cognitive index, whereas cannabis users with a family history of psychosis performed better in these domains. The main finding of the study is that there is an interaction between cannabis use and a family history of psychosis in the areas of verbal memory, executive function and global cognition: that is, cannabis use is associated with a better performance in patients with a family history of psychosis and a worse performance in those with no family history of psychosis. In order to confirm this hypothesis, future research should explore the actual expression of the endocannabinoid system in patients with and without a family history of psychosis. PMID:27513670

  12. Opposite Cannabis-Cognition Associations in Psychotic Patients Depending on Family History.

    Science.gov (United States)

    González-Pinto, Ana; González-Ortega, Itxaso; Alberich, Susana; Ruiz de Azúa, Sonia; Bernardo, Miguel; Bioque, Miquel; Cabrera, Bibiana; Corripio, Iluminada; Arango, Celso; Lobo, Antonio; Sánchez-Torres, Ana M; Cuesta, Manuel J

    2016-01-01

    The objective of this study is to investigate cognitive performance in a first-episode psychosis sample, when stratifying the interaction by cannabis use and familial or non-familial psychosis. Hierarchical-regression models were used to analyse this association in a sample of 268 first-episode psychosis patients and 237 controls. We found that cannabis use was associated with worse working memory, regardless of family history. However, cannabis use was clearly associated with worse cognitive performance in patients with no family history of psychosis, in cognitive domains including verbal memory, executive function and global cognitive index, whereas cannabis users with a family history of psychosis performed better in these domains. The main finding of the study is that there is an interaction between cannabis use and a family history of psychosis in the areas of verbal memory, executive function and global cognition: that is, cannabis use is associated with a better performance in patients with a family history of psychosis and a worse performance in those with no family history of psychosis. In order to confirm this hypothesis, future research should explore the actual expression of the endocannabinoid system in patients with and without a family history of psychosis. PMID:27513670

  13. Dietary history and nutritional state in treated coeliac patients.

    OpenAIRE

    Collins, B J; Bell, P M; Thomson, J M; Fee, D B; Wilson, E. A.; Love, A H

    1986-01-01

    The gluten content and nutritional adequacy of the diet of a group of adult coeliac patients supposedly following a gluten-free diet for at least one year were assessed. Results were considered in relation to the nutritional state of these patients, determined by anthropometric measurement, and the histological appearance of jejunal biopsies taken at the time of nutritional assessment. Imperfect gluten avoidance, mild malnutrition and mild histological abnormalities on jejunal biopsy were fre...

  14. Influence of metformin intake on the risk of bladder cancer in type 2 diabetes patients

    DEFF Research Database (Denmark)

    Goossens, Maria E; Buntinx, Frank; Zeegers, Maurice P;

    2015-01-01

    , SUs, insulin or more than one combination), all metformin users (1 + 2) was compared with SU only users using Cox proportional hazards models. The estimates were adjusted for age, gender, smoking status, BMI and diabetes duration. RESULTS: The inception cohort included 165,398 participants of whom 132...... users, even after adjustment for diabetes duration (HR = 1.13, 95% CI 0.90, 1.40). We found a pattern of decreasing risk of UBC with increasing duration of metformin intake, which was statistically not significant. CONCLUSION: Metformin has no influence on the risk of UBC compared with SU in type 2...

  15. The use of nationwide on-line prescription records improves the drug history in hospitalized patients

    DEFF Research Database (Denmark)

    Glintborg, Bente; Poulsen, Henrik E; Dalhoff, Kim P

    2008-01-01

    records through a real-time online electronic database What this study adds: Omission errors are frequent among hospitalized patients despite structured drug interviews and home visits. Pharmacy records may be used to minimize patients' recall bias and improve the medication lists.......What is already known about this subject: Structured medication interviews improve the medication history upon hospitalization. Pharmacy records are valid lists of the prescribed medications available to individual patients. In Denmark, treating doctors now have access to their patients' pharmacy...

  16. [What the patient's history tells us about their nonepileptic seizures].

    Science.gov (United States)

    Reuber, M; Micoulaud-Franchi, J-A; Gülich, E; Bartolomei, F; McGonigal, A

    2014-10-01

    The aetiology of "psychogenic" non-epileptic seizures (NES) remains poorly understood and the differentiation of NES from epilepsy can be a difficult. In the first part of this review article we focus on recent insights into the neurobiological underpinnings of NES. We summarise a number of studies demonstrating the importance of abnormalities of emotion regulation in patients with NES. Evidence for abnormal emotion regulation comes from both self-report and experimental studies of pre-conscious cognitive processes. These studies show that NES are not the only manifestation of abnormal mental processing in these patients and that excessive social threat avoidance and emotional dysregulation are also evident between seizures and may therefore contribute to disability beyond the seizures themselves. In the second part of this review, we describe the findings of a number of studies, which have examined differences between the communication behaviour of patients with NES and those with epilepsy. We argue, that, whilst these studies initially aimed to help clinicians with the differential diagnosis of NES and epilepsy, close sociolinguistic analysis of patient's talk can also provide clues about the aetiology of NES. We conclude that the interaction of patient with NES with the doctor can be interpreted as a manifestation of avoidance and a demonstration of helplessness perhaps intended to secure active support from the doctor. In the third part of this review, we suggest that a close reading of a transcript of the interaction between a patient with NES and her doctor (and perhaps attentive listening to how patients' talk about themselves and their disorder) can yield clues to the causes of NES in individual cases. PMID:25306078

  17. Ultimate treatment for a patient with severe traumatic brain injury without intake for 192 hours after Wenchuan massive earthquake

    Institute of Scientific and Technical Information of China (English)

    GU Jian-wen; ZHOU Hu-tian; YANG Tao; CHENG Jing-min; QU Yan; LI Cui-ying; LI Qing-jie; L(U) Ji-yun; CHENG Shou-long; LIU Jian-jun; KUANG Yong-qin; HUANG Hai-dong; YANG Li-bin; HE Wei-qi; ZHAO Kai; SONG Li-xin; ZHENG Xiao-dong; LIU Shu-xin; SUN Yan; HE Hong-lian; WU Jiang; LIU Xu-sheng; LU Min

    2009-01-01

    @@ At 14:28 (2:28 pm) on May 12, 2008, a magnitude 8 earthquake, which was a rare event, occurred in Sichuan Province of China and led to deaths of thousands of people. In the Longmen Mountain fault zone, which is located 40 miles from the earthquake center at Wenchuan, the Chinese military used a variety of treatment methods to rescue the injured and successfully treated a victim with severe traumatic brain injury (TBI) who survived without food or water intake for 192 hours. Two hundred and twenty-four hours after the earthquake, the patient underwent craniotomy and removal of an intracerebral hematoma. The injury to the patient was severe and the rescue time was the longest for this earthquake. Detailed information is provided in this report.

  18. Renal sympathetic denervation in patients with treatment-resistant hypertension after witnessed intake of medication before qualifying ambulatory blood pressure.

    Science.gov (United States)

    Fadl Elmula, Fadl Elmula Mohamed; Hoffmann, Pavel; Fossum, Eigil; Brekke, Magne; Gjønnæss, Eyvind; Hjørnholm, Ulla; Kjær, Vibeke N; Rostrup, Morten; Kjeldsen, Sverre E; Os, Ingrid; Stenehjem, Aud-E; Høieggen, Aud

    2013-09-01

    It is unknown whether the decline in blood pressure (BP) after renal denervation (RDN) is caused by denervation itself or concomitantly improved drug adherence. We aimed to investigate the BP lowering effect of RDN in true treatment-resistant hypertension by excluding patients with poor drug adherence. Patients with resistant hypertension (n=18) were referred for a thorough clinical and laboratory work-up. Treatment-resistant hypertension was defined as office systolic BP>140 mm Hg, despite maximally tolerated doses of ≥ 3 antihypertensive drugs, including a diuretic. In addition, ambulatory daytime systolic BP>135 mm Hg was required after witnessed intake of antihypertensive drugs to qualify. RDN (n=6) was performed with Symplicity Catheter System. The mean office and ambulatory BPs remained unchanged at 1, 3, and 6 months in the 6 patients, whereas there was no known change in antihypertensive medication. Two patients, however, had a fall in both office and ambulatory BPs. Our findings question whether BP falls in response to RDN in patients with true treatment-resistant hypertension. Additional research must aim to verify potential BP lowering effect and identify a priori responders to RDN before this invasive method can routinely be applied to patients with drug-resistant hypertension. Clinical Trial Registration- URL: http://www.clinicaltrials.gov. Unique identifier: NCT01673516.

  19. Intakes of Dietary Fiber, Vegetables, and Fruits and Incidence of Cardiovascular Disease in Japanese Patients With Type 2 Diabetes

    OpenAIRE

    Tanaka, Shiro; Yoshimura, Yukio; Kamada, Chiemi; Tanaka, Sachiko; Horikawa, Chika; Okumura, Ryota; ITO, Hideki; Ohashi, Yasuo; Akanuma, Yasuo; Yamada, Nobuhiro; Sone, Hirohito; ,

    2013-01-01

    OBJECTIVE Foods rich in fiber, such as vegetables and fruits, prevent cardiovascular disease (CVD) among healthy adults, but such data in patients with diabetes are sparse. We investigated this association in a cohort with type 2 diabetes aged 40–70 years whose HbA1c values were ≥ 6.5% in Japan Diabetes Society values. RESEARCH DESIGN AND METHODS In this cohort study, 1,414 patients were analyzed after exclusion of patients with history of CVDs and nonresponders to a dietary survey. Primary o...

  20. Improvement of regional cerebral blood flow after oral intake of branched-chain amino acids in patients with cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Mika Yamamoto; Motoh Iwasa; Kaname Matsumura; Yuri Nakagawa; Naoki Fujita; Yoshinao Kobayashi; Masahiko Kaito; Kan Takeda; Yukihiko Adachi

    2005-01-01

    AIM: To evaluate the effect of oral intake of branchedchain amino acids (BCAA) on brain perfusion in patients with liver cirrhosis.METHODS: Single photon emission computed tomography scans were performed in 43 patients with cirrhosis and in 15 age-matched healthy subjects.Twenty-nine out of forty-three patients were randomly treated with either BCAA granules or placebo, and single photon emission computed tomography was performed before and after the treatment. We measured the regional cerebral blood flow values using a threedimensional stereotaxic region of interest template.RESULTS: Cirrhotic patients had regions of significant hypoperfusion in the bilateral central (right P=0.039,P<0.05; left P = 0.006 P<0.01), parietal (right P=0.018, P<0.05;left P=0.009, P<0.01), angular (right P=0.039, P<0.05;left P = 0.008, P<0.01), and left pericallosal segments (P= 0.038 P<0.05) as compared with healthy subjects. A significant increase in cerebral perfusion was observed 70 min after the oral intake of BCAA in the angular (right P=0.012,P<0.05;left P=0.049, P<0.05), temporal (right P=0.012, P<0.05; left P=0.038, P<0.05), pericallosal segments (right P = 0.025,P<0.05; left P = 0.049, P<0.05) and left precentral (P=0.044, P<0.05), parietal (P=0.040, P<0.05) and thalamus (P=0.033, P<0.05). No significant change in perfusion was observed in the placebo group.CONCLUSION: Administration of BCAA rapidly improves cerebral perfusion.

  1. Family history, body mass index and survival in Japanese patients with stomach cancer: a prospective study.

    Science.gov (United States)

    Minami, Yuko; Kawai, Masaaki; Fujiya, Tsuneaki; Suzuki, Masaki; Noguchi, Tetsuya; Yamanami, Hideaki; Kakugawa, Yoichiro; Nishino, Yoshikazu

    2015-01-15

    Family history and nutritional status may affect the long-term prognosis of stomach cancer, but evidence is insufficient and inconsistent. To clarify the prognostic factors of stomach cancer, we conducted a prospective study of 1,033 Japanese patients with histologically confirmed stomach cancer who were admitted to a single hospital between 1997 and 2005. Family history of stomach cancer and pretreatment body mass index (BMI) were assessed using a self-administered questionnaire. Clinical data were retrieved from a hospital-based cancer registry. All patients were completely followed up until December, 2008. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated according to family history in parents and siblings and BMI category. During a median follow-up of 5.3 years, 403 all-cause and 279 stomach cancer deaths were documented. Although no association with family history was observed in the patients overall, analysis according to age group found an increased risk of all-cause death associated with a history in first degree relatives (HR = 1.61, 95% CI: 0.93-2.78, p = 0.09) and with a parental history (HR = 1.86, 95% CI: 1.06-3.26) among patients aged under 60 years at diagnosis. BMI was related to all-cause and stomach cancer death among patients aged 60 and over, showing a J-shaped pattern (HR of all-cause death = 2.28 for BMI stomach cancer, especially parental history, may affect mortality among younger stomach cancer patients, whereas nutritional status may be a prognostic factor in older patients.

  2. La influencia de la historia familiar de consumo de alcohol en hombres y mujeres The influence of family history on alcohol intake in males and females

    Directory of Open Access Journals (Sweden)

    Guillermina Natera-Rey

    2001-02-01

    Full Text Available OBJETIVO: Evaluar el riesgo para el uso excesivo de etanol en personas con historia familiar positiva de consumo de alcohol (HF+. MATERIAL Y MÉTODOS: Los datos corresponden a una muestra de población general (n= 8 890 y fueron recopilados a partir de una encuesta nacional de adicciones en población urbana de México, realizada en 1988. Se determinaron medidas epidemiológicas de frecuencia y asociación considerando los antecedentes de HF+ como factor de exposición. RESULTADOS: La prevalencia actual del consumo consuetudinario de alcohol fue de 13.7% para los hombres y 0.6% para las mujeres, las cifras para el síndrome de dependencia fueron 9.9% para hombres y 0.6% para las mujeres. Los hombres con HF+ tienen dos veces más probabilidad de desarrollar el síndrome de dependencia que aquellos con HF-. La razón de momios en el grupo de mujeres fue de 1.27. CONCLUSIONES: Se observaron patrones diferenciales por sexo en la transmisión de problemas de consumo. El consumo de los padres representa un factor de riesgo importante para el desarrollo del síndrome de dependencia de los hijos. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.htmlOBJETIVE: To assess the risk for alcohol abuse among individuals with a positive family history of alcohol abuse (FH+. MATERIAL AND METHODS: The study population was a sample (n=8 890 drawn from a 1988 national survey on addictions in Mexico City's urban population. Data analysis consisted of frequency and association measures, using family history of alcohol abuse as the exposure factor. RESULTS: Prevalence of heavy drinking was 13.7% for males and 0.6% for females. Alcohol dependence syndrome was found in 9.9% of males and 0.6% of females. Men with HF+ were twice more likely to develop dependence syndrome than HF- males. The odds ratio for women was 1.27. CONCLUSIONS: Differential patterns by gender were found for familial transmission of alcohol abuse

  3. Greater Calcium Intake is Associated with Better Bone Health Measured by Quantitative Ultrasound of the Phalanges in Pediatric Patients Treated with Anticonvulsant Drugs

    Directory of Open Access Journals (Sweden)

    Vicente Vera

    2015-12-01

    Full Text Available We aimed to investigate and compare the effects of chronic antiepileptic therapy on bone health in pediatric patients using quantitative ultrasound of the phalanges (QUS and controlling for potential confounding factors, particularly nutrient intake. The amplitude-dependent speed of sound (Ad-SoS was measured in 33 epileptic children and 32 healthy children aged 6.5 ± 3.1 and 6.3 ± 1.1 (mean ± SD years, respectively. There were no significant differences in the demographics such as age, weight and height between epileptic children and the control group children. None of the children in the epileptic or the treatment group were found to have a vitamin D deficiency. There were no significant differences in laboratory tests between groups. Lower QUS figures were found in the epileptic children (p = 0.001. After further adjustment for potential confounders such age, height, weight, calcium intake, vitamin D intake, physical activity and sex, the differences remained significant (p < 0.001. After further classification of the participants based on the tertile of calcium intake, no significant differences were found between patients and healthy controls in the greatest tertile of calcium intake (p = 0.217. We conclude that anticonvulsant therapy using valproate may lead to low bone mass in children and that an adequate intake of calcium might counteract such deleterious effects.

  4. Energy and protein intake and nutritional status in non-surgically treated patients with small cell anaplastic carcinoma of the lung

    Energy Technology Data Exchange (ETDEWEB)

    Enig, B.; Winther, E.; Hessov, I.

    The spontaneous food intake and nutritional status was assessed in 23 patients with small cell anaplastic carcinoma of the lung before and two times during a treatment period of 6 weeks. Radiation therapy was given for 2 weeks followed by a course of chemotherapy and another 2 weeks of radiation therapy. The energy intake decreased during the treatment from 146 to 130 per cent of basal metabolic rate. The protein intake remained unchanged (mean 0.9 g/kg body weight). There were insignificant and small losses of weight, body fat, free body mass and arm muscle circumference, and no changes were seen in serum albumin and serum transferrin. However, 6 patients suffered a weight loss of 5 per cent or more. No correlation existed between the nutritional parameters measured before treatment and the changes during treatment. Patients who suffered a loss of body weight could therefore not be singled out before the treatment.

  5. The association of functional oral intake and pneumonia in patients with severe traumatic brain injury

    DEFF Research Database (Denmark)

    Hansen, Trine Schow; Larsen, Klaus; Engberg, Aase Worså

    2008-01-01

    OBJECTIVES: To investigate the incidence and onset time of pneumonia for patients with severe traumatic brain injury (TBI) in the early phase of rehabilitation and to identify parameters associated with the risk of pneumonia. DESIGN: Observational retrospective cohort study. SETTING: Subacute...... rehabilitation department in a university hospital in Denmark. PARTICIPANTS: Patients (N=173) aged 16 to 65 years with severe TBI who were admitted during a 5-year period. Patients are transferred to the brain injury unit as soon as they ventilate spontaneously. INTERVENTIONS: Not applicable. MAIN OUTCOME...... MEASURE: Pneumonia. RESULTS: Twenty-seven percent of the patients admitted to the brain injury unit were in treatment for pneumonia; pneumonia developed in 12% of the patients during rehabilitation; the condition occurred within 19 days of admission in all but 1 patient. Of these patients, 81% received...

  6. Schizophrenia patients with a history of childhood trauma have a pro-inflammatory phenotype

    OpenAIRE

    Dennison, Una; McKernan, Declan P.; Cryan, John F; Dinan, Timothy G.

    2012-01-01

    Background. Increasing evidence indicates that childhood trauma is a risk factor for schizophrenia and patients with this syndrome have a pro-inflammatory phenotype. We tested the hypothesis that the pro-inflammatory phenotype in schizophrenia is associated with childhood trauma and that patients without a history of such trauma have a similar immune profile to healthy controls. Method. We recruited 40 schizophrenia patients and 40 controls, all of whom completed the Childhood Trauma ...

  7. BRCA1 status in Pakistani breast cancer patients with moderate family history

    International Nuclear Information System (INIS)

    Objective: To determine BRCA1 status in breast carcinoma patients of Pakistani origin. Study Design: Observational study. Place and Duration of Study: The Oncology Clinics of the Aga Khan University Hospital, Karachi, between May 2005 and December 2009. Methodology: Fifty three breast cancer patients based on clinical and laboratory diagnosis were recruited for this study. Moderate family history was defined as having a close relative (mother, daughter, sister) diagnosed with breast cancer under 45 years. Peripheral blood samples were collected from each patient in a 5 ml tube containing EDTA as anticoagulant. Subsequent to DNA extraction, mutational analysis of BRCA1 exons 2, 5, 6, 16, 20 and 22 was carried out using single strand conformation polymorphism (SSCP) assay while protein truncation test (PTT) was used to examine mutations in exon 11. All BRCA1 sequence variants were confirmed by DNA sequencing. Results: Twenty-three patients were diagnosed with early onset breast cancer, 30 patients had moderate family history. At the time of diagnosis, the median age of enrolled patients was 39 years (range 24-65 years). Out of 53 patients, analyzed by SSCP assay, mobility shift was detected in exon 6, 16 and 20 of three patients, whereas one patient was tested positive for mutation in exon 11 by PTT assays. All patients with BRCA1 mutations were further confirmed by DNA sequencing analysis. In exon 16 c.4837A > G was confirmed, which is a common polymorphism reported in several populations including Asians. Moreover, mutations in exon 6 (c.271T > G), exon 20 (c.5231 del G) and exon 11 (c.1123 T > G) were reported first time in the Pakistani population. Several BRCA1 mutations were observed in Pakistani breast cancer patients with moderate family history. Therefore, mutation-based genetic counselling for patients with moderate family history can facilitate management, if one first or second degree relative or early onset disease is apparent. (author)

  8. Finding the right balance: an evaluation of the adequacy of energy and protein intake in childhood cancer patients

    NARCIS (Netherlands)

    Brinksma, Aeltsje; Roodbol, Petrie F.; Sulkers, Esther; Bont, Eveline S.J.M. de; Burgerhof, Johannes G.M.; Tamminga, Rienk Y.J.; Jager-Wittenaar, Harriet; Tissing, Wim J.E.

    2014-01-01

    Background & aims: Despite a widespread belief that adequate dietary intake is needed to maintain weight during childhood cancer treatment, conclusive data about adequacy of intake are lacking. Therefore, we aimed to assess the adequacy of energy and protein intake in a heterogeneous childhood cance

  9. Finding the right balance : An evaluation of the adequacy of energy and protein intake in childhood cancer patients

    NARCIS (Netherlands)

    Brinksma, Aeltsje; Roodbol, Petrie F; Sulkers, Esther; de Bont, Eveline S J M; Burgerhof, Johannes G M; Tamminga, Rienk Y J; Jager-Wittenaar, Harriët; Tissing, Wim J E

    2015-01-01

    Background & aims: Despite a widespread belief that adequate dietary intake is needed to maintain weight during childhood cancer treatment, conclusive data about adequacy of intake are lacking. Therefore, we aimed to assess the adequacy of energy and protein intake in a heterogeneous childhood cance

  10. Central venous stenosis in haemodialysis patients without a previous history of catheter placement

    Energy Technology Data Exchange (ETDEWEB)

    Oguzkurt, Levent [Baskent University, Adana Teaching and Medical Research Centre, Department of Radiology, Adana (Turkey)]. E-mail: loguzkurt@yahoo.com; Tercan, Fahri [Baskent University, Adana Teaching and Medical Research Centre, Department of Radiology, Adana (Turkey); Yildirim, Sedat [Baskent University, Adana Teaching and Medical Research Centre, Department of Surgery, Adana (Turkey); Torun, Dilek [Baskent University, Adana Teaching and Medical Research Centre, Department of Nephrology, Adana (Turkey)

    2005-08-01

    Objective: To evaluate dialysis history, imaging findings and outcome of endovascular treatment in six patients with central venous stenosis without a history of previous catheter placement. Material and methods: Between April 2000 and June 2004, six (10%) of 57 haemodialysis patients had stenosis of a central vein without a previous central catheter placement. Venography findings and outcome of endovascular treatment in these six patients were retrospectively evaluated. Patients were three women (50%) and three men aged 32-60 years (mean age: 45 years) and all had massive arm swelling as the main complaint. The vascular accesses were located at the elbow in five patients and at the wrist in one patient. Results: Three patients had stenosis of the left subclavian vein and three patients had stenosis of the left brachiocephalic vein. The mean duration of the vascular accesses from the time of creation was 25.1 months. Flow volumes of the vascular access were very high in four patients who had flow volume measurement. The mean flow volume was 2347 ml/min. One of three patients with brachiocephalic vein stenosis had compression of the vein by the brachiocephalic artery. All the lesions were first treated with balloon angioplasty and two patients required stent placement on long term. Number of interventions ranged from 1 to 4 (mean: 2.1). Symptoms resolved in five patients and improved in one patient who had a stent placed in the left BCV. Conclusion: Central venous stenosis in haemodialysis patients without a history of central venous catheterization tends to occur or be manifested in patients with a proximal permanent vascular access with high flow rates. Balloon angioplasty with or without stent placement offers good secondary patency rates in mid-term.

  11. Beneficial effects of citrus juice fermented with Lactobacillus plantarum YIT 0132 on atopic dermatitis: results of daily intake by adult patients in two open trials.

    Science.gov (United States)

    Harima-Mizusawa, Naomi; Kamachi, Keiko; Kano, Mitsuyoshi; Nozaki, Daisuke; Uetake, Tatsuo; Yokomizo, Yuji; Nagino, Takayuki; Tanaka, Akira; Miyazaki, Kouji; Nakamura, Shinichiro

    2016-01-01

    This study aimed to examine whether daily intake of citrus juice containing heat-killed Lactobacillus plantarum YIT 0132 (LP0132-fermented juice) alleviates symptoms of atopic dermatitis. This was a natural extension of our previous study in which LP0132 was shown to enhance IL-10 production in vitro and LP0132-fermented juice was found to alleviate symptoms and enhance quality of life (QOL) in patients with Japanese cedar pollinosis. In two open trials, Trial 1 and Trial 2, 32 and 18 adult patients with mild to moderate atopic dermatitis consumed LP0132-fermented juice for 8 weeks. Skin conditions and QOL were subjectively evaluated using Skindex-16 before intake of the juice (Pre-treatment), 8 weeks after starting intake (Treatment) and 8 weeks after termination of intake (Post-treatment). Blood parameters were also analyzed. Comparison of the Treatment and Post-treatment time points with the Pre-treatment time point revealed significant reductions in the Skindex-16 overall score and the 3 domain subscores (symptoms, emotions, and functioning domains) in both trials. Moreover, blood levels of eosinophil cationic protein (ECP), total immunoglobulin E (IgE) and specific IgEs for Japanese cedar and cypress pollen were significantly attenuated in Trial 2. The findings suggest that daily intake of citrus fermented juice containing heat-killed LP0132 has beneficial effects on symptoms and QOL in patients with mild to moderate atopic dermatitis due to an immunomodulatory effect via attenuation of IgE and ECP. PMID:26858928

  12. Hysteroscopic Findings in Patients with A History of Two Implantation Failures Following In Vitro Fertilization

    Directory of Open Access Journals (Sweden)

    Ashraf Moini

    2012-01-01

    Full Text Available Background: This study was designed to evaluate the incidence of uterine pathologiesin infertile women with a history of two implantation failures after in vitro fertilization(IVF and estimate the effect of hysteroscopic correction on achieving a pregnancy inthese patients.Materials and Methods: The retrospective study population included 238 infertilewomen attended the outpatient infertility clinic between November 2007 and December2008. Patients with at least two previous IVF failures were eligible for this study.All patients had normal findings on hysterosalpingography performed prior their firstattempt for IVF. Standard transvaginal ultrasonography and diagnostic hysteroscopywere performed in patients before the subsequent IVF attempt.Results: Out of 238 patients with previous IVF failure who underwent hysteroscopicevaluation, 158 patients (66.4% showed normal uterine cavity. Abnormal cavity wasfound in 80 patients (33.6%. We found polyp as the most common abnormality (19.7%in the patients with previous history of IVF failure. The pregnancy rate was similar betweenIVF failure patients who treated by hysteroscopy for a detected uterine abnormality(24.6% and similar patients with normal uterine cavity (21.2% in hysteroscopicexaminations.Conclusion: The intrauterine lesions diagnosed by hysteroscopy in patients with previousIVF failure ranges from 0.8%-19.7%. Correction of abnormalities such as myoma and polypshowed good outcome, similar to that achieved in patients with a normal hysteroscopy.

  13. Influence of oral health condition on swallowing and oral intake level for patients affected by chronic stroke

    Directory of Open Access Journals (Sweden)

    Mituuti CT

    2014-12-01

    Full Text Available Cláudia T Mituuti,1 Vinicius C Bianco,2 Cláudia G Bentim,3 Eduardo C de Andrade,1 José H Rubo,2 Giédre Berretin-Felix1 1Speech Language and Hearing Department, 2Department of Prosthodontics, Bauru School of Dentistry/University of São Paulo, Bauru, Brazil; 3SORRI-BAURU, Bauru, Brazil Background: According to the literature, the occurrence of dysphagia is high in cases of stroke, and its severity can be enhanced by loss of teeth and the use of poorly fitting prostheses.Objective: To verify that the status of oral health influences the level of oral intake and the degree of swallowing dysfunction in elderly patients with stroke in chronic phase.Methods: Thirty elderly individuals affected by stroke in chronic phase participated. All subjects underwent assessment of their oral condition, with classification from the Functional Oral Intake Scale (FOIS and nasoendoscopic swallowing assessment to classify the degree of dysphagia. The statistical analysis examined a heterogeneous group (HG, n=30 and two groups designated by the affected body part, right (RHG, n=8 and left (LHG, n=11, excluding totally dentate or edentulous individuals without rehabilitation with more than one episode of stroke.Results: There was a negative correlation between the need for replacement prostheses and the FOIS scale for the HG (P=0.02 and RHG (P=0.01. Differences in FOIS between types of prostheses of the upper dental arch in the LHG (P=0.01 and lower dental arch in the RHG (P=0.04. A negative correlation was found between the number of teeth present and the degree of dysfunction in swallowing liquid in the LHG (P=0.05. There were differences in the performance in swallowing solids between individuals without prosthesis and those with partial prosthesis in the inferior dental arch (P=0.04 for the HG.Conclusion: The need for replacement prostheses, type of prostheses, and the number of teeth of elderly patients poststroke in chronic phase showed an association with

  14. Results of Atrial Fibrillation Ablation in Patients With or Without a History of Atrial Flutter

    Institute of Scientific and Technical Information of China (English)

    Lu chunshan; Liu Xingpeng; Dong Jianzeng; Ma Changsheng

    2006-01-01

    Objectives There are two kind of atrial flutter during circumferential ablation for atrial fibrillation (AF): new onset left atrial flutter (LAFL), with a history of atrial flutter (AFL). What is the relationship of AFL and AF? Whether there are some differences in clinical course and mechanism between the new onset LAFL and the with a history of AFL remained unclear. The aim of this study was to assess the impacts of circumferential ablation on the occurrence of arrhythmias in follow-up in 2 groups:( 1 ) patients with a history of AFL and AF, and (2)patients with new onset LAFL. Methods Data from 465 patients who had circumferential pulmonary vein ablation (CPVA) or segmental pulmonary vein ablation (SPVA) were analyzed. Patients with a history of AFL ablation and patients who had concomitant AFL ablation were included from analysis. Forty-one patients constituted the history of AFL group (group 1, aged 57±13 years, 7 females) and twenty-eight patients constituted the new onset LAFL group (group 2, aged 55±12 years, 6 females). bipolar recordings were obtained from the tricuspid annulus, coronary sinus,interatrial septum and left atrium. Target sites were identified by early, fragmented or double potentials and by concealed entrainment. Linear lesions were created between target sites and nearby anatomical barriers (1) typical atrial flutter (cycle length, 242±39 ms). cavotricuspid isthmus ablation was performed.(2) new onset LAFL (cycle length, 282±153 ms). 20 episodes of AAFs were documented in 20/28 (71.4%)patients. Target sites were identified around pulmonary veins (n=10), gap in linear lesion (n=7), left atrial roof lines (1 case). For those cases the ablation line between PV and mitral annulus was performed.Patients in Group 2 had larger left atria, higher incidence of AFL pre-CPVA, and lower ejection fraction. Results There was no significant difference in post-CPVA AF recurrence between Groups 1 and 2, but AFL incidence after CPVA was higher in Group

  15. A study on first intake assessments of in-patient referrals to psychiatric rehabilitation services

    Directory of Open Access Journals (Sweden)

    Geetha Desai

    2014-01-01

    Full Text Available Background: Psychiatric rehabilitation is an important component in mental health services. The rehabilitation needs of patients with mental illness have been highlighted in various studies. The studies on in-patient referrals to rehabilitation services however are sparse. This study describes the clinical and demographic details and the reasons for referrals to rehabilitation services during the in-patients stay. Materials and Methods: A semi-structured pro forma was used for the assessment of in-patients referred for the psychiatric rehabilitation services. The pro forma included socio-demographic details such as background, family resources, illness related details such as symptom status, risk assessment, medication details. The total number of referrals for a period of 5 months was collected and coded. Results: The total number of referrals for a period of 5 months was 216 and there were 197 forms available for the study. The mean age of the sample was 31.48 ± 10.46 years. Vocational rehabilitation was the commonest reason for referral to the in-patient services. Severe mental disorders were the most common diagnosis of patients refereed to the services. Conclusions: Patients with severe mental illness were most often referred to the in-patient services. This indicates that we need include to rehabilitation in the management plan at the earliest. Vocational rehabilitation is the most common reason for referrals and there is a need to develop services to cater to these needs.

  16. A Better Diet Quality is Attributable to Adequate Energy Intake in Hemodialysis Patients

    OpenAIRE

    Kim, Hyerang; Lim, Hyunjung; Choue, Ryowon

    2015-01-01

    Poor diet quality is one of strong predictors of subsequent increased mortality in hemodialysis patients. To determine diet quality and to define major problems contributing to poor diet quality in hemodialysis patients, a cross-sectional study was conducted between June 2009 and October 2010. Sixty-three hemodialysis patients (31 men, 32 women; aged 55.3 ± 11.9 years) in stable condition were recruited from the Artificial Kidney Center in Kyung Hee University, Seoul, Korea. Three-day diet re...

  17. Dietary intake of nutrients and its correlation with fatigue in multiple sclerosis patients

    OpenAIRE

    Sama Bitarafan; Mohammad-Hossein Harirchian; Shahriar Nafissi; Mohammad-Ali Sahraian; Mansoureh Togha; Fereydoun Siassi; Ahmad Saedisomeolia; Elham Alipour; Nakisa Mohammadpour; Maryam Chamary; Niyaz Mohammadzadeh Honarvar; Ali-Akbar Saboor-Yaraghi

    2014-01-01

    Background The role of nutrition in the progression of multiple sclerosis (MS) and related complications such as fatigue has been reported by several studies. The aim of this study is the assessment of nutritional status and its relationship with fatigue in multiple sclerosis patients. Methods This is a cross-sectional study, in which 101 relapsing-remitting MS patients were enrolled. The fatigue status was determined using the validated Persian version of of the Modified Fatigue Impact Scale...

  18. ASSOCIATION OF CAFFEINE INTAKE AND LIVER FIBROSIS IN PATIENTS WITH CHRONIC HEPATITIS C

    Directory of Open Access Journals (Sweden)

    Kalinca da Silva OLIVEIRA

    2015-03-01

    Full Text Available Background Caffeine consumption has been associated to decreased levels of liver enzymes and lower risk of fibrosis in patients with hepatitis C virus. Objectives This study aimed to evaluate the association between caffeine consumption and inflammatory activity or degree of liver fibrosis in patients with hepatitis C virus infection. Methods A cross-sectional study of patients with chronic hepatitis C virus infection treated in an outpatient Gastroenterology Unit of Santa Casa Hospital (Porto Alegre - Brasil. Patients were interviewed regarding the consumption of caffeine and anthropometric assessment was performed. Liver biopsy was performed in a maximum period of 36 months before inclusion in the study Results There were 113 patients, 67 (59.3% females, 48 (42.5% were aged between 52 and 62 years, and 101 (89.4% were white. The average caffeine consumption was 251.41 ± 232.32 mg/day, and 70 (62% patients consumed up to 250 mg/day of caffeine. There was no association between caffeine consumption and inflammatory activity on liver biopsy. On the other hand, when evaluating the caffeine consumption liver fibrosis an inverse association was observed. Conclusions The greater consumption of caffeine was associated with lower liver fibrosis. There was no association between caffeine consumption and inflammatory activity.

  19. Surgical History of Sleep Apnea in Pediatric Patients with Chiari Type 1 Malformation.

    Science.gov (United States)

    Pomeraniec, Isaac Jonathan; Ksendzovsky, Alexander; Yu, Pearl L; Jane, John A

    2015-10-01

    Sleep apnea represents a relative indication for posterior fossa decompression in pediatric patients with Chiari malformation type 1. Duraplasty was associated with improvement of sleep apnea in 100% of patients and dural splitting with improvement in 50% of patients. Duraplasty and dural splitting were associated with a similar reduction in tonsillar herniation on radiographic imaging of 58% (37% excluding tonsillectomy) and 35%, respectively. Longitudinal follow-up studies of patients with either neurologic deficits or severe symptoms will further elucidate the natural history of Chiari malformation type 1 and more appropriately gauge the risk-benefit tradeoff of surgical intervention.

  20. Approaches to the History of Patients: From the Ancient World to Early Modern Europe.

    Science.gov (United States)

    Stolberg, Michael

    2016-01-01

    This chapter looks from an early modernist's perspective at some of the major questions and methodological issues that writing the history of patients in the ancient world shares with similar work on Patientengeschichte in medieval and early modern Europe. It addresses, in particular, the problem of finding adequate sources that give access to the patients' experience of illness and medicine and highlights the potential as well as the limitations of using physicians' case histories for that purpose. It discusses the doctor-patient relationship as it emerges from these sources, and the impact of the patient's point of view on learned medical theory and practice. In conclusion, it pleads for a cautious and nuanced approach to the controversial issue of retrospective diagnosis, recommending that historians consistently ask in which contexts and in what way the application of modern diagnostic labels to pre-modern accounts of illness can truly contribute to a better historical understanding rather than distort it.

  1. A prospective study on weight loss and energy intake in patients with head and neck cancer, during diagnosis, treatment and revalidation.

    NARCIS (Netherlands)

    Berg, M.G. van den; Rasmussen-Conrad, E.L.; Gwasara, G.M.; Krabbe, P.F.M.; Naber, A.H.J.; Merkx, M.A.W.

    2006-01-01

    BACKGROUND & AIMS: Patients with head and neck carcinomas often loose a significant percentage of weight, which correlates with the complication rate. Only limited information is available on the moment and extent of weight loss and energy intake in time and the relation with type of treatment. The

  2. A prospective study on weight loss and energy intake in patients with head and neck cancer, during diagnosis, treatment and revalidation

    NARCIS (Netherlands)

    van den Berg, M G A; Rasmussen-Conrad, E L; Gwasara, G M; Krabbe, P F M; Naber, A.H.J.; Merkx, M A

    2006-01-01

    BACKGROUND & AIMS: Patients with head and neck carcinomas often loose a significant percentage of weight, which correlates with the complication rate. Only limited information is available on the moment and extent of weight loss and energy intake in time and the relation with type of treatment. The

  3. The relationship between vegetables and fruits intake and glycosylated hemoglobin values, lipids profiles and nitrogen status in type II inactive diabetic patients

    Directory of Open Access Journals (Sweden)

    Marjan Tabesh

    2013-01-01

    Conclusions : Intake of vegetables and fruits may reduce the glycosylated hemoglobin, therefore choosing the appropriate diet with high fruits and vegetables may help to develop antioxidant defense and reduce the HbA1C in diabetic patients but it did not have any impact on lipids profiles, BUN/creatinine and urine protein 24 h.

  4. Patients undergoing elective coronary artery bypass grafting exhibit poor pre-operative intakes of fruit, vegetables, dietary fibre, fish and vitamin D

    NARCIS (Netherlands)

    Ruiz-Nunez, B.; van den Hurk, G. H. A. M.; de Vries, J. H. M.; Mariani, M. A.; de Jongste, M. J. L.; Dijck-Brouwer, D. A. J.; Muskiet, F. A. J.

    2015-01-01

    CHD may ensue from chronic systemic low-grade inflammation. Diet is a modifiable risk factor for both, and its optimisation may reduce post-operative mortality, atrial fibrillation and cognitive decline. In the present study, we investigated the usual dietary intakes of patients undergoing elective

  5. Asymmetrical F-18 Flurorodeoxyglucose uptake in the breasts: A dilemma solved by patient history

    Science.gov (United States)

    Gupta, Ravi Kant; Tripathi, Madhavi; Sahoo, Manas Kumar; Nazar, Aftab Hasan; Agarwal, Krishankant; Kumar, Kunal; Damle, Nishikant; Bal, Chandrasekhar

    2016-01-01

    The present case highlights the importance of history taking in solving the dilemmas of variant F-18 FDG uptake on PET/CT. Asymmetrically increased, abnormal looking, FDG uptake in the right breast of our patient was related to her breast feeding practice. Because of personal preference the patient suckled her child from the right breast only. This resulted in asymmetry of size, increase in glandular breast parenchyma and FDG uptake in the breast that was suckled. PMID:26917909

  6. Preparing patients to travel abroad safely. Part 1: Taking a travel history and identifying special risks.

    OpenAIRE

    Thomas, R E

    2000-01-01

    OBJECTIVE: To present for family physicians without access to a travel clinic and the Internet the questions to ask about the medical history and itinerary of their patients traveling abroad. To suggest ways to identify and advise high-risk patients. QUALITY OF EVIDENCE: MEDLINE searches from 1990 to November 1998 located 51 articles on travel and diabetes, 37 on travel and chronic obstructive pulmonary disease (COPD), 63 on travel and heart disease, 192 on travel and pregnancy, and 298 on tr...

  7. Emergency anaesthetic management of a severely anaemic, chronic schizophrenic patient with history of neuroleptic malignant syndrome

    Directory of Open Access Journals (Sweden)

    Shrividya Chellam

    2011-01-01

    Full Text Available Administering anaesthesia to a patient with chronic schizophrenia is a challenge due to the increased risk of various perioperative complications. Neuroleptic agents are highly effective drugs used for the treatment of psychiatric disorders, but are rarely associated with neuroleptic malignant syndrome (NMS. Here, we describe the successful anaesthetic management of a patient of chronic schizophrenia with past history of NMS who presented in emergency with active bleeding per rectum and haemoglobin of 3 gm%.

  8. Protein intake during hemodialysis maintains a positive whole body protein balance in chronic hemodialysis patients

    NARCIS (Netherlands)

    Veeneman, JM; Kingma, HA; Boer, TS; Stellaard, F; De Jong, PE; Reijngoud, DJ; Huisman, RM

    2003-01-01

    Protein energy malnutrition is present in 18 to 56% of hemodialysis patients. Because hemodialysis has been regarded as a catabolic event, we studied whether consumption of a protein- and energy-nriched meal improves the whole body protein balance during dialysis in chronic hemodialysis (CHD) patien

  9. The importance of family history in young patients with endometrial cancer

    NARCIS (Netherlands)

    Berends, MJW; Kleibeuker, JH; de Vries, EGE; Mourits, MJE; Hollema, H; Pras, E; van der Zee, AGJ

    1999-01-01

    Endometrial cancer occurs primarily in postmenopausal women older than 60 years of age. Especially in young patients with endometrial cancer, a positive family history with respect to cancer and/or development of synchronous or metachronous tumors can be indicative of hereditary factors. One generic

  10. Pyridoxin-responsive anaemia in a patient with a history of polycythaemia vera

    NARCIS (Netherlands)

    vanGameren, [No Value; Wijnja, L; Louwes, H; deWolf, JTM

    1997-01-01

    Pancytopenia in the course of polycythaemia vera (PV) following the proliferative and stable phase, ultimately leads to a spent phase characterized by extensive marrow fibrosis. We describe a patient with a history of PV and pancytopenia caused by myelodysplasia, before a genuine end stage myelofibr

  11. Predicting utility of exercise tests based on history/holter in patients with premature ventricular contractions.

    Science.gov (United States)

    Robinson, Brad; Xie, Li; Temple, Joel; Octavio, Jenna; Srayyih, Maytham; Thacker, Deepika; Kharouf, Rami; Davies, Ryan; Gidding, Samuel S

    2015-01-01

    Premature ventricular contractions (PVCs) are considered benign in patients with structurally normal hearts, particularly if they suppress with exercise. Catecholaminergic polymorphic ventricular tachycardia (CPVT) requires exercise testing to unmask the malignant phenotype. We studied risk factors and Holter monitor variables to help predict the necessity of exercise testing in patients with PVCs. We retrospectively reviewed 81 patients with PVCs that suppressed at peak exercise and structurally normal hearts referred to the exercise laboratory in 2011. We reviewed 11 patients from 2003 to 2012 whose PVCs were augmented at peak exercise (mean age 13 ± 4 years; 52 % male, 180 exercise studies). We recorded clinical risk factors and comorbidities (family history of arrhythmia or sudden unexpected death [SUD], presence of syncope) and Holter testing parameters. Family history of VT or SUD (P = 0.011) and presence of VT on Holter (P = 0.011) were significant in predicting failure of PVCs to suppress at peak heart rate on exercise testing. Syncope was not statistically significant in predicting suppression (P = 0.18); however, CPVT was diagnosed in four patients with syncope during exercise. Quantity of PVCs, Lown grade, couplets on Holter, monomorphism, and PVC elimination at peak heart rate on Holter were not predictors of PVC suppression on exercise testing. Patients with syncope during exercise, family history of arrhythmia or SUD, or a Holter monitor showing VT warrant exercise testing to assess for CPVT.

  12. The Value of the History and Physical for Patients with Newly Diagnosed Brain Metastases Considering Radiosurgery

    Directory of Open Access Journals (Sweden)

    Ima ePaydar

    2016-03-01

    Full Text Available Background: For patients with brain metastases, systemic disease burden has historically been accepted as a major determinant of overall survival (OS. However, less research has focused on specific history and physical findings made by clinicians and how such findings pertain to patient outcomes at a given time point. The aim of this study is to determine how the initial clinical assessment of patients with brain metastases, as part of the history and physical at the time of consultation, correlates with patient prognosis.Methods: We evaluated a prospective, multi-institutional database of 1523 brain metastases in 507 patients who were treated with radiosurgery (Gamma Knife or CyberKnife from 2001-2014. Relevant history of present illness (HPI and past medical history (PMH variables included comorbidities, Eastern Cooperative Oncology Group (ECOG performance status, and seizure history. Physical exam findings included a sensory exam, motor exam, and cognitive function. Univariate and multivariate Cox regression analyses were used to identify predictors of OS.Results: 294 patients were included in the final analysis with a median OS of 10.8 months (95% C.I., 7.8-13.7 months. On univariate analysis, significant HPI predictors of OS included age, primary diagnosis, performance status, extracranial metastases, systemic disease status, and history of surgery. Significant predictors of OS from the PMH included cardiac, vascular, and infectious comorbidities. On a physical exam, findings consistent with cognitive deficits were predictive of worse OS. However, motor deficits or changes in vision were not predictive of worse OS. In the multivariate Cox regression analysis, predictors of worse OS were primary diagnosis (p=0.002, ECOG performance status (OR 1.73, p<0.001, and presence of extracranial metastases (OR 1.22, p=0.009.Conclusion: Neurologic deficits and systemic comorbidities noted at presentation are not associated with worse overall prognosis

  13. The single intake of levodopa modulates implicit learning in drug naïve, de novo patients with idiopathic Parkinson's disease.

    Science.gov (United States)

    Geffe, Sarah; Schindlbeck, Katharina A; Mehl, Arne; Jende, Johann; Klostermann, Fabian; Marzinzik, Frank

    2016-06-01

    Although dopamine is known to aggravate implicit learning, the exact impact on behaviour when feedback is unavailable remains unclear. Previous studies revealed that non-rewarded learning habits are affected in long-term dopaminergic treated patients with Parkinson's disease (PD). We studied the influence of a onetime levodopa intake on implicit learning in de novo, untreated PD patients. De novo PD patients (n = 22) before and after the single intake of levodopa and control subjects (n = 23) took part in a Go/NoGo paradigm. One stimulus was defined as target, which was first consistently preceded by one of three non-target stimuli (conditioning). This coupling was dissolved thereafter (deconditioning). In the 'Go version' subjects were asked to respond to the target by pressing a key, whereas in the 'NoGo version' response had to be inhibited. PD patients and controls (n = 14/n = 19) with an initial learning effect due to the target were included for further statistical analysis. Within the subgroup incorrect responses upon NoGo stimuli increased during the deconditioning phase. In contrast, the same patients failed to show any change after receiving 200 mg of levodopa. During the Go version, no change of the overall error rate between conditioning and deconditioning was detectable over all groups. Learning behaviour in untreated PD patients and healthy controls was indistinguishable. In contrast, the same patients varied in their implicit learning after one-time intake of levodopa, when actions had to be inhibited. Hence, the single intake of levodopa appears to modulate implicit learning behaviour in de novo PD patients. PMID:27106907

  14. Season of birth of breast cancer patients and its relation to patients' reproductive history in Tokyo, Japan.

    Directory of Open Access Journals (Sweden)

    Nakao,Hiroko

    1988-08-01

    Full Text Available Seasonal distribution of the birth dates of 405 pre-menopausal and 285 post-menopausal breast cancer patients was investigated in order to determine whether or not the season of their birth was related to various reproductive risk factors of breast cancer, including nulliparity, late age at first birth, early age at menarche, late age at menopause, and a history of benign breast diseases. The seasonal distributions of births were compared between groups of patients categorized according to whether they possessed each risk factor or not, separately for pre- and post-menopausal patients. Patients with the same menopausal status generally had the same seasonal distribution of births, irrespective of whether or not they possessed a risk factor. Moreover, low-risk patients exhibited more deviation in the seasonal distribution of birth from general births than the high-risk patients. These results suggest that the distinctive seasonal distribution of birth observed in breast cancer patients is basically a phenomenon independent from the effect of the reproductive history on the occurrence of breast cancer, and that specific seasonal factors are involved at the fetal or neonatal stage in the etiology of breast cancer.

  15. Characteristics of tuberculosis patients at intake in Cambodia, two provinces in China, and Viet Nam

    Directory of Open Access Journals (Sweden)

    Lauritsen Jens M

    2011-05-01

    Full Text Available Abstract Background The tuberculosis register is a critical data source for the information system of national tuberculosis control programs. From the information in the tuberculosis case register, it is possible to extend the standard analysis of age and sex characteristics among sputum smear-positive cases to all tuberculosis case categories. National tuberculosis programs might utilize such information to identify problems related to referral and access to diagnosis and treatment. Objectives Based on the electronic database we created, our objectives were to provide a detailed description of age and sex characteristics of tuberculosis patients at registration and to provide a comparison of age-specific sex characteristics among incident and prevalent sputum smear-positive cases. Methods A representative sample of tuberculosis case registers from 1 January 2003 to 31 December 2005 was selected in Cambodia, two provinces in China and Viet Nam. Age and sex characteristics of cases in the three separate prevalence surveys in the three jurisdictions (Cambodia: year 2002; China: year 2000; and Viet Nam: year 2006-2007 were obtained for comparison. Results A total 37,635 patients had been registered during the period in the selected units in the three countries. Cases were more frequently male in all three countries with 53%, 71%, and 69% in Cambodia, China, and Viet Nam, respectively. The ratios of the female-to-male odds in the notification system to that in the prevalence survey in smear-positive cases in Cambodia, China and Viet Nam were 2.1, 0.9, and 1.8, respectively. Because of the small proportion of extrapulmonary tuberculosis registered in China, we limited the analysis on age and sex distribution for extrapulmonary cases to Cambodia and Viet Nam. The proportion with extrapulmonary tuberculosis among all cases was 18.5% in Cambodia and 15.7% in Viet Nam, decreasing in frequency with increasing age. Conclusions Characteristics of patients

  16. Estimation of milk, dairy products and calcium intake in nutrition of the celiac patients

    OpenAIRE

    Ines Panjkota Krbavčić; Martina Sučić

    2007-01-01

    Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate a protein called gluten, which is found in wheat, rye, barley and possibly oats. The smallest amount of gluten in food damages the small intestine of these patients. In Croatia there is no data about nutrition and dietary habits of people with celiac disease. In celiac disease there is one and only cure: a gluten-free diet...

  17. The prevalence and impact of trauma history in eating disorder patients

    Directory of Open Access Journals (Sweden)

    Klas Backholm

    2013-11-01

    Full Text Available Background: Early experiences of traumatic events (TEs may be associated with subsequent eating disturbance. However, few studies have investigated overall exposure and trauma-type frequency in various types of eating disorders (EDs. Objective: This study aimed to investigate the prevalence and type of TEs in a nationally representative sample of Swedish ED patients. Method: Data from a database (Stepwise for specialized ED care were used. Trauma history was assessed as a part of the routine, initial assessment. Participants over the age of 18 with a diagnosed DSM-IV ED were included (N=4,524. Results: The number of patients having experienced at least one TE was 843 (18.6%, and 204 (24.2% reported at least one additional trauma. Sexual trauma was the most common form of TE (6.3%. There was no difference in overall traumatic exposure or in type of experienced trauma between the ED diagnostic subgroups (AN, BN, EDNOS, and BED. Overall traumatic exposure was linked to self-reported severity of ED symptoms, more secondary psychosocial impairment, psychiatric comorbidity, and negative self-image. Conclusions: Trauma history in ED patients merits attention. Results are partly in line with and partly in contrast to previous research. Measurement of trauma history has varied substantially in research on EDs, and this study adds to the indistinct literature on trauma history in ED.

  18. Ingestão alimentar em pacientes com doença inflamatória intestinal Food intake in patients with inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Alice Freitas da Silva

    2011-09-01

    Full Text Available RACIONAL: Pacientes com doença inflamatória intestinal podem apresentar deficiências nutricionais. OBJETIVO: Verificar a adequação da ingestão alimentar de pacientes com doença de Crohn e retocolite ulcerativa inespecífica. MÉTODOS: Para avaliação da ingestão alimentar de 55 pacientes, 28 com doença de Crohn e 27 com retocolite ulcerativa atendidos em ambulatório de gastroenterologia, utilizou-se o Recordatório Alimentar de 24 Horas e o Questionário de Frequência Alimentar. A atividade inflamatória da doença foi avaliada pelos níveis séricos de proteína C reativa e o Índice de Harvey e Bradshaw. Para comparação de médias foi usado o teste t não pareado e, para as médias não paramétricas, o teste de Mann-Whitney, considerando nível de significância valor de pBACKGROUND: Patients with inflammatory bowel disease may have nutritional deficiencies. AIM: To verify the adequacy of dietary intake of patients with Crohn's disease and ulcerative colitis. METHODS: To assess food intake of 55 patients, 28 with Crohn's disease and 27 with ulcerative colitis treated in the gastroenterology clinic, was used the 24-Hour Food Recall and Food Frequency Questionnaire. The inflammatory activity of the disease was evaluated by serum C-reactive protein and Harvey and Bradshaw Index. For comparison of means t test was used, and the average on non-parametric, the Mann-Whitney test, with level of significance p <0.05. RESULTS: The patients were aged between 19 and 63 years and time since diagnosis was 7.9 years (1 to 22. According to the food intake was identified deficiency in energy intake, fiber, iron, potassium, sodium, magnesium, calcium, menadione, riboflavin, niacin, folate, pantothenic acid, tocopherol and cholecalciferol in Crohn's disease and ulcerative colitis, active or in remission. The intake of vegetables, fruits, dairy products and beans were low, and intake of fats and sweets was higher than the recommendations

  19. Effects of feed composition on life history developments in feed intake, metabolism, growth and body composition of European eel, Anguilla anguilla

    NARCIS (Netherlands)

    Heinsbroek, L.T.N.; Hooff, P.L.A.; Swinkels, W.; Tanck, M.W.T.; Schrama, J.W.; Verreth, J.A.J.

    2007-01-01

    To examine the effect of feed composition on changes in feed intake and subsequent feed utilization with age, five populations of European eel, with an average initial body weight of 5 g each fed a different diet, were monitored for 302 d. The five feeds differed in their content of crude protein (3

  20. Intake of nutrients, fiber, and sugar in patients with nonalcoholic fatty liver disease in comparison to healthy individuals

    Directory of Open Access Journals (Sweden)

    Hamid Zolfaghari

    2016-01-01

    Conclusions: In total, it seems the type of dietary intake source is associated with NAFLD. Increasing saturated fatty acids and sugar and decreasing fiber, folic acid, Vitamin D, zinc, and potassium intake might play a role in the progression of this disease.

  1. Prevalence and characteristics of avoidant/restrictive food intake disorder in a cohort of young patients in day treatment for eating disorders

    OpenAIRE

    Nicely, Terri A; Lane-Loney, Susan; Masciulli, Emily; Hollenbeak, Christopher S.; Ornstein, Rollyn M

    2014-01-01

    Background Avoidant/Restrictive Food Intake Disorder (ARFID) is a “new” diagnosis in the recently published DSM-5, but there is very little literature on patients with ARFID. Our objectives were to determine the prevalence of ARFID in children and adolescents undergoing day treatment for an eating disorder, and to compare ARFID patients to other eating disorder patients in the same cohort. Methods A retrospective chart review of 7-17 year olds admitted to a day program for younger patients wi...

