WorldWideScience

Sample records for patient history methods

  1. [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.

  2. Statistical methods for history matching

    DEFF Research Database (Denmark)

    Johansen, Kent

    Denne afhandling beskriver statistiske metoder til history matching af olieproduktion. History matching er en vigtig del af driften af et oliefelt og er ofte forbundet med problemer relateret til kompleksiteten af reservoiret og selve størrelsen af reservoirsimuleringsmodellen. Begrebet history m...

  3. 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

    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......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...... 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....

  4. Thermal History Devices, Systems For Thermal History Detection, And Methods For Thermal History Detection

    KAUST Repository

    Caraveo Frescas, Jesus Alfonso; Alshareef, Husam N.

    2015-01-01

    Embodiments of the present disclosure include nanowire field-effect transistors, systems for temperature history detection, methods for thermal history detection, a matrix of field effect transistors, and the like.

  5. Thermal History Devices, Systems For Thermal History Detection, And Methods For Thermal History Detection

    KAUST Repository

    Caraveo Frescas, Jesus Alfonso

    2015-05-28

    Embodiments of the present disclosure include nanowire field-effect transistors, systems for temperature history detection, methods for thermal history detection, a matrix of field effect transistors, and the like.

  6. A history of geometrical methods

    CERN Document Server

    Coolidge, Julian Lowell

    2013-01-01

    Full and authoritative, this history of the techniques for dealing with geometric questions begins with synthetic geometry and its origins in Babylonian and Egyptian mathematics; reviews the contributions of China, Japan, India, and Greece; and discusses the non-Euclidean geometries. Subsequent sections cover algebraic geometry, starting with the precursors and advancing to the great awakening with Descartes; and differential geometry, from the early work of Huygens and Newton to projective and absolute differential geometry. The author's emphasis on proofs and notations, his comparisons betwe

  7. Family History in Young Patients With Stroke.

    Science.gov (United States)

    Thijs, Vincent; Grittner, Ulrike; Dichgans, Martin; Enzinger, Christian; Fazekas, Franz; Giese, Anne-Katrin; Kessler, Christof; Kolodny, Edwin; Kropp, Peter; Martus, Peter; Norrving, Bo; Ringelstein, Erich Bernd; Rothwell, Peter M; Schmidt, Reinhold; Tanislav, Christian; Tatlisumak, Turgut; von Sarnowski, Bettina; Rolfs, Arndt

    2015-07-01

    Family history of stroke is an established risk factor for stroke. We evaluated whether family history of stroke predisposed to certain stroke subtypes and whether it differed by sex in young patients with stroke. We used data from the Stroke in Fabry Patients study, a large prospective, hospital-based, screening study for Fabry disease in young patients (aged stroke in whom cardiovascular risk factors and family history of stroke were obtained and detailed stroke subtyping was performed. A family history of stroke was present in 1578 of 4232 transient ischemic attack and ischemic stroke patients (37.3%). Female patients more often had a history of stroke in the maternal lineage (P=0.027) than in the paternal lineage. There was no association with stroke subtype according to Trial of Org 10172 in Acute Stroke Treatment nor with the presence of white matter disease on brain imaging. Patients with dissection less frequently reported a family history of stroke (30.4% versus 36.3%; P=0.018). Patients with a parental history of stroke more commonly had siblings with stroke (3.6% versus 2.6%; P=0.047). Although present in about a third of patients, a family history of stroke is not specifically related to stroke pathogenic subtypes in patients with young stroke. Young women with stroke more often report stroke in the maternal lineage. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00414583. © 2015 American Heart Association, Inc.

  8. Prescribing Optimization Method for Improving Prescribing in Elderly Patients Receiving Polypharmacy Results of Application to Case Histories by General Practitioners

    NARCIS (Netherlands)

    Drenth-van Maanen, A. Clara; van Marum, Rob J.; Knol, Wilma; van der Linden, Carolien M. J.; Jansen, Paul A. F.

    2009-01-01

    Background: Optimizing polypharmacy is often difficult, and critical appraisal of medication use often leads to one or more changes. We developed the Prescribing Optimization Method (POM) to assist physicians, especially general practitioners (GPs), in their attempts to optimize polypharmacy in

  9. Comparisons between written and computerised patient histories

    NARCIS (Netherlands)

    Quaak, Martien; Westerman, R. Frans; van Bemmel, Jan H.

    1987-01-01

    Patient histories were obtained from 99 patients in three different ways: by a computerised patient interview (patient record), by the usual written interview (medical record), and by the transcribed record, which was a computerised version of the medical record. Patient complaints, diagnostic

  10. History based batch method preserving tally means

    International Nuclear Information System (INIS)

    Shim, Hyung Jin; Choi, Sung Hoon

    2012-01-01

    In the Monte Carlo (MC) eigenvalue calculations, the sample variance of a tally mean calculated from its cycle-wise estimates is biased because of the inter-cycle correlations of the fission source distribution (FSD). Recently, we proposed a new real variance estimation method named the history-based batch method in which a MC run is treated as multiple runs with small number of histories per cycle to generate independent tally estimates. In this paper, the history-based batch method based on the weight correction is presented to preserve the tally mean from the original MC run. The effectiveness of the new method is examined for the weakly coupled fissile array problem as a function of the dominance ratio and the batch size, in comparison with other schemes available

  11. Patient assessment: effective consultation and history taking.

    Science.gov (United States)

    Kaufman, Gerri

    This article explores patient consultation with specific reference to the Calgary-Cambridge consultation guide. It provides an overview of history taking and explores the patient's perspective during the consultation. The article also discusses the skills required to provide information effectively. In addition, the article addresses 'safety netting' and emphasises the interdependence of communication and consultation skills.

  12. Family History in Patients with Bipolar Disorder.

    Science.gov (United States)

    Özdemir, Osman; Coşkun, Salih; Aktan Mutlu, Elif; Özdemir, Pınar Güzel; Atli, Abdullah; Yilmaz, Ekrem; Keskin, Sıddık

    2016-09-01

    In this study, we aimed to better understand the genetic transmission of bipolar disorder by examining the family history of patients. Sixty-three patients with bipolar disorder and their families were included. The final sample comprised 156 bipolar patients and their family members. An inclusion criterion was the presence of bipolar disorder history in the family. The diagnosis of other family members was confirmed by analyzing their files, hospital records, and by calling them to the hospital. Sixty-five patients were women (41.6%) and 91 were men (58.3%) (ratio of men/women: 1.40). When analyzing the results in terms of the transition of disease from the mother's or father's side, similar results were obtained: 25 patients were from the mother's side and 25 patients were from the father's side in 63 cases. The results of our study support the fact that a significant relationship exists between the degree of kinship and the heritability of bipolar disorder and, furthermore, that the effect of the maternal and paternal sides is similar on the transmission of genetic susceptibility.

  13. Pattern of family history in stone patients.

    Science.gov (United States)

    Marickar, Y M Fazil; Salim, Abiya; Vijay, Adarsh

    2009-12-01

    Genetic predisposition to urolithiasis is a much discussed topic. The objective of this paper is to identify the types of family members of proved urinary stone patients, who have a history of urinary stone formation. The study population consisted of 2,157 urinary stone patients interviewed in 2003-2007 in the urinary stone clinic. Family members with stone history were classified as group 1--first order single (one person in the immediate family-father, mother, siblings, or children), group 2--first order multiple (more than one member in the above group), group 3--second order single (one person in the blood relatives in family--grandparents, grandchildren, uncles, aunts, cousins, etc.) and group 4--second order multiple (more than one member in the above group). Of the 2,157 patients studied, 349 patients gave positive history of stone disease constituting 16.18%. Of these, 321 were males and 28 were females. Subdivision of the family members showed that 282 patients (80.80%) had single family member with stones and the rest 67 (19.20%) had multiple family members with history of stone disease. Group 1 which constituted one family member in the immediate family had 255 involvements (father: 88, mother: 16, brother: 135, sister: 2, son: 10, and daughter: 4); Group 2 with multiple members in the immediate family constituted 51 relatives; of these, father and brother combination was the most common with 35 occurrences. Group 3 with one person in the distant relatives in family namely grandparents, grand children, uncles, aunts, cousins, etc. constituted 27 occurrences and Group 4 with more than one member in the distant family constituted 16 occurrences. It is concluded that single family member involvement was more than multiple involvements. Males predominated. Stone occurrence was more in the immediate family members than distant relatives. Brothers formed the most common group to be involved with stone disease. Study of stone risk in the family members should

  14. Alternate methods to teach history of anesthesia.

    Science.gov (United States)

    Desai, Manisha S; Desai, Sukumar P

    2014-02-01

    Residency programs in anesthesiology in the United States struggle to balance the conflicting needs of formal didactic sessions, clinical teaching, and clinical service obligations. As a consequence of the explosion in knowledge about basic and applied sciences related to our specialty, residents and fellows are expected to make substantial efforts to supplement formal lectures with self-study. There is strong evidence to suggest that members of the younger generation use nontraditional methods to acquire information. Although training programs are not required to include topics related to history of anesthesia (HOA) in the didactic curriculum, and despite the fact that such knowledge does not directly impact clinical care, many programs include such lectures and discussions. We describe and discuss our experience with 3 alternate modalities of teaching HOA.First, we provide brief descriptions of HOA-related historical narratives and novels within the domain of popular literature, rather than those that might be considered textbooks. Second, we analyze content in movies and videodiscs dealing with HOA and determine their utility as educational resources. Third, we describe HOA tours to sites in close proximity to our institutions, as well as those in locations elsewhere in the United States and abroad.We suggest that informal HOA teaching can be implemented by every residency program without much effort and without taking away from the traditional curriculum. Participating in this unique and enriching experience may be a means of academic advancement. It is our hope and expectation that graduates from programs that incorporate such exposure to HOA become advocates of history and may choose to devote a part of their academic career toward exploration of HOA.

  15. New method for determination of star formation history

    OpenAIRE

    Čeponis, Marius

    2017-01-01

    A New Method for Determination of Star Formation History Without stars there would not be any life and us. Almost all elements in our bodies are made in stars. Yet we still don‘t fully understand all the processes governing formation and evolution of stellar systems. Their star formation histories really help in trying to understand these processes. In this work a new Bayesian method for determination of star formation history is proposed. This method uses photometric data of resolved stars a...

  16. Prescription History of Emergency Department Patients Prescribed Opioids

    Directory of Open Access Journals (Sweden)

    Jason A Hoppe

    2013-05-01

    Full Text Available Introduction: To use Colorado’s prescription drug monitoring program (PDMP to describe the recent opioid prescription history of patients discharged from our emergency department (ED with a prescription for opioid pain medications.Methods: Retrospective cohort study of 300 adult ED patients who received an opioid prescription. We abstracted prescription histories for the six months prior to the ED visit from the PDMP, and abstracted clinical and demographic variables from the chart.Results: There were 5,379 ED visits during the study month, 3,732 of which were discharged. Providers wrote 1,165 prescriptions for opioid analgesics to 1,124/3,732 (30% of the patients. Median age was 36 years. Thirty-nine percent were male. Patients were 46% Caucasian, 26% African American, 22% Hispanic, 2% Asian and 4% other. These were similar to our overall ED population. There was substantial variability in the number of prescriptions, prescribers and total number of pills. A majority (205/296 of patients had zero or one prescription. The 90th percentile for number of prescriptions was seven, while the 10th percentile was zero. Patients in the highest decile tended to be older, with a higher proportion of Caucasians and females. Patients in the lowest decile resembled the general ED population. The most common diagnoses associated with opioid prescriptions were abdominal pain (11.5%, cold/flu symptoms (9.5%, back pain (5.4%, flank pain (5.0% and motor vehicle crash (4.7%.Conclusion: Substantial variability exists in the opioid prescription histories of ED patients, but a majority received zero or one prescription in the preceding six months. The top decile of patients averaged more than two prescriptions per month over the six months prior to ED visit, written by more than 6 different prescribers. There was a trend toward these patients being older, Caucasian and female. [West J Emerg Med. 2013;14(3:247–252.

  17. History as Method or Does Chronology Count?

    Science.gov (United States)

    Rose, Amy D.

    2016-01-01

    This articles introduces some of the differing approaches to historical research that are utilized within adult education and lifelong learning. It discusses archives, types of sources, and approaches to interpretation. Whenever the author talks about history or historical research one of two things happen: People get excited and start telling her…

  18. Is prevalence of colorectal polyps higher in patients with family history of colorectal cancer?

    OpenAIRE

    Murad-Regadas, Sthela Maria; Bezerra, Carla Camila Rocha; Peixoto, Ana Ligia Rocha; Regadas, Francisco Sérgio Pinheiro; Rodrigues, Lusmar Veras; Siebra, José Airton Gonçalves; da Silva Fernandes, Graziela Olivia; Vasconcelos, Rafael Aragão

    2015-01-01

    ABSTRACTObjectives:To assess the prevalence of polyps in patients with a family history of colorectal cancer, in comparison to asymptomatic individuals with indication for screening.Methods:A prospective study in a group of patients who underwent colonoscopy between 2012 and 2014. Patients were divided into two groups: Group I: no family history of colorectal cancer, and Group II: with a family history in first-degree relatives. Demographic characteristics, findings on colonoscopy...

  19. Breast Cancer Profile among Patients with a History of Chemoprevention

    Directory of Open Access Journals (Sweden)

    Freya R. Schnabel

    2016-01-01

    Full Text Available Purpose. This study identifies women with breast cancer who utilized chemoprevention agents prior to diagnosis and describes their patterns of disease. Methods. Our database was queried retrospectively for patients with breast cancer who reported prior use of chemoprevention. Patients were divided into primary (no history of breast cancer and secondary (previous history of breast cancer groups and compared to patients who never took chemoprevention. Results. 135 (6% of 2430 women used chemoprevention. In the primary chemoprevention group (n = 18, 1%, 39% had completed >5 years of treatment, and fully 50% were on treatment at time of diagnosis. These patients were overwhelmingly diagnosed with ER/PR positive cancers (88%/65% and were diagnosed with equal percentages (44% of IDC and DCIS. 117 (87% used secondary chemoprevention. Patients in this group were diagnosed with earlier stage disease and had lower rates of ER/PR-positivity (73%/65% than the nonchemoprevention group (84%/72%. In the secondary group, 24% were on chemoprevention at time of diagnosis; 73% had completed >5 years of treatment. Conclusions. The majority of patients who used primary chemoprevention had not completed treatment prior to diagnosis, suggesting that the timing of initiation and compliance to prevention strategies are important in defining the pattern of disease in these patients.

  20. John Dewey on History Education and the Historical Method

    Science.gov (United States)

    Fallace, Thomas D.

    2010-01-01

    This essay constructs a comprehensive view of Dewey's approach to history, the historical method, and history education. Drawing on Dewey's approach to the subject at the University of Chicago Laboratory School (1896-1904), Dewey's chapter on the historical method in "Logic: A Theory of Inquiry" (1938), and a critique of Dewey's…

  1. Patient Safety Movement: History and Future Directions.

    Science.gov (United States)

    Lark, Meghan E; Kirkpatrick, Kay; Chung, Kevin C

    2018-02-01

    Despite progress within the past 15 years, improving patient safety in health care remains an important public health issue. The history of safety policies, research, and development has revealed that this issue is more complex than initially perceived and is pertinent to all health care settings. Solutions, therefore, must be approached at the systems level and supplemented with a change in safety culture, especially in higher risk fields such as surgery. To do so, health care agents at all levels have started to prioritize the improvement of nontechnical skills such as teamwork, communication, and accountability, as reflected by the development of various checklists and safety campaigns. This progress may be sustained by adopting teamwork training programs that have proven successful in other high-risk industries, such as crew resource management in aviation. These techniques can be readily implemented among surgical teams; however, successful application depends heavily on the strong leadership and vigilance of individual surgeons. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  2. Digital methods for the history of psychology: Introduction and resources.

    Science.gov (United States)

    Fox Lee, Shayna

    2016-02-01

    At the York University Digital History of Psychology Laboratory, we have been working on projects that explore what digital methodologies have to offer historical research in our field. This piece provides perspective on the history and theory of digital history, as well as introductory resources for those who are curious about incorporating these methods into their own work. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  3. Making Pictures as a Method of Teaching Art History

    Science.gov (United States)

    Martikainen, Jari

    2017-01-01

    Inspired by the affective and sensory turns in the paradigm of art history, this article discusses making pictures as a method of teaching art history in Finnish Upper Secondary Vocational Education and Training (Qualification in Visual Expression, Study Programmes in Visual and Media Arts and Photography). A total of 25 students majoring in…

  4. Approaches and Methods of Periodization in Literary History

    Directory of Open Access Journals (Sweden)

    Naser Gholi Sarli

    2013-10-01

    Full Text Available Abstract One of the most fundamental acts of historiography is to classify historical information in diachronic axis. The method of this classification or periodization shows the theoretical approach of the historian and determines the structure and the form of his history. Because of multiple criteria of analysis and various literary genres, periodization in literary history is more complicated than that of general history. We can distinguish two approaches in periodization of literary history, although these can be used together: extrinsic or social-cultural approach (based on criteria extrinsic to literature and intrinsic or formalist approach (based on criteria intrinsic to literature. Then periodization in literary history can be formulated in different methods and may be based upon various criteria: chronological such as century, decade and year organic patterns of evolution great poets and writers literary emblems and evaluations of every period events, concepts and periods of general or political history analogy of literary history and history of ideas or history of arts approaches and styles of language dominant literary norms. These methods actually are used together and everyone has adequacy in special kind of literary history. In periodization of Persian contemporary literature, some methods and models current in periodization of poetry have been applied identically to periodization of prose. Periodization based upon century, decade and year is the simplest and most mechanical method but sometimes certain centuries in some countries have symbolic and stylistic meaning, and decades were used often for subdivisions of literary history, especially nowadays with fast rhythm of literary change. Periodization according to organic patterns of evolution equates the changes of literary history with the life phases of an organism, and offers an account of birth, mature and death (and sometimes re-birth of literary genres, but this method have

  5. Approaches and Methods of Periodization in Literary History

    Directory of Open Access Journals (Sweden)

    Dr. N. Gh. Sarli

    Full Text Available One of the most fundamental acts of historiography is to classify historical information in diachronic axis. The method of this classification or periodization shows the theoretical approach of the historian and determines the structure and the form of his history. Because of multiple criteria of analysis and various literary genres, periodization in literary history is more complicated than that of general history. We can distinguish two approaches in periodization of literary history, although these can be used together: extrinsic or social-cultural approach (based on criteria extrinsic to literature and intrinsic or formalist approach (based on criteria intrinsic to literature. Then periodization in literary history can be formulated in different methods and may be based upon various criteria: chronological such as century, decade and year; organic patterns of evolution; great poets and writers; literary emblems and evaluations of every period; events, concepts and periods of general or political history; analogy of literary history and history of ideas or history of arts; approaches and styles of language; dominant literary norms. These methods actually are used together and everyone has adequacy in special kind of literary history. In periodization of Persian contemporary literature, some methods and models current in periodization of poetry have been applied identically to periodization of prose. Periodization based upon century, decade and year is the simplest and most mechanical method but sometimes certain centuries in some countries have symbolic and stylistic meaning, and decades were used often for subdivisions of literary history, especially nowadays with fast rhythm of literary change.Periodization according to organic patterns of evolution equates the changes of literary history with the life phases of an organism, and offers an account of birth, mature and death (and sometimes re-birth of literary genres, but this method have

  6. Approaches and Methods of Periodization in Literary History

    Directory of Open Access Journals (Sweden)

    Naser Gholi Sarli

    2013-11-01

    Full Text Available Abstract One of the most fundamental acts of historiography is to classify historical information in diachronic axis. The method of this classification or periodization shows the theoretical approach of the historian and determines the structure and the form of his history. Because of multiple criteria of analysis and various literary genres, periodization in literary history is more complicated than that of general history. We can distinguish two approaches in periodization of literary history, although these can be used together: extrinsic or social-cultural approach (based on criteria extrinsic to literature and intrinsic or formalist approach (based on criteria intrinsic to literature. Then periodization in literary history can be formulated in different methods and may be based upon various criteria: chronological such as century, decade and year organic patterns of evolution great poets and writers literary emblems and evaluations of every period events, concepts and periods of general or political history analogy of literary history and history of ideas or history of arts approaches and styles of language dominant literary norms. These methods actually are used together and everyone has adequacy in special kind of literary history. In periodization of Persian contemporary literature, some methods and models current in periodization of poetry have been applied identically to periodization of prose. Periodization based upon century, decade and year is the simplest and most mechanical method but sometimes certain centuries in some countries have symbolic and stylistic meaning, and decades were used often for subdivisions of literary history, especially nowadays with fast rhythm of literary change. Periodization according to organic patterns of evolution equates the changes of literary history with the life phases of an organism, and offers an account of birth, mature and death (and sometimes re-birth of literary genres, but this method have

  7. 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…

  8. Lingua patientis: new words for patient communication and history taking.

    Science.gov (United States)

    Weaver, Donald F

    2017-11-01

    The English language sometimes fails in its ability to describe the severity or complexity of medical symptoms and complaints. In frustration, patients (or families) occasionally create new words to convey the subtleties of their medical history. Although medicine has created a comprehensive technical lexicon for physicians, we have failed to develop a corresponding patient-centric vocabulary (lingua patientis) that provides more accurate symptom description. The social networking of lingua patientis words might enhance history taking and afford improved appreciation of disease impact on individual patients. The English language is renowned for its capacity for flexibility and adaptability - we need to exploit this capacity for the benefit of our patients.

  9. A quantitative method for measuring the quality of history matches

    Energy Technology Data Exchange (ETDEWEB)

    Shaw, T.S. [Kerr-McGee Corp., Oklahoma City, OK (United States); Knapp, R.M. [Univ. of Oklahoma, Norman, OK (United States)

    1997-08-01

    History matching can be an efficient tool for reservoir characterization. A {open_quotes}good{close_quotes} history matching job can generate reliable reservoir parameters. However, reservoir engineers are often frustrated when they try to select a {open_quotes}better{close_quotes} match from a series of history matching runs. Without a quantitative measurement, it is always difficult to tell the difference between a {open_quotes}good{close_quotes} and a {open_quotes}better{close_quotes} matches. For this reason, we need a quantitative method for testing the quality of matches. This paper presents a method for such a purpose. The method uses three statistical indices to (1) test shape conformity, (2) examine bias errors, and (3) measure magnitude of deviation. The shape conformity test insures that the shape of a simulated curve matches that of a historical curve. Examining bias errors assures that model reservoir parameters have been calibrated to that of a real reservoir. Measuring the magnitude of deviation assures that the difference between the model and the real reservoir parameters is minimized. The method was first tested on a hypothetical model and then applied to published field studies. The results showed that the method can efficiently measure the quality of matches. It also showed that the method can serve as a diagnostic tool for calibrating reservoir parameters during history matching.

  10. A finite element method for SSI time history calculation

    International Nuclear Information System (INIS)

    Ni, X.; Gantenbein, F.; Petit, M.

    1989-01-01

    The method which is proposed is based on a finite element modelization for the soil and the structure and a time history calculation. It has been developed for plane and axisymmetric geometries. The principle of this method is presented, then applications are given, first to a linear calculation for which results will be compared to those obtained by standard methods. Then results for a non linear behavior are described

  11. A finite element method for SSI time history calculations

    International Nuclear Information System (INIS)

    Ni, X.M.; Gantenbein, F.; Petit, M.

    1989-01-01

    The method which is proposed is based on a finite element modelisation for the soil and the structure and a time history calculation. It has been developed for plane and axisymmetric geometries. The principle of this method will be presented, then applications will be given, first to a linear calculation for which results will be compared to those obtained by standard methods. Then results for a non linear behavior will be described

  12. History of Depression in Lung Cancer Patients

    DEFF Research Database (Denmark)

    Iachina, M; Brønserud, M M; Jakobsen, E

    2017-01-01

    . To estimate the effect of depression on the diagnostic process and the choice of treatment in lung cancer we fitted a logistic regression model and a Cox regression model adjusting for age, gender, resection and stage. RESULTS: Depression in a patient's anamnesis had no significant effect on the delay...

  13. 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)

  14. Lessons from history: asylum patients' Christmas experience.

    Science.gov (United States)

    Carpenter, Diane

    This article outlines the asylum building programme of the mid-to-late nineteenth century and focuses on case studies of the two Hampshire asylums built during this period, the subject of the author's doctoral thesis. It demonstrates the plight of 'pauper lunatic' before asylum reform and contrasts this with the improved quality of life provided by the Hampshire County Lunatic Asylum and the Borough of Portsmouth Lunatic Asylum respectively. Asylum care during this period followed the moral treatment regime which became the Victorian blueprint for mental health, components of which are illustrated. Criticism of this regime is addressed briefly and arguments are made against anachronistic analysis. Comparison with contemporary in-patient care and treatment is made concluding with a call to reconsider some of the better aspects of earlier care delivery. The particular experience of patients in Hampshire asylums at Christmas is used to exemplify the points raised.

  15. INNOVATIVE METHODS OF TEACHING HISTORY AT MODERN UNIVERSITIES

    Directory of Open Access Journals (Sweden)

    A. Yu. Suslov

    2017-01-01

    Full Text Available Introduction. As a discipline, History holds a specific place among disciplines of a humanitarian cycle of educational programs of higher education institutions regardless of university specialities. History plays an important role in the course of formation of a citizen and development of critical thinking of a personality as an element of a common culture. However, new federal standards require a drastic reduction of the classroom hours for studying a History course by students of non-humanitarian specialties, and, at the same time, enhancement of the contents of a discipline (its reorientation from History of Russia towards World History. Therefore, History programmes and courses demand up-to-date approaches, methods and didactic means to provide formation of holistic worldview of future experts.The aim of the article is to consider the features of innovative methods application in teaching history in high school taking into consideration modernization processes.Methodology and research methods. The research undertaken is based on activity and competence-based approaches. The methods of analysis and synthesis of the academic literature on the research topic were used; the methods of reflection and generalization of teaching activities of the Department of Humanitarian Disciplines of theKazanNationalResearchTechnologicalUniversity were applied as well.Results and scientific novelty. A modern view on historical education has been proposed as means of students’ systems thinking formation, designing the ideas about the world historical process among students, the mission ofRussia in this process, and evolution ofRussia as a part of the modern civilization. It is stated that History university course is designed not only to give the students strong subject knowledge, but also to create axiological orientations and abilities on the basis of the analysis of historical collisions, objective and subjective factors of society development. Moreover

  16. Scientific methods of research in archaeology, prehistory, and ancient history

    Energy Technology Data Exchange (ETDEWEB)

    Gentner, W [Max-Planck-Institut fuer Kernphysik, Heidelberg (Germany, F.R.)

    1977-12-01

    This contribution deals with some fields of archaeometry, i.e. the application of physical methods in archaeology: Age determination in glasses and potsherds with the aid of fission tracks and thermoluminescence, determination of the origin of coins and pottery by chemical analyses with the aid of neutron activation ('fingerprinting'), obtaining information on metal winning in ancient history with the aid of the C-14-method.

  17. 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...

  18. Brief history of patient safety culture and science.

    Science.gov (United States)

    Ilan, Roy; Fowler, Robert

    2005-03-01

    The science of safety is well established in such disciplines as the automotive and aviation industry. In this brief history of safety science as it pertains to patient care, we review remote and recent publications that have guided the maturation of this field that has particular relevance to the complex structure of systems, personnel, and therapies involved in caring for the critically ill.

  19. 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.

  20. A particle method for history-dependent materials

    Energy Technology Data Exchange (ETDEWEB)

    Sulsky, D.; Chen, Z.; Schreyer, H.L. [New Mexico Univ., Albuquerque, NM (United States)

    1993-06-01

    A broad class of engineering problems including penetration, impact and large rotations of solid bodies causes severe numerical problems. For these problems, the constitutive equations are history dependent so material points must be followed; this is difficult to implement in an Eulerian scheme. On the other hand, purely Lagrangian methods typically result in severe mesh distortion and the consequence is ill conditioning of the element stiffness matrix leading to mesh lockup or entanglement. Remeshing prevents the lockup and tangling but then interpolation must be performed for history dependent variables, a process which can introduce errors. Proposed here is an extension of the particle-in-cell method in which particles are interpreted to be material points that are followed through the complete loading process. A fixed Eulerian grid provides the means for determining a spatial gradient. Because the grid can also be interpreted as an updated Lagrangian frame, the usual convection term in the acceleration associated with Eulerian formulations does not appear. With the use of maps between material points and the grid, the advantages of both Eulerian and Lagrangian schemes are utilized so that mesh tangling is avoided while material variables are tracked through the complete deformation history. Example solutions in two dimensions are given to illustrate the robustness of the proposed convection algorithm and to show that typical elastic behavior can be reproduced. Also, it is shown that impact with no slip is handled without any special algorithm for bodies governed by elasticity and strain hardening plasticity.

  1. Bone health history in breast cancer patients on aromatase inhibitors.

    Directory of Open Access Journals (Sweden)

    Marilyn L Kwan

    Full Text Available A cross-sectional study was performed to assess bone health history among aromatase inhibitor (AI users before breast cancer (BC diagnosis, which may impact fracture risk after AI therapy and choice of initial hormonal therapy. A total of 2,157 invasive BC patients initially treated with an AI were identified from a prospective cohort study at Kaiser Permanente Northern California (KPNC. Data on demographic and lifestyle factors were obtained from in-person interviews, and bone health history and clinical data from KPNC clinical databases. The prevalence of osteoporosis and fractures in postmenopausal AI users was assessed, compared with 325 postmenopausal TAM users. The associations of bone health history with demographic and lifestyle factors in AI users were also examined. Among all initial AI users, 11.2% had a prior history of osteoporosis, 16.3% had a prior history of any fracture, and 4.6% had a prior history of major fracture. Postmenopausal women who were taking TAM as their initial hormonal therapy had significantly higher prevalence of prior osteoporosis than postmenopausal AI users (21.5% vs. 11.8%, p<0.0001. Among initial AI users, the associations of history of osteoporosis and fracture in BC patients with demographic and lifestyle factors were, in general, consistent with those known in healthy older women. This study is one of the first to characterize AI users and risk factors for bone morbidity before BC diagnosis. In the future, this study will examine lifestyle, molecular, and genetic risk factors for AI-induced fractures.

  2. The variational nodal method: history and recent accomplishments

    International Nuclear Information System (INIS)

    Lewis, E.E.

    2004-01-01

    The variational nodal method combines spherical harmonics expansions in angle with hybrid finite element techniques is space to obtain multigroup transport response matrix algorithms applicable to both deep penetration and reactor core physics problems. This survey briefly recounts the method's history and reviews its capabilities. The variational basis for the approach is presented and two methods for obtaining discretized equations in the form of response matrices are detailed. The first is that contained the widely used VARIANT code, while the second incorporates newly developed integral transport techniques into the variational nodal framework. The two approaches are combined with a finite sub element formulation to treat heterogeneous nodes. Applications are presented for both a deep penetration problem and to an OECD benchmark consisting of LWR MOX fuel assemblies. Ongoing work is discussed. (Author)

  3. The variational nodal method: some history and recent activity

    International Nuclear Information System (INIS)

    Lewis, E.E.; Smith, M.A.; Palmiotti, G.

    2005-01-01

    The variational nodal method combines spherical harmonics expansions in angle with hybrid finite element techniques in space to obtain multigroup transport response matrix algorithms applicable to a wide variety of reactor physics problems. This survey briefly recounts the method's history and reviews its capabilities. Two methods for obtaining discretized equations in the form of response matrices are compared. The first is that contained the widely used VARIANT code, while the second incorporates more recently developed integral transport techniques into the variational nodal framework. The two approaches are combined with a finite sub-element formulation to treat heterogeneous nodes. Results are presented for application to a deep penetration problem and to an OECD benchmark consisting of LWR Mox fuel assemblies. Ongoing work is discussed. (authors)

  4. Syncope cluster in a patient with vasovagal history.

    Science.gov (United States)

    Zyśko, Dorota; Sokalski, Leszek; Gajek, Jacek; Loboz-Grudzień, Krystyna

    2010-10-01

    We report a case of a 55 year-old man with a history of vasovagal syncope who experienced six unexpected syncopal events over the course of two hours. Two of these occurred in the supine position during ECG monitoring, which showed a long-lasting sinus pause. Before the last syncopal episode, the ECG recording was started at the moment when the patient had the recurrence of presyncopal symptoms. Recordings showed sinus rhythm slowing for 12 s and then sinus arrest lasting for 29 s. A thorough clinical examination revealed no relevant abnormalities. The patient was treated with a permanent pacemaker implantation.

  5. A Closer Look at Siblings of Patients with Schizophrenia: The Association of Depression History and Sex with Cognitive Phenotypes

    Science.gov (United States)

    Wisner, Krista M.; Elvevåg, Brita; Gold, James M.; Weinberger, Daniel R.; Dickinson, Dwight

    2010-01-01

    Background Siblings of patients with schizophrenia show impaired cognition and an increased prevalence of depression history. Although sex has been shown to moderate cognition in patients, this effect has not been examined in siblings. Here we elucidate how a history of depression and sex influences cognition in siblings unaffected by schizophrenia. Methods Unaffected siblings of patients with schizophrenia and unrelated healthy controls were evaluated neuropsychologically and completed structured clinical interviews. Participants with a depression history or no psychiatric history were selected for the sample. Cognitive performance of siblings (n = 366) and controls (n = 680) was first examined. Second, cognition of participants with a depression history and those without a psychiatric history was compared while additionally investigating the role of schizophrenia risk and sex. Results Relative to controls, siblings, with and without a psychiatric history, demonstrated significant (p siblings, but not in controls; whereas sex affected cognition in both siblings and controls. In siblings alone, sex significantly interacted with depression history to influence cognition. This interaction revealed that in male - but not female - siblings a history of depression was associated with greater cognitive impairments. Conclusion A history of depression impairs cognition in siblings, but not in controls. Moreover, depression history interacts with sex and demonstrates that only cognition in male siblings is significantly and additionally compromised by a history of depression. This interaction may be an important consideration for future phenotype and genetic association studies. PMID:21030214

  6. Optic Disc Drusen and Family History of Glaucoma-Results of a Patient-directed Survey.

    Science.gov (United States)

    Gramer, Gwendolyn; Gramer, Eugen; Weisschuh, Nicole

    2017-10-01

    Prospective evaluation of family history (FH) of glaucoma and FH of optic disc drusen (ODD) in patients with sonographically confirmed ODD. A total of 87 patients with ODD interviewed all their first-degree and second-degree relatives using a detailed questionnaire on whether an ophthalmologist had diagnosed or excluded glaucoma or ocular hypertension (OH). Using a second questionnaire, 62 of these patients also provided information about ODD in their FH. Control groups for FH of glaucoma consisted of 2170 patients with glaucoma or OH evaluated with the same methods and identical questions for FH of glaucoma in a previous study, and of 176 healthy individuals without glaucoma or ODD who were interviewed on family history of glaucoma. Glaucoma in FH was significantly more frequent in patients with ODD with an incidence of 20.7% compared with healthy controls with an incidence of 2.8%, and half as frequent as in glaucoma patients with an incidence of 40%. ODD in FH were found in 9.7% of patients with ODD. As there is a high frequency of family history of glaucoma in patients with ODD, evaluation of FH of ODD and FH of glaucoma is essential in patients with ODD. Glaucoma in FH of ODD patients requires intraocular pressure monitoring and whenever deemed beneficial timely initiation of intraocular pressure-lowering therapy.

  7. Medical History of Elderly Patients in the Emergency Setting: Not an Easy Point-of-Care Diagnostic Marker

    Directory of Open Access Journals (Sweden)

    Tobias Lindner

    2015-01-01

    Full Text Available Background. Medical histories are a crucially important diagnostic tool. Elderly patients represent a large and increasing group of emergency patients. Due to cognitive deficits, taking a reliable medical history in this patient group can be difficult. We sought to evaluate the medical history-taking in emergency patients above 75 years of age with respect to duration and completeness. Methods. Anonymous data of consecutive patients were recorded. Times for the defined basic medical history-taking were documented, as were the availability of other sources and times to assess these. Results. Data of 104 patients were included in the analysis. In a quarter of patients (25%, n=26 no complete basic medical history could be obtained. In the group of patients where complete data could be gathered, only 16 patients were able to provide all necessary information on their own. Including other sources like relatives or GPs prolonged the time until complete medical history from 7.3 minutes (patient only to 26.4 (+relatives and 56.3 (+GP minutes. Conclusions. Medical histories are important diagnostic tools in the emergency setting and are prolonged in the elderly, especially if additional documentation and third parties need to be involved. New technologies like emergency medical cards might help to improve the availability of important patient data but implementation of these technologies is costly and faces data protection issues.

  8. Condensed history Monte Carlo methods for photon transport problems

    International Nuclear Information System (INIS)

    Bhan, Katherine; Spanier, Jerome

    2007-01-01

    We study methods for accelerating Monte Carlo simulations that retain most of the accuracy of conventional Monte Carlo algorithms. These methods - called Condensed History (CH) methods - have been very successfully used to model the transport of ionizing radiation in turbid systems. Our primary objective is to determine whether or not such methods might apply equally well to the transport of photons in biological tissue. In an attempt to unify the derivations, we invoke results obtained first by Lewis, Goudsmit and Saunderson and later improved by Larsen and Tolar. We outline how two of the most promising of the CH models - one based on satisfying certain similarity relations and the second making use of a scattering phase function that permits only discrete directional changes - can be developed using these approaches. The main idea is to exploit the connection between the space-angle moments of the radiance and the angular moments of the scattering phase function. We compare the results obtained when the two CH models studied are used to simulate an idealized tissue transport problem. The numerical results support our findings based on the theoretical derivations and suggest that CH models should play a useful role in modeling light-tissue interactions

  9. Molecular Phylogenetic: Organism Taxonomy Method Based on Evolution History

    Directory of Open Access Journals (Sweden)

    N.L.P Indi Dharmayanti

    2011-03-01

    Full Text Available Phylogenetic is described as taxonomy classification of an organism based on its evolution history namely its phylogeny and as a part of systematic science that has objective to determine phylogeny of organism according to its characteristic. Phylogenetic analysis from amino acid and protein usually became important area in sequence analysis. Phylogenetic analysis can be used to follow the rapid change of a species such as virus. The phylogenetic evolution tree is a two dimensional of a species graphic that shows relationship among organisms or particularly among their gene sequences. The sequence separation are referred as taxa (singular taxon that is defined as phylogenetically distinct units on the tree. The tree consists of outer branches or leaves that represents taxa and nodes and branch represent correlation among taxa. When the nucleotide sequence from two different organism are similar, they were inferred to be descended from common ancestor. There were three methods which were used in phylogenetic, namely (1 Maximum parsimony, (2 Distance, and (3 Maximum likehoood. Those methods generally are applied to construct the evolutionary tree or the best tree for determine sequence variation in group. Every method is usually used for different analysis and data.

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

    International Nuclear Information System (INIS)

    Oguzkurt, Levent; Tercan, Fahri; Yildirim, Sedat; Torun, Dilek

    2005-01-01

    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. Evaluation of the patient with an exposure-related disease: the occupational and environmental history.

    Science.gov (United States)

    Papali, Alfred; Hines, Stella E

    2015-03-01

    Although the process of taking an occupational and environmental history has remained largely the same, the context in which it is done has changed dramatically over recent years. This review examines the role of the occupational and environmental history in the context of the changing nature of medical practice and discusses methods for evaluating patients with contemporary exposure-related respiratory illnesses. Surveillance for occupational lung disease using mnemonic devices, screening questions and the use of structured questionnaires can significantly increase the likelihood and accuracy of detection. Electronic health records likewise can be adapted to include the most important elements of the occupational and environmental history. The emergence of new technologies and industries will lead to respiratory diseases in novel occupational and environmental contexts. Using the methods described herein can make detecting these diseases easier and less time-consuming.

  12. Performing dynamic time history analyses by extension of the response spectrum method

    International Nuclear Information System (INIS)

    Hulbert, G.M.

    1983-01-01

    A method is presented to calculate the dynamic time history response of finite-element models using results from response spectrum analyses. The proposed modified time history method does not represent a new mathamatical approach to dynamic analysis but suggests a more efficient ordering of the analytical equations and procedures. The modified time history method is considerably faster and less expensive to use than normal time hisory methods. This paper presents the theory and implementation of the modified time history approach along with comparisons of the modified and normal time history methods for a prototypic seismic piping design problem

  13. Learning History in Early Childhood: Teaching Methods and Children's Understanding

    Science.gov (United States)

    Skjaeveland, Yngve

    2017-01-01

    This article discusses the teaching of history in early childhood education and care centres and children's understanding of history. Based on interviews with eight Norwegian early childhood education and care teachers and on interpretative phenomenological analysis, the article shows how the early childhood education and care centres teach…

  14. Psychological impact of family history risk assessment in primary care: a mixed methods study.

    Science.gov (United States)

    Birt, Linda; Emery, Jon D; Prevost, A Toby; Sutton, Stephen; Walter, Fiona M

    2014-08-01

    Routine family history risk assessment for chronic diseases could enable primary care practitioners to efficiently identify at-risk patients and promote preventive management strategies. To investigate patients' understanding and responses to family history risk assessment in primary care. A mixed methods study set in 10 Eastern England general practices. Participants in a family history questionnaire validation study were triaged into population or increased risk for four chronic diseases (type 2 diabetes, cardiovascular disease, breast cancer, colorectal cancer). Questionnaires completed immediately prior to the family history consultation (baseline) and 4 weeks later (follow-up) assessed the psychological impact, including State-Trait Anxiety Inventory scores. Semi-structured interviews explored the meaning participants gave to their personal familial disease risk. Four hundred and fifty-three participants completed both baseline and follow-up questionnaires and 30 were interviewed. At follow-up, there was no increase in anxiety among either group, or differences between the groups [difference in mean change 0.02, 95% confidence interval -2.04, 2.08, P = 0.98]. There were no significant changes over time in self-rated health in either group. At follow-up, participants at increased risk (n = 153) were more likely to have recent changes to behaviour and they had stronger intentions to make changes to diet (P = 0.001), physical activity (P = 0.006) and to seek further information in the future than those at population risk (n = 300; P assessment for familial risk of chronic diseases may be undertaken in primary care without causing anxiety or reducing self-rated health. Patient responses to family history risk assessment may inform promotion of preventive management strategies. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Trauma history is associated with prior suicide attempt history in hospitalized patients with major depressive disorder.

    Science.gov (United States)

    Brown, Lily A; Armey, Michael A; Sejourne, Corinne; Miller, Ivan W; Weinstock, Lauren M

    2016-09-30

    Although the relationships between PTSD, abuse history, and suicidal behaviors are well-established in military and outpatient samples, little data is available on this relationship in inpatient samples. This study examines the relationships between these variables and related demographic and clinical correlates in a sample of psychiatric inpatients with a diagnosis of major depressive disorder using electronic medical record (EMR) data. Controlling for relevant demographic and clinical variables, PTSD diagnosis and history of abuse were both significantly associated with history of suicide attempt, but in a combined model, only history of abuse remained as a significant predictor. Whereas history of abuse was associated with a history multiple suicide attempts, PTSD diagnosis was not. Both insurance status and gender acted as significant moderators of the relationship between history of abuse and history of suicide attempt, with males and those with public/no insurance having greater associations with history of suicide attempts when an abuse history was present. These data indicate the importance of documentation of PTSD, abuse history, and history of suicide attempts. The results also suggest that in the presence of an abuse history or PTSD diagnosis, additional time spent on safety and aftercare planning following hospital discharge may be indicated. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Quality of family history collection with use of a patient facing family history assessment tool.

    Science.gov (United States)

    Wu, R Ryanne; Himmel, Tiffany L; Buchanan, Adam H; Powell, Karen P; Hauser, Elizabeth R; Ginsburg, Geoffrey S; Henrich, Vincent C; Orlando, Lori A

    2014-02-13

    Studies have shown that the quality of family health history (FHH) collection in primary care is inadequate to assess disease risk. To use FHH for risk assessment, collected data must have adequate detail. To address this issue, we developed a patient facing FHH assessment tool, MeTree. In this paper we report the content and quality of the FHH collected using MeTree. A hybrid implementation-effectiveness study. Patients were recruited from 2009 to 2012. Two community primary care clinics in Greensboro, NC. All non-adopted adult English speaking patients with upcoming appointments were invited to participate. Education about and collection of FHH with entry into MeTree. We report the proportion of pedigrees that were high-quality. High-quality pedigrees are defined as having all the following criteria: (1) three generations of relatives, (2) relatives' lineage, (3) relatives' gender, (4) an up-to-date FHH, (5) pertinent negatives noted, (6) age of disease onset in affected relatives, and for deceased relatives, (7) the age and (8) cause of death (Prim Care31:479-495, 2004.). Enrollment: 1,184. Participant demographics: age range 18-92 (mean 58.8, SD 11.79), 56% male, and 75% white. The median pedigree size was 21 (range 8-71) and the FHH entered into MeTree resulted in a database of 27,406 individuals. FHHs collected by MeTree were found to be high quality in 99.8% (N = 1,182/1,184) as compared to quality of the FHH data that is collected and talking with relatives prior to the collection of FHH significantly improves the quantity and quality of the data provided. This allows more patients to be accurately risk stratified and offered appropriate preventive care guided by their risk level. NCT01372553.

  17. History of Comorbidities and Survival of Ovarian Cancer Patients, Results from the Ovarian Cancer Association Consortium

    DEFF Research Database (Denmark)

    Minlikeeva, Albina N; Freudenheim, Jo L; Eng, Kevin H

    2017-01-01

    carcinoma who participated in 23 studies included in the Ovarian Cancer Association Consortium, we explored associations between histories of endometriosis; asthma; depression; osteoporosis; and autoimmune, gallbladder, kidney, liver, and neurological diseases and overall and progression-free survival...... with ovarian cancer outcome in the overall sample nor in strata defined by histologic subtype, weight status, age at diagnosis, or stage of disease (local/regional vs. advanced).Conclusions: Histories of endometriosis; asthma; depression; osteoporosis; and autoimmune, gallbladder, kidney, liver, or neurologic......Background: Comorbidities can affect survival of ovarian cancer patients by influencing treatment efficacy. However, little evidence exists on the association between individual concurrent comorbidities and prognosis in ovarian cancer patients.Methods: Among patients diagnosed with invasive ovarian...

  18. Clinical Relevance of Trace Bands on Serum Electrophoresis in Patients Without a History of Gammopathy

    Science.gov (United States)

    Gwathmey, TanYa M.; Willis, Monte S.; Tatreau, Jason; Wang, Shaobin; McCudden, Christopher R.

    2015-01-01

    Serum protein electrophoresis (SPE) and immunofixation is commonly used to screen for plasma cell dyscrasias. Interpretation of these tests is qualitative by nature and can yield trace, faint, or scarcely visible immunoglobulin bands (TFS), which can be difficult to classify. Whether these bands should be reported at all is challenging given their unknown clinical significance. In the present study, we retrospectively analyzed 14,036 physician-ordered protein SPE and immunofixation electrophoresis (IFE) tests on serum and urine specimens (from 4,091 patients) during the period of 2000-2010. We found that 17% of all IFE results evaluated for the presence of monoclonal gammopathies (2,389 out of 14,036) contained TFS bands, representing 4.2% (173 out of 4091) of all patients evaluated. Sixty of these patients (42%) had no previous history of gammopathy, and were clinically evaluated over a mean period of up to five years from the original diagnosis of plasma cell pathology. None of these patients had progressed to multiple myeloma, lymphoplasmacytic lymphoma, plasmacytoma, or leukemia. The remaining 82 patients (58%) had a previous history of gammopathy, but had not progressed to any symptomatic plasma cell dyscrasia. Evaluation of these patients was followed for a median period of 4.3 years, with a mean of 21.5 IFE tests per individual. These data suggest that for patients without a previous history of gammopathy, the presence of TFS bands on serum protein electrophoresis does not warrant frequent follow up investigation as commonly practiced. Routine follow up of patients with a prior history of gammopathy, conversely, are warranted and may contribute to overall survival with multiple treatment options now available. For those interpreting IFE results, it may be worth considering these data when composing comments regarding suggested repeat testing frequency by SPE/IFE or alternate test methods. PMID:27683487

  19. Loop electrosurgical excision procedure in Greek patients with vaginal intraepithelial neoplasia and history of cervical cancer.

    Science.gov (United States)

    Terzakis, E; Androutsopoulos, G; Zygouris, D; Grigoriadis, C; Arnogiannaki, N

    2011-01-01

    The aim of our study was to evaluate the therapeutic effectiveness of loop electrosurgical excision procedure (LEEP) in Greek patients with vaginal intraepithelial neoplasia (VAIN) and history of cervical cancer. Between January 2002 and January 2009, eight women with histologically confirmed VAIN and history of cervical cancer were included in our study. For the LEEP procedure we used a high frequency Electrosurgery Unit with at least 80 W output. Complete response rate, at 12 months of follow-up, was 75%. Recurrence rate, at 12 months of follow-up, was 25%. Complete response rate, at 24 months of follow up, was 62.5%. Recurrence rate, at 24 months of follow up, was 37.5%. LEEP may constitute a valuable excisional method for the treatment of VAIN in cases with a history of cervical cancer. It provides an interpretable specimen of the whole lesion within a few minutes. It needs a short period of training and has low cost.

  20. 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.

  1. Communication patterns in audiologic rehabilitation history-taking: audiologists, patients, and their companions.

    Science.gov (United States)

    Grenness, Caitlin; Hickson, Louise; Laplante-Lévesque, Ariane; Meyer, Carly; Davidson, Bronwyn

    2015-01-01

    The nature of communication between patient and practitioner influences patient outcomes. Specifically, the history-taking phase of a consultation plays a role in the development of a relationship and in the success of subsequent shared decision making. There is limited research investigating patient-centered communication in audiology, and this study may be the first to investigate verbal communication in an adult audiologic rehabilitation context. This research aimed, first, to describe the nature of verbal communication involving audiologists, patients, and companions in the history-taking phase of initial audiology consultations and, second, to determine factors associated with communication dynamics. Sixty-three initial audiology consultations involving patients over the age of 55, their companions when present, and audiologists were audio-video recorded. Consultations were coded using the Roter Interaction Analysis System and divided into three consultation phases: history, examination, and counseling. This study analyzed only the history-taking phase in terms of opening structure, communication profiles of each speaker, and communication dynamics. Associations between communication dynamics (verbal dominance, content balance, and communication control) and 11 variables were evaluated using Linear Mixed Model methods. The mean length of the history-taking phase was 8.8 min (range 1.7 to 22.6). A companion was present in 27% of consultations. Results were grouped into three areas of communication: opening structure, information exchange, and relationship building. Examination of the history opening structure revealed audiologists' tendency to control the agenda by initiating consultations with a closed-ended question 62% of the time, followed by interruption of patient talk after 21.3 sec, on average. The aforementioned behaviors were associated with increased verbal dominance throughout the history and increased control over the content of questions. For the

  2. A History of Instructional Methods in Uncontracted and Contracted Braille

    Science.gov (United States)

    D'Andrea, Frances Mary

    2009-01-01

    This literature review outlines the history of the braille code as used in the United States and Canada, illustrating how both the code itself and instructional strategies for teaching it changed over time. The review sets the stage for the research questions of the recently completed Alphabetic Braille and Contracted Braille Study.

  3. Measurement Development in Reflective Supervision: History, Methods, and Next Steps

    Science.gov (United States)

    Tomlin, Angela M.; Heller, Sherryl Scott

    2016-01-01

    This issue of the "ZERO TO THREE" journal provides a snapshot of the current state of measurement of reflective supervision within the infant-family field. In this article, the authors introduce the issue by providing a brief history of the development of reflective supervision in the field of infant mental health, with a specific focus…

  4. History of religious delusions and psychosocial functioning among Mexican patients with paranoid schizophrenia.

    Science.gov (United States)

    Robles-García, Rebeca; López-Luna, Sonia; Páez, Francisco; Escamilla, Raúl; Camarena, Beatriz; Fresán, Ana

    2014-12-01

    The association between global functionality and religiosity among patients from developing and predominantly Catholic countries warrants attention. To compare religiosity and psychosocial functioning in Mexican schizophrenia patients with and without a history of religious delusions, seventy-four patients with paranoid schizophrenia were recruited. Patients with a history of religious delusions had more psychiatric hospitalizations and poorer psychosocial functioning compared with those without a history of religious delusions. No differences emerged between groups in the total scores of religiosity scales. A history of religious delusions rather than religiosity itself may have an influence on psychosocial functioning among Mexican patients with schizophrenia.

  5. Natural history of patients with non cirrhotic portal hypertension: Comparison with patients with compensated cirrhosis.

    Science.gov (United States)

    Gioia, Stefania; Nardelli, Silvia; Pasquale, Chiara; Pentassuglio, Ilaria; Nicoletti, Valeria; Aprile, Francesca; Merli, Manuela; Riggio, Oliviero

    2018-01-31

    The knowledge of natural history of patients with portal hypertension (PH) not due to cirrhosis is less well known than that of cirrhotic patients. To describe the clinical presentation and the outcomes of 89 patients with non-cirrhotic PH (25 with non-cirrhotic portal hypertension, INCPH, and 64 with chronic portal vein thrombosis, PVT) in comparison with 77 patients with Child A cirrhosis. The patients were submitted to a standardized clinical, laboratory, ultrasonographic and endoscopic follow-up. Variceal progression, incidence of variceal bleeding, portal vein thrombosis, ascites and survival were recorded. At presentation, the prevalence of varices, variceal bleeding and ascites was similar in the 3 groups. During follow-up, the rate of progression to varices at risk of bleeding (p portal hypertension in these patients and cannot be simply derived by the observation of cirrhotic patients. Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  6. The validity of the family history method for identifying Alzheimer disease.

    Science.gov (United States)

    Li, G; Aryan, M; Silverman, J M; Haroutunian, V; Perl, D P; Birstein, S; Lantz, M; Marin, D B; Mohs, R C; Davis, K L

    1997-05-01

    To examine the validity of the family history method for identifying Alzheimer disease (AD) by comparing family history and neuropathological diagnoses. Seventy-seven former residents of the Jewish Home and Hospital for the Aged, New York, NY, with neuropathological evaluations on record were blindly assessed for the presence of dementia and, if present, the type of dementia through family informants by telephone interviews. The Alzheimer's Disease Risk Questionnaire was used to collect demographic information and screen for possible dementia. If dementia was suspected, the Dementia Questionnaire was administered to assess the course and type of dementia, i.e., primary progressive dementia (PPD, likely AD), multiple infarct dementia, mixed dementia (i.e., PPD and multiple infarct dementia), and other dementias based on the modified Diagnostic and Statistical Manual of Mental Disorders, Third Edition, criteria. Sixty (77.9%) of 77 elderly subjects were classified as having dementia and 17 (22.1%) were without dementia by family history evaluation. Of the 60 elderly subjects with dementia, 57 (95%) were found at autopsy to have had neuropathological changes related to dementia. The sensitivity of the family history diagnosis for dementia with related neuropathological change was 0.84 (57 of 68) and the specificity was 0.67 (6 of 9). Using family history information to differentiate the type of dementia, the sensitivity for definite or probable AD (with or without another condition) was 0.69 (36 of 51) and the specificity was 0.73 (19 of 26). The majority (9 of 15) of patients testing false negative for PPD had a history of stroke associated with onset of memory changes, excluding a diagnosis of PPD. Identifying dementia, in general, and AD, in particular, has an acceptable sensitivity and specificity. As is true for direct clinical diagnosis, the major issue associated with misclassifying AD in a family history assessment is the masking effects of a coexisting non

  7. Survival Rate of Dental Implants in Patients with History of Periodontal Disease: A Retrospective Cohort Study.

    Science.gov (United States)

    Correia, Francisco; Gouveia, Sónia; Felino, António Campos; Costa, Ana Lemos; Almeida, Ricardo Faria

    To evaluate the differences between the survival rates of implants placed in patients with no history of periodontal disease (NP) and in patients with a history of chronic periodontal disease (CP). A retrospective cohort study was conducted in which all consenting patients treated with dental implants in a private clinic in Oporto, Portugal, from November 2, 2002 through February 11, 2011 were included. All patients were treated consecutively by the same experimental operator. This study aimed to analyze how the primary outcomes (presence of disease, time of placement, and time of loading) and the secondary outcomes (severity-generalized periodontitis, brand, implant length, prosthesis type, prosthesis metal-ceramic extension) influence the survival rate of dental implants. The survival analysis was performed through the Kaplan-Meier method, and the equality of survival distributions for all groups was tested with the log-rank test with a significance level of .05 for all comparisons. The sample consisted of 202 patients (47% NP and 53% CP) and 689 implants (31% NP and 69% CP). The survival rate in the NP and CP groups showed no statistically significant differences (95.8% versus 93.1%; P ≥ .05). Implants were lost before loading in 54.9% of the cases. The majority of the implants were lost in the first year and stabilized after the second year. Survival rates in the NP and CP patients showed no statistically significant differences when comparing the following factors: subclassification of the disease, implant brands, implant length (short/standard), type of prosthesis, extension of the prosthesis metal-ceramic, and time of placement and loading (P ≥ .05). This work disclosed no statistically significant differences in terms of survival rates when compared with the control group. Placing implants in patients with a history of periodontal disease appears to be viable and safe.

  8. The Relationship between Thyroid Function and Recent History of Suicide Attempt in Patients with Major Depression

    Directory of Open Access Journals (Sweden)

    Abbas Eshraghi

    2016-03-01

    Full Text Available Background and Objectives: Todays, evaluation of the relationship between thyroid function and some psychiatric diseases have been identified. However, studies on the relationship between thyroid function and suicide attempt are limited. The present study was carried out with the aim of evaluating thyroid function in patients attempting suicide. Methods: In this descriptive analytical study during the years 2011 and 2012, 88 patients with major depression and recent history of suicide attemp and 89 patients with major depression without history of recent suicide, who were hospitalized in the psychiatric ward of Hazrat Rasoul Akram Hospital in Tehran, were included in the study. The studied variables in this research included demographic variables, such as age, gender as well as clinical findings, such as thyroid function tests, including TSH, T3, T4. thyroid function tests were requested for patients when hospitalized with a diagnosis of major depression during the years 2011 and 2012, that these values were extracted from the patients’ medical records. Results: The two groups were matched in terms of age and gender. In patients with recent suicide attempt, 5 (5.6% cases of clinical hypothyroidism and 6 (6.8% cases of subclinical hypothyroidism, were reported. In the major depression patients without recent suicide attempt, there were 3 (3.3% cases of clinical hypothyroidism and 6 (6.7% cases of subclinical hypothyroidism, and the two groups had no significant difference in terms of the incidence of thyroid disease (p=0.75. Conclusion: According to the results of the present study, lower levels of T3 and T3 to T4 ratio can be one of the factors related to the recent history of suicide in patients with major depression.

  9. Atmospheric Metal Pollutants-Archives, Methods, and History

    International Nuclear Information System (INIS)

    Norton, Stephen A.

    2007-01-01

    Pollution of the atmosphere with cadmium (Cd), mercury (Hg), and lead (Pb) is a consequence of human activities. Natural archives are necessary to reconstruct the long-term history of metal deposition because accurate measurement of atmospheric deposition is a recent accomplishment. Reconstructions require: (1) accurate determination of concentrations of elements and isotopes, (2) accurate chronology of archives, and (3) archives that faithfully record atmosphere deposition. The most useful long-term archives are accumulations of ice and snow, peat, and lake sediment. Quantification of Cd deposition is uncommon because of its low concentration and substantial chemical mobility. Nonetheless, trends in peat and lake sediment are similar to those of Hg and Pb since ca. 1800 a.d. Both Hg and Pb are relatively chemically immobile and thus the peat and lake archives are believed to record historic trends of atmospheric deposition. Isotopic and concentration studies of Pb indicate a history of northern hemisphere atmospheric pollution extending back prior to 0 a.d. Although measurements of Hg concentration are now routine, isotopic measurements are in their infancy. Some Hg pollution sources have unique isotopic ratios, thereby contributing unique signals to the total Hg. Maximum accumulation rates of Hg and Pb occur up to 10 years later than for Cd (1970s versus 1960s in eastern North America, perhaps slightly later in Europe). By 2004, deposition of Cd, Hg, and Pb had declined from peak values in eastern North America more than 75, 75, and 90%, respectively

  10. History of the use of system method in research of properties of criminality

    Directory of Open Access Journals (Sweden)

    В. Ф. Оболенцев

    2013-10-01

    Full Text Available The article is devoted history of system method in criminology. Maintenance of criminology theories, offered the Ukrainian scientists is exposed. Perspective of the use of system method in criminology researches is grounded.

