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Sample records for patients seventy-two percent

  1. Pigmented villonodular synovitis: a crowdsourcing study of two hundred and seventy two patients.

    Science.gov (United States)

    van der Heijden, Lizz; Piner, Sheila R; van de Sande, Michiel Adrianus Josephus

    2016-12-01

    We aimed to ascertain the feasibility of crowdsourcing via Facebook for medical research purposes; by investigating surgical, oncological and functional outcome and quality-of-life (QOL) in patients with pigmented villonodular synovitis (PVNS) enrolled in a Facebook community (1112 members). Patients completed online open surveys on demographics, surgery and clinical outcomes (group 1); and patient-reported outcome measures (PROMs) including knee-injury osteoarthritis outcome score (KOOS), hip-disability osteoarthritis outcome score (HOOS), Toronto extremity salvage score (TESS) and SF-36 (group 2). Mean follow-up was 70 months (12-374). Consistency checks were performed with Cohen's kappa statistic for intra-rater agreement. The first survey was completed by 272 patients (group 1) and 72 patients completed the second (group 2). In group 1, recurrence-rate was 58 % (69/118) after arthroscopic, 36 % (35/97) after open and 50 % (5/10) after combined synovectomy (p = 0.003). In group 2, recurrence-rate was 67 % (26/39) after arthroscopic and 51 % (17/33) after open synovectomy (p = 0.19). Recurrence-risk was increased for diffuse disease (OR = 16; 95%CI = 3.2-85; p crowdsourcing seems a promising and innovative way of evaluating rare diseases including PVNS.

  2. An evaluation of 10 percent and 20 percent benzocaine gels in patients with acute toothaches

    Science.gov (United States)

    Hersh, Elliot V.; Ciancio, Sebastian G.; Kuperstein, Arthur S.; Stoopler, Eric T.; Moore, Paul A.; Boynes, Sean G.; Levine, Steven C.; Casamassimo, Paul; Leyva, Rina; Mathew, Tanya; Shibly, Othman; Creighton, Paul; Jeffers, Gary E.; Corby, Patricia M.A.; Turetzky, Stanley N.; Papas, Athena; Wallen, Jillian; Idzik-Starr, Cynthia; Gordon, Sharon M.

    2013-01-01

    Background The authors evaluated the efficacy and tolerability of 10 percent and 20 percent benzocaine gels compared with those of a vehicle (placebo) gel for the temporary relief of toothache pain. They also assessed the compliance with the label dose administration directions on the part of participants with toothache pain. Methods Under double-masked conditions, 576 participants self-applied study gel to an open tooth cavity and surrounding oral tissues. Participants evaluated their pain intensity and pain relief for 120 minutes. The authors determined the amount of gel the participants applied. Results The responders’ rates (the primary efficacy parameter), defined as the percentage of participants who had an improvement in pain intensity as exhibited by a pain score reduction of at least one unit on the dental pain scale from baseline for two consecutive assessments any time between the five- and 20-minute points, were 87.3 percent, 80.7 percent and 70.4 percent, respectively, for 20 percent benzocaine gel, 10 percent benzocaine gel and vehicle gel. Both benzocaine gels were significantly (P ≤ .05) better than vehicle gel; the 20 percent benzocaine gel also was significantly (P ≤ .05) better than the 10 percent benzocaine gel. The mean amount of gel applied was 235.6 milligrams, with 88.2 percent of participants applying 400 mg or less. Conclusions Both 10 percent and 20 percent benzocaine gels were more efficacious than the vehicle gel, and the 20 percent benzocaine gel was more efficacious than the 10 percent benzocaine gel. All treatments were well tolerated by participants. Practical Implications Patients can use 10 percent and 20 percent benzocaine gels to temporarily treat toothache pain safely. PMID:23633700

  3. Proceedings of the symposium on quantum- and opto-electronics, Bombay, India, February 25--28, 1974. [Seventy-two papers

    Energy Technology Data Exchange (ETDEWEB)

    1974-01-01

    Seventy-two papers are presented on quantum and optical electronics, with the majority of the papers dealing with lasers or laser applications. Some of the topics discussed include laser materials, spectroscopy, laser tuning and focusing, optical theory, holography, interferometry, and optical properties of solids. (PMA)

  4. Percent Coverage

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Percent Coverage is a spreadsheet that keeps track of and compares the number of vessels that have departed with and without observers to the numbers of vessels...

  5. Seventy two-hour glucose monitoring profiles in mild gestational diabetes mellitus: differences from healthy pregnancies and influence of diet counseling.

    Science.gov (United States)

    Carreiro, Marina Pimenta; Lauria, Márcio W; Naves, Gabriel Nino T; Miranda, Paulo Augusto C; Leite, Ricardo Barsaglini; Rajão, Kamilla Maria Araújo Brandão; de Aguiar, Regina Amélia Lopes Pessoa; Nogueira, Anelise Impeliziere; Ribeiro-Oliveira, Antônio

    2016-09-01

    To study glucose profiles of gestational diabetes (GDM) patients with 72 h of continuous glucose monitoring (CGM) either before (GDM1) or after (GDM2) dietary counseling, comparing them with nondiabetic (NDM) controls. We performed CGM on 22 GDM patients; 11 before and 11 after dietary counseling and compared them to 11 healthy controls. Several physiological and clinical characteristics of the glucose profiles were compared across the groups, including comparisons for pooled 24-h measures and hourly median values, summary measures representing glucose exposure (area under the median curves) and variability (amplitude, standard deviation, interquartile range), and time points related to meals. Most women (81.8%) in the GDM groups had fasting glucose 0.05). Both GDM groups spent more time with glucose levels above 140mg/dL when compared with the NDM group. No differences among the groups were found for: pooled measurements and hourly comparisons, exposure, nocturnal, fasting, between lunch and dinner and before meals, as well as after lunch (P>0.05 for all). The main differences between the mild GDM1 group and healthy controls were related to glucose variability and excursions above 140mg/dL, while glucose exposure was similar. Glucose levels after breakfast and dinner also discerned the GDM1 group. Dietary counseling was able to keep glucose levels to those of healthy patients. © 2016 European Society of Endocrinology.

  6. Consumption of oral hospital diets and percent adequacy of minerals in oncology patients as an indicative for the use of oral supplements.

    OpenAIRE

    Sá, Júlia Sommerlatte Manzoli de; Moreira, Daniele Caroline Faria; Silva, Karine Aparecida Louvera; Morgano, Marcelo Antonio; Quintaes, Késia Diego

    2014-01-01

    Background & aims: Deficiencies in the consumption of foods and nutrients favor malnutrition in patients. Considering the recommendations for the ingestion of minerals, the content, consumption and percent adequacy of the minerals (Ca, Cu, Fe, Mg, Mn, K, P, Na, Zn and Se) were evaluated amongst oncology patients who received oral diets isolated or associated with an oral food complement (OFC), evaluating the need and composition of an oral supplement. Methods: The mineral composition as deter...

  7. Percent Wetland Cover

    Data.gov (United States)

    U.S. Environmental Protection Agency — Wetlands act as filters, removing or diminishing the amount of pollutants that enter surface water. Higher values for percent of wetland cover (WETLNDSPCT) may be...

  8. Percent Wetland Cover (Future)

    Data.gov (United States)

    U.S. Environmental Protection Agency — Wetlands act as filters, removing or diminishing the amount of pollutants that enter surface water. Higher values for percent of wetland cover (WETLNDSPCT) may be...

  9. Lack of CD4+ T cell percent decrease in alemtuzumab-treated multiple sclerosis patients with persistent relapses.

    Science.gov (United States)

    Rolla, Simona; De Mercanti, Stefania Federica; Bardina, Valentina; Horakova, Dana; Habek, Mario; Adamec, Ivan; Cocco, Eleonora; Annovazzi, Pietro; Vladic, Anton; Novelli, Francesco; Durelli, Luca; Clerico, Marinella

    2017-12-15

    Alemtuzumab, a highly effective treatment for relapsing remitting multiple sclerosis (RRMS), induces lymphopenia especially of CD4+ T cells. Here, we report the atypical CD4+ T population behaviour of two patients with persistent disease activity despite repeated alemtuzumab treatments. Whereas lymphocytes count decreased and fluctuated accordingly to alemtuzumab administration, their CD4+ cell percentage was not or just mildly affected and was slightly below the lowest normal limit already before alemtuzumab. These cases anticipate further studies aimed to investigate whether the evaluation of the CD4+ cell percentage could represent a helpful tool to address the individual clinical response to alemtuzumab. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  10. Consumption of oral hospital diets and percent adequacy of minerals in oncology patients as an indicative for the use of oral supplements.

    Science.gov (United States)

    de Sá, Júlia S M; Moreira, Daniele C F; Louvera Silva, Karine A; Morgano, Marcelo A; Quintaes, Késia D

    2014-08-01

    Deficiencies in the consumption of foods and nutrients favor malnutrition in patients. Considering the recommendations for the ingestion of minerals, the content, consumption and percent adequacy of the minerals (Ca, Cu, Fe, Mg, Mn, K, P, Na, Zn and Se) were evaluated amongst oncology patients who received oral diets isolated or associated with an oral food complement (OFC), evaluating the need and composition of an oral supplement. The mineral composition as determined by ICP-OES, and the food consumption of the patients served regular, bland and soft diets, were evaluated on six non-consecutive weekdays. Patients with increased nutritional needs received OFC. The consumptions were calculated by deducting the weight of the leftovers from the value served. A total of 163 patients took part of which 59.5% were men, the mean age was 57 ± 15 years old, and 126 (77.3%), 27 (16.6%) and 10 (6.1%) were served the regular, bland and soft diets, respectively, with (23.0%), 8 (30.7%) and 4 (40.0%) receiving the OFC. Patient consumption was lower when the regular (74.2 vs 79.7%) and soft (68.9 vs 74.2%) diets were combined with OFC. For all diets, less was consumed at the lunch (61.2%-65.7%) and dinner (39.9%-62.8%) meals. Patients that received the OFC showed reduced meal consumption and higher Ca ingestion. The mineral contents of the diets were inadequate, with 66.8% of the patients ingesting Na above the UL and K below the nutritional recommendation (100%). The diet consumption, isolated or associated with OFC was insufficient, and hence the exclusion of OFC and the inclusion of a mineral supplement (without P and Na) was indicated to adequate ingestion to the nutritional recommendations. Copyright © 2013. Published by Elsevier Ltd.

  11. Model-based estimation of breast percent density in raw and processed full-field digital mammography images from image-acquisition physics and patient-image characteristics

    Science.gov (United States)

    Keller, Brad M.; Nathan, Diane L.; Conant, Emily F.; Kontos, Despina

    2012-03-01

    Breast percent density (PD%), as measured mammographically, is one of the strongest known risk factors for breast cancer. While the majority of studies to date have focused on PD% assessment from digitized film mammograms, digital mammography (DM) is becoming increasingly common, and allows for direct PD% assessment at the time of imaging. This work investigates the accuracy of a generalized linear model-based (GLM) estimation of PD% from raw and postprocessed digital mammograms, utilizing image acquisition physics, patient characteristics and gray-level intensity features of the specific image. The model is trained in a leave-one-woman-out fashion on a series of 81 cases for which bilateral, mediolateral-oblique DM images were available in both raw and post-processed format. Baseline continuous and categorical density estimates were provided by a trained breast-imaging radiologist. Regression analysis is performed and Pearson's correlation, r, and Cohen's kappa, κ, are computed. The GLM PD% estimation model performed well on both processed (r=0.89, p<0.001) and raw (r=0.75, p<0.001) images. Model agreement with radiologist assigned density categories was also high for processed (κ=0.79, p<0.001) and raw (κ=0.76, p<0.001) images. Model-based prediction of breast PD% could allow for a reproducible estimation of breast density, providing a rapid risk assessment tool for clinical practice.

  12. Twenty Percent of Patients May Remain Colonized With Methicillin-resistant Staphylococcus aureus Despite a Decolonization Protocol in Patients Undergoing Elective Total Joint Arthroplasty.

    Science.gov (United States)

    Baratz, Michael D; Hallmark, Ruth; Odum, Susan M; Springer, Bryan D

    2015-07-01

    Staphylococcus aureus is the most commonly isolated organism in periprosthetic joint infection (PJI). Resistant strains such as methicillin-resistant S aureus (MRSA) are on the rise, and many programs have instituted decolonization protocols. There are limited data on the success of S aureus nasal decolonization programs and their impact on PJI. The purposes of this study were to (1) determine the proportion of patients successfully decolonized using a 2-week protocol; (2) compare infection risks between our surveillance and decolonization protocol group against a historical control cohort to evaluate changes in proportions of S aureus infections; and (3) assess infection risk based on carrier type, comparing S aureus carriers with noncarrier controls. We retrospectively evaluated a group of 3434 patients who underwent elective primary and revision hip and knee arthroplasty over a 2-year period; each patient in the treatment group underwent a surveillance protocol, and a therapeutic regimen of mupurocin and chlorhexidine was instituted when colonization criteria were met. A 2009 to 2010 comparative historical cohort was chosen as the control group. We compared risks of infection between our treatment group and the historical control cohort. Furthermore, in patients who developed surgical site infections (SSIs), we compared the proportions of each S aureus type between the two cohorts. Finally, we compared infection rates based on carrier status. Surveillance for infection was carried out by the hospital infection control coordinator using the Centers for Disease Control and Prevention (CDC) criteria. During the time period of this study, the CDC defined hospital-acquired infection related to a surgical procedure as any infection diagnosed within 1 year of the procedure. With the numbers available, we had 41% power to detect a difference of 0.3% in infection rate between the treatment and control groups. To achieve 80% power, a total of 72,033 patients would be

  13. Inspiration: One Percent and Rising

    Science.gov (United States)

    Walling, Donovan R.

    2009-01-01

    Inventor Thomas Edison once famously declared, "Genius is one percent inspiration and ninety-nine percent perspiration." If that's the case, then the students the author witnessed at the International Student Media Festival (ISMF) last November in Orlando, Florida, are geniuses and more. The students in the ISMF pre-conference workshop…

  14. [Clinical features of 32 patients with cutaneous small vessel vasculitis].

    Science.gov (United States)

    López de Maturana, Donaldo; Amaro, Patricio; Segovia, Laura; Balestrini, Claudia

    2004-02-01

    The skin is a common target of small vessel vasculitis, with a wide assortment of pathological changes. This condition is usually associated to systemic diseases. To report the clinical and pathological features of patients with cutaneous small vessel vasculitis. A retrospective review of 32 patients with a pathological diagnosis of cutaneous vasculitis. Seventy two percent of patients were women. Cutaneous lesions were mainly located in the lower limbs (94%). The most common lesion was palpable purpura (62%). Connective tissue diseases and systemic vasculitis were the most commonly associated systemic diseases. Palpable purpura is the most common manifestation of cutaneous small vessel vasculitis, that is usually associated to connective tissue diseases or systemic vasculitis.

  15. [Quality of life of post-colostomy patients].

    Science.gov (United States)

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

    1995-09-10

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

  16. Cementless One-Stage Revision in Chronic Periprosthetic Hip Joint Infection. Ninety-One Percent Infection Free Survival in 56 Patients at Minimum 2-Year Follow-Up

    DEFF Research Database (Denmark)

    Lange, Jeppe; Troelsen, Anders; Solgaard, Søren

    2018-01-01

    was re-revision performed due to infection and was evaluated by competing risk analysis, with death and aseptic revision as competing events. All-cause mortality was evaluated by Kaplan-Meier survival analysis. Oxford Hip Score (OHS) was used as disease-specific patient-reported outcome measure. RESULTS......BACKGROUND: Cementless 1-stage revision in chronic periprosthetic hip joint infections is limited evaluated. The purpose of this study was to evaluate a specific treatment protocol in this patient group. METHODS: The study was performed as a multicenter, proof-of-concept, observational study...

  17. The Percent of Positive Biopsy Cores Improves Prediction of Prostate Cancer-Specific Death in Patients Treated With Dose-Escalated Radiotherapy

    International Nuclear Information System (INIS)

    Qian Yushen; Feng, Felix Y.; Halverson, Schuyler; Blas, Kevin; Sandler, Howard M.; Hamstra, Daniel A.

    2011-01-01

    Purpose: To examine the prognostic utility of the percentage of positive cores (PPC) at the time of prostate biopsy for patients treated with dose-escalated external beam radiation therapy. Methods and Materials: We performed a retrospective analysis of patients treated at University of Michigan Medical Center to at least 75 Gy. Patients were stratified according to PPC by quartile, and freedom from biochemical failure (nadir + 2 ng/mL), freedom from metastasis (FFM), cause-specific survival (CSS), and overall survival (OS) were assessed by log-rank test. Receiver operator characteristic (ROC) curve analysis was used to determine the optimal cut point for PPC stratification. Finally, Cox proportional hazards multivariate regression was used to assess the impact of PPC on clinical outcome when adjusting for National Comprehensive Cancer Network (NCCN) risk group and androgen deprivation therapy. Results: PPC information was available for 651 patients. Increasing-risk features including T stage, prostate-specific antigen, Gleason score, and NCCN risk group were all directly correlated with increasing PPC. On log-rank evaluation, all clinical endpoints, except for OS, were associated with PPC by quartile, with worse clinical outcomes as PPC increased, with the greatest impact seen in the highest quartile (>66.7% of cores positive). ROC curve analysis confirmed that a cut point using two-thirds positive cores was most closely associated with CSS (p = 0.002; area under ROC curve, 0.71). On univariate analysis, stratifying patients according to PPC less than or equal to 66.7% vs. PPC greater than 66.7% was prognostic for freedom from biochemical failure (p = 0.0001), FFM (p = 0.0002), and CSS (p = 0.0003) and marginally prognostic for OS (p = 0.055). On multivariate analysis, after adjustment for NCCN risk group and androgen deprivation therapy use, PPC greater than 66.7% increased the risk for biochemical failure (p = 0.0001; hazard ratio [HR], 2.1 [95% confidence

  18. Three percent diquafosol ophthalmic solution as an additional therapy to existing artificial tears with steroids for dry-eye patients with Sjögren's syndrome.

    Science.gov (United States)

    Yokoi, N; Sonomura, Y; Kato, H; Komuro, A; Kinoshita, S

    2015-09-01

    To investigate the long-term results of 3% diquafosol ophthalmic solution as an alternative therapy to existing ophthalmic solutions, including topical immunosuppression, for the treatment of dry eye in patients with Sjögren's syndrome. This study involved 14 female dry-eye patients (mean age: 62.4 years) with Sjögren's syndrome who insufficiently responded to their current therapy. In all patients, 3% diquafosol ophthalmic solution was administered six times daily for 12 months in substitution for artificial tears and sodium hyaluronate ophthalmic solution. Their use of corticosteroid eye drops remained unchanged from that prior to the treatment with diquafosol sodium. The subjective symptoms assessed, and ocular signs including tear meniscus radius and the tear film breakup time, and ocular-surface epithelial damage score were examined at 1, 2, 3, 4, 5, 6, 9, and 12 months after initiating treatment. Among the subjective symptoms, significant improvement was obtained in dryness at 2 months post treatment, in eye fatigue at 1, 2, 3, 4, and 12 months post treatment, and in pain at 1, 2, 6, and 12 months post treatment. Difficulty in opening the eye, foreign body sensation, and redness were also significantly ameliorated at various time-points. The tear meniscus radius and the tear film breakup time were significantly improved throughout the observation period, and the corneal epithelial staining scores were significantly decreased at 3 months post treatment. In dry-eye patients with Sjögren's syndrome, treatment with 3% diquafosol ophthalmic solution improved both symptoms and signs, and that effectiveness was maintained for 12 months.

  19. The Algebra of the Cumulative Percent Operation.

    Science.gov (United States)

    Berry, Andrew J.

    2002-01-01

    Discusses how to help students avoid some pervasive reasoning errors in solving cumulative percent problems. Discusses the meaning of ."%+b%." the additive inverse of ."%." and other useful applications. Emphasizes the operational aspect of the cumulative percent concept. (KHR)

  20. A Conceptual Model for Solving Percent Problems.

    Science.gov (United States)

    Bennett, Albert B., Jr.; Nelson, L. Ted

    1994-01-01

    Presents an alternative method to teaching percent problems which uses a 10x10 grid to help students visualize percents. Offers a means of representing information and suggests different approaches for finding solutions. Includes reproducible student worksheet. (MKR)

  1. Beyond Marbles: Percent Change and Social Justice

    Science.gov (United States)

    Denny, Flannery

    2013-01-01

    In the author's eighth year of teaching, she hit a wall teaching percent change. Percent change is one of the few calculations taught in math classes that shows up regularly in the media, and one that she often does in her head to make sense of the world around her. Despite this, she had been teaching percent change using textbook problems about…

  2. How I Love My 80 Percenters

    Science.gov (United States)

    Maturo, Anthony J.

    2002-01-01

    Don't ever take your support staff for granted. By support staff, I mean the people in personnel, logistics, and finance; the ones who can make things happen with a phone call or a signature, or by the same token frustrate you to no end by their inaction; these are people you must depend on. I've spent a lot of time thinking about how to cultivate relationships with my support staff that work to the advantage of both of us. The most important thing that have learned working with people, any people--and I will tell you how I learned this in a minute--is there are some folks you just can't motivate, so forget it, don't try; others you certainly can with a little psychology and some effort; and the best of the bunch, what I call the 80 percenters, you don't need to motivate because they're already on the team and performing beautifully. The ones you can't change are rocks. Face up to it, and just kick them out of your way. I have a reputation with the people who don't want to perform or be part of the team. They don't come near me. If someone's a rock, I pick up on it right away, and I will walk around him or her to find someone better. The ones who can be motivated I take time to nurture. I consider them my projects. A lot of times these wannabes are people who want to help but don't know how. Listen, you can work with them. Lots of people in organizations have the mindset that all that matters are the regulations. God forbid if you ever work outside those regulations. They've got one foot on that regulation and they're holding it tight like a baby holds a blanket. What you're looking for is that first sign that their minds are opening. Usually you hear it in their vocabulary. What used to sound like "We can't do that ... the regulations won't allow it ... we have never done this before," well, suddenly that changes to "We have options ... let's take a look at the options ... let me research this and get back to you." The 80 percenters you want to nurture too, but

  3. Relationship between breast sound speed and mammographic percent density

    Science.gov (United States)

    Sak, Mark; Duric, Nebojsa; Boyd, Norman; Littrup, Peter; Myc, Lukasz; Faiz, Muhammad; Li, Cuiping; Bey-Knight, Lisa

    2011-03-01

    Despite some shortcomings, mammography is currently the standard of care for breast cancer screening and diagnosis. However, breast ultrasound tomography is a rapidly developing imaging modality that has the potential to overcome the drawbacks of mammography. It is known that women with high breast densities have a greater risk of developing breast cancer. Measuring breast density is accomplished through the use of mammographic percent density, defined as the ratio of fibroglandular to total breast area. Using an ultrasound tomography (UST) prototype, we created sound speed images of the patient's breast, motivated by the fact that sound speed in a tissue is proportional to the density of the tissue. The purpose of this work is to compare the acoustic performance of the UST system with the measurement of mammographic percent density. A cohort of 251 patients was studied using both imaging modalities and the results suggest that the volume averaged breast sound speed is significantly related to mammographic percent density. The Spearman correlation coefficient was found to be 0.73 for the 175 film mammograms and 0.69 for the 76 digital mammograms obtained. Since sound speed measurements do not require ionizing radiation or physical compression, they have the potential to form the basis of a safe, more accurate surrogate marker of breast density.

  4. Morphological and Stress Vulnerability Indices for Human Coronary Plaques and Their Correlations with Cap Thickness and Lipid Percent: An IVUS-Based Fluid-Structure Interaction Multi-patient Study.

    Directory of Open Access Journals (Sweden)

    Liang Wang

    2015-12-01

    Full Text Available Plaque vulnerability, defined as the likelihood that a plaque would rupture, is difficult to quantify due to lack of in vivo plaque rupture data. Morphological and stress-based plaque vulnerability indices were introduced as alternatives to obtain quantitative vulnerability assessment. Correlations between these indices and key plaque features were investigated. In vivo intravascular ultrasound (IVUS data were acquired from 14 patients and IVUS-based 3D fluid-structure interaction (FSI coronary plaque models with cyclic bending were constructed to obtain plaque wall stress/strain and flow shear stress for analysis. For the 617 slices from the 14 patients, lipid percentage, min cap thickness, critical plaque wall stress (CPWS, strain (CPWSn and flow shear stress (CFSS were recorded, and cap index, lipid index and morphological index were assigned to each slice using methods consistent with American Heart Association (AHA plaque classification schemes. A stress index was introduced based on CPWS. Linear Mixed-Effects (LME models were used to analyze the correlations between the mechanical and morphological indices and key morphological factors associated with plaque rupture. Our results indicated that for all 617 slices, CPWS correlated with min cap thickness, cap index, morphological index with r = -0.6414, 0.7852, and 0.7411 respectively (p<0.0001. The correlation between CPWS and lipid percentage, lipid index were weaker (r = 0.2445, r = 0.2338, p<0.0001. Stress index correlated with cap index, lipid index, morphological index positively with r = 0.8185, 0.3067, and 0.7715, respectively, all with p<0.0001. For all 617 slices, the stress index has 66.77% agreement with morphological index. Morphological and stress indices may serve as quantitative plaque vulnerability assessment supported by their strong correlations with morphological features associated with plaque rupture. Differences between the two indices may lead to better plaque

  5. Evaluation of neurogenic dysphagia in Iraqi patients with acute stroke.

    Science.gov (United States)

    Hasan, Zeki N; Al-Shimmery, Ehsan K; Taha, Mufeed A

    2010-04-01

    To clinically assess neurogenic dysphagia, and to correlate its presence with demographic features, different stroke risk factors, anatomical arterial territorial stroke types, and pathological stroke types. Seventy-two stroke inpatients were studied between July 2007 and February 2008, at the Departments of Medicine and Neurology at Al-Yarmouk Teaching Hospital, Baghdad, and Rizgary Teaching Hospital, Erbil, Iraq. All patients were assessed using the Mann Assessment of Swallowing Ability score (MASA), Modified Rankin Scale, and the Stroke Risk Scorecard. All patients were reassessed after one month. There were 40 males and 32 females. Sixty-eight patients had ischemic stroke, and 4 had primary intracerebral hemorrhage (ICH). According to the MASA score, 55% of anterior circulation stroke (ACS) cases were associated with dysphasia, and 91% of lateral medullary syndrome cases were associated with dysphagia. Fifty-six percent of ACS dysphagic cases improved within the first month. Forty percent of dysphagic patients died in the one month follow up period, and in most, death was caused by aspiration pneumonia. We observed no significant differences regarding demographic features of dysphagia. Dysphagia can be an indicator of the severity of stroke causing higher mortality and morbidity in affected patients. It was not related to the stroke risk factors and the type of stroke. It is essential from a prognostic point of view to assess swallowing, and to treat its complications early.

  6. Analysis association of milk fat and protein percent in quantitative ...

    African Journals Online (AJOL)

    Analysis association of milk fat and protein percent in quantitative trait locus ... African Journal of Biotechnology ... Protein and fat percent as content of milk are high-priority criteria for financial aims and selection of programs in dairy cattle.

  7. 26 CFR 301.6226(b)-1 - 5-percent group.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 18 2010-04-01 2010-04-01 false 5-percent group. 301.6226(b)-1 Section 301.6226... ADMINISTRATION PROCEDURE AND ADMINISTRATION Assessment In General § 301.6226(b)-1 5-percent group. (a) In general. All members of a 5-percent group shall join in filing any petition for judicial review. The...

  8. Characterization of the uranium--2 weight percent molybdenum alloy

    International Nuclear Information System (INIS)

    Hemperly, V.C.

    1976-01-01

    The uranium-2 wt percent molybdenum alloy was prepared, processed, and age hardened to meet a minimum 930-MPa yield strength (0.2 percent) with a minimum of 10 percent elongation. These mechanical properties were obtained with a carbon level up to 300 ppM in the alloy. The tensile-test ductility is lowered by the humidity of the laboratory atmosphere

  9. CRED Cumulative Map of Percent Scleractinian Coral Cover at Saipan

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  10. CRED Cumulative Map of Percent Scleractinian Coral Cover at Sarigan

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  11. CRED Cumulative Map of Percent Scleractinian Coral Cover at Tutuila

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  12. CRED Cumulative Map of Percent Scleractinian Coral Cover at Anatahan

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  13. CRED Cumulative Map of Percent Scleractinian Coral Cover at Alamagan

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  14. CRED Cumulative Map of Percent Scleractinian Coral Cover at Agrihan

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  15. CRED Cumulative Map of Percent Scleractinian Coral Cover at Asuncion

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  16. CRED Cumulative Map of Percent Scleractinian Coral Cover at Aguijan

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  17. CRED Cumulative Map of Percent Scleractinian Coral Cover at Pagan

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  18. The relationships between percent body fat and other ...

    African Journals Online (AJOL)

    The relationships between percent body fat and other anthropometric nutritional predictors among male and female children in Nigeria. ... A weak significant positive correlation was observed between the percent body fat and height – armspan ratio ... There was evidence of overweight and obesity in both children. The mid ...

  19. The Texas Ten Percent Plan's Impact on College Enrollment

    Science.gov (United States)

    Daugherty, Lindsay; Martorell, Paco; McFarlin, Isaac, Jr.

    2014-01-01

    The Texas Ten Percent Plan (TTP) provides students in the top 10 percent of their high-school class with automatic admission to any public university in the state, including the two flagship schools, the University of Texas at Austin and Texas A&M. Texas created the policy in 1997 after a federal appellate court ruled that the state's previous…

  20. Knowledge, Attitude and Practices of Diabetic Patients in the United Arab Emirates

    Science.gov (United States)

    Al-Maskari, Fatma; El-Sadig, Mohamed; Al-Kaabi, Juma M.; Afandi, Bachar; Nagelkerke, Nicolas; Yeatts, Karin B.

    2013-01-01

    Introduction Diabetes self-management education is a cornerstone of diabetes care. However, many diabetics in the United Arab Emirates (UAE) lack sufficient knowledge about their disease due to illiteracy. Thus, before considering any possible intervention it was imperative to assess present knowledge, attitudes, and practices of patients towards the management of diabetes. Methods A random sample of 575 DM patients was selected from diabetes outpatient's clinics of Tawam and Al-Ain hospitals in Al-Ain city (UAE) during 2006–2007, and their knowledge attitude and practice assessed using a questionnaire modified from the Michigan Diabetes Research Training Center instrument. Results Thirty-one percent of patients had poor knowledge of diabetes. Seventy-two had negative attitudes towards having the disease and 57% had HbA1c levels reflecting poor glycemic control. Only seventeen percent reported having adequate blood sugar control, while 10% admitted non-compliance with their medications. Knowledge, practice and attitude scores were all statistically significantly positively, but rather weakly, associated, but none of these scores was significantly correlated with HbA1c. Conclusions The study showed low levels of diabetes awareness but positive attitudes towards the importance of DM care and satisfactory diabetes practices in the UAE. Programs to increase patients' awareness about DM are essential for all diabetics in the UAE in order to improve their understanding, compliance and management and, thereby, their ability to cope with the disease. PMID:23341913

  1. National Land Cover Database (NLCD) Percent Tree Canopy Collection

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The National Land Cover Database (NLCD) Percent Tree Canopy Collection is a product of the U.S. Forest Service (USFS), and is produced through a cooperative project...

  2. National Land Cover Database (NLCD) Percent Developed Imperviousness Collection

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The National Land Cover Database (NLCD) Percent Developed Imperviousness Collection is produced through a cooperative project conducted by the Multi-Resolution Land...

  3. Determination of percent calcium carbonate in calcium chromate

    International Nuclear Information System (INIS)

    Middleton, H.W.

    1979-01-01

    The precision, accuracy and reliability of the macro-combustion method is superior to the Knorr alkalimetric method, and it is faster. It also significantly reduces the calcium chromate waste accrual problem. The macro-combustion method has been adopted as the official method for determination of percent calcium carbonate in thermal battery grade anhydrous calcium chromate and percent calcium carbonate in quicklime used in the production of calcium chromate. The apparatus and procedure can be used to measure the percent carbonate in inorganic materials other than calcium chromate. With simple modifications in the basic apparatus and procedure, the percent carbon and hydrogen can be measured in many organic material, including polymers and polymeric formulations. 5 figures, 5 tables

  4. What Do Patients Want? Survey of Patient Desires for Education in an Urban University Hospital

    Directory of Open Access Journals (Sweden)

    Thomas Seibert

    2014-11-01

    Full Text Available Introduction: This study examines the emergency department (ED waiting room (WR population’s knowledge about the ED process and hospital function and explores the types of educational materials that might appeal to patients and their companions in an ED waiting room. Our goal was to identify potential high-impact opportunities for patient education. Methods: A 32-question survey about demographics, usage of primary care physicians (PCP, understanding of the ED and triage process, desire to know about delays, health education and understanding of teaching hospitals was offered to all qualified individuals. Results: Five hundred and forty-four surveys were returned. Fifty-five percent reported having a PCP, of which 53% (29% of all WR patients called a PCP prior to coming to the ED. It was found that 51.2% can define triage; 51% as an acuity assessment and 17% as a vital signs check. Sixty-nine percent knew why patients were seen according to triage priority. Seventy-two percent wanted to know about delays, yet only 25% wanted to know others’ wait times. People wanted updates every 41 minutes and only three percent wanted a physician to do this. Forty-one percent wanted information on how the ED functions, 60% via handouts and 43% via video. Information on updates and common medical emergencies is significantly more important than material on common illnesses, finding a PCP, or ED function (p<0.05. Median estimated time for medical workup ranged from 35 minutes for radiographs, to one hour for lab results, computed tomography, specialist consult, and admission. Sixty-nine percent knew the definition of a teaching hospital and of those, 87% knew they were at a teaching hospital. Subgroup analysis between racial groups showed significantly reduced knowledge of the definitions of triage and teaching hospitals and significantly increased desire for information on ED function in minority groups (p<0.05. Conclusion: The major findings in this study

  5. Evaluating radiotherapy patients' need for information: a study using a patient information booklet; Evaluation des besoins en information des patients suivis en radiotherapi: etude effectuee sur la base du livret de la radiotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Bonnet, V.; Romestaing, P.; Gerard, J.P.; Mornex, F. [Centre Hospitalier Universitaire Lyon-Sud, Dept. d' Oncologie-Radiotherapie, 69 - Pierre-Benite (France); Couvreur, C. [Institut Gustave Roussy, Dept. d' Oncologie-Radiotherapie, 94 - Villejuif (France); Demachy, P. [Centre Hospitalier V. Dupouy, Centre de Radiologie et de Traitement des Tumeurs, 95 - Argenteuil (France); Kimmel, F. [Centre de Radiologie et de Traitement des Tumeurs, 92 - Meudon-la-Foret (France); Milan, H. [Centre Georges-Francois-Leclerc, 21 - Dijon (France); Noel, D. [Hopital Pitie-Salpetriere, Dept. d' Oncologie-Radiotherapie, 75 - Paris (France); Pace, M. [Hopital d' Annecy, Dept. d' Oncologie-Radiotherapie, 74 - Annecy (France); Raison, C. [Centre Catherine-de-Sienne, 44 - Nantes (France); Compagnon, C. [Ligue Nationale Contre le Cancer, 75 -Paris (France); Pigeon, P. [Isis Research, 69 - Lyon (France)

    2000-08-01

    The French Radiotherapy-Oncology Society (SFRO) and the National Trade of Radiotherapists-Oncologists (SNRO) elaborated and published a patient information booklet on radiotherapy, in 1999. This present study appraises the pertinence of the form and substance of this booklet one year after its release. Eight radiotherapy centers participated in this research which evaluated 162 patients at treatment initiation. The conclusions of this study demonstrated the importance of clearly informing patients of their disease, treatment, and the secondary effects of treatment. It is essential to emphasize that 97% of the patients declared that an information booklet is a real necessity, and that the one provided by the SFRO responds to the majority of their concerns. Obtaining technical and practical knowledge resulted in a reassurance about their treatment. The most revealing result is that 87% requested direct communication about their illness, and that cancer be named by this word and not other, evasive terms. Seventy-two percent of the patients requested more information about their cancer, different treatment options, and quality of life issues in an attempt to psychologically prepare themselves to face an illness for which they have little control. Patients refuse to be passive, and claim the right to become 'partners' of the medical teams, concerning their treatment and recovery. (authors)

  6. Reporting Late Rectal Toxicity in Prostate Cancer Patients Treated With Curative Radiation Treatment

    International Nuclear Information System (INIS)

    Faria, Sergio L.; Souhami, Luis; Joshua, Bosede; Vuong, Te; Freeman, Carolyn R.

    2008-01-01

    Purpose: Long-term rectal toxicity is a concern for patients with prostate cancer treated with curative radiation. However, comparing results of late toxicity may not be straightforward. This article reviews the complexity of reporting long-term side effects by using data for patients treated in our institution with hypofractionated irradiation. Methods and Materials: Seventy-two patients with localized prostate cancer treated with hypofractionated radiotherapy alone to a dose of 66 Gy in 22 fractions were prospectively assessed for late rectal toxicity according to the Common Toxicity Criteria, Version 3, scoring system. Ninety percent of patients had more than 24 months of follow-up. Results are compared with data published in the literature. Results: We found an actuarial incidence of Grade 2 or higher late rectal toxicity of 27% at 30 months and a crude incidence of Grade 2 or higher late rectal toxicity of 18%. This was mostly severe toxicity documented during follow-up. The incidence of Grade 3 rectal toxicity at the last visit was 3% compared with 13% documented at any time during follow-up. Conclusion: Comparison of late toxicity after radiotherapy in patients with prostate cancer must be undertaken with caution because many factors need to be taken into consideration. Because accurate assessment of late toxicity in the evaluation of long-term outcome after radiotherapy in patients with localized prostate cancer is essential, there is a need to develop by consensus guidelines for assessing and reporting late toxicity in this group of patients

  7. Modeling percent tree canopy cover: a pilot study

    Science.gov (United States)

    John W. Coulston; Gretchen G. Moisen; Barry T. Wilson; Mark V. Finco; Warren B. Cohen; C. Kenneth Brewer

    2012-01-01

    Tree canopy cover is a fundamental component of the landscape, and the amount of cover influences fire behavior, air pollution mitigation, and carbon storage. As such, efforts to empirically model percent tree canopy cover across the United States are a critical area of research. The 2001 national-scale canopy cover modeling and mapping effort was completed in 2006,...

  8. Age-specific association between percent body fat and pulmonary ...

    African Journals Online (AJOL)

    This study describes the association between percent body fat and pulmonary function among apparently normal twenty male children tidal volume aged 4 years and twenty male children aged 10 years in Ogbomoso. The mean functional residual capacity of the lung in male children aged 10 years was significantly higher ...

  9. Analysis association of milk fat and protein percent in quantitative ...

    African Journals Online (AJOL)

    SAM

    2014-05-14

    May 14, 2014 ... African Journal of Biotechnology. Full Length ... quantitative trait locus (QTLs) on chromosomes 1, 6, 7 and 20 in ... Protein and fat percent as content of milk are high-priority criteria for financial aims and selection of programs ...

  10. Evaluating Equating Results: Percent Relative Error for Chained Kernel Equating

    Science.gov (United States)

    Jiang, Yanlin; von Davier, Alina A.; Chen, Haiwen

    2012-01-01

    This article presents a method for evaluating equating results. Within the kernel equating framework, the percent relative error (PRE) for chained equipercentile equating was computed under the nonequivalent groups with anchor test (NEAT) design. The method was applied to two data sets to obtain the PRE, which can be used to measure equating…

  11. School Designed To Use 80 Percent Less Energy

    Science.gov (United States)

    American School and University, 1975

    1975-01-01

    The new Terraset Elementary School in Reston, Virginia, uses earth as a cover for the roof area and for about 80 percent of the wall area. A heat recovery system will be used with solar collectors playing a primary role in heating and cooling. (Author/MLF)

  12. Matter power spectrum and the challenge of percent accuracy

    International Nuclear Information System (INIS)

    Schneider, Aurel; Teyssier, Romain; Potter, Doug; Stadel, Joachim; Reed, Darren S.; Onions, Julian; Pearce, Frazer R.; Smith, Robert E.; Springel, Volker; Scoccimarro, Roman

    2016-01-01

    Future galaxy surveys require one percent precision in the theoretical knowledge of the power spectrum over a large range including very nonlinear scales. While this level of accuracy is easily obtained in the linear regime with perturbation theory, it represents a serious challenge for small scales where numerical simulations are required. In this paper we quantify the precision of present-day N -body methods, identifying main potential error sources from the set-up of initial conditions to the measurement of the final power spectrum. We directly compare three widely used N -body codes, Ramses, Pkdgrav3, and Gadget3 which represent three main discretisation techniques: the particle-mesh method, the tree method, and a hybrid combination of the two. For standard run parameters, the codes agree to within one percent at k ≤1 h Mpc −1 and to within three percent at k ≤10 h Mpc −1 . We also consider the bispectrum and show that the reduced bispectra agree at the sub-percent level for k ≤ 2 h Mpc −1 . In a second step, we quantify potential errors due to initial conditions, box size, and resolution using an extended suite of simulations performed with our fastest code Pkdgrav3. We demonstrate that the simulation box size should not be smaller than L =0.5 h −1 Gpc to avoid systematic finite-volume effects (while much larger boxes are required to beat down the statistical sample variance). Furthermore, a maximum particle mass of M p =10 9 h −1 M ⊙ is required to conservatively obtain one percent precision of the matter power spectrum. As a consequence, numerical simulations covering large survey volumes of upcoming missions such as DES, LSST, and Euclid will need more than a trillion particles to reproduce clustering properties at the targeted accuracy.

  13. Matter power spectrum and the challenge of percent accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Aurel; Teyssier, Romain; Potter, Doug; Stadel, Joachim; Reed, Darren S. [Institute for Computational Science, University of Zurich, Winterthurerstrasse 190, 8057 Zurich (Switzerland); Onions, Julian; Pearce, Frazer R. [School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD (United Kingdom); Smith, Robert E. [Department of Physics and Astronomy, University of Sussex, Brighton, BN1 9QH (United Kingdom); Springel, Volker [Heidelberger Institut für Theoretische Studien, 69118 Heidelberg (Germany); Scoccimarro, Roman, E-mail: aurel@physik.uzh.ch, E-mail: teyssier@physik.uzh.ch, E-mail: dpotter@physik.uzh.ch, E-mail: stadel@physik.uzh.ch, E-mail: julian.onions@nottingham.ac.uk, E-mail: reed@physik.uzh.ch, E-mail: r.e.smith@sussex.ac.uk, E-mail: volker.springel@h-its.org, E-mail: Frazer.Pearce@nottingham.ac.uk, E-mail: rs123@nyu.edu [Center for Cosmology and Particle Physics, Department of Physics, New York University, NY 10003, New York (United States)

    2016-04-01

    Future galaxy surveys require one percent precision in the theoretical knowledge of the power spectrum over a large range including very nonlinear scales. While this level of accuracy is easily obtained in the linear regime with perturbation theory, it represents a serious challenge for small scales where numerical simulations are required. In this paper we quantify the precision of present-day N -body methods, identifying main potential error sources from the set-up of initial conditions to the measurement of the final power spectrum. We directly compare three widely used N -body codes, Ramses, Pkdgrav3, and Gadget3 which represent three main discretisation techniques: the particle-mesh method, the tree method, and a hybrid combination of the two. For standard run parameters, the codes agree to within one percent at k ≤1 h Mpc{sup −1} and to within three percent at k ≤10 h Mpc{sup −1}. We also consider the bispectrum and show that the reduced bispectra agree at the sub-percent level for k ≤ 2 h Mpc{sup −1}. In a second step, we quantify potential errors due to initial conditions, box size, and resolution using an extended suite of simulations performed with our fastest code Pkdgrav3. We demonstrate that the simulation box size should not be smaller than L =0.5 h {sup −1}Gpc to avoid systematic finite-volume effects (while much larger boxes are required to beat down the statistical sample variance). Furthermore, a maximum particle mass of M {sub p}=10{sup 9} h {sup −1}M{sub ⊙} is required to conservatively obtain one percent precision of the matter power spectrum. As a consequence, numerical simulations covering large survey volumes of upcoming missions such as DES, LSST, and Euclid will need more than a trillion particles to reproduce clustering properties at the targeted accuracy.

  14. Serum Predictors of Percent Lean Mass in Young Adults.

    Science.gov (United States)

    Lustgarten, Michael S; Price, Lori L; Phillips, Edward M; Kirn, Dylan R; Mills, John; Fielding, Roger A

    2016-08-01

    Lustgarten, MS, Price, LL, Phillips, EM, Kirn, DR, Mills, J, and Fielding, RA. Serum predictors of percent lean mass in young adults. J Strength Cond Res 30(8): 2194-2201, 2016-Elevated lean (skeletal muscle) mass is associated with increased muscle strength and anaerobic exercise performance, whereas low levels of lean mass are associated with insulin resistance and sarcopenia. Therefore, studies aimed at obtaining an improved understanding of mechanisms related to the quantity of lean mass are of interest. Percent lean mass (total lean mass/body weight × 100) in 77 young subjects (18-35 years) was measured with dual-energy x-ray absorptiometry. Twenty analytes and 296 metabolites were evaluated with the use of the standard chemistry screen and mass spectrometry-based metabolomic profiling, respectively. Sex-adjusted multivariable linear regression was used to determine serum analytes and metabolites significantly (p ≤ 0.05 and q ≤ 0.30) associated with the percent lean mass. Two enzymes (alkaline phosphatase and serum glutamate oxaloacetate aminotransferase) and 29 metabolites were found to be significantly associated with the percent lean mass, including metabolites related to microbial metabolism, uremia, inflammation, oxidative stress, branched-chain amino acid metabolism, insulin sensitivity, glycerolipid metabolism, and xenobiotics. Use of sex-adjusted stepwise regression to obtain a final covariate predictor model identified the combination of 5 analytes and metabolites as overall predictors of the percent lean mass (model R = 82.5%). Collectively, these data suggest that a complex interplay of various metabolic processes underlies the maintenance of lean mass in young healthy adults.

  15. New formula for calculation of cobalt-60 percent depth dose

    International Nuclear Information System (INIS)

    Tahmasebi Birgani, M. J.; Ghorbani, M.

    2005-01-01

    On the basis of percent depth dose calculation, the application of - dosimetry in radiotherapy has an important role to play in reducing the chance of tumor recurrence. The aim of this study is to introduce a new formula for calculating the central axis percent depth doses of Cobalt-60 beam. Materials and Methods: In the present study, based on the British Journal of Radiology table, nine new formulas are developed and evaluated for depths of 0.5 - 30 cm and fields of (4*4) - (45*45) cm 2 . To evaluate the agreement between the formulas and the table, the average of the absolute differences between the values was used and the formula with the least average was selected as the best fitted formula. The Microsoft Excel 2000 and the Data fit 8.0 soft wares were used to perform the calculations. Results: The results of this study indicated that one amongst the nine formulas gave a better agreement with the percent depth doses listed in the table of British Journal of Radiology . The new formula has two parts in terms of log (A/P). The first part as a linear function with the depth in the range of 0.5 to 5 cm and the other one as a second order polynomial with the depth in the range of 6 to 30 cm. The average of - the differences between the tabulated and the calculated data using the formula (Δ) is equal to 0.3 152. Discussion and Conclusion: Therefore, the calculated percent depth dose data based on this formula has a better agreement with the published data for Cobalt-60 source. This formula could be used to calculate the percent depth dose for the depths and the field sizes not listed in the British Journal of Radiology table

  16. YouTube videos in the English language as a patient education resource for cataract surgery.

    Science.gov (United States)

    Bae, Steven S; Baxter, Stephanie

    2017-08-28

    To assess the quality of the content of YouTube videos for cataract surgery patient education. Hotel Dieu Hospital, Kingston, Ontario, Canada. Observational study. "Cataract surgery," "cataract surgery for patients," and "cataract surgery patient education" were used as search terms. The first two pages of search results were reviewed. Descriptive statistics such as video length and view count were obtained. Two cataract surgeons devised 14 criteria important for educating patients about the procedure. Videos were analyzed based on the presence or absence of these criteria. Videos were also assessed for whether they had a primary commercial intent. Seventy-two videos were analyzed after excluding 48 videos that were duplicate, irrelevant, or not in English. The majority of videos came from a medical professional (71%) and many depicted a real cataract surgery procedure (43%). Twenty-one percent of the videos had a primary commercial intent to promote a practice or product. Out of a total possible 14 points, the mean number of usefulness criteria satisfied was only 2.28 ± 1.80. There was no significant difference in view count between the most useful videos and other videos (p = 0.94). Videos from medical organizations such as the National Health Service were more useful (p YouTube, but most are not adequately educational. Patients may be receiving biased information from videos created with primary commercial intent. Physicians should be aware of the type of information patients may be accessing on YouTube.

  17. Matter power spectrum and the challenge of percent accuracy

    OpenAIRE

    Schneider, Aurel; Teyssier, Romain; Potter, Doug; Stadel, Joachim; Onions, Julian; Reed, Darren S.; Smith, Robert E.; Springel, Volker; Pearce, Frazer R.; Scoccimarro, Roman

    2015-01-01

    Future galaxy surveys require one percent precision in the theoretical knowledge of the power spectrum over a large range including very nonlinear scales. While this level of accuracy is easily obtained in the linear regime with perturbation theory, it represents a serious challenge for small scales where numerical simulations are required. In this paper we quantify the precision of present-day $N$-body methods, identifying main potential error sources from the set-up of initial conditions to...

  18. Tranexamic Acid Reduced the Percent of Total Blood Volume Lost During Adolescent Idiopathic Scoliosis Surgery.

    Science.gov (United States)

    Jones, Kristen E; Butler, Elissa K; Barrack, Tara; Ledonio, Charles T; Forte, Mary L; Cohn, Claudia S; Polly, David W

    2017-01-01

    Multilevel posterior spine fusion is associated with significant intraoperative blood loss. Tranexamic acid is an antifibrinolytic agent that reduces intraoperative blood loss. The goal of this study was to compare the percent of total blood volume lost during posterior spinal fusion (PSF) with or without tranexamic acid in patients with adolescent idiopathic scoliosis (AIS). Thirty-six AIS patients underwent PSF in 2011-2014; the last half (n=18) received intraoperative tranexamic acid. We retrieved relevant demographic, hematologic, intraoperative and outcomes information from medical records. The primary outcome was the percent of total blood volume lost, calculated from estimates of intraoperative blood loss (numerator) and estimated total blood volume per patient (denominator, via Nadler's equations). Unadjusted outcomes were compared using standard statistical tests. Tranexamic acid and no-tranexamic acid groups were similar (all p>0.05) in mean age (16.1 vs. 15.2 years), sex (89% vs. 83% female), body mass index (22.2 vs. 20.2 kg/m2), preoperative hemoglobin (13.9 vs. 13.9 g/dl), mean spinal levels fused (10.5 vs. 9.6), osteotomies (1.6 vs. 0.9) and operative duration (6.1 hours, both). The percent of total blood volume lost (TBVL) was significantly lower in the tranexamic acid-treated vs. no-tranexamic acid group (median 8.23% vs. 14.30%, p = 0.032); percent TBVL per level fused was significantly lower with tranexamic acid than without it (1.1% vs. 1.8%, p=0.048). Estimated blood loss (milliliters) was similar across groups. Tranexamic acid significantly reduced the percentage of total blood volume lost versus no tranexamic acid in AIS patients who underwent PSF using a standardized blood loss measure.Level of Evidence: 3. Institutional Review Board status: This medical record chart review (minimal risk) study was approved by the University of Minnesota Institutional Review Board.

  19. SERIAL PERCENT-FREE PSA IN COMBINATION WITH PSA FOR POPULATION-BASED EARLY DETECTION OF PROSTATE CANCER

    Science.gov (United States)

    Ankerst, Donna Pauler; Gelfond, Jonathan; Goros, Martin; Herrera, Jesus; Strobl, Andreas; Thompson, Ian M.; Hernandez, Javier; Leach, Robin J.

    2016-01-01

    PURPOSE To characterize the diagnostic properties of serial percent-free prostate-specific antigen (PSA) in relation to PSA in a multi-ethnic, multi-racial cohort of healthy men. MATERIALS AND METHODS 6,982 percent-free PSA and PSA measures were obtained from participants in a 12 year+ Texas screening study comprising 1625 men who never underwent biopsy, 497 who underwent one or more biopsies negative for prostate cancer, and 61 diagnosed with prostate cancer. Area underneath the receiver-operating-characteristic-curve (AUC) for percent-free PSA, and the proportion of patients with fluctuating values across multiple visits were determined according to two thresholds (under 15% versus 25%) were evaluated. The proportion of cancer cases where percent-free PSA indicated a positive test before PSA > 4 ng/mL did and the number of negative biopsies that would have been spared by percent-free PSA testing negative were computed. RESULTS Percent-free PSA fluctuated around its threshold of PSA tested positive earlier than PSA in 71.4% (34.2%) of cancer cases, and among men with multiple negative biopsies and a PSA > 4 ng/mL, percent-free PSA would have tested negative in 31.6% (65.8%) instances. CONCLUSIONS Percent-free PSA should accompany PSA testing in order to potentially spare unnecessary biopsies or detect cancer earlier. When near the threshold, both tests should be repeated due to commonly observed fluctuation. PMID:26979652

  20. Quality of life, fatigue and mental health in patients with the m.3243A > G mutation and its correlates with genetic characteristics and disease manifestation.

    Science.gov (United States)

    Verhaak, Christianne; de Laat, Paul; Koene, Saskia; Tibosch, Marijke; Rodenburg, Richard; de Groot, Imelda; Knoop, Hans; Janssen, Mirian; Smeitink, Jan

    2016-03-18

    Mitochondrial disorders belong to the most prevalent inherited metabolic diseases with the m.3243A > G mutation reflecting being one of the most common mutations in mitochondrial DNA. Previous studies showed little relationship between mitochondrial genetics and disease manifestation. Relationship between genotype and disease manifestation with patient reported quality of life and other patient reported outcomes is still unexplored. Seventy-two out of the 122 invited adult patients with m.3243A > G mutation completed online standardized questionnaires on quality of life, functional impairment, fatigue and mental health as assessed by the RAND-SF36, the Sickness Impact Profile (SIP), the Checklist Individual Strength (CIS) and the Hospital Anxiety and Depression scale (HADS). Data were related to clinical manifestation reflected by the Newcastle Mitochondrial Disease Adult Scale (NMDAS) score and heteroplasmy levels of the mutation in urine epithelial cells. Patients reported impaired quality of life. Sixty percent showed severe levels of fatigue, and 37% showed clinical relevant mental health problems, which was significantly more than healthy norms. These patient reported health outcomes showed negligible relationship with levels of heteroplasmy (r = mental health problems, are only partly reflected by clinical assessments. In order to support patients more effectively, integration of patient reported outcomes, alongside symptoms of their disease, in clinical practice is warranted.

  1. Glioblastoma: single institutional experience with 48 patients treated with surgery, radiotherapy and chemotherapy; Glioblastoma: experiencia uni-institucional com 48 pacientes tratados com cirurgia, radioterapia e quimioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Potamianos, Carina Fernandes; Souza, Paulo Gustavo Cavalcanti de; Dias, Rodrigo Souza; Giordani, Adelmo Jose; Segreto, Helena Regina Comodo; Segreto, Roberto Araujo [Universidade Federal de Sao Paulo (UNIFESP/EPM), Sao Paulo SP, (Brazil). Setor de Radioterapia], e-mail: segreto.dmed@epm.br; Malheiros, Suzana Maria Fleury [Universidade Federal de Sao Paulo (UNIFESP/EPM), Sao Paulo, SP (Brazil). Dept. de Neurologia-Neurocirurgia

    2009-01-15

    Objective: to identify prognostic factors and evaluate the clinical outcome of patients with glioblastoma treated with surgery and radiotherapy combined or not with chemotherapy. Material and method: in this retrospective study, 48 patients with glioblastoma were treated between 1997 and 2007. All patients were classified according the recursive partitioning analysis (RPA) criteria. Results: the majority of patients were female, with 50 years of age or above. Performance status of 70 or greater were found in 70.8% of cases, and RPA classes V and VI prevailed. Seventy-two percent of patients were submitted to partial resection and 27.1% to total or subtotal resection. Chemotherapy was administered in 47.9% of patients and doses between 50 and 60 Gy were delivered in 72.9%. The median overall survival was 52 weeks. Conclusion: our data show an overall survival that approaches the related in others reports and were dependent of factors such as chemotherapy, dose of radiation and Karnofsky performance status. (author)

  2. Use of email, cell phone and text message between patients and primary-care physicians: cross-sectional study in a French-speaking part of Switzerland.

    Science.gov (United States)

    Dash, Jonathan; Haller, Dagmar M; Sommer, Johanna; Junod Perron, Noelle

    2016-10-05

    Physicians' daily work is increasingly affected by the use of emails, text messages and cell phone calls with their patients. The aim of this study was to describe their use between primary-care physicians and patients in a French-speaking part of Switzerland. A cross-sectional mail survey was conducted among all primary-care physicians of Geneva canton (n = 636). The questionnaire focused on the frequency of giving access to, type of use, advantages and disadvantages of email, cell phone calls and text messages communication between physicians and patients. Six hundred thirty-six questionnaires were mailed, 412 (65 %) were returned and 372 (58 %) could be analysed (37 refusals and three blanks). Seventy-two percent physicians gave their email-address and 74 % their cell phone number to their patients. Emails were used to respond to patients' questions (82 %) and change appointments (72 %) while cell phone calls and text messages were used to follow patients' health conditions. Sixty-four percent of those who used email communication never discussed the rules for email exchanges, and 54 % did not address confidentiality issues with their patients. Most commonly identified advantages of emails, cell phone calls and text messages were improved relationship with the patient, saving time (for emails) and improving the follow-up (for cell phone and text messages). The main disadvantages included misuse by the patient, interference with private life and lack of reimbursement. These tools are widely used by primary-care physicians with their patients. More attention should be paid to confidentiality, documentation and reimbursement when using email communication in order to optimize its use.

  3. Relationship between depression with FEV1 percent predicted and BODE index in chronic obstructive pulmonary disease

    Science.gov (United States)

    Gunawan, H.; Hanum, H.; Abidin, A.; Hanida, W.

    2018-03-01

    WHO reported more than 3 million people die from COPD in 2012 and are expected to rank third after cardiovascular and cancer diseases in the future. Recent studies reported the prevalence of depression in COPD patients was higher than in control group. So, it’s important for clinicians to understand the relationship of depression symptoms with clinical aspects of COPD. For determining the association of depression symptoms with lung function and BODE index in patients with stable COPD, a cross-sectional study was in 98 stable COPD outpatients from January to June 2017. Data were analyzed using Independent t-test, Mann-Whitney test, and Spearman’s rank correlation. COPD patients with depression had higher mMRC scores, and lower FEV1 percent predicted, and then 6-Minutes Walk Test compared to those without depression. There was a moderate strength of correlation (r=-0.43) between depression symptoms and FEV1 percent predicted, and strong correlation (r=0.614) between depression symptoms and BODE index. It indicates that BODE index is more accurate to describe symptoms of depression in COPD patients.

  4. THE DISCRIMINATIVE ABILITY OF PERCENT FREE PSA IN ...

    African Journals Online (AJOL)

    Blood samples were collected from all patients, and total PSA, free PSA and % free PSA were calculated in all specimens. Total PSA was measured using the Imx ... Un prélèvement de sang a été réalisé chez tous les patients avec un dosage du PSA total et de la fraction libre de PSA. Le PSA total a été mesuré par un kit ...

  5. Patients with schizophrenia and their finances: how they spend their money.

    Science.gov (United States)

    Borras, Laurence; Mohr, Sylvia; Boucherie, Maria; Dupont-Willemin, Sophie; Ferrero, François; Huguelet, Philippe

    2007-12-01

    Although most patients with schizophrenia rely on state financial support, little is known about their expenses and how they use the money at their discretion. However, the ability to budget is a predictive factor in rehabilitation. An assessment of financial management skills could make it possible to develop more appropriate psycho-social assistance. Fifty-seven outpatients with schizophrenia treated in the public sector in Geneva, Switzerland took part in the study. Psychosocial, diagnostic, neurocognitive and symptomatological measures were collected. Data were gathered on patients' incomes and quality of life. A prospective analysis of their expenses during a 1-month period was also performed. Median income was 4,125 Swiss francs per month (i.e., 3,372 US dollars). After paying fixed expenses (which were handled with or without the assistance of a representative payee), a mean of 400 Swiss francs remained at their disposal to use as they wished. Seventy-two percent of this money was devoted to the use of psychoactive substances (e.g., cigarettes, alcohol, cannabis) or various drinks in coffee houses, and 28% on leisure activities (trips, sports and other recreational activities). Eighty-four percent of patients would have liked to have more money for leisure activities. The study was well-accepted and led to modification of the treatment plan in 84% of cases. Most of the discretionary money patients received was used for buying substances with addictive properties; this may hinder the practice of activities favouring recovery. Thus, it appears essential to guide patients in the management of their budgets.

  6. Current practices in the management of patients with ureteral calculi in the emergency room of a university hospital

    Directory of Open Access Journals (Sweden)

    Oliver Rojas Claros

    2012-01-01

    Full Text Available OBJECTIVE: Urinary lithiasis is a common disease. The aim of the present study is to assess the knowledge regarding the diagnosis, treatment and recommendations given to patients with ureteral colic by professionals of an academic hospital. MATERIALS AND METHODS: Sixty-five physicians were interviewed about previous experience with guidelines regarding ureteral colic and how they manage patients with ureteral colic in regards to diagnosis, treatment and the information provided to the patients. RESULTS: Thirty-six percent of the interviewed physicians were surgeons, and 64% were clinicians. Forty-one percent of the physicians reported experience with ureterolithiasis guidelines. Seventy-two percent indicated that they use noncontrast CT scans for the diagnosis of lithiasis. All of the respondents prescribe hydration, primarily for the improvement of stone elimination (39.3%. The average number of drugs used was 3.5. The combination of nonsteroidal anti-inflammatory drugs and opioids was reported by 54% of the physicians (i.e., 59% of surgeons and 25.6% of clinicians used this combination of drugs (p = 0.014. Only 21.3% prescribe alpha blockers. CONCLUSION: Reported experience with guidelines had little impact on several habitual practices. For example, only 21.3% of the respondents indicated that they prescribed alpha blockers; however, alpha blockers may increase stone elimination by up to 54%. Furthermore, although a meta-analysis demonstrated that hydration had no effect on the transit time of the stone or on the pain, the majority of the physicians reported that they prescribed more than 500 ml of fluid. Dipyrone, hyoscine, nonsteroidal anti-inflammatory drugs, and opioids were identified as the most frequently prescribed drug combination. The information regarding the time for the passage of urinary stones was inconsistent. The development of continuing education programs regarding ureteral colic in the emergency room is necessary.

  7. One Percent Determination of the Primordial Deuterium Abundance

    Science.gov (United States)

    Cooke, Ryan J.; Pettini, Max; Steidel, Charles C.

    2018-03-01

    We report a reanalysis of a near-pristine absorption system, located at a redshift {z}abs}=2.52564 toward the quasar Q1243+307, based on the combination of archival and new data obtained with the HIRES echelle spectrograph on the Keck telescope. This absorption system, which has an oxygen abundance [O/H] = ‑2.769 ± 0.028 (≃1/600 of the solar abundance), is among the lowest metallicity systems currently known where a precise measurement of the deuterium abundance is afforded. Our detailed analysis of this system concludes, on the basis of eight D I absorption lines, that the deuterium abundance of this gas cloud is {log}}10({{D}}/{{H}})=-4.622+/- 0.015, which is in very good agreement with the results previously reported by Kirkman et al., but with an improvement on the precision of this single measurement by a factor of ∼3.5. Combining this new estimate with our previous sample of six high precision and homogeneously analyzed D/H measurements, we deduce that the primordial deuterium abundance is {log}}10{({{D}}/{{H}})}{{P}}=-4.5974+/- 0.0052 or, expressed as a linear quantity, {10}5{({{D}}/{{H}})}{{P}}=2.527+/- 0.030; this value corresponds to a one percent determination of the primordial deuterium abundance. Combining our result with a big bang nucleosynthesis (BBN) calculation that uses the latest nuclear physics input, we find that the baryon density derived from BBN agrees to within 2σ of the latest results from the Planck cosmic microwave background data. Based on observations collected at the W.M. Keck Observatory which is operated as a scientific partnership among the California Institute of Technology, the University of California, and the National Aeronautics and Space Administration. The Observatory was made possible by the generous financial support of the W.M. Keck Foundation.

  8. Total energy consumption in Finland increased by one percent

    International Nuclear Information System (INIS)

    Timonen, L.

    2000-01-01

    The total energy consumption in Finland increased by less than a percent in 1999. The total energy consumption in 1999 was 1310 PJ corresponding to about 31 million toe. The electric power consumption increased moderately by 1.6%, which is less than the growth of the gross national product (3.5%). The final consumption of energy grew even less, only by 0.5%. Import of electric power increased by 19% in 1999. The import of electric power was due to the availability of low-priced electric power on the Nordic electricity markets. Nuclear power generation increased by 5% and the consumption of wood-based fuels by 3%. The increment of the nuclear power generation increased because of the increased output capacity and good operability of the power plants. Wind power production doubles, but the share of it in the total energy consumption is only about 0.01%. The peat consumption decreased by 12% and the consumption of hydroelectric power by 15%. The decrease in production of hydroelectric power was compensated by an increase import of electric power. The consumption of fossil fuels, coal, oil and natural gas remained nearly the same as in 1998. The gasoline consumption, however, decreased, but the consumption of diesel oil increased due to the increased road transport. The share of the fossil fuels was nearly half of the total energy consumption. The consumption of renewable energy sources remained nearly the same, in 23% if the share of peat is excluded, and in 30% if the share of peat is included. Wood-based fuels are the most significant type of renewable fuels. The share of them in 1999 was over 80% of the total usage of the renewable energy sources. The carbon dioxide emissions in Finland decreased in 1999 by 1.0 million tons. The total carbon dioxide emissions were 56 million tons. The decrease was mainly due to the decrease of the peat consumption. The final consumption of energy increased by 0.5%, being hence about 1019 PJ. Industry is the main consumer of energy

  9. Evaluation of Outcomes in Adolescent Inflammatory Bowel Disease Patients Following Transfer From Pediatric to Adult Health Care Services: Case for Transition.

    Science.gov (United States)

    Cole, Rebecca; Ashok, Dhandapani; Razack, Abdul; Azaz, Amer; Sebastian, Shaji

    2015-08-01

    We aimed to evaluate the impact of a transition service on clinical and developmental outcomes in adolescent Inflammatory Bowel Disease (IBD) patients on transfer to adult health care services. We reviewed the records of IBD patients diagnosed in pediatric care following their transfer/attendance to the adult IBD service. The data on patients who attended the transition service were compared with those who did not pass through the transition service. Seventy-two patients were included in the study 41M and 31F. Forty-four patients went through the transition system (Group A), and 28 had no formalized transition arrangement before transfer (Group B). A significantly higher number of Group B patients needed surgery within 2 years of transfer when compared with patients in Group A (46% vs. 25%, p = .01). Sixty-one percent of patients in Group B needed at least one admission within 2 years of transfer when compared with 29% of Group A patients (p = .002). Nonattendance at clinics was higher in Group B patients with 78% having at least one nonattendance, whereas 29% of Group A failed to attend at least one appointment (p = .001). In addition, drug compliance rates were higher in the transition group when compared with Group B (89% and 46%, respectively; p = .002). A higher proportion of transitioned patients achieved their estimated maximum growth potential when completing adolescence. There was a trend toward higher dependence on opiates and smoking in Group B patients. In adolescent IBD patients, transition care is associated with better disease specific and developmental outcomes. Prospective studies of different models of transition care in IBD are needed. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  10. Does Asset Allocation Policy Explain 40, 90, 100 Percent of Performance?

    OpenAIRE

    Roger G. Ibbotson; Paul D. Kaplan

    2001-01-01

    Does asset allocation policy explain 40 percent, 90 percent, or 100 percent of performance? According to some well-known studies, more than 90 percent of the variability of a typical plan sponsor's performance over time is attributable to asset allocation. However, few people want to explain variability over time. Instead, an analyst might want to know how important it is in explaining the differences in return from one fund to another, or what percentage of the level of a typical fund's retu...

  11. 49 CFR 173.182 - Barium azide-50 percent or more water wet.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Barium azide-50 percent or more water wet. 173.182 Section 173.182 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS... Class 1 and Class 7 § 173.182 Barium azide—50 percent or more water wet. Barium azide—50 percent or more...

  12. 7 CFR 762.129 - Percent of guarantee and maximum loss.

    Science.gov (United States)

    2010-01-01

    ... loss. (a) General. The percent of guarantee will not exceed 90 percent based on the credit risk to the lender and the Agency both before and after the transaction. The Agency will determine the percentage of... PLP lenders will not be less than 80 percent. (d) Maximum loss. The maximum amount the Agency will pay...