  2. Case Histories in Late Byzantium: Reading the Patient in John Zacharias Aktouarios' On Urines.

    Science.gov (United States)

    Bouras-Vallianatos, Petros

    2016-01-01

    This paper provides the first analysis of case histories in the Byzantine period as they feature in the On Urines of John Zacharias Aktouarios (ca. 1275-ca. 1330). This group of clinical accounts is of special importance in that they have no counterpart in the Greek-speaking world since Galen. This study aims to illustrate various factors determining the patient's response to the physician's advice through close examination of John's clinical narratives. The first part deals with the terminology that John uses to indicate the patient's gender, age, social status, and clinical condition. The second part explores the significance of John's acquaintance with the patients, the patient's socio-economic background, and also the patient's experience in connection with the physician's professional expertise. PMID:26946687

  3. Rehabilitation of a patient with an elusive medical history and loss of occlusal vertical dimension.

    Science.gov (United States)

    Wong, Angela T T; Nguyen, Caroline T

    2013-01-01

    In this clinical report, we describe the medical history, diagnosis and prosthodontic treatment of a 61-year-old man with a previous history of oral cancer. Loss of a full upper denture and severe erosion of his teeth prompted the patient to seek treatment at the dental clinic at the British Columbia Cancer Agency. Although he stated that he was being treated for a sleeping disorder, hospital records revealed multiple recent admissions for alcoholism and depression. The patient's limited finances prevented complex restoration of worn lower dentition; thus, definitive treatment consisted of extraction of teeth with a poor prognosis, removal of a glandular odontogenic cyst and fabrication of a full maxillary prosthesis and a removable mandibular cast-metal overlay.

  4. Prenatal Detection of Peters' Plus Syndrome in a Patient with No Known Family History.

    Science.gov (United States)

    Shima, Yoshio; Migita, Makoto

    2016-01-01

    Peters' plus syndrome is a rare autosomal recessive condition characterized by a combination of typical ocular defects and other systemic abnormalities. We present a case of this uncommon syndrome that we diagnosed during a fetal ultrasonographical examination. Because the patient exhibited microcephaly and anterior staphyloma of the right eye and because impending rupture was feared, we performed ophthalmectomy during the neonatal period. Fetal ophthalmological anomalies are often detected during ultrasonographic examination targeting other systemic abnormalities, with positive family histories providing important diagnostic clues. This case is, to our knowledge, the first to be reported of prenatally diagnosed Peters' plus syndrome in a patient with no known family history in whom total blindness was prevented with an early referral to specialists. PMID:27430178

  5. Behavioral Economic Assessment of Price and Cocaine Consumption Following Self-Administration Histories which Produce Escalation of Either Final Ratios or Intake

    OpenAIRE

    Oleson, Erik B.; Roberts, David C.S.

    2008-01-01

    Various self-administration procedures are being developed to model specific aspects of the addiction process. For example, ‘increased cocaine intake over time’ has been modeled by providing long-access (LgA) to cocaine during daily self-administration sessions under a fixed-ratio (FR1) reinforcement schedule. Additionally, ‘increased time and energy devoted to acquire cocaine’ has been modeled by providing access to cocaine during daily self-administration sessions under a progressive-ratio ...

  6. Result of oral intake of glucose by healthy subjects and patients with essential hypertension on the binding and degradation of 125I-insulin by erythrocyte receptors

    International Nuclear Information System (INIS)

    The work presents the results of researches of binding and degradation of 125I-insulin by erythrocyte receptors in the patients with essential hypertension and healthy patients after glucose intake. In order to obtain full representation of the pattern of changes the serum IRI and glucose concentrations were assayed. Binding and degradation of 125I-insulin by erythrocyte receptors were determined with the method described by Gambhir (1977), modified by the authors. The modification consisted in usage of constant concentrations of iodized insulin (0.9 pg/0.1 ml) and bovine insulin (2.4 I.U./0.1 ml). Before administration of glucose and in 30, 60 and 120 minutes after, venous blood was collected from ulnar vein. All examined persons were in sitting position during the trial of glucose intake. Obtained results show, that blood insulin level in the patients with essential hypertension is statistically significantly higher than in healthy persons of similar anthropometric characteristics. Binding of 125-I-insulin to erythrocyte receptors in fasting state is statistically significantly lower. Degradation after glucose intake in the patients shows decreasing tendency, while in healthy persons-growing tendency. (author). 19 refs, 4 figs, 3 tabs

  7. The prevalence and impact of trauma history in eating disorder patients

    OpenAIRE

    Backholm, Klas; Isomaa, Rasmus; Birgegård, Andreas

    2013-01-01

    Background: Early experiences of traumatic events (TEs) may be associated with subsequent eating disturbance. However, few studies have investigated overall exposure and trauma-type frequency in various types of eating disorders (EDs).Objective: This study aimed to investigate the prevalence and type of TEs in a nationally representative sample of Swedish ED patients.Method: Data from a database (Stepwise) for specialized ED care were used. Trauma history was assessed as a part of the routine...

  8. Tracking Cancer Patients Medical History Using Wireless Emerging Technology : Near Field Communication

    Directory of Open Access Journals (Sweden)

    Shivang Bhagat

    2015-02-01

    Full Text Available The principal objective of this paper is to present an effective solution for storing and retrieving a cancer patient’s medical history in hospitals, clinics and wherever else need be. We have used latest technologies like Near Field Communication (NFC as a medium for communication, MySQL server for storing the database i.e. EHR (Electronic Health Record of patients and lastly an Android application which will provide the interface for the same.

  9. Celiac disease diagnosed after uncomplicated pregnancy in a patient with history of bulimia nervosa

    OpenAIRE

    Milisavljević Nemanja; Cvetković Mirjana; Nikolić Goran; Filipović Branka; Milinić Nikola

    2013-01-01

    Introduction. The association between celiac disease and eating disorders has been very rarely reported. This is the first report on celiac disease associated with bulimia in this part of Europe. Case report. An adult female patient with history of bulimia and one uncomplicated pregnancy was admitted to the Gastroenterology Department, due to long lasting dyspeptic symptoms, constipation, major weight loss and fatigue. After positive serological screening, the diagnosis of celiac diseas...

  10. Nasal Sinus Leiomyosarcoma in a Patient with History of Non-Hereditary Unilateral Treated Retinoblastoma

    OpenAIRE

    Fitzpatrick, Sarah G.; Woodworth, Bradford A.; Monteiro, Carmela; Makary, Raafat

    2010-01-01

    Hereditary patients with a history of treated retinoblastoma (RB) have a greatly increased risk of a broad spectrum of secondary malignancies appearing many years later, with a high incidence in the head and neck region. Leiomyosarcomas (LMS) account for up to 58% of these tumors. LMS in the sinonasal region generally are uncommon and are associated with a locally aggressive course and have a poor prognosis. RB may occur in two forms. The hereditary form is generally bilateral but can present...

  11. Patients undergoing elective coronary artery bypass grafting exhibit poor pre-operative intakes of fruit, vegetables, dietary fibre, fish and vitamin D.

    Science.gov (United States)

    Ruiz-Núñez, B; van den Hurk, G H A M; de Vries, J H M; Mariani, M A; de Jongste, M J L; Dijck-Brouwer, D A J; Muskiet, F A J

    2015-05-14

    CHD may ensue from chronic systemic low-grade inflammation. Diet is a modifiable risk factor for both, and its optimisation may reduce post-operative mortality, atrial fibrillation and cognitive decline. In the present study, we investigated the usual dietary intakes of patients undergoing elective coronary artery bypass grafting (CABG), emphasising on food groups and nutrients with putative roles in the inflammatory/anti-inflammatory balance. From November 2012 to April 2013, we approached ninety-three consecutive patients (80% men) undergoing elective CABG. Of these, fifty-five were finally included (84% men, median age 69 years; range 46-84 years). The median BMI was 27 (range 18-36) kg/m(2). The dietary intake items were fruits (median 181 g/d; range 0-433 g/d), vegetables (median 115 g/d; range 0-303 g/d), dietary fibre (median 22 g/d; range 9-45 g/d), EPA+DHA (median 0.14 g/d; range 0.01-1.06 g/d), vitamin D (median 4.9 μg/d; range 1.9-11.2 μg/d), saturated fat (median 13.1% of energy (E%); range 9-23 E%) and linoleic acid (LA; median 6.3 E%; range 1.9-11.3 E%). The percentages of patients with dietary intakes below recommendations were 62% (fruits; recommendation 200 g/d), 87 % (vegetables; recommendation 150-200 g/d), 73% (dietary fibre; recommendation 30-45 g/d), 91% (EPA+DHA; recommendation 0.45 g/d), 98% (vitamin D; recommendation 10-20 μg/d) and 13% (LA; recommendation 5-10 E%). The percentages of patients with dietary intakes above recommendations were 95% (saturated fat; recommendation < 10 E%) and 7% (LA). The dietary intakes of patients proved comparable with the average nutritional intake of the age- and sex-matched healthy Dutch population. These unbalanced pre-operative diets may put them at risk of unfavourable surgical outcomes, since they promote a pro-inflammatory state. We conclude that there is an urgent need for intervention trials aiming at rapid improvement of their diets to reduce peri-operative risks. PMID:25827177

  12. Influencia de la temperatura en la ingesta de pacientes hospitalizados Influence of temperature on food intake in hospitalized patients

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    I. González Molero

    2008-02-01

    , presentar náuseas o vómitos, cansancio y falta de autonomía. No hubo diferencias significativas en la cantidad de ingesta en función del sexo, peso, número de visitas, cantidad de medicación y grado de actividad. La temperatura de la comida fue clasificada como buena por el 62% de los pacientes, la presentación por el 95% y la humedad por el 85%. Al comparar a los pacientes con y sin carro isotérmico, no hubo diferencias en las características basales analizadas que pudiesen influir en la cantidad ingerida. Calificaron la temperatura como buena un 90% de los pacientes con carro isotérmico y un 57,2% sistema tradicional, siendo esta diferencia estadísticamente significativa (P = 0,000. Además hubo diferencias en la cantidad de comida ingerida entre los pacientes con y sin carro isotérmico, de modo que se lo comieron todo un 41% frente al 27,7% respectivamente siendo esta diferencia estadísticamente significativa (P = 0,007. No hubo diferencias en la calificación de humedad y presentación. Conclusiones: La mayoría de los pacientes (60% presentan disminución de apetito durante el ingreso. La proporción de ingresados que califican la temperatura como buena es mayor en los pacientes con el sistema de carros isotérmicos. La cantidad ingerida por los pacientes con carros isotérmicos es significativamente mayor que en los pacientes sin ellos.Background and objectives: Prevalence of hyponutrition in hospitalized patients is very high and it has been shown to be an important prognostic factor. Most of admitted patients depend on hospital food to cover their nutritional demands being important to assess the factors influencing their intake, which may be modified in order to improve it and prevent the consequences of inadequate feeding. In previous works, it has been shown that one of the worst scored characteristics of dishes was the temperature. The aim of this study was to assess the influence of temperature on patient's satisfaction and amount eaten depending

  13. Chronic diarrhea due to duodenal candidiasis in a patient with a history of kidney transplantation.

    Science.gov (United States)

    Nouri-Majalan, Nader; Moghaddasi, Sarasadat; Qane, Mohammad Davud; Shefaie, Farzane; Masoumi Dehshiri, Roghayyeh; Amirbaigy, Mohammad Kassem; Baghbanian, Mahmoud

    2014-11-01

    Candida infection in the small intestine is uncommon. We report an unusual case of duodenal candidiasis that presented as chronic diarrhea in a patient who had previously undergone kidney transplantation. A 60-year-old man presented with profuse watery diarrhea that had lasted 6 months 13 years after kidney transplantation. Upper gastrointestinal endoscopy results indicated candidiasis within the esophagus and duodenum. Biopsy results revealed active duodenitis with hyphal and yeast forms of Candida overlying the duodenal epithelium in periodic acid Schiff staining. The patient was successfully treated with fluconazole. After 6 months of follow-up, the patient had no complaint of diarrhea. Duodenal candidiasis may be the result of chronic diarrhea in patients with a history of kidney transplantation.

  14. Contact allergy due to lichens in patients with a history of photosensitivity.

    Science.gov (United States)

    Thune, P

    1977-10-01

    Ten patients with a history of photosensitivity and of a rash showed abnormal reactions to long-wave UVR. The rash occurred particularly in areas exposed to light, though other areas were occasionally involved. The development of the rash could in all patients be related to contact with lichens and although exposure to sunlight usually led to an aggravation of symptoms, some patients, particularly forestry workers, showed exacerbations even during the winter. Positive responses were observed in both irradiated and non-irradiated patch tests with different species of lichen and in several patients irradiation precipitated a stronger response. These findings suggest that lichens can cause both contact and photocontact dermatitis. The suspected allergens contained in these lichens are atranorin, physodalic and pysodic acids. PMID:145345

  15. Chronic diarrhea due to duodenal candidiasis in a patient with a history of kidney transplantation.

    Science.gov (United States)

    Nouri-Majalan, Nader; Moghaddasi, Sarasadat; Qane, Mohammad Davud; Shefaie, Farzane; Masoumi Dehshiri, Roghayyeh; Amirbaigy, Mohammad Kassem; Baghbanian, Mahmoud

    2014-11-01

    Candida infection in the small intestine is uncommon. We report an unusual case of duodenal candidiasis that presented as chronic diarrhea in a patient who had previously undergone kidney transplantation. A 60-year-old man presented with profuse watery diarrhea that had lasted 6 months 13 years after kidney transplantation. Upper gastrointestinal endoscopy results indicated candidiasis within the esophagus and duodenum. Biopsy results revealed active duodenitis with hyphal and yeast forms of Candida overlying the duodenal epithelium in periodic acid Schiff staining. The patient was successfully treated with fluconazole. After 6 months of follow-up, the patient had no complaint of diarrhea. Duodenal candidiasis may be the result of chronic diarrhea in patients with a history of kidney transplantation. PMID:25362226

  16. Short communication: Use of single nucleotide polymorphism genotypes and health history to predict future phenotypes for milk production, dry matter intake, body weight, and residual feed intake in dairy cattle.

    Science.gov (United States)

    Yao, C; Armentano, L E; VandeHaar, M J; Weigel, K A

    2015-03-01

    As feed prices have increased, the efficiency of feed utilization in dairy cattle has attracted increasing attention. In this study, we used residual feed intake (RFI) as a measurement of feed efficiency along with its component traits, adjusted milk energy (aMilkE), adjusted dry matter intake (aDMI), and adjusted metabolic body weight (aMBW), where the adjustment was for environmental factors. These traits may also be affected by prior health problems. Therefore, the carryover effects of 3 health traits from the rearing period and 10 health traits from the lactating period (in the same lactation before phenotype measurements) on RFI, aMilkE, aDMI, and aMBW were evaluated. Cows with heavier birth weight and greater body weight at calving of this lactation had significant increases in aMilkE, aDMI, and aMBW. The only trait associated with RFI was the incidence of diarrhea early in the lactation. Mastitis and reproductive problems had negative carryover effects on aMilkE. The aMBW of cows with metabolic disorders early in the lactation was lower than that of unaffected cows. The incidence of respiratory disease during lactating period was associated with greater aMBW and higher aDMI. To examine the contribution of health traits to the accuracy of predicted phenotype, genomic predictions were computed with or without information regarding 13 health trait phenotypes using random forests (RF) and support vector machine algorithms. Adding health trait phenotypes increased prediction accuracies slightly, except for prediction of RFI using RF. In general, the accuracies were greater for support vector machine than RF, especially for RFI. The methods described herein can be used to predict future phenotypes for dairy replacement heifers, thereby facilitating culling decisions that can lead to decreased feed costs during the rearing period. For these decisions, prediction of the animal's own phenotype is of greater importance than prediction of the genetic superiority or

  17. To investigate the relationship of alcohol intake and hepatocellular carcinoma among patients with hepatitis B virus infection%饮酒在HBV相关性肝细胞癌发生中的作用

    Institute of Scientific and Technical Information of China (English)

    朱桂婷; 娄国强; 施军平

    2011-01-01

    目的 探讨饮酒在HBV相关性肝细胞癌发生中的作用.方法 收集553例HBV相关性肝细胞癌患者和160例HBV感染的非肝癌患者进行回顾性调查研究,比较两组的人口学特征、病毒学指标和生化学指标,用比数比(OR值)计算相关因素的危险系数;根据患者饮酒量,将肝癌患者分为三组,比较三组各项指标,探讨饮酒在HBV相关性肝细胞癌发生中的作用.结果 肝癌组中AST、GGT、ALP、AFP高于正常上限者比对照组更多见(P<0.05).多元回归分析显示嗜酒、吸烟、有肝癌家族史与HBV感染者肝细胞癌的发生密切相关,其OR值分别为2.66,2.51,1.64.少量饮酒、嗜酒组的GGT、ALP高于正常上限者比无饮酒组多见(P<0.05).结论 在我国,嗜酒、吸烟、有肝癌家族史可增加HBV感染者发生肝细胞癌的风险性.同时有HBV感染和嗜酒习惯的患者发生肝细胞癌的主要因素是HBV,而非酒精.%Objective To investigate the relationship of alcohol intake and hepatocellular carcinoma among patients with hepatitis B virus infection.Methods A total of 553 patients with HCC and 160 control subjects affected with hepatitis B virus were recruited.Serum virology,serum biochemistry,as well as demographic information were studied.Finally,risk factors were selected by stepwise Logistic regression analyse.Odds ratios (ORs) were estimated for each risk factor.According to alcohol intake,HCC patients were divided into three groups,then to observe the differences between them.Results Elevated AST,GGT,ALP and AFP levels were seen more frequently in the HCC case groups compared to control group (P < 0.05 ).Multivariate analysis revealed that heavy alcohol use,smoking,positive family history of liver cancer is associated with HCC development among patients with hepatitis B virus infection.Significantly increased risk was found among patients for heavy alcohol use [A =2.66(2.01-3.50) ] and for smoking [A =2.51(1.66-3.80) ] and for

  18. Association of Self-efficacy and Decisional Balance with Stages of Change for Fiber Intake and Glycemic Control in Patients with Type 2 Diabetes

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    Parisa Keshani

    2015-09-01

    Full Text Available Background and Objectives: Constructs of behavioral models such as trans-theoretical model can be associated with healthy eating behaviors like increasing fiber intake. They can also be effective in improving these behaviors in patients with diabetes. This study aimed to assess the association of self-efficacy and decisional balance with stages of change for fiber intake and glycemic control in patients with type 2 diabetes. Materials and Methods: A cross-sectional study was conducted on 145 literate male and female patients with type 2 diabetes (aged 30 to 65 years they were randomly selected from the patients’ list of “Charity Foundation for Special Diseases” and ”Iranian Diabetes Society” in Tehran-Iran. Stages of change, self-efficacy, and decisional balance questionnaires were filled out, and three food records were used to assess their nutritional status. Blood samples were taken to assess fasting blood glucose, HbA1c, serum insulin, and insulin resistance. One-way ANOVA and logistic regression were used to analyze the data. The tests were done using the SPSS software (ver. 16. P<0.05 was considered significant. Results: 126 patients with type 2 diabetes completed the study. Participants’ mean age was 53.5±6.02 and 65% were men. Patients in post-action stages revealed higher self-efficacy than did those in pre-action stages (P=0.035. A relationship was observed between insulin resistance and self-efficacy (P=0.040. One unit increase in self-efficacy decreased the risk of insulin resistance by 12%, and each unit increase in decisional balance increased the chance of eating sufficient fiber by 2.2 times. There was also a significant relationship between the perceived cons (P<0.0001 and self-efficacy (P=0.037 with fiber intake after adjustment with confounders. Conclusions: This study suggests that there is a relationship between transtheoretical model constructs such as self-efficacy and decisional balance, especially cons, with

  19. CORRELATIONS BETWEEN AWARENESS OF ILLNESS (INSIGHT AND HISTORY OF ADDICTION IN HEROIN-ADDICTED PATIENTS

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    Angelo Giovanni Icro eMaremmani

    2012-07-01

    Full Text Available In a group of 1066 heroin addicts, who were seeking treatment for opioid agonist treatment, we looked for differences in historical, demographic and clinical characteristics, between patients with different levels of awareness of illness (insight. The results showed that, in the cohort studied, a majority of subjects lacked insight into their heroin-use behaviour. Compared with the impaired-insight group, those who possessed insight into their illness showed significantly greater awareness of past social, somatic and psychopathological impairments, and had a greater number of past treatment-seeking events for heroin addiction. In contrast with other psychiatric illnesses, the presence of awareness appears to be related to the passing of time and to the worsening of the illness. Methodologies to improve the insight of patients should, therefore, be targeted more directly on patients early in their history of heroin dependence, because the risk of lack of insight is greatest during this period.

  20. Assessment of Risk of Violent Behavior in Female Psychiatric Patients with a Criminal History

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    Makurina A.P.,

    2014-11-01

    Full Text Available We present the results of study of illegal actions predictors in individuals with mental disorders and discuss the specific features of female criminality. On a sample of 69 patients with a diagnosis of organic mental disorder and schizophrenia, with criminal histories, we applied clinical and psychological hermeneutic analysis, used questionnaires to determine the self-assessments of patients, self-control diagnosis, self-regulation style features, diagnosis of aggression and hostility, coping strategies, destructive attitudes in interpersonal relationships. It made possible to identify clinical, social and pathopsychological factors of aggressive behavior in forensic patients. These individual psychological characteristics of mentally ill women will improve the prognosis of their aggressive behavior, implement differentiated preventive measures in the hospital and to establish appropriate intervention programs

  1. Cancer history and other personal factors affect quality of life in patients with hepatitis C

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    Toro Charlene

    2005-06-01

    Full Text Available Abstract Background Although patients with chronic hepatitis C (CHC have been found to have reduced quality of life, little is known about how other characteristics affect their quality of life. The purpose of this study was to investigate the effect of other characteristics, including history of cancer, on quality of life in patients with CHC. Methods One hundred forty patients from clinics at three hospitals in New York City completed a detailed epidemiologic interview about demographic and lifestyle characteristics and the SF-36 measuring health-related quality of life. We compared results from our patients to normative data using t-tests of differences between means. We used multivariate analyses to determine other personal and health-related factors associated with quality of life outcomes. Results Compared to normative data, these patients had reduced quality of life, particularly on physical functioning. The summary Physical Component Score (PCS was 45.4 ± 10.6 and the Mental Component Score (MCS was 48.2 ± 11.1, vs norms of 50 ± 10.0; p-values were Conclusion Several health and lifestyle factors independently influence quality of life in CHC patients. Different factors are important for men and women.

  2. Plantar pressure distribution patterns during gait in diabetic neuropathy patients with a history of foot ulcers

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    Tatiana Almeida Bacarin

    2009-02-01

    Full Text Available OBJECTIVE: To investigate and compare the influence of a previous history of foot ulcers on plantar pressure variables during gait of patients with diabetic neuropathy. INTRODUCTION: Foot ulcers may be an indicator of worsening diabetic neuropathy. However, the behavior of plantar pressure patterns over time and during the progression of neuropathy, especially in patients who have a clinical history of foot ulcers, is still unclear. METHODS: Subjects were divided into the following groups: control group, 20 subjects; diabetic neuropathy patients without foot ulcers, 17 subjects; and diabetic neuropathy patients with at least one healed foot ulcer within the last year, 10 subjects. Plantar pressure distribution was recorded during barefoot gait using the Pedar-X system. RESULTS: Neuropathic subjects from both the diabetic neuropathy and DNU groups showed higher plantar pressure than control subjects. At midfoot, the peak pressure was significantly different among all groups: control group (139.4±76.4 kPa, diabetic neuropathy (205.3±118.6 kPa and DNU (290.7±151.5 kPa (p=0.008. The pressure-time integral was significantly higher in the ulcerated neuropathic groups at midfoot (CG: 37.3±11.4 kPa.s; DN: 43.3±9.1 kPa.s; DNU: 68.7±36.5 kPa.s; p=0.002 and rearfoot (CG: 83.3±21.2 kPa.s; DN: 94.9±29.4 kPa.s; DNU: 102.5±37.9 kPa.s; p=0.048. CONCLUSION: A history of foot ulcers in the clinical history of diabetic neuropathy subjects influenced plantar pressure distribution, resulting in an increased load under the midfoot and rearfoot and an increase in the variability of plantar pressure during barefoot gait. The progression of diabetic neuropathy was not found to influence plantar pressure distribution.

  3. Parental History of Type 2 Diabetes in Patients with Nonaffective Psychosis

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    Fernandez-Egea, Emilio; Miller, Brian; Bernardo, Miguel; Donner, Thomas; Kirkpatrick, Brian

    2009-01-01

    Introduction We attempted to replicate two previous studies which found an increased risk of diabetes in the relatives of schizophrenia probands. Methods N=34 patients with newly-diagnosed nonaffective psychosis and N=52 non-psychiatric controls were interviewed for parental history of Type 2 diabetes. Results In a logistic regression model that included multiple potential confounders, psychosis was a significant predictor of Type 2 diabetes in either parent (p<0.04). Discussion We found an increased prevalence of Type 2 diabetes in the parents of nonaffective psychosis subjects. This association may be due to shared environmental or genetic risk factors, or both. PMID:18031995

  4. Sun Exposure and Protection Habits in Pediatric Patients with a History of Malignancy.

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    Yael Levy-Shraga

    Full Text Available Survivors of childhood cancer are at high risk for developing non-melanoma skin cancer and therefore are firmly advised to avoid or minimize sun exposure and adopt skin protection measures. We aimed to compare sun exposure and protection habits in a cohort of pediatric patients with a history of malignancy to those of healthy controls.Case-control study of 143 pediatric patients with a history of malignancy (aged 11.2±4.6 y, Male = 68, mean interval from diagnosis 4.4±3.8 y and 150 healthy controls (aged 10.4±4.8 y, Male = 67. Sun exposure and protection habits were assessed using validated questionnaires.Patients and controls reported similar sun exposure time during weekdays (94±82 minutes/day vs. 81±65 minutes/day; p = 0.83, while during weekends patients spent significantly less time outside compared to controls (103±85 minutes/day vs. 124±87 minutes/day; p = 0.02. Time elapsed from diagnosis positively correlated with time spent outside both during weekdays (r = 0.194, p = 0.02 and weekends (r = 0.217, p = 0.01, and there was a step-up in sun exposure starting three years after diagnosis. There was no significant difference regarding composite sun protection score between patients and controls. Age was positively correlated with number of sunburns per year and sun exposure for the purpose of tanning, and was negatively correlated with the use of sun protection measures.Although childhood cancer survivors are firmly instructed to adopt sun protection habits, the adherence to these instructions is incomplete, and more attention should be paid to improve these habits throughout their lives. Since sunlight avoidance may results in vitamin D deficiency, dietary supplementation will likely be needed.

  5. Supportive periodontal therapy and periodontal biotype as prognostic factors in implants placed in patients with a history of periodontitis

    OpenAIRE

    Aguirre Zorzano, Luis Antonio; Vallejo Aisa, Francisco Javier; Estefanía Fresco, Ruth

    2013-01-01

    Objectives: To evaluate bone loss around implants placed in patients with a history of treated chronic periodontitis and who did or did not attend supportive periodontal therapy, after one year in function. Furthermore, the influence of periodontal biotype and level of plaque was also evaluated. Material and Methods: Forty-nine patients participated voluntarily in the study. All subjects had a history of chronic periodontitis, which had been previously treated. After the active treatment, 27 ...

  6. Risk of thyroid cancer in euthyroid asymptomatic patients with thyroid nodules with an emphasis on family history of thyroid cancer

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    JHwang, Shin Hye; Kim, Eun Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Kwak, Jin Young [Dept. of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-04-15

    To determine the factors associated with thyroid cancer, focusing on first-degree family history and ultrasonography (US) features, in euthyroid asymptomatic patients with thyroid nodules. This retrospective study included 1310 thyroid nodules of 1254 euthyroid asymptomatic patients who underwent US-guided fine-needle aspiration biopsy between November 2012 and August 2013. Nodule size and clinical risk factors- such as patient age, gender, first-degree family history of thyroid cancer, multiplicity on US and serum thyroid stimulating hormone (TSH) levels - were considered together with US features to compare benign and malignant nodules. Multiple logistic regression analysis was performed to assess the risk of thyroid malignancy according to clinical and US characteristics. Although all of the clinical factors and US findings were significantly different between patients with benign and malignant nodules, a solitary lesion on US (p = 0.041–0.043), US features and male gender (p < 0.001) were significant independent risk factors for thyroid malignancy in a multivariate analysis. Patient age, a first-degree family history of thyroid cancer and high normal serum TSH levels did not independently significantly increase the risk of thyroid cancer. However, multicollinearity existed between US assessment and patient age, first-degree family history of thyroid cancer and serum TSH values. Ultrasonography findings should be the primary criterion used to decide the management of euthyroid asymptomatic patients with thyroid nodules. The concept of first-degree family history as a risk factor for thyroid malignancy should be further studied in asymptomatic patients.

  7. Phase Angle and Handgrip Strength Are Sensitive Early Markers of Energy Intake in Hypophagic, Non-Surgical Patients at Nutritional Risk, with Contraindications to Enteral Nutrition

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    Riccardo Caccialanza

    2015-03-01

    Full Text Available The assessment of nutritional intakes during hospitalization is crucial, as it is known that nutritional status tends to worsen during the hospital stay, and this can lead to the negative consequences of malnutrition. International guidelines recommend the use of parenteral nutrition (PN in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition. However, to date, there are no published data regarding either energy intake or objective measurements associated with it in this patient population. The aim of the present exploratory methodological study was to evaluate whether phase angle (PhA and handgrip strength normalized for skeletal muscle mass (HG/SMM are sensitive early markers of energy intake in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition. We evaluated 30 eligible patients, who were treated with personalized dietary modifications and supplemental PN for at least one week during hospitalization. In a liner regression model adjusted for age, gender, basal protein intake and the basal value of each variable, a trend toward improvement of PhA and preservation of HG/SMM was observed in patients satisfying the estimated calorie requirements (N = 20, while a significant deterioration of these parameters occurred in those who were not able to reach the target (N = 10. The mean adjusted difference and 95% CI were +1.4° (0.5–2.3 (p = 0.005 for PhA and +0.23 (0.20–0.43 (p = 0.033 for HG/SMM. A significant correlation between PhA and HG/SMM variations was also observed (r = 0.56 (95% CI, 0.23–0.77; p = 0.0023. PhA and HG/SMM were able to distinguish between hypophagic, non-surgical patients at nutritional risk who satisfied their estimated caloric requirements and those who did not after a one-week personalized nutritional support. Clinical studies are warranted, in order to verify these preliminary observations and to validate the role of Ph

  8. Phase angle and handgrip strength are sensitive early markers of energy intake in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition.

    Science.gov (United States)

    Caccialanza, Riccardo; Cereda, Emanuele; Klersy, Catherine; Bonardi, Chiara; Cappello, Silvia; Quarleri, Lara; Turri, Annalisa; Montagna, Elisabetta; Iacona, Isabella; Valentino, Francesco; Pedrazzoli, Paolo

    2015-03-11

    The assessment of nutritional intakes during hospitalization is crucial, as it is known that nutritional status tends to worsen during the hospital stay, and this can lead to the negative consequences of malnutrition. International guidelines recommend the use of parenteral nutrition (PN) in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition. However, to date, there are no published data regarding either energy intake or objective measurements associated with it in this patient population. The aim of the present exploratory methodological study was to evaluate whether phase angle (PhA) and handgrip strength normalized for skeletal muscle mass (HG/SMM) are sensitive early markers of energy intake in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition. We evaluated 30 eligible patients, who were treated with personalized dietary modifications and supplemental PN for at least one week during hospitalization. In a liner regression model adjusted for age, gender, basal protein intake and the basal value of each variable, a trend toward improvement of PhA and preservation of HG/SMM was observed in patients satisfying the estimated calorie requirements (N = 20), while a significant deterioration of these parameters occurred in those who were not able to reach the target (N = 10). The mean adjusted difference and 95% CI were +1.4° (0.5-2.3) (p = 0.005) for PhA and +0.23 (0.20-0.43) (p = 0.033) for HG/SMM. A significant correlation between PhA and HG/SMM variations was also observed (r = 0.56 (95% CI, 0.23-0.77); p = 0.0023). PhA and HG/SMM were able to distinguish between hypophagic, non-surgical patients at nutritional risk who satisfied their estimated caloric requirements and those who did not after a one-week personalized nutritional support. Clinical studies are warranted, in order to verify these preliminary observations and to validate the role of PhA variations as early

  9. How can I maintain my patient with diabetes and history of foot ulcer in remission?

    Science.gov (United States)

    Miller, John D; Salloum, Michelle; Button, Alex; Giovinco, Nicholas A; Armstrong, David G

    2014-12-01

    Patients with diabetes and previous history of ulceration occupy the highest category of risk for reulceration and amputation. Annual recurrence rates of diabetic ulcerations have been reported as high as 34%, 61%, and 70% at 1, 3, and 5 years, respectively, with studies reporting 20% to 58% recurrence rate within 1 year. As the ever growing epidemic of diabetes expands globally, this sequelae of diabetic complication will continue to require increasing resources from the healthcare community to effectively manage. Recent data suggest that removal of preventative podiatric care from statewide reimbursement systems lead to significant and sustained increases in hospital admission (37%), charges (38%), length of stay (23%), and severe aggregate outcomes including amputation, sepsis and death (49%). The addition of comorbidities such as peripheral artery disease, poor nutrition, and non-adherence to preventive therapies not only increase a patient's likelihood for ulcer recurrence, but also cost of care and certainty of hospital admission. Currently, numerous efforts, guidelines, and industry generated products exist to prolong remission from ulceration; however, the clinical science for treating this patient population calls for much more effort. Despite this, data continue to suggest to demonstrate that appropriate follow-up care, shoe and insole modification, and patient education play a central role in reducing reulceration and amputation. Novel modalities for offloading and wearable sensor technologies offer the advantage of round-the-clock, patient specific and active response healthcare. These have the potential to detect, or even prevent, many wounds before they begin.

  10. The Natural History and Predictors for Intervention in Patients with Small Renal Mass Undergoing Active Surveillance

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    Zaher Bahouth

    2015-01-01

    Full Text Available Aim. To describe the natural history of small renal mass on active surveillance and identify parameters that could help in predicting the need for intervention in patients with small renal masses undergoing active surveillance. We also discuss the need for renal biopsy in the management of these patients. Methods. A retrospective analysis of 78 renal masses ≤4 cm diagnosed at our Urology Department at Bnai Zion Medical Center between September 2003 and March 2012. Results. Seventy patients with 78 small renal masses were analyzed. The mean age at diagnosis was 68 years (47–89. The mean follow-up period was 34 months (12–112. In 54 of 78 masses there was a growth of at least 2 mm between imaging on last available follow-up and diagnosis. Eight of the 54 (15% masses which grew in size underwent a nephron-sparing surgery, of which two were oncocytomas and six were renal cell carcinoma. Growth rate and mass diameter on diagnosis were significantly greater in the group of patients who underwent a surgery. Conclusions. Small renal masses might eventually be managed by active surveillance without compromising survival or surgical approach. All masses that were eventually excised underwent a nephron-sparing surgery. None of the patients developed metastases.

  11. A Short Bowel (Small Intestine = 40 cm, No Ileocecal Valve, and Colonic Inertia Patient Works Well with Oral Intake Alone without Parenteral Nutrition

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    Ming-Yi Liu

    2014-01-01

    Full Text Available We present a 50-year-old male who suffered from ischemic bowel disease, having undergone massive resection of small intestine and ileocecal valve. He had to cope with 40 cm proximal jejunum and 70 cm distal colon remaining. In the postoperative period parenteral nutrition (PN was used immediately for nutrition support and electrolyte imbalance correction. We gave him home PN as regular recommendation for the short bowel status after discharge from hospital. This patient has tolerated regular oral intake 2 months later and did not develop significant short bowel syndrome. There were several episodes of venous access infection which troubled this patient and admitted him for treatment during home PN. Therefore, we changed home PN to cyclic tapering pattern. The patient could maintain his nutrition and hydration with oral intake alone after tapering home PN 15 months later. He has survived more than one year without PN support and still maintained 80% ideal body weight with average albumin of 3.5 ± 0.2 mg/dL. Although patient was hospitalized every two months to supplement nutrients, however, this has greatly improved the quality of life.

  12. How I treat patients with a history of heparin-induced thrombocytopenia.

    Science.gov (United States)

    Warkentin, Theodore E; Anderson, Julia A M

    2016-07-21

    Heparin-induced thrombocytopenia (HIT) is a relatively common prothrombotic adverse drug reaction of unusual pathogenesis that features platelet-activating immunoglobulin G antibodies. The HIT immune response is remarkably transient, with heparin-dependent antibodies no longer detectable 40 to 100 days (median) after an episode of HIT, depending on the assay performed. Moreover, the minimum interval from an immunizing heparin exposure to the development of HIT is 5 days irrespective of the patient's previous heparin exposure status or history of HIT. This means that short-term heparin reexposure can be safely performed if platelet-activating antibodies are no longer detectable at reexposure baseline and is recommended when heparin is the clear anticoagulant of choice, such as for cardiac or vascular surgery. The risk of recurrent HIT 1 to 2 weeks after heparin reexposure is ∼2% to 5% and is attributable to formation of delayed-onset (or autoimmune-like) HIT antibodies that activate platelets even in the absence of pharmacologic heparin. Some studies suggest that longer-term heparin reexposure (eg, for chronic hemodialysis) may also be reasonable. However, for other antithrombotic indications that involve patients with a history of HIT (eg, treatment of venous thromboembolism or acute coronary syndrome), preference should be given to non-heparin agents such as fondaparinux, danaparoid, argatroban, bivalirudin, or one of the new direct-acting oral anticoagulants as appropriate. PMID:27114458

  13. A mimic's imitator: a cavitary pneumonia in a myasthenic patient with history of tuberculosis.

    Science.gov (United States)

    Garcia, Raquel Ramos; Bhanot, Nitin; Min, Zaw

    2015-01-01

    A 77-year-old man with myasthenia gravis receiving prednisone and plasmapheresis was found to have right upper lobe cavitary pneumonia on radiological imaging studies after thymectomy. He had a remote history of treated pulmonary tuberculosis (TB) at the age of 19. On the basis of history of TB and current prednisone therapy, reactivation of pulmonary TB was highly suspected. Branching Gram-positive bacilli were identified on bronchoalveolar lavage (BAL). BAL Ziehl-Neelsen Acid-fast bacilli stain was negative, but a modified Kinyoun stain revealed branching, beaded, filamentous bacilli, suggestive of Nocardia spp. Nocardia cyriacigeorgica grew from the BAL culture. Cerebral MRI demonstrated a right frontal lobe lesion, clinically correlated to be nocardial brain abscess. The patient was treated with three-drug antimicrobial therapy (trimethoprim-sulfamethoxazole, meropenem, linezolid) for 2 months, followed by an additional 10 months of trimethoprim-sulfamethoxazole. Amikacin would have been included in the initial three-drug regimen, but its use was contraindicated in our myasthenic patient because aminoglycoside would trigger fatal myasthenic crisis by neuromuscular blockage. Follow-up imaging studies revealed resolution of the lung and brain lesions. PMID:26150643

  14. Patient Impression and Satisfaction of a Self-administered, Automated Medical History Taking Device in the Emergency Department

    OpenAIRE

    Arora, Sanjay; Goldberg, Andrew D.; Menchine, Michael

    2014-01-01

    Introduction: We evaluated patient impressions and satisfaction of an innovative self-administered, hand-held touch-screen tablet to gather detailed medical information from emergency department (ED) patients in the waiting room prior to physician contact. Methods: Adult, medically stable patients presenting to the ED at Los Angeles County Hospital used the PatientTouche system to answer a series of questions about their current history of present illness and past medical/surgical hi...

  15. The Impact of Oxytocin on Food Intake and Emotion Recognition in Patients with Eating Disorders: A Double Blind Single Dose Within-Subject Cross-Over Design.

    Directory of Open Access Journals (Sweden)

    Youl-Ri Kim

    Full Text Available Social difficulties and problems related to eating behaviour are common features of both anorexia nervosa (AN and bulimia nervosa (BN. The aim of this study was to examine the impact of intranasal oxytocin on consummatory behaviour and emotional recognition in patients with AN and BN in comparison to healthy controls.A total of 102 women, including 35 patients with anorexia nervosa (AN, 34 patients with bulimia nervosa (BN, and 33 healthy university students of comparable age and intelligence, participated in a double-blind, single dose placebo-controlled cross-over study. A single dose of intranasal administration of oxytocin (40 IU (or a placebo was followed by an emotional recognition task and an apple juice drink. Food intake was then recorded for 24 hours post-test.Oxytocin produced no significant change in appetite in the acute or 24 hours free living settings in healthy controls, whereas there was a decrease in calorie consumption over 24 hours in patients with BN. Oxytocin produced a small increase in emotion recognition sensitivity in healthy controls and in patients with BN, In patients with AN, oxytocin had no effect on emotion recognition sensitivity or on consummatory behaviour.The impact of oxytocin on appetite and social cognition varied between people with AN and BN. A single dose of intranasal oxytocin decreased caloric intake over 24 hours in people with BN. People with BN showed enhanced emotional sensitivity under oxytocin condition similar to healthy controls. Those effects of oxytocin were not found in patients with AN.ClinicalTrials.gov KCT00000716.

  16. The Impact of Oxytocin on Food Intake and Emotion Recognition in Patients with Eating Disorders: A Double Blind Single Dose Within-Subject Cross-Over Design

    Science.gov (United States)

    Kim, Youl-Ri; Eom, Jin-Sup; Yang, Jae-Won; Kang, Jiwon; Treasure, Janet

    2015-01-01

    Background and Aim Social difficulties and problems related to eating behaviour are common features of both anorexia nervosa (AN) and bulimia nervosa (BN). The aim of this study was to examine the impact of intranasal oxytocin on consummatory behaviour and emotional recognition in patients with AN and BN in comparison to healthy controls. Materials A total of 102 women, including 35 patients with anorexia nervosa (AN), 34 patients with bulimia nervosa (BN), and 33 healthy university students of comparable age and intelligence, participated in a double-blind, single dose placebo-controlled cross-over study. A single dose of intranasal administration of oxytocin (40 IU) (or a placebo) was followed by an emotional recognition task and an apple juice drink. Food intake was then recorded for 24 hours post-test. Results Oxytocin produced no significant change in appetite in the acute or 24 hours free living settings in healthy controls, whereas there was a decrease in calorie consumption over 24 hours in patients with BN. Oxytocin produced a small increase in emotion recognition sensitivity in healthy controls and in patients with BN, In patients with AN, oxytocin had no effect on emotion recognition sensitivity or on consummatory behaviour. Conclusions The impact of oxytocin on appetite and social cognition varied between people with AN and BN. A single dose of intranasal oxytocin decreased caloric intake over 24 hours in people with BN. People with BN showed enhanced emotional sensitivity under oxytocin condition similar to healthy controls. Those effects of oxytocin were not found in patients with AN. Trial Registration ClinicalTrials.gov KCT0000716 PMID:26402337

  17. Structural and functional cerebral impairments in cirrhotic patients with a history of overt hepatic encephalopathy

    International Nuclear Information System (INIS)

    Objective: Diffuse brain atrophy has been observed in cirrhotic patients and recent reports have revealed the persistence of cognitive impairment after clinical resolution of overt hepatic encephalopathy. We sought to explore the continued influence of overt hepatic encephalopathy on neurological function by measuring brain resting-state inherent connectivity, based on an investigation of structural abnormalities. Methods: Neuropsychological tests and structural and functional magnetic resonance scanning were conducted in 20 healthy controls and 21 cirrhotic patients with a history of overt hepatic encephalopathy. The analysis of voxel-based morphometry and functional connectivity were performed to detect the alterations in brain structure and function, respectively. Results: Patients showed significantly worse performance in neuropsychological tests as compared with controls, despite apparently normal mental status. Analysis of voxel-based morphometry revealed a decrease in gray matter volume primarily in the midline regions, bilateral insular cortex and caudates, left parahippocampal gyrus, and right cerebellum posterior lobe, while the volume of the bilateral thalamus showed an increase. Of these regions, the posterior cingulate cortex with peak atrophy was selected as the origin for the analysis of functional connectivity. Typical patterns of a default mode network were identified in both groups. Decreased functional connectivity was found in the medial prefrontal gyrus, left inferior parietal lobule, and left middle temporal gyrus in the patients. Conclusions: Both functional and structural impairments were evident after apparent recovery from overt hepatic encephalopathy, demonstrating that brain dysfunction induced by hepatic encephalopathy persisted after clinical resolution and provided a basis for further evolution of the disease

  18. The Natural History and Outcomes of the Patients with Carcinosarcoma Involving Kidney and Renal Pelvis

    Directory of Open Access Journals (Sweden)

    Jue Wang

    2011-01-01

    Full Text Available Background. The objective of this paper was to examine the epidemiology, natural history, and prognostic factors of carcinosarcoma of the kidney and renal pelvis (CSKP using population-based registry. Patients and Methods. Forty-three patients with CSKP, diagnosed between January 1973 and December 2007, were identified from the national Surveillance, Epidemiology, and End Results (SEER database and reviewed. Results. 79% of all patients with known SEER stage were classified as having regional or distant stage; almost all the patients with known histology grade had poorly or undifferentiated histology. The median cancer specific survival was 6 months (95% CI 4–9. The 1-year cancer-specific survival rate for entire cohort was 30.2%. There were no differences in terms of age at diagnosis, histological grade, tumor stage on presentation, and frequency of nephrectomy between carcinosarcoma of kidney (CSK or renal pelvis (CSP. In multivariate analysis, age at diagnosis, tumor stage, and year of diagnosis were found to be significant predictors for cancer-specific survival. Conclusion. CSKP commonly presented as high-grade, advanced stage disease, and was associated with a poor prognosis regardless of location.

  19. Structural and functional cerebral impairments in cirrhotic patients with a history of overt hepatic encephalopathy

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Hua-Jun [Jiangsu Key Laboratory of Molecular Imaging and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009 (China); Zhu, Xi-Qi [Jiangsu Key Laboratory of Molecular Imaging and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009 (China); Department of Radiology, The Second Hospital of Nanjing, Medical School of Southeast University, Nanjing 210002 (China); Shu, Hao [Department of Neurology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009 (China); Yang, Ming; Zhang, Yi; Ding, Jie; Wang, Yu [Jiangsu Key Laboratory of Molecular Imaging and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009 (China); Teng, Gao-Jun, E-mail: gjteng@vip.sina.com [Jiangsu Key Laboratory of Molecular Imaging and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009 (China)

    2012-10-15

    Objective: Diffuse brain atrophy has been observed in cirrhotic patients and recent reports have revealed the persistence of cognitive impairment after clinical resolution of overt hepatic encephalopathy. We sought to explore the continued influence of overt hepatic encephalopathy on neurological function by measuring brain resting-state inherent connectivity, based on an investigation of structural abnormalities. Methods: Neuropsychological tests and structural and functional magnetic resonance scanning were conducted in 20 healthy controls and 21 cirrhotic patients with a history of overt hepatic encephalopathy. The analysis of voxel-based morphometry and functional connectivity were performed to detect the alterations in brain structure and function, respectively. Results: Patients showed significantly worse performance in neuropsychological tests as compared with controls, despite apparently normal mental status. Analysis of voxel-based morphometry revealed a decrease in gray matter volume primarily in the midline regions, bilateral insular cortex and caudates, left parahippocampal gyrus, and right cerebellum posterior lobe, while the volume of the bilateral thalamus showed an increase. Of these regions, the posterior cingulate cortex with peak atrophy was selected as the origin for the analysis of functional connectivity. Typical patterns of a default mode network were identified in both groups. Decreased functional connectivity was found in the medial prefrontal gyrus, left inferior parietal lobule, and left middle temporal gyrus in the patients. Conclusions: Both functional and structural impairments were evident after apparent recovery from overt hepatic encephalopathy, demonstrating that brain dysfunction induced by hepatic encephalopathy persisted after clinical resolution and provided a basis for further evolution of the disease.

  20. Association between cerebral cannabinoid 1 receptor availability and body mass index in patients with food intake disorders and healthy subjects: a [(18)F]MK-9470 PET study.

    Science.gov (United States)

    Ceccarini, J; Weltens, N; Ly, H G; Tack, J; Van Oudenhove, L; Van Laere, K

    2016-07-12

    Although of great public health relevance, the mechanisms underlying disordered eating behavior and body weight regulation remain insufficiently understood. Compelling preclinical evidence corroborates a critical role of the endocannabinoid system (ECS) in the central regulation of appetite and food intake. However, in vivo human evidence on ECS functioning in brain circuits involved in food intake regulation as well as its relationship with body weight is lacking, both in health and disease. Here, we measured cannabinoid 1 receptor (CB1R) availability using positron emission tomography (PET) with [(18)F]MK-9470 in 54 patients with food intake disorders (FID) covering a wide body mass index (BMI) range (anorexia nervosa, bulimia nervosa, functional dyspepsia with weight loss and obesity; BMI range=12.5-40.6 kg/m(2)) and 26 age-, gender- and average BMI-matched healthy subjects (BMI range=18.5-26.6 kg/m(2)). The association between regional CB1R availability and BMI was assessed within predefined homeostatic and reward-related regions of interest using voxel-based linear regression analyses. CB1R availability was inversely associated with BMI in homeostatic brain regions such as the hypothalamus and brainstem areas in both patients with FID and healthy subjects. However, in FID patients, CB1R availability was also negatively correlated with BMI throughout the mesolimbic reward system (midbrain, striatum, insula, amygdala and orbitofrontal cortex), which constitutes the key circuit implicated in processing appetitive motivation and hedonic value of perceived food rewards. Our results indicate that the cerebral homeostatic CB1R system is inextricably linked to BMI, with additional involvement of reward areas under conditions of disordered body weight.

  1. Association between cerebral cannabinoid 1 receptor availability and body mass index in patients with food intake disorders and healthy subjects: a [(18)F]MK-9470 PET study.

    Science.gov (United States)

    Ceccarini, J; Weltens, N; Ly, H G; Tack, J; Van Oudenhove, L; Van Laere, K

    2016-01-01

    Although of great public health relevance, the mechanisms underlying disordered eating behavior and body weight regulation remain insufficiently understood. Compelling preclinical evidence corroborates a critical role of the endocannabinoid system (ECS) in the central regulation of appetite and food intake. However, in vivo human evidence on ECS functioning in brain circuits involved in food intake regulation as well as its relationship with body weight is lacking, both in health and disease. Here, we measured cannabinoid 1 receptor (CB1R) availability using positron emission tomography (PET) with [(18)F]MK-9470 in 54 patients with food intake disorders (FID) covering a wide body mass index (BMI) range (anorexia nervosa, bulimia nervosa, functional dyspepsia with weight loss and obesity; BMI range=12.5-40.6 kg/m(2)) and 26 age-, gender- and average BMI-matched healthy subjects (BMI range=18.5-26.6 kg/m(2)). The association between regional CB1R availability and BMI was assessed within predefined homeostatic and reward-related regions of interest using voxel-based linear regression analyses. CB1R availability was inversely associated with BMI in homeostatic brain regions such as the hypothalamus and brainstem areas in both patients with FID and healthy subjects. However, in FID patients, CB1R availability was also negatively correlated with BMI throughout the mesolimbic reward system (midbrain, striatum, insula, amygdala and orbitofrontal cortex), which constitutes the key circuit implicated in processing appetitive motivation and hedonic value of perceived food rewards. Our results indicate that the cerebral homeostatic CB1R system is inextricably linked to BMI, with additional involvement of reward areas under conditions of disordered body weight. PMID:27404285

  2. Ingesta dietética en un grupo de pacientes fumadores de marihuana Dietary intakes in a group of marihuana smoking patients

    Directory of Open Access Journals (Sweden)

    D. A. De Luis

    2010-08-01

    Full Text Available Fundamentos: El uso de marihuana (cannabis sativa tiene efectos sobre el apetito, siendo los estudios en la literatura escasos. El objetivo de nuestro estudio fue evaluar la ingesta de un grupo de sujetos fumadores de marihuana. Pacientes y métodos: Se incluyeron un total de 32 varones. La edad media fue de 37,25 ± 8,8 años. A todos los pacientes se les determinó el peso corporal, la talla y el índice de masa corporal y se realizó una encuesta nutricional. Resultados: La ingesta calórica total fue de 3.350,1 ± 979 kcal/día. La distribución de calorías fue de un 44,3% en forma de hidratos de carbono, un 14% en proteínas y un 41,7% en grasas (50,6% grasas monoinsaturadas, 36,3% grasas saturadas y el 13,1% grasas polinsaturadas. La ingesta absoluta de proteínas fue evelada (109,6 ± 38,5 g/día así como la ingesta corregida por peso (1,62 ± 0,73. Con referencia a los minerales y vitaminas, existió una baja ingesta de vitamina D, E, ácido fólico, magnesio y yodo. Las ingestas de vitaminas A, C, K, tiamina, riboflavina, B6, niacina, B12, calcio, hierro y zinc fueron superiores a las recomendaciones internacionales. No existieron diferencias estadísticamente significativas en la ingesta dietética ni en el peso entre los dos grupos de consumidores de marihuana en funcion de la mediana de tiempo de consumo (19 años. Conclusiones: Los pacientes fumadores de marihuana realizan una dieta hipercalorica e hiperproteica, rica en grasas y con un aporte por encima de lo recomendado de micronutrientes. Todo ello sin relacionarse con el peso del paciente.Background: Marihuana use has effects on appetite; studies in the literature on this topic area are limited. The aim of our work was to evaluate the dietary intake of marihuana smoking patietns. Patients and methods: A total of 32 male subjects were enrolled (average age 37.25 ± 8.8 years. In all patients were determined weight, height and body mass index and a three days nutritional

  3. Insufficient voluntary intake of nutrients and energy in hospitalized patients Ingestión voluntariamente insuficiente de nutrientes y energía en pacientes hospitalizados

    Directory of Open Access Journals (Sweden)

    M. M. Tavares

    2007-10-01

    Full Text Available Aim: The aim of our study was to evaluate the inadequacy of voluntary energy and nutrient intake on the first day of hospital admission. Patients and methods: A cross-sectional study was carried out in two terciary care hospitals, with a probabilistic sample of 50% of in-patients. Dietary intake was evaluated by a 24-hour dietary recall, and undernutrition was screened through the Nutritional Risk Screening 2002 tool. The overall frequency of inadequate energy and nutrient intake was estimated using Dietary Reference Intakes. Results: Energy and nutrient intakes from 258 patients showed very low values for both men and women. No significant differences were found for energy and nutrient intakes across age groups (Objetivo: El propósito de nuestro estudio fue evaluar la inadecuación de la ingestión voluntaria de energía y nutrientes durante el primer día de ingreso hospitalario. Pacientes y métodos: Se realizó un estudio transversal en dos centros hospitalarios de atención terciaria con una muestra probabilística del 50% de pacientes ingresados. Se evaluó la ingestión alimenticia mediante un diario de 24 horas, y se hizo un cribado de desnutrición mediante la herramienta Nutritional Risk Screening 2002. Se estimó la falta de adecuación del consumo de energía y nutrientes mediante el Dietary Reference Intakes. Resultados: El consumo de energía y nutrientes en 258 pacientes mostró niveles muy bajos tanto en hombre como en mujeres. No se hallaron diferencias significativas en el consumo de energía y nutrientes entre los distintos grupos de edad (< 65 años y ≥ 65 años. Cuando se analizó la proporción de sujetos del estudio con consumo inadecuado de nutrientes, se halló una alta proporción de inadecuación. El grado de inadecuación fue mayor para la fibra, niacina, folato, vitamina B12, magnesio y zinc. No se hallaron diferencias significativas en la energía y los nutrientes estudiados y los consumos inferiores a 1/3 de las

  4. Preserved skeletal muscle protein anabolic response to acute exercise and protein intake in well-treated rheumatoid arthritis patients

    DEFF Research Database (Denmark)

    Mikkelsen, Ulla Ramer; Dideriksen, Kasper; Andersen, Mads Bisgaard;

    2015-01-01

    of the amino acid (13)C6-phenylalanine tracer in the overnight fasted state for 3 hours (BASAL) and 3 hours after intake of whey protein (0.5 g/kg lean body mass) alone (PROT, 3 hrs) and in combination with knee-extensor exercise (EX) with one leg (8 × 10 reps at 70 % of 1RM; PROT + EX, 3 hrs). Expression...

  5. Beneficial effects of citrus juice fermented with Lactobacillus plantarum YIT 0132 on atopic dermatitis: results of daily intake by adult patients in two open trials

    OpenAIRE

    HARIMA-MIZUSAWA, Naomi; Kamachi, Keiko; Kano, Mitsuyoshi; NOZAKI, Daisuke; UETAKE, Tatsuo; YOKOMIZO, Yuji; Nagino, Takayuki; Tanaka, Akira; MIYAZAKI, Kouji; Nakamura, Shinichiro

    2015-01-01

    This study aimed to examine whether daily intake of citrus juice containing heat-killed Lactobacillus plantarum YIT 0132 (LP0132-fermented juice) alleviates symptoms of atopic dermatitis. This was a natural extension of our previous study in which LP0132 was shown to enhance IL-10 production in vitro and LP0132-fermented juice was found to alleviate symptoms and enhance quality of life (QOL) in patients with Japanese cedar pollinosis. In two open trials, Trial 1 and Trial 2, 32 and 18 adult p...