  11. 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

    AIMS: To estimate and illustrate how the 10 years of weight change immediately preceding diabetes diagnosis vary with weight at the age of 20 years and with socio-demographic variables, risk factors and comorbidities at diagnosis. METHODS: Data were from a population-based cohort of 1320 persons...... 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.......3 years was 14.7 kg (interquartile range 6.0-23.0). Women gained weight more than men, and the lower the weight at age 20 years, the greater the weight gain. The average weight gain from 10 years prior to diabetes diagnosis until diagnosis, however, was only 1 kg and decreased markedly with age. These 10...

  12. A time-domain method to generate artificial time history from a given reference response spectrum

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Gang Sik [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of); Song, Oh Seop [Dept. of Mechanical Engineering, Chungnam National University, Daejeon (Korea, Republic of)

    2016-06-15

    Seismic qualification by test is widely used as a way to show the integrity and functionality of equipment that is related to the overall safety of nuclear power plants. Another means of seismic qualification is by direct integration analysis. Both approaches require a series of time histories as an input. However, in most cases, the possibility of using real earthquake data is limited. Thus, artificial time histories are widely used instead. In many cases, however, response spectra are given. Thus, most of the artificial time histories are generated from the given response spectra. Obtaining the response spectrum from a given time history is straightforward. However, the procedure for generating artificial time histories from a given response spectrum is difficult and complex to understand. Thus, this paper presents a simple time-domain method for generating a time history from a given response spectrum; the method was shown to satisfy conditions derived from nuclear regulatory guidance.

  13. A time-domain method to generate artificial time history from a given reference response spectrum

    International Nuclear Information System (INIS)

    Shin, Gang Sik; Song, Oh Seop

    2016-01-01

    Seismic qualification by test is widely used as a way to show the integrity and functionality of equipment that is related to the overall safety of nuclear power plants. Another means of seismic qualification is by direct integration analysis. Both approaches require a series of time histories as an input. However, in most cases, the possibility of using real earthquake data is limited. Thus, artificial time histories are widely used instead. In many cases, however, response spectra are given. Thus, most of the artificial time histories are generated from the given response spectra. Obtaining the response spectrum from a given time history is straightforward. However, the procedure for generating artificial time histories from a given response spectrum is difficult and complex to understand. Thus, this paper presents a simple time-domain method for generating a time history from a given response spectrum; the method was shown to satisfy conditions derived from nuclear regulatory guidance

  14. Teaching issues of contemporary history using historical sources and modern teaching methods

    Directory of Open Access Journals (Sweden)

    Gruber Gabriela

    2017-01-01

    Full Text Available The study of history is becoming increasingly less interesting to students, despite the fact that the history teaching process has been continuously modernized during recent years. It is an observation which can be perceived even if we don`t make an elaborated research in the field. Some empirical data show us that students in secondary and High Schools are less interested in studying History than in studying Geography or other social sciences. The number of students who are determined to study History in universities has significantly dropped in recent years [1]. Of course, there are multiple causes and the factors behind this change are numerous and varied. In this paper we handle only some changes in teaching History in High Schools, as they are designed in History Curricula and in History textbooks. Therefore during the first sequence of this paper we shall analyze the History Curricula for High School, 11th and 12th grades, regarding their finalities (competencies, some relevant contents and the recommended pedagogical approaches about the teaching methods and the auxiliary material. In the second part of the paper we propose some teaching activities through which students would practice the specific competencies from their Curriculum for History. We aim at presenting attractive teaching material and learning methods and applying the methodological recommendations from the High school Curricula for History, 11th and 12th grades.

  15. Association of abuse history with symptom severity and quality of life in patients with fibromyalgia.

    Science.gov (United States)

    Jiao, Juan; Vincent, Ann; Cha, Stephen S; Luedtke, Connie A; Oh, Terry H

    2015-03-01

    A high prevalence of abuse has been reported in patients with fibromyalgia. We aimed to examine the association between self-reported abuse history and symptom severity and quality of life (QOL) in 962 patients with fibromyalgia. All patients completed the Fibromyalgia Impact Questionnaire (FIQ) and the Short Form 36 health survey (SF-36). Multivariate regression analyses were performed. In total, 289 patients (30%) reported a history of abuse. Of those who specified abuse types, 161 patients (59%) reported more than 1 type of abuse (36% emotional, 32% physical, 25% sexual, and 7% verbal). Patients in the abuse group were younger and more likely to be female, unemployed, unmarried, and current smokers compared with patients who reported no abuse. After adjusting for these differences, abuse history was associated with worse symptoms, as indicated by a higher FIQ total score (P history was associated with worse QOL, with lower SF-36 scores in all domains except the physical component summary. In conclusion, abuse history in patients with fibromyalgia was associated with worse symptoms and QOL compared with those patients without abuse history. Future studies are needed to assess whether additional tailored interventions as part of fibromyalgia treatment are helpful for patients with a history of abuse.

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

    Science.gov (United States)

    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

  17. Mathematics and history: history and analysis epistemology: from exhaustion method to defined integral

    Directory of Open Access Journals (Sweden)

    Mario Mandrone

    2015-06-01

    Full Text Available The creation of the calculation (differential, in the terminology of Leibniz, bending in that of Newton is the event that, in the second half of the seventeenth century, marked, in a sense, the transition from classical to modern mathematics. The aim of this work is a historical analysis of the rigor and epistemological question and the "metaphysics" of calculus that takes account of the methods of the ancient (eg. Of Archimedes' method of exhaustion, as well as interpretations of Leibniz and Newton and their successors. The problem of searching for a sure foundation on which to base the calculus, glimpsed by D'Alembert in the theory of limits and taken up by Lagrange to the theory of infinite series, and that the derivative functions, found in Cachy the pioneer of a new way to seek rigor in analysis. The Cauchy setting will be tightened by Weierstrass in the second half of the 800 with the definition of limit, with the epsilon-delta method, which in turn is based on definitions concerning the real numbers. In this sense we speak of "arithmetisation" analysis.         Matematica e storia: storia ed epistemologia dell’analisi: dal metodo  di esaustione  all’integrale  definito La creazione del calcolo (differenziale, nella terminologia leibniziana flessionale in quella di Newton è l’evento che, nella seconda metà del seicento, ha segnato, in un certo senso, il passaggio dalla matematica classica a quella moderna. Obiettivo del presente lavoro è una analisi storica ed epistemologica della questione del rigore e della “metafisica” del calcolo infinitesimale che tenga conto dei metodi degli antichi (ad es.  del metodo di esaustione di Archimede, nonché delle interpretazioni di Leibniz e Newton e dei loro successori. Il problema della ricerca di un fondamento sicuro su cui basare il calcolo infinitesimale, intravisto da D’Alembert nella teoria dei limiti e ripreso da Lagrange con la teoria delle serie infinite e quella delle

  18. Model-murderers. Afterthoughts on the Goldhagen method and history

    NARCIS (Netherlands)

    Lorenz, C.F.G.

    2002-01-01

    This article analyses the theoretical and methodological structure of Goldhagen's book Hitler's Willing Executioners. It argues that the paradoxical success of HWE can better be understood when its paradoxical implicit theory and method are understood. Although Goldhagen claims that HWE embodies an

  19. Prognostic significance of cancer family history for patients with gastric cancer: a single center experience from China.

    Science.gov (United States)

    Liu, Xiaowen; Cai, Hong; Yu, Lin; Huang, Hua; Long, Ziwen; Wang, Yanong

    2016-06-14

    Family history of cancer is a risk factor for gastric cancer. In this study, we investigated the prognoses of gastric cancer patients with family history of cancer. A total of 1805 gastric cancer patients who underwent curative gastrectomy from 2000 to 2008 were evaluated. The clinicopathologic parameters and prognoses of gastric cancer patients with a positive family history (PFH) of cancer were compared with those with a negative family history (NFH). Of 1805 patients, 382 (21.2%) patients had a positive family history of cancer. Positive family history of cancer correlated with younger age, more frequent alcohol and tobacco use, worse differentiation, smaller tumor size, and more frequent tumor location in the lower 1/3 of the stomach. The prognoses of patients with a positive family history of cancer were better than that of patients with a negative family history. Family history of cancer independently correlated with better prognosis after curative gastrectomy in gastric cancer patients.

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

    Science.gov (United States)

    Slack, Warner V; 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.

  1. The prognostic value of family history among patients with urinary bladder cancer.

    Science.gov (United States)

    Egbers, Lieke; Grotenhuis, Anne J; Aben, Katja K; Alfred Witjes, J; Kiemeney, Lambertus A; Vermeulen, Sita H

    2015-03-01

    A history of urinary bladder cancer (UBC) in first-degree relatives increases UBC risk by twofold. The influence of positive family history on UBC prognosis is unknown. Here, we investigated association of first-degree UBC family history with clinicopathological characteristics and prognosis of UBC patients. Detailed clinical data of 1,465 non-muscle-invasive bladder cancer (NMIBC) and 250 muscle-invasive or metastatic bladder cancer (MIBC) patients, diagnosed from 1995 to 2010, were collected through medical file review. Competing risk analyses were used to compare recurrence-free survival (RFS) and progression-free survival (PFS) of NMIBC patients according to self-reported UBC family history. Overall survival in MIBC patients was estimated using Kaplan-Meier analysis. The added value of family history in prediction of NMIBC prognosis was quantified with Harrell's concordance-index. Hundred (6.8%) NMIBC and 14 (5.6%) MIBC patients reported UBC in first-degree relatives. Positive family history was statistically significantly associated with smaller tumor size and non-significantly with more favorable distribution of other tumor characteristics. In univariable analyses, positive family history correlated with longer RFS (p = 0.11) and PFS (p = 0.04). Hazard ratios for positive vs. negative family history after adjustment for clinicopathological characteristics were 0.75 (95% CI = 0.53-1.07) and 0.45 (95% CI = 0.18-1.12) for RFS and PFS, respectively. Five familial and 48 sporadic MIBC patients (Kaplan-Meier 10-year risk: 41% and 25%) died within 10 years. Family history did not improve the c-index of prediction models. This study shows that a first-degree family history of UBC is not clearly associated with NMIBC prognosis. Family history does not aid in prediction of NMIBC recurrence or progression. © 2014 The Authors. Published by Wiley Periodicals, Inc. on behalf of UICC.

  2. Sending family history questionnaires to patients before a colonoscopy improves genetic counseling for hereditary colorectal cancer.

    Science.gov (United States)

    Kessels, Koen; Eisinger, Joey D; Letteboer, Tom G; Offerhaus, G Johan A; Siersema, Peter D; Moons, Leon M G

    2017-06-01

    To investigate whether sending a family history questionnaire to patients prior to undergoing colonoscopy results in an increased availability of family history and better genetic counseling. A questionnaire was mailed to patients before they underwent outpatient colonoscopy at a university hospital in 2013. These patients' additional characteristics and referral for genetic evaluation were retrieved from the electronic medical records. Patients undergoing inpatient coloboscopy, with confirmed hereditary colorectal cancer (CRC) or inflammatory bowel disease were excluded. All study patients from 2010 to 2013 were matched with the database of the genetics department to determine who consulted a geneticist. A total of 6163 patients underwent colonoscopy from 2010 to 2013. Of 1421 who underwent colonoscopy in 2013, 53 (3.7%) consulted a geneticist, while 75 (1.6%) of 4742 patients undergoing colonoscopy between 2010 and 2012 did so (P history was not recorded in the electronic medical records of 393 (40.3%). In 129 (32.8%), family history was obtained from the completed questionnaire. In 2013, 49 (60.5%) out of 81 patients referred for genetic counseling were referred based on their family history. Eight (9.9%) patients were referred based on the completed questionnaire. Screening for hereditary CRC in a population undergoing outpatient colonoscopy with a questionnaire sent by mail resulted in an increased availability of family histories and genetic counseling. © 2017 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  3. History of hypertension, heart disease, and diabetes and ovarian cancer patient survival

    DEFF Research Database (Denmark)

    Minlikeeva, Albina N; Freudenheim, Jo L; Cannioto, Rikki A

    2017-01-01

    has not been studied extensively, particularly according to histological subtype. METHODS: Using pooled data from fifteen studies participating in the Ovarian Cancer Association Consortium, we examined the associations between history of hypertension, heart disease, diabetes, and medications taken...... strata of histological subtypes. RESULTS: History of diabetes was associated with increased risk of mortality (n = 7,674; HR = 1.12; 95% CI = 1.01-1.25). No significant mortality associations were observed for hypertension (n = 6,482; HR = 0.95; 95% CI = 0.88-1.02) or heart disease (n = 4,252; HR = 1...... was inversely associated with mortality, HR = 0.71; 95% CI = 0.53-0.94. CONCLUSIONS: Histories of hypertension, diabetes, and use of diuretics, beta blockers, insulin, and oral antidiabetic medications may influence the survival of ovarian cancer patients. Understanding mechanisms for these observations could...

  4. [Incidence of asthmatic attack during anesthesia in patients with a history of bronchial asthma].

    Science.gov (United States)

    Nonaka, M; Sakanashi, Y; Sugahara, K; Terasaki, H

    1999-07-01

    We investigated retrospectively, the incidence of intraoperative asthmatic attack in patients with bronchial asthma, and compared the past 5-year period (Jan 1, 1979 to Dec 31, 1983) and the recent 5-year period (July 1, 1990 to June 30, 1994). The influence of anesthetic methods, induction agents, and intervals between the most recent attack and anesthesia were evaluated. The incidence of the attack during anesthesia in patients with asthma was similar in both period, 6.7% in the past and 7.8% in the recent period. Patients who had a history of recurrent attacks within 2 years prior to anesthesia tended to have higher incidence of intraoperative attack in both periods. Furthermore, the incidence of asthmatic attack was significantly greater in patients receiving inhalational anesthetics for induction of anesthesia than in those given intravenous anesthetics in the recent period. Although inhalational anesthetics are considered to be used safely for asthmatic patients, care should be taken when volatile anesthetics are administered to asthmatic patients during induction of anesthesia.

  5. 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...... non-systolic CHF, and 57% had ischaemic heart disease. SETTING: 38 primary, secondary and tertiary hospitals in Denmark. MAIN OUTCOME MEASURES: Total mortality 5-8 years after inclusion in the registry. RESULTS: Female sex and preserved left ventricular systolic function was more common among patients...... with a history of hypertension. 72% of the patients died during follow up. A hypertension history did not affect mortality risk (hazard ratio (HR) 0.99, 95% confidence interval (CI) 0.92 to 1.07). Correction for differences between the normotensive and hypertensive groups at baseline in a multivariate model did...

  6. [The role of chronic gastritis in past medical history with NSAID administration in patients with osteoarthrosis].

    Science.gov (United States)

    Zak, M Iu

    2014-11-01

    122 patients with osteoarthrosis, who have in the past medical history verified chronic gastritis (50 males and 72 females) at the age from 42 to 64 have been examined. Control group was comprised of 40 patients with osteoarthrosis without gastroduodenal zone pathology in the past medical history. For arthralgia relief patients were prescribed meloxicam (average dose--12.5 - 1.39 mg daily) or nimesulide (average dose--150 ± 14.91 mg daily). As a result of this research it was determined that administration of selective NSAID (meloxicam and nimesulide) in patients with chronic gastritis in the past medical history raised the risk of NSAID gastropathy/dyspepsia 2.9 times (P 0.05) of erosive gastropathy. Patients with chronic gastritis in the past medical history when taking NSAID with the purpose of gastropathy prevention are recommended to undergo gastroprotective therapy.

  7. Frequency of persistant backache in patients of spinal anaesthesia in the absence of prior history of backache

    International Nuclear Information System (INIS)

    Farhat, N.; Rahman, F.U.; Gujua, S.K.

    2013-01-01

    To determine the frequency of persistant backache in patients of spinal anaesthesia in the absence of prior history of bachache. Study Design: Quasi experimental study. Place and Duration of Study: CMH Kharian from May 2008 to Sep 2009. Methods: Total 150 patients who were admitted at CMH Kharian during the study period were included in the study. The selection criteria included male and female patients above twenty years of age due for elective gynaecological, orthopaedics, urology and general surgical procedures. Only 112 patients reported for complete follow up for one year. Out of 112 patients, 61.6% were males while 38.4% were females. All patients with prior history of back pain were excluded from the study. Results: At the end of one year the frequency of persistent back pain after one year of spinal anaesthesia is (1/112) 0.89% in the absence of previous history of back pain. Conclusion: The results of this study indicate that frequency of persistant back pain after spinal anaesthesia in the absence of previous history of back pain is very low. (author)

  8. The effective and preventive factors of taking patients\\' history from the viewpoint of the students of Birjand Medical School in 2010-2011

    Directory of Open Access Journals (Sweden)

    Z. Khazaee

    2013-06-01

    Full Text Available Introduction: Taking patients' history and doing physical examinations help physicians to diagnose correctly and treat accordingly. There are several factors which may affect the quality of taking patients' history. This study aims to assess determinants of taking patients' history from the viewpoint of the students of Birjand Medical School. Methods: This descriptive study was carried out in 2010-2011 on all 137 medical trainees and interns studying at Birjand Medical School. To determine the students’ attitudes towards history taking and to evaluate their performance a questionnaire and a check-list were used, respectively. The data analyzed using SPSS software. Descriptive-deductive statistics (T-test were applied on the data. Results: The average score of the motivational factors was more than the preventive factors. Among the motivational factors, the statement “taking patient history is a basis of proper diagnosis and treatment” (3.58 and among the preventive factors the statement “taking patient history just to evade responsibility”(2.57had the highest scores. Moreover, there was a significant difference between the performance of trainees and interns in taking and recording patients’ history (P<0.005. Conclusion: Although the students held a positive attitude toward taking patients' history, they didn’t have satisfactory performance in recording disease symptoms, diagnosis and treatment plans this entails more attention. Observation of trainers on the process of history taking may help.

  9. Oral history and memories of Hansen's disease patients in two Colombian leper colonies: life trajectories, conflicts and resistance strategies.

    Science.gov (United States)

    Botero-Jaramillo, Natalia; Mora-Blanco, Jessica; Quesada-Jiménez, Nelson Daniel

    2017-01-01

    The paper examines the oral history of Hansen's disease in two Colombian communities that were leper colonies until 1961. The oral history around the disease allows us to connect individuals' memories with collective memory. This history remains an oral one, and few academic studies have documented it. We use oral history as a qualitative research method in order to analyze how the patients and those who lived alongside them positioned themselves in terms of the disease and how it permeated their entire existence, re-signifying the concepts of health and disease, normality and abnormality. We examine how, over the course of their lives, they engaged in resistance strategies that allowed them to get closer to normality, in their own sociocultural terms.

  10. The History of Infant Formula: Quality, Safety, and Standard Methods.

    Science.gov (United States)

    Wargo, Wayne F

    2016-01-01

    Food-related laws and regulations have existed since ancient times. Egyptian scrolls prescribed the labeling needed for certain foods. In ancient Athens, beer and wines were inspected for purity and soundness, and the Romans had a well-organized state food control system to protect consumers from fraud or bad produce. In Europe during the Middle Ages, individual countries passed laws concerning the quality and safety of eggs, sausages, cheese, beer, wine, and bread; some of these laws still exist today. But more modern dietary guidelines and food regulations have their origins in the latter half of the 19th century when the first general food laws were adopted and basic food control systems were implemented to monitor compliance. Around this time, science and food chemistry began to provide the tools to determine "purity" of food based primarily on chemical composition and to determine whether it had been adulterated in any way. Since the key chemical components of mammalian milk were first understood, infant formulas have steadily advanced in complexity as manufacturers attempt to close the compositional gap with human breast milk. To verify these compositional innovations and ensure product quality and safety, infant formula has become one of the most regulated foods in the world. The present paper examines the historical development of nutritional alternatives to breastfeeding, focusing on efforts undertaken to ensure the quality and safety from antiquity to present day. The impact of commercial infant formulas on global regulations is addressed, along with the resulting need for harmonized, fit-for-purpose, voluntary consensus standard methods.

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

    Science.gov (United States)

    Levy-Shraga, Yael; Cohen, Rinat; Ben Ami, Michal; Yeshayahu, Yonatan; Temam, Vered; Modan-Moses, Dalit

    2015-01-01

    Background 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. Methods Case-control study of 143 pediatric patients with a history of malignancy (aged 11.2±4.6y, Male = 68, mean interval from diagnosis 4.4±3.8y) and 150 healthy controls (aged 10.4±4.8y, Male = 67). Sun exposure and protection habits were assessed using validated questionnaires. Results Patients and controls reported similar sun exposure time during weekdays (94±82minutes/day vs. 81±65minutes/day; p = 0.83), while during weekends patients spent significantly less time outside compared to controls (103±85minutes/day vs. 124±87minutes/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. Conclusions 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. PMID:26348212

  12. Problematic Methods in teaching Modern History. An alternative or a necessity?

    Directory of Open Access Journals (Sweden)

    Yohany Peralta Pérez

    2012-06-01

    Full Text Available The article presents the results of the analysis from the study of the theoretical research on the use of problematic methods in Teaching Learning Process of Modern H istory course in Rafael Maria de Mendive University of Pinar del Rio. An anal ysis o f the use of problematic methods in the Process of Teaching Modern History course from the definition of method taking into account the theoretical assumptions of scholars of the subject matter and the advantages and disadvantages provided by the use of these methods in the Teaching Learning Process of Modern History course.

  13. Characteristics and risk factors of cerebrovascular accidents after percutaneous coronary interventions in patients with history of stroke.

    Science.gov (United States)

    Zhang, Hua; Feng, Li-qun; Bi, Qi; Wang, Yu-ping

    2010-06-01

    Percutaneous coronary intervention (PCI) is a well-established method for managing coronary diseases. However, the increasing use of PCI has led to an increased incidence of acute cerebrovascular accidents (CVA) related to PCI. In this study, we investigated the characteristics and risk factors of CVA after PCI in patients with known stroke history. Between January 1, 2005 and March 1, 2009, 621 patients with a history of stroke underwent a total of 665 PCI procedures and were included in this retrospective study. Demographic and clinical characteristics, previous medications, procedures, neurologic deficits, location of lesion and in-hospital clinical outcomes of patients who developed a CVA after the cardiac catheterization laboratory visit and before discharge were reviewed. Acute CVA was diagnosed in 53 (8.5%) patients during the operation or the perioperative period. Seventeen patients suffered from transient ischemic attack, thirty-four patients suffered from cerebral infarction and two patients suffered from cerebral hemorrhage. The risk factors for CVA after PCI in stroke patients were: admission with an acute coronary syndrome, use of an intra-aortic balloon pump, urgent or emergency procedures, diabetes mellitus, and poor left ventricular systolic function, arterial fibrillation, previous myocardial infarction, dyslipidemia, tobacco use, and no/irregular use of anti-platelet medications. The incidence of CVA during and after PCI in patients with history of stroke is much higher than that in patients without history of stroke. Patients with atrial fibrillation, previous myocardial infarction, diabetes mellitus, dyslipidemia, tobacco use, and no or irregular use of anti-platelet medications were at higher risk for recurrent stroke. This study showed a strong association between acute coronary syndromes and in-hospital stroke after PCI.

  14. Comparison of LMFBR piping response obtained using response spectrum and time history methods

    International Nuclear Information System (INIS)

    Hulbert, G.M.

    1981-04-01

    The dynamic response to a seismic event is calculated for a piping system using a response spectrum analysis method and two time history analysis methods. The results from the analytical methods are compared to identify causes for the differences between the sets of analytical results. Comparative methods are also presented which help to gain confidence in the accuracy of the analytical methods in predicting piping system structure response during seismic events

  15. Producing accurate wave propagation time histories using the global matrix method

    International Nuclear Information System (INIS)

    Obenchain, Matthew B; Cesnik, Carlos E S

    2013-01-01

    This paper presents a reliable method for producing accurate displacement time histories for wave propagation in laminated plates using the global matrix method. The existence of inward and outward propagating waves in the general solution is highlighted while examining the axisymmetric case of a circular actuator on an aluminum plate. Problems with previous attempts to isolate the outward wave for anisotropic laminates are shown. The updated method develops a correction signal that can be added to the original time history solution to cancel the inward wave and leave only the outward propagating wave. The paper demonstrates the effectiveness of the new method for circular and square actuators bonded to the surface of isotropic laminates, and these results are compared with exact solutions. Results for circular actuators on cross-ply laminates are also presented and compared with experimental results, showing the ability of the new method to successfully capture the displacement time histories for composite laminates. (paper)

  16. 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.

  17. Analysis of differences in exercise recognition by constraints on physical activity of hospitalized cancer patients based on their medical history.

    Science.gov (United States)

    Choi, Mi-Ri; Jeon, Sang-Wan; Yi, Eun-Surk

    2018-04-01

    The purpose of this study is to analyze the differences among the hospitalized cancer patients on their perception of exercise and physical activity constraints based on their medical history. The study used questionnaire survey as measurement tool for 194 cancer patients (male or female, aged 20 or older) living in Seoul metropolitan area (Seoul, Gyeonggi, Incheon). The collected data were analyzed using frequency analysis, exploratory factor analysis, reliability analysis t -test, and one-way distribution using statistical program SPSS 18.0. The following results were obtained. First, there was no statistically significant difference between cancer stage and exercise recognition/physical activity constraint. Second, there was a significant difference between cancer stage and sociocultural constraint/facility constraint/program constraint. Third, there was a significant difference between cancer operation history and physical/socio-cultural/facility/program constraint. Fourth, there was a significant difference between cancer operation history and negative perception/facility/program constraint. Fifth, there was a significant difference between ancillary cancer treatment method and negative perception/facility/program constraint. Sixth, there was a significant difference between hospitalization period and positive perception/negative perception/physical constraint/cognitive constraint. In conclusion, this study will provide information necessary to create patient-centered healthcare service system by analyzing exercise recognition of hospitalized cancer patients based on their medical history and to investigate the constraint factors that prevents patients from actually making efforts to exercise.

  18. History taking in TB patients at Likuni mission hospital in Malawi ...

    African Journals Online (AJOL)

    In the file audit for patients diagnosed and treated at Likuni Mission Hospital from January to July 1997 the results show unsystematic recording of patient history. Out of 88 case notes reviewed none contained patients' events before diagnosis was made. 34% had no duration of symptoms recorded and 19% had no ...

  19. Limitations of the condensed history method for low-energy electrons

    International Nuclear Information System (INIS)

    Martin, W.R.; Ballinger, C.T.; Rathkopf, J.A.

    1991-01-01

    A systematic evaluation of the conventional, condensed history electron transport methodology has been performed through comparisons with more accurate single-scatter Monte Carlo calculations. These comparisons highlight the inaccuracies associated with the condensed history method and indicate its range of validity. The condensed history method is used in codes such as MCNP4, SANDYL, ETRAN, ITS, and EGS and requires a number of restrictive assumptions about the scattering characteristics to make tractable the analytical solution to the infinite-medium transport equation. Distributions describing electron characteristics after multiple collisions (multiscatter distributions) are constructed from such solutions and serve as the heart of the condensed history codes. A two-level approach is taken to quantify the errors inherent in condensed history. First, conventional condensed history multiscattering distributions in energy and angle are compared directly with analogous distributions generated with a single-scatter Monte Carlo code. This recently developed code directly simulates individual electron interactions. Second, the conventional distributions are replaced in the condensed history code by distributions constructed via a single-scatter Monte Carlo simulation

  20. Is prevalence of colorectal polyps higher in patients with family history of colorectal cancer?

    Directory of Open Access Journals (Sweden)

    Sthela Maria Murad-Regadas

    2015-07-01

    Full Text Available Objectives: To assess the prevalence of polyps in patients with a family history of colorectal cancer, in comparison to asymptomatic individuals with indication for screening. Methods: A prospective study in a group of patients who underwent colonoscopy between 2012 and 2014. Patients were divided into two groups: Group I: no family history of colorectal cancer, and Group II: with a family history in first-degree relatives. Demographic characteristics, findings on colonoscopy, presence, location and histological type of polyps were evaluated, comparing the two groups. Results: 214 patients were evaluated: 162 in Group I and 52 in Group II. The distribution of patients with polyps was similar in relation to gender: polyps were evidenced in Group I in 33 (20% female patients vs. 10 (6% male patients (p = 1.00; in Group II, the presence of polyps was evidenced in 9 (17% female patients vs. 2 (4% male patients (p = 1.00. Polypoid lesions were found in 54 patients (25%, with 43 (26% in Group I and 11 (21% in Group II. The prevalence of adenomas was similar in both groups (Group I = 18/37% vs. Group II = 10/50% (p = 0.83. Conclusion: In this preliminary study, no correlation was found between prevalence of polyps and a family history of colorectal cancer. Resumo: Objetivos: Avaliar a prevalência de pólipos em pacientes com história familiar de câncer colorretal comparando com indivíduos assintomáticos com indicação para rastreamento. Métodos: Estudo prospectivo realizado em um grupo de indivíduos submetidos à colonoscopia entre 2012 e 2014. Os pacientes foram distribuídos em dois grupos: Grupo I: sem história familiar de câncer colorretal e Grupo II: com história familiar em parentes de primeiro grau. Avaliaram-se características demográficas, achados na colonoscopia, presença, localização e tipo histológico dos pólipos, comparando os dois grupos. Resultados: Foram avaliados 214 pacientes, 162 incluídas no grupo I e 52

  1. Increased fear-potentiated startle in major depressive disorder patients with lifetime history of suicide attempt.

    Science.gov (United States)

    Ballard, Elizabeth D; Ionescu, Dawn F; Vande Voort, Jennifer L; Slonena, Elizabeth E; Franco-Chaves, Jose A; Zarate, Carlos A; Grillon, Christian

    2014-06-01

    Suicide is a common reason for psychiatric emergency and morbidity, with few effective treatments. Anxiety symptoms have emerged as potential modifiable risk factors in the time before a suicide attempt, but few studies have been conducted using laboratory measures of fear and anxiety. We operationally defined fear and anxiety as increased startle reactivity during anticipation of predictable (fear-potentiated startle) and unpredictable (anxiety-potentiated startle) shock. We hypothesized that a lifetime history of suicide attempt (as compared to history of no suicide attempt) would be associated with increased fear-potentiated startle. A post-hoc analysis of fear- and anxiety-potentiated startle was conducted in 28 medication-free patients with Major Depressive Disorder (MDD) divided according to suicide attempt history. The magnitude of fear-potentiated startle was increased in depressed patients with lifetime suicide attempts compared to those without a lifetime history of suicide attempt (F(1,26)=5.629, p=.025). There was no difference in anxiety-potentiated startle by suicide attempt history. This is a post-hoc analysis of previously analyzed patient data from a study of depressed inpatients. Further replication of the finding with a larger patient sample is indicated. Increased fear-potentiated startle in suicide attempters suggests the role of amygdala in depressed patients with a suicide attempt history. Findings highlight the importance of anxiety symptoms in the treatment of patients at increased suicide risk. Published by Elsevier B.V.

  2. Postoperative delirium in patients with history of alcohol abuse.

    Science.gov (United States)

    Sousa, G; Pinho, C; Santos, A; Abelha, F J

    2017-04-01

    Postoperative delirium (POD) is an acute confusional state characterized by changes in consciousness and cognition, which may be fluctuating, developing in a small period of time. The aim of this study was to evaluate the relationship between alcohol abuse and the development of POD. We prospectively evaluated consecutively all postoperative patients admitted in the Post-anesthesia Care Unit over a 1-month period for delirium, using the Portuguese versions of the the Nursing Delirium Screening Scale. Before surgery, alcohol consumption was inquired and alcohol abuse was assessed by the CAGE (Cutting Down, Annoyance, Guilt and Eye-opener) questionnaire; a score ≥2 defined alcohol abuse. Fischer exact test or chi-square was applied for comparisons. Risk factors were analyzed in a multivariate analysis using a logistic regression with odds ratios (OR) and 95% confidence intervals (95%CI). Two hundred twenty-one patients were enrolled. Delirium was seen in 11% patients. The incidence of alcohol abuse was 10%. Patients with alcohol abuse were more frequently men (P<.001) and had a higher ASA physical status III/IV (P=.021). POD was more frequent in patients with alcohol abuse (30% vs. 9%; P=.002). Age (OR: 5.9; 95%CI: 2.2-15.9; P<.001 for patients ≥65years), ASA physical statusIII/IV (OR: 4.2; 95%CI: 1.7-10.7; P=.002) and alcohol abuse (OR: 4.2; 95%CI: 1.4-12.9; P=.013) were found to be independent predictors for POD. Older patients, higher ASA physical status and alcohol abuse were more frequent in patients with POD. Alcohol abuse was considered an independent risk factor for POD. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Methods of patient warming during abdominal surgery.

    Directory of Open Access Journals (Sweden)

    Li Shao

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

  4. Study on inelastic analysis method for structural design (1). Estimation method of loading history effect

    International Nuclear Information System (INIS)

    Tanaka, Yoshihiko; Kasahara, Naoto

    2003-05-01

    The advanced loop-type reactor system, one of the promising concepts in the Feasibility study of the FBR Cycle, adopts many innovative ideas to meet the challenging requirements for safety and economy. As a results, it seems that the structures of the reactor system would be subjected to severer loads than the predecessors. One of the countermeasures to them is the design by inelastic analysis. In the past, many studies showed that structural design by inelastic analysis is much more reasonable than one by conservative elastic analysis. However, inelastic analysis has hardly been adopted in nuclear design so far. One of the reasons is that inelastic analysis has loading history effect, that is, the analysis result would differ depending on the order of loads. It seems to be difficult to find the general solution for the loading history effect. Consequently, inelastic analysis output from the four deferent thermal load histories which consists of the thermal load cycle including the severest cold shock ('C') and the one including the severest hot shock ('H') were compared with each other. From this comparison, it was revealed that the thermal load history with evenly distributed 'H's among 'C's tend to give the most conservative damage estimation derived from inelastic analysis output. Therefore, such thermal load history pattern is proposed for the structural design by inelastic analysis. (author)

  5. [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. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  6. 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.

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

    International Nuclear Information System (INIS)

    Chen, Hua-Jun; Zhu, Xi-Qi; Shu, Hao; Yang, Ming; Zhang, Yi; Ding, Jie; Wang, Yu; Teng, Gao-Jun

    2012-01-01

    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

  8. Radiotherapy-induced depigmentation in breast cancer patients without prior history of vitiligo: A review

    Directory of Open Access Journals (Sweden)

    Roshankumar A Patil

    2017-01-01

    Full Text Available Background: Vitiligo is a relatively common pigment disorder. Exacerbation or complete depigmentation within the radiation portals as a result of the Koebner phenomenon in patients with preexisting vitiligo has been reported in the literature. However, new-onset vitiligo triggered by radiation in patients without prior history of the disorder is a rare occurrence. Methods: The authors report one such occurrence in a breast cancer patient wherein the depigmentation remained localised within the radiotherapy target volume without generalisation. This young lady had received adjuvant radiotherapy to the right breast and ipsilateral supraclavicular fossa to a dose of 50 Gy in 25 fractions followed by 15 Gy in 6 fractions to the tumour bed. Discussion: The authors present a short review of the literature and discussion on the etiopathogenesis and therapeutic implication of the condition in cancer management. Conclusion: This rare occurrence highlights the importance of taking decision on radiotherapy on a case-to-case basis in patients known to have vitiligo as it has direct bearing on the ultimate cosmetic and psychological outcome. However, it is also equally important to be aware that radiation-induced depigmentation be a precursor of subsequent new-onset generalised vitiligo.

  9. An Effective Teaching Method to Enhance History-Taking Skills for Chinese Medical Students

    Science.gov (United States)

    Huang, Simin; Xu, Peng; Feng, Lie; Lu, Chunting; Yang, Jing

    2018-01-01

    History taking is an extremely important skill for medical students to master. In China, medical students usually have opportunities to practise this skill on real patients after they have learned diagnostics and basic relevant theoretical knowledge. Today, however, several factors, such as increased enrolment of medical students and the need to…

  10. Evaluation of the natural history of patients who aspirate.

    Science.gov (United States)

    Bock, Jonathan M; Varadarajan, Varun; Brawley, Mary C; Blumin, Joel H

    2017-12-01

    The natural clinical progression of aspiration to eventual pulmonary compromise is not well understood. We hypothesized that dietary modification recommendations, Penetration-Aspiration Scale (PAS) score, and dysphagia etiology would be associated with changes in time to first pulmonary event and overall survival for patients with documented aspiration on radiologic testing. This study identified a cohort of patients with detectable unsensed penetration or aspiration on videofluoroscopic swallowing study (VFSS), and followed this cohort over time for development of pulmonary events and death. We then evaluated the association of aspiration severity and dietary modification recommendations on incidence of these endpoints. Retrospective chart review. A total of 2,616 VFSS exam reports were reviewed from our institution performed between January 1, 2009 and December 31, 2010. Aspiration or unsensed penetration (PAS of 5 or greater) was detected in 564 (21.5%) of these patients, who were then included in the study cohort. Medical records were reviewed retrospectively for development of pulmonary events (pneumonia, pneumonitis, or other life-threatening pulmonary illness) and all-cause mortality for up to 54 months after initial VFSS. Univariate Kaplan-Meier analysis and multivariate Cox regression were performed for time to first pulmonary event and survival predicted by recommended diet, PAS score, and dysphagia etiology. Dysphagia etiology was highly associated with increased development of pulmonary events for some patients, especially those with generalized nonspecific dysphagia due to deconditioning or frailty (hazard ratio [HZ] vs. stroke 2.95, 95% confidence interval [CI]: 1.53-5.69, P = .001) and esophageal dysphagia (HZ: 2.66, 95% CI: 1.17-6.02, P = .019). Dysphagia etiology was also associated with increased mortality for patients with generalized nonspecific dysphagia due to deconditioning or frailty (HZ: 3.32, 95% CI: 2.0-5.52, P dysphagia is associated

  11. A method of taking control rod history into account in core simulation calculations for BWR'S

    International Nuclear Information System (INIS)

    Hojerup, C.F.; Nonbol, E.

    1990-01-01

    The problem of taking control rod history into account in core simulator codes using precalculated cross sections has been examined, and two methods have been devised and tested. The very demanding first method, using the accumulated control rod in burn-up as a parameter, turned out to be even more inaccurate than the much less demanding second method, which only requires two full burn-up histories, one with the control rod in all the time, and another with the control rod out all the time. From the analysis it can be seen that the proper treatment of the control rod history is quite important, both for the cross sections, as several per cent on the reactivity are at stake, as for the pin powers, which for some pins are very much affected

  12. Methods for determining deformation history for chocolate tablet boudinage with fibrous crystals

    Science.gov (United States)

    Casey, M.; Dietrich, D.; Ramsay, J. G.

    1983-02-01

    Chocolate tablet boudinage with fibrous crystal growths between the boudinaged plates from two localities were studied. In one, from Leytron, Valais, Switzerland, the deformation history was found to be a succession of plane strain increments with the shortening direction perpendicular to the boudinaged sheet and the extension direction showing a progressive change in orientation within the sheet. The incremental and finite strains were evaluated. The other specimen, from Parys Mountain, Anglesey Great Britain, was found to have a more complex history with diachronous break up of the competent layer and flattening strain increments. It was found that under these circumstances the direct graphical methods of determining finite and incremental strains gave inconsistent results. A numerical model was developed which allowed the simulation of chocolate tablet structure with a complex deformation history. The model was applied to the Anglesey specimen and three possible strain histories for this structure were tried.

  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

    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...... 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. Multi-views storage model and access methods of conversation history in converged IP messaging system

    Science.gov (United States)

    Lu, Meilian; Yang, Dong; Zhou, Xing

    2013-03-01

    Based on the analysis of the requirements of conversation history storage in CPM (Converged IP Messaging) system, a Multi-views storage model and access methods of conversation history are proposed. The storage model separates logical views from physical storage and divides the storage into system managed region and user managed region. It simultaneously supports conversation view, system pre-defined view and user-defined view of storage. The rationality and feasibility of multi-view presentation, the physical storage model and access methods are validated through the implemented prototype. It proves that, this proposal has good scalability, which will help to optimize the physical data storage structure and improve storage performance.

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

    International Nuclear Information System (INIS)

    Halkett, Georgia K.B.; McKay, Janice; Shaw, Therese

    2011-01-01

    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.

  16. 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.

  17. A study of smart card for radiation exposure history of patient.

    Science.gov (United States)

    Rehani, Madan M; Kushi, Joseph F

    2013-04-01

    The purpose of this article is to undertake a study on developing a prototype of a smart card that, when swiped in a system with access to the radiation exposure monitoring server, will locate the patient's radiation exposure history from that institution or set of associated institutions to which it has database access. Like the ATM or credit card, the card acts as a secure unique "token" rather than having cash, credit, or dose data on the card. The system provides the requested radiation history report, which then can be printed or sent by e-mail to the patient. The prototype system is capable of extending outreach to wherever the radiation exposure monitoring server extends, at county, state, or national levels. It is anticipated that the prototype shall pave the way for quick availability of patient exposure history for use in clinical practice for strengthening radiation protection of patients.

  18. A Preoperative Medical History and Physical Should Not Be a Requirement for All Cataract Patients.

    Science.gov (United States)

    Schein, Oliver D; Pronovost, Peter J

    2017-07-01

    Cataract surgery poses minimal systemic medical risk, yet a preoperative general medical history and physical is required by the Centers for Medicare and Medicaid Services and other regulatory bodies within 1 month of cataract surgery. Based on prior research and practice guidelines, there is professional consensus that preoperative laboratory testing confers no benefit when routinely performed on cataract surgical patients. Such testing remains commonplace. Although not yet tested in a large-scale trial, there is also no evidence that the required history and physical yields a benefit for most cataract surgical patients above and beyond the screening performed by anesthesia staff on the day of surgery. We propose that the minority of patients who might benefit from a preoperative medical history and physical can be identified prospectively. Regulatory agencies should not constrain medical practice in a way that adds enormous cost and patient burden in the absence of value.

  19. History of thyroid disease and survival of ovarian cancer patients

    DEFF Research Database (Denmark)

    Minlikeeva, Albina N; Freudenheim, Jo L; Cannioto, Rikki A

    2017-01-01

    BACKGROUND: Findings from in vitro studies suggest that increased exposure to thyroid hormones can influence progression of ovarian tumours. However, epidemiologic evidence on this topic is limited. METHODS: We pooled data from 11 studies from the Ovarian Cancer Association Consortium. Using mult...

  20. Food allergy diagnosis in patients with elimination diet history. Preliminary report

    Directory of Open Access Journals (Sweden)

    Elsy Maureen Navarrete-Rodríguez

    2014-09-01

    Full Text Available Background: Food allergy diagnosis is performed by a double blind placebo controlled challenge; however, in a lot of patients, it is only based on clinical history, skin prick tests, or parents’ perception. There is a high frequency of elimination diets without an adequate approach. Objective: To analyze the results of diagnostic tests in a group of children with elimination diet-based on suspected food allergy and verify such studies with double blind placebo-controlled test challenge. Material and method: An observational, analytical and prospective study was done in a group of patients with elimination diet for suspected food allergy. We performed prick test, Prick-to-Prick test and patch test and the positive ones were verified by double-blind placebo-controlled challenge. Results: Fourty-three patients were included within a total of 1,935 tests. Both approach for immediate and late sensitivity had not statistically significant relationship between a positive test and the elimination of food. Until now, we had 4 (8% positive challenges out of 50. Conclusion: The frequency of allergy proved by double-blind placebo-controlled test in 50 challenges was of 8% (4/50, thus, in the preliminary report we found a high frequency of elimination diets without adequate support. It is very important that food allergy diagnosis is accurate and based on an appropriate approach; since the implementation of an elimination diet in pediatric population can have a negative influence on their growth and development.

  1. Diplopia after laser in situ keratomileusis (LASIK) in a patient with a history of strabismus.

    Science.gov (United States)

    Heinmiller, Laura J; Wasserman, Barry N

    2013-02-01

    In patients with a history of strabismus, refractive surgery can result in decompensation of ocular alignment, with subsequent diplopia. Refractive surgery in the management of strabismus has been described, although it remains controversial. We present a young adult with past history of strabismus surgery and new-onset diplopia after refractive surgery. Binocular diplopia was treated surgically with laser in situ keratomileusis. Copyright © 2013 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  2. The reliability of alcoholism history in patients with alcohol-related cirrhosis.

    Science.gov (United States)

    Yates, W R; Labrecque, D R; Pfab, D

    1998-01-01

    Alcoholic liver disease is considered an indication for liver transplantation when a candidate is felt to have a high likelihood of abstinence following transplantation. Historical variables such as duration of sobriety, duration and quantity of drinking, and treatment history are commonly used to estimate alcoholism prognosis, yet their reliability and validity in patients with alcoholic cirrhosis has received limited study. Fifty subjects (9 women and 41 men) with alcoholic cirrhosis underwent an alcoholism history interview. Each subject had a collateral source (usually a spouse) who was interviewed by a second interviewer blind to the subject's alcoholism history. The two histories were compared for duration of abstinence in months and estimated alcoholism relapse risk was calculated using the High-risk Alcoholism Relapse scale (HRAR). Duration of sobriety correlated highly between subject and collateral source (Spearman r= 0.96, P = 0.0001) as did HRAR total score (Spearman r = 0.72, P = 0.0001). Categorical assignments also showed high correlations with duration of sobriety (kappa = 0.97) and HRAR category (kappa = 0.63). When disagreements were present, collateral sources tended to underestimate severity of alcoholism. We conclude that patients with alcoholic liver disease provide a reliable history for alcoholism variables when compared with a collateral source, and that, when disagreements are present, subjects tend to report a more acute or severe alcohol problem. The results support the clinical use of patient history information in making decisions about medical interventions for alcoholic liver disease.

  3. Development of spectral history methods for pin-by-pin core analysis method using three-dimensional direct response matrix

    International Nuclear Information System (INIS)

    Mitsuyasu, T.; Ishii, K.; Hino, T.; Aoyama, M.

    2009-01-01

    Spectral history methods for pin-by-pin core analysis method using the three-dimensional direct response matrix have been developed. The direct response matrix is formalized by four sub-response matrices in order to respond to a core eigenvalue k and thus can be recomposed at each outer iteration in the core analysis. For core analysis, it is necessary to take into account the burn-up effect related to spectral history. One of the methods is to evaluate the nodal burn-up spectrum obtained using the out-going neutron current. The other is to correct the fuel rod neutron production rates obtained the pin-by-pin correction. These spectral history methods were tested in a heterogeneous system. The test results show that the neutron multiplication factor error can be reduced by half during burn-up, the nodal neutron production rates errors can be reduced by 30% or more. The root-mean-square differences between the relative fuel rod neutron production rate distributions can be reduced within 1.1% error. This means that these methods can accurately reflect the effects of intra- and inter-assembly heterogeneities during burn-up and can be used for core analysis. Core analysis with the DRM method was carried out for an ABWR quarter core and it was found that both thermal power and coolant-flow distributions were smoothly converged. (authors)

  4. Validity of a Simulation Game as a Method for History Teaching

    Science.gov (United States)

    Corbeil, Pierre; Laveault, Dany

    2011-01-01

    The aim of this research is, first, to determine the validity of a simulation game as a method of teaching and an instrument for the development of reasoning and, second, to study the relationship between learning and students' behavior toward games. The participants were college students in a History of International Relations course, with two…

  5. Lower LINE-1 methylation in first-episode schizophrenia patients with the history of childhood trauma.

    Science.gov (United States)

    Misiak, Błażej; Szmida, Elżbieta; Karpiński, Paweł; Loska, Olga; Sąsiadek, Maria M; Frydecka, Dorota

    2015-01-01

    We investigated methylation of DNA repetitive sequences (LINE-1 and BAGE) in peripheral blood leukocytes from first-episode schizophrenia (FES) patients and healthy controls (HCs) with respect to childhood adversities. Patients were divided into two subgroups based on the history of childhood trauma - FES(+) and FES(-) subjects. The majority of HCs had a negative history of childhood trauma - HCs(-) subjects. FES(+) patients had significantly lower LINE-1 methylation in comparison with FES(-) patients or HC(-) subjects. Emotional abuse and total trauma score predicted lower LINE-1 methylation in FES patients, while general trauma score was associated with lower BAGE methylation in HCs. Childhood adversities might be associated with global DNA hypomethylation in adult FES patients.

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

    International Nuclear Information System (INIS)

    Moatter, T.; Pervez, S.; Khan, S.; Azam, I.

    2011-01-01

    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)

  7. Prevalence and risk indicators of peri-implantitis in Korean patients with a history of periodontal disease: a cross-sectional study

    OpenAIRE

    Goh, Mi-Seon; Hong, Eun-Jin; Chang, Moontaek

    2017-01-01

    Purpose The aim of this study was to analyze the prevalence and risk indicators of peri-implantitis in Korean patients with history of periodontal disease. Methods A total of 444 patients with 1,485 implants were selected from patients who had been treated at the Department of Periodontology, Chonbuk National University Dental Hospital between July 2014 and June 2015. A group with a history of peri-implantitis (HP) (370 patients with 1,189 implants) and a group with a current peri-implantitis...

  8. A STUDY ON DYNAMIC LOAD HISTORY RECONSTRUCTION USING PSEUDO-INVERSE METHODS

    OpenAIRE

    Santos, Ariane Rebelato Silva dos; Marczak, Rogério José

    2017-01-01

    Considering that the vibratory forces generally cannot be measured directly at the interface of two bodies, an inverse method is studied in the present work to recover the load history in such cases. The proposed technique attempts to reconstruct the dynamic loads history by using a frequency domain analysis and Moore-Penrose pseudo-inverses of the frequency response function (FRF) of the system. The methodology consists in applying discrete dynamic loads on a finite element model in the time...

  9. Is it morally permissible for hospital nurses to access prisoner-patients' criminal histories?

    Science.gov (United States)

    Neiman, Paul

    2016-01-01

    In the United States, information about a person's criminal history is accessible with a name and date of birth. Ruth Crampton has studied nurses' care for prisoner-patients in hospital settings and found care to be perfunctory and reactive. This article examines whether it is morally permissible for nurses in hospital settings to access information about prisoner-patients' criminal histories. Nurses may argue for a right to such information based on the right to personal safety at work or the obligation to provide prisoner-patients with the care that they deserve. These two arguments are considered and rejected. It is further argued that accessing information about a prisoner-patient's criminal history violates nurses' duty to care. Care, understood through Sarah Ruddick's account as work and relationship, requires nurses to be open and unbiased in order to do their part in forming a caring relationship with patients. Knowledge of a prisoner-patient's criminal history inhibits the formation of this relationship and thus violates nurses' duty to care.

  10. Association of inflammatory markers with physical activity, family history and other diabetic complications in patients of diabetic retinopathy

    International Nuclear Information System (INIS)

    Zaidi, A.; Rashif, A.; Waheed, P.; Ishaq, M.

    2017-01-01

    Objective: To study the association of inflammatory markers with physical activity, family history and other complications among patients of diabetic retinopathy. Study Design: Cross sectional comparative study. Place and Duration of Study: Department of Biochemistry and Molecular Biology, Army Medical College, Rawalpindi in collaboration with Armed Forces Institute of Ophthalmology (AFIO) and Military Hospital Laboratories, Rawalpindi from Jan 2016 to Jun 2016. Material and Methods: A total of 90 diagnosed patients of diabetic retinopathy of ages 40-70 years were enrolled from Armed Forces Institute of Ophthalmology, Rawalpindi. Their inflammatory markers (ESR and CRP) were assessed and their levels were compared with their physical activity, family history and other complications of diabetes already developed in them. These were then compared with those of 90 normal healthy controls enrolled from general population using independent student's t test and one way Anova test for scale variables and Chi square test for nominal variables. Results: Both patients and controls were age and gender matched with mean age of 60 +- 8.9 years in patients and 59 +- 13.02 years in controls. Among 90 patients enrolled 51(56.7 percent) were males and 39 (43.3) were females. And among 90 controls 49 (54.4 percent) were males and 41(45.6 percent) were females. An inverse association was observed between inflammatory markers and physical activity with ap-value of 0.001. On the contrary a strong positive association was observed between inflammatory markers and family history and complications of diabetes with a p-value 0.001. Conclusion: There is an inverse association of inflammatory markers with physical activity and a direct association of these with family history and complications of diabetes among patients of diabetic retinopathy. (author)

  11. Comparative study of hostility in depressive patients with and without a suicide attempt history.

    Science.gov (United States)

    Christodoulou, Christos; Efstathiou, Vasiliki; Ferentinos, Panagiotis; Poulios, Antonios; Papadopoulou, Athanasia; Douzenis, Athanassios

    2017-08-01

    Hostility in association with depression seems to be connected to suicidal behavior. This study aimed to evaluate hostility and its dimensions in relation to depression in patients who suffered from diagnosed depression with and without a suicide attempt history. The study included 168 participants; 58 patients with depression and suicide attempt history, 55 patients with depression without a suicide attempt history and 55 healthy controls. Hostility was assessed with the Hostility and Direction of Hostility Questionnaire, while depression with the Beck Depression Inventory (BDI). Patients with depression and a suicide attempt history compared with the patients without attempt history presented statistically significantly higher total hostility (28.71 ± 6.43 vs 24.20 ± 7.66), extroverted hostility (17.16 ± 4.37 vs 14.15 ± 4.63), acting out hostility (6.03 ± 2.09 vs 4.73 ± 1.93), and self criticism (6.95 ± 2.12 vs 5.89 ± 2.32). No statistically significant differences were found between the two clinical groups in depression according to the BDI. Moreover depressive patients with suicide attempt history scored higher in all the hostility dimensions than the controls. Therefore, it could be suggested that hostility and especially its extrapunitive dimensions are associated with suicidal behavior, since no differences in depression were recorded between the two clinical groups.

  12. Reduced left precentral regional responses in patients with major depressive disorder and history of suicide attempts.

    Science.gov (United States)

    Tsujii, Noa; Mikawa, Wakako; Tsujimoto, Emi; Adachi, Toru; Niwa, Atsushi; Ono, Hisae; Shirakawa, Osamu

    2017-01-01

    Previous neuroimaging studies have revealed frontal and temporal functional abnormalities in patients with major depressive disorder (MDD) and a history of suicidal behavior. However, it is unknown whether multi-channel near-infrared spectroscopy (NIRS) signal changes among individuals with MDD are associated with a history of suicide attempts and a diathesis for suicidal behavior (impulsivity, hopelessness, and aggression). Therefore, we aimed to explore frontotemporal hemodynamic responses in depressed patients with a history of suicide attempts using 52-channel NIRS. We recruited 30 patients with MDD and a history of suicidal behavior (suicide attempters; SAs), 38 patient controls without suicidal behavior (non-attempters; NAs), and 40 healthy controls (HCs) matched by age, gender ratio, and estimated IQ. Regional hemodynamic responses during a verbal fluency task (VFT) were monitored using NIRS. Our results showed that severities of depression, impulsivity, aggression, and hopelessness were similar between SAs and NAs. Both patient groups had significantly reduced activation compared with HCs in the bilateral frontotemporal regions. Post hoc analyses revealed that SAs exhibited a smaller hemodynamic response in the left precentral gyrus than NAs and HCs. Furthermore, the reduced response in the left inferior frontal gyrus was negatively correlated with impulsivity level and hemodynamic responses in the right middle frontal gyrus were negatively associated with hopelessness and aggression in SAs but not in NAs and HCs. Our findings suggest that MDD patients with a history of suicide attempts demonstrate patterns of VFT-induced NIRS signal changes different from those demonstrated by individuals without a history of suicidal behaviors, even in cases where clinical symptoms are similar. NIRS has a relatively high time resolution, which may help visually differentiate SAs from NAs.

  13. A 'difficult' insect allergy patient: reliable history of a sting, but all testing negative.

    Science.gov (United States)

    Tracy, James M; Olsen, Jonathan A; Carlson, John

    2015-08-01

    Few conditions are as treatable as allergy to stinging insects, with venom immunotherapy (VIT) providing up to 98% protection to subsequent stings. The challenge with VIT is not in the treatment, but in the diagnosis. To offer VIT, one must determine a history of a systemic reaction to a stinging insect in conjunction with the presence venom-specific IgE. Current diagnostic methods, although sensitive and specific, are imperfect, and some newer testing options are not widely available. A conundrum occasionally faced is the patient with a reliable and compelling history of a systemic allergic reaction yet negative venom-specific testing. This diagnostic dilemma presents an opportunity to consider possible causes for this diagnostic challenge. Our evolving understanding of the role of occult mast cell disease may begin to help us understand this situation and develop appropriate management strategies. Venom-specific skin testing has long been the cornerstone of the evaluation of venom sensitivity and is often combined with in-vitro assays to add clarity, but even these occasionally may fall short. Exploring novel venom diagnostic testing methods may help to fill in some of the diagnostic gaps. Do currently available venom vaccines contain all the key venom species? Are there enough differences between insect species that we may simply be missing the relevant allergens? What is the significance of the antigenicity of carbohydrate moieties in venoms? What is the role of recombinant venom extracts? VIT is the definitive treatment for insect allergic individuals. To utilize VIT, identification of the relevant Hymenoptera is necessary. Unfortunately, this cannot always be accomplished. This deficiency can have several causes: a potential comorbid condition such as occult mast cell disease, limitations of currently available diagnostic resources, or testing vaccines with an insufficient coverage of relevant venom allergens. Exploring these potential causes may help to

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

    Science.gov (United States)

    Oguzkurt, Levent; Tercan, Fahri; Yildirim, Sedat; Torun, Dilek

    2005-08-01

    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. 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. 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. 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.

  15. Particle drag history in a subcritical post-shock flow - data analysis method and uncertainty

    Science.gov (United States)

    Ding, Liuyang; Bordoloi, Ankur; Adrian, Ronald; Prestridge, Kathy; Arizona State University Team; Los Alamos National Laboratory Team

    2017-11-01

    A novel data analysis method for measuring particle drag in an 8-pulse particle tracking velocimetry-accelerometry (PTVA) experiment is described. We represented the particle drag history, CD(t) , using polynomials up to the third order. An analytical model for continuous particle position history was derived by integrating an equation relating CD(t) with particle velocity and acceleration. The coefficients of CD(t) were then calculated by fitting the position history model to eight measured particle locations in the sense of least squares. A preliminary test with experimental data showed that the new method yielded physically more reasonable particle velocity and acceleration history compared to conventionally adopted polynomial fitting. To fully assess and optimize the performance of the new method, we performed a PTVA simulation by assuming a ground truth of particle motion based on an ensemble of experimental data. The results indicated a significant reduction in the RMS error of CD. We also found that for particle locating noise between 0.1 and 3 pixels, a range encountered in our experiment, the lowest RMS error was achieved by using the quadratic CD(t) model. Furthermore, we will also discuss the optimization of the pulse timing configuration.

  16. Severe hypoglycaemia in elderly patients with type 2 diabetes and coexistence of cardiovascular history.

    Science.gov (United States)

    Piątkiewicz, Paweł; Buraczewska-Leszczyńska, Bożena; Kuczerowski, Roman; Bernat-Karpińska, Małgorzata; Rabijewski, Michał; Kowrach, Marek

    2016-01-01

    Hypoglycaemia is a condition that occurs when blood glucose levels fall below 3.9 mmol/L (70 mg/dL), while hypoglycaemic coma is usually associated with glycaemia around 1.1 mmol/L (20 mg/dL). Recurrent severe hypoglycaemia may result in permanent neurological disorders and also has a negative impact on the cardiovascular system. To evaluate the causes of severe hypoglycaemia in elderly patients with type 2 diabetes and coexistence of cardiovascular history. We analysed retrospectively the history of 33 elderly patients with type 2 diabetes and coexistence of cardiovascular history, who were admitted to our clinic due to severe hypoglycaemia with loss of consciousness. The mean age of the patients was 76.0 ± 11.1 years, and the mean duration of diabetes was 12.0 ± 9.8 years. Glycated haemoglobin (HbA1c) was measured and the prevalence of cardiovascular diseases and therapeutic procedures were evaluated. In the group of patients with severe hypoglycaemia, the mean value of HbA1c was 6.3 ± 1.2% (44 ± 13.1 mmol/mol), which indicates a mean glucose value below 7.8 mmol/L (140 mg/dL). Ischaemic heart disease was diagnosed in 18 patients (eight had a history of myocardial infarction), and 22 patients had arterial hypertension. Severe hypoglycaemia requiring hospitalisation in elderly patients with type 2 diabetes and coexistence of cardiovascular history was related to insulin or sulfonylurea therapy. A low HbA1c level indicates inappropriate intensification of therapy and was associated with high risk of severe hypoglycaemic episodes in older people. The majority of severe hypoglycaemic episodes were observed in sulphonylurea or insulin-treated type 2 diabetic patients.

  17. MUSIDH, multiple use of simulated demographic histories, a novel method to reduce computation time in microsimulation models of infectious diseases.