  13. Estimation of the volume and percent uptake of the liver and spleen by SPECT

    International Nuclear Information System (INIS)

    Yamagata, Atushi

    1988-01-01

    The volume and percent uptake of the liver and spleen were estimated with single photon emission computed tomography (SPECT) using 99m Tc-phytate. Clinical usefulness of these parameters was evaluated by comparison with other liver function tests in 87 patients including 25 normal controls, 24 liver cirrhosis and 16 other chronic liver diseases. SPECT images were obtained by Maxi Camera 400T. Cut-off level for reconstruction of images and relationship between counts and activity (mCi) were obtained from phantom studies. Volumes estimated using SPECT and computed tomography were compared in 16 patients. Results obtained were as follows. 1) Optimal cut-off level for measurement of volumes for the liver was 37 % and for the spleen was 42 %. 2) Correlation between organ volumes estimated with CT and SPECT was good (r = 0.92 for the liver and r = 0.96 for the spleen), although volumes measured with SPECT were larger than those with CT. 3) Significant differences of percent uptake were observed between normal controls and liver cirrhosis. 4) Better correlation between spleen volumes and uptake was recognized in cases without liver cirrhosis than in cases with liver cirrhosis. The spleen uptake in liver cirrhosis was higher than those in others in comparison with the volume. 5) The liver/spleen ratio of 99m Tc-phytae uptake could most clearly differentiate liver cirrhosis from others. 6) Negative correlation was observed between liver volume or uptake and ICG (R 15 ). Estimation of volume and uptake of the liver and spleen could be a useful procedure to assess liver function, probably related with effective hepatic blood flow in liver cirrhosis. (author)

  14. Carotid bifurcation calcium and correlation with percent stenosis of the internal carotid artery on CT angiography

    International Nuclear Information System (INIS)

    McKinney, Alexander M.; Casey, Sean O.; Teksam, Mehmet; Truwit, Charles L.; Kieffer, Stephen; Lucato, Leandro T.; Smith, Maurice

    2005-01-01

    The aim of this paper was to determine the correlation between calcium burden (expressed as a volume) and extent of stenosis of the origin of the internal carotid artery (ICA) by CT angiography (CTA). Previous studies have shown that calcification in the coronary arteries correlates with significant vessel stenosis, and severe calcification (measured by CT) in the carotid siphon correlates with significant (greater than 50% stenosis) as determined angiographically. Sixty-one patients (age range 50-85 years) underwent CT of the neck with intravenous administration of iodinated contrast for a variety of conditions. Images were obtained with a helical multidetector array CT scanner and reviewed on a three-dimensional workstation. A single observer manipulated window and level to segment calcified plaque from vascular enhancement in order to quantify vascular calcium volume (cc) in the region of the bifurcation of the common carotid artery/ICA origin, and to measure the extent of ICA stenosis near the origin. A total of 117 common carotid artery bifurcations were reviewed. A ''significant'' stenosis was defined arbitrarily as >40% (to detect lesions before they become hemodynamically significant) of luminal diameter on CTA using NASCET-like criteria. All ''significant'' stenoses (21 out of 117 carotid bifurcations) had measurable calcium. We found a relatively strong correlation between percent stenosis and the calcium volume (Pearson's r= 0.65, P<0.0001). We also found that there was an even stronger correlation between the square root of the calcium volume and the percent stenosis as measured by CTA (r= 0.77, P<0.0001). Calcium volumes of 0.01, 0.03, 0.06, 0.09 and 0.12 cc were used as thresholds to evaluate for a ''significant'' stenosis. A receiver operating characteristic (ROC) curve demonstrated that thresholds of 0.06 cc (sensitivity 88%, specificity 87%) and 0.03 cc (sensitivity 94%, specificity 76%) generated the best combinations of sensitivity and

  15. A relação médico-paciente em Rio Branco/AC sob a ótica dos pacientes Patient - physician relationship in Acre, Rio Branco, from the patient's point of view

    Directory of Open Access Journals (Sweden)

    Maria das Graças Alves Pereira

    2005-06-01

    Full Text Available OBJETIVO: Avaliar, em uma Unidade de Saúde de Rio Branco, o nível de satisfação dos pacientes com a relação médico-paciente (RMP praticada. MÉTHODS: Estudo descritivo-analítico. Foram entrevistados 50 pacientes egressos de internação recente na Fundação Hospital Estadual do Acre (FUNDHACRE, com idades entre 18 e 50 anos. Foram excluídos pacientes em diálise ou UTI, com estado de consciência alterado, portadores de deficiência mental, impossibilitados de comunicação verbal e que não concordaram em participar. O teste de Qui-quadrado (chi2 foi usado para comparação entre as variáveis categóricas, com grau de significância para pBACKGROUND: The main objective of the present paper is to evaluate the satisfaction levels with the physician-patient relationship (PPR practiced at a health care unit of Rio Branco, Acre, Brazil. Interviews were carried out right after patients' dismissal from the "Fundação Hospital Estadual do Acre". METHODS: Descriptive and analytical analyses were performed. Fifty patients 18 to 50 years of age were studied. Semi-structured questionnaires were used. Patients with altered states of consciousness, mental deficiency or verbal communication impairment and those who were not willing to participate in the research were excluded. Descriptive data were appraised for SPSS®. RESULTS: Sixty-four percent of the patients (32/50 believe that the physician- patient relationship interferes with patients' improvement; Seventy percent (35/50 evaluated their physician-patient relationship as satisfactory and seventy two percent (36/50 considered positive, the attention received from physicians. Albeit results are in accordance with the cultural expectations, further research on this subject is recommended. CONCLUSIONS: the satisfaction with PPR, showed association with the variables related to the personal form of communication practiced between physicians and patients.

  16. Detection of viability by percent thallium uptake with conventional thallium scintigraphy

    International Nuclear Information System (INIS)

    Imai, Kamon; Araki, Yasushi; Horiuchi, Kou-ichi; Yumikura, Sei; Saito, Satoshi; Ozawa, Yukio; Kan-matsuse, Katsuo; Hagiwara, Kazuo.

    1994-01-01

    Thallium myocardial scintigraphy (TMS) is used for diagnosis of viability in infarcted myocardium before coronary revascularization. Underestimation of viability by TMS has been reported by many investigators. To evaluate viability precisely, thallium re-injection method or 24 hour delayed imaging is performed. However, these techniques are not convenient and are difficult to perform in clinical practice. Percent T1-uptake method was developed for predicting myocardial viability. To evaluate usefulness of this method, TMS was performed before and after PTCA in 23 patients with myocardial infarction. Left ventricle was divided into 3 layers, then each layer was divided into 4 segments (12 segments in total). Forth three segments showed recovery of perfusion on TMS after PTCA. Viability in infarcted myocardium is predicted by 1) redistribution (RD), 2) %T1-uptake≥45% on the image immediately after exercise (TE), and 3) %T1-uptake≥45% on delayed image (TD). Sensitivity was RD: 60%, TE: 90% and TD: 95% (p<0.001 vs. RD). Specificity was RD: 74%, TE: 68%, and TD: 60% (NS). Predictive accuracy (PA) was RD: 69%, TE: 77%, TD: 73% (NS). Compared with RD, %T1-uptake, either TE or TD, increased sensitivity with slightly improved PA, but decreased specificity slightly. Therefore %T1-uptake would be a sensitive and useful predictor to find patients who are most likely to benefit from re-vascularization. (author)

  17. CRED Cumulative Map of Percent Scleractinian Coral Cover at Kauai, 2005

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  18. CRED Cumulative Map of Percent Scleractinian Coral Cover at Niihau, 2005

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  19. CRED Cumulative Map of Percent Scleractinian Coral Cover at Raita Bank, 2001

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  20. CRED Cumulative Map of Percent Scleractinian Coral Cover at Kure Atoll, 2002-2004

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  1. CRED Cumulative Map of Percent Scleractinian Coral Cover at Stingray Shoals

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  2. CRED Cumulative Map of Percent Scleractinian Coral Cover at Ofu & Olosega

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  3. CRED Cumulative Map of Percent Scleractinian Coral Cover at Laysan Island, 2002-2004

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  4. CRED Cumulative Map of Percent Scleractinian Coral Cover at Eleven-Mile Bank

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  5. CRED Cumulative Map of Percent Scleractinian Coral Cover at Palmyra Atoll, 2002-2004

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  6. CRED Cumulative Map of Percent Scleractinian Coral Cover at Lisianski Island, 2001-2004

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  7. CRED Cumulative Map of Percent Scleractinian Coral Cover at Ta'u

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  8. CRED Cumulative Map of Percent Scleractinian Coral Cover at Gardner Pinnacles, 2003

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  9. CRED Cumulative Map of Percent Scleractinian Coral Cover at Pearl and Hermes Atoll, 2002-2004

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  10. CRED Cumulative Map of Percent Scleractinian Coral Cover at Molokai, 2005

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  11. CRED Cumulative Map of Percent Scleractinian Coral Cover at Guam, 2003

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  12. CRED Cumulative Map of Percent Scleractinian Coral Cover at Baker Island, 2002-2004

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  13. CRED Cumulative Map of Percent Scleractinian Coral Cover at French Frigate Shoals

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  14. CRED Cumulative Map of Percent Scleractinian Coral Cover at Maro Reef, 2001-2004

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry.

  15. The classification of osteonecrosis in patients with cancer: validation of a new radiological classification system

    International Nuclear Information System (INIS)

    Niinimäki, T.; Niinimäki, J.; Halonen, J.; Hänninen, P.; Harila-Saari, A.; Niinimäki, R.

    2015-01-01

    Aim: To validate a new, non-joint-specific radiological classification system that is suitable regardless of the site of the osteonecrosis (ON) in patients with cancer. Material and methods: Critical deficiencies in the existing ON classification systems were identified and a new, non-joint-specific radiological classification system was developed. Seventy-two magnetic resonance imaging (MRI) images of patients with cancer and ON lesions were graded, and the validation of the new system was performed by assessing inter- and intra-observer reliability. Results: Intra-observer reliability of ON grading was good or very good, with kappa values of 0.79–0.86. Interobserver agreement was lower but still good, with kappa values of 0.62–0.77. Ninety-eight percent of all intra- or interobserver differences were within one grade. Interobserver reliability of assessing the location of ON was very good, with kappa values of 0.93–0.98. Conclusion: All the available radiological ON classification systems are joint specific. This limitation has spurred the development of multiple systems, which has led to the insufficient use of classifications in ON studies among patients with cancer. The introduced radiological classification system overcomes the problem of joint-specificity, was found to be reliable, and can be used to classify all ON lesions regardless of the affected site. - Highlights: • Patients with cancer may have osteonecrosis lesions at multiple sites. • There is no non-joint-specific osteonecrosis classification available. • We introduced a new non-joint-specific osteonecrosis classification. • The validation was performed by assessing inter- and intra-observer reliability. • The classification was reliable and could be used regardless of the affected site.

  16. 46 CFR 42.20-7 - Flooding standard: Type “B” vessel, 60 percent reduction.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Flooding standard: Type âBâ vessel, 60 percent reduction... DOMESTIC AND FOREIGN VOYAGES BY SEA Freeboards § 42.20-7 Flooding standard: Type “B” vessel, 60 percent... applied to the following flooding standards: (1) If the vessel is 225 meters (738 feet) or less in length...

  17. Basal area or stocking percent: which works best in controlling density in natural shortleaf pine stands

    Science.gov (United States)

    Ivan L. Sander

    1986-01-01

    Results from a shortleaf pine thinning study in Missouri show that continually thinning a stand to the same basal area will eventually create an understocked stand and reduce yields. Using stocking percent to control thinning intensity allows basal area to increase as stands get older. The best yield should occur when shortleaf pine is repeatedly thinned to 60 percent...

  18. 12 CFR 741.4 - Insurance premium and one percent deposit.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Insurance premium and one percent deposit. 741... Insurance premium and one percent deposit. (a) Scope. This section implements the requirements of Section... payment of an insurance premium. (b) Definitions. For purposes of this section: (1) Available assets ratio...

  19. Evaluation of the influence of percent labeling of 99mTc-MIBI on nuclear medicine procedures in Recife, Pernambuco State, Brazil

    International Nuclear Information System (INIS)

    Pereira, Jucilene Maria

    2003-08-01

    The aim of this work was to evaluate the influence of percent labeling of the radiopharmaceutical 99m Tc-MIBI on the procedures adopted by the nuclear medicine clinics in Recife, Pernambuco State, Brazil, and their possible interference with image quality in myocardial perfusion examinations. This work was performed at two nuclear medicine services in Recife that use pharmaceuticals provided by two different manufacturers: Cardiolite, provided by Dupont and Cardiosyd, provided by SYDMA. The pH, percent labeling and stability of samples of 99m Tc-MIBI and the percent uptake in heart and liver of a number of patients were evaluated. The results showed that the pH values measured in all samples of both radiopharmaceuticals were within the limits recommended. In 48% of the Cardiolite samples, the percent labeling was less than 90%, which is the minimum recommended limit. On the other hand, 87,5% of the Cardiosyd samples measured values above 98%. Both radiopharmaceuticals had good labeling stability, even in samples with low percent labeling efficiencies. In spite of the higher percent labeling of Cardiosyd its heart uptake is similar to that observed with the Cardiolite, even when the percent labeling is lower than 90%. On the other hand, the image quality, according to physicians, evaluation was poorer for Cardiosyd images, due to high noise and poor sharpness. (author)

  20. Completion of the first approach to critical for the seven percent critical experiment

    International Nuclear Information System (INIS)

    Barber, A. D.; Harms, G. A.

    2009-01-01

    The first approach-to-critical experiment in the Seven Percent Critical Experiment series was recently completed at Sandia. This experiment is part of the Seven Percent Critical Experiment which will provide new critical and reactor physics benchmarks for fuel enrichments greater than five weight percent. The inverse multiplication method was used to determine the state of the system during the course of the experiment. Using the inverse multiplication method, it was determined that the critical experiment went slightly supercritical with 1148 fuel elements in the fuel array. The experiment is described and the results of the experiment are presented. (authors)

  1. EnviroAtlas - Minneapolis/St. Paul, MN - Estimated Percent Tree Cover Along Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  2. EnviroAtlas - Green Bay, WI - Estimated Percent Tree Cover Along Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  3. EnviroAtlas - Cleveland, OH - Estimated Percent Tree Cover Along Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  4. EnviroAtlas - Austin, TX - Estimated Percent Tree Cover Along Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  5. EnviroAtlas - New York, NY - Estimated Percent Tree Cover Along Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  6. EnviroAtlas - New Bedford, MA - Estimated Percent Tree Cover Along Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  7. EnviroAtlas - Portland, ME - Estimated Percent Tree Cover Along Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  8. EnviroAtlas - Woodbine, IA - Estimated Percent Tree Cover Along Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  9. EnviroAtlas - Milwaukee, WI - Estimated Percent Tree Cover Along Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  10. EnviroAtlas - Tampa, FL - Estimated Percent Tree Cover Along Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  11. EnviroAtlas - Pittsburgh, PA - Estimated Percent Tree Cover Along Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  12. EnviroAtlas - Phoenix, AZ - Estimated Percent Tree Cover Along Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  13. EnviroAtlas - Durham, NC - Estimated Percent Tree Cover Along Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  14. EnviroAtlas - Portland, OR - Estimated Percent Tree Cover Along Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  15. EnviroAtlas - Paterson, NJ - Estimated Percent Tree Cover Along Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  16. EnviroAtlas - Memphis, TN - Estimated Percent Tree Cover Along Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  17. EnviroAtlas - Fresno, CA - Estimated Percent Tree Cover Along Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  18. EnviroAtlas - Percent Urban Land Cover by 12-Digit HUC for the Conterminous United States

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the percent urban land for each 12-digit hydrologic unit code (HUC) in the conterminous United States. For the purposes of this...

  19. EnviroAtlas - Des Moines, IA - Estimated Percent Tree Cover Along Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  20. EnviroAtlas Estimated Percent Tree Cover Along Walkable Roads Web Service

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  1. 64 Percent of Asian and Pacific Islander Treatment Admissions Name Alcohol as Their Problem

    Science.gov (United States)

    Data Spotlight May 28, 2013 64 Percent of Asian and Pacific Islander Treatment Admissions Name Alcohol as ... common problem in the United States. 1 When Asians and Pacific Islanders (APIs) go to treatment, alcohol ...

  2. Map of percent scleractinian coral cover and sand along camera tow tracks in west Hawaii

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral and sand overlaid on bathymetry and landsat imagery northwest...

  3. WHK Student Internship Enrollment, Mentor Participation Up More than 50 Percent | Poster

    Science.gov (United States)

    By Nancy Parrish, Staff Writer The Werner H. Kirsten Student Internship Program (WHK SIP) has enrolled the largest class ever for the 2013–2014 academic year, with 66 students and 50 mentors. This enrollment reflects a 53 percent increase in students and a 56 percent increase in mentors, compared to 2012–2013 (43 students and 32 mentors), according to Julie Hartman, WHK SIP

  4. Experience with high percent step load decrease from full power in NPP Krsko

    International Nuclear Information System (INIS)

    Vukovic, V.

    2000-01-01

    The control system of NPP Kriko, is designed to automatically control the reactor in the power range between 15 and 100 percent of rated power for the following designed transients; - 10 percent step change in load; 5 percent per minute loading and unloading; step full load decrease with the aid of automatically initiated and controlled steam dump. Because station operation below 15 percent of rated power is designed for a period of time during startup or standby conditions, automatic control below 15 percent is not provided. The steam dump accomplishes the following functional tasks: it permits the nuclear plants to accept a sudden 95 percent loss of load without incurring reactor trip; it removes stored energy and residual heat following a reactor trip and brings the plant to equilibrium no-load conditions without actuation of the steam generator safety valves; it permits control of the steam generator pressure at no-load conditions and permits a manually controlled cooldown of the plant. The first two functional tasks are controlled by Tavg. The third is controlled by steam pressure. Interlocks minimise any possibility of an inadvertent actuation of steam dump system. This paper discusses relationships between designed (described) characteristics of plant and the data which are obtained during startup and/or first ten years of operation. (author)

  5. United States home births increase 20 percent from 2004 to 2008.

    Science.gov (United States)

    MacDorman, Marian F; Declercq, Eugene; Mathews, T J

    2011-09-01

    After a gradual decline from 1990 to 2004, the percentage of births occurring at home increased from 2004 to 2008 in the United States. The objective of this report was to examine the recent increase in home births and the factors associated with this increase from 2004 to 2008. United States birth certificate data on home births were analyzed by maternal demographic and medical characteristics. In 2008, there were 28,357 home births in the United States. From 2004 to 2008, the percentage of births occurring at home increased by 20 percent from 0.56 percent to 0.67 percent of United States births. This rise was largely driven by a 28 percent increase in the percentage of home births for non-Hispanic white women, for whom more than 1 percent of births occur at home. At the same time, the risk profile for home births has been lowered, with substantial drops in the percentage of home births of infants who are born preterm or at low birthweight, and declines in the percentage of home births that occur to teen and unmarried mothers. Twenty-seven states had statistically significant increases in the percentage of home births from 2004 to 2008; only four states had declines. The 20 percent increase in United States home births from 2004 to 2008 is a notable development that will be of interest to practitioners and policymakers. (BIRTH 38:3 September 2011). © 2011, Copyright the Authors. Journal compilation © 2011, Wiley Periodicals, Inc.

  6. Increased circulating fibrocytes are associated with higher reticulocyte percent in children with sickle cell anemia.

    Science.gov (United States)

    Karafin, Matthew S; Dogra, Shibani; Rodeghier, Mark; Burdick, Marie; Mehrad, Borna; Rose, C Edward; Strieter, Robert M; DeBaun, Michael R; Strunk, Robert C; Field, Joshua J

    2016-03-01

    Interstitial lung disease is common in patients with sickle cell anemia (SCA). Fibrocytes are circulating cells implicated in the pathogenesis of pulmonary fibrosis and airway remodeling in asthma. In this study, we tested the hypotheses that fibrocyte levels are: (1) increased in children with SCA compared to healthy controls, and (2) associated with pulmonary disease. Cross-sectional cohort study of children with SCA who participated in the Sleep Asthma Cohort Study. Fibrocyte levels were obtained from 45 children with SCA and 24 controls. Mean age of SCA cases was 14 years and 53% were female. In children with SCA, levels of circulating fibrocytes were greater than controls (P < 0.01). The fibrocytes expressed a hierarchy of chemokine receptors, with CXCR4 expressed on the majority of cells and CCR2 and CCR7 expressed on a smaller subset. Almost half of fibrocytes demonstrated α-smooth muscle actin activation. Increased fibrocyte levels were associated with a higher reticulocyte count (P = 0.03) and older age (P = 0.048) in children with SCA. However, children with increased levels of fibrocytes were not more likely to have asthma or lower percent predicted forced expiratory volume in 1 sec/forced vital capacity (FEV1 /FVC) or FEV1 than those with lower fibrocyte levels. Higher levels of fibrocytes in children with SCA compared to controls may be due to hemolysis. Longitudinal studies may be able to better assess the relationship between fibrocyte level and pulmonary dysfunction. © 2015 Wiley Periodicals, Inc.

  7. A comparison of methods of determining the 100 percent survival of preserved red cells

    International Nuclear Information System (INIS)

    Valeri, C.R.; Pivacek, L.E.; Ouellet, R.; Gray, A.

    1984-01-01

    Studies were done to compare three methods to determine the 100 percent survival value from which to estimate the 24-hour posttransfusion survival of preserved red cells. The following methods using small aliquots of 51 Cr-labeled autologous preserved red cells were evaluated: First, the 125 I-albumin method, which is an indirect measurement of the recipient's red cell volume derived from the plasma volume measured using 125 I-labeled albumin and the total body hematocrit. Second, the body surface area method (BSA) in which the recipient's red cell volume is derived from a body surface area nomogram. Third, an extrapolation method, which extrapolates to zero time the radioactivity associated with the red cells in the recipient's circulation from 10 to 20 or 15 to 30 minutes after transfusion. The three methods gave similar results in all studies in which less than 20 percent of the transfused red cells were nonviable (24-hour posttransfusion survival values of between 80-100%), but not when more than 20 percent of the red cells were nonviable. When 21 to 35 percent of the transfused red cells were nonviable (24-hour posttransfusion survivals of 65 to 79%), values with the 125 I-albumin method and the body surface area method were about 5 percent lower (p less than 0.001) than values with the extrapolation method. When greater than 35 percent of the red cells were nonviable (24-hour posttransfusion survival values of less than 65%), values with the 125 I-albumin method and the body surface area method were about 10 percent lower (p less than 0.001) than those obtained by the extrapolation method

  8. MFT homogeneity study at TNX: Final report on the low weight percent solids concentration

    International Nuclear Information System (INIS)

    Jenkins, W.J.

    1993-01-01

    A statistical design and analysis of both elemental analyses and weight percent solids analyses data was utilized to evaluate the MFT homogeneity at low heel levels and low agitator speed at both high and low solids feed concentrations. The homogeneity was also evaluated at both low and high agitator speed at the 6000+ gallons static level. The dynamic level portion of the test simulated feeding the Melter from the MFT to evaluate the uniformity of the solids slurry composition (Frit-PHA-Sludge) entering the melter from the MFT. This final report provides the results and conclusions from the second half of the study, the low weight percent solids concentration portion, as well as a comparison with the results from the first half of the study, the high weight percent solids portion

  9. Urban percent impervious surface and its relationship with land surface temperature in Yantai City, China

    International Nuclear Information System (INIS)

    Yu, Xinyang; Lu, Changhe

    2014-01-01

    This study investigated percent impervious surface area (PISA) extracted by a four-endmember normalized spectral mixture analysis (NSMA) method and evaluated the reliability of PISA as an indicator of land surface temperature (LST). Landsat Thematic Mapper (TM) and Enhanced Thematic Mapper Plus (ETM+) images for Yantai city, eastern China obtained from USGS were used as the main data source. The results demonstrated that four-endmember NSMA method performed better than the typical three-endmember one, and there was a strong linear relationship between LST and PISA for the two images, which suggest percent impervious surface area provides an alternative parameter for analyzing LST quantitatively in urban areas

  10. Cumulative percent energy deposition of photon beam incident on different targets, simulated by Monte Carlo

    International Nuclear Information System (INIS)

    Kandic, A.; Jevremovic, T.; Boreli, F.

    1989-01-01

    Monte Carlo simulation (without secondary radiation) of the standard photon interactions (Compton scattering, photoelectric absorption and pair protection) for the complex slab's geometry is used in numerical code ACCA. A typical ACCA run will yield: (a) transmission of primary photon radiation differential in energy, (b) the spectrum of energy deposited in the target as a function of position and (c) the cumulative percent energy deposition as a function of position. A cumulative percent energy deposition of photon monoenergetic beam incident on simplest and complexity tissue slab and Fe slab are presented in this paper. (author). 5 refs.; 2 figs

  11. The Determination of the Percent of Oxygen in Air Using a Gas Pressure Sensor

    Science.gov (United States)

    Gordon, James; Chancey, Katherine

    2005-01-01

    The experiment of determination of the percent of oxygen in air is performed in a general chemistry laboratory in which students compare the results calculated from the pressure measurements obtained with the calculator-based systems to those obtained in a water-measurement method. This experiment allows students to explore a fundamental reaction…

  12. Field method to measure changes in percent body fat of young women: The TIGER Study

    Science.gov (United States)

    Body mass index (BMI), waist (W) and hip (H) circumference (C) are commonly used to assess changes in body composition for field research. We developed a model to estimate changes in dual energy X-ray absorption (DXA) percent fat (% fat) from these variables with a diverse sample of young women fro...

  13. Generalized equations for estimating DXA percent fat of diverse young women and men: The Tiger Study

    Science.gov (United States)

    Popular generalized equations for estimating percent body fat (BF%) developed with cross-sectional data are biased when applied to racially/ethnically diverse populations. We developed accurate anthropometric models to estimate dual-energy x-ray absorptiometry BF% (DXA-BF%) that can be generalized t...

  14. European Community Can Reduce CO2 Emissions by Sixty Percent : A Feasibility Study

    NARCIS (Netherlands)

    Mot, E.; Bartelds, H.; Esser, P.M.; Huurdeman, A.J.M.; Laak, P.J.A. van de; Michon, S.G.L.; Nielen, R.J.; Baar, H.J.W. de

    1993-01-01

    Carbon dioxide (CO2) emissions in the European Community (EC) can be reduced by roughly 60 percent. A great many measures need to be taken to reach this reduction, with a total annual cost of ECU 55 milliard. Fossil fuel use is the main cause of CO2 emissions into the atmosphere; CO2 emissions are

  15. 48 CFR 836.606-73 - Application of 6 percent architect-engineer fee limitation.

    Science.gov (United States)

    2010-10-01

    ... architect-engineer fee limitation. 836.606-73 Section 836.606-73 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS SPECIAL CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Architect-Engineer Services 836.606-73 Application of 6 percent architect-engineer fee limitation...

  16. 46 CFR 42.20-8 - Flooding standard: Type “B” vessel, 100 percent reduction.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Flooding standard: Type âBâ vessel, 100 percent... LINES DOMESTIC AND FOREIGN VOYAGES BY SEA Freeboards § 42.20-8 Flooding standard: Type “B” vessel, 100...-11 as applied to the following flooding standards: (1) If the vessel is 225 meters (738 feet) or less...

  17. Identification of a novel percent mammographic density locus at 12q24.

    Science.gov (United States)

    Stevens, Kristen N; Lindstrom, Sara; Scott, Christopher G; Thompson, Deborah; Sellers, Thomas A; Wang, Xianshu; Wang, Alice; Atkinson, Elizabeth; Rider, David N; Eckel-Passow, Jeanette E; Varghese, Jajini S; Audley, Tina; Brown, Judith; Leyland, Jean; Luben, Robert N; Warren, Ruth M L; Loos, Ruth J F; Wareham, Nicholas J; Li, Jingmei; Hall, Per; Liu, Jianjun; Eriksson, Louise; Czene, Kamila; Olson, Janet E; Pankratz, V Shane; Fredericksen, Zachary; Diasio, Robert B; Lee, Adam M; Heit, John A; DeAndrade, Mariza; Goode, Ellen L; Vierkant, Robert A; Cunningham, Julie M; Armasu, Sebastian M; Weinshilboum, Richard; Fridley, Brooke L; Batzler, Anthony; Ingle, James N; Boyd, Norman F; Paterson, Andrew D; Rommens, Johanna; Martin, Lisa J; Hopper, John L; Southey, Melissa C; Stone, Jennifer; Apicella, Carmel; Kraft, Peter; Hankinson, Susan E; Hazra, Aditi; Hunter, David J; Easton, Douglas F; Couch, Fergus J; Tamimi, Rulla M; Vachon, Celine M

    2012-07-15

    Percent mammographic density adjusted for age and body mass index (BMI) is one of the strongest risk factors for breast cancer and has a heritable component that remains largely unidentified. We performed a three-stage genome-wide association study (GWAS) of percent mammographic density to identify novel genetic loci associated with this trait. In stage 1, we combined three GWASs of percent density comprised of 1241 women from studies at the Mayo Clinic and identified the top 48 loci (99 single nucleotide polymorphisms). We attempted replication of these loci in 7018 women from seven additional studies (stage 2). The meta-analysis of stage 1 and 2 data identified a novel locus, rs1265507 on 12q24, associated with percent density, adjusting for age and BMI (P = 4.43 × 10(-8)). We refined the 12q24 locus with 459 additional variants (stage 3) in a combined analysis of all three stages (n = 10 377) and confirmed that rs1265507 has the strongest association in the 12q24 region (P = 1.03 × 10(-8)). Rs1265507 is located between the genes TBX5 and TBX3, which are members of the phylogenetically conserved T-box gene family and encode transcription factors involved in developmental regulation. Understanding the mechanism underlying this association will provide insight into the genetics of breast tissue composition.

  18. Radial growth and percent of latewood in Scots pine provenance trials in Western and Central Siberia

    Directory of Open Access Journals (Sweden)

    S. R. Kuzmin

    2016-12-01

    Full Text Available Percent of latewood of Boguchany and Suzun Scots pine climatypes has been studied in two provenance trials (place of origin and trial place. For Boguchany climatype the place of origin is south taiga of Central Siberia (Krasnoyarsk Krai, the place of trial is forest-steppe zone of Western Siberia (Novosibirsk Oblast and vice versa for Suzun climatype – forest-steppe zone of Western Siberia is the place of origin, south taiga is the place of trial. Comparison of annual average values of latewood percent of Boguchany climatype in south taiga and forest-steppe revealed the same numbers – 19 %. Annual variability of this trait in south taiga is distinctly lower and equal to 17 %, in forest-steppe – 35 %. Average annual values of latewood percent of Suzun climatype in the place of origin and trial place are close (20 and 21 %. Variability of this trait for Suzun climatype is higher than for Boguchany and equal to 23 % in south taiga and 42 % in forest-steppe. Climatic conditions in southern taiga in Central Siberia in comparison with forest-steppe in Western Siberia make differences between climatypes stronger. Differences between climatypes are expressed in different age of maximal increments of diameter, different tree ring width and latewood percent values and in different latewood reaction to weather conditions.

  19. 40 CFR 60.1450 - How must I monitor opacity for air curtain incinerators that burn 100 percent yard waste?

    Science.gov (United States)

    2010-07-01

    ... curtain incinerators that burn 100 percent yard waste? 60.1450 Section 60.1450 Protection of Environment... Air Curtain Incinerators That Burn 100 Percent Yard Waste § 60.1450 How must I monitor opacity for air curtain incinerators that burn 100 percent yard waste? (a) Use EPA Reference Method 9 in appendix A of...

  20. 40 CFR 60.1925 - How must I monitor opacity for air curtain incinerators that burn 100 percent yard waste?

    Science.gov (United States)

    2010-07-01

    ... curtain incinerators that burn 100 percent yard waste? 60.1925 Section 60.1925 Protection of Environment... or Before August 30, 1999 Model Rule-Air Curtain Incinerators That Burn 100 Percent Yard Waste § 60.1925 How must I monitor opacity for air curtain incinerators that burn 100 percent yard waste? (a) Use...

  1. 40 CFR 62.15375 - What are the emission limits for air curtain incinerators that burn 100 percent yard waste?

    Science.gov (United States)

    2010-07-01

    ... curtain incinerators that burn 100 percent yard waste? 62.15375 Section 62.15375 Protection of Environment... Combustion Units Constructed on or Before August 30, 1999 Air Curtain Incinerators That Burn 100 Percent Yard Waste § 62.15375 What are the emission limits for air curtain incinerators that burn 100 percent yard...

  2. 40 CFR 60.1445 - What are the emission limits for air curtain incinerators that burn 100 percent yard waste?

    Science.gov (United States)

    2010-07-01

    ... curtain incinerators that burn 100 percent yard waste? 60.1445 Section 60.1445 Protection of Environment... Air Curtain Incinerators That Burn 100 Percent Yard Waste § 60.1445 What are the emission limits for air curtain incinerators that burn 100 percent yard waste? If your air curtain incinerator combusts...

  3. 40 CFR 62.15380 - How must I monitor opacity for air curtain incinerators that burn 100 percent yard waste?

    Science.gov (United States)

    2010-07-01

    ... curtain incinerators that burn 100 percent yard waste? 62.15380 Section 62.15380 Protection of Environment... Combustion Units Constructed on or Before August 30, 1999 Air Curtain Incinerators That Burn 100 Percent Yard Waste § 62.15380 How must I monitor opacity for air curtain incinerators that burn 100 percent yard...

  4. 40 CFR 60.1920 - What are the emission limits for air curtain incinerators that burn 100 percent yard waste?

    Science.gov (United States)

    2010-07-01

    ... curtain incinerators that burn 100 percent yard waste? 60.1920 Section 60.1920 Protection of Environment... or Before August 30, 1999 Model Rule-Air Curtain Incinerators That Burn 100 Percent Yard Waste § 60.1920 What are the emission limits for air curtain incinerators that burn 100 percent yard waste? If...

  5. Austrian Business Cycle Theory: Are 100 Percent Reserves Sufficient to Prevent a Business Cycle?

    Directory of Open Access Journals (Sweden)

    Philipp Bagus

    2010-02-01

    Full Text Available Authors in the Austrian tradition have made the credit expansion of a fractional reserve banking system as the prime cause of business cycles. Authors such as Selgin (1988 and White (1999 have argued that a solution to this problem would be a free banking system. They maintain that the competition between banks would limit the credit expansion effectively. Other authors such as Rothbard (1991 and Huerta de Soto (2006 have gone further and advocated a 100 percent reserve banking system ruling out credit expansion altogether. In this article it is argued that a 100 percent reserve system can still bring about business cycles through excessive maturity mismatching between deposits and loans.

  6. Amazing 7-day, super-simple, scripted guide to teaching or learning percents

    CERN Document Server

    Hernandez, Lisa

    2014-01-01

    Welcome to The Amazing 7-Day, Super-Simple, Scripted Guide to Teaching or Learning Percents. I have attempted to do just what the title says: make learning percents super simple. I have also attempted to make it fun and even ear-catching. The reason for this is not that I am a frustrated stand-up comic, but because in my fourteen years of teaching the subject, I have come to realize that my jokes, even the bad ones, have a crazy way of sticking in my students' heads. And should I use a joke (even a bad one) repetitively, the associations become embedded in their brains, many times to their cha

  7. TEM investigation of irradiated U-7 weight percent Mo dispersion fuel

    International Nuclear Information System (INIS)

    Van den Berghe, S.

    2009-01-01

    In the FUTURE experiment, fuel plates containing U-7 weight percent Mo atomized powder were irradiated in the BR2 reactor. At a burn-up of approximately 33 percent 235 U (6.5 percent FIMA or 1.41 10 21 fissions/cm 3 meat), the fuel plates showed an important deformation and the irradiation was stopped. The plates were submitted to detailed PIE at the Laboratory for High and Medium level Activity. The results of these examinations were reported in the scientific report of last year and published in open literature. Since then, the microstructural aspects of the FUTURE fuel were studied in more detail using transmission electron microscopy (TEM), in an attempt to understand the nature of the interaction phase and the fission gas behavior in the atomized U(Mo) fuel. The FUTURE experiment is regarded as the definitive proof that the classical atomized U(Mo) dispersion fuel is not stable under irradiation, at least in the conditions required for normal operation of plate-type fuel. The main cause for the instability was identified to be the irradiation behavior of the U(Mo)-Al interaction phase which is formed between the U(Mo) particles and the pure aluminum matrix during irradiation. It is assumed to become amorphous under irradiation and as such cannot retain the fission gas in stable bubbles. As a consequence, gas filled voids are generated between the interaction layer and the matrix, resulting in fuel plate pillowing and failure. The objective of the TEM investigation was the confirmation of this assumption of the amorphisation of the interaction phase. A deeper understanding of the actual nature of this layer and the fission gas behaviour in these fuels in general can allow a more oriented search for a solution to the fuel failures

  8. Residual volume on land and when immersed in water: effect on percent body fat.

    Science.gov (United States)

    Demura, Shinichi; Yamaji, Shunsuke; Kitabayashi, Tamotsu

    2006-08-01

    There is a large residual volume (RV) error when assessing percent body fat by means of hydrostatic weighing. It has generally been measured before hydrostatic weighing. However, an individual's maximal exhalations on land and in the water may not be identical. The aims of this study were to compare residual volumes and vital capacities on land and when immersed to the neck in water, and to examine the influence of the measurement error on percent body fat. The participants were 20 healthy Japanese males and 20 healthy Japanese females. To assess the influence of the RV error on percent body fat in both conditions and to evaluate the cross-validity of the prediction equation, another 20 males and 20 females were measured using hydrostatic weighing. Residual volume was measured on land and in the water using a nitrogen wash-out technique based on an open-circuit approach. In water, residual volume was measured with the participant sitting on a chair while the whole body, except the head, was submerged . The trial-to-trial reliabilities of residual volume in both conditions were very good (intraclass correlation coefficient > 0.98). Although residual volume measured under the two conditions did not agree completely, they showed a high correlation (males: 0.880; females: 0.853; P body fat computed using residual volume measured in both conditions was very good for both sexes (males: r = 0.902; females: r = 0.869, P body fat: -3.4 to 2.2% for males; -6.3 to 4.4% for females). We conclude that if these errors are of no importance, residual volume measured on land can be used when assessing body composition.

  9. Health plan auditing: 100-percent-of-claims vs. random-sample audits.

    Science.gov (United States)

    Sillup, George P; Klimberg, Ronald K

    2011-01-01

    The objective of this study was to examine the relative efficacy of two different methodologies for auditing self-funded medical claim expenses: 100-percent-of-claims auditing versus random-sampling auditing. Multiple data sets of claim errors or 'exceptions' from two Fortune-100 corporations were analysed and compared to 100 simulated audits of 300- and 400-claim random samples. Random-sample simulations failed to identify a significant number and amount of the errors that ranged from $200,000 to $750,000. These results suggest that health plan expenses of corporations could be significantly reduced if they audited 100% of claims and embraced a zero-defect approach.

  10. Comparative evaluation of PSA-Density, percent free PSA and total PSA

    OpenAIRE

    Ströbel, Greta

    2010-01-01

    BACKGROUND The objective of this study was to evaluate the prostate specific antigen (PSA) density (PSAD) (the quotient of PSA and prostate volume) compared with the percent free PSA (%fPSA) and total PSA (tPSA) in different total PSA (tPSA) ranges from 2 ng/mL to 20 ng/mL. Possible cut-off levels depending on the tPSA should be established. METHODS In total, 1809 men with no pretreatment of the prostate were enrolled between 1996 and 2004. Total and free PSA were measured with t...

  11. Running speed during training and percent body fat predict race time in recreational male marathoners.

    Science.gov (United States)

    Barandun, Ursula; Knechtle, Beat; Knechtle, Patrizia; Klipstein, Andreas; Rüst, Christoph Alexander; Rosemann, Thomas; Lepers, Romuald

    2012-01-01

    Recent studies have shown that personal best marathon time is a strong predictor of race time in male ultramarathoners. We aimed to determine variables predictive of marathon race time in recreational male marathoners by using the same characteristics of anthropometry and training as used for ultramarathoners. Anthropometric and training characteristics of 126 recreational male marathoners were bivariately and multivariately related to marathon race times. After multivariate regression, running speed of the training units (β = -0.52, P marathon race times. Marathon race time for recreational male runners may be estimated to some extent by using the following equation (r (2) = 0.44): race time ( minutes) = 326.3 + 2.394 × (percent body fat, %) - 12.06 × (speed in training, km/hours). Running speed during training sessions correlated with prerace percent body fat (r = 0.33, P = 0.0002). The model including anthropometric and training variables explained 44% of the variance of marathon race times, whereas running speed during training sessions alone explained 40%. Thus, training speed was more predictive of marathon performance times than anthropometric characteristics. The present results suggest that low body fat and running speed during training close to race pace (about 11 km/hour) are two key factors for a fast marathon race time in recreational male marathoner runners.

  12. Prenatal MRI fetal lung volumes and percent liver herniation predict pulmonary morbidity in congenital diaphragmatic hernia (CDH).

    Science.gov (United States)

    Zamora, Irving J; Olutoye, Oluyinka O; Cass, Darrell L; Fallon, Sara C; Lazar, David A; Cassady, Christopher I; Mehollin-Ray, Amy R; Welty, Stephen E; Ruano, Rodrigo; Belfort, Michael A; Lee, Timothy C

    2014-05-01

    The purpose of this study was to determine whether prenatal imaging parameters are predictive of postnatal CDH-associated pulmonary morbidity. The records of all neonates with CDH treated from 2004 to 2012 were reviewed. Patients requiring supplemental oxygen at 30 days of life (DOL) were classified as having chronic lung disease (CLD). Fetal MRI-measured observed/expected total fetal lung volume (O/E-TFLV) and percent liver herniation (%LH) were recorded. Receiver operating characteristic (ROC) curves and multivariate regression were applied to assess the prognostic value of O/E-TFLV and %LH for development of CLD. Of 172 neonates with CDH, 108 had fetal MRIs, and survival was 76%. 82% (89/108) were alive at DOL 30, 46 (52%) of whom had CLD. Neonates with CLD had lower mean O/E-TFLV (30 vs.42%; p=0.001) and higher %LH (21.3±2.8 vs.7.1±1.8%; p20% (AUC=0.78; p20% were highly associated with indicators of long-term pulmonary sequelae. On multivariate analysis, %LH was the strongest predictor of CLD in patients with CDH (OR: 10.96, 95%CI: 2.5-48.9, p=0.002). Prenatal measurement of O/E-TFLV and %LH is predictive of CDH pulmonary morbidity and can aid in establishing parental expectations of postnatal outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. A fuzzy neural network model to forecast the percent cloud coverage and cloud top temperature maps

    Directory of Open Access Journals (Sweden)

    Y. Tulunay

    2008-12-01

    Full Text Available Atmospheric processes are highly nonlinear. A small group at the METU in Ankara has been working on a fuzzy data driven generic model of nonlinear processes. The model developed is called the Middle East Technical University Fuzzy Neural Network Model (METU-FNN-M. The METU-FNN-M consists of a Fuzzy Inference System (METU-FIS, a data driven Neural Network module (METU-FNN of one hidden layer and several neurons, and a mapping module, which employs the Bezier Surface Mapping technique. In this paper, the percent cloud coverage (%CC and cloud top temperatures (CTT are forecast one month ahead of time at 96 grid locations. The probable influence of cosmic rays and sunspot numbers on cloudiness is considered by using the METU-FNN-M.

  14. Phased Acoustic Array Measurements of a 5.75 Percent Hybrid Wing Body Aircraft

    Science.gov (United States)

    Burnside, Nathan J.; Horne, William C.; Elmer, Kevin R.; Cheng, Rui; Brusniak, Leon

    2016-01-01

    Detailed acoustic measurements of the noise from the leading-edge Krueger flap of a 5.75 percent Hybrid Wing Body (HWB) aircraft model were recently acquired with a traversing phased microphone array in the AEDC NFAC (Arnold Engineering Development Complex, National Full Scale Aerodynamics Complex) 40- by 80-Foot Wind Tunnel at NASA Ames Research Center. The spatial resolution of the array was sufficient to distinguish between individual support brackets over the full-scale frequency range of 100 to 2875 Hertz. For conditions representative of landing and take-off configuration, the noise from the brackets dominated other sources near the leading edge. Inclusion of flight-like brackets for select conditions highlights the importance of including the correct number of leading-edge high-lift device brackets with sufficient scale and fidelity. These measurements will support the development of new predictive models.

  15. Percent wall thickness evaluated by Gd-DTPA enhanced cine MRI as an indicator of local parietal movement in hypertrophic cardiomyopathy

    International Nuclear Information System (INIS)

    Hirano, Masaharu

    1998-01-01

    Hypertrophic cardiomyopathy (HCM) is a cardiac disease, the basic pathology of which consists of a decrease in left ventricular dilation compliance due to uneven hypertrophy of the left ventricular wall. Magnetic resonance imaging (MRI) is useful in monitoring uneven parietal hypertrophy and kinetics in HCM patients. The present study was undertaken in 47 HCM patients who showed asymmetrical septal hypertrophy to determine if percent thickness can be an indicator of left ventricular local movement using cine MRI. Longest and shortest axis images were acquired by the ECG synchronization method using a 1.5 T MR imager. Cardiac function was analyzed based on longest axis cine images, and telediastolic and telesystolic parietal thickness were measured based on shorter axis cine images at the papillary muscle level. Parietal movement index and percent thickness were used as indicators of local parietal movement. The correlation between these indicators and parietal thickness was evaluated. The percent thickness changed at an earlier stage of hypertrophy than the parietal movement index, thus it is thought to be useful in detecting left ventricular parietal movement disorders at an early stage of HCM. (author)

  16. Percent wall thickness evaluated by Gd-DTPA enhanced cine MRI as an indicator of local parietal movement in hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Hirano, Masaharu [Tokyo Medical Coll. (Japan)

    1998-11-01

    Hypertrophic cardiomyopathy (HCM) is a cardiac disease, the basic pathology of which consists of a decrease in left ventricular dilation compliance due to uneven hypertrophy of the left ventricular wall. Magnetic resonance imaging (MRI) is useful in monitoring uneven parietal hypertrophy and kinetics in HCM patients. The present study was undertaken in 47 HCM patients who showed asymmetrical septal hypertrophy to determine if percent thickness can be an indicator of left ventricular local movement using cine MRI. Longest and shortest axis images were acquired by the ECG synchronization method using a 1.5 T MR imager. Cardiac function was analyzed based on longest axis cine images, and telediastolic and telesystolic parietal thickness were measured based on shorter axis cine images at the papillary muscle level. Parietal movement index and percent thickness were used as indicators of local parietal movement. The correlation between these indicators and parietal thickness was evaluated. The percent thickness changed at an earlier stage of hypertrophy than the parietal movement index, thus it is thought to be useful in detecting left ventricular parietal movement disorders at an early stage of HCM. (author)

  17. Personal Best Time, Percent Body Fat, and Training Are Differently Associated with Race Time for Male and Female Ironman Triathletes

    Science.gov (United States)

    Knechtle, Beat; Wirth, Andrea; Baumann, Barbara; Knechtle, Patrizia; Rosemann, Thomas

    2010-01-01

    We studied male and female nonprofessional Ironman triathletes to determine whether percent body fat, training, and/or previous race experience were associated with race performance. We used simple linear regression analysis, with total race time as the dependent variable, to investigate the relationship among athletes' percent body fat, average…

  18. 26 CFR 1.46-9 - Requirements for taxpayers electing an extra one-half percent additional investment credit.

    Science.gov (United States)

    2010-04-01

    ... percent additional investment credit for property described in section 46(a)(2)(D). Paragraph (c) of this...-half percent additional investment credit. 1.46-9 Section 1.46-9 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY INCOME TAX INCOME TAXES Rules for Computing Credit for Investment in...

  19. The Use of Gas Chromatography and Mass Spectrometry to Introduce General Chemistry Students to Percent Mass and Atomic Mass Calculations

    Science.gov (United States)

    Pfennig, Brian W.; Schaefer, Amy K.

    2011-01-01

    A general chemistry laboratory experiment is described that introduces students to instrumental analysis using gas chromatography-mass spectrometry (GC-MS), while simultaneously reinforcing the concepts of mass percent and the calculation of atomic mass. Working in small groups, students use the GC to separate and quantify the percent composition…

  20. 40 CFR 63.5885 - How do I calculate percent reduction to demonstrate compliance for continuous lamination/casting...

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 12 2010-07-01 2010-07-01 true How do I calculate percent reduction to... Pollutants: Reinforced Plastic Composites Production Testing and Initial Compliance Requirements § 63.5885 How do I calculate percent reduction to demonstrate compliance for continuous lamination/casting...

  1. 40 CFR 62.14815 - What are the emission limitations for air curtain incinerators that burn 100 percent wood wastes...

    Science.gov (United States)

    2010-07-01

    ... air curtain incinerators that burn 100 percent wood wastes, clean lumber and/or yard waste? 62.14815... Requirements for Commercial and Industrial Solid Waste Incineration Units That Commenced Construction On or Before November 30, 1999 Air Curtain Incinerators That Burn 100 Percent Wood Wastes, Clean Lumber And/or...

  2. Instability of Reference Diameter in the Evaluation of Stenosis After Coronary Angioplasty: Percent Diameter Stenosis Overestimates Dilative Effects Due to Reference Diameter Reduction

    International Nuclear Information System (INIS)

    Hirami, Ryouichi; Iwasaki, Kohichiro; Kusachi, Shozo; Murakami, Takashi; Hina, Kazuyoshi; Matano, Shigeru; Murakami, Masaaki; Kita, Toshimasa; Sakakibara, Noburu; Tsuji, Takao

    2000-01-01

    Purpose: To examine changes in the reference segment luminal diameter after coronary angioplasty.Methods: Sixty-one patients with stable angina pectoris or old myocardial infarction were examined. Coronary angiograms were recorded before coronary angioplasty (pre-angioplasty) and immediately after (post-angioplasty), as well as 3 months after. Artery diameters were measured on cine-film using quantitative coronary angiographic analysis.Results: The diameters of the proximal segment not involved in the balloon inflation and segments in the other artery did not change significantly after angioplasty, but the reference segment diameter significantly decreased (4.7%). More than 10% luminal reduction was observed in seven patients (11%) and more than 5% reduction was observed in 25 patients (41%). More than 5% underestimation of the stenosis was observed in 22 patients (36%) when the post-angioplasty reference diameter was used as the reference diameter, compared with when the pre-angioplasty measurement was used and more than 10% underestimation was observed in five patients (8%).Conclusion: This study indicated that evaluation by percent diameter stenosis, with the reference diameter from immediately after angioplasty, overestimates the dilative effects of coronary angioplasty, and that it is thus better to evaluate the efficacy of angioplasty using the absolute diameter in addition to percent luminal stenosis

  3. Comparison of Anaesthetic Efficacy of 4 percent Articaine Primary Buccal Infiltration Versus 2 percent Lidocaine Inferior Alveolar Nerve Block in Symptomatic Mandibular First Molar Teeth

    International Nuclear Information System (INIS)

    Zain, M.; Khattak, S. U. R.; Shah, S. A.; Fayyaz, M.; Sikandar, H.

    2016-01-01

    Objective: To evaluate success of pulpal anaesthesia of mandibular 1st molar by using 4 percentage articaine in buccal infiltration versus 2 percentage lidocaine in inferior alveolar nerve block. Study Design: Randomized control trial. Place and Duration of Study: Department of Operative Dentistry, Sardar Begum Dental College, Gandhara University, Peshawar, from March to August 2014. Methodology: One hundred and fifty-six emergency patients, who had 1st molar diagnosed with irreversible pulpitis, participated in the study. Subjects were divided into two groups by random allocation. One group received 4 percentage articaine buccal infiltration and the other group received inferior alveolar nerve block of 2 percentage lidocaine. Subjects self-reported pain response was recorded on Heft Parker Visual Analogue Scale after local anaesthetic administration during access cavity preparation and pulp extirpation. Results: Mean age of subjects was 31.46 ±10.994 years. The success rate of 4 percentage buccal infiltration was 76.9 percentage; whereas the success rate of 2 percentage lidocaine inferior alveolar nerve block was 62.8 percentage. There was no statistically significant difference between the two groups. Conclusion: 4 percentage articaine buccal infiltration can be considered a viable alternative to 2 percentage lidocaine inferior alveolar nerve block in securing successful pulpal anaesthesia for endodontic therapy. (author)

  4. Effect of serum testosterone and percent tumor volume on extra-prostatic extension and biochemical recurrence after laparoscopic radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Eu Chang Hwang

    2016-01-01

    Full Text Available Several studies have revealed that the preoperative serum testosterone and percent tumor volume (PTV predict extra-prostatic extension (EPE and biochemical recurrence (BCR after radical prostatectomy. This study investigated the prognostic significance of serum testosterone and PTV in relation to EPE and BCR after laparoscopic radical prostatectomy (LRP. We reviewed 520 patients who underwent LRP between 2004 and 2012. PTV was determined as the sum of all visually estimated tumor foci in every section. BCR was defined as two consecutive increases in the postoperative prostate-specific antigen (PSA >0.2 ng ml−1 . The threshold for serum total testosterone was 3.0 ng ml−1 . Multivariate logistic regression was used to define the effect of variables on the risk of EPE and BCR. A low serum testosterone (<3.0 ng ml−1 was associated with a high serum PSA, Gleason score, positive core percentage of the prostate biopsy, PTV, and all pathological variables. On multivariate analysis, similar to previous studies, the serum PSA, biopsy positive core percentage, Gleason score, and pathological variables predicted EPE and BCR. In addition, low serum testosterone (<3.0 ng ml−1 , adjusted OR, 8.52; 95% CI, 5.04-14.4, P= 0.001 predicted EPE and PTV (adjusted OR, 1.02; 95% CI, 1.01-1.05, P= 0.046 predicted BCR. In addition to previous predictors of EPE and BCR, low serum testosterone and PTV are valuable predictors of EPE and BCR after LRP.

  5. Immigrants in the one percent: The national origin of top wealth owners.

    Science.gov (United States)

    Keister, Lisa A; Aronson, Brian

    2017-01-01

    Economic inequality in the United States is extreme, but little is known about the national origin of affluent households. Households in the top one percent by total wealth own vastly disproportionate quantities of household assets and have correspondingly high levels of economic, social, and political influence. The overrepresentation of white natives (i.e., those born in the U.S.) among high-wealth households is well-documented, but changing migration dynamics suggest that a growing portion of top households may be immigrants. Because no single survey dataset contains top wealth holders and data about country of origin, this paper uses two publicly-available data sets: the Survey of Consumer Finances (SCF) and the Survey of Income and Program Participation (SIPP). Multiple imputation is used to impute country of birth from the SIPP into the SCF. Descriptive statistics are used to demonstrate reliability of the method, to estimate the prevalence of immigrants among top wealth holders, and to document patterns of asset ownership among affluent immigrants. Significant numbers of top wealth holders who are usually classified as white natives may be immigrants. Many top wealth holders appear to be European and Canadian immigrants, and increasing numbers of top wealth holders are likely from Asia and Latin America as well. Results suggest that of those in the top one percent of wealth holders, approximately 3% are European and Canadian immigrants, .5% are from Mexico or Cuban, and 1.7% are from Asia (especially Hong Kong, Taiwan, Mainland China, and India). Ownership of key assets varies considerably across affluent immigrant groups. Although the percentage of top wealth holders who are immigrants is relatively small, these percentages represent large numbers of households with considerable resources and corresponding social and political influence. Evidence that the propensity to allocate wealth to real and financial assets varies across immigrant groups suggests that

  6. Blood Glucose Levels Following Intra-Articular Steroid Injections in Patients with Diabetes: A Systematic Review.

    Science.gov (United States)

    Choudhry, M N; Malik, R A; Charalambous, Charalambos Panayiotou

    2016-03-22

    Parenterally administered steroids have been shown to affect the metabolism of glucose and to cause abnormal blood glucose levels in diabetic patients. These abnormal blood glucose levels in diabetic patients raise concerns that intra-articular steroid injections also may affect blood glucose levels. We performed a systematic review of studies examining the effect of intra-articular steroid injections on blood glucose levels in patients with diabetes mellitus. A literature search of the PubMed, EMBASE, AMED, and CINAHL databases using all relevant keywords and phrases revealed 532 manuscripts. After the application of inclusion criteria, seven studies with a total of seventy-two patients were analyzed. All studies showed a rise in blood glucose levels following intra-articular steroid injection. Four of the seven studies showed a substantial increase in blood glucose. Peak values reached as high as 500 mg/dL. The peak increase in blood glucose did not occur immediately following intra-articular steroid injection, and in some cases it took several days to occur. In many patients, post-injection hyperglycemia occurred within twenty-four to seventy-two hours. Intra-articular steroid injections may cause hyperglycemia in patients with diabetes mellitus, and patients should be warned of this complication. Diabetic patients should be advised to regularly monitor their blood glucose levels for up to a week after injection and should seek medical advice if safe thresholds are breached. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

  7. Role of percent tissue altered on ectasia after LASIK in eyes with suspicious topography.

    Science.gov (United States)

    Santhiago, Marcony R; Smadja, David; Wilson, Steven E; Krueger, Ronald R; Monteiro, Mario L R; Randleman, J Bradley

    2015-04-01

    To investigate the association of the percent tissue altered (PTA) with the occurrence of ectasia after LASIK in eyes with suspicious preoperative corneal topography. This retrospective comparative case-control study compared associations of reported ectasia risk factors in 129 eyes, including 57 eyes with suspicious preoperative Placido-based corneal topography that developed ectasia after LASIK (suspect ectasia group), 32 eyes with suspicious topography that remained stable for at least 3 years after LASIK (suspect control group), and 30 eyes that developed ectasia with bilateral normal topography (normal topography ectasia group). Groups were subdivided based on topographic asymmetry into high- or low-suspect groups. The PTA, preoperative central corneal thickness (CCT), residual stromal bed (RSB), and age (years) were evaluated in univariate and multivariate analyses. Average PTA values for normal topography ectasia (45), low-suspect ectasia (39), high-suspect ectasia (36), low-suspect control (32), and high-suspect control (29) were significantly different from one another in all comparisons (P topography ectasia groups, and CCT was not significantly different between any groups. Stepwise logistic regression revealed the PTA as the most significant independent variable (P topography. Less tissue alteration, or a lower PTA value, was necessary to induce ectasia in eyes with more remarkable signs of topographic abnormality, and PTA provided better discriminative capabilities than RSB for all study populations. Copyright 2015, SLACK Incorporated.

  8. Extrusion of the uranium-0.75 weight percent titanium alloy

    International Nuclear Information System (INIS)

    Jackson, R.J.; Lundberg, M.R.; Boland, J.F.

    1975-01-01

    Procedures are described for extruding the U--0.75 wt percent Ti alloy in the high alpha region (600 to 640 0 C) , and in the upper gamma region (900 to 1000 0 C). The casting of sound extrusion billets has importance in the production of sound extrusions, and procedures are given for casting sound billets up to 1,100 kilograms . Also important in producing sound extrusions is the use of glass lubricants. Reduction ratios of greater than 50 to 1 were achieved on reasonably sized billets. Extrusion constants of 48,000 pounds per square inch (psi) [296 megapascals (MPa)] for alpha phase (630 0 C) and 8,000 psi (56 MPa) for gamma phase (950 0 C) were achieved. Gamma-phase extrusion has preference over alpha-phase extrusion in that larger billets can be used and temperature control is not as critical. However alpha-phase extrusion offers better surface finish, less die wear, and fewer oxidation problems. Billets up to 14 inches in diameter have been successfully gamma-extruded and plans exist for extruding billets up to 20 inches (508 millimetres) in diameter. (U.S.)

  9. Percent body fat is a better predictor of cardiovascular risk factors than body mass index

    Energy Technology Data Exchange (ETDEWEB)

    Zeng, Qiang; Dong, Sheng-Yong; Sun, Xiao-Nan; Xie, Jing; Cui, Yi [International Medical Center, Chinese PLA General Hospital, Beijing (China)

    2012-04-20

    The objective of the present study was to evaluate the predictive values of percent body fat (PBF) and body mass index (BMI) for cardiovascular risk factors, especially when PBF and BMI are conflicting. BMI was calculated by the standard formula and PBF was determined by bioelectrical impedance analysis. A total of 3859 ambulatory adult Han Chinese subjects (2173 males and 1686 females, age range: 18-85 years) without a history of cardiovascular diseases were recruited from February to September 2009. Based on BMI and PBF, they were classified into group 1 (normal BMI and PBF, N = 1961), group 2 (normal BMI, but abnormal PBF, N = 381), group 3 (abnormal BMI, but normal PBF, N = 681), and group 4 (abnormal BMI and PBF, N = 836). When age, gender, lifestyle, and family history of obesity were adjusted, PBF, but not BMI, was correlated with blood glucose and lipid levels. The odds ratio (OR) and 95% confidence interval (CI) for cardiovascular risk factors in groups 2 and 4 were 1.88 (1.45-2.45) and 2.06 (1.26-3.35) times those in group 1, respectively, but remained unchanged in group 3 (OR = 1.32, 95%CI = 0.92-1.89). Logistic regression models also demonstrated that PBF, rather than BMI, was independently associated with cardiovascular risk factors. In conclusion, PBF, and not BMI, is independently associated with cardiovascular risk factors, indicating that PBF is a better predictor.

  10. EPIC Studies: Governments Finance, On Average, More Than 50 Percent Of Immunization Expenses, 2010-11.

    Science.gov (United States)

    Brenzel, Logan; Schütte, Carl; Goguadze, Keti; Valdez, Werner; Le Gargasson, Jean-Bernard; Guthrie, Teresa

    2016-02-01

    Governments in resource-poor settings have traditionally relied on external donor support for immunization. Under the Global Vaccine Action Plan, adopted in 2014, countries have committed to mobilizing additional domestic resources for immunization. Data gaps make it difficult to map how well countries have done in spending government resources on immunization to demonstrate greater ownership of programs. This article presents findings of an innovative approach for financial mapping of routine immunization applied in Benin, Ghana, Honduras, Moldova, Uganda, and Zambia. This approach uses modified System of Health Accounts coding to evaluate data collected from national and subnational levels and from donor agencies. We found that government sources accounted for 27-95 percent of routine immunization financing in 2011, with countries that have higher gross national product per capita better able to finance requirements. Most financing is channeled through government agencies and used at the primary care level. Sustainable immunization programs will depend upon whether governments have the fiscal space to allocate additional resources. Ongoing robust analysis of routine immunization should be instituted within the context of total health expenditure tracking. Project HOPE—The People-to-People Health Foundation, Inc.

  11. Percent body fat is a better predictor of cardiovascular risk factors than body mass index

    International Nuclear Information System (INIS)

    Zeng, Qiang; Dong, Sheng-Yong; Sun, Xiao-Nan; Xie, Jing; Cui, Yi

    2012-01-01

    The objective of the present study was to evaluate the predictive values of percent body fat (PBF) and body mass index (BMI) for cardiovascular risk factors, especially when PBF and BMI are conflicting. BMI was calculated by the standard formula and PBF was determined by bioelectrical impedance analysis. A total of 3859 ambulatory adult Han Chinese subjects (2173 males and 1686 females, age range: 18-85 years) without a history of cardiovascular diseases were recruited from February to September 2009. Based on BMI and PBF, they were classified into group 1 (normal BMI and PBF, N = 1961), group 2 (normal BMI, but abnormal PBF, N = 381), group 3 (abnormal BMI, but normal PBF, N = 681), and group 4 (abnormal BMI and PBF, N = 836). When age, gender, lifestyle, and family history of obesity were adjusted, PBF, but not BMI, was correlated with blood glucose and lipid levels. The odds ratio (OR) and 95% confidence interval (CI) for cardiovascular risk factors in groups 2 and 4 were 1.88 (1.45-2.45) and 2.06 (1.26-3.35) times those in group 1, respectively, but remained unchanged in group 3 (OR = 1.32, 95%CI = 0.92-1.89). Logistic regression models also demonstrated that PBF, rather than BMI, was independently associated with cardiovascular risk factors. In conclusion, PBF, and not BMI, is independently associated with cardiovascular risk factors, indicating that PBF is a better predictor

  12. The BDGP gene disruption project: Single transposon insertions associated with 40 percent of Drosophila genes

    Energy Technology Data Exchange (ETDEWEB)

    Bellen, Hugo J.; Levis, Robert W.; Liao, Guochun; He, Yuchun; Carlson, Joseph W.; Tsang, Garson; Evans-Holm, Martha; Hiesinger, P. Robin; Schulze, Karen L.; Rubin, Gerald M.; Hoskins, Roger A.; Spradling, Allan C.

    2004-01-13

    The Berkeley Drosophila Genome Project (BDGP) strives to disrupt each Drosophila gene by the insertion of a single transposable element. As part of this effort, transposons in more than 30,000 fly strains were localized and analyzed relative to predicted Drosophila gene structures. Approximately 6,300 lines that maximize genomic coverage were selected to be sent to the Bloomington Stock Center for public distribution, bringing the size of the BDGP gene disruption collection to 7,140 lines. It now includes individual lines predicted to disrupt 5,362 of the 13,666 currently annotated Drosophila genes (39 percent). Other lines contain an insertion at least 2 kb from others in the collection and likely mutate additional incompletely annotated or uncharacterized genes and chromosomal regulatory elements. The remaining strains contain insertions likely to disrupt alternative gene promoters or to allow gene mis-expression. The expanded BDGP gene disruption collection provides a public resource that will facilitate the application of Drosophila genetics to diverse biological problems. Finally, the project reveals new insight into how transposons interact with a eukaryotic genome and helps define optimal strategies for using insertional mutagenesis as a genomic tool.

  13. Examination of temperature-induced shape memory of uranium--5.3-to 6.9 weight percent niobium alloys

    International Nuclear Information System (INIS)

    Hemperly, V.C.

    1976-01-01

    The uranium-niobium alloy system was examined in the range of 5.3-to-6.9 weight percent niobium with respect to shape memory, mechanical properties, metallography, Coefficients of linear thermal expansion, and differential thermal analysis. Shape memory increased with increasing niobium levels in the study range. There were no useful correlations found between shape memory and the other tests. Coefficients of linear thermal expansion tests of as-quenched 5.8 and 6.2 weight percent niobium specimens, but not 5.3 and 6.9 weight percent niobium specimens, had a contraction component on heating, but the phenomenon was not a contributor to shape memory

  14. Angiotensin-Converting Inhibitors and Angiotensin II Receptor Blockers and Longitudinal Change in Percent Emphysema on Computed Tomography. The Multi-Ethnic Study of Atherosclerosis Lung Study

    Science.gov (United States)

    Parikh, Megha A.; Aaron, Carrie P.; Hoffman, Eric A.; Schwartz, Joseph E.; Madrigano, Jaime; Austin, John H. M.; Lovasi, Gina; Watson, Karol; Stukovsky, Karen Hinckley

    2017-01-01

    Rationale: Although emphysema on computed tomography (CT) is associated with increased morbidity and mortality in patients with and without spirometrically defined chronic obstructive pulmonary disease, no available medications target emphysema outside of alpha-1 antitrypsin deficiency. Transforming growth factor-β and endothelial dysfunction are implicated in emphysema pathogenesis, and angiotensin II receptor blockers (ARBs) inhibit transforming growth factor-β, improve endothelial function, and restore airspace architecture in murine models. Evidence in humans is, however, lacking. Objectives: To determine whether angiotensin-converting enzyme (ACE) inhibitor and ARB dose is associated with slowed progression of percent emphysema by CT. Methods: The Multi-Ethnic Study of Atherosclerosis researchers recruited participants ages 45–84 years from the general population from 2000 to 2002. Medication use was assessed by medication inventory. Percent emphysema was defined as the percentage of lung regions less than −950 Hounsfield units on CTs. Mixed-effects regression models were used to adjust for confounders. Results: Among 4,472 participants, 12% used an ACE inhibitor and 6% used an ARB at baseline. The median percent emphysema was 3.0% at baseline, and the rate of progression was 0.64 percentage points over a median of 9.3 years. Higher doses of ACE or ARB were independently associated with a slower change in percent emphysema (P = 0.03). Over 10 years, in contrast to a predicted mean increase in percent emphysema of 0.66 percentage points in those who did not take ARBs or ACE inhibitors, the predicted mean increase in participants who used maximum doses of ARBs or ACE inhibitors was 0.06 percentage points (P = 0.01). The findings were of greatest magnitude among former smokers (P emphysema. There was no evidence that ACE inhibitor or ARB dose was associated with decline in lung function. Conclusions: In a large population-based study, ACE

  15. Percent relative cumulative frequency analysis in indirect calorimetry: application to studies of transgenic mice.

    Science.gov (United States)

    Riachi, Marc; Himms-Hagen, Jean; Harper, Mary-Ellen

    2004-12-01

    Indirect calorimetry is commonly used in research and clinical settings to assess characteristics of energy expenditure. Respiration chambers in indirect calorimetry allow measurements over long periods of time (e.g., hours to days) and thus the collection of large sets of data. Current methods of data analysis usually involve the extraction of only a selected small proportion of data, most commonly the data that reflects resting metabolic rate. Here, we describe a simple quantitative approach for the analysis of large data sets that is capable of detecting small differences in energy metabolism. We refer to it as the percent relative cumulative frequency (PRCF) approach and have applied it to the study of uncoupling protein-1 (UCP1) deficient and control mice. The approach involves sorting data in ascending order, calculating their cumulative frequency, and expressing the frequencies in the form of percentile curves. Results demonstrate the sensitivity of the PRCF approach for analyses of oxygen consumption (.VO2) as well as respiratory exchange ratio data. Statistical comparisons of PRCF curves are based on the 50th percentile values and curve slopes (H values). The application of the PRCF approach revealed that energy expenditure in UCP1-deficient mice housed and studied at room temperature (24 degrees C) is on average 10% lower (p lower environmental temperature, there were no differences in .VO2 between groups. The latter is likely due to augmented shivering thermogenesis in UCP1-deficient mice compared with controls. With the increased availability of murine models of metabolic disease, indirect calorimetry is increasingly used, and the PRCF approach provides a novel and powerful means for data analysis.