  6. Diagnosis of congenital von Willebrand disease during a preoperative assessment in a multiple myeloma patient without bleeding history.

    Science.gov (United States)

    El Ouaaliti, Malika; Li, Rong; Gobin, Delphine; Bron, Dominique; Cantinieaux, Brigitte

    2016-07-01

    We report a rare case of type 2M von Willebrand disease diagnosed in an elderly multiple myeloma patient who had no personal and family bleeding history. This case report emphasis the importance to not systematically exclude a congenital vWD in adult patients when coagulation screening tests indicate toward a vWD. PMID:27386134

  7. Fibroblast Growth Factor 21 (FGF-21 in Peritoneal Dialysis Patients: Natural History and Metabolic Implications.

    Directory of Open Access Journals (Sweden)

    Elena González

    Full Text Available Human fibroblast growth factor 21 (FGF-21 is an endocrine liver hormone that stimulates adipocyte glucose uptake independently of insulin, suppresses hepatic glucose production and is involved in the regulation of body fat. Peritoneal dialysis (PD patients suffer potential interference with FGF-21 status with as yet unknown repercussions.The aim of this study was to define the natural history of FGF-21 in PD patients, to analyze its relationship with glucose homeostasis parameters and to study the influence of residual renal function and peritoneal functional parameters on FGF-21 levels and their variation over time.We studied 48 patients with uremia undergoing PD. Plasma samples were routinely obtained from each patient at baseline and at 1, 2 and 3 years after starting PD therapy.Plasma FGF-21 levels substantially increased over the first year and were maintained at high levels during the remainder of the study period (253 pg/ml (59; 685 at baseline; 582 pg/ml (60.5-949 at first year and 647 pg/ml (120.5-1116.6 at third year (p<0.01. We found a positive correlation between time on dialysis and FGF-21 levels (p<0.001, and also, those patients with residual renal function (RRF had significantly lower levels of FGF-21 than those without RRF (ρ -0.484, p<0.05. Lastly, there was also a significant association between FGF-21 levels and peritoneal protein losses (PPL, independent of the time on dialysis (ρ 0.410, p<0.05.Our study shows that FGF-21 plasma levels in incident PD patients significantly increase during the first 3 years. This increment is dependent on or is associated with RRF and PPL (higher levels in patients with lower RRF and higher PPL. FGF-21 might be an important endocrine agent in PD patients and could act as hormonal signaling to maintain glucose homeostasis and prevent potential insulin resistance. These preliminary results suggest that FGF-21 might play a protective role as against the development of insulin resistance over

  8. Metacognition and general functioning in patients with schizophrenia and a history of criminal behavior.

    Science.gov (United States)

    Bo, Sune; Kongerslev, Mickey; Dimaggio, Giancarlo; Lysaker, Paul H; Abu-Akel, Ahmad

    2015-02-28

    Metacognitive difficulties have been linked to social dysfunction in schizophrenia. However, research examining the role of metacognition in the social functioning of patients with a history of violence and criminality is very limited. This research is especially important for this group given their relatively poor prognosis and their risk to reoffend, as well as the promising benefits of integrating metacognitive approaches in psychosocial treatments. In this study, the association between metacognition and global social functioning was examined in 79 patients with schizophrenia with a criminal background. We also examined the association of positive, negative and disorganized symptoms with social functioning and the extent to which metacognition mediates this association. The results indicate that poor social functioning is associated with metacognitive difficulties and higher levels of delusions and Conceptual Disorganization. In addition, meditation analyses showed that metacognition accounted for about 11% of the total effect size of the association between delusions and social dysfunction, suggesting that the relationship between delusions and social dysfunction is partially driven by impaired metacognition. These findings underscore the importance of interventions designed to enhance the patients׳ metacognitive capacities, that is, the more proximal capacities linked to poorer social functioning.

  9. Metacognition and general functioning in patients with schizophrenia and a history of criminal behavior.

    Science.gov (United States)

    Bo, Sune; Kongerslev, Mickey; Dimaggio, Giancarlo; Lysaker, Paul H; Abu-Akel, Ahmad

    2015-02-28

    Metacognitive difficulties have been linked to social dysfunction in schizophrenia. However, research examining the role of metacognition in the social functioning of patients with a history of violence and criminality is very limited. This research is especially important for this group given their relatively poor prognosis and their risk to reoffend, as well as the promising benefits of integrating metacognitive approaches in psychosocial treatments. In this study, the association between metacognition and global social functioning was examined in 79 patients with schizophrenia with a criminal background. We also examined the association of positive, negative and disorganized symptoms with social functioning and the extent to which metacognition mediates this association. The results indicate that poor social functioning is associated with metacognitive difficulties and higher levels of delusions and Conceptual Disorganization. In addition, meditation analyses showed that metacognition accounted for about 11% of the total effect size of the association between delusions and social dysfunction, suggesting that the relationship between delusions and social dysfunction is partially driven by impaired metacognition. These findings underscore the importance of interventions designed to enhance the patients׳ metacognitive capacities, that is, the more proximal capacities linked to poorer social functioning. PMID:25582967

  10. Is nutrient intake a gender-specific cause for enhanced susceptibility to alcohol-induced liver disease in women?

    DEFF Research Database (Denmark)

    Wagnerberger, S.; Schäfer, C.; Schwarz, E.;

    2008-01-01

    of ALD in dependence on the sex of the patients. RESULTS: No significant differences between males and females with ALD were calculated for the intake (per kg body weight/day) of protein, carbohydrates, fat, and the intake (per kg body weight/day) of most micronutrients. In females with ALD, higher...... of ALD in animal experiments, the hypothesis of the present retrospective cross-sectional study was that gender-dependent (micro-) nutrient intake in patients with ALD may cause the higher susceptibility of women to this disease. METHODS: In 210 patients (male: 158, female: 52) with different stages...... of ALD (ALD1: mild stage of liver damage; ALD2: moderately severe changes of the liver with signs of hepatic inflammation; ALD3: severely impaired liver function) and in 336 controls (male: 208, female: 128), nutrient intake was determined by a computer-guided diet history, and related to the severity...

  11. Is nutrient intake a gender-specific cause for enhanced susceptibility to alcohol-induced liver disease in women?

    DEFF Research Database (Denmark)

    Wagnerberger, S.; Schafer, C.; Schwarz, E.;

    2008-01-01

    of ALD in dependence on the sex of the patients. Results: No significant differences between males and females with ALD were calculated for the intake (per kg body weight/day) of protein, carbohydrates, fat, and the intake (per kg body weight/day) of most micronutrients. In females with ALD, higher...... of ALD in animal experiments, the hypothesis of the present retrospective cross-sectional study was that gender-dependent (micro-) nutrient intake in patients with ALD may cause the higher susceptibility of women to this disease. Methods: In 210 patients (male: 158, female: 52) with different stages...... of ALD (ALD1: mild stage of liver damage; ALD2: moderately severe changes of the liver with signs of hepatic inflammation; ALD3: severely impaired liver function) and in 336 controls (male: 208, female: 128), nutrient intake was determined by a computer-guided diet history, and related to the severity...

  12. Analyzing complex patients' temporal histories: new frontiers in temporal data mining.

    Science.gov (United States)

    Sacchi, Lucia; Dagliati, Arianna; Bellazzi, Riccardo

    2015-01-01

    In recent years, data coming from hospital information systems (HIS) and local healthcare organizations have started to be intensively used for research purposes. This rising amount of available data allows reconstructing the compete histories of the patients, which have a strong temporal component. This chapter introduces the major challenges faced by temporal data mining researchers in an era when huge quantities of complex clinical temporal data are becoming available. The analysis is focused on the peculiar features of this kind of data and describes the methodological and technological aspects that allow managing such complex framework. The chapter shows how heterogeneous data can be processed to derive a homogeneous representation. Starting from this representation, it illustrates different techniques for jointly analyze such kind of data. Finally, the technological strategies that allow creating a common data warehouse to gather data coming from different sources and with different formats are presented.

  13. The Effect of Warm Water Intake on Bowel Movements in the Early Postoperative Stage of Patients Having Undergone Laparoscopic Cholecystectomy: A Randomized Controlled Trial.

    Science.gov (United States)

    Çalişkan, Nefise; Bulut, Hülya; Konan, Ali

    2016-01-01

    This study was aimed at determining the effect of oral administration of warm water during the postoperative initial stage on the time of first flatus in patients who had undergone laparoscopic cholecystectomy. In the literature, it is emphasized that warm water has favorable effects on intestinal movements such as "reliving gastrointestinal spasms and helping peristalsis return." This randomized controlled trial and experimental study was conducted in a university hospital between May and December 2011. In the study sample, we included a total of 60 patients; 30 were in the experimental group (drank warm water), while the other 30 composed the control group. Patients were randomized through a simple random sampling method. The experimental group was provided with 200 ml of warm water at 98.6°F (37°C) in the fourth postoperative hour and were made to drink it within 15 minutes. Patients received no oral intake other than warm water until the eighth postoperative hour. The oral feeding of both groups started in the eighth postoperative hour with fluids and soft food. They shifted to the normal diet as tolerated. In the analysis of the data and percentage numbers, chi-square test and Fisher's exact test, Student's t test, Mann-Whitney U test, Kruskal-Wallis variance, and correlation analysis were used. The results of the data were considered reliable and statistically significant when they were in the reliability interval of 95% and p .05). Groups were homogeneously distributed. Flatus expulsion in the experimental group was 11 ± 4.2 hours and was determined to be 18.6 ± 6 hours for patients in the control group (p .05). It was determined that warm water intake in the fourth postoperative hour significantly decreased the first flatus expulsion period and had a favorable impact on intestinal movements. PMID:27684632

  14. 血液透析患者膳食营养素摄入状况调查%Investigation of Dietary Nutrients Intake in Nemodialysis Patients

    Institute of Scientific and Technical Information of China (English)

    王淑霞

    2012-01-01

    目的:了解血液透析患者的膳食情况,并对其食物构成、营养素含量进行分析,以指导合理膳食,改善营养状况,更好地配合临床治疗。方法:采用膳食记录和24h回顾法对患者进行连续3d的饮食调查,根据2004、21309年版《中国食物成分表》计算出每日营养素的摄入量,与中国居民膳食营养素参考摄入量进行比较评价。结果:大部分血液透析患者膳食中谷类、蛋类摄入偏低,肉、奶、蔬莱、水果摄入不足。食物组成中以米、面、谷类摄入为主,杂粮摄入较少;肉食品以猪肉为主,海产品及蛋类、奶类摄入较少。营养素摄入中能量和蛋白质的摄入水平偏低;钠过量;钙、镁、磷等宏量元素和锌、铁、铜、硒、锰等微量元素摄入不足;维生素B,、维生素B,、维生素c等均未达到RNI要求。结论:我院血液透析患者膳食摄入普遍不足,膳食结构不合理,应根据个体情况进行调整。%[Objective] To understand the diet of hematodialysis patients and analyze the compositions of food and contents of nutrient to guide patients' rational diet, improve their nutritional status, and make them match clinical trenment preferablely. [Method] Use the diet records and 24h diet review to make a 3d diet investigation on the basis of Zhong Guo Shi Wu Cheng Fen Biao published in 2004 and 2009 to compute the everyday nutrient intake of hematodialysis patients and compare it with Food Nutriment Intake of Chinese Resident. [Result] Intake of grain, eggs , meat, milk, vegetables, fruits of most of hemodialysis patients was inadequate. Rice and grain was their main food, and the intake of food grain other than wheat and rice was less. They took pork as their main animal food but ate less marine product, eggs and milk. Energy, protein, macroelement (Ca, Mg, P, ect) and microelement (Zn, Fe, Cu, Se, Mn, ect) was insufficient in their nutrient

  15. Natural history and clinical assessment of Taiwanese patients with mucopolysaccharidosis IVA

    Science.gov (United States)

    2014-01-01

    Background Mucopolysaccharidosis IVA (MPS IVA) is a rare lysosomal storage disorder caused by N-acetylgalactosamine-6-sulfatase deficiency, which catalyzes a step in the catabolism of glycosaminoglycans, keratan sulfate and chondroitin-6-sulfate. This disease has a variable age of onset and rate of progression. Methods A retrospective analysis of medical records of 24 patients with MPS IVA (11 males, 13 females; current mean age ± SD, 12.6 ± 6.6 years; age range, 1.4-29.4 years) seen at 6 medical centers in Taiwan from January 1996 through June 2013 was performed. Results Mean ages of onset of symptoms and confirmed diagnosis were 2.0 ± 1.6 and 5.7 ± 4.5 years, respectively. The most prevalent clinical manifestations were kyphosis (100%), pectus carinatum (96%), abnormal gait (93%), striking short trunk dwarfism (92%), genu valgum (92%), and valvular heart disease (91%). Eight patients (33%) experienced at least one surgical procedure with the most common being ear tube insertion (25%), adenoidectomy (17%), tonsillectomy (13%), supraglottoplasty (13%), spinal decompression (13%), and spinal fusion (13%). The most prevalent cardiac valve abnormalities were aortic stenosis (45%) and mitral regurgitation (45%). At the time of the study, 8 out of 24 patients (33%) have died at the mean age of 17.2 ± 7.7 years. Conclusions An understanding of the natural history involved in MPS IVA may allow early diagnosis of the disease. All affected Taiwanese patients experienced significant functional limitations. Adequate evaluations and timely management may improve clinical outcomes and quality of life. PMID:24513086

  16. Epidemic History of Hepatitis C Virus among Patients with Inherited Bleeding Disorders in Iran

    Science.gov (United States)

    Samimi-Rad, Katayoun; Rahimnia, Ramin; Sadeghi, Mahdi; Malekpour, Seyed Amir; Marzban, Mona; Keshvari, Maryam; Kiani, Seyed Jalal; Alavian, Seyed-Moayed

    2016-01-01

    The high rate of hepatitis C virus (HCV) infection among transfusion related risk groups such as patients with inherited bleeding disorders highlighting the investigation on prevalent subtypes and their epidemic history among this group. In this study, 166 new HCV NS5B sequences isolated from patients with inherited bleeding disorders together with 29 sequences related to hemophiliacs obtained from a previous study on diversity of HCV in Iran were analyzed. The most prevalent subtype was 1a (65%), followed by 3a (18.7%),1b (14.5%),4(1.2%) and 2k (0.6%). Subtypes 1a and 3a showed exponential expansion during the 20th century. Whereas expansion of 3a started around 20 years earlier than 1a among the study patients, the epidemic growth of 1a revealed a delay of about 10 years compared with that found for this subtype in developed countries. Our results supported the view that the spread of 3a reached the plateau 10 years prior to the screening of blood donors for HCV. Rather, 1a reached the plateau when screening program was implemented. The differences observed in the epidemic behavior of HCV-1a and 3a may be associated with different transmission routes of two subtypes. Indeed, expansion of 1a was more commonly linked to blood transfusion, while 3a was more strongly associated to drug use and specially IDU after 1960. Our findings also showed HCV transmission through blood products has effectively been controlled from late 1990s. In conclusion, the implementation of strategies such as standard surveillance programs and subsiding antiviral treatments seems to be essential to both prevent new HCV infections and to decline the current and future HCV disease among Iranian patients with inherited bleeding disorders. PMID:27611688

  17. Epidemic History of Hepatitis C Virus among Patients with Inherited Bleeding Disorders in Iran.

    Science.gov (United States)

    Samimi-Rad, Katayoun; Rahimnia, Ramin; Sadeghi, Mahdi; Malekpour, Seyed Amir; Marzban, Mona; Keshvari, Maryam; Kiani, Seyed Jalal; Alavian, Seyed-Moayed

    2016-01-01

    The high rate of hepatitis C virus (HCV) infection among transfusion related risk groups such as patients with inherited bleeding disorders highlighting the investigation on prevalent subtypes and their epidemic history among this group. In this study, 166 new HCV NS5B sequences isolated from patients with inherited bleeding disorders together with 29 sequences related to hemophiliacs obtained from a previous study on diversity of HCV in Iran were analyzed. The most prevalent subtype was 1a (65%), followed by 3a (18.7%),1b (14.5%),4(1.2%) and 2k (0.6%). Subtypes 1a and 3a showed exponential expansion during the 20th century. Whereas expansion of 3a started around 20 years earlier than 1a among the study patients, the epidemic growth of 1a revealed a delay of about 10 years compared with that found for this subtype in developed countries. Our results supported the view that the spread of 3a reached the plateau 10 years prior to the screening of blood donors for HCV. Rather, 1a reached the plateau when screening program was implemented. The differences observed in the epidemic behavior of HCV-1a and 3a may be associated with different transmission routes of two subtypes. Indeed, expansion of 1a was more commonly linked to blood transfusion, while 3a was more strongly associated to drug use and specially IDU after 1960. Our findings also showed HCV transmission through blood products has effectively been controlled from late 1990s. In conclusion, the implementation of strategies such as standard surveillance programs and subsiding antiviral treatments seems to be essential to both prevent new HCV infections and to decline the current and future HCV disease among Iranian patients with inherited bleeding disorders. PMID:27611688

  18. Thyroid-Like Follicular Carcinoma of the Kidney in a Young Patient with History of Pediatric Acute Lymphoblastic Leukemia

    Directory of Open Access Journals (Sweden)

    William W. Wu

    2014-01-01

    Full Text Available Thyroid-like follicular carcinoma of the kidney (TLFCK is a rare histological variant of renal cell carcinoma not currently included in the World Health Organization classification of renal tumors. Only 24 previous cases of TLFCK have been reported to date. We report a case of TLFCK in a 19-year-old woman with history of pediatric acute lymphoblastic leukemia. This patient is the youngest with TLFCK to be reported to date and the first with history of lymphoblastic leukemia. The development of TLFCK in a young patient with history of lymphoblastic leukemia is interesting and suggests that genes involved in leukemogenesis may also be important for TLFCK pathogenesis. Recognition of TLFCK is important to distinguish it from other conditions that show thyroid-like features, as a misdiagnosis can result in adverse patient care.

  19. Effects of dietary guidance on the symptoms, quality of life and habitual dietary intake of patients with irritable bowel syndrome

    OpenAIRE

    MAZZAWI, TAREK; Hausken, Trygve; Gundersen, Doris Irene; El-Salhy, Magdy

    2013-01-01

    Diet is important in triggering the symptoms of irritable bowel syndrome (IBS). This study investigated the impact of dietary guidance on the symptoms, quality of life and habitual diet of patients with IBS. Forty‑six patients who fulfilled the Rome III criteria for the diagnosis of IBS were included. Of these patients, 17 completed the entire study. Each patient attended three sessions (~45 min in duration) and received individual guidance on their dietary management. The patients were asked...

  20. Olive oil intake is inversely related to cancer prevalence: a systematic review and a meta-analysis of 13800 patients and 23340 controls in 19 observational studies

    Directory of Open Access Journals (Sweden)

    Dimopoulos Meletios

    2011-07-01

    Full Text Available Abstract Dietary fat, both in terms of quantity and quality, has been implicated to cancer development, either positively or negatively. The aim of this work was to evaluate whether olive oil or monounsaturated fat intake was associated with the development of cancer. A systematic search of relevant studies, published in English, between 1990 and March 1, 2011, was performed through a computer-assisted literature tool (i.e., Pubmed. In total 38 studies were initially allocated; of them 19 case-control studies were finally studied (13800 cancer patients and 23340 controls were included. Random effects meta-analysis was applied in order to evaluate the research hypothesis. It was found that compared with the lowest, the highest category of olive oil consumption was associated with lower odds of having any type of cancer (log odds ratio = -0.41, 95%CI -0.53, -0.29, Cohran's Q = 47.52, p = 0.0002, I-sq = 62%; the latter was irrespective of the country of origin (Mediterranean or non-Mediterranean. Moreover, olive oil consumption was associated with lower odds of developing breast cancer (logOR = -0,45 95%CI -0.78 to -0.12, and a cancer of the digestive system (logOR = -0,36 95%CI -0.50 to -0.21, compared with the lowest intake. The strength and consistency of the findings states a hypothesis about the protective role of olive oil intake on cancer risk. However, it is still unclear whether olive oil's monounsaturated fatty acid content or its antioxidant components are responsible for its beneficial effects.

  1. Prognosis following transcatheter arterial embolization for 121 patients with unresectable hepatocellular carcinoma with or without a history of treatment

    Institute of Scientific and Technical Information of China (English)

    Atsushi Hiraoka; Seishi Kumano; Hiroaki Tanaka; Yoshimasa Yamashita; Norio Horiike; Teruhito Mochizuki; Morikazu Onji; Teru Kumagi; Masashi Hirooka; Takahide Uehara; Kiyotaka Kurose; Hidehito Iuchi; Yoichi Hiasa; Bunzo Matsuura; Kojiro Michitaka

    2006-01-01

    AIM: To retrospectively evaluate the prognosis of patients with hepatocellular carcinoma (HCC) with or without a history of therapy for HCC following transcatheter arterial embolization (TAE).METHODS: One hundred and twenty-one patients with HCC treated with TAE from 1992 to 2004 in our hospital were enrolled in this study. Eighty-four patients had a history of treatment for HCC, while 37 did not. At the time of entry, patients with extra-hepatic metastasis,portal vein tumor thrombosis, or Child-Pugh class C were excluded. TAE was repeated when recurrence of HCC was diagnosed by elevated tumor markers, or ultrasonography or dynamic computed tomography findings. RESULTS: Tumor size was larger and the number of tumors was fewer in patients without past treatment (P< 0.01). However, there were no differences in tumor node metastasis (TNM) stage or survival rate between the 2 groups. A bilobular tumor and high level of α-fetoprotein (AFP) (>100 ng/mL) were factors related to a poor prognosis in patients with a history of HCC. CONCLUSION: The prognosis following TAE is similar between HCC patients with and without past treatment.Early diagnosis of HCC or recurrent HCC and obtaining good local control against HCC before entry to a repeated TAE course can improve prognosis.

  2. Development and implementation of a music/activity therapy intake assessment for psychiatric patients. Part I: initial standardization procedures on data from university students.

    Science.gov (United States)

    Braswell, C; Brooks, D M; Decuir, A; Humphrey, T; Jacobs, K W; Sutton, K

    1983-01-01

    The stimulus for the Music/Activity Therapy Intake Assessment was a recent publication by the Joint Commission on Accreditation of Hospitals requiring for activity services, "assessment of the patient's needs, interests, life experiences, capacities, and deficiencies" (1981, p. 126). The Assessment was written in the spring of 1982 and contains four sections: Activity Preference, Organizational involvement, Attitude Survey, and Post-Interview Observations. The purpose of the present study was to investigate the psychometric properties of the Attitude Survey. The Attitude Survey was administered to 214 university students enrolled in three areas of study: human science, performance, and liberal arts. Results show that each of the three scales in the Survey is internally consistent (.63 to .74), that each scale measures a single large dimension, and that two of the three scales significantly discriminate between groups of students (p less than .05). The authors conclude that the Attitude Survey possesses adequate psychometric properties to justify its continued use as part of the Music/Activity Intake Assessment. PMID:10262389

  3. [Effective Dexmedetomidine Administration for the Prevention of Emergence Agitation and Postoperative Delirium in Patients with a History of Postoperative Delirium].

    Science.gov (United States)

    Fujisawa, Takanobu; Komasawa, Nobuyasu; Fujiwara, Atsushi; Kido, Haruki; Minami, Toshiaki

    2016-04-01

    We successfully performed intraoperative dexmedetomidine (DEX) administration for the prevention of emergence agitation or postoperative delirium after lung resection in four patients (71.3 ± 5.7 year old, 3 males and 1 female) with a past history of postoperative delirium. DEX was started at 0.35-0.45 μg x kg(-1) x hr(-1) continuously without loading. The average time from DEX initiation to extubation was 141.3 ± 94.4 minutes. No patient had emergence agitation, and DEX administration was continued until the following morning with monitoring in all patients without any symptoms of delirium. Intraoperative DEX administration may be beneficial for the prevention of emergence agitation or postoperative delirium in patients with a past history of postoperative delirium.

  4. Central obesity and dietary intake in HIV/AIDS patients Obesidade abdominal e consumo alimentar em portadores de HIV/Aids

    Directory of Open Access Journals (Sweden)

    Patrícia Constante Jaime

    2006-08-01

    Full Text Available OBJECTIVE: To assess the association between dietary intake and central obesity among people living with HIV/AIDS and receiving highly active antiretroviral therapy. METHODS: A cross-sectional study was conducted involving 223 adult individuals in the city of São Paulo city in 2002. The study population was classified according to central obesity, defined as waist-to-hip ratio >0.95 for men and >0.85 for women. The dietary variables studied were energy consumption (in calories and calories/kilo of body weight, macronutrients (in grams and % of energy intake, total fiber (grams and fruit and vegetables intake (grams. The potential confounders examined were sex, skin color, age, schooling, income, body mass index, physical activity, smoking habits, peripheral CD4+ T lymphocyte count and length of protease inhibitor use. The multiple logistic regression model was performed in order to evaluate the association between central obesity and dietary intake. RESULTS: The prevalence of central obesity was 45.7% and it was associated with greater consumption of lipids: for every increase of 10g of lipid intake the odds of central obesity increased 1.28 times. Carbohydrate consumption showed negative association (OR=0.93 with central obesity after adjustment for control variables. CONCLUSIONS: The results suggest that the amount of carbohydrates and lipids in the diet, regardless of total energy intake, may modify the chance of developing central obesity in the studied population. Nutritional interventions may be beneficial for preventing central obesity among HIV/AIDS patients.OBJETIVO: Avaliar a associação entre consumo alimentar e presença de obesidade abdominal em indivíduos infectados pelo HIV/Aids, em uso de terapia antiretroviral de alta potência. MÉTODOS: Trata-se de estudo transversal envolvendo 223 indivíduos adultos, realizado no município de São Paulo, em 2002. A população de estudo foi classificada de acordo com a obesidade

  5. Loss of FHIT expression in gastric mucosa of patients with family histories of gastric cancer and Helicobacter pylori infection

    Institute of Scientific and Technical Information of China (English)

    Krystyna Stec-Michalska; Slawomir Antoszczyk; Grazyna Klupinska; Barbara Nawrot

    2005-01-01

    AIM: To answer the question whether FHIT gene expression is affected by the family history of gastric carcinoma and the presence of Helicobacter pylori (Hpylori) in the gastric mucosa of patients with dyspepsia.METHODS: FHIT gene expression in two different topographic sites of the gastric mucosa of twenty-one patients with dyspepsia and with or without familial gastric carcinoma, infected or not infected with H pylori, was evaluated by reverse transcription-PCR (RT-PCR) and IMAGE QUANT methods. A rapid urease test and histopathological examination were used to determine H pylori colonization.RESULTS: In the gastric mucosa of patients with family histories of gastric carcinoma, the amount of FHIT protein mRNA was reduced down to 32%, and for patients with H pylori colonization, to 24% in comparison to controls with dyspepsia and without cancer in the family. FHIT expression was independent of the topography of specimens (corpus vsantrum), and for the control patients it was less sensitive to infection with H pylori. A considerable statistical difference in FHIT levels was observed in the gastric mucosa from the corpus of patients with family histories of gastric carcinoma in respect to H pylori colonization (P = 0.06). Macroscopic evaluation of the gastric mucosa demonstrated that pathologic changes classified according to the Sydney system had no significant influence on FHIT expression within each tested group of patients.CONCLUSION: Loss of FHIT expression was observed in patients with dyspepsia and family histories of gastric carcinoma, especially those infected with H pylori. Such results may constitute an early indication of the development of gastric carcinoma, which is associated with family factors including heredity and H pylori infection. The loss of the FHIT gene may serve as a marker for early diagnosis and prevention of gastric carcinoma, especially in context of early monitoring of H pylori infection in individuals with a record of familial stomach

  6. Patients with premature cardiovascular disease and a positive family history for cardiovascular disease are prone to recurrent events

    NARCIS (Netherlands)

    T.A. Mulders; Z. Meyer; C. van der Donk; A.A. Kroon; I. Ferreira; C.D.A. Stehouwer; S.J. Pinto-Sietsma

    2011-01-01

    Background: Premature cardiovascular disease (CVD) is treated in the same way as CVD of advanced age. However, in patients with premature CVD and a family history of CVD, different -possibly genetic-mechanisms may underlie this disease, which current medical treatment is not targeted to. This sugges

  7. Isolation of an NDM-5-producing ST16 Klebsiella pneumoniae from a Dutch patient without travel history abroad, August 2015

    NARCIS (Netherlands)

    Bathoorn, E.; Rossen, J. W.; Lokate, M.; Friedrich, A. W.; Hammerum, A. M.

    2015-01-01

    A New Delhi Metallo-beta-lactamase-5 (NDM-5)-producing ST16 Klebsiella pneumoniae strain was isolated from a Dutch patient in a long-term care facility without recent travel history abroad. Core genome multilocus sequence typing (cgMLST) revealed that the Dutch isolate was clonally related to isolat

  8. [Dis/arranged medical histories à la Friedrichsberg. Explorations of foreign patients by multilingual fellow patients in a German asylum about 1900].

    Science.gov (United States)

    Wulf, Stefan; Schmiedebach, Heinz-Peter

    2010-01-01

    This paper deals with two examples of a particular patient's activity at the Friedrichsberg Asylum in Hamburg in the beginning of the 20th century. Two multilingual patients assumed the function of interpreters in each case for a foreign fellow patient. They were involved to a great extent in the documentation of the medical histories. Conversations and interrogations carried out by them and recorded by their own hand are passed down in the medical files of their foreign-language fellow patients. After some preliminary remarks about the Friedrichsberg Asylum and its patients, the various activities of patients in the psychiatric institution and the importance of the patients' manner of speaking for the psychiatric diagnosis, the two cases are described in detail. The patient-interpreters were perceived as border-crossers, as "Figures of the Third".

  9. 新诊断的2型糖尿病患者营养素摄入量与营养参考指数(DRIs)对比分析%A comparative analysis of nutrients intake of newly diagnosed patients versus Dietary Reference Intake

    Institute of Scientific and Technical Information of China (English)

    车千红; 赵晴; 孙灿; 郭佳琦

    2012-01-01

    目的 将新诊断的T2DM患者营养素摄入量与中国居民膳食营养素参考摄入量(DRIs)对比分析.方法 采用24h膳食调查法连续3d对新诊断的T2DM患者进行膳食调查,计算每人每日热能和各种营养素的摄入量,结果与DRIs对比分析.结果 调查组人均脂肪摄入量明显高于推荐水平;维生素C、膳食纤维、钙等营养素平均每日摄入量均低于推荐水平.结论 提倡食物多样性,以中国居民平衡膳食宝塔为参照依据,对T2DM患者给予有针对性的营养素补充.%Objective To comparatively analyze the nutrient intake of patients with newly diagnosed type 2 diabetes (T2DM) and Dietary Reference Intakes (DRIs), for providing a scientific basis for preventing T2DM. Methods The 24 hours dietary investigation for 3 days in patients newly diagnosed as T2DM was adopted, calculating total energy and various nutrients intakes per person per day. We compared the surveyed results with the Dietary Reference Intakes (DRIs). Results The average daily fat intake was significantly higher in survey group than in the DRIs recommendation. The average daily intake of micronutrients such as dietary fiber, vitamin C, calcium etc was lower in survey group than in DRIs recommendation. Conclusions Advocating food diversification and following the Chinese residents balanced meal pagoda as reference, patients with type 2 diabetes may be given a targeted nutrient supplement

  10. Conformal radiotherapy for prostate cancer - Longer duration of acute genitourinary toxicity in patients with prior history of invasive urological procedure

    Energy Technology Data Exchange (ETDEWEB)

    Odrazka, Karel; Vanasek, Jaroslav; Vaculikova, Miloslava; Petera, Jiri; Zouhar, Milan; Zoul, Zdenk; Stejskal, Jan; Skrabkova, Zuzana; Kadeka, David [Charles Univ. Medical School and Teaching Hospital, Hradec Kralove (Czech Republic). Dept. of Radiotherapy and Oncology

    2001-11-01

    The incidence and predictors of acute toxicity were evaluated in patients treated with three-dimensional conformal radiotherapy (3D-CRT) for localized prostate cancer. Between December 1997 and November 1999, 116 patients with T1-T3 prostatic carcinoma were enrolled in the study. Ninety patients were treated with 70 Gy and 26 patients with T3 tumors received 74 Gy. Of the 116 patients 42 (36.2%) had a prior history of invasive urological procedure (IUP) (transurethral resection of the prostate or transvesical prostatectomy for benign prostatic hyperplasia). Acute gastrointestinal (GI) and genitourinary (GU) symptoms were graded according to the EORTC/RTOG scoring system. Toxicity duration after the completion of 3D-CRT was recorded. The majority of patients experienced only mild or no (Grade 1) acute toxicities. Medications for GI and GU symptoms (Grade 2) were required by 28.4% and 12.9% of patients, respectively. Only one case of Grade 3 GI toxicity (0.9%) was observed. Seven patients (6.1%) experienced severe GU toxicity (Grade 3 or 4). No correlation was found between acute toxicity and age, stage, dose (70 Gy vs. 74 Gy), IUP and pelvic lymphadenectomy. A significant relationship was observed between the duration of acute GU toxicity and prior IUP. Symptoms persisted for more than 4 weeks in 51.9% and 26.0% of patients with and without a prior history of IUP, respectively (p = 0.02). The incidence of acute complications, associated with 3D-CRT for prostate cancer, was acceptable in our cohort of patients. A prior history of IUP resulted in a significantly longer duration of acute GU toxicity.

  11. Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU per day on biochemical responses and the wellbeing of patients

    Directory of Open Access Journals (Sweden)

    Hu Amanda

    2004-07-01

    Full Text Available Abstract Background For adults, vitamin D intake of 100 mcg (4000 IU/day is physiologic and safe. The adequate intake (AI for older adults is 15 mcg (600 IU/day, but there has been no report focusing on use of this dose. Methods We compared effects of these doses on biochemical responses and sense of wellbeing in a blinded, randomized trial. In Study 1, 64 outpatients (recruited if summer 2001 25(OHD Results In Study 1, basal summer 25-hydroxyvitamin D [25(OHD] averaged 48 ± 9 (SD nmol/L. Supplementation for more than 6 months produced mean 25(OHD levels of 79 ± 30 nmol/L for the 15 mcg/day group, and 112 ± 41 nmol/L for the 100 mcg/day group. Both doses lowered plasma parathyroid hormone with no effect on plasma calcium. Between December and February, wellbeing score improved more for the 100-mcg/day group than for the lower-dosed group (1-tail Mann-Whitney p = 0.036. In Study 2, 25(OHD averaged 39 ± 9 nmol/L, and winter wellbeing scores improved with both doses of vitamin D (two-tail p Conclusion The highest AI for vitamin D brought summertime 25(OHD to >40 nmol/L, lowered PTH, and its use was associated with improved wellbeing. The 100 mcg/day dose produced greater responses. Since it was ethically necessary to provide a meaningful dose of vitamin D to these insufficient patients, we cannot rule out a placebo wellbeing response, particularly for those on the lower dose. This work confirms the safety and efficacy of both 15 and 100 mcg/day vitamin D3 in patients who needed additional vitamin D.

  12. Varenicline precipitating psychosis in a patient with no previous psychiatric history: a case report of a Spanish patient who was later diagnosed with paranoid personality disorder.

    Science.gov (United States)

    Forcen, Fernando Espi; Martinez, Fernando Luis Espi; Moya, Amparo Martinez

    2012-01-01

    Varenicline is gaining popularity for the treatment of nicotine dependence. General treatment guidelines recommend monitoring for behavioral changes in patients with a mental illness. There are very few cases reported on patients developing psychiatric symptoms with no previous history. We are reporting the case of a Spanish patient who had developed a first-psychotic episode after he was started on varenicline. He was ultimately diagnosed with a paranoid personality disorder. Therefore, prior to starting a patient on varenicline, the clinician must identify possible paranoid and other cluster A personality traits. It is essential to monitor for new onset of psychotic symptoms during the treatment with this drug.

  13. Perception and knowledge about dietary intake in patients with liver cirrhosis and its relationship with the level of education

    International Nuclear Information System (INIS)

    Objective: To determine patients perception and knowledge regarding diet in cirrhosis and its relationship with the level of patients education. Study Design: Cross-sectional observational study. Place and Duration of Study: This study was conducted at Gastroenterology Outpatient Clinics at the Aga Khan University Hospital, Karachi, the Aga Khan Health Services, Malir, Karachi and Hamdard University, Karachi, from January to December 2010. Methodology: Consecutive adult patients with compensated cirrhosis were enrolled. Demographic data, level of education, type and reason of food restriction as well as the source of dietary information was asked. Baseline laboratory test were performed, and nutritional status was assessed by BMI normogram. Results: Ninety patients, 58% male were enrolled. Mean age of the patient was 49 +- 11 years. Overall 73% of the patients were restricting fat, meat, fish and eggs in their diet; 53% were in uneducated group and 47% were in educated group (CI, 0.24-1.62, p-0.34). Twenty two patients (62.8%) in uneducated and 21 in educated group (68%) were restricting diet on the advice of their doctors, whereas 13 in uneducated group (37%) and 11 in educated group (32%) believed these dietary components to be harmful for the liver. Thirty two of uneducated patient (71.1%) and 28 of educated patients (62.2%) believed that vegetables, fruits and sugarcane had a beneficial effect on the liver. Main source of dietary information to the patients was the doctor. On sub-group analysis those who restricted diet irrespective of their educational level, had more patients with BMI less than 18.5 kg/m/sup 2/, (CI 0.01-0.94, p-0.001), haemoglobin less than 12 g/dl (CI 0- 0.03, p-0.001) and serum albumin less than 3 g/dl (CI 0.1- 03, p-0.001). Conclusion: Both educated and uneducated classes of the patients have improper knowledge and perception of diet in cirrhosis. Patients with cirrhosis who restricted diet, had relatively low BMI, haemoglobin and albumin

  14. Impact of diuretic treatment and sodium intake on plasma volume in patients with compensated systolic heart failure

    DEFF Research Database (Denmark)

    Bonfils, Peter K; Damgaard, Morten; Taskiran, Mustafa;

    2010-01-01

    AIMS: In patients with heart failure (HF), the use of diuretics may be a double-edged sword that can alleviate symptoms of congestion, but also result in over-diuresis and intravascular volume depletion. The purpose of the present study was to examine plasma volume (PV) in HF patients receiving...... difference in PV between patients with HF and control subjects (37.3 +/- 6.0 and 40.2 +/- 5.8 mL/kg, respectively, P = 0.092) with a significant tendency towards a contraction of PV with increasing use of diuretics (P = 0.031). There was no difference in extracellular volume between patients with HF...... and control subjects (P = 0.844). NT-proBNP plasma concentrations had no correlation to either sodium excretion (P = 0.193) or PV (P = 0.471) in patients with HF. CONCLUSION: Plasma volume in patients with HF was within normal limits, but patients treated with high doses of loop-diuretics tended to have...

  15. Abdominal aortic aneurysms do not develop more aggressively among patients with a positive family history of the disease

    DEFF Research Database (Denmark)

    Mejnert Jørgensen, Trine; Wemmelund, Holger; Green, Anders;

    aneurysm (AAA) strongly increases the risk of developing AAA, but it is still uncertain whether familial AAA’s develops differently than non-familial AAA’s. Objectives: To investigate whether familial AAA’s develop more aggressively than non-familial AAA’s by looking at growth rate, risk of surgery...... and rupture, as well as the size of the aneurysm at the time of diagnosis and the patient´s age at the time of operation, rupture and diagnosis. Design: Observational retrospective longitudinal study Materials: 318 patients (273 men and 45 women) with AAA diagnosed between 1996-2008 in Jutland, Denmark...... with information on family history of AAA, diameter of AAA throughout follow-up, surgery, ruptures, comorbidity, smoking, and use of medication. Methods: Patients with and without a family history of AAA were compared regarding mean age at diagnosis and surgery, diameter of AAA at diagnosis, risk of surgery...

  16. Improving students' confidence levels in communicating with patients and introducing students to the importance of history taking

    International Nuclear Information System (INIS)

    Background: Radiographers can have a marked impact on the way patients deal with their illness because they are often one of the first health professionals that patients see. Therefore, it is essential that radiographers have effective communication skills and are able to provide patients with the information they require. The purpose of this study was to test whether the introduction of additional education on communication and history taking improved students' communication skills. Methods: A short program on communication skills and history taking was introduced to third year undergraduate students prior to a clinical placements period. Three workshops were run; the third included a role play exercise using professional actors as simulated patients. Students completed questionnaires at baseline, following the three workshops and after their subsequent clinical placement. Descriptive statistics were calculated and logistic regression Generalized Estimating Equations models were fitted to test for differences over time in students' confidence levels. Results: Twenty-seven out of 36 students completed the baseline and final surveys. Students indicated they were highly satisfied with the workshops provided. Statistically significant differences were observed for seven items relating to student's confidence levels in communicating with patients after they had participated in the workshops and their subsequent clinical placement. Conclusion: The use of communication skills workshops involving actor/patients is an effective method of assisting students to develop their communication and history taking skills. This program has now been implemented into the mentioned undergraduate course and it is recommended that radiography students at other institutions be provided with the opportunity to develop their communication and history taking skills.

  17. Improving students' confidence levels in communicating with patients and introducing students to the importance of history taking

    Energy Technology Data Exchange (ETDEWEB)

    Halkett, Georgia K.B., E-mail: g.halkett@curtin.edu.a [WA Centre for Cancer and Palliative Care/Curtin Health Innovation Research Institute, Curtin University of Technology, Perth, Western Australia (Australia); Department of Imaging and Applied Physics, Curtin University of Technology, Perth, Western Australia (Australia); McKay, Janice [Department of Imaging and Applied Physics, Curtin University of Technology, Perth, Western Australia (Australia); Shaw, Therese [Child Health Promotion Research Centre, School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Western Australia (Australia)

    2011-02-15

    Background: Radiographers can have a marked impact on the way patients deal with their illness because they are often one of the first health professionals that patients see. Therefore, it is essential that radiographers have effective communication skills and are able to provide patients with the information they require. The purpose of this study was to test whether the introduction of additional education on communication and history taking improved students' communication skills. Methods: A short program on communication skills and history taking was introduced to third year undergraduate students prior to a clinical placements period. Three workshops were run; the third included a role play exercise using professional actors as simulated patients. Students completed questionnaires at baseline, following the three workshops and after their subsequent clinical placement. Descriptive statistics were calculated and logistic regression Generalized Estimating Equations models were fitted to test for differences over time in students' confidence levels. Results: Twenty-seven out of 36 students completed the baseline and final surveys. Students indicated they were highly satisfied with the workshops provided. Statistically significant differences were observed for seven items relating to student's confidence levels in communicating with patients after they had participated in the workshops and their subsequent clinical placement. Conclusion: The use of communication skills workshops involving actor/patients is an effective method of assisting students to develop their communication and history taking skills. This program has now been implemented into the mentioned undergraduate course and it is recommended that radiography students at other institutions be provided with the opportunity to develop their communication and history taking skills.

  18. Effect of Family History on Outcomes in Patients Treated With Definitive Brachytherapy for Clinically Localized Prostate Cancer

    International Nuclear Information System (INIS)

    Purpose: To determine the impact familial prostate cancer has on prognosis in men treated with brachytherapy for clinically localized prostate cancer. Methods and Materials: A total of 1,738 consecutive patients with prostate cancer (cT1-3, N0/X, M0) received low-dose-rate brachytherapy alone or in combination with external beam radiation therapy or hormone ablation from 1992 to 2005. The primary end-point was freedom from biochemical failure (FFBF) using the Phoenix definition. Minimum follow-up was 2 years and the median follow-up was 60 months (range, 24-197 months). Results: A total of 187 of 1,738 men (11%) had a family history of prostate cancer in a first-degree relative. For the low-risk patients, both groups had similar actuarial 5-year FFBF (97.2% vs. 95.5%, p = 0.516). For intermediate-risk patients, there was a trend toward improved biochemical control in men positive for family history (5-yr FFBF 100% vs. 93.6%, p = 0.076). For the high-risk patients, men with a positive family history had similar 5-year FFBF (92.8% vs. 85.2%, p = 0.124). On multivariate analysis, family history was not significant; use of hormones, high biologic effective dose, initial prostate-specific antigen value, and Gleason score were the significant variables predicting biochemical control. Conclusions: This is the first study to examine the relationship of familial prostate cancer and outcomed in men treated with brachytherapy alone or in combination therapy. Men with a positive family history have clinicopathologic characteristics and biochemical outcomes similar to those with sporadic disease

  19. Application of the structured history taking of medication use tool to optimise prescribing for older patients and reduce adverse events.

    Science.gov (United States)

    Cullinan, Shane; O'Mahony, Denis; Byrne, Stephen

    2016-04-01

    Background Older patients, due to polypharmacy, co-morbidities and often multiple prescribing doctors are particularly susceptible to medication history errors, leading to adverse drug events, patient harm and increased costs. Medication reconciliation at the point of admission to hospital can reduce medication discrepancies and adverse events. The Structured HIstory taking of Medication use (SHiM) tool was developed to provide a structure to the medication reconciliation process. There has been very little research with regards to SHiM, it's application to older patients and it's potential to reduce adverse events. Objective To determine whether application of SHiM could optimise older patients' prescriptions on admission to hospital, and in-turn reduce adverse events, compared to standard care. Setting A sub-study of a large clinical trial involving hospital inpatients over the age of 65 in five hospitals across Europe. Method A modified version of SHiM was used to obtain accurate drug histories for patients after the attending physician had obtained a medication list via standard methods. Discrepancies between the two lists were recorded and classified, and the clinical relevance of the discrepancies was determined. Whether discrepancies in patients' medication histories, as revealed by SHiM, resulted in actual clinical consequences was then investigated. As this study was carried out during the observation phase of the clinical trial, results were not communicated to the medical teams. Main outcome measure Discrepancies between medication lists and whether these resulted in clinical consequences. Results SHiM was applied to 123 patients. The mean age of the participants was 78 (±6). 200 discrepancies were identified. 90 patients (73 %) had at least one discrepancy with a median of 1.0 discrepancies per patient (IQR 0.00-2.25). 53 (26.5 %) were classified as 'unlikely to cause patient discomfort or clinical deterioration', 145 (72.5 %) as 'having potential

  20. Surgical outcome in patients taking concomitant or recent intake of oral isotretinoin: A multicentric Study-ISO-AIMS study

    Directory of Open Access Journals (Sweden)

    Omprakash Heggadahalli Mahadevappa

    2016-01-01

    Full Text Available Background: The current standard recommendation is to avoid surgical interventions in patients taking oral isotretinoin. However, this recommendation has been questioned in several recent publications. Aim: To document the safety of cosmetic and surgical interventions, among patients receiving or recently received oral isotretinoin. Materials and Methods: Association of Cutaneous Surgeons, India, in May 2012, initiated this study, at 11 centers in different parts of India. The data of 183 cases were collected monthly, from June 2012 to May 2013. Of these 61 patients had stopped oral isotretinoin before surgery and 122 were concomitantly taking oral isotretinoin during the study period. In these 183 patients, a total of 504 interventions were performed. These included[1] 246 sessions of chemical peels such as glycolic acid, salicylic acid, trichloroacetic acid, and combination peels;[2] 158 sessions of lasers such as ablative fractional laser resurfacing with erbium-doped yttrium aluminum garnet and CO2, conventional full face CO2laser resurfacing, laser-assisted hair reduction with long-pulsed neodymium-doped yttrium aluminum garnet, diode laser, and LASIK surgery;[3] 27 sessions of cold steel surgeries such as microneedling, skin biopsy, subcision, punch elevation of scars, excision of skin lesion, and wisdom tooth extraction;[4] 1 session of electrosurgery. Results: No significant side effects were noted in most patients. 2 cases of keloid were documented which amounted to 0.4% of side effects in 504 interventions, with a significant P value of 0.000. Reversible transient side effects were erythema in 10 interventions and hyperpigmentation in 15. Conclusion: The study showed that performing dermatosurgical and laser procedures in patients receiving or recently received isotretinoin is safe, and the current guidelines of avoiding dermatosurgical and laser interventions in such patients taking isotretinoin need to be revised.

  1. Decreased food intake is a risk factor for mortality in hospitalised patients: The NutritionDay survey 2006

    NARCIS (Netherlands)

    M. Hiesmayr; K. Schindler; E. Pernicka; C. Schuh; A. Schoeniger-Hekele; P. Bauer; A. Laviano; A.D. Lovell; M. Mouhieddine; T. Schuetz; S.M. Schneider; P. Singer; C. Pichard; P. Howard; C. Jonkers; I. Grecu; O. Ljungqvist

    2009-01-01

    Background & aims: Malnutrition is a known risk factor for the development of complications in hospitalised patients. We determined whether eating only fractions of the meals served is an independent risk factor for mortality. Methods: The NutritionDay is a multinational one-day cross-sectional surv

  2. Patient Impression and Satisfaction of a Self-administered, Automated Medical History-taking Device in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Sanjay Arora

    2014-02-01

    Full Text Available Introduction: We evaluated patient impressions and satisfaction of an innovative self-administered, hand-held touch-screen tablet to gather detailed medical information from emergency department (ED patients in the waiting room prior to physician contact. Methods: Adult, medically stable patients presenting to the ED at Los Angeles County Hospital used the PatientTouche system to answer a series of questions about their current history of present illness and past medical/surgical histories in English or Spanish. Patients then completed a survey rating their experience. Results: Among 173 participants, opinion of PatientTouche was strongly positive; 93.6% (95%CI 90.0–97.3% felt the physical product was easy to hold and handle, and 97.1% (94.6–99.6% felt the questions were detailed enough for them to fully describe their condition; 97.8% (95.4–100.0% felt using PatientTouche would help them organize their thoughts and communicate better with their physician, 94.8% (91.4–98.1% thought it would improve the quality of their care, and 97.1% (94.6– 99.6% expressed desire to use the product again in the future. Conclusion: The study was conducted at a largely Hispanic county ED, and only patients with 1 of 6 pre-determined chief complaints participated. We did not include a control group to assess if perceived improvements in communication translated to measurable differences. In this pilot study, patients were highly satisfied with all aspects of the PatientTouche self-administered, hand-held, touch-screen tablet. Importantly, subjects felt it would help them better communicate with their doctor, would improve their overall quality of care and overwhelmingly expressed a desire to use it in the future. [West J Emerg Med. 2014;15(1:35–40.

  3. Calcium, magnesium and potassium intake and mortality in women with heart failure: the Women's Health Initiative.

    Science.gov (United States)

    Levitan, Emily B; Shikany, James M; Ahmed, Ali; Snetselaar, Linda G; Martin, Lisa W; Curb, J David; Lewis, Cora E

    2013-07-14

    Although diet is thought to affect the natural history of heart failure (HF), nutrient intake in HF patients has not been well studied. Based on prior research linking high intake of Ca, Mg and K to improved cardiovascular health, we hypothesised that these nutrients would be inversely associated with mortality in people with HF. Of the 161 808 participants in the Women's Health Initiative (WHI), we studied 3340 who experienced a HF hospitalisation. These participants were followed for post-hospitalisation all-cause mortality. Intake was assessed using questionnaires on food and supplement intake. Hazard ratios (HR) and 95 % CI were calculated using Cox proportional hazards models adjusted for demographics, physical function, co-morbidities and dietary covariates. Over a median of 4·6 years of follow-up, 1433 (42·9 %) of the women died. HR across quartiles of dietary Ca intake were 1·00 (referent), 0·86 (95 % CI 0·73, 1·00), 0·88 (95 % CI 0·75, 1·04) and 0·92 (95 % CI 0·76, 1·11) (P for trend = 0·63). Corresponding HR were 1·00 (referent), 0·86 (95 % CI 0·71, 1·04), 0·88 (95 % CI 0·69, 1·11) and 0·84 (95 % CI 0·63, 1·12) (P for trend = 0·29), across quartiles of dietary Mg intake, and 1·00 (referent), 1·20 (95 % CI 1·01, 1·43), 1·06 (95 % CI 0·86, 1·32) and 1·16 (95 % CI 0·90, 1·51) (P for trend = 0·35), across quartiles of dietary K intake. Results were similar when total (dietary plus supplemental) nutrient intakes were examined. In summary, among WHI participants with incident HF hospitalisation, intakes of Ca, Mg and K were not significantly associated with subsequent mortality.

  4. Long-term prognosis after acute myocardial infarction in patients with a history of arterial hypertension. TRACE study group

    DEFF Research Database (Denmark)

    Gustafsson, F; Køber, L; Torp-Pedersen, C;

    1998-01-01

    after acute myocardial infarction. METHODS: A retrospective analysis of survival data on 6676 patients with acute myocardial infarction screened for entry into the TRAndolapril Cardiac Evaluation (TRACE) study. Follow-up time was 4-6 years. RESULTS: One thousand five hundred and seven (23......AIMS: The objective of the study was to investigate the influence of a history of arterial hypertension on long-term prognosis after an acute myocardial infarction in a representative population, and secondly to assess the impact on prognosis of left ventricular systolic function in hypertensives......%) of the patients had a history of arterial hypertension. During the time of observation 763 (50.6%) hypertensives and 2253 (43.7%) normotensives died, corresponding to a risk ratio for death in hypertensives of 1.23 (1.13-1.33, P

  5. Natural History and Outcome of Hepatic Vascular Malformations in a Large Cohort of Patients with Hereditary Hemorrhagic Teleangiectasia

    OpenAIRE

    Buscarini, Elisabetta; Leandro, Gioacchino; Conte, Dario; DANESINO, CESARE; Daina, Erica; Manfredi, Guido; Lupinacci, Guido; Brambilla, Gianfranco; Menozzi, Fernanda; De Grazia, Federico; Gazzaniga, Pietro; INAMA, GIUSEPPE; Bonardi, Roberto; Blotta, Pasquale; Forner, PierAngelo

    2011-01-01

    Background Hereditary hemorrhagic telangiectasia is a genetic disease characterized by teleangiectasias involving virtually every organ. There are limited data in the literature regarding the natural history of liver vascular malformations in hemorrhagic telangiectasia and their associated morbidity and mortality. Aim This prospective cohort study sought to assess the outcome of liver involvement in hereditary hemorrhagic telangiectasia patients. Methods We analyzed 16 years of surveillance d...

  6. Chronic thromboembolic pulmonary hypertension as a cause of dyspnoea in an older patient with a complex history

    OpenAIRE

    Kähler, C M

    2009-01-01

    A full diagnostic work-up for patients with pulmonary hypertension (PH) is vital. Classification and diagnosis of the underlying cause is important to ensure optimal management, but may be complicated by overlapping signs and symptoms. This case study describes how a full work-up identified chronic thromboembolic PH (CTEPH) as the cause of dyspnoea in a 68-yr-old male with a history of pulmonary embolism and an original diagnosis of chronic obstructive pulmonary disease. Key indicators includ...

  7. When patients portray their conduct as normal and healthy: an interactional challenge for thorough substance use history taking.

    Science.gov (United States)

    Denvir, Paul M

    2012-11-01

    Researchers and medical practitioners have argued that routine substance use histories are performed less frequently and less thoroughly than they should be. Previous research has identified a range of structural, attitudinal, and socio-cultural barriers that help to explain this pattern. Using conversation analytic (CA) methods, this paper complements previous work by exploring a potential interactional barrier to thorough substance use history taking in the USA. In response to routine substance use queries (e.g. "Do you drink alcohol?"), patients often do more than just providing information. They also convey normative stances toward their conduct, essentially making a case for how it should be understood by the physician. One stance that patients may take is that their conduct is normal and healthy. This paper describes three interactional practices that patients used to enact such a stance: 1) employing marked lexical, intonational, or interactional features when indicating no use of a substance; 2) volunteering normalizing details about the type, quantity, frequency, or circumstances of substance use; 3) providing minimizing characterizations of substance use. The paper explores some reasons why physicians treated these as appropriate and sufficient responses and did not seek additional details even when the information provided was quite superficial. Two social functions of patients' "normal/healthy" stances are discussed: 1) redirecting the physician's history taking to other topics and 2) presenting oneself as a health-conscious patient. "Normal/healthy" stances can represent an expression of patient agency, but can also present a dilemma for physicians, who must balance a concern for thoroughness with a concern for rapport. Recommendations for navigating this dilemma are discussed. PMID:22884752

  8. Case notes, case histories, and the patient's experience of insanity at Gartnavel Royal Asylum, Glasgow, in the nineteenth century.