    Science.gov (United States)

    Fischer, E A J; De Vlas, S J; Richardus, J H; Habbema, J D F

    2008-09-01

    Microsimulation of infectious diseases requires simulation of many life histories of interacting individuals. In particular, relatively rare infections such as leprosy need to be studied in very large populations. Computation time increases disproportionally with the size of the simulated population. We present a novel method, MUSIDH, an acronym for multiple use of simulated demographic histories, to reduce computation time. Demographic history refers to the processes of birth, death and all other demographic events that should be unrelated to the natural course of an infection, thus non-fatal infections. MUSIDH attaches a fixed number of infection histories to each demographic history, and these infection histories interact as if being the infection history of separate individuals. With two examples, mumps and leprosy, we show that the method can give a factor 50 reduction in computation time at the cost of a small loss in precision. The largest reductions are obtained for rare infections with complex demographic histories.

  18. Radiological and scintigraphic findings in patients with a clinical history of chronic inflammatory back pain

    International Nuclear Information System (INIS)

    Goei The, H.S.; Lemmens, A.J.; Goedhard, G.; Lokkerbol, H.; Rahmy, A.; Linden, S.M. van der; Cats, A.; Steven, M.M.

    1985-01-01

    The prevalence of radiological abnormalities of the sacroiliac joints, the manubriosternal joint, and the lumbar spine were assessed, and quantitative sacroiliac scintigraphy was performed in 151 patients with a history of chronic inflammatory back pain and in 31 controls with non-inflammatory back pain. Sacroiliitis was found in 124 patients (82%), manubriosternal lesions in 84 patients (56%), and lesions of the lumbar spine in 58 patients (38%). In 19 patients (13%), manubriosternal lesions provided the sole radiological abnormality and in five patients (3%) no radiological abnormality could be demonstrated at any of these sites. Quantitative sacroiliac scintigraphy showed increased values in 69 of 137 patients examined (50%), but also in 10 out of 12 control patients with disc degeneration (83%) and is, therefore, nonspecific for inflammatory lesions. Radiological examination of the manubriosternal joint is recommended in patients with inflammatory back pain without radiographic evidence of sacroiliitis. (orig.)

  19. Impact of Adding a Pictorial Display to Enhance Recall of Cancer Patient Histories: A Randomized Trial.

    Science.gov (United States)

    Wolch, Gary; Ghosh, Sunita; Boyington, Curtiss; Watanabe, Sharon M; Fainsinger, Robin; Burton-Macleod, Sarah; Thai, Vincent; Thai, JoAnn; Fassbender, Konrad

    2017-01-01

    Current health care delivery models have increased the need for safe and concise patient handover. Handover interventions in the literature have focused on the use of structured tools but have not evaluated their ability to facilitate retention of patient information. In this study, mock pictorial displays were generated in an attempt to create a snapshot of each patient's medical and social circumstances. These pictorial displays contained the patient's photograph and other disease- and treatment-related images. The objective of this randomized trial was to assess the ability of these snapshots to enhance delayed information recall by care providers. Participating physicians were given four advanced cancer patient histories to review, two at a time over two weeks. Pictorial image displays, referred to as the Electronic Whiteboard (EWB) were added, in a randomized manner to half of the textual histories. The impact of the EWB on information recall was tested in immediate and delayed time frames. Overall, patient information recall declined significantly over time, with or without the EWB. Still, this trial demonstrates significantly higher test scores after 24 hours with the addition of pictures to textual patient information, compared with textual information alone (P = 0.0002). A more modest improvement was seen with the addition of the EWB for questionnaires administered immediately after history review (P = 0.008). Most participants agreed that the EWB was a useful enhancement and that seeing a patient's photograph improved their ability to retain information. Most studies examining the institution of handover protocols in the health care setting have failed to harness the power of pictures and other representative images. This study demonstrates the ability of pictorial displays to improve both immediate and delayed recall of patient histories without increasing review time. These types of displays may be amenable to generation by software programs and

  20. Modified T-history method for measuring thermophysical properties of phase change materials at high temperature

    Science.gov (United States)

    Omaraa, Ehsan; Saman, Wasim; Bruno, Frank; Liu, Ming

    2017-06-01

    Latent heat storage using phase change materials (PCMs) can be used to store large amounts of energy in a narrow temperature difference during phase transition. The thermophysical properties of PCMs such as latent heat, specific heat and melting and solidification temperature need to be defined at high precision for the design and estimating the cost of latent heat storage systems. The existing laboratory standard methods, such as differential thermal analysis (DTA) and differential scanning calorimetry (DSC), use a small sample size (1-10 mg) to measure thermophysical properties, which makes these methods suitable for homogeneous elements. In addition, this small amount of sample has different thermophysical properties when compared with the bulk sample and may have limitations for evaluating the properties of mixtures. To avoid the drawbacks in existing methods, the temperature - history (T-history) method can be used with bulk quantities of PCM salt mixtures to characterize PCMs. This paper presents a modified T-history setup, which was designed and built at the University of South Australia to measure the melting point, heat of fusion, specific heat, degree of supercooling and phase separation of salt mixtures for a temperature range between 200 °C and 400 °C. Sodium Nitrate (NaNO3) was used to verify the accuracy of the new setup.

  1. A primary care audit of familial risk in patients with a personal history of breast cancer.

    Science.gov (United States)

    Nathan, Paul; Ahluwalia, Aneeta; Chorley, Wendy

    2014-12-01

    Breast cancer is the most common cancer diagnosed in women, both in the UK and worldwide. A small proportion of women are at very high risk of breast cancer, having a particularly strong family history. The National Institute for Health and Clinical Excellence (NICE) has advised that practitioners should not, in most instances, actively seek to identify women with a family history of breast cancer. An audit was undertaken at an urban primary care practice of 15,000 patients, using a paper-based, self-administered questionnaire sent to patients identified with a personal history of breast cancer. The aim of this audit was to determine whether using targeted screening of relatives of patients with breast cancer to identify familial cancer risk is worthwhile in primary care. Since these patients might already expected to have been risk assessed following their initial diagnosis, this audit acts as a quality improvement exercise. The audit used a validated family history questionnaire and risk assessment tool as a screening approach for identifying and grading familial risk in line with the NICE guidelines, to guide referral to the familial cancer screening service. The response rate to family history questionnaires was 54 % and the majority of patients responded positively to their practitioner seeking to identify familial cancer risks in their family. Of the 57 returned questionnaires, over a half (54 %) contained pedigrees with individuals eligible for referral. Patients and their relatives who are often registered with the practice welcome the discussion. An appropriate referral can therefore be made. The findings suggest a role for primary care practitioners in the identification of those at higher familial risk. However integrated systems and processes need designing to facilitate this work.

  2. The relationship of reported HIV risk and history of HIV testing among emergency department patients.

    Science.gov (United States)

    Merchant, Roland C; Freelove, Sarah M; Langan, Thomas J; Clark, Melissa A; Mayer, Kenneth H; Seage, George R; DeGruttola, Victor G

    2010-01-01

    Among a random sample of emergency department (ED) patients, we sought to determine the extent to which reported risk for human immunodeficiency virus (HIV) is related to ever having been tested for HIV. A random sample of patients (aged 18-64 years) from an adult, urban, northeastern United States, academic ED were surveyed about their history of ever having been tested for HIV and their reported HIV risk behaviors. A reported HIV risk score was calculated from the survey responses and divided into 4 levels, based on quartiles of the risk scores. Pearson's X(2) testing was used to compare HIV testing history and level of reported HIV risk. Logistic regression models were created to investigate the association between level of reported HIV risk and the outcome of ever having been tested for HIV. Of the 557 participants, 62.1% were female. A larger proportion of females than males (71.4% vs 60.6%; P history of injection-drug use, were associated with prior HIV testing for both genders. In the logistic regression analyses, there was no relationship between increasing level of reported HIV risk and a history of ever having been tested for HIV for males. For females, a history of ever having been tested was related to increasing level of reported risk, but not in a linear fashion. The relationship between reported HIV risk and history of testing among these ED patients was complex and differed by gender. Among these patients, having greater risk did not necessarily mean a higher likelihood of ever having been tested for HIV.

  3. 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.

  4. [Psychic factors in case histories of patients with alopecia areata--preliminary report].

    Science.gov (United States)

    Wygledowska-Kania, M; Bogdanowski, T

    1996-01-01

    We tested the significance of psychic factors in the etiopathogenesis of alopecia areata. We analysed the patient on the basis of a detailed examination based on the case history, including important events in his/her life, personality traits, serious events and the loss of emotional attachment. General important events happened to 80% of the patients, personality traits able to cause the disease were present in 73%, serious events in 62% and the loss of emotional attachment was also found in 62% of the patients. We tested 60 patients (31 women and 29 men). The evidence obtained from the detailed examination based on case histories indicated significantly frequent occurrence of the psychic factors preceding the occurrence of alopecia areata.

  5. Hepatic splenosis mimicking liver metastases in a patient with history of childhood immature teratoma

    Directory of Open Access Journals (Sweden)

    Jereb Sara

    2016-06-01

    Full Text Available Hepatic splenosis is rare condition, preceded by splenectomy or spleen trauma, the term refers to nodular implantation of normal splenic tissue in the liver. In patients with history of malignancy in particular, it can be mistaken for metastases and can lead to unnecessary diagnostic procedures or inappropriate treatment.

  6. 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

    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

  7. An Autopsy Case of Fulminant Amebic Colitis in a Patient with a History of Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Naoko Kawabe

    2016-01-01

    Full Text Available Generally, amebic colitis is localized around the mucosal membrane and often accompanied by diarrhea and abdominal pain. We describe a patient with a history of rheumatoid arthritis who had received prolonged steroid therapy. The patient complained of breathing difficulties because of rheumatoid lung disease. Although the patient was given antibacterial agent, the symptoms did not improve until death. We did an autopsy and found that he had fulminant amebic colitis, although the patient was not previously examined. Histochemical analysis revealed severe inflammation and full-thickness necrosis of the colon by ameba, suggesting the involvement of ameba in the progression of the overall condition.

  8. Quetiapine Induced Acute Dystonia in a patient with History of severe Head Injury

    OpenAIRE

    Robert G. Bota; Joanne W. Witkowski

    2010-01-01

    A patient with a history of severe head injury 10 years ago regained ability to walk after years of being bound to a wheelchair. During the last psychiatric hospitalization, quetiapine was increased to therapeutic dose using a normal titration. As a result the patient developed dystonia of multiple muscle groups requiring 4 days of hospitalization for remittance of symptoms. In this paper, we take a close look at the literature concerning extrapiramidal symptoms (EPS) in this context, and we ...

  9. Completeness of pedigree and family cancer history for ovarian cancer patients.

    Science.gov (United States)

    Son, Yedong; Lim, Myong Cheol; Seo, Sang Soo; Kang, Sokbom; Park, Sang Yoon

    2014-10-01

    To investigate the completeness of pedigree and of number of pedigree analysis to know the acceptable familial history in Korean women with ovarian cancer. Interview was conducted in 50 ovarian cancer patients for obtaining familial history three times over the 6 weeks. The completeness of pedigree is estimated in terms of familial history of disease (cancer), health status (health living, disease and death), and onset age of disease and death. The completion of pedigree was 79.3, 85.1, and 85.6% at the 1st, 2nd, and 3rd time of interview and the time for pedigree analysis was 34.3, 10.8, and 3.1 minutes, respectively. The factors limiting pedigree analysis were as follows: out of contact with their relatives (38%), no living ancestors who know the family history (34%), dispersed family member because of the Korean War (16%), unknown cause of death (12%), reluctance to ask medical history of relatives (10%), and concealing their ovarian cancer (10%). The percentage of cancers revealed in 1st (2%) and 2nd degree (8%) relatives were increasing through surveys, especially colorectal cancer related with Lynch syndrome (4%). Analysis of pedigree at least two times is acceptable in Korean woman with ovarian cancer from the first study. The completion of pedigree is increasing, while time to take family history is decreasing during three time survey.

  10. Adverse Pregnancy Outcomes of Patients with History of First-Trimester Recurrent Spontaneous Abortion

    Directory of Open Access Journals (Sweden)

    Jing Yang

    2017-01-01

    Full Text Available Although a history of first-trimester recurrent spontaneous abortion (FRSA is regarded as a risk factor in antenatal care, the characteristic of subsequent pregnancy outcome is not clearly elucidated. Here, a retrospective analysis was performed on the clinical data of 492 singleton pregnant women. 164 of them with the history of FRSA were enrolled in study group, compared to 328 deliveries without the history of FRSA. For maternal outcomes, patients in the study group delivered earlier with mean gestational age and the incidences of cesarean section and postpartum hemorrhage were higher compared to the control group. For placental outcomes, the incidence of placenta-mediated pregnancy complications (PMPC in the study group increased in terms of late-onset preeclampsia, oligohydramnios, early-onset fetal growth restriction, and second-trimester abortion. Patients in the study group were more likely to suffer from placenta accreta, placenta increta, and placenta percreta. For perinatal outcomes, the proportion of birth defects of newborns in the study group was greater. At last, logistic regression analyses showed that the history of FRSA was an independent risk factor for cesarean section and pregnancy complications. In conclusion, women with the history of FRSA are often exposed to an elevated incidence of maternal-placental-perinatal adverse pregnancy outcomes.

  11. Increased impulsivity associated with severity of suicide attempt history in patients with bipolar disorder.

    Science.gov (United States)

    Swann, Alan C; Dougherty, Donald M; Pazzaglia, Peggy J; Pham, Mary; Steinberg, Joel L; Moeller, F Gerard

    2005-09-01

    Impulsivity is a prominent and measurable characteristic of bipolar disorder that can contribute to risk for suicidal behavior. The purpose of this study was to investigate the relationship between impulsivity and severity of past suicidal behavior, a potential predictor of eventual suicide, in patients with bipolar disorder. In bipolar disorder subjects with either a definite history of attempted suicide or no such history, impulsivity was assessed with both a questionnaire (Barratt Impulsiveness Scale) and behavioral laboratory performance measures (immediate memory/delayed memory tasks). Diagnosis was determined with the Structured Clinical Interview for DSM-IV. Interviews of patients and review of records were used to determine the number of past suicide attempts and the medical severity of the most severe attempt. Subjects with a history of suicide attempts had more impulsive errors on the immediate memory task and had shorter response latencies, especially for impulsive responses. Impulsivity was highest in subjects with the most medically severe suicide attempts. Effects were not accounted for by presence of depression or mania at the time of testing. Barratt Impulsiveness Scale scores were numerically, but not significantly, higher in subjects with suicide attempts. A history of alcohol abuse was associated with greater probability of a suicide attempt. Multivariate analysis showed that ethanol abuse history and clinical state at the time of testing did not have a significant effect after impulsivity was taken into account. These results suggest that a history of severe suicidal behavior in patients with bipolar disorder is associated with impulsivity, manifested as a tendency toward rapid, unplanned responses.

  12. A tool for assessing case history and feedback skills in audiology students working with simulated patients.

    Science.gov (United States)

    Hughes, Jane; Wilson, Wayne J; MacBean, Naomi; Hill, Anne E

    2016-12-01

    To develop a tool for assessing audiology students taking a case history and giving feedback with simulated patients (SP). Single observation, single group design. Twenty-four first-year audiology students, five simulated patients, two clinical educators, and three evaluators. The Audiology Simulated Patient Interview Rating Scale (ASPIRS) was developed consisting of six items assessing specific clinical skills, non-verbal communication, verbal communication, interpersonal skills, interviewing skills, and professional practice skills. These items are applied once for taking a case history and again for giving feedback. The ASPIRS showed very high internal consistency (α = 0.91-0.97; mean inter-item r = 0.64-0.85) and fair-to-moderate agreement between evaluators (29.2-54.2% exact and 79.2-100% near agreement; κ weighted up to 0.60). It also showed fair-to-moderate absolute agreement amongst evaluators for single evaluator scores (intraclass correlation coefficient [ICC] r = 0.35-0.59) and substantial consistency of agreement amongst evaluators for three-evaluator averaged scores (ICC r = 0.62-0.81). Factor analysis showed the ASPIRS' 12 items fell into two components, one containing all feedback items and one containing all case history items. The ASPIRS shows promise as the first published tool for assessing audiology students taking a case history and giving feedback with an SP.

  13. Quetiapine Induced Acute Dystonia in a patient with History of severe Head Injury

    Directory of Open Access Journals (Sweden)

    Robert G. Bota

    2010-01-01

    Full Text Available A patient with a history of severe head injury 10 years ago regained ability to walk after years of being bound to a wheelchair. During the last psychiatric hospitalization, quetiapine was increased to therapeutic dose using a normal titration. As a result the patient developed dystonia of multiple muscle groups requiring 4 days of hospitalization for remittance of symptoms. In this paper, we take a close look at the literature concerning extrapiramidal symptoms (EPS in this context, and we suggest that in patients with a history of head injury, it is warranted to consider a slower titration of antipsychotic medications, including ones that are considered having a lower risk of EPS such as quetiapine.

  14. Plasma homovanillic acid and family history of psychotic disorders in bipolar I patients.

    Science.gov (United States)

    Zumárraga, Mercedes; Dávila, Ricardo; Basterreche, Nieves; Arrue, Aurora; Goienetxea, Biotza; González-Torres, Miguel Angel; Guimón, José

    2009-04-01

    It has been suggested that the family history of psychotic disorders is useful in defining homogeneous groups of bipolar patients. The plasma homovanillic acid (pHVA) concentrations have been related to the effect of antipsychotic treatment in psychotic patients. We have studied the influence of a positive family history of psychotic disorders both on the variation of pHVA levels and on the relation between pHVA concentrations and the clinical response to treatment. Clinical status and pHVA levels were assessed in 58 medication free patients before and after 4 weeks of treatment with olanzapine and lithium. Clinical improvement correlated positively with pHVA levels on the 28th day of treatment only in the patients having first degree relatives with psychotic disorders. The pHVA levels did not decrease after 28 days of treatment. Our results reinforce the idea that a positive family history of psychosis in psychotic bipolar disorders may constitute a good basis for sub-grouping these patients.

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

    Science.gov (United States)

    Niimi, Yukari; Ota, Katsumasa

    2013-01-01

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

  16. Clostridium difficile infection: Early history, diagnosis and molecular strain typing methods.

    Science.gov (United States)

    Rodriguez, C; Van Broeck, J; Taminiau, B; Delmée, M; Daube, G

    2016-08-01

    Recognised as the leading cause of nosocomial antibiotic-associated diarrhoea, the incidence of Clostridium difficile infection (CDI) remains high despite efforts to improve prevention and reduce the spread of the bacterium in healthcare settings. In the last decade, many studies have focused on the epidemiology and rapid diagnosis of CDI. In addition, different typing methods have been developed for epidemiological studies. This review explores the history of C. difficile and the current scope of the infection. The variety of available laboratory tests for CDI diagnosis and strain typing methods are also examined. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. The Life History Calendar Method and Multilevel Modeling: Application to Research on Intimate Partner Violence.

    Science.gov (United States)

    Yoshihama, Mieko; Bybee, Deborah

    2011-03-01

    Intimate partner violence (IPV) is prevalent and often recurrent in women's lives. To better understand the changing risk of IPV over the life course, which could guide more effective policies and program responses, methodological innovations are needed. Life History Calendar methods enhance respondents' recall of the timing of specific types of IPV experienced over the life course. Multilevel modeling provides a way to analyze individual and collective trajectories and examine covariates of IPV risk. We apply these complementary methods to examine IPV trajectories for a sample of women of Filipina descent living in the United States, examining life course timing and cohort effects. © The Author(s) 2011.

  18. The natural history of familial cerebral cavernomas: a retrospective MRI study of 40 patients

    International Nuclear Information System (INIS)

    Labauge, P.; Laberge, S.; Brunereau, L.; Levy, C.; Houtteville, J.P.

    2000-01-01

    Our objective was to determine the natural history and prognostic factors of familial forms of cerebral cavernous malformations (CCM). Cavernomas are one of the most common central nervous system vascular malformations. Familial CCM is increasingly diagnosed, but little is known about its natural history. In a national survey, we analysed clinical and MRI features of 173 patients from 57 unrelated French families. Of these 40 had undergone at least two clinical and MRI examinations. Occurrence of haemorrhage, new lesions, change in signal intensity and size of lesions have been studied by comparison between first and last MRI studies. The CCM were classified according to Zabramski et al. Mean follow-up was 3.2 years (range 0.5-6.5 years). We followed 232 cavernomas (mean 5.9 per patient, range 1-17). Serial MRI demonstrated changes in 28 patients (70 %). Bleeding occurred in 21 lesions (9.1 %) in 14 patients (35 %). The haemorrhagic risk was 2.5 % per lesion-year, higher in type I and brain-stem CCM. We saw 23 new lesions appear in 11 patients (27.5 %), with an incidence of 0.2 lesions per patient year. Signal change was observed in 11 patients (27.5 %), in 14 lesions (6 %), while 9 lesions (3.9 %) in 9 patients (22.5 %) changed significantly in size. (orig.)

  19. [Parathyroid cancer in a patient with previous history of hypernephroma: a clinical case].

    Science.gov (United States)

    Martín Navarro, J; Mendoza, E; Mateos, P; Cereceda, A; Coca, S

    2007-01-01

    We report the clinical case of a 55 year-old male patient, with a previous history of nephrectomy by hypernephroma sixteen years ago, first presenting hypercalcemia and rising of intact parathyroid hormone (iPTH) levels. A localization study revealed an intrathyroid nodule with cystic appearance. After undergoing a hemi-thyroidectomy, the patient is diagnosed with parathyroid carcinoma. This article analyzes previously published cases presenting parathyroidal pathologies associated with hypernephroma. A broader differential diagnosis--including the screening of parathyroidal pathologies should be considered in patients with hypercalcemia and hypernephroma.

  20. School History as a Method of Formation of Political Consciousness in Contemporary France

    Directory of Open Access Journals (Sweden)

    Nikolay V. Litvak

    2015-01-01

    Full Text Available The article discusses the attitude of the ruling elite in modern France to the school teaching of history, as the primary method of formation of political consciousness and outlook of the new generations. To achieve these purposes the complex of scientific and political methods is created. The programs are constantly changing, reflecting the general political struggle in French society, whose protagonists seek the arguments in support of their positions in history. In this context, the school programs are periodically in focus of urgent debates, and each their change is a compromise. The political approach is to form a state point of view of history, recorded in the programs required to study in schools. Those programs include a carefully selected set of topics, facts and personalities to be studied. In addition, the internal political struggle is coming not just about the form but the content too. In particular, for a number of years in the program a separate theme "Islam"is included, but not, for example, the theme "Christianity." However, supporters of the preservation of study of the Christian contribution to the history and the culture of France retain extensive relevant material included in a number of various subjects not directly devoted to Christianity. Informational approach to education is that the resources of the psyche and student's instructional time are very limited. The freedom of school teachers to refer to historical sources and even to interpret them within the broad framework is formally proclaimed. However, a program and a limited time to study it in conjunction with the responsibility of teachers for the results of their work, checked in exams, in fact does not leave them enough time to study an other point of view that goes beyond the official program.

  1. Natural history and surgical results in patients with unruptured intracranial aneurysms

    International Nuclear Information System (INIS)

    Okiyama, Koichi; Nagano, Osamu; Machida, Toshio; Serizawa, Toru; Ono, Junichi; Higuchi, Yoshinori

    2008-01-01

    The management of patients with unruptured intracranial aneurysms (UIAs) is controversial. We aimed to assess the natural history of UIAs and evaluate the surgical results. We analyzed 154 patients (181 saccular UIAs) with no history of subarachnoid hemorrhage (SAH) from a different aneurysm. Aneurysms were detected by magnetic resonance angiography (MRA) or by 3-dimensional CT angiography. Although the most frequent reason for the diagnosis was routine brain examinations of healthy patients or a vague symptom such as headache or dizziness, 15 patients were symptomatic. The natural history in patients who did not have surgery (follow-up group: 76 cases, 95 aneurysms) was assessed, and the surgical outcome of UIAs (surgical group: 78 cases, 86 aneurysms) was evaluated. Among 76 patients in the follow-up group, 7 had SAH. The mean latency period to aneurysm rupture was 3.2 months. The aneurysms with subsequent bleeding ranged from 5 to 25 mm (19.3 mm on average), whereas those without ranged from 1 to 28 mm (4.5 mm on average). The rupture rates of UIAs in anterior and posterior circulation were 6.2% and 14.3%, respectively. All ruptured cases were females. Mortality and morbidity associated with UIAs in the follow-up group were 3.9% and 3.9%, respectively. In the surgical group, no mortality was noted. Permanent morbidity associated with prospective repair of UIAs was 5.1%, although the morbidity of the patients with preoperative Rankin scores of 0 or 1 was 1.3%. Transient morbidity was observed in 6 patients (7.7%) with the size of the aneurysm 19.8 mm on average. The natural history and surgical results in patients with UIAs are modified by several factors including aneurysm size and location, the patient's age and gender, the medical status and the patient's preoperative Rankin score. The present results indicated that these factors should be considered in deciding whether to treat UIAs, and that careful assessment of the surgical benefits might be essential

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

    Science.gov (United States)

    Frewen, Paul A.; Oremus, Carolina; Lanius, Ruth A.; McKinnon, Margaret C.

    2016-01-01

    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. PMID:26927902

  3. 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.

  4. Natural history of vestibular schwannomas and hearing loss in NF2 patients.

    Science.gov (United States)

    Peyre, M; Bernardeschi, D; Sterkers, O; Kalamarides, M

    2015-07-13

    Bilateral vestibular schwannomas are the hallmark of neurofibromatosis 2 (NF2), occurring in 95% of patients. These tumors are associated with significant morbidity due to hearing loss, tinnitus, imbalance and facial weakness. As radiosurgery and chemotherapy have been recently introduced in the treatment armamentarium in addition to surgery, a thorough evaluation of vestibular schwannoma natural history is mandatory to determine the role and timing of each treatment modality. An exhaustive review of the literature was performed using the PubMed database concerning the natural history of tumor growth and hearing loss in NF2 patients with vestibular schwannomas. Although some aspects of vestibular schwannoma natural history remain uncertain (pattern of tumor growth, mean tumor growth rate), factors influencing growth such as age at presentation and paracrine factors are well established. Studies focusing on the natural history of hearing have highlighted different patterns of hearing loss and the possible role of intralabyrinthine tumors. The polyclonality of vestibular schwannomas in NF2 was recently unveiled, giving a new perspective to their growth mechanisms. An uniform evaluation of tumor growth using volumetric evaluation and hearing with standard classifications will ensure the use of common endpoints and should improve the quality of clinical trials as well as foster comparison among studies while ensuring more consistency in decision-making. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  5. Differences in knowledge related to dental implants between patients with and without a treatment history of dental implants.

    Science.gov (United States)

    Ken, Yukawa; Tachikawa, Noriko; Kasugai, Shohei

    2017-09-01

    This aim of this study was to investigate the differences between patients with and without a treatment history of dental implants by use of a questionnaire survey in order to determine the information that is required for patients undergoing dental implants. The questionnaires were given to 4512 patients who visited the Tokyo Medical and Dental University Hospital for oral implants between January 2012 and December 2014, and 2972 (66%) valid questionnaires were collected. There were 857 patients with a treatment history of dental implants and 2115 patients without. "Preservation of an adjacent tooth" was the reason that 32% of these patients chose implant therapy, and the patients without treatment history were significantly higher than the patients with one. Significantly, more patients without a treatment history of dental implants selected the after-effects of surgery and pain after surgery as their main concerns for implant therapy compared to those with a treatment history. In the question "Pain after surgery," the patients without treatment history did not know significantly lower than the patients with one. Patients without a treatment history of dental implants placed more importance on the preservation of healthy teeth. Because patients, in particular those without a treatment history of dental implants, are anxious about surgery, we should provide them with more information on treatment than we already do and explain the risks of treatment to them. To keep the credence between doctors and patients, informed consent and patient education on treatment are six important concerns. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Advocacy for the Archives and History Office of the SLAC National Accelerator Laboratory: Stages and Methods

    International Nuclear Information System (INIS)

    Deken, J.

    2009-01-01

    Advocating for the good of the SLAC Archives and History Office (AHO) has not been a one-time affair, nor has it been a one-method procedure. It has required taking time to ascertain the current and perhaps predict the future climate of the Laboratory, and it has required developing and implementing a portfolio of approaches to the goal of building a stronger archive program by strengthening and appropriately expanding its resources. Among the successful tools in the AHO advocacy portfolio, the Archives Program Review Committee has been the most visible. The Committee and the role it serves as well as other formal and informal advocacy efforts are the focus of this case study My remarks today will begin with a brief introduction to advocacy and outreach as I understand them, and with a description of the Archives and History Office's efforts to understand and work within the corporate culture of the SLAC National Accelerator Laboratory. I will then share with you some of the tools we have employed to advocate for the Archives and History Office programs and activities; and finally, I will talk about how well - or badly - those tools have served us over the past decade.

  7. A method for evaluating basement exhumation histories from closure age distributions of detrital minerals

    International Nuclear Information System (INIS)

    Lovera, Oscar M.; Grove, Marty; Kimbrough, David L.; Abbott, Patrick L.

    1999-01-01

    We have developed a two-dimensional, thermokinetic model that predicts the closure age distributions of detrital minerals from pervasively intruded and differentially exhumed basement. Using this model, we outline a method to determine the denudation history of orogenic regions on the basis of closure age distributions in synorogenic to postorogenic forearc strata. At relatively high mean denudation rates of 0.5 km m.y.-1 sustained over millions of years, magmatic heating events have minimal influence upon the age distributions of detrital minerals such as K-feldspar that are moderately retentive of radiogenic Ar. At lower rates, however, the effects of batholith emplacement may be substantial. We have applied the approach to detrital K-feldspars from forearc strata derived from the deeply denuded Peninsular Ranges batholith (PRB). Agreement of the denudation history deduced from the detrital K-feldspar data with thermochronologic constraints from exposed PRB basement lead us to conclude that exhumation histories of magmatic arcs should be decipherable solely from closure age distributions of detrital minerals whose depositional age is known. (c) 1999 American Geophysical Union

  8. [The Classification of Headache: Important Aspects of Patient's History and Clinical Diagnostic].

    Science.gov (United States)

    Kamm, Katharina; Ruscheweyh, Ruth; Eren, Ozan; Straube, Andreas

    2017-03-01

    Headache disorders are the most occuring symptoms in human population. Basis for a successful therapy of headaches is a definite diagnosis, which needs in turn valid criteria for the graduation of headaches. Corresponding to the classification of the International Headache Society (IHS) especially relevant questions about patient's history and clinical examination lead to a diagnosis. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Characteristics of female patients with sexual dysfunction who also had a history of blunt perineal trauma.

    Science.gov (United States)

    Munarriz, Ricardo; Talakoub, Lily; Somekh, Nir N; Lehrfeld, Todd; Chudnovsky, Aleksander; Flaherty, Elizabeth; Goldstein, Irwin

    2002-01-01

    Perineal trauma can occur in both genders, however, data supporting the relationship between sexual dysfunction and blunt perineal trauma in women is lacking. This study reviewed the patient characteristics of women with sexual dysfunction who also had a history of blunt perineal trauma. A neurogenic form of sexual dysfunction has been implicated, with primary complaints of orgasm disorder and abnormalities noted on genital sensory testing. Further research in this area is needed.

  10. Hepatic splenosis mimicking liver metastases in a patient with history of childhood immature teratoma

    OpenAIRE

    Jereb, Sara; Trotovsek, Blaz; Skrbinc, Breda

    2016-01-01

    Abstract Background Hepatic splenosis is rare condition, preceded by splenectomy or spleen trauma, the term refers to nodular implantation of normal splenic tissue in the liver. In patients with history of malignancy in particular, it can be mistaken for metastases and can lead to unnecessary diagnostic procedures or inappropriate treatment. Case report Twenty-two-year old male was treated for immature teratoma linked to undescended right testicle after birth. On regular follow-up examination...

  11. [A brief history of resuscitation - the influence of previous experience on modern techniques and methods].

    Science.gov (United States)

    Kucmin, Tomasz; Płowaś-Goral, Małgorzata; Nogalski, Adam

    2015-02-01

    Cardiopulmonary resuscitation (CPR) is relatively novel branch of medical science, however first descriptions of mouth-to-mouth ventilation are to be found in the Bible and literature is full of descriptions of different resuscitation methods - from flagellation and ventilation with bellows through hanging the victims upside down and compressing the chest in order to stimulate ventilation to rectal fumigation with tobacco smoke. The modern history of CPR starts with Kouwenhoven et al. who in 1960 published a paper regarding heart massage through chest compressions. Shortly after that in 1961Peter Safar presented a paradigm promoting opening the airway, performing rescue breaths and chest compressions. First CPR guidelines were published in 1966. Since that time guidelines were modified and improved numerously by two leading world expert organizations ERC (European Resuscitation Council) and AHA (American Heart Association) and published in a new version every 5 years. Currently 2010 guidelines should be obliged. In this paper authors made an attempt to present history of development of resuscitation techniques and methods and assess the influence of previous lifesaving methods on nowadays technologies, equipment and guidelines which allow to help those women and men whose life is in danger due to sudden cardiac arrest. © 2015 MEDPRESS.

  12. Case histories portraying different methods of installing liners for verticle barriers

    International Nuclear Information System (INIS)

    Burke, G.K.; Crockford, R.M.; Achhorner, F.N.

    1997-01-01

    The installation of liners for vertical barriers is difficult and has been a learning experience for every contractor making the attempt. Soil stratigraphy and hydrogeologic conditions can vary over short distances, creating a variety of problems. This is particularly so when working near landfills and documentation of the as-built condition is poor. Successful installation requires detailed planning and knowledge of what to expect, as well as alternate plans for potential problems. Several successful methods of panel connection will be presented as well as a variety of installation techniques. Project case histories will be reviewed, highlighting the challenges associated with specific construction techniques

  13. Illnesses in siblings of US patients with bipolar disorder relate to multigenerational family history and patients severity of illness.

    Science.gov (United States)

    Post, Robert M; Altshuler, Lori L; Kupka, Ralph; McElroy, Susan L; Frye, Mark A; Rowe, Michael; Grunze, Heinz; Suppes, Trisha; Keck, Paul E; Nolen, Willem A

    2017-01-01

    Patients with bipolar disorder from the US have more early-onset illness and a greater familial loading for psychiatric problems than those from the Netherlands or Germany (abbreviated here as Europe). We hypothesized that these regional differences in illness burden would extend to the patients siblings. Outpatients with bipolar disorder gave consent for participation in a treatment outcome network and for filling out detailed questionnaires. This included a family history of unipolar depression, bipolar disorder, suicide attempt, alcohol abuse/dependence, drug abuse/dependence, and "other" illness elicited for the patients' grandparents, parents, spouses, offspring, and siblings. Problems in the siblings were examined as a function of parental and grandparental problems and the patients' adverse illness characteristics or poor prognosis factors (PPFs). Each problem in the siblings was significantly (pUS than in those from Europe. In the US, problems in the parents and grandparents were almost uniformly associated with the same problems in the siblings, and sibling problems were related to the number of PPFs observed in the patients. Family history was based on patient report. Increased familial loading for psychiatric problems extends through 4 generations of patients with bipolar disorder from the US compared to Europe, and appears to "breed true" into the siblings of the patients. In addition to early onset, a variety of PPFs are associated with the burden of psychiatric problems in the patients' siblings and offspring. Greater attention to the multigenerational prevalence of illness in patients from the US is indicated. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. High 15-F2t-Isoprostane Levels in Patients with a Previous History of Nonmelanoma Skin Cancer: The Effects of Supplementary Antioxidant Therapy

    Directory of Open Access Journals (Sweden)

    Betânia de Jesus e Silva de Almendra Freitas

    2015-01-01

    Full Text Available Background. Phase I of this study was aimed at comparing the profiles of oxidative stress biomarkers in patients with history of nonmelanoma skin cancer (NMSC, previously treated with surgery, to the healthy subjects. Phase II aimed to evaluate the effects of supplementary antioxidant therapy on the levels of biomarkers in the case group. Materials and Methods. In Phase I, oxidative stress biomarkers were measured in blood samples obtained from 24 healthy subjects and 60 patients with history of NMSC previously treated with surgery. In Phase II, the 60 patients with history of NMSC were randomized into two subgroups, one receiving placebo (n=34 and the other (n=26 receiving vitamin C, vitamin E, and zinc supplementation for 8 weeks, followed by reevaluation of biomarkers. Results. In Phase I, patients with history of NMSC showed increased plasma concentrations of all biomarkers, but only 15-F2t-isoprostane was significantly higher than in the healthy subjects. Risk of NMSC increased by 4% for each additional 1 pg/mL increase in 15-F2t-isoprostane. In Phase II, supplementation did not significantly reduce levels of oxidative stress biomarkers. Conclusion. Patients with history of NMSC had significantly high 15-F2t-isoprostane plasma levels; supplementation did not result in significant reduction of oxidative stress biomarkers. This trial was registered with ClinicalTrials.gov (ID NCT02248584.

  15. Non-alcoholic Korsakoff syndrome in psychiatric patients with a history of undiagnosed Wernicke's encephalopathy.

    Science.gov (United States)

    Nikolakaros, Georgios; Ilonen, Tuula; Kurki, Timo; Paju, Janina; Papageorgiou, Sokratis G; Vataja, Risto

    2016-11-15

    Wernicke's encephalopathy is often undiagnosed, particularly in non-alcoholics. There are very few reports of non-alcoholic patients diagnosed with Korsakoff syndrome in the absence of a prior diagnosis of Wernicke's encephalopathy and no studies of diffusion tensor imaging in non-alcoholic Korsakoff syndrome. We report on three non-alcoholic psychiatric patients (all women) with long-term non-progressive memory impairment that developed after malnutrition accompanied by at least one of the three Wernicke's encephalopathy manifestations: ocular abnormalities, ataxia or unsteadiness, and an altered mental state or mild memory impairment. In neuropsychological examination, all patients had memory impairment, including intrusions. One patient had mild cerebellar vermis atrophy in MRI taken after the second episode of Wernicke's encephalopathy. The same patient had mild hypometabolism in the lateral cortex of the temporal lobes. Another patient had mild symmetrical atrophy and hypometabolism of the superior frontal lobes. Two patients were examined with diffusion tensor imaging. Reduced fractional anisotropy values were found in the corona radiata in two patients, and the uncinate fasciculus and the inferior longitudinal fasciculus in one patient. Our results suggest that non-alcoholic Korsakoff syndrome is underdiagnosed. Psychiatric patients with long-term memory impairment may have Korsakoff syndrome and, therefore, they should be evaluated for a history of previously undiagnosed Wernicke's encephalopathy. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Comparison of patients by family history with gastric and non-gastric cancer.

    Science.gov (United States)

    Zhou, Xue-Fu; He, Yu-Long; Song, Wu; Peng, Jian-Jun; Zhang, Chang-Hua; Li, Wen; Wu, Hui

    2009-06-07

    To compare the gastric cancer (GC) patients by their family history with gastric and non-GC. Positive family histories within second-degree relatives and clinicopathological features were obtained for 256 patients. Of the 256 probands, 112 (76 male, 36 female) were incorporated into familial GC (FGC) group: at least two GC members; 144 (98 male, 46 female) were included in the non-FGC group (relatives only affected with non-GCs). Of 399 tumors in relatives (181 from FGC against 212 from non-FGC), GC was the most frequent, followed by esophageal, hepatocellular, and colorectal cancer. Nasopharyngeal cancer was next to lung cancer but prior to breast and urogenital cancers. Most affected members aggregated within first-degree relatives (FGC: 66 siblings, 48 fathers, 31 mothers, four offspring; non-FGC: 56 fathers, 55 siblings, 43 mothers, and 15 offspring). The ratio of males to females in affected first-degree relatives was usually higher in male probands. Paternal history of GC was a slight risk for GC in males (OR = 1.19, 95% CI: 0.53-2.69), while risk of GC by maternal history of non-GCs was increased in females (OR = 0.46, 95% CI: 0.22-0.97). Diffuse-GC was the major histological type in all subgroups. Difference in tumor sites between the two groups was derived from an excess of upper sites in non-FGC female probands. Distribution of associated non-GCs in a family history of GC may vary with geographic areas. GC may have different genetic and/or environmental etiology in different families, and a certain subtype may be inherited in a female-influenced fashion.

  17. Monitoring and predicting the risk of violence in residential facilities. No difference between patients with history or with no history of violence.

    Science.gov (United States)

    de Girolamo, Giovanni; Buizza, Chiara; Sisti, Davide; Ferrari, Clarissa; Bulgari, Viola; Iozzino, Laura; Boero, Maria Elena; Cristiano, Giuseppe; De Francesco, Alessandra; Giobbio, Gian Marco; Maggi, Paolo; Rossi, Giuseppe; Segalini, Beatrice; Candini, Valentina

    2016-09-01

    Most people with mental disorders are not violent. However, the lack of specific studies in this area and recent radical changes in Italy, including the closure of six Forensic Mental Hospitals, has prompted a more detailed investigation of patients with aggressive behaviour. To compare socio-demographic, clinical and treatment-related characteristics of long-term inpatients with a lifetime history of serious violence with controls; to identify predictors of verbal and physical aggressive behaviour during 1-year follow-up. In a prospective cohort study, patients living in Residential Facilities (RFs) with a lifetime history of serious violence were assessed with a large set of standardized instruments and compared to patients with no violent history. Patients were evaluated bi-monthly with MOAS in order to monitor any aggressive behaviour. The sample included 139 inpatients, 82 violent and 57 control subjects; most patients were male. The bi-monthly monitoring during the 1-year follow-up did not show any statistically significant differences in aggressive behaviour rates between the two groups. The subscale explaining most of the MOAS total score was aggression against objects, although verbal aggression was the most common pattern. Furthermore, verbal aggression was significantly associated with aggression against objects and physical aggression. Patients with a history of violence in RFs, where treatment and clinical supervision are available, do not show higher rates of aggressiveness compared to patients with no lifetime history of violence. Since verbal aggression is associated with more severe forms of aggression, prompt intervention is warranted to reduce the risk of escalation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. 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)

    Yoshimoto, Masataka; Sakamoto, Goi; Sugano, Haruo; Kasumi, Fujio; Fukami, Atsuo; Kuno, Keijiro.

    1984-01-01

    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)

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

    Science.gov (United States)

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

    2013-01-01

    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. 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 disease was confirmed with histopathology examination of duodenal biopsy specimen. Complicated interactions between celiac disease and bulimia can make them difficult to diagnose and treat. It is important to consider the presence of celiac disease in patients with bulimia and gastrointestinal symptoms.

  20. A study on the stress history condensation method for a fatigue monitoring system

    International Nuclear Information System (INIS)

    Ko, Hanok; Jhung, Myungjo; Lee, Kihyoung

    2014-01-01

    Fatigue damage is the one of important aging mechanisms. Time-varying thermal, pressure and mechanical loads produce perturbations of stress cycles primarily at the surface of a component. Stress cycles of sufficient magnitude cause fatigue damage, which can ultimately lead to cracking of the component. According to NUREG-1801, fatigue monitoring systems identify acceptable aging management programs, including programs for fatigue and cyclic operation. In a monitoring system, the rainflow counting method is mainly used as the stress cycle counting method. Before determining the stress cycles using rainflow counting method, stress extremum (or peak/valley) must be identified. Because real stress history contains large numbers of very small cycles, which may be a result of digitization noise, these cycles will slow down the analysis and distort the scaling of graphical displays. As a result, it is found that stress cycles smaller than a threshold value are discarded by using the proposed method. In this paper, an engineering methodology which extracts extremum from the real-time transient data, so-called SEE, has been developed. The proposed method is very simple and so fast because it only uses the difference between the input value and local peak/valley. The stress cycles counted by two methods are compared with those counted by only rainflow counting method and it is found that stress cycles smaller than a threshold value were eliminated

  1. Heightened aversion to risk and loss in depressed patients with a suicide attempt history.

    Science.gov (United States)

    Baek, Kwangyeol; Kwon, JaeHyung; Chae, Jeong-Ho; Chung, Yong An; Kralik, Jerald D; Min, Jung-Ah; Huh, HyuJung; Choi, Kyung Mook; Jang, Kuk-In; Lee, Na-Bin; Kim, Sunyoung; Peterson, Bradley S; Jeong, Jaeseung

    2017-09-11

    Suicide attempters have been found to be impaired in decision-making; however, their specific biases in evaluating uncertain outcomes remain unclear. Here we tested the hypothesis that suicidal behavior is associated with heightened aversion to risk and loss, which might produce negative predictions about uncertain future events. Forty-five depressed patients with a suicide attempt history, 47 nonsuicidal depressed patients, and 75 healthy controls participated in monetary decision-making tasks assessing risk and loss aversion. Suicide attempters compared with the other groups exhibited greater aversion to both risk and loss during gambles involving potential loss. Risk and loss aversion correlated with each other in the depressed patients, suggesting that a common pathophysiological mechanism underlies these biases. In addition, emotion regulation via suppression, a detrimental emotional control strategy, was positively correlated with loss aversion in the depressed patients, also implicating impairment in regulatory processes. A preliminary fMRI study also found disrupted neural responses to potential gains and losses in the subgenual anterior cingulate cortex, insula cortex, and left amygdala, brain regions involved in valuation, emotion reactivity, and emotion regulation. The findings thus implicate heightened negative valuation in decision-making under risk, and impaired emotion regulation in depressed patients with a history of suicide attempts.

  2. [Blood pressure lowering therapy for mild hypertensive patients with a history of stroke].

    Science.gov (United States)

    Ishikawa, Eiichi; Ibayashi, Setsuro

    2008-08-01

    Hypertension is the primary and one of the major risk factors for stroke. Many hypertensive patients with a history of stroke might have mild to moderate hypertension at the same time. In order to prevent recurrence of cardiovascular diseases including stroke, we should lower their blood pressure levels, carefully and slowly below less than 140/90 mmHg or much lower. Additionally, the patients having any occlusion or stenoses in their carotid and/or intracranial arteries, or even in old-old patients with atherosclerosis, might need further consideration for the cerebral blood flow insufficiency in the course of blood pressure lowering therapy. Although the advantages of inhibitors of renin-angiotensin system are lionized these days (advertisement based medicine: ABM), we should never forget to select more favorable antihypertensive drugs for each patient in case by case (individual based medicine: IBM), to get the definite blood pressure lowering effects without worsening any complications. We also need further gathering of many evidences in a net-work-meta-analysis way, on blood pressure lowering therapy in those hypertensive patients with a history of stroke (evidence based medicine: EBM).

  3. Stereotactic Radiosurgery versus Natural History in Patients with Growing Vestibular Schwannomas.

    Science.gov (United States)

    Tu, Albert; Gooderham, Peter; Mick, Paul; Westerberg, Brian; Toyota, Brian; Akagami, Ryojo

    2015-08-01

    Objective To describe our experience with stereotactic radiosurgery and its efficacy on growing tumors, and then to compare this result with the natural history of a similar cohort of non-radiation-treated lesions. Study Design A retrospective chart review and cohort comparison. Methods The long-term control rates of patients having undergone radiosurgery were collected and calculated, and this population was then compared with a group of untreated patients from the same period of time with growing lesions. Results A total of 61 patients with growing vestibular schwannomas treated with radiosurgery were included. After a mean of 160 months, we observed a control rate of 85.2%. When compared with a group of 36 patients with growing tumors who were yet to receive treatment (previously published), we found a corrected control rate or relative risk reduction of only 76.8%. Conclusion Radiosurgery for growing vestibular schwannomas is less effective than previously reported in unselected series. Although radiosurgery still has a role in managing this disease, consideration should be given to the actual efficacy that may be calculated when the natural history is known. We hope other centers will similarly report their experience on this cohort of patients.

  4. The natural history and management of patients with congenital deficits associated with lumbosacral lipomas.

    Science.gov (United States)

    Tu, Albert; Hengel, Ross; Cochrane, D Douglas

    2016-04-01

    Many patients with lumbosacral lipoma are asymptomatic; however, a significant proportion will have neurological deficits present at birth. Implication of these deficits with respect to natural history and management are not well understood. A retrospective review of all infants with lumbosacral lipoma seen at BCCH between 1997 and 2013 was carried out. The study population was stratified on the presence of a congenital, non-progressive deficit and subdivided on treatment approach. The subsequent developments of deficits resulting in untethering procedures were recorded. Of the 44 infants in this study, 24 patients had no neurologic deficit while 20 patients had a fixed, non-progressive deficit evident at birth. Ten of 24 patients without a neurological deficit at birth underwent a prophylactic untethering with 3 eventually requiring repeat untethering after, on average, 62.7 months. Eleven of 14 asymptomatic, monitored patients required untethering for clinical deterioration. Two required a second untethering procedure after 48.7 months. Ten of 20 infants with congenital deficits present at birth underwent prophylactic untethering, and 4 required further surgery after 124 months. Ten patients underwent observation with 8 eventually requiring surgery. Two required repeat untethered after 154 months. The complication rates and operative burden for patients are similar whether prophylactic or delayed surgery is performed. The presence of congenital neurologic deficit does not affect the likelihood of deterioration in patients managed expectantly; prophylactic detethering of these patients did not prevent delayed neurologic deterioration. Comparing the need for repeat surgery in prophylactically untethered patients with initial untethering of patients operated upon at the time of deterioration, prophylactic untethering may confer a benefit with respect to subsequent symptomatic tethering if complication rates are low. However, in a setting with multidisciplinary

  5. A Rare Reason of Ileus in Renal Transplant Patients With Peritoneal Dialysis History: Encapsulated Peritoneal Sclerosis.

    Science.gov (United States)

    Gökçe, Ali Murat; Özel, Leyla; İbişoğlu, Sevinç; Ata, Pınar; Şahin, Gülizar; Gücün, Murat; Kara, V Melih; Özdemir, Ebru; Titiz, M İzzet

    2015-12-01

    Encapsulating peritoneal sclerosis is a rare complication of long-term peritoneal dialysis ranging from moderate inflammation of peritoneal structures to severe sclerosing peritonitis and encapsulating peritoneal sclerosis. Complicated it, ileus may occur during or after peritoneal dialysis treatment or after kidney transplant. We sought to evaluate 3 posttransplant encapsulating peritoneal sclerosis through clinical presentation, radiologic findings, and outcomes. We analyzed 3 renal transplant patients with symptoms of encapsulating peritoneal sclerosis admitted posttransplant to our hospital with ileus between 2012 and 2013. Conservative treatment was applied to the patients whenever necessary to avoid surgery. One patient improved with medical therapy. Surgical treatment was delayed and we decided it as a last resort, in 2 cases with no response to conservative treatment for a long time. Finally, patients with peritoneal dialysis history should be searched carefully before renal transplant for intermittent bowel obstruction story.

  6. The natural history of cystic echinococcosis in untreated and albendazole-treated patients.

    Science.gov (United States)

    Solomon, N; Kachani, M; Zeyhle, E; Macpherson, C N L

    2017-07-01

    The World Health Organization (WHO) treatment protocols for cystic echinococcosis (CE) are based on the standardized ultrasound (US) classification. This study examined whether the classification reflected the natural history of CE in untreated and albendazole-treated patients. Data were collected during mass US screenings in CE endemic regions among transhumant populations, the Turkana and Berber peoples of Kenya and Morocco. Cysts were classified using the WHO classification. Patient records occurring prior to treatment, and after albendazole administration, were selected. 852 paired before/after observations of 360 cysts from 257 patients were analyzed. A McNemar-Bowker χ 2 test for symmetry was significant (palbendazole-treated patients was significant (palbendazole-induced changes. Regressions may reflect the stability of CE3B cysts. Copyright © 2017. Published by Elsevier B.V.

  7. Hermann Cohen's Das Princip der Infinitesimal-Methode: The history of an unsuccessful book.

    Science.gov (United States)

    Giovanelli, Marco

    2016-08-01

    This paper offers an introduction to Hermann Cohen's Das Princip der Infinitesimal-Methode (1883), and recounts the history of its controversial reception by Cohen's early sympathizers, who would become the so-called 'Marburg school' of Neo-Kantianism, as well as the reactions it provoked outside this group. By dissecting the ambiguous attitudes of the best-known representatives of the school (Paul Natorp and Ernst Cassirer), as well as those of several minor figures (August Stadler, Kurd Lasswitz, Dimitry Gawronsky, etc.), this paper shows that Das Princip der Infinitesimal-Methode is a unicum in the history of philosophy: it represents a strange case of an unsuccessful book's enduring influence. The "puzzle of Cohen's Infinitesimalmethode," as we will call it, can be solved by looking beyond the scholarly results of the book, and instead focusing on the style of philosophy it exemplified. Moreover, the paper shows that Cohen never supported, but instead explicitly opposed, the doctrine of the centrality of the 'concept of function', with which Marburg Neo-Kantianism is usually associated. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. SPME-Based Ca-History Method for Measuring SVOC Diffusion Coefficients in Clothing Material.

    Science.gov (United States)

    Cao, Jianping; Liu, Ningrui; Zhang, Yinping

    2017-08-15

    Clothes play an important role in dermal exposure to indoor semivolatile organic compounds (SVOCs). The diffusion coefficient of SVOCs in clothing material (D m ) is essential for estimating SVOC sorption by clothing material and subsequent dermal exposure to SVOCs. However, few studies have reported the measured D m for clothing materials. In this paper, we present the solid-phase microextraction (SPME) based C a -history method. To the best of our knowledge, this is the first try to measure D m with known relative standard deviation (RSD). A thin sealed chamber is formed by a circular ring and two pieces of flat SVOC source materials that are tightly covered by the targeted clothing materials. D m is obtained by applying an SVOC mass transfer model in the chamber to the history of gas-phase SVOC concentrations (C a ) in the chamber measured by SPME. D m 's of three SVOCs, di-iso-butyl phthalate (DiBP), di-n-butyl phthalate (DnBP), and tris(1-chloro-2-propyl) phosphate (TCPP), in a cotton T-shirt can be obtained within 16 days, with RSD less than 3%. This study should prove useful for measuring SVOC D m in various sink materials. Further studies are expected to facilitate application of this method and investigate the effects of temperature, relative humidity, and clothing material on D m .

  9. Voice related quality of life in pediatric patients with a history of prematurity.

    Science.gov (United States)

    Walz, Patrick C; Hubbell, Michael P; Elmaraghy, Charles A

    2014-07-01

    To determine incidence of dysphonia in patients with history of prematurity and evaluate the correlation between dysphonia and risk factors unique to premature infants. The aim of this study is to determine parent-perceived vocal quality in patients with history of prematurity and whether duration of intubation, number of intubations, and incidence of patent ductus arteriosus repair were correlated with these perceptions. Cohort study of premature patients presenting to outpatient clinics from January 2010 to January 2013 in tertiary care center. Patients gestational age ≤37 weeks at birth without history of tracheostomy or known vocal fold pathology were eligible. A volunteer sample was obtained from patients presenting in Otolaryngology clinics from January 2010 to January 2013 whose parents agreed to complete surveys. Outcomes were assessed via parental completion of pediatric voice outcomes score (pVOS) and pediatric voice-related quality of life (pVRQOL) instruments. The primary outcome assessed was the incidence of dysphonia in infants with a history of prematurity without known vocal pathology. Additionally, patient factors associated with dysphonia were evaluated. The hypothesis tested was formulated prior to data collection. Sixty-nine participants were included. Mean age at follow-up was 28 (3-197) months. Mean gestational age was 29 (23-37) weeks. Mean intubation duration was 3 (0-22) weeks and median number of intubations was 1 (range 0-5). Voice outcome scores varied widely with pVRQOL scores demonstrating a mean of 89.2±18.1 (25-100) and pVOS with a mean of 11.4±2.2 (0-13). Univariate analysis utilized Spearman correlation coefficients for continuous variables and Wilcoxon Two-sample test for categorical groups. Significance was set at pquality in premature patients. Further study is required to correlate parent perceptions with objective vocal quality data and physical findings of vocal pathology. These data may increase the clinician's suspicion

  10. k{sub 0}-neutron activation analysis based method at CDTN: history, development and main achievements

    Energy Technology Data Exchange (ETDEWEB)

    Menezes, Maria Ângela de B.C.; Jacimovic, Radojko; Dalmazio, Ilza, E-mail: menezes@cdtn.br, E-mail: id@cdtn.br, E-mail: radojko.jacimovic@ijs.si [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte - MG (Brazil); Jožef Stefan Institute, Department of Environmental Sciences, Ljubljana (Slovenia)

    2017-11-01

    Neutron Activation Analysis (NAA) is an analytical technique to assay the elemental chemical composition in samples of several matrices. It has been applied by the Laboratory for Neutron Activation Analysis, located at Centro de Desenvolvimento da Tecnologia Nuclear (Nuclear Technology Development Centre) /Comissao Nacional de Energia Nuclear (Brazilian Commission for Nuclear Energy), CDTN/CNEN, since the starting up of the TRIGA MARK I IPR-R1 reactor, in 1960. Among the methods of this technique, the k{sub 0}-standardization method, which was established at CDTN in 1995, is the most efficient and in 2003 it was re-established and optimized. This paper is about the history and the main achievements since then. (author)

  11. k_0-neutron activation analysis based method at CDTN: history, development and main achievements

    International Nuclear Information System (INIS)

    Menezes, Maria Ângela de B.C.; Jacimovic, Radojko; Dalmazio, Ilza

    2017-01-01

    Neutron Activation Analysis (NAA) is an analytical technique to assay the elemental chemical composition in samples of several matrices. It has been applied by the Laboratory for Neutron Activation Analysis, located at Centro de Desenvolvimento da Tecnologia Nuclear (Nuclear Technology Development Centre) /Comissao Nacional de Energia Nuclear (Brazilian Commission for Nuclear Energy), CDTN/CNEN, since the starting up of the TRIGA MARK I IPR-R1 reactor, in 1960. Among the methods of this technique, the k_0-standardization method, which was established at CDTN in 1995, is the most efficient and in 2003 it was re-established and optimized. This paper is about the history and the main achievements since then. (author)

  12. Family history and its association to curve size and treatment in 1,463 patients with idiopathic scoliosis.

    Science.gov (United States)

    Grauers, Anna; Danielsson, Aina; Karlsson, Magnus; Ohlin, Acke; Gerdhem, Paul

    2013-11-01

    To study family history in relation to curve severity, gender, age at diagnosis and treatment in idiopathic scoliosis. A self-assessment questionnaire on family history of scoliosis was administered to 1,463 untreated, brace or surgically treated idiopathic scoliosis patients. Out of the 1,463 patients, 51 % had one or more relatives with scoliosis. There was no significant difference between females and males, nor between juvenile and adolescent study participants in this respect (p = 0.939 and 0.110, respectively). There was a significant difference in maximum curve size between patients with one or more relatives with scoliosis (median 35°, interquartile range 25) and patients without any relative with scoliosis (median 32°, interquartile range 23) (p = 0.022). When stratifying patients according to treatment (observation, brace treatment or surgery), we found that it was more common to have a relative with scoliosis among the treated patients (p = 0.011). The OR for being treated was 1.32 (95% CI 1.06-1.64) when the patient had a relative with scoliosis, compared to not having. Larger curve sizes were found in patients with a family history of scoliosis than in the ones without. No relation between family history and gender or between family history and age at onset of idiopathic scoliosis was found. Although the presence of a family history of scoliosis may not be a strong prognostic risk factor, it indicates that these patients are at higher risk of developing a more severe curve.

  13. Association between Patient History and Physical Examination and Osteoarthritis after Ankle Sprain.

    Science.gov (United States)

    van Ochten, John M; de Vries, Anja D; van Putte, Nienke; Oei, Edwin H G; Bindels, Patrick J E; Bierma-Zeinstra, Sita M A; van Middelkoop, Marienke

    2017-09-01

    Structural abnormalities on MRI are frequent after an ankle sprain. To determine the association between patient history, physical examination and early osteoarthritis (OA) in patients after a previous ankle sprain, 98 patients with persistent complaints were selected from a cross-sectional study. Patient history taking and physical examination were applied and MRI was taken. Univariate and multivariable analyses were used to test possible associations. Signs of OA (cartilage loss, osteophytes and bone marrow edema) were seen in the talocrural joint (TCJ) in 40% and the talonavicular joint (TNJ) in 49%. Multivariable analysis showed a significant positive association between swelling (OR 3.58, 95%CI 1.13;11.4), a difference in ROM of passive plantar flexion (OR 1.09, 95%CI 1.01;1.18) and bone edema in the TCJ. A difference in ROM of passive plantar flexion (OR 1.07, 95%CI 1.00;1.15) and pain at the end range of dorsiflexion/plantar flexion (OR 5.23, 95%CI 1.88;14.58) were associated with osteophytes in the TNJ. Pain at the end of dorsiflexion/plantar flexion, a difference in ROM of passive plantar flexion and swelling seem to be associated with features of OA (bone marrow edema, osteophytes) in the TCJ and TNJ. Our findings may guide physicians to predict structural joint abnormalities as signs of osteoarthritis. 1b. © Georg Thieme Verlag KG Stuttgart · New York.