  16. Comparison of breast percent density estimation from raw versus processed digital mammograms

    Science.gov (United States)

    Li, Diane; Gavenonis, Sara; Conant, Emily; Kontos, Despina

    2011-03-01

    We compared breast percent density (PD%) measures obtained from raw and post-processed digital mammographic (DM) images. Bilateral raw and post-processed medio-lateral oblique (MLO) images from 81 screening studies were retrospectively analyzed. Image acquisition was performed with a GE Healthcare DS full-field DM system. Image post-processing was performed using the PremiumViewTM algorithm (GE Healthcare). Area-based breast PD% was estimated by a radiologist using a semi-automated image thresholding technique (Cumulus, Univ. Toronto). Comparison of breast PD% between raw and post-processed DM images was performed using the Pearson correlation (r), linear regression, and Student's t-test. Intra-reader variability was assessed with a repeat read on the same data-set. Our results show that breast PD% measurements from raw and post-processed DM images have a high correlation (r=0.98, R2=0.95, p<0.001). Paired t-test comparison of breast PD% between the raw and the post-processed images showed a statistically significant difference equal to 1.2% (p = 0.006). Our results suggest that the relatively small magnitude of the absolute difference in PD% between raw and post-processed DM images is unlikely to be clinically significant in breast cancer risk stratification. Therefore, it may be feasible to use post-processed DM images for breast PD% estimation in clinical settings. Since most breast imaging clinics routinely use and store only the post-processed DM images, breast PD% estimation from post-processed data may accelerate the integration of breast density in breast cancer risk assessment models used in clinical practice.

  17. Does One Know the Properties of a MICE Solid or Liquid Absorber to Better than 0.3 Percent?

    International Nuclear Information System (INIS)

    Green, Michael A.; Yang, Stephanie Q.

    2006-01-01

    This report discusses the report discusses whether the MICE absorbers can be characterized to ±0.3 percent, so that one predict absorber ionization cooling within the absorber. This report shows that most solid absorbers can be characterized to much better than ±0.3 percent. The two issues that dominate the characterization of the liquid cryogen absorbers are the dimensions of the liquid in the vessel and the density of the cryogenic liquid. The thickness of the window also plays a role. This report will show that a liquid hydrogen absorber can be characterized to better than ±0.3 percent, but a liquid helium absorber cannot be characterized to better and ±1 percent

  18. Map of percent scleractinian coral cover along camera tows and ROV tracks in the Auau Channel, Island of Maui, Hawaii

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry and landsat imagery. Optical data were...

  19. EnviroAtlas - Percent of Each 12-Digit HUC in the Contiguous U.S. with Potentially Restorable Wetlands

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset shows the percent of each 12-digit Hydrologic Unit (HUC) subwatershed in the contiguous U.S. with potentially restorable wetlands. Beginning...

  20. EnviroAtlas - Percent Land Cover with Potentially Restorable Wetlands on Agricultural Land per 12-Digit HUC - Contiguous United States

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset shows the percent land cover with potentially restorable wetlands on agricultural land for each 12-digit Hydrologic Unit (HUC) watershed in...

  1. Map of percent scleractinian coral cover and sand along camera tows and ROV tracks of West Maui, Hawaii

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral and sand overlaid on bathymetry and landsat imagery. Optical...

  2. FINANCIAL PROBLEMS OF BOTTOM 40 PERCENT BUMIPUTERA IN MALAYSIA: A POSSIBLE SOLUTION THROUGH WAQF-BASED CROWDFUNDING

    OpenAIRE

    Abidullah ABID; Muhammad Hakimi Mohd SHAFIAI

    2017-01-01

    Low savings by the bottom 40 percent Bumiputera triggered low wealth accumulation and greater wealth inequality. The issue behind the low savings is the increase in food prices, taxes, and interest rates for the borrowers. In response to these problems, the Malaysian government provides cash transfer BRIM as one of redistributive measures. However, it is still not enough as many of the bottom 40 percent are neglected to avail the facility. In such circumstances, the role of community-based ca...

  3. Small Cell Carcinoma of the Urinary Bladder: A Retrospective, Multicenter Rare Cancer Network Study of 107 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Pasquier, David, E-mail: d-pasquier@o-lambret.fr [Academic Radiation Oncology Department, Centre Oscar Lambret, Lille (France); Barney, Brandon [Mayo Clinic, Rochester, Minnesota (United States); Sundar, Santhanam [Department of Oncology, Nottingham University Hospitals National Health Service Trust, Nottingham (United Kingdom); Poortmans, Philip [Department of Radiation Oncology, Radboud university medical center, Nijmegen (Netherlands); Villa, Salvador [Radiation Oncology, Catalan Institute of Oncology, H. Universitari Germans Trías, Badalona, Barcelona (Spain); Nasrallah, Haitam [Division of Oncology, Rambam Health Care Campus and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa (Israel); Boujelbene, Noureddine [Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland); Ghadjar, Pirus [Department of Radiation Oncology, Bern University Hospital, Bern (Switzerland); Lassen-Ramshad, Yasmin [Department of Oncology, Aarhus University Hospital, Aarhus (Denmark); Senkus, Elżbieta [Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk (Poland); Oar, Andrew [Genesis Cancer Care, Southport (Australia); Roelandts, Martine [Institut Jules Bordet, Brussels (Belgium); Amichetti, Maurizio [Provincial Agency for Proton Therapy, Trento (Italy); Vees, Hansjoerg [Department of Radiation Oncology, Hopital de Sion, Sion (Switzerland); Zilli, Thomas [Department of Radiation Oncology, Geneva University Hospital, Geneva (Switzerland); Ozsahin, Mahmut [Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland)

    2015-07-15

    Purpose: Small cell carcinomas of the bladder (SCCB) account for fewer than 1% of all urinary bladder tumors. There is no consensus regarding the optimal treatment for SCCB. Methods and Materials: Fifteen academic Rare Cancer Network medical centers contributed SCCB cases. The eligibility criteria were as follows: pure or mixed SCC; local, locoregional, and metastatic stages; and age ≥18 years. The overall survival (OS) and disease-free survival (DFS) were calculated from the date of diagnosis according to the Kaplan-Meier method. The log-rank and Wilcoxon tests were used to analyze survival as functions of clinical and therapeutic factors. Results: The study included 107 patients (mean [±standard deviation, SD] age, 69.6 [±10.6] years; mean follow-up time, 4.4 years) with primary bladder SCC, with 66% of these patients having pure SCC. Seventy-two percent and 12% of the patients presented with T2-4N0M0 and T2-4N1-3M0 stages, respectively, and 16% presented with synchronous metastases. The most frequent curative treatments were radical surgery and chemotherapy, sequential chemotherapy and radiation therapy, and radical surgery alone. The median (interquartile range, IQR) OS and DFS times were 12.9 months (IQR, 7-32 months) and 9 months (IQR, 5-23 months), respectively. The metastatic, T2-4N0M0, and T2-4N1-3M0 groups differed significantly (P=.001) in terms of median OS and DFS. In a multivariate analysis, impaired creatinine clearance (OS and DFS), clinical stage (OS and DFS), a Karnofsky performance status <80 (OS), and pure SCC histology (OS) were independent and significant adverse prognostic factors. In the patients with nonmetastatic disease, the type of treatment (ie radical surgery with or without adjuvant chemotherapy vs conservative treatment) did not significantly influence OS or DFS (P=.7). Conclusions: The prognosis for SCCB remains poor. The finding that radical cystectomy did not influence DFS or OS in the patients with nonmetastatic disease

  4. Small Cell Carcinoma of the Urinary Bladder: A Retrospective, Multicenter Rare Cancer Network Study of 107 Patients.

    Science.gov (United States)

    Pasquier, David; Barney, Brandon; Sundar, Santhanam; Poortmans, Philip; Villa, Salvador; Nasrallah, Haitam; Boujelbene, Noureddine; Ghadjar, Pirus; Lassen-Ramshad, Yasmin; Senkus, Elżbieta; Oar, Andrew; Roelandts, Martine; Amichetti, Maurizio; Vees, Hansjoerg; Zilli, Thomas; Ozsahin, Mahmut

    2015-07-15

    Small cell carcinomas of the bladder (SCCB) account for fewer than 1% of all urinary bladder tumors. There is no consensus regarding the optimal treatment for SCCB. Fifteen academic Rare Cancer Network medical centers contributed SCCB cases. The eligibility criteria were as follows: pure or mixed SCC; local, locoregional, and metastatic stages; and age ≥18 years. The overall survival (OS) and disease-free survival (DFS) were calculated from the date of diagnosis according to the Kaplan-Meier method. The log-rank and Wilcoxon tests were used to analyze survival as functions of clinical and therapeutic factors. The study included 107 patients (mean [±standard deviation, SD] age, 69.6 [±10.6] years; mean follow-up time, 4.4 years) with primary bladder SCC, with 66% of these patients having pure SCC. Seventy-two percent and 12% of the patients presented with T2-4N0M0 and T2-4N1-3M0 stages, respectively, and 16% presented with synchronous metastases. The most frequent curative treatments were radical surgery and chemotherapy, sequential chemotherapy and radiation therapy, and radical surgery alone. The median (interquartile range, IQR) OS and DFS times were 12.9 months (IQR, 7-32 months) and 9 months (IQR, 5-23 months), respectively. The metastatic, T2-4N0M0, and T2-4N1-3M0 groups differed significantly (P=.001) in terms of median OS and DFS. In a multivariate analysis, impaired creatinine clearance (OS and DFS), clinical stage (OS and DFS), a Karnofsky performance status <80 (OS), and pure SCC histology (OS) were independent and significant adverse prognostic factors. In the patients with nonmetastatic disease, the type of treatment (ie radical surgery with or without adjuvant chemotherapy vs conservative treatment) did not significantly influence OS or DFS (P=.7). The prognosis for SCCB remains poor. The finding that radical cystectomy did not influence DFS or OS in the patients with nonmetastatic disease suggests that conservative treatment is appropriate in this

  5. [Local treatment of cervical intraepithelial neoplasia with a 5 percent fluorouracil ointment].

    Science.gov (United States)

    Barten, G

    1987-01-01

    The results of treatment of histologically proven cervical intraepithelial neoplasia (CIN) in 10 women are described. Two of them had CIN I and 8 CIN III. All patients had a application of 5 g 5 per cent 5-fluorouracil cream in a cervical cup daily over a period of 12 hours for one week. All 10 patients have been examined colposcopically, cytological and by biopsy following therapy. In 8 women cone biopsie were done 6-12 months afterwards for having a final diagnosis 2 patients having CIN I pretherapeutically were follow up for 16 months with cytology, colposcopy and punch biopsy. In 6 cases we found better findings (Twice complete healing, twice only CIN I and twice CIN II as residues). In 4 cases severe dysplasia and carcinoma in situ could be found in endocervix. Based on these results were recommended more (not only one) treatment cycles for local efficient chemotherapy using 5 per cent 5-fluorouracil cream.

  6. Development and Cross-Validation of Equation for Estimating Percent Body Fat of Korean Adults According to Body Mass Index

    Directory of Open Access Journals (Sweden)

    Hoyong Sung

    2017-06-01

    Full Text Available Background : Using BMI as an independent variable is the easiest way to estimate percent body fat. Thus far, few studies have investigated the development and cross-validation of an equation for estimating the percent body fat of Korean adults according to the BMI. The goals of this study were the development and cross-validation of an equation for estimating the percent fat of representative Korean adults using the BMI. Methods : Samples were obtained from the Korea National Health and Nutrition Examination Survey between 2008 and 2011. The samples from 2008-2009 and 2010-2011 were labeled as the validation group (n=10,624 and the cross-validation group (n=8,291, respectively. The percent fat was measured using dual-energy X-ray absorptiometry, and the body mass index, gender, and age were included as independent variables to estimate the measured percent fat. The coefficient of determination (R², standard error of estimation (SEE, and total error (TE were calculated to examine the accuracy of the developed equation. Results : The cross-validated R² was 0.731 for Model 1 and 0.735 for Model 2. The SEE was 3.978 for Model 1 and 3.951 for Model 2. The equations developed in this study are more accurate for estimating percent fat of the cross-validation group than those previously published by other researchers. Conclusion : The newly developed equations are comparatively accurate for the estimation of the percent fat of Korean adults.

  7. [Impact of Different Percent Tissue Altered Values on Visual Outcome after Refractive Small Incision Lenticule Extraction (ReLEx SMILE)].

    Science.gov (United States)

    Breyer, D R H; Hagen, P; Kaymak, H; Klabe, K; Auffarth, G U; Kretz, F T A

    2017-01-01

    Purpose   To compare the visual outcomes after ReLEx SMILE treatment of eyes with low and high PTA values (PTA: percent tissue altered) within a follow-up period of up to 3 years and to assess whether a high PTA value might contribute to the development of keratectasia, as is the case for LASIK. Methods   This retrospective analysis comprises results from 313 eyes (189 patients) with a PTA value of less than 40 % and of 373 eyes (213 patients) with a PTA value of at least 40 %. Preoperatively and up to 3 years after SMILE surgery, refraction values, monocular corrected (CDVA) and uncorrected distant visual acuity (UDVA) and wavefront data were evaluated. Results   One to 3 years after surgery, the group with PTA lines in 1.1 % (0.0 %) of the cases. Loss of one line occurred in 1.1 % (3.6 %) of the eyes, whereas 97.7 % (96.4 %) remained unchanged or gained lines. With respect to predictability of the spherical equivalent, 92.0 % (78.6 %) of the eyes were within ± 0.5D and 97.7 % (92.9 %) were within ± 1.0D. The group with high PTA values displayed a slightly but significantly greater undercorrection of about 0,25D. 74.4 % (71.8 %) achieved UDVA of at least 20/20 and 96.5 % (87.1 %) achieved at least 20/25. The mean UDVA was - 0.03 ± 0.10logMAR (0.01 ± 0.12logMAR) and its mean difference to the preoperative CDVA was 0.00 ± 0.09logMAR (0.03 ± 0.12logMAR). Conclusion   ReLEx SMILE is a safe and effective corneal refractive treatment, even for PTA values of 40 % and more. Eyes with high PTA values did not display any evidence of keratectasia development within the 3-year follow-up of this study. Georg Thieme Verlag KG Stuttgart · New York.

  8. Validity of anthropometric procedures to estimate body density and body fat percent in military men

    Directory of Open Access Journals (Sweden)

    Ciro Romélio Rodriguez-Añez

    1999-12-01

    Full Text Available The objective of this study was to verify the validity of the Katch e McArdle’s equation (1973,which uses the circumferences of the arm, forearm and abdominal to estimate the body density and the procedure of Cohen (1986 which uses the circumferences of the neck and abdominal to estimate the body fat percent (%F in military men. Therefore data from 50 military men, with mean age of 20.26 ± 2.04 years serving in Santa Maria, RS, was collected. The circumferences were measured according with Katch e McArdle (1973 and Cohen (1986 procedures. The body density measured (Dm obtained under water weighting was used as criteria and its mean value was 1.0706 ± 0.0100 g/ml. The residual lung volume was estimated using the Goldman’s e Becklake’s equation (1959. The %F was obtained with the Siri’s equation (1961 and its mean value was 12.70 ± 4.71%. The validation criterion suggested by Lohman (1992 was followed. The analysis of the results indicated that the procedure developed by Cohen (1986 has concurrent validity to estimate %F in military men or in other samples with similar characteristics with standard error of estimate of 3.45%. . RESUMO Através deste estudo objetivou-se verificar a validade: da equação de Katch e McArdle (1973 que envolve os perímetros do braço, antebraço e abdômen, para estimar a densidade corporal; e, o procedimento de Cohen (1986 que envolve os perímetros do pescoço e abdômen, para estimar o % de gordura (%G; para militares. Para tanto, coletou-se os dados de 50 militares masculinos, com idade média de 20,26 ± 2,04 anos, lotados na cidade de Santa Maria, RS. Mensurou-se os perímetros conforme procedimentos de Katch e McArdle (1973 e Cohen (1986. Utilizou-se a densidade corporal mensurada (Dm através da pesagem hidrostática como critério de validação, cujo valor médio foi de 1,0706 ± 0,0100 g/ml. Estimou-se o volume residual pela equação de Goldman e Becklake (1959. O %G derivado da Dm estimou

  9. A model for growth of beta-phase particles in zirconium-2.5 wt percent niobium

    International Nuclear Information System (INIS)

    Chow, C.K.; Liner, Y.; Rigby, G.L.

    1984-08-01

    The kinetics of the α → β phase change in Zr-2.5 percent Nb pressure-tube material at constant temperature have been studied. The volume-fraction change of the β phase due to diffusion in an infinite α-phase matrix was considered, and a mathematical model with a numerical solution was developed to predict the transient spherical growth of the β-phase region. This model has been applied to Zr-2.5 wt percent Nb, and the calculated results compared to experiment

  10. Triple antithrombotic therapy is the independent predictor for the occurrence of major bleeding complications: analysis of percent time in therapeutic range.

    Science.gov (United States)

    Naruse, Yoshihisa; Sato, Akira; Hoshi, Tomoya; Takeyasu, Noriyuki; Kakefuda, Yuki; Ishibashi, Mayu; Misaki, Masako; Abe, Daisuke; Aonuma, Kazutaka

    2013-08-01

    Triple antithrombotic therapy increases the risk of bleeding events in patients undergoing percutaneous coronary intervention. However, it remains unclear whether good control of percent time in therapeutic range is associated with reduced occurrence of bleeding complications in patients undergoing triple antithrombotic therapy. This study included 2648 patients (70 ± 11 years; 2037 men) who underwent percutaneous coronary intervention with stent in the Ibaraki Cardiovascular Assessment Study registry and received dual antiplatelet therapy with or without warfarin. Clinical end points were defined as the occurrence of major bleeding complications (MBC), major adverse cardiac and cerebrovascular event, and all-cause death. Among these 2648 patients, 182 (7%) patients received warfarin. After a median follow-up period of 25 months (interquartile range, 15-35 months), MBC had occurred in 48 (2%) patients, major adverse cardiac and cerebrovascular event in 484 (18%) patients, and all-cause death in 206 (8%) patients. Multivariable Cox regression analysis revealed that triple antithrombotic therapy was the independent predictor for the occurrence of MBC (hazard ratio, 7.25; 95% confidence interval, 3.05-17.21; Prange value did not differ between the patients with and without MBC occurrence (83% [interquartile range, 50%-90%] versus 75% [interquartile range, 58%-87%]; P=0.7). However, the mean international normalized ratio of prothrombin time at the time of MBC occurrence was 3.3 ± 2.1. Triple antithrombotic therapy did not have a predictive value for the occurrence of all-cause death (P=0.1) and stroke (P=0.2). Triple antithrombotic therapy predisposes patients to an increased risk of MBC regardless of the time in therapeutic range.

  11. Study of extraterrestrial disposal of radioactive wastes. Part 3: Preliminary feasibility screening study of space disposal of the actinide radioactive wastes with 1 percent and 0.1 percent fission product contamination

    Science.gov (United States)

    Hyland, R. E.; Wohl, M. L.; Finnegan, P. M.

    1973-01-01

    A preliminary study was conducted of the feasibility of space disposal of the actinide class of radioactive waste material. This waste was assumed to contain 1 and 0.1 percent residual fission products, since it may not be feasible to completely separate the actinides. The actinides are a small fraction of the total waste but they remain radioactive much longer than the other wastes and must be isolated from human encounter for tens of thousands of years. Results indicate that space disposal is promising but more study is required, particularly in the area of safety. The minimum cost of space transportation would increase the consumer electric utility bill by the order of 1 percent for earth escape and 3 percent for solar escape. The waste package in this phase of the study was designed for normal operating conditions only; the design of next phase of the study will include provisions for accident safety. The number of shuttle launches per year required to dispose of all U.S. generated actinide waste with 0.1 percent residual fission products varies between 3 and 15 in 1985 and between 25 and 110 by 2000. The lower values assume earth escape (solar orbit) and the higher values are for escape from the solar system.

  12. Improved parenchymal liver enhancement with extended delay on Gd-EOB-DTPA-enhanced MRI in patients with parenchymal liver disease: associated clinical and imaging factors

    International Nuclear Information System (INIS)

    Esterson, Y.B.; Flusberg, M.; Oh, S.; Mazzariol, F.; Rozenblit, A.M.; Chernyak, V.

    2015-01-01

    Aim: To establish the effect of prolonged hepatobiliary phase (HBP) delay time on hepatic enhancement in patients with parenchymal liver disease (PLD). Materials and methods: Gadoxetate disodium (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) examinations with HBP were obtained after 20- (HBP-20) and 30-minute (HBP-30) delays in patients with PLD. For each patient, the Model for End-Stage Liver Disease (MELD) score, total and direct bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), prothrombin time (PT), and partial thromboplastin time (PTT) were recorded. Signal intensities of the liver, main portal vein, and spleen on pre-contrast, HBP-20, and HBP-30 were documented. Signal intensities were used to calculate liver relative enhancement (LRE), liver–spleen index (LSI), and liver–portal vein index (LPI) for HBP-20 and HBP-30. Improved hepatic enhancement was considered if two or more indices were higher on HBP-30 than HBP-20. A logistic regression model was constructed with improved hepatic enhancement as the outcome. Results: One hundred and twenty-nine patients underwent 142 MRIs. Mean LRE, LSI, and LPI each increased from HBP-20 to HBP-30 (p = 0.004, p < 0.001, and p < 0.001, respectively). Seventy-two point five percent of cases demonstrated improved hepatic enhancement. The odds ratios for improved hepatic enhancement were 0.85 for MELD score (p = 0.02) and 3.2 for the 3 T scanner (p = 0.02), adjusted for age and sex. Conclusion: Increasing HBP delay to 30 minutes improves hepatic enhancement in patients with PLD, particularly if using a 3 T scanner. This effect is attenuated with higher MELD scores. -- Highlights: •Increasing hepatobiliary phase delay improves hepatic enhancement in liver disease. •This effect is enhanced if using a 3T scanner. •This effect is attenuated with higher MELD scores

  13. Frequency of ECG abnormalities in patients of chronic obstructive pulmonary disease accordigng to disease severity

    International Nuclear Information System (INIS)

    Shabbir, A.; Zaidi, S. B. H.; Nisar, S.

    2017-01-01

    Objective: The objective of this study was to find out the frequency of ECG abnormalities in patients of COPD in relation to disease severity. Study Design: Cross Sectional study. Place and Duration of Study: This study was carried out at the Department of Medicine, Military Hospital Rawalpindi, from Oct 2011 to Jun 2012. Material and Methods: All patients presenting to the Department of Medicine both inpatient and outpatient, with diagnosis of COPD were included in the study. Patients with cardiac comorbidities were excluded. Also, patients on diuretics and long term oxygen therapy were excluded. A total of three hundred and forty three patients (343) were included in the study. Spirometry of all these patients was done to determine the FEV1 and FVC in order to classify the grade of severity of COPD. Standard 12 lead ECG of all these patients was done to find out the various ECG abnormalities. Results: About 77 (22.5 percent) patients had mild COPD, while moderate COPD was seen in 121 (35.3 percent). Severe COPD was seen in 100 (29.2 percent) patients and very severe COPD was seen in 45 (13.1 percent) patients. The most common ECG abnormalities noted was right atrial enlargement (RAE) in 6 (7.8 percent) patients of mild COPD, 27 (22.3 percent) patients of moderate, 48 (48 percent) patients of severe and 24 (53.3 percent) patients of very severe COPD. Right ventricular hypertrophy (RVH) in 1 (1.3 percent) patient of mild, 7 (5.8 percent) patients of moderate, 19 (19 percent) patients of severe and 12 (26.7 percent) patients of very severe COPD. Sinus tachycardia was present in 6 (7.8 percent) patients of mild, 17 (14 percent) patients of moderate, 19 (19 percent) patients of severe and 10 (22.2 percent) patients of very severe COPD. Right bundle branch block (RBBB) was seen in 5 (6.5 percent) patients of mild, 9 (7.4 percent) patients of moderate, 13 (13 percent) patients of severe and 9 (20 percent) patients of very severe COPD. SVT was present in 1 (1.3 percent

  14. At least eighty percent of brain grey matter is modifiable by physical activity: A review study.

    Science.gov (United States)

    Batouli, Seyed Amir Hossein; Saba, Valiallah

    2017-08-14

    The human brain is plastic, i.e. it can show structural changes in response to the altered environment. Physical activity (PA) is a lifestyle factor which has significant associations with the structural and functional aspects of the human brain, as well as with the mind and body health. Many studies have reported regional/global brain volume increments due to exercising; however, a map which shows the overall extent of the influences of PAs on brain structure is not available. In this study, we collected all the reports on brain structural alterations in association with PA in healthy humans, and next, a brain map of the extent of these effects is provided. The results of this study showed that a large network of brain areas, equal to 82% of the total grey matter volume, were associated with PA. This finding has important implications in utilizing PA as a mediator factor for educational purposes in children, rehabilitation applications in patients, improving the cognitive abilities of the human brain such as in learning or memory, and preventing age-related brain deteriorations. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. 40 CFR 63.8055 - How do I comply with a weight percent HAP limit in coating products?

    Science.gov (United States)

    2010-07-01

    ... HAP limit in coating products? 63.8055 Section 63.8055 Protection of Environment ENVIRONMENTAL...: Miscellaneous Coating Manufacturing Alternative Means of Compliance § 63.8055 How do I comply with a weight percent HAP limit in coating products? (a) As an alternative to complying with the requirements in Table 1...

  16. 26 CFR 1.46-8 - Requirements for taxpayers electing additional one-percent investment credit (TRASOP's).

    Science.gov (United States)

    2010-04-01

    ... conversion price which is no greater than the fair market value of that common stock at the time the plan... subject to a limitation, then stock representing at least 50 percent of the fair market value of the... common stock, Class A and Class B. Their fair market values per share are $1 and $.50, respectively, and...

  17. Objectively-determined intensity- and domain-specific physical activity and sedentary behavior in relation to percent body fat.

    Science.gov (United States)

    Scheers, Tineke; Philippaerts, Renaat; Lefevre, Johan

    2013-12-01

    This study examined the independent and joint associations of overall, intensity-specific and domain-specific physical activity and sedentary behavior with bioelectrical impedance-determined percent body fat. Physical activity was measured in 442 Flemish adults (41.4 ± 9.8 years) using the SenseWear Armband and an electronic diary. Two-way analyses of covariance investigated the interaction of physical activity and sedentary behavior with percent body fat. Multiple linear regression analyses, adjusted for potential confounders, examined the associations of intensity-specific and domain-specific physical activity and sedentary behavior with percent body fat. Results showed a significant main effect for physical activity in both genders and for sedentary behavior in women, but no interaction effects. Light activity was positively (β = 0.41 for men and 0.43 for women) and moderate (β = -0.64 and -0.41), vigorous (β = -0.21 and -0.24) and moderate-to-vigorous physical activity (MVPA) inversely associated with percent body fat, independent of sedentary time. Regarding domain-specific physical activity, significant associations were present for occupation, leisure time and household chores, irrespective of sedentary time. The positive associations between body fat and total and domain-specific sedentary behavior diminished after MVPA was controlled for. MVPA during leisure time, occupation and household chores may be essential to prevent fat gain. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  18. Math Academy: Dining Out! Explorations in Fractions, Decimals, & Percents. Book 4: Supplemental Math Materials for Grades 3-8

    Science.gov (United States)

    Rimbey, Kimberly

    2007-01-01

    Created by teachers for teachers, the Math Academy tools and activities included in this booklet were designed to create hands-on activities and a fun learning environment for the teaching of mathematics to the students. This booklet contains the "Math Academy--Dining Out! Explorations in Fractions, Decimals, and Percents," which teachers can use…

  19. 7 CFR 205.303 - Packaged products labeled “100 percent organic” or “organic.”

    Science.gov (United States)

    2010-01-01

    ..., verifying organic certification of the operations producing such ingredients, and: Provided further, That... (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Labels, Labeling, and Market Information § 205.303 Packaged products labeled “100 percent organic” or “organic.” (a) Agricultural products...

  20. 17 CFR 210.3-09 - Separate financial statements of subsidiaries not consolidated and 50 percent or less owned persons.

    Science.gov (United States)

    2010-04-01

    ... financial statements of subsidiaries not consolidated and 50 percent or less owned persons. (a) If any of... consolidated financial statements required by §§ 210.3-01 and 3-02. However, these separate financial... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Separate financial statements...

  1. Percent of Impervious Cover

    Data.gov (United States)

    U.S. Environmental Protection Agency — High amounts of impervious cover (parking lots, rooftops, roads, etc.) can increase water runoff, which may directly enter surface water. Runoff from roads often...

  2. The 4-percent universe

    CERN Document Server

    Panek, Richard

    2012-01-01

    It is one of the most disturbing aspects of our universe: only four per cent of it consists of the matter that makes up every star, planet, and every book. The rest is completely unknown. Acclaimed science writer Richard Panek tells the story of the handful of scientists who have spent the past few decades on a quest to unlock the secrets of “dark matter" and the even stranger substance called “dark energy". These are perhaps the greatest mysteries in science,and solving them will reshape our understanding of the universe and our place in it. The stakes could not be higher. Panek's fast-paced

  3. Percent Forest Cover (Future)

    Data.gov (United States)

    U.S. Environmental Protection Agency — Forests provide economic and ecological value. High percentages of forest cover (FORPCTFuture) generally indicate healthier ecosystems and cleaner surface water....

  4. Percent Forest Cover

    Data.gov (United States)

    U.S. Environmental Protection Agency — Forests provide economic and ecological value. High percentages of forest cover (FORPCT) generally indicate healthier ecosystems and cleaner surface water. More...

  5. Procalcitonin increase in early identification of critically ill patients at high risk of mortality

    DEFF Research Database (Denmark)

    Jensen, Jens Ulrik; Heslet, L; Jensen, TH

    2006-01-01

    OBJECTIVE: To investigate day-by-day changes in procalcitonin and maximum obtained levels as predictors of mortality in critically ill patients. DESIGN: Prospective observational cohort study. SETTING:: Multidisciplinary intensive care unit at Rigshospitalet, Copenhagen University Hospital......, a tertiary reference hospital in Denmark. PATIENTS: Four hundred seventy-two patients with diverse comorbidity and age admitted to this intensive care unit. INTERVENTIONS: Equal in all patient groups: antimicrobial treatment adjusted according to the procalcitonin level. MEASUREMENTS AND MAIN RESULTS: Daily...... in the intensive care unit and in a 30-day follow-up period. A total of 3,642 procalcitonin measurements were evaluated in 472 critically ill patients. We found that a high maximum procalcitonin level and a procalcitonin increase for 1 day were independent predictors of 90-day all-cause mortality...

  6. Determinants of prevalent vertebral fractures and progressive bone loss in long-term hemodialysis patients.

    Science.gov (United States)

    Mares, Jan; Ohlidalova, Kristina; Opatrna, Sylvie; Ferda, Jiri

    2009-01-01

    Skeletal fractures are common in hemodialysis (HD) patients. However, consensus regarding technique and site of bone examination has not been reached in HD patients. Seventy-two patients (44% females) aged 65 (1.4) years, treated with HD for 43 (4.6) months were examined with quantitative computed tomography and 53 of them re-examined after 1 year. Bone mineral density (BMD) of lumbar spine was established separately for cortical and trabecular bone, prevalent vertebral fractures were determined. Data are given as mean (standard error). At least one vertebral fracture was discovered in 15 (21%) patients. In a logistic regression model, fractures were best predicted by cortical BMD: OR 0.96 (CI 0.94, 0.99), p multiple regression analysis, time on dialysis was found to be independently correlated to cortical BMD (R = 0.35, p decrement may impose an increased risk of fractures on long-term dialysis patients.

  7. Thirty Percent of Female Footballers Terminate Their Careers Due to Injury - A Retrospective Study Among Former Polish Players.

    Science.gov (United States)

    Grygorowicz, Monika; Michałowska, Martyna; Jurga, Paulina; Piontek, Tomasz; Jakubowska, Honorata; Kotwicki, Tomasz

    2017-09-27

    Female football is becoming an increasingly popular women's team sports discipline around the world. The Women's Football Committee in Polish Football Association (WFC_PFA) has developed a long-term strategic plan to popularize the discipline across the country and enhance girls' participation. On one hand, it is postulated to increase the number of female footballers, and on the other hand it is crucial to decrease the number of girls quitting football prematurely. To find the reasons for sports career termination among female football players. cross-sectional with retrospective information about reasons of career termination. On-line questionnaire was filled out by on-line access. Ninety-three former female footballers. factors leading to career termination. Participants completed the on-line questionnaire. The analysis was performed referring to two groups: "injury group" - in which the injury was the main reason for quitting football, and "other group" - in which the female player stopped playing football due to all other factors. Thirty percent of former Polish female football players terminated their career due to a long-term treatment for an injury. Over 27 percent (27.7%) females had ended their careers because they were not able to reconcile sports with work/studying. Over 10 percent (10.8%) of former football players reported that becoming a wife and/or mother was the reason for career termination. Losing motivation and interest in sport was reported by 9.2%(n=6) of present study participants who decided to terminate the career due to non-injury reasons. The results clearly show that more effort is needed to support female football players, especially after an injury, so that they do not quit the sport voluntarily.

  8.  Running speed during training and percent body fat predict race time in recreational male marathoners

    Directory of Open Access Journals (Sweden)

    Barandun U

    2012-07-01

    Full Text Available  Background: Recent studies have shown that personal best marathon time is a strong predictor of race time in male ultramarathoners. We aimed to determine variables predictive of marathon race time in recreational male marathoners by using the same characteristics of anthropometry and training as used for ultramarathoners.Methods: Anthropometric and training characteristics of 126 recreational male marathoners were bivariately and multivariately related to marathon race times.Results: After multivariate regression, running speed of the training units (β=-0.52, P<0.0001 and percent body fat (β=0.27, P <0.0001 were the two variables most strongly correlated with marathon race times. Marathon race time for recreational male runners may be estimated to some extent by using the following equation (r2 = 0.44: race time (minutes = 326.3 + 2.394 × (percent body fat, % – 12.06 × (speed in training, km/hours. Running speed during training sessions correlated with prerace percent body fat (r=0.33, P=0.0002. The model including anthropometric and training variables explained 44% of the variance of marathon race times, whereas running speed during training sessions alone explained 40%. Thus, training speed was more predictive of marathon performance times than anthropometric characteristics.Conclusion: The present results suggest that low body fat and running speed during training close to race pace (about 11 km/hour are two key factors for a fast marathon race time in recreational male marathoner runners.Keywords: body fat, skinfold thickness, anthropometry, endurance, athlete

  9. The Divisia real energy intensity indices: Evolution and attribution of percent changes in 20 European countries from 1995 to 2010

    International Nuclear Information System (INIS)

    Fernández González, P.; Landajo, M.; Presno, M.J.

    2013-01-01

    This paper analyzes the evolution of real energy efficiency in the European Union and the attribution across countries of its percent change. Relying on a multiplicative energy intensity approach that is implemented through the Sato-Vartia Logarithmic Mean Divisia Index method, we decompose the change in aggregate energy intensity in 20 European countries for the period from 1995 to 2010. A comparative analysis of real energy intensity indices is also carried out. In addition, a new tool to monitor changes in real energy intensity in greater detail is applied. The attribution analysis of IDA (Index Decomposition Analysis) as proposed by Choi and Ang (Choi KH, Ang BW. Attribution of changes in Divisia real energy intensity index – an extension to index decomposition analysis. Energy Economics 2012;34:171–6) is used in order to assess the contribution of each individual sector to the percent change in real energy intensity. Results indicate that the European countries, particularly the former communist ones, made a remarkable effort to improve energy efficiency. Our analysis also suggests some strategies –including promotion and adaptation to more efficient techniques, innovation, improved use of technologies, R and D, and substitution for higher quality energies-, which are of particular interest to the industry sector -including construction- in ex-communist EU members, and to the industry and transport plus hotels and restaurants sectors in Western countries. - Highlights: • We apply a single and multi-period attribution analysis approach [1]. • Technical change, improved use of tech and quality energies, keys to AEI drop. • Real energy intensity shows valuable progress in former communist European members. • The biggest attribution of percent change in real energy intensity was to Industry. • Western EU: Services and Agriculture poor contributors to real energy intensity drop

  10. The NASA Plan: To award eight percent of prime and subcontracts to socially and economically disadvantaged businesses

    Science.gov (United States)

    1990-01-01

    It is NASA's intent to provide small disadvantaged businesses, including women-owned, historically black colleges and universities and minority education institutions the maximum practicable opportunity to receive a fair proportion of NASA prime and subcontracted awards. Annually, NASA will establish socioeconomic procurement goals including small disadvantaged business goals, with a target of reaching the eight percent level by the end of FY 1994. The NASA Associate Administrators, who are responsible for the programs at the various NASA Centers, will be held accountable for full implementation of the socioeconomic procurement plans. Various aspects of this plan, including its history, are discussed.

  11. Barium enema in frail elderly patients.

    Science.gov (United States)

    Segal, R; Khahil, A; Leibovitz, A; Gil, I; Annuar, M; Habot, B

    2000-01-01

    Barium enema (BE) examinations for the investigation of suspected colonic disease are often unsuccessful in elderly patients. The purpose of this study was to evaluate the success rate of BE in hospitalized frail elderly patients. Four hundred and seventy-two elderly patients hospitalized for different reasons underwent BE examinations. The medical charts and radiological reports were retrospectively reviewed. One hundred and ninety-two (41%) BE examinations were considered inadequate; mostly (32%) because of inappropriate preparation. Sixty-seven patients (14%) were not cooperative and could not retain the contrast material, and in 25 patients (5%), the examination failed due to both these reasons. The characteristics associated with unsuccessful BE examination were the mean number of medical problems (p < 0.001), the mean number of scheduled medications (p < 0.05) and in particular the long-term use of laxatives (p < 0.01) or antiparkinsonian drugs (p < 0.01). Of great significance in predicting an inadequate BE were the patient's functional status (p < 0.001) and the presence of dementia (p < 0.001). The high percentage of unsuccessful BEs in the frail elderly suggests that clinicians should carefully consider the need for that examination in these patients. We suggest that only in patients where there is a clear suspicion of a bleeding or obstructing tumor should a BE examination be performed, and even in these cases, colonoscopy or CT may be preferable as the initial examination in the frail elderly. Copyright 2000 S. Karger AG, Basel

  12. Intravenous lignocain 2 percent (plain) efficacy in attenuation of stress response to laryngoscopy and endotracheal intubation with impact on in-hospital morbidity and mortality

    International Nuclear Information System (INIS)

    Ahmed, M.S.; Qureshi, M.N.; Uddin, S.S.; Hussain, R.M.

    2016-01-01

    Objective: To evaluate the efficacy of plain lignocain in attenuation of stress response to laryngoscopy and endotracheal intubation with impact on in-hospital mortality or morbidity. Study Design: A randomized control trial. Place and Duration of Study: Our study was carried out from December 2013-14, at tertiary-care hospital. Material and Methods: Patients (n=100 total) were randomized, using non-probability convenient sampling, dividing the population in two groups. Group A (n=50) as control, and in group B (n=50) Injection lignocain plain 2 percent at the rate 1.5 mg/kg was used 3 minutes prior to intubation. Both the groups were observed for changes in hemodynamic parameters i.e. heart rate (HR) systolic and diastolic blood pressure, Mean Arterial Pressure for every minute after baseline (0) and for 5 consecutive minutes (1, 2, 3, 4, and 5). Deviation of >20 percent from baseline was considered significant. The mortality (death within hospital, irrespective of cause) and morbidity (defined as emergence of 4 condition as hypertensive encephalopathy, Acute Coronary Syndrome, Lab proven Myocardial Infarction and negative pulmonary edema) within 10 days of hospitalization were noted. Results: Statistically significant (p-value extremely significant at confidence interval of 98 degrees) results were obtained in the effect of study drug; however, 10 days of hospitalization remained inconclusive for emerging morbidity categories strictly due to the intubation reflexes. We consider few technicalities in peri-operative management resulted in such events. Conclusion: Lignocain is effective in blunting the pressor response towards laryngoscopy and intubation. However the impact on mortality/ morbidity for four conditions remained inconclusive. (author)

  13. FINANCIAL PROBLEMS OF BOTTOM 40 PERCENT BUMIPUTERA IN MALAYSIA: A POSSIBLE SOLUTION THROUGH WAQF-BASED CROWDFUNDING

    Directory of Open Access Journals (Sweden)

    Abidullah ABID

    2017-02-01

    Full Text Available Low savings by the bottom 40 percent Bumiputera triggered low wealth accumulation and greater wealth inequality. The issue behind the low savings is the increase in food prices, taxes, and interest rates for the borrowers. In response to these problems, the Malaysian government provides cash transfer BRIM as one of redistributive measures. However, it is still not enough as many of the bottom 40 percent are neglected to avail the facility. In such circumstances, the role of community-based cash and credit transfer schemes such as cash waqf can be more fruitful. However due to inefficiency of the awqaf institutions regarding financial management, the system cannot contribute effectively. Therefore, the main aim of the paper is to provide an efficient mechanism which can ensure effectiveness in terms of transparency, collection and distribution of cash endowments and its benefits. Hence, by means of library research, we have proposed a conceptual framework. It is suggested that collection and distribution of cash waqf through crowdfunding platform would solve both transparency, collection and distribution issues. This study would provide a ground for those researchers and practitioners who are working on finding the right approach to implement waqf in more efficient way.

  14. Percent voluntary inactivation and peak force predictions with the interpolated twitch technique in individuals with high ability of voluntary activation

    International Nuclear Information System (INIS)

    Herda, Trent J; Walter, Ashley A; Hoge, Katherine M; Stout, Jeffrey R; Costa, Pablo B; Ryan, Eric D; Cramer, Joel T

    2011-01-01

    The purpose of this study was to examine the sensitivity and peak force prediction capability of the interpolated twitch technique (ITT) performed during submaximal and maximal voluntary contractions (MVCs) in subjects with the ability to maximally activate their plantar flexors. Twelve subjects performed two MVCs and nine submaximal contractions with the ITT method to calculate percent voluntary inactivation (%VI). Additionally, two MVCs were performed without the ITT. Polynomial models (linear, quadratic and cubic) were applied to the 10–90% VI and 40–90% VI versus force relationships to predict force. Peak force from the ITT MVC was 6.7% less than peak force from the MVC without the ITT. Fifty-eight percent of the 10–90% VI versus force relationships were best fit with nonlinear models; however, all 40–90% VI versus force relationships were best fit with linear models. Regardless of the polynomial model or the contraction intensities used to predict force, all models underestimated the actual force from 22% to 28%. There was low sensitivity of the ITT method at high contraction intensities and the predicted force from polynomial models significantly underestimated the actual force. Caution is warranted when interpreting the % VI at high contraction intensities and predicted peak force from submaximal contractions

  15. Effects of age, adipose percent, and reproduction on PCB concentrations and profiles in an extreme fasting North Pacific marine mammal.

    Directory of Open Access Journals (Sweden)

    Sarah H Peterson

    Full Text Available Persistent organic pollutants, including polychlorinated biphenyls (PCBs, are widely distributed and detectable far from anthropogenic sources. Northern elephant seals (Mirounga angustirostris biannually travel thousands of kilometers to forage in coastal and open-ocean regions of the northeast Pacific Ocean and then return to land where they fast while breeding and molting. Our study examined potential effects of age, adipose percent, and the difference between the breeding and molting fasts on PCB concentrations and congener profiles in blubber and serum of northern elephant seal females. Between 2005 and 2007, we sampled blubber and blood from 58 seals before and after a foraging trip, which were then analyzed for PCBs. Age did not significantly affect total PCB concentrations; however, the proportion of PCB congeners with different numbers of chlorine atoms was significantly affected by age, especially in the outer blubber. Younger adult females had a significantly greater proportion of low-chlorinated PCBs (tri-, tetra-, and penta-CBs than older females, with the opposite trend observed for hepta-CBs, indicating that an age-associated process such as parity (birth may significantly affect congener profiles. The percent of adipose tissue had a significant relationship with inner blubber PCB concentrations, with the highest mean concentrations observed at the end of the molting fast. These results highlight the importance of sampling across the entire blubber layer when assessing contaminant levels in phocid seals and taking into account the adipose stores and reproductive status of an animal when conducting contaminant research.

  16. Double-Blind Crossover Study to Compare Pain Experience During Inferior Alveolar Nerve Block Administration Using Buffered Two Percent Lidocaine in Children.

    Science.gov (United States)

    Chopra, Radhika; Jindal, Garima; Sachdev, Vinod; Sandhu, Meera

    2016-01-01

    Buffering of anesthetic solutions has been suggested to reduce pain on injection and onset of anesthesia. The purpose of this study was to assess the reduction in pain on injection during inferior alveolar nerve block administration in children. A double blind crossover study was designed where 30 six- to 12-year-old patients received two sessions of inferior alveolar nerve block scheduled one week apart. Two percent lidocaine with 1:200,000 epinephrine was given during one appointment, and a buffered solution was given during the other. Pain on injection was assessed using the sound, eye, and motor (SEM) scale, and the time to onset was assessed after gingival probing. The Heft-Parker visual analogue scale (HP-VAS) was self recorded by the patient after administration of local anesthesia. When tested using Mann-Whitney analysis, no significant differences were found between the SEM scores (P=0.71) and HP-VAS scores (P=0.93) for the two solutions used. Student's t test was used to assess the difference in the onset of anesthesia, which was also found to be statistically insignificant (P=0.824). Buffered lidocaine did not reduce the pain on injection or time to onset of anesthesia for inferior alveolar nerve block in children.

  17. Patient preparation for intravenous urography: are we practising evidence-based medicine?

    International Nuclear Information System (INIS)

    Singh, S.; Reddicliffe, N.; Parker, D.A.

    2008-01-01

    Aim: To identify the current practice of patient preparation prior to intravenous urography (IVU) in England and Wales. Methods: Seventy-two hospitals were contacted to request details regarding the duration of fluid restriction, adherence to a low-residue diet, or use of laxatives for patient preparation before IVU examinations. Results: Results showed that out of 45 hospitals that still use IVU, only six (13.3%) did not follow a patient-preparation regime. The vast majority of the hospitals contacted (87.6%), implemented either fluid and/or food restriction, or prescribed laxatives. The duration of fluid and food restriction varied from 2-12 h duration, and some departments advocated 48 h of laxatives. Conclusion: A large proportion of hospitals are not practising evidence-based medicine in relation to IVU, and we suggest that the practice of patient preparation should be abandoned

  18. Temporal divergence of percent body fat and body mass index in pre-teenage children: the LOOK longitudinal study.

    Science.gov (United States)

    Telford, R D; Cunningham, R B; Abhayaratna, W P

    2014-12-01

    The index of body mass related to stature, (body mass index, BMI, kgm(-2) ), is widely used as a proxy for percent body fat (%BF) in cross-sectional and longitudinal investigations. BMI does not distinguish between lean and fat mass and in children, the cross-sectional relationship between %BF and BMI changes with age and sex. While BMI increases linearly with age from age 8 to 12 years in both boys and girls, %BF plateaus off between 10 and 12 years. Repeated measures in children show a systematic decrease in %BF for any given BMI from age 8 to 10 to 12 years. Because changes in BMI misrepresent changes in %BF, its use as a proxy of %BF should be avoided in longitudinal studies in this age group. Body mass index (BMI, kgm(-2) ) is commonly used as an indicator of pediatric adiposity, but with its inability to distinguish changes in lean and fat mass, its use in longitudinal studies of children requires careful consideration. To investigate the suitability of BMI as a surrogate of percent body fat (%BF) in pediatric longitudinal investigations. In this longitudinal study, healthy Australian children (256 girls and 278 boys) were measured at ages 8.0 (standard deviation 0.3), 10.0 and 12.0 years for height, weight and percent body fat (%BF) by dual-energy X-ray absorptiometry. The patterns of change in the means of %BF and BMI were different (P < 0.001). While mean BMI increased linearly from 8 to 12 years of age, %BF did not change between 10 and 12 years. Relationships between %BF and BMI in boys and girls were curvilinear and varied with age (P < 0.001) and gender (P < 0.001); any given BMI corresponding with a lower %BF as a child became older. Considering the divergence of temporal patterns of %BF and BMI between 10 and 12 years of age, employment of BMI as a proxy for %BF in absolute or age and sex standardized forms in pediatric longitudinal investigations is problematical. © 2013 The Authors. Pediatric Obesity © 2013 International Association

  19. Investigation of LMFBR prototype 7A heaters and the metallurgy of the platinum-8 weight percent tungsten alloy

    International Nuclear Information System (INIS)

    Ludwig, R.L.

    1976-09-01

    A Liquid Metal Fast Breeder Reactor 7A prototype heater failure was analyzed. The failure was due to melting of the platinum-8 weight percent tungsten alloy (Pt-8 W) alloy winding caused by a loss of contact with the inside boron nitride insulation. An attempt to simulate a failure revealed that elemental boron forms a low-melting mixture with Pt-8 W, but a means by which boron might be present in an actual heater was not determined. A time/temperature/grain size study of various Pt-8 W alloy samples resulted in behavior which would be expected from a single-phase, solid-solution alloy. The results of the study were useful in estimating the temperatures reached at various locations along the length of two failed 7A prototype heaters

  20. Thermal effects in equilibrium surface segregation in a copper/10-atomic-percent-aluminum alloy using Auger electron spectroscopy

    Science.gov (United States)

    Ferrante, J.

    1972-01-01

    Equilibrium surface segregation of aluminum in a copper-10-atomic-percent-aluminum single crystal alloy oriented in the /111/ direction was demonstrated by using Auger electron spectroscopy. This crystal was in the solid solution range of composition. Equilibrium surface segregation was verified by observing that the aluminum surface concentration varied reversibly with temperature in the range 550 to 850 K. These results were curve fitted to an expression for equilibrium grain boundary segregation and gave a retrieval energy of 5780 J/mole (1380 cal/mole) and a maximum frozen-in surface coverage three times the bulk layer concentration. Analyses concerning the relative merits of sputtering calibration and the effects of evaporation are also included.

  1. Cheatgrass percent cover change: Comparing recent estimates to climate change − Driven predictions in the Northern Great Basin

    Science.gov (United States)

    Boyte, Stephen P.; Wylie, Bruce K.; Major, Donald J.

    2016-01-01

    Cheatgrass (Bromus tectorum L.) is a highly invasive species in the Northern Great Basin that helps decrease fire return intervals. Fire fragments the shrub steppe and reduces its capacity to provide forage for livestock and wildlife and habitat critical to sagebrush obligates. Of particular interest is the greater sage grouse (Centrocercus urophasianus), an obligate whose populations have declined so severely due, in part, to increases in cheatgrass and fires that it was considered for inclusion as an endangered species. Remote sensing technologies and satellite archives help scientists monitor terrestrial vegetation globally, including cheatgrass in the Northern Great Basin. Along with geospatial analysis and advanced spatial modeling, these data and technologies can identify areas susceptible to increased cheatgrass cover and compare these with greater sage grouse priority areas for conservation (PAC). Future climate models forecast a warmer and wetter climate for the Northern Great Basin, which likely will force changing cheatgrass dynamics. Therefore, we examine potential climate-caused changes to cheatgrass. Our results indicate that future cheatgrass percent cover will remain stable over more than 80% of the study area when compared with recent estimates, and higher overall cheatgrass cover will occur with slightly more spatial variability. The land area projected to increase or decrease in cheatgrass cover equals 18% and 1%, respectively, making an increase in fire disturbances in greater sage grouse habitat likely. Relative susceptibility measures, created by integrating cheatgrass percent cover and temporal standard deviation datasets, show that potential increases in future cheatgrass cover match future projections. This discovery indicates that some greater sage grouse PACs for conservation could be at heightened risk of fire disturbance. Multiple factors will affect future cheatgrass cover including changes in precipitation timing and totals and

  2. 27 CFR 30.61 - Table 1, showing the true percent of proof spirit for any indication of the hydrometer at...

    Science.gov (United States)

    2010-04-01

    ... percent of proof spirit for any indication of the hydrometer at temperatures between zero and 100 degrees... true percent of proof spirit for any indication of the hydrometer at temperatures between zero and 100... hydrometer likely to occur in practice at temperatures between zero and 100 degrees Fahrenheit and shall be...

  3. 40 CFR 62.14820 - How must I monitor opacity for air curtain incinerators that burn 100 percent wood wastes, clean...

    Science.gov (United States)

    2010-07-01

    ... curtain incinerators that burn 100 percent wood wastes, clean lumber, and/or yard waste? 62.14820 Section... Requirements for Commercial and Industrial Solid Waste Incineration Units That Commenced Construction On or Before November 30, 1999 Air Curtain Incinerators That Burn 100 Percent Wood Wastes, Clean Lumber And/or...

  4. Palliative care for patients with cancer: do patients receive the care they consider important? A survey study.

    Science.gov (United States)

    Heins, Marianne; Hofstede, Jolien; Rijken, Mieke; Korevaar, Joke; Donker, Gé; Francke, Anneke

    2018-04-17

    In many countries, GPs and home care nurses are involved in care for patients with advanced cancer. Given the varied and complex needs of these patients, providing satisfactory care is a major challenge for them. We therefore aimed to study which aspects of care patients, GPs and home care nurses consider important and whether patients receive these aspects. Seventy-two Dutch patients with advanced cancer, 87 GPs and 26 home care nurses rated the importance of support when experiencing symptoms, respect for patients' autonomy and information provision. Patients also rated whether they received these aspects. Questionnaires were based on the CQ index palliative care. Almost all patients rated information provision and respect for their autonomy as important. The majority also rated support when suffering from specific symptoms as important, especially support when in pain. In general, patients received the care they considered important. However, 49% of those who considered it important to receive support when suffering from fatigue and 23% of those who wanted to receive information on the expected course of their illness did not receive this or only did so sometimes. For most patients with advanced cancer, the palliative care that they receive matches what they consider important. Support for patients experiencing fatigue may need more attention. When symptoms are difficult to control, GPs and nurses may still provide emotional support and practical advice. Furthermore, we recommend that GPs discuss patients' need for information about the expected course of their illness.

  5. Evaluation of the influence of percent labeling of {sup 99m}Tc-MIBI on nuclear medicine procedures in Recife, Pernambuco State, Brazil; Avaliacao da influencia do percentual de marcacao do {sup 99m}Tc-MIBI em procedimentos de medicina nuclear em Recife, PE

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Jucilene Maria

    2003-08-15

    The aim of this work was to evaluate the influence of percent labeling of the radiopharmaceutical {sup 99m}Tc-MIBI on the procedures adopted by the nuclear medicine clinics in Recife, Pernambuco State, Brazil, and their possible interference with image quality in myocardial perfusion examinations. This work was performed at two nuclear medicine services in Recife that use pharmaceuticals provided by two different manufacturers: Cardiolite, provided by Dupont and Cardiosyd, provided by SYDMA. The pH, percent labeling and stability of samples of {sup 99m}Tc-MIBI and the percent uptake in heart and liver of a number of patients were evaluated. The results showed that the pH values measured in all samples of both radiopharmaceuticals were within the limits recommended. In 48% of the Cardiolite samples, the percent labeling was less than 90%, which is the minimum recommended limit. On the other hand, 87,5% of the Cardiosyd samples measured values above 98%. Both radiopharmaceuticals had good labeling stability, even in samples with low percent labeling efficiencies. In spite of the higher percent labeling of Cardiosyd its heart uptake is similar to that observed with the Cardiolite, even when the percent labeling is lower than 90%. On the other hand, the image quality, according to physicians, evaluation was poorer for Cardiosyd images, due to high noise and poor sharpness. (author)

  6. Using administrative data to estimate time to breast cancer diagnosis and percent of screen-detected breast cancers – a validation study in Alberta, Canada.

    Science.gov (United States)

    Yuan, Y; Li, M; Yang, J; Winget, M

    2015-05-01

    Appropriate use of administrative data enables the assessment of care quality at the population level. Our objective was to develop/validate methods for assessing quality of breast cancer diagnostic care using administrative data, specifically by identifying relevant medical tests to estimate the percentage screen/symptom-detected cancers and time to diagnosis. Two databases were created for all women diagnosed with a first-ever breast cancer in years 2007-2010 in Alberta, Canada, with dates of medical tests received in years 2006-2010. One purchased database had test results and was used to determine the 'true' first relevant test of a cancer diagnosis. The other free administrative database had test types but no test results. Receiver operating characteristic curves and concordance rates were used to assess estimates of percent screen/symptom-detected breast cancers; Log-rank test was used to assess time to diagnosis obtained from the two databases. Using a look-back period of 4-6 months from cancer diagnosis to identify relevant tests resulted in over 94% concordance, sensitivity and specificity for classifying patients into screen/symptom-detected group; good agreement between the distributions of time to diagnosis was also achieved. Our findings support the use of administrative data to accurately identify relevant tests for assessing the quality of breast cancer diagnostic care. © 2014 John Wiley & Sons Ltd.

  7. Low-Reynolds Number Aerodynamics of an 8.9 Percent Scale Semispan Swept Wing for Assessment of Icing Effects

    Science.gov (United States)

    Broeren, Andy P.; Woodard, Brian S.; Diebold, Jeffrey M.; Moens, Frederic

    2017-01-01

    Aerodynamic assessment of icing effects on swept wings is an important component of a larger effort to improve three-dimensional icing simulation capabilities. An understanding of ice-shape geometric fidelity and Reynolds and Mach number effects on the iced-wing aerodynamics is needed to guide the development and validation of ice-accretion simulation tools. To this end, wind-tunnel testing and computational flow simulations were carried out for an 8.9 percent-scale semispan wing based upon the Common Research Model airplane configuration. The wind-tunnel testing was conducted at the Wichita State University 7 by 10 ft Beech wind tunnel from Reynolds numbers of 0.8×10(exp 6) to 2.4×10(exp 6) and corresponding Mach numbers of 0.09 to 0.27. This paper presents the results of initial studies investigating the model mounting configuration, clean-wing aerodynamics and effects of artificial ice roughness. Four different model mounting configurations were considered and a circular splitter plate combined with a streamlined shroud was selected as the baseline geometry for the remainder of the experiments and computational simulations. A detailed study of the clean-wing aerodynamics and stall characteristics was made. In all cases, the flow over the outboard sections of the wing separated as the wing stalled with the inboard sections near the root maintaining attached flow. Computational flow simulations were carried out with the ONERA elsA software that solves the compressible, threedimensional RANS equations. The computations were carried out in either fully turbulent mode or with natural transition. Better agreement between the experimental and computational results was obtained when considering computations with free transition compared to turbulent solutions. These results indicate that experimental evolution of the clean wing performance coefficients were due to the effect of three-dimensional transition location and that this must be taken into account for future

  8. Splenic contraction in patients with various disorders

    Energy Technology Data Exchange (ETDEWEB)

    Iio, Atsushi; Murase, Kenya; Ito, Hisao; Watanabe, Yuji; Kawamura, Masashi; Hamamoto, Ken

    1986-03-01

    To investigate the pathophysiology of human spleen, splenic contraction following subcutaneous injection of epinephrine was measured in 45 patients with various disorders using single photon emission computed tomography (SPECT). The splenic contraction rates and percent decreases in splenic counts (ejection rates) in 5 controls were 34.5 +- 10.0 percent (mean +- SD) and 16.4 +- 6.9 percent respectively. With regard to non-Hodgkin lymphoma, the splenic contraction and ejection rates in 8 patients with no splenic involvement diagnosed by CT and/or /sup 67/Ga scintigraphy were 27.3 +- 7.0 percent and 9.4 +- 7.0 percent respectively, while these values in 6 patients with splenic involvement diagnosed by presence of splenomegaly, CT and/or /sup 67/Ga scintigraphy were 12.8 +- 5.8 percent and 2.5 +- 1.6 percent respectively. Both the values in the patients with splenic involvement were low (p < 0.01, p < 0.1) compared with those in the patients without splenic involvement. The splenic contraction and ejection rates in 7 patients with splenomegaly due to portal hypertension were averaged 33.5 +- 6.7 percent and 13.8 +- 4.5 percent respectively. These values were comparable to those in controls. All 3 patients with leukemia and splenomegaly showed exceedingly low values of the splenic contraction and ejection rates. The values were also remarkably low in a patient with splenic metastasis of unknown origin.

  9. The relationships between the amount of spared tissue, percent signal change, and accuracy in semantic processing in aphasia.

    Science.gov (United States)

    Sims, Jordyn A; Kapse, Kushal; Glynn, Peter; Sandberg, Chaleece; Tripodis, Yorghos; Kiran, Swathi

    2016-04-01

    Recovery from aphasia, loss of language following a cerebrovascular incident (stroke), is a complex process involving both left and right hemispheric regions. In our study, we analyzed the relationships between semantic processing behavioral data, lesion size and location, and percent signal change from functional magnetic resonance imaging (fMRI) data. This study included 14 persons with aphasia in the chronic stage of recovery (six or more months post stroke), along with normal controls, who performed semantic processing tasks of determining whether a written semantic feature matched a picture or whether two written words were related. Using region of interest (ROI) analysis, we found that left inferior frontal gyrus pars opercularis and pars triangularis, despite significant damage, were the only regions to correlate with behavioral accuracy. Additionally, bilateral frontal regions including superior frontal gyrus, middle frontal gyrus, and anterior cingulate appear to serve as an assistive network in the case of damage to traditional language regions that include inferior frontal gyrus, middle temporal gyrus, supramarginal gyrus, and angular gyrus. Right hemisphere posterior regions including right middle temporal gyrus, right supramarginal gyrus, and right angular gyrus are engaged in the case of extensive damage to left hemisphere language regions. Additionally, right inferior frontal gyrus pars orbitalis is presumed to serve a monitoring function. These results reinforce the importance of the left hemisphere in language processing in aphasia, and provide a framework for the relative importance of left and right language regions in the brain. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Thermal performance measurements of a 100 percent polyester MLI [multilayer insulation] system for the Superconducting Super Collider

    International Nuclear Information System (INIS)

    Boroski, W.N.; Gonczy, J.D.; Niemann, R.C.

    1989-09-01

    Thermal performance measurements of a 100 percent polyester multilayer insulation (MLI) system for the Superconducting Super Collider (SSC) were conducted in a Heat Leak Test Facility (HLTF) under three experimental test arrangements. Each experiment measured the thermal performance of a 32-layer MLI blanket instrumented with twenty foil sensors to measure interstitial layer temperatures. Heat leak values and sensor temperatures were monitored during transient and steady state conditions under both design and degraded insulating vacuums. Heat leak values were measured using a heatmeter. MLI interstitial layer temperatures were measured using Cryogenic Linear Temperature Sensors (CLTS). Platinum resistors monitored system temperatures. High vacuum was measured using ion gauges; degraded vacuum employed thermocouple gauges. A four-wire system monitored instrumentation sensors and calibration heaters. An on-line computerized data acquisition system recorded and processes data. This paper reports on the instrumentation and experimental preparation used in carrying out these measurements. In complement with this paper is an associate paper bearing the same title head, but with the title extension 'Part 2: Laboratory results (300K--80K). 13 refs., 7 figs

  11. Validating a virtual source model based in Monte Carlo Method for profiles and percent deep doses calculation

    Energy Technology Data Exchange (ETDEWEB)

    Del Nero, Renata Aline; Yoriyaz, Hélio [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Nakandakari, Marcos Vinicius Nakaoka, E-mail: hyoriyaz@ipen.br, E-mail: marcos.sake@gmail.com [Hospital Beneficência Portuguesa de São Paulo, SP (Brazil)

    2017-07-01

    The Monte Carlo method for radiation transport data has been adapted for medical physics application. More specifically, it has received more attention in clinical treatment planning with the development of more efficient computer simulation techniques. In linear accelerator modeling by the Monte Carlo method, the phase space data file (phsp) is used a lot. However, to obtain precision in the results, it is necessary detailed information about the accelerator's head and commonly the supplier does not provide all the necessary data. An alternative to the phsp is the Virtual Source Model (VSM). This alternative approach presents many advantages for the clinical Monte Carlo application. This is the most efficient method for particle generation and can provide an accuracy similar when the phsp is used. This research propose a VSM simulation with the use of a Virtual Flattening Filter (VFF) for profiles and percent deep doses calculation. Two different sizes of open fields (40 x 40 cm² and 40√2 x 40√2 cm²) were used and two different source to surface distance (SSD) were applied: the standard 100 cm and custom SSD of 370 cm, which is applied in radiotherapy treatments of total body irradiation. The data generated by the simulation was analyzed and compared with experimental data to validate the VSM. This current model is easy to build and test. (author)

  12. Secondary scintillation yield of xenon with sub-percent levels of CO2 additive for rare-event detection

    Science.gov (United States)

    Henriques, C. A. O.; Freitas, E. D. C.; Azevedo, C. D. R.; González-Díaz, D.; Mano, R. D. P.; Jorge, M. R.; Fernandes, L. M. P.; Monteiro, C. M. B.; Gómez-Cadenas, J. J.; Álvarez, V.; Benlloch-Rodríguez, J. M.; Borges, F. I. G. M.; Botas, A.; Cárcel, S.; Carríon, J. V.; Cebrían, S.; Conde, C. A. N.; Díaz, J.; Diesburg, M.; Esteve, R.; Felkai, R.; Ferrario, P.; Ferreira, A. L.; Goldschmidt, A.; Gutiérrez, R. M.; Hauptman, J.; Hernandez, A. I.; Hernando Morata, J. A.; Herrero, V.; Jones, B. J. P.; Labarga, L.; Laing, A.; Lebrun, P.; Liubarsky, I.; López-March, N.; Losada, M.; Martín-Albo, J.; Martínez-Lema, G.; Martínez, A.; McDonald, A. D.; Monrabal, F.; Mora, F. J.; Moutinho, L. M.; Muñoz Vidal, J.; Musti, M.; Nebot-Guinot, M.; Novella, P.; Nygren, D. R.; Palmeiro, B.; Para, A.; Pérez, J.; Querol, M.; Renner, J.; Ripoll, L.; Rodríguez, J.; Rogers, L.; Santos, F. P.; dos Santos, J. M. F.; Simón, A.; Sofka, C.; Sorel, M.; Stiegler, T.; Toledo, J. F.; Torrent, J.; Tsamalaidze, Z.; Veloso, J. F. C. A.; Webb, R.; White, J. T.; Yahlali, N.; NEXT Collaboration

    2017-10-01

    Xe-CO2 mixtures are important alternatives to pure xenon in Time Projection Chambers (TPC) based on secondary scintillation (electroluminescence) signal amplification with applications in the important field of rare event detection such as directional dark matter, double electron capture and double beta decay detection. The addition of CO2 to pure xenon at the level of 0.05-0.1% can reduce significantly the scale of electron diffusion from 10 mm /√{m} to 2.5 mm /√{m}, with high impact on the discrimination efficiency of the events through pattern recognition of the topology of primary ionization trails. We have measured the electroluminescence (EL) yield of Xe-CO2 mixtures, with sub-percent CO2 concentrations. We demonstrate that the EL production is still high in these mixtures, 70% and 35% relative to that produced in pure xenon, for CO2 concentrations around 0.05% and 0.1%, respectively. The contribution of the statistical fluctuations in EL production to the energy resolution increases with increasing CO2 concentration, being smaller than the contribution of the Fano factor for concentrations below 0.1% CO2.

  13. Guidance for growth factors, projections, and control strategies for the 15 percent rate-of-progress plans

    International Nuclear Information System (INIS)

    1993-03-01

    Section 182(b)(1) of the Clean Air Act (Act) requires all ozone nonattainment areas classified as moderate and above to submit a State Implementation Plan (SIP) revision by November 15, 1993, which describes, in part, how the areas will achieve an actual volatile organic compound (VOC) emissions reduction of at least 15 percent during the first 6 years after enactment of the Clean Air Act Amendments of 1990 (CAAA). In addition, the SIP revision must describe how any growth in emissions from 1990 through 1996 will be fully offset. It is important to note that section 182(b)(1) also requires the SIP for moderate areas to provide for reductions in VOC and nitrogen oxides (NOx) emissions as necessary to attain the national primary ambient air quality standard for ozone by November 15, 1996. The guidance document focuses on the procedures for developing 1996 projected emissions inventories and control measures which moderate and above ozone nonattainment areas must include in their rate-of-progress plans. The document provides technical guidance to support the policy presented in the 'General Preamble: Implementation of Title I of the CAAA of 1990' (57 FR 13498)

  14. Similarity in percent body fat between white and Vietnamese women: implication for a universal definition of obesity.