    Science.gov (United States)

    Andrews, J

    1998-08-01

    This article is concerned primarily with questions as to how and why case notes were produced and utilized, and how they may (or may not) be used by historians. More specifically, it discusses how the Glasgow Royal Asylum's case notes may be deployed to access patients' experiences of madness and confinement. The deficiencies and biases of the case record are also explored. So too is the relationship of case notes with other asylum based records, including reception order questionnaires, with a separate section on patient writings as part of the case history corpus. This leads into an analysis of how the Asylum's case notes became case histories and for what purposes. These subjects are related to changes and continuities in medical ideologies about insanity, social attitudes to the insane and the nature of medical practice in asylums. Some fundamental shifts in emphasis in the use of the case note and case history occurred in this period. These shifts were associated with an increased emphasis on organic interpretations of mental disease and on clinical approaches to insanity; with the medicalization of asylum records and the wider discourse on insanity, and with declining deference to the public at large in the presentation of cases. The survey concludes by analysing the changing place of patient testimony within the case record. PMID:11620430

  9. Assessment of time interval between tramadol intake and seizure and second drug-induced attack

    Directory of Open Access Journals (Sweden)

    Bahareh Abbasi

    2015-11-01

    Full Text Available Background: Tramadol is a synthetic drug which is prescribed in moderate and severe pain. Tramadol overdose can induce severe complications such as consciousness impairment and convulsions. This study was done to determine the convulsions incidence after tramadol use until one week after hospital discharge. Methods: This prospective study was done in tramadol overdose patients without uncontrolled epilepsy and head injury history. All cases admitted in Loghman and Rasol Akram Hospitals, Tehran, Iran from 1, April 2011 to 1, April 2012 were included and observed for at least 12 hours. Time interval between tramadol intake and first seizure were record. Then, patients with second drug-induced seizure were recognized and log time between the first and second seizure was analyzed. The patients were transferred to the intensive care unit (ICU if clinical worsening status observed. One week after hospital discharge, telephone follow-up was conducted. Results: A total of 150 patients with a history of tramadol induced seizures (141 men, 9 women, age: 23.23±5.94 years were enrolled in this study. Convulsion was seen in 104 patients (69.3%. In 8 out of 104 patients (7.6% two or more convulsion was seen. Time interval between tramadol use and the onset of the first and second seizure were 0.93±0.17 and 2.5±0.75 hours, respectively. Tramadol induced seizures are more likely to occur in males and patients with a history of drug abuse. Finally, one hundred forty nine patients (99.3% were discharged with good condition and the only one patient died from tramadol overdose. Conclusion: The results of the study showed tramadol induced seizure most frequently occurred within the first 4 hours of tramadol intake. The chance of experiencing a second seizure exists in the susceptible population. Thus, 4 hours after drug intake is the best time for patients to be hospital discharged.

  10. Is the control of dietary cholesterol intake sufficiently effective to ameliorate nonalcoholic fatty liver disease?

    Institute of Scientific and Technical Information of China (English)

    Munechika; Enjoji; Makoto; Nakamuta

    2010-01-01

    In our examination of the distribution of abdominal fat,dietary intake and biochemical data in patients with nonalcoholic fatty liver disease(NAFLD),non-obese NAFLD patients without insulin resistance presented a characteristic pattern of dietary intake.Dietary cholesterol intake was superabundant in non-obese patients compared with obese patients,although total energy and carbohydrate intake was not excessive.Namely,excess cholesterol intake appears to be one of the main factors associated with NAFLD devel...

  11. The efficacy of telephonic follow up in prevention of suicidal reattempt in patients with suicide attempt history

    Directory of Open Access Journals (Sweden)

    Seyed Ghafur Mousavi

    2014-01-01

    Full Text Available Background: prevention of suicide is one of priority world health. Suicide is one of the preventable causes of death. The aim of this study is evaluation of telephone follow up on suicide reattempt. Materials and Methods : This randomized controlled clinical trial is a prospective study which has been done in Noor Hospital of Isfahan-Iran, at 2010. 139 patients who have suicide attempt history divided in one of two groups, randomly, 70 patients in" treatment as usual (TAU" and 69 patients in "brief interventional control (BIC. Seven telephone contact with BIC group patients have been done "during six months" and two questionnaires have been filled in each session. The data has been analyzed by descriptive and Chi-square test, under SPSS. Results : No significant differences of suicide reattempt has been found between two groups (P = 0.18, but significant reduction in frequency of suicidal thoughts (P = 0.007 and increase in hope at life (P = 0.001 was shown in intervention group. Conclusion : Telephones follow up in patients with suicide history decrease suicidal thought frequency" and increase hope in life, significantly.

  12. HPARSER: extracting formal patient data from free text history and physical reports using natural language processing software.

    Science.gov (United States)

    Sponsler, J L

    2001-01-01

    A prototype, HPARSER, processes a patient history and physical report such that specific data are obtained and stored in a patient data record. HPARSER is a recursive transition network (RTN) parser, and includes English and medical grammar rules, lexicon, and database constraints. Medical grammar rules augment the grammar rule base and specify common phrases seen in patient reports (e.g., "pupils are equal and reactive"). Each database constraint associates a grammar rule with a database table and attribute. Constraint behavior is such that if a rule is satisfied, data is extracted from the parse tree and stored into the database. Control reports guided construction of grammar and constraint rules. Test reports were processed with the control rules. 85% of test report sentences parsed and a 60% data capture rate, compared to controls, was achieved. HPARSER demonstrates use of an RTN to parse patient reports, and database constraints to transfer formal data from parse trees into a database.

  13. Differences in the distribution of cytogenetic subtypes between multiple myeloma patients with and without a family history of monoclonal gammopathy and multiple myeloma

    OpenAIRE

    Greenberg, Alexandra J.; Cousin, Margot; Kumar, Shaji; Ketterling, Rhett P.; Knudson, Ryan A; Larson, Dirk; Colby, Colin; Scott, Christopher; Vachon, Celine M.; Rajkumar, S. Vincent

    2013-01-01

    We previously reported an increased risk of monoclonal gammopathy of undetermined significance (MGUS) in first-degree relatives of MGUS and multiple myeloma patients. Here, we examine whether primary cytogenetic categories of myeloma differ between patients with and without a family history of MGUS or myeloma. We studied 201 myeloma patients with available data on family history and molecular cytogenetic classification. Myeloma with trisomies was more common in probands who had an affected fi...

  14. Investigation of Actual Intake of Protein and Energy by Perioperative Patients%外科围手术期患者蛋白质能量补充量的调查

    Institute of Scientific and Technical Information of China (English)

    李永进; 郑燕萍; 石玮; 王新成

    2001-01-01

    目的了解外科围手术期患者蛋白质、能量供给量,并进行评价。方法对 90 例外科围手术期患者采用称重法计算出经口摄取的蛋白质和能量,按医嘱处方计算出经胃肠外途径补给的蛋白质和能量,并计算出实际补充量和基础需要量的百分比。结果患者每天蛋白质实际摄入量为(31.96±22.21)g,能量摄入量为 4537 kJ;体格检查及生化指标均显示出不同程度的营养不良。结论外科围手术期患者蛋白质和能量摄入量远低于基础需要量。%Objective To investigate the intake of protein and energy by perioperative patients for evaluation.Methods By weighing method,the mouth-intake of protein and energy was calculated and according to the doctors′advice intake through non-gastrointestinal tract was also calculated,then the percentage between actual intake and basic demand was figured out.Results The daily intake of protein was(31.96±22.21)g while it was 4537 kJ for energy;both physical examination and biological indexes showed malnutrition to various degrees.Conclusion The actual intake of protein and energy by perioperative patients is much lower than the basic demand.

  15. Activity in Pregnancy for Patients with a History of Preterm Birth.

    Science.gov (United States)

    Satterfield, Nichelle; Newton, Edward R; May, Linda E

    2016-01-01

    Preterm birth remains a leading cause of neonatal morbidity and mortality throughout the world. Numerous risk factors for preterm birth have been identified, including non-Hispanic black race, a variety of social and behavioral factors, infections, and history of a prior preterm delivery. Of these, a history of prior spontaneous preterm birth is one of the strongest risk factors. Traditionally, women with a history of preterm birth or those deemed at high risk for preterm delivery have been placed on bed rest or a reduced activity regimen during their pregnancy. However, there is little evidence to support this recommendation. Recent research has suggested that regular physical activity and exercise during pregnancy is safe and does not increase the risk of preterm delivery. Therefore, physicians should encourage women with a history of preterm birth to exercise throughout pregnancy according to guidelines published by the American College of Obstetricians and Gynecologists as long as they are receiving regular prenatal care and their current health status permits exercise. However, there are no randomized controlled trials evaluating exercise prescription in women with a history of preterm birth, hence additional research is needed in this area.

  16. Association of folate intake, dietary habits, smoking and COX-2 promotor-765G > C polymorphism with K-ras mutation in patients with colorectal cancer

    International Nuclear Information System (INIS)

    Background: Understanding the role of environmental and molecular influences on the nature and rate of K-ras mutations in colorectal neoplasms is crucial. COX-2 polymorphisms -765G > C may play a role in carcinogenic processes in combination with specific life-style conditions or dependent on the racial composition of a particular population. If mutational events play an important role in colorectal carcinogenesis sequence, one can hypothesize that modification of these events by life-style or other factors would be a useful prevention strategy. Aim of work: To explore the association between K-ras mutation and potential variables known or suspected to be related to the risk of colorectal cancer (CRC) as well as determining the possible modulating effect of the COX-2 polymorphism, —765G > C. Subjects and methods: The study was conducted on 80 patients with colorectal cancer from Tropical Medicine and Gastrointestinal Tract endoscopy Departments and those attending clinic of the National Cancer Institute, Cairo University during the period extending from April 2009 to March 2010. Full history taking with emphasis on the risk factors of interest, namely age, sex, family history, smoking and dietary history. Serum CEA and CA19-9, RBCs folic acid and occult blood in stool were done to all samples. K-ras protooncogene mutation at codon 12 (exon 1) and cyclooxygenase 2 (COX-2) —765G > C polymorphism were determined by PCR-RFLP. Results: The K-ras mutation was positive in 23 (28.7%) patients. COX-2 polymorphism revealed GG in 62.5%, GC in 26.2 % and CC genotype was found in 11.3 % of cases. The mean red blood cell folic acid level was lower in the K-ras positive group (100.96 ± 51.3 ng/ml) than the negative group (216.6 ± 166.4 ng/ml), (P < 0.01). Higher folate levels were found in males than females (median = 173 ng/ml and 85 ng/ml; respectively, P = 0.002) with adjusted odds ratio (OR) of 0.984. Only, the RBCs folate (P = 0.0018) followed by gender (P = 0

  17. Natural history of cytomegalovirus infection in a series of patients diagnosed with moderate-severe ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Valeria Criscuoli; Maria Rosa Rizzuto; Luigi Montalbano; Elena Gallo; Mario Cottone

    2011-01-01

    AIM: To evaluate the natural history of human cytomegalovirus (HCMV) infection in a series of 28 ulcerative colitis patients in whom the search for HCMV was positive.METHODS: A series of 85 patients with moderate-severe ulcerative colitis flare-up were evaluated for a HCMV search by performing a haematoxylin and eosin stain,immunohistochemical assay and nested polymerase chain reaction on rectal biopsies. Among 85 screened patients (19 of whom were steroid resistant/dependant),28 were positive for HCMV; after remission the patients were followed up clinically and histologically.RESULTS: Among the 22 patients with complete followup,in 8 (36%) patients HCMV-DNA persisted in the intestinal specimens. Among the HCMV positive patients,4 (50%) experienced at least one moderate-severe flare-up of colitis without evidence of peripheral HCMV.Among the 14 HCMV negative patients, 3 with pouches developed pouchitis and 5 out of 11 (45%) experienced a colitis flare-up.CONCLUSION: Our preliminary results suggest that HCMV may remain in the colon after an acute colitis flareup despite remission; it seems that the virus is not responsible for the disease relapse.

  18. Immunoepidemiological profiling of onchocerciasis patients reveals associations with microfilaria loads and ivermectin intake on both individual and community levels.

    Science.gov (United States)

    Arndts, Kathrin; Specht, Sabine; Debrah, Alexander Y; Tamarozzi, Francesca; Klarmann Schulz, Ute; Mand, Sabine; Batsa, Linda; Kwarteng, Alexander; Taylor, Mark; Adjei, Ohene; Martin, Coralie; Layland, Laura E; Hoerauf, Achim

    2014-02-01

    Mass drug administration (MDA) programmes against Onchocerca volvulus use ivermectin (IVM) which targets microfilariae (MF), the worm's offspring. Most infected individuals are hyporesponsive and present regulated immune responses despite high parasite burden. Recently, with MDA programmes, the existence of amicrofilaridermic (a-MF) individuals has become apparent but little is known about their immune responses. Within this immunoepidemiological study, we compared parasitology, pathology and immune profiles in infection-free volunteers and infected individuals that were MF(+) or a-MF. The latter stemmed from villages in either Central or Ashanti regions of Ghana which, at the time of the study, had received up to eight or only one round of MDA respectively. Interestingly, a-MF patients had fewer nodules and decreased IL-10 responses to all tested stimuli. On the other hand, this patient group displayed contrary IL-5 profiles following in vitro stimulation or in plasma and the dampened response in the latter correlated to reduced eosinophils and associated factors but elevated neutrophils. Furthermore, multivariable regression analysis with covariates MF, IVM or the region (Central vs. Ashanti) revealed that immune responses were associated with different covariates: whereas O. volvulus-specific IL-5 responses were primarily associated with MF, IL-10 secretion had a negative correlation with times of individual IVM therapy (IIT). All plasma parameters (eosinophil cationic protein, IL-5, eosinophils and neutrophils) were highly associated with MF. With regards to IL-17 secretion, although no differences were observed between the groups to filarial-specific or bystander stimuli, these responses were highly associated with the region. These data indicate that immune responses are affected by both, IIT and the rounds of IVM MDA within the community. Consequently, it appears that a lowered infection pressure due to IVM MDA may affect the immune profile of community

  19. Processing of decision-making and social threat in patients with history of suicidal attempt: A neuroimaging replication study.

    Science.gov (United States)

    Olié, Emilie; Ding, Yang; Le Bars, Emmanuelle; de Champfleur, Nicolas Menjot; Mura, Thibault; Bonafé, Alain; Courtet, Philippe; Jollant, Fabrice

    2015-12-30

    Suicidal vulnerability has been related to impaired value-based decision-making and increased sensitivity to social threat, mediated by the prefrontal cortex. Using functional magnetic resonance imaging, we aimed at replicating these previous findings by measuring brain activation during the Iowa Gambling Task and an emotional faces viewing task. Participants comprised 15 euthymic suicide attempters (history of depression and suicidal behavior) who were compared with 23 euthymic patient controls (history of depression without suicidal history) and 35 healthy controls. The following five model-based regions of interest were investigated: the orbitofrontal cortex (OFC), ventrolateral prefrontal cortex (VLPFC), anterior cingulate cortex (ACC), medial (MPFC) and dorsal prefrontal cortex (DPFC). Suicide attempters relative to patient controls showed (1) increased response to angry vs. neutral faces in the left OFC and the VLPFC, as previously reported; (2) increased response to wins vs. losses in the right OFC, DPFC and ACC; (3) decreased response to risky vs. safe choices in the left DPFC; and (4) decreased response to sad vs. neutral faces in the right ACC. This study links impaired valuation processing (here for signals of social threat, sadness and reward) to prefrontal cortex dysfunction in suicide attempters. These long-term deficits may underlie the impaired decision-making and social difficulties found in suicide attempters. PMID:26483212

  20. Dissociative symptoms are associated with reduced neuropsychological performance in patients with recurrent depression and a history of trauma exposure

    Directory of Open Access Journals (Sweden)

    Melissa Parlar

    2016-02-01

    Full Text Available Background: Although preliminary work suggests that dissociative symptoms may impact neuropsychological performance in trauma-exposed populations, the relation between dissociation and cognitive performance has not been explored in patients with depression. Objective: The present study examined dissociative symptoms in relation to neuropsychological performance in participants with a primary diagnosis of recurrent major depressive disorder (MDD and a history of trauma exposure. Method: Twenty-three participants with MDD and 20 healthy controls who did not differ in age, sex, education, or IQ were assessed. In addition to a standardized neuropsychological battery assessing frontotemporally mediated cognitive processes, participants completed clinical measures assessing dissociative symptoms, illness severity, and past history of trauma exposure. Results: Among participants with MDD, greater severity of derealization was associated with reduced performance on measures of delayed visuospatial recall and recognition on a task of verbal memory recognition. In addition, more severe depersonalization was associated with slower processing speed and a response style lending itself toward better performance in a less active environment. Conclusions: These findings point toward dissociative symptoms as a transdiagnostic factor associated with neuropsychological dysfunction in patients with depression and a history of trauma. Limitations and recommendations for future research are discussed.

  1. The role of patient-clinician information engagement and information seeking from nonmedical channels in fruit and vegetable intake among cancer patients.

    Science.gov (United States)

    Moldovan-Johnson, Mihaela; Martinez, Lourdes; Lewis, Nehama; Freres, Derek; Hornik, Robert C

    2014-12-01

    Previous research suggests positive effects of health information seeking on prevention behaviors such as diet, exercise, and fruit and vegetable consumption. The present study builds upon this research and strengthens causal claims from it by examining the lagged effect of patient-clinician information engagement on fruit and vegetable consumption as well as the indirect effect on the outcome through seeking information from nonmedical channels. The results are based on data collected from a randomly drawn sample of breast, prostate, and colorectal cancer patients from the Pennsylvania Cancer Registry who completed mail surveys in the Fall of 2006 and 2007. There was a 65% response rate for baseline subjects (resulting n = 2,013); of those, 1,293 were interviewed 1 year later, and 1,257 were available for our analyses. Results show a positive lagged main effect of patient-clinician information engagement at baseline on fruit and vegetable consumption at follow-up (B = 0.26, SE = 0.10, p = .01). The mediation analysis shows that patient-clinician information engagement leads to increased fruit and vegetable consumption among cancer patients, in part through patients' information seeking from nonmedical channels. Implications of these findings for the cancer patient population and for physicians are discussed.

  2. Lip movement in patients with a history of unilateral cleft lip.

    NARCIS (Netherlands)

    Rutjens, C.A.W.; Spauwen, P.H.M.; Lieshout, P.H.H.M. van

    2001-01-01

    OBJECTIVE: The influence of a repaired cleft lip on the stability of coordination between upper and lower lip in nonspeech and speech tasks was investigated. DESIGN: First, we looked at the effects of a secondary cleft lip repair in three individuals. Second, we compared subjects with a history of r

  3. Protein intake in renal disease.

    Science.gov (United States)

    Pollock, C A; Ibels, L S; Zhu, F Y; Warnant, M; Caterson, R J; Waugh, D A; Mahony, J F

    1997-05-01

    The dietary protein intake (DPI) of 766 patients (aged 7 to 88 yr) was determined from 24-h urinary urea and protein excretion by urea kinetic modelling. Five hundred sixty-five patients had a normal serum creatinine concentration, and of these 565, 385 patients had no dietary modification advised and 180 were advised to follow a low-protein diet. The remaining 201 patients had an increased serum creatinine concentration; 148 of these 201 patients had been advised to restrict their DPI. Patients with a normal serum creatinine concentration who had no dietary restriction had a significantly higher DPI than those advised to restrict their protein intake (1.08 +/- 0.01 versus 0.96 +/- 0.02 g/kg per day (mean +/- SEM), P level of renal dysfunction, independent of dietary advice (P level (P level (P levels (P Adaptation to a high-protein diet after instigation of dialysis is unsuccessful in the short term, irrespective of whether or not advice is given regarding a low-protein diet before dialysis is initiated. However, 6 to 9 months after the commencement of dialysis, a significant increase in protein intake occurs, which in the hemodialysis population correlates with dialysis delivery.

  4. Squamous Cell Carcinoma and Multiple Bowen's Disease in a Patient with a History of Consumption of Traditional Chinese Herbal Balls

    Directory of Open Access Journals (Sweden)

    Joon Seok

    2015-07-01

    Full Text Available Arsenic has been classified as a class I human carcinogen, meaning that there is sufficient evidence of carcinogenicity to humans. Arsenic, however, remains a common contaminant in a number of traditional Chinese herbal balls. A 64-year-old man presented with an erythematous erosive patch on the left palm, multiple yellowish scaly patches on the right palm and an erythematous hyperkeratotic patch with bleeding on the left foot dorsum. He also had similar skin lesions on the back and buttock. He had a past medical history of chronic exposure to arsenic through consumption of traditional Chinese herbal balls. Skin biopsy revealed Bowen's disease on the left palm and squamous cell carcinoma on left foot dorsum. We report this case to emphasize that we should investigate patient's history thoroughly, including the use of Chinese herbal balls to find out arsenicism.

  5. Inflammatory markers in patients with metabolic syndrome after the intake of fatty acids n-3 and conjugated linoleic acid (CLA

    Directory of Open Access Journals (Sweden)

    Campos Mondragón, M.G; Oliart Ros, R. M. ; Angulo Guerrero, J. O.

    2013-03-01

    Full Text Available ABSTRACTIntroduction: The metabolic syndrome (MS increa -ses the odds of dying for cardiovascular disease, theworld’s leading cause of death. It has been shown thatpolyunsaturated fatty acids have a protective role in cardiovascular disease and its comorbidities.Objective: To assess the effect of three kinds ofpolyunsaturated fatty acids on the chronic inflammation in MS.Methods: The study group was 45 adults with MSdiagnose according to IDF criteria. Each group of treatment was assigned cuasi-randomly to 15 subjects during six weeks: a 1.8 g/d n-3 (1.08 g eicosapentoaenoicacid EPA + 0.72 g docosahexaenoic acid DHA, b 2.0g/d conjugated linoleic acid (CLA, 50:50, cis9:trans11,trans10:cis12, c 40 g/d walnut Juglans regia. The results at the beginning and the end of the essay werecompared in each group, using the t-Student test and p <0.01 as statistical signification value.Results:In the patients supplemented with n-3 fattyacids, significantly decreased the level of IL-6 (from9.81 ±1.28 to 8.47 ±0.81 pg/ml, p=0.002, leptin(from 25.94 ±5.06 ng/ml to 20.53 ±3.96 ng/ml,p=0.003 and homocysteine (from 18.80 ±1.95 to16.72 ±1.99 µmol/l, p=0.007, in erythrocytes decreased the percentage α-linolenic content (from 1.90±0.77 to 1.26 ±0.17 %, p=0.004 and the n6/n3 rate(from 4.48 ±1.06 to 3.11 a ±0.60, p=0.000, while increased the percentage of EPA (from 1.13 ±0.45 to1.58 ±0.42 %, p=0.009 and DHA (from 2.61 ±0.36 to4.64 ±0.91 %, p=0.000. In the group that consumedwalnut declined the levels of TNF-α (from 8.75 ±2.06pg/ml to 6.68 ±0.97 pg/ml, p=0.002 and IL-6 (from10.61 ±1.45 to 8.72 ±0.79 pg/ml, p=0.000, in erythrocytes increased the α-linolenic content (from 1.86±0.65 to 2.62 ±0.72 %, p=0.005. In the group thatconsumed CLA decreased the level of homocysteine(from 18.01 ±2.65 to 15.34 ±2.26 µmol/l, p=0.006.Conclusions: The groups that consumed n-3 fattyacids in supplements (EPA/DHA and in walnut, becameevident the modification in

  6. CLINICAL CASE HISTORY OF EPTIFIBATIDE USE DURING CORONARY INTERVENTION IN PATIENT WITH CORONARY FAILURE

    Directory of Open Access Journals (Sweden)

    K. A. Kireev

    2015-01-01

    Full Text Available Clinical case history of endovascular intervention in infarct related coronary artery with 4 sirolimus-eluting stents implantation and their further thrombosis during early postoperative period is described. Percutaneous coronary intervention was successful after the balanced medication with 2 antiplatelet drugs (acetylsalicylic acid and clopidogrel and heparin. There were not any reasons for additional prescription of antiplatelet medicine. It seems that one of the main reasons of the stent thrombosis was the extended area of 4 sirolimus-eluting stents implantation into the affected vessel. After the analysis of our clinical case history we propose that for stent thrombosis prevention in multistent (≥4 drugeluting stents interventions it is necessary to apply additional antiplatelet drug – glycoprotein IIb/IIIa inhibitor eptifibatide.

  7. Predictive Value of Having Positive Family History of Cardiovascular Disorders, Diabetes Mellitus, Dyslipidemia, and Hypertension in Non-Alcoholic Fatty Liver Disease Patients

    Directory of Open Access Journals (Sweden)

    Hossein Khedmat

    2013-05-01

    Full Text Available In the present study, we examined the relationship between family history of cardiovascular diseases (CVD, dyslipidemia, hypertension, and diabetes with laboratorial abnormalities and syndromes in Iranian patients with non-alcoholic fatty liver disease (NAFLD. A total of 332 NAFLD patients from our outpatient clinic were consecutively entered into analysis. Exclusion criteria were having diabetes mellitus and fasting blood glucose over 126, active hepatitis B virus infection, having HCV positive serology, and to be under corticosteroid therapy. Family history of CVD, diabetes, dyslipidemia, and hypertension were taken from patients and related to the study variables. Family history of cardiovascular diseases (CVD was associated with low HDL levels (P=0.05. Patients with positive family history of diabetes mellitus were significantly more likely to have AST/ALT levels proportion of higher than one (P=0.044. Family history of dyslipidemia was a predictor for hypertriglyceridemia (P=0.02, higher prothrombin time levels (P=0.013, lower albumin (P=0.024 and T4 (P=0.043 levels. Family history of hypertension was associated with dysglycemia/diabetes (P=0.038, high ALT (P=0.008, and low TIBC (P=0.007 and albumin levels (P=0.001. Family history for CVD, diabetes, dyslipidemia, and hypertension were of clinical importance in the Iranian patients with NAFLD. We therefore recommend that physicians should precisely get family history of main disorders in all NAFLD patients; and to pay more attention to those having the mentioned family histories. Further studies with larger patient population and prospective approach are needed for confirming our findings.

  8. Adult-onset presentation of a hyperornithinemia-hyperammonemia-homocitrullinuria patient without prior history of neurological complications.

    Science.gov (United States)

    Tezcan, Kamer; Louie, Kristal T; Qu, Yong; Velasquez, Jorge; Zaldivar, Frank; Rioseco-Camacho, Natalia; Camacho, José Angel

    2012-01-01

    The Hyperornithinemia-Hyperammonemia-Homocitrullinuria (HHH) syndrome is a disorder of the urea cycle and ornithine degradation pathway caused by mutations in the mitochondrial ornithine transporter, ORNT1 (SLC25A15). In general, the majority of patients with HHH syndrome come to medical attention during infancy or early school years with symptoms such as learning disabilities, changes in cognitive development, spasticity, or liver dysfunction. In this report, we describe a 35-year-old male of Indian descent who was diagnosed with HHH syndrome after he presented to the emergency room with gastroenteritis, disorientation, and slurred speech. Molecular analysis revealed that this patient was heterozygous for two ORNT1 mutations, p.[Gly220Arg(+)Arg275X] (c.[658G>A(+)823C>T]) that had been previously reported in homozygous probands who presented during the first year of life. Cellular studies revealed that the ORNT1 p.Gly220Arg mutation was nonfunctional but targeted to the mitochondria. Given that this patient was a successful college graduate on a vegetarian diet without a prior history of learning or neurological impairment, additional factors such as gene redundancy, environmental, and epigenetic factors may have contributed to the delay in onset of presentation and lack of any previous symptoms. To the best of our knowledge, this is the first reported case of an adult-onset HHH syndrome presentation without a prior history of neurological or cognitive deficiency.

  9. Stroke patients with a past history of cancer are at increased risk of recurrent stroke and cardiovascular mortality.

    Directory of Open Access Journals (Sweden)

    Kui-Kai Lau

    Full Text Available BACKGROUND AND PURPOSE: Cancer patients are at increased risk of cardiovascular and cerebrovascular events. It is unclear whether cancer confers any additional risk for recurrent stroke or cardiovascular mortality after stroke. METHODS: This was a single center, observational study of 1,105 consecutive Chinese ischemic stroke patients recruited from a large stroke rehabilitation unit based in Hong Kong. We sought to determine whether patients with cancer are at higher risk of recurrent stroke and cardiovascular mortality. RESULTS: Amongst 1,105 patients, 58 patients (5.2% had cancer, of whom 74% were in remission. After a mean follow-up of 76 ± 18 months, 241 patients developed a recurrent stroke: 22 in patients with cancer (38%, annual incidence 13.94%/year, substantially more than those without cancer (21%, 4.65%/year (p<0.01. In a Cox regression model, cancer, age and atrial fibrillation were the 3 independent predictors of recurrent stroke with a hazard ratio (HR of 2.42 (95% confidence interval (CI: 1.54-3.80, 1.01 (1.00-1.03 and 1.35 (1.01-1.82 respectively. Likewise, patients with cancer had a higher cardiovascular mortality compared with those without cancer (4.30%/year vs. 2.35%/year, p = 0.08. In Cox regression analysis, cancer (HR: 2.08, 95% CI: 1.08-4.02, age (HR: 1.04, 95% CI 1.02-1.06, heart failure (HR: 3.06, 95% CI 1.72-5.47 and significant carotid atherosclerosis (HR: 1.55, 95% CI 1.02-2.36 were independent predictors for cardiovascular mortality. CONCLUSIONS: Stroke patients with a past history of cancer are at increased risk of recurrent stroke and cardiovascular mortality.

  10. First Episode of Psychosis in a Middle-Aged Patient with a 14-Year History of Conversion Disorder

    Directory of Open Access Journals (Sweden)

    Vaios Peritogiannis

    2014-01-01

    Full Text Available We present a case of a middle-aged male patient with a long history of conversion disorder and histrionic personality, who presented with newly onset psychotic symptoms while being engaged to treatment with a community mental health team in a primary care setting. The symptoms could not be attributed to an organic cause. After a short course of olanzapine treatment which caused adverse effects, the symptomatology responded well to low dose amisulpride. Conversion symptoms were stable throughout the psychotic episode. This case illustrates the complex interplay between disorders classified in different categories (somatoform versus psychotic disorders.

  11. Morphine delays the onset of action of prasugrel in patients with prior history of ST-elevation myocardial infarction.

    Science.gov (United States)

    Thomas, Mark R; Morton, Allison C; Hossain, Rashed; Chen, Beining; Luo, Lei; Shahari, Nur Nazihah B Md; Hua, Peng; Beniston, Richard G; Judge, Heather M; Storey, Robert F

    2016-07-01

    Delays in the onset of action of prasugrel during primary percutaneous coronary intervention (PPCI) have been reported and could be related to the effects of morphine on gastric emptying and subsequent intestinal absorption. The study objective was to determine whether morphine delays the onset of action of prasugrel in patients with a prior history of ST-elevation myocardial infarction (STEMI) treated with PPCI. This was a crossover study of 11 aspirin-treated patients with prior history of STEMI treated with PPCI, for which prasugrel and morphine had been previously administered. Patients were randomised to receive either morphine (5 mg) or saline intravenously followed by 60 mg prasugrel. Blood samples were collected before randomised treatment and over 24 hours after prasugrel administration. The inhibitory effects of prasugrel on platelets were determined using the VerifyNow P2Y12 assay and light transmission aggregometry. Plasma levels of prasugrel and prasugrel active metabolite were measured. Platelet reactivity determined by VerifyNow PRU, VerifyNow % Inhibition and LTA was significantly higher at 30-120 minutes (min) when morphine had been co-administered compared to when saline had been co-administered. Morphine, compared to saline, significantly delayed adequate platelet inhibition after prasugrel administration (158 vs 68 min; p = 0.006). Patients with delayed onset of platelet inhibition also had evidence of delayed absorption of prasugrel. In conclusion, prior administration of intravenous morphine significantly delays the onset of action of prasugrel. Intravenous drugs may be necessary to reduce the risk of acute stent thrombosis in morphine-treated STEMI patients undergoing PPCI. PMID:27099137

  12. High-producing MBL2 genotypes increase the risk of acute and chronic carditis in patients with history of rheumatic fever

    DEFF Research Database (Denmark)

    Schafranski, MD; Pereira Ferrari, L; Scherner, D;

    2008-01-01

    with a history of RF. Polymorphisms in exon 1 and in the X/Y promoter region of the MBL2 gene were determined by PCR-SSP in 149 patients with a history of RF and 147 controls. Genotypes associated with the high production of MBL (YA/YA and YA/XA) were more frequent in the patients with acute (26/35, 74...

  13. The use of nationwide on-line prescription records improves the drug history in hospitalized patients

    DEFF Research Database (Denmark)

    Glintborg, Bente; Poulsen, Henrik E; Dalhoff, Kim P

    2008-01-01

    records through a real-time online electronic database What this study adds: Omission errors are frequent among hospitalized patients despite structured drug interviews and home visits. Pharmacy records may be used to minimize patients' recall bias and improve the medication lists....

  14. Frailty is associated with a history with more falls in elderly hospitalised patients

    DEFF Research Database (Denmark)

    Schultz, Martin; Rosted, Elizabeth; Sanders, Suzanne

    2015-01-01

    patients' ISAR score and falls (p = 0.03). CONCLUSION: To prevent further falls and readmissions, it is crucial not only to focus on elderly people's presenting problems, but also on their dizziness and falls, especially in cognitively impaired elderly patients, and to make a plan for further assessment......INTRODUCTION: When elderly people are admitted to hospital, their risk of falling may often not be recognised. The risk of falling in the elderly is linked to frailty. In a Danish study, it was found that the "Identification of Seniors at Risk" screen (ISAR) predicted the patients' amount of health...... problems, days in hospital and readmission. It may therefore also be a predictor of frailty. This study aimed to evaluate how many elderly patients were admitted to an emergency department (ED) because of a fall and to examine if there was a correlation between these patients and their ISAR score. METHODS...

  15. Evaluating trial of scar in patients with a history of caesarean section

    Directory of Open Access Journals (Sweden)

    Aliya Islam

    2011-01-01

    Full Text Available Aims: To analyze the outcome of trial of scar in patients with previous caesarean section and to assess the fetal and maternal complications after trial of scar. Patients and Methods : The study was conducted at Military Hospital, Rawalpindi, Pakistan, with 375 pregnant patients who had a previous delivery by caesarean and who had regular antenatal checkup. Data were recorded on special pro-forms designed for the purpose. Results : The results from the 375 patients who had one previous lower segment caesarean section due to non-recurrent causes were analyzed and compared with national and international studies. Indications of previous caesarean section (non-recurrent causes included malpresentations, fetal distress/cord prolapse, failure to progress, severe pregnancy-induced hypertension/eclampsia and twins with abnormal lie of the first twin. 0 218 patients reported spontaneous labor. Among these patients, 176 delivered vaginally and 42 patients had repeat caesarean sections. There were a total of 157 patients who experienced induction of labor. 97 patients were induced by cervical ripening with mechanical method, followed by artificial rupture of membranes and augmentation (if required with syntocinon infusion. 60 patients were induced with prostaglandin E 2 vaginal tablet. Conclusion : This study concludes that females with a prior caesarean are at increased risk for subsequent caesareans, regardless of mode of delivery. Eliminating vaginal-birth-after-caesarean will not eliminate the risk. Therefore, vaginal birth after caesarean should be encouraged in selected cases from obstetric units to reduce the risks of repeated caesarean sections. Failed vaginal-birth-after-caesarean can result in increased morbidity than that with elective caesarean section.

  16. Ruptured Heterotopic Tubal Pregnancy for a Patient with a History of Segmental Salpingectomy from Ectopic Pregnancy: A Case Report

    International Nuclear Information System (INIS)

    Heterotopic pregnancy refers to the simultaneous development of an intrauterine pregnancy and an extrauterine pregnancy. We experienced a case of a ruptured heterotopic pregnancy for a patient with a history of a right segmental salpingectomy from an ectopic pregnancy. The 30-year-old patient with amenorrhea for six weeks complained of lower abdominal pain with hypovolemic shock. Transabdominal ultrasonography showed diffuse hemoperitoneum with a structure similar to an ectatic tube or a deformed cyst with no echogenic double ring or peripheral hypervascularity in the right adnexa and an intrauterine gestational sac. We considered a ruptured corpus luteum cyst as an ultrasonographic finding and found a ruptured tubal mass in the right salpinx and hemoperitoneum through an emergency laparotomy. We performed a right salpingectomy, and the histopathologic report confirmed ectopic pregnancy.

  17. Postinduction Paced Pulseless Electrical Activity in a Patient With a History of Oropharyngeal Instrumentation–Induced Reflex Circulatory Collapse

    Science.gov (United States)

    Kline, Ryan J.; Pham, Ky; Labrie-Brown, Carmen L.; Mancuso, Ken; LeLorier, Paul; Riopelle, James; Kaye, Alan David

    2016-01-01

    Background: Reflex hypotension and bradycardia have been reported to occur following administration of several drugs associated with administration of anesthesia and also following a variety of procedural stimuli. Case Report: A 54-year-old postmenopausal female with a history of asystole associated with sedated upper gastrointestinal endoscopy and post–anesthetic-induction tracheal intubation received advanced cardiac resuscitation after insertion of a temporary transvenous pacemaker failed to prevent pulseless electrical activity. The patient's condition stabilized, and she underwent successful cataract extraction, intraocular lens implantation, and pars plana vitrectomy. Conclusion: Cardiac pacemaker insertion prior to performance of a procedure historically associated with reflex circulatory collapse can be expected to protect a patient from bradycardia but not necessarily hypotension. PMID:27660584

  18. Ruptured Heterotopic Tubal Pregnancy for a Patient with a History of Segmental Salpingectomy from Ectopic Pregnancy: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Kyung Bum; Namkung, Sook; Hong, Myung Sun; Kim, Heung Cheol; Cho, Young; Choi, Young Hee [Chuncheon Sacred Heart Hospital, Chyncheon (Korea, Republic of)

    2012-06-15

    Heterotopic pregnancy refers to the simultaneous development of an intrauterine pregnancy and an extrauterine pregnancy. We experienced a case of a ruptured heterotopic pregnancy for a patient with a history of a right segmental salpingectomy from an ectopic pregnancy. The 30-year-old patient with amenorrhea for six weeks complained of lower abdominal pain with hypovolemic shock. Transabdominal ultrasonography showed diffuse hemoperitoneum with a structure similar to an ectatic tube or a deformed cyst with no echogenic double ring or peripheral hypervascularity in the right adnexa and an intrauterine gestational sac. We considered a ruptured corpus luteum cyst as an ultrasonographic finding and found a ruptured tubal mass in the right salpinx and hemoperitoneum through an emergency laparotomy. We performed a right salpingectomy, and the histopathologic report confirmed ectopic pregnancy.

  19. Differences in history of sexual behavior between patients with oropharyngeal squamous cell carcinoma and patients with squamous cell carcinoma at other head and neck sites

    Science.gov (United States)

    Dahlstrom, Kristina R.; Li, Guojun; Tortolero-Luna, Guillermo; Wei, Qingyi; Sturgis, Erich M.

    2010-01-01

    Background An emerging epidemic of human papillomavirus (HPV)-associated oropharyngeal cancer has been proposed. We compared the sexual behaviors of patients with squamous cell carcinoma of the oropharynx (SCCOP) and patients with squamous cell carcinoma of non-oropharyngeal head and neck sites (SCCNOP) to expand our understanding of sexual behavior as a risk factor for HPV-associated head and neck cancer. Methods The sexual history of 165 SCCOP patients and 87 SCCNOP patients was determined in a hospital-based case-case comparison study. Results SCCOP patients were significantly more likely than SCCNOP patients to have had >9 lifetime sex partners (odds ratio [OR]=39.2; 95% confidence interval [CI]=8.2–187.3), to have engaged in oral-genital sex (OR=3.5; 95% CI=1.1–11.1), and to have had > 4 oral-genital sex partners (OR=8.6; 95% CI=2.2–33.4). Conclusions The findings of this study suggest that some risk factors are site specific and provide further evidence that certain sexual behaviors increase the risk of HPV-associated SCCOP. PMID:20737488

  20. Smoking history, nicotine dependence and opioid use in patients with chronic non-malignant pain

    DEFF Research Database (Denmark)

    Plesner, K; Jensen, H I; Højsted, J

    2016-01-01

    BACKGROUND: Previous studies have demonstrated a positive association between smoking and addiction to opioids in patients with chronic non-malignant pain. This could be explained by a susceptibility in some patients to develop addiction. Another explanation could be that nicotine influences both...... pain and the opioid system. The objective of the study was to investigate whether smoking, former smoking ± nicotine use and nicotine dependence in patients with chronic non-malignant pain were associated with opioid use and addiction to opioids. METHODS: The study was a cross-sectional study carried...... as in the general population. The prevalence of patients using opioids was 54% and the prevalence of addiction to opioids was 6%. No significant differences in addiction were found between the different smoking groups, but smokers and former smokers using nicotine tended to use opioids more frequently and at higher...

  1. PATIENTS WITH END STAGE CANCER: LIFE HISTORY, PSYCHO-EMOTIONAL ASPECTS, RELATIONSHIP WITH THE NURSING STAFF.

    Directory of Open Access Journals (Sweden)

    Ivanete Ribeiro do Nascimento

    2013-12-01

    Full Text Available Breast cancer is one of the cancers most feared by women for its high incidence and its psychological effects that affect the perception of sexuality and self-image. Objective: To identify the difficulties of nursing professionals in the treatment of patients with cancer, from the standpoint of a terminally ill patient of breast cancer. Methodology: This is a case study of a patient who is in the terminal stages of breast cancer. We carried out the survey of literature in journals indexed the databases LILACS and SciELO Open Access and English, on terminally ill cancer. Results: Feelings of loneliness and sadness were softened and smoothed by the attitude and disposition of nursing professionals. In moments of intervention needs of physical care, nursing care was provided. Conclusion: The nursing staff has always demonstrated skills in treating patients with cancer, providing quality care, humane and comprehensive, meeting all your needs biopsicoespiritual.

  2. The natural history of growth in patients with Hunter syndrome: Data from the Hunter Outcome Survey (HOS).

    Science.gov (United States)

    Parini, Rossella; Jones, Simon A; Harmatz, Paul R; Giugliani, Roberto; Mendelsohn, Nancy J

    2016-04-01

    Hunter syndrome (mucopolysaccharidosis type II) affects growth but the overall impact is poorly understood. This study investigated the natural history of growth and related parameters and their relationship with disease severity (as indicated by cognitive impairment). Natural history data from males followed prospectively in the Hunter Outcome Survey registry and not receiving growth hormone or enzyme replacement therapy, or before treatment start, were analysed (N=676; January 2014). Analysis of first-reported measurements showed short stature by 8years of age; median age-corrected standardized height score (z-score) in patients aged 8-12years was -3.1 (1st, 3rd quartile: -4.3, -1.7; n=68). Analysis of growth velocity using consecutive values found no pubertal growth spurt. Patients had large head circumference at all ages, and above average body weight and body mass index (BMI) during early childhood (median z-score in patients aged 2-4years, weight [n=271]: 1.7 [0.9, 2.4]; BMI [n=249]: 2.0 [1.1, 2.7]). Analysis of repeated measurements over time found greater BMI in those with cognitive impairment than those without, but no difference in height, weight or head circumference. Logistic regression modelling (data from all time points) found that increased BMI was associated with the presence of cognitive impairment (odds ratio [95% CI], 3.329 [2.313-4.791]), as were increased weight (2.365 [1.630-3.433]) and head circumference (1.749 [1.195-2.562]), but not reduced height. Unlike some other MPS disorders, there is no evidence at present for predicting disease severity in patients with Hunter syndrome based on changes in growth characteristics. PMID:26846156

  3. Rapid assessment of dietary calcium intake.

    Science.gov (United States)

    Nordblad, Mikaela; Graham, Fiona; Mughal, M Zulf; Padidela, Raja

    2016-07-01

    A five-food item food frequency questionnaire (FFQ) and a 3-day food diary (3DFD) were used to estimate daily dietary calcium (Ca) intake in 32 patients aged 1-17 years. Median and IQR of Ca intake from 3DFD was 840 mg and 438 mg while from FFQ it was 700 mg and 987 mg, respectively. The non-parametrical Bland-Altman limits of agreement plot between two methods showed that most of the values fell between the limits of agreement at +794 mg and -388 mg. The FFQ had a specificity of 93% in identifying children who consumed inadequate amount of dietary Ca and a sensitivity of 78% in identifying children whose dietary Ca intake exceeded UK's Reference Nutrient Intake. Thus the FFQ allows rapid estimation of children with low daily dietary Ca intake in the clinic setting; however it does not replace 3DFD. PMID:26662924

  4. Natural history of postural instability in breast cancer patients treated with taxane-based chemotherapy: A pilot study.

    Science.gov (United States)

    Monfort, Scott M; Pan, Xueliang; Patrick, Robyn; Singaravelu, Janani; Loprinzi, Charles L; Lustberg, Maryam B; Chaudhari, Ajit M W

    2016-07-01

    Over 230,000 new cases of breast cancer are expected to be diagnosed in the United States in 2015. Taxane-based chemotherapy is often an effective treatment, but can also cause adverse symptoms in patients due to neurotoxicity. These side effects can impair postural control in patients; however, this instability has scarcely been quantified. The purpose of this pilot study was to gain insight into the natural history of postural instability in breast cancer patients being treated with taxane-based chemotherapy. Thirty-two breast cancer patients (31 female/1 male; 47.6±11.2 year; 16 stage II/16 stage III) completed eyes open and eyes closed quiet standing trials in the oncology clinic where they were being treated. These trials were collected at five timepoints throughout their chemotherapy treatment: (1) before initiating chemotherapy to provide a baseline, (2-4) before starting subsequent chemotherapy cycles, and (5) 1-3 months after receiving their last taxane infusion. After the first chemotherapy cycle, patients demonstrated increases in 95% confidence ellipse area of center of pressure (CoP) [45.2%, p=0.01] and root mean squared CoP excursion [18%, p=0.006] compared to baseline values for the eyes closed condition. These balance deficiencies progressed with cumulative taxane exposure. Postural instability persisted 1-3 months after completing chemotherapy with increases in 95% CoP ellipse area [86.8%, p=0.002], root mean squared CoP excursion [32.6%, p=0.001], and mean CoP velocity [30.4%, p=0.024]. The balance impairments demonstrated by patients in this study appear to be clinically relevant when compared to balance impairments previously reported in other patient populations. PMID:27341530

  5. Natural History of Adolescent Idiopathic Scoliosis in Skeletally Mature Patients: A Critical Review.

    Science.gov (United States)

    Agabegi, Steven S; Kazemi, Namdar; Sturm, Peter F; Mehlman, Charles T

    2015-12-01

    The surgical treatment of adolescent idiopathic scoliosis is dependent on several factors, including curve type and magnitude, degree of curve progression, skeletal maturity, and other considerations, such as pain and cosmesis. The most common indication for surgery is curve progression. Most authors agree that surgical treatment should be considered in skeletally mature patients with curves > 50° because of the risk of progression into adulthood. Furthermore, most authors would agree that curves measuring < 40° to 45° in skeletally mature patients should be observed. When a skeletally mature patient with a curve measuring between 45° to 55° is presenting to an orthopaedic surgeon, it is not uncommon that the patient has no pain, no progression, and no imbalance. The generally accepted belief has been that curves that reach 50° are likely to progress into adulthood, progressing at a rate of 1° per year, based largely on the Iowa studies. However, the level of evidence for this is relatively weak, and the existing literature is equivocal in supporting the practice of performing surgery on these patients.

  6. Intradiploic occipital pseudomeningocele in a patient with remote history of surgical treatment of Chiari malformation.

    Science.gov (United States)

    Mahaney, Kelly B; Menezes, Arnold H

    2014-11-01

    An intradiploic CSF pseudocyst is a rare entity that has been described in association with trauma, as a sequela of untreated hydrocephalus, or occasionally as a congenital finding in older adults. The authors present the case of a woman with a remote history of a posterior fossa intradural procedure, in which she underwent Chiari malformation decompression, Silastic substitute-assisted duraplasty, and occipitocervical fusion; she presented 19 years later with recurrent symptoms of Chiari malformation. She was found to have an occipital intradiploic pseudomeningocele, arising within her dorsal occipitocervical fusion mass and resulting in dorsal hindbrain compression. She underwent a posterior fossa decompression and revision of her failed duraplasty, and she had a good recovery. This case demonstrates intradiploic CSF pseudomeningocele as a rare potential delayed complication of an intradural procedure for the treatment of Chiari malformation with occipitocervical fusion.

  7. Huge Benign Ovarian Cystic Teratoma in a Patient with a History of Hansen’s Disease

    Directory of Open Access Journals (Sweden)

    Patrick I. Okonta

    2014-01-01

    Full Text Available Mature ovarian cystic teratomas are common benign ovarian neoplasm derived from germ cells. With increasing availability of ultrasound services even in developing countries, the diagnosis of benign ovarian tumour is made earlier and the size of the ovarian tumour at diagnosis is relatively small. It is unusual to find an ovarian cystic teratoma larger than 10 cm. We report a huge mature ovarian cystic teratoma in a multipara with a history of Hansen’s disease. We conclude that, in circumstances where women have restricted access to health care, the unusual finding of mature ovarian cystic teratoma larger than 10 cm is possible due to delayed presentation for diagnosis and treatment.

  8. Squamous cell carcinoma of hypopharynx in a patient with history of celiac disease

    Institute of Scientific and Technical Information of China (English)

    A Akhavan; A Seifadini

    2012-01-01

    Celiac disease is a gluten-related malabsorption in small intestine occurring in genetically susceptible patients. In this disease the risk of many malignancies is increased the most important of which being non-Hodgkin lymphoma of small intestine. Other malignancies include adenocarcinoma of small intestine and squamous cell carcinoma of esophagus and melanoma. As to our knowledge so far only one case of celiac disease associated with hypopharyngeal squamous cell carcinoma has been reported. In this article we presented a patient suffering from celiac disease with squamous cell carcinoma of hypopharynx. She underwent chemotherapy and radiation therapy, unfortunately however she died because of progress of disease. So, in patients with celiac disease we should pay attention to various malignancies and when cases of cancers are accompanied by malabsorption we must think of celiac disease involvement.

  9. Effect of dietary education program on the nutrient intake in diabetic patients%膳食宣教方式对糖尿病患者营养素摄入的影响

    Institute of Scientific and Technical Information of China (English)

    骆伟群; 张东云

    2015-01-01

    Objective:To explore the effect of dietary education program on the nutrient intake in diabetic patients .Methods:Patients with di-abetes were randomly divided into the control group and the observation group, the former provided traditional nutrition education for diabetes and the latter traditional nutrition education with real -food based dietary education for this disease.The nutrient intake before and after education was compared in the two groups.Results:In the control group, both energy and carbohydrate intake was significantly lower and the intake of dietary fi-ber, calcium, vitamin B2 and vitamin C was significantly higher after intervention than that before intervention ( P <0.05).In the observation group, the intake of energy, carbohydrate, fat, cholesterol and salt after intervention was significantly lower, while the intake of dietary fiber, cal-cium, Fe, Zinc, vitamin B1, vitamin B2 and vitamin C was significantly higher than that before intervention ( P <0.05).After intervention, the intake of energy, fat, cholesterol and salt was significantly lower and the intake of dietary fiber, calcium, Fe, Zinc, vitamin B1 and vitamin C was significantly higher in the observation group than that in the control group ( P <0 .05 ) .Conclusion:There is a great effect of traditional nutrition education with real-food based dietary education on the improvement of the nutrient intake for diabetic patients .%目的:探讨膳食宣教对糖尿病患者营养素摄入的影响。方法:将糖尿病患者随机分为对照组和观察组,对照组给予传统的糖尿病营养宣教,观察组在此基础上给予膳食实物宣教,比较两组患者在宣教前后的营养素摄入情况。结果:对照组干预后的热量和碳水化合物摄入量明显低于干预前,膳食纤维、钙、维生素B2和维生素C 的摄入量明显高于干预前( P <0.05);观察组干预后的热量、碳水化合物、脂肪、胆固醇、盐摄入量均明

  10. [NDT-Bobath method used in the rehabilitation of patients with a history of ischemic stroke].

    Science.gov (United States)

    Klimkiewicz, Paulina; Kubsik, Anna; Woldańska-Okońska, Marta

    2012-01-01

    Ischemic stroke is the third leading cause of death and disability in human. The vitally important problem after ischemic stroke is hemiparesis of the body. The most common methods used in improving the mobility of patients after ischemic stroke is a Bobath-NDT (Neuro-Developmental Treatment - Bobath), which initiated the Berta and Karel Bobath for children with cerebral palsy. It is a method designed to neurophysiological recovery of these vital functions that the patient was lost due to illness, and wants it back. PMID:23289255

  11. Chemical gastritis after chronic bromazepam intake: a case report

    Directory of Open Access Journals (Sweden)

    Krakamp Bernd

    2010-07-01

    Full Text Available Abstract Background We describe a rare case of diffuse macroscopic discoloration and chemical gastritis due to chronic bromazepam intake. The chemical composition of pharmaceuticals has to be considered at endoscopy and it is evident that some chemical substances damage the epithelial tissue and lead to clinical symptoms. Case Presentation Endoscopy was performed in an 82-year-old patient due to gastroesophageal reflux symptoms and epigastric pain. Gastroscopy showed a hiatal hernia and a scarred duodenal bulb. More striking was the yellow-brownish discoloration of the gastric and the duodenal mucosa. The gastric antrum and the duodenal bulb showed local discoloration that could not be rinsed off. The medical history indicated that bromazepam (6 mg had been used daily as a sleeping aid in the previous two years. The histopathological findings showed appearances of chemical gastritis. Within the lamina propria and on the epithelial surface there were granules. There was no foreign body reaction to these granules. Corpus mucosa showed a mild chronic gastritis. Conclusions If discoloration of the mucosa at endoscopy is seen, a careful drug history must be sought. This is the first case in literature that shows a chemical gastritis after bromazepam intake.

  12. Countertransference : Condensed History and Personal View of Issues With Regressed Patients

    OpenAIRE

    Boyer, L. Bryce

    1994-01-01

    Freud’s ambivalently negative attitude toward countertransference discouraged systematic study until some psychoanalysts, predominantly Kleinians, began to treat patients with narcissistic neuroses. Recognizing the need to understand the unconscious and conscious contribution of the analyst to the therapeutic process, Heimann, Rosenfeld, Balint, and Racker pioneered in serious study of countertransference. Racker and Boyer found that unresolved countertransference problem...

  13. Service utilization by schizophrenic patients in Groningen and South-Verona : An event-history analysis

    NARCIS (Netherlands)

    Sytema, S; Micciolo, R; Tansella, M

    1996-01-01

    The question addressed to in this paper is whether severely mentally ill patients are treated differently in a community mental health service without the back-up of a mental hospital (South-Verona, Italy) compared with an institution-based system in which mental hospitals, although highly modernize

  14. Discrepancies between sources providing the medication histories of acutely hospitalised patients

    DEFF Research Database (Denmark)

    Karkov, Louise Lindved; Schytte-Hansen, Simon; Nørgaard, Lotte Stig

    2010-01-01

    general practitioner (GP) and the in-home care provider. A discrepancy was defined as any disagreement or omission of information between the four sources concerning name, form, strength and dose for each drug with which the patient was being treated. Main outcome measure The number of discrepancies...

  15. Preoperative Biliary Drainage in Patients with Obstructive Jaundice: History and Current Status

    NARCIS (Netherlands)

    N.A. van der Gaag; J.J. Kloek; S.M.M. de Castro; O.R.C. Busch; T.M. van Gulik; D.J. Gouma

    2009-01-01

    Preoperative biliary drainage (PBD) has been introduced to improve outcome after surgery in patients suffering from obstructive jaundice due to a potentially resectable proximal or distal bile duct/pancreatic head lesion. In experimental models, PBD is almost exclusively associated with beneficial r

  16. Natural history and outcome of patients with intramural hematomas and penetrating aortic ulcers.

    Science.gov (United States)

    Mousa, Albeir Y; Bozzay, Joseph; AbuRahma, Ali F

    2015-06-01

    All pathologies of acute aortic syndromes should be precisely diagnosed for prompt therapy. Intramural hematomas, as well as penetrating ulcers can be encountered in these patients. Presentations, clinical scenarios, and proper management are outlined in this review, which sums up available current literature to provide the vascular specialist with an adequate understanding of these unique syndromes.