  14. PROMOTER POLYMORPHISM OF IL-1β GENE IN PATIENTS WITH A HISTORY OF ACUTE MYOCARDIAL INFARCTION

    Directory of Open Access Journals (Sweden)

    A. V. Shevchenko

    2010-01-01

    Full Text Available We have performed analysis of associations between IL-1β gene promoter polymorphism (-511C/T and -31 T/C variants, and conventional cardiovascular risk factors in the patients living in the West Siberia who had previously a history of myocardial infarction (MI. We are shown a strong linkage disequilibrium between IL-1β -31C/T (rs1143627, and IL-1β-511T/C (rs16944. Significant differences in frequency distributions of some compound genotypes were observed between healthy and patients with a history of MI. E.g., frequency of IL-1β-31CC/-511CT genotype was detected in 5.5 % of healthy population, while being absent among MI patients. A frequency of IL-1β (-31/-511 CC/CT genotype showed significant differences between MI patients under 55 years, as compared to healthy persons. Hence, the analyzed IL-1β promoter polymorphisms may be considered as an additional constitutional factor predisposing for vascular alterations.

  15. The natural history of postoperative venous thromboemboli in gynecologic oncology: a prospective study of 382 patients

    International Nuclear Information System (INIS)

    Clarke-Pearson, D.L.; Synan, I.S.; Colemen, R.E.; Hinshaw, W.; Creasman, W.T.

    1984-01-01

    Three hundred eighty-two patients who underwent major operations for gynecologic malignancy were studied prospectively to determine the natural history of postoperative venous thromboemboli. Iodine 125-labeled fibrinogen leg counting, to diagnose deep venous thrombosis, was performed daily. Sixty-three patients (17%) developed postoperative venous thromboembolic complications. Deep venous thrombosis initially arose in the calf veins in 52 patients. Twenty-seven percent of these thrombi lysed spontaneously. Four percent of thrombi in the calf veins progressed to deep venous thrombosis in the femoral vein, and 4% resulted in pulmonary emboli. Nine other patients developed proximal deep venous thrombosis without prior thrombosis in the calf veins. One patient with proximal deep venous thrombosis also had a pulmonary embolus. Two patients with no evidence of deep venous thrombosis on prospective 125 I-labeled fibrinogen leg counting developed pulmonary emboli, including one fatal pulmonary embolus that was found at autopsy to have arisen from the internal iliac veins. Fifty percent of all venous thromboemboli were detected within 48 hours of operation, although two patients developed significant deep venous thrombosis and pulmonary emboli after discharge from the hospital. These results add important information to our understanding of this disease process, and raise issues related to appropriate treatment and prophylaxis of venous thromboembolism in patients after gynecologic operations

  16. Projective methodical system of students training to the course «History of computer science»

    OpenAIRE

    С А Виденин

    2008-01-01

    Components of teachers readiness to professional activity are described in the item. The projective methods of training to a course « History of computer science « in favour to improve professional grounding of students' are considered.

  17. A Novel 3D Viscoelastic Acoustic Wave Equation Based Update Method for Reservoir History Matching

    KAUST Repository

    Katterbauer, Klemens

    2014-12-10

    The oil and gas industry has been revolutionized within the last decade, with horizontal drilling and hydraulic fracturing enabling the extraction of huge amounts of shale gas in areas previously considered impossible and the recovering of hydrocarbons in harsh environments like the arctic or in previously unimaginable depths like the off-shore exploration in the South China sea and Gulf of Mexico. With the development of 4D seismic, engineers and scientists have been enabled to map the evolution of fluid fronts within the reservoir and determine the displacement caused by the injected fluids. This in turn has led to enhanced production strategies, cost reduction and increased profits. Conventional approaches to incorporate seismic data into the history matching process have been to invert these data for constraints that are subsequently employed in the history matching process. This approach makes the incorporation computationally expensive and requires a lot of manual processing for obtaining the correct interpretation due to the potential artifacts that are generated by the generally ill-conditioned inversion problems. I have presented here a novel approach via including the time-lapse cross-well seismic survey data directly into the history matching process. The generated time-lapse seismic data are obtained from the full wave 3D viscoelastic acoustic wave equation. Furthermore an extensive analysis has been performed showing the robustness of the method and enhanced forecastability of the critical reservoir parameters, reducing uncertainties and exhibiting the benefits of a full wave 3D seismic approach. Finally, the improved performance has been statistically confirmed. The improvements illustrate the significant improvements in forecasting that are obtained via readily available seismic data without the need for inversion. This further optimizes oil production in addition to increasing return-on-investment on oil & gas field development projects, especially

  18. The history of ironware in Japan revealed by the AMS-carbon 14 age method

    International Nuclear Information System (INIS)

    Fujio, Shin'ichirou

    2005-01-01

    This paper focuses on the influence what the AMS-carbon 14 age method attains to the history of the iron in the Japanese Islands. The research team in National Museum of Japanese History makes a clear that the Yayoi period began in 10 Cen. cal BC. However, there was a problem in this. It is iron. If the Yayoi period has started in the 10th Cen. BC, it means that the ironware in Japanese Islands had spread early rather than it spreads in China. The research team reexamined the ironware excavated from Magarita site in the Fukuoka Pref. considered to be the oldest ironware in Japan. Consequently, the excavation situation was indefinite and it turned out that we cannot specify the time to belong. Furthermore, 36 ironwares in the initial and early Yayoi were also already found by that time cannot be specified except for two points. Therefore, it turned out that Japanese ironware appeared in the 3rd century of B.C. What does this mean? Although it had been thought that the beginning of agriculture in Japan and the appearance of ironware were simultaneous, it turned out that agriculture has appeared early about in 700 years. Therefore, it became clear that agriculture of Japan started at the Stone Age. (author)

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Optiwave Refractive Analysis may not work well in patients with previous history of radial keratotomy

    Directory of Open Access Journals (Sweden)

    Fuxiang Zhang

    2018-06-01

    Full Text Available Purpose: To report a case of significant hyperopic outcome (both eyes following Optiwave Refractive Analysis (ORA intraocular lens (IOL power recommendation in a cataract patient with history of 8 cut radial keratotomy (RK in each eye. Observations: It is hypothesized that increased intraocular pressure (IOP from phacoemulsification could make the RK cuts swell, and change cornea shape intraoperatively. In this unique scenario, the corneal curvature readings from ORA could be quite different from preoperative readings or from stabilized postoperative corneal measurements. The change in corneal curvature could also affect the anterior chamber depth and axial length readings, skewing multiple parameters on which ORA bases recommendations for IOL power. Conclusions and importance: ORA has been widely used among cataract surgeons on patients with history of RK, but it's validation, unlike for laser-assisted in-situ keratomileusis (LASIK and photorefractive keratectomy (PRK, has yet to be established by peer reviewed studies. Surgeons should be cautious when using ORA on RK patients. Keywords: Intraoperative aberrometry, ORA, RK, IOL power

  2. Fluid history computation methods for reactor safeguards problems using MNODE computer program

    International Nuclear Information System (INIS)

    Huang, Y.S.; Savery, C.W.

    1976-10-01

    A method for predicting the pressure-temperature histories of air, water liquid, and vapor flowing in a zoned containment as a result of high energy pipe rupture is described. The computer code, MNODE, has been developed for 12 connected control volumes and 24 inertia flow paths. Predictions by the code are compared with the results of an analytical gas dynamic problem, semiscale blowdown experiments, full scale MARVIKEN test results, Battelle-Frankfurt model PWR containment test data. The MNODE solutions to NRC/AEC subcompartment benchmark problems are also compared with results predicted by other computer codes such as RELAP-3, FLASH-2, CONTEMPT-PS. The analytical consideration is consistent with Section 6.2.1.2 of the Standard Format (Rev. 2) issued by U.S. Nuclear Regulatory Commission in September 1975

  3. Classification of older adults with/without a fall history using machine learning methods.

    Science.gov (United States)

    Lin Zhang; Ou Ma; Fabre, Jennifer M; Wood, Robert H; Garcia, Stephanie U; Ivey, Kayla M; McCann, Evan D

    2015-01-01

    Falling is a serious problem in an aged society such that assessment of the risk of falls for individuals is imperative for the research and practice of falls prevention. This paper introduces an application of several machine learning methods for training a classifier which is capable of classifying individual older adults into a high risk group and a low risk group (distinguished by whether or not the members of the group have a recent history of falls). Using a 3D motion capture system, significant gait features related to falls risk are extracted. By training these features, classification hypotheses are obtained based on machine learning techniques (K Nearest-neighbour, Naive Bayes, Logistic Regression, Neural Network, and Support Vector Machine). Training and test accuracies with sensitivity and specificity of each of these techniques are assessed. The feature adjustment and tuning of the machine learning algorithms are discussed. The outcome of the study will benefit the prediction and prevention of falls.

  4. A Cohort Study of the Natural History of Odontoid Pseudoarthrosis Managed Nonoperatively in Elderly Patients.

    Science.gov (United States)

    Hong, Jennifer; Zaman, Rifat; Coy, Shannon; Pastel, David; Simmons, Nathan; Ball, Perry; Mirza, Sohail; Abdu, William; Pearson, Adam; Lollis, S Scott

    2018-06-01

    Although the primary goal of treatment of type II odontoid fracture is bony union, some advocate continued nonsurgical management of minimally symptomatic older patients who have fibrous union or minimal fracture motion. The risk of this strategy is unknown. We reviewed our long-term outcomes after dens nonunion to define the natural history of Type II odontoid fractures in elderly patients managed nonoperatively. A retrospective chart review of 50 consecutive adults aged 65 or older with Type II odontoid fracture initially managed nonsurgically from 1998 to 2012 at a single tertiary care institution was conducted. Particular attention was paid to patients who had orthosis removal despite absent bony fusion. Patients were contacted prospectively by telephone and followed until death, surgical intervention, or last known contact. Fifty patients initially were managed nonsurgically; of these, 21 (42.0%) proceeded to bony fusion, 3 (6%) underwent delayed surgery for persistent instability, and 26 (52%) had orthosis removal despite the lack of solid arthrodesis on imaging. The last group had a median follow-up of 25 months (range 4-158 months), with 20 of 26 (76.9%) followed until death. Of these patients, 1 patient developed progressive quadriplegia and dysphagia 11 months after initial injury. Compared with patients with spontaneous union, patients with nonunion had shorter life expectancy, despite no significant differences between the groups with respect to age, sex, injury mechanism, radiographic variables, or follow-up duration. Orthosis removal despite fracture nonunion may be reasonable in elderly patients with Type II dens fractures. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. A Time Domain Update Method for Reservoir History Matching of Electromagnetic Data

    KAUST Repository

    Katterbauer, Klemens

    2014-03-25

    The oil & gas industry has been the backbone of the world\\'s economy in the last century and will continue to be in the decades to come. With increasing demand and conventional reservoirs depleting, new oil industry projects have become more complex and expensive, operating in areas that were previously considered impossible and uneconomical. Therefore, good reservoir management is key for the economical success of complex projects requiring the incorporation of reliable uncertainty estimates for reliable production forecasts and optimizing reservoir exploitation. Reservoir history matching has played here a key role incorporating production, seismic, electromagnetic and logging data for forecasting the development of reservoirs and its depletion. With the advances in the last decade, electromagnetic techniques, such as crosswell electromagnetic tomography, have enabled engineers to more precisely map the reservoirs and understand their evolution. Incorporating the large amount of data efficiently and reducing uncertainty in the forecasts has been one of the key challenges for reservoir management. Computing the conductivity distribution for the field for adjusting parameters in the forecasting process via solving the inverse problem has been a challenge, due to the strong ill-posedness of the inversion problem and the extensive manual calibration required, making it impossible to be included into an efficient reservoir history matching forecasting algorithm. In the presented research, we have developed a novel Finite Difference Time Domain (FDTD) based method for incorporating electromagnetic data directly into the reservoir simulator. Based on an extended Archie relationship, EM simulations are performed for both forecasted and Porosity-Saturation retrieved conductivity parameters being incorporated directly into an update step for the reservoir parameters. This novel direct update method has significant advantages such as that it overcomes the expensive and ill

  6. Tubular Adenoma in the Indiana Pouch of a Patient With a History of Bladder Exstrophy

    Directory of Open Access Journals (Sweden)

    Madeleine G. Manka

    2015-09-01

    Full Text Available An increased risk of neoplasm has been noted when bowel segments are used for urinary diversion. Particularly true for ureterosigmoidostomy, colonic adenocarcinoma has rarely been reported following Indiana Pouch diversion. This report describes a 42-year-old woman with a history of bladder exstrophy who developed a polyp in her Indiana Pouch 24 years after its creation. The polyp, found incidentally, was a tubular adenoma with high-grade dysplasia. Due to its malignant potential, the polyp was resected with preservation of the Indiana Pouch. This case highlights the need for lifetime surveillance in urinary reservoir patients who received diversions at a young age.

  7. Chronic obstructive pulmonary disease history assessment in Spain: a multidimensional chronic obstructive pulmonary disease evaluation. Study methods and organization.

    Science.gov (United States)

    López-Campos, José Luis; Peces-Barba, Germán; Soler-Cataluña, Juan José; Soriano, Joan B; de Lucas Ramos, Pilar; de-Torres, Juan P; Marín, José M; Casanova, Ciro

    2012-12-01

    This present paper describes the method and the organization of the study known as the COPD History Assessment In SpaiN (CHAIN), whose main objective is to evaluate the long-term natural history of a chronic obstructive pulmonary disease (COPD) patient cohort from a multidimensional standpoint and to identify clinical phenotypes, in comparison with another non-COPD control cohort. CHAIN is a multicenter, observational study of prospective cohorts carried out at 36 Spanish hospitals. Both cohorts will be followed-up during a 5-year study period with complete office visits every 12 months and telephone interviews every 6 months in order to evaluate exacerbations and the vital state of the subjects. The recruitment period for cases was between 15 January 2010 and 31 March 2012. At each annual visit, information will be collected on: (i) clinical aspects (socio-economic situation, anthropometric data, comorbidities, smoking, respiratory symptoms, exacerbations, quality of life, anxiety-depression scale, daily life activities, treatments); (ii) respiratory function (spirometry, blood gases, hyperinflation, diffusion, respiratory pressures); (iii) BODE index (main study variable); (iv) peripheral muscle function, and (v) blood work-up (including IgE and cardiovascular risk factors). In addition, a serum bank will be created for the future determination of biomarkers. The data of the patients are anonymized in a database with a hierarchical access control in order to guarantee secure information access. The CHAIN study will provide information about the progression of COPD and it will establish a network of researchers for future projects related with COPD. Copyright © 2012 SEPAR. Published by Elsevier Espana. All rights reserved.

  8. Polycythemia vera: the natural history of 1213 patients followed for 20 years. Gruppo Italiano Studio Policitemia.

    Science.gov (United States)

    1995-11-01

    To reassess the natural history of polycythemia vera and to obtain reliable estimates of both incidence of thrombosis and survival for use in defining the sample size for therapeutic clinical trials. Retrospective cohort study of patients with polycythemia who had been followed for 20 years. 11 Italian hematology institutions. 1213 patients with polycythemia vera, which was diagnosed according to criteria established by the Polycythemia Vera Study Group and commonly used in clinical practice. All-cause mortality, venous and arterial thrombosis, and hematologic and nonhematologic neoplastic disease. Myocardial infarction and stroke were classified as major thrombotic events, and venous and peripheral arterial thrombosis were considered minor thrombotic events. The number of patients who died and the number of those who had major thrombotic events (combined end point) were used as a comprehensive measure of the benefit-risk ratio associated with the use of myelosuppressive agents. 634 fatal and nonfatal arterial and venous thromboses were recorded in 485 patients (41%); 36% of these episodes occurred during follow-up in 230 patients (19%), and 64% occurred either at presentation or before diagnosis. Thrombotic events occurred more frequently in the 2 years preceding diagnosis, suggesting a causal relation between the latent myeloproliferative disorder and the vascular event. The incidence of thrombosis during follow-up was 3.4%/y; older patients or those with a history of thrombosis had a higher risk for thrombosis. Overall mortality was 2.9/100 patients per year; thrombotic events and hematologic or nonhematologic cancers had similar effects on mortality. Patients receiving chemotherapy died three to four times more frequently than those not receiving chemotherapy. The increased risk for cancer in patients receiving myelosuppressive agents was seen approximately 6 years after diagnosis. In addition, the combined end point, computed as the sum of the hardest

  9. PAR-Q & YOU Questionnaire and cardiovascular history of elderly patients on dialysis engaged in physical activity

    Directory of Open Access Journals (Sweden)

    Jorge Enrique Moreno-Collazos

    2017-10-01

    Full Text Available Introduction: During the last few years, physical activity has become a therapeutic tool and a protective mechanism for the elderly; it reduces cardiovascular risk in patients undergoing different types of dialysis and receiving palliative care. Objective: The aim of this study was to establish the inclusion criteria for a therapeutic physical activity program through the use of the PAR-Q & YOU Questionnaire with elderly patients treated with different types of hemodialysis, and to relate it with cardiovascular risk factors. Methods: Pearson's chi-squared test was used to determine the possible association among variables, considering the medical history and discomfort caused by physical activity against the results of PAR-Q & YOU. Binary logistic regression was used with the variables in the chi-squared test. Conclusions: Through logistic regression, we found that cardiovascular history was 10.44 times more significant to establish the relevance of the PAR-Q & YOU as a basic assessment instrument for the inclusion in a physical activity program which is part of a physiotherapy-led renal rehabilitation.

  10. Natural history and quality of life in patients with cystine urolithiasis: a single centre study.

    Science.gov (United States)

    Parr, Justin M; Desai, Devang; Winkle, David

    2015-10-01

    To describe the natural history and quality of life (QoL) in patients with cystine urolithiasis. A cohort study was carried out involving participants recruited from a single surgeon's case mix. Patients with cystinuria and related urolithiasis were invited to complete a questionnaire involving demographic information, use of medical treatment, surgical interventions and the 36-item short-form 36-item short-form health survey (SF-36). In all, 14 patients completed the survey. The SF-36 survey showed lower QoL than the general public in seven of eight domains. The mean interventional rate in patients with cystinuria was 10.6 procedures per patient. Most patients reported previous use of d-penicillamine and urinary alkalinisation medications, with most ceasing due to side-effects or lack of perceived efficacy. Cystinuria is associated with a high rate of surgical intervention and lower QoL than the general public. Individuals with this condition report that medical management is either ineffective or poorly tolerated. There is a need for further improvements in medical management of cystinuria, to reduce the rate of operative intervention. © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd.

  11. Fluid overload correction and cardiac history influence brain natriuretic peptide evolution in incident haemodialysis patients.

    Science.gov (United States)

    Chazot, Charles; Vo-Van, Cyril; Zaoui, Eric; Vanel, Thierry; Hurot, Jean Marc; Lorriaux, Christie; Mayor, Brice; Deleaval, Patrick; Jean, Guillaume

    2011-08-01

    Brain natriuretic peptide (BNP) is a cardiac peptide secreted by ventricle myocardial cells under stretch constraint. Increased BNP has been shown associated with increased mortality in end-stage renal disease patients. In patients starting haemodialysis (HD), both fluid overload and cardiac history are frequently present and may be responsible for a high BNP plasma level. We report in this study the evolution of BNP levels in incident HD patients, its relationship with fluid removal and cardiac history as well as its prognostic value. Forty-six patients (female/male: 21/25; 68.6 ± 14.5 years old) surviving at least 6 months after HD treatment onset were retrospectively analysed. Plasma BNP (Chemoluminescent Microparticule ImmunoAssay on i8200 Architect Abbott, Paris, France; normal value < 100 pg/mL) was assessed at HD start and during the second quarter of HD treatment (Q2). At dialysis start, the plasma BNP level was 1041 ± 1178 pg/mL (range: 14-4181 pg/mL). It was correlated with age (P = 0.0017) and was significantly higher in males (P = 0.0017) and in patients with cardiac disease history (P = 0.001). The plasma BNP level at baseline was not related to the mortality risk. At Q2, predialysis systolic blood pressure (BP) decreased from 140.5 ± 24.5 to 129.4 ± 20.6 mmHg (P = 0.0001) and the postdialysis body weight by 7.6 ± 8.4% (P < 0.0001). The BNP level decreased to 631 ± 707 pg/mL (P = 0.01) at Q2. Its variation was significantly correlated with systolic BP decrease (P = 0.006). A high BNP level was found associated with an increased risk of mortality. Hence, plasma BNP levels decreased during the first months of HD treatment during the dry weight quest. Whereas initial BNP values were not associated with increased mortality risk, the BNP level at Q2 was independently predictive of mortality. Hence, BNP is a useful tool to follow patient dehydration after dialysis start. Initial fluid overload may act as a confounding factor for its value as a

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Contingency management is especially efficacious in engendering long durations of abstinence in patients with sexual abuse histories

    OpenAIRE

    Petry, Nancy M.; Ford, Julian D.; Barry, Danielle

    2011-01-01

    Exposure to sexual victimization is prevalent among persons with substance use disorders (SUDs). Contingency management (CM) treatments utilize concrete and relatively immediate positive reinforcers to retain patients in treatment and reduce substance use, and CM may have particular benefits for patients with histories of sexual victimization. Using data from three randomized trials of CM (N = 393), this study evaluated main and interactive effects of sexual abuse history and treatment condit...

  14. Oral histories: a simple method of assigning chronological age to isotopic values from human dentine collagen.

    Science.gov (United States)

    Beaumont, Julia; Montgomery, Janet

    2015-01-01

    Stable isotope ratios of carbon (δ(13)C) and nitrogen (δ(15)N) in bone and dentine collagen have been used for over 30 years to estimate palaeodiet, subsistence strategy, breastfeeding duration and migration within burial populations. Recent developments in dentine microsampling allow improved temporal resolution for dietary patterns. A simple method is proposed which could be applied to human teeth to estimate chronological age represented by dentine microsamples in the direction of tooth growth, allowing comparison of dietary patterns between individuals and populations. The method is tested using profiles from permanent and deciduous teeth of two individuals. Using a diagrammatic representation of dentine development by approximate age for each human tooth (based on the Queen Mary University of London Atlas), this study estimated the age represented by each dentine section. Two case studies are shown: comparison of M1 and M2 from a 19th century individual from London, England, and identification of an unknown tooth from an Iron Age female adult from Scotland. The isotopic profiles demonstrate that variations in consecutively-forming teeth can be aligned using this method to extend the dietary history of an individual or identify an unknown tooth by matching the profiles.

  15. A study on the optimization of referring method about medical images using MIH (Medical Image History)

    International Nuclear Information System (INIS)

    Kim, Sun Chil; Kim, Jung Min

    2002-01-01

    The recent development of embodiment technology of the medical images makes most medical institutions introduce PACS (Picture Archiving and Communication System) in haste. However lots of PACS solutions, currently developed and distributed, haven't been able to serve the convenience of users and to satisfy user's demand because of economic limitations and administrator-oriented con-siderations in the process of development. So we have developed MIH (Medical Image History), by which we can search and refer to the patient's medical images and information with few restrictions of time and space for diagnosis and treatment. The program will contribute to the improvement in the medical environment and meet the clients' need. We'll make more effort to develop the application which insures the better quality of medical images. MIH manages the patient's image files and medical records like film chart in connection with time. This trial will contribute to the reduction of the economical loss caused by unnecessary references and improve the quality in the medical services. The demand on the development of the program which refers to the medical data quickly and keeps them stable will be continued by the medical institute. This will satisfy the client's demand and improve the service to the patients in that the program will be modified from the standpoint of the users. MIH is trying to keep user-oriented policy and to apply the benefit of the analog system to the digital environment. It is necessary to lead the public to the better understanding that the systematic management and referring of the medical images is as important as the quality of the images

  16. A study on the optimization of referring method about medical images using MIH (Medical Image History)

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sun Chil; Kim, Jung Min [College of Health Sciences, Korea University, Seoul (Korea, Republic of)

    2002-09-15

    The recent development of embodiment technology of the medical images makes most medical institutions introduce PACS (Picture Archiving and Communication System) in haste. However lots of PACS solutions, currently developed and distributed, haven't been able to serve the convenience of users and to satisfy user's demand because of economic limitations and administrator-oriented con-siderations in the process of development. So we have developed MIH (Medical Image History), by which we can search and refer to the patient's medical images and information with few restrictions of time and space for diagnosis and treatment. The program will contribute to the improvement in the medical environment and meet the clients' need. We'll make more effort to develop the application which insures the better quality of medical images. MIH manages the patient's image files and medical records like film chart in connection with time. This trial will contribute to the reduction of the economical loss caused by unnecessary references and improve the quality in the medical services. The demand on the development of the program which refers to the medical data quickly and keeps them stable will be continued by the medical institute. This will satisfy the client's demand and improve the service to the patients in that the program will be modified from the standpoint of the users. MIH is trying to keep user-oriented policy and to apply the benefit of the analog system to the digital environment. It is necessary to lead the public to the better understanding that the systematic management and referring of the medical images is as important as the quality of the images.

  17. The moment of inertia method to calculate equivalent ranges in non-proportional tension–torsion histories

    Directory of Open Access Journals (Sweden)

    Marco Antonio Meggiolaro

    2015-07-01

    Full Text Available A critical issue in multiaxial damage calculation in non-proportional (NP histories is to find the equivalent stress or strain ranges and mean components associated with each rainflow-counted cycle of the stress (or strain path. A traditional way to find such ranges is to use enclosing surface methods, which search for convex enclosures, such as balls or prisms, of the entire history path in stress or strain diagrams. These methods only work for relatively simple load histories, since the enclosing surfaces lose information of the original history. This work presents an approach to evaluate equivalent stress and strain ranges in NP histories, called the moment of inertia (MOI method. It is an integral approach that assumes the path contour in the stress diagram is a homogeneous wire with a unit mass. The center of mass of such wire gives then the mean component of the path, while the moments of inertia of the wire can be used to obtain the equivalent stress or strain ranges. Experimental results obtained from the literature for 13 different multiaxial histories prove the effectiveness of the MOI method to predict fatigue lives.

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

    International Nuclear Information System (INIS)

    JHwang, Shin Hye; Kim, Eun Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Kwak, Jin Young

    2016-01-01

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  20. Clinical features and psychiatric comorbidities of borderline personality disorder patients with versus without a history of suicide attempt.

    Science.gov (United States)

    Sher, Leo; Fisher, Amanda M; Kelliher, Caitlin H; Penner, Justin D; Goodman, Marianne; Koenigsberg, Harold W; New, Antonia S; Siever, Larry J; Hazlett, Erin A

    2016-12-30

    Patients with borderline personality disorder (BPD) are at high risk for suicidal behavior. However, many BPD patients do not engage in suicidal behavior. In this study, we compared clinical features of BPD patients with or without a history of suicide attempts and healthy volunteers. Compared with healthy volunteers, both BPD groups had higher Affective Lability Scale (ALS), ALS - Depression-Anxiety Subscale, Barratt Impulsivity Scale (BIS), and Lifetime History of Aggression (LHA) scores and were more likely to have a history of temper tantrums. BPD suicide attempters had higher ALS, ALS - Depression-Anxiety Subscale and LHA scores and were more likely to have a history of non-suicidal self-injury or temper tantrums compared to BPD non-attempters. Also, BPD suicide attempters were more likely to have a history of comorbid major depressive disorder and less likely to have comorbid narcissistic personality disorder (NPD) in comparison to BPD non-attempters. About 50% of study participants in each BPD group had a history of comorbid substance use disorder (SUD). Our study indicates that BPD patients with a history of suicide attempt are more aggressive, affectively dysregulated and less narcissistic than BPD suicide non-attempters. Published by Elsevier Ireland Ltd.

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

    Directory of Open Access Journals (Sweden)

    Milisavljević Nemanja

    2013-01-01

    Full Text Available 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 disease was confirmed with histopathology examination of duodenal biopsy specimen. Conclusion. Complicated interactions between celiac disease and bulimia can make them difficult to diagnose and treat. It is important to consider the presence of celiac disease in patients with bulimia and gastrointestinal symptoms.

  2. History of the Innovation of Damage Control for Management of Trauma Patients: 1902-2016.

    Science.gov (United States)

    Roberts, Derek J; Ball, Chad G; Feliciano, David V; Moore, Ernest E; Ivatury, Rao R; Lucas, Charles E; Fabian, Timothy C; Zygun, David A; Kirkpatrick, Andrew W; Stelfox, Henry T

    2017-05-01

    To review the history of the innovation of damage control (DC) for management of trauma patients. DC is an important development in trauma care that provides a valuable case study in surgical innovation. We searched bibliographic databases (1950-2015), conference abstracts (2009-2013), Web sites, textbooks, and bibliographies for articles relating to trauma DC. The innovation of DC was then classified according to the Innovation, Development, Exploration, Assessment, and Long-term study model of surgical innovation. The "innovation" of DC originated from the use of therapeutic liver packing, a practice that had previously been abandoned after World War II because of adverse events. It then "developed" into abbreviated laparotomy using "rapid conservative operative techniques." Subsequent "exploration" resulted in the application of DC to increasingly complex abdominal injuries and thoracic, peripheral vascular, and orthopedic injuries. Increasing use of DC laparotomy was followed by growing reports of postinjury abdominal compartment syndrome and prophylactic use of the open abdomen to prevent intra-abdominal hypertension after DC laparotomy. By the year 2000, DC surgery had been widely adopted and was recommended for use in surgical journals, textbooks, and teaching courses ("assessment" stage of innovation). "Long-term study" of DC is raising questions about whether the procedure should be used more selectively in the context of improving resuscitation practices. The history of the innovation of DC illustrates how a previously abandoned surgical technique was adapted and readopted in response to an increased understanding of trauma patient physiology and changing injury patterns and trauma resuscitation practices.

  3. Changes in smoking habit among patients with a history of oral squamous cell carcinoma (OSCC).

    Science.gov (United States)

    Poveda-Roda, Rafael; Bagán, José V; Jiménez-Soriano, Yolanda; Margaix-Muñoz, Maria; Sarrión-Pérez, Gracia

    2010-09-01

    To determine the changes in smoking habit among patients with oral squamous cell carcinoma (OSCC) diagnosed and treated in the Service of Stomatology (Valencia University General Hospital. Valencia, Spain). The study involved 123 patients with a history of OSCC interviewed by telephone on their smoking habits at the time of the diagnosis and modifications in habits subsequently. The mean age at diagnosis was 60 years and 9 months (standard deviation, SD +/- 12 years and 2 months). Males predominated (61.8%) over females (38.2%). The mean time from the diagnosis of OSCC to the survey was 4 years and 6 months (SD +/- 3 years and 6 months). Almost one-half of the patients (45.5%) were active smokers at the time of the diagnosis, with a mean duration of the habit of 34.9 years (SD +/- 12 years and 7 months). In turn, 19.5% of the patients were ex-smokers at diagnosis, with an average of 13 years and 9 months (SD +/- 9 years and 4 months) from smoking cessation to the development of cancer. A total of 57.1% of the smokers abandoned the habit at diagnosis, 8.9% continued to smoke to the same extent as before, and 33.9% reduced smoking. A full 44.4 % of our patients diagnosed with OSCC continued to smoke despite warnings of the risks, and although the majority claimed to have reduced their smoking habit, interventional strategies would be indicated to help ensure complete smoking cessation.

  4. The end of medical confidentiality? Patients, physicians and the state in history.

    Science.gov (United States)

    Rieder, Philip; Louis-Courvoisier, Micheline; Huber, Philippe

    2016-09-01

    Medical confidentiality has come under attack in the public sphere. In recent disasters both journalists and politicians have questioned medical confidentiality and claimed that in specific contexts physicians should be compelled to communicate data on their patients' health. The murders of innocent individuals by a suicidal pilot and a Swiss convicted criminal have generated polemical debates on the topic. In this article, historical data on medical confidentiality is used to show that medical practices of secrecy were regularly attacked in the past, and that the nature of medical confidentiality evolved through time depending on physicians' values and judgements. Our demonstration is based on three moments in history. First, at the end of the 16th century, lay authorities put pressure on physicians to disclose the names of patients suffering from syphilis. Second, in the 18th century, physicians faced constant demands for information about patients' health from relatives and friends. Third, employers and insurance companies in the 20th century requested medical data on sick employees. In these three different situations, history reveals that the concept of medical confidentiality was plastic, modelled in the first instance to defend well-to-do patients, in the second instance it was adapted to accommodate the physician's social role and, finally, to defend universal values and public health. Medical secrecy was, and is today, a medical and societal norm that is shaped collectively. Any change in its definition and enforcement was and should be the result of negotiations with all social actors concerned. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Best possible medication history for hemodialysis patients obtained by a pharmacy technician.

    Science.gov (United States)

    Leung, Marianna; Jung, Joanne; Lau, Wynnie; Kiaii, Mercedeh; Jung, Beverly

    2009-09-01

    Outpatients undergoing hemodialysis are at high risk for adverse drug events. Limited resources make it challenging for pharmacists to routinely obtain a best possible medication history (BPMH). The primary objective was to determine whether, for patients undergoing hemodialysis, a pharmacy technician has the skills to obtain a BPMH that would allow a pharmacist to identify drug-related problems. The secondary objectives were to determine the number and types of medication discrepancies and drug-related problems identified and the time required by the technician to complete the BPMH. All patients treated in the hemodialysis unit during the study period were included, except for those who required an interpreter or were unable to participate in an in-person interview. A single technician was taught how to interview patients according to a structured format. For each patient, the technician's BMPH was verified by a pharmacist. The agreement rate between technician and pharmacists was determined, along with the number and types of discrepancies and drug-related problems identified. The technician interviewed 99 patients. Of the 1334 medication orders reviewed, the technician and pharmacists agreed on all but 15 (agreement rate 98.9%). A total of 358 medication discrepancies were noted for 93 patients (3.8 discrepancies per patient). Of these, 210 (59%) were undocumented intentional discrepancies, and 148 (41%) were unintentional discrepancies (most commonly errors of commission). Of the 135 drug-related problems identified, the majority involved dosing problems or nonadherence. The technician required an average of 17 min for each interview. An adequately trained technician was capable of interviewing patients to create a BPMH. A variety of medication discrepancies and drug-related problems were identified. Generation of a BPMH by a technician is a useful approach allowing pharmacists to identify drug-related problems.

  6. History Matters

    Institute of Scientific and Technical Information of China (English)

    2017-01-01

    In 2002, she began working as alecturer at Minzu University of China.Now, she teaches English, historicalliterature, ancient Chinese history,historical theory and method, ancientsocial history of China, ancient palacepolitical history of China and the historyof the Sui and Tang dynasties and thePeriod of Five Dynasties.

  7. Clinical characteristics of patients with tinnitus evaluated with the Tinnitus Sample Case History Questionnaire in Japan: A case series.

    Directory of Open Access Journals (Sweden)

    Takashi Kojima

    Full Text Available The Tinnitus Sample Case History Questionnaire was determined as a standardized questionnaire for obtaining patient case histories and for characterizing patients into subgroups at the Tinnitus Research Initiative in 2006. In this study, we developed a Japanese version of this questionnaire for evaluating the clinical characteristics of patients with tinnitus. The Japanese version of the questionnaire will be available for evaluating treatments for tinnitus and for comparing data on tinnitus in research centers.To evaluate the clinical characteristics of patients with tinnitus in Japan using a newly developed Japanese version of Tinnitus Sample Case History Questionnaire.This was a prospective study based on patient records.University hospitals, general hospitals, and clinics.We collected patient data using a Japanese translated version of the Tinnitus Sample Case History Questionnaire. In total, 584 patients who visited our institutions in Japan between August 2012 and March 2014 were included (280 males and 304 females; age 13-92 years; mean age, 60.8. We examined patients after dividing them into two groups according to the presence or absence of hyperacusis. The collected results were compared with those from the Tinnitus Research Initiative database.Compared with the TRI database, there were significantly more elderly female patients and fewer patients with trauma-associated tinnitus. There was a statistically lower ratio of patients with hyperacusis. We found that patients with tinnitus in addition to hyperacusis had greater tinnitus severity and exhibited higher rates of various complications.The Japanese version of the Tinnitus Sample Case History Questionnaire developed in this study can be a useful tool for evaluating patients with tinnitus in Japan. The results of this multicenter study reflect the characteristics of patients with tinnitus who require medical care in Japan. Our data provides a preliminary basis for an international

  8. Single-Case Research Methods: History and Suitability for a Psychological Science in Need of Alternatives.

    Science.gov (United States)

    Hurtado-Parrado, Camilo; López-López, Wilson

    2015-09-01

    This paper presents a historical and conceptual analysis of a group of research strategies known as the Single-Case Methods (SCMs). First, we present an overview of the SCMs, their history, and their major proponents. We will argue that the philosophical roots of SCMs can be found in the ideas of authors who recognized the importance of understanding both the generality and individuality of psychological functioning. Second, we will discuss the influence that the natural sciences' attitude toward measurement and experimentation has had on SCMs. Although this influence can be traced back to the early days of experimental psychology, during which incipient forms of SCMs appeared, SCMs reached full development during the subsequent advent of Behavior Analysis (BA). Third, we will show that despite the success of SCMs in BA and other (mainly applied) disciplines, these designs are currently not prominent in psychology. More importantly, they have been neglected as a possible alternative to one of the mainstream approaches in psychology, the Null Hypothesis Significance Testing (NHST), despite serious controversies about the limitations of this prevailing method. Our thesis throughout this section will be that SCMs should be considered as an alternative to NHST because many of the recommendations for improving the use of significance testing (Wilkinson & the TFSI, 1999) are main characteristics of SCMs. The paper finishes with a discussion of a number of the possible reasons why SCMs have been neglected.

  9. Single grains, thermal histories, and the 40Ar/39Ar method

    International Nuclear Information System (INIS)

    Wright, Norrie

    1989-01-01

    A key part in unraveling the history of the physical evolution of the earth is knowledge of the earth's thermal history. 40 Ar/ 39 Ar step heating of mineral samples provides a means of defining a local thermal history. to do this accurately the challenge is to extract meaningful diffusion parameters from a mineral's Arrhenius plot. In the case of biotite single grains, where the laboratory release of argon is a complex process, this can be a difficult task. (12 refs., 5 figs.)

  10. Assessment of Medical Student and Resident/Fellow Knowledge, Comfort, and Training With Sexual History Taking in LGBTQ Patients.

    Science.gov (United States)

    Hayes, Victoria; Blondeau, Whitney; Bing-You, Robert G

    2015-05-01

    Sexual health is an important aspect of overall health. Barriers to taking an adequate patient sexual history exist. Few studies have explored medical learners' comfort, knowledge, and training surrounding taking sexual histories with lesbian, gay, bisexual, transgender, questioning/queer (LGBTQ) patients specifically. A 10-question survey was offered to medical students and resident/fellows at one US institution. Survey questions reflected participants' knowledge, comfort, and training related to sexual history taking with attention to LGBTQ care. A total of 159 surveys were returned (rate of 42%). A significantly lower level of comfort existed with taking sexual histories and managing sexual health issues in the LGBTQ segment of the patient population versus all patients, especially in the advanced training group. Participants recognized the importance of understanding their patients' overall sexual health, though medical students rated this as more important than the resident/fellow group did. A correlation existed between both comfort with taking sexual histories and discussing safe sexual practices and management of sexual issues, suggesting that further training would be helpful in this area. Twenty percent of the respondents reported receiving no training at all in eliciting sexual histories in LGBTQ patients. The most preferred format in this study for future training was interviewing standardized patients. Medical students and resident/fellows reported a significantly lower level of comfort with sexual history-taking and management of sexual issues in the LGBTQ population. A comprehensive training format that not only views sexual health as an integral part of overall patient health, but also integrates LGBTQ care, is needed in medical education.

  11. Perceptions of tanning risk among melanoma patients with a history of indoor tanning.

    Science.gov (United States)

    Nergard-Martin, Jennifer; Caldwell, Chauncey; Barr, Morgan; Dellavalle, Robert P; Solomon, James A

    2018-01-01

    A new US Food and Drug Administration (FDA) regulation classified tanning beds as class II, requiring indoor tanning facilities to inform users of the risk of skin cancer in efforts to reverse the growing trend in indoor tanning. However, little is known from the patient's perspective on whether knowledge of the risk of skin cancer development is a deterrent to indoor tanning. There also is conflicting literature regarding the relationship among frequency of indoor tanning, age at onset of melanoma diagnosis, and characteristics of diagnosis in melanoma patients with a history of indoor tanning. An international survey was conducted in patients 18 years and older who self-reported being diagnosed with melanoma after indoor tanning. The purpose of this study was to investigate the patients' perspective on indoor-tanning behaviors as associated with the severity of their melanomas and the time frame in which they were diagnosed as well as their perceived views on the safety of indoor tanning and the frequency in which they continue to tan indoors.

  12. [Thoughts and methods of study on acupuncture medical history: an example of Mr. MA Ji-Xing].

    Science.gov (United States)

    Yang, Feng; Zhu, Ling

    2014-03-01

    Mr. MA Ji-xing has devoted himself into the study of acupuncture medical history for more than 70 years. As a result, a great work of Zhenjiuxue Tongshi (see text), History of Acupuncture-Moxibustion) has been completed. The author has expensively studied for history of acupuncture medicine in time and space. Base on abundant historical materials, deliberate textual research as well as strategically situated academic view, it is considered as a masterpiece of acupuncture on real significance. It is worthwhile to note that the book has a systematic and profound explanation on Bian-stone therapy, unearthed literature relics of acupuncture, the bronze figure or illustration of acupoint as well as special topics of Japan and Korea acupuncture history. Filled several gaps of the field, and explored some significant new paths of study, it laid the groundwork for the profound study and unscramble of traditional acupuncture theory as well as the investigation of the academic history, which is considered to have a profound and persistent influence. The careful sorting and profound digging of many distinguish thoughts and methods of Mr. MA Ji-xing in the study of acupuncture medical history has significant meaning in references and enlightenment of the future research on acupuncture medical history.

  13. Factors Influencing Suicidal Tendencies of Patients with Diagnosis of Attempted Suicide in Medical History and Potential Prevention of Relapse Prevention.

    Science.gov (United States)

    Kotrbová, Kvetoslava; Dóci, Ivan; Hamplová, Lidmila; Dvořák, Vít; Selingerová, Šárka; Růžičková, Veronika; Chmelařová, Šárka

    2017-12-01

    The authors researched the incidence of suicidal thoughts and related factors in 123 patients of the psychiatric ward of the Hospital of České Budějovice with diagnosed attempted suicide in their medical history for the period from January 2013 – June 2015. The research was carried out in two stages. At the beginning of the hospitalization, quantitative data collection was implemented using a semi-structured questionnaire, followed by qualitative research conducted with semi-structured phone conversation, based on previous patient's written consent. The research data were statistically processed to obtain information about the character of relations among individual characteristics. To quantify them, the Bayesian Network (BN) was constructed, and to identify relations among individual characteristics, the Hill-Climbing algorithm was used. Before deriving the network, variables were discretized. The network parameters were set based on a data matrix using the maximal plausibility method. The results of analysed set show that the probability of suicidal thoughts is high, achieving a value of 0.750 (0.781 for women and 0.724 for men). If the patient visits a contact centre for drug-addicted persons, the probability of suicidal thoughts decreases to 0.683. If the patient visits a psychotherapist, the values of 0.736 are achieved. If a daily care centre is visited, the estimated risk rises to 0.832 and the probability of the patient repetitively attempting suicide is 0.606. If the interviewed person regularly consumes alcohol, the probable relapse amounts to 0.616. But if the person consumes alcohol from time to time, the probability rises to 0.701. In case of abstinence, the probable relapse decreases to 0.565. The incidence of suicidal thoughts in observed patients was high, and the amount of risk was influenced by gender, by visiting follow-up care facilities, psychotherapy, and particularly by the frequency of alcohol consumption. Intermittent alcohol

  14. The natural history of interstitial cystitis: a survey of 374 patients.

    Science.gov (United States)

    Koziol, J A; Clark, D C; Gittes, R F; Tan, E M

    1993-03-01

    A survey directed at determining the natural history of interstitial cystitis was conducted at our clinic. Information on demographics, risk factors, symptoms, pain and psychosocial factors was elicited from 374 patients who satisfied the National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases criteria for interstitial cystitis and had all been diagnosed as having interstitial cystitis by a urologist. With regard to demographics, patients were predominantly female (89.8%) and white (94.1%), with a mean age of 53.8 +/- 0.7 years (standard error) and age at the first symptoms of 42.5 +/- 0.8 years. Information on 25 potential risk factors included 44.4% of the women reporting hysterectomy, 38.2% of the patients having strong sensitivities or allergic reactions to medication and only 2.7% being diabetic. With regard to interstitial cystitis symptoms, frequency and urgency were reported by 91.7% and 89.3% of the patients, respectively, while pelvic pain, pelvic pressure and bladder spasms were reported by more than 60% of respondents and burning by 56%. Location and degree of pain were also reported. Urination relieved or lessened interstitial cystitis pain for 73.6% of the patients and medication was effective for 46.8%. Other behaviors (for example hot baths, heating pads, lying down or sitting) were less effective. Conversely, stress, constrictive clothing and intercourse increased interstitial cystitis pain in more than 50% of the patients. In addition, acidic, alcoholic or carbonated beverages, and coffee or tea increased interstitial cystitis pain in more than 50% of the patients. More than 60% of the patients were unable to enjoy usual activities or were excessively fatigued and 53.7% reported depression. Travel, employment, leisure activities and sleeping were adversely affected in more than 80% of the patients. Pain location and degree differed significantly between patients with and without ulcers in the bladder. In addition, there was an

  15. Analyzing the History of Falls in Patients with Severe Knee Osteoarthritis.

    Science.gov (United States)

    Tsonga, Theano; Michalopoulou, Maria; Malliou, Paraskevi; Godolias, George; Kapetanakis, Stylianos; Gkasdaris, Grigorios; Soucacos, Panagiotis

    2015-12-01

    One out of three adults over the age of 65 years and one out of two over the age of 80 falls annually. Fall risk increases for older adults with severe knee osteoarthritis, a matter that should be further researched. The main purpose of this study was to investigate the history of falls including frequency, mechanism and location of falls, activity during falling and injuries sustained from falls examining at the same time their physical status. The secondary purpose was to determine the effect of age, gender, chronic diseases, social environment, pain elsewhere in the body and components of health related quality of life such as pain, stiffness, physical function, and dynamic stability on falls frequency in older adults aged 65 years and older with severe knee osteoarthritis. An observational longitudinal study was conducted on 68 patients (11 males and 57 females) scheduled for total knee replacement due to severe knee osteoarthritis (grade 3 or 4) and knee pain lasting at least one year or more. Patients were personally interviewed for fall history and asked to complete self-administered questionnaires, such as the 36-item Short Form Health Survey (SF-36) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and physical performance test was performed. The frequency of falls was 63.2% for the past year. The majority of falls took place during walking (89.23%). The main cause of falling was stumbling (41.54%). There was a high rate of injurious falling (29.3%). The time patients needed to complete the physical performance test implied the presence of disability and frailty. The high rates of fall risk, the high disability levels, and the low quality of life were confirmed by questionnaires and the mobility test. Patients with severe knee osteoarthritis were at greater risk of falling, as compared to healthy older adults. Pain, stiffness, limited physical ability, reduced muscle strength, all consequences of severe knee osteoarthritis

  16. Clinical Outcomes and History of Fall in Patients with Atrial Fibrillation Treated with Oral Anticoagulation: Insights From the ARISTOTLE Trial.

    Science.gov (United States)

    Rao, Meena P; Vinereanu, Dragos; Wojdyla, Daniel M; Alexander, John H; Atar, Dan; Hylek, Elaine M; Hanna, Michael; Wallentin, Lars; Lopes, Renato D; Gersh, Bernard J; Granger, Christopher B

    2018-03-01

    We assessed outcomes among anticoagulated patients with atrial fibrillation and a history of falling, and whether the benefits of apixaban vs warfarin are consistent in this population. Of the 18,201 patients in the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) study, 16,491 had information about history of falling-753 with history of falling and 15,738 without history of falling. The primary efficacy outcome was stroke or systemic embolism; the primary safety outcome was major bleeding. When compared with patients without a history of falling, patients with a history of falling were older, more likely to be female and to have dementia, cerebrovascular disease, depression, diabetes, heart failure, osteoporosis, fractures, and higher CHA 2 DS 2 -VASc (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, prior Stroke or TIA or thromboembolism, Vascular disease, Age 65-74 years, Sex category female) and HAS-BLED (Hypertension, Abnormal renal and liver function, Stroke, Bleeding, Labile international normalized ratio, Elderly, Drugs or alcohol) scores. Patients with a history of falling had higher rates of major bleeding (adjusted hazard ratio [HR] 1.39; 95% confidence interval [CI], 1.05-1.84; P = .020), including intracranial bleeding (adjusted HR 1.87; 95% CI, 1.02-3.43; P = .044) and death (adjusted HR 1.70; 95% CI, 1.36-2.14; P < .0001), but similar rates of stroke or systemic embolism and hemorrhagic stroke. There was no evidence of a differential effect of apixaban compared with warfarin on any outcome, regardless of history of falling. Among those with a history of falling, subdural bleeding occurred in 5 of 367 patients treated with warfarin and 0 of 386 treated with apixaban. Patients with atrial fibrillation and a history of falling receiving anticoagulation have a higher risk of major bleeding, including intracranial, and death. The efficacy and safety of apixaban compared

  17. Metaphor, Materiality, and Method: The Central Role of Embodiment in the History of Education

    Science.gov (United States)

    Gleason, Mona

    2018-01-01

    Delivered as one of the keynote addresses at the International Standing Committee on the History of Education (ISCHE) Conference held in Chicago in August 2016, this paper offers a broad review of how the body and embodiment have been incorporated into histories of education. Based on this historiography, I extend three "inspiring…

  18. Conceptualising patient empowerment: a mixed methods study

    NARCIS (Netherlands)

    Bravo, P.; Edwards, A.; Barr, P.J.; Scholl, I.; Elwyn, G.; Mcallister, M.

    2015-01-01

    BACKGROUND: In recent years, interventions and health policy programmes have been established to promote patient empowerment, with a particular focus on patients affected by long-term conditions. However, a clear definition of patient empowerment is lacking, making it difficult to assess

  19. The digital history of the anglophone vocabulary of psychology: An exploration using Zipfian methods.

    Science.gov (United States)

    Benjafield, John G

    2016-05-01

    The digital humanities are being applied with increasing frequency to the analysis of historically important texts. In this study, the methods of G. K. Zipf are used to explore the digital history of the vocabulary of psychology. Zipf studied a great many phenomena, from word frequencies to city sizes, showing that they tend to have a characteristic distribution in which there are a few cases that occur very frequently and many more cases that occur very infrequently. We find that the number of new words and word senses that writers contribute to the vocabulary of psychology have such a Zipfian distribution. Moreover, those who make the most contributions, such as William James, tend also to invent new metaphorical senses of words rather than new words. By contrast, those who make the fewest contributions tend to invent entirely new words. The use of metaphor makes a text easier for a reader to understand. While the use of new words requires more effort on the part of the reader, it may lead to more precise understanding than does metaphor. On average, new words and word senses become a part of psychology's vocabulary in the time leading up to World War I, suggesting that psychology was "finding its language" (Danziger, 1997) during this period. (c) 2016 APA, all rights reserved).

  20. A Survey of Coping Strategies With Stress in Patients With Acute Myocardial Infarction and Individuals Without a History of Fixed Myocardial Infarction.

    Science.gov (United States)

    Sadr Bafghi, Seyed Mahmood; Ahmadi, Nastaran; Yassini Ardekani, Seyyed Mojtaba; Jafari, Lida; Bitaraf Ardekani, Bahareh; Heydari, Roya; Maroufi, Fahame; Faraji, Reza

    2018-02-01

    This study aimed at investigating the coping strategies with stress in patients with acute myocardial infarction (MI) and individuals without a history of fixed MI and cardiovascular disorders. This case-control crossover study was conducted from March 2015 to February 2016 on 220 patients with acute MI (MI patients) as case group and 220 patients without any history of MI and cardiovascular diseases as the control group using availability sampling method. To collect the required data, demographic information questionnaire, Holms-Raheh life stress inventory, perceived stress questionnaire, and coping inventory for stressful situations (CISS) were applied. On the basis of our findings, 118 patients (53.6%) with MI used emotion-focused coping strategy. Ninety-seven patients (82.2%) with MI who used emotion-focused coping strategy had negative perceived stress. Additionally, 71 patients (60.2%) with MI who had used emotion-focused coping strategy suffered from very high level of stress. The most MI patients had very high level of stress while most people in control group had high level of stress. Most MI patients that had very high level of stress cope with it in emotion-focused coping strategy and it proves that people with higher levels of stress are more likely to use inefficient coping strategies.

  1. Evaluation of the first seizure patient: Key points in the history and physical examination.

    Science.gov (United States)

    Nowacki, Tomasz A; Jirsch, Jeffrey D

    2017-07-01

    This review will present the history and physical examination as the launching point of the first seizure evaluation, from the initial characterization of the event, to the exclusion of alternative diagnoses, and then to the determination of specific acute or remote causes. Clinical features that may distinguish seizures from alternative diagnoses are discussed in detail, followed by a discussion of acute and remote first seizure etiologies. This review article is based on a discretionary selection of English language articles retrieved by a literature search in the PubMed database, and the authors' clinical experience. The first seizure is a dramatic event with often profound implications for patients and family members. The initial clinical evaluation focuses on an accurate description of the spell to confirm the diagnosis, along with careful scrutiny for previously unrecognized seizures that would change the diagnosis more definitively to one of epilepsy. The first seizure evaluation rests primarily on the clinical history, and to a lesser extent, the physical examination. Even in the era of digital EEG recording and neuroimaging, the initial clinical evaluation remains essential for the diagnosis, treatment, and prognostication of the first seizure. Copyright © 2016. Published by Elsevier Ltd.

  2. Microsporidial keratoconjunctivitis in an immunocompetent patient with a past history of laser in situ keratomilieusis surgery

    Directory of Open Access Journals (Sweden)

    M L Bommala

    2011-01-01

    Full Text Available Ocular infection with microsporidia has been documented in both immunocompetent and immunocompromised patients. Sources and mode of human infection with microsporidia have been difficult to ascertain although exposure to water may be an important risk factor. Of four genera that have been reported in human disease, only the genera Nosema, Encephalitozoon and Septata are documented to cause ocular infection. Here, in our case a healthy 30-year-old man who had undergone bilateral laser in situ keratomilieusis surgery two and half years back presented with a 10-day history of redness and 4-day history of blurring of vision in the right eye. On presentation, his best-corrected visual acuity was 20/20 partial in both eyes. Slit lamp examination revealed multiple pin head shaped infiltrates in the right cornea. Examination of the left eye was unremarkable. Based on microscopic demonstration of numerous microsporidial spores in the corneal scrapings, a diagnosis of microsporidial keratitoconjunctivitis was made. On treatment with oral albendazole, the cornea became clear with complete resolution of symptoms and signs within two weeks.

  3. The use of virtual patients to teach medical students history taking and communication skills.

    Science.gov (United States)

    Stevens, Amy; Hernandez, Jonathan; Johnsen, Kyle; Dickerson, Robert; Raij, Andrew; Harrison, Cyrus; DiPietro, Meredith; Allen, Bryan; Ferdig, Richard; Foti, Sebastian; Jackson, Jonathan; Shin, Min; Cendan, Juan; Watson, Robert; Duerson, Margaret; Lok, Benjamin; Cohen, Marc; Wagner, Peggy; Lind, D Scott

    2006-06-01

    At most institutions, medical students learn communication skills through the use of standardized patients (SPs), but SPs are time and resource expensive. Virtual patients (VPs) may offer several advantages over SPs, but little data exist regarding the use of VPs in teaching communication skills. Therefore, we report our initial efforts to create an interactive virtual clinical scenario of a patient with acute abdominal pain to teach medical students history-taking and communication skills. In the virtual scenario, a life-sized VP is projected on the wall of an examination room. Before the virtual encounter, the student reviews patient information on a handheld tablet personal computer, and they are directed to take a history and develop a differential diagnosis. The virtual system includes 2 networked personal computers (PCs), 1 data projector, 2 USB2 Web cameras to track the user's head and hand movement, a tablet PC, and a microphone. The VP is programmed with specific answers and gestures in response to questions asked by students. The VP responses to student questions were developed by reviewing videotapes of students' performances with real SPs. After obtaining informed consent, 20 students underwent voice recognition training followed by a videotaped VP encounter. Immediately after the virtual scenario, students completed a technology and SP questionnaire (Maastricht Simulated Patient Assessment). All participants had prior experience with real SPs. Initially, the VP correctly recognized approximately 60% of the student's questions, and improving the script depth and variability of the VP responses enhanced most incorrect voice recognition. Student comments were favorable particularly related to feedback provided by the virtual instructor. The overall student rating of the virtual experience was 6.47 +/- 1.63 (1 = lowest, 10 = highest) for version 1.0 and 7.22 +/- 1.76 for version 2.0 (4 months later) reflecting enhanced voice recognition and other

  4. In Vitro Culturing and Live Imaging of Drosophila Egg Chambers: A History and Adaptable Method.

    Science.gov (United States)

    Peters, Nathaniel C; Berg, Celeste A

    2016-01-01

    The development of the Drosophila egg chamber encompasses a myriad of diverse germline and somatic events, and as such, the egg chamber has become a widely used and influential developmental model. Advantages of this system include physical accessibility, genetic tractability, and amenability to microscopy and live culturing, the last of which is the focus of this chapter. To provide adequate context, we summarize the structure of the Drosophila ovary and egg chamber, the morphogenetic events of oogenesis, the history of egg-chamber live culturing, and many of the important discoveries that this culturing has afforded. Subsequently, we discuss various culturing methods that have facilitated analyses of different stages of egg-chamber development and different types of cells within the egg chamber, and we present an optimized protocol for live culturing Drosophila egg chambers.We designed this protocol for culturing late-stage Drosophila egg chambers and live imaging epithelial tube morphogenesis, but with appropriate modifications, it can be used to culture egg chambers of any stage. The protocol employs a liquid-permeable, weighted "blanket" to gently hold egg chambers against the coverslip in a glass-bottomed culture dish so the egg chambers can be imaged on an inverted microscope. This setup provides a more buffered, stable, culturing environment than previously published methods by using a larger volume of culture media, but the setup is also compatible with small volumes. This chapter should aid researchers in their efforts to culture and live-image Drosophila egg chambers, further augmenting the impressive power of this model system.

  5. Life histories in occupational therapy clinical practice.

    Science.gov (United States)

    Frank, G

    1996-04-01

    This article defines and compares several narrative methods used to describe and interpret patients' lives. The biographical methods presented are case histories, life-charts, life histories, life stories, assisted autobiography, hermeneutic case reconstruction, therapeutic employment, volitional narratives, and occupational storytelling and story making. Emphasis is placed the clinician as a collaborator and interpreter of the patient's life through ongoing interactions and dialogue.

  6. Hepatic splenosis mimicking liver metastases in a patient with history of childhood immature teratoma.

    Science.gov (United States)

    Jereb, Sara; Trotovsek, Blaz; Skrbinc, Breda

    2016-06-01

    Hepatic splenosis is rare condition, preceded by splenectomy or spleen trauma, the term refers to nodular implantation of normal splenic tissue in the liver. In patients with history of malignancy in particular, it can be mistaken for metastases and can lead to unnecessary diagnostic procedures or inappropriate treatment. Twenty-two-year old male was treated for immature teratoma linked to undescended right testicle after birth. On regular follow-up examinations no signs of disease relapse or long-term consequences were observed. He was presented with incidental finding of mature cystic teratoma after elective surgery for what appeared to be left-sided inguinal hernia. The tumour was most likely a metastasis of childhood teratoma. Origin within remaining left testicle was not found. Upon further imaging diagnostics, several intrahepatic lesions were revealed. Based on radiologic appearance they were suspicious to be metastases. The patient underwent two ultrasound guided fine-needle aspiration biopsies. Cytologic diagnosis was inconclusive. Histology of laparoscopically obtained tissue disclosed presence of normal splenic tissue and led to diagnosis of hepatic splenosis. Though hepatic splenosis is rare, it needs to be included in differential diagnosis of nodular hepatic lesions. Accurate interpretation of those lesions is crucial for appropriate management of the patient. If diagnosis eludes after cytologic diagnostics alone, laparoscopic excision of nodular lesion is warranted before considering more extensive liver resection.

  7. 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.