    Science.gov (United States)

    Ho-Pham, Lan T; Lai, Thai Q; Nguyen, Nguyen D; Barrett-Connor, Elizabeth; Nguyen, Tuan V

    2010-06-01

    It has been widely assumed that for a given BMI, Asians have higher percent body fat (PBF) than whites, and that the BMI threshold for defining obesity in Asians should be lower than the threshold for whites. This study sought to test this assumption by comparing the PBF between US white and Vietnamese women. The study was designed as a comparative cross-sectional investigation. In the first study, 210 Vietnamese women ages between 50 and 85 were randomly selected from various districts in Ho Chi Minh City (Vietnam). In the second study, 419 women of the same age range were randomly selected from the Rancho Bernardo Study (San Diego, CA). In both studies, lean mass (LM) and fat mass (FM) were measured by dual-energy X-ray absorptiometry (DXA) (QDR 4500; Hologic). PBF was derived as FM over body weight. Compared with Vietnamese women, white women had much more FM (24.8 +/- 8.1 kg vs. 18.8 +/- 4.9 kg; P or=30, 19% of US white women and 5% of Vietnamese women were classified as obese. Approximately 54% of US white women and 53% of Vietnamese women had their PBF >35% (P = 0.80). Although white women had greater BMI, body weight, and FM than Vietnamese women, their PBF was virtually identical. Further research is required to derive a more appropriate BMI threshold for defining obesity for Asian women.

  15. Higher percent body fat in young women with lower physical activity level and greater proportion Pacific Islander ancestry.

    Science.gov (United States)

    Black, Nate; Nabokov, Vanessa; Vijayadeva, Vinutha; Novotny, Rachel

    2011-11-01

    Samoan women exhibit high rates of obesity, which can possibly be attenuated through diet and physical activity. Obesity, and body fatness in particular, is associated with increased risk for chronic diseases. Ancestry, physical activity, and dietary patterns have been associated with body composition. Using a cross-sectional design, the relative importance of proportion of Pacific Islander (PI) ancestry, level of physical activity, and macronutrients among healthy women in Honolulu, Hawai'i, ages 18 to 28 years was examined. All data were collected between January 2003 and December 2004. Percent body fat (%BF) was determined by whole body dual energy x-ray absorptiometry (DXA). Nutrient data were derived from a three-day food record. Means and standard deviations were computed for all variables of interest. Bivariate correlation analysis was used to determine correlates of %BF. Multiple regression analysis was used to determine relative contribution of variables significantly associated with %BF. Proportion of PI ancestry was significantly positively associated with %BF (P=0.0001). Physical activity level was significantly negatively associated with %BF (P=0.0006). Intervention to increase physical activity level of young Samoan women may be effective to decrease body fat and improve health. CRC-NIH grant: 0216.

  16. Insomnia in patients with COPD.

    Science.gov (United States)

    Budhiraja, Rohit; Parthasarathy, Sairam; Budhiraja, Pooja; Habib, Michael P; Wendel, Christopher; Quan, Stuart F

    2012-03-01

    Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality and may frequently be associated with sleep disturbances. However, the correlates of insomnia in COPD patients have not been well characterized. The aim of the current study was to describe the prevalence of insomnia disorder in COPD and to elucidate the demographic and clinical characteristics of COPD patients that are associated with insomnia. Cross-sectional study. Clinic-based sample from an academic hospital. Patients with stable COPD. An interviewer-conducted survey was administered to 183 participants with COPD. Seventy-two of these participants (30 with and 42 without insomnia) maintained a sleep diary and underwent actigraphy for 7 days. Insomnia (chronic sleep disturbance associated with impaired daytime functioning) was present in 27.3% of participants. Current tobacco users (odds ratio (OR), 2.13) and those with frequent sadness/anxiety (OR, 3.57) had higher odds, but oxygen use was associated with lower odds (OR, 0.35) of insomnia. Patients with insomnia had worse quality of life and a higher prevalence of daytime sleepiness. Actigraphy revealed shorter sleep duration and lower sleep efficiency, and a sleep diary revealed worse self-reported sleep quality in participants with insomnia. Insomnia disorder is highly prevalent in patients with COPD; current tobacco use and sadness/anxiety are associated with a higher prevalence, and oxygen use with a lower prevalence of insomnia; patients with insomnia have poorer quality of life and increased daytime sleepiness; and insomnia is associated with worse objective sleep quality.

  17. Niobium 1 percent zirconium/potassium and titanium/potassium life-test heat pipe design and testing

    Science.gov (United States)

    Sena, J. Tom; Merrigan, Michael A.

    Experimental lifetime performance studies currently in progress use Niobium 1 percent Zirconium (Nb-1Zr) and Titanium (Ti) heat pipes with potassium (K) as the working fluid. A heat pipe life test matrix was developed for testing the heat pipes. Because the corrosion rates in alkali metal heat pipes are affected by temperature and working fluid evaporation flux, the variable parameters of the experimental matrix are established as steady operating temperature and input heat flux density. Total impurity inventory is a factor in corrosion rate so impurity levels are being evaluated in the heat pipe materials before and after testing. Eight Nb-1Zr/K heat pipes were designed, fabricated, and tested. Two of the heat pipes have completed testing whereas the other six are currently in test. These are gravity assist heat pipes operating in a reflux mode. The heat pipes are tested by sets, one set of two and two sets of three heat pipes. Three Ti/K heat pipes are also in life test. These heat pipes are tested as a set in a horizontal position in a capillary pumped annular flow mode. Each of the heat pipes is encapsulated in a quartz vacuum container with a water calorimeter over the vacuum container for power throughput measurements. Thermocouples are attached to the heat pipes for measuring temperature. Heat input to the heat pipes is via an RF coil. The heat pipes are operating at between 800 and 900 K, with heat input fluxes of 13.8 to 30 W/sq cm. Of the Nb-1Zr/K heat pipes, two of the heat pipes have been in operation for 14,000 hours, three over 10,000 hours, and three over 7,000 hours. The Ti/K heat pipes have been in operation for 1,266 hours.

  18. SU-D-209-02: Percent Depth Dose Curves for Fluoroscopic X-Ray Beam Qualities Incorporating Copper Filtration

    Energy Technology Data Exchange (ETDEWEB)

    Wunderle, K [Cleveland Clinic Foundation, Cleveland, OH (United States); Wayne State University School of Medicine, Detroit, MI (United States); Godley, A; Shen, Z; Dong, F [Cleveland Clinic Foundation, Cleveland, OH (United States); Rakowski, J [Wayne State University School of Medicine, Detroit, MI (United States)

    2016-06-15

    Purpose: The purpose of this investigation was to quantify percent depth dose (PDD) curves for fluoroscopic x-ray beam qualities incorporating added copper filtration. Methods: A PTW (Freiburg, Germany) MP3 water tank was used with a Standard Imaging (Middleton, WI) Exradin Model 11 Spokas Chamber to measure PDD curves for 60, 80, 100 and 120 kVp x-ray beams with copper filtration ranging from 0.0–0.9 mm at 22cm and 42cm fields of view from 0 to 150 mm of water. A free-in-air monitor chamber was used to normalize the water tank data to fluctuations in output from the fluoroscope. The measurements were acquired on a Siemens (Erlangen, Germany) Artis ZeeGo fluoroscope. The fluoroscope was inverted from the typical orientation providing an x-ray beam originating from above the water tank. The water tank was positioned so that the water level was located at 60cm from the focal spot; which also represents the focal spot to interventional reference plane distance for that fluoroscope. Results: PDDs for 60, 80, 100, and 120 kVp with 0 mm of copper filtration compared well to previously published data by Fetterly et al. [Med Phys, 28, 205 (2001)] for those beam qualities given differences in fluoroscopes, geometric orientation, type of ionization chamber, and the water tank used for data collection. PDDs for 60, 80, 100, and 120 kVp with copper filtration were obtained and are presented, which have not been previously investigated and published. Conclusion: The equipment and processes used to acquire the reported data were sound and compared well with previously published data for PDDs without copper filtration. PDD data for the fluoroscopic x-ray beams incorporating copper filtration can be used as reference data for estimating organ or soft tissue dose at depth involving similar beam qualities or for comparison with mathematical models.

  19. Is air-displacement plethysmography a reliable method of detecting ongoing changes in percent body fat within obese children involved in a weight management program?

    DEFF Research Database (Denmark)

    Ewane, Cecile; McConkey, Stacy A; Kreiter, Clarence D

    2010-01-01

    (percent body fat) over time. The gold standard method, hydrodensitometry, has severe limitations for the pediatric population. OBJECTIVE: This study examines the reliability of air-displacement plethysmography (ADP) in detecting percent body fat changes within obese children over time. METHODS: Percent...... body fat by ADP, weight, and body mass index (BMI) were measured for eight obese children aged 5-12 years enrolled in a weight management program over a 12-month period. These measurements were taken at initial evaluation, 1.5 months, 3 months, 6 months, and 12 months to monitor the progress...... of the subjects and detect any changes in these measures over time. Statistical analysis was used to determine the reliability of the data collected. RESULTS: The reliability estimate for percent body fat by ADP was 0.78. This was much lower than the reliability of BMI, 0.98, and weight measurements, 0...

  20. Small Business Administration (SBA) Loan Program Performance- Charge Off Rates as a Percent of Unpaid Principal Balance (UPB) Amount by Program

    Data.gov (United States)

    Small Business Administration — Reflects charge off rates, as a percent of the UPB amounts, at the end of the fiscal year for the major loan programs and aggregate totals for the small direct and...

  1. An experimental investigation of the rate of hydrogen absorption in zirconium-2.5 wt percent niobium from steam/hydrogen mixtures at elevated temperatures

    International Nuclear Information System (INIS)

    Langman, V.J.

    1984-08-01

    The test specifications for an experimental program to study the rate of hydrogen absorption in zirconium-2.5 weight percent niobium pressure tube material from steam/hydrogen mixtures at elevated temperatures are discussed

  2. CRED Cumulative Map of Percent Scleractinian Coral Cover along towed camera sled tracks and AUV dive tracks at Rota Island, Commonwealth of the Northern Mariana Islands

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This map displays optical validation observation locations and percent coverage of scleractinian coral overlaid on bathymetry. Optical data were collected by CRED...

  3. Enhancing the efficacy of treatment for temporomandibular patients with muscular diagnosis through cognitive-behavioral intervention, including hypnosis: a randomized study.

    Science.gov (United States)

    Ferrando, Maite; Galdón, María José; Durá, Estrella; Andreu, Yolanda; Jiménez, Yolanda; Poveda, Rafael

    2012-01-01

    This study evaluated the efficacy of a cognitive-behavioral therapy (CBT), including hypnosis, in patients with temporomandibular disorders (TMDs) with muscular diagnosis. Seventy-two patients (65 women and 7 men with an average age of 39 years) were selected according to the Research Diagnostic Criteria for TMD, and assigned to the experimental group (n = 41), receiving the 6-session CBT program, and the control group (n = 31). All patients received conservative standard treatment for TMD. The assessment included pain variables and psychologic distress. There were significant differences between the groups, the experimental group showing a higher improvement in the variables evaluated. Specifically, 90% of the patients under CBT reported a significant reduction in frequency of pain and 70% in emotional distress. The improvement was stable over time, with no significant differences between posttreatment and 9-month follow-up. CBT, including hypnosis, significantly improved conservative standard treatment outcome in TMD patients. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. 3D MRI for Quantitative Analysis of Quadrant Percent Breast Density: Correlation with Quadrant Location of Breast Cancer.

    Science.gov (United States)

    Chen, Jeon-Hor; Liao, Fuyi; Zhang, Yang; Li, Yifan; Chang, Chia-Ju; Chou, Chen-Pin; Yang, Tsung-Lung; Su, Min-Ying

    2017-07-01

    Breast cancer occurs more frequently in the upper outer (UO) quadrant, but whether this higher cancer incidence is related to the greater amount of dense tissue is not known. Magnetic resonance imaging acquires three-dimensional volumetric images and is the most suitable among all breast imaging modalities for regional quantification of density. This study applied a magnetic resonance imaging-based method to measure quadrant percent density (QPD), and evaluated its association with the quadrant location of the developed breast cancer. A total of 126 cases with pathologically confirmed breast cancer were reviewed. Only women who had unilateral breast cancer located in a clear quadrant were selected for analysis. A total of 84 women, including 47 Asian women and 37 western women, were included. An established computer-aided method was used to segment the diseased breast and the contralateral normal breast, and to separate the dense and fatty tissues. Then, a breast was further separated into four quadrants using the nipple and the centroid as anatomic landmarks. The tumor was segmented using a computer-aided method to determine its quadrant location. The distribution of cancer quadrant location, the quadrant with the highest QPD, and the proportion of cancers occurring in the highest QPD were analyzed. The highest incidence of cancer occurred in the UO quadrant (36 out of 84, 42.9%). The highest QPD was also noted most frequently in the UO quadrant (31 out of 84, 36.9%). When correlating the highest QPD with the quadrant location of breast cancer, only 17 women out of 84 (20.2%) had breast cancer occurring in the quadrant with the highest QPD. The results showed that the development of breast cancer in a specific quadrant could not be explained by the density in that quadrant, and further studies are needed to find the biological reasons accounting for the higher breast cancer incidence in the UO quadrant. Copyright © 2017 The Association of University Radiologists

  5. 2013 Cholesterol Guidelines Revisited: Percent LDL Cholesterol Reduction or Attained LDL Cholesterol Level or Both for Prognosis?

    NARCIS (Netherlands)

    Bangalore, Sripal; Fayyad, Rana; Kastelein, John J.; Laskey, Rachel; Amarenco, Pierre; Demicco, David A.; Waters, David D.

    2016-01-01

    The 2013 American College of Cardiology (ACC)/American Heart Association (AHA) guideline on the treatment of blood cholesterol recommends moderate- to high-intensity statins for patients with atherosclerotic cardiovascular disease but departs from the traditional treat-to-target approach. Whether

  6. Breaking bad news: patients' preferences and health locus of control.

    Science.gov (United States)

    Martins, Raquel Gomes; Carvalho, Irene Palmares

    2013-07-01

    To identify patients' preferences for models of communicating bad news and to explore how such preferences, and the reasons for the preferences, relate with personality characteristics, specifically patients' health locus of control (HLC): internal/external and 'powerful others' (PO). Seventy-two patients from an oncology clinic watched videotaped scenarios of a breaking bad news moment, selected the model they preferred, filled an HLC scale and were interviewed about their choices. Data were analyzed with Chi-square, Kruskal-Wallis and Mann-Whitney tests. Interviews were content-analyzed. 77.8% preferred an "empathic professional", 12.5% a "distanced expert" and 9.7% an "emotionally burdened expert". Preferences varied significantly with HLC scores (patients with higher internal locus of control (ILC) and lower PO preferred the empathic model), presence of cancer, age and education. Patients explained their preferences through aspects of Caring, Professionalism, Wording, Time and Hope. ILC registered significant differences in regards to Wording and Time, whereas PO was associated with Hope and Time. HLC is an important dimension that can help doctors to better know their patients. Knowing whether patients attribute their health to their own behaviors or to chance/others can help tailor the disclosure of bad news to their specific preferences. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  7. Estimation of breast percent density in raw and processed full field digital mammography images via adaptive fuzzy c-means clustering and support vector machine segmentation

    Energy Technology Data Exchange (ETDEWEB)

    Keller, Brad M.; Nathan, Diane L.; Wang Yan; Zheng Yuanjie; Gee, James C.; Conant, Emily F.; Kontos, Despina [Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104 (United States); Applied Mathematics and Computational Science, University of Pennsylvania, Philadelphia, Pennsylvania 19104 (United States); Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104 (United States)

    2012-08-15

    Purpose: The amount of fibroglandular tissue content in the breast as estimated mammographically, commonly referred to as breast percent density (PD%), is one of the most significant risk factors for developing breast cancer. Approaches to quantify breast density commonly focus on either semiautomated methods or visual assessment, both of which are highly subjective. Furthermore, most studies published to date investigating computer-aided assessment of breast PD% have been performed using digitized screen-film mammograms, while digital mammography is increasingly replacing screen-film mammography in breast cancer screening protocols. Digital mammography imaging generates two types of images for analysis, raw (i.e., 'FOR PROCESSING') and vendor postprocessed (i.e., 'FOR PRESENTATION'), of which postprocessed images are commonly used in clinical practice. Development of an algorithm which effectively estimates breast PD% in both raw and postprocessed digital mammography images would be beneficial in terms of direct clinical application and retrospective analysis. Methods: This work proposes a new algorithm for fully automated quantification of breast PD% based on adaptive multiclass fuzzy c-means (FCM) clustering and support vector machine (SVM) classification, optimized for the imaging characteristics of both raw and processed digital mammography images as well as for individual patient and image characteristics. Our algorithm first delineates the breast region within the mammogram via an automated thresholding scheme to identify background air followed by a straight line Hough transform to extract the pectoral muscle region. The algorithm then applies adaptive FCM clustering based on an optimal number of clusters derived from image properties of the specific mammogram to subdivide the breast into regions of similar gray-level intensity. Finally, a SVM classifier is trained to identify which clusters within the breast tissue are likely

  8. Estimation of breast percent density in raw and processed full field digital mammography images via adaptive fuzzy c-means clustering and support vector machine segmentation

    International Nuclear Information System (INIS)

    Keller, Brad M.; Nathan, Diane L.; Wang Yan; Zheng Yuanjie; Gee, James C.; Conant, Emily F.; Kontos, Despina

    2012-01-01

    Purpose: The amount of fibroglandular tissue content in the breast as estimated mammographically, commonly referred to as breast percent density (PD%), is one of the most significant risk factors for developing breast cancer. Approaches to quantify breast density commonly focus on either semiautomated methods or visual assessment, both of which are highly subjective. Furthermore, most studies published to date investigating computer-aided assessment of breast PD% have been performed using digitized screen-film mammograms, while digital mammography is increasingly replacing screen-film mammography in breast cancer screening protocols. Digital mammography imaging generates two types of images for analysis, raw (i.e., “FOR PROCESSING”) and vendor postprocessed (i.e., “FOR PRESENTATION”), of which postprocessed images are commonly used in clinical practice. Development of an algorithm which effectively estimates breast PD% in both raw and postprocessed digital mammography images would be beneficial in terms of direct clinical application and retrospective analysis. Methods: This work proposes a new algorithm for fully automated quantification of breast PD% based on adaptive multiclass fuzzy c-means (FCM) clustering and support vector machine (SVM) classification, optimized for the imaging characteristics of both raw and processed digital mammography images as well as for individual patient and image characteristics. Our algorithm first delineates the breast region within the mammogram via an automated thresholding scheme to identify background air followed by a straight line Hough transform to extract the pectoral muscle region. The algorithm then applies adaptive FCM clustering based on an optimal number of clusters derived from image properties of the specific mammogram to subdivide the breast into regions of similar gray-level intensity. Finally, a SVM classifier is trained to identify which clusters within the breast tissue are likely fibroglandular, which

  9. Head and neck multidisciplinary team meetings: Effect on patient management.

    Science.gov (United States)

    Brunner, Markus; Gore, Sinclair M; Read, Rebecca L; Alexander, Ashlin; Mehta, Ankur; Elliot, Michael; Milross, Chris; Boyer, Michael; Clark, Jonathan R

    2015-07-01

    The purpose of this study was for us to present our findings on the prospectively audited impact of head and neck multidisciplinary team meetings on patient management. We collected clinical data, the pre-multidisciplinary team meeting treatment plan, the post-multidisciplinary team meeting treatment plans, and follow-up data from all patients discussed at a weekly multidisciplinary team meeting and we recorded the changes in management. One hundred seventy-two patients were discussed in 39 meetings. In 52 patients (30%), changes in management were documented of which 20 (67%) were major. Changes were statistically more likely when the referring physician was a medical or radiation oncologist, when the initial treatment plan did not include surgery, and when the histology was neither mucosal squamous cell cancer nor a skin malignancy. Compliance to the multidisciplinary team meeting treatment recommendation was 84% for all patients and 70% for patients with changes in their treatment recommendation. Head and neck multidisciplinary team meetings changed management in almost a third of the cases. © 2014 Wiley Periodicals, Inc.

  10. The fear of using tramadol for pain control (tramadolophobia) among Egyptian patients with cancer.

    Science.gov (United States)

    Alsirafy, Samy A; Saleh, Radfan N; Fawzy, Radwa; Alnagar, Ahmed A; Hammad, Ahmed M; El-Sherief, Wessam; Farag, Dina E; Radwan, Riham H

    2015-01-01

    The fear of using tramadol for pain control (tramadolophobia) by Egyptian patients with cancer is a frequent problem in our practice. This study was conducted to explore the prevalence of and the reasons behind tramadolophobia among Egyptian patients with cancer. A structured interview including open-ended and closed questions. The study included 178 adult patients with cancer from two cancer centers in Cairo and Sharkia, Egypt. The source of information about tramadol was a non-healthcare-related source in 168 (94 percent) patients, mainly the media (50 percent). The believed uses of tramadol were abuse related in 94 (53 percent) patients, stimulant (physical, sexual, and to boost alertness) in 59 (33 percent), and analgesic in 55 (31 percent). Twenty-six (15 percent) patients gave history of tramadol use, largely (69 percent) as a stimulant. In case tramadol was prescribed for pain control, 90 (51 percent) patients refused to take it, 59 (33 percent) patients agreed to take it with concern about addiction, and only 29 (16 percent) patients agreed without concerns. Among those who refused taking tramadol for pain, the mentioned reason of refusal was addiction-related fears in 57 percent. The stigmatization and misconceptions about tramadol may have resulted in tramadolophobia among the majority of Egyptian patients with cancer. This further complicates the barriers to cancer pain control in Egypt. Being the only available World Health Organization step-II analgesic in Egypt, interventions to overcome tramadolophobia should be taken.

  11. Clinical and laboratory profile of dengue fever patients admitted in combined military hospital rawalpindi in year 2015

    International Nuclear Information System (INIS)

    Rehman, M. M. U.; Zakaria, M.; Mustafvi, S. A.

    2017-01-01

    Objective: The purpose of this study was to determine the pattern of clinical presentations, haematological and biochemical abnormalities, and outcome of dengue fever patients admitted in Combined Military Hospital (CMH) Rawalpindi in year 2015. Study Design: A descriptive cross sectional study. Place and Duration of Study: Department of Medicine, CMH Rawalpindi, from January 2015 to December 2015. Material and Methods: Patients meeting the inclusion criteria were admitted at CMH Rawalpindi and blood serology was done to confirm the diagnosis of dengue fever. Cases with positive dengue serology were included in the study. Clinical symptoms, signs, investigations and outcome of these patients were recorded on a proforma. Blood samples were taken for analysis. Chest X-Ray and ultrasound abdomen were done on required basis. Results: Out of forty confirmed cases of dengue fever, there were 25 (62.5 percent) males and 15 (37.5 percent) females. Mean age was 40 years. There were 39 cases (97.5 percent) of dengue fever and one case (2.5 percent) of dengue shock syndrome.There was no case of dengue haemorrhagic syndrome. Maximum cases were seen in the month of October 2015.The clinical features noted were: headache and myalgias 62.5 percent, chills and rigors 57.5 percent, retro-orbital pain 42.5 percent, vomiting 35.0 percent, pruritus 27 percent, skin rash 20 percent, abdominal pain 20 percent, diarrhoea 10 percent, bleeding 2.5 percent, ascites and pleural effusion 2.5 percent, and hepatomegaly 15 percent. The laboratory findings were: leucopenia 85 percent and thrombocytopenia 92.5 percent. Serum alanine transaminase (ALT), urea, and creatinine were raised in 30 percent, 2.5 percent and 7.5 percent cases respectively. Mortality was 2.5 percent. Conclusion: This study showed that patients admitted to CMH hospital had a milder presentation of dengue fever in the year 2015. (author)

  12. Discordance of exercise thallium testing with coronary arteriography in patients with atypical presentations

    International Nuclear Information System (INIS)

    Bungo, M.W.; Leland, O.S. Jr.

    1983-01-01

    Eighty-one patients with diagnostically difficult clinical presentations suggesting coronary disease underwent symptom-limited maximal-exercise treadmill testing (ETT) and exercise radionuclide scanning with 201 Tl. Results of these tests were in agreement in only 47 percent of the cases. Either exercise thallium or ETT was positive in 94 percent of patients with disease. Among a population with a disease prevalence of 67 percent, agreement between exercise thallium an ETT predicted disease in 92 percent of instances or excluded disease in 82 percent of instances. Frequent discordance between these two tests in 53 percent of the cases unfortunately limits this usefulness

  13. Blood Pressure Home Monitoring in Hypertensive Patients Attending ...

    African Journals Online (AJOL)

    Blood Pressure Home Monitoring in Hypertensive Patients Attending a Tertiary ... Sixty percent of the patients were aged 50 - 69 years. ... Patients with high BP readings reported that they exercise more and reduced their daily salt intake.

  14. Sudden death in patients with myocardial infarction and left ventricular dysfunction, heart failure, or both

    DEFF Research Database (Denmark)

    Solomon, Scott D; Zelenkofske, Steve; McMurray, John J V

    2005-01-01

    BACKGROUND: The risk of sudden death from cardiac causes is increased among survivors of acute myocardial infarction with reduced left ventricular systolic function. We assessed the risk and time course of sudden death in high-risk patients after myocardial infarction. METHODS: We studied 14......,609 patients with left ventricular dysfunction, heart failure, or both after myocardial infarction to assess the incidence and timing of sudden unexpected death or cardiac arrest with resuscitation in relation to the left ventricular ejection fraction. RESULTS: Of 14,609 patients, 1067 (7 percent) had an event...... percent confidence interval, 0.11 to 0.18 percent) after 2 years. Patients with a left ventricular ejection fraction of 30 percent or less were at highest risk in this early period (rate, 2.3 percent per month; 95 percent confidence interval, 1.8 to 2.8 percent). Nineteen percent of all sudden deaths...

  15. Severe traumatic brain injury: outcome in patients with diffuse axonal injury managed conservatively in Hospital Sultanah Aminah, Johor Bahru--an observational study.

    Science.gov (United States)

    Liew, B S; Johari, S A; Nasser, A W; Abdullah, J

    2009-12-01

    Patients with isolated severe head injury with diffuse axonal injury and without any surgical lesion may be treated safely without cerebral resuscitation and intracranial pressure (ICP) monitoring. Seventy two patients were divided into three groups of patients receiving treatment based on ICP-CPP-targeted, or conservative methods either with or without ventilation support. The characteristics of these three groups were compared based on age, gender, Glasgow Coma Scale (GCS), pupillary reaction to light, computerized tomography scanning according to the Marshall classification, duration of intensive care unit (ICU) stays, Glasgow Outcome Score (GOS) and possible complications. There were higher risk of mortality (p < 0.001), worse GCS improvement upon discharge (p < 0.001) and longer ICU stays (p = 0.016) in ICP group compared to Intubation group. There were no significant statistical differences of GOS at 3rd and 6th months between all three groups.

  16. Perfusion MRI derived indices of microvascular shunting and flow control correlate with tumor grade and outcome in patients with cerebral glioma

    DEFF Research Database (Denmark)

    Tietze, Anna; Mouridsen, Kim; Lassen-Ramshad, Yasmin

    2015-01-01

    Objectives: Deficient microvascular blood flow control is thought to cause tumor hypoxia and increase resistance to therapy. In glioma patients, we tested whether perfusion-weighted MRI (PWI) based indices of microvascular flow control provide more information on tumor grade and patient outcome...... than does the established PWI angiogenesis marker, cerebral blood volume (CBV). Material and Methods: Seventy-two glioma patients (sixty high-grade, twelve low-grade gliomas) were included. Capillary transit time heterogeneity (CTH) and COV, its ratio to blood mean transit time, provide indices...... of microvascular flow control and the extent to which oxygen can be extracted by tumor tissue. The ability of these parameters and CBV to differentiate tumor grade were assessed by receiver operating characteristic curves and logistic regression. Their ability to predict time to progression and overall survival...

  17. Clinical study of CT-guided sclerotherapy using 50 percent acetic acid in the treatment of renal cyst

    International Nuclear Information System (INIS)

    Pang Jun; Han Changli; Zhang Zhaofu; Dai Jingru

    2007-01-01

    Objective: To investigate the efficacy of 50% acetic acid as a renal cyst sclerotherapy agent, and with further comparison to that of absolute alcohol. Methods: Eighty five patients with renal cyst were undergone sclerotherapy through spiral CT guidance including 43 cases with absolute alcohol and the others with 50% acetic acid as selerosing agents. All the cysts were aspirated under CT-guidance, beforehand. The selerosising agents were withdrawn from the cysts after a definite period of retention. Results: The disappearance rates of cyst cavity with absolute alcohol and acetic acid were 55.81% and 71.42%, respectively. Complication occurenee rates with absolute alcohol and acetic acid were 16.28% and 4.76%, respectively. The average retention periods of absolute alcohol and acetic acid in cyst were (20±4) minutes, and (10±2)minutes, respectively. Statistical analysis demonstrated that all the data in two groups were significantly different. Conclusion: Using 50% acetic acid as sclerosising agent in treating renal cyst possesses the better effect and less side effect, providing a tendency to replace the traditional therapy. (authors)

  18. The effect of baking soda/hydrogen peroxide dentifrice (Mentadent) and a 0.12 percent chlorhexidine gluconate mouthrinse (Peridex) in reducing gingival bleeding.

    Science.gov (United States)

    Taller, S H

    1993-01-01

    The purpose of this study was to determine the effectiveness of a baking soda/hydrogen peroxide dentifrice, Mentadent, and a 0.12 percent chlorhexidine gluconate mouthrinse, Peridex, in reducing gingival bleeding. Forty subjects were divided into three groups; the baking soda group, the chlorhexidine group and the control group. All groups received oral hygiene instruction and brushed and flossed three times per day. Bleeding point scores were evaluated at baseline and at five weeks. The baking soda/hydrogen peroxide group used the supplied dentifrice as their sole toothpaste. The 0.12 percent chlorhexidine group used the mouthrinse twice per day. The control group performed oral hygiene as instructed. At five weeks, the 0.12 percent chlorhexidine mouthrinse significantly reduced gingival bleeding. The dentifrice and control groups revealed no statistically significant reductions. The results indicate that the 0.12 percent chlorhexidine mouthrinse is useful in improving oral health, whereas the baking soda/hydrogen peroxide dentifrice offered no advantages to conventional oral hygiene.

  19. 26 CFR 7.48-2 - Election of forty-percent method of determining investment credit for movie and television films...

    Science.gov (United States)

    2010-04-01

    ... investment credit for movie and television films placed in service in a taxable year beginning before January... Election of forty-percent method of determining investment credit for movie and television films placed in... the Tax Reform Act of 1976 (90 Stat. 1595), taxpayers who placed movie or television films (here...

  20. 20 CFR 645.213 - Who may be served as an individual in the “other eligibles” (30 percent) provision?

    Science.gov (United States)

    2010-04-01

    ... section 475(4) under part E of the Social Security Act, or (c)(1) Is a custodial parent with income below 100 percent of the poverty line, determined in accordance with the most recent HHS Poverty Guidelines... of paragraph (c)(1) of this section, income is defined as total family income for the last six months...

  1. Favorable recycling photocatalyst TiO2/CFA: Effects of loading percent of TiO2 on the structural property and photocatalytic activity

    International Nuclear Information System (INIS)

    Shi Jianwen; Chen Shaohua; Ye Zhilong; Wang Shumei; Wu Peng

    2010-01-01

    A series of photocatalysts TiO 2 /CFA were prepared using coal fly ash (CFA), waste discharged from coal-fired power plant, as substrate, and then these photocatalysts were characterized by scanning electron microscope, X-ray diffraction analysis, nitrogen adsorption test and ultraviolet-visible absorption analysis. The effects of loading percent of TiO 2 on the photocatalytic activity and re-use property of TiO 2 /CFA were evaluated by the photocatalytic decoloration and mineralization of methyl orange solution. The results show that the pore volume and the specific surface area of the TiO 2 /CFA both increased with the increase in the loading percent of TiO 2 , which improved the photocatalytic activity of TiO 2 /CFA. However, when the loading percent of TiO 2 was too high (up to 54.51%), superfluous TiO 2 was easy to break away from CFA in the course of water treatment, which was disadvantaged to the recycling property of TiO 2 /CFA. In this study, the optimal loading percent of TiO 2 was 49.97%, and the efficiencies of photocatalytic decoloration and mineralization could be maintained above 99% and 90%, respectively, when the photocatalyst was used repeatedly, without any decline, even at the sixth cycle.

  2. 29 CFR 794.130 - Not more than 25 percent of sales may be to customers engaged in bulk distribution of petroleum...

    Science.gov (United States)

    2010-07-01

    ... engaged in bulk distribution of petroleum products for resale. 794.130 Section 794.130 Labor Regulations... PETROLEUM DISTRIBUTORS UNDER SECTION 7(b)(3) OF THE FAIR LABOR STANDARDS ACT Exemption From Overtime Pay... percent of sales may be to customers engaged in bulk distribution of petroleum products for resale. As a...

  3. Prevalence of Recognised and Unrecognised Depression among Medical and Surgical Patients in a Tertiary Care Hospital

    International Nuclear Information System (INIS)

    Rahman, A. S.; Jamal, Q.; Riaz, M.

    2015-01-01

    Objective: To observe the prevalence of recognised and unrecognised depression among in-patients. Methods: The cross-sectional study was conducted from June 2012 to May 2013 at a tertiary care hospital in Karachi, and comprised patients admitted in the Medicine and Surgical departments at the time. Patients with known history of depression or on anti-depressants or on anti-psychotics, or with suicidal attempt were excluded. The prevalence of unrecognised depression was then perceived using Patient Health Qurstionnaire-9. Statistical analysis was performed using SPSS 20. Results: Of the 1180 patients, 432(36.6 percent) either had history of depression or on were on anti-depressants. The study sample, as such, comprised 748(65 percent), and of them 399(53 percent) were from the Medicine and 349(47 percent) patients were from Surgery department. Prevalence of recognised depression was 36.6 percent; 48 percent in Medical and 14 percent in Surgical patients. Unrecognised depression was 51.2 percent; 45.3 percent in Medical and 53.6 in Surgical patients. Overall prevalence was 87.9 percent; 93.4 percent in Medical and 53 percent in Surgical patients. Gender was not found to be significantly associated with depression in Medical (p= 0.367) and Surgical (p=0.606) patients. No depression was found in 48(12 percent) Medical patients and 131(37.5 percent) Surgical patients. Conclusion: More than one-third of in-patients had co-morbid depression diagnoses, mostly unrecognised by their clinicians. (author)

  4. An analysis of pretreatment characteristics and the risk of PSA failure by race and ethnicity in prostate cancer patients treated with definitive radiotherapy

    International Nuclear Information System (INIS)

    Coleman, Cardella W.; Lewis, Pamalar P.; Kroll, Stewart M.; Roach, Mack

    1997-01-01

    Purpose/Objective: This study was performed to: (1) determine the pretreatment characteristics of racially and ethnically diverse men who were treated with definitive radiotherapy for prostate cancer and; (2) to assess whether race or ethnicity is an independent prognostic factor for biochemical failure using the serum PSA (prostate specific antigen) as a marker of disease free status. Materials and Methods: Between 1987 and 1995, 505 men, (including 487 with pretreatment PSA determined), were treated with radiotherapy for adenocarcinoma of the prostate in the Department of Radiation Oncology at the UCSF or its affiliated hospitals and form the basis of this analysis. These patients were referred from local VA, County, HMO and private facilities in the Northern California Bay Area and represent a diverse group by race, ethnicity and social economic status. PSA failure was defined as a PSA >1.0 ng/ml or rises of ≥ 0.5 ng/ml in 1 year. Results: The median PSA for all patients was 11.5 ng/ml and the mean was 20.8 ng/ml. The mean Gleason score was 5.95, and was similar among treatment groups. Twenty percent of the patients were T1, 56% were T2 and 24% were T3/4. The maximum dose at depth (Dmax) was 71.5 in 42% of the patients. Seventy two men (14%) received neoadjuvant +/- adjuvant hormonal therapy combined with radiotherapy. With a median follow-up exceeding 2 years, 47% of the patients are disease free at 4 years. Major pretreatment characteristics by race or ethnicity are summarized below: On univariate analysis, the relative risk of PSA failure in Blacks compared to Whites was 1.04 (95% confidence interval, 0.72- 1.52, p = 0.82) and in others compared to Whites was 1.12 (95% confidence interval, 0.55 - 2.28, p = 0.77). On multivariate analysis, neither race nor ethnicity were independently significant predictors of outcome. For example, the relative risk of PSA failure in Blacks was 0.88 (95% confidence interval, 0.59 - 1.32, p = 0.53). Factors that influenced

  5. Comparison of seasonal variation in the fasting respiratory quotient of young Japanese, Polish and Thai women in relation to seasonal change in their percent body fat

    Directory of Open Access Journals (Sweden)

    Morinaka Tomoko

    2012-05-01

    Full Text Available Abstract Background From the viewpoint of human physiological adaptability, we previously investigated seasonal variation in the amount of unabsorbed dietary carbohydrates from the intestine after breakfast in Japanese, Polish and Thai participants. In this investigation we found that there were significant seasonal variations in the amount of unabsorbed dietary carbohydrates in Japanese and Polish participants, while we could not find significant seasonal variation in Thai participants. These facts prompted us to examine seasonal variations in the respiratory quotient after an overnight fast (an indicator of the ratio of carbohydrate and fat oxidized after the last meal with female university students living in Osaka (Japan, Poznan (Poland and Chiang Mai (Thailand. Methods We enrolled 30, 33 and 32 paid participants in Japan, Poland and Thailand, respectively, and measurements were taken over the course of one full year. Fasting respiratory quotient was measured with the participants in their postabsorptive state (after 12 hours or more fasting before respiratory quotient measurement. Respiratory quotient measurements were carried out by means of indirect calorimetry using the mixing chamber method. The percent body fat was measured using an electric bioelectrical impedance analysis scale. Food intake of the participants in Osaka and Poznan were carried out by the Food Frequency Questionnaire method. Results There were different seasonal variations in the fasting respiratory quotient values in the three different populations; with a significant seasonal variation in the fasting respiratory quotient values in Japanese participants, while those in Polish and Thai participants were non-significant. We found that there were significant seasonal changes in the percent body fat in the three populations but we could not find any significant correlation between the fasting respiratory quotient values and the percent body fat. Conclusions There were

  6. Daptomycin experience in critical care patients: results from a registry.

    Science.gov (United States)

    Brown, Jack E; Fominaya, Cory; Christensen, Keith J; McConnell, Scott A; Lamp, Kenneth C

    2012-04-01

    Vancomycin is often the drug of choice in critically ill patients with gram-positive infections, although circumstances often prevent its use. In these situations, clinicians are frequently left with limited data regarding alternative agents. To describe patients with reported sepsis receiving daptomycin in a critical care unit. This multicenter, noncomparative, noninterventional study identified patients in critical care units, using the Cubicin Outcomes Registry and Experience (CORE) 2005-2009 registry. A descriptive account of patient characteristics, infectious etiology, outcomes at the end of daptomycin therapy, and 30-day mortality is reported. Nonevaluable patients were excluded from the efficacy analysis but included in the safety analysis. We identified 128 patients, 98 (77%) of whom were evaluable for efficacy. Patient characteristics for the efficacy population were 55 (56%) males, 30 (31%) aged 66 years or older, 38 (39%) had creatinine clearance less than 30 mL/min, and 27 (28%) were on dialysis. Common underlying diseases included acute or chronic renal failure 44 (45%), hypertension 40 (41%), and diabetes 27 (28%). Seventy-two (73%) patients were bacteremic. The most common pathogens found were methicillin-resistant Staphylococcus aureus (32%), vancomycin-resistant Enterococcus faecium (21%), and coagulase-negative staphylococci (20%). Prior to daptomycin, antibiotics were used in 84 (86%) patients, most commonly vancomycin (65/84; 77%). The median (range) initial daptomycin dose was 6 mg/kg (3-10) and duration of 10 days (1-58). Overall success rate was 70% (31% cured; 39% improved). Twelve adverse events possibly related to daptomycin were reported in 9 of 128 (7%) patients in the safety population; 4 of these in 4 (3%) patients were serious. The mortality rate within 30 days of completing daptomycin was 42 of 128 (33%) patients. These data provide preliminary results on the use of daptomycin in critically ill patients with complicated conditions

  7. The daily life of patients with dementia: A comparative study between the information provided by the caregiver and direct patient assessment

    Directory of Open Access Journals (Sweden)

    Lucia Aparecida Bressan

    Full Text Available Abstract The functionality concept is very important, as the diagnosis of dementia presupposes the existence of functional impairment. Instruments assessing functional performance present some limitations. In most cases, the assessment is based on the caregiver's report. Some studies in international literature have evaluated this issue and concluded that a difference exists between the caregiver's report and direct patient assessment. American and European caregivers tend to underestimate the patient's functional limitations. However, this issue has hitherto not been investigated in our context. Objective: To compare the caregiver's information with direct assessment of the patient's performance based on the same functional assessment questionnaire. Methods: Seventy-two patients and caregivers were attended by the Occupational Therapy service of the Behavioral Neurology Outpatient Clinic between 1999 and 2001, 25 of whom fulfilled the inclusion criteria: having a confirmed diagnosis of dementia according to the DSM-IV; having attended three or more return appointments, and where the caregiver belonged to the patient's family nucleus. The remaining subjects were excluded because of non-adherence to treatment or refusal to participate in the study. The Functional Activities Questionnaire by Pfeffer et al., 1982 was applied to patients in a laboratory simulation, while another evaluator interviewed the respective caregivers. The data were analyzed based on the weighted Kappa coefficient, and Wilcoxon test. Results: There were significative differences between caregiver's answers and direct observation of the patient's performance. The information provided by the caregivers proved unreliable since caregivers underestimated the patient's functional capacity.

  8. Sphenoid Sinus Diseases: A Review of 1,442 Patients

    Directory of Open Access Journals (Sweden)

    Supranee Fooanant

    2017-01-01

    Full Text Available Objective. To review and report diseases of the sphenoid sinus from the literature and from a university hospital. Methods. Inpatients’ data were retrospectively gathered and reviewed from January 2006 to June 2016. Clinical data, imaging, organisms, and pathological reports were collected. Pathology was divided into infection/inflammation, tumor, and miscellaneous. A literature review was performed with the search term “isolated sphenoid disease” in PubMed. Original primary studies with 20 patients or more were reviewed. Results and Discussion. One hundred and twenty-two patients were enrolled. Seventy-two subjects were female (59%. The average age was 54.3 years (±18.0. Imaging abnormalities were found incidentally in 27 patients (22.1%. The most common symptom was headache (63.9%. Visual loss, the second most common symptom, was more frequent in the tumor group (30.6% versus 54.2%. From the literature review, 21 primary studies with 1,320 total patients were included. From all studies and the present study, infection/inflammation was the most common pathology (75% [95% confidence interval (CI: 0.696, 0.804]. Overall, tumors were found in 18.9% and malignant tumors in 7.0% [95% CI: 0.045, 0.095]. Conclusion. A specific diagnosis of a sphenoid lesion is needed during active investigation. Infection/inflammation was the most common pathology and malignancy was found in 7%.

  9. Low-dose intranasal versus oral midazolam for routine body MRI of claustrophobic patients

    Energy Technology Data Exchange (ETDEWEB)

    Tschirch, Frank T.C.; Goepfert, Kerstin; Brunner, Genevieve; Weishaupt, Dominik [University Hospital Zuerich, Institute of Diagnostic Radiology, Zuerich (Switzerland); Froehlich, Johannes M. [Klus-Apotheke, Zuerich (Switzerland)

    2007-06-15

    The purpose of this study was to assess prospectively the potential of low-dose intranasal midazolam compared to oral midazolam in claustrophobic patients undergoing routine body magnetic resonance imaging (MRI). Seventy-two adult claustrophobic patients referred for body MRI were randomly assigned to one of two treatment groups (TG1 and TG2). The 36 patients of TG1 received 7.5 mg midazolam orally 15 min before MRI, whereas the 36 patients of TG2 received one (or, if necessary, two) pumps of a midazolam nasal spray into each nostril immediately prior to MRI (in total, 1 or 2 mg). Patients' tolerance, anxiety and sedation were assessed using a questionnaire and a visual analogue scale immediately before and after MRI. Image quality was evaluated using a five-point-scale. In TG1, 18/36 MRI examinations (50%) had to be cancelled, the reduction of anxiety was insufficient in 12/18 remaining patients (67%). In TG2, 35/36 MRI examinations (97%) were completed successfully, without relevant adverse effects. MRI image quality was rated higher among patients of TG2 compared to TG1 (p<0.001). Low-dose intranasal midazolam is an effective and patient-friendly solution to overcome anxiety in claustrophobic patients in a broad spectrum of body MRI. Its anxiolytic effect is superior to that of the orally administrated form. (orig.)

  10. Effect of curing methods, packaging and gamma irradiation on the weight loss and dry matter percent of garlic during curing and storage

    International Nuclear Information System (INIS)

    Mahmoud, A.A.; El-Oksh, I.I.; Farag, S.E.A.

    1988-01-01

    The Egyptian garlic plants, showed higher percent of weight loss at 17 or 27 days from curing compared to those of Chinese plants. The curing period of 17 days seemed satisfactory for the Egyptian cultivar, whereas, 27 days seemed to be enough for the Chinese garlic. No significant differences were observed between common and shaded curing methods in weight loss per cent. The Chinese garlic contained higher dry matter percentage than those of the Egyptian cultivar. Shaded cured plants of the two cultivars contained higher dry matter percent than those subjected to the common curing methods. Irradiation of garlic bulbs, shaded curing method and sack packaging decreased, in general the weight loss during storage in comparison with other treatments

  11. The Influences of Percent of Tributyl Phosphate and Ratio of Feed and Solvent on the Uranium-Thorium Extraction of Thorex Process

    International Nuclear Information System (INIS)

    Setyadji, Moch; Endang Susiantini

    2002-01-01

    The investigation of uranium and thorium extraction in water phase of thorex process first cycle using tributyl phosphate diluted in kerosine as extractant has been done. The one stage extractor was used. The effects of percent of tributyl phosphate and ratio of feed and solvent on the extraction efficiency and distribution coefficients of uranium and thorium were studied. The result of experiment showed that percent of tributyl phosphate and ratio of feed and solvent very influence on the extraction efficiency and distribution coefficients of uranium and thorium. The best results were reached at about 55% of tributyl phosphate and ratio of feed and solvent was 1:3. The extraction efficiencies of uranium and thorium and distribution coefficients of uranium and thorium at the condition above were 90% , 90.4% , 9.0 and 9.4. (author)

  12. 45 CFR 284.21 - What will we do if the State's child poverty rate increased five percent or more over the two...

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false What will we do if the State's child poverty rate... IN A STATE OR TERRITORY'S CHILD POVERTY RATE IS THE RESULT OF THE TANF PROGRAM § 284.21 What will we do if the State's child poverty rate increased five percent or more over the two-year period? (a) If...

  13. Evaluating the relationship between biomass, percent groundcover and remote sensing indices across six winter cover crop fields in Maryland, United States

    Science.gov (United States)

    Prabhakara, Kusuma; Hively, W. Dean; McCarty, Gregory W.

    2015-07-01

    Winter cover crops are an essential part of managing nutrient and sediment losses from agricultural lands. Cover crops lessen sedimentation by reducing erosion, and the accumulation of nitrogen in aboveground biomass results in reduced nutrient runoff. Winter cover crops are planted in the fall and are usually terminated in early spring, making them susceptible to senescence, frost burn, and leaf yellowing due to wintertime conditions. This study sought to determine to what extent remote sensing indices are capable of accurately estimating the percent groundcover and biomass of winter cover crops, and to analyze under what critical ranges these relationships are strong and under which conditions they break down. Cover crop growth on six fields planted to barley, rye, ryegrass, triticale or wheat was measured over the 2012-2013 winter growing season. Data collection included spectral reflectance measurements, aboveground biomass, and percent groundcover. Ten vegetation indices were evaluated using surface reflectance data from a 16-band CROPSCAN sensor. Restricting analysis to sampling dates before the onset of prolonged freezing temperatures and leaf yellowing resulted in increased estimation accuracy. There was a strong relationship between the normalized difference vegetation index (NDVI) and percent groundcover (r2 = 0.93) suggesting that date restrictions effectively eliminate yellowing vegetation from analysis. The triangular vegetation index (TVI) was most accurate in estimating high ranges of biomass (r2 = 0.86), while NDVI did not experience a clustering of values in the low and medium biomass ranges but saturated in the higher range (>1500 kg/ha). The results of this study show that accounting for index saturation, senescence, and frost burn on leaves can greatly increase the accuracy of estimates of percent groundcover and biomass for winter cover crops.

  14. Diffusion Lung Capacity Changes in Hodgkin Lymphoma Patients Before and After ABVD Chemotherapy

    International Nuclear Information System (INIS)

    Abdullah, M.; Alam, S.; Majid, A.; Zafar, W.

    2016-01-01

    Background: Chemotherapy consisting of Adriamycin, Bleomycin, Vinblastine, and Doxorubicin (ABVD), which is the mainstay of treatment in Hodgkins Lymphoma (HL), is associated with both acute and long-term pulmonary toxicity primarily due to Bleomycin. Bleomycin induced pulmonary toxicity (BPT) is clinically detected using diffusing lung capacity for carbon monoxide (DLCO). The objective of this study was to evaluate changes in DLCO in HL patients before and after ABVD chemotherapy. Methods: Medical records of all adult HL patients treated with ABVD chemotherapy at a single centre in Lahore, Pakistan during the entire calendar year 2012 were analysed. Patients with pre-existing pulmonary dysfunction, history of thoracic surgery and smokers were excluded. Results: A total of 179 HL patients were identified during the study period who received ABVD chemotherapy. Out of these, 93 (51.95 percent) patients had undergone both a pre- and post-chemotherapy DLCO measurements. The remaining patients had only one DLCO reading available and were not included in the analysis. The mean percentage difference between pre- and post-chemotherapy values for DLCO (5.49 percent; 95 percent confidence interval [CI] 1.56-9.43 percent) and for Haemoglobin-adjusted DLCO (8.24 percent; 95 percent CI 3.90-12.57 percent) were statistically significant at p<0.01. Diffusing lung capacity for carbon (DLCO) values declined from pre-treatment to post-treatment by 1-10 percent in 23 (24.7 percent) patients, by 10-20 percent in 19 (20.4 percent) patients, by 20-30 percent in 10 (10.8 percent) patients and >30 percent in 10 (10.8 percent) patients. After adjusting for age, a 1mg/m/sup 2/ increase in dose of Bleomycin was significantly associated with 0.14 percent (95 percent CI: 0.03-0.25 percent) decline in DLCO and 0.13 percent (95 percent CI: 0.10-0.26 percent) decline in haemoglobin-adjusted DLCO from pre-treatment value. Conclusions: Mild to moderate dysfunction in diffusion lung capacity is

  15. The relationship between cerebral oxygen saturation changes and post operative neurologic complications in patients undergoing cardiac surgery

    International Nuclear Information System (INIS)

    Negargar, S.; Mahmoudpour, A.; Taheri, R.; Sarvin, S.

    2007-01-01

    To study the relationship between cerebral oxygen saturation changes and postoperative neurologic complications. Seventy two adult patients with ASA class II, III who were scheduled for elective cardiac surgery, were randomized into three groups: Group I: with CPB (on -pump) Group II: without CPB (off- pump) Group III: valve surgery. Neuropsychological outcome was assessed by the Mini-Mental State Examination (MMSE). Cerebral oxygen saturation was also measured. There was no statistical difference in desaturation of more than 20% among three groups (P=0.113) but it was significant between group I and II (P=0.042). Changes of rSo/sub 2/ in different hours of surgery was significant in group I and group II (P=0.0001 in both) but it was not significant in group III ( P=0.075) . Although cerebral oximetry is a noninvasive and useful method of monitoring during cardiac surgery, it has low accuracy to determine postoperative neurologic complications. (author)

  16. Flaxseed oil supplementation manipulates correlations between serum individual mol % free fatty acid levels and insulin resistance in type 2 diabetics. Insulin resistance and percent remaining pancreatic β-cell function are unaffected.

    Science.gov (United States)

    Barre, D E; Mizier-Barre, K A; Griscti, O; Hafez, K

    2016-10-01

    Elevated total serum free fatty acids (FFAs) concentrations have been suggested, controversially, to enhance insulin resistance and decrease percent remaining β-cell function. However, concentrations of individual serum FFAs have never been published in terms of their relationship (correlation) to homeostatic model assessment-insulin resistance (HOMA-IR) and percent remaining β-cell function (HOMA-%β) in the type 2 diabetics (T2Ds). Alpha-linolenic acid consumption has a negative correlation with the insulin resistance, which in turn is negatively correlated with the remaining β-cell function. The primary objective was to test the hypothesis that there would be different relationship (correlation) between the blood serum individual free FFA mol % levels and HOMA-IR and/or HOMA-%β in T2D. The secondary objective was to test the hypothesis that flaxseed oil, previously being shown to be ineffective in the glycemic control in T2Ds, may alter these correlations in a statistically significant manner as well as HOMA-IR and/or HOMA-%β. Patients were recruited via a newspaper advertisement and two physicians have been employed. All the patients came to visit one and three months later for a second visit. At the second visit, the subjects were randomly assigned (double blind) to flaxseed or safflower oil treatment for three months, until the third visit. Different statistically significant correlations or trends towards among some serum individual free FFA mol % levels and HOMA-IR and HOMA-%β, pre- and post-flaxseed and safflower oil supplementation were found. However, flaxseed oil had no impact on HOMA-IR or HOMA-%β despite statistically significant alterations in correlations compared to baseline HOMA-IR. The obtained data indicate that high doses of flaxseed oil have no statistically significant effect on HOMA-IR or HOMA-%β in T2Ds, probably due to the additive effects of negative and positive correlations.

  17. MANAGEMENT OF DIABETES MELLITUS IN DIABETIC PATIENTS: ISFAHAN. 1999

    Directory of Open Access Journals (Sweden)

    P ABAZARI

    2001-06-01

    Full Text Available Introduction. Diabetic control and its acute and chronic complications needed to investigate the characteristics medical and self care in diabetics. This evaluation can detect conflicts in this field and provide the possibility of better planning to arrive the ideal control of diabetes. Methods. This study was a cross sectional survey. Samples were 344 diabetic patients who were living in Isfahan. Data was collected by a questionnaire described diabetics contextual characteristics, position of medical services use, position of diabetic education, self blood glucose monitoring (SMBG, attendance to diet regimen and so on. Questionnaires were cmpeleted through interview. Results. Mean age of patients was 56.5±13.6 years. More than fifty percent (57.7 percent were female. More than one third (57.6 percent were illiterate. Patients had 1 to 40 years history of diabetes. More than one forth (27.4 percent did not seek medical advice and 61.2 percent had referred to physician only when they were encountering with a problem for example lack of insulin or oral hypoglycemic agents. Over eighty percent never had foot examination by their physicians. Only 7.4 percent, had heared about glycosylated hemoglubine. This test had not been accomplished for 95.9 percent of patients. 46.2 percent had not performed self foot examination till study time. More than eighty percent of interviewers had reported their lost blood glucose value above 130 mg/dl. Only ten percent of the study population had performed 5MBG. About fifty percent (45.3 percent, did not educated about diabetes. Only 26.8 percent reported that they always follow their dietary regimen. Discussion. Results of this survey showed irregular calls to physicians, poor blood glucose control, high rate of hospitalization due to acute and chronic diabetes complications, irregular blood glucose monitoring. Diabetes management needs more attention in our city.

  18. Thai dental practitioners' knowledge and attitudes regarding patients with HIV.

    Science.gov (United States)

    Rungsiyanont, Sorasun; Lam-Ubol, Aroonwan; Vacharotayangul, Piamkamon; Sappayatosok, Kraisorn

    2013-09-01

    To investigate the knowledge and attitudes of Thai dental practitioners regarding patients with HIV, a cross-sectional study using self-administered questionnaires was conducted. The questionnaires requested demographic information and included questions evaluating the knowledge and attitude of dental practitioners towards HIV. The results were analyzed using Scheffe method for multiple comparisons at the 95 percent confidence level. Out of 1,200 questionnaires sent, 446 questionnaires were returned (response rate 37.2 percent). The subjects included final (sixth)-year dental students (11.9 percent), general dentists (29.1 percent), specialist dentists (15.5 percent), dental hygienists (30.5 percent), and dental assistants (13 percent). More than 80 percent of the dental practitioners correctly answered the questions testing their basic knowledge of HIV such as routes of transmission and common opportunistic infections. However, knowledge about HIV pathogenesis, complications, and advances in HIV management was lacking. Dental hygienists and dental assistants had statistically significant lower scores in knowledge about HIV than other groups. Sixty-seven percent of dental practitioners said they feel worried when treating patients with HIV, and 20.4 percent said they would deny treatment for patients with HIV if possible. While knowledge about HIV may be adequate among dental practitioners in Thailand, greater effort should be put into emphasizing positive attitudes towards patients with HIV.

  19. Age-Specific Cutoff Value for the Application of Percent Free Prostate-Specific Antigen (PSA) in Chinese Men with Serum PSA Levels of 4.0–10.0 ng/ml

    Science.gov (United States)

    Xie, Liping; He, Dalin; Zhou, Liqun; Xu, Chuanliang; Gao, Xu; Ren, Shancheng; Wang, Fubo; Ma, Lulin; Wei, Qiang; Yin, Changjun; Tian, Ye; Sun, Zhongquan; Fu, Qiang; Ding, Qiang; Zheng, Junhua; Ye, Zhangqun; Ye, Dingwei; Xu, Danfeng; Hou, Jianquan; Xu, Kexin; Yuan, Jianlin; Gao, Xin; Liu, Chunxiao; Pan, Tiejun; Sun, Yinghao

    2015-01-01

    Objective The influence of age on the performance of percent free prostate-specific antigen (%fPSA) in diagnosing prostate cancer (PCa) in East Asians is controversial. We tested the diagnostic performance of %fPSA in a multi-center biopsy cohort in China and identified the proper age-specific cutoff values to avoid unnecessary biopsies. Methods Consecutive patients with a prostate-specific antigen (PSA) level of 4.0–10.0 ng/ml or 10.1–20.0 ng/ml who underwent transrectal ultrasound-guided or transperineal prostate biopsy were enrolled from 22 Chinese medical centers from Jan 1, 2010 to Dec 31, 2013. The diagnostic accuracy of PSA and %fPSA was determined using the area under the receiver operating characteristic (ROC) curve (AUC). Age-specific cutoff values were calculated using ROC curve analysis. Results The median %fPSA was much lower in younger patients compared with older patients with a PSA level of 4.0–10.0 ng/ml or 10.1–20.0 ng/ml. The AUC of %fPSA was higher than PSA only in older patients. In patients aged 50 to 59 years, %fPSA failed to improve the diagnosis compared with PSA in these two PSA ranges. Age-specific cutoff values were 24%, 27% and 32% for patients aged 60–69, 70–79 and ≥80 years, respectively, to reduce unnecessary biopsies in men with PSA levels of 4.0–10.0 ng/ml to detect 90% of all PCa. Conclusions The effectiveness of %fPSA is correlated with age in the Chinese population. Age-specific cutoff values would help avoid unnecessary biopsies in the Chinese population. PMID:26091007

  20. Study design and percent recoveries of anthropogenic organic compounds with and without the addition of ascorbic acid to preserve water samples containing free chlorine, 2004-06

    Science.gov (United States)

    Valder, Joshua F.; Delzer, Gregory C.; Price, Curtis V.; Sandstrom, Mark W.

    2008-01-01

    The National Water-Quality Assessment (NAWQA) Program of the U.S. Geological Survey (USGS) began implementing Source Water-Quality Assessments (SWQAs) in 2002 that focus on characterizing the quality of source water and finished water of aquifers and major rivers used by some of the larger community water systems in the United States. As used for SWQA studies, source water is the raw (ambient) water collected at the supply well prior to water treatment (for ground water) or the raw (ambient) water collected from the river near the intake (for surface water). Finished water is the water that is treated, which typically involves, in part, the addition of chlorine or other disinfection chemicals to remove pathogens, and is ready to be delivered to consumers. Finished water is collected before the water enters the distribution system. This report describes the study design and percent recoveries of anthropogenic organic compounds (AOCs) with and without the addition of ascorbic acid to preserve water samples containing free chlorine. The percent recoveries were determined by using analytical results from a laboratory study conducted in 2004 by the USGS's National Water Quality Laboratory (NWQL) and from data collected during 2004-06 for a field study currently (2008) being conducted by the USGS's NAWQA Program. The laboratory study was designed to determine if preserving samples with ascorbic acid (quenching samples) adversely affects analytical performance under controlled conditions. During the laboratory study, eight samples of reagent water were spiked for each of five analytical schedules evaluated. Percent recoveries from these samples were then compared in two ways: (1) four quenched reagent spiked samples analyzed on day 0 were compared with four quenched reagent spiked samples analyzed on day 7 or 14, and (2) the combined eight quenched reagent spiked samples analyzed on day 0, 7, or 14 were compared with eight laboratory reagent spikes (LRSs). Percent

  1. The pharmacists' role in improving guideline compliance for thyroid function testing in patients with heart failure.

    Science.gov (United States)

    Ziman, Melanie E; Bui, Hien T; Smith, Craig S; Tsukiji, Lori A; Asmatey, Veda M; Chu, Steven B; Miano, John S

    2012-04-01

    This single-center retrospective pilot program's objective was to utilize outpatient pharmacists to improve laboratory test adherence in chronic heart failure (CHF) patients overdue for thyroid function testing, thereby demonstrating the value of the outpatient pharmacist and justifying possible clinical role expansion. Thyroid disorders may contribute to CHF development, progression, and exacerbation. Testing is the standard of care in CHF patients per American Heart Association's 2009 Guidelines. Delinquency was defined as labs not conducted within 1 year in patients with euthyroid history, within 6 months in patients with thyroid dysfunction, abnormal labs at any time without follow-up, or lab absence after thyroid medication initiation, adjustment, or discontinuation. Targeted 80 nonpregnant adult CHF patients with delinquent thyroid function tests were counseled to get thyroid labs at point of sale, via telephone, e-mail, or letter. In collaboration with physicians, pharmacists ordered thyroid-stimulating hormone (TSH) and free T4 (FT4) labs. For patients with abnormal laboratory results, pharmacists coordinated drug therapy and follow-up labs. Data were collected from November 1, 2009 to March 30, 2010. Seventy-two patients (90%) previously delinquent for thyroid function testing received relevant thyroid labs. Ten patients (12.5%) with abnormal thyroid function tests not on prior drug therapy received treatment.

  2. ROE Carbon Storage - Percent Change

    Data.gov (United States)

    U.S. Environmental Protection Agency — This polygon dataset depicts the percentage change in the amount of carbon stored in forests in counties across the United States, based on the difference in carbon...

  3. The 1 Percent Under Siege?

    DEFF Research Database (Denmark)

    Harrington, Brooke

    2016-01-01

    By exposing the sheer scale of offshore finance, the Panama Papers have re-fuelled global resentment towards tax-avoiding elites. Are the rich immoral?......By exposing the sheer scale of offshore finance, the Panama Papers have re-fuelled global resentment towards tax-avoiding elites. Are the rich immoral?...

  4. Percent Forest Adjacent to Streams

    Data.gov (United States)

    U.S. Environmental Protection Agency — The type of vegetation along a stream influences the water quality in the stream. Intact buffer strips of natural vegetation along streams tend to intercept...

  5. Percent Agriculture Adjacent to Streams

    Data.gov (United States)

    U.S. Environmental Protection Agency — The type of vegetation along a stream influences the water quality in the stream. Intact buffer strips of natural vegetation along streams tend to intercept...

  6. Caregiver reports of patient-initiated violence in psychosis.

    Science.gov (United States)

    Onwumere, Juliana; Grice, Sarah; Garety, Philippa; Bebbington, Paul; Dunn, Graham; Freeman, Daniel; Fowler, David; Kuipers, Elizabeth

    2014-07-01

    Aggressive behaviour in psychosis is not uncommon. Community provision for people with psychosis has left informal caregivers to take on a greater role in their care. However, few studies have explored links between patient-initiated violence in mental health caregiving relationships and caregiver functioning. Our study investigated caregiver reports of aggressive acts committed by their relative with psychosis and their links to caregiver appraisals of the caregiving relationship and caregiver outcomes. Caregivers of patients with a recent relapse of psychosis, recruited to a psychological therapy trial, completed the audiotaped Camberwell Family Interview at baseline. This semi-structured interview includes questions on the quality of the relationship between caregiver and patient, and patient history of violence. Seventy-two transcripts of interviews were assessed for reports of patient-initiated violence. One-half of the caregiver sample (52.9%) reported an incident of patient-initiated violence during their interview; 62.2% of these involved violence toward themselves, and 24.3% toward property. Reports of patient violence were associated with caregiver ratings of hostility expressed toward patients, lower self-esteem, and emotion-focused coping. People caring on their own were more likely to report incidents of patient violence. Younger patients, males, and inpatients were more frequently identified as having a history of this kind of violence. Our findings suggested that caregiver reports of patient-initiated violence in psychosis are not uncommon. Mental health staff need to be aware of the risks of such violence for caregivers of people with psychosis, and consider appropriate procedures for minimizing it.

  7. Body Mass Index, percent body fat, and regional body fat distribution in relation to leptin concentrations in healthy, non-smoking postmenopausal women in a feeding study

    Directory of Open Access Journals (Sweden)

    Campbell William

    2007-01-01

    Full Text Available Abstract Background The relationship between BMI and leptin has been studied extensively in the past, but previous reports in postmenopausal women have not been conducted under carefully controlled dietary conditions of weight maintenance using precise measures of body fat distribution. The aim of the present study was to examine the association between serum leptin concentration and adiposity as estimated by BMI and dual energy x-ray absorptiometry (DEXA measures (percent body fat, central and peripheral fat, and lean mass in postmenopausal women. Methods This study was conducted as a cross-sectional analysis within the control segment of a randomized, crossover trial in which postmenopausal women (n = 51 consumed 0 (control, 15 (one drink, and 30 (two drinks g alcohol (ethanol/d for 8 weeks as part of a controlled diet. BMIs were determined and DEXA scans were administered to the women during the 0 g alcohol treatment, and a blood sample was collected at baseline and week 8 of each study period for leptin analysis. Results and discussion In multivariate analysis, women who were overweight (BMI > 25 to ≤ 30 kg/m2 had a 2-fold increase, and obese women (BMI > 30 kg/m2 had more than a 3-fold increase in serum leptin concentrations compared to normal weight (BMI ≤25 kg/m2 women. When the models for the different measures of adiposity were assessed by multiple R2, models which included percent body fat explained the highest proportion (approximately 80% of the serum leptin variance. Conclusion Under carefully controlled dietary conditions, we confirm that higher levels of adiposity were associated with higher concentrations of serum leptin. It appears that percent body fat in postmenopausal women may be the best adiposity-related predictor of serum leptin.

  8. Celiac Disease and Drug-Based Therapies: Inquiry into Patients Demands.

    Science.gov (United States)

    Branchi, Federica; Tomba, Carolina; Ferretti, Francesca; Norsa, Lorenzo; Roncoroni, Leda; Bardella, Maria Teresa; Conte, Dario; Elli, Luca

    2016-01-01

    Medical research is looking for alternative drug-based options to the gluten-free diet (GFD) for celiac disease. We aimed at evaluating the need for alternative therapies perceived by celiac patients. During the 2013 meeting of the Lombardy section of the Italian Celiac Patients Association, adult subjects were invited to fill in a questionnaire investigating their clinical profile in relation to compliance to the diet, quality of life (QOL) as well as their opinion on alternative therapies. Three hundred and seventy two patients (76 m, mean age 41.7 ± 13.9 years) completed the questionnaire. Patients reported a significant improvement in health status (HS) and QOL after the diet was started (p < 0.001). The GFD was accepted by 88% patients, but the need for alternative therapies was reported by 65%. Subjects expressing the need for a drug-based therapy showed a lower increase in QOL (p = 0.003) and HS (p = 0.005) on GFD. The preferred option for an alternative therapy was the use of enzymes (145 subjects), followed by a vaccine (111 subjects). The GFD is favorably accepted by most celiac patients. Nevertheless, a proportion of patients pronounce themselves in favor of the development of alternative drugs. © 2016 S. Karger AG, Basel.

  9. Experience in thyroid scintigraphy with Ethiopian patients

    International Nuclear Information System (INIS)

    Demena, Solomon

    1993-01-01

    One thousand and thirty seven thyroid scintigraphy examinations done in the Nuclear Medicine Unit of Tikur Anbesma Hospital, Addis Abeba, Ethiopia between December 1984 and September 1989 were analyzed to assess their diagnostic value. Thirty one percent of the referrals were to investigate clinically detectable solitary nodules, and of these fifty-six percent had ''cold'' nodules and twenty-three percent ''hot'' nodules. Fifty-five percent of the referrals for evaluation of goitre were for multi nodular goitres and twelve percent for diffuse. Thirteen of fifty-three cases with suspected ectopic thyroid tissue were positive. Little useful information was obtained in the evaluation of goitre. It is concluded that thyroid scintigraphy was an unnecessary investigation in the evaluation of goitres in euthyroid patients. Its primary role was in the investigation of the solitary nodule, ectopic thyroid tissue and the retresternal goitre. Therefore, only selected patients should be investigated with thyroid scintigraphy

  10. The analysis of 14.8 percent cold leg break without the application of hydroaccumulators in the PMK-NHV test facility

    International Nuclear Information System (INIS)

    Szabados, L.; Ezsoel, Gy.; Perneczky, L.