  17. Sperm macrocephaly syndrome in a patient without AURKC mutations and with a history of recurrent miscarriage.

    Science.gov (United States)

    Molinari, Emanuela; Mirabelli, Marzia; Raimondo, Stefania; Brussino, Alessandro; Gennarelli, Gianluca; Bongioanni, Francesca; Revelli, Alberto

    2013-02-01

    This paper reports a case of recurrent miscarriage in a patient affected by a variant phenotype of sperm macrocephaly syndrome (SMS). SMS is usually related to specific sperm characteristics (large head, multiple tail) and homozygous mutations in the aurora kinase C gene (AURKC). However, the present case observed large-headed spermatozoa with no flagellar abnormalities and no mutations detectable by AURKC sequencing. Furthermore, the patient had repeatedly conceived by intracytoplasmic sperm injection, but pregnancy always aborted. This study performed morphological analysis (Papanicolau staining), annexin V/propidium iodide staining, sperm chromatin structure assay (SCSA), fluorescence in-situ hybridization (FISH) and transmission electron microscopy. This study observed large-headed, mono-tailed, mono-centriolar spermatozoa characterized by abnormal chromatin and swollen mitochondria. SCSA revealed a high ratio of late apoptotic cells with fairly intact amount of DNA. The FISH analysis showed 100% disomy rate. As far as is known, this is the first study to include gene sequencing, TEM, cytogenetic analysis and sperm DNA fragmentation in a case of SMS and also to report recurrent miscarriage related to this specific condition. SMS may be associated with important abnormalities of the sperm subcellular structure and with disomy even in the absence of mutations in the AURKC coding sequence. Sperm macrocephaly syndrome (SMS) is a rare condition that affects spermatozoa and is related to infertility. It is characterized by a specific phenotype of large-headed, multi-tailed spermatozoa with an abnormal chromosomal status. A very few pregnancies have been obtained so far in SMS patients by means of IVF procedures. We present a case of SMS that differs from the classical syndrome as we observed large-headed spermatozoa without tail abnormalities. The affected patient had achieved three pregnancies following IVF, but all aborted. We carried out a detailed examination of

  18. The contribution of proprioceptive information to postural control in elderly and patients with Parkinson's disease with a history of falls.

    Science.gov (United States)

    Bekkers, Esther M J; Dockx, Kim; Heremans, Elke; Vercruysse, Sarah; Verschueren, Sabine M P; Mirelman, Anat; Nieuwboer, Alice

    2014-01-01

    Proprioceptive deficits negatively affect postural control but their precise contribution to postural instability in Parkinson's disease (PD) is unclear. We investigated if proprioceptive manipulations differentially affect balance, measured by force plates, during quiet standing in 13 PD patients and 13 age-matched controls with a history of falls. Perceived limits of stability (LoS) were derived from the differences between maximal center of pressure (CoP) displacement in anterior-posterior (AP) and medio-lateral (ML) direction during a maximal leaning task. Task conditions comprised standing with eyes open (EO) and eyes closed (EC): (1) on a stable surface; (2) an unstable surface; and (3) with Achilles tendon vibration. CoP displacements were calculated as a percentage of their respective LoS. Perceived LoS did not differ between groups. PD patients showed greater ML CoP displacement than elderly fallers (EF) across all conditions (p = 0.043) and tended to have higher postural sway in relation to the LoS (p = 0.050). Both groups performed worse on an unstable surface and during tendon vibration compared to standing on a stable surface with EO and even more so with EC. Both PD and EF had more AP sway in all conditions with EC compared to EO (p postural control in fallers with and without PD. PD fallers showed higher ML sway after sensory manipulations, as a result of which these values approached their perceived LoS more closely than in EF. We conclude that despite a similar fall history, PD patients showed more ML instability than EF, irrespective of sensory manipulation, but had a similar reliance on ankle proprioception. Hence, we recommend that rehabilitation and fall prevention for PD should focus on motor rather than on sensory aspects.

  19. Lifetime suicide attempt history, quality of life, and objective functioning among HIV/AIDS patients with alcohol and illicit substance use disorders.

    Science.gov (United States)

    Walter, Kimberly N; Petry, Nancy M

    2016-05-01

    This cross-sectional study evaluated lifetime prevalence of suicide attempts in 170 HIV/AIDS patients with substance use disorders and the impact of suicide attempt history on subjective indices of quality of life and objective indices of cognitive and physical functioning. All patients met the diagnostic criteria for past-year cocaine or opioid use disorders and 27% of patients also had co-occurring alcohol use disorders. Compared to their counterparts without a history of a suicide attempt, patients with a history of a suicide attempt (n = 60, 35.3%) had significantly poorer emotional and cognitive quality of life scores (ps quality-of-life scores. Lifetime suicide attempt status was unrelated to objective indices of cognitive functioning, but there was a non-significant trend (p = .07) toward lower viral loads in those with a lifetime suicide attempt relative to those without. The findings indicate that suicide attempt histories are prevalent among HIV/AIDS patients with substance use disorders and relate to poorer perceived emotional and cognitive quality of life, but not objective functioning. HIV/AIDS patients with substance use disorders should be screened for lifetime histories of suicide attempts and offered assistance to improve perceived emotional and cognitive functioning.

  20. Effects of standardized water intake direction on constipation for hospitalized psychiatric patients%规范化饮水指导对住院精神病患者便秘的影响

    Institute of Scientific and Technical Information of China (English)

    杨起萍; 沈红霞; 张碧蓉

    2015-01-01

    Objective:To investigate effects of standardized water intake direction on constipation for hospitalized psychiatric patients. Methods:389 patients were selected and randomly divided into observation group (194 cases) and control group (195 ca-ses) . The control group received routine health guidance, while the observation group received standardized water intake direction based on the routine health guidance. The constipation situations of the two groups were compared. Results:There was no significant difference in the constipation situations 2 weeks after admission between the two groups (P>0. 05); however, there were significant differences in the constipation situations 1 and 2 months after admission (P>0. 05). There was no significant difference in the water in-take compliance 2 weeks after admission between the two groups (P>0. 05); however, there were significant differences in the water intake compliance 1 and 2 months after admission (P>0. 05). Conclusions: The daily per capita water above 1500ml, and a small number of times of drinking can reduce the mental patients' incidence of constipation. Standardized nursing guidance can improve the compliance of water intake for these patients.%目的::探讨规范化饮水指导对住院精神病患者便秘的影响。方法:选择389例患者,采用随机法分为观察组194例和对照组195例。对照组患者接受精神科常规健康指导,观察组患者在此基础上接受规范化饮水指导,比较两组患者的便秘情况。结果:两组患者在入院2周便秘发生数比较差异无显著意义(P>0.05);入院1月和入院2个月便秘发生数比较差异有统计学意义(P0.05),入院1月和入院2个月饮水依从性比较差异有统计学意义(P<0.05)。结论:每日每人饮水在1500 ml以上,且少量多次饮用,可以降低住院精神病患者的便秘发生率,规范化指导能促进患者饮水的依从性。

  1. Effectiveness of simple balancing training program in elderly patients with history of frequent falls

    Directory of Open Access Journals (Sweden)

    Kuptniratsaikul V

    2011-05-01

    Full Text Available Vilai Kuptniratsaikul1, Rungnirand Praditsuwan2, Prasert Assantachai3, Teerada Ploypetch1, Suthipol Udompunturak4, Julaporn Pooliam41Department of Rehabilitation Medicine, 2Department of Medicine, 3Department of Preventive Medicine, 4Office for Research and Development, Siriraj Hospital, Mahidol University, ThailandObjective: To study the effectiveness of simply-performed balancing exercises in fall prevention.Design: Pre- and post-trial.Setting: University hospital from January 2009 to May 2010.Participants: Elderly with falls in the previous year.Intervention: Simple balancing exercise was performed at home every day and was recorded in the booklet.Measurements: New falling events and a battery of balancing abilities including the Timed Up and Go Test (TUGT, chair stand, functional reach, and Berg balance scale-short form were evaluated at baseline, 3-, 6-, 9-, and 12-month periods. Fear of falling and quality of life scores were assessed at baseline and 12-month periods.Results: 146 subjects were recruited, 116 female (79.5% with a mean age of 67.1 years. At the end of the study, 49% of participants had not fallen. All of the balancing abilities were compared between frequent and infrequent fallers and were significantly improved (P < 0.001 except for functional reach in the frequent fall group. Most subjects (72%–79% complied well with the exercise program. However, compliance had no effect on balancing abilities. About 36.4% of participants had adverse events from exercise, of which knee pain was the top ranked. The quality of life and the fall efficacy scores increased significantly at the end of the study. Factors affecting falling were compliance with exercise (adjusted odds ratio [OR]: 2.55, 95% confidence intervals [CI]: 1.04, 6.30 and a history of falling ≥3 times in the previous year (adjusted OR: 3.76, 95% CI: 1.18, 11.98.Conclusion: Performing simply-designed balancing exercises, at least 3 days per week, can increase

  2. Intake of specific carotenoids and the risk of epithelial ovarian cancer.

    Science.gov (United States)

    Zhang, Min; Holman, C D'Arcy J; Binns, Colin W

    2007-07-01

    There has been considerable interest in the role of carotenoids in the chemoprevention of cancer. However, few studies have examined the association between intake of specific carotenoids and the risk of epithelial ovarian cancer and the results for carotenoids have been inconclusive. To investigate whether the intake of alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein and zeaxanthin, and lycopene is inversely associated with ovarian cancer risk, a case-control study was conducted in China during 1999-2000. The cases were 254 patients with histologically confirmed epithelial ovarian cancer and 652 age-matched controls were randomly recruited during the same period. Habitual dietary intake and lifestyle were collected by face-to-face interview using a validated and reliable FFQ. The US Department of Agriculture nutrient composition database was used to calculate the intake of specific carotenoids. Unconditional logistic regression analyses were used to estimate OR and 95 % CI, accounting for age, locality, education, BMI, smoking, tea drinking, parity, oral contraceptive use, hormone replacement therapy, menopausal status, family history of ovarian cancer, physical activity and energy intake. Compared with the highest v. the lowest quartile of intake, the adjusted OR were 0.39 (95 % CI 0.23, 0.66) for alpha-carotene, 0.51 (95 % CI 0.31, 0.84) for beta-carotene, 0.51 (95 % CI 0.31, 0.83) for beta-cryptoxanthin, 0.45 (0.27, 0.76) for lutein and zeaxanthin, and 0.33 (95 % CI 0.20, 0.56) for total carotenoids, with statistically significant tests for trend. It is concluded that a higher intake of carotenoids can reduce the risk of epithelial ovarian cancer. PMID:17367574

  3. Novel de novo BRCA2 mutation in a patient with a family history of breast cancer

    DEFF Research Database (Denmark)

    Hansen, Thomas V O; Bisgaard, Marie Luise; Jønson, Lars;

    2008-01-01

    exhibiting a ductal carcinoma at the age of 40. METHODS: Variations were identified by denaturing high performance liquid chromatography (dHPLC) and sequencing of the BRCA1 and BRCA2 genes. The effect of the mutation on splicing was examined by exon trapping in COS-7 cells and by RT-PCR on RNA isolated from...... whole blood. The paternity was determined by single nucleotide polymorphism (SNP) microarray analysis. Parental origin of the de novo mutation was determined by establishing mutation-SNP haplotypes by variant specific PCR, while de novo and mosaic status was investigated by sequencing of DNA from...... and synthesis of a truncated BRCA2 protein. The aberrant splicing was verified by RT-PCR analysis on RNA isolated from whole blood of the affected patient. The mutation was not found in any of the patient's parents or in the mother's carcinoma, showing it is a de novo mutation. Variant specific PCR indicates...

  4. Immediate, Early, and Conventional Implant Placement in a Patient with History of Periodontitis

    Directory of Open Access Journals (Sweden)

    Alessandro Lanza

    2015-01-01

    Full Text Available The aim of this paper is to describe a case of implant-prosthetic rehabilitation in a patient with periodontitis, focusing on the different timing of implant placement. After initial periodontal treatment, teeth with advanced mobility degree and severe bone resorption were extracted. At different healing time oral implants were placed in a prosthetic-guided position. After osseointegration period the implants were loaded and the results at one year of follow-up are presented.

  5. Immediate, early, and conventional implant placement in a patient with history of periodontitis.

    Science.gov (United States)

    Lanza, Alessandro; Scognamiglio, Fabio; Femiano, Felice; Lanza, Michele

    2015-01-01

    The aim of this paper is to describe a case of implant-prosthetic rehabilitation in a patient with periodontitis, focusing on the different timing of implant placement. After initial periodontal treatment, teeth with advanced mobility degree and severe bone resorption were extracted. At different healing time oral implants were placed in a prosthetic-guided position. After osseointegration period the implants were loaded and the results at one year of follow-up are presented. PMID:25949833

  6. Immediate, Early, and Conventional Implant Placement in a Patient with History of Periodontitis

    OpenAIRE

    Alessandro Lanza; Fabio Scognamiglio; Felice Femiano; Michele Lanza

    2015-01-01

    The aim of this paper is to describe a case of implant-prosthetic rehabilitation in a patient with periodontitis, focusing on the different timing of implant placement. After initial periodontal treatment, teeth with advanced mobility degree and severe bone resorption were extracted. At different healing time oral implants were placed in a prosthetic-guided position. After osseointegration period the implants were loaded and the results at one year of follow-up are presented.

  7. Unusual elevation of CEA in a patient with history of colon cancer.

    Science.gov (United States)

    Hsu, Tzu-Chi

    2006-12-01

    A 35-year-old female received right hemicolectomy for a poorly differentiated adenocarcinoma of the ascending colon with lymph node metastasis (1/28) in February 1997. CEA was 1.68 ng/microl prior to colectomy. Adjuvant chemotherapy with weekly 5-FU and leucovorin intravenously was started following surgery and discontinued after 17 doses in May 1997. She received bilateral salpingo-ophorecctomy for metastatic cancer in August 1999. Intravenous chemotherapy was resumed with weekly 5-FU and leucovorin intravenously in August 1999. CEA was 93.8 ng/microl in November 1999. Intravenous chemotherapy was discontinued after 20 doses and oral chemotherapy with futraful and leucovorin was started in January 2000. CEA was found to be 240.3 ng/microl in December 1999 and then elevated to 1521.3 ng/microl in June 2001, which was 10 months after resection of metastatic ovarian cancer. No metastatic lesions could be detected, however, with image studies. The CEA decreased to 396.6 ng/microl three months later. Futraful was switched to uracil-tegafur (UFUR) in September 2001. The CEA for the patient ranged from 68.5 to 298.9 ng/microl for the following 5 years without aggressive chemotherapy. No evidence of recurrence could be demonstrated by imaging studies. The patient is not a smoker and denied exposure to a smoking environment. She was also not known to have persistent infections, inflammatory bowel disease, pancreatitis, cirrhosis of the liver, or any benign tumors. The current case suggested that: (i) elevation of CEA is not necessarily well correlated with presence of metastatic colon cancer; (ii) some patients may live with elevated CEA for years without evidence of recurrence or metastasis; (iii) aggressive chemotherapy may not be necessary in patients with only elevated CEA. PMID:17060406

  8. Ultrasound diagnosis for retrojugular lymphadenopathy in the patient having a history of total thyroidectomy due to thyroid malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Seung Min; Kim, Dong Wook [Busan Paik Hospital/Inje Univ. College of Medicine, Busan (Korea, Republic of)

    2012-07-15

    This study aimed to assess the accuracy of ultrasound (US) diagnosis for retrojugular lymphadenopathy in patients who had undergone total thyroidectomy, due to thyroid malignancy. During a follow up period after total thyroidectomy, due to known thyroid malignancy, 41 patients underwent US diagnosis and US guided fine needle aspiration for retrojugular lymphadenopathy. Each lymphadenopathy was prospectively classified by a single radiologist into 1 of 3 diagnostic categories: 'benign', 'indeterminate for malignancy', and 'malignant'. Based on the cytohistopathology result, thyroglobulin tittering, and sonographic follow up, the adequacy of US diagnosis for retrojugular lymphadenopathy was assessed. Of the 41 retrojugular lymphadenopathies, malignant (n = 25) and benign (n = 16) lymphadenopathy were finally confirmed. Excluding 15 lymph nodes with indeterminate US diagnosis, the sensitivity, specificity, positive and negative predictive values, accuracy, and false positive and negative rates of US diagnosis were 100%, 66.7%, 95.8%, 100%, 96.2%, 0%, and 10%, respectively. There was no significant difference in the incidence of retrojugular lymphadenopathy, according to age, sex, and location (p > 0.05). In the patient with a history of total thyroidectomy, due to thyroid malignancy, US diagnosis for retrojugular lymphadenopathy showed a high accuracy.

  9. Differences in trauma history and psychopathology between PTSD patients with and without co-occurring dissociative disorders

    Directory of Open Access Journals (Sweden)

    Pascal Wabnitz

    2013-11-01

    Full Text Available Background: The interplay between different types of potentially traumatizing events, posttraumatic symptoms, and the pathogenesis of PTSD or major dissociative disorders (DD has been extensively studied during the last decade. However, the phenomenology and nosological classification of posttraumatic disorders is currently under debate. The current study was conducted to investigate differences between PTSD patients with and without co-occurring major DD with regard to general psychopathology, trauma history, and trauma-specific symptoms. Methods: Twenty-four inpatients were administered the Clinician-Administered PTSD Scale for DSM-IV (CAPS and the Mini-Structured Clinical Interview for DSM-IV Dissociative Disorders (MINI-SKID-D to assess DD and PTSD. Additionally, participants completed questionnaires to assess general psychopathology and health status. Results: Symptom profiles and axis I comorbidity were similar in all patients. Traumatic experiences did not differ between the two groups, with both reporting high levels of childhood trauma. Only trauma-specific avoidance behavior and dissociative symptoms differed between groups. Conclusion: Results support the view that PTSD and DD are affiliated disorders that could be classified within the same diagnostic category. Our results accord with a typological model of dissociation in which profound forms of dissociation are specific to DD and are accompanied with higher levels of trauma-specific avoidance in DD patients.

  10. Intake of dairy products in relation to periodontitis in older danish adults

    DEFF Research Database (Denmark)

    Adegboye, Amanda R A; Christensen, Lisa B; Holm-Pedersen, Poul;

    2012-01-01

    This cross-sectional study investigates whether calcium intakes from dairy and non-dairy sources, and absolute intakes of various dairy products, are associated with periodontitis. The calcium intake (mg/day) of 135 older Danish adults was estimated by a diet history interview and divided...

  11. Secondary Lymphoma in a Patient with a History of Unilateral Retinoblastoma

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    Banu Kozanoglu

    2015-03-01

    Full Text Available Second malignancies develop with increased incidence in patients with herediter retinoblastoma. The most common second malignancies in retinoblastoma survivors are soft tissue sarcoma and osteosarcoma. Lymphoma developing as a second malignancy has rarely been reported. Here we report a case of lymphoma diagnosed in a 13 year-old-boy, 12 years after the diagnosis of unilateral retinoblastoma having heterozygous p.R552 (c.1654C> T mutation, treated with enucleation and radiotherapy. The risk of second tumour is higher in the hereditary retinoblastoma, especially in cases undergoing external beam radiation therapy. [Cukurova Med J 2015; 40(Suppl 1: 33-37

  12. Small cell neuroendocrine carcinoma of tracheostomy site in a patient with a history of juvenile laryngeal papillomatosis.

    Science.gov (United States)

    Violet Wilmot, Victoria; Nixon, Iain James; Nixon, Ioanna Fragkandrea

    2016-01-01

    Juvenile laryngeal papillomatosis is the commonest cause of benign epithelial tumours of the larynx. Following diagnostic biopsy, surgical debulking is the mainstay of therapy. The condition is often recurrent with further papillomas forming after debridement, requiring serial procedures and occasionally demanding tracheostomy. Rarely, the disease can undergo malignant transformation; most commonly to squamous cell carcinoma. We describe the first reported case of small cell neuroendocrine carcinoma occurring in the previous tracheostomy site of a 29-year-old male with a history of juvenile laryngeal papillomatosis. The patient, with a background of multiple treatments for juvenile papillomas, presented with voice change, breathing difficultly and erythema at the site of previous tracheostomy. Induction chemotherapy followed by chemoradiation was used to treat the lesion with a good response to initial therapy. PMID:27507691

  13. Coronary artery bypass grafting in a patient with history of esophagectomy, hypothyroidism, hypertension and type 2 diabetes mellitus: a case report

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yang-yang; YE Jiang-chuan; WEI Lei; ZHANG Shi-jiang

    2012-01-01

    Coronary artery bypass grafting (CABG) is a mature procedure in treating patients with coronary artery diseases.We report a patient undergoing CABG had history of esophageal cancer and multiple underlying diseases:hypothyroidism,type 2 diabetes mellitus and hypertension.A CABG with midline sternotomy was safely performed in the presence of thyroid replacement therapy and intensive control of blood pressure and blood glucose.The patient recovered postoperatively with supportive care.

  14. The Digital Asthma Patient: The History and Future of Inhaler Based Health Monitoring Devices.

    Science.gov (United States)

    Kikidis, Dimitrios; Konstantinos, Votis; Tzovaras, Dimitrios; Usmani, Omar S

    2016-06-01

    The wave of digital health is continuously growing and promises to transform healthcare and optimize the patients' experience. Asthma is in the center of these digital developments, as it is a chronic disease that requires the continuous attention of both health care professionals and patients themselves. The accurate and timely assessment of the state of asthma is the fundamental basis of digital health approaches and is also the most significant factor toward the preventive and efficient management of the disease. Furthermore, the necessity of inhaled medication offers a basic platform upon which modern technologies can be integrated, namely the inhaler device itself. Inhaler-based monitoring devices were introduced in the beginning of the 1980s and have been evolving but mainly for the assessment of medication adherence. As technology progresses and novel sensing components are becoming available, the enhancement of inhalers with a wider range of monitoring capabilities holds the promise to further support and optimize asthma self-management. The current article aims to take a step for the mapping of this territory and start the discussion among healthcare professionals and engineers for the identification and the development of technologies that can offer personalized asthma self-management with clinical significance. In this direction, a technical review of inhaler based monitoring devices is presented, together with an overview of their use in clinical research. The aggregated results are then summarized and discussed for the identification of key drivers that can lead the future of inhalers.

  15. Dietary intake of phytoestrogens

    NARCIS (Netherlands)

    Bakker MI; SIR

    2004-01-01

    The dietary intake of phytoestrogens supposedly influences a variety of diseases, both in terms of beneficial and adverse effects. This report describes current knowledge on dietary intakes of phytoestrogens in Western countries, and briefly summarizes the evidence for health effects. The predominan

  16. Diagnostic values of chest pain history, ECG, troponin and clinical gestalt in patients with chest pain and potential acute coronary syndrome assessed in the emergency department.

    Science.gov (United States)

    Mokhtari, Arash; Dryver, Eric; Söderholm, Martin; Ekelund, Ulf

    2015-01-01

    In the assessment of chest pain patients with suspected acute coronary syndrome (ACS) in the emergency department (ED), physicians rely on global diagnostic impressions ('gestalt'). The aim of this study was to determine the diagnostic value of the ED physician's overall assessment of ACS likelihood, and the values of the main diagnostic modalities underlying this assessment, namely the chest pain history, the ECG and the initial troponin result. 1,151 consecutive ED chest pain patients were prospectively included. The ED physician's interpretation of the chest pain history, the ECG, and the global likelihood of ACS were recorded on special forms. The discharge diagnoses were retrieved from the medical records. A chart review was carried out to determine whether patients with a non-ACS diagnosis at the index visit had ACS or suffered cardiac death within 30 days. The gestalt was better than its components both at ruling in ("Obvious ACS", LR 29) and at ruling out ("No Suspicion of ACS", LR 0.01) ACS. In the "Strong suspicion of ACS" group, 60% of the patients did not have ACS. A positive TnT (LR 24.9) and an ischemic ECG (LR 8.3) were strong predictors of ACS and seemed superior to pain history for ruling in ACS. In patients with a normal TnT and non-ischemic ECG, chest pain history typical of AMI was not a significant predictor of AMI (LR 1.9) while pain history typical of unstable angina (UA) was a moderate predictor of UA (LR 4.7). Clinical gestalt was better than its components both at ruling in and at ruling out ACS, but overestimated the likelihood of ACS when cases were assessed as strong suspicion of ACS. Among the components of the gestalt, TnT and ECG were superior to the chest pain history for ruling in ACS, while pain history was superior for ruling out ACS.

  17. [Premature birth in patient with cervix incompetence and history of myasthenia gravis].

    Science.gov (United States)

    Fuentealba, Maximiliano; Troncoso, Miguel; Vallejos, Joaquin; Ponce, Sebastian; Villablanca, Nelson; Melita, Pablo

    2013-09-01

    Cervical incompetence it's a dilatation of the cervix during the third trimester of pregnancy that ends with the interruption of it. The incidence in Chile is about 0.1-2% of the total pregnancies and it's one of the causes of preterm birth. A 34 years old pregnant patient. Timectomized at age 18 to treat her miastenia gravis, previously trated with medication, had 4 previous preterm labours all of them under 25 weeks and vaginal births. All fetuses died postpartum. A cerclage was made during the third, fourth and fifth pregnancies. She didn't present hypertension during the gestation and no cervical diameter under 15mm. Since the fourth gestation the following tests are taken: Antifosfolipidic antibodies, APTT,PT. All the results are either normal or negative. Microbial cultures were negative. No amniocentesis was made. A McDonald cervical cerclage was made during pregnancies number 3, 4 and 5 on the 16th week to delay the labor. Also oral micronized progesterone, on a 400mg/24 hours dosis, was administered to avoid preterm birth. On the 24th week the pharmacological treatment started including Intramuscular Betamethasone, 12 mg/24 hours (2 doses), to induce lung maturity on the fetus. It is thought that the administration of progesterone could have improved the situation of the patient, because it acts as a labour repressants. The use of cerclage could have helped, but the factors that may influence the effectiveness of this method are unknown. Perhaps there is some immunologic factor associated with the miastenia gravis that alters the normal course of pregnancy.

  18. Predictors of malignancy in EUS-guided FNA for mediastinal lymphadenopathy in patients without history of lung cancer

    Directory of Open Access Journals (Sweden)

    Luz Leticia

    2011-01-01

    Full Text Available Background: Mediastinal lymphadenopathy (ML poses a great diagnostic challenge. Objective: To investigate the predictors of malignancy in endoscopic ultrasound (EUS-guided fine-needle aspiration (FNA of ML in patients without known lung cancer. Design: Retrospective study. Setting: Tertiary referral center. Methods: One hundred eight patients without known lung cancer who underwent EUS guided-FNA for ML between 2000 and 2007. All subjects underwent EUS-guided FNA. Data was collected on patients′ demographics, and lymph node (LN characteristics. Diagnosis of LN malignancy was based on FNA findings and clinical follow-up. Results: One hundred eight patients were analyzed; 58 (54% were men and 87 (79% were Caucasian. Mean age was 55 years. Prior malignancy was present in 48 (43% patients. A total of 126 FNA samples from 126 distinct LNs were performed. Twenty-five (20% LNs were positive for malignancy. Mean short and long-axis for LNs were 13 and 29 mms respectively. Round shape and sharp borders were found in 29 (15% and 25 (22% LNs, correspondingly. Independent predictors of a malignant FNA were: Prior cancer (OR 13.10; 95% CI 2.7-63.32; P = 0.001, short axis (OR 1.10; 95% CI 1.00-1.22; P = 0.041 and sharp LN borders (OR 5.47; 95% CI 1.01-29.51; P = 0.048. Age, race, gender, long axis, round shape were not associated with cancer in our cohort. Limitations: Retrospective design and lack of surgical gold standard. Conclusions: Increased risk of malignancy was associated with prior history of cancer, larger LN short axis and presence of LN sharp borders. These predictors may help guide endoscopists perform FNA in malignant LNs, increasing the overall efficiency of EUS-FNA for ML.

  19. Predictors of barefoot plantar pressure during walking in patients with diabetes, peripheral neuropathy and a history of ulceration.

    Directory of Open Access Journals (Sweden)

    Ruth Barn

    Full Text Available Elevated dynamic plantar foot pressures significantly increase the risk of foot ulceration in diabetes mellitus. The aim was to determine which factors predict plantar pressures in a population of diabetic patients who are at high-risk of foot ulceration.Patients with diabetes, peripheral neuropathy and a history of ulceration were eligible for inclusion in this cross sectional study. Demographic data, foot structure and function, and disease-related factors were recorded and used as potential predictor variables in the analyses. Barefoot peak pressures during walking were calculated for the heel, midfoot, forefoot, lesser toes, and hallux regions. Potential predictors were investigated using multivariate linear regression analyses. 167 participants with mean age of 63 years contributed 329 feet to the analyses.The regression models were able to predict between 6% (heel and 41% (midfoot of the variation in peak plantar pressures. The largest contributing factor in the heel model was glycosylated haemoglobin concentration, in the midfoot Charcot deformity, in the forefoot prominent metatarsal heads, in the lesser toes hammer toe deformity and in the hallux previous ulceration. Variables with local effects (e.g. foot deformity were stronger predictors of plantar pressure than global features (e.g. body mass, age, gender, or diabetes duration.The presence of local deformity was the largest contributing factor to barefoot dynamic plantar pressure in high-risk diabetic patients and should therefore be adequately managed to reduce plantar pressure and ulcer risk. However, a significant amount of variance is unexplained by the models, which advocates the quantitative measurement of plantar pressures in the clinical risk assessment of the patient.

  20. Influence of family history, irradiation and anti-cancer drug (mitomycin C) on the occurrence of multiple primary neoplasms in breast carcinoma patients

    International Nuclear Information System (INIS)

    The influence of family history, irradiation and anti-cancer drug (Mitomycin C) on the occurrence of multiple primary neoplasms was analysed using the person-year method in 1359 Japanese breast carcinoma patients. There were 111 multiple primary neoplasms, including bilaterl breast cancer, in 109 patients; the incidence rate was 0.0072 per person-year. The incidence rate in patients with a family history of cancer was 1.29 times higher than in those without. In the bilateral breast cancer group there was about a 3 times higher frequency of family history of breast cancer. Irradiation therapy raised the occurrence of multiple primary neoplasms 1.28 fold, and Mitomycin C (40 mg) had no effect on the occurrence of neoplasms during a 10-year observation period. (author)

  1. 老年住院患者经口摄入不足的危险因素分析%Risk factors analysis of inadequate oral intake in elderly in-patients

    Institute of Scientific and Technical Information of China (English)

    耿梦雅; 方亮; 万和芝; 徐骅; 吴婉清

    2015-01-01

    目的:分析老年住院患者经口摄入不足的危险因素及探讨针对性护理措施。方法总结2012年2月~2014年2月入住本院经口进食老年患者489例的临床资料,采用多因素Logistic回归分析老年住院患者经口摄入不足的危险因素,并提出针对性护理措施。结果单因素分析显示老年经口摄入不足与食欲欠佳、吞咽困难、疼痛、照顾者不周、口腔不适、多重用药6个因素有关。多因素Logistic回归分析显示,食欲欠佳(P<0.01)、吞咽困难(P<0.01)、疼痛(P<0.01)及多重用药(P<0.01)是住院老年患者经口摄入不足的独立危险因素。结论经口摄入不足在老年住院患者中存在较高的发生率,并且与多种危险因素相关;根据危险因素采取有针对性的护理措施,可以明显降低老年营养不良的发生率,改善预后。%Objective To investigate the risk factors of inadequate oral intake in elderly in-patients and corresponding nursing measures. Methods Data of 489 elderly patients with reduced oral intake admitted into our hospital from February 2012 to June 2014 were summarized.The risk factors of reduced oral intake in elderly in-patients were ana-lyzed by multivariate Logistic regression analysis.Corresponding nursing measures were proposed. Results Univariate analysis showed that elderly patient with reduced oral intake was associated with six factors including poor appetite,dif-ficulty swallowing,pain,loose caregivers,oral discomfort,multiple drugs.Multiariable Logistic regression analysis showed that poor appetite (P<0.01),difficulty swallowing (P<0.01),pain (P<0.01)and polypharmacy (P<0.01)was independent risk factor of elderly patients with reduced oral intake respectively. Conclusion It is high incidence rate of inadequate oral intake in elderly in-patients.Taking targeted nursing measures according to risk factors can significantly reduce the in-cidence rate of malnutrition,so as to improve

  2. Lifetime Suicide Attempt History, Quality of Life, and Objective Functioning among HIV/AIDS Patients with Alcohol and Illicit Substance Use Disorders

    Science.gov (United States)

    Walter, Kimberly N.; Petry, Nancy M.

    2016-01-01

    This cross-sectional study evaluated lifetime prevalence of suicide attempts in 170 HIV/AIDS patients with substance use disorders and the impact of suicide attempt history on subjective indices of quality of life and objective indices of cognitive and physical functioning. Compared to their counterparts without a history of a suicide attempt, patients with a history of a suicide attempt (n = 60, 35.3%) had significantly poorer emotional and cognitive quality of life scores (ps quality of life scores. Lifetime suicide attempt status was unrelated to objective indices of cognitive functioning, but there was a non-significant trend (p = .07) toward lower viral loads in those with a lifetime suicide attempt relative to those without. The findings indicate that suicide attempt histories are prevalent among HIV/AIDS patients with substance use disorders and relate to poorer perceived emotional and cognitive quality of life, but not objective functioning. HIV/AIDS patients with substance use disorders should be screened for lifetime histories of suicide attempts and offered assistance to improve perceived emotional and cognitive functioning. PMID:25953963

  3. Natural history and manifestations of the hypermobility type Ehlers-Danlos syndrome: a pilot study on 21 patients.

    Science.gov (United States)

    Castori, Marco; Camerota, Filippo; Celletti, Claudia; Danese, Chiara; Santilli, Valter; Saraceni, Vincenzo Maria; Grammatico, Paola

    2010-03-01

    Hypermobility type Ehlers-Danlos syndrome (HT-EDS) is a relatively frequent, although commonly misdiagnosed variant of Ehlers-Danlos syndrome, mainly characterized by marked joint instability and mild cutaneous involvement. Chronic pain, asthenia, and gastrointestinal and pelvic dysfunction are characteristic additional manifestations. We report on 21 HT-EDS patients selected from a group of 40 subjects with suspected mild hereditary connective tissue disorder. General, mucocutaneous, musculoskeletal, cardiovascular, neurologic, gastrointestinal, urogynecological, and ear-nose-throat abnormalities are investigated systematically and tabulated. Six distinct clinical presentations of HT-EDS are outlined, whose tabulation is a mnemonic for the practicing clinical geneticist in an attempt to diagnose this condition accurately. With detailed clinical records and phenotype comparison among patients of different ages, the natural history of the disorder is defined. Three phases (namely, hypermobility, pain, and stiffness) are delineated based on distinguishing manifestations. A constellation of additional, apparently uncommon abnormalities is also identified, including dolichocolon, dysphonia, and Arnold-Chiari type I malformation. Their further investigation may contribute to an understanding of the pathogenesis of the protean manifestations of HT-EDS, and a more effective approach to the evaluation and management of affected individuals. PMID:20140961

  4. New-onset panic, depression with suicidal thoughts, and somatic symptoms in a patient with a history of lyme disease.

    Science.gov (United States)

    Garakani, Amir; Mitton, Andrew G

    2015-01-01

    Lyme Disease, or Lyme Borreliosis, caused by Borrelia burgdorferi and spread by ticks, is mainly known to cause arthritis and neurological disorders but can also cause psychiatric symptoms such as depression and anxiety. We present a case of a 37-year-old man with no known psychiatric history who developed panic attacks, severe depressive symptoms and suicidal ideation, and neuromuscular complaints including back spasms, joint pain, myalgias, and neuropathic pain. These symptoms began 2 years after being successfully treated for a positive Lyme test after receiving a tick bite. During inpatient psychiatric hospitalization his psychiatric and physical symptoms did not improve with antidepressant and anxiolytic treatments. The patient's panic attacks resolved after he was discharged and then, months later, treated with long-term antibiotics for suspected "chronic Lyme Disease" (CLD) despite having negative Lyme titers. He however continued to have subsyndromal depressive symptoms and chronic physical symptoms such as fatigue, myalgias, and neuropathy. We discuss the controversy surrounding the diagnosis of CLD and concerns and considerations in the treatment of suspected CLD patients with comorbid psychiatric diagnoses.

  5. New-Onset Panic, Depression with Suicidal Thoughts, and Somatic Symptoms in a Patient with a History of Lyme Disease

    Science.gov (United States)

    Garakani, Amir; Mitton, Andrew G.

    2015-01-01

    Lyme Disease, or Lyme Borreliosis, caused by Borrelia burgdorferi and spread by ticks, is mainly known to cause arthritis and neurological disorders but can also cause psychiatric symptoms such as depression and anxiety. We present a case of a 37-year-old man with no known psychiatric history who developed panic attacks, severe depressive symptoms and suicidal ideation, and neuromuscular complaints including back spasms, joint pain, myalgias, and neuropathic pain. These symptoms began 2 years after being successfully treated for a positive Lyme test after receiving a tick bite. During inpatient psychiatric hospitalization his psychiatric and physical symptoms did not improve with antidepressant and anxiolytic treatments. The patient's panic attacks resolved after he was discharged and then, months later, treated with long-term antibiotics for suspected “chronic Lyme Disease” (CLD) despite having negative Lyme titers. He however continued to have subsyndromal depressive symptoms and chronic physical symptoms such as fatigue, myalgias, and neuropathy. We discuss the controversy surrounding the diagnosis of CLD and concerns and considerations in the treatment of suspected CLD patients with comorbid psychiatric diagnoses. PMID:25922779

  6. Relationship between flow volume curve and CT findings in non-smoking patients with long histories of bronchial asthma

    International Nuclear Information System (INIS)

    This study was conducted to verify whether bronchial asthma (BA) alone causes pulmonary emphysema (PE), and to examine the computed tomography (CT) findings in non-smokers with BA demonstrating the flow volume curve (FV curve) characteristic of PE. Non-smoking patients with a history of BA for more than 20 years were divided into 2 groups: the dogleg pattern group (n=5), with an FV curve characteristic of PE, and the concave pattern group (n=16) with an FV curve characteristic of BA. CT scans was performed using CT values (level, 900 H.U.; width, 400 H.U.) that facilitate detection of a low attenuation area (LAA), and using conventional CT values (level, 700 H.U.; width, 1,300 H.U.). LAA (including air trapping), thickness of the bronchial wall, and partial atelectasis were compared between the 2 groups. PE was not detected, although air trapping was found in all subjects. The thickness of the airway was greater in the dogleg pattern than in the concave pattern. The incidences of air trapping and partial atelectasis were higher in the former than in the latter. BA alone may not cause PE. Some BA patients without PE show the FV curve characteristic of PE, reflecting an increase in the thickness of the airway wall and a decrease in the pulmonary ventilation probably due to the air trapping and the partial atelectasis. (author)

  7. Isolation of pathogenic Escherichia coli from stool samples of diarrhoeal patients with history of raw milk consumption

    Directory of Open Access Journals (Sweden)

    M. N. Brahmbhatt

    2013-07-01

    Full Text Available Aim: To detect the occurrence of pathogenic Escherichia coli from stool samples of diarrhoeal patients with history of raw milk consumption and to determine the public health significance of isolates, especially their role in causing human diseases.Materials and Methods: Atotal of 100 stool samples from diarrhoeal patients, with history of raw milk consumption were collected from primary health centres in and around Anand city, under aseptic conditions and a total of 50 raw milk samples were collected from milk vendors, retail shops located in Anand city in sterilized sample bottles. MacConkey broth was used for the enrichment of all the samples and inoculation was done on MacConkey agar and EMB agar was used as the selective media. This was followed by the confirmation of isolates using biochemical tests. For the serotyping,E. coli isolates were sent to the National Salmonella and Escherichia Centre, Central Research Institute (CRI, Kasauli, Himachal Pradesh.Detection of virulence genes was performed using PCR technique.Results: During the present investigation, 26 (52% E. coli isolates from 50 milk samples and 59 (59% E. coli isolates from 100 stool samples were recovered. Out of 85 E. coli isolates sent for serotyping, 74 isolates could be typed which were further distributed into 13 different serogroups O2, O4, O8, O17, O22, O25, O29, O36, O45, O60, O90, O116 and O172, whereas 8 isolates were found untypable and 3 isolates were reported rough isolates. Of the 59 E. coli isolates from stool samples of diarrhoeal patients tested, 15 isolates (25.42% were reported to be positive for stx genes, among that 6 (10.16% were positive for stx1 gene, 9 (15.25% isolates were positive for stx2 gene, while 3 isolates (5.08% were positive for eaeA gene. In this study, 21 E. coliisolates were found to be Shiga toxin producing E. coli (STEC while none of the isolates were positive for the serotype O157. Conclusions: Our present findings indicate that raw

  8. Intake of Dairy Products in Relation to Periodontitis in Older Danish Adults

    OpenAIRE

    Berit L Heitmann; Boucher, Barbara J; Kirsten Avlund; Poul Holm-Pedersen; Christensen, Lisa B.; Adegboye, Amanda R. A.

    2012-01-01

    This cross-sectional study investigates whether calcium intakes from dairy and non-dairy sources, and absolute intakes of various dairy products, are associated with periodontitis. The calcium intake (mg/day) of 135 older Danish adults was estimated by a diet history interview and divided into dairy and non-dairy calcium. Dairy food intake (g/day) was classified into four groups: milk, cheese, fermented foods and other foods. Periodontitis was defined as the number of teeth with attachment lo...

  9. Prevalence of benign and malignant thyroid nodules in patients with previous history of radiotherapy for Tinea capitis in childhood (in khorosan province)

    International Nuclear Information System (INIS)

    Increased prevalence of thyroid cancer was noted in patients with previous history of radiotherapy of the head and neck region in childhood. According to previous research, radiotherapy for Ti nia capitis was using up to 30 years ago in Khorasan Province. This study tries to evaluate prevalence of benign and malignant thyroid nodules and detect and treat these patients earlier to prevent more complications and increased cost. Methods and patients: Using mass media, we recalled all patients with history of radiotherapy for Tinea capitis in childhood. A questionnaire was filled for each patient and thyroid examination, thyroid scan and thyroid sonography were performed. Fine needle aspiration biopsy (FNAB) was done if a thyroid nodule larger than 1 cm was palpable. Serum TSH was measured in all patients. Also thyroid surgery was recommended for all patients with thyroid nodules more than 1 cm. A control group was defined from a group of patients who referred for non thyroidal sonography to radiology department of Ghaem hospital. These patients also were evaluated by clinical examination and thyroid sonography. Results: We studied 180 patients with mean age of 47.7 years and 127 age and sex m etched controls. Thyroid nodules was palpated in 45.5% of patients and 7% of controls (P0.01). The mean largest diameter of nodules were 24.8 mm in patients and 10.8 mm in control group (P<0.001). 75% of patients were agreed with FNAB and 5% of them had suspicious cytology results. No suspicious or malignant results was noted in control group. Twenty seven patients (33.7%) were operated. Pathological results were benign in 89.9% and malignant in 1% of patients. His study showed that thyroid nodules and thyroid neo plasma were significantly more larger in the patients group. Thyroid neoplasm were more frequent in younger patients with latent thyroid (from radiotherapy) of less than 40 years, so aggressive evaluation is recommended in these group

  10. Heterotopic ossification in combat amputees from Afghanistan and Iraq wars: Five case histories and results from a small series of patients

    Directory of Open Access Journals (Sweden)

    Ted Melcer, PhD

    2011-01-01

    Full Text Available Heterotopic ossification (HO is excess bone growth in soft tissues that frequently occurs in the residual limbs of combat amputees injured in Operation Iraqi Freedom and Operation Enduring Freedom, or Iraq and Afghanistan wars, respectively. HO can interfere with prosthetic use and walking and delay patient rehabilitation. This article describes symptomatic and/or radiographic evidence of HO in a patient series of combat amputees rehabilitating at a military amputee care clinic (27 patients/33 limbs. We conducted a retrospective review of patient records and physician interviews to document evidence of HO symptoms in these limbs (e.g., pain during prosthetic use, skin breakdown. Results showed HO-related symptoms in 10 of the 33 residual limbs. Radiographs were available for 25 of the 33 limbs, and a physician identified at least moderate HO in 15 of the radiographs. However, 5 of the 15 patients who showed at least moderate radiographic HO did not report adverse symptoms. Five individual patient histories described HO onset, symptoms, treatments, and outcomes. These case histories illustrated how HO location relative to pressure-sensitive/pressure-tolerant areas of the residual limb may determine whether patients experienced symptoms. These histories revealed the uncommon but novel finding of potential benefits of HO for prosthetic suspension.

  11. 护患合作质量控制对提高维持性血液透析患者液体摄入依从性的研究%Study on cooperation between nurses and patients quality control improving fluid intake maintenance hemodialysis patients compliance

    Institute of Scientific and Technical Information of China (English)

    冯艳平

    2015-01-01

    Objective:To investigate the collaborative nurse quality control team activities,to improve the patients with maintenance hemodialysis ( MHD) effect of fluid intake compliance. Methods:The study of maintenance hemodialysis patients cannot effectively restrict fluid intake,analysed the reasons and set goals,formulate implementation measures,including perfecting the nurse theory knowledge training,strengthen the liquid intake of health education,im-prove the teaching AIDS,mission profile and water control protocol individualized fluid intake control scheme,a family support system,revised standard health education path. Comparison before and after the implementation of patient compliance and satisfaction of fluid intake. Results:The patients undergoing after six months,compliance of liquid intake activity was obviously better than the former (P<0. 05). Activities before the patients health education to liq-uid intake of satisfaction was 80. 59%,after the desired target by 92. 54%. Conclusion:The nurse collaborative quality control team activity in patients with MHD control fluid intake method for continuous quality improvement, which can effectively improve patient′s fluid intake compliance,make dialysis period between the added value of body quality control within the prescribed scope. Effectively improve the patient satisfaction of liquid intake of health education, embodies the connotation of the quality of nursing service.%目的::探讨开展护患合作型质量控制小组活动,对提高维持性血液透析( MHD)患者液体摄入依从性的效果。方法:本研究通过对MHD患者不能有效限制液体摄入的原因进行分析,设定目标,制订实施对策,包括完善护士理论知识培训考核,加强液体摄入健康教育,完善宣教资料及控制液体教具,协议个性化液体摄入控制方案,建立家庭支持系统,修订健康教育标准路径。比较实施前后患者对液体摄入的依从性

  12. Natural history of markers of collagen turnover in patients with early diastolic dysfunction and impact of eplerenone.

    LENUS (Irish Health Repository)

    Mak, George J

    2012-02-01

    OBJECTIVES: This study was designed to evaluate the impact of eplerenone on collagen turnover in preserved systolic function heart failure (HFPSF). BACKGROUND: Despite growing interest in abnormal collagen metabolism as a feature of HFPSF with diastolic dysfunction, the natural history of markers of collagen turnover and the impact of selective aldosterone antagonism on this natural history remains unknown. METHODS: We evaluated 44 patients with HFPSF, randomly assigned to control (n = 20) or eplerenone 25 mg daily (n = 24) for 6 months, increased to 50 mg daily from 6 to 12 months. Serum markers of collagen turnover and inflammation were analyzed at baseline and at 6 and 12 months and included pro-collagen type-I and -III aminoterminal peptides, matrix metalloproteinase type-2, interleukin-6 and -8, and tumor necrosis factor-alpha. Doppler-echocardiographic assessment of diastolic filling indexes and tissue Doppler analyses were also obtained. RESULTS: The mean age of the patients was 80 +\\/- 7.8 years; 46% were male; 64% were receiving an angiotensin-converting enzyme inhibitor, 34% an angiotensin-II receptor blocker, and 68% were receiving beta-blocker therapy. Pro-collagen type-III and -I aminoterminal peptides, matrix metalloproteinase type-2, interleukin-6 and -8, and tumor necrosis factor-alpha increased with time in the control group. Eplerenone treatment had no significant impact on any biomarker at 6 months but attenuated the increase in pro-collagen type-III aminoterminal peptide at 12 months (p = 0.006). Eplerenone therapy was associated with modest effects on diastolic function without any impact on clinical variables or brain natriuretic peptide. CONCLUSIONS: This study demonstrates progressive increases in markers of collagen turnover and inflammation in HFPSF with diastolic dysfunction. Despite high background utilization of renin-angiotensin-aldosterone modulators, eplerenone therapy prevents a progressive increase in pro-collagen type

  13. Caffeine intake and fecundability

    DEFF Research Database (Denmark)

    Jensen, Tina Kold; Henriksen, T B; Hjollund, N H;

    1998-01-01

    and caffeine intake from different sources on the probability of conception. From 1992 to 1995, a total of 430 couples were recruited after a nationwide mailing of a personal letter to 52,255 trade union members who were 20 to 35 years old, lived with a partner, and had no previous reproductive experience...... between caffeine intake and fecundability was analyzed in a logistic regression model with the outcome at each cycle (pregnant or not pregnant) in a Cox discrete model calculating the fecundability odds-ratio (FR). Compared to nonsmoking women with caffeine intake less than 300 mg/d, nonsmoking women who...... caffeine and smoking is biologically plausible, and the lack of effect among smokers may be due to faster metabolism of caffeine. Our findings suggest that especially nonsmoking women who wish to achieve a pregnancy might benefit from a reduced caffeine intake....

  14. Patient and primary care provider experience using a family health history collection, risk stratification, and clinical decision support tool: a type 2 hybrid controlled implementation-effectiveness trial

    OpenAIRE

    Wu, R. Ryanne; Orlando, Lori A.; Himmel, Tiffany L; Buchanan, Adam H; Powell, Karen P; Hauser, Elizabeth R.; Agbaje, Astrid B; Henrich, Vincent C.; Ginsburg, Geoffrey S.

    2013-01-01

    Background Family health history (FHH) is the single strongest predictor of disease risk and yet is significantly underutilized in primary care. We developed a patient facing FHH collection tool, MeTree©, that uses risk stratification to generate clinical decision support for breast cancer, colorectal cancer, ovarian cancer, hereditary cancer syndromes, and thrombosis. Here we present data on the experience of patients and providers after integration of MeTree© into 2 primary care practices. ...

  15. Selective deficits in semantic verbal fluency in patients with a first affective episode with psychotic symptoms and a positive history of mania.

    LENUS (Irish Health Repository)

    Kravariti, Eugenia

    2009-05-01

    Neurocognitive dysfunction is likely to represent a trait characteristic of bipolar disorder, but the extent to which it comprises \\'core\\' deficits as opposed to those secondary to longstanding illness or intellectual decline is unclear. We investigated neuropsychological performance in an epidemiologically derived sample of patients with a first affective episode with psychotic symptoms and a positive history of mania, compared to community controls.

  16. Diagnostic Value of History Taking and Physical Examination to Assess Effusion of the Knee in Traumatic Knee Patients in General Practice

    NARCIS (Netherlands)

    Kastelein, Marlous; Luijsterburg, Pim A.; Wagemakers, Harry A.; Bansraj, Santusha C.; Berger, Marjolein Y.; Koes, Bart W.; Bierma-Zeinstra, Sita M.

    2009-01-01

    Objective: To assess the diagnostic value of history taking and physical examination for knee joint effusion in patients with a knee injury who consult their general practitioner (GP). In addition, to determine the association between effusion seen on magnetic resonance imaging (MRI) and internal de

  17. Discovery of a sexual stage in Trichophyton onychocola, a presumed geophilic dermatophyte isolated from toenails of patients with a history of T. rubrum onychomycosis

    DEFF Research Database (Denmark)

    Hubka, Vit; Nissen, Christoffer V; Jensen, Rasmus Hare;

    2015-01-01

    -old man. The patient had a history of great toenail infection caused by T. rubrum in 2004 and presented with suspected relapse in 2011 and 2013. Trichophyton onychocola was the only microbial agent isolated at the second visit in 2013 and the identification was confirmed by DNA sequencing. Direct...

  18. Analysis of mammographic findings and patient history data with genetic algorithms for the prediction of breast cancer biopsy outcome

    Science.gov (United States)

    Frederick, Erik D.; Floyd, Carey E., Jr.

    1998-06-01

    A decision model is presented to increase the specificity of breast biopsy directly optimized on the receiver operating characteristic (ROC) area index. ROC area has higher clinical significance as a performance measure than the traditional metric mean-squared error (MSE). Excisional biopsy as practiced is highly sensitive to cancer but nonspecific; only one in three biopsies is malignant. Data for this study consists of 500 cases randomly selected from patients who underwent excisional biopsy for definitive diagnosis of breast cancer. For each case, inputs to the model consist of mammographic findings and patient history features. Outputs from the model built may be thresholded to correspond to the decision to biopsy a suspicious breast lesion. While clinically relevant, ROC area is a discontinuous function which cannot be optimized directly so a genetic algorithm approach is used to train a nonlinear artificial neural network. Performance using the genetic algorithm method of training was similar to that of a decision model trained using the traditional approach for this data set. ROC areas were obtained after training using three different approaches: genetic algorithm training optimized on ROC area produced an ROC area of 0.845 +/- 0.039, genetic algorithm training optimized on MSE produced an ROC area of 0.845 +/- 0.039, and traditional training using backpropagation produced an ROC area of 0.848 +/- 0.039. Despite the similar performance measures for models trained on this data, it is possible that with different data sets, training on ROC instead of MSE will produce models with significantly different performance. In this case, the genetic algorithm approach will prove useful.

  19. Individual placement and support (IPS) for patients with offending histories: the IPSOH feasibility cluster randomised trial protocol

    Science.gov (United States)

    Khalifa, N; Talbot, E; Schneider, J; Walker, D M; Bates, P; Bird, Y; Davies, D; Brookes, C; Hall, J; Völlm, B

    2016-01-01

    Introduction People with involvement in forensic psychiatric services face many obstacles to employment, arising from their offending, as well as their mental health problems. This study aims to assess the feasibility of conducting a randomised controlled trial (RCT) to evaluate the effectiveness of individual placement and support (IPS), in improving employment rates and associated psychosocial outcomes in forensic psychiatric populations. IPS has been found consistently to achieve employment rates above 50% in psychiatric patients without a history of involvement in criminal justice services. Methods/design This is a single-centre feasibility cluster RCT. Clusters will be defined according to clinical services in the community forensic services of Nottinghamshire Healthcare NHS Foundation Trust (NHCT). IPS will be implemented into 2 of the randomly assigned intervention clusters in the community forensic services of NHCT. A feasibility cluster RCT will estimate the parameters required to design a full RCT. The primary outcome is the proportion of people in open employment at 12-month follow-up. Secondary outcome measures will include employment, educational activities, psychosocial and economic outcomes, as well as reoffending rates. Outcome measures will be recorded at baseline, 6 months and 12 months. In accordance with the UK Medical Research Council guidelines on the evaluation of complex interventions, a process evaluation will be carried out; qualitative interviews with patients and staff will explore general views of IPS as well as barriers and facilitators to implementation. Fidelity reviews will assess the extent to which the services follow the principles of IPS prior, during and at the end of the trial. Ethics and dissemination Ethical approval was obtained from the East Midlands Research Ethics Committee-Nottingham 1 (REC reference number 15/EM/0253). Final and interim reports will be prepared for project funders, the study sponsor and clinical

  20. New-Onset Panic, Depression with Suicidal Thoughts, and Somatic Symptoms in a Patient with a History of Lyme Disease

    Directory of Open Access Journals (Sweden)

    Amir Garakani

    2015-01-01

    Full Text Available Lyme Disease, or Lyme Borreliosis, caused by Borrelia burgdorferi and spread by ticks, is mainly known to cause arthritis and neurological disorders but can also cause psychiatric symptoms such as depression and anxiety. We present a case of a 37-year-old man with no known psychiatric history who developed panic attacks, severe depressive symptoms and suicidal ideation, and neuromuscular complaints including back spasms, joint pain, myalgias, and neuropathic pain. These symptoms began 2 years after being successfully treated for a positive Lyme test after receiving a tick bite. During inpatient psychiatric hospitalization his psychiatric and physical symptoms did not improve with antidepressant and anxiolytic treatments. The patient’s panic attacks resolved after he was discharged and then, months later, treated with long-term antibiotics for suspected “chronic Lyme Disease” (CLD despite having negative Lyme titers. He however continued to have subsyndromal depressive symptoms and chronic physical symptoms such as fatigue, myalgias, and neuropathy. We discuss the controversy surrounding the diagnosis of CLD and concerns and considerations in the treatment of suspected CLD patients with comorbid psychiatric diagnoses.