  8. Differences in trauma history and psychopathology between PTSD patients with and without co-occurring dissociative disorders

    Science.gov (United States)

    Wabnitz, Pascal; Gast, Ursula; Catani, Claudia

    2013-01-01

    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. PMID:24298325

  9. Gastroduodenal safety of Nimesulid (Nimesil, Berlin Chemie in rheumatic patients with history of ulcer

    Directory of Open Access Journals (Sweden)

    A. E. Karateyev

    2003-01-01

    Full Text Available Objective. To assess safety of nimesulid in rheumatic pts with history of ulcer or multiple erosions (ME of stomach and/or duodenal mucosa. Methods. 42 pts with rheumatic diseases aged 22-73 years were included. AH had gastric or duodenal ulcers or ME (n>10 connected with NSAID treatment and confirmed by endoscopy no more than 6 months before the beginning of the study. Pts were included after healing of ulcers and erosions. The pts were randomized to receive Nimesulid 200 mg/day (group 1 or Diclofenac suppositoria 100 mg/day + ranitidine 150 mg/day (group 2. Esophagogastroduodenoscopy was performed before and 12 weeks after the beginning of treatment. Results. Relapse of stomach ulcer was observed in I pts of group 1 (5,6%. Relapse of NSAID-induced ulcers and ME was noted in 6 pts of group 2 (33,3%: in 4 cases stomach ulcers, in 1 case stomach ME, in 1 case duodenal ulcer (p=0,0424. Presence of gastralgias and dyspepsia was noted in 36,8% pts of group 1 and in 20% pts of group 2 (p=0,0539. In 1 pts of group 2 gastralgias were the reason for premature endoscopy. Conclusion. Nimesil (Nimesulid can be considered as a more safe drug than classical NSAIDs with smaller risk of serious gastroduodenal complications development in rheumatic pts with ulcer history. The results of the study allow to recommend Nimesulid as a drug of choice for treatment of pts with history of NSAID-induced gastropathy.

  10. History matching of transient pressure build-up in a simulation model using adjoint method

    Energy Technology Data Exchange (ETDEWEB)

    Ajala, I.; Haekal, Rachmat; Ganzer, L. [Technische Univ. Clausthal, Clausthal-Zellerfeld (Germany); Almuallim, H. [Firmsoft Technologies, Inc., Calgary, AB (Canada); Schulze-Riegert, R. [SPT Group GmbH, Hamburg (Germany)

    2013-08-01

    The aim of this work is the efficient and computer-assisted history-matching of pressure build-up and pressure derivatives by small modification to reservoir rock properties on a grid by grid level. (orig.)

  11. A Time Domain Update Method for Reservoir History Matching of Electromagnetic Data

    KAUST Repository

    Katterbauer, Klemens; Hoteit, Ibrahim; Sun, Shuyu

    2014-01-01

    production forecasts and optimizing reservoir exploitation. Reservoir history matching has played here a key role incorporating production, seismic, electromagnetic and logging data for forecasting the development of reservoirs and its depletion

  12. SECONDARY PREVENTION OF CARDIOVASCULAR DISEASES AMONG PATIENTS OF DIFFERENT AGE GROUPS WITH A HISTORY OF MYOCARDIAL INFARCTION BY THE EXAMPLE OF OUTPATIENT CARDIOLOGY INSTITUTION

    Directory of Open Access Journals (Sweden)

    S. B. Fitilev

    2017-01-01

    Full Text Available Aim. To study secondary prevention of cardiovascular diseases among patients of different age groups with a history of myocardial infarction by the example of outpatient cardiology institution.Material and methods. Retrospective pharmacoepidemiological study was conducted by analyzing the medical records of 825 patients with a history of myocardial infarction, who visited the outpatient cardiology institution for the first time in 2011. Patients were divided into two groups according to their age: younger than 60 years (n=308, and 60 years and older (n=517.Results. The population of elderly patients was more severe: significantly more often patients had disability and comorbidities. The prevalence of the main modifiable risk factors could not be assessed fully due to the lack of information in patients’ medical records. Elderly patients were significantly less likely to receive β-blockers (80.3% and statins (63.8%. No significant differences were found in daily doses of the main prescribed preventive drugs between two groups.Conclusion. Secondary prevention of cardiovascular diseases among patients of different age groups could not be considered proper, as there is low level of attention to the modifiable risk factors and recommendation on their correction. A tendency to under-prescription of angiotensin converting enzyme inhibitors was revealed, as well as significantly lower number of recommendations for taking statins and β-adrenoblockers in the group of elderly patients.

  13. Generate tri-directional spectra-compatible time histories using HHT method

    International Nuclear Information System (INIS)

    Li, Bo; Xie, Wei-Chau; Pandey, Mahesh D.

    2016-01-01

    Highlights: • Hilbert–Huang Transform are applied to modify real earthquake records. • Generate tri-directional time histories compatible with target spectra. • Both GRS and FRS are considered as target spectra. • Target spectra with multiple damping ratios are considered. - Abstract: This paper proposes two algorithms to generate spectrum-compatible time histories based on two approaches recommended by USNRC Standard Review Plan 3.7.1. Hilbert–Huang Transform technique is used to analyze frequency contents and amplitudes of seed motions. Through adjusting the frequency contents and amplitudes of seed motions, spectrum-compatible time histories are obtained. The first algorithm is to generate tri-directional time histories compatible with multi-damping target design spectra (ground response spectra or floor response spectra). The second algorithm is to generate tri-directional time histories compatible with single-damping target design spectra. Examples are presented to demonstrate versatility of these two proposed algorithms to generate spectra-compatible time histories.

  14. Generate tri-directional spectra-compatible time histories using HHT method

    Energy Technology Data Exchange (ETDEWEB)

    Li, Bo; Xie, Wei-Chau, E-mail: xie@uwaterloo.ca; Pandey, Mahesh D.

    2016-11-15

    Highlights: • Hilbert–Huang Transform are applied to modify real earthquake records. • Generate tri-directional time histories compatible with target spectra. • Both GRS and FRS are considered as target spectra. • Target spectra with multiple damping ratios are considered. - Abstract: This paper proposes two algorithms to generate spectrum-compatible time histories based on two approaches recommended by USNRC Standard Review Plan 3.7.1. Hilbert–Huang Transform technique is used to analyze frequency contents and amplitudes of seed motions. Through adjusting the frequency contents and amplitudes of seed motions, spectrum-compatible time histories are obtained. The first algorithm is to generate tri-directional time histories compatible with multi-damping target design spectra (ground response spectra or floor response spectra). The second algorithm is to generate tri-directional time histories compatible with single-damping target design spectra. Examples are presented to demonstrate versatility of these two proposed algorithms to generate spectra-compatible time histories.

  15. 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

    doses than never smokers and former smokers not using nicotine. CONCLUSIONS: The study supports previous evidence that smoking is associated with chronic pain. Our data suggest that information about use of nicotine substitution in chronic non-malignant patients are relevant both in a clinical setting......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...

  16. 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

    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......: A descriptive cohort study was conducted including patients aged 65 years or older admitted to the ED, n = 198. The following data were collected: ISAR screen, cause of admittance. Furthermore, a retrospective journal review was performed by a specialist in geriatrics. RESULTS: Prior to admission, 31% had...

  17. THE COOPERATIVE INTERNATIONAL NEUROMUSCULAR RESEARCH GROUP DUCHENNE NATURAL HISTORY STUDY—A LONGITUDINAL INVESTIGATION IN THE ERA OF GLUCOCORTICOID THERAPY: DESIGN OF PROTOCOL AND THE METHODS USED

    Science.gov (United States)

    McDonald, Craig M.; Henricson, Erik K.; Abresch, R. Ted; Han, Jay J.; Escolar, Diana M.; Florence, Julaine M.; Duong, Tina; Arrieta, Adrienne; Clemens, Paula R.; Hoffman, Eric P.; Cnaan, Avital

    2014-01-01

    Contemporary natural history data in Duchenne muscular dystrophy (DMD) is needed to assess care recommendations and aid in planning future trials. Methods The Cooperative International Neuromuscular Research Group (CINRG) DMD Natural History Study (DMD-NHS) enrolled 340 individuals, aged 2–28 years, with DMD in a longitudinal, observational study at 20 centers. Assessments obtained every 3 months for 1 year, at 18 months, and annually thereafter included: clinical history; anthropometrics; goniometry; manual muscle testing; quantitative muscle strength; timed function tests; pulmonary function; and patient-reported outcomes/ health-related quality-of-life instruments. Results Glucocorticoid (GC) use at baseline was 62% present, 14% past, and 24% GC-naive. In those ≥6 years of age, 16% lost ambulation over the first 12 months (mean age 10.8 years). Conclusions Detailed information on the study methodology of the CINRG DMD-NHS lays the groundwork for future analyses of prospective longitudinal natural history data. These data will assist investigators in designing clinical trials of novel therapeutics. PMID:23677550

  18. Patient Satisfaction With Postpartum Teaching Methods.

    Science.gov (United States)

    Wagner, Debra L; Washington, Cynthia

    2016-01-01

    Postpartum discharge instructions are a crucial part of a mother's birth experience. Finding the method to provide those discharge instructions in a manner that increases the mother's satisfaction with her hospital experience is important. This quasi-experimental study examined the relationship between new mothers' interaction with nurses providing postpartum instructions by the traditional and class methods and their satisfaction with discharge teaching. The results indicated new mothers were satisfied with both methods of discharge teaching; however, they were more likely to report stronger agreement with overall satisfaction with the traditional method of discharge teaching than with attending the discharge class.

  19. F8 and F9 mutations in US haemophilia patients: correlation with history of inhibitor and race/ethnicity.

    Science.gov (United States)

    Miller, C H; Benson, J; Ellingsen, D; Driggers, J; Payne, A; Kelly, F M; Soucie, J M; Craig Hooper, W

    2012-05-01

    Both genetic and treatment-related risk factors contribute to the development of inhibitors in haemophilia. An inhibitor surveillance system piloted at 12 US sites has the goal of assessing risk factors through prospective data collection. This report examines the relationship of genotype and race/ethnicity to history of inhibitor in a large cohort of US haemophilia patients. Mutation analysis was performed on 676 haemophilia A (HA) and 153 haemophilia B (HB) patients by sequencing, Multiplex Ligation-dependent Probe Amplification, and PCR for inversions in F8 introns 22 (inv22) and 1 (inv1). Two HB patients with deletions had history of inhibitor. In severe HA, frequency of history of inhibitor was: large deletion 57.1%, splice site 35.7%, inv22 26.8%, nonsense 24.5%, frameshift 12.9%, inv1 11.1% and missense 9.5%. In HA, 19.6% of 321 White non-Hispanics (Whites), 37.1% of 35 Black non-Hispanics (Blacks) and 46.9% of 32 Hispanics had history of inhibitor (P = 0.0003). Mutation types and novel mutation rates were similar across ethnicities. When F8 haplotypes were constructed, Whites and Hispanics showed only H1 and H2. Within H1, history of inhibitor was 12.4% in Whites, 40.0% in Blacks (P = 0.009) and 32.4% in Hispanics (P = 0.002). Inhibitor frequency is confirmed to vary by mutation type and race in a large US population. White patients with history of inhibitor did not exhibit rare F8 haplotypes. F8 gene analysis did not reveal a cause for the higher inhibitor frequencies in Black and Hispanic patients. © 2011 Blackwell Publishing Ltd.

  20. Prior history of non-melanoma skin cancer is associated with increased mortality in patients with chronic lymphocytic leukemia

    Science.gov (United States)

    Toro, Jorge R.; Blake, Patrick W.; Björkholm, Magnus; Kristinsson, Sigurdur Y.; Wang, Zhuoqiao; Landgren, Ola

    2009-01-01

    We investigated whether a previous diagnosis of non-melanoma skin cancer among chronic lymphocytic leukemia patients is a predictor of poor outcome. Using the Swedish Cancer Registry, we conducted a population-based study to evaluate the survival patterns among chronic lymphocytic leukemia patients with and without non-melanoma skin cancer. Cox proportional hazards regression models were used and Kaplan-Meier curves were constructed. Of a total of 12,041 chronic lymphocytic leukemia cases identified, 236 cases, including 111 squamous cell cancer, had a prior history of non-melanoma skin cancer. Chronic lymphocytic leukemia patients with a prior history of non-melanoma skin cancer had a 1.29-fold (95% CI 1.10–1.52; p=0.0024) increased risk of dying; and those with a history of squamous cell cancer had a further elevated 1.86-fold (95% CI 1.46–2.36; p<0.0001) risk of dying. Kaplan-Meier plots showed that patients with a history of non-melanoma skin cancer, particularly those with squamous cell cancer, had significantly poorer survival than chronic lymphocytic leukemia patients without non-melanoma skin cancer (p<0.0001; log-rank test). Non-melanoma skin cancer may be a novel clinical predictor of worse chronic lymphocytic leukemia outcome. PMID:19794092

  1. The history of childhood trauma is associated with lipid disturbances and blood pressure in adult first-episode schizophrenia patients.

    Science.gov (United States)

    Misiak, Błażej; Kiejna, Andrzej; Frydecka, Dorota

    2015-01-01

    It has repeatedly been found that early-life traumatic events may contribute to metabolic dysregulation. Therefore, the aim of this study was to investigate the association between the history of childhood trauma and cardiovascular risk factors in first-episode schizophrenia (FES) patients. The history of childhood trauma was assessed using the Early Trauma Inventory Self Report - Short Form (ETISR-SF) in 83 FES patients. Based on the ETISR-SF, patients were divided into those with positive and negative history of childhood trauma: FES(+) and FES(-) patients. Serum levels of fasting glucose lipids, homocysteine, vitamin B12 and folate, as well as anthropometric parameters and resting systolic and diastolic blood pressure (SBP and DBP) were measured. The history of childhood trauma was associated with higher low-density lipoprotein (LDL) levels, SBP and DBP after covarying for age, gender, body mass index, education and chlorpromazine equivalent. There were significant correlations between scores of distinct ETISR-SF subscales and LDL, high-density lipoprotein, SBP, DBP and the number of metabolic syndrome criteria. Results of this study indicate that traumatic events during childhood might be related to higher resting blood pressure and higher LDL levels in adult FES patients. Copyright © 2015. Published by Elsevier Inc.

  2. Uncovering History for Future History Teachers

    Science.gov (United States)

    Fischer, Fritz

    2010-01-01

    The art of history teaching is at a crossroads. Recent scholarship focuses on the need to change the teaching of history so students can better learn history, and insists that history teachers must move beyond traditional structures and methods of teaching in order to improve their students' abilities to think with history. This article presents…

  3. Cost-effectiveness of pioglitazone in type 2 diabetes patients with a history of macrovascular disease: a German perspective

    Directory of Open Access Journals (Sweden)

    Massi-Benedetti Massimo

    2009-05-01

    Full Text Available Abstract Background The aim of this study was to project health-economic outcomes relevant to the German setting for the addition of pioglitazone to existing treatment regimens in patients with type 2 diabetes, evidence of macrovascular disease and at high risk of cardiovascular events. Methods Event rates corresponding to macrovascular outcomes from the Prospective Pioglitazone Clinical Trial in Macrovascular Events (PROactive study of pioglitazone were used with a modified version of the CORE Diabetes Model to simulate outcomes over a 35-year time horizon. Direct medical costs were accounted from a healthcare payer perspective in year 2005 values. Germany specific costs were applied for patient treatment, hospitalization and management. Both costs and clinical benefits were discounted at 5.0% per annum. Results Over patient lifetimes pioglitazone treatment improved undiscounted life expectancy by 0.406 years and improved quality-adjusted life expectancy by 0.120 quality-adjusted life years (QALYs compared to placebo. Direct medical costs (treatment plus complication costs were marginally higher for pioglitazone treatment and calculation of the incremental cost-effectiveness ratio (ICER produced a value of €13,294 per QALY gained with the pioglitazone regimen versus placebo. Acceptability curve analysis showed that there was a 78.2% likelihood that pioglitazone would be considered cost-effective in Germany, using a "good value for money" threshold of €50,000 per QALY gained. Sensitivity analyses showed that the results were most sensitive to changes in the simulation time horizon. After adjustment for the potential stabilization of pancreatic β-cell function with pioglitazone treatment, the ICER was €6,667 per QALY gained for pioglitazone versus placebo. Conclusion The findings of this modelling analysis indicated that, for patients with a history of macrovascular disease, addition of pioglitazone to existing therapy reduces the long

  4. Effect of attitudes towards patients on sexual history taking: a survey of Iranian-American physicians in California, USA.

    Science.gov (United States)

    Rashidian, Mitra; Minichiello, Victor; Knutsen, Synnove F; Ghamsary, Mark

    2017-11-01

    Although obtaining sexual history from patients is essential, the attitudes of physicians can become a barrier to sexual health care. Iranian-American physicians may face particular challenges because talking about sexuality is considered a taboo within their culture. Our study examined these physicians' attitudes when taking a sexual history from their patients. In 2013, a self-administrated questionnaire was sent to 1550 Iranian-American physicians in California, USA. Using factor analysis, the principal components approach with a Varimax rotation was used on a set of 12-item questions (five-point Likert scales) to detect latent factors that explain attitudes affecting sexual history taking. Scores are generated to determine physicians' attitudes towards sexual history taking. In total, 354 questionnaires were returned (23% response rate). Three factors were identified as internally consistent (Cronbach's α=0.84 - 0.94): (1) attitude towards various patients; (2) female sexuality; and (3) age and marriage. Significant association were found between these three factors and some variables such as physicians' gender, country of medical graduation, religion, birthplace and age. Results revealed that cultural attitudes are important factors affecting physicians' involvement in sexual history taking. Additional studies from this population and other subpopulations of US physicians are needed. New strategies that reflect on physicians' attitude on sexual healthcare delivery is needed. If confirmed in other studies, our findings could have implications for the training of medical graduates globally.

  5. Primary care physician management, referral, and relations with specialists concerning patients at risk for cancer due to family history.

    Science.gov (United States)

    Wood, M E; Flynn, B S; Stockdale, A

    2013-01-01

    Risk stratification based on family history is a feature of screening guidelines for a number of cancers and referral guidelines for genetic counseling/testing for cancer risk. Our aim was to describe primary care physician perceptions of their role in managing cancer risk based on family history. Structured interviews were conducted by a medical anthropologist with primary care physicians in 3 settings in 2 north-eastern states. Transcripts were systematically analyzed by a research team to identify major themes expressed by participants. Forty interviews were conducted from May 2003 through May 2006. Physicians provided a diversity of views on roles in management of cancer risk based on family history, management practices and patient responses to risk information. They also provided a wide range of perspectives on criteria used for referral to specialists, types of specialists referred to and expected management roles for referred patients. Some primary care physicians appeared to make effective use of family history information for cancer risk management, but many in this sample did not. Increased focus on efficient assessment tools based on recognized guidelines, accessible guides to management options, and patient education and decision aids may be useful directions to facilitate broader use of family history information for cancer risk management. Copyright © 2013 S. Karger AG, Basel.

  6. Testing survey-based methods for rapid monitoring of child mortality, with implications for summary birth history data.

    Science.gov (United States)

    Brady, Eoghan; Hill, Kenneth

    2017-01-01

    Under-five mortality estimates are increasingly used in low and middle income countries to target interventions and measure performance against global development goals. Two new methods to rapidly estimate under-5 mortality based on Summary Birth Histories (SBH) were described in a previous paper and tested with data available. This analysis tests the methods using data appropriate to each method from 5 countries that lack vital registration systems. SBH data are collected across many countries through censuses and surveys, and indirect methods often rely upon their quality to estimate mortality rates. The Birth History Imputation method imputes data from a recent Full Birth History (FBH) onto the birth, death and age distribution of the SBH to produce estimates based on the resulting distribution of child mortality. DHS FBHs and MICS SBHs are used for all five countries. In the implementation, 43 of 70 estimates are within 20% of validation estimates (61%). Mean Absolute Relative Error is 17.7.%. 1 of 7 countries produces acceptable estimates. The Cohort Change method considers the differences in births and deaths between repeated Summary Birth Histories at 1 or 2-year intervals to estimate the mortality rate in that period. SBHs are taken from Brazil's PNAD Surveys 2004-2011 and validated against IGME estimates. 2 of 10 estimates are within 10% of validation estimates. Mean absolute relative error is greater than 100%. Appropriate testing of these new methods demonstrates that they do not produce sufficiently good estimates based on the data available. We conclude this is due to the poor quality of most SBH data included in the study. This has wider implications for the next round of censuses and future household surveys across many low- and middle- income countries.

  7. Treatment of patients with a history of penicillin allergy in a large tertiary-care academic hospital.

    Science.gov (United States)

    Picard, Matthieu; Bégin, Philippe; Bouchard, Hugues; Cloutier, Jonathan; Lacombe-Barrios, Jonathan; Paradis, Jean; Des Roches, Anne; Laufer, Brian; Paradis, Louis

    2013-01-01

    Prescribing antibiotics to patients with a history of penicillin allergy is common in clinical practice. Opting for non-beta-lactam antibiotics has its inconveniences and is often unnecessary, because most of these patients are in fact not allergic. This study aimed to determine how physicians in a large Canadian tertiary-care academic hospital without allergists on staff treat patients with a history of penicillin allergy. A retrospective study was conducted during a 1-year period among all patients hospitalized in the intensive care unit, coronary care unit, and internal medicine wards. Files of patients with a record of penicillin allergy were reviewed to assess the need for antibiotics during their hospitalization and the decision-making process underlying the choice of antibiotic. The additional costs of alternative antibiotics were calculated. The files of 1738 patients admitted over a 1-year period were hand reviewed. A history of penicillin allergy was found in 172 patients (9.9%). The allergic reaction was described in only 30% of cases and left unmentioned in 20.7%. Beta-lactam antibiotics were used on 56 occasions despite a history of penicillin allergy. The use of alternative antibiotics in place of the beta-lactam standard of care carried an additional cost of $15,672 Canadian. Alleged penicillin allergy is common among hospitalized patients and leads to substantial additional costs. Poor documentation of penicillin allergy likely reflects a lack of knowledge on this issue in the medical community, which impairs optimal treatment of these patients. Increased education on this matter is needed, and allergists on staff could be part of the solution. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  8. Time-history simulation of civil architecture earthquake disaster relief- based on the three-dimensional dynamic finite element method

    Directory of Open Access Journals (Sweden)

    Liu Bing

    2014-10-01

    Full Text Available Earthquake action is the main external factor which influences long-term safe operation of civil construction, especially of the high-rise building. Applying time-history method to simulate earthquake response process of civil construction foundation surrounding rock is an effective method for the anti-knock study of civil buildings. Therefore, this paper develops a civil building earthquake disaster three-dimensional dynamic finite element numerical simulation system. The system adopts the explicit central difference method. Strengthening characteristics of materials under high strain rate and damage characteristics of surrounding rock under the action of cyclic loading are considered. Then, dynamic constitutive model of rock mass suitable for civil building aseismic analysis is put forward. At the same time, through the earthquake disaster of time-history simulation of Shenzhen Children’s Palace, reliability and practicability of system program is verified in the analysis of practical engineering problems.

  9. Methods in Teaching Region and Diversity in U.S. Western Women's History

    Science.gov (United States)

    Jackson-Abernathy, Brenda K.

    2013-01-01

    History teachers may well feel challenged with the task of bringing women into their American West curriculums due to the great diversity of women in the West during the nineteenth century. At the same time, the past thirty years or so have produced a plethora of monographs, articles, and primary source collections on women in the American West.…

  10. Bringing Disability History Alive in Schools: Promoting a New Understanding of Disability through Performance Methods

    Science.gov (United States)

    Shah, Sonali; Wallis, Mick; Conor, Fiona; Kiszely, Phillip

    2015-01-01

    The transfer of disability history research to new generation audiences is crucial to allow lessons from the past to impact the future inclusion and equality agenda. As today's children are the policy makers and the legislators of tomorrow, it is important for them to have opportunities to engage with disability life story narratives to understand…

  11. La historia de la Literatura: sus problemas y methodos (The History of Literature: Problems and Methods)

    Science.gov (United States)

    Dopico, Blanca

    1975-01-01

    In order to achieve its goals, the study of literary history should follow a "programmed process." Such a process would help solve problems in the following areas: bibliography, text criticism, interpretation and explanation, dates and chronology, authenticity, source and origin etc. (Text is in Spanish.) (DS)

  12. Beyond Motivation - History as a method for the learning of meta-discursive rules in mathematics

    DEFF Research Database (Denmark)

    Kjeldsen, Tinne Hoff; Blomhøj, Morten

    2012-01-01

    In this paper, we argue that history might have a profound role to play for learning mathematics by providing a self-evident (if not indispensable) strategy for revealing meta-discursive rules in mathematics and turning them into explicit objects of reflection for students. Our argument is based...

  13. Is a history of cesarean section a risk factor for abnormal uterine bleeding in patients with uterine leiomyoma?

    Science.gov (United States)

    Kinay, Tugba; Basarir, Zehra O; Tuncer, Serap F; Akpinar, Funda; Kayikcioglu, Fulya; Koc, Sevgi; Karakaya, Jale

    2016-08-01

    To determine whether a history of cesarean section was a risk factor for abnormal uterine bleeding in patients with uterine leiomyomas, and to identify other risk factors for this symptom. We analyzed retrospectively, the medical records of patients who underwent hysterectomies due to the presence of uterine leiomyomas during a 6-year period (2009 and 2014) at Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey. Uterine leiomyoma was diagnosed based on histopathological examination of hysterectomy specimens. Demographic characteristics, and laboratory and histopathological findings were compared between patients with uterine leiomyoma with and without abnormal uterine bleeding. In total, 501 (57.9%) patients had abnormal uterine bleeding and 364 (42.1%) patients had other symptoms. A history of cesarean section was more common in patients with abnormal uterine bleeding than in those with other symptoms (17.6% versus 9.3%, p=0.001; odds ratio [OR]: 2.1; 95% confidence interval [CI]: 1.4-3.3). The presence of a submucosal leiomyoma (OR: 2.1; 95% CI: 1.5-3.1) and coexistent adenomyosis (OR: 1.6; 95% CI: 1.1-2.4) were also associated with abnormal uterine bleeding. A history of cesarean section was an independent risk factor for abnormal uterine bleeding in patients with uterine leiomyomas; submucosal leiomyoma and coexisting adenomyosis were also independent risk factors.

  14. 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

    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 .... CONCLUSION: A history of arterial hypertension is a moderate risk factor for mortality after an acute myocardial infarction in patients aged 65 years or less. This excess risk is present at all levels of left ventricular systolic function....

  15. Seizure threshold and the half-age method in bilateral electroconvulsive therapy in Japanese patients.

    Science.gov (United States)

    Yasuda, Kazuyuki; Kobayashi, Kaoru; Yamaguchi, Masayasu; Tanaka, Koichi; Fujii, Tomokazu; Kitahara, Yuichi; Tamaoki, Toshio; Matsushita, Yutaka; Nunomura, Akihiko; Motohashi, Nobutaka

    2015-01-01

    Seizure threshold (ST) in electroconvulsive therapy (ECT) has not been reported previously in Japanese patients. We investigated ST in bilateral ECT in Japanese patients using the dose-titration method. The associations between demographic and clinical characteristics and ST were analyzed to identify the predictors of ST. Finally, the validity of the half-age method for the stimulus dose was evaluated. Fifty-four Japanese patients with mood disorder, schizophrenia, and other psychotic disorders received an acute course of bilateral ECT using a brief-pulse device. ST was determined at the first session using a fixed titration schedule. ST was correlated with age, sex, body mass index, history of previous ECT, and psychotropic drugs on multiple regression analysis. Furthermore, the rate of accomplished seizures was calculated using the half-age method. Mean ST was 136 mC. ST was influenced by age, sex, history of previous ECT, and medication with benzodiazepines. The accomplished seizure rate using the half-age method was 72%, which was significantly lower in men and subjects on benzodiazepines. ST in Japanese patients was equal to or slightly higher than that previously reported in other ethnic groups, which might be attributable, at least in part, to high prevalence of and large-dose benzodiazepine prescription. Higher age, male gender, no history of ECT, and benzodiazepines were related to higher ST. The half-age method was especially useful in female patients and subjects without benzodiazepine medication. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  16. History from within? Contextualizing the new neurohistory and seeking its methods.

    Science.gov (United States)

    Burman, Jeremy Trevelyan

    2012-02-01

    "Histories from below" sought to give voice to those ordinary folk whose social position had failed to afford them great power, wealth, or responsibility: the neglected undocumented. Now, Lynn Hunt (2009) calls for a revolution that would task historians with giving voice to feelings--what I will call a "history from within." This is what led her to endorse Daniel Lord Smail's (2008) suggestion that historians appeal to neuroscience and thereby construct a "new neurohistory." The purpose would be to introduce a common factor to all human stories: a tool to think with when describing what it was like (cf. Nagel, 1974). If successful, this would be quite powerful: in Hunt's view, such a project could lead to a universalization of human rights. But the program is not without challenges, one of which is to provide an acceptable explanation for the type of looping causation that applies to bio-cultural kinds. Smail's solution involves an appeal to evolutionary theory, but how this solves the problem of causation is not clear. Here, therefore, an attempt is made to clarify his solution. Smail and Hunt's views on the role of evidence in history are also made plain. The paper then concludes by importing related ideas from the recent history of philosophy. If one is going to have a brain-based view of felt-history, then the neurohistorian's task is to situate historical individuals in contexts of shared experience--to not just read evidence through lenses of intellectual "thought collectives" (generalized from paradeigma), but also through "experiential" or "moral categories" (aisthánomai).

  17. Clinical impact of abnormal FDG uptake in pulmonary nodules detected by CT in patients with only history of non-lung cancers

    International Nuclear Information System (INIS)

    Wong, C.O.; Nunez, R.; Welsh, R.J.; Chmielewski, G.W.; Hill, E.A.; Hill, J.C.; Ravikrishnan, K.P.; Darlene Fink-Bennett; Dworkin, H.J.

    2001-01-01

    Objective: The aim is to assess the clinical impact of positive FDG uptake in single (SPN) or multiple (MPN) pulmonary nodules detected by CT in patients with known past history of non-lung cancers (but no known lung cancers). Materials and Methods: Twenty-eight sequential patients with non-lung cancers (15 breast, 8 colon, 5 prostate) referred for evaluation of SPN or MPN by PET over a period of two years were included. F-18 FDG PET images, covering chest and upper abdomen, were interpreted blindly and then correlated with CT findings for the precise location of abnormal FDG uptake in the chest. Results: There was a significant number of abnormal FDG uptake in both SPN or MPN. Positive abnormal uptake suggestive of malignancy was found in 25% of patients in the form of SPN and 39% of patients in the form of MPN (p<0.03). Positive cases in the pattern of multiple foci of pulmonary uptake were attributed to metastatic disease. Otherwise positive cases were followed by tissue diagnosis and/or surgical attention. The negative cases were followed clinically. Of the 11 positive cases of MPN, 2 patients (18%) showed only abnormal FDG uptake in just one of the nodules, which was later confirmed at surgery to be a primary cancer of lung in both patients. Conclusion: These results suggest that PET scan would be just as useful in patients with SPN and known non-lung cancers as other patients with no history of any cancers. Not all patients with non-lung cancer and MPN have pulmonary metastasis by PET criteria. PET may single out a primary lung malignancy in patients with non-lung cancer and MPN. PET has thus great clinical impact in these patients with pulmonary nodules and known non-lung cancers as the management would otherwise be completely different in situations revealed by the study

  18. 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.

  19. 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)

    Treglia, Giorgio; Luca, Giovanella; Barbara, Muoio; Carmelo, Caldarella

    2014-01-01

    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

  20. Identification of risk products for fragrance contact allergy: a case-referent study based on patients' histories.

    Science.gov (United States)

    Johansen, J D; Andersen, T F; Kjøller, M; Veien, N; Avnstorp, C; Andersen, K E; Menné, T

    1998-06-01

    Fragrances are the first or second most common cause of contact allergy in dermatitis patients. The aim of this study was to identify risk products for fragrance contact allergy. The design was a case-control study with a case group of 78 fragrance-mix-positive eczema patients and two control groups, one consisting of 1,279 subjects selected as a random sample of the general population and the other consisting of 806 fragrance-mix-negative eczema patients. The identification of risk products was based on the patients' histories of rash to scented products. Analysis of the associations between first-time rash caused by different specified product categories and fragrance mix sensitivity was performed using logistic regression. It was found that first-time rash caused by deodorant sprays and/or perfumes were related to fragrance contact allergy in a comparison with both control groups. The risk (odds ratio) of being diagnosed as fragrance allergic was 2.3 to 2.9 greater in cases of a history of first-time rash to deodorant sprays and 3.3 to 3.4 greater in cases of a history of rash to perfumes than if no such history were present. First-time rash to cleansing agents, deodorant sticks, or hand lotions was also statistically significant but only in comparison with one of the control groups. Safety evaluation of fragrance materials used in perfumes and deodorant sprays should be performed with special attention.

  1. Systematic review of patient history and physical examination to diagnose chronic low back pain originating from the facet joints.

    Science.gov (United States)

    Maas, E T; Juch, J N S; Ostelo, R W J G; Groeneweg, J G; Kallewaard, J W; Koes, B W; Verhagen, A P; Huygen, F J P M; van Tulder, M W

    2017-03-01

    Patient history and physical examination are frequently used procedures to diagnose chronic low back pain (CLBP) originating from the facet joints, although the diagnostic accuracy is controversial. The aim of this systematic review is to determine the diagnostic accuracy of patient history and/or physical examination to identify CLBP originating from the facet joints using diagnostic blocks as reference standard. We searched MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane Collaboration database from inception until June 2016. Two review authors independently selected studies for inclusion, extracted data and assessed the risk of bias. We calculated sensitivity and specificity values, with 95% confidence intervals (95% CI). Twelve studies were included, in which 129 combinations of index tests and reference standards were presented. Most of these index tests have only been evaluated in single studies with a high risk of bias. Four studies evaluated the diagnostic accuracy of the Revel's criteria combination. Because of the clinical heterogeneity, results were not pooled. The published sensitivities ranged from 0.11 (95% CI 0.02-0.29) to 1.00 (95% CI 0.75-1.00), and the specificities ranged from 0.66 (95% CI 0.46-0.82) to 0.91 (95% CI 0.83-0.96). Due to clinical heterogeneity, the evidence for the diagnostic accuracy of patient history and/or physical examination to identify facet joint pain is inconclusive. Patient history and physical examination cannot be used to limit the need of a diagnostic block. The validity of the diagnostic facet joint block should be studied, and high quality studies are required to confirm the results of single studies. Patient history and physical examination cannot be used to limit the need of a diagnostic block. The validity of the diagnostic facet joint block should be studied, and high quality studies are required to confirm the results of single studies. © 2016 European Pain Federation - EFIC®.

  2. Marathon maternity oral history project: Exploring rural birthing through narrative methods.

    Science.gov (United States)

    Orkin, Aaron; Newbery, Sarah

    2014-01-01

    To explore how birthing and maternity care are understood and valued in a rural community. Oral history research. The rural community of Marathon, Ont, with a population of approximately 3500. A purposive selection of mothers, grandmothers, nurses, physicians, and community leaders in the Marathon medical catchment area. Interviews were conducted with a purposive sample, employing an oral history research methodology. Interviews were conducted non-anonymously in order to preserve the identity and personhood of participants. Interview transcripts were edited into short narratives. Oral histories offer perspectives and information not revealed in other quantitative or qualitative research methodologies. Narratives re-personalize and humanize medical research by offering researchers and practitioners the opportunity to bear witness to the personal stories affected through medical decision making. Eleven stand-alone narratives, published in this issue of Canadian Family Physician, form the project's findings. Similar to a literary text or short story, they are intended for personal reflection and interpretation by the reader. Presenting the results of these interviews as narratives requires the reader to participate in the research exercise and take part in listening to these women's voices. The project's narratives will be accessible to readers from academic and non-academic backgrounds and will interest readers in medicine and allied health professions, medical humanities, community development, gender studies, social anthropology and history, and literature. Sharing personal birthing experiences might inspire others to reevaluate and reconsider birthing practices and services in other communities. Where local maternity services are under threat, Marathon's stories might contribute to understanding the meaning and challenges of local birthing, and the implications of losing maternity services in rural Canada.

  3. Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests.

    Science.gov (United States)

    Décary, Simon; Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

    2018-01-01

    To assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears. Prospective diagnostic study. Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling. Consecutive patients with a knee complaint (n = 279) and consulting one of the participating orthopaedic surgeons (n = 3) or sport medicine physicians (n = 2). Not applicable. History elements and physical examination tests performed independently were compared to the reference standard: an expert physicians' composite diagnosis including history elements, physical tests and confirmatory magnetic resonance imaging. Penalized logistic regression (LASSO) was used to identify history elements and physical examination tests associated with the diagnosis of ACL tear and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity (Se), specificity (Sp), predictive values and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CI) were calculated. Forty-three individuals received a diagnosis of partial or complete ACL tear (15.4% of total cohort). The Lachman test alone was able to diagnose partial or complete ACL tears (LR+: 38.4; 95%CI: 16.0-92.5). Combining a history of trauma during a pivot with a "popping" sensation also reached a high diagnostic validity for partial or complete tears (LR+: 9.8; 95%CI: 5.6-17.3). Combining a history of trauma during a pivot, immediate effusion after trauma and a positive Lachman test was able to identify individuals with a complete ACL tear (LR+: 17.5; 95%CI: 9.8-31.5). Finally, combining a negative history of pivot or a negative popping sensation during trauma with a negative Lachman or pivot shift test was able to exclude both partial or complete ACL tears (LR-: 0.08; 95%CI: 0.03-0.24). Diagnostic clusters combining history elements and physical

  4. Life Expectancies Applied to Specific Statuses: a History of the Indicators and the Methods of Calculation {Population, 3, 1998)

    OpenAIRE

    N. Brouard; J.-M. Robine; E. Cambois

    1999-01-01

    Cambois (Emmanuelle), Robin? (Jean-Marie), Brouard (Nicolas).- Life Expectancies Applied to Specific Statuses: A History of the Indicators and the Methods of Calculation Indicators of life expectancy applied to specific statuses, such as the state of health or professional status, were introduced at the end of the 1930s and are currently the object of renewed interest. Because they relate mortality to different domains (health, professional activity) applied life expectancies reflect simultan...

  5. [Neurocognitive Performance in Euthymic Bipolar I Patients With and Without History of Psychosis From a Multimodal Intervention Program: PRISMA].

    Science.gov (United States)

    Molina, Marcela; Palacio, Juan David; Vargas, Cristian; Díaz-Zuluaga, Ana María; Agudelo Berruecos, Yuli; Ospina, Sigifredo; López-Jaramillo, Carlos

    Patients with bipolar disorder type I (BDI) have an increased prevalence of psychotic symptoms, and these have been associated with higher cognitive impairment; however the issue has not been settled with the available evidence. To determine if the history of psychotic symptoms in a Colombian sample with BDI is associated with greater cognitive impairment. A case-control study was performed that included patients with BDI from the l PRISMA study. Of the 203 eligible subjects, 123 participants were included; 71 had a history of psychosis, and 52 did not. Cognitive function was characterised by neuropsychological tests that assessed intellectual coefficient, attention, executive function, verbal fluency, auditory and visual memory, and spatial location. No differences were found in most of the neuropsychological test results between the groups after adjusting for age, education, sex, duration of the disease, number of episodes, and use of benzodiazepines; however, there was differences in semantic FAS (P=.01), with a better performance in the group with a prior history of psychosis. The results suggest that there are no significant differences in the cognitive performance between patients with BDI in euthymic stage, with and without history of psychosis. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  6. 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)

    Leprat, Frederic; Alapetite, Claire; Rosselli, Filippo; Ridet, Agnes; Schlumberger, Martin; Sarasin, Alain; Suarez, Horacio G.; Moustacchi, Ethel

    1998-01-01

    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

  7. 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

    Title: Abdominal aortic aneurysms no not develop more aggressively among patients with a positive family history of the disease Authors: Trine M. M. Joergensen, Holger Wemmelund, Anders Green, Jes Lindholt, Kim Houlind. Introduction: It is well known, that a family history of abdominal aortic...... 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...

  8. 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

  9. Organophosphorus pentavalent compounds: history, synthetic methods of preparation and application as insecticides and antitumor agents

    International Nuclear Information System (INIS)

    Santos, Viviane Martins Rebello dos; Donnici, Claudio Luis; DaCosta, Joao Batista Neves; Caixeiro, Janaina Marques Rodrigues

    2007-01-01

    This paper is a review of the history, synthesis and application of organophosphorus compounds, especially of those of pentavalent phosphorus, such as phosphoramidates, phosphorothioates, phosphonates and phosphonic acids with insecticide and anticancer activities. The organophosphorus compounds with agrochemical applications show great structural variety, They include not only insecticides, but also fungicides, herbicides, and others. The large variety of commercially available organophosphorus pesticides is remarkable. Even more interesting is the high efficiency of some organophosphorus compounds as anticancer agents such as cyclophosphamide and its derivatives. (author)

  10. Methods and complications of septic induced abortion in patients managed at a tertiary care hospital.

    Science.gov (United States)

    Jabeen, Alia; Dawood, Nasira Sabiha; Riaz, Shazia; Tanveer, Shamaila

    2013-01-01

    To study the methods used for the termination of pregnancy and associated complications of induced abortion. This descriptive study was conducted in the department of obstetrics and gynaecology, Fauji Foundation Hospital Rawalpindi. One Hundred patients were included in the study who was admitted with the history of induced abortion. The patients were assessed by detailed history and thorough clinical examination according to the study protocol. Data was collected on a specially designed Performa. Patients were interviewed in privacy and factors contributing to termination of pregnancy like age, parity, socioeconomic status and contraceptive failure were determined. Methods used for the procedure, status of abortionist were asked. Complications were determined by history, clinical examination and ultrasound examination. In view of all above data recommendations of preventing unwanted pregnancies were made. All patients were married and 57% of women belonged to age group of 31-40 years. Fifty-four 54% were grand multipara. In 63% of patients, induced abortion was carried out by Dai's. Most commonly used method was instrumentation (72%). Financial problems (46.7% ) and high parity (40%) were the most common factors contributing to termination of pregnancy. Serious complications like uterine perforation with or without bowel injury were accounted in 13% of women, septicaemia in 61%, peritonitis in 15% and DIC in 2%. During the study period illegally induced abortion accounted for 2% maternal deaths. Prevalence of poverty, illiteracy, grand multiparity and non-compliance of contraception were strong determinants of induced abortion, instrumentation being the most commonly used procedure resulting in high morbidity and mortality.

  11. Smoking History Predicts Sensitivity to PARP Inhibitor Veliparib in Patients with Advanced Non-Small Cell Lung Cancer.

    Science.gov (United States)

    Reck, Martin; Blais, Normand; Juhasz, Erzsebet; Gorbunova, Vera; Jones, C Michael; Urban, Laszlo; Orlov, Sergey; Barlesi, Fabrice; Kio, Ebenezer; Keilholz, Ulrich; Qin, Qin; Qian, Jiang; Nickner, Caroline; Dziubinski, Juliann; Xiong, Hao; Mittapalli, Rajendar K; Dunbar, Martin; Ansell, Peter; He, Lei; McKee, Mark; Giranda, Vincent; Ramalingam, Suresh S

    2017-07-01

    Tobacco-related NSCLC is associated with reduced survival and greater genomic instability. Veliparib, a potent poly(adenosine diphosphate-ribose) polymerase inhibitor, augments platinum-induced DNA damage. A phase 2 trial of untreated advanced NSCLC showed a trend for improved outcomes (hazard ratio [HR] = 0.80, 95% confidence interval: 0.54-1.18, p = 0.27 for overall survival and HR = 0.72, 95% CI: 0.45-1.15, p = 0.17 for progression-free survival) when veliparib was added to carboplatin/paclitaxel. Here we report an exploratory analysis by smoking history. Patients were randomized 2:1 to receive carboplatin/paclitaxel with veliparib, 120 mg (n = 105), or placebo (n = 53). Patients were stratified by histologic subtype and smoking history (recent smokers [n = 95], former smokers [n = 42], and never-smokers [n = 21]). Plasma cotinine level was measured as a chemical index of smoking. Mutation status was assessed by whole exome sequencing (n = 38). Smoking history, histologic subtype, age, Eastern Cooperative Oncology Group performance status, sex, and geographic region predicted veliparib benefit in univariate analyses. In multivariate analysis, history of recent smoking was most predictive for veliparib benefit. Recent smokers treated with veliparib derived significantly greater progression-free survival and overall survival benefits (HR = 0.38 [p Smoking history predicted for efficacy with a veliparib-chemotherapy combination; toxicity was acceptable regardless of smoking history. A prespecified analysis of recent smokers is planned for ongoing phase 3 studies of veliparib in NSCLC. Copyright © 2017 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

  12. Neutrophil-to-lymphocyte ratio predicting suicide risk in euthymic patients with bipolar disorder: Moderatory effect of family history.

    Science.gov (United States)

    Ivković, Maja; Pantović-Stefanović, Maja; Dunjić-Kostić, Bojana; Jurišić, Vladimir; Lačković, Maja; Totić-Poznanović, Sanja; Jovanović, Aleksandar A; Damjanović, Aleksandar

    2016-04-01

    Neutrophil-to-lymphocyte ratio (NLR) has been independently related to bipolar disorder (BD) and factors associated with suicidal risk. The aim of our study was to explore the relationship between NLR and suicide risk in euthymic BD patients. We also sought to propose a model of interaction between NLR and stress-diathesis factors, leading to suicidal risk in BD. The study group consisted of 83 patients diagnosed with BD (36 suicide attempters; 47 suicide non-attempters), compared to the healthy control group (n=73) and matched according to age, gender, and body mass index (BMI). NLR was measured according to the complete blood count. Mood symptoms have been assessed by Young Mania Rating Scale and Montgomery-Asberg Depression Rating Scale. Early trauma and acute stress were evaluated by Early Trauma Inventory Self Report-Short Form and List of Threatening Experiences Questionnaire, respectively. Suicide risk has been assessed by Suicide Behaviors Questionnaire-Revised (SBQ-R). Significant correlation was found between NLR and SBQ-R score. The main effects of suicide attempts on NLR, after covarying for confounders, were observed, indicating increased NLR in BD suicide attempters compared to healthy controls. We found significant moderatory effects of family history on NLR relationship to suicidal risk, with NLR being significant positive predictor of suicidal risk only in the patients with positive family history of suicide attempts. The results suggest an enhancing effect of positive family history of suicide attempts on predictive effect of NLR on suicide risk. Our data support the idea that immune markers can predict suicide attempt risk in BD, but only in the subpopulation of BD patients with family history of suicide attempts. This could lead to prevention in suicide behavior in the patient population at particular risk of suicide. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Mechanical dyssynchrony of the left atrium during sinus rhythm is associated with history of stroke in patients with atrial fibrillation.

    Science.gov (United States)

    Ciuffo, Luisa; Inoue, Yuko Y; Tao, Susumu; Gucuk Ipek, Esra; Balouch, Muhammad; Lima, Joao A C; Nazarian, Saman; Spragg, David D; Marine, Joseph E; Berger, Ronald D; Calkins, Hugh; Ashikaga, Hiroshi

    2018-04-01

    We sought to evaluate the relationship between left atrial (LA) mechanical dyssynchrony and history of stroke or transient ischaemic attack (TIA) in patients with atrial fibrillation (AF). We hypothesized that mechanical dyssynchrony of the LA is associated with history of stroke/TIA independent of LA function and Cardiac failure, Hypertension, Age, Diabetes, Stroke/transient ischaemic attack (TIA), VAscular disease, and Sex category (CHA2DS2-VASc) score in patients with AF. We conducted a cross-sectional study of 246 patients with a history of AF (59 ± 10 years, 29% female, 26% non-paroxysmal AF) referred for catheter ablation to treat drug-refractory AF who underwent preablation cardiac magnetic resonance (CMR) in sinus rhythm. Using tissue-tracking CMR, we measured the LA longitudinal strain and strain rate in each of 12 equal-length segments in two- and four-chamber views. We defined indices of LA mechanical dyssynchrony, including the standard deviation of the time to the peak longitudinal strain (SD-TPS). Patients with a prior history of stroke or TIA (n = 23) had significantly higher SD-TPS than those without (n = 223) (39.9 vs. 23.4 ms, P stroke/TIA after adjusting for the CHA2DS2-VASc score, LA minimum index volume, and the peak LA longitudinal strain (P stroke/TIA more accurately than CHA2DS2-VASc score alone (c-statistics: 0.82 vs. 0.75, P stroke/TIA in patients with AF.

  14. Long-term urinary toxicity after 3-dimensional conformal radiotherapy for prostate cancer in patients with prior history of transurethral resection

    International Nuclear Information System (INIS)

    Sandhu, Ajaypal S.; Zelefsky, Michael J.; Lee, Henry J.; Lombardi, Danna; Fuks, Zvi; Leibel, Steven A.

    2000-01-01

    Purpose: To report on the long-term urinary morbidity among prostate cancer patients with a prior history of a transurethral resection of the prostate (TURP) treated with high-dose 3-dimensional conformal radiotherapy (3D-CRT). Methods and Materials: Between 1988 and 1997, 1100 patients with clinically localized prostate cancer were treated with 3D-CRT. Of these, 120 patients (8%) were identified as having had a prior TURP and are the subjects of this analysis. The median age was 71 years (range: 49-83 years). The clinical stages of the patients were T1c: 33 (28%); T2a: 38 (32%); T2b: 15 (13%); and T3: 34 (27%). Neoadjuvant androgen ablation therapy was given to 39 (33%). The median radiation dose prescribed to the planning target volume was 75.6 Gy (range: 64.8-81 Gy). The median elapsed time from TURP to initiation of 3D-CRT was 69 months (range: 4-360 months). The median follow-up time was 51 months (range: 18-109 months). Results: Five patients of the 120 with a prior history of TURP (4%) developed a urethral stricture after 3D-CRT which was corrected with dilatation. The 5-year actuarial likelihood of ≥ Grade 2 late urinary toxicities was 9%. No Grade 4 urinary toxicities were observed in this group of patients. Among 110 patients who were completely continent of urine prior to 3D-CRT, 10 (9%) developed stress incontinence requiring 1 pad daily for protection or experienced occasional leakage (not requiring pad protection). The 5-year incidence of ≥ Grade 1 stress incontinence was 18% in patients who developed acute ≥ Grade 2 GU symptoms during the course of 3D-CRT compared to 7% for patients who experienced Grade 1 or no acute urinary symptoms (p = 0.05). The radiation dose (≥75.6 Gy vs. <75.6 Gy), the number of prior TURP procedures, or the volume of resected tissue at the time of TURP had no significant impact on the long-term urinary morbidity outcome. A multivariate analysis demonstrated that the presence of Grade 2 acute urinary symptoms was the

  15. Details acquired from medical history and patients' experience of empathy--two sides of the same coin.

    Science.gov (United States)

    Ohm, Friedemann; Vogel, Daniela; Sehner, Susanne; Wijnen-Meijer, Marjo; Harendza, Sigrid

    2013-05-09

    History taking and empathetic communication are two important aspects in successful physician-patient interaction. Gathering important information from the patient's medical history is needed for effective clinical decision making while empathy is relevant for patient satisfaction. We wanted to investigate whether medical students near graduation are able to combine both skills as required in daily medical practice. Thirty near graduates from Hamburg Medical School participated in an assessment for clinical competences including a consultation hour with five standardized patients. Each patient interview was videotaped and standardized patients rated participants with the CARE questionnaire for consultation and relational empathy. All videotaped interviews were rated with a checklist based on the number of important medical aspects for each case. Data were analysed with the linear mixed model to correct for random effects. Regression analysis was performed to look for correlations between the number of questions asked by a participant and their respective empathy rating. Of the 123 aspects that could have been gathered in total, students only requested 56.4% (95% CI 53.5-59.3). While no difference between male and female participants was found, a significant difference (pexercising both skills combined as required in physicians' daily practice.

  16. Traumatic Exposure History as a Risk Factor for Chronic Pain in Adult Patients with Sickle Cell Disease.

    Science.gov (United States)

    Works, Teresa; Jones, Sasia; Grady, James; Andemariam, Biree

    2016-02-01

    This article describes the impact of the integration of a licensed clinical social worker (LCSW) with expertise in behavioral health on identification of risk factors for chronic pain in a cohort of adults with sickle cell disease. Authors conducted a retrospective chart review of all visits to the adult sickle cell center during the first six months of LCSW integration. Demographics, clinical history, and LCSW notes were reviewed. Overall, 71 patients were introduced to the LCSW; 55 percent of them had chronic pain. Patients with chronic pain were older, used opioids daily, took hydroxyurea, reported higher daily pain scores, and underwent more acute care visits and hospitalizations for pain with longer stays. Fifty-eight (81 percent) patients requested concrete social work services such as transportation and housing. Thirty-two patients (55 percent) expressed a desire for mental health counseling while receiving concrete services. Twenty-two (69 percent) of these patients self-disclosed at least one traumatic experience. In fact, a statistically significant relationship between chronic pain and a history of trauma was identified (p = 0.001). Results suggest that sickle cell patients should receive clinical social work services to assess for traumatic exposures that may influence chronic pain.

  17. Article Commentary: Activity in Pregnancy for Patients with a History of Preterm Birth

    Directory of Open Access Journals (Sweden)

    Nichelle Satterfield

    2016-01-01

    Full Text Available 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.

  18. Enhancing Student Empathetic Engagement, History-Taking, and Communication Skills During Electronic Medical Record Use in Patient Care.

    Science.gov (United States)

    LoSasso, Alisa Alfonsi; Lamberton, Courtney E; Sammon, Mary; Berg, Katherine T; Caruso, John W; Cass, Jonathan; Hojat, Mohammadreza

    2017-07-01

    To examine whether an intervention on proper use of electronic medical records (EMRs) in patient care could help improve medical students' empathic engagement, and to test the hypothesis that the training would reduce communication hurdles in clinical encounters. Seventy third-year medical students from the Sidney Kimmel Medical College at Thomas Jefferson University were randomly divided into intervention and control groups during their six-week pediatric clerkship in 2012-2013. The intervention group received a one-hour training session on EMR-specific communication skills, including discussion of EMR use, the SALTED mnemonic and technique (Set-up, Ask, Listen, Type, Exceptions, Documentation), and role-plays. Both groups completed the Jefferson Scale of Empathy (JSE) at the clerkship's start and end. At clerkship's end, faculty and standardized patients (SPs) rated students' empathic engagement in SP encounters, using the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and their history-taking and communication skills. Faculty mean ratings on the JSPPPE, history-taking skills, and communication skills were significantly higher for the intervention group than the control group. SP mean ratings on history-taking skills were significantly higher for the intervention group than the control group. Both groups' JSE mean scores increased pretest to posttest, but the changes were not significant. The intervention group's posttest JSE mean score was higher than the control group's, but the difference was not significant. The findings suggest that a simple intervention providing specialized training in EMR-specific communication can improve medical students' empathic engagement in patient care, history-taking skills, and communication skills.

  19. Long-Term Natural History of Adult Wolff-Parkinson-White Syndrome Patients Treated With and Without Catheter Ablation.

    Science.gov (United States)

    Bunch, T Jared; May, Heidi T; Bair, Tami L; Anderson, Jeffrey L; Crandall, Brian G; Cutler, Michael J; Jacobs, Victoria; Mallender, Charles; Muhlestein, Joseph B; Osborn, Jeffrey S; Weiss, J Peter; Day, John D

    2015-12-01

    There are a paucity of data about the long-term natural history of adult Wolff-Parkinson-White syndrome (WPW) patients in regard to risk of mortality and atrial fibrillation. We sought to describe the long-term outcomes of WPW patients and ascertain the impact of ablation on the natural history. Three groups of patients were studied: 2 WPW populations (ablation: 872, no ablation: 1461) and a 1:5 control population (n=11 175). Long-term mortality and atrial fibrillation rates were determined. The average follow-up for the WPW group was 7.9±5.9 (median: 6.9) years and was similar between the ablation and nonablation groups. Death rates were similar between the WPW group versus the control group (hazard ratio, 0.96; 95% confidence interval, 0.83-1.11; P=0.56). Nonablated WPW patients had a higher long-term death risk compared with ablated WPW patients (hazard ratio, 2.10; 95% confidence interval: 1.50-20.93; P<0.0001). Incident atrial fibrillation risk was higher in the WPW group compared with the control population (hazard ratio, 1.55; 95% confidence interval, 1.29-1.87; P<0.0001). Nonablated WPW patients had lower risk than ablated patients (hazard ratio, 0.39; 95% confidence interval, 0.28-0.53; P<0.0001). Long-term mortality rates in WPW patients are low and similar to an age-matched and gender-matched control population. WPW patients that underwent the multifactorial process of ablation had a lower mortality compared to nonablated WPW patients. Atrial fibrillation rates are high long-term, and ablation does not reduce this risk. © 2015 American Heart Association, Inc.

  20. The natural history of cardiac and pulmonary function decline in patients with duchenne muscular dystrophy.

    Science.gov (United States)

    Roberto, Rolando; Fritz, Anto; Hagar, Yolanda; Boice, Braden; Skalsky, Andrew; Hwang, Hosun; Beckett, Laurel; McDonald, Craig; Gupta, Munish

    2011-07-01

    Retrospective review of scoliosis progression, pulmonary and cardiac function in a series of patients with Duchenne Muscular Dystrophy (DMD). To determine whether operative treatment of scoliosis decreases the rate of pulmonary function loss in patients with DMD. It is generally accepted that surgical intervention should be undertaken in DMD scoliosis once curve sizes reach 35° to allow intervention before critical respiratory decline has occurred. There are conflicting reports, however, regarding the effect of scoliosis stabilization on the rate of pulmonary function decline when compared to nonoperative cohorts. We reviewed spinal radiographs, echocardiograms, and spirometry, hospital, and operative records of all patients seen at our tertiary referral center from July 1, 1992 to June 1, 2007. Data were recorded to Microsoft Excel (Microsoft, Redmond, WA) and analyzed with SAS (SAS Institute, Cary, NC) and R statistical processing software (www.r-project.org). The percent predicted forced vital capacity (PPFVC) decreased 5% per year before operation. The mean PPFVC was 54% (SD = 21%) before operation with a mean postoperative PPFVC of 43% (SD = 14%). Surgical treatment was associated with a 12% decline in PPFVC independent of other treatment variables. PPFVC after operation declined at a rate of 1% per year and while this rate was lower, it was not significantly different than the rate of decline present before operation (P = 0.18). Cardiac function as measured by left ventricular fractional shortening declined at a rate of 1% per year with most individuals exhibiting a left ventricular fractional shortening rate of more than 30 before operation. Operative treatment of scoliosis in DMD using the Luque Galveston method was associated with a reduction of forced vital capacity related to operation. The rate of pulmonary function decline after operation was not significantly reduced when compared with the rate of preoperative forced vital capacity decline.

  1. Primary prevention in patients with a strong family history of coronary heart disease.

    Science.gov (United States)

    Burke, Lora A

    2003-01-01

    The interplay of genetic and environmental factors places first-degree relatives of individuals with premature coronary heart disease at greater risk of developing the disease than the general population. Disease processes, such as dyslipidemia, hypertension, and glucose and insulin metabolism, and lifestyle habits, such as eating and exercise patterns, as well as socioeconomic status aggregate in families with coronary heart disease. The degree of risk associated with a family history varies with the degree of relationship and the age at onset of disease. All individuals with a family history of premature heart disease should have a thorough coronary risk assessment performed, which can be initiated in an office visit. Absolute risk for coronary heart disease determination will predict the intensity of preventive interventions. This article reviews the components of risk determination and primary prevention in individuals with a strong family history of coronary heart disease.

  2. Early Activation of Cardiosurgical Patients: History and Terminology (a review of literature

    Directory of Open Access Journals (Sweden)

    I. A. Kozlov

    2010-01-01

    Full Text Available In foreign countries, the anesthesiological and resuscitative tactics that ensure the maximally rapid discontinuation of mechanical ventilation are regarded as a fundamental therapeutic component of the so-called fast-track cardiac surgery that provides a shorter length of hospital stay, an intensified therapeutic process, and lower-cost treatment. In the Russian literature, this methodic approach is customarily designated early activation, by bearing in mind that discontinuation of mechanical ventilation is a key point of postoperative recovery of the patients’ physical activity. The main Russian and foreign publications on the specific features of therapeutic tactics in early periods after cardiac surgery are historically analyzed. The paper covers the polemic between the supporters and opponents of the earliest activation of patients operated on under extracorporeal circulation, the change of views on a need for obligatory postoperative mechanical ventilation, and the impact of the rate of activation and physical activity on the quality of rehabilitation. Terminology and clinicians’ points of views on the optimum activation periods are analyzed. Key words: early activation, operations under extracorporeal circulation, tracheal extubation in an operating room, early tracheal extubation, postoperative rehabilitation of cardiosurgical patients.

  3. Remembrance of Things Past: A History of the Socratic Method in the United States

    Science.gov (United States)

    Schneider, Jack

    2013-01-01

    The Socratic method is a common touchstone in conversations about classroom pedagogy, widely believed to enhance student engagement and promote critical thinking. Understood as the historical inheritance of antiquity, the method is generally accepted by teachers, administrators, and scholars as a legitimate approach to instruction. As this article…

  4. Methods to score vertebral deformities in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Lems, W. F.; Jahangier, Z. N.; Raymakers, J. A.; Jacobs, J. W.; Bijlsma, J. W.