    1990-12-01

    A series of reactor safety tests have been performed in the experimental reactor simulation facility PMK-NHV of the Paks Nuclear Power Plant, Hungary, with and without the use of hydroaccumulator (SIT) operation. 14.8 percent cold leg break simulation experiments are reported without SITs in action, and the measurement results were analyzed using the RELAP5/mod2 computer code. The description of the experiment is followed by the parameter variations and their analysis, together with an interpretation of the measurement results. The lessons from the LOCA simulation tests are evaluated. (R.P.) 10 refs.; 48 figs.; 3 tabs

  11. Genome-Wide Study of Percent Emphysema on Computed Tomography in the General Population. The Multi-Ethnic Study of Atherosclerosis Lung/SNP Health Association Resource Study

    Science.gov (United States)

    Manichaikul, Ani; Hoffman, Eric A.; Smolonska, Joanna; Gao, Wei; Cho, Michael H.; Baumhauer, Heather; Budoff, Matthew; Austin, John H. M.; Washko, George R.; Carr, J. Jeffrey; Kaufman, Joel D.; Pottinger, Tess; Powell, Charles A.; Wijmenga, Cisca; Zanen, Pieter; Groen, Harry J. M.; Postma, Dirkje S.; Wanner, Adam; Rouhani, Farshid N.; Brantly, Mark L.; Powell, Rhea; Smith, Benjamin M.; Rabinowitz, Dan; Raffel, Leslie J.; Hinckley Stukovsky, Karen D.; Crapo, James D.; Beaty, Terri H.; Hokanson, John E.; Silverman, Edwin K.; Dupuis, Josée; O’Connor, George T.; Boezen, H. Marike; Rich, Stephen S.

    2014-01-01

    Rationale: Pulmonary emphysema overlaps partially with spirometrically defined chronic obstructive pulmonary disease and is heritable, with moderately high familial clustering. Objectives: To complete a genome-wide association study (GWAS) for the percentage of emphysema-like lung on computed tomography in the Multi-Ethnic Study of Atherosclerosis (MESA) Lung/SNP Health Association Resource (SHARe) Study, a large, population-based cohort in the United States. Methods: We determined percent emphysema and upper-lower lobe ratio in emphysema defined by lung regions less than −950 HU on cardiac scans. Genetic analyses were reported combined across four race/ethnic groups: non-Hispanic white (n = 2,587), African American (n = 2,510), Hispanic (n = 2,113), and Chinese (n = 704) and stratified by race and ethnicity. Measurements and Main Results: Among 7,914 participants, we identified regions at genome-wide significance for percent emphysema in or near SNRPF (rs7957346; P = 2.2 × 10−8) and PPT2 (rs10947233; P = 3.2 × 10−8), both of which replicated in an additional 6,023 individuals of European ancestry. Both single-nucleotide polymorphisms were previously implicated as genes influencing lung function, and analyses including lung function revealed independent associations for percent emphysema. Among Hispanics, we identified a genetic locus for upper-lower lobe ratio near the α-mannosidase–related gene MAN2B1 (rs10411619; P = 1.1 × 10−9; minor allele frequency [MAF], 4.4%). Among Chinese, we identified single-nucleotide polymorphisms associated with upper-lower lobe ratio near DHX15 (rs7698250; P = 1.8 × 10−10; MAF, 2.7%) and MGAT5B (rs7221059; P = 2.7 × 10−8; MAF, 2.6%), which acts on α-linked mannose. Among African Americans, a locus near a third α-mannosidase–related gene, MAN1C1 (rs12130495; P = 9.9 × 10−6; MAF, 13.3%) was associated with percent emphysema. Conclusions: Our results suggest that some genes previously identified as

  12. Winter ecology of the Porcupine caribou herd, Yukon: Part III, Role of day length in determining activity pattern and estimating percent lying

    Directory of Open Access Journals (Sweden)

    D. E. Russell

    1986-06-01

    Full Text Available Data on the activity pattern, proportion of time spent lying and the length of active and lying periods in winter are presented from a 3 year study on the Porcupine caribou herd. Animals were most active at sunrise and sunset resulting in from one (late fall, early and mid winter to two (early fall and late winter to three (spring intervening lying periods. Mean active/lying cycle length decreased from late fall (298 mm to early winter (238 min, increased to a peak in mid winter (340 min then declined in late winter (305 min and again in spring (240 min. Mean length of the lying period increased throughout the 3 winter months from 56 min m early winter to 114 min in mid winter and 153 min in late winter. The percent of the day animals spent lying decreased from fall to early winter, increased throughout the winter and declined in spring. This pattern was related, in part, to day length and was used to compare percent lying among herds. The relationship is suggested to be a means of comparing quality of winter ranges.

  13. Percent free prostate-specific antigen is effective to predict prostate biopsy outcome in Chinese men with prostate-specific antigen between 10.1 and 20.0 ng ml−1

    Science.gov (United States)

    Chen, Rui; Zhou, Li-Qun; Cai, Xiao-Bing; Xie, Li-Ping; Huang, Yi-Ran; He, Da-Lin; Gao, Xu; Xu, Chuan-Liang; Ding, Qiang; Wei, Qiang; Yin, Chang-Jun; Ren, Shan-Cheng; Wang, Fu-Bo; Tian, Ye; Sun, Zhong-Quan; Fu, Qiang; Ma, Lu-Lin; Zheng, Jun-Hua; Ye, Zhang-Qun; Ye, Ding-Wei; Xu, Dan-Feng; Hou, Jian-Quan; Xu, Ke-Xin; Yuan, Jian-Lin; Gao, Xin; Liu, Chun-Xiao; Pan, Tie-Jun; Sun, Ying-Hao

    2015-01-01

    Percent free prostatic-specific antigen (%fPSA) has been introduced as a tool to avoid unnecessary biopsies in patients with a serum PSA level of 4.0–10.0 ng ml−1, however, it remains controversial whether %fPSA is effective in PSA range of 10.1–20.0 ng ml−1 in both Chinese and Western population. In this study, the diagnostic performance of %fPSA and serum PSA in predicting prostate cancer (PCa) and high-grade PCa (HGPCa) was analyzed in a multi-center biopsy cohort of 5915 consecutive Chinese patients who underwent prostate biopsy in 22 hospitals across China from January 1, 2010 to December 31, 2013. The indication for biopsy was PSA>4.0 ng ml−1 or/and suspicious digital rectal examination. Total and free serum PSA determinations were performed by three types of electrochemiluminescence immunoassays with recalibration to the World Health Organization standards. The diagnostics accuracy of PSA, %fPSA and %fPSA in combination with PSA (%fPSA + PSA) was determined by the area under the receivers operating characteristic curve (AUC). %fPSA was more effective than PSA in men aged ≥60 years old. The AUC was 0.584 and 0.635 in men aged ≥60 years old with a PSA of 4.0–10.0 ng ml−1 and 10.1–20.0 ng ml−1, respectively. The AUC of %fPSA was superior to that of PSA in predicting HGPCa in patients ≥60 years old in these two PSA range. Our results indicated that %fPSA is both statistically effective and clinical applicable to predict prostate biopsy outcome in Chinese patients aged ≥60 years old with a PSA of 4.0–10.0 ng ml−1 and 10.1–20.0 ng ml−1. PMID:25926603

  14. Percent free prostate-specific antigen is effective to predict prostate biopsy outcome in Chinese men with prostate-specific antigen between 10.1 and 20.0 ng ml(-1).

    Science.gov (United States)

    Chen, Rui; Zhou, Li-Qun; Cai, Xiao-Bing; Xie, Li-Ping; Huang, Yi-Ran; He, Da-Lin; Gao, Xu; Xu, Chuan-Liang; Ding, Qiang; Wei, Qiang; Yin, Chang-Jun; Ren, Shan-Cheng; Wang, Fu-Bo; Tian, Ye; Sun, Zhong-Quan; Fu, Qiang; Ma, Lu-Lin; Zheng, Jun-Hua; Ye, Zhang-Qun; Ye, Ding-Wei; Xu, Dan-Feng; Hou, Jian-Quan; Xu, Ke-Xin; Yuan, Jian-Lin; Gao, Xin; Liu, Chun-Xiao; Pan, Tie-Jun; Sun, Ying-Hao

    2015-01-01

    Percent free prostatic-specific antigen (%fPSA) has been introduced as a tool to avoid unnecessary biopsies in patients with a serum PSA level of 4.0-10.0 ng ml-1 , however, it remains controversial whether %fPSA is effective in PSA range of 10.1-20.0 ng ml-1 in both Chinese and Western population. In this study, the diagnostic performance of %fPSA and serum PSA in predicting prostate cancer (PCa) and high-grade PCa (HGPCa) was analyzed in a multi-center biopsy cohort of 5915 consecutive Chinese patients who underwent prostate biopsy in 22 hospitals across China from January 1, 2010 to December 31, 2013. The indication for biopsy was PSA>4.0 ng ml-1 or/and suspicious digital rectal examination. Total and free serum PSA determinations were performed by three types of electrochemiluminescence immunoassays with recalibration to the World Health Organization standards. The diagnostics accuracy of PSA, %fPSA and %fPSA in combination with PSA (%fPSA + PSA) was determined by the area under the receivers operating characteristic curve (AUC). %fPSA was more effective than PSA in men aged ≥60 years old. The AUC was 0.584 and 0.635 in men aged ≥60 years old with a PSA of 4.0-10.0 ng ml-1 and 10.1-20.0 ng ml-1 , respectively. The AUC of %fPSA was superior to that of PSA in predicting HGPCa in patients ≥60 years old in these two PSA range. Our results indicated that %fPSA is both statistically effective and clinical applicable to predict prostate biopsy outcome in Chinese patients aged ≥60 years old with a PSA of 4.0-10.0 ng ml-1 and 10.1-20.0 ng ml-1 .

  15. Pain Control In Cancer Patients By Opiate Use

    Directory of Open Access Journals (Sweden)

    Mohagheghi M A

    2003-07-01

    Full Text Available Opioids are increasingly being recognized as the primary treatment for cancer pain management. Optimal treatment of cancer pain involves assessing its characteristics, considering different management strategies, evaluating side effects and adverse drug reactions and establishing the most appropriate therapeutic regimen. This study was designed to review the current status of pain management for advanced cancer cases using opioid analgesics."nMaterials and Methods: A questionnaire was used to collect data on demographics, disease characteristics, and opioids use indicators in 700 cases of advanced cancer patients."nResults: A total of 700 cancer cases, 42 percent females and 58 percent males, between 17-80 years age range (Mean age of 57.25 were studied retrospectively. Cancers of breast (21 percent, colorectal (12 percent, lung (7 percent, stomach (7 percent and bone either primary or metastatic (6 percent in women and stomach (17 percent, lung (12 percent, colorectal (11 percent, prostate (9 percent , and bone (8 percent in men were the most common causes of opioids prescription in study group respectively. Advanced primary cancer (in 52 percent, bone metastasis (in 32 percent, and treatment complications (in 7 percent were considered as physical basis for pain in patients. Morphine (by injection, Opium (by oral intake and methadone (injection and/or oral were the most common opioids prescribed. Using equianalgesic conversion chart, the daily dosages and therapeutics schedules of morphine administration were as follows:"n43 percent received 21-30 mg. in 2-4 divided doses"n27 percent received >30 mg. in 3-5 divided doses"n21 percent received 11-20 mg. in 2-3 divided doses"n9 percent received 5-10 mg. in 1-2 divided doses"nConclusion: Pain management of cancer patients is not adequate and opioid use is not rational. New educational and managerial strategies are needed to optimize cancer pain treatment in routine medical practice. To overcome

  16. Diffusion-weighted MR imaging of kidneys in patients with chronic kidney disease: initial study

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Xueqin; Fang, Wenqiang; Ling, Huawei; Chai, Weimin; Chen, Kemin [Ruijin Hospital Shanghai, Jiaotong University School of Medicine, Department of Radiology, Shanghai (China)

    2010-04-15

    To prospectively evaluate the feasibility of diffusion-weighted (DW) magnetic resonance (MR) imaging in the assessment of renal function in patients with chronic kidney disease (CKD). Seventy-two healthy volunteers and 43 patients underwent coronal echo-planar DW MR imaging of the kidneys with a single breath-hold time of 16 s. The patients were grouped according to five stages as indicated by the K/DOQI CKD (kidney disease outcome quality initiative). The apparent diffusion coefficient (ADC) value of the kidneys was calculated with high b values (b = 500 s/mm{sup 2}). The ADC values were compared between patients and healthy volunteers, and among different stages. For statistical analysis, Student's t tests, ANOVA, Pearson's correlation tests, and Spearman's correlation tests were used. No difference between the cortex and medulla could be observed on DW images of all volunteers. Patients with CKD had significantly lower renal ADC (t = -4.383, P = 0.000) than volunteers. The ADC values of kidneys were significantly lower than normal at most stages of CKD, except CKD1. There was a negative correlation between the ADCs and serum creatinine (sCr) level (P = 0.000) amongst the patients. Diffusion-weighted MR imaging is feasible in the assessment of renal function, especially in the detection of early stage renal failure of CKD. (orig.)

  17. Diffusion-weighted MR imaging of kidneys in patients with chronic kidney disease: initial study

    International Nuclear Information System (INIS)

    Xu, Xueqin; Fang, Wenqiang; Ling, Huawei; Chai, Weimin; Chen, Kemin

    2010-01-01

    To prospectively evaluate the feasibility of diffusion-weighted (DW) magnetic resonance (MR) imaging in the assessment of renal function in patients with chronic kidney disease (CKD). Seventy-two healthy volunteers and 43 patients underwent coronal echo-planar DW MR imaging of the kidneys with a single breath-hold time of 16 s. The patients were grouped according to five stages as indicated by the K/DOQI CKD (kidney disease outcome quality initiative). The apparent diffusion coefficient (ADC) value of the kidneys was calculated with high b values (b = 500 s/mm 2 ). The ADC values were compared between patients and healthy volunteers, and among different stages. For statistical analysis, Student's t tests, ANOVA, Pearson's correlation tests, and Spearman's correlation tests were used. No difference between the cortex and medulla could be observed on DW images of all volunteers. Patients with CKD had significantly lower renal ADC (t = -4.383, P = 0.000) than volunteers. The ADC values of kidneys were significantly lower than normal at most stages of CKD, except CKD1. There was a negative correlation between the ADCs and serum creatinine (sCr) level (P = 0.000) amongst the patients. Diffusion-weighted MR imaging is feasible in the assessment of renal function, especially in the detection of early stage renal failure of CKD. (orig.)

  18. Gender determines cortisol and alpha-amylase responses to acute physical and psychosocial stress in patients with borderline personality disorder.

    Science.gov (United States)

    Inoue, Ayako; Oshita, Harumi; Maruyama, Yoshihiro; Tanaka, Yoshihiro; Ishitobi, Yoshinobu; Kawano, Aimi; Ikeda, Rie; Ando, Tomoko; Aizawa, Saeko; Masuda, Koji; Higuma, Haruka; Kanehisa, Masayuki; Ninomiya, Taiga; Akiyoshi, Jotaro

    2015-07-30

    Borderline personality disorder (BPD) is characterized by affective instability, unstable relationships, and identity disturbance. We measured salivary alpha-amylase (sAA) and salivary cortisol levels in all participants during exposure to the Trier Social Stress Test (TSST) and an electric stimulation stress. Seventy-two BPD patients were compared with 377 age- and gender- matched controls. The State and Trait versions of the Spielberger Anxiety Inventory test (STAI-S and STAI-T, respectively), the Profile of Mood State (POMS) tests, and the Beck Depression Inventory (BDI), the Depression and Anxiety Cognition Scale (DACS) were administered to participants before electrical stimulation. Following TSST exposure, salivary cortisol levels significantly decreased in female patients and significantly increased in male patients compared with controls. POMS tension-anxiety, depression-dejection, anger-hostility, fatigue, and confusion scores were significantly increased in BPD patients compared with controls. In contrast, vigor scores were significantly decreased in BPD patients relative to controls. Furthermore, STAI-T and STAI-S anxiety scores and BDI scores were significantly increased in BPD patient compared with controls. DACS scores were significantly increased in BPD patient compared with controls. Different stressors (e.g., psychological or physical) induced different responses in the HPA and SAM systems in female or male BPD patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. [Care for immigrant patients: facts and professionals' perception in 6 primary health care zones in Navarre].

    Science.gov (United States)

    Fuertes Goñi, Maria Carmen; Elizalde, L; De Andrés, M R; García Castellano, P; Urmeneta, S; Uribe, J M; Bustince, P

    2010-01-01

    To describe utilisation of health care services and motives for consultation in Primary Care in the native and the immigrant population, and compare this with the perception of primary care professionals. Data was collected on health care activity during the year 2006 for all people registered (N=86,966) in the 6 basic health care zones with the highest proportion of immigrants (14.4%) and on the following variables: country of origin, age, sex, year of inscription in the public health service. The health card and OMI-AP programme databases were used. A qualitative methodology of focus groups and in-depth interviews was employed. Seventy-two point four percent of immigrants requested care from the primary care professionals in 2006, of whom 50% proceeded from Ecuador and 70% were between 25 and 44 years old. Eighty-two percent of the natives made consultations and required more referrals to specialised care than the immigrants of the same age group. The most frequent consultation with natives and with immigrants was "acute respiratory infections" (7 to 23% according to age group). The second most frequent with immigrants was "administrative problems". The consultations with immigrants were not related to preventive aspects such as smoking and there were more consultations (p>0.001) for gynaeco-obstetric episodes (10.7%) and those related to work (19%) or psychosomatic problems (8.5%). The perception of the primary care professionals was that the immigrants carry out more consultations than the natives and generate a certain "disorder" in the clinic. Immigrants use healthcare services less than the native population. Nonetheless, this fact is not perceived in this way by the primary care professionals. Fewer preventive activities are carried out with immigrants, who suffer from more labour and psychosomatic problems.

  20. A study of high alpha dynamics and flow visualization for a 2.5-percent model of the F-18 HARV undergoing wing rock

    Science.gov (United States)

    Quast, Thomas; Nelson, Robert C.; Fisher, David F.

    1991-01-01

    Free-to-roll experiments and flow visualization studies have been conducted for a 2.5-percent model of the F-18 undergoing unsteady wing rock oscillations. Data have been acquired in the form of roll angle time histories as well as video recordings and 35 mm photography of the forebody and leading edge extension vortices. The time histories were differentiated to produce angular velocity and angular acceleration. From this the roll moment as a function of time and/or roll angle could be estimated. A thorough analysis of the data has revealed a genuine wing-rock phenomenon. Off-surface flow visualization was used to identiify the forebody and LEX vortex core positions and their interaction in both static and dynamic configurations. A direct correlation between the dynamic data and visualized vortex activity during the wing-rock motion has been made.

  1. Poppet valve control of throat stability bypass to increase stable airflow range of a Mach 2.5. inlet with 60 percent internal contraction

    Science.gov (United States)

    Mitchell, G. A.; Sanders, B. W.

    1975-01-01

    The throat of a Mach 2.5 inlet with a coldpipe termination was fitted with a stability-bypass system. System variations included several stability bypass entrance configurations. Poppet valves controlled the bypass airflow. The inlet stable airflow range achieved with each configuration was determined for both steady state conditions and internal pulse transients. Results are compared with those obtained without a stability bypass system. Transient results were also obtained for the inlet with a choke point at the diffuser exit and for the inlet with large and small stability bypass plenum volumes. Poppet valves at the stability bypass exit provided the inlet with a stable airflow range of 20 percent or greater at all static and transient conditions.

  2. Abnormal histopathology, fat percent and hepatic apolipoprotein A I and apolipoprotein B100 mRNA expression in fatty liver hemorrhagic syndrome and their improvement by soybean lecithin.

    Science.gov (United States)

    Song, Yalu; Ruan, Jiming; Luo, Junrong; Wang, Tiancheng; Yang, Fei; Cao, Huabin; Huang, Jianzhen; Hu, Guoliang

    2017-10-01

    To investigate the etiopathogenesis of fatty liver hemorrhagic syndrome (FLHS) and the protective effects of soybean lecithin against FLHS in laying hens, 135 healthy 300-day-old Hyline laying hens were randomly divided into groups: control (group 1), diseased (group 2), and protected (group 3). Each group contained 45 layers with 3 replicates. The birds in these 3 groups were fed a control diet, a high-energy/low-protein (HELP) diet or the HELP diet supplemented with 3% soybean lecithin instead of maize. The fat percent in the liver was calculated. Histopathological changes in the liver were determined by staining, and the mRNA expression levels of apolipoproteinA I (apoA I) and apolipoprotein B100 (apoB100) in the liver were determined by RT-PCR. The results showed that the fat percent in the liver of group 2 was much higher (P steatosis in the liver cell on d 30 and 60. The mRNA expression levels of apoA I and apoB100 in the livers were variable throughout the experiment. The expression level of apoA I in group 2 significantly decreased on d 60 (P < 0.05); the expression level of apoB100 slightly increased on d 30 in group 2, while it sharply decreased on d 60. Compared to group 1, the expression level of apoB100 showed no significant difference in group 3 (P < 0.05). This study indicated that FLHS induced pathological changes and abnormal expression of apoA I and apoB100 in the livers of laying hens and that soybean lecithin alleviated these abnormal changes. © 2017 Poultry Science Association Inc.

  3. Prostate-specific antigen density values among patients with symptomatic prostatic enlargement in Nigeria.

    Science.gov (United States)

    Udeh, Emeka I; Nnabugwu, Ikenna I; Ozoemena, Francis O; Ugwumba, Fred O; Aderibigbe, Adesina S O; Ohayi, Samuel R; Echetabu, Kevin N

    2016-06-29

    This study aims to estimate the prostate-specific antigen density (PSAD) cutoff level for detecting prostate cancer (CAP) in Nigerian men with "grey zone PSA" (4-10 ng/ml) and normal digital rectal examination findings. We addressed this research question: Is the international PSAD cutoff of 0.15 ideal for detecting CAP in our symptomatic patients with "grey zone PSA?" To estimate the prostate-specific antigen density (PSAD) cutoff level for detecting CAP in Nigerian men with "grey zone PSA" (4-10 ng/ml) and normal digital rectal examination findings. Prospective. A tertiary medical center in Enugu, Nigeria. Two hundred and fifty-four men with either benign prostatic hyperplasia (BPH) or CAP were recruited. Patients with PSA above 4 ng/ml or abnormal digital rectal examination or hypoechoic lesion in the prostate were biopsied. PSAD and histology report of BPH or CAP. Ninety-seven patients had CAP while 157 had benign prostatic hyperplasia (BPH). Seventy-two patients had their serum PSA value within the range of 4.0 and 10 ng/ml. PSAD cutoff level to detect CAP was 0.04 (sensitivity 95.88 %; specificity 28.7 %). The PSAD cutoff level generated for Nigerian men in this study is 0.04 which is relatively different from international consensus. This PSAD cutoff level has a positive correlation with histology and could detect patients with CAP who have "grey zone PSA."

  4. Clinical pathological characteristics of systemic lupus erythematosus patients presenting at a tertiary care hospital - a single centre study

    International Nuclear Information System (INIS)

    Shiram, S.A.; Ahmed, M.; Nisar, S.

    2018-01-01

    Objective: To determine the frequency of clinopathological characteristics of systemic lupus erythematosus (SLE) patients presenting to Military Hospital (MH) Rawalpindi. Study Design: Descriptive cross sectional study. Place and Duration of Study: The study was carried out at MH Rawalpindi, from Jan 2011 to Dec 2013. Material and Methods: All patients presenting to Rheumatology department, MH Rawalpindi with a diagnosis of SLE were included in this study. Presenting features, clinical profile and laboratory parameters of patients were recorded. Results: A total of 76 patients were included in this study, 70 (92.1%) were females and 6 (7.9%) male patients with female- male ratio of 11.6:1. Mean age at presentation was 33 ± 8.31 years. Seventy two patients (94.7%) were anti nuclear antibody (ANA) positive, 63 (83%) were positive for anti-double stranded deoxyribonucleic acid (anti-dsDNA) antibody and 6 (7.9%) were anti Smith positive. Seventy (92.1%) patients had musculoskeletal symptoms, 65 patients (85.5%) had fever, 36 (47.4%) patients had cutaneous symptoms, and 20 patients (26.3%) had oral ulcers. About 13 patients (17.1%) had alopecia and 15 patients (19.7%) had serositis. Forty two patients (55.3%) had nephritis, 20 patients (26.3%) had lupus cerebritis, 57 patients (75%) had hematological involvement, 9 patients (11.83%) had pulmonary involvement, 8 patients (10.5%) had rheumatoid arthritis (RA) factor positive and 7 patients (9.2%) had overlap syndrome. Conclusion: Renal and hematological involvement was more common in this study population while mucocutaneous features and neuropsychiatric features were comparable to many local studies with exception to that of Lahore based study that showed much higher percentage of these features. These results reflect the need to have a high index of suspicion for kidney and hematological involvement in SLE patients. (author)

  5. A multidisciplinary protocol for planned skin-preserving delayed breast reconstruction for patients with locally advanced breast cancer requiring postmastectomy radiation therapy: 3-year follow-up.

    Science.gov (United States)

    Kronowitz, Steven J; Lam, Candace; Terefe, Welela; Hunt, Kelly K; Kuerer, Henry M; Valero, Vicente; Lance, Samuel; Robb, Geoffrey L; Feng, Lei; Buchholz, Thomas A

    2011-06-01

    The authors examined the safety of a protocol for planned skin-preserving delayed breast reconstruction after postmastectomy radiotherapy with placement of a tissue expander for patients with locally advanced breast cancer (stages IIB and III). The authors compared 47 patients treated according to the protocol between December 2003 and May 2008 with 47 disease-stage-matched control patients who underwent standard delayed reconstruction after postmastectomy radiotherapy (no skin preservation or tissue expander) during the same period. Protocol-group complication rates were 21 percent for skin-preserving mastectomy and placement of the expander (stage 1), 5 percent for postmastectomy radiotherapy, 25 percent for expander reinflation after radiotherapy, and 24 percent for skin-preserving delayed reconstruction. The complication rate for standard delayed reconstruction was 38 percent. Tissue-expander loss rates were 32 percent overall, 9 percent for stage 1, 5 percent for postmastectomy radiotherapy, and 22 percent for reinflation. Wound-healing complications after reconstruction occurred in 3 percent of protocol-group and 10 percent of control-group patients. The median follow-up time for patients still alive at last follow-up was 40 months (range, 8.5 to 85.3 months). Three-year recurrence-free survival rates were 92 percent (95 percent CI, 83 to 100 percent) and 86 percent (95 percent CI, 76 to 98 percent) for the protocol and control groups, respectively (p = 0.87). In patients with locally advanced breast cancer, skin-preserving mastectomy with a deflated tissue expander on the chest wall during postmastectomy radiotherapy does not increase locoregional recurrence risk and is associated with lower complication rates of definitive reconstruction.

  6. Depression and Suicide in Schizophrenic Patients.

    Science.gov (United States)

    Salama, Aziz A.

    1988-01-01

    Identified schizophrenic patients as distinctive subgroup of patients who can suffer from major depressive illness and can commit suicide. Found 22.4 percent of 620 schizophrenics in psychiatric facility showed symptoms of major depressive episode. Seven patients committed suicide during acute phase of illness, 9 attempted suicide while…

  7. Effects of behavioral therapy on weight loss in overweight and obese patients with schizophrenia or schizoaffective disorder.

    Science.gov (United States)

    Brar, Jaspreet S; Ganguli, Rohan; Pandina, Gahan; Turkoz, Ibrahim; Berry, Sally; Mahmoud, Ramy

    2005-02-01

    Obesity is common in persons with schizophrenia. Besides its adverse health effects, obesity reduces quality of life and contributes to the social stigma of schizophrenia. This 14-week, multicenter, open-label, rater-blinded, randomized study evaluated the effects of a group-based behavioral treatment (BT) for weight loss in overweight and obese stable patients with DSM-IV schizophrenia or schizoaffective disorder who had been switched from olanzapine to risperidone. Participants were randomly assigned to receive BT or usual clinical care (UC). BT included 20 sessions during which patients were taught to reduce caloric intake. In UC, patients were encouraged to lose weight but received no special advice about weight reduction. The primary outcome measure was change in body weight. Seventy-two patients were enrolled. The mean +/- SD weight loss at endpoint was significant in both groups (p or = 5% of their body weight at endpoint (26.5% [9/34] and 10.8% [4/37], respectively; p = .082). A post hoc analysis of patients attending at least 1 BT session showed that significantly more patients in the BT than the UC group had lost > or = 5% of their body weight at endpoint (32.1% [9/28] vs. 10.8% [4/37], respectively, p = .038) and at week 14 (complete population; 40.9% [9/22] and 14.3% [4/28], respectively, p = .027). BT may be an effective method for weight reduction in patients with chronic psychotic illness.

  8. Treatment outcomes of patients co-infected with tuberculosis and HIV at Chiang Mai University Hospital, Thailand.

    Science.gov (United States)

    Limmahakhun, S; Chaiwarith, R; Nuntachit, N; Sirisanthana, T; Supparatpinyo, K

    2012-06-01

    Thailand has been greatly affected by the tuberculosis (TB) and HIV syndemic. This study aimed to determine treatment outcomes among HIV/TB co-infected patients. A retrospective cohort study was conducted at Chiang Mai University Hospital from 1 January 2000 to 31 December 2009. Of 171 patients, 100 patients were male (58.5%) and the mean age was 36.8 ± 8.0 years. Seventy-two patients (42.1%) had pulmonary tuberculosis. Median CD4+ count before TB treatment was 69 cells/mm(3) (interquartile range [IQR] 33, 151). The overall mortality was 3.5% (6 patients). Immune reconstitution inflammatory syndrome (IRIS) occurred in eight patients (6.0%). Disseminated TB infections increased risk of death (odds ratio [OR] = 2.55, 95% confidence interval [CI] 1.25, 5.18) and IRIS (OR = 9.16, 95% CI 1.67, 50.07). Initiating combination antiretroviral therapy (cART) within two months after TB treatment increased risk of IRIS (OR = 6.57, 95% CI 1.61-26.86) and physicians caring for HIV/TB co-infected patients should be aware of this condition.

  9. EFFICACY OF MOHS" SURGERY IN PATIENTS WITH SKIN CANCER: (AL-ZAHRA HOSPITAL; SEP. 1999 - DEC. 2000

    Directory of Open Access Journals (Sweden)

    A ASILIAN

    2001-03-01

    Full Text Available Introduction: Modified Mohs" Surgery (MMS has not ever been performed for management of skin cancers in Iran. The aim of this study was evaluation of the efficacy of MMS in recurrence, metastasis rate and cosmetic results. Methods: Fifty one patients with known indications for MMS were selected. They were operated under standard method of MMS, followed and evaluated for a 12 months period about recurrence, metastasis and cosmetic results. Results: 58 tumors from 51 patients were operated. 27.5 percent of patients were females and 72.5 percent were males (57.4± 13.4 year. Eight percent had more than one tumor. In 84 percent, MMS was the first treatment procedure. Anatomically lesions of scalp and face, trunk, and limbs constituted 92.5 percent, 1.9 percent, and 5.6 percent, respectively. Mean size of lesions was 16.9 mm (range: 4-70. The number of layers to clear the tumors was 1-5 (mean: 1.5. Histologically 81 percent of lesions were BCC, 9.4 percent SCC. Immediate reconstruction was performed in all patients as follows: 37 percent primary simple closure, 5.5 percent secondary healing, 50 percent skin flaps, 3.7 percent skin grafts and 3.7 percent a combination model. The percent of relative frequency of recurrence was 3.7 with no case of metastasis. Cosmetic results were excellent in 35 percent, good in 50 percent, intertmediate in 11.5 percent and poor in 3.5 percent of cases. Discussion: Despite paucity of patients" number, higher incidence of tumors in males of 50 or more, higher occurrence on scalp and face and most frequently occurring as BCC is prominently evident. One year recurrence rate of 3.7 percent is probably due to paucity of patients. Cosmetic results were mostly favorable (85 percent, and unfavorable results were due to secondary healing and large facial lesions repaired with flaps. For more valid evaluations, long term studies with greater number of patients is recommended.

  10. Anti-cyclic citrullinated peptide antibodies in rheumatoid arthritis patients

    International Nuclear Information System (INIS)

    Fakhr, A.; Ahmed, M.; Bashir, M.; Hakim, F.; Basri, R.

    2017-01-01

    Objective: To detect the anti cyclic citrullinated peptide (Anti-CCP) antibody in rheumatoid arthritis (RA) patients to determine its diagnostic value in Pakistani patients. Study Design: Cross sectional study. Place and Duration of Study: Military Hospital (MH) Rawalpindi, from January 2013 to June 2015. Material and Methods: A total of 58 patients with complications of rheumatoid arthritis were recruited in the study using convenient sampling technique after their informed consent. Age and gender of the patients were recorded. Blood was collected from the patients subjected to ELISA based detection of anti-CCP and latex agglutination test for detection of Rheumatoid Factor (RF). Data obtained were analyzed using Microsoft excel 2010. Results: Among the fifty eight RA patients, 40 percent were males and 60 percent were females. Age ranged between 12 to 80 years (mean age 49.74 +- 16.81 years) of the males RA patients and was higher as compared to females (mean age 43.2 +-16.70 years). ELISA based detection of anti-CCP antibody showed that about 91 percent of RA patients were positive for anti CCP antibody. About 72 percent were positive for anti CCP antibody alone, 19 percent were positive for both anti-CCP and RF and 9 percent were positive for RF. Conclusion: The results concluded that a higher percentage of the RA patients are positive for anti-CCP antibody marking its importance as a diagnostic marker. Anti-CCP has more sensitivity as compared to RF in RA patients. (author)

  11. Subject positioning in the BOD POD® only marginally affects measurement of body volume and estimation of percent body fat in young adult men.

    Directory of Open Access Journals (Sweden)

    Maarten W Peeters

    Full Text Available INTRODUCTION: The aim of the study was to evaluate whether subject positioning would affect the measurement of raw body volume, thoracic gas volume, corrected body volume and the resulting percent body fat as assessed by air displacement plethysmography (ADP. METHODS: Twenty-five young adult men (20.7±1.1 y, BMI = 22.5±1.4 kg/m(2 were measured using the BOD POD® system using a measured thoracic gas volume sitting in a 'forward bent' position and sitting up in a straight position in random order. RESULTS: Raw body volume was 58±124 ml (p<0.05 higher in the 'straight' position compared to the 'bent' position. The mean difference in measured thoracic gas volume (bent-straight = -71±211 ml was not statistically significant. Corrected body volume and percent body fat in the bent position consequently were on average 86±122 ml (p<0.05 and 0.5±0.7% (p<0.05 lower than in the straight position respectively. CONCLUSION: Although the differences reached statistical significance, absolute differences are rather small. Subject positioning should be viewed as a factor that may contribute to between-test variability and hence contribute to (inprecision in detecting small individual changes in body composition, rather than a potential source of systematic bias. It therefore may be advisable to pay attention to standardizing subject positioning when tracking small changes in PF are of interest. The cause of the differences is shown not to be related to changes in the volume of isothermal air in the lungs. It is hypothesized and calculated that the observed direction and magnitude of these differences may arise from the surface area artifact which does not take into account that a subject in the bent position exposes more skin to the air in the device therefore potentially creating a larger underestimation of the actual body volume due to the isothermal effect of air close to the skin.

  12. Patients for patient safety in China: a cross sectional study.

    Science.gov (United States)

    Zhang, Qiongwen; Li, Yulin; Li, Jing; Mao, Xuanyue; Zhang, Lijuan; Ying, Qinghua; Wei, Xin; Shang, Lili; Zhang, Mingming

    2012-02-01

    To investigate the baseline status of patients' awareness, knowledge, and attitudes to patient safety in China, and to determine the factors that influence patients' involvement in patient safety. We conducted a cross sectional survey using questionnaires adapted from recent studies on patient safety from outside China. The items included medical errors, infection, medication safety, and other aspects of patient safety. The questionnaire included 17 items and 5 domains. The survey was conducted between Jan. 2009 and Dec. 2010 involving 1000 patients from ten grade-A hospitals in seven provinces or cities in China. Most patients from the surgery departments completed the questionnaires voluntarily and anonymously. Five reviewers independently input the data into Microsoft Excel 2003, and the data were double-checked. Data were analyzed using SPSS 15.0 software for differences in the perceptions and attitudes of patients toward patient safety among different genders, ages, and regions. We distributed 1000 questionnaires and collected 959 completed questionnaires (response rate: 96%). Among the respondents, 58% of patients did not know what medical error is. Sixty-five percent of patients wanted disclosure of all medical errors. After errors occurred, 58% of patients wanted explanations of all possible harms that had resulted. Among 187 patients who had experienced medical errors, 83% of patients had sought appropriate legal action. About 52% of patients understood hospital infection, but 28% patients did not know that infections could occur in hospital. Seventy-eight percent of patients thought that medical staff should wash their hands before examining patients. More than half of the patients (68%) were willing to remind the staff of hygiene if they saw unsanitary conditions in a health clinic. Only 14% of patients knew the side effects of medications that they took. The majority of patients surveyed expressed willingness to contribute to patient safety, but their

  13. Customized versus population-based growth curves: prediction of low body fat percent at term corrected gestational age following preterm birth.

    Science.gov (United States)

    Law, Tameeka L; Katikaneni, Lakshmi D; Taylor, Sarah N; Korte, Jeffrey E; Ebeling, Myla D; Wagner, Carol L; Newman, Roger B

    2012-07-01

    Compare customized versus population-based growth curves for identification of small-for-gestational-age (SGA) and body fat percent (BF%) among preterm infants. Prospective cohort study of 204 preterm infants classified as SGA or appropriate-for-gestational-age (AGA) by population-based and customized growth curves. BF% was determined by air-displacement plethysmography. Differences between groups were compared using bivariable and multivariable linear and logistic regression analyses. Customized curves reclassified 30% of the preterm infants as SGA. SGA infants identified by customized method only had significantly lower BF% (13.8 ± 6.0) than the AGA (16.2 ± 6.3, p = 0.02) infants and similar to the SGA infants classified by both methods (14.6 ± 6.7, p = 0.51). Customized growth curves were a significant predictor of BF% (p = 0.02), whereas population-based growth curves were not a significant independent predictor of BF% (p = 0.50) at term corrected gestational age. Customized growth potential improves the differentiation of SGA infants and low BF% compared with a standard population-based growth curve among a cohort of preterm infants.

  14. Estimation of perimortal percent carboxy-heme in nonstandard postmortem specimens using analysis of carbon monoxide by GC/MS and iron by flame atomic absorption spectrophotometry.

    Science.gov (United States)

    Middleberg, R A; Easterling, D E; Zelonis, S F; Rieders, F; Rieders, M F

    1993-01-01

    In decomposed, formalin-fixed, embalmed, exhumed, and some fire-dried cases in which normal blood is unavailable, the usual methods for determination of carboxyhemoglobin saturation frequently fail. To address these specimens, a method utilizing both gas chromatography/mass spectrometric (GC/MS) determination of carbon monoxide (CO) and flame atomic absorption spectrophotometry (FAAS) determination of iron (Fe), in the same specimen, was developed. The method is reported here, along with its application to seven pertinent forsensic death investigations. The CO analytical methodology involves acid liberation of the gas from the specimen aliquot in a headspace vial. After heating and equilibrating, a sample of the headspace vapor is injected into the GC/MS system with a gastight syringe. Quantitation is achieved by standard addition comparison utilizing the ideal gas law equation. Iron is quantified by FAAS analysis of the same aliquot used for the CO determination, following nitric acid digestion. The concentration is determined by comparison to a standard curve. A formula for determining the minimum percent carboxy-heme saturation was derived by using the ratio of the amount of CO to the amount of Fe in the aliquot analyzed. Tissue types analyzed include spleen, liver, muscle, dried blood, and unspecified decomposed tissue.

  15. EFFECT OF STRESS ON THE PERCENT BODY WEIGHT CHANGE AND MRNA EXPRESSION OF IGF-1, SURVIVINE AND HSP-70 GENE IN THE HIERARCHIAL FOLLICLES OF JAPANESE QUAIL

    Directory of Open Access Journals (Sweden)

    N Shit

    2014-12-01

    Full Text Available The present study was carried out to explore the effect of stress on body weight and the mRNA expression of IGF-1, Survivine and HSP-70 gene in the hierarchial follicles of Japanese quail. A total 24 birds (10 weeks were taken and stress was induced by immobilization daily for 2hrs (between 9.00 - 11.00 AM throughout the study (10 days. Four birds were sacrificed on 1, 2, 4, 6, 8 and 10 days of the treatment. Hierarchial follicles (F1, F2 & F3 were aseptically collected to quantify the expression of IGF-1, Survivine and HSP-70 gene using real-time PCR technique. The percent body weight reduction increased and reached highest (21.30% on 10th day. The fold expression of IGF-1 gene was significantly ((P=0.05 down regulated in advance to the time of experiment. However, the fold expression of survivine gene was significantly (P=0.05 up regulated and the intensity was highest (17 fold in F-3 follicle on 4th day of experiment. No significant change in the mRNA expression of HSP-70 gene was evident in this study. From this study it may be concluded that stress brings physio-molecular change through HPA activation, which not only causes tissue regression also modifies the cellular mechanism.

  16. Do patient expectations about arthroplasty at initial presentation for hip or knee pain differ by sex and ethnicity?

    Science.gov (United States)

    Lavernia, Carlos J; Contreras, Juan S; Parvizi, Javad; Sharkey, Peter F; Barrack, Robert; Rossi, Mark D

    2012-10-01

    Many studies show gender and ethnic differences in healthcare utilization and outcomes. Patients' presurgical cognitions regarding surgical outcomes also may vary by gender and ethnicity and play a role in explaining utilization and outcome differences. However, it is unclear whether and to what extent gender and ethnicity play a role in patients' presurgical cognitions. Do gender and ethnicity influence outcome expectations? Is arthroplasty-related knowledge affected by gender and ethnicity? Do gender and ethnicity influence willingness to pay for surgery? In a prospective, multicenter study we gave 765 patients an anonymous questionnaire on expectations, arthroplasty knowledge, and preferences before their consultation for hip and/or knee pain, from March 2005 to July 2007. Six hundred seventy-two of the 765 patients (88%) completed questionnaires. Non-Hispanics and men were more likely to indicate they would be able to engage in more activities. Non-Hispanics and men had greater arthroplasty knowledge. Hispanics and women were more likely to report they would not pay for a total joint arthroplasty (TJA) relative to non-Hispanics and men. Sex and ethnic differences in patients presenting for their initial visit to the orthopaedists for hip or knee pain influence expectations, knowledge, and preferences concerning TJAs. Longitudinal study of relationships between patients' perceptions and utilization or outcomes regarding TJA is warranted.

  17. Evaluation of generalized pruritus in patients without primary skin lesions in Razi Hospital

    Directory of Open Access Journals (Sweden)

    Jomhori P

    2001-09-01

    Full Text Available Pruritus is an unpleasant sensation that provokes the desire to scratch. It has long been recognized as a presenting or concomitant symptom of many systemic diseases. Indeed, generalized pruritus is reported to be associated with underlying diseases in 10-50 percent of cases. This study was conducted to investigate the underlying diseases in pruritic patients without primary skin lesion. Seventy-five patients with at least one-month history of pruritus with no primary skin lesions, presenting to dermatological clinics of Razi Hospital, from April 97 until December 99 were evaluated. The work up procedure consisted of medical history, physical examination, laboratory findings (CBC, ESR, blood chemistry, thyroid function tests, urinalysis, stool exam, chest X-ray and in selected cases, additional specific tests. Fifty-four patients were female, and 21 male the mean age was 45.7y±16.41, and the mean duration of pruritus, 21.8m±21. In 43 patients (75.4 percent, no abnormal finding was detected. Five patients (6.66 percent had atopy. In the remaining 27 patients (36 percent, the following abnormalities were found: Iron deficiency in 6 patients (8 percent, diabetes mellitus in 6 patients (8 percent, hyperthyroidism in 4 patients (5.33 percent, hypothyroidism in 2 patients (2.66 percent, lymphoma in 3 patients (4 percent, chronic hepatitis, hypocalcaemia, cholelithiasis, psychosis and chronic renal failure each in one patient (1.3 percent. Evaluation of patients with pruritus may be a valuable tool for early detection of underlying systemic diseases.

  18. Laboratory errors and patient safety.

    Science.gov (United States)

    Miligy, Dawlat A

    2015-01-01

    Laboratory data are extensively used in medical practice; consequently, laboratory errors have a tremendous impact on patient safety. Therefore, programs designed to identify and reduce laboratory errors, as well as, setting specific strategies are required to minimize these errors and improve patient safety. The purpose of this paper is to identify part of the commonly encountered laboratory errors throughout our practice in laboratory work, their hazards on patient health care and some measures and recommendations to minimize or to eliminate these errors. Recording the encountered laboratory errors during May 2008 and their statistical evaluation (using simple percent distribution) have been done in the department of laboratory of one of the private hospitals in Egypt. Errors have been classified according to the laboratory phases and according to their implication on patient health. Data obtained out of 1,600 testing procedure revealed that the total number of encountered errors is 14 tests (0.87 percent of total testing procedures). Most of the encountered errors lay in the pre- and post-analytic phases of testing cycle (representing 35.7 and 50 percent, respectively, of total errors). While the number of test errors encountered in the analytic phase represented only 14.3 percent of total errors. About 85.7 percent of total errors were of non-significant implication on patients health being detected before test reports have been submitted to the patients. On the other hand, the number of test errors that have been already submitted to patients and reach the physician represented 14.3 percent of total errors. Only 7.1 percent of the errors could have an impact on patient diagnosis. The findings of this study were concomitant with those published from the USA and other countries. This proves that laboratory problems are universal and need general standardization and bench marking measures. Original being the first data published from Arabic countries that

  19. Analysis of small field percent depth dose and profiles: Comparison of measurements with various detectors and effects of detector orientation with different jaw settings

    Directory of Open Access Journals (Sweden)

    Henry Finlay Godson

    2016-01-01

    Full Text Available The advent of modern technologies in radiotherapy poses an increased challenge in the determination of dosimetric parameters of small fields that exhibit a high degree of uncertainty. Percent depth dose and beam profiles were acquired using different detectors in two different orientations. The parameters such as relative surface dose (DS, depth of dose maximum (Dmax, percentage dose at 10 cm (D10, penumbral width, flatness, and symmetry were evaluated with different detectors. The dosimetric data were acquired for fields defined by jaws alone, multileaf collimator (MLC alone, and by MLC while the jaws were positioned at 0, 0.25, 0.5, and 1.0 cm away from MLC leaf-end using a Varian linear accelerator with 6 MV photon beam. The accuracy in the measurement of dosimetric parameters with various detectors for three different field definitions was evaluated. The relative DS(38.1% with photon field diode in parallel orientation was higher than electron field diode (EFD (27.9% values for 1 cm ×1 cm field. An overestimation of 5.7% and 8.6% in D10depth were observed for 1 cm ×1 cm field with RK ion chamber in parallel and perpendicular orientation, respectively, for the fields defined by MLC while jaw positioned at the edge of the field when compared to EFD values in parallel orientation. For this field definition, the in-plane penumbral widths obtained with ion chamber in parallel and perpendicular orientation were 3.9 mm, 5.6 mm for 1 cm ×1 cm field, respectively. Among all detectors used in the study, the unshielded diodes were found to be an appropriate choice of detector for the measurement of beam parameters in small fields.

  20. Control chart analysis of data regarding 0.2% yield strength (YS) and percent total circumferential elongation (%TCE) for zircaloy clad tubes for PHWR and BWR fuels

    International Nuclear Information System (INIS)

    Yadav, M.B.; Singh, Hari; Vaidyanathan, S.; Sood, D.D.; Raghavan, S.V.; Bandyopadhyay, A.K.; Kulkarni, P.G.

    1992-01-01

    Zircaloy cladding tubes for PHWR and BWR fuels are manufactured and tested at Nuclear Fuel Complex (NFC), Hyderabad. Atomic Fuels Division is carrying out the quality assurance of the fuels on behalf of Nuclear Power Corporation (NPC). In this paper an attempt has been made to assess whether the quality of the clad tubes has met the requirements specified for the two mechanical properties of the tubes namely 0.2% yield strength and percent total circumferential elongation using control chart technique. For this purpose data for about 100 lots in each case were used. Process means and process standard deviations for these properties and the control limits for the corresponding control charts were estimated. The main findings are: (i) In case of PHWR tubes the production quality level with respect to 0.2% YS is higher, while that in case of %TCE is lower causing rejection of lots. On the other hand in the case of BWR tubes the production quality levels with respect to both the properties are higher than the required one. (ii) With respect to 0.2% YS, in case of BWR tubes a change in the pattern of distribution is detected beyond the lot serial no.47. However in case of PHWR tubes, though the data falls into two groups, no such pattern is seen. A modification in the acceptance/rejection criterion of the lot has been suggested. It is also pointed out that to have a correct picture of the total variation it is necessary to study the within tube variation. (author). 4 figs, 2 tabs

  1. Perturbation and Nonlinear Dynamic Analysis of Acoustic Phonatory Signal in Parkinsonian Patients Receiving Deep Brain Stimulation

    Science.gov (United States)

    Lee, Victoria S.; Zhou, Xiao Ping; Rahn, Douglas A., III; Wang, Emily Q.; Jiang, Jack J.

    2008-01-01

    Nineteen PD patients who received deep brain stimulation (DBS), 10 non-surgical (control) PD patients, and 11 non-pathologic age- and gender-matched subjects performed sustained vowel phonations. The following acoustic measures were obtained on the sustained vowel phonations: correlation dimension (D[subscript 2]), percent jitter, percent shimmer,…

  2. Sexual Advances by Patients in Dental Practice: Implications for the Dental and Dental Hygiene Curricula.

    Science.gov (United States)

    Chiodo, Gary T.; And Others

    1992-01-01

    A survey of Oregon dentists (n=248) and dental hygienists (n=235) investigated frequency of patient-initiated sexual advances and methods of dealing with them. Up to 44 percent experienced 1 or more patient verbal advances, and 23 percent experienced physical advances during a 5-year period. Inclusion of related issues in professional curricula is…

  3. Therapeutic consequences of oesophageal function studies in patients with benign oesophageal disease

    DEFF Research Database (Denmark)

    Jakobsen, Erik; Kruse-Andersen, S; Wallin, Lene

    1988-01-01

    making the final decision for therapy. Eleven percent of the patients referred with a diagnosis of hiatal hernia or reflux had achalasia or oesophageal spasm. Nine percent of the patients referred for motility disorders had reflux-related disease. The referral diagnosis was changed to a diagnosis...

  4. A virtual patient educational activity to improve interprofessional competencies: A randomized trial.

    Science.gov (United States)

    Shoemaker, Michael J; de Voest, Margaret; Booth, Andrew; Meny, Lisa; Victor, Justin

    2015-01-01

    The purpose of the present study was to determine whether an interprofessional virtual patient educational activity improved interprofessional competencies in pharmacy, physician assistant, and physical therapy graduate students. Seventy-two fifth semester pharmacy (n = 33), fourth semester physician assistant (n = 27) and fourth semester physical therapy (n = 12) graduate students participated in the study. Participants were stratified by discipline and randomized into control (n = 38) and experimental groups (n = 34). At baseline and at study completion, all participants completed an original, investigator-developed survey that measured improvement in selected Interprofessional Education Collaborative (IPEC) competencies and the Readiness for Interprofessional Learning Scale (RIPLS). The experimental group had statistically significantly greater odds of improving on a variety of IPEC competencies and RIPLS items. The use of a single, interprofessional educational activity resulted in having a greater awareness of other professions' scopes of practice, what other professions have to offer a given patient and how different professions can collaborate in patient care.

  5. Plasma levels of Transforming Growth Factor Beta in HIV-1 patients with oral candidiasis

    Science.gov (United States)

    Izadi, A; Asadikaram, G; Nakhaee, N; Hadizadeh, S; Ayatollahi Mousavi, A

    2015-01-01

    Background and Purpose: TGF-β is a potent regulator and suppressor of the immune system and overproduction of this cytokine may contribute to immunosuppression in HIV-infected patients. Increasing population of immunosuppressed patients has resulted in increasingly frequent of fungal infections, including oral candidiasis. The aim of this study was to evaluate the plasma levels of TGF-β under in vivo conditions. Materials and Methods: Seventy- two samples were obtained from the oral cavities of HIV-positive Iranian patients and cultured on Sabouraud’s dextrose agar and CHROMagar. Also blood samples were obtained to assess TGF-β levels using ELISA technique. Results: Thirty-three out of 72 oral samples yielded candida isolates, Candida albicans in 14 and non-albicans candida in 19.Fungal infection decreased significantly more TGF-β level than non-fungal infection also HIV negative were significantly more TGF-β than HIV positive. Conclusion: Our findings suggest a significant interaction between fungal infection and HIV on expression of Transforming Growth Factor Beta. PMID:28680977

  6. A prospective study of the effects of radioiodine therapy for hyperthyroidism in patients with minimally active graves' ophthalmopathy.

    Science.gov (United States)

    Perros, Petros; Kendall-Taylor, Pat; Neoh, Chris; Frewin, Sarah; Dickinson, Jane

    2005-09-01

    Radioiodine is an effective and safe treatment for hyperthyroidism but has been implicated as a risk factor for deterioration or new presentation of Graves' ophthalmopathy (GO). Prophylactic glucocorticoids appear to prevent this effect. The objective of this study was to document the course of GO after radioiodine therapy. This was a prospective observational study. Patients were assessed at baseline and 2, 4, 6, and 12 months after radioiodine therapy. The study was conducted at a tertiary referral center. Seventy-two GO patients with minimally active eye disease participated in the study. A fixed dose of radioiodine was administered. T(4) was commenced 2 wk later to prevent hypothyroidism. Change in activity and severity of GO were analyzed. Exophthalmometer readings, the width of the palpebral aperture, diplopia scores, and the clinical activity score improved significantly. By clinically significant criteria, the eye disease improved in four patients (transiently in three of the four cases), most likely attributable to the natural course of the disease. No patient's eyes deteriorated. Radioiodine is not associated with deterioration of GO in patients with minimally active eye disease when postradioiodine hypothyroidism is prevented.

  7. Retrospective analysis of oncogenic human papilloma virus and Epstein-Barr virus prevalence in Turkish nasopharyngeal cancer patients.

    Science.gov (United States)

    Tatlı Doğan, Hayriye; Kılıçarslan, Aydan; Doğan, Mehmet; Süngü, Nuran; Güler Tezel, Gaye; Güler, Gülnur

    2016-11-01

    Nasopharyngeal carcinoma (NPC) is associated with the Epstein-Barr virus (EBV). Human papilloma virus (HPV) has also been detected in NPC cases. In this retrospective study, we analyze the frequency of EBV and HPV infection in 82 Turkish patients with NPC. A total of 82 were evaluated for EBV and HPV. In situ hybridization (ISH) was performed for EBV. HPV-ISH and P16 immunohistochemistry used to determine the HPV status. Seventy-two of the 82 (87%) NPC patients were EBV-positive. The highest rate of EBV-positivity was found in undifferentiated NPC patients, which accounted for 65 of 68 (95.6%) undifferentiated cases. One of the 82 NPC patients whose tumor was non-keratinizing differentiated, contained HPV. Our data shows that EBV is closely associated with NPC in Turkey. We found lower rates of HPV-positivity in NPC patients than in North American populations. In addition, both EBV and HPV-negativity were more associated with decreased survival than EBV-positive cases. Copyright © 2016 Elsevier GmbH. All rights reserved.

  8. Dietary changes among breast cancer patients in Malaysia.

    Science.gov (United States)

    Shaharudin, Soraya Hanie; Sulaiman, Suhaina; Shahril, Mohd Razif; Emran, Nor Aina; Akmal, Sharifah Noor

    2013-01-01

    Breast cancer patients often show an interest in making dietary changes after diagnosis of breast cancer to improve their health condition and prevent cancer recurrence. The objective of the study was to determine changes in dietary intake 2 years after diagnosis among breast cancer patients. One hundred sixteen subjects were asked to complete a semiquantitative food frequency questionnaire, diet recalls, and dietary changes questionnaire to assess dietary intake before and after diagnosis. The information on sociodemographic background, cancer treatment history, and anthropometric indices was also collected. Seventy-two subjects considered diet as a contributing factor to breast cancer, and 67 subjects changed their dietary habits after breast cancer diagnosis. The reasons for changes in diet were physician and dietitian advice and desire to cure cancer. The sources of information were derived from their physician, mass media, and family members. Total energy, protein, total fat, fatty acids, and vitamin E intake were significantly decreased after diagnosis. Meanwhile, the intake of β-carotene and vitamin C increased significantly after diagnosis. The changes included reduction in red meat, seafood, noodles, and poultry intake. An increased consumption of fruits, vegetables, fish, low-fat milk, and soy products was observed. The subjects tended to lower high-fat foods intake and started to eat more fruits and vegetables. Breast cancer patients had changed to a healthier diet after breast cancer diagnosis, although the changes made were small. This will be helpful to dietitians in providing a better understanding of good eating habits that will maintain patients' health after breast cancer diagnosis.

  9. Factors associated with management of cervical cancer patients at ...

    African Journals Online (AJOL)

    Forty-seven percent of the cervical cancer patients were referred to Ocean Road Cancer Institute for radiotherapy and or chemotherapy. Patients discharged home for palliative care were 30% and 17% patients died at the hospital. Known HIV positive patients were significantly associated with death and terminal care seen ...

  10. Bronchoscopic management of patients with symptomatic airway stenosis and prognostic factors for survival.

    Science.gov (United States)

    Okiror, Lawrence; Jiang, Li; Oswald, Nicola; Bille, Andrea; Rajesh, Pala; Bishay, Ehab; Steyn, Richard; Naidu, Babu; Kalkat, Maninder

    2015-05-01

    Interventional bronchoscopy is effective in the management of patients with symptomatic airway obstruction for both malignant and benign conditions. The main aim of this study is to report our experience with emergency interventional bronchoscopy in patients with symptomatic airway obstruction and identify prognostic factors for survival. This is a retrospective observational study of patients undergoing emergency interventional bronchoscopy over a 4-year period. Survival times were analyzed separately for patients with benign and malignant airway obstruction by the Kaplan-Meier method. Between June 2009 and July 2013, 168 emergency interventional bronchoscopies were performed in 112 patients for airway obstruction. The median age was 63 years (range, 20 to 86), and 91 patients (54%) patients were female. Seventy-two cases (43%) had airway obstruction due to malignant disease. There were 3 in-hospital deaths (2.7%). Median survival of the study population was 5.6 months (range, 0 to 51) with a median follow-up of 7.3 months (range, 0 to 51). Median survival for patients with malignant airway obstruction was 3.5 months (range, 0 to 21), and 9.8 months (range, 0.1 to 51) for those with benign disease. Airway intervention facilitated palliative chemotherapy in 32 patients (44%) of those with malignant airway obstruction. At multivariate analysis in patients with malignant airway obstruction, presence of stridor (hazard ratio 1.919, 95% confidence interval: 1.082 to 3.404, p = 0.026) and not receiving postprocedure chemotherapy (hazard ratio 2.05, 95% confidence interval: 1.156 to 3.636, p = 0.014) were independent prognostic factors for death. Emergency interventional bronchoscopy for airway obstruction is safe, relieved symptoms, and facilitated palliative chemotherapy, which improved survival. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. The impact of ureteral Double-J stent insertion following ureterorenoscopy in patients with ureteral stones accompanied by perirenal fat stranding

    Directory of Open Access Journals (Sweden)

    Ercan Ogreden

    2018-03-01

    Full Text Available Objective: To evaluate the impact of ureteral stent insertion following semirigid ureterorenoscopy (URS in patients with perirenal fat stranding (PFS due to ureteral stones. Material and methods: Data of 600 patients who underwent URS were analyzed retrospectively. Seventy-two patients detected to have PFS accompanying ureteral stone were included. Patients who did not undergo double J (DJ stent insertion following semirigid URS were classified as Group I (n: 52, while those who underwent stent insertion were classified as Group II (n: 20. Side distribution; localization of the stones, stone size, presence of fever, urinary tract infection (UTIs and urosepsis rates were compared in the two groups. Results: The average age of the patients was 44.4 (20-71 years. Male/female ratio and side of the stone location showed similar distribution in both groups (p > 0.05. Fever occurred in 23 cases (44.2% in Group I and in 15 cases (75% in Group II (p = 0.038. UTIs occurred in 15 cases (28.9% in Group I and in 12 cases (60% in Group II (p = 0.03. Urosepsis presented in 3 (5.8% and 5 (25% of the patients in Group I and II, respectively (p = 0.033. Conclusions: According to our results, ureteral DJ stent insertion following URS in patients with PFS due to ureteral stone caused an increase on postoperative infection related complications.

  12. Effect of breeding strategy and feeding system on the within-herd variation of lean meat percents in Danish slaughter pigs.

    Science.gov (United States)

    Stege, H; Bagger, J; Nielsen, J P; Ersbøll, A K

    2011-08-01

    In several countries slaughter pigs are paid for individually, according to slaughter weight and lean meat percent (LMP). Production of uniform batches of pigs within the optimal weight and LMP limits will obtain the best price. Therefore, all pigs should have a similar growth rate (average daily gain, ADG) and reach an appropriate slaughter weight within the same time period. LMP may serve as a proxy for ADG since pigs with low LMP have significantly higher ADG than pigs with high LMP and vice versa. Both breeding strategy and feeding system may influence the range of variation among pigs. The aim of this study was to test the two following hypotheses: (1) Herds purchasing breeding gilts have a higher mean value and a lower variation (standard deviation) in LMP than herds producing their own breeding gilts and (2) Herds using restricted feeding of finishers have a higher mean value and a lower variation (standard deviation) in LMP than herds with ad libitum feeding of finishers. The study included 72 herds and a total of 345,132 pigs slaughtered during one year. Among the 72 herds, 40 were home-breeders and 32 purchased breeding gilts from a breeding company. Nineteen herds used restricted feeding, of which 8 (42%) were home-breeders. Fifty-three herds used ad libitum feeding, of which 32 (60%) were home-breeders. Breeding strategy had a significant effect on SDLMP (p=0.003), where purchase of breeding gilts resulted in a significantly lower standard deviation of the monthly LMP compared to home-bred gilts (a difference in median SDLMP of 0.2 percentage points or 8% difference between groups). Feeding system had a significant effect on the meanLMP (p<0.001), with a significantly higher meanLMP in herds using restrictive feeding compared to ad libitum feeding (60.7% versus 60.0%). Restrictive feeding also resulted in a significantly lower SDLMP (p<0.001) compared to ad libitum feeding (2.2% versus 2.5% or a 12% difference between groups). Copyright © 2011 Elsevier

  13. Impaired CD4+ and T-helper 17 cell memory response to Streptococcus pneumoniae is associated with elevated glucose and percent glycated hemoglobin A1c in Mexican Americans with type 2 diabetes mellitus.

    Science.gov (United States)

    Martinez, Perla J; Mathews, Christine; Actor, Jeffrey K; Hwang, Shen-An; Brown, Eric L; De Santiago, Heather K; Fisher Hoch, Susan P; McCormick, Joseph B; Mirza, Shaper

    2014-01-01

    Individuals with type 2 diabetes are significantly more susceptible to pneumococcal infections than healthy individuals of the same age. Increased susceptibility is the result of impairments in both innate and adaptive immune systems. Given the central role of T-helper 17 (Th17) and T-regulatory (Treg) cells in pneumococcal infection and their altered phenotype in diabetes, this study was designed to analyze the Th17 and Treg cell responses to a whole heat-killed capsular type 2 strain of Streptococcus pneumoniae. Patients with diabetes demonstrated a lower frequency of total CD+T-cells, which showed a significant inverse association with elevated fasting blood glucose. Measurement of specific subsets indicated that those with diabetes had, low intracellular levels of interleukin (IL)-17, and lower pathogen-specific memory CD4+ and IL-17+ cell numbers. No significant difference was observed in the frequency of CD4+ and Th17 cells between those with and without diabetes. However, stratification of data by obesity indicated a significant increase in frequency of CD4+ and Th17 cells in obese individuals with diabetes compared with nonobese individual with diabetes. The memory CD+T-cell response was associated inversely with both fasting blood glucose and percent glycated hemoglobin A1c. This study demonstrated that those with type 2 diabetes have a diminished pathogen-specific memory CD4+ and Th17 response, and low percentages of CD+T-cells in response to S. pneumoniae stimulation. Copyright © 2014 Mosby, Inc. All rights reserved.

  14. Prevalence and characteristics of resistant hypertensive patients in an Asian population

    Directory of Open Access Journals (Sweden)

    Rabia Naseem

    2017-07-01

    Conclusion: Nearly one in ten hypertensive patients had true resistant hypertension, and twenty-five percent of patients had pseudo-resistance. Resistance hypertensions is significantly associated with female gender, older age, obesity, dietary noncompliance and increased use of NSAIDs.

  15. Randomized controlled trial of a patient decision-making aid for orthodontics.

    Science.gov (United States)

    Parker, Kate; Cunningham, Susan J; Petrie, Aviva; Ryan, Fiona S

    2017-08-01

    Patient decision-making aids (PDAs) are instruments that facilitate shared decision making and enable patients to reach informed, individual decisions regarding health care. The objective of this study was to assess the efficacy of a PDA compared with traditional information provision for adolescent patients considering fixed appliance orthodontic treatment. Before treatment, orthodontic patients were randomly allocated into 2 groups: the intervention group received the PDA and standard information regarding fixed appliances, and the control group received the standard information only. Decisional conflict was measured using the Decisional Conflict Scale, and the levels of decisional conflict were compared between the 2 groups. Seventy-two patients were recruited and randomized in a ratio of 1:1 to the PDA and control groups. Seventy-one patients completed the trial (control group, 36; PDA group, 35); this satisfied the sample size calculation. The median total Decisional Conflict Scale score in the PDA group was lower than in the control group (15.63 and 19.53, respectively). However, this difference was not statistically significant (difference between groups, 3.90; 95% confidence interval of the difference, -4.30 to 12.11). Sex, ethnicity, age, and the time point at which patients were recruited did not have significant effects on Decisional Conflict Scale scores. No harm was observed or reported for any participant in the study. The results of this study showed that the provision of a PDA to adolescents before they consented for fixed appliances did not significantly reduce decisional conflict. There may be a benefit in providing a PDA for some patients, but it is not yet possible to say how these patients could be identified. This trial was registered with the Harrow National Research Ethics Committee (reference 12/LO/0279). The protocol was not published before trial commencement. Copyright © 2017. Published by Elsevier Inc.

  16. Serum cortisol and dehydroepiandrosterone-sulfate levels after balneotherapy and physical therapy in patients with fibromyalgia.

    Science.gov (United States)

    Semiz, Esra A; Hizmetli, Sami; Semiz, Murat; Karadağ, Ahmet; Adalı, Merve; Tuncay, Mehmet S; Alim, Bulent; Hayta, Emrullah; Uslu, Ali U

    2016-05-01

    To investigated serum cortisol and serum dehydroepiandrosterone-sulphate (DHEA-S) levels between fibromyalgia (FMS) patients and a control group, and the effect of balneotherapy (BT) on these hormones.   Seventy-two patients with FMS and 39 healthy volunteers were included in the study. This prospective and cross-sectional study was carried out in the Medical Faculty, Physical Medicine and Rehabilitation Clinic, Cumhuriyet University, Cumhuriyet, Turkey between June 2012 and June 2013. Patients were divided into 2 groups. There were 40 patients in the first group, consisting of BT and physical therapy (PT) administered patients. There were 32 FMS patients in the second group who were only administered PT. Thirty-nine healthy volunteers were enrolled as a control group.   Cortisol was observed to be lower in FMS patients compared with the controls  (10.10±4.08 µg/dL and 11.78±3.6 µg/dL; p=0.033). Serum DHEA-S level was observed to be lower in FMS patients compared with the controls (89.93±53.96 µg/dL and 143.15±107.92 µg/dL; p=0.015). Average serum cortisol levels of patients receiving BT were determined to be 9.95±3.20 µg/dL before treatment and 9.06±3.77µg/dL after treatment; while average serum DHEA-S levels were 77.60±48.05 µg/dL before treatment, and 76.84±48.71 µg/dL after treatment. No significant changes were determined in serum cortisol and DHEA-S levels when measured again after BT and PT.   Low levels of serum cortisol and DHEA-S were suggested to be associated with the physiopathology of FMS.

  17. Electrophysiological changes in patients with liver cirrhosis in a tertiary care hospital in karachi, pakistan

    International Nuclear Information System (INIS)

    Parkash, O.; Mohyuddin, G.R.; Ayub, A.; Nazir, I.