  1. Valoración de la ingesta de nutrientes y energía en paciente crítico bajo terapia nutricional enteral Nutrients and energy intake assessment in the critically ill patient on enteral nutritional therapy

    Directory of Open Access Journals (Sweden)

    J. Abilés

    2005-04-01

    vitaminas y minerales. Las recomendaciones utilizadas como referencia corresponden a ingestas suficientes para cubrir requerimientos de individuos sanos, por lo tanto, los valores obtenidos en nuestro estudio muestran una adecuación superior al 75%, salvo casos particulares como la vitamina A y el magnesio. Sin embargo al observar la figura 3, el cual nos muestra la adecuación de las ingestas vitamínicas a las dosis recomendadas para pacientes enfermos, la ingesta es inferior al 25% de lo requerido en todos los casos, estas deficiencias repercuten de manera significativa en la cicatrización, el sistema inmune, el cardiovascular y el nervioso así como en el metabolismo del resto de macronutrientes, provocando un desequilibrio en el sistema antioxidante y empeorando la situación clínica del paciente. Conclusiones: El presente estudio nos confirma la necesidad de monitorizar de una manera personalizada las necesidades nutricionales en el paciente crítico y adaptar las recomendaciones a sus cambios metabólicos, ya que las mismas no están claramente definidas para estas situaciones en la actualidad. Es necesario aportar dosis de micronutrientes que se acerquen más a sus necesidades y así preservar o mejorar el estado nutricional y el equilibrio del sistema antioxidante, haciendo más eficaz el tratamiento clínico aplicado.Introduction and objectives: The critically ill patient is especially susceptible to malnutrition due to his/her hypermetabolic state that leads to an increase in the nutritional requirementes, which many times are not compensated with the administered enteral formulas. The assessment of nutritional intake is essential in this kind of patients to know to what level their energetic and nutritional requirements are fulfilled, improving and monitoring in the most individualized possible way to indicated clinical and nutritional therapu. Methodology: This is a retrospective study in which all patients admitted to the Intensive Care Unit of Virgen de

  2. Associação entre o estado nutricional e a ingestão dietética em pacientes com fibrose cística Association between nutritional status and dietary intake in patients with cystic fibrosis

    Directory of Open Access Journals (Sweden)

    Míriam Isabel Souza dos Santos Simon

    2009-10-01

    Full Text Available OBJETIVO: Determinar a relação entre o estado nutricional e a ingestão dietética de pacientes com fibrose cística. MÉTODOS: Estudo transversal com 85 pacientes com fibrose cística entre 6 e 18 anos de idade. A ingestão dietética foi avaliada pelo registro alimentar de 3 dias com a pesagem dos alimentos consumidos. Os desfechos avaliados foram os seguintes indicadores do estado nutricional: percentual da relação peso/estatura (%P/E, percentil do índice de massa corpórea (IMC, escore Z para estatura/idade (E/I e peso/idade (P/I, e percentual de ingestão dietética comparada a Recommended Dietary Allowances (RDAs. RESULTADOS: A prevalência de pacientes eutróficos foi de 77,7%, considerando o IMC acima do percentil 25 como ponto de corte, e 83,5% estavam acima de 90% do %P/E. A média de ingestão, avaliada em 82 pacientes, foi de 124,5% da RDA. Nas análises de regressão logística univariada, encontrou-se uma associação significativa entre a variável independente ingestão calórica e o desfecho escore Z E/I. O modelo de análise multivariado, elaborado a partir do desfecho escore Z E/I e ajustado para idade, VEF1, colonização por Staphylococcus aureus resistente à meticilina e número de internações hospitalares, demonstrou que um aumento de 1% da ingestão calórica em relação à RDA diminui em 2% a chance de ter déficit de estatura (OR = 0,98; IC95%: 0,96-1,00. A escolaridade materna demonstrou uma associação limítrofe (p = 0,054. CONCLUSÕES: Houve baixa prevalência de desnutrição nesta amostra. O modelo de estudo demonstrou evidências da associação entre a ingestão dietética e o estado nutricional, sendo esta ingestão um fator preditor de crescimento nesses pacientes.OBJECTIVE: To determine the relationship between nutritional status and dietary intake in patients with cystic fibrosis. METHODS: Cross-sectional study involving 85 cystic fibrosis patients between 6 and 18 years of age. Dietary intake was

  3. Nutrient intake of pregnant women at high risk of gestational diabetes

    Directory of Open Access Journals (Sweden)

    Jelena Meinilä

    2015-05-01

    Full Text Available Background: The prevalence of gestational diabetes (GDM has been increasing along with the obesity pandemic. It is associated with pregnancy complications and a risk of type 2 diabetes. Objective: To study nutrient intake among pregnant Finnish women at increased risk of GDM due to obesity or a history of GDM. Design: Food records from obese women or women with GDM history (n=394 were examined at baseline (≤20 weeks of pregnancy of the Finnish Gestational Diabetes Prevention Study. Results: The pregnant women had a mean fat intake of 33 en% (SD 7, saturated fatty acids (SFA 12 en% (SD 3, and carbohydrate 46 en% (SD 6. Sucrose intake among pregnant women with GDM history was 7 en% (SD 3, which was different from the intake of the other pregnant women, 10 en% (SD 4 (p<0.001. Median intakes of folate and vitamins A and D provided by food sources were below the Finnish national nutrition recommendation, but, excluding vitamin A, supplements raised the total intake to the recommended level. The frequency of use of dietary supplements among pregnant women was 77%. Conclusions: The observed excessive intake of SFA and low intake of carbohydrates among women at high risk of GDM may further increase their risk of GDM. A GDM history, however, seems to reduce sucrose intake in a future pregnancy. Pregnant women at high risk of GDM seem to have insufficient intakes of vitamin D and folate from food and thus need supplementation, which most of them already take.

  4. The activity of serum beta-galactosidase in colon cancer patients with a history of alcohol and nicotine dependence: preliminary data

    Directory of Open Access Journals (Sweden)

    Napoleon Waszkiewicz

    2013-08-01

    Full Text Available Introduction: Beta-galactosidase (GAL is a lysosomal exoglycosidase involved in the catabolism of glycoconjugates through the sequential release of beta-linked terminal galactosyl residues. The stimulation of activity of exoglycosidases and other degradative enzymes has been noted in cancers as well as in alcohol and nicotine addiction separately. This is the first study to evaluate the activity of the serum senescence marker GAL in colon cancer patients with a history of alcohol and nicotine dependence, as a potential factor of worse cancer prognosis.Material and Methods: The material was serum of 18 colon cancer patients and 10 healthy volunteers. Ten colon cancer patients met alcohol and nicotine dependence criteria. The activity of beta-galactosidase (pkat/ml was determined by the colorimetric method. Comparisons between groups were made using the Kruskal-Wallis analysis and differences evaluated using the Mann-Whitney U test. Spearman’s rank correlation coefficient was used to measure the statistical dependence between two variables.Results: The activity of serum GAL was significantly higher in colon cancer patients with a history of alcohol and nicotine dependence, in comparison to colon cancer patients without a history of drinking/smoking (p=0.015; 46�0increase, and the controls (p=0.0002; 81�0increase. The activity of serum GAL in colon cancer patients without a history of alcohol/nicotine dependence was higher than the activity in the controls (p = 0.043; 24�0increase.Discussion/Conclusion: Higher activity of beta-galactosidase may potentially reflect the accelerated growth of the cancer, invasion, metastases, and maturation, when alcohol and nicotine dependence coincide with colon cancer. For a better prognosis of colon cancer, alcohol and nicotine withdrawal seems to be required.

  5. [Beyond the treatment and care: the History of the doctor-patient relationship as a source to think the nurse-patient relationship in the XXIst century].

    Science.gov (United States)

    Poisson, Michel

    2015-09-01

    The history of the relationship between doctors and patients shows that it is possible to find traces of attention from doctors towards patients as far back as the Antiquity. Nevertheless, at that time, this solicitude is made essentially in the name of nature through the sick individual. With the Middle Ages and the rise and growing importance of Christianity, the notion of person appeared, rising beyond the physical limits of the individual. At that time, the solicitude is then made in the name of God transcending, in that way, the sick person. It is only at the end of the XIXth century, with the movement of social transformation and secularization of the medical care, that it is possible to detect the notion of subject in the medical relation as proved by the emergence of the psychoanalysis. But at the same time, the spectacular evolution of medicine in its scientific component and its increasing importance during the next century made that it focused mainly on a naturalistic vision of the world of the medical care, to the detriment, most of the time, of a personal vision taking into account the deep-rooted social characters of the sick subject. From then on, the nursing profession could be seen, at the beginning of the XXIth century, as complementary to the medicine, through the development and the implementation of a dominant personal relation type without neglecting the naturalistic relation type. This prospect could be possible on the condition of developing the scientific knowledge allowing to give consistency and thickness to this way of seeing and acting centered on the person. An approach doubtless inspired by the care, yet going further its emotional and ethical meaning, in order to understand and to act better. PMID:26685551

  6. 老年透析患者饮食蛋白摄入和营养状态的研究%Nutritional status and dietary protein intake in elderly patients on dialysis

    Institute of Scientific and Technical Information of China (English)

    史均宝; 孙玲华; 张晓宇; 郑丹侠; 王悦

    2011-01-01

    Objective The aim of this study was to compare nutritional status in elderly patients undergoing different modalities of dialysis.Methods A cross-sectional study was performed in elderly patients on dialysis treated in Peking University Third Hospital between Jan.and Dec., 2008.Nutritional status including dietary record, blood biochemistry, subjective global assessment (SGA), and body weight were assessed for each patient.Results Atotal of 141 patients aged ≥ 65 years were included in this study.Patients were treated with hemodialysis (HD, n=63) or peritoneal dialysis (PD, n =78).In patients treated with HD and PD, the prevalence of malnutrition assessed by SGA was 33.3% and 30.8% (P > 0.05), respectively, and the dietary protein intake normalized by ideal body weight was (0.94 ± 0.23)g/(kg · day) and (0.87 ± 0.27) g/(kg · day) (P > 0.05),respectively, without significant differences between the 2 groups.However, PD patients had significantly higher values of serum cholesterol, serum low density lipoprotein and subcutaneous fat compared to HD patients (P <0.05).Conclusions Our findings revealed that most elderly dialysis patients maintained good nutritional status despite their dietary protein intake lower than that recommended by K/DOQI.However, abnormal lipid metabolism should be concerned in elderly PD patients.%目的 探讨不同透析方式对老年透析患者营养状态的影响.方法 对2008年1月至12月在北京大学第三医院肾内科接受透析的老年患者进行横断面调查,营养状态的评估包括饮食记录、生物化学指标、主观综合性营养评估(subjective global assess-ment,SGA)及体测量4个方面.结果 共141例老年(年龄≥65岁)透析患者,其中78例腹膜透析患者,63例血液透析患者.老年腹膜透析患者平均标化饮食蛋白质摄入(norma-lized dietary protein intake,NDPI)为(0.87±0.27)g/(kg·d),营养不良发生率为30.8%,老年血液透析患者平均NDPI为(0.94±0.23)g

  7. Demographic study of port wine stain patients attending a laser clinic: family history, prevalence of naevus anaemicus and results of prior treatment.

    Science.gov (United States)

    Mills, C M; Lanigan, S W; Hughes, J; Anstey, A V

    1997-07-01

    All patients with port wine stains (PWS) attending a tunable dye laser clinic were examined by one author (SWL), forming a large group which has allowed study of the demographic data of such patients. Two hundred and eighty-three patients, 217 females (median age 24 years, range 0.5-73) and 66 males (median age 20 years, range 0.75-72), were examined. The PWS were on the face in 226, neck in 69, trunk in 36, upper limb in 35 and lower limb in 29. The commonest lesional colour was purple (63 patients), while 39 naevi were pink/red, 35 pink/ purple and 35 pink. The naevus was flat in 255 patients, cobblestoned in 28, associated with hypertrophy in 31 and with scarring in 22. Seventy-two patients (25.4%) had a positive family history of birthmarks, 20 strawberry haemangiomas and 22 PWS, the family history of PWS being higher than expected for the prevalence of this naevus in the population. One hundred and forty-six patients were also examined for naevus anaemicus which was noted in 12 (8.2%), confirming an association between these two naevi. Ninety-four patients had received previous treatment, most commonly with the argon laser (56 patients), of whom only five reported a good result, and 17 of 22 patients with treatment-related scarring had been treated with this laser. Cosmetic camouflage was used in 109 (38.5%) of patients, who usually had PWS on the face (94%), of whom only 46 (16%) had received advice of its use. PMID:9499604

  8. Nutritional Adequacy of Dietary Intake in Women with Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    Susan K. Raatz

    2015-05-01

    Full Text Available Understanding nutrient intake of anorexia nervosa (AN patients is essential for the treatment. Therefore, estimates of total energy and nutrient consumption were made in a group of young women (19 to 30 years with restricting and binge purge subtypes of AN participating in an ecological momentary assessment study. Participants completed three nonconsecutive 24-hour diet recalls. Mean nutrient intakes were stratified by subtype and by quartiles of energy intake and compared to the age specific Dietary Reference Intake (DRI levels, as well as to the reported intakes from the What We Eat In America (WWEIA dietary survey 2011–2012. Reported intake was determined for energy, macronutrients, and micronutrients. The mean body mass index (BMI for all participants was 17.2 ± 0.1 kg/m2. Reported nutrient intake was insufficient for participants in quartiles 1–3 of both AN subtypes when compared to the DRIs. Intake reported by participants in quartile 4 of both subgroups met requirements for most nutrients and even met or exceeded estimated energy needs. Counseling of AN patients should be directed to total food consumption to improve energy intake and to reduce individual nutritional gaps.

  9. Exploring Personality Features in Patients with Affective Disorders and History of Suicide Attempts: A Comparative Study with Their Parents and Control Subjects

    Directory of Open Access Journals (Sweden)

    Beatriz Camarena

    2014-01-01

    Full Text Available Personality traits are important candidate predictors of suicidal behavior. Several studies have reported an association between personality/temperament traits and suicidal behavior, suggesting personality traits as intermediary phenotypes related to suicidal behavior. Thus, it is possible that suicide attempts can be accounted for by increased familial rates of risk personality traits. The aim of this work was to evaluate personality traits in affective disorder patients with attempted suicide and to compare them with the personality trait scores of their parents. In addition, ITC scores in the two groups were compared with a healthy control sample. The patients evaluated met the DSM-IV criteria for major depression disorder or dysthymia and had a documented history of suicide attempts. Psychiatric diagnoses of patients and parents were done according to the SCID-I and the personality was assessed using the Temperament and Character Inventory. We analyzed 49 suicide attempt subjects and their parents (n=95 and 89 control subjects. We observed that temperament and character dimensions were similar between patients and their parents (P>0.05. In particular, we observed that high HA and low P, SD, and CO were shared among families. Our study is the first to report that the personality traits of affective disorder patients with a history of attempted suicide are shared between patients and their parents.

  10. Solitary Plasmacytoma of the Sternum Mimicking Bone Metastasis in a Patient with a History of Breast Cancer Evaluated by F-18-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Treglia, Giorgio; Luca, Giovanella [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Barbara, Muoio; Carmelo, Caldarella [Catholic Univ., Rome (Italy)

    2014-06-15

    A 65-year-old woman with a history of breast cancer (stage T2N0M0 treated with left breast conservative therapy 7 years previously followed by hormone therapy) underwent fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) for restaging due to increased serum tumour markers levels (CA15-3, 37 U/ml and CEA, 8 ng/ml). The patient presented thoracic pain before performing F-18-FDG PET/CT. PET/CT demonstrated an area of increased F-18-FDG uptake corresponding to an osteolytic lesion occupying the upper sternum suspicious for bone metastasis. No other areas of abnormal F-18-FDG uptake were detected in the rest of the body. Based on this PET/CT finding, the patient performed biopsy of the sternal lesion. Histology demonstrated the presence of a sternal plasmacytoma and the patient was addressed to radiation therapy. The role of F-18-FDG PET/CT in patients with multiple myeloma is well known, whereas only some articles evaluated the usefulness of this method in patients with solitary plasmacytomas. In particular, F-18-FDG PET/CT may be useful in demonstrating the evolution of solitary plasmacytomas in multiple myeloma. In our case F-18-FDG PET/CT was useful in detecting a solitary plasmacytoma of the sternum mimicking bone metastasis in a patient with history of breast cancer, correctly addressing to further histological evaluation.

  11. Solitary Plasmacytoma of the Sternum Mimicking Bone Metastasis in a Patient with a History of Breast Cancer Evaluated by F-18-FDG PET/CT

    International Nuclear Information System (INIS)

    A 65-year-old woman with a history of breast cancer (stage T2N0M0 treated with left breast conservative therapy 7 years previously followed by hormone therapy) underwent fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) for restaging due to increased serum tumour markers levels (CA15-3, 37 U/ml and CEA, 8 ng/ml). The patient presented thoracic pain before performing F-18-FDG PET/CT. PET/CT demonstrated an area of increased F-18-FDG uptake corresponding to an osteolytic lesion occupying the upper sternum suspicious for bone metastasis. No other areas of abnormal F-18-FDG uptake were detected in the rest of the body. Based on this PET/CT finding, the patient performed biopsy of the sternal lesion. Histology demonstrated the presence of a sternal plasmacytoma and the patient was addressed to radiation therapy. The role of F-18-FDG PET/CT in patients with multiple myeloma is well known, whereas only some articles evaluated the usefulness of this method in patients with solitary plasmacytomas. In particular, F-18-FDG PET/CT may be useful in demonstrating the evolution of solitary plasmacytomas in multiple myeloma. In our case F-18-FDG PET/CT was useful in detecting a solitary plasmacytoma of the sternum mimicking bone metastasis in a patient with history of breast cancer, correctly addressing to further histological evaluation

  12. Daily Pomegranate intake has no impact on PSA levels in patients with advanced prostate cancer - Results of a phase IIb randomized controlled trial

    OpenAIRE

    Stenner-Liewen, Frank; Liewen, Heike; Cathomas, Richard; Renner, Christoph; Petrausch, Ulf; Sulser, Tullio; Spanaus, Katharina; Seifert, Hans Helge; Strebel, Räto Thomas; Knuth, Alexander; Samaras, Panagiotis; Müntener, Michael

    2013-01-01

    Pomegranate has been shown to prolong PSA doubling time in early prostate cancer, but no data from a placebo controlled trial has been published yet. The objective of this study was to prospectively evaluate the impact of pomegranate juice in patients with prostate cancer. We conducted a phase IIb, double blinded, randomized placebo controlled trial in patients with histologically confirmed prostate cancer. Only patients with a PSA value ≥ 5ng/ml were included. The subjects consumed 500 ml of...

  13. Plantar pressure in diabetic peripheral neuropathy patients with active foot ulceration, previous ulceration and no history of ulceration: a meta-analysis of observational studies.

    Directory of Open Access Journals (Sweden)

    Malindu Eranga Fernando

    Full Text Available AIMS: Elevated dynamic plantar pressures are a consistent finding in diabetes patients with peripheral neuropathy with implications for plantar foot ulceration. This meta-analysis aimed to compare the plantar pressures of diabetes patients that had peripheral neuropathy and those with neuropathy with active or previous foot ulcers. METHODS: Published articles were identified from Medline via OVID, CINAHL, SCOPUS, INFORMIT, Cochrane Central EMBASE via OVID and Web of Science via ISI Web of Knowledge bibliographic databases. Observational studies reporting barefoot dynamic plantar pressure in adults with diabetic peripheral neuropathy, where at least one group had a history of plantar foot ulcers were included. Interventional studies, shod plantar pressure studies and studies not published in English were excluded. Overall mean peak plantar pressure (MPP and pressure time integral (PTI were primary outcomes. The six secondary outcomes were MPP and PTI at the rear foot, mid foot and fore foot. The protocol of the meta-analysis was published with PROPSERO, (registration number CRD42013004310. RESULTS: Eight observational studies were included. Overall MPP and PTI were greater in diabetic peripheral neuropathy patients with foot ulceration compared to those without ulceration (standardised mean difference 0.551, 95% CI 0.290-0.811, p<0.001; and 0.762, 95% CI 0.303-1.221, p = 0.001, respectively. Sub-group analyses demonstrated no significant difference in MPP for those with neuropathy with active ulceration compared to those without ulcers. A significant difference in MPP was found for those with neuropathy with a past history of ulceration compared to those without ulcers; (0.467, 95% CI 0.181- 0.753, p = 0.001. Statistical heterogeneity between studies was moderate. CONCLUSIONS: Plantar pressures appear to be significantly higher in patients with diabetic peripheral neuropathy with a history of foot ulceration compared to those with diabetic

  14. Assessment of regional lung ventilation by electrical impedance tomography in a patient with unilateral bronchial stenosis and a history of tuberculosis

    OpenAIRE

    Liégina Silveira Marinho; Nathalia Parente de Sousa; Carlos Augusto Barbosa da Silveira Barros; Marcelo Silveira Matias; Luana Torres Monteiro; Marcelo do Amaral Beraldo; Eduardo Leite Vieira Costa; Marcelo Britto Passos Amato; Marcelo Alcantara Holanda

    2013-01-01

    Bronchial stenosis can impair regional lung ventilation by causing abnormal, asymmetric airflow limitation. Electrical impedance tomography (EIT) is an imaging technique that allows the assessment of regional lung ventilation and therefore complements the functional assessment of the lungs. We report the case of a patient with left unilateral bronchial stenosis and a history of tuberculosis, in whom regional lung ventilation was assessed by EIT. The EIT results were compared with those obtain...

  15. Assessment of regional lung ventilation by electrical impedance tomography in a patient with unilateral bronchial stenosis and a history of tuberculosis*

    OpenAIRE

    de Sousa, Nathalia Parente; Marinho, Liégina Silveira; Barros, Carlos Augusto Barbosa da Silveira; Matias, Marcelo Silveira; Monteiro, Luana Torres; Beraldo, Marcelo do Amaral; Costa, Eduardo Leite Vieira; Amato, Marcelo Britto Passos; Holanda, Marcelo Alcantara

    2013-01-01

    Bronchial stenosis can impair regional lung ventilation by causing abnormal, asymmetric airflow limitation. Electrical impedance tomography (EIT) is an imaging technique that allows the assessment of regional lung ventilation and therefore complements the functional assessment of the lungs. We report the case of a patient with left unilateral bronchial stenosis and a history of tuberculosis, in whom regional lung ventilation was assessed by EIT. The EIT results were compared with those obtain...

  16. Impaired DNA repair as assessed by the 'comet' assay in patients with thyroid tumors after a history of radiation therapy: A preliminary study

    International Nuclear Information System (INIS)

    Purpose: Patients with a history of head and neck irradiation in childhood are at risk to develop thyroid tumors. The aim of this study was to determine if an impairment of DNA strand breaks repair could account for this observation. Methods and Materials: Circulating unstimulated lymphocytes of a group of 13 patients who developed thyroid tumors after radiotherapy were submitted to the alkaline single-cell gel electrophoresis assay (SCGE or 'comet' assay) after in vitro exposure to 2 and 5 Gy of γ-rays. A control group of 8 healthy donors and 2 cases with a history of neck irradiation who did not develop a thyroid tumor were also analysed. The immediate response was compared to that observed after 15, 30, and 60 min of postexposure incubation periods. Results: Induction of DNA strand breaks is a dose-dependent process. The SCGE assay parameters did not differ significantly between patients and controls immediately (t = 0) after irradiation at the two doses used. As compared to healthy donors, a slower kinetics of repair was found in the patients. The proportion of residual damage at 60 min postirradiation was significantly (p < 0.01) higher in patients than in controls, at both doses analysed. Flow cytometric analysis of apoptosis and p53 protein status studied before and after irradiation showed no apparent relationship with the repair capacity. Conclusion: This preliminary study suggests that a subgroup of patients who develop thyroid tumors after a history of irradiation are partially defective in the late restitution of in vitro radiation-induced DNA strand breaks. This deficiency could be a predisposing factor to radiation-associated thyroid tumorigenesis. Detection of susceptible individuals using the simple and rapid comet assay, especially children receiving radiotherapeutic treatment, may allow a preventive surveillance for radiation-associated epithelial thyroid tumor development

  17. Pre-diagnostic smoking behaviour and poorer prognosis in a German breast cancer patient cohort - Differential effects by tumour subtype, NAT2 status, BMI and alcohol intake

    NARCIS (Netherlands)

    Seibold, P.; Vrieling, A.; Heinz, J.; Obi, N.; Sinn, H.P.; Flesch-Janys, D.; Chang-Claude, J.

    2014-01-01

    BACKGROUND: Inconsistent associations of smoking and breast cancer-specific mortality might be explained by subgroups of patients with different susceptibility to harmful effects of smoking. METHODS: We used a prospective cohort of 3340 postmenopausal breast cancer patients aged 50-74 and diagnosed

  18. Natural history and role of radiation in patients with supratentorial and infratentorial WHO grade II ependymomas: results from a population-based study.

    Science.gov (United States)

    Aizer, Ayal A; Ancukiewicz, Marek; Nguyen, Paul L; Macdonald, Shannon M; Yock, Torunn I; Tarbell, Nancy J; Shih, Helen A; Loeffler, Jay S; Oh, Kevin S

    2013-12-01

    Patients with World Health Organization (WHO) grade II supratentorial ependymomas are commonly observed after gross total resection (GTR), although supporting data are limited. We sought to characterize the natural history of such tumors. We used the Surveillance, Epidemiology, and End Results program to identify 112 patients ages 0-77 diagnosed with WHO grade II ependymomas between 1988 and 2007, of whom 63 (56 %) and 49 (44 %) had supratentorial and infratentorial primaries, respectively. Inclusion criteria were strict to ensure patient homogeneity. Of 33 patients with supratentorial tumors after GTR, 18 (55 %) received adjuvant radiation therapy and 15 (45 %) did not. Ependymoma-specific mortality (ESM) was the primary endpoint. With a median follow up of 4.5 years, only 1 of 33 patients with supratentorial ependymoma died of their disease after GTR; the 5-year estimate of ESM in this population was 3.3 % (95 % CI 0.2-14.8 %). Among patients with infratentorial ependymomas after GTR, the 5-year estimate of ESM was 8.7 % (95 % CI 1.4-24.6 %). In patients with subtotally resected tumors, 5-year estimates of ESM in patients with supratentorial and infratentorial primaries were 20.1 % (95 % CI 8.0-36.2 %) and 12.3 % (95 % CI 2.9-28.8 %), respectively. Among the whole cohort, on both univariable and multivariable regression, extent of resection was predictive of ESM, while tumor location and use of radiation were not. After GTR, patients with WHO grade II supratentorial ependymomas have a very favorable natural history with low associated cancer-specific mortality. Observation, with radiation reserved as a salvage option, may be a reasonable postoperative strategy in this population.

  19. Intellectual History, Social History, Cultural History...and Our History.

    Science.gov (United States)

    Nord, David Paul

    1990-01-01

    Defines and explores the links among intellectual, social, and cultural history. Warns that an adequate foundation must be laid in the economic and institutional social history of mass media before communication historians jump into cultural history. (SR)

  20. Quality of life, dietary intake and nutritional status assessment in hospital admitted cancer patients Calidad de vida, ingesta dietética y valoración del estado nutricional en pacientes ingresados con cáncer

    Directory of Open Access Journals (Sweden)

    J. Trabal

    2006-08-01

    Full Text Available Objectives: The objectives of this study were to assess the quality of life (QoL, nutritional status, and quantitative food intakes of non-terminal admitted cancer patients receiving oral feeding. As well as to evaluate what kind of relation exists between the quality of life, and the nutritional status and current intake Scope: Medical Oncology and Radiotherapy Service ward at the Hospital Clínic de Barcelona. Subjects: Fifty admitted patients in the Service ward. Interventions: There was a follow-up of the dietary intake during 3 working days through direct observation, as well as an assessment of anthropometrical and biochemical parameters, a record of symptomatology related data, and a QoL assessment through the EORTC QLQC30 questionnaire. Results: Our data show that 32.6% of the patients did not reach 25 kcal/kg/day, and 23.3% did not even fulfill 1g protein/kg/day. Concerning QoL, mean score for global health status and overall QoL for all patients was 46.2. Compared to the general population, there were important deficits among cancer patients regarding physical, role and social functioning. The most pronounced differences in the symptom scales were for fatigue, and in single items for appetite loss and constipation. A low protein intake was associated to a poorer perception on physical functioning (p=0.01, and fatigue was close to significance (p=0.058. No significant differences were found regarding caloric intake and QoL. Conclusions: A significant percentage of patients who received exclusive oral feeding did not cover a minimum acceptable quantity of their protein-energy requirements. Our results point-out that poor food intakes can affect QoL by themselves.Objetivos: Los objetivos de este estudio fueron valorar la calidad de vida (QoL, el estado nutricional y la ingesta dietética cuantitativa realizada en pacientes oncológicos no terminales ingresados que recibieron alimentación oral. Así mismo evaluar qué tipo de relaci

  1. Legionella pneumophila in bronchoalveolar lavage samples of patients suffering from severe respiratory infections: Role of age, sex and history of smoking in the prevalence of bacterium

    Directory of Open Access Journals (Sweden)

    Faradonbeh Fatemeh Alaei

    2015-01-01

    Full Text Available Introduction. Legionella pneumophila is the most commonly detected cause of legionellosis, which is an acute respiratory tract infection with high morbidity and mortality rates. Objective. The aim of this study was to investigate the prevalence rate of L. pneumophila in bronchoalveolar lavages and study the role of sex, age and history of smoking as risk factors for susceptibility to the bacterium. Methods. One hundred bronchoalveolar lavage samples were collected from the Iranian health centers and immediately transferred to laboratory. The samples were cultured and those that were L. pneumophila positive were subjected to PCR method with respect to the 16S rRNA gene. Results. Twelve out of 100 samples were positive for L. pneumophila (12%. Patients older than 70 years had the highest incidence of L. pneumophila (17.77%. Prevalence of L. pneumophila in male and female patients was 14.81% and 8.69%, respectively. Total incidence of L. pneumophila in patients with and without history of smoking was 18% and 6%, respectively. There were significant differences in the incidence of bacterium between groups of our study. Conclusion. Sex, age and history of smoking are predominant risk factors for the occurrence of L. pneumophila. However, more studies should be undertaken to confirm these results.

  2. Plasma dipeptidyl peptidase-IV activity in patients with type-2 diabetes mellitus correlates positively with HbAlc levels, but is not acutely affected by food intake

    DEFF Research Database (Denmark)

    Ryskjaer, Jakob; Deacon, Carolyn F.; Carr, Richard D;

    2006-01-01

    hormones are metabolized quickly by the enzyme dipeptidyl peptidase-IV (DPP-IV). It is well known that type-2 diabetic patients have an impaired incretin effect. Therefore, the aim of the present study was to investigate plasma DPP-IV activity in the fasting and the postprandial state in type-2 diabetic...... patients, DPP-IV activity was positively correlated to FPG and HbAlc and negatively to the duration of diabetes and age of the patients. No postprandial changes were seen in plasma DPP-IV activity in any of the groups. CONCLUSIONS: Plasma DPP-IVactivity increases in the fasting state and is positively...

  3. Paediatric environmental health history taking: Why bother?

    NARCIS (Netherlands)

    G.W. ten Tusscher; M.M. Leijs; J.G. Koppe

    2006-01-01

    Environmental health history taking is often not part of standard medical history taking for clinical physicians. During recent years attention has been placed on home environments and asthma and allergies, high caloric intake and obesity and type 2 diabetes mellitus, yet environmental health histor

  4. Nutritient intake of young children with Prader–Willi syndrome

    Directory of Open Access Journals (Sweden)

    Marianne Lindmark

    2010-03-01

    Full Text Available Background: Prader–Willi syndrome (PWS is a rare genetic disorder resulting in obesity. The diets for young children with PWS must balance the importance of preventing development of obesity with the need to supply sufficient energy and essential nutrients. Objective: To investigate the nutritional intake for children with PWS 2, 3, and 4 years of age and compare it with Nordic Nutritional Recommendations (NNR and intake of healthy controls. Design: Assessments of food intake for six children 2–4 years of age were performed twice a year. At the age of 2 and 3 years data was obtained by using food recall interviews and at 4 year of age a pre-coded food-diary was used. Results: The energy intake for the 2-year-old children was 3.25 MJ/day (SD 0.85 and for the 3- and 4-year olds 3.62 MJ/day (SD 0.73 and 4.07 MJ/day (SD 0.39 MJ, respectively. These intakes are 61%, 68%, and 77% of the estimated energy requirements in NNR for healthy 2-, 3- and 4-year-old children, respectively, and 60% and 66% of the energy intakes of 2- and 4-year-old children in reference populations. The children's BMI-for-age score and length growth was within the normal range during the study period. The intake of fat was about 25 E% in all age groups and reduced when compared with reference populations. In 25% of the assessments the fat intake was 20 E% or below. The intake of iron was below recommendations in all age groups both with and without supplementation. The mean intake of vitamin D and tocopherol was below recommendations when intakes were determined excluding dietary supplementations. Conclusions: More large-scale investigations on nutritional intake are needed to further investigate dietary challenges for this patient group.

  5. Bohmian Histories and Decoherent Histories

    OpenAIRE

    Hartle, James B.

    2002-01-01

    The predictions of the Bohmian and the decoherent (or consistent) histories formulations of the quantum mechanics of a closed system are compared for histories -- sequences of alternatives at a series of times. For certain kinds of histories, Bohmian mechanics and decoherent histories may both be formulated in the same mathematical framework within which they can be compared. In that framework, Bohmian mechanics and decoherent histories represent a given history by different operators. Their ...

  6. Intake to Production Ratio

    DEFF Research Database (Denmark)

    Nazaroff, William; Weschler, Charles J.; Little, John C.;

    2012-01-01

    to protect public health.OBJECTIVES: We introduce the intake-to-production ratio (IPR) as an economy-wide quantitative indicator of the extent to which chemical production results in human exposure.METHODS: The IPR was evaluated as the ratio of two terms: aggregate rate of chemical uptake in a human......BACKGROUND: Limited data are available to assess human exposure to thousands of chemicals currently in commerce. Information that relates human intake of a chemical to its production and use can help inform understanding of mechanisms and pathways that control exposure and support efforts...... Protection Agency, as well as other published data, to estimate the IPR for nine chemicals in the United States. Results are reported in units of parts per million, where 1 ppm indicates 1 g of chemical uptake for every million grams of economy-wide use.RESULTS: Estimated IPR values for the studied compounds...

  7. Food, fat, family and friends: studies on the impact of the social environment on dietary intake.

    OpenAIRE

    Feunekes, G.I.J.

    1996-01-01

    The impact of the social environment on food and fat intake was investigated in several samples including family members, close friends, and meal time companions in the Netherlands. Firstly, a food frequency questionnaire to assess the intake of fat, fatty acids and cholesterol was developed. Biomarker-based validity (n = 99), relative validity against a dietary history (n = 191), and reproducibility (n = 93) were satisfactory for adults.Up to 40% of the variance in fat intake, expressed as %...

  8. Patient-generated aspects in oral rehabilitation decision making I. Comparison of traditional history taking and an individual systematic interview method

    DEFF Research Database (Denmark)

    Øzhayat, Esben Boeskov; Gotfredsen, Klaus; Elverdam, Beth;

    2009-01-01

    Decision making in oral rehabilitation is often based on diagnoses related to impairment of different oral functions. In making the decision when to treat, the dentist must work in cooperation with the patient. By incorporating patient-generated aspects into the decision making process, the denti...... percentage of the participants were positive towards the use of the SEIQoL-DW method in their treatment planning. The SEIQoL-DW was considered to be a viable tool for decision making in oral rehabilitation.......Decision making in oral rehabilitation is often based on diagnoses related to impairment of different oral functions. In making the decision when to treat, the dentist must work in cooperation with the patient. By incorporating patient-generated aspects into the decision making process, the dentist...... it with a traditional history taking, in generating information to be used in decision making in oral rehabilitation. Fifty-seven participants in need of oral rehabilitation were enrolled in the study. The participants underwent a traditional history taking and were interviewed using the SEIQoL-DW method. The SEIQo...

  9. The effect of protein intake and resistance training on muscle mass in acutely ill old medical patients - A randomized controlled trial

    DEFF Research Database (Denmark)

    Buhl, Sussi F; Andersen, Aino L; Andersen, Jens Rikardt;

    2016-01-01

    standard care. Secondary outcomes were changes in muscle strength, functional ability and body weight. METHODS: 29 acutely admitted old (>65 years) patients were randomly assigned to the intervention (n = 14) or to standard care (n = 15). The Intervention Group received 1.7 g protein/kg/day during...... differences were found. CONCLUSION: No significant effect on muscle mass was observed in this group of acutely ill old medical patients. High compliance was achieved with the dietary intervention, but resistance training was challenging. Clinical trials identifier NCT02077491....

  10. Diagnostic value of history and physical examination in patients suspected of sciatica due to disc herniation : a systematic review

    NARCIS (Netherlands)

    Vroomen, PCAJ; de Krom, MCTFM; Knottnerus, JA

    1999-01-01

    We conducted a systematic review of the literature from 1965-1994 to assess the value of history and physical examination in the diagnosis of sciatica due to disc herniation; we also included population characteristics and features of the study design affecting diagnostic value. Studies on the diagn

  11. Leiomyosarcoma of the breast in a patient with a 10-year-history of cyclophosphamide exposure: a case report

    OpenAIRE

    De la Pena, Jennifer; Wapnir, Irene

    2008-01-01

    A 50 year old woman with a 10-year history of systemic lupus erythematosus (SLE) and intermittent low-dose cyclophosphamide therapy developed a palpable mass at the periphery of her left breast. Ultrasound guided core biopsy revealed a spindle cell neoplasm characterized on final pathology as a low grade leiomyosarcoma.

  12. 'Insane emigrants' in transit: Psychiatric patients' files as a source for the history of return migration, c. 1910

    NARCIS (Netherlands)

    G. Blok

    2015-01-01

    This article highlights a source that can contribute to the history of migration and mental health: the case records of Eastern European emigrants who tried to enter America at the beginning of the twentieth century, but were refused entrance because of their alleged insanity. Some of these unfortun

  13. Dietary intake of female bariatric patients after anti-obesity gastroplasty Ingestão dietética de pacientes bariátricas femininas após gastroplastia anti-obesidade

    Directory of Open Access Journals (Sweden)

    Maria Carolina G. Dias

    2006-04-01

    Full Text Available PURPOSE: Roux-en-Y gastric bypass is a popular and successful operation for the treatment of morbid obesity. However, it greatly restricts ingestion and moderately interferes with absorption of food, thus potentially paving the way for undernutrition, especially during the first year before patients adapt to the new condition. Aiming to document actual dietary intake during this period, a prospective observational study was performed. METHODS: Forty consecutive patients were investigated using a 24-hour dietary recall technique every 3 months after surgery for 1 year. Females only were accepted for greater homogeneity of the sample. All received a vitamin and mineral supplement on a daily basis as a postoperative routine. A questionnaire was employed regarding general, nutritional, and gastrointestinal changes as well as consumption of medications. Dietary intake was analyzed after data processing using the Virtual Nutri software package (São Paulo, SP, Brazil. RESULTS: The surgical response was within the expected range, with about 67% excess weight loss at the end of the 1st year, and the same occurred with gastrointestinal symptoms and drug requirements. Daily energy intake on the 4 analyzed occasions was 529.4 ± 47.4, 710.9 ± 47.6, 833.2 ± 72.0, and 866.2 ± 95,1 kcal/day (mean ± SEM; protein intake was increased in the same proportion at 6 and 9 months, but reduced at 12 months. Thus, patients did not meet standard recommendations regarding calories and proteins, even at the end of the 1st year; iron and zinc intake were also inadequate, although deficiencies were probably staved off by the prescribed supplement preparation. CONCLUSIONS: 1 The risk for postoperative undernutrition was evidenced up to 1 year, while spontaneous improvement in food intake was slow and inefficient; 2 Specific protocols should be devised to improve nutrition and health during the postoperative phase until successful dietary adaptation is achieved

  14. Dietary Intake Research in Asian Children: Significance and Challenges.

    Science.gov (United States)

    Henry, Christiani Jeyakumar

    2015-01-01

    Food intake studies have a long history. However, until a few decades ago, there was limited quantitative data on feeding patterns and food intake in infants and children living in South Asia. The recent SEANUT study and MING study have provided several new insights into the dietary patterns of children living in China, Indonesia, Malaysia, Thailand and Vietnam. The complexity and variety of Asian diets makes the collation of dietary information a challenge. The double burden of under-nutrition and over-nutrition is prevalent in many Asian countries. Compared to obesity, stunting is widespread in South East Asia. Our future challenge is to develop food intake assessment techniques which can be refined and made available as a common dietary assessment tool across this region. Successful nutritional intervention can only be achieved if we know what Asian children eat. Dietary intake research will be a key factor in realizing our goal to eradicate malnutrition in this region. PMID:26598852

  15. Focal nodular hyperplasia-like lesions in patients with cavernous transformation of the portal vein: prevalence, MR findings and natural history

    Energy Technology Data Exchange (ETDEWEB)

    Marin, Daniele [Duke University Medical Center, Department of Radiology, Durham, NC (United States); University of Rome Sapienza, Department of Radiological Sciences, Rome (Italy); Galluzzo, Anna; Brancatelli, Giuseppe [Universita di Palermo, Istituto di Radiologia, Palermo (Italy); Plessier, Aurelie; Valla, Dominique [Service d' Hepatologie, Hopital Beaujon, Clichy (France); Vilgrain, Valerie [Assistance Publique des Hopitaux de Paris, APHP, Hopital Beaujon, Department of Radiology, Clichy (France); Universite Paris 7 Denis Diderot, Paris (France)

    2011-10-15

    To retrospectively investigate the prevalence, MR findings, natural history, and association with other hepatic lesions of focal nodular hyperplasia (FNH)-like lesions in a cohort of consecutive patients with cavernous transformation of the portal vein (CTPV). This retrospective IRB-approved study comprised 58 patients (32 men, 26 women; average age, 50 years) with CTPV who underwent liver MR imaging between 2000 and 2008. MR images were assessed by two radiologists in consensus for the presence of (a) FNH-like lesions and other liver lesions, and (b) other imaging findings. Patients were assigned to a stable or progressive clinical course based on lesion characteristics at follow-up. Twelve of 58 patients (21%) had 38 FNH-like lesions (average size, 1.3 cm). Common findings of FNH-like lesions were isointensity on T2-weighted images (82%), intense and homogeneous enhancement during the arterial phase, and lack of washout during the hepatic venous and interstitial phases (100%). FNH-like lesions were found with other benign liver lesions (1 hemangioma, 1 adenoma) in two patients. Three (25%) patients with FNH-like lesions showed a progressive clinical course. FNH-like lesions are commonly detected in patients with CTPV. Most lesions demonstrate benign imaging findings and stable clinical course. (orig.)

  16. One-year intranasal application of growth hormone releasing peptide-2 improves body weight and hypoglycemia in a severely emaciated anorexia nervosa patient

    OpenAIRE

    Haruta, Izumi; Fuku, Yuki; Kinoshita, Kazuhisa; Yoneda, Koichi; Morinaga, Akinori; Amitani, Marie; Amitani, Haruka; Asakawa, Akihiro; Sugawara, Hideki; Takeda, Yasuo; Bowers, Cyril Y.; Inui, Akio

    2015-01-01

    Background In Japan, growth hormone releasing peptide-2 (GHRP-2) is clinically used as a diagnostic agent for growth hormone secretion deficiency, but the therapeutic application of GHRP-2 has not been studied in anorexia nervosa. GHRP-2 reportedly exhibits agonistic action for ghrelin receptor and increases food intake. Methods We administered GHRP-2 to a patient with a 20-year history of anorexia nervosa to determine whether GHRP-2 treatment increases food intake and body weight. GHRP-2 was...

  17. DETERMINATION OF PROTEIN CATABOLIC RATE IN PATIENTS ON CHRONIC INTERMITTENT HEMODIALYSIS - UREA OUTPUT MEASUREMENTS COMPARED WITH DIETARY-PROTEIN INTAKE AND WITH CALCULATION OF UREA GENERATION RATE

    NARCIS (Netherlands)

    STEGEMAN, CA; HUISMAN, RM; DEROUW, B; JOOSTEMA, A; DEJONG, PE

    1995-01-01

    We assessed the agreement between different methods of determining protein catabolic rate (PCR) in hemodialysis patients and the possible influence of postdialysis urea rebound and the length of the interdialytic interval on the PCR determination. Protein catabolic rate derived from measured total u

  18. Analysis of the interaction between transcription factor 7-like 2 genetic variants with nopal and wholegrain fibre intake: effects on anthropometric and metabolic characteristics in type 2 diabetes patients.

    Science.gov (United States)

    López-Ortiz, M M; Garay-Sevilla, M E; Tejero, M E; Perez-Luque, E L

    2016-09-01

    The transcription factor 7-like 2 (TCF7L2) genetic variants have shown differential effect on low-fat and high-fat diet in obese subjects. Nopal is a Mexican variety of cactus that is a traditional food and has been used in the treatment of diabetes. Its hypoglycaemic effect may be because of its soluble fibre (mucopolysaccharide) content. This study analysed the effects of the rs7903146 and rs12255372 TCF7L2 variants on anthropometric, metabolic and hormonal parameters in type 2 diabetes mellitus patients who consumed fibre from either nopal tortilla or wholegrain bread for 8 weeks. We followed-up seventy-four patients who consumed an individualised isoenergetic diet that included nopal tortilla (Diet 1) and sixty-three patients with a diet that included wholegrain bread (Diet 2). Anthropometric, metabolic and hormonal measures were collected at baseline and final intervention. The size effect and carry-over effect were estimated. To assess the interaction of genotype and diets, we used a general linear model repeated-measures analysis. Minor allele frequency of rs7903146T was 0·27 and for rs12255372T it was 0·13. At 8 weeks after Diet 1 intake, weight, BMI, waist and hip circumference decreased (P=0·00015) in rs7903146CC and rs12255372GG genotypes. In particular, patients carrying of the rs7903146CC and consuming Diet 1 showed a reduction in waist circumference of more than 2·5 cm compared with Diet 2 (P<0·001). No significant interaction between rs7903146 or rs12255372 and diet was seen in this study. In conclusion, in the carriers of the rs7903146CC and rs12255372GG wild types, significant changes in all anthropometric measures were observed, and had better response to both diets. PMID:27480250

  19. Prophylactic lithium treatment and cognitive performance in patients with a long history of bipolar illness: no simple answers in complex disease-treatment interplay.

    Science.gov (United States)

    Pfennig, Andrea; Alda, Martin; Young, Trevor; MacQueen, Glenda; Rybakowski, Janusz; Suwalska, Aleksandra; Simhandl, Christian; König, Barbara; Hajek, Tomas; O'Donovan, Claire; Wittekind, Dirk; von Quillfeldt, Susanne; Ploch, Jana; Sauer, Cathrin; Bauer, Michael

    2014-01-01

    Cognitive impairment in patients with bipolar disorder (BD) is not restricted to symptomatic phases. It is also present in euthymia. There is evidence of differences in the brain's structure between bipolar patients and healthy individuals, as well as changes over time in patients. Lithium constitutes the gold standard in long-term prophylactic treatment. Appropriate therapy that prevents new episodes improves the disease's course and reduces the frequency of harmful outcomes. Interestingly, preclinical data suggest that lithium has a (additional) neuroprotective effect. There is limited data on its related effects in humans and even less on its long-term application. In this multi-center cross-sectional study from the International Group for the Study of Lithium-treated Patients (IGSLi), we compared three groups: bipolar patients without long-term lithium treatment (non-Li group; visual backward masking (VBM) task. A total of 142 subjects were included, 31 in the non-Li and 58 in the Li group, as well as 53 healthy controls. Treated patients with long-standing BD and controls did not differ significantly in overall cognitive functioning and verbal learning, recall, and recognition; regardless of whether lithium had been part of the treatment. Patients, however, demonstrated poorer early visual information processing than healthy controls, with the lithium-treated patients performing worse than those without. Our data suggest that bipolar patients with a long illness history and effective prophylactic treatment do not reveal significantly impaired general cognitive functioning or verbal learning and memory. However, they are worse at processing early visual information. Accompanying volumetric and spectroscopic data suggest cell loss in patients not treated with lithium that may be counterbalanced by long-term lithium treatment. PMID:25540718

  20. ÁCIDOS GRASOS EN LA DIETA DIABETES MELLITUS E INSULINO RESISTENCIA Unsaturated fatty acids intake and its relationship with insulin resistance in diabetes mellitus patients

    Directory of Open Access Journals (Sweden)

    Clara Eugenia Pérez G

    2006-06-01

    Full Text Available La resistencia a la insulina es característica de la diabetes mellitus tipo 2. Como parte del tratamiento se recomienda los diabéticos, sustituir en las dietas los ácidos grasos saturados y el colesterol por ácidos grasos monoinsaturados; sin que estén del todo claro los mecanismos bioquímicos que beneficiarían a los pacientes. Es probable, entre otros mecanismos, que los ácidos grasos monoin­saturados aumenten la sensibilidad a la insulina. Esta revisión analiza la relación entre el tipo de ácido graso en la dieta y la resistencia a insulina en la diabetes mellitus tipo 2.One of the most important characteristic in the obese patient with diabetes mellitus type 2 is the noticeable insulin resistance. Physicians recommended to these patients replace saturated fatty acids and cholesterol by greater dietary monounsaturated fatty acids content, without being absolutely sure about the biochemical mechanisms by which, this change, might help then. It is possible that monounsaturated fatty acids increase sensitivity to the insulin within another mechanism. The following revision is focused in the relationship between the type of dietary fatty acids ingestion and the resistance to insulin in diabetes mellitus type 2 patients.

  1. A Case of Extensive Spinal Cysticercosis Involving the Whole Spinal Canal in a Patient with a History of Cerebral Cysticercosis

    OpenAIRE

    Shin, Dong Ah; Shin, Hyun Chul

    2009-01-01

    Although cysticercosis is the most common parasitic disease affecting the central nervous system, spinal cysticercosis is rare. A rare form of spinal cysticercosis involving the whole spinal canal is presented. A 45-year-old Korean male had a history of intracranial cysticercosis and showed progressive paraparesis. Spinal magnetic resonance scan showed multiple cysts compressing the spinal cord from C1 to L1. Three different levels (C1-2, T1-3, and T11-L1) required operation. Histopathologica...

  2. Peptides and Food Intake

    Directory of Open Access Journals (Sweden)

    Carmen Sobrino Crespo

    2014-04-01

    Full Text Available Nutrients created by the digestion of food are proposed to active G protein coupled receptors on the luminal side of enteroendocrine cells e.g. the L-cell. This stimulates the release of gut hormones. Hormones released from the gut and adipose tissue play an important rol in the regulation of food intake and energy expenditure (1.Many circulating signals, including gut hormones, can influence the activity of the arcuate nucleus (ARC neurons directly, after passing across the median eminence. The ARC is adjacent to the median eminence, a circumventricular organ with fenestrated capillaries and hence an incomplete blood-brain barrier (2. The ARC of the hypothalamus is believed to play a crucial role in the regulation of food intake and energy homeostasis. The ARC contains two populations of neurons with opposing effect on food intake (3. Medially located orexigenic neurons (i.e those stimulating appetite express neuropeptide Y (NPY and agouti-related protein (AgRP (4-5. Anorexigenic neurons (i.e. those inhibiting appetite in the lateral ARC express alpha-melanocyte stimulating hormone (α-MSH derived from pro-opiomelanocortin (POMC and cocaine and amphetamine-regulated transcript (CART (6. The balance between activities of these neuronal circuits is critical to body weight regulation.In contrast, other peripheral signals influence the hypothalamus indirectly via afferent neuronal pathway and brainstem circuits. In this context gastrointestinal’s vagal afferents are activated by mechanoreceptors and chemoreceptors, and converge in the nucleus of the tractus solitaries (NTS of the brainstem. Neuronal projections from the NTS, in turn, carry signals to the hypotalamus (1, 7. Gut hormones also alter the activity of the ascending vagal pathway from the gut to the brainstem. In the cases of ghrelin and Peptide tyrosine tyrosine (PYY, there are evidences for both to have a direct action on the arcuate nucleus and an action via the vagus nerve a

  3. Ethanol intake and sup 3 H-serotonin uptake II: A study in alcoholic patients using platelets sup 3 H-paroxetine binding

    Energy Technology Data Exchange (ETDEWEB)

    Daoust, M.; Boucly, P. (U.F.R. de Medecine et Pharmacie, Saint Etienne du Rouvrary (France)); Ernouf, D. (Institut du Medicament, Tours (France)); Breton, P. (Centre National de Transfusion Sanguine de Rouen (France)); Lhuintre, J.P.

    1991-01-01

    The kinetic parameters of {sup 3}H-paroxetine binding and {sup 3}H-serotonin uptake were studied in platelets of alcoholic patients. There was no difference between alcoholic and non alcoholic subjects in {sup 3}H-paroxetine binding. When binding and {sup 3}H-serotonin uptake were studied, in the same plasma of the same subjects, the Vmax of serotonin uptake was increased in alcoholics. The data confirm the involvement of serotonin uptake system in alcohol dependance and suggest that serotonin uptake and paroxetine binding sites may be regulated independently in this pathology.

  4. Increased brain amyloid deposition in patients with a lifetime history of major depression: evidenced on {sup 18}F-florbetapir (AV-45/Amyvid) positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Kuan-Yi; Chen, Chia-Hsiang; Liu, Chia-Yih [Chang Gung Memorial Hospital and Chang Gung University, Department of Psychiatry, Tao-Yuan (China); Hsiao, Ing-Tsung; Hsieh, Chia-Ju [Chang Gung Memorial Hospital, Department of Nuclear Medicine and Molecular Imaging Center, Tao-Yuan (China); Chang Gung University, Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Tao-Yuan (China); Chen, Cheng-Sheng [Kaohsiung Medical University Hospital, Department of Psychiatry, Kaohsiung (China); Wai, Yau-Yau [Chang Gung Memorial Hospital, Department of Radiology, Tao-Yuan (China); Chang, Chee-Jen [Chang Gung University, Graduate Institute of Clinical Medical Science, Tao-Yuan (China); Chang Gung University, Clinical Informatics and Medical Statistics Research Center, Tao-Yuan (China); Chang Gung Memorial Hospital, Biostatistical Center for Clinical Research, Tao-Yuan (China); Tseng, Hsiao-Jung [Chang Gung Memorial Hospital, Biostatistical Center for Clinical Research, Tao-Yuan (China); Yen, Tzue-Chen; Lin, Kun-Ju [Chang Gung University, Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Tao-Yuan (China); Chang Gung Memorial Hospital, Department of Nuclear Medicine and Molecular Imaging Center, Tao-Yuan (China)

    2014-04-15

    The literature suggests that a history of depression is associated with an increased risk of developing Alzheimer's disease (AD). The aim of this study was to examine brain amyloid accumulation in patients with lifetime major depression using {sup 18}F-florbetapir (AV-45/Amyvid) PET imaging in comparison with that in nondepressed subjects. The study groups comprised 25 depressed patients and 11 comparison subjects who did not meet the diagnostic criteria for AD or amnestic mild cognitive impairment. Vascular risk factors, homocysteine and apolipoprotein E (ApoE) genotype were also examined. The standard uptake value ratio (SUVR) of each volume of interest was analysed using whole the cerebellum as the reference region. Patients with a lifetime history of major depression had higher {sup 18}F-florbetapir SUVRs in the precuneus (1.06 ± 0.08 vs. 1.00 ± 0.06, p = 0.045) and parietal region (1.05 ± 0.08 vs. 0.98 ± 0.07, p = 0.038) than the comparison subjects. Voxel-wise analysis revealed a significantly increased SUVR in depressed patients in the frontal, parietal, temporal and occipital areas (p < 0.01). There were no significant associations between global {sup 18}F-florbetapir SUVRs and prior depression episodes, age at onset of depression, or time since onset of first depression. Increased {sup 18}F-florbetapir binding values were found in patients with late-life major depression relative to comparison subjects in specific brain regions, despite no differences in age, sex, education, Mini Mental Status Examination score, vascular risk factor score, homocysteine and ApoE ε4 genotype between the two groups. A longitudinal follow-up study with a large sample size would be worthwhile. (orig.)