    1997-01-01

    The objective was to compare four different scoring methods for vertebral deformities: the semiquantitative Kleerekoper score and three quantitative scores (according to Minne, Melton and Raymakers) in patients with rheumatoid arthritis (RA). Lateral radiographs of the thoracic and lumbar vertebral

  5. The history of transdisciplinary race classification: methods, politics and institutions, 1840s-1940s.

    Science.gov (United States)

    McMahon, Richard

    2018-03-01

    A recently blossoming historiographical literature recognizes that physical anthropologists allied with scholars of diverse aspects of society and history to racially classify European peoples over a period of about a hundred years. They created three successive race classification coalitions - ethnology, from around 1840; anthropology, from the 1850s; and interwar raciology - each of which successively disintegrated. The present genealogical study argues that representing these coalitions as 'transdisciplinary' can enrich our understanding of challenges to disciplinary specialization. This is especially the case for the less well-studied nineteenth century, when disciplines and challenges to disciplinary specialization were both gradually emerging. Like Marxism or structuralism, race classification was a holistic interpretive framework, which, at its most ambitious, aimed to structure the human sciences as a whole. It resisted the organization of academia and knowledge into disciplines with separate organizational institutions and research practices. However, the 'transdisciplinarity' of this nationalistic project also bridged emerging borderlines between science and politics. I ascribe race classification's simultaneous longevity and instability to its complex and intricately entwined processes of political and interdisciplinary coalition building. Race classification's politically useful conclusions helped secure public support for institutionalizing the coalition's component disciplines. Institutionalization in turn stimulated disciplines to professionalize. They emphasized disciplinary boundaries and insisted on apolitical science, thus ultimately undermining the 'transdisciplinary' project.

  6. Prevalence and risk indicators of peri-implantitis in Korean patients with a history of periodontal disease: a cross-sectional study.

    Science.gov (United States)

    Goh, Mi-Seon; Hong, Eun-Jin; Chang, Moontaek

    2017-08-01

    The aim of this study was to analyze the prevalence and risk indicators of peri-implantitis in Korean patients with history of periodontal disease. A total of 444 patients with 1,485 implants were selected from patients who had been treated at the Department of Periodontology, Chonbuk National University Dental Hospital between July 2014 and June 2015. A group with a history of peri-implantitis (HP) (370 patients with 1,189 implants) and a group with a current peri-implantitis (CP) (318 patients with 1,004 implants) were created based on the radiographic and clinical assessments of implants. The prevalence of peri-implantitis was calculated at both the patient and implant levels. The influence of risk variables on the occurrence of peri-implantitis was analyzed using generalized estimating equations analysis. The prevalence of peri-implantitis in the HP and CP groups ranged from 6.7% to 19.7%. The cumulative peri-implantitis rate in the HP group estimated with the Kaplan-Meier method was higher than that in the CP group over the follow-up period. Among the patient-related risk variables, supportive periodontal therapy (SPT) was the only significant risk indicator for the occurrence of peri-implantitis in both groups. In the analysis of implant-related variables, implants supporting fixed dental prosthesis (FDP) and implants with subjective discomfort were associated with a higher prevalence of peri-implantitis than single implants and implants without subjective discomfort in the HP group. The presence of subjective discomfort was the only significant implant-related variable predictive of peri-implantitis in the CP group. Within the limitations of this study, the prevalence of peri-implantitis in Korean patients with a history of periodontal disease was similar to that reported in other population samples. Regular SPT was important for preventing peri-implantitis. Single implants were found to be less susceptible to peri-implantitis than those supporting FDP

  7. Early traumatic life events, parental attitudes, family history, and birth risk factors in patients with depressive disorder and healthy controls.

    Science.gov (United States)

    Bandelow, Borwin; Gutermann, Julia; Peter, Helmut; Wedekind, Dirk

    2013-02-01

    Only few studies have compared the frequency of traumatic life events during childhood in inpatients with depression with a healthy control group. Consecutively admitted inpatients with depression (n = 79), most of whom belonged to the melancholic subtype (n = 73; 92.4%), and healthy controls (n = 110) were investigated using a comprehensive retrospective interview with 203 questions regarding childhood traumatic life events, parental attitudes, family history of psychiatric disorders and birth risk factors. Depressed patients had significantly more severe traumatic events (mean score 1.33; SD 1.4) than control subjects (0.85; SD 1.2) on a 0-10 point "severe trauma scale". 70.9% (n = 56) of the depressed patients, but only 48.2% (n = 53) of the controls reported at least one severe traumatic event. When looking at single events, only few differences were found between patients and controls. Compared to controls, patients described significantly higher rates of psychiatric disorders in their families, in particular depression. Parental rearing styles were rated as more unfavorable in the patient group. In a logistic regression model, of all possible etiological factors examined, only a family history of psychiatric disorders showed a significant influence (OR = 3.6). Melancholic depression seems to be less associated with traumatic events than other psychiatric disorders.

  8. Knee-Extension Torque Variability and Subjective Knee Function in Patients with a History of Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Goetschius, John; Hart, Joseph M

    2016-01-01

    When returning to physical activity, patients with a history of anterior cruciate ligament reconstruction (ACL-R) often experience limitations in knee-joint function that may be due to chronic impairments in quadriceps motor control. Assessment of knee-extension torque variability may demonstrate underlying impairments in quadriceps motor control in patients with a history of ACL-R. To identify differences in maximal isometric knee-extension torque variability between knees that have undergone ACL-R and healthy knees and to determine the relationship between knee-extension torque variability and self-reported knee function in patients with a history of ACL-R. Descriptive laboratory study. Laboratory. A total of 53 individuals with primary, unilateral ACL-R (age = 23.4 ± 4.9 years, height = 1.7 ± 0.1 m, mass = 74.6 ± 14.8 kg) and 50 individuals with no history of substantial lower extremity injury or surgery who served as controls (age = 23.3 ± 4.4 years, height = 1.7 ± 0.1 m, mass = 67.4 ± 13.2 kg). Torque variability, strength, and central activation ratio (CAR) were calculated from 3-second maximal knee-extension contraction trials (90° of flexion) with a superimposed electrical stimulus. All participants completed the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, and we determined the number of months after surgery. Group differences were assessed using independent-samples t tests. Correlation coefficients were calculated among torque variability, strength, CAR, months after surgery, and IKDC scores. Torque variability, strength, CAR, and months after surgery were regressed on IKDC scores using stepwise, multiple linear regression. Torque variability was greater and strength, CAR, and IKDC scores were lower in the ACL-R group than in the control group (P Torque variability and strength were correlated with IKDC scores (P Torque variability, strength, and CAR were correlated with each other (P Torque variability alone

  9. System identification by methods from the statistical signal theory, history and state of the art

    International Nuclear Information System (INIS)

    Christensen, Palle; Gundersen, Vidar B.

    1999-01-01

    Condition monitoring is an important area in which the OECD Halden Reactor Project has developed several tools. This paper presents a general overview of methods utilised in diagnosis systems, signal validation systems and process optimisation systems such as EFD, Mocom, Aladdin and PEANO. An overview of lessons learned on diagnosis of technical systems with special reference to system identification is reported. The analysis of input-output behaviour by special, suitable methods may be used as a tool for diagnosis. An overview of methods for empirical modelling and data analysis and their major differences is presented. It is explained how system identification methods and transforms may be used to build models based on observed data from a system. According to the Webster dictionary diagnosis is 'Investigation or analysis of the cause or nature of a condition, situation or a problem.' By examining data collected from a process the aim is to detect abnormal conditions and if possible understand what has been the cause of the observed problem. Section 1 gives a retrospective view at the development in the field of system identification. Section 2 presents a classification of the methods, while section 3 provides some practical advice on how diagnosis can be carried out by means of system identification methods (author) (ml)

  10. Impact of chemotherapy-induced amenorrhea in breast cancer patients: the evaluation of ovarian function by menstrual history and hormonal levels

    Science.gov (United States)

    2013-01-01

    Background Chemotherapy-induced amenorrhea (CIA) is one of the most frequent therapy-related adverse events observed in breast cancer patients who have undergone chemotherapy. Although the characteristics of CIA have been studied in Western countries, little is known about CIA in Asian. We conducted a retrospective analysis to assess the characteristics and influencing factors of CIA and its association with menopause in Chinese women who underwent adjuvant chemotherapy for early-stage breast cancer. Methods Seventy-three premenopausal women who underwent adjuvant chemotherapy for early stage (stages I to III) breast cancer were analyzed. Patient clinical characteristics, treatment regimes, menstrual information, and serum hormone values were collected retrospectively. Characteristic factors relevant to the onset of CIA and menopause were also estimated. Results Approximately 83.6% of patients developed CIA. Older patients (>40 years old) had higher CIA incidence compared with younger patients (P amenorrhea as determined by menstrual history and hormone levels (P = 0.0028). In women aged 46 to 49 years, the beginning of permanent amenorrhea was detected earlier via the clinical method than via the hormonal method (2 months versus 23 months, P amenorrhea was 19 months in the hormonal test and 2 months in the clinical test (P = 0.0112). Conclusions Age at diagnosis is a predictor of the onset of amenorrhea and transformation into menopause among premenopausal breast cancer patients. Adjuvant tamoxifen therapy substantially affects the onset of menopause. A delay of the onset of serum hormone postmenopausal status was observed compared with clinical symptoms. This interval was approximately 21 months in patients aged 46 to 49 years and 17 months in patients aged over 50 years. This interval is significant in the clinical estimate of the menstrual status. PMID:23688389

  11. 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)

    Arja, V.J.; Balestrini, V.R.; Sandrin, A.L.; Conci, E.C.; Serra, C.M.; Joekes, S.

    2002-01-01

    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

  12. Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests

    Science.gov (United States)

    Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

    2018-01-01

    Objective To assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears. Design Prospective diagnostic study. Settings Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling. Participants Consecutive patients with a knee complaint (n = 279) and consulting one of the participating orthopaedic surgeons (n = 3) or sport medicine physicians (n = 2). Interventions Not applicable. Main outcome measures History elements and physical examination tests performed independently were compared to the reference standard: an expert physicians’ composite diagnosis including history elements, physical tests and confirmatory magnetic resonance imaging. Penalized logistic regression (LASSO) was used to identify history elements and physical examination tests associated with the diagnosis of ACL tear and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity (Se), specificity (Sp), predictive values and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CI) were calculated. Results Forty-three individuals received a diagnosis of partial or complete ACL tear (15.4% of total cohort). The Lachman test alone was able to diagnose partial or complete ACL tears (LR+: 38.4; 95%CI: 16.0–92.5). Combining a history of trauma during a pivot with a “popping” sensation also reached a high diagnostic validity for partial or complete tears (LR+: 9.8; 95%CI: 5.6–17.3). Combining a history of trauma during a pivot, immediate effusion after trauma and a positive Lachman test was able to identify individuals with a complete ACL tear (LR+: 17.5; 95%CI: 9.8–31.5). Finally, combining a negative history of pivot or a negative popping sensation during trauma with a negative Lachman or pivot shift test was able to exclude both partial or complete ACL tears (LR

  13. Treatment of patients with a history of heparin-induced thrombocytopenia and anti-lepirudin antibodies with argatroban.

    Science.gov (United States)

    Harenberg, Job; Job, Harenberg; Jörg, Ingrid; Ingrid, Jörg; Fenyvesi, Tivadar; Tivadar, Fenyvesi; Piazolo, Lukas; Lukas, Piazolo

    2005-02-01

    Patients with heparin-induced thrombocytopenia (HIT) type II require anticoagulation with non-heparin immediate acting anticoagulants. Danaparoid may cross react with HIT-antibodies and lepirudin may generate anti-lepirudin antibodies influencing anticoagulation. We hypothesised, that the synthetic small molecular thrombin inhibitor argatroban does not induce immunoglobulins reacting towards lepirudin in patients with anti-lepirudin antibodies in the history and that titration of the anticoagulation may be easier with argatroban. We report on the treatment of four patients of a study, which was terminated prematurely due to official warnings for a repeated use of lepirudin. Two patients each received argatroban and lepirudin intravenously. A blinded assessor adjusted the doses of the anticoagulants to 1.5-3.0 fold prolongation of the aPTT. Ecarin clotting time (ECT), concentrations of lepirudin (ELISA) and of argatroban (gas-chromatography with mass spectrometry), and the generation of lepirudin antibodies (ELISA) were measured. APTT-adjusted dosages for argatroban was 2.0-2.6 microg/kg.min and for lepirudin 48-149 microg/kg.h. ECT was prolonged 2.1 to 4.5-fold with lepirudin and 4 to 7-fold with argatroban. The concentration of lepirudin ranged between 750 and 1500 ng/ml and of argatroban between 400 and 1100 ng/ml. Patients on argatroban did not generate immunoglobulin IgG reacting towards lepirudin in contrast to both patients on lepirudin who developed anti-lepirudin antibodies. Both treatments were well tolerated. Despite the low number of patients argatroban seems to lead to a more stable anticoagulant response than lepirudin resulting in a lower variability of the dosage for prophylaxis or treatment of thromboembolism of patients with a history of HIT and lepirudin antibodies.

  14. Global Monitoring of Water Supply and Sanitation: History, Methods and Future Challenges

    Science.gov (United States)

    Bartram, Jamie; Brocklehurst, Clarissa; Fisher, Michael B.; Luyendijk, Rolf; Hossain, Rifat; Wardlaw, Tessa; Gordon, Bruce

    2014-01-01

    International monitoring of drinking water and sanitation shapes awareness of countries’ needs and informs policy, implementation and research efforts to extend and improve services. The Millennium Development Goals established global targets for drinking water and sanitation access; progress towards these targets, facilitated by international monitoring, has contributed to reducing the global disease burden and increasing quality of life. The experiences of the MDG period generated important lessons about the strengths and limitations of current approaches to defining and monitoring access to drinking water and sanitation. The methods by which the Joint Monitoring Programme (JMP) of WHO and UNICEF tracks access and progress are based on analysis of data from household surveys and linear regression modelling of these results over time. These methods provide nationally-representative and internationally-comparable insights into the drinking water and sanitation facilities used by populations worldwide, but also have substantial limitations: current methods do not address water quality, equity of access, or extra-household services. Improved statistical methods are needed to better model temporal trends. This article describes and critically reviews JMP methods in detail for the first time. It also explores the impact of, and future directions for, international monitoring of drinking water and sanitation. PMID:25116635

  15. [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.

  16. Scientific method, history, Darwinism and laicism: a Giovanni Jervis's intellectual biography.

    Science.gov (United States)

    Corbellini, Gilberto; Sirgiovanni, Elisabetta

    2012-01-01

    Some authors marked a change of perspective from the early to the late Jervis's thought, in terms of a supposed turn towards conservatism. That laid him open to criticism from some Leftist Italian intellectuals. The aim of this paper is to show that conservatism never was a Jervis's thought feature. Mainly, subjects and methods leading the development of his philosophical views suggest a continuity between earlier writings and later ones. All over his thought, in fact, the idea of preeminence of scientific method and historical contextualization convinced him about naturalistic approaches to human behavior, which came to support his Darwinism and laicism in approaching socio-psychological and socio-political issues.

  17. Methods to improve patient recruitment and retention in stroke trials

    DEFF Research Database (Denmark)

    Berge, Eivind; Stapf, Christian; Al-Shahi Salman, Rustam

    2016-01-01

    Background: The success of randomized-controlled stroke trials is dependent on the recruitment and retention of a sufficient number of patients, but fewer than half of all trials meet their target number of patients. Methods: We performed a search and review of the literature, and conducted...... a survey and workshop among 56 European stroke trialists, to identify barriers, suggest methods to improve recruitment and retention, and make a priority list of interventions that merit further evaluation. Results: The survey and workshop identified a number of barriers to patient recruitment...... and retention, from patients’ incapacity to consent, to handicaps that prevent patients from participation in trial-specific follow-up. Methods to improve recruitment and retention may include simple interventions with individual participants, funding of research networks, and reimbursement of new treatments...

  18. Practical Management of Patients with a History of Immediate Hypersensitivity to Common non-Beta-Lactam Drugs.

    Science.gov (United States)

    Macy, Eric

    2016-01-01

    Immediate hypersensitivity reactions to medications are among the most feared adverse drug reactions, because of their close association with anaphylaxis. This review discusses a practical management approach for patients with a history of an immediate hypersensitivity to a non-beta-lactam medication, where reexposure to the implicated, or similar, medication is clinically necessary. Mechanisms associated with severe immediate hypersensitivity reactions include IgE-mediated mast cell activation, complement-mediated mast cell activation, and direct mast cell activation. Immediate hypersensitivity reactions may also be mediated by vasodilators, other pharmacologic mechanisms, or be secondary to underlying patient-specific biochemical abnormalities such as endocrine tumors or chronic spontaneous urticaria. The key features in the reaction history and the biochemistry of the implicated medication are discussed. Most individuals with a history of immediate hypersensitivity to a medication, who require reuse of that drug, can be safely retreated with a therapeutic course of the implicated drug after a full-dose challenge, graded challenge, or desensitization, with or without premedication and/or any preliminary diagnostic testing, depending on the specific situation.

  19. Thematic, conceptual and iconic metamorphosis: the construction of a morphological history epistemological method

    Directory of Open Access Journals (Sweden)

    Maurício de Carvalho Ramos

    2015-12-01

    Full Text Available In this essay, I propose the construction of an epistemological historical method through a morphological perspective. That involves the elaboration of a genetic rational process of conceptualization in which problems, themes and concepts organize in historical expressions increasingly more objective and determinated. Such expressions should be articulated generating a continuum of metamorphosis of a concept or conceptual core. This continuum should be capable of conferring intelligibility for scientific culture units without restrictions of spatial, temporal and conceptual amplitude. The connection of morphological and historical components that I propose is based on the results as well as the method used by Carlo Ginzburg in Myths, emblems and signs, especially in High and low: the theme of forbidden knowledge in the sixteenth and seventeenth centuries. After presenting a characterization of the minimal components of the historical epistemological method, I will start to incorporate elements of Ginsburg’s historical morphology through a dialogue in which I’ll try to understand how the author proceeds methodically and conceptually in his investigation. Finally, through a preliminary study of an alchemical emblem in which Hermes is the central figure, I will make a morphological experiment of application of this procedure to the scope of the scientific culture of chemistry

  20. A method for determining fire history in coniferous forests in the Mountain West

    Science.gov (United States)

    Stephen F. Arno; Kathy M. Sneck

    1977-01-01

    Describes a method for determining historic fire frequency, intensity, and size from cross sections collected from fire-scarred trees and tree age classes determined through increment borings. Tells how to interpret the influence of fire in stand composition and structure and how to identify effects of modern fire suppression.

  1. METHOD OF TREATMENT OF CONSTITUTIONAL PUBERTY RETARDATION IN BOYS (CASE HISTORY

    Directory of Open Access Journals (Sweden)

    A. A. Sinitsina

    2012-01-01

    Full Text Available The results of examination of a 15-year-old boy with growth and puberty retardation are analyzed in this article. On the grounds of performed complex examination the patient was found physical development delay, changes at the endocrinal status, as well as pathological signs on X-ray, rheo- and electroencephalography, which are characteristic for functional growth and puberty retardation. In order to correct the found disturbances transcranial magnetotherapy was carried out. During the performed treatment improvement of the physical development characteristics, endocrinal status and data of rheo- and electroencephalography were noted.

  2. Longitudinal study of visual function in patients with relapsing-remitting multiple sclerosis with and without a history of optic neuritis.

    Science.gov (United States)

    González Gómez, A; García-Ben, A; Soler García, A; García-Basterra, I; Padilla Parrado, F; García-Campos, J M

    2017-03-15

    The contrast sensitivity test determines the quality of visual function in patients with multiple sclerosis (MS). The purpose of this study is to analyse changes in visual function in patients with relapsing-remitting MS with and without a history of optic neuritis (ON). We conducted a longitudinal study including 61 patients classified into 3 groups as follows: a) disease-free patients (control group); b) patients with MS and no history of ON; and c) patients with MS and a history of unilateral ON. All patients underwent baseline and 6-year follow-up ophthalmologic examinations, which included visual acuity and monocular and binocular Pelli-Robson contrast sensitivity tests. Monocular contrast sensitivity was significantly lower in MS patients with and without a history of ON than in controls both at baseline (P=.00 and P=.01, respectively) and at 6 years (P=.01 and P=.02). Patients with MS and no history of ON remained stable throughout follow-up whereas those with a history of ON displayed a significant loss of contrast sensitivity (P=.01). Visual acuity and binocular contrast sensitivity at baseline and at 6 years was significantly lower in the group of patients with a history of ON than in the control group (P=.003 and P=.002 vs P=.006 and P=.005) and the group with no history of ON (P=.04 and P=.038 vs P=.008 and P=.01). However, no significant differences were found in follow-up results (P=.1 and P=.5). Monocular Pelli-Robson contrast sensitivity test may be used to detect changes in visual function in patients with ON. Copyright © 2017 The Author(s). Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Methods for teaching effective patient communication techniques to radiography students.

    Science.gov (United States)

    Makely, S

    1990-07-01

    Teaching students to communicate effectively with patients has always been part of the radiography curriculum in the USA. However, developing these skills has become even more important in recent times due to several factors. Patients who have been well versed in what to expect from the examination being conducted are in a better position to co-operate with the radiographer. This increases the chances of producing optimal results from an examination at the first attempt, thus reducing radiation exposure, patient discomfort and the overall cost of conducting the procedure. Also, increased competition among health care providers has resulted in more emphasis being placed on patient, or customer, satisfaction. Radiographers are in the 'front line' of patient care. Patients often have more interaction with radiographers than with physicians or other medical specialists. Radiographers who practise effective communication techniques with their patients can alleviate anxiety and make an important contribution to the overall satisfaction of the patient with respect to the quality of service and care they receive. This article describes instructional methods being used in the USA to help develop effective patient communication techniques, and reports the findings of a study among radiography educators as to which of these methods are thought to be most successful.

  4. Texas Medication Algorithm Project, phase 3 (TMAP-3): clinical results for patients with a history of mania.

    Science.gov (United States)

    Suppes, Trisha; Rush, A John; Dennehy, Ellen B; Crismon, M Lynn; Kashner, T Michael; Toprac, Marcia G; Carmody, Thomas J; Brown, E Sherwood; Biggs, Melanie M; Shores-Wilson, Kathy; Witte, Bradley P; Trivedi, Madhukar H; Miller, Alexander L; Altshuler, Kenneth Z; Shon, Steven P

    2003-04-01

    The Texas Medication Algorithm Project (TMAP) assessed the clinical and economic impact of algorithm-driven treatment (ALGO) as compared with treatment-as-usual (TAU) in patients served in public mental health centers. This report presents clinical outcomes in patients with a history of mania (BD), including bipolar I and schizoaffective disorder, bipolar type, during 12 months of treatment beginning March 1998 and ending with the final active patient visit in April 2000. Patients were diagnosed with bipolar I disorder or schizoaffective disorder, bipolar type, according to DSM-IV criteria. ALGO was comprised of a medication algorithm and manual to guide treatment decisions. Physicians and clinical coordinators received training and expert consultation throughout the project. ALGO also provided a disorder-specific patient and family education package. TAU clinics had no exposure to the medication algorithms. Quarterly outcome evaluations were obtained by independent raters. Hierarchical linear modeling, based on a declining effects model, was used to assess clinical outcome of ALGO versus TAU. ALGO and TAU patients showed significant initial decreases in symptoms (p =.03 and p <.001, respectively) measured by the 24-item Brief Psychiatric Rating Scale (BPRS-24) at the 3-month assessment interval, with significantly greater effects for the ALGO group. Limited catch-up by TAU was observed over the remaining 3 quarters. Differences were also observed in measures of mania and psychosis but not in depression, side-effect burden, or functioning. For patients with a history of mania, relative to TAU, the ALGO intervention package was associated with greater initial and sustained improvement on the primary clinical outcome measure, the BPRS-24, and the secondary outcome measure, the Clinician-Administered Rating Scale for Mania (CARS-M). Further research is planned to clarify which elements of the ALGO package contributed to this between-group difference.

  5. 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.

  6. Utility of the History and Physical Examination in the Detection of Acute Coronary Syndromes in Emergency Department Patients

    Directory of Open Access Journals (Sweden)

    Zachary DW Dezman

    2017-05-01

    Full Text Available Chest pain accounts for approximately 6% of all emergency department (ED visits and is the most common reason for emergency hospital admission. One of the most serious diagnoses emergency physicians must consider is acute coronary syndrome (ACS. This is both common and serious, as ischemic heart disease remains the single biggest cause of death in the western world. The history and physical examination are cornerstones of our diagnostic approach in this patient group. Their importance is emphasized in guidelines, but there is little evidence to support their supposed association. The purpose of this article was to summarize the findings of recent investigations regarding the ability of various components of the history and physical examination to identify which patients presenting to the ED with chest pain require further investigation for possible ACS. Previous studies have consistently identified a number of factors that increase the probability of ACS. These include radiation of the pain, aggravation of the pain by exertion, vomiting, and diaphoresis. Traditional cardiac risk factors identified by the Framingham Heart Study are of limited diagnostic utility in the ED. Clinician gestalt has very low predictive ability, even in patients with a non-diagnostic electrocardiogram (ECG, and gestalt does not seem to be enhanced appreciably by clinical experience. The history and physical alone are unable to reduce a patient’s risk of ACS to a generally acceptable level (<1%. Ultimately, our review of the evidence clearly demonstrates that “atypical” symptoms cannot rule out ACS, while “typical” symptoms cannot rule it in. Therefore, if a patient has symptoms that are compatible with ACS and an alternative cause cannot be identified, clinicians must strongly consider the need for further investigation with ECG and troponin measurement.

  7. Using qualitative methods to understand factors contributing to patient satisfaction among dermatology patients: a systematic review.

    Science.gov (United States)

    Gibbons, Caitlin; Singh, Sanminder; Gibbons, Brittany; Clark, Caitlin; Torres, Josefina; Cheng, Michelle Y; Wang, Elizabeth A; Armstrong, April W

    2018-05-01

    In this systematic review, we aimed to synthesize data that identify factors contributing to patient satisfaction in dermatology care using qualitative methods. We performed a comprehensive search of the literature using the PubMed database for articles published between January 1, 2000 and February 9, 2015. The initial search yielded 186 articles, of which 13 were included after applying inclusion and exclusion criteria. The systematic review of 13 articles included a total of 330 patients. Using in-field observations and semistructured interviews, studies found that qualitative methods and analysis increased the provider's sensitivity to patient needs and enhanced patient care. Analyses using qualitative methods found increased patient satisfaction in their healthcare provider is associated with (1) confidence in the provider's diagnosis, (2) perception of patient-centered, individualized recommendations and (3) quality of patient education and provider explanation during a visit. Patient satisfaction is measured using either quantitative or qualitative methods. Quantitative methods result in standardized data that often does not capture the nuances of patient experience. In contrast, qualitative methodology is integral to gathering patient perspectives on patient care and satisfaction and should be included in future research models.

  8. Cooling history of the Valles Caldera, New Mexico using ESR dating method

    International Nuclear Information System (INIS)

    Ogoh, K.; Toyoda, S.; Ikeda, S.; Ikeya, M.; Goff, F.

    1993-01-01

    ESR dating was made at the Valles caldera by using the Al center and Ti center in quartz grains separated from the layers of the Valles Rhyolite. Obtained ESR ages were much younger than those by other methods (fission track and 39 Ar- 40 Ar). A reported thermal event of about 10-40 ka ago might explain the difference between the above ages. (author)

  9. Circulating angiotensin-converting enzyme 2 activity in patients with chronic kidney disease without previous history of cardiovascular disease.

    Science.gov (United States)

    Anguiano, Lidia; Riera, Marta; Pascual, Julio; Valdivielso, José Manuel; Barrios, Clara; Betriu, Angels; Mojal, Sergi; Fernández, Elvira; Soler, María José

    2015-07-01

    Patients with cardiovascular (CV) disease have an increased circulating angiotensin-converting enzyme 2 (ACE2) activity, but there is little information about changes in ACE2 in chronic kidney disease (CKD) patients without history of CV disease. We examined circulating ACE2 activity in CKD patients at stages 3-5 (CKD3-5) and in dialysis (CKD5D) without any history of CV disease. Circulating ACE2 activity was measured in human ethylenediamine-tetraacetic acid (EDTA)-plasma samples from the NEFRONA study (n = 2572): control group (CONT) (n = 568), CKD3-5 (n = 1458) and CKD5D (n = 546). Different clinical and analytical variables such as gender; age; history of diabetes mellitus (DM), dyslipidemia and hypertension; glycaemic, renal, lipid and anaemia profiles; vitamin D analogues treatment and antihypertensive treatments (angiotensin-converting enzyme inhibitor and angiotensin receptor blockade) were analysed. Circulating ACE2 and ACE activities were measured using modified fluorimetric assay for EDTA-plasma samples, where zinc chloride was added to recover enzymatic activity. In CKD3-5 and CKD5D, significant decrease in circulating ACE2 activity was observed when compared with CONT, but no differences were found between CKD3-5 and CKD5 when performing paired case-control studies. By multivariate linear regression analysis, male gender and advanced age were identified as independent predictors of ACE2 activity in all groups. Diabetes was identified as independent predictor of ACE2 activity in CKD3-5. Significant increase in the activity of circulating ACE was found in CKD3-5 and CKD5D when compared with CONT and in CKD5D when compared with CKD3-5. By multiple regression analysis, female gender and younger age were identified as independent predictors of ACE activity in CONT and CKD3-5. Diabetes was also identified as an independent predictor of ACE activity in CKD3-5 patients. Circulating ACE2 and ACE activities can be measured in human EDTA-plasma samples with zinc

  10. Ambulatory orthopaedic surgery patients' emotions when using different patient education methods.

    Science.gov (United States)

    Heikkinen, Katja; Salanterä, Sanna; Leppänen, Tiina; Vahlberg, Tero; Leino-Kilpi, Helena

    2012-07-01

    A randomised controlled trial was used to evaluate elective ambulatory orthopaedic surgery patients' emotions during internet-based patient education or face-to-face education with a nurse. The internet-based patient education was designed for this study and patients used websites individually based on their needs. Patients in the control group participated individually in face-to-face patient education with a nurse in the ambulatory surgery unit. The theoretical basis for both types of education was the same. Ambulatory orthopaedic surgery patients scored their emotions rather low at intervals throughout the whole surgical process, though their scores also changed during the surgical process. Emotion scores did not decrease after patient education. No differences in patients' emotions were found to result from either of the two different patient education methods.

  11. Clinical characteristics of depressed patients with a history of suicide attempts: results from the CRESCEND study in South Korea.

    Science.gov (United States)

    Park, Min-Hyeon; Kim, Tae-Suk; Yim, Hyeon-Woo; Jeong, Seung Hee; Lee, Chul; Lee, Chang-Uk; Kim, Jae-Min; Jung, Sung-Won; Lee, Min-Soo; Jun, Tae-Youn

    2010-10-01

    South Korea is a country with one of the highest suicide rates in the world, and the suicide rate is still on the rise. The purpose of this study was to determine the sociodemographic and clinical characteristics of suicide attempts and risk factors related to suicide attempts among depressed patients in South Korea. Among the 1183 participants, 21.4% had a history of a suicide attempt. When the severity of depression was controlled, the risk factors for patients who attempted suicide included younger age, experienced significant life events before 12 years of age, psychotic symptoms, and previous depressive episodes. The characteristics of attempted suicide in depressed patients in South Korea can be summarized as a high suicide attempt rate with no difference in the number of suicide attempts and lethality between males and females. This unique tendency is probably related to the sociodemographic and cultural characteristics of South Korea.

  12. Lack of Clinical Relevance of ANA and ASMA Positivity in Patients with Liver Transplantation without a History of Autoimmune Diseases.

    Science.gov (United States)

    Pellegrini, Lucienne; Parrilli, Gianpaolo; Santonicola, Antonella; Cinquanta, Luigi; Caputo, Cesare; Ciacci, Carolina; Zingone, Fabiana

    2017-01-01

    The relevance of isolated autoimmunity elevation in orthotopic liver transplantation (OLT) patients is unknown. Our aim was to analyse how serum autoantibodies change in time and to evaluate their clinical relevance in OLT patients. Patients were invited to provide samples to evaluate ANA, AMA, ASMA, and LKM at the time of enrolment ( T 0), after 6 months ( T 6), and after 12 months ( T 12). We included 114 patients in the study (76% males, median age 62.5 years), finding isolated elevation of at least one serum antibody in up to 80% of them. We described fluctuating positive autoantibodies in the one year of observation, with only 45.6% of patients positive for ANA and less than 2% positive for ASMA, at all three times. Isolated elevation of tissue antibodies was not related to gender, age, HCC at transplant, early rejection, cause of transplantation, immunotherapy taken, and age at the time of the study. We did not detect a higher prevalence of positive autoimmunity in patients with signs of liver injury. ANA and ASMA evaluation in patients with liver transplantation and no history of autoimmune disease has no clinical relevance, since it varies in time and is not related to any risk factors or liver injury. Routine autoimmunity evaluation should be avoided.

  13. Assessing Crowdsourced POI Quality: Combining Methods Based on Reference Data, History, and Spatial Relations

    Directory of Open Access Journals (Sweden)

    Guillaume Touya

    2017-03-01

    Full Text Available With the development of location-aware devices and the success and high use of Web 2.0 techniques, citizens are able to act as sensors by contributing geographic information. In this context, data quality is an important aspect that should be taken into account when using this source of data for different purposes. The goal of the paper is to analyze the quality of crowdsourced data and to study its evolution over time. We propose two types of approaches: (1 use the intrinsic characteristics of the crowdsourced datasets; or (2 evaluate crowdsourced Points of Interest (POIs using external datasets (i.e., authoritative reference or other crowdsourced datasets, and two different methods for each approach. The potential of the combination of these approaches is then demonstrated, to overcome the limitations associated with each individual method. In this paper, we focus on POIs and places coming from the very successful crowdsourcing project: OpenStreetMap. The results show that the proposed approaches are complementary in assessing data quality. The positive results obtained for data matching show that the analysis of data quality through automatic data matching is possible but considerable effort and attention are needed for schema matching given the heterogeneity of OSM and the representation of authoritative datasets. For the features studied, it can be noted that change over time is sometimes due to disagreements between contributors, but in most cases the change improves the quality of the data.

  14. Contribution of outstanding teachers from Western Ukraine of late XIX – early XX century to development of theory and methods of teaching history

    Directory of Open Access Journals (Sweden)

    Zinoviia Nahachevska

    2017-02-01

    Full Text Available The article provides analysis of theses from works of prominent representatives of educational thought in Western Ukraine of late XIX – early XX century, which are related to solving problems of teaching history in elementary and secondary schools in the region. The emphasis is placed on the actualization of content and methods of teaching by V. VilshanetskaZhukovetska, A. Kopystianskyi, M. Korduba, and K. Malytska.Key words: elementary and secondary schools (gymnasia, curricula, content, principles and methods of teaching history, school textbooks, anthropologization and humanization of history, study of local lore.

  15. TREATMENT OF TRANSCONDYLAR EXTENSOR FRACTURES OF THE HUMERUS IN CHILDREN: ON THE ISSUE OF HISTORY OF THE METHOD “COLLAR AND CUFF”

    Directory of Open Access Journals (Sweden)

    A. S. Zolotov

    2013-01-01

    Full Text Available The article is devoted to the history of one of the methods of conservative treatment humeral transcondylar extensor fractures in children - a method «collar and cuff». The second and very common name of this method is connected with the name of the american orthopaedist Walter Blount. «The method of Blount» is mentioned in many domestic and foreign sources. Nevertheless the analysis of publications on the history of the discussed method of treatment indicates the priority in this matter other famous doctor - British podiatrist Robert Jones.

  16. Qualitative Methods in Patient-Centered Outcomes Research.

    Science.gov (United States)

    Vandermause, Roxanne; Barg, Frances K; Esmail, Laura; Edmundson, Lauren; Girard, Samantha; Perfetti, A Ross

    2017-02-01

    The Patient-Centered Outcomes Research Institute (PCORI), created to fund research guided by patients, caregivers, and the broader health care community, offers a new research venue. Many (41 of 50) first funded projects involved qualitative research methods. This study was completed to examine the current state of the science of qualitative methodologies used in PCORI-funded research. Principal investigators participated in phenomenological interviews to learn (a) how do researchers using qualitative methods experience seeking funding for, implementing and disseminating their work; and (b) how may qualitative methods advance the quality and relevance of evidence for patients? Results showed the experience of doing qualitative research in the current research climate as "Being a bona fide qualitative researcher: Staying true to research aims while negotiating challenges," with overlapping patterns: (a) researching the elemental, (b) expecting surprise, and (c) pushing boundaries. The nature of qualitative work today was explicitly described and is rendered in this article.

  17. Identification of Kininogen 1 as a Serum Protein Marker of Colorectal Adenoma in Patients with a Family History of Colorectal Cancer

    Science.gov (United States)

    Yu, Jiekai; Huang, Yanqin; Lin, Chen; Li, Xiaofen; Fang, Xuefeng; Zhong, Chenhan; Yuan, Ying; Zheng, Shu

    2018-01-01

    The serum protein markers of colorectal adenoma in patients with a family history of colorectal cancer have been rarely reported. Serum samples from colorectal adenoma patients with or without a family history of colorectal cancer and healthy controls were profiled using Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry (MALDI-TOF-MS). The model to distinguish colorectal adenoma patients with a family history of colorectal cancer from atypical hereditary colorectal families (CRA-H) and sporadic colorectal adenoma patients without a family history of colorectal cancer (CRA-S) was established with 85.0% accuracy. The model distinguishing CRA-H from healthy individuals was established with 90.0% specificity and 86.7% sensitivity. Additionally, five peaks (2202, 5821, 3260, 2480, and 2218) showing differential expression in advanced colorectal adenoma patients with a family history of colorectal cancer were selected. The protein Kininogen 1 (KNG1) was identified in colorectal adenoma patients and validated using Western Blotting. KNG1 may be a biomarker for colorectal adenoma patients with a family history of colorectal cancer. PMID:29535795

  18. Hypocalcemia after thyroidectomy in patients with a history of bariatric surgery.

    Science.gov (United States)

    Chereau, Nathalie; Vuillermet, Cindy; Tilly, Camille; Buffet, Camille; Trésallet, Christophe; du Montcel, Sophie Tezenas; Menegaux, Fabrice

    2017-03-01

    Hypocalcemia is a common complication after total thyroidectomy. Previous bariatric surgery could be a higher factor risk for hypocalcemia due to alterations in calcium absorption and vitamin D deficiency. To evaluate incidence and factors involved in the risk of hypocalcemia (transient and permanent) and the postoperative outcomes of these patients after total thyroidectomy. University hospital in Paris, France. All patients who had previously undergone obesity surgery (i.e., Roux-en-Y gastric bypass, sleeve gastrectomy, or adjustable gastric band) who had a total thyroidectomy from 2006 to 2015 were included. No patient was lost to follow-up. Each patient was matched 1:1 with a patient who had no previous bariatric surgery for age, gender, body mass index, and year of surgery. Forty-eight patients were identified (43 female; mean age 48.9±9.2 yr). Nineteen patients (40%) had a postoperative hypocalcemia: transient in 14 patients (29.2%) and permanent in 5 patients (10.4%). No significant predictive clinical or biochemical factors were found for hypocalcemia risk, except for the type of bariatric procedure: Bypass surgery had a 2-fold increased risk of hypocalcemia compared to others procedures (60% versus 30%, P = .05). In the matched pair analysis, the risk of hypocalcemia was significantly higher in patients with previous bariatric surgery than in the matched cohort (40% versus 15%, P = .006). Patients with previous bariatric surgery have an increased risk for hypocalcemia after total thyroidectomy, especially after Roux-en-Y gastric bypass. Careful and prolonged follow-up of calcium, vitamin D, and parathyroid hormone levels should be suggested for these patients. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  19. Chloroma of the testis in a patient with a history of acute myeloid leukemia

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Sanei

    2017-01-01

    Full Text Available Chloroma, or granulocytic sarcoma, is a rare extramedullary solid hematologic cancer, found concomitant with acute myeloid leukemia. It is infrequently associated with other myeloproliferative disorders or chronic myelogenous leukemia. Chloroma of the testis after allogeneic bone marrow transplantation is particularly sparsely represented in the literature. It is suggested that an appropriate panel of marker studies be performed along with clinical correlation and circumspection to avoid misleading conclusions. We report an interesting case of a 32-year-old male with a clinical history of acute myelogenous leukemia, postallogeneic peripheral blood stem cell transplantation that was found to have chloroma of the right testis.

  20. Chloroma of the testis in a patient with a history of acute myeloid leukemia.

    Science.gov (United States)

    Sanei, Mohammad Hossein; Shariati, Matin

    2017-01-01

    Chloroma, or granulocytic sarcoma, is a rare extramedullary solid hematologic cancer, found concomitant with acute myeloid leukemia. It is infrequently associated with other myeloproliferative disorders or chronic myelogenous leukemia. Chloroma of the testis after allogeneic bone marrow transplantation is particularly sparsely represented in the literature. It is suggested that an appropriate panel of marker studies be performed along with clinical correlation and circumspection to avoid misleading conclusions. We report an interesting case of a 32-year-old male with a clinical history of acute myelogenous leukemia, postallogeneic peripheral blood stem cell transplantation that was found to have chloroma of the right testis.

  1. Cyclophosphamide-induced cardiomyopathy in a patient with seminoma and a history of mediastinal irradiation

    International Nuclear Information System (INIS)

    Kamezaki, Kenjirou; Fukuda, Takahiro; Makino, Shigeyoshi; Harada, Mine

    2005-01-01

    A 17-year-old man with mediastinal seminoma was treated with chemotherapy and mediastinal irradiation therapy. Then he received high-dose chemotherapy containing cyclophosphamide (CY) followed by autologous peripheral blood stem cell transplantation. He suffered from CY-induced cardiomyopathy beginning six days after the administration of high-dose CY. The predictable factors associated with the onset of CY-induced cardiomyopathy are not precisely known. It is suggested that the history of mediastinal irradiation was responsible for the onset of cardiomyopathy. (author)

  2. Hepatitis C infection in patients with hereditary bleeding disorders: epidemiology, natural history, and management.

    Science.gov (United States)

    Papadopoulos, Nikolaos; Argiana, Vasiliki; Deutsch, Melanie

    2018-01-01

    Hereditary bleeding disorders include a group of diseases with abnormalities of coagulation. Prior to 1990, infection with hepatitis C virus (HCV) was mainly transmitted via pooled plasma products as a treatment for hereditary bleeding disorders. Anti-HCV positivity in these patients may be as high as >70% in some areas, while some of them have also been coinfected with human immunodeficiency virus. Since about 20% of HCV-infected patients clear the infection naturally, chronic HCV infection represents a significant health problem in this group of patients. Mortality due to chronic HCV infection is estimated to be >10 times higher in patients with hemophilia than in the general population, and is mainly due to liver cirrhosis and hepatocellular carcinoma. The antiviral treatment of HCV in patients with hereditary bleeding disorders is not different from that of any other infected patients. Nevertheless, many patients with hereditary bleeding disorders have declined (Peg)interferon-based treatment because of side effects. In recent years, multiple orally administrated direct-acting antivirals (DAAs) have been approved for HCV treatment. Unfortunately, there is not much experience from treating these patients with DAA regimens, as major studies and real-life data did not include adequate numbers of patients with inherited hemorrhagic disorders. However, the available data indicate that DAAs have an excellent safety profile with a sustained virological response rate of >90%.

  3. Characterization of Korean Red Ginseng (Panax ginseng Meyer: History, preparation method, and chemical composition

    Directory of Open Access Journals (Sweden)

    Sang Myung Lee

    2015-10-01

    Full Text Available It has been reported that Korean Red Ginseng has been manufactured for 1,123 y as described in the GoRyeoDoGyeong record. The Korean Red Ginseng manufactured by the traditional preparation method has its own chemical component characteristics. The ginsenoside content of the red ginseng is shown as Rg1: 3.3 mg/g, Re: 2.0 mg/g, Rb1: 5.8 mg/g, Rc:1.7 mg/g, Rb2: 2.3 mg/g, and Rd: 0.4 mg/g, respectively. It is known that Korean ginseng generally consists of the main root and the lateral or fine roots at a ratio of about 75:25. Therefore, the red ginseng extract is prepared by using this same ratio of the main root and lateral or fine roots and processed by the historical traditional medicine prescription. The red ginseng extract is prepared through a water extraction (90°C for 14–16 h and concentration process (until its final concentration is 70–73 Brix at 50–60°C. The ginsenoside contents of the red ginseng extract are shown as Rg1: 1.3 mg/g, Re: 1.3 mg/g, Rb1: 6.4 mg/g, Rc:2.5 mg/g, Rb2: 2.3 mg/g, and Rd: 0.9 mg/g, respectively. Arginine-fructose-glucose (AFG is a specific amino-sugar that can be produced by chemical reaction of the process when the fresh ginseng is converted to red ginseng. The content of AFG is 1.0–1.5% in red ginseng. Acidic polysaccharide, which has been known as an immune activator, is at levels of 4.5–7.5% in red ginseng. Therefore, we recommended that the chemical profiles of Korean Red Ginseng made through the defined traditional method should be well preserved and it has had its own chemical characteristics since its traditional development.

  4. 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.

  5. [High myopic patients: A survey of their history, feelings, beliefs and needs].

    Science.gov (United States)

    Gaucher, D; Chartier, C; Cohen, S-Y; Malecaze, F; Souied, E H; Weber, M; Leveziel, N

    2016-01-01

    High myopia (HM), which affects 0.9 to 3.1% of the population, is a major cause of vision loss. The purpose of this investigation was to study and evaluate the impact of their high myopia on the daily lives of patients and to better understand their expectations in order to better meet their needs. The survey was conducted between February 19 and March 21, 2014. To be eligible, patients had to have myopia of at least -8 diopters and be over 40 years of age, with or without myopic complications. Patients' degree of myopia was defined as the optical prescription of their worse eye. The 123 patients included were interviewed by phone using a questionnaire developed and validated by a scientific committee composed of experts and members of the patients' Association against myopic maculopathy (AMAM). The phone interview, semi-structured, lasted 20 minutes. On average, myopia was -11.7 diopters. Women accounted for 71% of the population, 89% of patients were under 65 years and were mostly professionals (65%). Over half of the subjects reported myopic complications; 5% of patients had choroidal neovascularization (CNV). Only 29% had been informed of the risk of CNV or maculopathy. HM was a handicap in sports for 64% of patients, in leisure activities for 51%, and in professional activities for more than a quarter (28%). Only 56% of HM patients reported living perfectly well with their condition. This survey is the first study on the daily life of people with HM aiming to analyze their social and emotional environment. It shows that HM has a profound impact on the daily lives of patients and may affect social life and professional activity. Most myopic patients possess incomplete or unclear information about the nature and risk of myopic complications. They expressed the desire to be better informed about their condition earlier, before the onset of complications. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  6. A quick seismic assessment method for jacket type offshore structures by combining push-over and nonlinear time history analyses

    Energy Technology Data Exchange (ETDEWEB)

    Karimiyan, S.; Hosseini, M. [International Inst. of Earthquake Engineering and Seismology, Tehran (Iran, Islamic Republic of); Karimiyan, M. [Islamic Azad Univ., Tehran (Iran, Islamic Republic of). Earthquake Eng. Dept., School of Engineering

    2010-07-01

    Several offshore structures are located in seismic regions. In order to upgrade their seismic behaviour, their seismic vulnerability must be evaluated. It is thought that the most reliable type of analysis for seismic evaluation is nonlinear time history analysis (NLTHA), however, it is known to be a very time consuming method. This paper presented a quick procedure by combining the push over analysis (POA) and the NLTHA. The paper discussed both methods in detail. In order to identify the more critical members of the structure, based on the range of their plastic deformations, some POA were first performed. The NLTHA was then performed, focusing on the critical members, to obtain their vulnerability with higher reliability. An offshore structure of jacket type, installed in the Lavan oil field in the Persian Gulf in 1970, was also considered in order to demonstrate the efficiency of the proposed method. It was concluded from the numerical results that combining POA and NLTHA was a quick and reliable seismic evaluation method. The results demonstrated that although the vulnerability of the jacket structure was not very high, the level of damage was not the same for different members, and was dependent on their location in the structure and also its geometric orientation and load bearing situation. 6 refs., 1 tab., 8 figs.

  7. Comparing Exercise Prescription Methods in Knee Osteoarthritis Patients in Malaysia

    Directory of Open Access Journals (Sweden)

    D’Gasper Dineesha

    2018-03-01

    Full Text Available Aim: This study was a qualitative study that investigated the exercise prescription method in knee osteoarthritis patients in Malaysia. It purposed to find out the most common and effective method used by physiotherapist in prescribing exercises for knee osteoarthritis patients in Malaysia. Method: This study used a self-administered survey questionnaire. The subjects recruited for this study were diagnosed with knee osteoarthritis, age range of between 50 to 80 years old.The methods of delivery were divided into three categories, which include only verbal instructions, verbal instruction together with demonstration and lastly a combination of all three methods including verbal instruction, demonstration and handouts with diagrams. Results: The results showed that 52% received their exercise prescription with verbal instruction and together with demonstration, about 43% of them received all three types of methods which included the verbal instruction, demonstration and take home handouts and 5% of them only received verbal instruction. Out of 5% who received verbal instruction alone, only 1% understood the exercises and the remaining 4% did not and 45% out of 52% who received verbal and demonstration method understood the exercises and the remaining 7% did not. 5% who received only verbal instruction did not seem to continue the exercises at home. 52% received verbal instruction together with demonstration, with about 44% of them having continued their exercises but the remaining 8% did not. 43% who received all three methods reported to continue. Conclusion: The best method of delivering exercises to knee osteoarthritis patients was proven to be the method with a combination of verbal instruction, demonstration together with a take home handout. This method showed very positive outcome and should be implemented and emphasized more in both the government and private sectors of physiotherapy departments.

  8. Genotypic classification of patients with Wolfram syndrome: insights into the natural history of the disease and correlation with phenotype.

    Science.gov (United States)

    de Heredia, Miguel López; Clèries, Ramón; Nunes, Virginia

    2013-07-01

    Wolfram syndrome is a degenerative, recessive rare disease with an onset in childhood. It is caused by mutations in WFS1 or CISD2 genes. More than 200 different variations in WFS1 have been described in patients with Wolfram syndrome, which complicates the establishment of clear genotype-phenotype correlation. The purpose of this study was to elucidate the role of WFS1 mutations and update the natural history of the disease. This study analyzed clinical and genetic data of 412 patients with Wolfram syndrome published in the last 15 years. (i) 15% of published patients do not fulfill the current -inclusion criterion; (ii) genotypic prevalence differences may exist among countries; (iii) diabetes mellitus and optic atrophy might not be the first two clinical features in some patients; (iv) mutations are nonuniformly distributed in WFS1; (v) age at onset of diabetes mellitus, hearing defects, and diabetes insipidus may depend on the patient's genotypic class; and (vi) disease progression rate might depend on genotypic class. New genotype-phenotype correlations were established, disease progression rate for the general population and for the genotypic classes has been calculated, and new diagnostic criteria have been proposed. The conclusions raised could be important for patient management and counseling as well as for the development of treatments for Wolfram syndrome.

  9. Influencing factors for early acute cerebrovascular accidents in patients with stroke history following off-pump coronary artery bypass grafting.

    Science.gov (United States)

    Wang, Bin; Jia, Ming; Jia, Shijie; Wan, Jiuhe; Zhou, Xiao; Luo, Zhimin; Zhou, Ye; Zhang, Jianqun

    2014-06-01

    To analyse risk factors for early acute cerebrovascular accidents following off-pump coronary artery bypass grafting (OPCAB) in patients with stroke history, and to propose preventive measures to reduce the incidence of these events. A total of 468 patients with a history of stroke underwent OPCAB surgery in Beijing Anzhen Hospital of China from January 2010 to September 2012. They were retrospectively divided into two groups according to the occurrence of early acute cerebrovascular accidents within 48 hours following OPCAB. Multivariate logistic regression analysis was used to find risk or protective factors for early acute cerebrovascular accidents following the OPCAB. Fifty-two patients (11.1%) suffered from early acute cerebrovascular accidents in 468 patients, including 39 cases of cerebral infarction, two cases of cerebral haemorrhage, 11 cases of transient ischaemic attack (TIA). There were significant differences between the two groups in preoperative left ventricular ejection fraction ≤ 35%, severe bilateral carotid artery stenosis, poorly controlled hypertension, intraoperative application of Enclose® II proximal anastomotic device, postoperative acute myocardial infarction, atrial fibrillation, hypotension, ventilation time > 48h, ICU duration >48h and mortality. Multivariate logistic regression analysis showed that preoperative severe bilateral carotid stenosis (OR=6.378, 95%CI: 2.278-20.987) and preoperative left ventricular ejection fraction ≤ 35% (OR=2.737, 95%CI: 1.267-6.389), postoperative acute myocardial infarction (OR=3.644, 95%CI: 1.928-6.876), postoperative atrial fibrillation (OR=3.104, 95%CI:1.135∼8.016) and postoperative hypotension (OR=4.173, 95%CI: 1.836∼9.701) were independent risk factors for early acute cerebrovascular accidents in patients with a history of stroke following OPCAB procedures, while intraoperative application of Enclose® II proximal anastomotic device was protective factor (OR=0.556, 95%CI: 0.337-0.925). This

  10. [Symptoms of myasthenia gravis in a patient with a history of thymectomy for invasive thymoma].

    Science.gov (United States)

    Giraldo, Lilliana María; Duque, Camilo; Uribe, Carlos Santiago; Hernández, Olga Helena

    2015-01-01

    Myasthenia gravis is an antibody-mediated autoimmune disease. Approximately 10-15% of patients present with a thymoma, the presence of which is associated with greater severity of symptoms, myasthenic crisis, and irresponsiveness to front-line therapy. A thymectomy is recommended in young patients with generalized myasthenia gravis and in all patients presenting with thymoma. The patient was a 43-year-old woman, who first showed symptoms of myasthenic crisis in 2005 and presented with invasive thymoma managed with thymectomy and radiotherapy. In the subsequent three years, the patient presented with severe symptoms and two myasthenic crises that required mechanical ventilation and immunoglobulin treatment. Contrast chest computed tomography examinations showed no recurrence. Between 2009 and 2012, the patient experienced decreased symptom severity. In 2013, the patient presented with an exacerbation of symptoms; a contrast chest magnetic resonance scan showed a lesion in the anterior mediastinum, previously observed in 2011, suggestive of residual tissue as opposed to fibrosis. Regular management was started with immunoglobulins; a positron emission tomography scan was inconclusive, requiring a new resection, which showed no evidence of tumor recurrence. Patients with myasthenia gravis and those with myasthenia-related thymoma both share thymectomy as an element of treatment. However, following the procedure, exacerbation or reappearance of symptoms does not necessarily represent new alterations in the thymus.

  11. Diagnostic value of patient characteristics, history, and six clinical tests for traumatic anterior shoulder instability

    NARCIS (Netherlands)

    van Kampen, D.A.; van den Berg, T.; van der Woude, H.J.; Castelein, R.M.; Terwee, C.B.; Willems, W.J.

    2013-01-01

    Background: It is unknown which combination of patient information and clinical tests might beoptimal for the diagnosis of traumatic anterior shoulder instability. This study aimed to determinethe diagnostic value of individual clinical tests and to develop a prediction model that combined patient

  12. Characterization of phase change materials for thermal control of photovoltaics using Differential Scanning Calorimetry and Temperature History Method

    International Nuclear Information System (INIS)

    Hasan, A.; McCormack, S.J.; Huang, M.J.; Norton, B.

    2014-01-01

    Highlights: • Five PCM are characterized using tow techniques for PV temperature regulation. • Thermophysical properties of interest are determined and compared with literature. • Determined PCM properties are discussed as criteria for PV temperature regulation. • One PCM identified as potential candidate for PV temperature regulation. - Abstract: Five solid–liquid phase change materials comprising three basic classes, paraffin waxes, salt hydrates and mixtures of fatty acids were thermophysically characterized for thermal regulation applications in photovoltaics. The PCM were investigated using Differential Scanning Calorimetry and Temperature History Method to find their thermophysical properties of interest. The relationship between thermophysical properties of the PCM and their choice as temperature regulators in photovoltaics is discussed in relation to the ambient conditions under which PV systems operate

  13. Suicide among Young People and Adults in Ireland: Method Characteristics, Toxicological Analysis and Substance Abuse Histories Compared

    Science.gov (United States)

    Larkin, Celine; Wall, Amanda; McAuliffe, Carmel; McCarthy, Jacklyn; Williamson, Eileen; Perry, Ivan J.

    2016-01-01

    Objective Information on factors associated with suicide among young individuals in Ireland is limited. The aim of this study was to identify socio-demographic characteristics and circumstances of death associated with age among individuals who died by suicide. Methods The study examined 121 consecutive suicides (2007–2012) occurring in the southern eastern part of Ireland (Cork city and county). Data were obtained from coroners, family informants, and health care professionals. A comparison was made between 15-24-year-old and 25-34-year-old individuals. Socio-demographic characteristics of the deceased, methods of suicide, history of alcohol and drug abuse, and findings from toxicological analysis of blood and urine samples taken at post mortem were included. Pearson’s χ2 tests and binary logistic regression analysis were performed. Results Alcohol and/or drugs were detected through toxicological analysis for the majority of the total sample (79.5%), which did not differentiate between 15-24-year-old and 25-34-year-old individuals (74.1% and 86.2% respectively). Compared to 25-34-year-old individuals, 15-24-year-old individuals were more likely to engage in suicide by hanging (88.5%). Younger individuals were less likely to die by intentional drug overdose and carbon monoxide poisoning compared to older individuals. Younger individuals who died between Saturday and Monday were more likely to have had alcohol before dying. Substance abuse histories were similar in the two age groups. Conclusion Based on this research it is recommended that strategies to reduce substance abuse be applied among 25-34-year-old individuals at risk of suicide. The wide use of hanging in young people should be taken into consideration for future means restriction strategies. PMID:27898722

  14. A Method for Developing Standard Patient Education Program.

    Science.gov (United States)

    Lura, Carolina Bryne; Hauch, Sophie Misser Pallesgaard; Gøeg, Kirstine Rosenbeck; Pape-Haugaard, Louise

    2018-01-01

    In Denmark, patients being treated on Haematology Outpatients Departments get instructed to self-manage their blood sample collection from Central Venous Catheter (CVC). However, this is a complex and risky procedure, which can jeopardize patient safety. The aim of the study was to suggest a method for developing standard digital patient education programs for patients in self-administration of blood samples drawn from CVC. The Design Science Research Paradigm was used to develop a digital patient education program, called PAVIOSY, to increase patient safety during execution of the blood sample collection procedure by using videos for teaching as well as procedural support. A step-by-step guide was developed and used as basis for making the videos. Quality assurance through evaluation with a nurse was conducted on both the step-by-step guide and the videos. The quality assurance evaluation of the videos showed; 1) Errors due to the order of the procedure can be determined by reviewing the videos despite that the guide was followed. 2) Videos can be used to identify errors - important for patient safety - in the procedure, which are not identifiable in a written script. To ensure correct clinical content of the educational patient system, health professionals must be engaged early in the development of content and design phase.

  15. 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...

  16. Influence of family history of major depression, bipolar disorder, and suicide on clinical features in patients with major depression and bipolar disorder.

    Science.gov (United States)

    Serretti, Alessandro; Chiesa, Alberto; Calati, Raffaella; Linotte, Sylvie; Sentissi, Othman; Papageorgiou, Konstantinos; Kasper, Siegfried; Zohar, Joseph; De Ronchi, Diana; Mendlewicz, Julien; Amital, Daniela; Montgomery, Stuart; Souery, Daniel

    2013-03-01

    The extent to which a family history of mood disorders and suicide could impact on clinical features of patients suffering from major depression (MD) and bipolar disorder (BD) has received relatively little attention so far. The aim of the present work is, therefore, to assess the clinical implications of the presence of at least one first- and/or second-degree relative with a history of MD, BD and suicide in a large sample of patients with MD or BD. One thousand one hundred and fifty-seven subjects with MD and 686 subjects with BD were recruited within the context of two large projects. The impact of a family history of MD, BD, and suicide-considered both separately and together-on clinical and socio-demographic variables was investigated. A family history of MD, BD, and suicide was more common in BD patients than in MD patients. A positive family history of mood disorders and/or suicide as well as a positive family history of MD and BD separately considered, but not a positive history of suicide alone, were significantly associated with a comorbidity with several anxiety disorders and inversely associated with age of onset. The clinical implications as well as the limitations of our findings are discussed.