    2017-01-01

    Electrophysiological changes in cirrhosis are well known but least investigated especially in our country hence we wanted to see electrophysiological changes especially QT interval in cirrhotic patients. Methods: A cross-sectional study was conducted at Aga Khan University Hospital Karachi (AKUH) in which medical records (duration 2008-2010) of cirrhotic patients were reviewed. Results: Three hundred and eighty cirrhotic patients' charts were studied, 227 (59.7 percent) were male and mean age of this cohort was 52.8+-12.6 years. The most common cause for CLD was Hepatitis C (CHC) in 260 (68.4 percent), NBNC in 56(14.7 percent) and HBV in 51 (13.4 percent). Only 225 had complete ECG workup, the mean corrected QT interval was 0.44+-0.067 sec. Among the electrophysiological abnormalities, 79 (35 percent) had a prolonged corrected QT interval, 7 (3.1 percent) had a prolonged PR interval (>0.22s) and prolonged QRS duration was seen in 23 (10.4 percent) patients. QT prolongation was seen in 1 of the 5 patients with Child Class A (20 percent), 22 of the 73 patients with Child Class B (30.1 percent), and 25 of the 61 patients with Child Class C (41 percent). However, this difference however was not statistically significant. (p value=.331). Conclusion: We conclude that QT prolongation is more frequent in patients with liver cirrhosis especially when the disease is more advanced like in Child C hence these patients are more prone to sudden cardiac death. Moreover, this study shows that the risk associated with QT prolongation is present through all classes of liver cirrhosis. We recommend that routine cardiac screening with ECG of all cirrhotic patients be performed. (author)

  18. Oropharyngeal Dysphagia in Acute Stroke Patients

    OpenAIRE

    Faezeh Asadollahpour; Kowsar Baghban; Mojgan Asadi; Ehsan Naderifar; Maryam Dehghani

    2015-01-01

    Background: The objective of this study was to investigate the prevalence of different kinds of swallowing disorder and it’s severity in patients after stroke. Patients and Methods: In this cross sectional study, 91 consecutive stroke patients were screened by the Northwestern Dysphagia Patient Check Sheet (NDPCS) and the Gugging Swallowing Screen (GUSS). Results: Forty seven percent of those assessed demonstrated signs of oropharyngeal dysphagia. Mild dysphagia was seen in (10.98%) pat...

  19. Severity of psychosis syndrome and change of metabolic abnormality in chronic schizophrenia patients: severe negative syndrome may be related to a distinct lipid pathophysiology.

    Science.gov (United States)

    Chen, S-F; Hu, T-M; Lan, T-H; Chiu, H-J; Sheen, L-Y; Loh, E-W

    2014-03-01

    Metabolic abnormality is common among schizophrenia patients. Some metabolic traits were found associated with subgroups of schizophrenia patients. We examined a possible relationship between metabolic abnormality and psychosis profile in schizophrenia patients. Three hundred and seventy-two chronic schizophrenia patients treated with antipsychotics for more than 2 years were assessed with the Positive and Negative Syndrome Scale. A set of metabolic traits was measured at scheduled checkpoints between October 2004 and September 2006. Multiple regressions adjusted for sex showed negative correlations between body mass index (BMI) and total score and all subscales; triglycerides (TG) was negatively correlated with total score and negative syndrome, while HDLC was positively correlated with negative syndrome. When sex interaction was concerned, total score was negatively correlated with BMI but not with others; negative syndrome was negatively correlated with BMI and positively with HDLC. No metabolic traits were correlated with positive syndrome or general psychopathology. Loss of body weight is a serious health problem in schizophrenia patients with severe psychosis syndrome, especially the negative syndrome. Schizophrenia patients with severe negative syndrome may have a distinct lipid pathophysiology in comparison with those who were less severe in the domain. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  20. Prospective radiological study concerning a series of patients suffering from conductive or mixed hearing loss due to superior semicircular canal dehiscence.

    Science.gov (United States)

    Martin, Christian; Chahine, Pierre; Veyret, Charles; Richard, Céline; Prades, Jean Michel; Pouget, Jean François

    2009-08-01

    The aim of this study is to appreciate the incidence of patients with isolated conductive hearing loss with normal drum due to superior semicircular canal dehiscence (SCD). It is a prospective radiological study. Two hundred and seventy-two patients with a normal drum suffering from isolated unilateral or bilateral conductive or mixed hearing loss were included in a prospective radiological study. A high resolution computerized tomography (HRCT) was performed in all the patients. Those who were found to have a unilateral or bilateral SCD underwent further etiological, clinical, audiologic evaluation. Ten patients with conductive or mixed hearing loss were found to have a unilateral or bilateral SCD. The disease was bilateral in five cases, and most often associated with a dehiscence of the tegmen tympani on both sides, supporting the theory of the congenital nature of the disease. There was no clear correlation between symptoms and the size of the SCD. Because patients were not suffering from incapacitating vestibular symptoms, they were not operated for surgical occlusion of the SCD, and were referred to a hearing aid specialist to improve hearing. Conductive or mixed hearing loss due to SCD is relatively frequent, justifying in our opinion that a systematic HRCT be carried out before surgery of any patient with conductive hearing loss.

  1. Efficacy and Safety of a Colistin Loading Dose, High-Dose Maintenance Regimen in Critically Ill Patients With Multidrug-Resistant Gram-Negative Pneumonia.

    Science.gov (United States)

    Elefritz, Jessica L; Bauer, Karri A; Jones, Christian; Mangino, Julie E; Porter, Kyle; Murphy, Claire V

    2017-09-01

    Emergence of multidrug-resistant (MDR) gram-negative (GN) pathogens and lack of novel antibiotics have increased the use of colistin, despite unknown optimal dosing. This study aimed to evaluate the safety and efficacy of a colistin loading dose, high-dose (LDHD) maintenance regimen in patients with MDR-GN pneumonia. A retrospective cohort analysis was performed comparing critically ill patients with MDR-GN pneumonia pre- and postimplementation of a colistin LDHD guideline with a primary outcome of clinical cure. Safety was assessed using incidence of acute kidney injury (AKI) based on RIFLE (risk, injury, failure, loss, end-stage renal disease) criteria. Seventy-two patients met the inclusion criteria (42 preimplementation and 30 postimplementation). Clinical cure was achieved in 23 (55%) patients in the preimplementation group and 20 (67%) patients in the postimplementation group ( P = .31). AKI occurred in 50% of the patients during the preimplementation period and 58% during the postimplementation period ( P = .59) with no difference in initiation rates of renal replacement therapy. The increased clinical cure rate after implementation of the colistin LDHD guideline did not reach statistical significance. The LDHD guideline, however, was not associated with an increased incidence of AKI, despite higher intravenous colistin doses. Opportunity exists to optimize colistin dosage while balancing toxicity, but larger studies are warranted.

  2. Treatment Efficacy and Compliance in Patients with Diabetic Macular Edema Treated with Ranibizumab in a Real-Life Setting

    Directory of Open Access Journals (Sweden)

    Anne-Laurence Best

    2018-01-01

    Full Text Available Purpose. To assess real-life efficacy of ranibizumab and treatment compliance of patients with vision loss secondary to diabetic macular edema (DME. Methods. A retrospective study was conducted in DME patients treated with ranibizumab. Patients were monitored every 4 weeks for visual acuity (VA and central retinal thickness (CRT by SD-OCT. All patients received a loading dose of 3 monthly injections followed by retreatments on an as-needed basis. The primary endpoint was the change in VA at M12. Patient compliance to the follow-up and the correlation between the injection number and VA were also investigated. Compliance was compared to that of neovascular age-related macular degeneration (nAMD patients. Results. Seventy-two eyes of 55 consecutive DME patients were included. At baseline, the mean VA was 56.5 letters and CRT was 470 μm. At M12, the mean VA was 63.4 letters (p 70 letters, the mean VA change was +6.9 letters, and the mean CRT was 361.9 μm (p=0.0001 after a mean number of 5.33 intravitreal injections. In patients who received ≥7 injections, the VA gain and final VA were significantly higher than in patients who received <7 injections. At M12, 25.45% of DME patients were lost to follow-up versus 16.8% of nAMD patients (n=55. Discussion/Conclusion. Our study confirms the real-life efficacy of ranibizumab in DME at M12 and the need for a large number of injections to achieve better visual outcomes. We also showed a trend to a lower compliance in diabetic versus nAMD patients.

  3. Illinois' Forests 2005

    Science.gov (United States)

    Susan J. Crocker; Gary J. Brand; Brett J. Butler; David E. Haugen; Dick C. Little; Dacia M. Meneguzzo; Charles H. Perry; Ronald J. Piva; Barry T. Wilson; Christopher W. Woodall

    2009-01-01

    The first full, annualized inventory of Illinois' forests reports more than 4.5 million acres of forest land with an average of 459 trees per acre. Forest land is dominated by oak/hickory forest types, which occupy 65 percent of total forest land area. Seventy-two percent of forest land consists of sawtimber, 20 percent contains poletimber, and 8 percent contains...

  4. Relationship between personality and disability in patients with major depressive disorder.

    Science.gov (United States)

    Güleç, Medine Yazici; Hocaoğlu, Ciçek

    2011-01-01

    The co-morbidity of major depressive disorder (MDD ) with personality disorders (PDs) in patients with long-standing work disability at a psychiatry clinic was investigated. The purpose of our study was to evaluate personality for contributing to disability in patients with MDD and to investigate the relationship with these two psychometric characters in patients with MDD. Seventy-two patients with a MDD and 72 healthy controls were assessed by means of both clinician and self-rating scales for depression, anxiety, disability, and the SCID-II personality inventory. There was no difference between the personality parameters of the groups regarding schizotypal and antisocial PDs. Avoidant personality was found to be less common in the patient group (p=0.030). Dependent (p less than 0.001), obsessive (p=0.003), passive-aggressive (p=0.025), self-defeating (p less than 0.001), paranoid (p less than 0.001), schizoid (p=0.012), histrionic (p=0.001), narcissistic (p less than 0.001), and borderline (p less than 0.001) PDs in patients were more common than in controls. On the disability sub-scales, physical role limitation, vitality, social functioning, emotional role limitation, and mental health were significantly lower in patient group than normal control group. While Cluster A was not related to any disability subscale, Cluster B had a positive correlation with vitality and mental health, whereas Cluster C and Cluster NOS had a negative correlation with emotional role limitation. Only the emotional role limitation predicts the presence of depression, whereas only self-defeating, obsessive, paranoid, and passive aggressive personality predict the emotional role limitation. Patients with MDD have personality and disability problems. PDs in depression contribute to disability. Our results demonstrated that the emotional role limitation is the unique sub-scale that predicts the MDD group.

  5. Some approaches to treatment of patients with thyroid nodular diseases in the Semipalatinsk region of Kazakhstan.

    Science.gov (United States)

    Zhumadilov, Zhaxybay; Hoshi, Masaharu; Takeichi, Nobuo; Abisheva, Gulniaz; Taooka, Yasuyuki; Bhattarcharjee, Deborshi; Kamiya, Kenji

    2003-12-01

    It was determined by experts that in the region adjacent to the Semipalatinsk Nuclear Test Site thyroid nodular prevalence was significantly associated with radiation dose from nuclear weapons testing. The medical rehabilitation of patients is of special practical and scientific importance in this region. Some patients have contraindications for surgery and radioiodine or refuse them for various reasons. Percutaneous intranodular injection therapy by "Paoscle" (PIITP) was used for treatment of patients with benign thyroid nodular diseases. The study group included a total of 107 patients (mainly "pretoxic" and "compensated" nodules). Seventy-four patients received PIITP on an out-patient basis. Seventy-two of them were women and 2 men, mean age, 52.9 +/- 1.3 years; range 26 to 77 years. Thyroid ultrasound examination, fine-needle aspiration biopsy, thyroid function tests and cytopathology were performed in all patients to evaluate the effectiveness of treatment. The nodule volume reduction rate for patients with thyroid adenomas was 56 % on average and 60.2 % in the case of colloid nodules. The reduction rate of thyroid adenomas with necrotic and cystic degeneration was higher and reached 72 %. The suggested method is indicated for cases of benign nodular thyroid diseases (cysts, adenomas, adenomas with necrotic and cystic degeneration, colloid nodules, polynodular goiter). We did not reveal any complications or thyroid test abnormalities after the treatment. A tendency to normalization of the blood serum thyroglobulin level and antibodies to thyroglobulin was documented. Analysis of the treatment results revealed that this approach is effective, inexpensive, safe, well tolerated and can be used on an outpatient basis.

  6. B-type natriuretic peptide as a marker for heart failure in patients with acute stroke.

    Science.gov (United States)

    Koenig, Matthew A; Puttgen, H Adrian; Prabhakaran, Vivek; Reich, Daniel; Stevens, Robert D

    2007-09-01

    To determine whether serum N-terminal pro-B-type natriuretic peptide (N-BNP), a biomarker of myocardial wall stress, is specific to acute heart failure (HF) in patients hospitalized with stroke. Case-control study. Tertiary hospital, Neurosciences Critical Care Unit and Stroke Unit. Consecutive patients with acute ischemic or hemorrhagic stroke who were evaluated for HF. None. Cases and controls were classified, respectively, as patients with or without HF, defined according to modified Framingham criteria. Seventy-two patients were evaluated, 39 with ischemic stroke, 22 with aneurysmal subarachnoid hemorrhage (SAH), and 11 with intracerebral hemorrhage (ICH). Thirty-four patients (47%) met criteria for HF, and 47 patients (65%) had systolic or diastolic left ventricular (LV) dysfunction on echocardiogram. Serum N-BNP was measured a median of 48 h following the onset of stroke and was increased (> 900 pg/ml) in 56 patients (78%), with higher levels in non-survivors (11898 +/- 12741 vs 4073 +/-5691; p = 0.001). In a multiple regression model, N-BNP elevation was not independently associated with HF (OR 5.4, 95% CI 0.8-36.0, p = 0.084). At a cut-off of 900 pg/ml, the sensitivity of N-BNP for HF was 94%, specificity 37%, positive predictive value (PPV) 57%, and negative predictive value (NPV) 88%. For systolic or diastolic LV dysfunction, the sensitivity of N-BNP was 89%, specificity 44%, PPV 75%, and NPV 69%. These results demonstrate that N-BNP elevation is not specific to HF or LV dysfunction in patients with acute ischemic stroke, SAH, and ICH.

  7. Web-based audiovisual patient information system--a study of preoperative patient information in a neurosurgical department.

    Science.gov (United States)

    Gautschi, Oliver P; Stienen, Martin N; Hermann, Christel; Cadosch, Dieter; Fournier, Jean-Yves; Hildebrandt, Gerhard

    2010-08-01

    In the current climate of increasing awareness, patients are demanding more knowledge about forthcoming operations. The patient information accounts for a considerable part of the physician's daily clinical routine. Unfortunately, only a small percentage of the information is understood by the patient after solely verbal elucidation. To optimise information delivery, different auxiliary materials are used. In a prospective study, 52 consecutive stationary patients, scheduled for an elective lumbar disc operation were asked to use a web-based audiovisual patient information system. A combination of pictures, text, tone and video about the planned surgical intervention is installed on a tablet personal computer presented the day before surgery. All patients were asked to complete a questionnaire. Eighty-four percent of all participants found that the audiovisual patient information system lead to a better understanding of the forthcoming operation. Eighty-two percent found that the information system was a very helpful preparation before the pre-surgical interview with the surgeon. Ninety percent of all participants considered it meaningful to provide this kind of preoperative education also to patients planned to undergo other surgical interventions. Eighty-four percent were altogether "very content" with the audiovisual patient information system and 86% would recommend the system to others. This new approach of patient information had a positive impact on patient education as is evident from high satisfaction scores. Because patient satisfaction with the informed consent process and understanding of the presented information improved substantially, the audiovisual patient information system clearly benefits both surgeons and patients.

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

    Science.gov (United States)

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

    1994-01-01

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

  9. Predicting Radiation Pneumonitis After Stereotactic Ablative Radiation Therapy in Patients Previously Treated With Conventional Thoracic Radiation Therapy

    International Nuclear Information System (INIS)

    Liu Hui; Zhang Xu; Vinogradskiy, Yevgeniy Y.; Swisher, Stephen G.; Komaki, Ritsuko; Chang, Joe Y.

    2012-01-01

    Purpose: To determine the incidence of and risk factors for radiation pneumonitis (RP) after stereotactic ablative radiation therapy (SABR) to the lung in patients who had previously undergone conventional thoracic radiation therapy. Methods and Materials: Seventy-two patients who had previously received conventionally fractionated radiation therapy to the thorax were treated with SABR (50 Gy in 4 fractions) for recurrent disease or secondary parenchymal lung cancer (T 10 and mean lung dose (MLD) of the previous plan and the V 10 -V 40 and MLD of the composite plan were also related to RP. Multivariate analysis revealed that ECOG PS scores of 2-3 before SABR (P=.009), FEV1 ≤65% before SABR (P=.012), V 20 ≥30% of the composite plan (P=.021), and an initial PTV in the bilateral mediastinum (P=.025) were all associated with RP. Conclusions: We found that severe RP was relatively common, occurring in 20.8% of patients, and could be predicted by an ECOG PS score of 2-3, an FEV1 ≤65%, a previous PTV spanning the bilateral mediastinum, and V 20 ≥30% on composite (previous RT+SABR) plans. Prospective studies are needed to validate these predictors and the scoring system on which they are based.

  10. Association between response rates and survival outcomes in patients with newly diagnosed multiple myeloma. A systematic review and meta-regression analysis.

    Science.gov (United States)

    Mainou, Maria; Madenidou, Anastasia-Vasiliki; Liakos, Aris; Paschos, Paschalis; Karagiannis, Thomas; Bekiari, Eleni; Vlachaki, Efthymia; Wang, Zhen; Murad, Mohammad Hassan; Kumar, Shaji; Tsapas, Apostolos

    2017-06-01

    We performed a systematic review and meta-regression analysis of randomized control trials to investigate the association between response to initial treatment and survival outcomes in patients with newly diagnosed multiple myeloma (MM). Response outcomes included complete response (CR) and the combined outcome of CR or very good partial response (VGPR), while survival outcomes were overall survival (OS) and progression-free survival (PFS). We used random-effect meta-regression models and conducted sensitivity analyses based on definition of CR and study quality. Seventy-two trials were included in the systematic review, 63 of which contributed data in meta-regression analyses. There was no association between OS and CR in patients without autologous stem cell transplant (ASCT) (regression coefficient: .02, 95% confidence interval [CI] -0.06, 0.10), in patients undergoing ASCT (-.11, 95% CI -0.44, 0.22) and in trials comparing ASCT with non-ASCT patients (.04, 95% CI -0.29, 0.38). Similarly, OS did not correlate with the combined metric of CR or VGPR, and no association was evident between response outcomes and PFS. Sensitivity analyses yielded similar results. This meta-regression analysis suggests that there is no association between conventional response outcomes and survival in patients with newly diagnosed MM. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Thallium-201 is comparable to technetium-99m-sestamibi for estimating cardiac function in patients with abnormal myocardial perfusion imaging

    Directory of Open Access Journals (Sweden)

    Ming-Che Wu

    2015-11-01

    Full Text Available We analyzed the left-ventricular functional data obtained by cardiac-gated single-photon emission computed tomography myocardial perfusion imaging (MPI with thallium-201 (Tl-201 and technetium-99m-sestamibi (MIBI protocols in different groups of patients, and compared the data between Tl-201 and MIBI. Two hundred and seventy-two patients undergoing dipyridamole stress/redistribution Tl-201 MPI and 563 patients undergoing 1-day rest/dipyridamole stress MIBI MPI were included. Higher mean stress ejection fraction (EF, rest EF, and change in EF (ΔEF were noticed in the normal MPI groups by both Tl-201 and MIBI protocols. Higher mean EF was observed in the females with normal MPI results despite their higher mean age. Comparisons between the Tl-201 and MIBI groups suggested a significant difference in all functional parameters, except for the rest end diastolic volume/end systolic volume and ΔEF between groups with negative MPI results. For the positive MPI groups, there was no significant difference in all parameters, except for the change in end diastolic volume and change in end systolic volume after stress between both protocols. The Tl-201 provides comparable left-ventricular functional data to MIBI cardiac-gated single-photon emission computed tomography in patients with positive MPI results, and may therefore be undertaken routinely for incremental functional information that is especially valuable to this patient group.

  12. Obstructive sleep apnoea syndrome in a patient with retrosternal goiter: a case report

    International Nuclear Information System (INIS)

    Sevketbeyoglu, H.; Kara, K.; Ince, M.; Karaagac, H.

    2012-01-01

    Full text: Introduction: Obstructive sleep apnoea syndrome (OSAS) is associated with a large number of predisposing factors (obesity, nasal obstruction, adenoid hypertrophy, macroglossia etc.). In addition to these factors goiter and hypothyroidism have been reported to be associated with OSAS. Objectives and tasks: In our case with retrosternal goiter, values of OSAS before and after thyroidectomy were shown. Materials and methods: Seventy-two years old, BMI: 26,8 kg/m 2 , female patient was admitted our hospital because of complaints to stop breathing during sleep, snoring, morning headache and daytime drowsiness. Results: Thorax CT and ultrasonography of thyroid shown retrosternal goiter and left tracheal deviation. Severe OSAS was diagnosed by polysomnography (PSG). Thyroid function tests were normal. Apneahypopnea index (AHI) was 63,1/h. Patients was performed 7 cm H 2 O nasal continuous positive airway pressure (gvrnCPAP). AHI was 11,4/h under nCPAP. One month after OSAS diagnosis the patient underwent thyroidectomy operation. Pathological examination was reported as multinodular GOITER. In postoperative period CPAP treatment couldn't continue, because patient was not compliant. In postoperative 8-th weeks, PSG was performed; AHI was 34,8/h. The patient's weight and BMI didn't change. Conclusion: In our case, despite absence of continued CPAP treatment after thyroidectomy, symptoms and PSG values improved partially. As a result of these findings, especially, compression of upper airway and deterioration of venous circulation of patients with large goiter may lead to an increase in OSAS symptoms. During patients with OSAS are treated with CPAP, goiter needs to be investigated

  13. Insulin resistance is associated with impaired cardiac sympathetic innervation in patients with heart failure.

    Science.gov (United States)

    Paolillo, S; Rengo, G; Pellegrino, T; Formisano, R; Pagano, G; Gargiulo, P; Savarese, G; Carotenuto, R; Petraglia, L; Rapacciuolo, A; Perrino, C; Piscitelli, S; Attena, E; Del Guercio, L; Leosco, D; Trimarco, B; Cuocolo, A; Perrone-Filardi, P

    2015-10-01

    Insulin resistance (IR) represents, at the same time, cause and consequence of heart failure (HF) and affects prognosis in HF patients, but pathophysiological mechanisms remain unclear. Hyperinsulinemia, which characterizes IR, enhances sympathetic drive, and it can be hypothesized that IR is associated with impaired cardiac sympathetic innervation in HF. Yet, this hypothesis has never been investigated. Aim of the present observational study was to assess the relationship between IR and cardiac sympathetic innervation in non-diabetic HF patients. One hundred and fifteen patients (87% males; 65 ± 11.3 years) with severe-to-moderate HF (ejection fraction 32.5 ± 9.1%) underwent iodine-123 meta-iodobenzylguanidine ((123)I-MIBG) myocardial scintigraphy to assess sympathetic innervation and Homeostasis Model Assessment Insulin Resistance (HOMA-IR) evaluation to determine the presence of IR. From (123)I-MIBG imaging, early and late heart to mediastinum (H/M) ratios and washout rate were calculated. Seventy-two (63%) patients showed IR and 43 (37%) were non-IR. Early [1.68 (IQR 1.53-1.85) vs. 1.79 (IQR 1.66-1.95); P = 0.05] and late H/M ratio [1.50 (IQR 1.35-1.69) vs. 1.65 (IQR 1.40-1.85); P = 0.020] were significantly reduced in IR compared with non-IR patients. Early and late H/M ratio showed significant inverse correlation with fasting insulinemia and HOMA-IR. Cardiac sympathetic innervation is more impaired in patients with IR and HF compared with matched non-IR patients. These findings shed light on the relationship among IR, HF, and cardiac sympathetic nervous system. Additional studies are needed to clarify the pathogenetic relationship between IR and HF. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  14. Clinical Features of Patients with Basedow's Disease and High Serum IgG4 Levels.

    Science.gov (United States)

    Torimoto, Keiichi; Okada, Yosuke; Kurozumi, Akira; Narisawa, Manabu; Arao, Tadashi; Tanaka, Yoshiya

    2017-01-01

    Objective IgG4-related disease is a recently characterized condition presenting with high blood IgG4 levels, swelling of organs, and hypertrophic lesions. This disease is associated with thyroid disease, Hashimoto's disease, and Riedel's thyroiditis. However, there is little information on the association between IgG4-related disease and Basedow's disease. We herein defined the clinical features of patients with Basedow's disease and high IgG4 levels. Methods We compared two groups of patients with Basedow's disease (n=72) who had either normal IgG4 levels (IgG4 levels (≥135 mg/dL; n=5 [6.9%], mean IgG4: 206±116 mg/dL, IgG4/IgG ratio: 10.6%±3.3%). Patients Seventy-two newly diagnosed, untreated patients with Basedow's disease. Results Compared to the normal IgG4 group, patients in the high IgG4 group were predominantly male and showed a significantly higher thyroid low-echo score (1.8±0.4 vs. 1.2±0.5) and eosinophil count (363±354/mm 2 vs. 136±122/mm 2 ). Five patients had high IgG4 levels: one had a pancreatic lesion, and four had thyroid lesions. Conclusion Patients with Basedow's disease and high IgG4 levels may represent a new subtype of Basedow's disease. Further studies with larger sample sizes are needed.

  15. Septic bursitis in immunocompromised patients.

    Science.gov (United States)

    Roschmann, R A; Bell, C L

    1987-10-01

    A retrospective analysis of 29 patients with septic bursitis was undertaken to ascertain if immunocompromised patients differed in their clinical presentations, type of organisms cultured, and outcome when compared with their non-immunocompromised cohorts. Thirty episodes of septic bursitis occurred in 29 patients, 43 percent of which occurred in immunocompromised patients. Despite similar clinical presentations, the bursae of immunocompromised patients took three times longer to sterilize and had a much higher bursal white blood cell count when compared with the bursae of non-immunocompromised patients. The bacteriologic spectrum was essentially identical in both groups; there were no cases in which gram-negative organisms were recovered from infected bursae. No cases of septic bursitis were seen in neutropenic patients. The most common factors contributing to an immunocompromised state were alcoholism or steroid therapy. A successful resolution of septic bursitis was seen in all the patients in the immunocompromised groups.

  16. Patient information and patient preparation in orthognathic surgery : A medical audit study

    NARCIS (Netherlands)

    Rittersma, J.; Casparie, A.F.; Reerink, E.

    1980-01-01

    In 110 patients who had undergone various kinds of orthognathic surgery, patient satisfaction was measured by means of a written questionnaire. Ninety-four percent expressed satisfaction, both with regard to total preparation and the final outcome of the surgical procedure itself. Twenty to forty

  17. Assessment of Personality Types and Locus of Control in Multiple Sclerosis Patients

    Directory of Open Access Journals (Sweden)

    Sh. Mazaheri

    2008-07-01

    Full Text Available Introduction & Objective: Multiple sclerosis (MS is an autoimmune disease with unknown cause. MS is one of the disabling neurologic diseases in adult especially young range that myelin part of central nervous system (CNS is destructed. The aim of this study was assessment of types A and B personality and internal and external locus of control in multiple sclerosis (MS patients and comparison of the results with control group.Materials & Methods: In a case-control study, 30 patients with MS and 30 normal persons as control group evaluated with neurological examination, Rotter locus of control test and Friedman-Rosenman questionnaire for detection of types A and B personality. We employed to analyze the results.Results: 43 percent and 57 percent of MS patients had internal and external locus of control respectively. 63 percent and 37 percent of MS patients had type A and B personality respectively. 60 percent and 40 percent of control group had internal and external locus of control respectively. 20 percent and 80 percent of control group had type A and B personality respectively. Difference between personality type in two groups was significant (P<0.01.Conclusions: In this study, MS patients had more type A personality in comparison to control group.

  18. Clinical profile and outcome of acute encephalitis syndrome (AES patients treated in College of Medical Sciences-Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Lekhjung J Thapa

    2014-01-01

    Full Text Available Objective: Acute encephalitis syndrome is a cause of significant morbidity and mortality in Nepal. Although Japanese encephalitis virus (JEV was thought to be a major cause for acute encephalitis syndrome, more non-Japanese encephalitis virus cases are reported. The outcome of patients with acute encephalitis syndrome is variable. Our study was designed to study the clinical profile and outcome of patients with acute encephalitis syndrome managed in tertiary care center in central Nepal. Methods: The record of patients admitted with diagnosis of acute encephalitis syndrome,from January 2010 to December 2010 in College of Medical Sciences-Teaching Hospital (CMS-TH was reviewed. They were classified clinically as meningitis, encephalitis and meningoencephalitis. The clinical details and reports of the patients were recorded and analyzed. Results: Total of 85 cases of meningitis and encephalitis were identified. Mean age was 19.18 years. Fifty-six (65.9% patients were males and 29 (34.1% were females. Sixty (70.58% patients had meningitis, 8 (9.41% had encephalitis, and 17 (20.0% had meningoencephalitis. JE serology was positive in 4 patients (4.7%. Seventy-two (84.7% patients made full recovery and were discharged from hospital. Thirteen (15.3% patients left against medical advice (LAMA. Conclusion: Acute encephalitis syndrome is still a major public health problem in Nepal. Few of these patients have Japanese Encephalitis. There is a trend towards improved outcome because of availability of improved health services. However, financial constraint remains a challenge in management of acute encephalitis syndrome. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-2, 31-37 DOI: http://dx.doi.org/10.3126/jcmsn.v9i2.9685

  19. Imaging Changes in Pediatric Intracranial Ependymoma Patients Treated With Proton Beam Radiation Therapy Compared to Intensity Modulated Radiation Therapy

    International Nuclear Information System (INIS)

    Gunther, Jillian R.; Sato, Mariko; Chintagumpala, Murali; Ketonen, Leena; Jones, Jeremy Y.; Allen, Pamela K.; Paulino, Arnold C.; Okcu, M. Fatih; Su, Jack M.; Weinberg, Jeffrey; Boehling, Nicholas S.; Khatua, Soumen; Adesina, Adekunle; Dauser, Robert; Whitehead, William E.; Mahajan, Anita

    2015-01-01

    Purpose: The clinical significance of magnetic resonance imaging (MRI) changes after radiation therapy (RT) in children with ependymoma is not well defined. We compared imaging changes following proton beam radiation therapy (PBRT) to those after photon-based intensity modulated RT (IMRT). Methods and Materials: Seventy-two patients with nonmetastatic intracranial ependymoma who received postoperative RT (37 PBRT, 35 IMRT) were analyzed retrospectively. MRI images were reviewed by 2 neuroradiologists. Results: Sixteen PBRT patients (43%) developed postradiation MRI changes at 3.8 months (median) with resolution by 6.1 months. Six IMRT patients (17%) developed changes at 5.3 months (median) with 8.3 months to resolution. Mean age at radiation was 4.4 and 6.9 years for PBRT and IMRT, respectively (P=.06). Age at diagnosis (>3 years) and time of radiation (≥3 years) was associated with fewer imaging changes on univariate analysis (odds ratio [OR]: 0.35, P=.048; OR: 0.36, P=.05). PBRT (compared to IMRT) was associated with more frequent imaging changes, both on univariate (OR: 3.68, P=.019) and multivariate (OR: 3.89, P=.024) analyses. Seven (3 IMRT, 4 PBRT) of 22 patients with changes had symptoms requiring intervention. Most patients were treated with steroids; some PBRT patients also received bevacizumab and hyperbaric oxygen therapy. None of the IMRT patients had lasting deficits, but 2 patients died from recurrent disease. Three PBRT patients had persistent neurological deficits, and 1 child died secondarily to complications from radiation necrosis. Conclusions: Postradiation MRI changes are more common with PBRT and in patients less than 3 years of age at diagnosis and treatment. It is difficult to predict causes for development of imaging changes that progress to clinical significance. These changes are usually self-limiting, but some require medical intervention, especially those involving the brainstem

  20. Urodynamic Bladder Patterns in Spinal Cord Injury Patients

    International Nuclear Information System (INIS)

    Aziz, T.; Khan, A. A.; Iqbal, S.; Aziz, U.; Jilani, S.; Ayyub, A.

    2017-01-01

    Objective: To determine the frequency of various neurogenic bladder patterns in patients with traumatic spinal cord injury presenting at Armed Forces Institute of Rehabilitation Medicine Rawalpindi based on urodynamic studies. Study Design: Descriptive cross sectional study. Place and Duration of Study: Armed Forces Institute of Rehabilitation Medicine (AFIRM) Rawalpindi, from Jul 2014 to Jun 2016. Material and Methods: One hundred and forty traumatic spinal cord injury patients fulfilling the inclusion criteria were included both from indoor and outdoor departments through non-probability purposive sampling. Urodynamic studies were performed using the urodynamic equipment at urodynamic laboratory. Data were collected and recorded on specialized proforma by the principal investigator. Results: Among 140 study participants detrusor overactivity was found in 100 patients out of which 76 (76 percent) had thoracic level of injury, 20 (20 percent) had cervical level and 4 (4 percent) had lumbar level of injury. Detrusor areflexia was the bladder pattern in 40 patients out of which 26 (65 percent) had thoracic level of injury, 10 (25 percent) had cervical level, and 4 (10 percent) had lumbar level of injury. Conclusion: Detrusor overactivity was the commonest neurogenic bladder pattern among the traumatic spinal cord injury patients. (author)

  1. Working hours of surgical residence: perspective of a group of surgeons in a regional hospital in Hong Kong.

    Science.gov (United States)

    Lo, Siu-Fai; Spurgeon, Peter

    2007-01-01

    The Accreditation Council for Graduate Medical Education and European working time directive have restricted residents' workweek to 80 and 48 hours, respectively. Impacts on resident's training and health services are under evaluation in western countries. However, relevant studies are deficient in Hong Kong. Surgeons in a regional hospital of Hong Kong were recruited. Opinions were collected by semi-structured questionnaire. Response rate was 82%. Most respondents agreed that residents' work hours should be limited. Seventy-two percent thought that the addition of physician assistants, nurse practitioners and ancillary staff could help decrease the workload of residents. More than 60% thought that residents should have post-call afternoon off. Seventy-two percent worried that the number of operations residents performed would decrease. Only half agreed that long work hours was part of resident training and 56.3% agreed that the training period should be lengthened because of limiting work hours. Ninety-four percent agreed that sleep-deprived residents would create more medical errors; 72% thought that long work hours would impair quality of care. Surprisingly, only 28% thought that limiting work hours would compromise continued patient care. Most respondents opine that resident work hours should be regulated and welcome minor rescheduling of residents' workflow. The impacts on residents' training and patient care require further evaluation.

  2. College clinic service quality and patient satisfaction.

    Science.gov (United States)

    Deshwal, Pankaj; Ranjan, Vini; Mittal, Geetika

    2014-01-01

    The purpose of this paper is to identify the service quality dimensions that play an important role in patient satisfaction in campus clinics in Delhi; assess student satisfaction with service; and suggests ways to improve areas of dissatisfaction. A questionnaire was distributed to students who had completed at least two consultations at the college clinic. Convenience sampling was used to approach respondents. The questionnaire uses modified SERVQUAL and other instruments, including original dimensions and those constructed through detailed discussions. Factor analyses, reliability tests and the Kaiser-Meyer-Olkin measure of sampling adequacy were conducted. The final sample had a total of 445 respondents. After factor analysis, the authors found that the dimensions affecting patient satisfaction are: staff professionalism; clinic staff reliability; clinic accessibility and basic facilities; tangibles; cleanliness; awareness of the clinic/diseases and how clinic staff deals with emergencies. Most students were satisfied with the professionalism of the clinic staff. More than 70 percent of the respondents reported that the clinic staff paid good attention to them. The campus clinic was deemed reliable by more than 50 percent of respondents. The students found the clinic's location convenient, with more than 50 percent supporting its location. However, there was dissatisfaction among the students regarding the tangibles of the clinic, with more than 50 percent favoring upgrading. There was satisfaction among the respondents regarding the availability of the doctor after clinic hours, but contact details for the clinic staff were not easily accessible on campus. More than 60 percent of respondents were satisfied with the cleanliness of the campus clinic. More than 50 percent felt that the campus clinic was not equipped to deal with emergencies efficiently. At the same time, 90 percent of respondents reported the availability of referral facilities in case of

  3. Space Shuttle main engine powerhead structural modeling, stress and fatigue life analysis. Volume 3: Stress summay of blades and nozzles at FPL and 115 percent RPL loads. SSME HPFTP and HPOTP blades and nozzles

    Science.gov (United States)

    Hammett, J. C.; Hayes, C. H.; Price, J. M.; Robinson, J. K.; Teal, G. A.; Thomson, J. M.; Tilley, D. M.; Welch, C. T.

    1983-01-01

    Gasdynamic environments applied to the turbine blades and nozzles of the HPFTP and HPOTP were analyzed. Centrifugal loads were applied to blades to account for the pump rotation of FPL and 115 percent RPL. The computer models used in the blade analysis with results presented in the form of temperature and stress contour plots are described. Similar information is given for the nozzles.

  4. Patient satisfaction and efficacy of vacuum-assisted excision biopsy of fibroadenomas

    Energy Technology Data Exchange (ETDEWEB)

    Thurley, P. [Nottingham Breast Institute, Nottingham University Hospitals NHS Trust, Nottingham (United Kingdom)], E-mail: pthurley@doctors.org.uk; Evans, A.; Hamilton, L.; James, J.; Wilson, R. [Nottingham Breast Institute, Nottingham University Hospitals NHS Trust, Nottingham (United Kingdom)

    2009-04-15

    Aim: To establish the efficacy, complications, and patient satisfaction for vacuum-assisted biopsy (VAB) excision of fibroadenomas. Materials and methods: All patients referred for VAB of benign lesions from 11 December 2002 to 30 November 2006 were identified prospectively, and the following data were recorded: age, histology, lesion size, and completeness of excision. A questionnaire was sent at least a year after the procedure to assess pain, complications, residual palpable lesions, and cosmetic result. Results: One hundred and thirty-four patients were referred for VAB, 81 had fibroadenomas. Fifty-nine percent replied to the questionnaire. Fifty-four percent of patients reported no pain during the procedure, 8% rated their pain at {>=}3/10. Thirty-two percent had no pain the week after the procedure, 55% had pain {>=}3/10. Seventy-nine percent had no palpable mass at the site of the original lesion. Ninety-four percent would recommend the procedure to others and would prefer further VAB to surgery. Bruising was common, one patient required aspiration of a haematoma. Six percent developed infections, all resolved with antibiotic therapy. Eighty-five percent of patients were completely satisfied with the cosmetic result. Interval ultrasound was performed in 36 patients. A palpable mass was present in 11%, a non-palpable mass in 19%, and no mass in 70%. Conclusion: VAB excision is well-tolerated, safe, and popular with a high initial success rate for fibroadenomas. Bruising and pain are common the week after the procedure.

  5. Patient satisfaction and efficacy of vacuum-assisted excision biopsy of fibroadenomas

    International Nuclear Information System (INIS)

    Thurley, P.; Evans, A.; Hamilton, L.; James, J.; Wilson, R.

    2009-01-01

    Aim: To establish the efficacy, complications, and patient satisfaction for vacuum-assisted biopsy (VAB) excision of fibroadenomas. Materials and methods: All patients referred for VAB of benign lesions from 11 December 2002 to 30 November 2006 were identified prospectively, and the following data were recorded: age, histology, lesion size, and completeness of excision. A questionnaire was sent at least a year after the procedure to assess pain, complications, residual palpable lesions, and cosmetic result. Results: One hundred and thirty-four patients were referred for VAB, 81 had fibroadenomas. Fifty-nine percent replied to the questionnaire. Fifty-four percent of patients reported no pain during the procedure, 8% rated their pain at ≥3/10. Thirty-two percent had no pain the week after the procedure, 55% had pain ≥3/10. Seventy-nine percent had no palpable mass at the site of the original lesion. Ninety-four percent would recommend the procedure to others and would prefer further VAB to surgery. Bruising was common, one patient required aspiration of a haematoma. Six percent developed infections, all resolved with antibiotic therapy. Eighty-five percent of patients were completely satisfied with the cosmetic result. Interval ultrasound was performed in 36 patients. A palpable mass was present in 11%, a non-palpable mass in 19%, and no mass in 70%. Conclusion: VAB excision is well-tolerated, safe, and popular with a high initial success rate for fibroadenomas. Bruising and pain are common the week after the procedure

  6. A comparison between patients with epiphora and cataract of the activity limitations they experience in daily life due to their visual disability.

    Science.gov (United States)

    Bohman, Elin; Wyon, Maria; Lundström, Mats; Dafgård Kopp, Eva

    2018-02-01

    The objective of this study was to compare patients with epiphora and cataract in terms of the activity limitations they experience in daily life due to their visual disability and to validate the use of the Catquest-9SF questionnaire for epiphora patients. Seventy-two consecutively encountered adult patients with confirmed lacrimal obstruction and listed for dacryocystorhinostomy (DCR) or lacrimal intubation at the St. Erik Eye Hospital, Stockholm, Sweden, completed the Catquest-9SF questionnaire, which measures activity limitations in daily life due to visual disability. The psychometric qualities of the Catquest-9SF results obtained from this group of patients were evaluated by Rasch analysis. Rasch analysis was further employed to convert the ordinal raw data to a Rasch score for comparison with the preoperative scores of patients registered in the Swedish National Cataract Register (NCR) during March 2013. The Catquest-9SF exhibited good psychometric qualities when investigating epiphora patients, with the exception of a misfit for Item 4, the item regarding facial recognition. On the Rasch scale (-5.43 = no activity limitations to +5.01 = severe activity limitations), the mean score for epiphora patients was -0.82 while for patients listed for 1st eye and 2nd eye cataract surgery it was -0.17 and -0.76, respectively. An equivalence test confirmed that the reported visual disability of epiphora patients was not significantly different from visual disability reported by patients waiting for 2nd eye cataract surgery. The Catquest-9SF is a valid measure of visual disability in patients with epiphora. Epiphora patients experience visual disability to the same degree as patients awaiting 2nd eye cataract surgery. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  7. Changes in plasma ghrelin and leptin levels in patients with peptic ulcer and gastritis following eradication of Helicobacter pylori infection.

    Science.gov (United States)

    Kasai, Chika; Sugimoto, Kazushi; Moritani, Isao; Tanaka, Junichiro; Oya, Yumi; Inoue, Hidekazu; Tameda, Masahiko; Shiraki, Katsuya; Ito, Masaaki; Takei, Yoshiyuki; Takase, Kojiro

    2016-10-04

    Helicobacter pylori (H. pylori) infection and eradication therapy have been known to influence gastric ghrelin and leptin secretion, which may lead to weight gain. However, the exact relationship between plasma ghrelin/leptin levels and H. pylori infection has remained controversial. The aim of this study was to investigate plasma ghrelin and leptin levels in H. pylori-positive and -negative patients, to compare the two levels of the hormones before and after H. pylori eradication, and to examine the correlation between body mass index (BMI) and active ghrelin or leptin levels, as well as that between atrophic pattern and active ghrelin or leptin levels. Seventy-two H. pylori-positive patients who underwent upper gastrointestinal endoscopy, 46 diagnosed as having peptic ulcer and 26 as atrophic gastritis, were enrolled. Control samples were obtained from 15 healthy H. pylori-negative volunteers. The extent of atrophic change of the gastric mucosa was assessed endoscopically. Body weight was measured and blood was collected before and 12 weeks after H. pylori eradication therapy. Blood samples were taken between 8 and 10 AM after an overnight fast. Plasma ghrelin levels were significantly lower in H. pylori-positive patients than in H. pylori-negative patients. In particular, plasma active ghrelin levels were significantly lower in patients with gastritis compared with patients with peptic ulcer. Plasma ghrelin levels decreased after H. pylori eradication in both peptic ulcer and gastritis patients, while plasma leptin levels increased only in peptic ulcer patients. Plasma leptin levels and BMI were positively correlated, and active ghrelin levels and atrophic pattern were weakly negatively correlated in peptic ulcer patients. H. pylori infection and eradication therapy may affect circulating ghrelin/leptin levels. This finding suggests a relationship between gastric mucosal injury induced by H. pylori infection and changes in plasma ghrelin and leptin levels.

  8. Pulmonic stenosis in dogs: survival and risk factors in a retrospective cohort of patients.

    Science.gov (United States)

    Locatelli, C; Spalla, I; Domenech, O; Sala, E; Brambilla, P G; Bussadori, C

    2013-09-01

    To assess survival and risk factors in dogs with pulmonic stenosis. A retrospective review of medical case records of all cases of pulmonic stenosis >50 mmHg, undergoing pulmonary balloon valvuloplasty or not. Survival curves and multivariate analysis were calculated in the overall population and in subgroups. One hundred and seventy-two cases were included. Factors negatively affecting survival were clinical signs [hazard ratio (HR) 3 · 44, P Dogs with severe pulmonic stenosis undergoing pulmonary balloon valvuloplasty (HR 0 · 47, P = 0 · 047) and asymptomatic dogs with moderate pulmonic stenosis (HR 0 · 10, P = 0 · 042) had a better outcome. Younger age at diagnosis was correlated with poorer outcome in right-sided congestive heart failure dogs (HR 14 · 02, P = 0 · 01). Clinical signs, valve morphology type B and age at diagnosis are risk factors in pulmonic stenosis patients. Pulmonary balloon valvuloplasty is a reasonable treatment choice in dogs with severe pulmonic stenosis. © 2013 British Small Animal Veterinary Association.

  9. Sex-specific predictive power of 6-minute walk test in chronic heart failure is not enhanced using percent achieved of published reference equations.

    Science.gov (United States)

    Frankenstein, Lutz; Zugck, Christian; Nelles, Manfred; Schellberg, Dieter; Katus, Hugo; Remppis, Andrew

    2008-04-01

    The 6-minute walk test (6MWT) is an established prognostic tool in chronic heart failure. The strong influence of height, weight, age, and sex on 6MWT distance may be accounted for by using percentage achieved of predicted value rather than uncorrected 6MWT values. The study included 1069 patients (862 men) with a mean age 55.2 +/- 11.7 years and mean left ventricular ejection fraction of 29% +/- 10%, attending the heart failure clinic of the University of Heidelberg between 1995 and 2005. The predictive power and accuracy of 6MWT and achieved percentage values according to all available published equations for mortality and mortality or transplant combined were tested separately for each sex. The percentage values varied largely between equations. For all equations, women in New York Heart Association (NYHA) functional class I had higher values than men. Although the 6MWT significantly discriminated all NYHA classes for both sexes, only 1 equation discriminated all NYHA classes. No significant differences in the area under the receiver operating-characteristic curve were noted between achieved percentage values and 6MWT. Despite strong univariate significance, achieved percentage values did not retain multivariate significance. The 6MWT was independent from N-terminal brain natriuretic propeptide, NYHA, left ventricular ejection fraction, and peak oxygen uptake. We confirmed 6MWT to be a strong and independent risk predictor for both sexes. Because the prognostic power of 6MWT is not enhanced using percentage achieved of published reference equations, we suggest recalibration of these reference values rather than discarding this approach.

  10. Phosphorylated AKT and MAPK expression in primary tumours and in corresponding metastases and clinical outcome in colorectal cancer patients receiving irinotecan-cetuximab

    Directory of Open Access Journals (Sweden)

    Scartozzi Mario

    2012-04-01

    Full Text Available Abstract Background Clinical observations suggested that a non negligible proportion of patients, ranging from 40% to 70%, does not seem to benefit from the use of anti-EGFR targeted antibodies even in the absence of a mutation of the K- RAS gene. The EGFR pathway activation via the Ras-Raf-MAP-kinase and the protein-serine/threonine kinase AKT could determine resistance to anti-EGFR treatment. Methods We tested the interaction between phosphorylated AKT and MAPK expression in colorectal tumours and corresponding metastases and global outcome in K-RAS wild type patients receiving irinotecan-cetuximab. Results Seventy-two patients with histologically proven metastatic colorectal cancer, treated with Irinotecan and Cetuximab based chemotherapy, were eligible for our analysis. In metastases pAKT correlated with RR (9% vs. 58%, p = 0.004, PFS (2.3 months vs.9.2 months p  Discussion pAKT and pMAPK expression in metastases may modulate the activity of EGFR-targeted antibodies. We could speculate that in patients with pAKT and pMAPK metastases expression targeting these factors may be crucial.

  11. Impact of extracorporeal shockwave therapy on tooth mobility in adult orthodontic patients: a randomized single-center placebo-controlled clinical trial.

    Science.gov (United States)

    Falkensammer, Frank; Rausch-Fan, Xiaohui; Schaden, Wolfgang; Kivaranovic, Danijel; Freudenthaler, Josef

    2015-03-01

    This RCT investigated the effect of non-invasive extracorporeal shockwaves on tooth mobility in orthodontic patients after active treatment. Seventy-two adult patients were included in the study. Immediately after active orthodontic treatment, patients were assigned to a treatment or a placebo group based on block randomization. The orthodontic patients were required to be otherwise healthy. The region of interest was the anterior portion of the mandible. The treatment group received a single shockwave treatment with 1000 impulses while the placebo group was treated with an acoustic sham. Tooth mobility was evaluated over a period of 6 months using a Periotest and manual testing. Pocket probing depths, bleeding on probing and the irregularity index were also assessed. Tooth mobility reduced significantly over 6 months in both groups, but shockwaves achieved significantly more rapid reduction on manual testing. Probing depth was significantly reduced while the irregularity index remained stable. Bleeding on probing was significantly reduced in the treatment group. No anti-inflammatory effect could be derived due to possible initial group differences. The mobility of teeth aligned by orthodontic treatment reduces over time. Shockwave treatment appeared to reduce tooth mobility more rapidly. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. [Impacts on physical and mental health of patients with polycystic ovary syndrome treated with electroacupuncture:a randomized controlled trial].

    Science.gov (United States)

    Jin, Chunlan; Pang, Ran; Huang, Jianmei; Jing, Xianghong; Wu, Zhongchao; Zhao, Jiping

    2016-06-12

    To explore the impacts on physical and mental health of the patients with polycystic ovary syndrome (PCOS) treated with electroacupuncture (EA) or Diane 35. Seventy-two patients of PCOS were randomized into an acupuncture group and a western medication group, 36 cases in each group. In the acupuncture group, acupuncture was applied to relieving liver stagnation and regulating qi activity at Ganshu (BL 18), Danzhong (CV 17), Qimen (LR 14), Zhongwan (CV 4), Tianshu (ST 25), Guanyuan (CV 4), Zigong (EX-CA 1), Sanyinjiao (SP 6), Zusanli (ST 36) and Taichong (LR 3). After qi arrival, the electric stimulation was added for 30 min. Acupuncture treatment was given 3 times a week. In the western medication group, Diane 35 was taken since the 5th day of menstruation and lasted for 21 days. The cycle of treatment was 3 months in the two groups. Before treatment and at the end of treatment, the symptom scores were evaluated and the self-report symptom inventory, symptom checklist-90 (SCL-90) was used for the mental health evaluation and the comparison was made between the two groups. Compared with those before treatment in the same group, the symptom scores were reduced significantly after treatment in the two groups (both P medication group (all P <0.05). EA with relieving liver stagnation and regulating qi activity reduces the symptom scores of PCOS and SCL-90 scores, acting on regulating both physical and mental conditions. The effects achieved with acupuncture are better than those with Diane 35.

  13. The incidence of vitamin, mineral, herbal, and other supplement use in facial cosmetic patients.

    Science.gov (United States)

    Zwiebel, Samantha J; Lee, Michelle; Alleyne, Brendan; Guyuron, Bahman

    2013-07-01

    Dietary supplement use is common in the United States. Some herbal supplements may cause coagulopathy, hypertension, or dry eyes. The goal of this study is to reveal the incidence of herbal supplement use in the cosmetic surgery population. A retrospective chart review of 200 patients undergoing facial cosmetic surgery performed by a single surgeon was performed. Variables studied included patient age, sex, surgical procedure, herbal medication use, and intraoperative variables. Exclusion criteria were age younger than 15 years, noncosmetic procedures such as trauma, and incomplete preoperative medication form. Patients were subdivided into the supplement user group (herbal) and the supplement nonuser group (nonherbal). Statistical analysis included descriptive statistics, t test, and chi-square analysis. The incidence of supplement use was 49 percent in the 200 patients; 24.5 percent of patients used only vitamins or minerals, 2.5 percent of patients used only animal- and plant-based (nonvitamin/mineral) supplements, and 22 percent of patients used both types of supplements. In the herbal group, patients used an average of 2.8 supplements. The herbal and nonherbal groups differed significantly in sex (herbal, 89.8 percent female; nonherbal, 77.5 percent; p use is prevalent in the facial cosmetic surgery population, especially in the older female population. Considering the potential ill effects of these products on surgery and recovery, awareness and careful documentation and prohibiting the patients from the consumption of these products will increase the safety and reduce the recovery following cosmetic procedures.

  14. Iodixanol in femoral arteriography

    International Nuclear Information System (INIS)

    Thorstensen, Oe.; Albrechtsson, U.; Calissendorff, B.; Larusdottir, H.; Norgren, L.; Tengvar, M.; Bolstad, B.; Aspelin, P.

    1994-01-01

    Two contrast media, iodixanol (Visipaque, Nycomed) 270 mg I/ml and iohexol (Omnipaque, Nycomed) 300 mg I/ml, were compared in femoral arteriography, in 147 patients. Both contrast media were diagnostically effective for use in femoral arteriography, without any significant difference. Pain was reported in connection with injection of iohexol by 36% of the patients, after injection of iodixanol none reported pain. Seventy-two percent of the patients in the iodixanol group reported a sensation of warmth in connection with contrast injection versus 90% in the iohexol group. The average intensity of the warmth was greater with iohexol than with iodixanol. Fourteen percent of patients in the iodixanol group and 1% in the iohexol group reported one or more subjective adverse events. (orig.)

  15. Pain Levels Within 24 Hours After UFE: A Comparison of Morphine and Fentanyl Patient-Controlled Analgesia

    International Nuclear Information System (INIS)

    Kim, Hyun S.; Czuczman, Gregory J.; Nicholson, Wanda K.; Pham, Luu D.; Richman, Jeffrey M.

    2008-01-01

    The purpose of this study was to assess the presence and severity of pain levels during 24 h after uterine fibroid embolization (UFE) for symptomatic leiomyomata and compare the effectiveness and adverse effects of morphine patient-controlled analgesia (PCA) versus fentanyl PCA. We carried out a prospective, nonrandomized study of 200 consecutive women who received UFE and morphine or fentanyl PCA after UFE. Pain perception levels were obtained on a 0-10 scale for the 24-h period after UFE. Linear regression methods were used to determine pain trends and differences in pain trends between two groups and the association between pain scores and patient covariates. One hundred eighty-five patients (92.5%) reported greater-than-baseline pain after UFE, and 198 patients (99%) required IV opioid PCA. One hundred thirty-six patients (68.0%) developed nausea during the 24-h period. Seventy-two patients (36%) received morphine PCA and 128 (64%) received fentanyl PCA, without demographic differences. The mean dose of morphine used was 33.8 ± 26.7 mg, while the mean dose of fentanyl was 698.7 ± 537.4 μg. Using this regimen, patients who received morphine PCA had significantly lower pain levels than those who received fentanyl PCA (p < 0.0001). We conclude that patients develop pain requiring IV opioid PCA within 24 h after UFE. Morphine PCA is more effective in reducing post-uterine artery embolization pain than fentanyl PCA. Nausea is a significant adverse effect from opioid PCA.

  16. Patient identification errors are common in a simulated setting.

    Science.gov (United States)

    Henneman, Philip L; Fisher, Donald L; Henneman, Elizabeth A; Pham, Tuan A; Campbell, Megan M; Nathanson, Brian H

    2010-06-01

    We evaluate the frequency and accuracy of health care workers verifying patient identity before performing common tasks. The study included prospective, simulated patient scenarios with an eye-tracking device that showed where the health care workers looked. Simulations involved nurses administering an intravenous medication, technicians labeling a blood specimen, and clerks applying an identity band. Participants were asked to perform their assigned task on 3 simulated patients, and the third patient had a different date of birth and medical record number than the identity information on the artifact label specific to the health care workers' task. Health care workers were unaware that the focus of the study was patient identity. Sixty-one emergency health care workers participated--28 nurses, 16 technicians, and 17 emergency service associates--in 183 patient scenarios. Sixty-one percent of health care workers (37/61) caught the identity error (61% nurses, 94% technicians, 29% emergency service associates). Thirty-nine percent of health care workers (24/61) performed their assigned task on the wrong patient (39% nurses, 6% technicians, 71% emergency service associates). Eye-tracking data were available for 73% of the patient scenarios (133/183). Seventy-four percent of health care workers (74/100) failed to match the patient to the identity band (87% nurses, 49% technicians). Twenty-seven percent of health care workers (36/133) failed to match the artifact to the patient or the identity band before performing their task (33% nurses, 9% technicians, 33% emergency service associates). Fifteen percent (5/33) of health care workers who completed the steps to verify patient identity on the patient with the identification error still failed to recognize the error. Wide variation exists among health care workers verifying patient identity before performing everyday tasks. Education, process changes, and technology are needed to improve the frequency and accuracy of

  17. THE IMMUNOLOGICAL CHARACTERISTIC OF RA PATIENTS WITH ANAEMIA

    Directory of Open Access Journals (Sweden)

    A. E. Sizikov

    2014-07-01

    Full Text Available Abstract. The aim of the investigation was to study the immunological characteristics of RA patients with anaemia. Clinical and laboratory data including the percentage of the main lymphocyte subclasses, phagocyte and DTH-effector activity, serum concentration of immunoglobulins, the percentage of cells producing IFNγ and/or IL-4 and percent of monocytes producing TNF. We revealed some significant clinical, laboratory and immunological differences between RA patients and healthy donors and between patients with and without anaemia. Our data demonstrate RA anemic patients to have more severe disorders than patients without anaemia. We also revealed some significant immunological differences between RA patients and healthy donors and between patients with and without anaemia, including percent of cells producing IFNγ and/or IL-4. Our data permit to conclude that RA patients have many different immunological disturbances, more severe in anaemic patients.

  18. Maitake mushroom (Grifola frondosa) extract induces ovulation in patients with polycystic ovary syndrome: a possible monotherapy and a combination therapy after failure with first-line clomiphene citrate.

    Science.gov (United States)

    Chen, Jui-Tung; Tominaga, Kunihiko; Sato, Yoshiaki; Anzai, Hideo; Matsuoka, Ryo

    2010-12-01

    Insulin resistance is a prominent feature of polycystic ovary syndrome (PCOS), and insulin-sensitizing drugs are used to induce ovulation. Recently, it was reported that an extract from Maitake mushroom (Grifola frondosa) improves insulin resistance. The objective was to explore the effects of Maitake extract (SX-fraction: MSX) to induce ovulation in patients with PCOS in comparison with and in combination with clomiphene citrate (CC). We conducted an open trial with 80 patients with PCOS at three clinics in Japan. Seventy-two (72) new patients were randomly assigned to receive MSX or CC monotherapy for up to 12 weeks. Eighteen (18) patients who did not respond to MSX or CC were subjected to combination therapy of MSX and CC for up to 16 weeks. Eight (8) patients with documented history of failure to CC received combination therapy from the beginning. Ovulation was assessed by ultrasonography. Twenty-six (26) patients in the MSX group and 31 in the CC group were evaluated for ovulation. The ovulation rates for MSX and CC were as follows: 76.9% (20/26) and 93.5% (29/31), respectively by the patients (NS), and 41.7% (30/72) and 69.9% (58/83), respectively, by the cycles (p = 0.0006). In the combination therapy, 7 of 7 patients who failed in MSX monotherapy and 6 of 8 patients who failed in CC monotherapy showed ovulation. The present study suggests that MSX alone may induce ovulation in PCOS patients and may be useful as an adjunct therapy for patients who failed first-line CC treatment.

  19. Patients Commonly Believe Their Heart Failure Hospitalizations Are Preventable and Identify Worsening Heart Failure, Nonadherence, and a Knowledge Gap as Reasons for Admission.

    Science.gov (United States)

    Gilotra, Nisha A; Shpigel, Adam; Okwuosa, Ike S; Tamrat, Ruth; Flowers, Deirdre; Russell, Stuart D

    2017-03-01

    There are few data describing patient-identified precipitants of heart failure (HF) hospitalization. We hypothesized a patient's perception of reason for or preventability of an admission may be related to 30-day readmission rates. Ninety-four patients admitted with decompensated HF from July 2014 to March 2015 completed a brief questionnaire regarding circumstances leading to admission. Thirty-day outcomes were assessed via telephone call and chart review. Mean age was 58 ± 14 years, with 60% blacks (n = 56) and 41% females (n = 39). Median left ventricular ejection fraction was 30%; 27 had preserved ejection fraction. Seventy-two patients identified their hospitalization to be due to HF (± another condition). Most common patient-identified precipitants of admission were worsening HF (n = 37) and dietary nonadherence (n = 11). Readmitted patients tended to have longer time until first follow-up appointment (21 vs 8 days). Seven of the 42 patients who identified their hospitalization as preventable were readmitted compared with 21/49 who believed their hospitalization was unpreventable (P = .012). On multivariate regression analysis, patients who thought their hospitalization was preventable were less likely to be readmitted (odds ratio 0.31; 95% confidence interval 0.10-0.91; P = .04). Almost 50% of patients believe their HF hospitalization is preventable, and these patients appear to be less likely to be readmitted within 30 days. Notably, patients cite nonadherence and lack of knowledge as reasons hospitalizations are preventable. These results lend insight into possible interventions to reduce HF readmissions. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Pattern of Leukaemia Patients Admitted in Ayub Teaching Hospital Abbottabad

    International Nuclear Information System (INIS)

    Khan, T. M.

    2016-01-01

    Background: Any tissue of the body can give rise to cancer. However, those tissues which multiply rapidly are at high risk of developing cancer and haematopoietic system is one of them. Neoplasms of this system are known as leukaemia and lymphoma, according to the types of white cells involved.Study of cancer patterns in different societies, however can contribute a substantial knowledge about the aetiology of cancer. The present Study was designed and aimed to estimate the frequency of different types of leukaemia in patients admitted in Ayub Teaching hospital Abbottabad. Methods: Data from the patients admitted at oncology Department of Ayub Teaching Hospital Abbottabad from 2010 to 2015 was collected and analysed to calculate cumulative and year-wise frequency of leukaemia and its major types. Frequency distribution with reference to gender and age was also calculated. Results: In our analysis about 16 percent patients had acute myelocytic leukaemia and 32 percent patients had acute lymphocytic leukaemia; while chronic myeloid leukaemia outnumbered chronic lymphocytic leukaemia (11 percent and 3 percent); Hodgkin lymphoma was seen in 18 percent cases while Non Hodgkin lymphoma (NHL) was present in 20 percent cases. Out of the total, 150 cases (75 percent) belonged to mountainous areas of Hazara, i.e., 40 cases belonged to Kohistan, another 40 cases were residents of Battagram, 45 cases belonged to hilly areas of Mansehra and 25 cases to Kaghan valley, while only 50 (25 percent) cases were from the plain areas of Abbottabad and Haripur districts, i.e., 20 and 30 cases respectively. Conclusion: Leukaemia is more common in hilly areas of Hazara, since majority of the cases belonged to well-known mountainous regions of Kohistan, Battagram, Kaghan or Mansehra and only few cases belonged to the plain areas of Abbottabad and Haripur districts. (author)

  1. Coral Diseases Following Massive Bleaching in 2005 Cause 60 Percent Decline in Coral Cover and Mortality of the Threatened Species, Acropora Palmata, on Reefs in the U.S. Virgin Islands

    Science.gov (United States)

    Rogers, Caroline S.

    2008-01-01

    Record-high seawater temperatures and calm seas in the summer of 2005 led to the most severe coral bleaching (greater than 90 percent bleached coral cover) ever observed in the U.S. Virgin Islands (USVI) (figs. 1 and 2). All but a few coral species bleached, including the threatened species, Acropora palmata. Bleaching was seen from the surface to depths over 20 meters.

  2. The question about increasing of thermoelectrical Q and percent of the yield of the semiconductor material on the basis of chalcogenides of the bismuth and antimony under conditions of experimental-industrial production

    International Nuclear Information System (INIS)

    Magerramov, A.A.; Barkhalov, B.S.

    2005-01-01

    Full text : Different methods of the receiving of monocrystalline ingots of the semiconductor materials for thermo electrical inverter of energy have been considered. On the basis of the analyses of theoretical and experimental data generated series of recommendations, directed to increase thermo electrical Q receiving from thermo electrical materials and increasing percent of yield of semiconductor materials on the basis of chalcogenides of the bismuth and antimony on the basis of industrial production

  3. Low bone mineral density as a risk factor for osteoporosis and ways of its correction in male patients with ankylosing spondylosis

    Directory of Open Access Journals (Sweden)

    O. A. Pirogova

    2014-09-01

    Full Text Available Objective: to estimate bone mineral density (BMD in men with ankylosing spondylosis (AS.Subjects and methods. Seventy-two male patients (mean age 43.2±9.1 years diagnosed with extended- or late-stage AS (according to the 1984 modified New York criteria (a study group were followed up. A control group consisted of 70 apparently healthy men of the same age (46.7±1.9 years with neither a history of bone fractures and no complains about osteoporosis (OP. In the study and control groups, BMD was determined by dual-energy X-ray absorptiometry.Results. The patients with AS were found to have statistically significantly lower BMD in the femoral neck and lumbar spine. In the study group, osteopenic syndrome (OPS was identified in 44 (61.1%: osteopenia (OPe in 16 (22.2% and OP in 28 (38.9%. In the control group, OPS was detected in 16 (21.62% patients, OPe in 12 (16.21%, and OP in 4 (5.40%. Lower BMD was noted in both the femoral neck and lumbar spine in the extended stage of AS and only in the femoral neck in its late stage.

  4. Low bone mineral density as a risk factor for osteoporosis and ways of its correction in male patients with ankylosing spondylosis

    Directory of Open Access Journals (Sweden)

    O. A. Pirogova

    2014-01-01

    Full Text Available Objective: to estimate bone mineral density (BMD in men with ankylosing spondylosis (AS.Subjects and methods. Seventy-two male patients (mean age 43.2±9.1 years diagnosed with extended- or late-stage AS (according to the 1984 modified New York criteria (a study group were followed up. A control group consisted of 70 apparently healthy men of the same age (46.7±1.9 years with neither a history of bone fractures and no complains about osteoporosis (OP. In the study and control groups, BMD was determined by dual-energy X-ray absorptiometry.Results. The patients with AS were found to have statistically significantly lower BMD in the femoral neck and lumbar spine. In the study group, osteopenic syndrome (OPS was identified in 44 (61.1%: osteopenia (OPe in 16 (22.2% and OP in 28 (38.9%. In the control group, OPS was detected in 16 (21.62% patients, OPe in 12 (16.21%, and OP in 4 (5.40%. Lower BMD was noted in both the femoral neck and lumbar spine in the extended stage of AS and only in the femoral neck in its late stage.

  5. BiRd (clarithromycin, lenalidomide, dexamethasone): an update on long-term lenalidomide therapy in previously untreated patients with multiple myeloma.

    Science.gov (United States)

    Rossi, Adriana; Mark, Tomer; Jayabalan, David; Christos, Paul; Zafar, Faiza; Pekle, Karen; Pearse, Roger; Chen-Kiang, Selina; Coleman, Morton; Niesvizky, Ruben

    2013-03-14

    The combination of clarithromycin, lenalidomide, and dexamethasone (BiRd) was evaluated as therapy for treatment-naive symptomatic multiple myeloma (MM), with overall response at 2 years of 90%. We reviewed the long-term follow-up of initial BiRd therapy. Seventy-two patients were given dexamethasone 40 mg weekly, clarithromycin 500 mg twice daily, and lenalidomide 25 mg daily on days 1 to 21 of a 28-day cycle. After a median follow-up of 6.6 years, overall response rates were 93%, with a very good partial response or better of 68%. Median progression-free survival was 49 months. Evaluation for the development of second primary malignancies (SPMs) was conducted, and no increase in incidence was noted in our cohort of patients who received frontline immunomodulatory therapy. BiRd remains a highly potent and safe regimen for frontline therapy in patients with MM without apparent increase in risk of SPMs. This trial was registered at www.clinicaltrials.gov as #NCT00151203.

  6. Comparison of ultrasound evaluation of patients of obstructive jaundice with endoscopic retrograde cholangio-pancreatography findings

    International Nuclear Information System (INIS)

    Farrukh, S.Z.U.I.; Siddiqui, A.R.; Haqqi, S.A.; Muhammad, A.J.