  5. Prognostic value of myocardial perfusion SPECT imaging in elderly patients without history of coronary artery disease and low prevalence of them

    International Nuclear Information System (INIS)

    Elderly patients without history of coronary artery disease are difficult to characterized because the clinical symptoms are often atypical, occult or absent. On the other hand, these patients frequently cannot achieve adequate level of exercise during stress testing and this limitation can compromise the diagnostic and prognostic ability of the test. Generally the prognostic value of myocardial perfusion SPECT is well established for a general population but not for elderly patients. Aim: This study assessed the prognostic value of Tc99m-sestamibi SPECT in a group of patients older than 65 years with low prevalence of coronary artery disease. Material and Methods: Population: 161 consecutive patients older than 65 years without history of coronary artery disease and low prevalence of them were studied with Tc99m-sestamibi SPECT perfusion imaging. Mean age 71 years old (65-87), male 55%, mean pretest likelihood 11%. Risk factors: diabetes 17%, high blood pressure 74%, high cholesterol 45%, smokers 88%. Stress test: bicycle exercise 39% and dipyridamole 61%. Myocardial perfusion SPECT: semiquantitative analysis to evaluate perfusion defects with a 14-segments model and 4-point scoring system for uptake reduction. Scintigraphic indices: SSS (sum of the stress scores), SRS (sum of the rest scores) and SDS (SSS-SRS). Follow up: cardiac events: hard (acute myocardial infarction and cardiac death) and soft (need for PTCA/CABG and angina). Results: Mean follow up: 508 days. Events rate: hard 0.6% (1 acute myocardial infarction), soft 5.6%. Univariate analysis identified sex (p=0.017) and SDS (p=0.009) as cardiac events predictors. Complete or reduced (independent variables which predicted events) logistic regression analysis correctly predicted the absence of events but did not predict the presence of events. Conclusion: In this elderly population with a low clinical risk where the stress test is a suboptimal method of study for coronary artery disease, semiquantitative

  6. Increased brain amyloid deposition in patients with a lifetime history of major depression: evidenced on 18F-florbetapir (AV-45/Amyvid) positron emission tomography

    International Nuclear Information System (INIS)

    The literature suggests that a history of depression is associated with an increased risk of developing Alzheimer's disease (AD). The aim of this study was to examine brain amyloid accumulation in patients with lifetime major depression using 18F-florbetapir (AV-45/Amyvid) PET imaging in comparison with that in nondepressed subjects. The study groups comprised 25 depressed patients and 11 comparison subjects who did not meet the diagnostic criteria for AD or amnestic mild cognitive impairment. Vascular risk factors, homocysteine and apolipoprotein E (ApoE) genotype were also examined. The standard uptake value ratio (SUVR) of each volume of interest was analysed using whole the cerebellum as the reference region. Patients with a lifetime history of major depression had higher 18F-florbetapir SUVRs in the precuneus (1.06 ± 0.08 vs. 1.00 ± 0.06, p = 0.045) and parietal region (1.05 ± 0.08 vs. 0.98 ± 0.07, p = 0.038) than the comparison subjects. Voxel-wise analysis revealed a significantly increased SUVR in depressed patients in the frontal, parietal, temporal and occipital areas (p 18F-florbetapir SUVRs and prior depression episodes, age at onset of depression, or time since onset of first depression. Increased 18F-florbetapir binding values were found in patients with late-life major depression relative to comparison subjects in specific brain regions, despite no differences in age, sex, education, Mini Mental Status Examination score, vascular risk factor score, homocysteine and ApoE ε4 genotype between the two groups. A longitudinal follow-up study with a large sample size would be worthwhile. (orig.)

  7. Dietary fat intake and functional dyspepsia.

    Science.gov (United States)

    Khodarahmi, Mahdieh; Azadbakht, Leila

    2016-01-01

    A few studies have assessed the effects of fat intake in the induction of dyspeptic symptoms. So, the aim of this study was to review the articles regarding the dietary fat intake and FD. We used electronic database of PubMed to search. These key words were chosen: FD, dietary fat, dyspeptic symptom, energy intake and nutrients. First, articles that their title and abstract were related to the mentioned subject were gathered. Then, full texts of related articles were selected for reading. Finally, by excluding four articles that was irrelevant to subject, 19 relevant English papers by designing clinical trial, cross-sectional, case-control, prospective cohort, and review that published from 1992 to 2012 were investigated. Anecdotally, specific food items or food groups, particularly fatty foods have been related to dyspepsia. Laboratory studies have shown that the addition of fat to a meal resulted in more symptoms of fullness, bloating, and nausea in dyspeptic patients. Studies have reported that hypersensitivity of the stomach to postprandial distension is an essential factor in the generation of dyspeptic symptoms. Small intestinal infusions of nutrients, particularly fat, exacerbate this hypersensitivity. Moreover, evidence showed that perception of gastric distension increased by lipids but not by glucose. Long chain triglycerides appear to be more potent than medium chain triglycerides in inducing symptoms of fullness, nausea, and suppression of hunger. Thus, Fatty foods may exacerbate dyspeptic symptoms. Therefore, it seems that a reduction in intake of fatty foods may useful, although this requires more evaluations. PMID:27195249

  8. Estimates of food and macronutrient intake in a random sample of Northern Ireland adolescents.

    Science.gov (United States)

    Strain, J J; Robson, P J; Livingstone, M B; Primrose, E D; Savage, J M; Cran, G W; Boreham, C A

    1994-09-01

    Estimates of food consumption and macronutrient intake were obtained from a randomly selected population sample (2%) of 1015 adolescents aged 12 and 15 years in Northern Ireland during the 1990/1991 school year. Dietary intake was assessed by diet history with photographic album to estimate portion size. Reported median energy intakes were 11.0 and 13.1 MJ/d for boys aged 12 and 15 years respectively and 9.2 and 9.1 MJ/d for girls of these ages. Protein, carbohydrate and total sugars intakes as a percentage of total energy varied little between the age and sex groups and were approximately 11, 49 and 20% respectively of daily total energy intakes. Median dietary fibre intakes were approximately 20 and 24 g/d for boys aged 12 and 15 years respectively and 18 and 19 g/d for girls of these ages. Major food sources of energy (as a percentage of total energy intakes) were bread and cereals (15-18%), cakes and biscuits (12-14%), chips and crisps (13-14%), dairy products (9-11%), meat and meat products (9-11%) and confectionery (9%). Fruit and vegetable intakes were low at about 2.5% and 1.5% respectively of total energy intakes. Median fat intakes were high at 39% of total daily energy intakes. Major food sources of fat as a percentage of total fat intakes were from the food groupings: chips and crisps (16-19%), meat and meat products (14-17%), fats and oils (14-16%), cakes and biscuits (13-16%) and dairy products (12-15%). Median intakes of saturated fatty acids were also high at approximately 15% of daily total energy intake while intakes of monounsaturated fatty acids averaged 12% of daily total energy intake. Median polyunsaturated fatty acid (PUFA) intakes were low, comprising 5.2 and 5.5% of daily total energy intake for boys aged 12 and 15 years respectively and were lower than the PUFA intakes (5.9 and 6.3% of daily total energy intake) for girls of these ages. About 1.3% for boys and 1.4% for girls of daily total energy intake was in the form of n-3 PUFA. Ca and

  9. The value of surveillance mammography of the contralateral breast in patients with a history of breast cancer

    NARCIS (Netherlands)

    Lu, W.L.; Schaapveld, M.; Jansen, L.; Bagherzadegan, E.; Sahinovic, M.M.; Baas, P.C.; Hanssen, L.M.H.C.; van der Mijle, H.C.J.; Brandenburg, J.D.; Wiggers, T.; de Bock, G.H.

    2009-01-01

    Purpose: To determine the contribution of surveillance mammography to the early detection of metachronous contralateral. breast cancer (MCBC) and to assess its impact on the survival of breast cancer patients with relation to compliance. Method: Breast cancer patients (5589) were identified using fi

  10. Alcohol consumption in patients with primary sclerosing cholangitis

    Institute of Scientific and Technical Information of China (English)

    Hannes Hagstr(o)m; Per St(a)l; Knut Stokkeland; Annika Bergquist

    2012-01-01

    AIM:To assess the alcohol drinking patterns in a cohort of primary sclerosing cholangitis (PSC) patients and the possible influence on the development of fibrosis.METHODS:Ninety-six patients with PSC were evaluated with a validated questionnaire about a patient's lifetime drinking habits:the lifetime drinking history (LDH) questionnaire.In addition,clinical status,transient elastography and biochemistry values were analysed and registered.Patients were defined as having either significant or non-significant fibrosis.Significant fibrosis was defined as either an elastography value of ≥ 17.3 kPa or the presence of clinical signs of cirrhosis.Patients were divided into two groups depending on their alcohol consumption patterns; no/low alcohol consumption (one drink or unit/d) and moderate/high alcohol consumption (≥ 1 drink or unit/d).LDH data were calculated to estimate lifetime alcohol intake (LAI),current alcohol intake,drinks per year before and after diagnosis of PSC.We also calculated the number of episodes of binge-drinking (defined as consuming ≥ 5 drinks per occasion) in total,before and after the diagnosis of PSC.RESULTS:The mean LAI was 3882 units of alcohol,giving a mean intake after onset of alcohol consumption of 2.6 units per week.Only 9% of patients consumed alcohol equal to or more than one unit per day.Current alcohol intake in patients with significant fibrosis (n =26) was less than in patients without significant fibrosis (n =70),as shown by lower values of phosphatidylethanol (B-PEth) (0.1 μmol/L vs 0.33 μmol/L,respectively,P =0.002) and carbohydrate-deficient transferrin (CDT)(0.88% vs 1.06%,respectively,P =0.02).Self-reported LAI was similar between the two groups.Patients with significant fibrosis reduced their alcohol intake after diagnosis from 103 to 88 units per year whereas patients without fibrosis increased their alcohol intake after PSC diagnosis from 111 to 151 units/year.There were no correlations between elastography

  11. Oral Dryness, Dietary Intake, and Alterations in Taste

    DEFF Research Database (Denmark)

    Dynesen, Anja Weirsøe

    2015-01-01

    that could be followed by tooth loss. These are all complications that theoretically may have a negative impact on dietary intake. Although the literature does not present a direct association between decreased salivary secretion and malnutrition, it is concluded that salivary gland dysfunction may add...... to the conditions that make it difficult to maintain an adequate dietary intake in some individuals. Also, the opposite can occur. Thus, persons with an inadequate dietary intake may present with xerostomia and decreased salivary secretion. Therefore, clinical recommendations for counseling of dry mouth patients...

  12. Sarcomatoid carcinoma of the jejunum presenting as obscure gastrointestinal bleeding in a patient with a history of gliosarcoma

    Science.gov (United States)

    Alfonso Puentes, Nidia; Jimenez-Alfaro Larrazabal, Carmen; García Higuera, Maria Isabel

    2014-01-01

    Small bowel malignant tumors are rare and sarcomatoid carcinomas have rarely been reported at this site. We report a 56-year-old woman, with history of an excised gliosarcoma, who presented with recurrent obscure gastrointestinal bleeding. She underwent endoscopy and colonoscopy, which failed to identify the cause of the bleeding. The abdominal computed tomography scan located a tumor in the small bowel. Pathology revealed a jejunal sarcomatoid carcinoma. She developed tumor recurrence and multiple liver metastases shortly after surgery. Immunohistochemistry is required for accurate diagnosis. Sarcomatoid carcinoma is a rare cause of obscure gastrointestinal bleeding, which is associated with a poor prognosis. PMID:24759341

  13. Gastric carcinoid tumor in a patient with a past history of gastrointestinal stromal tumor of the stomach

    Institute of Scientific and Technical Information of China (English)

    Chien-Yuan Hung; Ming-Jen Chen; Shou-Chuan Shih; Tsang-Pai Liu; Yu-Jan Chan; Tsang-En Wang; Wen-Hsiung Chang

    2008-01-01

    Gastrointestinal stromal tumor is the most common mesenchymal tumor in the gastrointestinal tract. It may coexist with other type of cancers, and if so, the tumors usually involve the stomach. The most common associated cancers are gastrointestinal carcinomas. We report a 65-year-old woman with a history of gastric gastrointestinal stromal tumor who had undergone subtotal segmental gastrectomy. New polypoid lesions were detected on a follow-up gastroscopy one year later. The lesions were biopsied and found to be carcinoid tumors. There was serum hypergastrinemia, and type 1 gastric carcinoid tumor was diagnosed. A total gastrectomy was performed. Pathologic examination revealed both carcinoid tumors and a recurrent gastrointestinal stromal tumor.

  14. Histological and molecular biology diagnosis of neurocysticercosis in a patient without history of travel to endemic areas – Case report

    Directory of Open Access Journals (Sweden)

    L’Ollivier C.

    2012-11-01

    Full Text Available Background: in endemic areas, neurocysticercosis appears mainly as a single, large, spherical and non-enhancing intracranial cyst. Case presentation: an atypical case of neurocysticercosis (NCC in a French Caucasian, without history of travel to endemic areas, was confirmed by histology and molecular speciation. Imaging was atypical, showing several hook-bearing scolices visible in the cyst, while the serology employed was non-contributary. Conclusions: NCC should be considered when multiple taeniid scolices are observed within the same cystic lesion.

  15. Dietary intake increases serum levels of carboxymethil-lysine (CML in diabetic patients La ingesta dietaria de carboximetil-lisina (CML aumenta los niveles plasmáticos de este compuesto en pacientes diabéticos

    Directory of Open Access Journals (Sweden)

    N. Jara

    2012-08-01

    Full Text Available Introduction: Advanced glycation end products are produced endogenously, in association with hyperglycemia and oxidative stress. They can also be generated during cooking or food processing and, once absorbed, alter protein function and promote inflammation. Methods: We selected 40 healthy male subjects, 17 patients with type 2 diabetes of both sexes and 15 patients with type 1 diabetes of both sexes. Each participant underwent both a food frequency questionnaire (FFQ and 24-hour dietary recall specially adapted for measuring CML intake, anthropometry, measurement of blood pressure and biochemical parameters in blood and urine. Results: Serum CML levels were significantly higher in patients with diabetes compared to healthy subjects (p 0.04, showing a direct relationship between dietary intake and serum levels of CML in T2D patients (r 0.53 p 0.03. sCML levels correlated positively with length of diabetes mellitus, and inversely with body mass index (BMI. The most important dietary factor contributing to raise CML levels in these patients with diabetes was the consumption of milk powder. Conclusion: Serum levels of CML were found to be higher among diabetic subjects, associated to length of diabetes as expected, but also with the ingestion of foods containing higher amounts of ML. The consumption of milk powder in this group is a major determinant of increased serum levels.Introducción: Los productos avanzados de la glicación se producen de forma endógena en relación con la hiperglucemia y el estrés oxidativo. También pueden generarse durante el cocinado o el procesamiento de los alimentos; una vez absorbidos, alteran la función proteica y favorecen la inflamación. Métodos: Seleccionamos a 40 hombres sanos, 17 pacientes con diabetes tipo 2 de ambos sexos y 15 pacientes con diabetes tipo 1 de ambos sexos. A cada participante se le realizó un cuestionario de frecuencia de consumo de alimentos (CFA y un recordatorio de 24 horas

  16. 高蛋白质摄入进行饮食调整后对腹膜透析病人营养状况的影响%High protein intake on nutritional status of peritoneal dialysis patients after adjusting the diet

    Institute of Scientific and Technical Information of China (English)

    李慧

    2013-01-01

      目的探讨SJH高蛋白质饮食摄入对腹膜透析病人营养状况的影响。方法将我院2011年1月至2012年1月进行腹膜透析的40例病人的蛋白质摄入量进行评估,其每日饮食蛋白质摄入(daily protein intake,DPI)均〉1.2g/(kg·d)。观察病人饮食DPI和热量摄入(daily energy intake,DEI)前后各种营养指标的变化,并对病人的生活质量和生活满意度进行评分。结果40例腹膜透析的病人半年后2人转为血液透析,4人移植,2人死亡,透析的时间为1个月至24个月,平均10.8个月,经过饮食调整后患者的高磷血症、高钾血症、LBM、SGA、及酸中毒均有所改善,所有患者饮食调整后胃肠道症状均无加重。结论高蛋白质的摄入对腹膜透析病人有较大的影响,经过营养师为其制定合理的食谱并指导蛋白质和能量的正确摄入后,所有腹膜透析病人的营养状况和生活质量均得到满意改善。%Objective To investigate the effects of diet of high protein SJH on the nutritional status of peritoneal dialysis patients. Evaluation of 40 patients in our hospital from 2011 January to 2012 January were peritoneal dialysis protein intake, the daily dietary protein intake (daily protein intake, DPI) are '1.2g/(kg•d). Observe the patient DPI diet and calorie intake (daily energy intake, DEI) changes of various nutrition index before and after, and the patient's quality of life and life satisfaction score. Results 40 cases of peritoneal dialysis patients six months after the 2 switch to hemodialysis, 4 grafts, 2 people died, dialysis time was 1 months to 24 months, average 10.8 months, after eating, after adjustment for hyperphosphatemia in patients with hyperkalemia, LBM, SGA, and acidosis were improved in all patients after adjustment, diet, gastrointestinal symptoms were not aggravated. Conclusion the high protein intake have a great effect on peritoneal dialysis patients, after a

  17. Estradiol valerate and alcohol intake: dose-response assessments

    Science.gov (United States)

    Quirarte, Gina L; Reid, Larry D; de la Teja, I Sofía Ledesma; Reid, Meta L; Sánchez, Marco A; Díaz-Trujillo, Arnulfo; Aguilar-Vazquez, Azucena; Prado-Alcalá, Roberto A

    2007-01-01

    Background An injection of estradiol valerate (EV) provides estradiol for a prolonged period. Recent research indicates that a single 2.0 mg injection of EV modifies a female rat's appetite for alcoholic beverages. This research extends the initial research by assessing 8 doses of EV (from .001 to 2.0 mg/female rat), as well assessing the effects of 2.0 mg EV in females with ovariectomies. Results With the administration of EV, there was a dose-related loss of bodyweight reaching the maximum loss, when it occurred, at about 4 days after injections. Subsequently, rats returned to gaining weight regularly. Of the doses tested, only the 2.0 mg dose produced a consistent increase in intake of ethanol during the time previous research indicated that the rats would show enhanced intakes. There was, however, a dose-related trend for smaller doses to enhance intakes. Rats with ovariectomies showed a similar pattern of effects, to intact rats, with the 2 mg dose. After extensive histories of intake of alcohol, both placebo and EV-treated females had estradiol levels below the average measured in females without a history of alcohol-intake. Conclusion The data support the conclusion that pharmacological doses of estradiol can produce enduring changes that are manifest as an enhanced appetite for alcoholic beverages. The effect can occur among females without ovaries. PMID:17335585

  18. Estado nutricional e adequação da ingestão de energia e nutrientes em pacientes com insuficiência cardíaca Estado nutricional y adecuación de la ingesta de energía y nutrientes en pacientes con insuficiencia cardiaca Nutritional status and adequacy of energy and nutrient intakes among heart failure patients

    Directory of Open Access Journals (Sweden)

    Bárbara Hatzlhoffer Lourenço

    2009-11-01

    Full Text Available FUNDAMENTO: Maior conhecimento sobre o estado nutricional e a ingestão de energia e nutrientes é necessário para auxiliar no tratamento de pacientes com insuficiência cardíaca (IC. OBJETIVO: Verificar o estado nutricional e analisar a adequação da ingestão de energia, macro e micronutrientes de pacientes com IC em atendimento ambulatorial. MÉTODOS: Foram coletados dados antropométricos e de ingestão alimentar habitual de 125 pacientes (72% homens, 52,1±9,8 anos, IMC 26,9±4,4 kg/m². As variáveis antropométricas foram comparadas entre os sexos, e analisou-se a adequação da ingestão de energia e nutrientes perante as recomendações. RESULTADOS: Depleção ou risco de depleção das reservas musculares estava presente em 38,4% dos pacientes (associação com sexo masculino; p FUNDAMENTO: Para ayudar en el tratamiento de pacientes con insuficiencia cardiaca (IC es necesario un mayor conocimiento sobre el estado nutricional y la ingesta de energía y nutrientes. OBJETIVO: Verificar el estado nutricional y analizar la adecuación de la ingesta de energía, macro y micronutrientes de pacientes con IC en atención ambulatoria. MÉTODOS: Se recolectaron datos antropométricos y de la ingesta alimentaria habitual de 125 pacientes (72% hombres, 52,1±9,8 años, IMC 26,9±4,4 kg/m². Se compararon las variables antropométricas de ambos sexos y se analizó la adecuación de la ingesta de energía y nutrientes frente a las recomendaciones. RESULTADOS: En el 38,4% de los pacientes (asociación con sexo masculino; p SUMMARY: Increased knowledge about nutritional status and energy and nutrient intakes is required to improve the treatment of patients with heart failure (HF. OBJECTIVES: To verify the nutritional status and evaluate the adequacy of energy, macronutrient and micronutrient intakes in patients with HF in outpatient clinical settings. METHODS: We collected anthropometric and habitual dietary intake data of 125 patients (72% men, 52

  19. Effectiveness of L-thyroxine treatment on TSH suppression during pregnancy in patients with a history of thyroid carcinoma after total thyroidectomy and radioiodine ablation

    International Nuclear Information System (INIS)

    There are scarce data about the optimal increase of L-thyroxine dose during pregnancy in patients with a history of thyroid carcinoma. The first aim of the study was to find out if routine therapeutic measures enable adequate TSH suppression in pregnancy. The other aim was to find out the optimal dose of L-thyroxine for TSH suppression in pregnant women. In this retrospective observational study, we analysed 36 pregnancies of 32 women with a history of thyroid carcinoma. Before pregnancy, all of them underwent total thyroidectomy and radioiodine ablation of thyroid remnant, and they were on suppressive doses of L-thyroxine. Thyroid function tests were obtained before, during and after pregnancy. Mean L-thyroxine dose before pregnancy, in the first, second and, third trimester and after delivery was 149, 147, 155, 165 and 158 micrograms daily, respectively. TSH concentration remained suppressed in 9 pregnancies, it was within normal range in 22 and elevated in 5 pregnancies. The mean dose of L-thyroxine in patients with suppressed TSH before pregnancy, in the first, second and, third trimester and after delivery was 154, 154, 164, 160 and 161 micrograms daily, respectively. When the dose had to be changed, the mean increase of the dose was 31.5 micrograms daily. The range of changes in TSH concentration during pregnancy in the patients who have been on suppressive L-thyroxine therapy before conception is quite wide. TSH was adequately suppressed in only 25% of pregnancies. The dose of L-thyroxine in patients with suppressed TSH in the first, second and third trimester was 154, 164 and 160 micrograms daily, respectively

  20. Using transprofessional care in the emergency department to reduce patient admissions: A retrospective audit of medical histories.

    Science.gov (United States)

    Morphet, Julia; Griffiths, Debra Lee; Crawford, Kimberley; Williams, Allison; Jones, Tamsin; Berry, Belinda; Innes, Kelli

    2016-01-01

    The demand for emergency department (ED) services has increased significantly, due to our increasingly ageing population and limited access to primary care. This article reports outcomes from a transprofessional model of care in an ED in Victoria, Australia. Nurses, physiotherapists, social workers, and occupational therapists undertook additional education to increase the range of services they could provide and thereby expedite patient flow through the ED. One hundred patients who received this service were matched against 50 patients who did not. The most common reasons for patient admission were limb injury/limb pain (n = 47, 23.5%) and falls (n = 46, 23.0%). Transprofessional interventions included applying supportive bandages, slings, zimmer splints and controlled ankle motion (CAM) boots, and referral to new services such as case management and mental health teams. The rate of hospital admissions was significantly lower in the transprofessional group (n = 27, 18.0%) than in the reference group (n = 19, 38%, p = 0.005). This group also had a slightly lower re-presentation rate (n = 4, 2.7%) than patients in the reference group (n = 2, 4.0%). There are many benefits that support this model of care that in turn reduces ED overcrowding and work stress. A transprofessional model may offer a creative solution to meeting the varied needs of patients presenting for emergency care. PMID:26954260

  1. Asymptomatic cerebrovascular lesions detected by magnetic resonance imaging in patients with systemic lupus erythematosus lacking a history of neuropsychiatric events

    Energy Technology Data Exchange (ETDEWEB)

    Nomura, Kumiko; Yamano, Shigeru; Ikeda, Yukiko [Nara Medical Univ., Kashihara (Japan)] (and others)

    1999-10-01

    To clarify the extent of asymptomatic cerebrovascular involvement in systemic lupus erythematosus (SLE). Cerebral magnetic resonance imaging (MRI) findings and ultrasonography findings of 100 patients with SLE lacking present or past clinical neurologic deficits were compared with 66 age-matched volunteers to determine the combined intima-media thickness (IMT) of the common carotid artery, and tests for anti-cardiolipin antibodies (aCL). Thirty-eight patients, but only 2 controls, showed imaging abnormalities. Among 23 SLE patients with cerebrovascular lesions by MRI who underwent single-photon emission computed tomography (SPECT), 14 showed hypoperfusion of the lesion. The IMT value and prevalence of aCL did not differ between the 55 SLE patients tested and controls. SLE disease activity index (SLEDAI) as assessed by a quantitative clinical index was significantly greater in patients with brain lesions than in those without. The prevalence of asymptomatic brain lesions in SLE patients is high, and shows a relationship to disease activity. (author)

  2. Fiber intake and inflammation in type 1 diabetes

    OpenAIRE

    Bernaud, Fernanda S R; Beretta, Mileni Vanti; do Nascimento, Cigléa; Escobar, Fabrícia; Gross, Jorge L.; Azevedo, Mirela J; Ticiana C. Rodrigues

    2014-01-01

    Background Higher intake of dietary fiber is associated with lower risk of coronary heart disease, the leading cause of mortality among people with type 1 diabetes. The protective effect includes the anti-inflammatory properties of some foods. Population-based studies have shown an inverse association between some nutritional habits and high sensitive -C-reactive protein (hs-CRP). This study aimed to ascertain the association between fiber intake and hs-CPR levels in patients with type 1 diab...

  3. Selected micronutrient intake and the risk of colorectal cancer.

    OpenAIRE

    Ferraroni, M; La Vecchia, C.; D'Avanzo, B; De Negri, E.; Franceschi, S; Decarli, A

    1994-01-01

    The relationship between estimated intake of selected micronutrients and the risk of colorectal cancer was analysed using data from a case-control study conducted in northern Italy. The study was based on 828 patients with colon cancer, 498 with rectal cancer and 2,024 controls in hospital for acute, non-neoplastic, non-digestive tract diseases. Relative risks (RRs) of intake quintiles were computed after allowance for age, sex and other major potential confounding factors, including an estim...

  4. EFFECTS OF SIX MONTHS OF COMBINED AEROBIC AND RESISTANCE TRAINING FOR ELDERLY PATIENTS WITH A LONG HISTORY OF TYPE 2 DIABETES

    Directory of Open Access Journals (Sweden)

    Sijie Tan

    2012-09-01

    Full Text Available This study evaluated the effects of a 6-month combined aerobic and resistance training program on the body composition, glycemic control, lipid profile, and functional capacity of older patients with a long history of type 2 diabetes. 25 subjects (65.9 ± 4. 2 yrs; M/F: 13/12 with a long history of type 2 diabetes (16.7 ± 6.7 yrs were randomly allocated into either the exercise or control groups. The exercise group trained three sessions a week. Each session consisted of a warm-up period, 30 minutes of moderate aerobic exercise, 10 minutes of resistance training with five leg muscle exercises (two sets of 10-12 repetitions at 50-70% of 1RM for each activity, and a cool-down period. The variables of body composition, glycemic control, lipid profile, and functional capacity were measured before and after the study period. Exercise training decreased waist-hip ratio and body fat of the trained subjects. Concentrations of fasting and 2-hour post-glucose challenge plasma glucose and serum insulin, and glycosylated hemoglobin decreased significantly in the exercise group. Exercise training improved the lipid profile and also increased the leg muscle strength and 6-minute walking distance of the trained subjects. The control group, however, increased their body fat and fasting plasma glucose, while other variables were not changed during the study period. The current results demonstrate that elderly patients with a long history of type 2 diabetes can benefit from the 6-month combined aerobic and resistance training program

  5. Episodic sucrose intake during food restriction increases synaptic abundance of AMPA receptors in nucleus accumbens and augments intake of sucrose following restoration of ad libitum feeding.

    Science.gov (United States)

    Peng, X-X; Lister, A; Rabinowitsch, A; Kolaric, R; Cabeza de Vaca, S; Ziff, E B; Carr, K D

    2015-06-01

    Weight-loss dieting often leads to loss of control, rebound weight gain, and is a risk factor for binge pathology. Based on findings that food restriction (FR) upregulates sucrose-induced trafficking of glutamatergic AMPA receptors to the nucleus accumbens (NAc) postsynaptic density (PSD), this study was an initial test of the hypothesis that episodic "breakthrough" intake of forbidden food during dieting interacts with upregulated mechanisms of synaptic plasticity to increase reward-driven feeding. Ad libitum (AL) fed and FR subjects consumed a limited amount of 10% sucrose, or had access to water, every other day for 10 occasions. Beginning three weeks after return of FR rats to AL feeding, when 24-h chow intake and rate of body weight gain had normalized, subjects with a history of sucrose intake during FR consumed more sucrose during a four week intermittent access protocol than the two AL groups and the group that had access to water during FR. In an experiment that substituted noncontingent administration of d-amphetamine for sucrose, FR subjects displayed an enhanced locomotor response during active FR but a blunted response, relative to AL subjects, during recovery from FR. This result suggests that the enduring increase in sucrose consumption is unlikely to be explained by residual enhancing effects of FR on dopamine signaling. In a biochemical experiment which paralleled the sucrose behavioral experiment, rats with a history of sucrose intake during FR displayed increased abundance of pSer845-GluA1, GluA2, and GluA3 in the NAc PSD relative to rats with a history of FR without sucrose access and rats that had been AL throughout, whether they had a history of episodic sucrose intake or not. A history of FR, with or without a history of sucrose intake, was associated with increased abundance of GluA1. A terminal 15-min bout of sucrose intake produced a further increase in pSer845-GluA1 and GluA2 in subjects with a history of sucrose intake during FR

  6. Secondary Sclerosing Cholangitis in Critically Ill Patients: Clinical Presentation, Cholangiographic Features, Natural History, and Outcome: A Series of 16 Cases.

    Science.gov (United States)

    Leonhardt, Silke; Veltzke-Schlieker, Wilfried; Adler, Andreas; Schott, Eckart; Eurich, Dennis; Faber, Wladimir; Neuhaus, Peter; Seehofer, Daniel

    2015-12-01

    Secondary sclerosing cholangitis in critically ill patients (SSC-CIP) is an important differential diagnosis in patients presenting with cholestasis and PSC-like cholangiographic changes in endoscopic retrograde cholangiography (ERC). As a relatively newly described entity, SSC-CIP is still underdiagnosed, and the diagnosis is often delayed. The present study aims to improve the early detection of SSC-CIP and the identification of its complications.A total of 2633 records of patients who underwent or were listed for orthotopic liver transplantation at the University Hospital Charité, Berlin, were analyzed retrospectively. The clinical presentation and outcome (mean follow-up 62.7 months) of the 16 identified SSC-CIP cases were reviewed.Cholestasis was the first sign of SSC-CIP. GGT was the predominant enzyme of cholestasis. Hypercholesterolemia occurred in at least 75% of the patients. SSC-CIP provoked a profound weight loss (mean 18 kg) in 94% of our patients. SSC-CIP was diagnosed by ERC in all patients. The 3 different cholangiographic features detected correspond roughly to the following stages: (I) evidence of biliary casts, (II) progressive destruction of intrahepatic bile ducts, and (III) picture of pruned tree. Biliary cast formation is a hallmark of SSC-CIP and was seen in 87% of our cases. In 75% of the patients, the clinical course was complicated by cholangiosepsis, cholangitic liver abscesses, acalculous cholecystitis, or gallbladder perforation. SSC-CIP was associated with worse prognosis; transplant-free survival was ∼40 months (mean).Because of its high rate of serious complications and unfavorable prognosis, it is imperative to diagnose SSC-CIP early and to differentiate SSC-CIP from other types of sclerosing cholangitis. Specific characteristics enable identification of SSC-CIP. Early cooperation with a transplant center and special attention to biliary complications are required after diagnosis of SSC-CIP. PMID:26656347

  7. 慢性肾病患者磷、钾、食盐摄入知识调查%Questionnaire and analysis on the intake of phosphorus, potassium and salt in 100 pa-tients with chronic kidney disease

    Institute of Scientific and Technical Information of China (English)

    周宏伟; 赵霞; 江红

    2015-01-01

    Objective To investigate the intake of phosphorus , potassium and salt in admitted patients with chronic kidney disease (CKD) and provide reference for the nutritional education for CKD patients further .Methods Self-designed questionnaire was used among 100 CKD patients .Results Up to 92%CKD patients showed a proper understanding of salt control , 68%and 65%patients showed a proper understanding of potassium control and hidden salt respectively , and only 40%patients showed a proper un-derstanding of phosphorus control .From according to degree of mastery , CKD patients presented the best mastery of low-phosphorous food ( vegetables , fruits and processed rice and wheat );their mastery of livers , nuts and mushrooms in the category of phosphorus-rich food was good;their mastery of milk , meat, coarse cereals and eggs was relatively poor .The proportions of CKD patients presenting the best mastery of cereal grains and melon vegetables (low-potassium food) reached 96.9%and 93.8%respectively;their mastery of ba-nanas as potassium-rich food was good and that of other food was relatively lower: their mastery of meat was only 6.3%.In terms of salt control behaviors , 21%CKD patients adopted specific quantitative tools;69%CKD patients paid attention to controlling food salt intake but took no further quantitative methods .The proportion of patients taking no salt control measures was still up to 10%. Conclusions The education of understanding of phosphorus , potassium and hidden salt and the guidanee of selection of specific food should be strengthened for CKD patients , so as to enhance their consciousness of self-management .%目的:调查住院慢性肾病( chronic kidney disease ,CKD)患者磷、钾、食盐摄入情况,为进一步开展CKD患者营养宣教提供依据。方法对100例CKD患者采用自行设计的问卷调查。结果 CKD患者对限盐了解最高,占92%,对限钾和隐性盐了解较好,分别占68%、65%;对于

  8. Food intake and the nutritional status of women undergoing chemotherapy.

    Science.gov (United States)

    Ferreira, Isabela Borges; Marinho, Eduarda da Costa; Custódio, Isis Danyelle Dias; Gontijo, Cristiana Araújo; Paiva, Carlos Eduardo; Crispim, Cibele Aparecida; Maia, Yara Cristina de Paiva

    2016-06-01

    The objective behind this study was the analysis of food intake and the nutritional status of women with breast cancer (BC) undergoing chemotherapy (CT). The quantitative dietary evaluation was performed in accordance with Dietary Reference Intakes (DRI), whereas the qualitative evaluation was performed through the Brazilian Healthy Eating Index - Revised (BHEI-R).From among the total number of patients (n = 20), 60% (n = 12) presented waist circumference, equal to or higher than 88cm. It was noted that 75% (n = 15) individuals were overweight. The average intake for calcium, copper, iron, dietary fiber, magnesium, potassium, vitamin A, niacin, vitamin B6 and zinc, were found to be below adequate intake levels, while the intake of vitamin C, phosphorus, manganese, sodium and thiamine were all found to be above DRIs recommendations. As for the analysis of the BHEI-R, 80% (n = 16) of the patients presented a "diet that needs modifications", while 20% (n = 4) presented a "healthy diet". Noted from these observations was the presence of a high overweight rate, a discrepancy in the intake of micronutrients and a diet that needed improvements. In this manner, the establishment and use of a nutritional intervention protocol are very important when it comes to the improvement of the diet in patients with BC and who are undergoing CT. PMID:27383354

  9. Arylesterase activity is associated with antioxidant intake and paraoxonase-1 (PON1) gene methylation in metabolic syndrome patients following an energy restricted diet.

    Science.gov (United States)

    de la Iglesia, Rocio; Mansego, Maria L; Sánchez-Muniz, Francisco J; Zulet, M Angeles; Martinez, J Alfredo

    2014-01-01

    The arylesterase (ARE) activity linked to the paraoxonase-1 (PON1) gene is known to protect lipoproteins from oxidation and provide defense against metabolic syndrome (MetS) and cardiovascular diseases. The epigenetic regulation of enzymatic activities is gaining importance nowadays. This research aimed to assess the potential relationships between the ARE activity with the methylation levels of the PON1 gene transcriptional regulatory region, anthropometrics, biochemical markers and antioxidant dietary components. Forty-seven subjects (47 ± 10 y.o; BMI 36.2 ± 3.8 kg/m(2); 46.8 % female) with MetS features, who followed a six-month energy-restricted dietary weight-loss intervention, were included in this study (www.clinicaltrials.gov; NCT01087086). Anthropometric, biochemical, enzymatic and dietary data were assessed using validated procedures. PON1 transcriptional regulatory region methylation was analyzed by a microarray technical approach. Volunteers reduced ARE activity in parallel with body weight (p = 0.005), BMI (p = 0.006), total fat mass (p = 0.020), diastolic blood pressure (p = 0.018), mean blood pressure (p = 0.022) and triglycerides (p = 0.014). Methylation levels of some CpG sites of the PON1 gene correlated negatively with ARE activity (p < 0.05). Interestingly, dietary vitamin C (p = 0.001), tocopherols (p = 0.009) and lycopene (p = 0.038) were positively associated with ARE activity and showed an inverse correlation (p = 0.004, p = 0.029 and p = 0.021, respectively) with the methylation of some selected CpG sites of the PON1 gene. In conclusion, ARE activity decreased in parallel with MetS-related markers associated to the energy restriction, while dietary antioxidants might enhance the ARE activity by lowering the PON1 gene methylation in patients with MetS features.

  10. Gastric tubes and airway management in patients at risk of aspiration: history, current concepts, and proposal of an algorithm.

    Science.gov (United States)

    Salem, M Ramez; Khorasani, Arjang; Saatee, Siavosh; Crystal, George J; El-Orbany, Mohammad

    2014-03-01

    Rapid sequence induction and intubation (RSII) and awake tracheal intubation are commonly used anesthetic techniques in patients at risk of pulmonary aspiration of gastric or esophageal contents. Some of these patients may have a gastric tube (GT) placed preoperatively. Currently, there are no guidelines regarding which patient should have a GT placed before anesthetic induction. Furthermore, clinicians are not in agreement as to whether to keep a GT in situ, or to partially or completely withdraw it before anesthetic induction. In this review we provide a historical perspective of the use of GTs during anesthetic induction in patients at risk of pulmonary aspiration. Before the introduction of cricoid pressure (CP) in 1961, various techniques were used including RSII combined with a head-up tilt. Sellick initially recommended the withdrawal of the GT before anesthetic induction. He hypothesized that a GT increases the risk of regurgitation and interferes with the compression of the upper esophagus during CP. He later modified his view and emphasized the safety of CP in the presence of a GT. Despite subsequent studies supporting the effectiveness of CP in occluding the esophagus around a GT, Sellick's early view has been perpetuated by investigators who recommend partial or complete withdrawal of the GT. On the basis of available information, we have formulated an algorithm for airway management in patients at risk of aspiration of gastric or esophageal contents. The approach in an individual patient depends on: the procedure; type and severity of the underlying pathology; state of consciousness; likelihood of difficult airway; whether or not the GT is in place; contraindications to the use of RSII or CP. The algorithm calls for the preanesthetic use of a large-bore GT to remove undigested food particles and awake intubation in patients with achalasia, and emptying the pouch by external pressure and avoidance of a GT in patients with Zenker diverticulum. It also

  11. [Endogenous blood ethanol in alcoholic patients and healthy subjects with and without a family history of alcoholism].

    Science.gov (United States)

    Pron'ko, P S; Shishkin, S N; Kolesnikov, V B; Volynets, S I; Ostrovskiĭ, Iu M

    1987-01-01

    Levels of endogenous ethanol were studied in healthy males, 12-13-year-old boys (sons of alcoholics and normal fathers) and alcoholic patients (after discontinuation of all drugs). The results showed no significant differences between the groups. On the other hand endogenous ethanol concentrations were higher than normal in oligophrenic boys irrespective of whether their fathers were alcoholics or healthy subjects. In the abstinence period endogenic ethanol concentrations were the minimal in patients with delirium tremens and a severe abstinence syndrome, the dynamics of this parameter in the process of treatment being dependent on the severity of the abstinence syndrome and on the nature of treatment.

  12. Vitamin K Intake and Atherosclerosis

    Science.gov (United States)

    It has been hypothesized that insufficient intake of vitamin K may increase soft tissue calcification due to impaired gamma-carboxylation of the vitamin K-dependent protein, matrix gamma-carboxyglutamic acid (MGP). The evidence to support this putative role of vitamin K intake in atherosclerosis is ...

  13. Job strain and alcohol intake

    DEFF Research Database (Denmark)

    Heikkilä, Katriina; Nyberg, Solja T; Fransson, Eleonor I;

    2012-01-01

    The relationship between work-related stress and alcohol intake is uncertain. In order to add to the thus far inconsistent evidence from relatively small studies, we conducted individual-participant meta-analyses of the association between work-related stress (operationalised as self-reported job...... strain) and alcohol intake....

  14. Effects of early supplemental parenteral nutrition on nutrition intakes and clinical outcomes in trauma patients%早期添加肠外营养对创伤患者营养摄入和预后的影响

    Institute of Scientific and Technical Information of China (English)

    肖桂珍; 唐丽群; 段鹏凯; 邱小文; 苏磊

    2013-01-01

    目的 观察创伤患者早期添加肠外营养(PN)后蛋白质和能量摄入的变化,及对预后的影响.方法 采用回顾性对照研究方法,将195例创伤患者按伤后7d内是否添加PN分为对照组(105例)和混合营养组(90例).比较两组的营养支持时间、14d内蛋白质和能量的摄入及临床结局的差异.结果 两组患者伤情程度一致,急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、损伤严重度评分(ISS)和格拉斯哥昏迷评分(GCS)无明显差异.与对照组相比,混合营养组开始营养支持的时间(h)较早(40.0±21.0比55.1±23.5,P<0.01),肠内营养(EN)开始时间(h)延迟(75.2±54.5比55.1±23.5,P<0.01),48 h内EN比例低[14.4%(13/90)比43.8%(46/105),P<0.01],恢复口服饮食的时间(d)无统计学差异(10.8±3.7比11.4±3.6,P>0.05).混合营养组在治疗3、7、t4d摄人的能量(kJ)均优于对照组(3d:3981.6±2209.3比2683.2±1414.9,7 d:5477.5±2008.4比3619.1 ± 1429.9,14 d:6250.2±2533.2比5199.9±1972.7,P<0.05或P<0.01);两组蛋白质的摄入量(g)均较低,混合营养组治疗3d明显低于对照组(20.6±18.4比26.5± 13.8 P<0.05).与对照组比较,混合营养组住院时间(d)明显延长(73.9±62.5比50.9±33.3,P<0.01),而病死率[4.4%(4/90)比3.8%(4/t05)]、感染和急性呼吸窘迫综合征(ARDS)的发生率[8.9%(8/90)比3.8%(4/105),5.6%(5/90)比7.6%(8/105)]、机械通气时间(d:8.3±4.6比7.3±4.7)、ICU停留时间(d:17.6±13.2比14.2±11.3)均无统计学差异(均P>0.05).结论 虽然创伤患者早期加用PN能增加能量摄入,但不规范的PN不能改变创伤患者的预后,并可增加住院天数.%Objective To evaluate energy and protein intake changes in early supplemental parenteral nutrition (PN) in trauma patients,and to assess its impact on clinical outcomes.Methods Clinical results of patients receiving or not receiving additional PN during the first 7 days after injury were retrospectively

  15. The prophylactic reduction of aluminium intake.

    Science.gov (United States)

    Lione, A

    1983-02-01

    The use of modern analytical methods has demonstrated that aluminium salts can be absorbed from the gut and concentrated in various human tissues, including bone, the parathyroids and brain. The neurotoxicity of aluminium has been extensively characterized in rabbits and cats, and high concentrations of aluminium have been detected in the brain tissue of patients with Alzheimer's disease. Various reports have suggested that high aluminium intakes may be harmful to some patients with bone disease or renal impairment. Fatal aluminium-induced neuropathies have been reported in patients on renal dialysis. Since there are no demonstrable consequences of aluminium deprivation, the prophylactic reduction of aluminium intake by many patients would appear prudent. In this report, the major sources of aluminium in foods and non-prescription drugs are summarized and alternative products are described. The most common foods that contain substantial amounts of aluminium-containing additives include some processed cheeses, baking powders, cake mixes, frozen doughs, pancake mixes, self-raising flours and pickled vegetables. The aluminium-containing non-prescription drugs include some antacids, buffered aspirins, antidiarrhoeal products, douches and haemorrhoidal medications. The advisability of recommending a low aluminium diet for geriatric patients is discussed in detail. PMID:6337934

  16. Structured data entry for narrative data in a broad specialty: patient history and physical examination in pediatrics.

    NARCIS (Netherlands)

    S.E. Bleeker (Sacha); G. Derksen-Lubsen (Gerarda); A.M. van Ginneken (Astrid); J. van der Lei (Johan); H.A. Moll (Henriëtte)

    2006-01-01

    textabstractBACKGROUND: Whereas an electronic medical record (EMR) system can partly address the limitations, of paper-based documentation, such as fragmentation of patient data, physical paper records missing and poor legibility, structured data entry (SDE, i.e. data entry based on selection of pre

  17. High yield criteria for emergency cranial computed tomography in adult patients with no history of head injury

    OpenAIRE

    Harris, J.; Draper, H.; Rhodes, A; Stevens, J.

    2000-01-01

    Objectives—A recent American study identified clinical factors which effectively predicted those patients who would have significant findings on cranial computed tomography. It was proposed to apply these criteria in a UK setting and to determine whether modifications could be made to improve their efficiency.

  18. Natural history of tuberculosis: duration and fatality of untreated pulmonary tuberculosis in HIV negative patients: a systematic review

    NARCIS (Netherlands)

    E.W. Tiemersma; M.J. van der Werf; M.W. Borgdorff; B.G. Williams; N.J.D. Nagelkerke

    2011-01-01

    Background The prognosis, specifically the case fatality and duration, of untreated tuberculosis is important as many patients are not correctly diagnosed and therefore receive inadequate or no treatment. Furthermore, duration and case fatality of tuberculosis are key parameters in interpreting epid

  19. Semi-quantitative assessment of cerebral blood flow with {sup 99m}Tc-HMPAO SPET in type I diabetic patients with no clinical history of cerebrovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Quirce, R.; Carril, J.M.; Jimenez-Bonilla, J.F.; Amado, J.A.; Gutierrez-Mendiguchia, C.; Banzo, I.; Blanco, I.; Uriarte, I.; Montero, A. [Servicio de Medicina Nuclear, Hospital Universitario Marques de Valdecilla, Santander (Spain)

    1997-12-01

    In 65 type I diabetic patients we prospectively evaluated brain perfusion by means of single-photon emission tomography after the injection of 740- 1110 MBq of technetium-99m hexamethylpropylene amine oxime. Thirty-five of the patients presented complications secondary to their diabetes. None showed CNS symptoms. A semiquantitative analysis was performed drawing 50 symmetrical regions of interest (ROIs) per patient. The relative contribution of each ROI to the total blood flow in each slice was compared with the relative contribution of the same ROI in a control group of ten healthy volunteers. Relative values of any ROI in the study group higher or lower than the mean {+-}2 SD in respect of the same ROI in the control group were considered abnormal. The results revealed hypoperfusion in 207 ROIs in the 65 patients with diabetes mellitus: of these ROIs, 113 were frontal, 10 frontotemporal, 20 temporal, 18 parietal, 11 occipital and 35 cerebellar. A total of 137 ROIs showed hyperperfusion: 17 frontal, 3 frontotemporal, 19 temporal, 18 parietal, 19 parieto-occipital, 29 occipital and 32 cerebellar. Out of 65 type I diabetic patients, 61 showed at least one hypoperfused ROI (P = 0.0064 vs. controls) and 25 showed more than three hypoperfused ROIs. None of the control subjects showed more than three hypoperfused regions (P<0.001). The results obtained demonstrate the existence of subclinical abnormalities of brain blood perfusion in patients with type I diabetes mellitus and no history of cerebrovascular disease, thereby allowing the initiation of intensive preventive measures. (orig.) With 3 figs., 5 tabs., 33 refs.

  20. Semi-quantitative assessment of cerebral blood flow with 99mTc-HMPAO SPET in type I diabetic patients with no clinical history of cerebrovascular disease

    International Nuclear Information System (INIS)

    In 65 type I diabetic patients we prospectively evaluated brain perfusion by means of single-photon emission tomography after the injection of 740- 1110 MBq of technetium-99m hexamethylpropylene amine oxime. Thirty-five of the patients presented complications secondary to their diabetes. None showed CNS symptoms. A semiquantitative analysis was performed drawing 50 symmetrical regions of interest (ROIs) per patient. The relative contribution of each ROI to the total blood flow in each slice was compared with the relative contribution of the same ROI in a control group of ten healthy volunteers. Relative values of any ROI in the study group higher or lower than the mean ±2 SD in respect of the same ROI in the control group were considered abnormal. The results revealed hypoperfusion in 207 ROIs in the 65 patients with diabetes mellitus: of these ROIs, 113 were frontal, 10 frontotemporal, 20 temporal, 18 parietal, 11 occipital and 35 cerebellar. A total of 137 ROIs showed hyperperfusion: 17 frontal, 3 frontotemporal, 19 temporal, 18 parietal, 19 parieto-occipital, 29 occipital and 32 cerebellar. Out of 65 type I diabetic patients, 61 showed at least one hypoperfused ROI (P = 0.0064 vs. controls) and 25 showed more than three hypoperfused ROIs. None of the control subjects showed more than three hypoperfused regions (P<0.001). The results obtained demonstrate the existence of subclinical abnormalities of brain blood perfusion in patients with type I diabetes mellitus and no history of cerebrovascular disease, thereby allowing the initiation of intensive preventive measures. (orig.)

  1. Stigma, social reciprocity and exclusion of HIV/AIDS patients with illicit drug histories: A study of Thai nurses' attitudes

    Directory of Open Access Journals (Sweden)

    Stoové Mark A

    2008-08-01

    Full Text Available Abstract Background Stigma is a key barrier for the delivery of care to patients living with HIV/AIDS (PLWHA. In the Asia region, the HIV/AIDS epidemic has disproportionately affected socially marginalised groups, in particular, injecting drug users. The effect of the stigmatising attitudes towards injecting drug users on perceptions of PLWHA within the health care contexts has not been thoroughly explored, and typically neglected in terms of stigma intervention. Methods Semi-structured interviews were conducted with a group of twenty Thai trainee and qualified nurses. Drawing upon the idea of 'social reciprocity', this paper examines the constructions of injecting drug users and PLWHA by a group of Thai nurses. Narratives were explored with a focus on how participants' views concerning the high-risk behaviour of injecting drug use might influence their attitudes towards PLWHA. Results The analysis shows that active efforts were made by participants to separate their views of patients living with HIV/AIDS from injecting drug users. While the former were depicted as patients worthy of social support and inclusion, the latter were excluded on the basis that they were perceived as irresponsible 'social cheaters' who pose severe social and economic harm to the community. Absent in the narratives were references to wider socio-political and epidemiological factors related to drug use and needle sharing that expose injecting drug users to risk; these behaviours were constructed as individual choices, allowing HIV positive drug users to be blamed for their seropositive status. These attitudes could potentially have indirect negative implications on the nurses' opinions of patients living with HIV/AIDS more generally. Conclusion Decreasing the stigma associated with illicit drugs might play crucial role in improving attitudes towards patients living with HIV/AIDS. Providing health workers with a broader understanding of risk behaviours and redirecting

  2. Anti-N-methyl-d-aspartate receptor encephalitis in a patient with a 7-year history of being diagnosed as schizophrenia: complexities in diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Huang C

    2015-06-01

    Full Text Available Chaohua Huang,1,2,4,* Yukun Kang,1,* Bo Zhang,1 Bin Li,1 Changjian Qiu,1 Shanming Liu,1 Hongyan Ren,1,2 Yanchun Yang,1 Xiehe Liu,1 Tao Li,1–3 Wanjun Guo1,21Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2State Key Laboratory of Biotherapy, Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 3Mental Health Education Center, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 4Mental Health Center, Affiliated Hospital of Luzhou Medical College, Luzhou, People’s Republic of China*These authors contributed equally to this workAbstract: Anti-N-methyl-d-aspartate receptor (NMDAR encephalitis is a form of autoimmune encephalitis associated with antibodies against the NR1 subunits of NMDARs. Although new-onset acute prominent psychotic syndromes in patients with NMDAR encephalitis have been well documented, there is a lack of case studies on differential diagnosis and treatment of anti-NMDAR encephalitis after a long-term diagnostic history of functional psychotic disorders. The present study reports an unusual case of anti-NMDAR encephalitis. The patient had been diagnosed with schizophrenia 7 years earlier, and was currently hospitalized for acute-onset psychiatric symptoms. The diagnosis became unclear when the initial psychosis was confounded with considerations of other neurotoxicities (such as neuroleptic malignant syndrome. Finally, identification of specific immunoglobulin G NR1 autoantibodies in the cerebrospinal fluid and greater effectiveness of immunotherapy over antipsychotics alone (which has been well documented in anti-NMDAR encephalitis indicated the diagnosis of anti-NMDAR encephalitis in this case. Based on the available evidence, however, the relationship between the newly diagnosed anti-NMDAR encephalitis and the seemingly clear, long-term history of schizophrenia in the preceding 7

  3. Avoidant/Restrictive Food Intake Disorder

    Science.gov (United States)

    ... Intake Disorder Binge Eating Disorder Bulimia Nervosa Pica Rumination Disorder Avoidant/restrictive food intake disorder is characterized ... Intake Disorder Binge Eating Disorder Bulimia Nervosa Pica Rumination Disorder NOTE: This is the Consumer Version. CONSUMERS: ...

  4. Intake of dairy products in relation to periodontitis in older Danish adults.

    Science.gov (United States)

    Adegboye, Amanda R A; Christensen, Lisa B; Holm-Pedersen, Poul; Avlund, Kirsten; Boucher, Barbara J; Heitmann, Berit L

    2012-09-01

    This cross-sectional study investigates whether calcium intakes from dairy and non-dairy sources, and absolute intakes of various dairy products, are associated with periodontitis. The calcium intake (mg/day) of 135 older Danish adults was estimated by a diet history interview and divided into dairy and non-dairy calcium. Dairy food intake (g/day) was classified into four groups: milk, cheese, fermented foods and other foods. Periodontitis was defined as the number of teeth with attachment loss ≥3 mm. Intakes of total dairy calcium (Incidence-rate ratio (IRR) = 0.97; p = 0.021), calcium from milk (IRR = 0.97; p = 0.025) and fermented foods (IRR = 0.96; p = 0.03) were inversely and significantly associated with periodontitis after adjustment for age, gender, education, sucrose intake, alcohol consumption, smoking, physical activity, vitamin D intake, heart disease, visits to the dentist, use of dental floss and bleeding on probing, but non-dairy calcium, calcium from cheese and other types of dairy food intakes were not. Total dairy foods (IRR = 0.96; p = 0.003), milk (IRR = 0.96; p = 0.028) and fermented foods intakes (IRR = 0.97; p = 0.029) were associated with reduced risk of periodontitis, but cheese and other dairy foods intakes were not. These results suggest that dairy calcium, particularly from milk and fermented products, may protect against periodontitis. Prospective studies are required to confirm these findings.