  17. Turbidite event history--Methods and implications for Holocene paleoseismicity of the Cascadia subduction zone

    Science.gov (United States)

    Goldfinger, Chris; Nelson, C. Hans; Morey, Ann E.; Johnson, Joel E.; Patton, Jason R.; Karabanov, Eugene B.; Gutierrez-Pastor, Julia; Eriksson, Andrew T.; Gracia, Eulalia; Dunhill, Gita; Enkin, Randolph J.; Dallimore, Audrey; Vallier, Tracy; Kayen, Robert; Kayen, Robert

    2012-01-01

    Turbidite systems along the continental margin of Cascadia Basin from Vancouver Island, Canada, to Cape Mendocino, California, United States, have been investigated with swath bathymetry; newly collected and archive piston, gravity, kasten, and box cores; and accelerator mass spectrometry radiocarbon dates. The purpose of this study is to test the applicability of the Holocene turbidite record as a paleoseismic record for the Cascadia subduction zone. The Cascadia Basin is an ideal place to develop a turbidite paleoseismologic method and to record paleoearthquakes because (1) a single subduction-zone fault underlies the Cascadia submarine-canyon systems; (2) multiple tributary canyons and a variety of turbidite systems and sedimentary sources exist to use in tests of synchronous turbidite triggering; (3) the Cascadia trench is completely sediment filled, allowing channel systems to trend seaward across the abyssal plain, rather than merging in the trench; (4) the continental shelf is wide, favoring disconnection of Holocene river systems from their largely Pleistocene canyons; and (5) excellent stratigraphic datums, including the Mazama ash and distinguishable sedimentological and faunal changes near the Pleistocene-Holocene boundary, are present for correlating events and anchoring the temporal framework. Multiple tributaries to Cascadia Channel with 50- to 150-km spacing, and a wide variety of other turbidite systems with different sedimentary sources contain 13 post-Mazama-ash and 19 Holocene turbidites. Likely correlative sequences are found in Cascadia Channel, Juan de Fuca Channel off Washington, and Hydrate Ridge slope basin and Astoria Fan off northern and central Oregon. A probable correlative sequence of turbidites is also found in cores on Rogue Apron off southern Oregon. The Hydrate Ridge and Rogue Apron cores also include 12-22 interspersed thinner turbidite beds respectively. We use 14C dates, relative-dating tests at channel confluences, and

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

    International Nuclear Information System (INIS)

    Nam, Kyung Bum; Namkung, Sook; Hong, Myung Sun; Kim, Heung Cheol; Cho, Young; Choi, Young Hee

    2012-01-01

    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.

  20. Pattern of Family Planning Methods used by Antenatal Patients in ...

    African Journals Online (AJOL)

    This study aimed at assessing the pattern of family planning methods used by antenatal patients at Federal Medical Centre, Owo, Ondo State, Nigeria. The study was conducted between December,2007 and February,2008 at the antenatal clinic of the hospital. Ethical clearance was obtained from the Ethical committee of ...

  1. A nursing case history: the patient with mycotic aneurysm secondary to endocarditis.

    Science.gov (United States)

    Leith, B; Furimsky, I

    1995-03-01

    Due to the advent of antibiotics, mycotic aneurysms, also known as infective aneurysms, now represent only 2.5-5% of all aneurysms. The existing research on this topic is old and scarce. It is highly probably that a neuroscience nurse will care for this type of patient at some point during his/her career. The patient with a mycotic aneurysm is usually critically ill. A 46% mortality has been noted and is related to the multiple problems of these types of patients. Currently, if and when to surgically intervene is controversial. The case of "Mr. C.", a patient at the Montreal Neurological Hospital who developed a mycotic aneurysm secondary to subacute bacterial endocarditis, will be presented. His course in hospital, the medical management and treatment as well as the nursing care and educational needs will be described.

  2. 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.

  3. Effectiveness of simple balancing training program in elderly patients with history of frequent falls.

    Science.gov (United States)

    Kuptniratsaikul, Vilai; Praditsuwan, Rungnirand; Assantachai, Prasert; Ploypetch, Teerada; Udompunturak, Suthipol; Pooliam, Julaporn

    2011-01-01

    To study the effectiveness of simply-performed balancing exercises in fall prevention. Pre- and post-trial. University hospital from January 2009 to May 2010. Elderly with falls in the previous year. Simple balancing exercise was performed at home every day and was recorded in the booklet. 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. 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 (Pfall 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). Performing simply-designed balancing exercises, at least 3 days per week, can increase balancing abilities, and decrease fall rates in the elderly with a history of previous falls. However, strategies to encourage elderly compliance may prevent falling.

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

    Science.gov (United States)

    Schultz, Martin; Rosted, Elizabeth; Sanders, Suzanne

    2015-06-01

    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. A descriptive cohort study was conducted including patients aged 65 years or older admitted to the ED, n = 198. The following data were collected: ISAR screen, cause of admittance. Furthermore, a retrospective journal review was performed by a specialist in geriatrics. Prior to admission, 31% had experienced a fall. Of those, 67% were not referred for further fall assessment. Patients who had experienced falls had more health problems than patients without falls (mean 5.7 versus mean 4.4 (p = 0.00)) and more had cognitive impairment (31% versus 14% (p = 0.00)). A positive correlation was found between patients' ISAR score and falls (p = 0.03). 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 and follow-up. We suggest the ISAR screen as a supplement to measurement of vital signs as it may predict frailty and falls. not relevant.

  5. Modeling Patient No-Show History and Predicting Future Outpatient Appointment Behavior in the Veterans Health Administration.

    Science.gov (United States)

    Goffman, Rachel M; Harris, Shannon L; May, Jerrold H; Milicevic, Aleksandra S; Monte, Robert J; Myaskovsky, Larissa; Rodriguez, Keri L; Tjader, Youxu C; Vargas, Dominic L

    2017-05-01

    Missed appointments reduce the efficiency of the health care system and negatively impact access to care for all patients. Identifying patients at risk for missing an appointment could help health care systems and providers better target interventions to reduce patient no-shows. Our aim was to develop and test a predictive model that identifies patients that have a high probability of missing their outpatient appointments. Demographic information, appointment characteristics, and attendance history were drawn from the existing data sets from four Veterans Affairs health care facilities within six separate service areas. Past attendance behavior was modeled using an empirical Markov model based on up to 10 previous appointments. Using logistic regression, we developed 24 unique predictive models. We implemented the models and tested an intervention strategy using live reminder calls placed 24, 48, and 72 hours ahead of time. The pilot study targeted 1,754 high-risk patients, whose probability of missing an appointment was predicted to be at least 0.2. Our results indicate that three variables were consistently related to a patient's no-show probability in all 24 models: past attendance behavior, the age of the appointment, and having multiple appointments scheduled on that day. After the intervention was implemented, the no-show rate in the pilot group was reduced from the expected value of 35% to 12.16% (p value < 0.0001). The predictive model accurately identified patients who were more likely to miss their appointments. Applying the model in practice enables clinics to apply more intensive intervention measures to high-risk patients. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  6. Natural history and magnetic resonance imaging follow-up in 9 Sturge-Weber Syndrome patients and clinical correlation.

    Science.gov (United States)

    Udani, Vrajesh; Pujar, Suresh; Munot, Pinki; Maheshwari, Shailendra; Mehta, Nirad

    2007-04-01

    The natural history of Sturge-Weber Syndrome is variable where some patients have refractory epilepsy and persistent neurologic deficits while others do well. Also, evolution of MRI abnormalities is largely unknown. This long-term follow-up study tries to address these two issues. This retrospective and later prospective study followed 9 children with confirmed SWS. Clinical details of seizures, stroke-like episodes, neurologic and developmental deficits were ascertained specifically. Patients were divided into those with onset below or after 6 months of age for analysis. Disease was classified as active or inactive and correlations were made with the use of aspirin. All past, as well as prospectively acquired imaging was reviewed by two independent blinded neuroradiologists and the images were analysed as ictal (temporally related to seizure/stroke-like event) or interictal. Degree and extent of leptomeningeal enhancement was specifically looked for. Four boys and five girls were followed up for a mean of 6.1 years. Disease activity subsided in 8/9. Early-onset patients had a severe early course with significant residual deficits while late-onset patients did uniformly well. In 6 patients where aspirin was used, a stable course ensued. There was a significant increase in degree/extent of leptomeningeal enhancement during an ictus which returned to the baseline in the interictal state in all 7 patients where both images were available. Focal cerebral atrophy worsened in early-onset cases. In conclusion, SWS patients with onset of seizures/stroke-like events before 6 months of age seem to do worse with a severe early course and persistent neurologic deficits. However the course stabilizes after 5 years of age in most. Late-onset SWS patients have a benign course. Aspirin use is associated with a stable course though further studies are needed. The leptomeningeal enhancement appears to increase during acute events before returning to baseline suggesting that extent

  7. Modeling patient safety incidents knowledge with the Categorial Structure method.

    Science.gov (United States)

    Souvignet, Julien; Bousquet, Cédric; Lewalle, Pierre; Trombert-Paviot, Béatrice; Rodrigues, Jean Marie

    2011-01-01

    Following the WHO initiative named World Alliance for Patient Safety (PS) launched in 2004 a conceptual framework developed by PS national reporting experts has summarized the knowledge available. As a second step, the Department of Public Health of the University of Saint Etienne team elaborated a Categorial Structure (a semi formal structure not related to an upper level ontology) identifying the elements of the semantic structure underpinning the broad concepts contained in the framework for patient safety. This knowledge engineering method has been developed to enable modeling patient safety information as a prerequisite for subsequent full ontology development. The present article describes the semantic dissection of the concepts, the elicitation of the ontology requirements and the domain constraints of the conceptual framework. This ontology includes 134 concepts and 25 distinct relations and will serve as basis for an Information Model for Patient Safety.

  8. Secondary Sclerosing Cholangitis in Critically Ill Patients: Clinical Presentation, Cholangiographic Features, Natural History, and Outcome

    Science.gov (United States)

    Leonhardt, Silke; Veltzke-Schlieker, Wilfried; Adler, Andreas; Schott, Eckart; Eurich, Dennis; Faber, Wladimir; Neuhaus, Peter; Seehofer, Daniel

    2015-01-01

    Abstract 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

  9. Automated patient and medication payment method for clinical trials

    Directory of Open Access Journals (Sweden)

    Yawn BP

    2013-01-01

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

  10. 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

    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......BACKGROUND: BRCA2 germ-line mutations predispose to breast and ovarian cancer. Mutations are widespread and unclassified splice variants are frequently encountered. We describe the parental origin and functional characterization of a novel de novo BRCA2 splice site mutation found in a patient...... 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...

  11. Suicide among Young People and Adults in Ireland: Method Characteristics, Toxicological Analysis and Substance Abuse Histories Compared.

    Science.gov (United States)

    Arensman, Ella; Bennardi, Marco; Larkin, Celine; Wall, Amanda; McAuliffe, Carmel; McCarthy, Jacklyn; Williamson, Eileen; Perry, Ivan J

    2016-01-01

    Information on factors associated with suicide among young individuals in Ireland is limited. The aim of this study was to identify socio-demographic characteristics and circumstances of death associated with age among individuals who died by suicide. The study examined 121 consecutive suicides (2007-2012) occurring in the southern eastern part of Ireland (Cork city and county). Data were obtained from coroners, family informants, and health care professionals. A comparison was made between 15-24-year-old and 25-34-year-old individuals. Socio-demographic characteristics of the deceased, methods of suicide, history of alcohol and drug abuse, and findings from toxicological analysis of blood and urine samples taken at post mortem were included. Pearson's χ2 tests and binary logistic regression analysis were performed. Alcohol and/or drugs were detected through toxicological analysis for the majority of the total sample (79.5%), which did not differentiate between 15-24-year-old and 25-34-year-old individuals (74.1% and 86.2% respectively). Compared to 25-34-year-old individuals, 15-24-year-old individuals were more likely to engage in suicide by hanging (88.5%). Younger individuals were less likely to die by intentional drug overdose and carbon monoxide poisoning compared to older individuals. Younger individuals who died between Saturday and Monday were more likely to have had alcohol before dying. Substance abuse histories were similar in the two age groups. Based on this research it is recommended that strategies to reduce substance abuse be applied among 25-34-year-old individuals at risk of suicide. The wide use of hanging in young people should be taken into consideration for future means restriction strategies.

  12. Suicide among Young People and Adults in Ireland: Method Characteristics, Toxicological Analysis and Substance Abuse Histories Compared.

    Directory of Open Access Journals (Sweden)

    Ella Arensman

    Full Text Available Information on factors associated with suicide among young individuals in Ireland is limited. The aim of this study was to identify socio-demographic characteristics and circumstances of death associated with age among individuals who died by suicide.The study examined 121 consecutive suicides (2007-2012 occurring in the southern eastern part of Ireland (Cork city and county. Data were obtained from coroners, family informants, and health care professionals. A comparison was made between 15-24-year-old and 25-34-year-old individuals. Socio-demographic characteristics of the deceased, methods of suicide, history of alcohol and drug abuse, and findings from toxicological analysis of blood and urine samples taken at post mortem were included. Pearson's χ2 tests and binary logistic regression analysis were performed.Alcohol and/or drugs were detected through toxicological analysis for the majority of the total sample (79.5%, which did not differentiate between 15-24-year-old and 25-34-year-old individuals (74.1% and 86.2% respectively. Compared to 25-34-year-old individuals, 15-24-year-old individuals were more likely to engage in suicide by hanging (88.5%. Younger individuals were less likely to die by intentional drug overdose and carbon monoxide poisoning compared to older individuals. Younger individuals who died between Saturday and Monday were more likely to have had alcohol before dying. Substance abuse histories were similar in the two age groups.Based on this research it is recommended that strategies to reduce substance abuse be applied among 25-34-year-old individuals at risk of suicide. The wide use of hanging in young people should be taken into consideration for future means restriction strategies.

  13. 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

  14. Targeted methods for measuring patient satisfaction in a radiological center

    International Nuclear Information System (INIS)

    Maurer, M.H.; Stein, E.; Schreiter, N.F.; Renz, D.M.; Poellinger, A.

    2010-01-01

    Purpose: To investigate two event-oriented methods for evaluating patient satisfaction with radiological services like outpatient computed tomography (CT) examinations. Materials and Methods: 159 patients (55 % men, 45 % women) were asked to complete a questionnaire to provide information about their satisfaction with their examination. At first, patients were asked to spontaneously recall notably positive and negative aspects (so-called 'critical incidents', critical incident technique = CIT) of the examination. Subsequently a flow chart containing all single steps of the examination procedure was shown to all patients. They were asked to point out the positive and negative aspects they perceived at each step (so-called sequential incident technique = SIT). Results: The CIT-based part of the questionnaire yielded 356 comments (183 positive and 173 negative), which were assigned to one of four categories: interaction of staff with patient, procedure and organization, CT examination, and overall setting of the examination. Significantly more detailed comments regarding individual aspects of the CT examination were elicited in the second part of the survey, which was based on the SIT. There were 1413 statements with a significantly higher number of positive comments (n = 939, 66 %) versus negative comments (n = 474, 34 %; p < 0.001). Conclusion: The critical and sequential incident techniques are suitable to measure the subjective satisfaction with the delivery of radiological services such as CT examinations. Positive comments confirm the adequacy of the existing procedures, while negative comments provide direct information about how service quality can be improved. (orig.)

  15. Prediction of broadband ground-motion time histories: Hybrid low/high-frequency method with correlated random source parameters

    Science.gov (United States)

    Liu, P.; Archuleta, R.J.; Hartzell, S.H.

    2006-01-01

    We present a new method for calculating broadband time histories of ground motion based on a hybrid low-frequency/high-frequency approach with correlated source parameters. Using a finite-difference method we calculate low- frequency synthetics (structure. We also compute broadband synthetics in a 1D velocity model using a frequency-wavenumber method. The low frequencies from the 3D calculation are combined with the high frequencies from the 1D calculation by using matched filtering at a crossover frequency of 1 Hz. The source description, common to both the 1D and 3D synthetics, is based on correlated random distributions for the slip amplitude, rupture velocity, and rise time on the fault. This source description allows for the specification of source parameters independent of any a priori inversion results. In our broadband modeling we include correlation between slip amplitude, rupture velocity, and rise time, as suggested by dynamic fault modeling. The method of using correlated random source parameters is flexible and can be easily modified to adjust to our changing understanding of earthquake ruptures. A realistic attenuation model is common to both the 3D and 1D calculations that form the low- and high-frequency components of the broadband synthetics. The value of Q is a function of the local shear-wave velocity. To produce more accurate high-frequency amplitudes and durations, the 1D synthetics are corrected with a randomized, frequency-dependent radiation pattern. The 1D synthetics are further corrected for local site and nonlinear soil effects by using a 1D nonlinear propagation code and generic velocity structure appropriate for the site’s National Earthquake Hazards Reduction Program (NEHRP) site classification. The entire procedure is validated by comparison with the 1994 Northridge, California, strong ground motion data set. The bias and error found here for response spectral acceleration are similar to the best results that have been published by

  16. Life-History Traits of the Model Organism Pristionchus pacificus Recorded Using the Hanging Drop Method: Comparison with Caenorhabditis elegans.

    Science.gov (United States)

    Gilarte, Patricia; Kreuzinger-Janik, Bianca; Majdi, Nabil; Traunspurger, Walter

    2015-01-01

    The nematode Pristionchus pacificus is of growing interest as a model organism in evolutionary biology. However, despite multiple studies of its genetics, developmental cues, and ecology, the basic life-history traits (LHTs) of P. pacificus remain unknown. In this study, we used the hanging drop method to follow P. pacificus at the individual level and thereby quantify its LHTs. This approach allowed direct comparisons with the LHTs of Caenorhabditis elegans recently determined using this method. When provided with 5×10(9) Escherichia coli cells ml(-1) at 20°C, the intrinsic rate of natural increase of P. pacificus was 1.125 (individually, per day); mean net production was 115 juveniles produced during the life-time of each individual, and each nematode laid an average of 270 eggs (both fertile and unfertile). The mean age of P. pacificus individuals at first reproduction was 65 h, and the average life span was 22 days. The life cycle of P. pacificus is therefore slightly longer than that of C. elegans, with a longer average life span and hatching time and the production of fewer progeny.

  17. Life-History Traits of the Model Organism Pristionchus pacificus Recorded Using the Hanging Drop Method: Comparison with Caenorhabditis elegans.

    Directory of Open Access Journals (Sweden)

    Patricia Gilarte

    Full Text Available The nematode Pristionchus pacificus is of growing interest as a model organism in evolutionary biology. However, despite multiple studies of its genetics, developmental cues, and ecology, the basic life-history traits (LHTs of P. pacificus remain unknown. In this study, we used the hanging drop method to follow P. pacificus at the individual level and thereby quantify its LHTs. This approach allowed direct comparisons with the LHTs of Caenorhabditis elegans recently determined using this method. When provided with 5×10(9 Escherichia coli cells ml(-1 at 20°C, the intrinsic rate of natural increase of P. pacificus was 1.125 (individually, per day; mean net production was 115 juveniles produced during the life-time of each individual, and each nematode laid an average of 270 eggs (both fertile and unfertile. The mean age of P. pacificus individuals at first reproduction was 65 h, and the average life span was 22 days. The life cycle of P. pacificus is therefore slightly longer than that of C. elegans, with a longer average life span and hatching time and the production of fewer progeny.

  18. Determining individual variation in growth and its implication for life-history and population processes using the empirical Bayes method.

    Directory of Open Access Journals (Sweden)

    Simone Vincenzi

    2014-09-01

    Full Text Available The differences in demographic and life-history processes between organisms living in the same population have important consequences for ecological and evolutionary dynamics. Modern statistical and computational methods allow the investigation of individual and shared (among homogeneous groups determinants of the observed variation in growth. We use an Empirical Bayes approach to estimate individual and shared variation in somatic growth using a von Bertalanffy growth model with random effects. To illustrate the power and generality of the method, we consider two populations of marble trout Salmo marmoratus living in Slovenian streams, where individually tagged fish have been sampled for more than 15 years. We use year-of-birth cohort, population density during the first year of life, and individual random effects as potential predictors of the von Bertalanffy growth function's parameters k (rate of growth and L∞ (asymptotic size. Our results showed that size ranks were largely maintained throughout marble trout lifetime in both populations. According to the Akaike Information Criterion (AIC, the best models showed different growth patterns for year-of-birth cohorts as well as the existence of substantial individual variation in growth trajectories after accounting for the cohort effect. For both populations, models including density during the first year of life showed that growth tended to decrease with increasing population density early in life. Model validation showed that predictions of individual growth trajectories using the random-effects model were more accurate than predictions based on mean size-at-age of fish.

  19. Determining individual variation in growth and its implication for life-history and population processes using the empirical Bayes method.

    Science.gov (United States)

    Vincenzi, Simone; Mangel, Marc; Crivelli, Alain J; Munch, Stephan; Skaug, Hans J

    2014-09-01

    The differences in demographic and life-history processes between organisms living in the same population have important consequences for ecological and evolutionary dynamics. Modern statistical and computational methods allow the investigation of individual and shared (among homogeneous groups) determinants of the observed variation in growth. We use an Empirical Bayes approach to estimate individual and shared variation in somatic growth using a von Bertalanffy growth model with random effects. To illustrate the power and generality of the method, we consider two populations of marble trout Salmo marmoratus living in Slovenian streams, where individually tagged fish have been sampled for more than 15 years. We use year-of-birth cohort, population density during the first year of life, and individual random effects as potential predictors of the von Bertalanffy growth function's parameters k (rate of growth) and L∞ (asymptotic size). Our results showed that size ranks were largely maintained throughout marble trout lifetime in both populations. According to the Akaike Information Criterion (AIC), the best models showed different growth patterns for year-of-birth cohorts as well as the existence of substantial individual variation in growth trajectories after accounting for the cohort effect. For both populations, models including density during the first year of life showed that growth tended to decrease with increasing population density early in life. Model validation showed that predictions of individual growth trajectories using the random-effects model were more accurate than predictions based on mean size-at-age of fish.

  20. 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

    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 between the data...

  1. Phenotypes of COPD patients with a smoking history in Central and Eastern Europe: the POPE Study

    Science.gov (United States)

    Koblizek, Vladimir; Milenkovic, Branislava; Barczyk, Adam; Tkacova, Ruzena; Somfay, Attila; Zykov, Kirill; Tudoric, Neven; Kostov, Kosta; Zbozinkova, Zuzana; Svancara, Jan; Sorli, Jurij; Krams, Alvils; Miravitlles, Marc

    2017-01-01

    Chronic obstructive pulmonary disease (COPD) represents a major health problem in Central and Eastern European (CEE) countries; however, there are no data regarding clinical phenotypes of these patients in this region. Participation in the Phenotypes of COPD in Central and Eastern Europe (POPE) study was offered to stable patients with COPD in a real-life setting. The primary aim of this study was to assess the prevalence of phenotypes according to predefined criteria. Secondary aims included analysis of differences in symptom load, comorbidities and pharmacological treatment. 3362 patients with COPD were recruited in 10 CEE countries. 63% of the population were nonexacerbators, 20.4% frequent exacerbators with chronic bronchitis, 9.5% frequent exacerbators without chronic bronchitis and 6.9% were classified as asthma–COPD overlap. Differences in the distribution of phenotypes between countries were observed, with the highest heterogeneity observed in the nonexacerbator cohort and the lowest heterogeneity observed in the asthma–COPD cohort. There were statistically significant differences in symptom load, lung function, comorbidities and treatment between these phenotypes. The majority of patients with stable COPD in CEE are nonexacerbators; however, there are distinct differences in surrogates of disease severity and therapy between predefined COPD phenotypes. PMID:28495687

  2. Brucellosis With Multi-Organ Involvement in a Patient With History of Composite Aortic Graft and Hepatitis B.

    Science.gov (United States)

    Dehghan Manshadi, Seyed Ali; Rezahosseini, Omid; Abdi Liaei, Zahra

    2016-11-01

    The brucellosis with multi-organ involvement in a patient with a history of the composite aortic graft (Bentall procedure) and Hepatitis B infection is rare. A 35-year-old man presented to us with fever and loss of consciousness. Four years ago, he was IDU and underwent cardiac surgery because of endocarditis. Recently lumbar spondylodiscitis was diagnosed. The Wright (1/320) and Coombs Wright tests (1/640) were positive. After CNS imaging, lumbar puncture was done. The CSF pleocytosis was lymphocyte dominant. In cardiac echocardiography, large vegetation on prosthetic aortic valve leaflets was seen. The brain MRI was reported abnormal. Treatment of brucellosis started with Ceftriaxone, Doxycycline, Rifampin and Gentamycin. After 4 days, he became oriented, and fever was disappeared then we continued the treatment for 16 days. The patient discharged and followed by daily phone calls. As symptoms of abdominal pain and jaundice were presented on the fifth day, he re-admitted. The patient expired because of hepatorenal and cardiac insufficiency. Drug side effects, activation of Hepatitis B and embolism of cardiac vegetation to other organs were suspected causes of death. We do not suggest medical therapy without cardiac surgery in such cases. When combination therapy is necessary for brucellosis in an HBsAg-positive patient, hepatitis virus activity should be assess by HBV-DNA PCR and the dose of drugs with known hepatotoxic effects such as rifampin and co-trimoxazole should be adjust. Combination therapy with quinolones instead of hepatoxic drugs is one of our suggustions.

  3. 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.

  4. Investigation on Carbohydrate Counting Method in Type 1 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Osman Son

    2014-01-01

    Full Text Available Objective. The results from Diabetes Control and Complications Trial (DCCT have propounded the importance of the approach of treatment by medical nutrition when treating diabetes mellitus (DM. During this study, we tried to inquire carbohydrate (Kh count method’s positive effects on the type 1 DM treatment’s success as well as on the life quality of the patients. Methods. 22 of 37 type 1 DM patients who applied to Eskişehir Osmangazi University, Faculty of Medicine Hospital, Department of Endocrinology and Metabolism, had been treated by Kh count method and 15 of them are treated by multiple dosage intensive insulin treatment with applying standard diabetic diet as a control group and both of groups were under close follow-up for 6 months. Required approval was taken from the Ethical Committee of Eskişehir Osmangazi University, Medical Faculty, as well as informed consent from the patients. The body weight of patients who are treated by carbohydrate count method and multiple dosage intensive insulin treatment during the study beginning and after 6-month term, body mass index, and body compositions are analyzed. A short life quality and medical research survey applied. At statistical analysis, t-test, chi-squared test, and Mann-Whitney U test were used. Results. There had been no significant change determined at glycemic control indicators between the Kh counting group and the standard diabetic diet and multiple dosage insulin treatment group in our study. Conclusion. As a result, Kh counting method which offers a flexible nutrition plan to diabetic individuals is a functional method.

  5. Illnesses in siblings of US patients with bipolar disorder relate to multigenerational family history and patients severity of illness

    NARCIS (Netherlands)

    Post, Robert M.; Altshuler, Lori L.; Kupka, Ralph; McElroy, Susan L.; Frye, Mark A.; Rowe, Michael; Grunze, Heinz; Suppes, Trisha; Keck, Paul E.; Nolen, Willem A.

    2017-01-01

    Background: Patients with bipolar disorder from the US have more early-onset illness and a greater familial loading for psychiatric problems than those from the Netherlands or Germany (abbreviated here as Europe). We hypothesized that these regional differences in illness burden would extend to the

  6. "Take Me through the History of Your Weight": Using Qualitative Interviews to Create Personalized Weight Trajectories to Understand the Development of Obesity in Patients Preparing for Bariatric Surgery.

    Science.gov (United States)

    Lynch, Amanda I; McGowan, Elizabeth; Zalesin, Kerstyn C

    2018-03-15

    Obesity can develop during any life stage. Understanding the contexts within which obesity develops can inform our understanding of the disease and help tailor interventions specific to life stages. Using life-course theory as a guiding framework, this study aimed to explain the development of obesity in bariatric surgery patients by creating personalized weight trajectories. Qualitative methods using semistructured interviews were used to uncover participants' experiences with and explanations for the development of obesity. A grounded theory approach using the constant comparative method was used to analyze transcripts for categories and themes. Thirty pre-bariatric surgery patients (24 women, 6 men) were recruited from a bariatric surgery center; 25 participants were available for follow-up. Participants were interviewed before surgery and at 6 and 12 months postsurgery. Four weight history groups were created based on patterns of weight changes from adolescence through adulthood: Always Heavy, Late Peak, Steady Progression, and Weight Cycling. Participants' explanations for weight changes centered around themes of transitions and life-course events or stressors. Differences in the weight history groups could be explained by the timing of transitions, life events, and responses to stress. The development of obesity does not follow the same pattern for all individuals. Weight gain patterns can be explained by the timing of life-course events, stressors, and the type and effects of environmental transitions. Weight management counseling should include strategies tailored to an individual's current life-stage and circumstance, but also acknowledge previous responses to transitions and stressors. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  7. Update History of This Database - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available List Contact us PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods ...B link & Genome analysis methods English archive site is opened. 2012/08/08 PGDBj... Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods is opened. About This...ate History of This Database - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive ...

  8. Early maladaptive schemas of emotional deprivation, social isolation, shame and abandonment are related to a history of suicide attempts among patients with major depressive disorders.

    Science.gov (United States)

    Ahmadpanah, Mohammad; Astinsadaf, Sommayyeh; Akhondi, Amineh; Haghighi, Mohammad; Sadeghi Bahmani, Dena; Nazaribadie, Marzieh; Jahangard, Leila; Holsboer-Trachsler, Edith; Brand, Serge

    2017-08-01

    Patients with psychiatric disorders have an exceptionally high risk of completed or attempted suicide. This holds particularly true for patients with major depressive disorders. The aim of the present study was to explore whether patients with major depressive disorders (MDD) and a history of suicide attempts differed in their early maladaptive schemas from patients with MDD but without such a history or from healthy controls. Ninety participants took part in the study. Of these, 30 were patients with MDD who had made a recent suicide attempt; 30 were patients with MDD but no suicide attempts, and 30 were gender- and age-matched healthy controls. Participants completed questionnaires covering socio-demographic characteristics and the Young Schema Questionnaire (YSQ- RE2R) to assess early maladaptive schemas. Experts rated patients' MDD with the Montgomery-Asberg Depression Rating Scale. Patients did not differ in experts' ratings of symptoms of depression. Compared to healthy controls, patients with MDD recorded higher scores on maladaptive schemas such as recognition seeking, negativity/pessimism, and insufficient self-control. Compared to patients without suicide attempts and healthy controls, those who had made a suicide attempt had higher scores on dimensions such as failure, mistrust, emotional inhibition, social isolation, and abandonment/instability. Compared to healthy controls, patients with MDD had more pronounced maladaptive schemas, but this was more marked in patients with a history of suicide attempts. The results suggest that suicide attempts and poorer psychological functioning are related. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. 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. © The Author(s) 2016.

  10. Bupropion perceived as a stimulant by two patients with a previous history of cocaine misuse

    Directory of Open Access Journals (Sweden)

    Alessandro E. Vento

    2013-12-01

    Full Text Available BACKGROUND AND OBJECTIVE: Despite animal studies having shown a generalisation of the bupropion cue to cocaine, this drug has been used in cocaine abuse with mixed results. We here aimed at describing two cases which contradict current knowledge. CASE REPORTS: We describe two cases of former cocaine abusers who reported a cocaine-like sensation upon taking bupropion. Bupropion improved patients' depression without any increase in cocaine craving. One of the patients increased without doctor consultation his dose on an as needed basis. CONCLUSIONS: The issue of bupropion cue generalisation to cocaine needs further elucidation. People with past cocaine addiction need to be informed on the potential of bupropion to elicit cocaine-like cues and be invited to adhere to medical prescription, because bupropion has been associated with fatalities in some cases.

  11. Metabolic and cardiovascular risk in patients with a history of differentiated thyroid carcinoma: A case-controlled cohort study.

    Science.gov (United States)

    Giusti, Massimo; Mortara, Lorenzo; Degrandi, Roberta; Cecoli, Francesca; Mussap, Michele; Rodriguez, Guido; Ferone, Diego; Minuto, Francesco

    2008-09-29

    Hyperthyroidism seems to increase metabolic and cardiovascular risk, while the effects of sub-clinical hyperthyroidism are controversial. We evaluated metabolic and cardiovascular parameters in differentiated thyroid carcinoma (DTC) patients with suppressed thyrotropin (TSH) due to levo-thyroxine (L-T4) therapy. We studied DTC patients and, as a control group, patients with a history of surgery for non-malignant thyroid pathology. Significantly higher insulin and lower HDL-cholesterol levels were recorded in DTC subjects. In both groups, insulin levels were significantly related with body mass index (BMI) but not with age or L-T4 dosage. In DTC patients, a significant negative correlation was seen between HDL-cholesterol and BMI or L-T4 dosage. In both groups, intima-media thickness (IMT) correlated positively with age, BMI, glucose levels and systolic blood pressure. In DTC patients, increased IMT was significantly correlated with glycated hemoglobin (HbA1c), cholesterol and triglycerides. In DTC patients, C-reactive protein correlated positively with insulin, insulin resistance, triglycerides and systolic blood pressure, and negatively with HDL-cholesterol. In both DTC and control subjects, fibrinogen correlated positively with age, BMI, increased IMT, HbA1c and systolic blood pressure. In DTC subjects, plasma fibrinogen concentrations correlated positively with insulin resistance, cholesterol and LDL-cholesterol, and negatively with TSH levels. Our data confirm that the favorable evolution of DTC can be impaired by a high incidence of abnormal metabolic and cardiovascular data that are, at least in part, related to L-T4 therapy. These findings underline the need for adequate L-T4 titration.

  12. Metabolic and cardiovascular risk in patients with a history of differentiated thyroid carcinoma: A case-controlled cohort study

    Directory of Open Access Journals (Sweden)

    Giusti Massimo

    2008-09-01

    Full Text Available Abstract Hyperthyroidism seems to increase metabolic and cardiovascular risk, while the effects of sub-clinical hyperthyroidism are controversial. We evaluated metabolic and cardiovascular parameters in differentiated thyroid carcinoma (DTC patients with suppressed thyrotropin (TSH due to levo-thyroxine (L-T4 therapy. We studied DTC patients and, as a control group, patients with a history of surgery for non-malignant thyroid pathology. Significantly higher insulin and lower HDL-cholesterol levels were recorded in DTC subjects. In both groups, insulin levels were significantly related with body mass index (BMI but not with age or L-T4 dosage. In DTC patients, a significant negative correlation was seen between HDL-cholesterol and BMI or L-T4 dosage. In both groups, intima-media thickness (IMT correlated positively with age, BMI, glucose levels and systolic blood pressure. In DTC patients, increased IMT was significantly correlated with glycated hemoglobin (HbA1c, cholesterol and triglycerides. In DTC patients, C-reactive protein correlated positively with insulin, insulin resistance, triglycerides and systolic blood pressure, and negatively with HDL-cholesterol. In both DTC and control subjects, fibrinogen correlated positively with age, BMI, increased IMT, HbA1c and systolic blood pressure. In DTC subjects, plasma fibrinogen concentrations correlated positively with insulin resistance, cholesterol and LDL-cholesterol, and negatively with TSH levels. Our data confirm that the favorable evolution of DTC can be impaired by a high incidence of abnormal metabolic and cardiovascular data that are, at least in part, related to L-T4 therapy. These findings underline the need for adequate L-T4 titration.

  13. An configuration method of patient service cloud for the home patient with multi sensor network

    International Nuclear Information System (INIS)

    Noji, Tamotsu; Arino, Masashi; Saito, Mayuko; Horii, Minoru; Ogino, Tadashi; Suto, Yasuzo; Sasaki, Hitoshi; Mansei, Kouiti

    2010-01-01

    We are advancing the research of patient service cloud in the global medical collaboration network system based on 3D electronic referral letters. In this paper it proposes one configuration method of private cloud that aims at the home care patient's health care and independence support based on voice navigation system (VONAVS). We evaluate 3D image compression rate, try image compositing Cloud's configuration by the multi sensor network, and search for the configuration method of the remote image diagnosis. The proposed configuration method expands the possibility to the global medical collaboration network system for new large areas such as a telemedicine, an emergency care, and home medical care. (author)

  14. Economic evaluation in patient safety: a literature review of methods.

    Science.gov (United States)

    de Rezende, Bruna Alves; Or, Zeynep; Com-Ruelle, Laure; Michel, Philippe

    2012-06-01

    Patient safety practices, targeting organisational changes for improving patient safety, are implemented worldwide but their costs are rarely evaluated. This paper provides a review of the methods used in economic evaluation of such practices. International medical and economics databases were searched for peer-reviewed publications on economic evaluations of patient safety between 2000 and 2010 in English and French. This was complemented by a manual search of the reference lists of relevant papers. Grey literature was excluded. Studies were described using a standardised template and assessed independently by two researchers according to six quality criteria. 33 articles were reviewed that were representative of different patient safety domains, data types and evaluation methods. 18 estimated the economic burden of adverse events, 3 measured the costs of patient safety practices and 12 provided complete economic evaluations. Healthcare-associated infections were the most common subject of evaluation, followed by medication-related errors and all types of adverse events. Of these, 10 were selected that had adequately fulfilled one or several key quality criteria for illustration. This review shows that full cost-benefit/utility evaluations are rarely completed as they are resource intensive and often require unavailable data; some overcome these difficulties by performing stochastic modelling and by using secondary sources. Low methodological transparency can be a problem for building evidence from available economic evaluations. Investing in the economic design and reporting of studies with more emphasis on defining study perspectives, data collection and methodological choices could be helpful for strengthening our knowledge base on practices for improving patient safety.

  15. Radiology clinical synopsis: a simple solution for obtaining an adequate clinical history for the accurate reporting of imaging studies on patients in intensive care units

    International Nuclear Information System (INIS)

    Cohen, Mervyn D.; Alam, Khurshaid

    2005-01-01

    Lack of clinical history on radiology requisitions is a universal problem. We describe a simple Web-based system that readily provides radiology-relevant clinical history to the radiologist reading radiographs of intensive care unit (ICU) patients. Along with the relevant history, which includes primary and secondary diagnoses, disease progression and complications, the system provides the patient's name, record number and hospital location. This information is immediately available to reporting radiologists. New clinical information is immediately entered on-line by the radiologists as they are reviewing images. After patient discharge, the data are stored and immediately available if the patient is readmitted. The system has been in routine clinical use in our hospital for nearly 2 years. (orig.)

  16. History of the Buttonhole Technique.

    Science.gov (United States)

    Misra, Madhukar

    2015-01-01

    The constant side method of access cannulation in hemodialysis, popularly known as the 'buttonhole' method, has an interesting history. Dr. Zbylut J. Twardowski, a Polish nephrologist, discovered this technique by pure serendipity in 1972. A patient with a complicated vascular access history and limited options for cannulation was repeatedly 'stuck' at the same sites by a nurse. Soon it was noticed that the cannulation at the same spot became easier with time. Since the needles were being reused, the sharpness of the needles decreased with time and the bluntness of the needle seemed to minimize the damage to the cannulation tract (another serendipity!). This method soon became popular among patients, and many patients started using this technique. This chapter traces the invention of this technique and its subsequent development following Dr. Twardowski's emigration to the USA. © 2015 S. Karger AG, Basel.

  17. Effect of a family history of psoriasis and age on comorbidities and quality of life in patients with moderate to severe psoriasis: Results from the ARIZONA study.

    Science.gov (United States)

    López-Estebaranz, Jose Luis; Sánchez-Carazo, Jose Luis; Sulleiro, Sara

    2016-04-01

    Psoriasis is a chronic inflammatory skin disease whose clinical characteristics vary from patient to patient. We aimed to analyze how comorbidities and quality of life (QoL, as per the Dermatology Life Quality Index [DLQI]) may be affected by a family history of psoriasis and by age. The ARIZONA study was a multicenter, cross-sectional study in 1022 adult patients diagnosed with moderate to severe psoriasis at least 6 months prior to inclusion. The severity of psoriasis and the proportion of patients with comorbidities were not affected by the presence of a family history. The regression analysis revealed that the presence of a family history of psoriasis was associated with the effect on the patient's QoL (P = 0.002), regardless of disease severity. The mean DLQI total score varied significantly across age groups (5.1 ± 5.3 for the 18-30-year group, 5.7 ± 6.5 for the 31-60-year group and 3.8 ± 5.1 for the >60-year group; P = 0.001). In conclusion, the presence of a family history of psoriasis appears to disrupt QoL in patients with moderate to severe psoriasis, but it hardly affected the prevalence of comorbid conditions. The effect of age on QoL was particularly noticeable in younger patients, highlighting its negative impact. As expected, older patients appeared to be burdened with a higher number of comorbidities than their younger counterparts. © 2015 Japanese Dermatological Association.

  18. BRCA mutation carrier detection. A model-based cost-effectiveness analysis comparing the traditional family history approach and the testing of all patients with breast cancer

    Science.gov (United States)

    Norum, Jan; Grindedal, Eli Marie; Heramb, Cecilie; Karsrud, Inga; Ariansen, Sarah Louise; Undlien, Dag Erik; Schlichting, Ellen; Mæhle, Lovise

    2018-01-01

    Background Identification of BRCA mutation carriers among patients with breast cancer (BC) involves costs and gains. Testing has been performed according to international guidelines, focusing on family history (FH) of breast and/or ovarian cancer. An alternative is testing all patients with BC employing sequencing of the BRCA genes and Multiplex Ligation Probe Amplification (MLPA). Patients and methods A model-based cost-effectiveness analysis, employing data from Oslo University Hospital, Ullevål (OUH-U) and a decision tree, was done. The societal and the healthcare perspectives were focused and a lifetime perspective employed. The comparators were the traditional FH approach used as standard of care at OUH-U in 2013 and the intervention (testing all patients with BC) performed in 2014 and 2015 at the same hospital. During the latter period, 535 patients with BC were offered BRCA testing with sequencing and MLPA. National 2014 data on mortality rates and costs were implemented, a 3% discount rate used and the costing year was 2015. The incremental cost-effectiveness ratio was calculated in euros (€) per life-year gained (LYG). Results The net healthcare cost (healthcare perspective) was €40 503/LYG. Including all resource use (societal perspective), the cost was €5669/LYG. The univariate sensitivity analysis documented the unit cost of the BRCA test and the number of LYGs the prominent parameters affecting the result. Diagnostic BRCA testing of all patients with BC was superior to the FH approach and cost-effective within the frequently used thresholds (healthcare perspective) in Norway (€60 000–€80 000/LYG). PMID:29682331

  19. ANALYSIS OF MUTATIONS OF TUBERCULOUS MYCOBACTERIA DEFINING DRUG RESISTANCE IN HIV POSITIVE AND HIV NEGATIVE TUBERCULOSIS PATIENTS WITHOUT PRIOR HISTORY OF TREATMENT IN SVERDLOVSK REGION

    Directory of Open Access Journals (Sweden)

    G. V. Panov

    2017-01-01

    Full Text Available Goal of the study: to identify profile of mutations of tuberculous mycobacteria responsible for resistance to anti-tuberculosis drugs in HIV positive and HIV negative tuberculosis patients without prior history of treatment.Materials and methods. 165 strains of tuberculous mycobacteria from HIV positive patients and 166 strains of tuberculous mycobacteria from HIV negative patients were studied in Sverdlovsk Region (TB Dispensary, Yekaterinburg. Mutations in genes were identified using microchips of TB-BIOCHIP® and TB-BIOCHIP®-2 in compliance with the manufacturer's guidelines (OOO Biochip-IMB, Moscow.Results. It was observed that 85/165 (51.52% strains isolated from HIV positive tuberculosis patients and 58/166 (34.94% strains isolated from tuberculosis patients not associated with HIV possessed MDR genotype (p < 0.01. The majority of MDR strains had mutations in the 531th codon of rpoB (Ser→Leu and 315th codon of katG (Ser→Thr (64/85, 75.29% and 38/58, 65.52% respective the groups, resulting in the high level of resistance to rifampicin and isoniazid. Each group also had approximately equal ratio (11/165, 6.67% and 12/166, 7.23% respective the groups of strains with genomic mutations defining the resistance to isoniazid, rifampicin and fluoruquinolones. No confident difference was found in mutation patterns of genome of tuberculous mycobacteria isolated from HIV positive and HIV negative tuberculosis patients

  20. Use of observation followed by outpatient stress testing in chest pain patients with prior coronary artery disease history: An evaluation of prognostic utility.

    Science.gov (United States)

    Khalil, Yasser; Schwartz, Melvin H; Pandey, Prasant S; Abdul Latif, Maida S; Matsumura, Martin E

    2015-06-01

    To determine the outcomes of patients with chest pain (CP) and prior history of coronary artery disease (CAD) managed with observation followed by outpatient stress myocardial perfusion imaging (MPI). Retrospective analysis of patients with CP managed with observation followed by outpatient stress MPI, comparing cardiovascular (CV) event rates stratified by CAD history. 375 patients were included: 111 with and 264 without a CAD history. All patients underwent outpatient stress MPI within 72 h of observation. MPI identified patients at risk for CV events. However, while patients with negative MPI and without a CAD history had very low rates of short- and long-term CAD events (0.8%, 0.8%, and 1.3% at 30 days, 1 year, and 3 years, respectively), event rates of those with a negative test but a CAD history were significantly higher (2.6%, 5.3%, and 6.6% at 30 days, 1 year and 3 years, respectively; p = 0.044 and p = 0.034 compared to CAD- patients at 1 year and 3 years, respectively). In a multivariable logistic regression model, a positive MPI proved to be an independent predictor of long-term CV events in patients with CP and prior CAD. Observation followed by stress MPI can effectively risk stratify CP patients with prior CAD for CV risk. These patients are at increased risk of CV events even after a low-risk stress MPI study. Patients presenting with CP and managed with a strategy of observation followed by a negative stress MPI warrant close short- and long-term monitoring for recurrent events.

  1. A study on the natural history of scanning behaviour in patients with visual field defects after stroke.

    Science.gov (United States)

    Loetscher, Tobias; Chen, Celia; Wignall, Sophie; Bulling, Andreas; Hoppe, Sabrina; Churches, Owen; Thomas, Nicole A; Nicholls, Michael E R; Lee, Andrew

    2015-04-24

    A visual field defect (VFD) is a common consequence of stroke with a detrimental effect upon the survivors' functional ability and quality of life. The identification of effective treatments for VFD is a key priority relating to life post-stroke. Understanding the natural evolution of scanning compensation over time may have important ramifications for the development of efficacious therapies. The study aims to unravel the natural history of visual scanning behaviour in patients with VFD. The assessment of scanning patterns in the acute to chronic stages of stroke will reveal who does and does not learn to compensate for vision loss. Eye-tracking glasses are used to delineate eye movements in a cohort of 100 stroke patients immediately after stroke, and additionally at 6 and 12 months post-stroke. The longitudinal study will assess eye movements in static (sitting) and dynamic (walking) conditions. The primary outcome constitutes the change of lateral eye movements from the acute to chronic stages of stroke. Secondary outcomes include changes of lateral eye movements over time as a function of subgroup characteristics, such as side of VFD, stroke location, stroke severity and cognitive functioning. The longitudinal comparison of patients who do and do not learn compensatory scanning techniques may reveal important prognostic markers of natural recovery. Importantly, it may also help to determine the most effective treatment window for visual rehabilitation.

  2. Systematic review of bariatric surgery liver biopsies clarifies the natural history of liver disease in patients with severe obesity.

    Science.gov (United States)

    Bedossa, Pierre; Tordjman, Joan; Aron-Wisnewsky, Judith; Poitou, Christine; Oppert, Jean-Michel; Torcivia, Adriana; Bouillot, Jean-Luc; Paradis, Valerie; Ratziu, Vlad; Clément, Karine

    2017-09-01

    Non-alcoholic fatty liver disease (NAFLD) is a frequent complication of morbid obesity, but its severity varies greatly and thus there is a strong need to better define its natural history in these patients. Liver biopsies were systematically performed in 798 consecutive patients with severe obesity undergoing bariatric surgery. Histology was compared with clinical, biological, anthropometrical and body composition characteristics. Patients with presumably normal liver (n=179, 22%) were significantly younger at bariatric surgery than patients with NAFLD (37.0 vs 44.4 years, pliver reported the onset of obesity at a significantly younger age than those with NAFLD (14.8 vs 20.0 year, pliver disease severity (presumably normal liver: 1.00, steatosis: 1.21, non-alcoholic steatohepatitis (NASH): 1.34, pliver: 50%, steatosis: 49.1%, NASH: 47.4%, pliver disease but only in female patients (presumably normal liver: 8543 picolitres, steatosis: 9156 picolitres, NASH: 9996 picolitres). These results suggest that young adults are more prone to store fat in subcutaneous tissue and reach the threshold of bariatric surgery indication before their liver is damaged. A shift of fat storage from subcutaneous to visceral adipose tissue compartment is associated with liver damages. Liver might also be targeted by subcutaneous hypertrophic adipocytes in females since hypertrophic adipocytes are more exposed to lipolysis and to the production of inflammatory mediators. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. Clinical management methods for out-patients with alcohol dependence

    Directory of Open Access Journals (Sweden)

    Boulze Isabelle

    2006-02-01

    Full Text Available Abstract Background In France outpatient centres for the care of alcoholics are healthcare establishments providing medical, psychological and social support. Although they meet the practical needs of these patients, their degree of use in each of these domains and the respective mobilisation of different skills by the care team are not well understood. Our aim was therefore to determine in detail the management involved as a function of the severity of alcohol dependence. For this purpose, all the procedures involved were compiled in a thesaurus describing its type (psychological, medical, social, reception, its scheduled or unscheduled nature, its method (face-to-face, telephone, letter and its duration. The severity of dependence was evaluated using the Addiction Severity Index (ASI. Results 45 patients were included and followed-up during 291 ± 114 days. The mean initial ASI scores (± SD were: medical (M = 0.39 ± 0.3, working-income (ER = 0.5 ± 0.3, alcohol (A = 0.51 ± 0.2, illicit drugs (D = 0.07 ± 0.08, legal (L = 0.06 ± 0.13, familial and social environment (FS = 0.34 ± 0.26, psychological (P = 0.39 ± 0.22. The total number of procedures was 1341 (29.8 per patient corresponding to 754.4 hours (16.7 per patient. The intensity of management peaked during the first month of treatment, and then declined rapidly; the maximum incidence of abstinence was observed during the 3rd month of management. Interviews with patients, group therapy and staff meetings represented 68.7%, 9.9% and 13.9% of all procedures, respectively. In patients with severe dependence, as compared to moderate, management was twice as intense in the psychological and social domains, but not in the medical domain. The ASI questionnaire was completed a second time by 24 patients, after an average of 3.2 months. The improvement was significant in the M, A, D and P domains only. Conclusion This study provided an overview of the methods employed in managing a sample of

  4. Concordance between peri-areolar blue dye and peri-incisional radiotracer injections for sentinel node mapping in patients with a history of primary breast cancer excisonal biopsy.

    Science.gov (United States)

    Mehrabibahar, M; Azizi, S; Jangjoo, A; Saremi, E; Kakhki, V R Dabbagh; Sadeghi, R; Chicken, D W; Keshtgar, M

    2014-01-01

    We evaluated the concordance between peri-areolar blue dye and peri-incisional radiotracer injections for axillary sentinel node mapping of patients with the history of previous breast lesion excisional biopsy. 80 patients with the history of previous excisional biopsy of the breast lesions were included. All patients received two injections of 99mTc-antimony sulfide colloid in both ends of incision line in an intradermal fashion. 2 mL patient blue V dye was injection to all patients in the peri-areolar area of the index quadrant after induction of anesthesia. All blue or hot nodes were harvested as sentinel lymph nodes. At least one sentinel node could be detected during surgery in 79 patients. In total 94 sentinel nodes were detected. All detected sentinel nodes were hot. In three patients sentinel nodes were detected by gamma probe but not blue dye. The tumor location in all of these patients was in the upper lateral quadrant and the incision line was extended into the axillary tail of the breast in all of them. 91 out of 94 sentinel nodes were stained blue, which amounts to 95.8% concordance between blue dye and radiotracer on a per node analysis. Single peri-areolar injection in the index quadrant would suffice for sentinel node mapping of patients with history of excisional biopsy. Care should be taken in patients with large excisional biopsy in the extreme proximity to axilla.

  5. Systematization of types and methods of radiation therapy methods and techniques of irradiation of patients

    International Nuclear Information System (INIS)

    Vajnberg, M.Sh.

    1991-01-01

    The paper is concerned with the principles of systematization and classification of types and methods of radiation therapy, approaches to the regulation of its terminology. They are based on the distinction of the concepts of radiation therapy and irradiation of patients. The author gives a consice historical review of improvement of the methodology of radiation therapy in the course of developing of its methods and facilities. Problems of terminology are under discussion. There is a table of types and methods of radiation therapy, methods and techniques of irradiation. In the appendices one can find a table of typical legends and examples of graphic signs to denote methods of irradiation. Potentialities of a practical use of the system are described

  6. A survey on psychiatric patients' use of non-medical alternative practitioners: incidence, methods, estimation, and satisfaction.

    Science.gov (United States)

    Demling, J H; Neubauer, S; Luderer, H-J; Wörthmüller, M

    2002-12-01

    We investigated to what extent psychiatric inpatients consult Heilpraktiker, i.e. non-academically trained providers of complementary and alternative medicine (CAM), which diagnostic and therapeutic methods Heilpraktiker employ, how patients assess Heilpraictikers' professional competence, CAM in general and issues of satisfaction for those who have had experience with Heilpraktiker. Four hundred and seventy three patients admitted to a psychiatric university department during a 9-month period filled out a questionnaire developed for this investigation. About one third of the patients had consulted a Heilpraktiker, a quarter of these for their current psychiatric illness. Women were in the majority. Patients with the highest secondary school education consulted Heilpraktiker less often. There was considerable 'customer loyalty' towards Heilpraktiker. Largely the same diagnostic and treatment methods were employed for mental illness as for somatic complaints. Except for iridology, exotic or dangerous methods played a secondary role. Patients generally revealed a very positive attitude toward Heilpraktiker and CAM, although methods were rated differently. CAM enjoyed greater appreciation among women and patients who had consulted Heilpraktiker. Patients with personal experience were, on the whole, very satisfied with the professional competence, with the atmosphere in the practice and staff concern for the patient's well-being. Degree of satisfaction correlated closely with frequency of consultation. More patients with neurotic disorders considered the cost unreasonable than others, despite comparatively frequent visits. Psychiatric patients seek out Heilpraktiker to a considerable degree. Especially those who have relevant experience rank Heilpraktiker highly, in particular due to their 'psychotherapeutic' attitude, but professional competence is also valued. Methods of CAM received mixed reviews from patients but are generally seen in a positive light. It is

  7. History and future of human cadaver preservation for surgical training: from formalin to saturated salt solution method.

    Science.gov (United States)

    Hayashi, Shogo; Naito, Munekazu; Kawata, Shinichi; Qu, Ning; Hatayama, Naoyuki; Hirai, Shuichi; Itoh, Masahiro

    2016-01-01

    Traditionally, surgical training meant on-the-job training with live patients in an operating room. However, due to advancing surgical techniques, such as minimally invasive surgery, and increasing safety demands during procedures, human cadavers have been used for surgical training. When considering the use of human cadavers for surgical training, one of the most important factors is their preservation. In this review, we summarize four preservation methods: fresh-frozen cadaver, formalin, Thiel's, and saturated salt solution methods. Fresh-frozen cadaver is currently the model that is closest to reality, but it also presents myriad problems, including the requirement of freezers for storage, limited work time because of rapid putrefaction, and risk of infection. Formalin is still used ubiquitously due to its low cost and wide availability, but it is not ideal because formaldehyde has an adverse health effect and formalin-embalmed cadavers do not exhibit many of the qualities of living organs. Thiel's method results in soft and flexible cadavers with almost natural colors, and Thiel-embalmed cadavers have been appraised widely in various medical disciplines. However, Thiel's method is relatively expensive and technically complicated. In addition, Thiel-embalmed cadavers have a limited dissection time. The saturated salt solution method is simple, carries a low risk of infection, and is relatively low cost. Although more research is needed, this method seems to be sufficiently useful for surgical training and has noteworthy features that expand the capability of clinical training. The saturated salt solution method will contribute to a wider use of cadavers for surgical training.

  8. Home Non Invasive Ventilation (NIV) treatment for COPD patients with a history of NIV-treated exacerbation

    DEFF Research Database (Denmark)

    Ankjærgaard, Kasper Linde; Tønnesen, Philip; Laursen, Lars Christian

    2016-01-01

    have been able to reduce mortality and the number of repeat respiratory failure and readmissions by continuing the acute noninvasive ventilatory therapy as a long-term therapy. METHODS: Multi-center open label randomized controlled trial of 150 patients having survived an admission with noninvasive...

  9. Pressure-reduction and preservation in custom-made footwear of patients with diabetes and a history of plantar ulceration

    NARCIS (Netherlands)

    Waaijman, R.; Arts, M. L. J.; Haspels, R.; Busch-Westbroek, T. E.; Nollet, F.; Bus, S. A.

    2012-01-01

    Diabet. Med. 29, 15421549 (2012) Abstract Aims To assess the value of using in-shoe plantar pressure analysis to improve and preserve the offloading properties of custom-made footwear in patients with diabetes. Methods Dynamic in-shoe plantar pressures were measured in new custom-made footwear of

  10. Impact of Sexual Trauma on HIV Care Engagement: Perspectives of Female Patients with Trauma Histories in Cape Town, South Africa.

    Science.gov (United States)

    Watt, Melissa H; Dennis, Alexis C; Choi, Karmel W; Ciya, Nonceba; Joska, John A; Robertson, Corne; Sikkema, Kathleen J

    2017-11-01

    South African women have disproportionately high rates of both sexual trauma and HIV. To understand how sexual trauma impacts HIV care engagement, we conducted in-depth qualitative interviews with 15 HIV-infected women with sexual trauma histories, recruited from a public clinic in Cape Town. Interviews explored trauma narratives, coping behaviors and care engagement, and transcripts were analyzed using a constant comparison method. Participants reported multiple and complex traumas across their lifetimes. Sexual trauma hindered HIV care engagement, especially immediately following HIV diagnosis, and there were indications that sexual trauma may interfere with future care engagement, via traumatic stress symptoms including avoidance. Disclosure of sexual trauma was limited; no women had disclosed to an HIV provider. Routine screening for sexual trauma in HIV care settings may help to identify individuals at risk of poor care engagement. Efficacious treatments are needed to address the psychological and behavioral sequelae of trauma.

  11. Differential diagnosis and recovery of acute bilateral foot drop in a patient with a history of low back pain: A case report.

    Science.gov (United States)

    Lomaglio, Melanie; Canale, Bob

    2017-06-01

    Acute bilateral foot drop is rare and may be due to peripheral or central lesions. The purpose of this case report was to describe the differential diagnosis and recovery of a patient with low back pain (LBP) that awoke with bilateral foot drop. A 39-year-old man with a history of LBP awoke with a steppage gait pattern. Spinal imaging and tapping were negative for sinister pathologies. A subsequent history taken by the physical therapist uncovered that the patient had previously taken a narcotic and slept in a kneeling position to relieve his LBP. Strength and sensory testing revealed isolated impairments in the fibular nerve distribution, and bilateral fibular palsy was suspected and later confirmed with electrophysiological studies. Surgical fibular nerve decompression was performed, and the patient underwent physical therapy. Five months later the patient demonstrated antigravity strength and a partial return of sensation. By 17 months, his Lower Extremity Functional Scale had improved from 17/80 to 78/80, revealing a near complete recovery. The patient's history of LBP was a "red herring" that delayed the diagnosis and caused undue stress to the patient. This case stresses the importance of a thorough history and clinical examination.

  12. The natural history of hereditary motor and sensory neuropathy with proximal dominant involvement (HMSN-P) in 97 Japanese patients.

    Science.gov (United States)

    Fujisaki, Natsumi; Suwazono, Shugo; Suehara, Masahito; Nakachi, Ryo; Kido, Miwako; Fujiwara, Yoshihisa; Oshiro, Saki; Tokashiki, Takashi; Takashima, Hiroshi; Nakagawa, Masanori

    2018-02-01

    Hereditary motor and sensory neuropathy with proximal dominant involvement (HMSN-P) is a motor and sensory neuronopathy with autosomal dominant inheritance, adult onset, slowly progressive course, and is associated with TRK-fused gene (TFG) mutation. At advanced stages, respiratory failure and dysphagia becomes life-threatoning, and patients typically die by their 70s. Although there is currently no evidence for effective treatment, a therapy may be found by elucidation of the function of TFG. Recently its pathomechanism has been proposed to be associated with abnormalities in protein transfer from the endoplasmic reticulum. Such pathomechanisms might involve a similar process in amyotrophic lateral sclerosis; thus, its pathomechanisms and treatment strategy might make it a good model for neurodegenerative disorders. It is of great value to clarify the natural history of HMSN-P, in oder to judge the treatment effect. By evaluating 97 patients (79 out of 97 were examined and all confirmed with p.Pro 285 Leu mutation) in this study, it was confirmed that this disease follows a uniform course in the earlier stages, and there are individual differences in the onset between 20 and 30 years. Such uniformity might be due to the proposed single gene abnormality. At advanced stages, there are larger individual differences in the progression, but the reasons for these are unknown. Longer survival might be achieved with a better care for respiratory failure and dysphagia if such cares were undertaken at appropriate times.