    2017-01-01

    Ultrasonography has proven to be quite effective in differentiating hepatocellular from obstructive cause of jaundice in various studies. This study was conducted with the aim to determine the efficacy of ultrasonography and Endoscopic Retrograde Cholangio-Pancreatography (ERCP) in the diagnosis of obstructive reason of jaundice. Methods: In this descriptive case series, 200 patients with >15 years age of either gender with cholestatic liver enzymes were included, i.e., those patients who had an ultrasound prior to ERCP at the department of gastroenterology of Patel Hospital, Karachi. Patients known to have liver disease with cholestatic jaundice had imaging other than ultrasound were excluded. The results of ultrasonography and ERCPs were compared in particularly looking for the cause of obstruction. Results: Out of total 200 patients, mean age was 41.22+-12.46 years with 107 (53.5 percent) females. Ability of ultrasound in correctly diagnosing obstructive reason for stone CBD was found to be 72.5 percent, dilated CBD without reason 41.7 percent, proximal obstruction, 63.15 percent, distal CBD obstruction 60 percent, and sludge 66.7 percent. Overall ability of ultrasound in correctly diagnosing the cause of obstruction was 64.17 percent. Conclusion: Ultrasound is recommended as the initial examination, which provides a guide to choose patients for either a more advanced non-invasive imaging like MRCP or to an invasive procedure like ERCP. (author)

  7. Detection of seventy-two anabolic and androgenic steroids and/or their esters in horse hair using ultra-high performance liquid chromatography-high resolution mass spectrometry in multiplexed targeted MS2 mode and gas chromatography-tandem mass spectrometry.

    Science.gov (United States)

    Choi, Timmy L S; Kwok, Karen Y; Kwok, Wai Him; Tsoi, Yeuki Y K; Wong, Jenny K Y; Wan, Terence S M

    2018-06-20

    Anabolic and androgenic steroids (AAS) are banned substances in both human and equine sports. They are often administered intramuscularly to horses in esterified forms for the purpose of extending their time of action. The authors' laboratory has previously reported an UHPLC/HRMS method using quadrupole-Orbitrap mass spectrometer in full scan and parallel reaction monitoring (PRM) mode for the detection of 48 AAS and/or their esters in horse hair. However, two injections were required due to the long duty cycle time. In this paper, an UHPLC/HRMS method using multiplexed targeted MS 2 mode was developed and validated to improve the coverage to 65 AAS and/or their esters in a single injection. In addition, a GC/MS/MS method in selected reaction monitoring (SRM) mode was developed to screen for another seven AAS and/or their esters not adequately covered by the UHPLC/HRMS method using the same sample extract after derivatisation with pentafluoropropionic anhydride. The UHPLC/HRMS and GC/MS/MS methods in combination allowed the detection of 72 AAS and/or their esters with estimated limits of detection down to sub to low ppb levels with good interday precision. Method applicability was demonstrated by the detection of boldione and 4-androstenedione in two out-of-competition hair samples and testosterone propionate in a referee hair sample. Copyright © 2018 Elsevier B.V. All rights reserved.

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    MEASURE: Pneumonia. RESULTS: Twenty-seven percent of the patients admitted to the brain injury unit were in treatment for pneumonia; pneumonia developed in 12% of the patients during rehabilitation; the condition occurred within 19 days of admission in all but 1 patient. Of these patients, 81% received...

  9. Appropriate Frequency and Interval of Neck Ultrasonography Surveillance during the First 10 Years after Total Thyroidectomy in Patients with Papillary Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Yoo Jin Lee

    2018-03-01

    Full Text Available BackgroundNo previous study has employed the frequency and interval of follow-up ultrasonography (US during the first 10 years after total thyroidectomy in patients with papillary thyroid carcinoma (PTC. The aim of this study was to determine the appropriate frequency and interval of follow-up US during the first 10 years in patients who have undergone total thyroidectomy for PTC.MethodsTwo hundred seventy-two patients underwent total thyroidectomy for PTC at our institution from January 2006 to December 2007. Nineteen patients were excluded because of lack of US follow-up data for the neck. Follow-up US was performed by one of two radiologists in all patients. Tumor recurrence/persistence was confirmed by histopathology.ResultsThe mean interval between surgery and the final follow-up US examination was 79.0 months, and the mean number of follow-up US sessions was 5.9 in the 253 evaluable patients. Eleven patients (4.3% developed tumor recurrence/persistence, which was detected on follow-up US within 5 years after total thyroidectomy in all cases. T and N stages were independently associated with tumor recurrence/persistence. The interval between surgery and first suspicion of tumor recurrence/persistence on follow-up US was ≤12 months in six patients and 20, 35, 41, 53, and 60 months in the remaining five patients.ConclusionFor detection of tumor recurrence/persistence after total thyroidectomy in patients with PTC, one or two sessions of follow-up US during the first 2 years, depending on T and N stages and one session of follow-up US in every second year during the following 8 years may be appropriate.

  10. Nasopharyngeal carcinomas: analysis of patient, tumor and treatment characteristics determining outcome

    International Nuclear Information System (INIS)

    Erkal, Haldun S.; Serin, Meltem; Cakmak, Ahmet

    2001-01-01

    Purpose: The present study reviews the experience in treatment of 447 patients with nasopharyngeal carcinomas, analyzing patient, tumor and treatment characteristics determining outcome. Materials and methods: There were 322 males and 125 females, their ages ranging from 7 to 85 years (median, 45 years). Two-hundred and seventy-two patients had World Health Organization (WHO) type 3 carcinomas, 123 patients had T4 tumors and 320 patients had metastatic cervical lymph nodes. Three-hundred and eight patients were treated with radiation therapy alone and 139 patients with chemotherapy in combination with radiation therapy. Cumulative radiation dose to primary tumor ranged from 50 to 76 Gy (median, 70 Gy) and radiation dose to metastatic cervical lymph nodes ranged from 46 to 74 Gy (median, 66 Gy). Results: Follow-up ranged from 0.1 to 19.5 years (mean, 7.6 years). Local complete response was achieved in 357 patients. In multivariate analysis, T-classification, cumulative radiation dose to primary tumor and treatment with chemotherapy in combination with radiation therapy predicted local response. Nodal complete response was achieved in 272 patients. In multivariate analysis, N-classification and radiation dose to metastatic cervical lymph nodes predicted nodal response. Local failure was observed in 70 patients, nodal failure in 35 patients and systemic failure in 114 patients. Overall survival, disease-free survival and disease-specific survival were 33, 32 and 37%, respectively, at 10 years. In multivariate analysis, age, T-classification, N-classification, radiation dose and treatment with chemotherapy in combination with radiation therapy predicted overall survival whereas T-classification, N-classification, radiation dose and treatment with chemotherapy in combination with radiation therapy predicted both disease-free survival and disease-specific survival. Conclusions: Radiation therapy alone appears to be an adequate and viable treatment for patients with early

  11. Percent Daily Value: What Does It Mean?

    Science.gov (United States)

    Healthy Lifestyle Nutrition and healthy eating What do the Daily Value numbers mean on food labels? Answers from ... 15, 2016 Original article: http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/food-and- ...

  12. Percent Forest Adjacent to Streams (Future)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The type of vegetation along a stream influences the water quality in the stream. Intact buffer strips of natural vegetation along streams tend to intercept...

  13. Percent change in population 2000-2020

    Data.gov (United States)

    U.S. Environmental Protection Agency — This data is part of the Regional Environmental Vulnerability Assessment (ReVA) in USEPA Region 3. This variable was created as part of a set of indicators that...

  14. Percent Change in Population 1990-2000

    Data.gov (United States)

    U.S. Environmental Protection Agency — This data is part of the Regional Environmental Vulnerability Assessment (ReVA) in USEPA Region 3. This variable was created as part of a set of indicators that...

  15. Percent Agriculture Adjacent to Streams (Future)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The type of vegetation along a stream influences the water quality in the stream. Intact buffer strips of natural vegetation along streams tend to intercept...

  16. Percent Agricultural Land Cover on Steep Slopes

    Data.gov (United States)

    U.S. Environmental Protection Agency — Clearing land for agriculture tends to increase soil erosion. The amount of erosion is related to the steepness of the slope, farming methods used and soil type....

  17. Caring for Latino patients.

    Science.gov (United States)

    Juckett, Gregory

    2013-01-01

    Latinos comprise nearly 16 percent of the U.S. population, and this proportion is anticipated to increase to 30 percent by 2050. Latinos are a diverse ethnic group that includes many different cultures, races, and nationalities. Barriers to care have resulted in striking disparities in quality of health care for these patients. These barriers include language, lack of insurance, different cultural beliefs, and in some cases, illegal immigration status, mistrust, and illiteracy. The National Standards for Culturally and Linguistically Appropriate Services address these concerns with recommendations for culturally competent care, language services, and organizational support. Latinos have disproportionately higher rates of obesity and diabetes mellitus. Other health problems include stress, neurocysticercosis, and tuberculosis. It is important to explore the use of alternative therapies and belief in traditional folk illnesses, recognizing that health beliefs are dependent on education, socioeconomic status, and degree of acculturation. Many-but not all-folk and herbal treatments can be safely accommodated with conventional therapy. Physicians must be sensitive to Latino cultural values of simpatia (kindness), personalismo (relationship), respeto (respect), and modestia (modesty). The LEARN technique can facilitate cross-cultural interviews. Some cultural barriers may be overcome by using the "teach back" technique to ensure that directions are correctly understood and by creating a welcoming health care environment for Latino patients.

  18. The influence of procedure delay on resource use: a national study of patients with open tibial fracture.

    Science.gov (United States)

    Sears, Erika Davis; Burke, James F; Davis, Matthew M; Chung, Kevin C

    2013-03-01

    The purpose of this study was to (1) understand national variation in delay of emergency procedures in patients with open tibial fracture at the hospital level and (2) compare length of stay and cost in patients cared for at the best- and worst-performing hospitals for delay. The authors retrospectively analyzed the 2003 to 2009 Nationwide Inpatient Sample. Adult patients with open tibial fracture were included. Hospital probability of delay in performing emergency procedures beyond the day of admission was calculated. Multilevel linear regression random-effects models were created to evaluate the relationship between the treating hospital's tendency for delay (in quartiles) and the log-transformed outcomes of length of stay and cost. The final sample included 7029 patients from 332 hospitals. Patients treated at hospitals in the fourth (worst) quartile for delay were estimated to have 12 percent (95 percent CI, 2 to 21 percent) higher cost compared with patients treated at hospitals in the first quartile. In addition, patients treated at hospitals in the fourth quartile had an estimated 11 percent (95 percent CI, 4 to 17 percent) longer length of stay compared with patients treated at hospitals in the first quartile. Patients with open tibial fracture treated at hospitals with more timely initiation of surgical care had lower cost and shorter length of stay than patients treated at hospitals with less timely initiation of care. Policies directed toward mitigating variation in care may reduce unnecessary waste.

  19. Is there an optimal level of positive expiratory pressure (PEP) to improve walking tolerance in patients with severe COPD?

    Science.gov (United States)

    Russo, Davide; Simonelli, Carla; Paneroni, Mara; Saleri, Manuela; Piroddi, Ines Maria Grazia; Cardinale, Francesco; Vitacca, Michele; Nicolini, Antonello

    2016-07-01

    The application of positive expiratory pressure (PEP) devices during exercise had been proposed in order to counteract the pulmonary hyperinflation, reduce the dyspnea and thus increase the exercise tolerance in patients with severe chronic obstructive pulmonary disease (COPD). This randomized controlled crossover trial investigated the effect of two different levels of PEP (1 cmH2O and 10 cmH2O) on distance covered at 6minute walk test (6MWT) in patients with severe COPD. Secondary outcomes were the evaluation of PEP effects on physiological and pulmonary function variables. Seventy-two severe COPD patients, referred to our hospitals as in and out patients, were recruited. A basal 6MWT without devices was performed on the first day, and then repeated with PEP 1 cmH2O (PEP1) and 10 cmH2O (PEP10), with a randomized crossover design. Slow and forced spirometries, including the inspiratory capacity measure, were repeated before and after each 6MWT. 50 patients (average age 69,92 year, mean FEV1 41,42% of predicted) concluded the trial. The 6MWT improved significantly among both PEP levels and baseline (323,8 mt at baseline vs. 337,8 PEP1 and 341,8 PEP10; p<.002 and p<.018, respectively). The difference between PEP10 and PEP1 did not reach the significance. No improvements were found in pulmonary function, symptoms and physiological variables after the 6MWT. In patients with severe COPD, the application of 1 cmH2O of PEP seems to improve the exercise tolerance as 10 cmH2O, with similar dyspnea. Further studies should investigate the effects of low levels of PEP on aerobic training programs. Copyright © 2016 SEPAR. Published by Elsevier Espana. All rights reserved.

  20. Transdermal fentanyl for pain caused by radiotherapy in head and neck cancer patients treated in an outpatient setting. A multicenter trial in Taiwan

    International Nuclear Information System (INIS)

    Chang, J.T.C.; Lin Chienyu; Wang Hungming; Lin Jinching; Lee Moonsing; Chen Yujen

    2010-01-01

    This study evaluated the efficacy and safety of transdermal fentanyl in the outpatient treatment of head and neck cancer patients with pain caused by radiotherapy. Patients with a visual analogue scale score ≥4 were invited to participate in the study. The following variables were collected: visual analogue scale, the Brief Pain Inventory, concomitant pain medications and adverse effects. A total of 163 head and neck cancer patients were enrolled (148 males and 15 females; median age, 53 years; age range, 21-72 years). Seventy-two (44%) patients had a visual analogue scale score >6 at enrollment, despite the use of non-steroidal anti-inflammatory drugs or weak opioids. Ninety-four (57.7%) patients received concurrent chemotherapy. A total of 88 patients completed the study, whereas 55 underwent a drop-out by side effects. The most frequently reported adverse events were vomiting (23.9%) and nausea (16.6%). Treatment with transdermal fentanyl resulted in a significant decrease in visual analogue scale and Brief Pain Inventory scores that persisted during treatment. In the overall efficacy evaluation, the pain-alleviating effect, the easiness of application and the overall impression of transdermal fentanyl were rated as good by 54.5%, 65.9% and 59.1% of the completers, respectively. Effects of transdermal fentanyl were rated as good by 64.8% of the investigators. Our data provide evidence that transdermal fentanyl is effective and relatively easy to use for outpatient treatment of pain control in head and neck cancer patients following radiotherapy in selected patients. Reduction of side effects and effective pain management need to be paramount in the management of head and neck cancer patients undergoing radiotherapy. (author)

  1. Impact of Health Care Provider's Training on Patients ...

    African Journals Online (AJOL)

    Material and Methods: A situation analysis was done before training to assess existing practice of providers' communication skills and patient's satisfaction. All care providers in labour ward were trained and their practice was assessed before and after training. A ten percent sample of patients delivered in hospital before ...

  2. Effect of Social Intolerance on Psychological Distress in Cardiac Patients

    International Nuclear Information System (INIS)

    Zonash, R.; Arouj, K.

    2017-01-01

    Background: The patients with diverse cardiac issues and physical illness experience different levels of social intolerance, depression, anxiety and stress. Objectives: To explore the relationship between social intolerance and psychological distress among cardiac patients and investigate the effect of different type of cardiac illness, its duration and physical symptoms on social intolerance and psychological distress. Study design, settings and duration: Cross-sectional study, conducted at Benazir Bhutto Hospital (BBH), Rawalpindi Institute of Cardiology (RIC), Hearts International Hospital (HIH) and Pakistan Institute of Medical Sciences (PIMS) from September-December, 2014. Patients and Methods: The sample size of 180 adult cardiac patients was collected. These patients were selected from the cardiac units of 4 hospitals of Rawalpindi using purposive sampling. Social intolerance was assessed using Frustration Discomfort Scale (FDS), distress was assessed using depression anxiety and stress scale (DASS) Results: Out of 180 patients, 53.3 percent were males and 46.7 percent females. Their ages ranged from 20 to 60 years. Results revealed significant discomfort intolerance, (p < 0.01) entitlement (p < 0.05) and emotional intolerance (p < 0.01) in these patients. There was 45 percent variance in depression, while discomfort intolerance (p < 0.01) and achievement frustration (p< 0.01) showed 35 percent variance in anxiety. Conclusion: Cardiac patients suffer from major emotional distress.(author)

  3. Hypothyroidism in hepatitis c patients on pegylated interferon therapy

    International Nuclear Information System (INIS)

    Hameed, M.A.; Mehmood, A.; Farooq, M.A.; Nabi, G.U.; Toor, I. H.

    2017-01-01

    Chronic hepatitis has become a major health problem all over the world especially in the third world countries. The most common cause of chronic hepatitis in Pakistan is hepatitis C which can lead to liver cirrhosis and hepatocellular carcinoma. In Pakistan Pegylated Interferon Alpha is still corner stone of therapy for chronic hepatitis C. One of the major side effect of this therapy is the development of thyroid dysfunction, i.e., hypothyroidism and hyperthyroidism. This study was done to assess the frequency of hypothyroidism in hepatitis C patients after three months of pegylated interferon therapy. Method: This study was conducted from 1st October 2013 to 31st march 2014 at outpatients department (OPD) of Gastroenterology and Hepatology, Lahore General Hospital Lahore. Descriptive case series study design was used. The sample of 200 patients was taken from the patients who visited OPD and fulfil the inclusion criteria of the study. Serum thyroid stimulating hormone level (TSH) was done before and after completion of three months therapy at centre for Nuclear Medicine (CENUM) laboratory, Mayo Hospital, Lahore by immune-radiometric assay (IRMA) and patients having TSH>4.0 mIU/L (normal range: 0.2-4.0 mIU/L) were considered hypothyroid. Results: The mean age of the patients was 36.29+-8.5 years. One hundred and twenty-three (61.5 percent) were male and 77 (38.5 percent) were female. After 3 months of interferon therapy, 163 (81.5 percent) patients were euthyroid and 37(18.5 percent) patients were having thyroid dysfunction. There were total 29 (14.5 percent) hypothyroid patients; 8 (27.6 percent) were male and 21 (72.4 percent) female. Conclusion: It is concluded from this study that frequency of hypothyroidism in patients with chronic hepatitis C was 14.5 percent after treatment with pegylated interferon therapy for 3 months. Female patients were more prone to develop hypothyroidism as compared to male patients. (author)

  4. Evaluation of four methods for separation of lymphocytes from normal individuals and patients with cancer and tuberculosis.

    Science.gov (United States)

    Patrick, C C; Graber, C D; Loadholt, C B

    1976-01-01

    An optimal technique was sought for lymphocyte recovery from normal and chronic diseased individuals. Lymphocytes were separated by four techniques: Plasmagel, Ficoll--Hypaque, a commercial semiautomatic method, and simple centrifugation using blood drawn from ten normal individuals, ten cancer patients, and ten tuberculosis patients. The lymphocyte mixture obtained after using each method was analyzed for percent recovery, amount if contamination by erythrocytes and neutrophils, and percent viability. The results show that the semiautomatic method yielded the best percent recovery of lymphocytes for normal individuals, while the simple centrifugation method contributed the highest percent recovery for cancer and tuberculosis patients. The Ficoll-Hypaque method gave the lowest erythrocyte contamination for all three types of individuals tested, while the Plasmagel method gave the lowest neutrophil contamination for all three types of individuals. The simple centrifugation method yielded all viable lymphocytes and thus gave the highest percent viability.

  5. Incidence of Phobias in Iranian Psychiatric Patients

    Directory of Open Access Journals (Sweden)

    L. DANESHMAND

    1975-01-01

    Full Text Available During 1972 a study was undertaken in Roozbeh Mental Hospital of Tehran University to investigate the prevalence of phobias among the patients suffering from one type or another ofmental disorders. It was found that about 10 percent of the total patients visited in the hospital were suffering from phobia. Moreover, darkness, corpse, crowd, pet animals, fear from cancer and syphilis accounted for 79%of the most common phobias, among the 655 recorded cases.

  6. Management of penetrating colon and rectal injuries in the pediatric patient.

    Science.gov (United States)

    Haut, Elliott R; Nance, Michael L; Keller, Martin S; Groner, Jonathan I; Ford, Henri R; Kuhn, Ann; Tuchfarber, Barbara; Garcia, Victor; Schwab, C William; Stafford, Perry W

    2004-09-01

    Management of civilian penetrating colon injuries in the adult has evolved from the universal use of fecal diversion to the highly selective use of colostomy. We hypothesized that a similar management approach was appropriate for the pediatric population. A retrospective review of pediatric patients (age trauma centers for the period January 1990 through June 2001. For the period of review, 53 children with a penetrating colorectal injury were identified. Firearms caused 89 percent of the injuries. The colon was injured in 83 percent (n = 44) of patients and the rectum in 17 percent (n = 9) of patients. The colorectal injury was managed without colostomy in 62 percent (n = 33) and with colostomy in 38 percent (colon = 11, rectum = 9). All rectal injuries were treated with colostomy. The hospital length of stay was longer in the colostomy group (17.6 days vs. 11.4 days). The complication rate was higher in the colostomy group (55 percent vs. 27 percent), which included two patients with stoma-related complications. There was no mortality in this series. Primary repair was used safely in most cases of civilian penetrating colon injuries in the pediatric population. All rectal injuries were treated with colostomy in this series. Fecal diversion was used selectively. Colostomy was performed for selected cases of colon wounds associated with shock, multiple blood transfusions, multiple other injuries, extensive contamination, and high-velocity weapons. In the absence of these associated factors, primary repair appears justified.

  7. Effectiveness of newspaper advertising for patient recruitment into a clinical trial.

    Science.gov (United States)

    Hapca, Adrian; Jennings, Claudine G; Wei, Li; Wilson, Adam; MacDonald, Thomas M; Mackenzie, Isla S

    2014-06-01

    To measure the impact of newspaper advertising across Scotland on patient interest, and subsequent recruitment into the Standard Care vs. Celecoxib Outcome Trial (SCOT), a clinical trial investigating the cardiovascular safety of non-steroidal anti-inflammatory drugs in patients with osteoarthritis or rheumatoid arthritis. Newspaper advertisements about the SCOT trial were placed sequentially in regional and national Scottish newspapers. The number of phone calls as a result of exposure to the advertisements and ongoing study recruitment rates were recorded before, during and after the advertising campaign. To enroll in SCOT individuals had to be registered with a participating GP practice. The total cost for the advertising campaign was £46 250 and 320 phone calls were received as a result of individuals responding to the newspaper advertisements. One hundred and seventy-two individuals were identified as possibly suitable to be included in the study. However only 36 were registered at participating GP practices, 17 completed a screening visit and 15 finally were randomized into the study. The average cost per respondent individual was £144 and the average cost per randomized patient was £3083. Analysis of recruitment rate trends showed that there was no impact of the newspaper advertising campaign on increasing recruitment into SCOT. Advertisements placed in local and national newspapers were not an effective recruitment strategy for the SCOT trial. The advertisements attracted relatively small numbers of respondents, many of whom did not meet study inclusion criteria or were not registered at a participating GP practice. © 2013 The British Pharmacological Society.

  8. Use of the internet by patients attending specialist clinics in Sri Lanka: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Kommalage Mahinda

    2009-02-01

    Full Text Available Abstract Background The internet is a relatively new medium of disseminating health information. Studies on Internet usage for health information are mainly done in developed countries and very few studies have been carried out in developing countries. Methods The Internet usage of patients who were attending specialist clinics in Teaching Hospital Karapitiya and Southern Hospital in Galle, Sri Lanka was investigated. The study was carried out on the following specialities; General Medicine, Pediatrics, General Surgery and Cardiothoracic surgery. Information was collected using an investigator-administered questionnaire while patients were waiting for a consultation. Results Three hundred and fifty five patients (or guardians in the Pediatric clinic participated in the study. One hundred seventy two (48.3% participants have heard about the Internet. There was a relationship between awareness of the Internet and age, educational level and the clinic attended. There was no difference of awareness depending on the gender or the hospital. Only three participants (0.97% have used the Internet to find information about their disease conditions. Close relatives searched the Internet about the conditions of two participants. Altogether, the Internet was used to search information on the disease condition of five participants (1.4%. Conclusion Very low usage of the Internet for health information retrieval in this study is probably due to low awareness of the Internet and low educational level. This low usage of Internet and the associated reasons shown in this study can be generalized to Sri Lanka and probably to other low-income countries that have lower educational level than Sri Lanka.

  9. Effectiveness of newspaper advertising for patient recruitment into a clinical trial

    Science.gov (United States)

    Hapca, Adrian; Jennings, Claudine G; Wei, Li; Wilson, Adam; MacDonald, Thomas M; Mackenzie, Isla S

    2014-01-01

    Aims To measure the impact of newspaper advertising across Scotland on patient interest, and subsequent recruitment into the Standard Care vs. Celecoxib Outcome Trial (SCOT), a clinical trial investigating the cardiovascular safety of non-steroidal anti-inflammatory drugs in patients with osteoarthritis or rheumatoid arthritis. Methods Newspaper advertisements about the SCOT trial were placed sequentially in regional and national Scottish newspapers. The number of phone calls as a result of exposure to the advertisements and ongoing study recruitment rates were recorded before, during and after the advertising campaign. To enroll in SCOT individuals had to be registered with a participating GP practice. Results The total cost for the advertising campaign was £46 250 and 320 phone calls were received as a result of individuals responding to the newspaper advertisements. One hundred and seventy-two individuals were identified as possibly suitable to be included in the study. However only 36 were registered at participating GP practices, 17 completed a screening visit and 15 finally were randomized into the study. The average cost per respondent individual was £144 and the average cost per randomized patient was £3083. Analysis of recruitment rate trends showed that there was no impact of the newspaper advertising campaign on increasing recruitment into SCOT. Conclusions Advertisements placed in local and national newspapers were not an effective recruitment strategy for the SCOT trial. The advertisements attracted relatively small numbers of respondents, many of whom did not meet study inclusion criteria or were not registered at a participating GP practice. PMID:24283948

  10. Physicians report on patient encounters involving direct-to-consumer advertising.

    Science.gov (United States)

    Weissman, Joel S; Blumenthal, David; Silk, Alvin J; Newman, Michael; Zapert, Kinga; Leitman, Robert; Feibelmann, Sandra

    2004-01-01

    We surveyed a national sample of 643 physicians on events associated with visits during which patients discussed an advertised drug. Physicians perceived improved communication and education but also thought that direct-to-consumer advertising (DTCA) led patients to seek unnecessary treatments. Physicians prescribed the advertised drug in 39 percent of DTCA visits but also recommended lifestyle changes and suggested other treatments. Referring to visits when the DTCA drug was prescribed, 46 percent said that it was the most effective drug, and 48 percent said that others were equally effective. Prescribing DTCA drugs when other effective drugs are available warrants further study.

  11. Can a fifty percent increase in public sector wages improve the position of public sector employees in the long run? An assessment of the public-private income gap in Hungary

    OpenAIRE

    Szilvia Hamori; Anna Lovasz

    2011-01-01

    We provide a detailed descriptive analysis of the long-term effects of the 50 percent public sector wage increase initiated by the government in 2002 in order to improve the relative situation of public sector workers. The aim of this policy was to attract high quality workers to the public sector, and to counteract the problem of "brain drain," the loss of high-skilled workers to abroad. To study the effects on the public-private income gap - and on high-skilled workers in particular - we em...

  12. Attitudes towards Prosthodontic Clinical Decision-Making for Edentulous Patients among South West Deanery Dental Foundation Year One Dentists

    Directory of Open Access Journals (Sweden)

    Andrew Barber

    2016-05-01

    Full Text Available The aim of this study was to describe Dental Foundation year one dentists’ attitudes towards prosthodontic decision making for edentulous patients, and identify whether there are gender differences in these attitudes. All South West Deanery trainees were invited to take part in the study between May and June 2011 and a previously piloted questionnaire was administered to the trainees by their training programme directors. The questionnaire posed questions based upon a clinical scenario of discussing treatment options with patients. Seventy-two questionnaires were used in the analysis (91% overall response rate. Trainees perceived their own values to be less important than the patient’s values (p < 0.001 in decision making, but similar to the patient’s friend’s/relative’s values (p = 0.1. In addition, the trainees perceived the patient’s values to be less important than their friend’s/relatives (p < 0.001. Sixty-six per cent of trainees acknowledged an influence from their own personal values on their presentation of material to patients who are in the process of choosing among different treatment options, and 87% thought their edentulous patients were satisfied with the decision making process when choosing among different treatment options. Fifty-eight per cent of trainees supported a strategy of negotiation between patients and clinicians (shared decision making. There was no strong evidence to suggest gender had an influence on the attitudes towards decision making. The finding of a consensus towards shared decision making in the attitudes of trainees, and no gender differences is encouraging and is supportive of UK dental schools’ ability to foster ethical and professional values among dentists.

  13. Vertebral artery ostial stent placement for atherosclerotic stenosis in 72 consecutive patients: clinical outcomes and follow-up results

    International Nuclear Information System (INIS)

    Taylor, Robert A.; Memon, Muhammad Zeeshan; Qureshi, Adnan I.; Vazquez, Gabriela; Siddiq, Farhan; Hayakawa, Minako; Chaloupka, John C.

    2009-01-01

    The study's purpose is to report the technical and clinical outcomes of a patient cohort that underwent vertebral artery ostium stent placement for atherosclerotic stenosis. We retrospectively analyzed a prospectively collected database of neurointerventional procedures performed at a single center from 1999 to 2005. Outcome measures included recurrent transient neurological deficits (TNDs), stroke, and death. Kaplan-Meier analysis was used to estimate stroke- and/or death-free survival at 12 months. Cox proportional hazard was used to identify risk factors for recurrent vertebrobasilar ischemic events. Seventy-two patients with 77 treated vertebral ostial lesions were included. The 30-day stroke and/or death rate was 5.2% (n = 4), although no event was directly related to the vertebral ostium stent placement. Three procedure-related strokes were secondary to attempted stent placement at other sites (one carotid artery and two basilar arteries), and the one death was secondary to the presenting stroke severity. The mean clinical follow-up time available for 66 patients was 9 months. There were 14 TNDs (21%), two strokes (3%), and two deaths (3%) recorded in the follow-up. Recurrent vertebrobasilar ischemic events occurred in nine patients (seven TNDs and two strokes). No recurrent stroke and/or deaths were related to the treated vertebral ostium. Stroke- and/or death-free survival rate (including periprocedural stroke and/or death) was 89 ± 5% at 12 months. No vascular risk factor was significantly associated with recurrent vertebrobasilar ischemic events. Vertebral artery ostium stent placement can be safely and effectively performed with a low rate of recurrent stroke in the territory of the treated vessel. Patients who also underwent attempted treatment of a tandem intracranial stenosis appeared to be at highest risk for periprocedure stroke. (orig.)

  14. Multi-centre European study of breakthrough cancer pain: pain characteristics and patient perceptions of current and potential management strategies

    DEFF Research Database (Denmark)

    Davies, Andrew; Zeppetella, Giovambattista; Andersen, Steen

    2011-01-01

    This study involved 320 cancer patients from four Northern European countries. Patients with breakthrough pain were questioned about the characteristics of their pain, the current management of their pain, and the acceptability/utility of alternative routes of administration. The median number...... of episodes was 3/day. Forty-four percent patients reported incident-type pain, 39% spontaneous-type pain, and 17% a combination of these pains. The median duration was 60 min, and the median time to peak intensity was 15 min. Three percent patients reported "mild" pain, 37% "moderate" pain, and 60% "severe......" pain. Ninety percent patients stated that the pain interfered with their daily activities. All patients were using opioids as rescue medication (mainly oral morphine/oxycodone), whilst 28% patients were using non-opioids, and 50% patients were using non-pharmacological interventions. Only 55% patients...

  15. Quantitative analysis of Esophageal Transit of Radionuclide in Patients with Dermatomyositis-Polymyositis

    International Nuclear Information System (INIS)

    Chung, June Key; Lee, Myung Chul; Koh, Chang Soon; Lee, Myung Hae

    1989-01-01

    Esophageal transit of radionuclide was quantitatively analyzed in 29 patients with dermatomyositis-polymyositis Fourteen patients (48.3%) showed retention of tracer in oropharynx. The mean value of percent retention of oropharynx was 15.5+16.6%. Esophageal dysfunction was found in 19 patients (65.5%). Among them 4 showed mild, 12 showed moderate and 3 showed severe esophageal dysfunction. Dysphagia was found in 11 patients (37.9%), which was closely related to percent retention of oropharynx. Quantitative analysis of esophageal transit of radionuclide seemed to be a useful technique for evaluation of dysphagia in patients with dermatomyositis-polymyositis.

  16. Patient retention at dental school clinics: a marketing perspective.

    Science.gov (United States)

    Makarem, Suzanne C; Coe, Julie M

    2014-11-01

    The purpose of this investigation was to examine the drivers of patient retention at dental school clinics from a services marketing perspective. An analysis of patient characteristics at Virginia Commonwealth University School of Dentistry, screened between August 2010 and July 2011 (N=3604), was performed using descriptive statistics, cross-tabulations, and a binary logistic regression. The main findings were that 42 percent of patients in the study were retained and that no response to communication efforts (36 percent) and financial problems (28 percent) constituted the most common reasons for non-retention. Older age, having insurance, and living within a sixty-mile radius were significant drivers of retention (pskills to better service them, and consequently increasing retention. This will lead to providing a continuum of care and student education and to ensuring the sustainability and quality of the school's educational programs.

  17. The Shift From Sentinel Lymph Node Biopsy Performed Either Before or After Neoadjuvant Systemic Therapy in the Clinical Negative Nodes of Breast Cancer Patients. Results, and the Advantages and Disadvantages of Both Procedures.

    Science.gov (United States)

    Fernandez-Gonzalez, Sergi; Falo, Catalina; Pla, Maria Jesus; Pernas, Sonia; Bajen, Maite; Soler, Teresa; Ortega, Raul; Quetglas, Cecilia; Perez-Martin, Xavier; Fernandez Montoli, Maria Eulalia; Campos, Miriam; Varela-Rodriguez, Mar; Ponce, Jordi; Garcia-Tejedor, Amparo

    2018-02-01

    In patients with breast cancer who are candidates for neoadjuvant therapy (NAT), the timing of when to perform sentinel lymph node biopsy (SLNB) remains under discussion. The aim of this study was to compare the advantages and disadvantages of SLNB performed before and after NAT. One hundred seventy-two patients, T1c to T3 and N0 (clinically and according to ultrasound) candidates for NAT were included. We compared the outcomes of 2 groups: (1) 122 patients of whom SLNB was performed before NAT (pre-NAT) from December 2006 to April 2014; and (2) 50 patients with SLNB performed after NAT (post-NAT) from May 2014 to July 2016. Both groups were homogeneous in baseline patient characteristics. The SLNB was positive in 50 patients [41.7%] (33 macrometastases [66%] and 17 micrometastases [34%]) versus 6 patients [12%] (5 macrometastases [83.3%] and 1 micrometastases [16.7%]) in pre- and post-NAT groups, respectively. The lymphadenectomy was performed in 34 patients [28.3%] versus 4 patients [8%], with an odds ratio of 3.48 (95% confidence interval, 1.3-9.3). The recurrences in the pre-NAT group after a median follow-up of 62 months were 12 systemic, 2 local and systemic, and none axillary. In the post-NAT group were no recurrences after a median follow-up of 16 months. Finally, SLNB after NAT reduces the delay in starting NAT from 24 to 14 days (medians; P < .001) and the identification of the SLNB was in 122 patients [100%] versus 49 patients [98%]. SLNB performed after NAT significantly reduces the rate of lymphadenectomies without any increase in recurrences at early follow-up. Furthermore, it allows systemic treatment to be started earlier without interfering in the SLNB identification rate. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Association of Neglect-Like Symptoms with Anxiety, Somatization, and Depersonalization in Complex Regional Pain Syndrome.

    Science.gov (United States)

    Michal, Matthias; Adler, Julia; Reiner, Iris; Wermke, Andreas; Ackermann, Tatiana; Schlereth, Tanja; Birklein, Frank

    2017-04-01

    Many patients with complex regional pain syndrome (CRPS) report some foreignness of the affected limb, which is referred to as "neglect-like symptoms" (NLS). Despite similarities of the NLS reports to symptoms of body image disturbances in mental disorders, no study has been conducted to examine such associations. We investigated 50 patients with CRPS and 45 pain control patients (N = 27, chronic limb pain; N = 18, migraine headache). NLS, anxiety, depression, depersonalization, and somatization were assessed using validated questionnaires. Seventy-two percent of the CRPS patients reported at least one NLS vs 29.6% and 33.3% in the two patient control groups. In limb pain controls, NLS correlated with pain intensity. In CRPS patients, NLS correlated with anxiety (rho = 0.658, P  psychological studies. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  19. Diagnostic value of frozen section study for thyroid nodules in patients referred to Shariati Hospital 1997-2000

    Directory of Open Access Journals (Sweden)

    "Shirzad M

    2001-11-01

    Full Text Available Frozen section is a useful method in the diagnosis of different malignancies including those of thyroid origin. However, there are still controversies about its application, sensitivity and specificity for thyroid neoplasm. In this study, diagnostic value of frozen section (FS was compared with permanent histopathologic and Fine Needle Aspiration (FNA. In this study, which was conducted in process research method, permanent sample, FNA, and frozen section results in 214 patients was compared. All of these 214 patients had been seeking medical evaluation for thyroid nodules between years 1997 and 1999 in Shariati hospital. All pathologic evaluations were performed by pathology staff of this hospital. Permanent pathology was considered as the gold standard; so the specificity, sensitivity and diagnostic precision of FNA and FS were evaluated on the basis of its results. We use Macnemar test for this purpose. The number of patients during this period were 214 (160 women and 54 men. Mean age of our patients was 42.3±5.4 and their age ranged between 12 to 84 years. Pathologic results revealed that 163 of the patients (76 percent had benign lesions, and 51 of them (24 percent had malignant lesions. Thyroid malignancies comparised papillary carcinoma (70 percent, follicular carcinoma (13.5 percent, papilofollicular carcinoma (6 percent, medulary carcinoma (6 percent, Hurtle cell carcinoma (4 percent and anaplastic carcinoma (5 percent. FNA was done in all of the patients before surgery and was able to determine the status of nodules in 150 patients. Sensitivity, specificity and precision of FNA in these 150 patients were 72, 96 and 90 percents respectively. When FNA was unable to determine the status of a nodule (64 remaining patients, FS was applied to do the job. A sensitivity of 36 percent, specificity of 85 percent and precision of 73 percent was found in this group of patients. Macnemar test showed that there is no significant difference between

  20. Evaluation of Survival Rate and Effective Factors in Acute Myocardial Infarction Patients in Emam Hospital (Year 2000

    Directory of Open Access Journals (Sweden)

    M Maghsoodloo

    2002-09-01

    Full Text Available Introduction: For the time being we have considered that the myocardial infarction is an increasing event in Islamic Republic of Iran and there are many procedures and methods which can help us to diminish the number of death from this ongoing event. The main aim of this research is to determine the survival rate in those patients who have had acute myocardial infarction and the association of it with different variables. Methods and Materials: The present research is a descriptive case-series study which evaluates the 100 cases of acute myocardial infarction who had been admitted in Tehran Emam Khomeini Hospital during the year 1999. Results: The mean age of patients was 57 years. The peak of attack rates was in spring and autumn. Investigating of the past history of these patients reviled that 41 percent had been smokers, 63.5 percent have had the history of previous ischemic heart disease, 41 percent have had hyper cholestrolemia, 34 percent had hypertension, 18 percent had diabetes mellitus, 9 percent had mitral rigurgitation and 9 percent had heart block. The Survival rate in our study has been calculated 68 percent in first 28 days of disease. Conclusion: In our study we concluded that there is significant correlation between survival rate and past history of hypertension, ischemic heart disease, tobacco smoking and clip classification.

  1. Mutations of the phenylalanine hydroxylase gene in patients with phenylketonuria in Shanxi, China

    Directory of Open Access Journals (Sweden)

    Yong-An Zhou

    2012-01-01

    Full Text Available The variation in mutations in exons 3, 6, 7, 11 and 12 of the phenylalanine hydroxylase (PAH gene was investigated in 59 children with phenylketonuria (PKU and 100 normal children. Three single nucleotide polymorphisms were detected by sequence analysis. The mutational frequencies of cDNA 696, cDNA 735 and cDNA 1155 in patients were 96.2%, 76.1% and 7.6%, respectively, whereas in healthy children the corresponding frequencies were 97.0%, 77.3% and 8.3%. In addition, 81 mutations accounted for 61.0% of the mutant alleles. R111X, H64 > TfsX9 and S70 del accounted for 5.1%, 0.8% and 0.8% mutation of alleles in exon 3, whereas EX6-96A > G accounted for 10.2% mutation of alleles in exon 6. R243Q had the highest incidence in exon 7 (12.7%, followed by Ivs7 +2T>A (5.1% and T278I (2.5%. G247V, R252Q, L255S, R261Q and E280K accounted for 0.8% while Y356X and V399V accounted for 5.9% and 5.1%, respectively, in exon 11. R413P and A434D accounted for 5.9% and 2.5%, respectively, in exon 12. Seventy-two variant alleles accounted for the 16 mutations observed here. The mutation characteristics and distributions demonstrated that EX6-96A > G and R243Q were the hot regions for mutations in the PAH gene in Shanxi patients with PKU.

  2. Adaptation of the Tool to Estimate Patient Costs Questionnaire into Indonesian Context for Tuberculosis-affected Households.

    Science.gov (United States)

    Fuady, Ahmad; Houweling, Tanja A; Mansyur, Muchtaruddin; Richardus, Jan H

    2018-01-01

    Indonesia is the second-highest country for tuberculosis (TB) incidence worldwide. Hence, it urgently requires improvements and innovations beyond the strategies that are currently being implemented throughout the country. One fundamental step in monitoring its progress is by preparing a validated tool to measure total patient costs and catastrophic total costs. The World Health Organization (WHO) recommends using a version of the generic questionnaire that has been adapted to the local cultural context in order to interpret findings correctly. This study is aimed to adapt the Tool to Estimate Patient Costs questionnaire into the Indonesian context, which measures total costs and catastrophic total costs for tuberculosis-affected households. the tool was adapted using best-practice guidelines. On the basis of a pre-test performed in a previous study (referred to as Phase 1 Study), we refined the adaptation process by comparing it with the generic tool introduced by the WHO. We also held an expert committee review and performed pre-testing by interviewing 30 TB patients. After pre-testing, the tool was provided with complete explanation sheets for finalization. seventy-two major changes were made during the adaptation process including changing the answer choices to match the Indonesian context, refining the flow of questions, deleting questions, changing some words and restoring original questions that had been changed in Phase 1 Study. Participants indicated that most questions were clear and easy to understand. To address recall difficulties by the participants, we made some adaptations to obtain data that might be missing, such as tracking data to medical records, developing a proxy of costs and guiding interviewers to ask for a specific value when participants were uncertain about the estimated market value of property they had sold. the adapted Tool to Estimate Patient Costs in Bahasa Indonesia is comprehensive and ready for use in future studies on TB

  3. Peritonitis bacteriana espontánea: estudio en pacientes cirróticos descompensados con ascitis Spontaneous bacterial peritonitis in decompensated cirrhotic patients with ascites

    Directory of Open Access Journals (Sweden)

    Fernando Montoya Maya

    1995-02-01

    . coli y estreptococos del grupo viridans debe tenerse en cuenta para la adecuada selección de la terapia empírica antibacteriana.

    Between February 1993 and March 1994 a prospective descriptive study was carried out in 25 cirrhotic patients (three of them on two occasions with clinical or ultrasonographic ascites; they were hospitalized in the Internal Medicine ward of San Vicente de Paúl Hospital, in Medellín, Colombia, because of decompensation. All of them went through diagnostic paracentesis with cytologic, bacteriologic and chemical studies. Average age was 43.9 years (13 to 77 years, 13 were women (52% and 12 men (48%. Infection of the ascitic fluid was found in 11 cases (39.3%, namely: Bacterascites 6 cases (monomicrobial 3 cases (27.3%, polymicrobial 3 cases (27.3%», spontaneous bacterial peritonitis 3 cases (polymicrobial 2 cases (18.2% and monomicrobial1 case (9.1 %» and neutrocytic ascites 2 cases (18.2%. Seventy two percent of the infectious episodes caused fever (p < 0.01 and in 46% there was abdominal pain (p < 0.1. AII patients with infected ascites belonged to Child's classification C. Serum albumin levellower than 2 g/dl was a risk factor for developing infection. Escherichia coli was cultivated on 5 occasions (45.5%, viridans group of Streptococci in 5 (45.5%, anaerobes in 3 (27.3% and other bacteria in 3 (27.3%. Mortality due to infected ascites was 27.3% (3 cases, comparable to that produced by other causes that was 29.4% (5/17. We conclude that ascitic fluid infection is a common complication in decompensated cirrhotic patients. Thecardinal clinical signs are fever and abdominal pain. The frequent isolation of E. coli and viridans group Streptococci has to be taken into account for the initiation of antibiotic therapy in cases with clinical suspicion.

  4. Prognostic implications of c-Ki-ras2 mutations in patients with advanced colorectal cancer treated with 5-fluorouracil and interferon: a study of the eastern cooperative oncology group (EST 2292)

    Science.gov (United States)

    Wadler, S; Bajaj, R; Neuberg, D; Agarwal, V; Haynes, H; Benson, A B

    1997-01-01

    Mutations in c-Ki-ras2 (ras) occur in about 40% of patients with colorectal cancers and occur early in the pathogenesis of this disease. To evaluate the prognostic value of mutations in ras, the Eastern Cooperative Oncology Group (ECOG) conducted a retrospective study (EST 2292) to determine the frequency of mutations in patients with advanced colorectal cancer, and to determine whether ras mutations were associated with altered response to therapy and survival. Patients were enrolled from four studies: P-Z289, an ECOG phase II trial of 5-fluorouracil (5-FU) and interferon (IFN) in patients with advanced colorectal cancer; P-Z991, an ECOG phase I trial of 5-FU and IFN in patients with advanced malignancies; and two trials from the Albert Einstein College of Medicine in patients with advanced colorectal cancer treated with 5-FU and either IFN-alpha or IFN-beta. All patients had advanced colorectal carcinoma and had sufficient histologic material available for analysis for the presence and type of ras, using polymerase chain reaction and dot-blot analysis with sets of probes sufficient to detect all the common mutations of ras at codons 12, 13, and 61. Seventy-two patients were enrolled in this trial. Mutations in ras were detected in 25 (35%), including 17 (23%) in codon 12, four (6%) in codon 13, and four (6%) in codon 61. There was no correlation between the presence of a ras mutation and age, sex, Dukes' stage, histology, or tumor markers. Thirty-one of 72 patients (43%) responded to therapy with 5-FU and IFN, and 10 of 31 responders (32%) and 15 of 41 nonresponders (37%) had mutations in ras. There was no difference in response rates or overall survival between the groups with and without ras mutations. It is unlikely that ras mutations will have significant prognostic value for either response to therapy or survival in patients with colorectal carcinomas treated with 5-FU and IFN.

  5. Evaluation of the patient with suspected extrahepatic biliary obstruction

    International Nuclear Information System (INIS)

    Watson, C.G.

    1975-01-01

    In most patients, obstructive jaundice can be differentiated from intrahepatic cholestatic jaundice employing conventional clinical, radiologic, and laboratory techniques. Roughly 20 percent of these patients will remain without a diagnosis. During the past decade, several invasive and noninvasive techniques for visualizing the biliary tree have been developed, increasing the diagnostic yield to over 90 percent. The combination of selective visceral arteriography and percutaneous transhepatic cholangiography is currently the preferred approach. Duodenoscopy with retrograde choledochopancreatography, as an alternative approach, will become increasingly utilized in the near future. An exploratory laparotomy for jaundice of undetermined etiology should not be undertaken without first performing one or the other of the above procedures

  6. Predictive value of myocardial perfusion scintigraphy after stress in patients without previous myocardial infarction

    International Nuclear Information System (INIS)

    Tuner, D.A.; Battle, W.E.; Deshmukh, H.; Colandrea, M.A.; Snyder, G.J.; Fordham, E.W.; Messer, J.V.

    1978-01-01

    Seventy-five patients who had chest pain but no history or ECG evidence of myocardial infarction (MI) underwent myocardial-stress perfusion scintigraphy (MSPS) with thallium-201, treadmill-stress testing (TST), and coronary cineangiography (CA). The sensitivities of MSPS and TST for coronary stenosis greater than or equal to 75 percent were 68 percent and 71 percent, respectively; their specificities were 97 percent and 79 percent, respectively (0.1 greater than p greater than 0.05). When the character of a patient's chest pain is considered, Bayesian analysis leads to the following conclusions: MSPS can be useful in pre-CA screening of patients with chest pain but no MI if their pain is thought to be of uncertain or nonischemic origin; the sensitivity of Tl-201 MSPS is not sufficient for pre-CA screening of patients without MI who have typical or atypical angina pectoris; the sensitivity of MSPS would have to be approximately 95 percent in order for the test to be useful in pre-CA screening of patients who have atypical angina pectoris; MSPS may be superior to TST in these applications; and it is not clear that there is any advantage in combining MSPS and TST into a single screening test rather than using MSPS alone

  7. Marketing to older patients: perceptions of service quality.

    Science.gov (United States)

    Brand, R R; Cronin, J J; Routledge, J B

    1997-01-01

    Marketing has taken on increased importance in the United States' health care industry, especially with respect to Americans aged 55 and older. Given that health care costs account for 14 percent of the GNP of the U.S., and that older Americans represent nearly 25 percent of all health care expenditures, the ability of physicians to assess the perceptions of service quality, service value, and satisfaction and the effects of these variables on patient loyalty with respect to older patients is very important. A comprehensive model of patient behavior is introduced and tested. The results suggest the medical office staff and the expertise of the physician play particularly important roles in older patients' perceptions of service quality. In addition, strong relationships were found between (1) Service Quality and Satisfaction, (2) Satisfaction and Patient Behavior (repeated use of the physician), and (3) Service Quality and Patient Behavior. Conclusions and suggestions for future research are offered.

  8. Abutment tooth loss in patients with overdentures.

    Science.gov (United States)

    Ettinger, Ronald L; Qian, Fang

    2004-06-01

    Since the 1960s, the use of natural teeth as overdenture abutments has become part of accepted clinical practice. Several longitudinal studies have been conducted, but tooth loss has not been reported to be a significant problem. The aim of this study was to identify the incidence and causes of tooth loss in a prospective cohort study of subjects wearing overdentures. The study, conducted between 1973 and 1994, evaluated 273 subjects (62.3 percent male) with a mean age of 59.6 years. Of the 273 subjects with 666 abutments, 74 lost 133 abutments. The most common cause of tooth loss was periodontal disease (29.3 percent) followed by periapical lesions (18.8 percent) and caries (16.5 percent). Through logistic regression, the authors found that subjects who lost teeth were more likely to have medical problems that could cause soft-tissue lesions of the oral mucosa, were less likely to use fluoride daily and were less likely to return for yearly recall visits. The authors found 22 vertical fractures in 17 subjects. Chi2 analysis revealed that overdenture teeth in the maxillary arch that were opposed by natural teeth were more likely to experience vertical fractures. In a study that followed up some patients for as long as 22 years, the rate of tooth loss was 20.0 percent. Many of these failures could have been prevented if patients had practiced better oral hygiene. The findings suggest that if a dentist recommends overdenture therapy, the patient needs to be examined regularly to reduce the risk of experiencing caries and periodontal disease. Also, if the abutments are in the maxilla and are opposed by natural teeth, the dentist should consider using thimble crowns to reduce the risk of vertical fractures.

  9. Patients ≥ 75 years with acute coronary syndrome but without critical epicardial coronary disease: prevalence, characteristics, and outcome

    Science.gov (United States)

    Wong, Vincent; Farah, Ahmed; von Korn, Hubertus; Memisevic, Nedim; Richter, Stefan; Tukhiashvili, Ketevan; Lauer, Bernward; Ohlow, Marc-Alexander

    2015-01-01

    Objective Absence of significant epicardial coronary artery disease (CAD) in patients with acute onset of chest pain and elevation of myocardial necrosis markers is occasionally observed. The aim of this study was to analyse the clinical characteristics and outcome of such patients with advanced age. Methods We retrospectively analysed 4,311 patients with acute onset of chest pain plus necrosis marker elevation. Two hundred and seventy two patients without CAD on angiogram (6.3%) were identified. Out of them, 50 (1.2%) patients ≥ 75 years (Group I) were compared with (1) 222 acute coronary syndrome (ACS) patients without CAD on angiogram < 75 years (Group II), and (2) 610 consecutive patients ≥ 75 years with Non-ST-elevation Myocardial Infarction (NSTEMI) undergoing percutaneous coronary intervention (Group III). Results Group I compared to Group III patients made up for more females (64.0% vs. 49.2%; P < 0.0001), and had more severe anginal symptoms on presentation [Canadian Cardiovascular Society (CCS) class I/II, 26.0% vs. 49.8%; P = 0.02]. Group I patients also had lower troponin levels (0.62 ± 0.8 ng/mL vs. 27 ± 74 ng/mL; P < 0.02), lower leukocyte count (9.4 ± 3.13 × 109 vs. 12 ± 5.1 × 109; P = 0.001) and better preserved left ventricular function (56.7% ± 14.3% vs. 45% ± 11%; P < 0.0001). Event-free survival (cardiac death, myocardial infarction, recurrent angina, and re-hospitalisation) was more frequent in Group I and II patients compared to Group III patients (64.9%, 66.7%, and 41.6%, respectively; P < 0.0001). Conclusions ACS in patients ≥ 75 years without CAD is very infrequent, associated with a (1) similar outcome compared to ACS patients < 75 years without CAD, and (2) significant better outcome compared to NSTEMI patients ≥ 75 years. PMID:25678899

  10. Patterns of recurrence after selective postoperative radiation therapy for patients with head and neck squamous cell carcinoma

    International Nuclear Information System (INIS)

    Murakami, Naoya; Matsumoto, Fumihiko; Yoshimoto, Seiichi; Ito, Yoshinori; Mori, Taisuke; Ueno, Takao; Tuchida, Keisuke; Kashihara, Tairo; Kobayashi, Kazuma; Harada, Ken; Kitaguchi, Mayuka; Sekii, Shuhei; Umezawa, Rei; Takahashi, Kana; Inaba, Koji; Igaki, Hiroshi; Itami, Jun

    2016-01-01

    The radiation field for patients with postoperative head and neck squamous cell carcinoma is narrower in our institution than in Western countries to reduce late radiation related toxicities. This strategy is at a risk of loco-regional or distant metastasis. However, because patients are more closely checked than in Western countries by every 1 to 2 months intervals and it is supposed that regional recurrences are identified and salvage surgeries are performed more quickly. Therefore, it is considered that patient survival would not be compromised with this strategy. The aim of this study was to investigate the feasibility of this strategy retrospectively. Patients who underwent neck dissection with close or positive margin, extra-capsular spread (ECS), multiple regional lymph node metastasis, pT4, with or without primary tumor resection were treated with postoperative radiation therapy. The volume of radiation field, especially the coverage of prophylactic regional lymph node area, was discussed among head and neck surgeons and radiation oncologists taking into account the clinical factors including patient’s age, performance status, number of positive lymph nodes, size of metastatic lymph nodes, extension of primary tumor beyond the midline, and existence of ECS. Seventy-two patients were identified who were treated with postoperative radiation therapy for head and neck squamous cell carcinoma between November 2005 and December 2014. There were 20 patients with oropharynx, 19 with hypopharynx, 7 with larynx, 23 with oral cavity, and 3 with other sites. Thirty eight patients had their neck irradiated bilaterally and 34 unilaterally. Median follow-up period for patients without relapse was 20.7 months (5.1–100.7). Thirty two patients had disease relapse after treatment including 22 loco-regional recurrence and 14 distant metastases. Among 22 loco-regional recurrence, seven patients underwent salvage surgery and one of them was no relapse at the time of the

  11. e effect of nurse-patient language barrier on patients' satisfaction

    International Nuclear Information System (INIS)

    Ali M. Al-Khathami; Sulieman W. Kojan; Mohammed A. Aljumah; Hussein Alqahtani; Hind Alrwaili

    2010-01-01

    To study Saudi patients' perception of nursing care delivered by non-Arabic speaking nurses (NASNs). A cross-sectional survey of randomly selected patients admitted to King Abdul-Aziz Medical City, Riyadh, Saudi Arabia during the summer of 2009. We conducted structured face-to-face interviews, and the Institutional Review Board approved the study. 47% were men. Half was illiterate or had a low level of education. Eighty percent was served by NASNs. Most believed that the Arabic language is important to provide high quality of care. Two thirds reported difficulties in understanding nursing instructions, and felt that NASNs could not understand their concerns on many occasions. Half believed that NASNs are more susceptible to error. Seventy percent felt uncomfortable dealing with a nurse who cannot communicate in the same language, and 30% question the reliability of information delivered by NASNs. Patients noticed that NASN avoid (50%) or end conversation (70%) due to language barriers. Sixty-one percent reported that NASNs never or rarely called the interpreter. Overall satisfaction of nursing care was high (90%), with no significant difference between patients who were served by Arabic versus NASNs. Our patients were concerned about the language barrier during nursing care delivery. It may lead to miscommunication and compromise the patient-nurse relationship. Further exploration of this issue (Author).

  12. Survey of commercially available chocolate- and cocoa-containing products in the United States. 2. Comparison of flavan-3-ol content with nonfat cocoa solids, total polyphenols, and percent cacao.

    Science.gov (United States)

    Miller, Kenneth B; Hurst, W Jeffrey; Flannigan, Nancy; Ou, Boxin; Lee, C Y; Smith, Nancy; Stuart, David A

    2009-10-14

    A survey of a broad range of chocolate- and cocoa-containing products marketed in the United States was conducted to provide a more detailed analysis of flavan-3-ol monomers, oligomers, and polymers, which can be grouped into a class of compounds called procyanidins. Samples consisted of the three or four top-selling products within the following six categories: natural cocoa powder, unsweetened baking chocolate, dark chocolate, semisweet baking chips, milk chocolate, and chocolate syrup. Composite samples were characterized for percent fat (% fat), percent nonfat cocoa solids (% NFCS), antioxidant level by ORAC, total polyphenols, epicatechin, catechin, total monomers, and flavan-3-ol oligomers and polymers (procyanidins). On a gram weight basis epicatechin and catechin content of the products follow in decreasing order: cocoa powder > baking chocolate > dark chocolate = baking chips > milk chocolate > chocolate syrup. Analysis of the monomer and oligomer profiles within product categories shows there are two types of profiles: (1) products that have high monomers with decreasing levels of oligomers and (2) products in which the level of dimers is equal to or greater than the monomers. Results show a strong correlation (R(2) = 0.834) of epicatechin to the level of % NFCS and also very good correlations for N = 2-5 oligomers to % NFCS. A weaker correlation was observed for catechin to % NFCS (R(2) = 0.680). Other analyses show a similar high degree of correlation with epicatechin and N = 2-5 oligomers to total polyphenols, with catechin being less well correlated to total polyphenols. A lesser but still good correlation exists between the calculated percent cacao (calcd % cacao) content, a proxy for percent cacao, and these same flavanol measures, with catechin again showing a lesser degree of correlation to calcd % cacao. Principal component analysis (PCA) shows that the products group discretely into five classes: (1) cocoa powder, (2) baking chocolate, (3) dark

  13. Dual-energy x-ray absorptiometry to measure the effects of a thirteen-week moderate to vigorous aquatic exercise and nutritional education intervention on percent body fat in adults with intellectual disabilities from group home settings.

    Science.gov (United States)

    Casey, Amanda; Boyd, Colin; Mackenzie, Sasho; Rasmussen, Roy

    2012-05-01

    People with intellectual disability are more likely to be obese and extremely obese than people without intellectual disability with rates remaining elevated among adults, women and individuals living in community settings. Dual-energy X-ray absorptiometry measured the effects of a 13-week aquatic exercise and nutrition intervention on percent body fat in eight adults with intellectual disabilities (aged 41.0 ± 13.7 yrs) of varying fat levels (15%-39%) from two group homes. A moderate to vigorous aquatic exercise program lasted for the duration of 13 weeks with three, one-hour sessions held at a 25m pool each week. Nutritional assistants educated participants as to the importance of food choice and portion size. A two-tailed Wilcoxon matched-pairs signed-ranks test determined the impact of the combined intervention on body fat percentage and BMI at pre and post test. Median body fat percentage (0.8 %) and BMI (0.3 kg/m(2)) decreased following the exercise intervention, but neither were statistically significant, p = .11 and p = .55, respectively. The combined intervention was ineffective at reducing percent body fat in adults with intellectual disability according to dual-energy X-ray absorptiometry. These results are in agreement with findings from exercise alone interventions and suggest that more stringent nutritional guidelines are needed for this population and especially for individuals living in group home settings. The study did show that adults with intellectual disability may participate in moderate to vigorous physical activity when given the opportunity.

  14. Improved predictive value of GRACE risk score combined with platelet reactivity for 1-year cardiovascular risk in patients with acute coronary syndrome who underwent coronary stent implantation.

    Science.gov (United States)

    Li, Shan; Liu, Hongbin; Liu, Jianfeng; Wang, Haijun

    2016-11-01

    Both high platelet reactivity (HPR) and Global Registry of Acute Coronary Events (GRACE) risk score have moderate predictive value for major adverse cardiovascular disease (CVD) events in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI), whereas the prognostic significance of GRACE risk score combined with platelet function testing remains unclear. A total of 596 patients with non-ST elevation ACS who underwent PCI were enrolled. The P2Y 12 reaction unit (PRU) value was measured by VerifyNow P2Y 12 assay and GRACE score was calculated by GRACE risk 2.0 calculator. Patients were stratified by a pre-specified cutoff value of PRU 230 and GRACE score 140 to assess 1-year risk of cardiovascular death, non-fatal myocardial infarction (MI), and stent thrombosis. Seventy-two (12.1%) patients developed CVD events during 1-year follow-up. Patients with CVD events had a higher PRU value (244.6 ± 50.9 vs. 203.7 ± 52.0, p risk independently. Compared to patients with normal platelet reactivity (NPR) and GRACE score risk (HR: 5.048; 95% CI: 2.268-11.237; p risk score yielded superior risk predictive capacity beyond GRACE score alone, which is shown by improved c-statistic value (0.871, p = 0.002) as well as net reclassification improvement (NRI 0.263, p risk of adverse CVD events. The combination of platelet function testing and GRACE score predicted 1-year CVD risk better.

  15. Proctalgia fugax: demographic and clinical characteristics. What every doctor should know from a prospective study of 54 patients.

    Science.gov (United States)

    de Parades, Vincent; Etienney, Isabelle; Bauer, Pierre; Taouk, Milad; Atienza, Patrick

    2007-06-01

    This prospective study was designed to describe a typical attack of proctalgia fugax. Patients were recruited from May 2003 to June 2004. Whatever the reason for consultation, they were systematically asked: "Do you ever suffer intermittent and recurring anorectal pain lasting for at least three seconds?" If the answer was yes, they were interviewed with a questionnaire and had a proctologic examination. The criterion for proctalgia fugax was a positive answer with a negative examination. The study included 1,809 patients. Fifty-four of these patients (3 percent) had proctalgia fugax and 83 percent of them had never sought medical advice for this problem. The mean age was 51 (range, 18-87) years. Thirty-seven patients were females (69 percent). The onset of pain was sudden and without a trigger factor in 85 percent of cases. Attacks occurred in the daytime (33 percent) as well as at night (35 percent). The pain was described as cramping, spasm-like, or stabbing in 76 percent of cases. It did not radiate in 93 percent of cases. There were no concomitant symptoms in 81 percent of cases. Attacks stopped spontaneously in 67 percent of cases. The average duration was 15 minutes (range, 5 seconds to 90 minutes). The average annual number of attacks was 13 (range, 1-180). Proctalgia fugax affects twice as many females as males at approximately aged 50 years. Commonly the roughly once-monthly attack occurs as a sudden pain with no trigger factor, diurnally as often as nocturnally. The nonradiating cramp, spasm, or stabbing pain, without concomitant symptoms, is most severe on average after 15 minutes and declines spontaneously.

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

    International Nuclear Information System (INIS)

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

    1981-01-01

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

  17. Management of constipation in palliative care patients undergoing opioid therapy: is polyethylene glycol an option?

    Science.gov (United States)

    Wirz, Stefan; Klaschik, Eberhard

    2005-01-01

    This study assessed the efficacy of laxative use for treatment of constipation in patients receiving opioid therapy, with special attention to polyethylene glycol 3350/electrolyte solution (PEG-ES). Computerized data from 206 patients were analyzed using descriptive statistics. Subgroups were analyzed using confirmatory statistics. Constipation occurred in 42.7 percent of patients. Laxatives were administered to 74.3 percent of these patients using a standardized step scheme, with good results in 78.4 percent. As a therapy for constipation, the combined administration of PEG-ES, sodium picosulphate, and liquid paraffin proved most effective, although statistical analysis yielded no significance. Early use of PEG-ES using a step scheme holds promise for treatment of opioid-related constipation in palliative care patients, although further investigation is warranted.

  18. Differences between Proxy and Patient Assessments of Cancer Care Experiences and Quality Ratings.

    Science.gov (United States)

    Roydhouse, Jessica K; Gutman, Roee; Keating, Nancy L; Mor, Vincent; Wilson, Ira B

    2018-04-01

    To assess the impact of proxy survey responses on cancer care experience reports and quality ratings. Secondary analysis of data from Cancer Care Outcomes Research and Surveillance (CanCORS). Recruitment occurred from 2003 to 2005. The study was a cross-sectional observational study. The respondents were patients with incident colorectal or lung cancer or their proxies. Analyses used linear regression models with an independent variable for proxy versus patient responses as well as study site and clinical covariates. The outcomes were experiences with medical care, nursing care, care coordination, and care quality rating. Multiple imputation was used for missing data. Among 6,471 respondents, 1,011 (16 percent) were proxies. The proportion of proxy respondents varied from 6 percent to 28 percent across study sites. Adjusted proxy scores were modestly higher for medical care experiences (+1.28 points [95 percent CI:+ 0.05 to +2.51]), but lower for nursing care (-2.81 [95 percent CI: -4.11 to -1.50]) and care coordination experiences (-2.98 [95 percent CI: -4.15 to -1.81]). There were no significant differences between adjusted patient and proxy ratings of quality. Proxy responses have small but statistically significant differences from patient responses. However, if ratings of care are used for financial incentives, such differences could be exaggerated across practices or areas if proxy use varies. © Health Research and Educational Trust.

  19. High-dose intensity modulated radiation therapy for prostate cancer: early toxicity and biochemical outcome in 772 patients

    International Nuclear Information System (INIS)

    Zelefsky, Michael J.; Fuks, Zvi; Hunt, Margie; Yamada, Yoshiya; Marion, Christine; Ling, C. Clifton; Amols, Howard; Venkatraman, E.S.; Leibel, Steven A.

    2002-01-01

    Purpose: To report the acute and late toxicity and preliminary biochemical outcomes in 772 patients with clinically localized prostate cancer treated with high-dose intensity-modulated radiotherapy (IMRT). Methods and Materials: Between April 1996 and January 2001, 772 patients with clinically localized prostate cancer were treated with IMRT. Treatment was planned using an inverse-planning approach, and the desired beam intensity profiles were delivered by dynamic multileaf collimation. A total of 698 patients (90%) were treated to 81.0 Gy, and 74 patients (10%) were treated to 86.4 Gy. Acute and late toxicities were scored by the Radiation Therapy Oncology Group morbidity grading scales. PSA relapse was defined according to The American Society of Therapeutic Radiation Oncology Consensus Statement. The median follow-up time was 24 months (range: 6-60 months). Results: Thirty-five patients (4.5%) developed acute Grade 2 rectal toxicity, and no patient experienced acute Grade 3 or higher rectal symptoms. Two hundred seventeen patients (28%) developed acute Grade 2 urinary symptoms, and one experienced urinary retention (Grade 3). Eleven patients (1.5%) developed late Grade 2 rectal bleeding. Four patients (0.1%) experienced Grade 3 rectal toxicity requiring either one or more transfusions or a laser cauterization procedure. No Grade 4 rectal complications have been observed. The 3-year actuarial likelihood of ≥ late Grade 2 rectal toxicity was 4%. Seventy-two patients (9%) experienced late Grade 2 urinary toxicity, and five (0.5%) developed Grade 3 urinary toxicity (urethral stricture). The 3-year actuarial likelihood of ≥ late Grade 2 urinary toxicity was 15%. The 3-year actuarial PSA relapse-free survival rates for favorable, intermediate, and unfavorable risk group patients were 92%, 86%, and 81%, respectively. Conclusions: These data demonstrate the feasibility of high-dose IMRT in a large number of patients. Acute and late rectal toxicities seem to be

  20. Implications of normal exercise electrocardiographic results in patients with angiographically documented coronary artery disease. Correlation with left ventricular function and myocardial perfusion

    International Nuclear Information System (INIS)

    Hakki, A.H.; DePace, N.L.; Colby, J.; Iskandrian, A.S.

    1983-01-01

    The purpose of this study was to examine the incidence and implications of false-negative exercise electrocardiographic results among 216 consecutive patients with angiographically documented coronary artery disease (50 percent diameter narrowing or greater of one or more vessels). Exercise electrocardiography gave negative (false-negative) results in 23 patients and positive (true-positive) results in 102 patients, and were nondiagnostic in the rest. Exercise thallium-201 imaging was performed in 88 patients. The extent of coronary artery disease was quantitated by a scoring system that takes into consideration the degree and site of narrowing in the major vessels and their branches. The exercise heart rate was higher in patients with false-negative than in patients with true-positive exercise electrocardiographic results (161 +/- 18 versus 133 +/- 24 beats per minute, mean +/- SD; p less than 0.0001). Q-wave infarction was present in two patients (9 percent) with false-negative and 20 patients (20 percent) with true-positive exercise electrocardiographic results; left ventricular asynergy at rest was observed in 13 patients (57 percent) with false-negative and in 74 patients (74 percent) with true-positive results. Patients with false-negative results had less extensive coronary disease than did patients with true-positive results (score 5.8 +/- 3.6 versus 9.2 +/- 5.0; p . 0.0025). Angina during exercise was less frequent in patients with false-negative results (p less than 0.01). Abnormal exercise thallium-201 images were seen in 15 of 20 patients (75 percent) with false-negative results and in 56 of 68 patients (82 percent) with true-positive results

  1. Androgen suppression plus radiation vs. radiation alone for patients with D1 (pN+) adenocarcinoma of the prostate (results based on a national prospective randomized trial RTOG 85-31)

    International Nuclear Information System (INIS)

    Lawton, Colleen A.; Pajak, Thomas F.; Byhardt, Roger; Sause, William T.; Hanks, Gerald E.; Russell, Anthony H.; Rotman, Marvin; Porter, Arthur; McGowan, David G.; DelRowe, John D.; Pilepich, Miljenko V.