  5. Intake of dairy products in relation to periodontitis in older Danish adults.

    Science.gov (United States)

    Adegboye, Amanda R A; Christensen, Lisa B; Holm-Pedersen, Poul; Avlund, Kirsten; Boucher, Barbara J; Heitmann, Berit L

    2012-09-01

    This cross-sectional study investigates whether calcium intakes from dairy and non-dairy sources, and absolute intakes of various dairy products, are associated with periodontitis. The calcium intake (mg/day) of 135 older Danish adults was estimated by a diet history interview and divided into dairy and non-dairy calcium. Dairy food intake (g/day) was classified into four groups: milk, cheese, fermented foods and other foods. Periodontitis was defined as the number of teeth with attachment loss ≥3 mm. Intakes of total dairy calcium (Incidence-rate ratio (IRR) = 0.97; p = 0.021), calcium from milk (IRR = 0.97; p = 0.025) and fermented foods (IRR = 0.96; p = 0.03) were inversely and significantly associated with periodontitis after adjustment for age, gender, education, sucrose intake, alcohol consumption, smoking, physical activity, vitamin D intake, heart disease, visits to the dentist, use of dental floss and bleeding on probing, but non-dairy calcium, calcium from cheese and other types of dairy food intakes were not. Total dairy foods (IRR = 0.96; p = 0.003), milk (IRR = 0.96; p = 0.028) and fermented foods intakes (IRR = 0.97; p = 0.029) were associated with reduced risk of periodontitis, but cheese and other dairy foods intakes were not. These results suggest that dairy calcium, particularly from milk and fermented products, may protect against periodontitis. Prospective studies are required to confirm these findings. PMID:23112910

  6. The effects of different amounts of iodine intake on the immune status of patients with Graves disease%不同碘摄入量对Graves病自身免疫的影响

    Institute of Scientific and Technical Information of China (English)

    苏俊平; 苏胜偶; 张博; 陈云霞; 刘春燕; 姬淑君; 于欣; 边芳

    2012-01-01

    目的 探讨不同碘摄入量对Graves病(GD)患者体内细胞免疫、体液免疫的影响.方法 对甲状腺细针细胞学检查诊断为GD的患者,依据尿碘中位数(MUI)489.5 μg/L分为GD Ⅰ组(高于MUI)与GDⅡ组(低于MUI),分别对其进行游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、促甲状腺素(TSH)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、甲状腺激素受体抗体(TRAb)、肿瘤坏死因子(TNF-α)联合测定.分析两组各指标的差异及相关性.结果 GD Ⅰ组TRAb高于GDⅡ组[分别为(1.4±0.2)、(1.2±0.1)U/L,t =5.62,P<0.05];GD Ⅰ组TPOAb、TGAb阳性率(分别为84.2%、78.9%)高于GDⅡ组(62.5%、50.0%)(x2值分别为4.71、7.10,P<0.05,P <0.01),且GD Ⅰ组TPOAb、TGAb高滴度组所占百分比高于GDⅡ组(x2值分别为6.79、10.70,P均<0.05).相关分析显示,TNF-α与TRAb、TPOAb呈直线正相关(r值分别为0.489、0.563,P均<0.01).结论 高碘摄入加重GD患者的自身免疫,应限制GD患者的摄碘量.%Objective To investigate the effects of different amounts of iodine intake on the cellular and humoral immune in Grave's disease (GD) patients.Methods The clinical GD cases were diagnosed by thyroid fine needle Cytology examination.Patients in GD group are divided into GD group Ⅰ and GD group Ⅱ based on the median of urine iodine.The blood levels of FT4,FT3,TSH,TPOAb,TGAb,TRAb and TNF-t were detected.The difference and association of these parameters between these groups were analyzed.Results The TNF-αt level in GD Ⅰ group was higher than that of GD Ⅱ group( P > 0.05 ) ;The average level of TRAb of GD Ⅰgroup ( [ 1.4 ±0.2 ] U/L) were higher than that of GD Ⅱ group ( [ 1.2 ± 0.1 ] U/L) ( P < 0.05 ) ;The positive rates of TGAb and TPOAb of GD Ⅰ group were higher than that of GD Ⅱ group ( P < 0.05 ).The percentages of patients with high level of TGAb and TPOAb in GD Ⅰ group ( 78.9% 、84.2% ) were

  7. Bridging Developmental Boundaries: Lifelong Dietary Patterns Modulate Life Histories in a Parthenogenetic Insect

    OpenAIRE

    Roark, Alison M.; Bjorndal, Karen A.

    2014-01-01

    Determining the effects of lifelong intake patterns on performance is challenging for many species, primarily because of methodological constraints. Here, we used a parthenogenetic insect (Carausius morosus) to determine the effects of limited and unlimited food availability across multiple life-history stages. Using a parthenogen allowed us to quantify intake by juvenile and adult females and to evaluate the morphological, physiological, and life-history responses to intake, all without the ...

  8. Psychopathology in 90 consecutive human immunodeficiency virus-seropositive and acquired immune deficiency syndrome patients with mostly intravenous drug use history.

    Science.gov (United States)

    Perretta, P; Nisita, C; Zaccagnini, E; Lorenzetti, C; Nuccorini, A; Cassano, G B; Akiskal, H S

    1996-01-01

    This report presents systematic clinical data regarding psychiatric diagnoses, personal and family psychiatric histories, and symptomatologic aspects of 90 consecutive human immunodeficiency virus (HIV)-seropositive and acquired immune deficiency syndrome (AIDS) patients, of whom slightly less than two thirds were at risk due to intravenous drug abuse. In addition, a comparison was made between the distribution patterns of these variables at various stages of HIV illness and related at-risk behaviors. Eighty-four percent of the patients met criteria for a spectrum of DSM-III-R diagnoses (mostly affective) that were associated with high rates of affective and alcohol abuse disorders among first-degree relatives. Mood disorders did not differ significantly between the two main groups at risk (intravenous drug users [IVDUs] v others) by gender, age, or stage of illness. The overall data from the rating scales show high levels of psychic and somatic anxiety in the early stages of illness, whereas cognitive symptoms, retardation, and disorientation are dominant in later stages. A noteworthy finding in this study is that many depressed patients demonstrated current and/or past hypomanic, hyperthymic, or cyclothymic features with no evidence of brain damage detectable by computed axial tomography (CAT). These temperamental attributes, which preceded HIV infection, may have served as risk factors for both drug abuse and impulsive sexual behavior in all types of at-risk groups. PMID:8826691

  9. History of chronic comorbidity and risk of chemotherapy-induced febrile neutropenia in patients with non-Hodgkin lymphoma not receiving granulocyte colony-stimulating factor prophylaxis.

    Science.gov (United States)

    Chao, Chun; Rodriguez, Roberto; Page, John H; Yang, Su-Jau; Huynh, Julie; Chia, Victoria M

    2015-01-01

    We conducted a cohort study to examine the association between a wide variety of chronic comorbidities and risk of febrile neutropenia (FN) in patients with non-Hodgkin lymphoma (NHL) from 2000 to 2009 treated with chemotherapy at Kaiser Permanente Southern California. History of comorbidities and FN events were identified using electronic medical records. Cox model adjusting for propensity score was used to determine the association between a comorbid condition and FN. Models that additionally adjusted for cancer stage, baseline absolute neutrophil count, chemotherapy regimen and dose reduction were also evaluated. A total of 2480 patients with NHL were included, and 60% received CHOP/R-CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone, with or without rituximab). In total, 236 (9.5%) patients developed FN in the first chemotherapy cycle. Anemia (adjusted hazard ratio [HR] = 1.6, 95% confidence interval [1.2-2.2]), HIV infection (HR = 3.8 [2.0-6.7]) and rheumatoid diseases (HR = 2.4 [1.3-4.0]) were associated with significantly increased risk of FN. These results provide evidence that chronic comorbidity increases the risk of FN. PMID:24684228

  10. Case report of right hamate hook fracture in a patient with previous fracture history of left hamate hook: is it hamate bipartite?

    Directory of Open Access Journals (Sweden)

    Norton Sandra

    2006-10-01

    Full Text Available Abstract Background Hamate hook fracture is a common fracture in golfers and others who play sports that involve rackets or sticks such as tennis or hockey. This patient had a previous hamate fracture in the opposing wrist along with potential features of hamate bipartite. Case presentation A 19 year old male presented with a complaint of right wrist pain on the ulnar side of the wrist with no apparent mechanism of injury. The pain came on gradually one week before being seen in the office and he reported no prior care for the complaint. His history includes traumatic left hamate hook fracture with surgical excision. Conclusion The patient was found to have marked tenderness over the hamate and with a prior fracture to the other wrist, computed tomography of the wrist was ordered revealing a fracture to the hamate hook in the right wrist. He was referred for surgical evaluation and the hook of the hamate was excised. Post-surgically, the patient was able to return to normal activity within eight weeks. This case is indicative of fracture rather than hamate bipartite. This fracture should be considered in a case of ulnar sided wrist pain where marked tenderness is noted over the hamate, especially after participation in club or racket sports.

  11. Learning history

    NARCIS (Netherlands)

    Peters, Richard

    2015-01-01

    Hilary speaks here with Professor Rik Peters an historian-philosopher who develops the Learning History as a method for engaging with socially relevant action in Holland. Thinking of history as a way to bridge to practical scenario planning, he is helping cities in Holland grapple with integration o

  12. Intellectual History

    DEFF Research Database (Denmark)

    In the 5 Questions book series, this volume presents a range of leading scholars in Intellectual History and the History of Ideas through their answers to a brief questionnaire. Respondents include Michael Friedman, Jacques le Goff, Hans Ulrich Gumbrecht, Jonathan Israel, Phiip Pettit, John Pocock...

  13. Romerrigets historie

    DEFF Research Database (Denmark)

    Christiansen, Erik

    Romerrigets historie fra Roms legendariske grundlæggelse i 753 f.v.t. til Heraklios' tronbestigelse i 610 e.v.t.......Romerrigets historie fra Roms legendariske grundlæggelse i 753 f.v.t. til Heraklios' tronbestigelse i 610 e.v.t....

  14. Cannabis abuse : a phenomenological study of the causative factors as perceived by patients with a history of Cannabis use, admitted at Bophelong Psychiatric Hospital in the North West Province / Boitumelo Susan Patricia Ramphomane

    OpenAIRE

    Ramphomane, Boitumelo Susan Patricia

    2005-01-01

    A phenomenological study was carried out to find out from patients with a history of cannabis use. admitted at Bophelong Psychiatric Hospital, reasons or factors that caused them to use/abuse cannabis. An original sample of 30 male patients between the ages of 16-30 years was selected from chronic (rehabilitation) wards of mentally stable patients awaiting discharge. Out of the 30 subjects, 10 protocols were selected for phenomenological explication. An unstructured type of interview was c...

  15. Implementing Mass Cytometry at the Bedside to Study the Immunological Basis of Human Diseases: Distinctive Immune Features in Patients with a History of Term or Preterm Birth.

    Science.gov (United States)

    Gaudillière, Brice; Ganio, Edward A; Tingle, Martha; Lancero, Hope L; Fragiadakis, Gabriela K; Baca, Quentin J; Aghaeepour, Nima; Wong, Ronald J; Quaintance, Cele; El-Sayed, Yasser Y; Shaw, Gary M; Lewis, David B; Stevenson, David K; Nolan, Garry P; Angst, Martin S

    2015-09-01

    Single-cell technologies have immense potential to shed light on molecular and biological processes that drive human diseases. Mass cytometry (or Cytometry by Time Of Flight mass spectrometry, CyTOF) has already been employed in clinical studies to comprehensively survey patients' circulating immune system. As interest in the "bedside" application of mass cytometry is growing, the delineation of relevant methodological issues is called for. This report uses a newly generated dataset to discuss important methodological considerations when mass cytometry is implemented in a clinical study. Specifically, the use of whole blood samples versus peripheral blood mononuclear cells (PBMCs), design of mass-tagged antibody panels, technical and analytical implications of sample barcoding, and application of traditional and unsupervised approaches to analyze high-dimensional mass cytometry datasets are discussed. A mass cytometry assay was implemented in a cross-sectional study of 19 women with a history of term or preterm birth to determine whether immune traits in peripheral blood differentiate the two groups in the absence of pregnancy. Twenty-seven phenotypic and 11 intracellular markers were simultaneously analyzed in whole blood samples stimulated with lipopolysaccharide (LPS at 0, 0.1, 1, 10, and 100 ng mL(-1)) to examine dose-dependent signaling responses within the toll-like receptor 4 (TLR4) pathway. Complementary analyses, grounded in traditional or unsupervised gating strategies of immune cell subsets, indicated that the prpS6 and pMAPKAPK2 responses in classical monocytes are accentuated in women with a history of preterm birth (FDR<1%). The results suggest that women predisposed to preterm birth may be prone to mount an exacerbated TLR4 response during the course of pregnancy. This important hypothesis-generating finding points to the power of single-cell mass cytometry to detect biologically important differences in a relatively small patient cohort. PMID

  16. 既往脑卒中患者急性心肌梗死的处理%Management of acute myocardial infarction patients with prior stroke history

    Institute of Scientific and Technical Information of China (English)

    吴炜; 张抒扬

    2011-01-01

    Summary: It is not rare that acute myocardial infarction patients have prior stroke history,which brings a serious of clinical problems in management of myocardial infarction. The antiplatelet,anticoagulation,thrombolysis and percutaneous coronary intervention therapy in treatment of myocardial infarction may cause recurrent stroke,especially the life-threatening intracranial hemorrhage. This leads to the dilemma confronted by cardiovascular practitioners.In the article, we represent how to make intervention,thrombolysis or conservative strategy in acutemyocardial infarction patients with prior stroke history, and the effect of antiplatelet and anticoagulation on stroke,to help to improve our clinical practices.%急性心肌梗死患者存在脑卒中病史者并不少见,而既往脑卒中病史为急性心肌梗死的处理带来了一系列的临床问题.常规心肌梗死处理过程中存在的抗血小板、抗凝、溶栓和经皮冠状动脉介入治疗可能会造成卒中复发,尤其是致命性的颅内出血,导致心血管医生在处理急性心肌梗死时面临两难抉择.文章对既往卒中患者出现急性心肌梗死时如何选择介入治疗、溶栓治疗或保守治疗策略,以及抗血小板、抗凝治疗对卒中的影响进行了阐述,以提高医生的临床实践能力.

  17. Alectinib induced CNS radiation necrosis in an ALK+NSCLC patient with a remote (7 years) history of brain radiation.

    Science.gov (United States)

    Ou, Sai-Hong Ignatius; Weitz, Michael; Jalas, John R; Kelly, Daniel F; Wong, Vanessa; Azada, Michele C; Quines, Oliver; Klempner, Samuel J

    2016-06-01

    Alectinib is a second generation ALK inhibitor that has significant clinical activity in central nervous system (CNS) metastases in anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC). Pseudoprogression (PsP) due to radiation necrosis during alecitnib treatment of central nervous system (CNS) metastases from ALK-rearranged NSCLC as been reported. Hence, distinguishing radiation-related PsP from alectinib-induced radiographic changes is important to avoid erroneous early trial discontinuation and abandonment of an effective treatment. However, it remains difficult to assess casuality of radiation necrosis is related to recent direct radiation or induced by alectinib treatment or both. It is also unknown how long from previous radiation can alectinib still induce radiation necrosis. Here we reported a crizotinib-refractory ALK-positive NSCLC patient who develop radiation necrosis in one of his metastatic CNS lesions after approximately 12 months of alectinib treatment who otherwise had on-going CNS response on alectinib. His most recent radiation to his CNS metastases was 7 years prior to the start of alectinib. This case illustrates that in the setting of pror CNS radiation, given the significant clinical activity of alectinib in CNS metastases in ALK-positive NSCLC patients the risk of CNS radiation necrosis remains long after previous radiation to the CNS metastases has been completed and can occur after durable response of treatment. PMID:27133743

  18. Afferent signals regulating food intake.

    Science.gov (United States)

    Bray, G A

    2000-08-01

    Food intake is a regulated system. Afferent signals provide information to the central nervous system, which is the centre for the control of satiety or food seeking. Such signals can begin even before food is ingested through visual, auditory and olfactory stimuli. One of the recent interesting findings is the demonstration that there are selective fatty acid taste receptors on the tongue of rodents. The suppression of food intake by essential fatty acids infused into the stomach and the suppression of electrical signals in taste buds reflect activation of a K rectifier channel (K 1.5). In animals that become fat eating a high-fat diet the suppression of this current by linoleic acid is less than that in animals that are resistant to obesity induced by dietary fat. Inhibition of fatty acid oxidation with either mercaptoacetate (which blocks acetyl-CoA dehydrogenase) or methylpalmoxirate will increase food intake. When animals have a choice of food, mercaptoacetate stimulates the intake of protein and carbohydrate, but not fat. Afferent gut signals also signal satiety. The first of these gut signals to be identified was cholecystokinin (CCK). When CCK acts on CCK-A receptors in the gastrointestinal tract, food intake is suppressed. These signals are transmitted by the vagus nerve to the nucleus tractus solitarius and thence to higher centres including the lateral parabrachial nucleus, amygdala, and other sites. Rats that lack the CCK-A receptor become obese, but transgenic mice lacking CCK-A receptors do not become obese. CCK inhibits food intake in human subjects. Enterostatin, the pentapeptide produced when pancreatic colipase is cleaved in the gut, has been shown to reduce food intake. This peptide differs in its action from CCK by selectively reducing fat intake. Enterostatin reduces hunger ratings in human subjects. Bombesin and its human analogue, gastrin inhibitory peptide (also gastrin-insulin peptide), reduce food intake in obese and lean subjects. Animals

  19. Response to Proximal Restorations Placed Either Subgingivally or Following Crown Lengthening in Patients with No History of Periodontal Disease.

    Science.gov (United States)

    Oppermann, Rui Vicente; Gomes, Sabrina Carvalho; Cavagni, Juliano; Cayana, Ezymar Gomes; Conceição, Ewerton Nocchi

    2016-01-01

    The purpose of this study was to compare the impact of resin restorations placed supragingivally or impinging periodontal biologic width (PBW). Ten patients (aged 19 to 35 years) with at least two contralateral teeth (premolars and molars) in need of proximal subgingival restorations participated. Test group (TG) (impingement of PBW with transsurgical restorations) and control croup (CG) (supragingival restorations after crown lengthening) were randomly assigned. Visible plaque (VP), bleeding on probing (BOP), periodontal probing depth (PPD), and clinical attachment loss (CAL) were evaluated at baseline and at 45, 90, and 180 days, and by transperiodontal probing at baseline and 180 days. Generalized estimating equations, Wald test, and t test were used (P ≤ .05). VP and BOP were reduced and maintained at low levels (less than 10% from day 45 on). PPD initially reduced in the TG. At day 180, no intra- or intergroup differences were observed (P > .05). CAL was higher in the CG after surgery (P crown lengthening.

  20. Pulmonary Carbon Dioxide Elimination for Cardiac Output Monitoring in Peri-operative and Critical Care Patients: History and Current Status

    Directory of Open Access Journals (Sweden)

    Philip J. Peyton

    2013-01-01

    Full Text Available Minimally invasive measurement of cardiac output as a central component of advanced haemodynamic monitoring has been increasingly recognised as a potential means of improving perioperative outcomes in patients undergoing major surgery. Methods based upon pulmonary carbon dioxide elimination are among the oldest techniques in this field, with comparable accuracy and precision to other techniques. Modern adaptations of these techniques suitable for use in the perioperative and critical are environment are based on the differential Fick approach, and include the partial carbon dioxide rebreathing method. The accuracy and precision of this approach to cardiac output measurement has been shown to be similar to other minimally invasive techniques. This paper reviews the underlying principles and evolution of the method, and future directions including recent adaptations designed to deliver continuous breath-by-breath monitoring of cardiac output.

  1. SEDIMENT CONTROL FOR IRRIGATION INTAKES

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The analysis of the sediment problems in irrigation engineeringwas carried out, and the layout, the method as well as the effect of sediment control for irrigation intake structures in China were briefly introduced.

  2. Protein leverage and energy intake.

    Science.gov (United States)

    Gosby, A K; Conigrave, A D; Raubenheimer, D; Simpson, S J

    2014-03-01

    Increased energy intakes are contributing to overweight and obesity. Growing evidence supports the role of protein appetite in driving excess intake when dietary protein is diluted (the protein leverage hypothesis). Understanding the interactions between dietary macronutrient balance and nutrient-specific appetite systems will be required for designing dietary interventions that work with, rather than against, basic regulatory physiology. Data were collected from 38 published experimental trials measuring ad libitum intake in subjects confined to menus differing in macronutrient composition. Collectively, these trials encompassed considerable variation in percent protein (spanning 8-54% of total energy), carbohydrate (1.6-72%) and fat (11-66%). The data provide an opportunity to describe the individual and interactive effects of dietary protein, carbohydrate and fat on the control of total energy intake. Percent dietary protein was negatively associated with total energy intake (F = 6.9, P protein. The analysis strongly supports a role for protein leverage in lean, overweight and obese humans. A better appreciation of the targets and regulatory priorities for protein, carbohydrate and fat intake will inform the design of effective and health-promoting weight loss diets, food labelling policies, food production systems and regulatory frameworks.

  3. Food intake assessment and quality of life in women with fibromyalgia

    OpenAIRE

    Emmanuelle Dias Batista; Aline Andretta; Renata Costa de Miranda; Jéssica Nehring; Eduardo dos Santos Paiva; Maria Eliana Madalozzo Schieferdecker

    2016-01-01

    ABSTRACT Objective: To compare the food intake of women with and without fibromyalgia and verify if the food intake of patients with fibromyalgia interferes with the pain and quality of life. Methods: Study participants were women with fibromyalgia (FM) seen in Fibromyalgia Outpatient Clinic, Hospital das Clínicas/UFPR and a control group (CT) with healthy women. Data collection was conducted from March to October 2012. For the assessment of food intake we used the Food Registration and ana...

  4. Assessment of regional lung ventilation by electrical impedance tomography in a patient with unilateral bronchial stenosis and a history of tuberculosis

    Directory of Open Access Journals (Sweden)

    Liégina Silveira Marinho

    2013-12-01

    Full Text Available Bronchial stenosis can impair regional lung ventilation by causing abnormal, asymmetric airflow limitation. Electrical impedance tomography (EIT is an imaging technique that allows the assessment of regional lung ventilation and therefore complements the functional assessment of the lungs. We report the case of a patient with left unilateral bronchial stenosis and a history of tuberculosis, in whom regional lung ventilation was assessed by EIT. The EIT results were compared with those obtained by ventilation/perfusion radionuclide imaging. The patient was using nasal continuous positive airway pressure (CPAP for the treatment of obstructive sleep apnea syndrome. Therefore, we studied the effects of postural changes and of the use of nasal CPAP. The EIT revealed heterogeneous distribution of regional lung ventilation, the ventilation being higher in the right lung, and this distribution was influenced by postural changes and CPAP use. The EIT assessment of regional lung ventilation produced results similar to those obtained with the radionuclide imaging technique and had the advantage of providing a dynamic evaluation without radiation exposure.

  5. Hemobilia secondary to hepatic artery pseudoaneurysm:An unusual complication of bile leakage in a patient with a history of a resected Ⅲb Klatskin tumor

    Institute of Scientific and Technical Information of China (English)

    Dimitrios Siablis; Zafiria G. Papathanassiou; Dimitrios Karnabatidis; Nikolaos Christeas; Constantine Vagianos

    2005-01-01

    we report a case of a 74-year-old woman with a 16-year history of a double bilo-enteric anastomosis due to resected hilar cholangiocarcinoma [Type Ⅲb Klatskin tumor]. The patient presented with cholangitis secondary to benign anastomotic stenosis which resulted in a large intrahepatic biloma. In order to restore the patency of the anastomosis and overcome cholangitis, several attempts took place,including endobiliary stenting, balloon-assisted biloplasty and transhepatic billiary drainage. Anastomotic patencywas achieved, complicated, however, by persistent upper gastro-intestinal bleeding, presented as hemobilia. A biloma-induced pseudoaneurysm of the left hepatic artery was diagnosed. This had ruptured into the biliary tract,and presented the actual cause of the hemobilia. Selective embolism of the pseudoaneurysm resulted in control of the hemorrhage, and was successfully combined with transhepatic dilatation of the anastomosis and percutaneous drainage of the biloma. The patient was ultimately cured and seems to be in excellent condition, 5 mo after treatment.

  6. Serum Malondialdehyde and Lipid Profile Levels of Young Patients "Haven’t a Family History of Hypertension": A New Study for Cases in the Civic Society

    Directory of Open Access Journals (Sweden)

    *R. H. Jasim

    2011-09-01

    Full Text Available This study was designed to evaluate the effect of the oxidative stress in sera of young patients without a family history of hypertension, then find the relation of it to lipid profile. The study involved 56 young healthy (30.5 ± 4.7 years and 23 healthy elderly volunteers (66.3 ± 3.5 years, these individuals were compared with 67 patients (28.6 ± 5.0 years, attending the Gastro Intestinal and Liver Centre at Al Sader Medical City and several specialized clinics in Najaf government. Malondialdehyde level was measured by TBARS assay as reflection to the oxidative stress effect. Using standard enzymatic assays, TG, TC, HDL-C, VLDL- -C, and LDL-C values were measured for patients and controls on the same day of sample obtainment. Levels of serum MDA, TG, VLDL-C, and LDL-C were significantly raised (p<0.005 in hypertensive patients group when compared with young and elderly controls, while non significant variations were obtained when the control groups were compared together. Daytime SBP and DBP were both strong positive correlated (r=0.82, p<0.005 for SBP, and r=0.95, p<0.005 for DBP with the MDA in hypertensive patients, but in elderly controls only the correlation between SBP and MDA levels was statistically significant (r=0.61, p<0.005. Sera TG, VLDL-C, and LDL-C levels showed the same of MDA results when they were correlated to SBP and DBP, while correlations between blood pressure with sera TC were moderate positively in the study groups. In spite of; HDL-C levels in hypertensive patients were within the levels of those of two control groups, HDL-C levels showed negatively correlation with both SBP and DBP. Notably, there was a positive correlation (r=0.60, p<0.005 between serum LDL-C levels and SBP of elderly controls, no such correlations were observed when the relation was between Daytime SBP and DBP and VLDL-C or LDL-C of young controls the highly significant positive correlation (r = 0.94 at p<0.005 of MDA and TG of the hypertensive

  7. Estrogen Intake and Copper Depositions: Implications for Alzheimer's Disease

    Directory of Open Access Journals (Sweden)

    Florian Amtage

    2014-06-01

    Full Text Available We present a patient with chronic postmenopausal estrogen intake with presence of Kayser-Fleischer ring in the cornea and Alzheimer's disease and discuss the pathophysiological mechanisms of estrogen intake and copper accumulation in various tissues, including the central nervous system. Sonography was compatible with copper accumulation in the basal ganglia, but the patient showed no clinical signs of Wilson's disease. Magnetic resonance imaging and positron emission tomography revealed a typical pattern for Alzheimer's disease. We propose increased copper levels as a direct effect of estrogen intake due to an augmented ATP7A-mRNA in the intestine. Moreover, we discuss the impact of elevated free serum copper on accompanying Alzheimer's disease, knowing that copper plays a crucial role in the formation of amyloid plaques and tau aggregation. This might offer a partial explanation for the observation that postmenopausal estrogen therapy is associated with a higher risk of mild cognitive impairment and Alzheimer's disease.

  8. Numerical Simulation of a Hypersonic Air Intake

    OpenAIRE

    Soumyajit Saha; Debasis Chakraborty

    2015-01-01

    Numerical simulations were carried out to study the unsteady flow in an intake of hypersonic air-breathing vehicle. Unsteady RANS simulations were performed to examine started flow of the intake when cowl surface is parallel to the ramp surface. Though started, the flow was unsteady due to flow separation bubbles inside intake. Intake with larger cowl opening at which intake unstarted was also simulated. Simulations indicated unstarted flow, with large pressure oscillations. The numerically s...

  9. Feed intake and oxygen consumption in fish

    OpenAIRE

    Subramanian, S.

    2013-01-01

    In fish, the voluntary feed intake is influenced by dietary, environmental and/or physiological factors. It is well known that under hypoxia the concentration of oxygen in the water (DO) determines the feed intake of fish. However at non-limiting water DO levels (normoxia), several other mechanisms might play a role in feed intake regulation. Under hypoxia feed intake and oxygen consumption are interrelated. In this thesis we proposed the ‘oxystatic’ concept of feed intake regulat...

  10. Dairy products and calcium intake during pregnancy and dental caries in children

    OpenAIRE

    Tanaka Keiko; Miyake Yoshihiro; Sasaki Satoshi; Hirota Yoshio

    2012-01-01

    Abstract Background Maternal nutrition status during pregnancy may affect fetal tooth development, formation, and mineralization, and may affect dental caries susceptibility in children. We investigated the association between maternal intake of dairy products and calcium during pregnancy and the risk of childhood dental caries. Methods Subjects were 315 Japanese mother-child pairs. Data on maternal intake during pregnancy were assessed through a diet history questionnaire. Outcome data was c...

  11. Dietary sodium intake and the risk of airway hyperreactivity in a random adult population.

    OpenAIRE

    Britton, J.; Pavord, I; Richards, K; Knox, A; Wisniewski, A; Weiss, S.; Tattersfield, A

    1994-01-01

    BACKGROUND--High dietary sodium intake has been identified as a potential cause of asthma and airway hyperreactivity. This study was designed to test the hypothesis that dietary sodium intake is an independent determinant of the risk of hyperreactivity in the general population, and to assess the role of atopy in the association between these factors. METHODS--Airway reactivity to methacholine, atopy, 24 hour urinary sodium excretion, and self-reported smoking and symptom history were measure...

  12. Salt intake and hypertension therapy.

    Science.gov (United States)

    Milan, Alberto; Mulatero, Paolo; Rabbia, Franco; Veglio, Franco

    2002-01-01

    Hypertension is a risk factor for cardiovascular and renal organ damage. Environmental conditions affect the development of high blood pressure (BP), although genetic influences are also important. Current international guidelines recommend reducing dietary sodium to no more than 100 mmol (about 2.4 g sodium or approximately 6 g salt) per day to prevent BP rising; the current intake of sodium in industrialized countries is approximately double the recommended amount. Clinical trials (DASH and TOHP studies) have shown that dietary factors are fundamental in the prevention and control of BP. Low dietary sodium intake is particularly effective in preventing hypertension in subjects with an increased risk such as the overweight, borderline hypertensives or the elderly. A low-salt diet combined with anti-hypertensive therapies facilitates BP reduction independent of race. The hypotensive effect of calcium channel blockers is less dependent on salt intake than other drugs, such as ACE inhibitors or diuretics. Reduced sodium intake associated with other dietary changes (such as weight loss, and increasing potassium, calcium and magnesium intake) are important instruments for the prevention and therapy of hypertension. PMID:11936420

  13. Hypothalamic food intake regulation in a cancer-cachectic mouse model

    NARCIS (Netherlands)

    Dwarkasing, J.T.; Dijk, van M.; Dijk, F.J.; Boekschoten, M.V.; Faber, J.; Argiles, J.M.; Laviano, A.; Müller, M.R.; Witkamp, R.F.; Norren, van K.

    2014-01-01

    Background Appetite is frequently affected in cancer patients leading to anorexia and consequently insufficient food intake. In this study, we report on hypothalamic gene expression profile of a cancer-cachectic mouse model with increased food intake. In this model, mice bearing C26 tumour have an i

  14. Identification of MGB1 as a Marker in the Differential Diagnosis of Lung Tumors in Patients with a History of Breast Cancer by Analysis of Publicly Available SAGE Data

    OpenAIRE

    Koga, Takaomi; Horio, Yoshitsugu; Mitsudomi, Tetsuya; Takahashi, Takashi; Yatabe, Yasushi

    2004-01-01

    The risk of developing second primary cancers is increased in patients with breast cancer. The lung is one of the major target organs, and therefore a differential diagnosis between primary and metastatic cancers is required for the treatment of lung tumors in patients with a history of breast cancer. However, biopsy specimens frequently result in small, fragmented tissues containing only a few, degenerated cancer cells. We attempted to find a useful marker for differential diagnosis, using t...

  15. Linjefaget historie

    DEFF Research Database (Denmark)

    Rasch-Christensen, Andreas

    Afhandlingen er en undersøgelse af linjefaget historie ved læreruddannelsen. Med fokus på subjektperspektivet peger afhandlingen på en række afgørende udviklingsperspektiver for læreruddannelsen, uddannelsen af historielærere og folkeskolens historieundervisning.......Afhandlingen er en undersøgelse af linjefaget historie ved læreruddannelsen. Med fokus på subjektperspektivet peger afhandlingen på en række afgørende udviklingsperspektiver for læreruddannelsen, uddannelsen af historielærere og folkeskolens historieundervisning....

  16. Matematikkens historie

    DEFF Research Database (Denmark)

    Hansen, Vagn Lundsgaard

    2009-01-01

    Matematikkens historie i syv kapitler: 1. Matematik i støbeskeen; 2. Matematikkens græske arv; 3. Den gyldne tidsalder for hinduer og arabere; 4. Matematik i Kina; 5. Renæssancens matematik; 6. Regning med infinitesimaler ser dagens lys; 7. Matematik i det tyvende århundrede.......Matematikkens historie i syv kapitler: 1. Matematik i støbeskeen; 2. Matematikkens græske arv; 3. Den gyldne tidsalder for hinduer og arabere; 4. Matematik i Kina; 5. Renæssancens matematik; 6. Regning med infinitesimaler ser dagens lys; 7. Matematik i det tyvende århundrede....

  17. Environmental history

    DEFF Research Database (Denmark)

    Pawson, Eric; Christensen, Andreas Aagaard

    2016-01-01

    Environmental history is an interdisciplinary pursuit that has developed as a form of conscience to counter an increasingly powerful, forward-looking liberal theory of the environment. It deals with the relations between environmental ideas and materialities, from the work of the geographers George...... risks”. These are exposed by environmental history’s focus on long-run analysis and its narrative form that identifies the stories that we tell ourselves about nature. How a better understanding of past environmental transformations helps to analyse society and agency, and what this can mean...... for solutions and policies, is the agenda for an engaged environmental history from now on....

  18. Nutritional adequacy of dietary intake in women with anorexia nervosa

    Science.gov (United States)

    Background: Understanding nutrient intake of anorexia nervosa (AN) patients is essential for the establishment of dietary treatment. Design: Women, aged 19 to 30 years, with both restricting and binge purge types of AN, participating in an ecological momentary assessment study, completed three nonc...

  19. Dietary polyphenol intake in Europe

    DEFF Research Database (Denmark)

    Zamora-Ros, Raul; Knaze, Viktoria; Rothwell, Joseph A;

    2016-01-01

    , followed by non-Mediterranean (non-MED) and MED countries. The main polyphenol contributors were phenolic acids (52.5-56.9 %), except in men from MED countries and in the UK health-conscious group where they were flavonoids (49.1-61.7 %). Coffee, tea, and fruits were the most important food sources......BACKGROUND/OBJECTIVES: Polyphenols are plant secondary metabolites with a large variability in their chemical structure and dietary occurrence that have been associated with some protective effects against several chronic diseases. To date, limited data exist on intake of polyphenols in populations....... The current cross-sectional analysis aimed at estimating dietary intakes of all currently known individual polyphenols and total intake per class and subclass, and to identify their main food sources in the European Prospective Investigation into Cancer and Nutrition cohort. METHODS: Dietary data at baseline...

  20. Necrotizing RPGN with linear anti IgG deposits in a patient with history of granulomatosis with polyangiitis: a case report

    Directory of Open Access Journals (Sweden)

    Parekh N

    2014-11-01

    Full Text Available Ninad Parekh, Edward Epstein, Suzanne El-Sayegh Department of Medicine, Division of Nephrology, Staten Island University Hospital, Staten Island, NY, USA Introduction: Diagnosing the etiology of a rapidly progressive glomerulonephritis is of vital importance to guide appropriate therapeutic management. This case highlights the complexity involved in establishing diagnosis when presentation is atypical. In certain cases diagnosis cannot be established based on clinical presentation or biopsy findings alone, and critical analysis of biopsy findings in context of clinical presentation is crucial to guide the clinical decision-making process.Case presentation: A 47-year-old Hispanic male with history of granulomatosis with polyangiitis (GPA in remission on azathioprine, presented with fatigue and lethargy. Physical examination was unremarkable. Laboratory data revealed elevated creatinine and otherwise normal electrolytes. Urinalysis showed numerous dysmorphic red blood cells with few red cell casts. His serologic results were all negative except anti-proteinase-3 antibody at very low titers. Kidney biopsy showed necrotizing crescentic glomerulonephritis with linear immunoglobulin G staining along the basement membrane.Conclusion: This case presented conflicting serologic and histopathologic findings. The presence of anti-proteinase-3 antibody supported diagnosis of recurrence of GPA. However, linear staining of immunoglobulin G (IgG on immunofluorescence (IF staining of renal biopsy supported anti-glomerular basement membrane (GBM disease. The treatment of anti-GBM disease and GPA both involve immunosuppression with prednisone and cyclophosphamide. However, patients with anti-GBM disease are also treated with plasmapheresis early in the disease presentation to prevent further damage. The patient with GPA, on the other hand, was shown to benefit from plasmapheresis only in the case of severe renal disease (serum creatinine level more than 5 mg/dL or

  1. Correlation of nutritional status and food intake in hemodialysis patients Correlação entre estado nutricional e ingestão alimentar em pacientes de hemodiálise

    Directory of Open Access Journals (Sweden)

    Alvaro A. C. Morais

    2005-06-01

    Full Text Available BACKGROUND: Patients in end-stage renal disease often suffer from poor appetite, various comorbidities, and dietary restrictions. Despite regular hemodialysis, nutritional imbalances are frequently reported. Aiming to correlate nutritional status with food ingestion, a prospective study was done in an outpatient group. METHODS: Stable patients undergoing chronic hemodialysis for at least 3 months (n = 44 were investigated by dietary recall and standard anthropometric, biochemical, and bioimpedance determinations, including subjective and objective global assessment. The mean age of the group was 47.0 ± 16.9 years, and 63.6% were men. Body mass index was 22.2 ± 3.9 kg/m² (mean ± SD, calorie intake was 1471 ± 601 kcal/day (20.7 ± 6.7 kcal/kg/day, and protein ingestion was 74.3 ± 16.6 g protein/day (1.2 g/kg/day. Dietary and clinical findings were correlated with nutritional indices by linear regression analysis. RESULTS: Malnutrition estimated by subjective global assessment was very common (>90%, despite the fact that body mass index and serum albumin were within an acceptable range in the majority of the population. Objective global assessment yelded roughly comparable numerical findings, with 6.8% being well nourished, 61.4% at nutritional risk or lightly undernourished, 29.6% moderately malnourished, and 2.3% severely malnourished. Total calorie intake was devoid of associations, but protein, carbohydrate, and lipid input positively correlated with triceps skinfold (P=.02. Lipid ingestion was the only marker directly associated with arm circumference, and it correlated with body mass index, as well as with total body fat (bioimpedance analysis (P OBJETIVOS: Pacientes em fase final de enfermidade renal frequentemente sofrem de falta de apetite, várias comorbidades e restrições dietéticas, e a despeito de hemodiálise regular, desequilíbrios nutricionais são frequentemente relatados. Com o propósito de correlacionar estado

  2. Food intake and nutritional status after gastrectomy

    DEFF Research Database (Denmark)

    Bisballe, S; Buus, S; Lund, B;

    1986-01-01

    Food intake and nutritional status was studied in 67 patients, who had had a gastrectomy 2-30 years earlier, and in a randomly selected, matched group of healthy persons. The gastrectomized patients weighed less than the control persons (women 56.4 +/- 9.5 vs 61.4 +/- 6.9 kg; P less than 0.05; men...... 72.4 +/- 12.5 vs 77.7 +/- 9.2 kg; P less than 0.02). Compared to the controls the gastrectomized women had a significantly lower fat-free mass (37.8 +/- 4.1 vs 40.7 +/- 4.3 kg; P less than 0.02), whereas the gastrectomized men had a lower fat mass (17.0 +/- 7.8 vs 21.2 +/- 6.0 kg; P less than 0...

  3. Cultural history as polyphonic history

    Directory of Open Access Journals (Sweden)

    Burke, Peter

    2010-06-01

    Full Text Available This texts offers a reflection on the origins and actual development of the field of cultural history through a comparison with the term that has served as title for this seminar: “polyphonic history”. The author provides an overview of the themes that have structured the seminar (the history of representations, the history of the body and the cultural history of science with the aim of making explicit and clarifying this plurality of voices in the field of history as well as its pervasiveness in other research areas.

    En este texto se ofrece una reflexión sobre el origen y actual desarrollo del campo de la historia cultural a través de una comparación con el término que ha dado título a este seminario: “historia polifónica”. El autor propone un recorrido por las áreas temáticas que han conformado la estructura del seminario (la historia de las representaciones, la historia del cuerpo y la historia cultural de la ciencia con el objeto de explicitar y explicar esta pluralidad de voces en el campo de la historia, así como su repercusión en otras áreas del conocimiento.

  4. Perceived Fall Risk and Functional Decline: Gender Differences in Patient's Willingness to Discuss Fall Risk, Fall History, or to Have a Home Safety Evaluation

    Science.gov (United States)

    Greenberg, Marna Rayl; Moore, Elizabeth C.; Nguyen, Michael C.; Stello, Brian; Goldberg, Arnold; Barraco, Robert D.; Porter, Bernadette G.; Kurt, Anita; Dusza, Stephen W.; Kane, Bryan G.

    2016-01-01

    The CDC reports that among older adults, falls are the leading cause of injury-related death and rates of fall-related fractures among older women are twice those of men. We set out to 1) determine patient perceptions (analyzed by gender) about their perceived fall risk compared to their actual risk for functional decline and death and 2) to report their comfort level in discussing their fall history or a home safety plan with their provider. Elders who presented to the Emergency Department (ED†) were surveyed. The survey included demographics, the Falls Efficacy Scale (FES) and the Vulnerable Elders Survey (VES); both validated surveys measuring fall concern and functional decline. Females had higher FES scores (mean 12.3, SD 5.9) than males (mean 9.7, SD 5.9 p = .007) in the 146 surveys analyzed. Females were more likely to report an increased fear of falling, and almost three times more likely to have a VES score of 3 or greater than males (OR = 2.86, 95% CI: 1.17-7.00, p = .02). A strong correlation was observed between FES and VES scores (r = 0.80, p < .001). No difference in correlation was observed between males and females, p = .26. Participants (77 percent) reported they would be comfortable discussing their fall risk with a provider; there was no difference between genders (p = .57). In this study, irrespective of gender, there appears to be a high association between subjects’ perceived fall risk and risk for functional decline and death. The majority of patients are likely willing to discuss their fall risk with their provider. These findings may suggest a meaningful opportunity for fall risk mitigation in this setting. PMID:27354852

  5. Cardiometabolic Effects of Cheese Intake

    DEFF Research Database (Denmark)

    Thorning, Tanja Kongerslev

    In several countries, the dietary guidelines for preventing CVD focus on reducing the intake of saturated fat. A high cheese intake in particular may however not be associated with CVD risk, despite a high content of saturated fat. This could be due to a reduced digestibility of fat in cheese...... of cheese-matrix may influence the HDL-cholesterol response, while the ripening duration may affect the level of free fatty acids and insulin in the blood. Furthermore the results showed that a diet with saturated fat in cheese or meat caused a higher HDL-cholesterol, but not LDL-cholesterol, compared...

  6. Pulmonary hyalinizing granuloma with associated elevation in serum and tissue IgG4 occurring in a patient with a history of sarcoidosis.

    Science.gov (United States)

    Chapman, Erin M; Gown, Allen; Mazziotta, Robert; Churg, Andrew

    2012-05-01

    Pulmonary hyalinizing granulomas (PHGs) are unusual fibrosclerotic inflammatory lung lesions. The organ-based manifestations of the recently defined IgG4-related sclerosing disease typically show dense fibrosis and heavy lymphoplasmacytic infiltrates. IgG4-related sclerosing disease is also defined by increased serum IgG4 levels and increased tissue levels of IgG4-positive plasma cells. The morphologic features of PHG overlap with those seen in IgG4-related sclerosing disease, and this suggests that PHG may be a form of IgG4-related sclerosing disease. We present a case of a 51-year-old man with a history of sarcoidosis who presented with slowly enlarging pulmonary nodules. Histologic evaluation of one of the nodules yielded a diagnosis of PHG. Further investigation demonstrated both elevated serum IgG4 and elevated tissue IgG4-positive plasma cells in the PHG. In previous reports, lesions that are now considered part of IgG4-related sclerosing disease were documented in patients also diagnosed with PHG, although these reports date from before the description of IgG4 sclerosing disease. This case provides the first definitive evidence that PHG is part of the spectrum of IgG4-related sclerosing disease. PMID:22498827

  7. Influential factors of precise intake and output record for patients with rheumatic heart disease and its nursing interventions%风湿性心脏病患者出入量准确记录的影响因素及护理对策

    Institute of Scientific and Technical Information of China (English)

    张翠娟; 刘喜梅; 任怡

    2011-01-01

    Objective To analyze influential factors of precise intake and output record for patients with rheumatic heart disease so as to facilitate nurses to implement appropriate nursing intervention on them.Methods 60 patients with rheumatic heart diseases were randomly selected; influential factors of their precise intake and output record were analyzed; the effects of nursing intervention on them were compared in a self-contrast way. Results Influential factors of precise intake and output record for patients with rheumatic heart disease included patients themselves, nursing care education and propaganda not being in place, and impreciseness of measuring tools. Nursing intervention could control and reduce occurrence of postoperative complications, and shorten hospital stay. Conclusions It' s very important to strictly control the balance of intake and output for patients with rheumatic heart disease, which is one of the symbols for evaluating the quality of basic nursing care.%目的 分析影响风湿性心脏病患者出入量记录准确的影响因素,以采取相应护理措施进行干预.方法 随机选择风心病患者60例,分析影响出入量记录准确性的因素,采用对照方式比较护理干预前后出入量记录的准确效果.结果 风心病患者影响准确记录出入量的原因主要有患者个人因素、护理宣教不到位、测量工具不准确等;护理干预可控制并减少了术后并发症的发生,缩短患者术后住院时间.结论 严格控制风心病患者出入量平衡至关重要,是评价基础护理质量的标志之一.

  8. Why History?

    Science.gov (United States)

    Duffy, Robert E.

    1988-01-01

    Examines the way in which studying history contributes to intellectual development. Identifies five mental attributes it enhances: perspective--gained from placing people, events, institutions against larger background; encounter--confronting great ideas, personalities, etc.; relativism in a pluralistic world--developed from immersion in other…

  9. Business History

    DEFF Research Database (Denmark)

    Hansen, Per H.

    2012-01-01

    This article argues that a cultural and narrative perspective can enrich the business history field, encourage new and different questions and answers, and provide new ways of thinking about methods and empirical material. It discusses what culture is and how it relates to narratives. Taking...

  10. Potted history

    OpenAIRE

    Dijk, T. van

    2010-01-01

    The Jordan Valley was once populated by a people, now almost forgotten by historians, with whom the pharaoh of Egypt sought favour. That is the conclusion reached by Niels Groot, the first researcher to take a PhD at the Delft-Leiden Centre for Archaeology, Art History and Science.

  11. Effects of caffeine intake and smoking on neurocognition in schizophrenia.

    Science.gov (United States)

    Núñez, Christian; Stephan-Otto, Christian; Cuevas-Esteban, Jorge; Maria Haro, Josep; Huerta-Ramos, Elena; Ochoa, Susana; Usall, Judith; Brébion, Gildas

    2015-12-30

    Although most studies support the beneficial effects of caffeine on neurocognition, its effects have never been assessed in psychiatric patients. In addition, results from studies in smokers are contradictory. Moreover, there are no data available about the neurocognitive effects of caffeine and tobacco together. We explored the concomitant effects of regular caffeine and tobacco intake on neurocognition in 52 schizophrenic patients and 61 healthy controls. Verbal fluency, processing speed, and working, visual and verbal memory were assessed. For each measurement, two tasks with two levels of complexity were administered. Our results showed that caffeine intake had beneficial effects on male schizophrenic patients only in complex tasks requiring deeper cognitive processing (semantic fluency, cognitive speed, working memory, and visual memory). Female patients and controls were unaffected. In contrast, smoking had a negative effect on male, but not on female, schizophrenic patients in semantic fluency. The effects of smoking in controls were inconsistent. In conclusion, our data showed, for the first time, beneficial effects of caffeine intake on neurocognition in male schizophrenic patients. These data suggest that further research of therapeutics based on caffeine is needed, as this could be beneficial for schizophrenic patients. In contrast, smoking appears to be detrimental.

  12. Acompanhamento nutricional de cirróticos com história pregressa de alcoolismo Nutrition follow-up o cirrhotic patients with history of alcoholism

    Directory of Open Access Journals (Sweden)

    Nelzir Trindade Reis

    1998-12-01

    Full Text Available A desnutrição proteíco-energética é freqüente nos pacientes cirróticos e representa um sério risco no aumento das taxas de morbi-mortalidade desta população. Independente do fator etiológico sua prevalência é alta e repercute em ambos os sexos. Este estudo de casos objetivou verificar o impacto da injúria cirrose alcoólica no estado nutricional e a eficácia do tratamento dietoterápico na reversão da depleção nutricional. Foram estudados 50 pacientes (47 homens e 3 mulheres atendidos no Ambulatório de Nutrição onde foi realizada avaliação nutricional objetiva com os parâmetros antropométricos, bioquímicos, clínicos e história dietética em três momentos distintos (início, 8º e 18º mês de tratamento. Os resultados iniciais revelaram que 96% dos cirróticos apresentavam algum nível de desnutrição e, no 18º mês tiveram normalização dos parâmetros nutricionais.The protein-calorie malnutrition is very common in the cirrhotic patients and it represents a risk in the morbidity and mortality rates increase. Independently of the etiologic factor, its prevalence is high and has repercussions in both sexes. This cases study had the objective of verifying the impact of alcoholic cirrhosis in the nutritional status and the efficacy of the diet therapy in the reversion of malnutrition. Fifty patients (47 men and 3 women were studied. They were attended at the Nutrition Ambulatory, where an objective nutritional assessment was carried out wish anthropometric, biochemical and clinical parameters and dietetic history in three distinct moments (beginning, 8th and 18th month of treatment. The first results revealed that 96% of the cirrhotic patients presented some level of malnutrition and in the 18th month the nutritional parameters were normalized.

  13. Preventing accidents at intake towers

    Energy Technology Data Exchange (ETDEWEB)

    Villegas, F. (INTEGRAL S.A., Medellin, CO (United States))

    1994-03-01

    Strong air blow-outs occurring in the intake tower of Guatape Hydroelectric Power Plant in Colombia have caused two serious accidents recently. The causes of the accidents were investigated and recommendations are made here to prevent future repetitions of these dangerous events. (UK)

  14. Symptoms of Anxiety and Depression Are Correlates of Angina Pectoris by Recent History and an Ischemia-Positive Treadmill Test in Patients with Documented Coronary Artery Disease in the Pimi Study

    Directory of Open Access Journals (Sweden)

    Mark W. Ketterer

    2011-01-01

    Full Text Available Objective. We tested the association of specific psychological characteristics in patients having stable coronary disease with the reporting of anginal symptoms during daily activities, and positive exercise testing. Methods. One hundred and ninety-six patients with documented CAD enrolled in the Psychophysiological Investigations of Myocardial Ischemia (PIMI Study completed an anginal history questionnaire and a battery of psychometric tests. They also underwent standardized exercise treadmill tests. Results. Patients with a recent history of angina were more likely to be female, and had higher Beck Depression (P=.002, State Anxiety (P=.001, Trait Anxiety (P=.03, Harm Avoidance (P=.04 and Muscle Tension (P=.004 scores than patients who had no recent history of angina. Along with several treadmill variables indicating more severe disease state and reduced exercise tolerance, patients who developed angina on a positive treadmill test also displayed higher scores on the Beck Depression Inventory (P=.003 and State Anxiety (P=.004 scales. Conclusions. Several psychological characteristics, and most notably anxiety and depression, are strong correlates of recent angina and angina in the presence of ischemia provoked by treadmill testing.

  15. Monosodium glutamate intake, dietary patterns and asthma in Chinese adults.

    Directory of Open Access Journals (Sweden)

    Zumin Shi

    Full Text Available OBJECTIVES: Emerging evidence shows that diet is related to asthma. The aim of this analysis was to investigate the association between monosodium glutamate (MSG intake, overall dietary patterns and asthma. METHODS: Data from 1486 Chinese men and women who participated in the Jiangsu Nutrition Study (JIN were analyzed. In this study, MSG intake and dietary patterns were quantitatively assessed in 2002. Information on asthma history was collected during followed-up in 2007. RESULTS: Of the sample, 1.4% reported ever having asthma. MSG intake was not positively associated with asthma. There was a significant positive association between 'traditional' (high loadings on rice, wheat flour, and vegetable food pattern and asthma. No association between 'macho' (rich in meat and alcohol, 'sweet tooth' (high loadings on cake, milk, and yoghurt 'vegetable rich' (high loadings on whole grain, fruit, and vegetable food patterns and asthma was found. Smoking and overweight were not associated with asthma in the sample. CONCLUSION: While a 'Traditional' food pattern was positively associated with asthma among Chinese adults, there was no significant association between MSG intake and asthma.

  16. Associações entre ingestão energética, proteica e de fósforo em pacientes portadores de doença renal crônica em tratamento hemodialítico Associations between energy, protein, and phosphorus intakes in patients with chronic kidney disease on hemodialysis

    Directory of Open Access Journals (Sweden)

    Denise Entrudo Pinto

    2009-12-01

    Full Text Available INTRODUÇÃO: A nutrição desempenha papel fundamental nas doenças renais. A recomendação nutricional deve ofertar uma dieta hiperproteica, adequada em energia e fósforo segundo o Kidney Disease Outcomes Quality Initiative (K/DOQI. É necessário controlar e/ou prevenir as complicações da Doença Renal Crônica (DRC, pois ela impõe desafios clínicos diretamente ligados ao estado nutricional. OBJETIVO: Investigar as associações entre a ingestão energética, proteica e de fósforo em pacientes em hemodiálise (HD. PACIENTES E MÉTODOS: Estudo observacional envolvendo 72 pacientes em HD, em dois hospitais de Porto Alegre/RS/Brasil. Foram coletados dados referentes ao perfil antropométrico (peso, altura e índice de massa corporal - IMC e do registro alimentar de três dias (ingestão de energia, proteína e fósforo. O teste de correlação de Spearman foi utilizado para avaliar as associações entre as variáveis do registro alimentar (p INTRODUCTION: Nutrition plays an important role in kidney disease. The nutritional recommendation is to offer a high-protein diet, adequate in energy and phosphorus according to the Kidney Disease Outcomes Quality Initiative (K/DOQI guidelines. Control and/or prevention of the complications of chronic kidney disease (CKD are essential, because CKD poses clinical challenges directly related to the nutritional status. OBJECTIVE: To investigate the possible associations between energy, protein, and phosphorus intakes in hemodialysis (HD patients. METHODS: Observational study involving 72 HD patients from two hospitals in the city of Porto Alegre, Brazil. Anthropometric data [weight, height, body mass index (IMB] were collected and three-day food intake (daily energy, protein, and phosphorus intakes was recorded. Spearman correlation was used to evaluate associations between food intake variables (p < 0.05. RESULTS: The energy, protein, and phosphorus intakes were 28 ± 10 kcal/kg/day, 1,1 ± 0.4 g

  17. Ildens historier

    DEFF Research Database (Denmark)

    Lassen, Henrik Roesgaard

    have been written by Andersen. In several chapters the curiously forgotten history of fire-lighting technology is outlined, and it is demonstrated that "Tællelyset" is written by a person with a modern perspective on how to light a candle - among other things. The central argument in the book springs......In December 2012 a manuscript entitled "Tællelyset" ['The Tallow Candle'] was discovered in an archive. The story was subsequently presented to the world as Hans Christian Andersen's first fairy tale and rather bombastically celebrated as such. In this book it is demonstrated that the text cannot...... from a point-by-point tracing of 'the origins and history' of Hans Christian Andersen's famous fairy tales. Where did the come from? How did they become the iconic texts that we know today? On this background it becomes quite clear that "Tællelyset" is a modern pastiche and not a genuine Hans Christian...

  18. Sommerferiens historie

    DEFF Research Database (Denmark)

    Lützen, Karin

    2011-01-01

    Summer holiday is a pleasure which did not become available to many people until the 20th Century. The article describes the early mountain rambles of the bourgeoisie and their holidays in seaside boarding houses. Outdoor pursuits and stays in boarding houses at bathing resorts also became favour...... pattern. Finally, the history of the special holiday camps is told, which were established by American Jews because they were excluded from many hotels....

  19. An animal model of differential genetic risk for methamphetamine intake

    Directory of Open Access Journals (Sweden)

    Tamara ePhillips

    2015-09-01

    Full Text Available The question of whether genetic factors contribute to risk for methamphetamine (MA use and dependence has not been intensively investigated. Compared to human populations, genetic animal models offer the advantages of control over genetic family history and drug exposure. Using selective breeding, we created lines of mice that differ in genetic risk for voluntary MA intake and identified the chromosomal addresses of contributory genes. A quantitative trait locus was identified on chromosome 10 that accounts for more than 50% of the genetic variance in MA intake in the selected mouse lines. In addition, behavioral and physiological screening identified differences corresponding with risk for MA intake that have generated hypotheses that are testable in humans. Heightened sensitivity to aversive and certain physiological effects of MA, such as MA-induced reduction in body temperature, are hallmarks of mice bred for low MA intake. Furthermore, unlike MA-avoiding mice, MA-preferring mice are sensitive to rewarding and reinforcing MA effects, and to MA-induced increases in brain extracellular dopamine levels. Gene expression analyses implicate the importance of a network enriched in transcription factor genes, some of which regulate the mu opioid receptor gene, Oprm1, in risk for MA use. Neuroimmune factors appear to play a role in differential response to MA between the mice bred for high and low intake. In addition, chromosome 10 candidate gene studies provide strong support for a trace amine associated receptor 1 gene, Taar1, polymorphism in risk for MA intake. MA is a trace amine-associated receptor 1 (TAAR1 agonist, and a non-functional Taar1 allele segregates with high MA consumption. Thus, reduced TAAR1 function has the potential to increase risk for MA use. Overall, existing findings support the MA drinking lines as a powerful model for identifying genetic factors involved in determining risk for harmful MA use. Future directions include the

  20. Coanda hydro intake screen testing and evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Howarth, J.

    2001-07-01

    The objective of this project has been to evaluate the effectiveness, suitability and cost benefit of the Aquashear Coanda effect, maintenance free intake screen for use in small hydro system intakes. (author)