  13. Acute retinal necrosis results in low vision in a young patient with a history of herpes simplex virus encephalitis.

    Science.gov (United States)

    Shahi, Sanjeet K

    2017-05-01

    Acute retinal necrosis (ARN), secondary to herpes simplex encephalitis, is a rare syndrome that can present in healthy individuals, as well as immuno-compromised patients. Most cases are caused by a secondary infection from the herpes virus family, with varicella zoster virus being the leading cause of this syndrome. Potential symptoms include blurry vision, floaters, ocular pain and photophobia. Ocular findings may consist of severe uveitis, retinal vasculitis, retinal necrosis, papillitis and retinal detachment. Clinical manifestations of this disease may include increased intraocular pressure, optic disc oedema, optic neuropathy and sheathed retinal arterioles. A complete work up is essential to rule out cytomegalovirus retinitis, herpes simplex encephalitis, herpes virus, syphilis, posterior uveitis and other conditions. Depending on the severity of the disease, the treatment options consist of anticoagulation therapy, cycloplegia, intravenous acyclovir, systemic steroids, prophylactic laser photocoagulation and pars plana vitrectomy with silicon oil for retinal detachment. An extensive history and clinical examination is crucial in making the correct diagnosis. Also, it is very important to be aware of low vision needs and refer the patients, if expressing any sort of functional issues with completing daily living skills, especially reading. In this article, we report one case of unilateral ARN 20 years after herpetic encephalitis. © 2016 Optometry Australia.

  14. Relationship between flow volume curve and CT findings in non-smoking patients with long histories of bronchial asthma

    Energy Technology Data Exchange (ETDEWEB)

    Kawamoto, Hitoshi; Kambe, Masayuki; Yamagata, Mitsunori; Nakajima, Hidekatsu [Hiroshima Univ. (Japan). School of Medicine; Yamane, Kousuke; Kuraoka, Toshihiko; Miyamura, Isao

    2001-08-01

    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)

  15. Eyeball pressure stimulation induces subtle sympathetic activation in patients with a history of moderate or severe traumatic brain injury.

    Science.gov (United States)

    Wang, Ruihao; Hösl, Katharina M; Ammon, Fabian; Markus, Jörg; Koehn, Julia; Roy, Sankanika; Liu, Mao; de Rojas Leal, Carmen; Muresanu, Dafin; Flanagan, Steven R; Hilz, Max J

    2018-06-01

    After traumatic brain injury (TBI), there may be persistent central-autonomic-network (CAN) dysfunction causing cardiovascular-autonomic dysregulation. Eyeball-pressure-stimulation (EPS) normally induces cardiovagal activation. In patients with a history of moderate or severe TBI (post-moderate-severe-TBI), we determined whether EPS unveils cardiovascular-autonomic dysregulation. In 51 post-moderate-severe-TBI patients (32.7 ± 10.5 years old, 43.1 ± 33.4 months post-injury), and 30 controls (29.1 ± 9.8 years), we recorded respiration, RR-intervals (RRI), systolic and diastolic blood-pressure (BPsys, BPdia), before and during EPS (120 sec; 30 mmHg), using an ocular-pressure-device (Okulopressor®). We calculated spectral-powers of mainly sympathetic low (LF: 0.04-0.15 Hz) and parasympathetic high (HF: 0.15-0.5 Hz) frequency RRI-fluctuations, sympathetically mediated LF-powers of BPsys, and calculated normalized (nu) LF- and HF-powers of RRI. We compared parameters between groups before and during EPS by repeated-measurement-analysis-of-variance with post-hoc analysis (significance: p < 0.05). At rest, sympathetically mediated LF-BPsys-powers were significantly lower in the patients than the controls. During EPS, only controls significantly increased RRIs and parasympathetically mediated HFnu-RRI-powers, but decreased LF-RRI-powers, LFnu-RRI-powers, and LF-BPsys-powers; in contrast, the patients slightly though significantly increased BPsys upon EPS, without changing any other parameter. In post-moderate-severe-TBI patients, autonomic BP-modulation was already compromised at rest. During EPS, our patients failed to activate cardiovagal modulation but slightly increased BPsys, indicating persistent CAN dysregulation. Our findings unveil persistence of subtle cardiovascular-autonomic dysregulation even years after TBI. Copyright © 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  16. Le poids de l'histoire: A la recherche d'une pedagogie (The Weight of History: In Search of a Method).

    Science.gov (United States)

    Bourbeau-Walker, Micheline

    1984-01-01

    It is proposed that while the sciences have progressed steadily, language teaching methods have swung like a pendulum between two broad approaches: formal and functional. The history of this pattern is outlined, current practices are discussed, and the possibility of escaping from this polarizing cycle is examined. (MSE)

  17. Technetium-99m-HMPAO SPECT in the evaluation of patients with a remote history of traumatic brain injury: a comparison with x-ray computed tomography.

    Science.gov (United States)

    Gray, B G; Ichise, M; Chung, D G; Kirsh, J C; Franks, W

    1992-01-01

    The functional imaging modality has potential for demonstrating parenchymal abnormalities not detectable by traditional morphological imaging. Fifty-three patients with a remote history of traumatic brain injury (TBI) were studied with SPECT using 99mTc-hexamethylpropyleneamineoxime (HMPAO) and x-ray computed tomography (CT). Overall, 42 patients (80%) showed regional cerebral blood flow (rCBF) deficits by HMPAO SPECT, whereas 29 patients (55%) showed morphological abnormalities by CT. Out of 20 patients with minor head injury, 12 patients (60%) showed rCBF deficits and 5 patients (25%) showed CT abnormalities. Of 33 patients with major head injury, 30 patients (90%) showed rCBF deficits and 24 patients (72%) showed CT abnormalities. Thus, HMPAO SPECT was more sensitive than CT in detecting abnormalities in patients with a history of TBI, particularly in the minor head injury group. In the major head injury group, three patients showed localized cortical atrophy by CT and normal rCBF by HMPAO SPECT. In the evaluation of TBI patients, HMPAO SPECT is a useful technique to demonstrate regional brain dysfunction in the presence of morphological integrity as assessed by CT.

  18. A theoretical study on the accuracy of the T-history method for enthalpy–temperature curve measurement: analysis of the influence of thermal gradients inside T-history samples

    International Nuclear Information System (INIS)

    Mazo, Javier; Delgado, Mónica; Lázaro, Ana; Dolado, Pablo; Peñalosa, Conchita; Marín, José María; Zalba, Belén

    2015-01-01

    The present work analyses the effect of radial thermal gradients inside T-history samples on the enthalpy temperature curve measurement. A conduction heat transfer model has been utilized for this purpose. Some expressions have been obtained that relate the main dimensionless numbers of the experiments with the deviations in specific heat capacity, phase change enthalpy and phase change temperature estimations. Although these relations can only be strictly applied to solid materials (e.g. measurements of shape stabilized phase change materials), they can provide some useful and conservative bounds for the deviations of the T-history method. Biot numbers emerge as the most relevant dimensionless parameters in the accuracy of the specific heat capacity and phase change enthalpy estimation whereas this model predicts a negligible influence of the temperature levels used for the experiments or the Stefan number. (paper)

  19. Characterization of BRCA1/2 mutations in patients with family history of breast cancer in Armenia [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Sofi Atshemyan

    2017-01-01

    Full Text Available Background. Breast cancer is one of the most common cancers in women worldwide. The germline mutations of the BRCA1 and BRCA2 genes are the most significant and well characterized genetic risk factors for hereditary breast cancer. Intensive research in the last decades has demonstrated that the incidence of mutations varies widely among different populations. In this study we attempted to perform a pilot study for identification and characterization of mutations in BRCA1 and BRCA2 genes among Armenian patients with family history of breast cancer and their healthy relatives. Methods. We performed targeted exome sequencing for BRCA1 and BRCA2 genes in 6 patients and their healthy relatives. After alignment of short reads to the reference genome, germline single nucleotide variation and indel discovery was performed using GATK software. Functional implications of identified variants were assessed using ENSEMBL Variant Effect Predictor tool. Results. In total, 39 single nucleotide variations and 4 indels were identified, from which 15 SNPs and 3 indels were novel. No known pathogenic mutations were identified, but 2 SNPs causing missense amino acid mutations had significantly increased frequencies in the study group compared to the 1000 Genome populations. Conclusions. Our results demonstrate the importance of screening of BRCA1 and BRCA2 gene variants in the Armenian population in order to identity specifics of mutation spectrum and frequencies and enable accurate risk assessment of hereditary breast cancers.

  20. Patient satisfaction with doctor-patient interactions: a mixed methods study among diabetes mellitus patients in Pakistan.

    Science.gov (United States)

    Jalil, Aisha; Zakar, Rubeena; Zakar, Muhammad Zakria; Fischer, Florian

    2017-02-21

    Patient satisfaction with doctor-patient interactions is an indicator of physicians' competence. The satisfaction of diabetes patients is rarely studied in public diabetes clinics of Pakistan. Thus, this study aims to analyse the association between patient satisfaction and five dimensions of medical interaction: technical expertise, interpersonal aspects, communication, consultation time, and access/availability. A cross-sectional mixed methods study was conducted during July and August 2015 in the largest public diabetes outpatient clinic in Punjab province. We used the criterion sampling method to identify 1164 patients who: (i) were adult (18 years and above), (ii) had diabetes mellitus, (iii) had made at least three previous visits to the same clinic. The data was collected through face-to-face interviews. The structured part of the questionnaire was based on demographic characteristics and the Patient Satisfaction Questionnaire (PSQ-III). We translated the questionnaire into Urdu and pretested it with 25 patients in a similar context. Data storage and analysis were carried out using SPSS (version 22.0). Bivariate analyses and multinomial logistic regression model were used to generate the quantitative findings. Out of the 1164 eligible patients approached for interviews, 1095 patients completed the structured questionnaire and 186 respondents provided qualitative information in comments section. We conducted a thematic content analysis of qualitative responses in order to explain the quantitative findings. Demographic characteristics such as gender, education and occupation were significantly associated with the levels of patient satisfaction. The dimensions of doctor-patient interaction were significantly associated with patient satisfaction: technical expertise (OR = .87; 95% CI = .84-.91), interpersonal aspects (OR = .82; 95% CI = .77-.87), communication (OR = .83; 95% CI = .78-.89), time dimension (OR = .90; 95% CI = .81

  1. [Effects of two different methods for airway humidification for patients with tracheostomy: a Meta-analysis].

    Science.gov (United States)

    Wang, Jing; Pi, Hongying

    2016-01-01

    To evaluate the effects of two different kinds of airway humidification for tracheostomy patients, and to provide their relevant clinical effect and suggestions for their use. Online databases, including PubMed, EMBASE, JBI evidence-based nursing center library, the Cochrane Library, and Chinese databases (CNKI, Wanfang database, VIP, CBM) were searched systematically up to March 2015. Randomized controlled trials (RCTs) were considered eligible for inclusion if the following criteria were met: no history of respiratory tract infection; satisfactory nutritional status; tracheotomy performed; 18 years older. Two different humidification methods were used. Continuous airway humidification was used in the experiment group, while intermittent airway humidification was used in the control group. Two qualified reviewers reviewed the original articles, evaluating the quality of articles, and data were extracted independently. The enrolled RCTs were analyzed by Meta-analysis. A total of nine RCTs were included, containing 631 cases, among them 316 cases in expertment group, and 315 cases in control group. Continuous airway humidification was shown to be able to reduce the incidence of irritable cough [odds ratio (OR) = 0.20, 95% confidence interval (95%CI) = 0.12-0.34, P humidification for tracheostomy patients. Because the number of including articles was relative small, and the quality of some articles was poor, it is impossible to draw a reliable conclusion that continuous airway humidification could lower the incidence of complications for patients undergone tracheostomy.

  2. The relationship between history and physical examination findings and the outcome of electrodiagnostic testing in patients with sciatica referred to physical therapy.

    Science.gov (United States)

    Savage, Nathan J; Fritz, Julie M; Thackeray, Anne

    2014-07-01

    Cross-sectional diagnostic accuracy study. To investigate the relationship between history and physical examination findings and the outcome of electrodiagnostic testing in patients with sciatica referred to physical therapy. Electrodiagnostic testing is routinely used to evaluate patients with sciatica. Recent evidence suggests that the presence of radiculopathy identified with electrodiagnostic testing may predict better functional outcomes in these patients. While some patient history and physical examination findings have been shown to predict the presence of disc herniation or neurological insult, little is known about their relationship to the results of electrodiagnostic testing. Electrodiagnostic testing was performed on 38 patients with sciatica who participated in a randomized trial that compared different physical therapy interventions. The diagnostic gold standard was the presence or absence of radiculopathy, based on the results of the needle electromyographic examination. Diagnostic sensitivity and specificity values were calculated, along with corresponding likelihood ratios, for select patient history and physical examination variables. No significant relationship was found between select patient history and physical examination findings, analyzed individually or in combination, and the outcome of electrodiagnostic testing. Diagnostic sensitivity values ranged from 0.03 (95% confidence interval [CI]: 0.00, 0.24) to a high of 0.95 (95% CI: 0.72, 0.99), and specificity values ranged from 0.10 (95% CI: 0.02, 0.34) to a high of 0.95 (95% CI: 0.72, 0.99). Positive likelihood ratios ranged from 0.15 (95% CI: 0.01, 2.87) to a high of 2.33 (95% CI: 0.71, 7.70), and negative likelihood ratios ranged from 2.00 (95% CI: 0.35, 11.48) to a low of 0.50 (95% CI: 0.03, 8.10). In this investigation, the relationship between patient history and physical examination findings and the outcome of electrodiagnostic testing among patients with sciatica was not found to be

  3. 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.

    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

  4. 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.

  5. Natural history and retinal structure in patients with Usher syndrome type 1 owing to MYO7A mutation.

    Science.gov (United States)

    Lenassi, Eva; Saihan, Zubin; Cipriani, Valentina; Le Quesne Stabej, Polona; Moore, Anthony T; Luxon, Linda M; Bitner-Glindzicz, Maria; Webster, Andrew R

    2014-02-01

    To evaluate the phenotypic variability and natural history of ocular disease in a cohort of 28 individuals with MYO7A-related disease. Mutations in the MYO7A gene are the most common cause of Usher syndrome type 1, characterized by profound congenital deafness, vestibular arreflexia, and progressive retinal degeneration. Retrospective case series. Twenty-eight patients from 26 families (age range, 3-65 years; median, 32) with 2 likely disease-causing variants in MYO7A. Clinical investigations included fundus photography, optical coherence tomography, fundus autofluorescence (FAF) imaging, and audiologic and vestibular assessments. Longitudinal visual acuity and FAF data (over a 3-year period) were available for 20 and 10 study subjects, respectively. Clinical, structural, and functional characteristics. All patients with MYO7A mutations presented with features consistent with Usher type 1. The median visual acuity for the cohort was 0.39 logarithm of the minimum angle of resolution (logMAR; range, 0.0-2.7) and visual acuity in logMAR correlated with age (Spearman's rank correlation coefficient, r = 0.71; Ppatients tested had relatively preserved foveal autofluorescence surrounded by a ring of high density, 4 of 22 had increased signal in the fovea with no obvious hyperautofluorescent ring, and 5 of 22 had widespread hypoautofluorescence corresponding to retinal pigment epithelial atrophy. Despite a number of cases presenting with a milder phenotype, there seemed to be no obvious genotype-phenotype correlation. MYO7A-related ocular disease is variable. Central vision typically remains preserved at least until the third decade of life, with 50% of affected individuals reaching legal blindness by 40 years of age. Distinct phenotypic subsets were identified on FAF imaging. A specific allele, previously reported in nonsyndromic deafness, may be associated with a mild retinopathy. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights

  6. Primary Dermal Melanoma in a Patient with a History of Multiple Malignancies: A Case Report with Molecular Characterization

    Directory of Open Access Journals (Sweden)

    Germana Sini

    2013-07-01

    Full Text Available Introduction: Primary dermal melanoma (PDM is a recently described clinical entity accounting for less than 1% of all melanomas. Histologically, it is located in the dermis or subcutaneous tissue, and it shows no connections with the overlying epidermis. The differential diagnosis is principally made along with that of metastatic cutaneous melanoma. Case Report: A 72-year-old Caucasian woman with a history of multiple cancers (metachronous bilateral breast cancer, meningioma, clear cell renal cell carcinoma, uterine fibromatosis and intestinal adenomatous polyposis, came to our attention with a nodular lesion on her back. After removal of the lesion, the histology report indicated malignant PDM or metastatic malignant melanoma. The clinical and instrumental evaluation of the patient did not reveal any other primary tumour, suggesting the primitive nature of the lesion. The absence of an epithelial component argued for a histological diagnosis of PDM. Subsequently, the patient underwent a wide surgical excision with sentinel node biopsy, which was positive for metastatic melanoma. Finally, the mutational status was studied in the main genes that regulate proliferation, apoptosis and cellular senescence. No pathogenetic mutations in CDKN2A, BRAF, NRAS, KRAS, cKIT, TP53 and PTEN genes were observed. This suggests that alternative pathways and low-frequency alterations may be involved. Conclusions: The differential diagnosis between PDM and isolated metastatic melanoma depends on the negativity of imaging studies and clinical findings for other primary lesions. This distinction is important because 5-year survival rates in such cases are higher than in metastatic cases (80-100 vs. 5-20%, respectively.

  7. Art and Sonic Mining in the Archives: Methods for Investigating the Wartime History of Birmingham School of Art

    Science.gov (United States)

    Vaughan, Sian

    2018-01-01

    "Absconditi Viscus" (or "Hidden Entries") is a series of sound compositions based on the history of Birmingham School of Art during the First World War. Sound artist Justin Wiggan explored the concept of historical sonic information that although lost could still potentially permeate the archival record and the fabric of the…

  8. [Experience feedback committee: a method for patient safety improvement].

    Science.gov (United States)

    François, P; Sellier, E; Imburchia, F; Mallaret, M-R

    2013-04-01

    An experience feedback committee (CREX, Comité de Retour d'EXpérience) is a method which contributes to the management of safety of care in a medical unit. Originally used for security systems of civil aviation, the method has been adapted to health care facilities and successfully implemented in radiotherapy units and in other specialties. We performed a brief review of the literature for studies reporting data on CREX established in hospitals. The review was performed using the main bibliographic databases and Google search results. The CREX is designed to analyse incidents reported by professionals. The method includes monthly meetings of a multi-professional committee that reviews the reported incidents, chooses a priority incident and designates a "pilot" responsible for investigating the incident. The investigation of the incident involves a systemic analysis method and a written synthesis presented at the next meeting of the committee. The committee agrees on actions for improvement that are suggested by the analysis and follows their implementation. Systems for the management of health care, including reporting systems, are organized into three levels: the medical unit, the hospital and the country as a triple loop learning process. The CREX is located in the base level, short loop of risk management and allows direct involvement of care professionals in patient safety. Safety of care has become a priority of health systems. In this context, the CREX can be a useful vehicle for the implementation of a safety culture in medical units. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  9. [Treatment Methods for Patients with Dupuytren's Disease in Switzerland].

    Science.gov (United States)

    Marks, M; Krefter, C; Herren, D B

    2016-06-01

    The objective of this study was to investigate what treatment options are currently used in Switzerland for Dupuytren's disease. Furthermore, regional preferences and treatment differences based on surgeon experience were analysed. In this survey, an electronic questionnaire was sent to all members of the Swiss Society for Hand Surgery. Participants were asked to indicate their current treatment methods for Dupuytren's disease. In addition, 8 standard patient cases were presented to identify the preferred treatment option. Furthermore, sociodemographic data of the participants were gathered. In total, 70 questionnaires were completed, corresponding to a response rate of 34%. Fasciectomy is performed by 94% of participants, while 59% inject collagenase in certain cases, 40% perform open fasciotomy, and 24% carry out percutaneous needle aponeurotomy if the indication is given. 20% of responders offer one of these techniques, 50% offer 2, 23% offer 3, and 7% offer all 4 treatment techniques. In the case of isolated metacarpophalangeal joint contracture, 51% of participants inject collagenase, whereas fasciectomy is preferred for the treatment of proximal interphalangeal joint contractures or in cases of recurrence. In German-speaking Switzerland, the treatment strategy has changed towards applying collagenase injections in the past 5 years. In this part of the country, 83% of surgeons now use more collagenase than 5 years ago, whereas only 33% of surgeons in French-speaking Switzerland have changed their treatment strategy in favour of collagenase injections (p=0.027). Surgeons with less than 10 years of experience apply more collagenase than their more experienced colleagues (79 vs. 54%, p=0.131). In Switzerland, fasciectomy is the preferred option for treating patients with Dupuytren's disease. In recent years, however, collagenase injection has become more and more popular. More research is needed to define guidelines for the treatment of patients with Dupuytren

  10. Sharing Histories-a transformative learning/teaching method to empower community health workers to support health behavior change of mothers.

    Science.gov (United States)

    Altobelli, Laura C

    2017-08-23

    One of the keys to improving health globally is promoting mothers' adoption of healthy home practices for improved nutrition and illness prevention in the first 1000 days of life from conception. Customarily, mothers are taught health messages which, even if simplified, are hard to remember. The challenge is how to promote learning and behavior change of mothers more effectively in low-resource settings where access to health information is poor, educational levels are low, and traditional beliefs are strong. In addressing that challenge, a new learning/teaching method called "Sharing Histories" is in development to improve the performance of female community health workers (CHWs) in promoting mothers' behaviors for maternal, neonatal and child health (MNCH). This method builds self-confidence and empowerment of CHWs in learning sessions that are built on guided sharing of their own memories of childbearing and child care. CHWs can later share histories with the mother, building her trust and empowerment to change. For professional primary health care staff who are not educators, Sharing Histories is simple to learn and use so that the method can be easily incorporated into government health systems and ongoing CHW programs. I present here the Sharing Histories method, describe how it differs from other social and behavior change methods, and discuss selected literature from psychology, communications, and neuroscience that helps to explain how and why this method works as a transformative tool to engage, teach, transform, and empower CHWs to be more effective change agents with other mothers in their communities, thereby contributing to the attainment of the Sustainable Development Goals.

  11. WIMS-AECL/RFSP code validation of reactivity calculations following a long shutdown using the simple-cell history-based method

    International Nuclear Information System (INIS)

    Ardeshiri, F.; Donnelly, J.V.; Arsenault, B.

    1998-01-01

    The purpose of this analysis is to validate the Reactor Fuelling Simulation Program (RFSP) using the simple-cell model (SCM) history-based method in a startup simulation following a reactor shutdown period. This study is part of the validation work for history-based calculations, using the WIMS-AECL code with the ENDF/B-V library, and the SCM linked to the RFSP code. In this work, the RFSP code with the SCM history-based method was used to track a 1-year period of the Point Lepreau reactor operating history, that included a 12-day reactor shutdown and subsequent startup. Measured boron and gadolinium concentrations were used in the RFSP simulations, and the predicted values of core reactivity were compared to the reference (pre-shutdown) value. The discrepancies in core reactivity are shown to be better than ±2 milli-k at any time, and better than about ±0.5 milli-k towards the end of the startup transient. The results of this analysis also show that the calculated maximum channel and bundle powers are within an acceptable range during both the core-follow and the reactor startup simulations. (author)

  12. A method for developing standard patient education program

    DEFF Research Database (Denmark)

    Lura, Carolina Bryne; Hauch, Sophie Misser Pallesgaard; Gøeg, Kirstine Rosenbeck

    2018-01-01

    for developing standard digital patient education programs for patients in self-administration of blood samples drawn from CVC. The Design Science Research Paradigm was used to develop a digital patient education program, called PAVIOSY, to increase patient safety during execution of the blood sample collection...... of the educational patient system, health professionals must be engaged early in the development of content and design phase....

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

    DEFF Research Database (Denmark)

    Schafranski, Marcelo Derbli; Pereira Ferrari, Lílian; Scherner, Daniela

    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...... patients presenting MBL2 genotypes related to the low production of MBL (10/14, 71% vs. 10/28, 36%; p=0.048, OR 0.22, 95% CI 0.05-0.89). We concluded that MBL2 genotypes associated with the high production of MBL seem to be involved in the pathogenesis of rheumatic carditis and its progression to CRHD....

  14. Sixteen-slice multidetector computed tomographic virtual cystoscopy in the evaluation of a patient with suspected bladder tumor and history of bladder carcinoma operation.

    Science.gov (United States)

    Basak, Muzaffer; Ozkurt, Huseyin; Tanriverdi, Orhan; Cay, Esra; Aydin, Mustafa; Miroglu, Cengiz

    2009-01-01

    The purpose of this study was to evaluate the use of virtual cystoscopy performed with multidetector computed tomography (CT) in patients with suspected bladder tumors and histories of bladder carcinoma operation. Thirty-six patients (29 men and 7 women) with a mean age of 66 years (range, 24-88 years) with suspected bladder tumors and histories of bladder carcinoma operation were included in this prospective study. Virtual cystoscopy was performed by 16-slice multidetector CT scanner. The bladder was filled with diluted contrast material solution through a Foley catheter. Then, all patients underwent conventional cystoscopy examination. Two reviewers found 18 lesions detected by virtual cystoscopy by consensus, whereas 19 lesions were depicted by conventional cystoscopy. At virtual and conventional cystoscopies, the conditions of 3 patients, 2 with chronic inflammations and 1 with foreign body reaction, were wrongly diagnosed as tumors. At conventional cystoscopy, one patient's result was wrongly interpreted as normal. In pathologic evaluation, all tumors were diagnosed as transitional cell carcinoma. Bladder tumor can be noninvasively diagnosed using virtual cystoscopy. Use of virtual cystoscopy should be considered inpatients who present with hematuria or have histories of bladder carcinoma operation and are for follow-up because of its lesser complication risk and its being a less invasive, easily applied procedure without need of anesthesia. In the future, owing to the development of the CT technology and image processing technique, virtual cystoscopy may have a part in the detection of bladder cancer.

  15. Simple and effective method to lower body core temperatures of hyperthermic patients.

    Science.gov (United States)

    O'Connor, John P

    2017-06-01

    Hyperthermia is a potentially life threatening scenario that may occur in patients due to accompanying morbidities, exertion, or exposure to dry and arid environmental conditions. In particular, heat stroke may result from environmental exposure combined with a lack of thermoregulation. Key clinical findings in the diagnosis of heatstroke are (1) a history of heat stress or exposure, (2) a rectal temperature greater than 40 °C, and (3) central nervous system dysfunction (altered mental state, disorientation, stupor, seizures, or coma) (Prendergast and Erickson, 2014 [1]). In these patients, it is important to bring the body's core temperature down to acceptable levels in a short period of time to avoid tissue/organ injury or death (Yoder, 2001; Casa et al., 2007 [2,3]). A number of potential approaches, both non-invasive and invasive, may be used to lower the temperature of these individuals. Non-invasive techniques generally include: evaporative cooling, ice water immersion, whole-body ice packing, strategic ice packing, and convective cooling. Invasive approaches may include gastric lavage or peritoneal lavage (Schraga and Kates [4]). The efficacy of these methods vary and select treatment approaches may be unsuitable for specific individuals (Schraga and Kates [4]). In this work, the effectiveness of radiation cooling of individuals as a stand-alone treatment and comparisons with existing noninvasive techniques are presented. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Perianesthetic refractory anaphylactic shock with cefuroxime in a patient with history of penicillin allergy on multiple antihypertensive medications

    Directory of Open Access Journals (Sweden)

    Deb Sanjay Nag

    2017-03-01

    Full Text Available We report a case of perianesthetic refractory anaphylactic shock with cefuroxime in a patient with history of penicillin allergy on regular therapy with atenolol, losartan, prazosin and nicardipine. Severe anaphylactic shock was only transiently responsive to 10 mL of (1:10,000 epinephrine and needed norepinephrine and dopamine infusion. Supportive therapy with vasopressors and inotropes along with mechanical ventilation for the next 24 hours resulted in complete recovery. She was successfully operated upon 2 weeks later with the same anesthetic drugs but intravenous ciprofloxacin as the alternative antibiotic for perioperative prophylaxis. Resumo: Relatamos um caso de choque anafilático refratário no período perianestésico com cefuroxima em paciente com história de alergia à penicilina em terapia regular com atenolol, losartan, prazosina e nicardipine. O choque anafilático grave foi apenas transitoriamente responsivo a 10 mL de epinefrina (1:10000 e precisou de infusão de norepinefrina e dopamina. A terapia de apoio com vasopressores e inotrópicos, juntamente com ventilação mecânica por 24 horas resultaram em recuperação completa. A paciente foi operada com sucesso duas semanas mais tarde, com os mesmos agentes anestésicos, mas com ciprofloxacina intravenosa como antibiótico alternativo para a profilaxia perioperatória. Keywords: Anaphylaxis, Perianesthetic, Cefuroxime, Palavras-chave: Anafilaxia, Perianestésico, Cefuroxima

  17. 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

  18. Serum protein profile of Malaria patients through SDS-PAGE method ...

    African Journals Online (AJOL)

    Serum protein profile of Malaria patients through SDS-PAGE method. ... reliable method in the diagnosis of antibodies produced against Plasmodium spps. ... of malaria patients may be undertaken for study to develop possible future vaccine.

  19. Simulation of patient encounters using a virtual patient in periodontology instruction of dental students: design, usability, and learning effects in history-taking skills

    DEFF Research Database (Denmark)

    Janda, M.S.; Mattheos, N.; Nattestad, A.

    2004-01-01

    computer-assisted learning, effectiveness of learning, health education, patient simulation, virtual patient......computer-assisted learning, effectiveness of learning, health education, patient simulation, virtual patient...

  20. Novel bed integrated ventilation method for hospital patient rooms

    DEFF Research Database (Denmark)

    Bivolarova, Mariya Petrova; Melikov, Arsen Krikor; Kokora, Monika

    2014-01-01

    This study presents a novel method for advanced ventilation of hospital wards leading to improved air quality at reduced ventilation rate. The idea is to evacuate the bio-effluents generated from patients’ body by local exhaustion before being spread in the room. This concept was realized by using...... a mattress having a suction opening from which bio-effluents generated from human body are exhausted. Experiments were conducted in a full-scale two-bed hospital room mock-up, 4.7 x 5.3 x 2.6 m3 (W x L x H). Only one of the patients’ beds was equipped with the ventilated mattress. The room was air...... conditioned via mixing total volume ventilation system supplying air through a ceiling mounted diffuser. All experiments were performed at room air temperature of 23ºC. A thermal manikin was used to simulate a polluting patient on the bed equipped with the ventilated mattress. Two heated dummies were used...

  1. Historia natural del carcinoma hepatocelular en una cohorte de pacientes de un hospital comarcal Natural history of hepatocellular carcinoma in a cohort of patients from a county hospital

    Directory of Open Access Journals (Sweden)

    M. Vergara

    2008-11-01

    Full Text Available Introducción: el carcinoma hepatocelular (CHC es una neoplasia con una elevada incidencia y una alta mortalidad. Objetivo: nuestro objetivo es la descripción de la historia natural de una cohorte de pacientes con CHC e identificar variables asociadas a supervivencia. Material y métodos: estudio retrospectivo y descriptivo de pacientes diagnosticados de CHC entre 1995-2002. Las variables cualitativas se expresaron mediante frecuencias y porcentajes y las cuantitativas con mediana y desviación típica. La supervivencia se estimó mediante el método de Kaplan Meyer y la prueba de Log Rank. Resultados: se analizaron un total de 154 pacientes con CHC. La ratio hombre-mujer fue de 2,9/1. La edad media de 68 ± 9 años. El 82% de los pacientes fueron exitus en un tiempo medio de seguimiento de 28 meses. La mediana de supervivencia fue de 21,5 meses (IC 95%: 16,98-26,04. Se realizó tratamiento con intención curativa en un 40,3% y el resto tratamiento paliativo. Las variables asociadas a la supervivencia fueron: presencia o no de ascitis, el número de lesiones en el momento del diagnóstico y si el tratamiento realizado fue con intención curativa o no. No hubieron diferencias estadísticamente significativas respecto a: sexo, edad, etiología de la cirrosis y estadio de Child en el momento del diagnóstico. Conclusiones: los factores asociados a una menor supervivencia en los pacientes con carcinoma hepatocelular fueron la presencia de ascitis y el número de lesiones en el momento del diagnóstico. La realización de tratamiento con intención curativa se asocia a una mayor supervivencia.Background: hepatocellular carcinoma (HCC is a cancer with high incidence and mortality. Objective: our aim was to describe the natural history of a patient cohort with HCC, and to identify the factors associated with survival. Patients and methods: a retrospective and descriptive study of patients diagnosed with HCC between 1995 and 2002. Qualitative variables

  2. Validating the history-based method in DRAGON/DONJON using G2 core follow-up

    International Nuclear Information System (INIS)

    Varin, E.; Marleau, G.

    2005-01-01

    Operating CANDU-6 reactors are refueled on power to compensate for the loss in reactivity resulting from fuel burnup. Since the selection of channels to refuel on any single day relies on the results of a diffusion based finite reactor calculation, it is important that the program that simulates the reactor operations uses information that reflects as accurately as possible the core condition at any specific time. These reactor simulations therefore require, as an input, the average properties associated with each of the 4560 individual fuel bundles present in the core. The calculation procedure, where the properties of each fuel bundle are generated independently at each time step using a lattice cell code, is called the history-based approach. We have implemented such a history-based approach by coupling directly the finite reactor code DONJON with the lattice cell code DRAGON. Here we validate our methodology by comparing DONJON/DRAGON simulation results with operation data for the Gentilly-2 reactor. (author)

  3. Bohmian histories and decoherent histories

    International Nuclear Information System (INIS)

    Hartle, James B.

    2004-01-01

    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 predictions for the probabilities of histories of a closed system therefore generally differ. However, in an idealized model of measurement, the predictions of Bohmian mechanics and decoherent histories coincide for the probabilities of records of measurement outcomes. The formulations are thus difficult to distinguish experimentally. They may differ in their accounts of the past history of the Universe in quantum cosmology

  4. Evaluation methods on the nutritional status of stroke patients.

    Science.gov (United States)

    Wang, J; Luo, B; Xie, Y; Hu, H-Y; Feng, L; Li, Z-N

    2014-01-01

    This study was designed to assess the effect of particular tools on the nutritional status of patients with stroke risk factors; to analyze these risk factors; to construct an assessment table; and to enable nurses to conduct fast and accurate assessment of the nutritional status of patients with stroke. Various nutritional assessment tools were employed to assess the nutritional status of stroke patients [(Nutritional Risk Screening 2002, NRS2002); (mini nutritional assessment, MNA), (subjective global assessment SGA), (malnutrition universal screening, MUST); (body composition, BCA)]. The leading disease-related factors of cerebral apoplexy were observed in patients with malnutrition. And a statistical analysis was conducted. The significant risk factors of cerebral apoplexy in malnourished patients older than 70 years were swallowing dysfunctions, disturbance of consciousness and reliance or half-reliance on feeding practices. The significant risk factors of malnutrition in patients with cerebral apoplexy were the decline in upper limb muscle strength, decline in the performance of various activities, loss of appetite and gastrointestinal symptoms. Disorders that affect the nutritional status of stroke patients can be used as evaluation tools, as described in the evaluation table. The clinical relevance of this study includes the following: to enable the clinical nursing staff to easily assess the patient's nutritional status in a timely manner; to improve compliance with nutritional evaluation; to provide clinical nutrition support to patients with stroke; and to provide a scientific basis for the improvement of the clinical outcomes of patients with cerebral apoplexy.

  5. Pharmacy collected medication histories in an observation unit

    Directory of Open Access Journals (Sweden)

    Gabrielle L Procopio

    2015-08-01

    Full Text Available Background: Clear processes to facilitate medication reconciliation in a hospital setting are still undefined. The observation unit allows for a high patient turnover rate, where obtaining accurate medication histories is critical. Objectives: The objective of this study was to assess the ability of pharmacists and student pharmacists to identify discrepancies in medication histories obtained at triage in observation patients. Methods: Pharmacists and student pharmacists obtained a medication history for each patient placed in observation status. Patients were excluded if they were unable to provide a medication history and family, caregiver, or community pharmacy was also unable to provide the history. A comparison was made between triage and pharmacy collected medication histories to identify discrepancies. Results: A total of 501 medications histories were collected, accounting for 3213 medication records. There were 1176 (37% matched medication records and 1467 discrepancies identified, including 808 (55% omissions, 296 (20.2% wrong frequency, 278 (19% wrong dose, 51 (3.5% discontinued, and 34 (2.3% wrong medication. There was an average of 2.9 discrepancies per patient profile. In all, 76 (15% of the profiles were matched. The median time to obtain a medication history was 4 min (range: 1–48 min. Conclusion: Pharmacy collected medication histories in an observation unit identify discrepancies that can be reconciled by the interdisciplinary team.

  6. 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

    Trichophyton onychocola is a recently described geophilic dermatophyte that has been isolated from a toenail of Czech patient with a history of onychomycosis due to T. rubrum and clinical suspicion of relapse. In this study, we report a similar case from Denmark in an otherwise healthy 56-year......-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...... and the two isolates were successfully mated. The mating experiments with related heterothallic species T. thuringiense and Arthroderma melis were negative. The sexual state showed all typical signs of arthroderma-morph and is described by using optical as well as scanning electron microscopy. The sexual...

  7. Family History Is a Risk Factor for COPD

    Science.gov (United States)

    Hokanson, John E.; Lynch, David A.; Washko, George R.; Make, Barry J.; Crapo, James D.; Silverman, Edwin K.

    2011-01-01

    Background: Studies have shown that family history is a risk factor for COPD, but have not accounted for family history of smoking. Therefore, we sought to identify the effects of family history of smoking and family history of COPD on COPD susceptibility. Methods: We compared 821 patients with COPD to 776 control smokers from the Genetic Epidemiology of COPD (COPDGene) Study. Questionnaires captured parental histories of smoking and COPD, as well as childhood environmental tobacco smoke (ETS) exposure. Socioeconomic status was defined by educational achievement. Results: Parental history of smoking (85.5% case patients, 82.9% control subjects) was more common than parental history of COPD (43.0% case patients, 30.8% control subjects). In a logistic regression model, parental history of COPD (OR, 1.73; P < .0001) and educational level (OR, 0.48 for some college vs no college; P < .0001) were significant predictors of COPD, but parental history of smoking and childhood ETS exposure were not significant. The population-attributable risk from COPD family history was 18.6%. Patients with COPD with a parental history had more severe disease, with lower lung function, worse quality of life, and more frequent exacerbations. There were nonsignificant trends for more severe emphysema and airway disease on quantitative chest CT scans. Conclusions: Family history of COPD is a strong risk factor for COPD, independent of family history of smoking, personal lifetime smoking, or childhood ETS exposure. Although further studies are required to identify genetic variants that influence COPD susceptibility, clinicians should question all smokers, especially those with known or suspected COPD, regarding COPD family history. PMID:21310839

  8. Cow's Milk Desensitization in Anaphylactic Patients: A New Personalized-dose Method.

    Science.gov (United States)

    Babaie, Delara; Nabavi, Mohammad; Arshi, Saba; Mesdaghi, Mehrnaz; Chavoshzadeh, Zahra; Bemanian, Mohammad Hasan; Tafakori, Mitra; Amirmoini, Mehrdad; Esmailzadeh, Hosein; Molatefi, Rasoul; Rekabi, Mahsa; Akbarpour, Nadieh; Masoumi, Farimah; Fallahpour, Morteza

    2017-02-01

    Cow's milk allergy (CMA) is the most frequent food allergy in children and oral immunotherapy (OIT) is a promising approach for treatment of patients. The most challenging cases are anaphylactic with coexisting asthma and proposing safe protocols is crucial especially in high risk groups. Considering that CMA varies among patients, an individualized OIT protocol would be beneficial to achieve a safer and more efficient method of desensitization. 18 children more than 3 years of age with IgE-mediated CMA were enrolled. CMA was confirmed by positive skin prick test (SPT) and positive oral food challenge (OFC) and 60% of individuals had a convincing history of persistent asthma. SPT with milk extracts, whole fresh milk and serially diluted milk concentrations were performed.  The dilution of milk that induced 3-5 mm of wheal in each individual was selected as the starting dilution for OIT. Desensitization began by 1 drop of the defined dilution and continued increasingly. Overall, 16 out of 18 children (88.8%) achieved the daily intake of 120 mL of milk. Four out of these 16 children accomplished the protocol without any adverse allergic reactions. 12 patients experienced mild to severe reactions. Wheal and erythema in SPT (p≤0.001), and sIgE (p≤0.003) to most milk allergens were significantly decreased following desensitization. We successfully desensitized 16 of 18 children with IgE-mediated CMA by individualized desensitization protocol. Individualizing the OIT protocol would be helpful to save time and perhaps to relieve the allergic symptoms after ingesting cow's milk intake.

  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. Inaccuracy of transthoracic echocardiography for the identification of right-sided vegetation in patients with no history of intravenous drug abuse or cardiac device insertion.

    Science.gov (United States)

    Xie, Jiang; Liu, Shuang; Yang, Jinghua; Xu, Jie; Zhu, Guangfa

    2014-06-01

    The use of transthoracic echocardiography (TTE) to identify right-sided infective endocarditis (RSIE) vegetation is controversial. Data are scarce for patients with no history of intravenous drug abuse (IVDA) or cardiac device insertion. This study analysed the consistency of presurgical echocardiographic results with surgical findings for vegetation identification, and the factors that influence accuracy of echocardiography. This retrospective trial divided infective endocarditis (IE) patients into three subgroups according to the results of their presurgical TTE: left-sided native IE (LSNIE), left-sided prosthetic valve IE (LSPIE) and RSIE. The accuracy of TTE was tested by comparing vegetation (number and location), detected presurgery by TTE, with actual findings during surgery. In total, 416 patients were analysed, 322 with LSNIE, 31 with LSPIE and 63 with RSIE. Consistency between TTE findings and surgical results was lower in the RSIE group compared with the LSPIE and LSNIE groups. Consistency was lowered by the presence of vegetation in multiple locations and atypical distribution--both of which were increased in the RSIE group. The chance of vegetation in both sides of the heart rose with increased numbers of vegetation locations in RSIE patients. A high proportion of RSIE patients had congenital heart defects, mostly ventricular septal defects. TTE may be unsuitable for RSIE patients with no history of IVDA or cardiac device insertion, because multifocal and atypically distributed vegetation may influence detection accuracy. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  11. History, Theory and Ethics of Medicine”: The Last Ten Years. A Survey of Course Content, Methods and Structural Preconditions at Twenty-nine German Medical Faculties

    Science.gov (United States)

    Schildmann, Jan; Bruns, Florian; Hess, Volker; Vollmann, Jochen

    2017-01-01

    Objective: “History, Theory, Ethics of Medicine” (German: “Geschichte, Theorie, Ethik der Medizin”, abbreviation: GTE) forms part of the obligatory curriculum for medical students in Germany since the winter semester 2003/2004. This paper presents the results of a national survey on the contents, methods and framework of GTE teaching. Methods: Semi-structured questionnaire dispatched in July 2014 to 38 institutions responsible for GTE teaching. Descriptive analysis of quantitative data and content analysis of free-text answers. Results: It was possible to collect data from 29 institutes responsible for GTE teaching (response: 76%). There is at least one professorial chair for GTE in 19 faculties; two professorial chairs or professorships remained vacant at the time of the survey. The number of students taught per academic year ranges from 350. Teaching in GTE comprises an average of 2.18 hours per week per semester (min: 1, max: 6). Teaching in GTE is proportionally distributed according to an arithmetic average as follows: history: 35.4%, theory 14.7% and ethics 49.9%. Written learning objectives were formulated for GTE in 24 faculties. The preferred themes of teaching in history, theory or ethics which according to respondents should be taught comprise a broad spectrum and vary. Teaching in ethics (79 from a max. of 81 possible points) is, when compared to history (61/81) and theory (53/81), attributed the most significance for the training of medical doctors. Conclusion: 10 years after the introduction of GTE the number of students and the personnel resources available at the institutions vary considerably. In light of the differences regarding the content elicited in this study the pros and cons of heterogeneity in GTE should be discussed. PMID:28584871

  12. "History, Theory and Ethics of Medicine": The Last Ten Years. A Survey of Course Content, Methods and Structural Preconditions at Twenty-nine German Medical Faculties.

    Science.gov (United States)

    Schildmann, Jan; Bruns, Florian; Hess, Volker; Vollmann, Jochen

    2017-01-01

    Objective: "History, Theory, Ethics of Medicine" (German: "Geschichte, Theorie, Ethik der Medizin", abbreviation: GTE) forms part of the obligatory curriculum for medical students in Germany since the winter semester 2003/2004. This paper presents the results of a national survey on the contents, methods and framework of GTE teaching. Methods: Semi-structured questionnaire dispatched in July 2014 to 38 institutions responsible for GTE teaching. Descriptive analysis of quantitative data and content analysis of free-text answers. Results: It was possible to collect data from 29 institutes responsible for GTE teaching (response: 76%). There is at least one professorial chair for GTE in 19 faculties; two professorial chairs or professorships remained vacant at the time of the survey. The number of students taught per academic year ranges from 350. Teaching in GTE comprises an average of 2.18 hours per week per semester (min: 1, max: 6). Teaching in GTE is proportionally distributed according to an arithmetic average as follows: history: 35.4%, theory 14.7% and ethics 49.9%. Written learning objectives were formulated for GTE in 24 faculties. The preferred themes of teaching in history, theory or ethics which according to respondents should be taught comprise a broad spectrum and vary. Teaching in ethics (79 from a max. of 81 possible points) is, when compared to history (61/81) and theory (53/81), attributed the most significance for the training of medical doctors. Conclusion: 10 years after the introduction of GTE the number of students and the personnel resources available at the institutions vary considerably. In light of the differences regarding the content elicited in this study the pros and cons of heterogeneity in GTE should be discussed.

  13. Why do women not return family history forms when referred to breast cancer genetics services? A mixed-method study.

    Science.gov (United States)

    Hanning, Kirstie A; Steel, Michael; Goudie, David; McLeish, Lorna; Dunlop, Jackie; Myring, Jessica; Sullivan, Frank; Berg, Jonathan; Humphris, Gerry; Ozakinci, Gozde

    2015-10-01

    Personal and family data forms, completed by women referred to breast cancer genetics clinics, are valuable tools for verification and extension of family history, crucial steps in accurate risk evaluation. A significant minority of women do not complete and return these forms, despite reminders, even when completion is a pre-requisite for a clinic appointment. To facilitate access of women at increased familial risk of breast cancer to screening and counselling services by investigating reasons for non-return of the forms. Based on a single regional 'breast cancer family' service in the UK, Analysis of quantitative data comparing women who did not return forms (n = 55) with those who had done so (n = 59), together with qualitative evaluation of potential barriers to form-completion through semi-structured telephone interviews with a random subset of 'non-returners' (n = 23). Non-returners have higher proportions of the very young (below the age at which surveillance could be offered) and of women from lower social deprivation categories. Interviews revealed that the majority of non-returners are anxious, rather than unconcerned about their breast cancer risk and circumstances and attitudes contributed to non-compliance. Twenty-one participants confirmed that they would welcome an appointment at a 'breast cancer family' clinic, but nine did not attend for the appointment. They were significantly younger than those who attend, but were not at lower familial risk. Many women who fail to complete and return a family history form would benefit from risk assessment and genetic counselling. Several steps are suggested that might help them access the relevant services. © 2014 John Wiley & Sons Ltd.

  14. Plantar pressure in diabetic peripheral neuropathy patients with active foot ulceration, previous ulceration and no history of ulceration: a meta-analysis of observational studies.

    Science.gov (United States)

    Fernando, Malindu Eranga; Crowther, Robert George; Pappas, Elise; Lazzarini, Peter Anthony; Cunningham, Margaret; Sangla, Kunwarjit Singh; Buttner, Petra; Golledge, Jonathan

    2014-01-01

    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. 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). 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, pdiabetic peripheral neuropathy with a history of foot ulceration compared to those with diabetic neuropathy without a history of ulceration. More homogenous data is needed to confirm these findings.

  15. Diagnostic utility of patient history and physical examination data to detect spondylolysis and spondylolisthesis in athletes with low back pain: A systematic review.

    Science.gov (United States)

    Grødahl, Linn Helen J; Fawcett, Louise; Nazareth, Madeleine; Smith, Richard; Spencer, Simon; Heneghan, Nicola; Rushton, Alison

    2016-08-01

    In adolescent athletes, low back pain has a 1-year prevalence of 57% and causes include spondylolysis and spondylolisthesis. An accurate diagnosis enables healing, prevention of progression and return to sport. To evaluate the diagnostic utility of patient history and physical examination data to identify spondylolysis and/or spondylolisthesis in athletes. Systematic review was undertaken according to published guidelines, and reported in line with PRISMA. Key databases were searched up to 13/11/15. athletic population with LBP, patient history and/or physical examination accuracy data for spondylolysis and/or spondylolisthesis, any study design including raw data. Two reviewers independently assessed risk of bias (ROB) using QUADAS-2. A data extraction sheet was pre-designed. Pooling of data and investigation for heterogeneity enabled a qualitative synthesis of data across studies. Of the eight included studies, two were assessed as low ROB, one of which also had no concerns regarding applicability. Age (75% for spondylolisthesis. Step-deformity palpation demonstrated 60-88% sensitivity and 87-100% specificity for spondylolisthesis. The one-legged hyperextension test was not supported for spondylolysis (sensitivity 50-73%, specificity 0-87%). No recommendations can be made utilising patient history data. Based on one low ROB study, step deformity palpation may be useful in diagnosing spondylolisthesis. No physical tests demonstrated diagnostic utility for spondylolysis. Further research is required. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Histories electromagnetism

    International Nuclear Information System (INIS)

    Burch, Aidan

    2004-01-01

    Working within the HPO (History Projection Operator) Consistent Histories formalism, we follow the work of Savvidou on (scalar) field theory [J. Math. Phys. 43, 3053 (2002)] and that of Savvidou and Anastopoulos on (first-class) constrained systems [Class. Quantum Gravt. 17, 2463 (2000)] to write a histories theory (both classical and quantum) of Electromagnetism. We focus particularly on the foliation-dependence of the histories phase space/Hilbert space and the action thereon of the two Poincare groups that arise in histories field theory. We quantize in the spirit of the Dirac scheme for constrained systems

  17. Assessment of family history of substance abuse for preventive interventions with patients experiencing chronic pain: A quality improvement project.

    Science.gov (United States)

    Pestka, Elizabeth; Nash, Virginia; Evans, Michele; Cronin, Joan; Bee, Susan; King, Susan; Osborn, Kristine; Gehin, Jessica; Weis, Karen; Loukianova, Larissa

    2016-04-01

    This quality improvement project demonstrates that RN Care Managers, in a chronic pain programme, can assess for a family history of substance abuse in 5-10 min. Information informs treatment based on specific high risk criteria. Benefits include heightened awareness of the genetic and environmental risks associated with a family history of substance abuse, an opportunity to participate in motivational interventions to prevent or minimize consequences of substance use disorders, and likely substantial overall health-care cost savings. © 2015 John Wiley & Sons Australia, Ltd.

  18. Multidisciplinary study: DCD method applied to patients with eating disorders

    Directory of Open Access Journals (Sweden)

    Marina Conese

    2009-06-01

    Full Text Available Eating disorders are quite common in clinical practice and can include out-of-control behaviours and thoughts that powerfully reinforce unhealthy eating patterns. They include anorexia nervosa and bulimia nervosa and Binge Eating Disorder. We conducted a trial on 102 patients (89 females and 13 males to investigate the efficacy of “DCD method” (appropriate dietary education associated to New-Electrosculpture on patients with obesity and eating disorders. The study underlines the efficacy of “DCD method”, especially when supported by behavioural therapy, in obese and overweight patients.

  19. Initial clinical validation of Health Heritage, a patient-facing tool for personal and family history collection and cancer risk assessment.

    Science.gov (United States)

    Baumgart, Leigh A; Postula, Kristen J Vogel; Knaus, William A

    2016-04-01

    Personal and family health histories remain important independent risk factors for cancer; however they are currently not being well collected or used effectively. Health Heritage was designed to address this need. The purpose of this study was to validate the ability of Health Heritage to identify patients appropriate for further genetic evaluation and to accurately stratify cancer risk. A retrospective chart review was conducted on 100 random patients seen at an adult genetics clinic presenting with concern for an inherited predisposition to cancer. Relevant personal and family history obtained from the patients' medical records was entered into Health Heritage. Recommendations by Health Heritage were compared to national guidelines of eligibility for genetic evaluation. Agreement between Health Heritage referral for genetic evaluation and guideline eligibility for genetic evaluation was 97% (sensitivity 98% and specificity 88%). Risk stratification for cancer was also compared between Health Heritage and those documented by a geneticist. For patients at increased risk for breast, ovarian, or colorectal cancer as determined by the geneticist, risk stratification by Health Heritage agreed 90, 93, and 75%, respectively. Discordances in risk stratification were attributed to both complex situations better handled by the geneticist and Health Heritage's adherence to incorporating all information into its algorithms. Health Heritage is a clinically valid tool to identify patients appropriate for further genetic evaluation and to encourage them to confirm the assessment and management recommendations with cancer genetic experts. Health Heritage also provides an estimate of cancer risk that is complementary to a genetics team.

  20. History of Major Depressive Disorder Prospectively Predicts Worse Quality of Life in Women with Breast Cancer

    Science.gov (United States)

    Small, Brent J.; Minton, Susan; Andrykowski, Michael; Jacobsen, Paul B.

    2012-01-01

    Background Data are scarce about whether past history of major depressive disorder in the absence of current depression places breast cancer patients at risk for worse quality of life. Purpose The current study prospectively examined quality of life during chemotherapy in breast cancer patients with a history of resolved major depressive disorder (n=29) and no history of depression (n=144). Methods Women with Stages 0–II breast cancer were assessed prior to and at the completion of chemotherapy. Major depressive disorder was assessed via structured interview and quality of life with the SF-36. Results Patients with past major depressive disorder displayed greater declines in physical functioning relative to patients with no history of depression (p≤0.01). Conclusions Findings suggest that breast cancer patients with a history of resolved major depressive disorder are at increased risk for declines in physical functioning during chemotherapy relative to patients with no history of depression. PMID:22167580

  1. Large scale organisational intervention to improve patient safety in four UK hospitals: mixed method evaluation

    Science.gov (United States)

    Benning, Amirta; Ghaleb, Maisoon; Suokas, Anu; Dixon-Woods, Mary; Dawson, Jeremy; Barber, Nick; Franklin, Bryony Dean; Girling, Alan; Hemming, Karla; Carmalt, Martin; Rudge, Gavin; Naicker, Thirumalai; Nwulu, Ugochi; Choudhury, Sopna

    2011-01-01

    Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (Porganisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296

  2. Large scale organisational intervention to improve patient safety in four UK hospitals: mixed method evaluation.

    Science.gov (United States)

    Benning, Amirta; Ghaleb, Maisoon; Suokas, Anu; Dixon-Woods, Mary; Dawson, Jeremy; Barber, Nick; Franklin, Bryony Dean; Girling, Alan; Hemming, Karla; Carmalt, Martin; Rudge, Gavin; Naicker, Thirumalai; Nwulu, Ugochi; Choudhury, Sopna; Lilford, Richard

    2011-02-03

    To conduct an independent evaluation of the first phase of the Health Foundation's Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Mixed method evaluation involving five substudies, before and after design. NHS hospitals in the United Kingdom. Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. The SPI1 was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration--monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)--there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for "difference in difference" 2

  3. The Olson method for detection of acute myocardial ischemia in patients with coronary occlusion.

    Science.gov (United States)

    Lindow, Thomas; Olson, Charles W; Swenne, Cees A; Man, Sumche; Pahlm, Olle

    An automated ECG-based method may provide diagnostic support in the management of patients with acute coronary syndrome. The Olson method has previously proved to accurately identify the culprit artery in patients with acute coronary occlusion. The Olson method was applied to 360 patients without acute myocardial ischemia and 52 patients with acute coronary occlusion. This study establishes the normal variation of the Olson wall scores in patients without acute myocardial ischemia, which provides the basis for implementation of the Olson method for triage of patients with acute coronary syndrome. All patients with acute occlusion had Olson wall scores above the upper limit of normal. The Olson method can be used for ischemia detection with very high sensitivity. Future studies are needed to explore specificity in patients with non-ischemic ST elevation. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. [Pathology of the nervous system in conscripts with drug abuse in past medical history: symptomatology, diagnostics methods].

    Science.gov (United States)

    Litvintsev, B S; Odinak, M M; Kovalenko, A P; Efimtsev, A Iu; Tarumov, D A; Petrov, A D; Lisianskiĭ, D A

    2014-08-01

    Authors examined 60 female and male patients (average age 25.8±2.7 years) with confirmed diagnosis - drug abuse. Average duration of drug abuse was approximately 9±3.3 years. At the moment of examination patients had been fully in remission for 3 weeks. The following non-invasive procedures were undertaken: stimulation electroneuromyogrphy and brain MRI. Received results showed that drug abuse leads to diffuse lesion of the nervous system, which manifests itself as vegetative disorders, scattered neurological symptoms, polyneuropathy. Authors gave recommendations in the field of military examination with the aim of detection of nervous disorders caused by drug abuse.

  5. [Ultrasonic methods and semiotics in patients with vasculogenic erectile dysfunction].

    Science.gov (United States)

    Zhukov, O B; Zubarev, A R

    2001-01-01

    The authors have developed criteria for ultrasonic assessment of cavernous bodies, arterial and venous circulation in normal penile vessels and in erectile dysfunction in 125 patients; describe modern ultrasound modalities in differential diagnosis of various forms of vasculogenic erectile dysfunction basing on the experience with 92 patients; validate hydrodynamic role of the tunica albuginea in pathogenesis of venocorporal dysfunction and pathological venous drainage. Early ischemic signs of arterial insufficiency were revealed.

  6. History of thyroid disease and survival of ovarian cancer patients: results from the Ovarian Cancer Association Consortium, a brief report.

    Science.gov (United States)

    Minlikeeva, Albina N; Freudenheim, Jo L; Cannioto, Rikki A; Eng, Kevin H; Szender, J Brian; Mayor, Paul; Etter, John L; Cramer, Daniel W; Diergaarde, Brenda; Doherty, Jennifer A; Dörk, Thilo; Edwards, Robert; deFazio, Anna; Friel, Grace; Goodman, Marc T; Hillemanns, Peter; Høgdall, Estrid; Jensen, Allan; Jordan, Susan J; Karlan, Beth Y; Kjær, Susanne K; Klapdor, Rüdiger; Matsuo, Keitaro; Mizuno, Mika; Nagle, Christina M; Odunsi, Kunle; Paddock, Lisa; Rossing, Mary Anne; Schildkraut, Joellen M; Schmalfeldt, Barbara; Segal, Brahm H; Starbuck, Kristen; Terry, Kathryn L; Webb, Penelope M; Zsiros, Emese; Ness, Roberta B; Modugno, Francesmary; Bandera, Elisa V; Chang-Claude, Jenny; Moysich, Kirsten B

    2017-09-26

    Findings from in vitro studies suggest that increased exposure to thyroid hormones can influence progression of ovarian tumours. However, epidemiologic evidence on this topic is limited. We pooled data from 11 studies from the Ovarian Cancer Association Consortium. Using multivariate Cox proportional hazards models, we estimated associations between hyper- and hypothyroidism and medications prescribed for these conditions with 5-year all-cause survival among women diagnosed with invasive ovarian cancer. Overall, there was a nonsignificant association with history of hyperthyroidism (n=160 cases) and mortality (HR=1.22; 95% CI=0.97-1.53). Furthermore, diagnosis of hyperthyroidism within the 5 years before ovarian cancer diagnosis was associated with an increased risk of death (HR=1.94; 95% CI=1.19-3.18). A more modest association was observed with history of hypothyroidism (n=624 cases) and mortality (HR=1.16; 95% CI=1.03-1.31). Neither duration of hypothyroidism nor use of thyroid medications was associated with survival. In this large study of women with ovarian cancer, we found that recent history of hyperthyroidism and overall history of hypothyroidism were associated with worse 5-year survival.

  7. 'Insane emigrants' in transit: Psychiatric patients' files as a source for the history of return migration, c. 1910

    NARCIS (Netherlands)

    Blok, G.

    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 allege