    1996-01-01

    Purpose/Objective: To evaluate the effect of immediate androgen suppression in conjunction with standard external beam irradiation versus radiation alone on a group of pathologically staged lymph node positive patients with adenocarcinoma of the prostate. Methods and Materials: A national prospective randomized trial of standard external beam irradiation plus immediate androgen suppression vs. external beam irradiation alone was initiated in 1985 for patients with locally advanced adenocarcinoma of the prostate. One hundred seventy two of the patients in this trial had biopsy proven pathologically involved lymph nodes. Ninety Eight of these patients received radiation plus the immediate androgen suppression (LHRH agonist) while 74 received radiation alone with hormonal manipulation instituted at the time of relapse. Results: With a median followup of 3.9 years actuarial progression free survival at five years was 56% for the patients who received radiation plus immediate LHRH agonist versus 33% patients who received radiation alone with hormonal manipulation at relapse (p = .0009). Since all of these patients had locally advanced disease (i.e. pathologically positive lymph nodes) stage does not explain this difference in outcome and gleason grade was not statistically different between the two groups. Although not statistically different at this point both overall survival and cause specific survival favor radiation and immediate LHRH agonist. Actuarial overall survival at five years for the radiation and LHRH group was 69% versus 59% for the radiation alone group who received androgen suppression at relapse. Actuarial cause specific survival at five years was 84% for the radiation and immediate LHRH agonist group and 73% for the radiation alone group. Conclusion: Patients with adenocarcinoma of the prostate and pathologically involved pelvic lymph nodes (pN+ or clinical stage D 1 ) should be seriously considered for external beam irradiation plus immediate

  2. Processing and microstructure of Nb-1 percent Zr-0.1 percent C alloy sheet

    Science.gov (United States)

    Uz, Mehmet; Titran, Robert H.

    1992-01-01

    A systematic study was carried out to evaluate the effects of processing on the microstructure of Nb-1 wt. pct. Zr-0.1 wt. pct. C alloy sheet. The samples were fabricated by cold rolling different sheet bars that were single-, double- or triple-extruded at 1900 K. Heat treatment consisted on one- or two-step annealing of different samples at temperatures ranging from 1350 to 1850 K. The assessment of the effects of processing on microstructure involved characterization of the precipitates including the type, crystal structure, chemistry and distribution within the material as well as an examination of the grain structure. A combination of various analytical and metallographic techniques were used on both the sheet samples and the residue extracted from them. The results show that the relatively coarse orthorhombic Nb2C carbides in the as-rolled samples transformed to rather fine cubic monocarbides of Nb and Zr with varying Zr/Nb ratios upon subsequent heat treatment. The relative amount of the cubic carbides and the Zr/Nb ratio increased with increasing number of extrusions prior to cold rolling. Furthermore, the size and the aspect ratio of the grains appear to be strong functions of the processing history of the material. These and other results obtained will be presented with the emphasis on a possible relationship between processing and microstructure.

  3. Consanguinity Ratio in Beta-Thalassemia Major Patients in District Bannu

    International Nuclear Information System (INIS)

    Khan, M. S.; Ahmed, M.; Khan, R. A.; Mushtaq, N.; Shah, M. W. U.

    2015-01-01

    Objective: To assess the frequency of consanguinity in b-thalassemia major patients and its association with age, gender and hepatitis C virus antibody positivity. Methods: The cross-sectional study was conducted from June 2013 to July 2014 at various hospitals of district Bannu in the North Western Khyber Pakhtunkhwa province of Pakistan. Data was recorded on a predesigned questionnaire. Results: Out of 180 subjects, 133(74 percent) parents were cousins, while 47(26 percent) were unrelated. The frequency of anti-hepatitis C virus antibody positivity was 14(7.77 percent). Conclusion: High prevalence of the disease in the study region was due to consanguineous marriages. (author)

  4. Is dietary pattern of schizophrenia patients different from healthy subjects?

    Directory of Open Access Journals (Sweden)

    Amani Reza

    2007-05-01

    Full Text Available Abstract Background There are limited findings about dietary patterns and food preferences among patients suffering from schizophrenia. The main objective of this study was therefore to compare the nutritional pattern of schizophrenia patients with that of matched healthy subjects. Methods The dietary pattern of 30 hospitalized 16–67 years old schizophrenic patients (11 female was compared with that of 30 healthy age and sex matched individuals as control group. Subjects' anthropometric measurements including weight, height and body mass index (BMI, semi-quantitative food frequency (FFQ, medical and food history questionnaires were also collected and FFQs were then scored using Food Guide Pyramid to obtain the dietary scores. Percent body fat (%BF was measured using bioelectrical impedance analysis (BIA method. Results Female patients had more %BF and lower dietary pattern scores than that of their controls (32 ± 3.6 vs 27.7 ± 4.6 percent and 43.2 ± 11.9 vs 54.5 ± 10.7 points; respectively, p Conclusion Schizophrenia patients have poor nutritional patterns. In particular, female patients have more percent body fat and lower dietary pattern scores compared with their healthy controls. All patients used to consume more fats and sweet drinks frequently. The findings of this study suggest that schizophrenia patients need specific medical nutrition therapies through limiting dietary fats and sugars intakes and weight control. Whether obesity is the consequence of disease, dietary preference or medications used remains to be cleared.

  5. EVALUATION OF QUANTITATIVE THYROID SCINTIGRAPHY FOR DIAGNOSIS AND STAGING OF DISEASE SEVERITY IN CATS WITH HYPERTHYROIDISM: COMPARISON OF THE PERCENT THYROIDAL UPTAKE OF PERTECHNETATE TO THYROID-TO-SALIVARY RATIO AND THYROID-TO-BACKGROUND RATIOS.

    Science.gov (United States)

    Peterson, Mark E; Guterl, Jade N; Rishniw, Mark; Broome, Michael R

    2016-07-01

    Thyroid scintigraphy is commonly used for evaluation of cats with hyperthyroidism, with the thyroid-to-salivary ratio (T/S) being the most common method to quantify the degree of thyroid activity and disease. Calculation of thyroid-to-background ratios (T/B) or percent thyroidal uptake of (99m) TcO(-) 4 (TcTU) has only been reported in a few studies. The purpose of this prospective, cross-sectional study was to evaluate a number of quantitative scintigraphic indices as diagnostic tests for hyperthyroidism, including the T/S, three different T/B, TcTU, and estimated thyroid volume. Of 524 cats referred to our clinic for evaluation of suspected hyperthyroidism, the diagnosis was confirmed (n = 504) or excluded (n = 20) based on results of a serum thyroid panel consisting of thyroxine (T4 ), triiodothyronine (T3 ), free T4 (fT4 ), and thyroid-stimulating hormone (TSH) concentrations. In the hyperthyroid cats, median values for TcTU, T/S, and three T/B ratios were all significantly higher (P hyperthyroidism, but the T/S ratio had the highest test accuracy. The T/S ratio correlated strongly with the TcTU (r = 0.85). However, the TcTU had a higher and more significant correlation (P metabolic activity of the feline adenomatous thyroid gland. © 2016 American College of Veterinary Radiology.

  6. Verification tests for GRAD, a computer program to predict nonuniform deformation and failure of Zr-2.5 wt percent Nb pressure tubes during a postulated loss-of-coolant accident

    International Nuclear Information System (INIS)

    Shewfelt, R.S.W.; Godin, D.P.

    1985-03-01

    During a postulated loss-of-coolant accident in a CANDU reactor, the temperature of the pressure tubes could rise sufficiently so that ballooning could occur. It is also likely that there would be a variation in temperature around the tube circumference, causing the deformation to be nonuniform. Since the deformation of the pressure tube controls how the core heat is transferred to the surrounding moderator, which is a large heat sink, a computer program, GRAD, has been developed to predict this nonuniform deformation. Numerous biaxial creep tests were done, where the temperature of internally pressurized sections of Zr-2.5 wt percent Nb pressure tubes were ramped to check the ability of GRAD to predict the resulting nonuniform deformation and possible tube failure. GRAD was successful in predicting the average transverse creep strain observed during the tests and the local transverse creep strain at the end of the tests. GRAD was also able to predict the failure time and average transverse creep strain at failure for all the specimens that failed

  7. Health Information Exchange: What do patients want?

    Science.gov (United States)

    Medford-Davis, Laura N; Chang, Lawrence; Rhodes, Karin V

    2017-12-01

    To determine whether emergency department patients want to share their medical records across health systems through Health Information Exchange and if so, whether they prefer to sign consent or share their records automatically, 982 adult patients presenting to an emergency department participated in a questionnaire-based interview. The majority (N = 906; 92.3%) were willing to share their data in a Health Information Exchange. Half (N = 490; 49.9%) reported routinely getting healthcare outside the system and 78.6 percent reported having records in other systems. Of those who were willing to share their data in a Health Information Exchange, 54.3 percent wanted to sign consent but 90 percent of those would waive consent in the case of an emergency. Privacy and security were primary concerns of patients not willing to participate in Health Information Exchange and preferring to sign consent. Improved privacy and security protections could increase participation, and findings support consideration of "break-the-glass" provider access to Health Information Exchange records in an emergent situation.

  8. Diagnosis and treatment of 409 patients with prostatitis syndromes

    NARCIS (Netherlands)

    de la Rosette, J. J.; Hubregtse, M. R.; Meuleman, E. J.; Stolk-Engelaar, M. V.; Debruyne, F. M.

    1993-01-01

    We reviewed 409 patients who had prostatitis syndromes during the period 1985-1991. Urine analysis, x-ray film of abdomen, and sonograms of the kidneys did not contribute to the diagnosis of prostatitis. In 22 percent of the urine samples, slight-to-moderate atypia was seen in urine cytology but no

  9. Blood Pressure Home Monitoring in Hypertensive Patients Attending ...

    African Journals Online (AJOL)

    Results: Two hundred and five hypertensive patients who practice HMBP were recruited into this study. Sixty percent of ... communicating BP readings to their physicians is needed. ... (DOAJ), African Journal Online, Bioline International, Open-J-Gate and Pharmacy Abstracts .... to analyze relationships between continuous.

  10. Hysterosalpingography (HSG) findings: Of infertile patients in Ilorin ...

    African Journals Online (AJOL)

    Purpose/Background: Infertility is a major gynecological complaint in Nigeria, constituting about fifty percent (50%) of gynecological clinic attendance1-3. Hysterosalpingography (HSG) is used as a first line investigative procedure for evaluating infertility cases. An analysis of HSG findings of patients with primary and ...

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

    Science.gov (United States)

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

    2015-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Priscila Freitas-Lima

    2015-04-01

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

  13. Multiple constitutional aetiological factors in bone marrow failure syndrome (BMFS) patients from north India.

    Science.gov (United States)

    Varma, Neelam; Varma, Subhash; Marwaha, Ram Kumar; Malhotra, Pankaj; Bansal, Deepak; Malik, Kiran; Kaur, Sukhdeep; Garewal, Gurjeevan

    2006-07-01

    A large number of patients diagnosed with bone marrow failure syndromes (BMFS), comprising aplastic anaemia (AA) and myelodysplastic syndromes (MDS), remain aetiologically uncharacterized worldover, especially in resource constrained set up. We carried out this study to identify a few constitutional causes in BMFS patients attending a tertiary care hospital in north India. Peripheral blood lymphocyte cultures were performed (with and without clastogens) in a cohort of 135 consecutive BMFS patients, in order to detect Fanconi anaemia (FA), Down's syndrome (+21), trisomy 8 (+8) and monosomy 7 (-7). Constitutional factors were detected in 17 (12.6%) patients. FA defect was observed in 24.07 percent (13/54), 16.66 percent (1/6) and 2.85 percent (1/35) paediatric aplastic anaemia, paediatric MDS and adult MDS patients respectively. Down's syndrome was detected in 5.00 percent (2/40) adult aplastic anaemia patients. None of the patients revealed trisomy 8 or monosomy 7. Presence of an underlying factor determines appropriate management, prognostication, family screening and genetic counselling of BMFS patients. Special tests required to confirm or exclude constitutional aetiological factors are not available to majority of the patients in our country. Diepoxybutane (DEB) test yielded better results than mitomycin C (MMC) test in our experience.

  14. Causes and indications for reoperation in valve replacement and coronary artery bypass graft (CABG in 915 patients in cardiac surgery department in Imam Khomeini Hospital, 1374-77

    Directory of Open Access Journals (Sweden)

    Radmehr H

    2001-08-01

    Full Text Available Valvular and coronary artery disease are among the most important causes of disability and death in the world and Iran as well. Every year, half a million death because of these diseases is reported in United State. The incidence of degenerative and valvular diseases of heart is increasing. Considering the industrialization of our country, the incidence of these kind of problems are increasing as well. In this study, there is an attempt to recognize the causes of cardiac surgery. We conducted a retrospective study in 915 cardiac surgery patients (630 CABG and 285 valve replacement from 1374 to 1377. In CABG patients, there were 46 cases of reoperation (78.3 percent male 21.7 percent female. The most reoperations for bleeding was less than 24 hours in 90.3 percent. In valvular patients the causes of reoperation were: A Valvular complications (female/male=3/1, B Non valvular complications (female/male=1/3. The most common nonvalvular complication was bleeding (66.6 percent. The most common valvular complication was bioprosthetic valve degeneration. The meantime between two operation in valvular complications was 11.8 years. In all cases (915 the incidence of bleeding was 3.8 percent, mediastinitis 0.8 percent, cardiac tamponade 0.8 percent and GI bleeding 0.5 percent.

  15. NUTRITIONAL STATUS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE : A CROSS SECTIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Rabindra Kumar

    2015-10-01

    Full Text Available INTRODUCTION : Changes in nutritional status, such as weight loss and malnutrition, are a very common complication in patients with chronic obstructive pulmonary disease (COPD.These changes primarily affect the patients' quality of life and functional capacity and they are also independent prognostic indicators of both morbidity and mortality. The above information inspired us to evaluate the nutritional status in these patients by measuring daily oral intake and anthropom etric measures. METHOD : This cross - sectional study was conducted during the period October 2008 to April 2009. Seventy two COPD patients in the age group of 40 - 65 years, with an FEV (1 < 65% of predicted and an FEV (1/FVC ratio < 70% were included in the study. All the patients were assessed for anthropometric parameters such as height, body weight (BW, Body Mass Index (BMI, Hip Circumference, waist circumference and mid upper arm circumference (MUAC. Daily dietary intakes were calculated by 24 hour re call method with the help of cups, spoons, and glasses which were standardized with commonly consumed recipes. Standardized models of chapatti, rice, fruits, and snacks items were used for accurate data. Energy and nutrient intakes were derived using the N utritive value of Indian foods. RESULTS : The prevalence of under nutrition were (30/72 41.6% based on body mass index (<18.5 kg/m(2 and (46/72 63.8% based on mid - upper arm circumference (<24 cm.More number of patients was above 60 years of age in the income grouping 3000 - 5000 INR / month living with family members of more than 3 per house. The daily intake of food as compared to reference RDA is as follows energy 54.51%, carbohydrates 84.85%, protein60.52% and Fats 71.2%. CONCLUSION : The prevalence of u nder nutrition were (30/72 41.6% based on body mass index (<18.5 kg/m2 and (46/72 63.8% based on mid - upper arm circumference (<24 cm . Nutritional assessment should be made mandatory in order to recognize

  16. The chest features of patients with the novel influenza type A H1N1 on high resolution CT

    International Nuclear Information System (INIS)

    Shi Yuxin; Li Shujuan; Zhou Su; Shi Suodi; Zhang Zhiyong

    2010-01-01

    Objective: To explore the chest features of patients with the novel influenza type A H1N1 on HRCT. Methods: One hundred and seventy-two chest HRCT examinations on 163 cases with Influenza type A H1N1 (9 cases were reexamed) were retrospectively analyzed using standard pulmonary window and mediastinal window, respectively. HRCT imaging appearances were summarized. Results: Ninety-seven cases showed normal on chest HRCT, while the others showed abnormalities of parenchymal and interstitial. Among them, HRCT identified ground-glass opacity in 35 cases (53.0%), centrilobular nodules in 30 cases (45.5%), thickening of intralobular septa in 31 cases (47.0%), intralobular thin reticulation and micro-nodule in 8 cases (12.1%), single-lobular inflammation in 19 cases (28.8%), consolidation of lung (the large consolidation and multiple small consolidations) in 15 cases (22.7%), pulmonary atelectasis in 3 cases (4.5%), and irregular lines in 2 cases (3.0%). Pleurisy was also revealed including 8 cases with right pleurisy, 5 cases with left pleurisy, 5 cases with left pleurisy, and 19 cases with bilateral pleurisy. Mediastinal and axillary lymphadenopathy were found in 7 cases, who were spared of pleural effusion. All above abnormalities resolved quickly after anti-virus treatment. Conclusion: Parenchymal and interstitial abnormalities, mediastinum and axillary fossa lymphadenopathy, and pleural effusion were the common findings on HRCT in patients with Influenza type A H1N1, which were similar to those of other viral pneumonia. (authors)

  17. Comparison of Electric Toothbrush, Persica and Chlorhexidine Mouthwashes on Reduction of Gingival Enlargement in Orthodontic Patients: A Randomised Clinical Trial.

    Science.gov (United States)

    Farhadian, Nasrin; Bidgoli, Mohsen; Jafari, Farhad; Mahmoudzadeh, Majid; Yaghobi, Mahdi; Miresmaeili, Amirfarhang

    2015-01-01

    To compare the efficacy of chlorhexidine, Persica mouthwash and electric toothbrushes in improving gingival enlargement in patients with fixed orthodontic appliances. Seventy-two orthodontic patients with at least two sites of gingival enlargement were randomly allocated into four equal groups: 1) manual toothbrush; 2) electric toothbrush; 3) manual toothbrush+Persica mouthwash; 4) manual toothbrush+chlorhexidine mouthwash. All participants were instructed to brush their teeth at least twice a day. The subjects in groups 3 and 4 were instructed to use Persica or chlorhexidine according to the respective manufacturer's instructions. Bleeding on probing (BOP) index, gingival index (GI), O'Leary's plaque index (PI) and constructed hyperplastic index (HI) of all the subjects were measured in a blind manner at the start of the study and 2 weeks later. Changes of indices in the entire oral cavity and individual affected teeth were analysed with SPSS 16 using chi-square, ANOVA, ANCOVA, LSD and the paired t-test. In the entire oral cavity, there was a statistically significant improvement in indices in all the groups except for HI, which significantly improved only in group 4 (p=0.001). Data of individual teeth with hyperplastic gingiva showed significant reduction of all the variables except for HI in group 1 (p=0.08). No significant differences were found between groups 1 and 2 or between groups 3 and 4. The efficacy of Persica was similar to that of chlorhexidine in improving gingival conditions. None of the treatment modalities could reduce gingival enlargement to the clinically acceptable level of health.

  18. Recruiting former melanoma patients via hospitals in comparison to office-based dermatologists in a register-based cohort study that required indirect contact

    Directory of Open Access Journals (Sweden)

    S. R. Zeissig

    2017-11-01

    Full Text Available Abstract Background There are detailed reviews about different recruitment strategies, but not with regard to differences between recruitment of hospital-based versus office-based physicians. Within this study, the two different recruitment schemes are compared. Advantages and disadvantages of different ways of recruitment in registry-based studies are discussed. Methods In a cross-sectional cancer-registry-based study, long-term melanoma patients were contacted by dermatologists rather than directly by the registry on the basis of the legal situation. Logistic regression models and generalized estimating equations were used to assess effects of various patient and physician characteristics on participation and data quality. Especially differences between hospital-based versus office-based dermatologists are evaluated. Results Seventy two out of 112 contacted dermatologists took part in the study (64.3%. The cooperation proportion was 52.2% (689 participants/1320 contacted patients. Participants and non-participants differed regarding age and sex, but not regarding other social demographic factors and cancer stage. We did not observe a difference in patient participation between hospital-based versus office-based dermatologists (OR 1.08 [CI 0.84–1.39]; p = 0.57. However, medical data provided by the cancer registry were better for participants registered and recruited by hospitals. Conclusions In cohort studies with epidemiological cancer registries, recruitment via physicians has potential disadvantages and is more complex. If this indirect way of contact is mandatory, we recommend recruitment procedures including hospital-based rather than office-based physicians. However, physician characteristics were not associated with outcome.

  19. Effect of extracorporeal magnetic energy stimulation on bothersome lower urinary tract symptoms and quality of life in female patients with stress urinary incontinence and overactive bladder.

    Science.gov (United States)

    Lo, Tsia-Shu; Tseng, Ling-Hong; Lin, Yi-Hao; Liang, Ching-Chung; Lu, Ching-Yi; Pue, Leng Boi

    2013-11-01

    The aim of this study was to investigate the efficacy of extracorporeal magnetic stimulation (EMS) for the treatment of bothersome and severe symptoms of stress urinary incontinence (SUI) and overactive bladder syndrome (OAB) in female patients. A retrospective review was conducted on patients with SUI and OAB who were referred to EMS therapy. Successful treatment for the bothersome symptoms of OAB and SUI was defined as score ≤1 for questions 2 and 3 on the Urodynamic Distress Inventory-6. The objective cure of SUI and OAB was defined as no urinary leakage during the cough stress test and any urgency, urge incontinence and voiding frequency of less than eight times per 24 h based on the 3-day bladder diary, after the 9 weeks of treatment, respectively. Ninety-three patients with SUI or OAB underwent a 9-week course of EMS at 20 min twice weekly. Seventy-two (77%) patients completed EMS treatment. Geographical factor and poor economic status were two main factors for dropout. A total of 94.1% (32 of 34) and 86.8% (33 of 38) of subjects had successful treatment for the bothersome symptoms of OAB and SUI, respectively. In contrast, the cure rate for OAB and SUI was only 61.7% and 42.1%, respectively. There was also a significant improvement in both Urogenital Distress Inventory Short Form (bothersome on lower urinary tract symptoms) and the Incontinence Impact Questionnaire Short Form (quality of life) total score in both groups after EMS. EMS is a safe and effective alternative method for treating SUI and OAB. Further studies are needed to evaluate the long-term efficacy. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.

  20. Patient perspectives of patient-controlled analgesia (PCA) and methods for improving pain control and patient satisfaction.

    Science.gov (United States)

    Patak, Lance S; Tait, Alan R; Mirafzali, Leela; Morris, Michelle; Dasgupta, Sunavo; Brummett, Chad M

    2013-01-01

    This study aimed to (1) identify patient-controlled analgesia (PCA) attributes that negatively impact patient satisfaction and ability to control pain while using PCA and (2) obtain data on patient perceptions of new PCA design features. We conducted a prospective survey study of postoperative pain control among patients using a PCA device. The survey was designed to evaluate patient satisfaction with pain control, understanding of PCA, difficulties using PCA, lockout-period management, and evaluation of new PCA design features. A total of 350 eligible patients completed the survey (91%). Patients who had difficulties using PCA were less satisfied (P PCA. Forty-nine percent of patients reported not knowing if they would receive medicine when they pushed the PCA button, and of these, 22% believed that this uncertainty made their pain worse. The majority of patients preferred the proposed PCA design features for easier use, including a light on the button, making it easier to find (57%), and a PCA button that vibrates (55%) or lights up (70%), alerting the patient that the PCA pump is able to deliver more medicine. A majority of patients, irrespective of their satisfaction with PCA, preferred a new PCA design. Certain attributes of current PCA technology may negatively impact patient experience, and modifications could potentially address these concerns and improve patient outcomes.

  1. Results of the patterns of care study for esophageal cancer patients treated with radiotherapy and surgery

    International Nuclear Information System (INIS)

    Gomi, Kohtaro; Oguchi, Masahiko; Yamashita Takashi

    2001-01-01

    A Patterns of Care Study examined the records of patients with thoracic esophageal cancer treated with radiotherapy and surgery in 1995 through 1997. Thirty-one percent of patients received preoperative radiotherapy; 61% of these received chemotherapy. Sixty six percent of patients received postoperative radiotherapy. Significant variables for overall survival in multivariate analysis include presence of macroscopic residual tumors (risk ratio=2.66), sex female (0.49), photon energy higher than 4 MV (0.50), Karnofsky performance status greater than 70 (0.55) and the use of chemotherapy (1.64). The value of preoperative concurrent chemotherapy and radiotherapy should be tested in a randomized trial. (author)

  2. Utilisation of ophthalmic services by foreign nationals in Johor: a review of 452 patients.

    Science.gov (United States)

    Hooi, S H; Hooi, S T

    2003-10-01

    Between 1st January 1999 and 31st December 2000, 452 foreign nationals were treated at the Department of Ophthalmology, Hospital Sultanah Aminah, Johor Bahru. Eighty-five percent were male. The peak age range was from 21 to 30 years old. The patients were predominantly Indonesians (61%). A history of trauma was present in 63% of patients. Eight percent of eyes had severe visual impairment. Six patients (1.3%) were blind by WHO standards. Traumatic eye conditions, inflammatory/allergic eye conditions and degenerative eye conditions comprised 66%, 13% and 10% respectively of ocular pathology seen. The commonest ocular findings were corneal foreign body, corneal abrasion and subconjunctival haemorrhage.

  3. Frequency of gastric varices in patients with portal hypertension based on endoscopic findings

    International Nuclear Information System (INIS)

    Mir, A.W.; Chaudry, A.A.; Mir, S.; Ahmed, N.; Khan, A.A.; Shahzadi, M.

    2017-01-01

    To find out the frequency of gastric varices in patients with portal hypertension based on endoscopic findings. Study Design: Descriptive Study. Place and Duration of Study: Department of Gastroenterology, Military Hospital, Rawalpindi from Jan to Jun 2011. Material and Methods: All patients fulfilling the inclusion criteria were selected through consecutive sampling. The patients presenting with hematemesis, melena or ascites with portal hypertension on ultrasound abdomen were admitted in the hospital. The patients were first stabilized hemodynamically and then kept empty stomach for at least four hours before endoscopy. The patients were sedated with intravenous midazolam and endoscopic findings obtained were entered on the patient proforma. Results: The overall frequency of gastric varices was 11 percent, whereas 89 percent had no gastric varices. Conclusion: A large number of patients with portal hypertension have gastric varices. It is recommended that endoscopy be carried out in all patients with identified portal hypertension. (author)

  4. Stage II recovery behavior of a series of ion-irradiated platinum (gold) alloys as studied by field-ion microscopy. [0. 10, 0. 62, and 4. 0 at. percent Au and pure Pt

    Energy Technology Data Exchange (ETDEWEB)

    Wei, C.Y.; Seidman, D.N.

    1976-11-01

    Direct and visible evidence was obtained for long-range migration of self-interstitial atoms (SIAs) in Stage II of three different ion-irradiated platinum (gold) alloys. Field-ion microscope (FIM) specimens of Pt--0.10, 0.62 and 4.0 at. percent Au alloys were irradiated in-situ with 30-keV W/sup +/ or Pt/sup +/ ions at a tip temperature of 35 to 41 K at 2 x 10/sup -9/ torr. Direct observation of the surfaces of the FIM specimens during isochronal warming experiments to 100 K showed that a flux of SIAs crossed the surfaces of the specimens between 40 to 100 K. The spectrum for each alloy consisted of two recovery peaks (substages II/sub B/ and II/sub C/). The results are explained on the basis of an impurity-delayed diffusion mechanism employing a two-level trapping model. The application of this diffusion model to the isochronal recovery spectra yielded a dissociation enthalpy (DELTAh/sub li-Au//sup diss/) and an effective diffusion coefficient for each substage; for substage II/sub B/ DELTAh/sub li-Au//sup diss/ (II/sub B/) = 0.15 eV and for substage II/sub C/ DELTAh/sub li-Au//sup diss/ (II/sub C/) = 0.24 eV. A series of detailed control experiments was also performed to show that the imaging electric field had not caused the observed long-range migration of SIAs and that the observed effects were not the result of surface artifacts. 14 figures, 6 tables.

  5. Oral care for patients with head and neck cancer in Hokkaido University Hospital

    International Nuclear Information System (INIS)

    Hata, Hironobu; Yamazaki, Yutaka; Imamachi, Kenji

    2011-01-01

    We have been providing oral care for patients with head and neck cancer in Hokkaido University Hospital since 2007. In this paper, we report clinical statistics of the 254 head and neck cancer patients who received oral care. About 80 percent of these patients were treated with radiation therapy, so it is important to cope with adverse events related to such therapy. Oral care is helpful for cancer patients when it is started as soon as possible (at least 1 week before radiation therapy is started). The percentage of patients who could start oral care 4 days before radiation therapy gradually increased to about 60 percent by fiscal 2009. In fiscal 2010, the percentage decreased to its lowest level of 37.9 percent. To start oral care for all patients 7 days before irradiation, we are going to change our system and start oral care in the outpatient period. In their hometowns, oral care was continued for only 19 (27.0 percent) of the 74 patients who could not visit our hospital. An important task for our project is to establish a medical cooperation system for discharged patients treated for head and neck cancer. (author)

  6. Heart rate awareness in patients with chronic stable heart failure. A multi-center observational study.

    LENUS (Irish Health Repository)

    Moran, D

    2014-08-23

    We assessed adherence to European Society of Cardiology heart rate guidelines (i.e. heart rates less than 70bpm) in patients with chronic stable heart failure. We also investigated the percent of patients on target doses of rate controlling drugs.

  7. Patient-Reported Outcomes following Breast Conservation Therapy and Barriers to Referral for Partial Breast Reconstruction.

    Science.gov (United States)

    Vrouwe, Sebastian Q; Somogyi, Ron B; Snell, Laura; McMillan, Catherine; Vesprini, Danny; Lipa, Joan E

    2018-01-01

    The purpose of this study was to evaluate the self-reported aesthetic outcome of breast conservation therapy in a generalized sample of patients, and to describe potential barriers to referral for partial breast reconstruction. Consecutive breast conservation therapy patients completing radiotherapy over a 1-year period at a regional cancer center were identified. Eligible patients were contacted by means of mail/e-mail and invited to participate. Participants completed the BREAST-Q breast conservation therapy module along with a questionnaire examining feelings about breast reconstruction. Multiple regression analysis was performed using the satisfaction with breasts scale as the dependent variable. Surveys were completed by 185 of 592 eligible participants (response rate, 31.3 percent; mean age, 61 years) an average of 38 months after lumpectomy. The mean score for the BREAST-Q satisfaction with breasts scale was 59 of 100. Younger age (p = 0.038), lumpectomy reexcision (p = 0.018), and lumpectomy at a nonacademic center (p = 0.026) were significantly associated with lower satisfaction. Bra size, months from lumpectomy, and tumor quadrant/size were not significantly associated with satisfaction (p > 0.05). The most common statements regarding reconstruction were "I don't feel the need for it" (60.0 percent), "I don't like the thought of having breast implants" (22.7 percent), and "I don't want any more surgeon/doctor visits" (22.2 percent). Before lumpectomy, only 1.6 percent had a consultation for reconstruction, and only 22.7 percent were aware of this option. If offered, 33.1 percent of patients would have attended this consultation. There is an unmet demand for partial breast reconstruction, with an opportunity to advocate and increase awareness on behalf of patients undergoing breast conservation therapy.

  8. Bacteraemia Caused by Escherichia Coli in Cancer Patients at a Specialist Center in Pakistan

    International Nuclear Information System (INIS)

    Parveen, A.; Sultan, F.; Saleem, S.; Nazeer, S. H.; Raza, A.; Zafar, W.; Nizamuddin, S.; Mahboob, A.

    2015-01-01

    Objective: To analyse the antimicrobial susceptibility patterns of Escherichia coli bacteraemia among cancer patients, and to assess the risk factors and outcomes of multidrug-resistant Escherichia coli bacteraemia. Methods: The retrospective study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, and comprised medical records of patients with Escherichia coli bacteraemia presenting between December 2012 and November 2013. Multivariable logistic regression analyses were used to determine the factors associated with the development and 30-day mortality of multidrug-resistant Escherichia coli bacteraemia. Results: Out of 1603 episodes of bacteraemia, 227(35.6 percent) were caused by E.coli, of which 98(43.2 percent) were multidrug-resistant. In multivariable analysis, age less than 18 years (adjusted odds ratio 3.92; 95 percent confidence interval 1.43-10.68), presence of central venous catheter (adjusted odds ratio 2.12; 95 percent confidence interval 1.04-4.33) and exposure to piperacillin/tazobactam within 90 days prior to infection (adjusted odds ratio 2.37; 95 percent confidence interval 1.15-4.86) were identified as independent risk factors for acquisition of multidrug-resistant Escherichia coli bacteraemia. The overall 30 day mortality rate was 35.2 percent (80/227). Risk factors for mortality were intensive care unit admission (adjusted odds ratio 3.95; 95 percent confidence interval 1.79-8.71) and profound neutropenia (adjusted odds ratio 4.03; 95 percent confidence interval 1.55-10.49). Conclusion: Bloodstream infections with multidrug-resistant Escherichia coli were common in cancer patients. However it was not a predictor of mortality. (author)

  9. Professional and social activity of patients after heart transplant.

    Science.gov (United States)

    Marcinkowska, Urszula; Kukowka, Karol; Gałeczka, Michał; Pudlo, Robert; Zakliczyński, Michał; Zembala, Marian

    2015-01-01

    The aim of the study is to describe both professional and social activities of patients after heart transplant. Ninety-five heart transplant patients treated at the Silesian Center for Heart Diseases in Zabrze were surveyed, comprising 29 women (30.5%) and 66 men (69.5%). The average age of respondents was 54.3 years old (standard deviation (SD) = 15 years); the average period that had elapsed since the heart transplant was 7.1 years (SD = 4 years). We designed a questionnaire as a tool for collecting information from patients. Twenty-five percent of patients worked at the time of completion of the questionnaire. Eighty percent of those patients were working before and after the transplant, 20%--only after transplantation (p surveyed, 52.5% said that their financial situation had not changed whereas 34.5% of those surveyed reported a change for the worse. Thirty-seven percent of respondents reported changes in family relationships. Seventy-seven percent reported that they received help from family members, as compared with 19% who did not. Only 25.3% of the patients treated at the Silesian Centre for Heart Diseases after heart transplant are employed and it is one of the lowest employment rates in this category of patients in Europe. One third of working patients have the same work place as they had before their operation. Heart transplant is a cause of changes in family relationships. Most often family bonds are strengthened but sometimes family members become nervous, impatient and unwilling to talk about the transplant. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  10. Patient satisfaction

    Directory of Open Access Journals (Sweden)

    Bhanu Prakash

    2010-01-01

    Full Text Available Patient satisfaction is an important and commonly used indicator for measuring the quality in health care. Patient satisfaction affects clinical outcomes, patient retention, and medical malpractice claims. It affects the timely, efficient, and patient-centered delivery of quality health care. Patient satisfaction is thus a proxy but a very effective indicator to measure the success of doctors and hospitals. This article discusses as to how to ensure patient satisfaction in dermatological practice.

  11. Patient satisfaction.

    Science.gov (United States)

    Prakash, Bhanu

    2010-09-01

    Patient satisfaction is an important and commonly used indicator for measuring the quality in health care. Patient satisfaction affects clinical outcomes, patient retention, and medical malpractice claims. It affects the timely, efficient, and patient-centered delivery of quality health care. Patient satisfaction is thus a proxy but a very effective indicator to measure the success of doctors and hospitals. This article discusses as to how to ensure patient satisfaction in dermatological practice.

  12. Nutritional status of cancer patients admitted for chemotherapy at the National Kidney and Transplant Institute.

    Science.gov (United States)

    Montoya, J E; Domingo, F; Luna, C A; Berroya, R M; Catli, C A; Ginete, J K; Sanchez, O S; Juat, N J; Tiangco, B J; Jamias, J D

    2010-11-01

    Malnutrition is common among cancer patients. This study aimed to determine the overall prevalence of malnutrition among patients undergoing chemotherapy and to determine the predictors of malnutrition among cancer patients. A cross-sectional study was conducted on 88 cancer patients admitted for chemotherapy at the National Kidney and Transplant Institute, Philippines, from October to November 2009. Subjective Global Assessment (SGA), anthropometric data and demographic variables were obtained. Descriptive statistics, ANOVA and logistic regression analysis were performed between the outcome and variables. A total of 88 cancer patients were included in the study. The mean age of the patients was 55.7 +/- 14.8 years. The mean duration of illness was 9.7 +/- 8.7 months and the mean body mass index (BMI) was 22.9 kg/m2. The mean Karnofsky performance status was 79.3. 29.55 percent of the patients had breast cancer as the aetiology of their illness. 38 patients (43.2 percent) had SGA B and four (4.5 percent) had SGA C, giving a total malnutrition prevalence of 47.7 percent. The patients were statistically different with regard to their cancer stage (p is less than 0.001), weight (p is 0.01), BMI (p is 0.004), haemoglobin level (p is 0.001) and performance status by Karnofsky score (p is less than 0.001), as evaluated by ANOVA. Logistic regression analysis showed that cancer stage and Karnofsky performance score were predictors of malnutrition. About 47.7 percent of cancer patients suffer from malnutrition, as classified by SGA. Only cancer stage and Karnofsky performance status scoring were predictive of malnutrition in this select group of patients.

  13. [Pulmonary infections in patients with rheumatoid arthritis].

    Science.gov (United States)

    Takayanagi, Noboru; Tsuchiya, Yutaka; Tokunaga, Daidou; Miyahara, Yousuke; Yamaguchi, Shouzaburo; Saito, Hiroo; Ubukata, Mikio; Kurashima, Kazuyoshi; Yanagisawa, Tsutomu; Sugita, Yutaka

    2007-06-01

    We studied 149 rheumatoid arthritis (RA) patients (mean age 68.0 years; 68 men, 81 women) with pulmonary infections. The mean age at the onset of RA and the duration of RA was 57.2 +/- 15.2 years and 10.9 +/- 11.5 years, respectively. Pulmonary infections included nontuberculous mycobacteriosis in 59 patients (Mycobacterium avium complex infection, 50 cases : Mycobacterium kansasii infection, 4 cases; others, 5 cases), pneumonia in 46 patients, pulmonary tuberculosis in 28 patients, pulmonary aspergillosis in 12 patients, pulmonary cryptococcosis in 5 patients, Pneumocystis jiroveci pneumonia in 5 patients, lung abscess in 9 patients, exacerbation of bronchiectasis in 7 patients, and empyema in 4 patients. One hundred percent of patients with exacerbation of bronchiectasis, 91.7% of patients with pulmonary aspergillosis, 87% of patients with pneumonia, and 81.4% of patients with nontuberculous mycobacteriosis had underlying lung diseases. The pulmonary infections during therapy with steroids were pulmonary tuberculosis (78.6%), pneumonia (65.2%), and pulmonary aspergillosis (58.3%), while the pulmonary infections during methotrexate treatment were Pneumocystis jiroveci pneumonia (80%), pulmonary cryptococcosis (40%), and pulmonary tuberculosis (28.6%). Pulmonary infections in RA patients who were taking TNFalpha inhibitors included 1 patient each with nontuberculous mycobacteriosis, pneumonia, pulmonary tuberculosis, and Pneumocystis jiroveci pneumonia. Among the RA patients with lung abscess, malignancy was noted in 55.6%, and diabetes mellitus in 22.2%. Pseudomonas aeruginosa was the second-most-common cause of pneumonia and cause of all exacerbations of bronchiectasis. As well as immunosuppressive medications (steroids, methotrexate, TNFalpha inhibitors) and systemic comorbid diseases, underlying lung diseases could be one of the risk factor for pulmonary infections in patients with RA. The dominant risk factor for each pulmonary infection in patients with RA

  14. Variation in Surgical Quality Measure Adherence within Hospital Referral Regions: Do Publicly Reported Surgical Quality Measures Distinguish among Hospitals That Patients Are Likely to Compare?

    Science.gov (United States)

    Safavi, Kyan C; Dai, Feng; Gilbertsen, Todd A; Schonberger, Robert B

    2014-01-01

    Objective To determine whether surgical quality measures that Medicare publicly reports provide a basis for patients to choose a hospital from within their geographic region. Data Source The Department of Health and Human Services' public reporting website, Medicare Claims Processing Manual Baltimore, MD CMS http://www.medicare.gov/hospitalcompare. Study Design We identified hospitals (n = 2,953) reporting adherence rates to the quality measures intended to reduce surgical site infections (Surgical Care Improvement Project, 1–3) in 2012. We defined regions within which patients were likely to compare hospitals using the hospital referral regions (HRRs) from the Dartmouth Atlas of Health Care Project. We described distributions of reported SCIP adherence within each HRR, including medians, interquartile ranges (IQRs), skewness, and outliers. Principal Findings Ninety-seven percent of HRRs had median SCIP-1 scores ≥95 percent. In 93 percent of HRRs, half of the hospitals in the HRR were within 5 percent of the median hospital's score. In 62 percent of HRRs, hospitals were skewed toward the higher rates (negative skewness). Seven percent of HRRs demonstrated positive skewness. Only 1 percent had a positive outlier. SCIP-2 and SCIP-3 demonstrated similar distributions. Conclusions Publicly reported quality measures for surgical site infection prevention do not distinguish the majority of hospitals that patients are likely to choose from when selecting a surgical provider. More studies are needed to improve public reporting's ability to positively impact patient decision making. PMID:24611578

  15. Tribal implementation of a patient-centred medical home model in Alaska accompanied by decreased hospital use

    Directory of Open Access Journals (Sweden)

    Janet M. Johnston

    2013-08-01

    Full Text Available Background. Between 1995 and 1998, tribally owned Southcentral Foundation (SCF incrementally assumed responsibility from the Indian Health Service (IHS for primary care services on the Alaska Native Medical Center (ANMC campus in Anchorage, Alaska. In 1999, SCF began implementing components of a Patient-Centered Medical Home (PCMH model to improve access and continuity of care. Objective. To evaluate hospitalisation trends before, during and after PCMH implementation. Design. Time series analysis of aggregated medical record data. Methods. Regression analysis with correlated errors was used to estimate trends over time for the percent of customer-owners hospitalised overall and for specific conditions during 4 time periods (March 1996–July 1999: SCF assumes responsibility for primary care; August 1999–July 2000: PCMH implementation starts; August 2000–April 2005: early post-PCMH implementation; May 2005–December 2009: later post-PCMH implementation. Analysis was restricted to individuals residing in Southcentral Alaska and receiving health care at ANMC. Results. The percent of SCF customer-owners hospitalised per month for any reason was steady before and during PCMH implementation, declined steadily immediately following implementation and subsequently stabilised. The percent hospitalised per month for unintentional injury or poisoning also declined during and after the PCMH implementation. Among adult asthma patients, the percent hospitalised annually for asthma declined prior to and during implementation and remained lower thereafter. The percent of heart failure patients hospitalised annually for heart failure remained relatively constant throughout the study period while the percent of hypertension patients hospitalised for hypertension shifted higher between 1999 and 2002 compared to earlier and later years. Conclusion. Implementation of PCMH at SCF was accompanied by decreases in the percent of customer-owners hospitalised monthly

  16. Comparison of Epidural Analgesia with Transversus Abdominis Plane Analgesia for Postoperative Pain Relief in Patients Undergoing Lower Abdominal Surgery: A Prospective Randomized Study.

    Science.gov (United States)

    Iyer, Sadasivan Shankar; Bavishi, Harshit; Mohan, Chadalavada Venkataram; Kaur, Navdeep

    2017-01-01

    Anesthesiologists play an important role in postoperative pain management. For analgesia after lower abdominal surgery, epidural analgesia and ultrasound-guided transversus abdominis plane (TAP) block are suitable options. The study aims to compare the analgesic efficacy of both techniques. Seventy-two patients undergoing lower abdominal surgery under spinal anesthesia were randomized to postoperatively receive lumbar epidural catheter (Group E) or ultrasound-guided TAP block (Group T) through intravenous cannulas placed bilaterally. Group E received 10 ml 0.125% bupivacaine stat and 10 ml 8 th hourly for 48 h. Group T received 20 ml 0.125% bupivacaine bilaterally stat and 20 ml bilaterally 8 th hourly for 48 h. Pain at rest and on coughing, total paracetamol and tramadol consumption were recorded. Analgesia at rest was comparable between the groups in the first 16 h. At 24 and 48 h, Group E had significantly better analgesia at rest ( P = 0.001 and 0.004 respectively). Patients in Group E had significantly higher number of patients with nil or mild pain on coughing at all times. Paracetamol consumption was comparable in both groups, but tramadol consumption was significantly higher in Group T at the end of 48 h ( P = 0.001). For lower abdominal surgeries, analgesia provided by intermittent boluses of 0.125% is comparable for first 16 h between epidural and TAP catheters. However, the quality of analgesia provided by the epidural catheter is superior to that provided by TAP catheters beyond that both at rest and on coughing with reduced opioid consumption.

  17. Childhood liver diseases in Ga-Rankuwa Hospital, South Africa ...

    African Journals Online (AJOL)

    Rankuwa Hospital Histopathology Laboratory. Design: A retrospective study. Setting: Ga-Rankuwa Histopathology Laboratory. Subjects: Seventy two patients who underwent a liver biopsy during the study period. Methods: Laboratory records ...

  18. 15N nitrogen-balance studies in patients with testicular feminization, their relatives, and in normal subjects

    International Nuclear Information System (INIS)

    Zachman, M.; Zagalak, M.; Voellmin, J.A.; Prader, A.

    1975-01-01

    Fourteen subjects (4 with testicular feminization, 2 mothers, 1 aunt and 1 father of these patients, 2 normal women, 2 normal men and 2 normal prepubertal boys) were given 0.1 to 0.2 g/kg of 50 percent 15 N-labeled NH 4 Cl before and after 6 daily injections of testosterone (T) 15 mg/m 2 ). In 24-hour urine specimens collected on the test days, 15 N was calculated from total N (Kjeldahl) and the percentage of 15 N (mass spectrometry or 15 N-analyzer Isocommerz). In all normal subjects, urinary 15 N-balance was influenced positively by T (+31.3 +- 8.4 percent), in prepubertal boys more (+43 to +66 percent) than in women (+20 to +30 percent) and men (+6 to +23). In testicular feminization, 15 N-balance not only failed to become more positive, but was even reduced (-24.7 +- 17.6 percent). The father of a patient had only a slight response (+7 percent) as one of the normal males, probably because of higher endogenous T-levels in adult males. One mother and the aunt had no response (-7.4 to + 1.5 percent). In the mother, the balance became slightly positive (+10 percent) on oral contraceptives. The other mother, who was on estrogen treatment prior to and during the test, had a positive but insufficient change of balance (+17 percent). It is concluded that this test allows detection of patients with testicular feminization and possibly also healthy female carriers. In these cases, estrogen treatment appears to positively influence the response to T

  19. Overall Survival in Patients With Advanced Melanoma Who Received Nivolumab Versus Investigator's Choice Chemotherapy in CheckMate 037: A Randomized, Controlled, Open-Label Phase III Trial.

    Science.gov (United States)

    Larkin, James; Minor, David; D'Angelo, Sandra; Neyns, Bart; Smylie, Michael; Miller, Wilson H; Gutzmer, Ralf; Linette, Gerald; Chmielowski, Bartosz; Lao, Christopher D; Lorigan, Paul; Grossmann, Kenneth; Hassel, Jessica C; Sznol, Mario; Daud, Adil; Sosman, Jeffrey; Khushalani, Nikhil; Schadendorf, Dirk; Hoeller, Christoph; Walker, Dana; Kong, George; Horak, Christine; Weber, Jeffrey

    2018-02-01

    Purpose Until recently, limited options existed for patients with advanced melanoma who experienced disease progression while receiving treatment with ipilimumab. Here, we report the coprimary overall survival (OS) end point of CheckMate 037, which has previously shown that nivolumab resulted in more patients achieving an objective response compared with chemotherapy regimens in ipilimumab-refractory patients with advanced melanoma. Patients and Methods Patients were stratified by programmed death-ligand 1 expression, BRAF status, and best prior cytotoxic T-lymphocyte antigen-4 therapy response, then randomly assigned 2:1 to nivolumab 3 mg/kg intravenously every 2 weeks or investigator's choice chemotherapy (ICC; dacarbazine 1,000 mg/m 2 every 3 weeks or carboplatin area under the curve 6 plus paclitaxel 175 mg/m 2 every 3 weeks). Patients were treated until they experienced progression or unacceptable toxicity, with follow-up of approximately 2 years. Results Two hundred seventy-two patients were randomly assigned to nivolumab (99% treated) and 133 to ICC (77% treated). More nivolumab-treated patients had brain metastases (20% v 14%) and increased lactate dehydrogenase levels (52% v 38%) at baseline; 41% of patients treated with ICC versus 11% of patients treated with nivolumab received anti-programmed death 1 agents after randomly assigned therapy. Median OS was 16 months for nivolumab versus 14 months for ICC (hazard ratio, 0.95; 95.54% CI, 0.73 to 1.24); median progression-free survival was 3.1 months versus 3.7 months, respectively (hazard ratio, 1.0; 95.1% CI, 0.78 to 1.436). Overall response rate (27% v 10%) and median duration of response (32 months v 13 months) were notably higher for nivolumab versus ICC. Fewer grade 3 and 4 treatment-related adverse events were observed in patients on nivolumab (14% v 34%). Conclusion Nivolumab demonstrated higher, more durable responses but no difference in survival compared with ICC. OS should be interpreted with

  20. Frequency of hypomagnesemia in patients with uncontrolled type II diabetes mellitus

    International Nuclear Information System (INIS)

    Siddiqui, M.U.; Ali, I.; Asghar, S.P.; Ahmed, M.R.

    2016-01-01

    Objective: The objective of this study was to determine the frequency of Hypomagnesemia in patients with uncontrolled type II diabetes mellitus. Study Design: Cross-sectional study. Place and Duration of Study: Department of Medicine, PNS Shifa Naval Hospital Karachi, from Jul 2012 to Dec 2012 over a period of six months. Material and Methods: In this study, three hundred and twenty three patients of uncontrolled diabetes mellitus type-II on oral hypoglycemic agents for more than five years, presenting to medical OPD, were recruited. All patients fulfilled inclusion and exclusion criteria. Blood samples of all patients for serum HbA1c and serum magnesium levels were analyzed at the time of enrollment. Statistical analysis was done on SPSS 20. Results: Out of 323 patients, 243 (75.23 percent) were males and 80 (24.76 percent) were females with the age ranging from 40 - 65 years (mean age and SD 54.76 +- 6.43). Hypomagnesemia was found in 117 patients, without any significant difference in men and women (38.45 percent and 35.39 percent respectively). The mean duration of diabetes was 12.5 years (ranging from 5 to 22 years). By frequency test in SPSS-20, the highest frequency of hypomagnesemia (49.42 percent) is seen in (8.6-9.0) HbA1c group while lowest frequency hypomagnesemia (15.38 percent) is seen in (>10.0) HbA1c level group mean standard deviation and p-value calculated by Pearson correlation statistic in SPSS-20 for quantitative variables (HbA1c, Magnesium level). Conclusion: Hypomagnesemia is frequent in poorly controlled type-II diabetes mellitus having increased level of HbA1c. So it may be prudent in clinical practice to periodically monitor plasma magnesium and HbA1c in type-II diabetes mellitus patients. (author)

  1. Relationship of body mass index to percent body fat and waist circumference among schoolchildren in Japan - the influence of gender and obesity: a population-based cross-sectional study

    Directory of Open Access Journals (Sweden)

    Ochiai Hirotaka

    2010-08-01

    Full Text Available Abstract Background Although the correlation coefficient between body mass index (BMI and percent body fat (%BF or waist circumference (WC has been reported, studies conducted among population-based schoolchildren to date have been limited in Japan, where %BF and WC are not usually measured in annual health examinations at elementary schools or junior high schools. The aim of the present study was to investigate the relationship of BMI to %BF and WC and to examine the influence of gender and obesity on these relationships among Japanese schoolchildren. Methods Subjects included 3,750 schoolchildren from the fourth and seventh grade in Ina-town, Saitama Prefecture, Japan between 2004 and 2008. Information about subject's age, sex, height, weight, %BF, and WC was collected from annual physical examinations. %BF was measured with a bipedal biometrical impedance analysis device. Obesity was defined by the following two criteria: the obese definition of the Centers for Disease Control and Prevention, and the definition of obesity for Japanese children. Pearson's correlation coefficients between BMI and %BF or WC were calculated separately for sex. Results Among fourth graders, the correlation coefficients between BMI and %BF were 0.74 for boys and 0.97 for girls, whereas those between BMI and WC were 0.94 for boys and 0.90 for girls. Similar results were observed in the analysis of seventh graders. The correlation coefficient between BMI and %BF varied by physique (obese or non-obese, with weaker correlations among the obese regardless of the definition of obesity; most correlation coefficients among obese boys were less than 0.5, whereas most correlations among obese girls were more than 0.7. On the other hand, the correlation coefficients between BMI and WC were more than 0.8 among boys and almost all coefficients were more than 0.7 among girls, regardless of physique. Conclusions BMI was positively correlated with %BF and WC among Japanese

  2. Oral Rehydration Therapy in Burn Patients

    Science.gov (United States)

    2014-04-24

    Burn Any Degree Involving 20-29 Percent of Body Surface; Burn Any Degree Involving 30-39 Percent of Body Surface; Burn Any Degree Involving 40-49 Percent of Body Surface; Burn Any Degree Involving 50-59 Percent of Body Surface; Burn Any Degree Involving 60-65 Percent of Body Surface

  3. Analysis of effectiveness of the palliative treatment of metastatic bone's pain with 188Re-HEDP

    International Nuclear Information System (INIS)

    Savio, E.; Zeledon, P.; Paolino, A.; De Marco, E.; Gaudino, J.

    2003-01-01

    The objective of the study was to evaluate the treatment effectiveness with 188Re-HEDP in a group of 27 patients, who had received 36 doses. A pharmaceutical care programme was also added in order to improve drug follow-up after treatment. Two levels of doses were administered: 30 or 60 mCi. Initially a trace dose was given in order to estimate the therapeutic dose, which was individualise according to bone uptake of the radiopharmaceutical. Bone uptake was determined measuring radioactivity in urine samples (0, 1, 2, 4 and 6 hs), because the radiopharmaceutical showed only renal elimination. Multiple dose schedules with with 3 months between both doses were also tried. Seventy two percent showed an algesic effect during the first week post-treatment, with was kept during one month, while seven tenn (17%) percent of the patients the effect was kept for two of more months. Opioid analgesic (third level of OMS scale) were diminished in eighty two percent of the patients and AINES drugs in seventy one percent. The pharmaceutical care programme also showed the importance of the radio pharmacist role to improve treatment outcomes. 188Re-HEDP effectiveness was achieved in 100% of the patients, but with different pain palliation response in time and/or drug intake, with a suitable radiological safety

  4. How patients can improve the accuracy of their medical records.

    Science.gov (United States)

    Dullabh, Prashila M; Sondheimer, Norman K; Katsh, Ethan; Evans, Michael A

    2014-01-01

    Assess (1) if patients can improve their medical records' accuracy if effectively engaged using a networked Personal Health Record; (2) workflow efficiency and reliability for receiving and processing patient feedback; and (3) patient feedback's impact on medical record accuracy. Improving medical record' accuracy and associated challenges have been documented extensively. Providing patients with useful access to their records through information technology gives them new opportunities to improve their records' accuracy and completeness. A new approach supporting online contributions to their medication lists by patients of Geisinger Health Systems, an online patient-engagement advocate, revealed this can be done successfully. In late 2011, Geisinger launched an online process for patients to provide electronic feedback on their medication lists' accuracy before a doctor visit. Patient feedback was routed to a Geisinger pharmacist, who reviewed it and followed up with the patient before changing the medication list shared by the patient and the clinicians. The evaluation employed mixed methods and consisted of patient focus groups (users, nonusers, and partial users of the feedback form), semi structured interviews with providers and pharmacists, user observations with patients, and quantitative analysis of patient feedback data and pharmacists' medication reconciliation logs. (1) Patients were eager to provide feedback on their medications and saw numerous advantages. Thirty percent of patient feedback forms (457 of 1,500) were completed and submitted to Geisinger. Patients requested changes to the shared medication lists in 89 percent of cases (369 of 414 forms). These included frequency-or dosage changes to existing prescriptions and requests for new medications (prescriptions and over-the counter). (2) Patients provided useful and accurate online feedback. In a subsample of 107 forms, pharmacists responded positively to 68 percent of patient requests for

  5. Peptic ulcer disease and other complications in patients receiving dexamethasone palliation for brain metastasis

    International Nuclear Information System (INIS)

    Penzner, R.D.; Lipsett, J.A.

    1982-01-01

    A retrospective analysis was done of 106 patients who received radiation therapy for brain metastasis. Dexamethasone therapy was instituted in 97 patients. Peptic ulcer disease developed in 5 of 89 patients (5.6 percent) who received a dosage of at least 12 mg a day, but did not occur in patients who received a lower dose or in those who did not receive steroids. The interval between institution of dexamethasone therapy and the development of peptic ulcer disease ranged from three to nine weeks. Two patients had perforated ulcers, one of whom required surgical resection. Peptic ulcer disease contributed to the general deterioration and death of three of the five patients. Overall, in 14 of the 89 patients (15.7 percent) a complication of steroid therapy developed in the form of peptic ulcer disease, steroid myopathy or diabetes mellitus (or a combination of these)

  6. Stress thallium-201 myocardial scintigraphy for the detection of individual coronary arterial lesions in patients with and without previous myocardial infarction

    International Nuclear Information System (INIS)

    Rigo, P.; Bailey, I.K.; Griffith, L.S.; Pitt, B.; Wagner, H.N. Jr.; Becker, L.C.

    1981-01-01

    The value of stress thallium-201 scintigraphy for detecting individual coronary arterial stenoses was analyzed in 141 patients with angiographically proved coronary artery disease, 101 with and 40 without a previous myocardial infarction. In patients without infarction, the sensitivity for detecting greater than 50 percent narrowing in the left anterior descending, the right and the left circumflex coronary artery was 66, 53 and 24 percent, respectively. In those with a previous infarction, the sensitivity for demonstrating disease in the artery corresponding to the site of infarction was 100 percent for the left anterior descending, 79 percent for the right and 63 percent for the left circumflex coronary artery. In patients with a prior anterior infarction, concomitant right or left circumflex coronary arterial lesions were detected in only 1 of 12 cases, whereas in those with previous inferior or inferolateral infarction, the sensitivity for left anterior descending coronary artery disease was 69 percent. Because of the reasonably high sensitivity for detecting left anterior descending arterial disease, irrespective of the presence and location of previous infarction, myocardial scintigraphy was useful in identifying multivessel disease in patients with a previous inferior infarction. However, because of its relative insensitivity for right or left circumflex coronary artery disease, scintigraphy proved to be a poor predictor of multivessel disease in patients with a prior anterior infarction and in patients without previous myocardial infarction

  7. Access to Digital Communication Technology and Perceptions of Telemedicine for Patient Education among American Indian Patients with Diabetes.

    Science.gov (United States)

    Mathieson, Kathleen; Leafman, Joan S; Horton, Mark B

    2017-01-01

    Health care access for medically underserved patients managing chronic conditions is challenging. While telemedicine can support patient education and engagement, the "digital divide" may be particularly problematic among the medically underserved. This study evaluated physical access to digital devices, use of e-mail and social media tools, and perceptions of telemedicine among American Indian (AI) patients with diabetes mellitus (DM). Survey data were collected from AI patients with DM during teleophthalmology exams. Eighty-eight percent of patients had access to digital device(s), 70% used e-mail, and 56% used social media. Younger age and greater education were positively associated with e-mail and social media use (p < .05). Most (60%) considered telemedicine an excellent medium for health-related patient education. American Indian patients with DM had access enabling patient education via telemedicine. Future work should examine patient technology preferences and effectiveness of technology-based education in improving outcomes among medically underserved populations.

  8. 125I therapy in Graves' disease. Long-term results in 355 patients

    International Nuclear Information System (INIS)

    McDougall, I.R.; Greig, W.R.

    1976-01-01

    Because of the physical and radiobiologic differences between 125 I and 131 I, a trial using 125 I to treat hyperthyroidism was undertaken in the hope of controlling hyperthyroidism without causing subsequent hypothyroidism. Three hundred fifty-five patients with diffuse toxic goitres were treated and have been under review for an average of 49.4 months: 63.4 percent are euthyroid, 33.5 percent are hypothyroid, and 3.1 percent remain hyperthyroid. Different groups of patients received a wide range of doses of 125 I (4.0 to 56.0 mCi), and the lowest incidence of hypothyroidism (23 percent) was in the group that received between 6.0 and 10.5 mCi. Sixty-three percent of the patients whose initial dose was greater than 20.0 mCi are hypothyroid. Persistent hyperthyroidism was common in patients who received small doses. Because of the high incidence of posttreatment hypothyroidism in this series and because 131 I has stood the test of time, we believe that 131 I is the radionuclide of choice for the routine treatment of hyperthyroidism

  9. Auckland City Hospital's Ortho-Geriatric Service: an audit of patients aged over 65 with fractured neck of femur.

    Science.gov (United States)

    Wimalasena, Bodhi; Harris, Roger

    2016-07-01

    The aims of this audit were to collect the Minimum Data Set outlined by the Australia New Zealand Hip Fracture Registry (ANZHFR), assess patient characteristics, analyse process of care, and evaluate how this compares to NICE guidelines for hip fracture care, as well as to Auckland Hospital data from 2007. Retrospective case record audit of patients with fractured neck of femur aged 65 years and over admitted under Orthopaedics over a 4-month period in 2013. Ninety-one patients were audited; mean age was 83 years, 68% were female. Both inpatient and 30-day mortality was 5%. 120-day mortality was 15%. Seventy-six percent of patients were admitted from ED within the national health target prescribed period of 6 hours. Only one patient was treated non-surgically. Eighty-six percent had surgery within 48 hours of admission. Eighty-two percent of patients had rehabilitation and treatment by Older People's Health. Of those living at home pre-fracture, 76% returned home on discharge. Thirty-seven percent of patients were able to walk unaided prior to hip fracture, but only 1% on discharge. Average overall length of stay was 22 days. Bisphosphonates were prescribed for 56% of patients. Compared to 2007, Auckland City Hospital has demonstrated a significant improvement in the rate of provision of timely surgery for hip fracture patients. Most patients are receiving the guideline recommended fracture-specific surgical interventions. The assessment and treatment of osteoporosis needs further attention.

  10. Comparison of Survival Rates, Tumor Stages, and Localization in between Obese and Nonobese Patients with Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Hakan Kocoglu

    2016-01-01

    Full Text Available Purpose. In this study we tried to determine the association between body-mass index (BMI, survival rate, and the stage of tumor at the time of diagnosis in patients with gastric cancer. Methods. A total of 270 gastric cancer patients’ hospital records were retrospectively evaluated. Patients were grouped according to their BMI at the time of tumor diagnosis. Tumor stages at admission were compared according to their BMI values. Results. There were no differences in OS among BMI subgroups (p=0.230. The percent of patients with stage III tumor was significantly higher in nonobese while the percent of stage IV tumor was surprisingly higher in obese patients (p was 0.011 and 0.004, resp.. Percent of patients who did not have any surgical intervention was significantly lower in overweight and obese patients than normal and/or underweight patients. Conclusions. At the time of diagnosis, obese patients had significantly higher percent of stage IV tumor than nonobese patients. Despite of that, there were no differences in survival rates among BMI subgroups. Our study results are consistent with “obesity paradox” in gastric cancer patients. We also did not find any relationship between BMI and localization of gastric tumor.

  11. CRT-D Therapy in Patients with Decompensated NYHA Class-Four CHF

    Directory of Open Access Journals (Sweden)

    Faisal Zaeem

    2012-01-01

    Full Text Available Background. ACC-HRS Guidelines for Cardiac Resynchronization Therapy ICD implantation (CRT-D do not include patients with advanced nonambulatory NYHA class-four CHF due to an expectation of limited survival. There is little data available from these large multicenter randomized studies to support or refute this claim. Purpose. We evaluated the outcomes of patients with advanced nonambulatory NYHA class-four CHF who received CRT-D devices as an attempt to improve the clinical status and promote hospital discharge. Methods. Sixteen (of our six hundred and seventy CRT-D patients were classified as advanced nonambulatory NYHA Class four inotrope/vasodilator/diuretic-dependent patients. These patients were analyzed retrospectively for weaning success to oral medications, hospital discharge, hemodynamic stability, and survival over eighteen months. Results. Thirteen of sixteen patients were discharged to home within two weeks of implantation. The survival to hospital discharge, as well as at six, twelve, and eighteen months was positive (ninety-four percent, seventy-five percent, sixty-nine percent, sixty-nine percent, resp.. The groups showed significant improvements in systolic blood pressure, renal function, left ventricular ejection fraction, and CHF class. Conclusion. CRT-D in advanced nonambulatory NYHA four patients proved feasible and beneficial. These findings suggest that the strategy merits further study.

  12. Characteristics of prescribers whose patients shop for opioids: results from a cohort study.

    Science.gov (United States)

    Cepeda, M Soledad; Fife, Daniel; Berlin, Jesse A; Mastrogiovanni, Gregory; Yuan, Yingli

    2012-01-01

    Little is known about the prevalence of opioid shoppers in clinical practices and the relation between prescriber characteristics and the risk of having opioid shoppers. Describe the prevalence of opioid shoppers in prescribers' practices. Assess the relation between prescribers' characteristics and patient opioid shopping behavior. Retrospective cohort study using a large US retail prescription database. Patients with ≥1 opioid dispensing were followed 18 months. These patients' prescribers are the focus of the study. A patient was a "shopper" if he or she had opioid prescriptions written by ≥1 prescriber with ≥1 day of overlap filled at ≥3 pharmacies and a "heavy shopper" if he or she had ≥5 shopping episodes. The proportions of shoppers by prescriber and the proportion of prescribers with ≥1 shopper or heavy shopper were calculated. Among 858,290 opioid prescribers, most (87 percent) had no shoppers and 98 percent had no heavy shoppers. Prescribers who were aged 70-79 years, male, or who prescribed schedule II opioids had an increased likelihood of having shoppers. As the number of patients for whom a prescriber prescribed opioids increased, the proportion of shoppers also increased. Prescribers with 66 or more patients receiving opioids, who represented 25 percent of prescribers, prescribed for 82 percent of all shoppers. The great majority of opioid prescribers appear to have no shoppers in their practice. Any educational program will be more cost effective if targeted to prescribers of schedule II opioids with a large volume of patients requiring opioids.

  13. Patient opinion

    DEFF Research Database (Denmark)

    Zurita, Laura; Nøhr, Christian

    2004-01-01

    The paper is based upon a case study and aims to provide information abouit patients values and communication that will be useful in the design of more patient friendly health system.......The paper is based upon a case study and aims to provide information abouit patients values and communication that will be useful in the design of more patient friendly health system....

  14. Patient-Centered Research

    Science.gov (United States)

    Shridharani, KV; Yuen, W; Huang, D; Pan, C

    2000-01-01

    PURPOSE Complementary and Alternative Medicine (CAM) can be defined as medical practices not taught widely at US medical schools or generally available at US hospitals. National studies suggest that between 30–40% of the general US population use CAM. These users tend to be more educated, have higher incomes, and are more likely to be between the ages of 30–49. However, to date, no study has documented the use of CAM among the homebound population, patients who are usually elderly, debilitated, and have less access to medical care. We studied the use of alternative therapies in homebound patients of the Mount Sinai Visiting Doctors Program serving the inner city of New York. METHODS Eligibility for the study was limited to patients who are in the Visiting Doctors Program, and whose mini-mental status exam score was greater than 20 or who were deemed competent to complete the survey by their primary care provider. Participant's CAM use was assessed by a survey administered by an interviewer at the patient's home. RESULTS Forty-nine consecutive, eligible patients were interviewed and a survey completed. Among the respondents, 84% were women, the mean age was 78.6 (STD = 14.1). Respondents were 51% Caucasian, 27% African-American, 14% Hispanic and 8% other. On rating their own health, 69% rated it as poor to fair, 22% rated it as good, and 8% rated it as very good to excellent. Sixty-nine percent of the respondents reported using one or more CAM in the past 12 months. Commonly used CAM included: vitamins/minerals (33%) [excluding MVI, calcium], spiritual healing (27%), and herbal remedies (20%). Spiritual healing included prayer and faith healing. The most common herbal remedies were garlic, ginger, and chamomile tea. Among CAM users, their main sources of information about CAM came from their own physicians (32%), family/friends/co-workers (18%), and newspaper/radio/TV (18%). CONCLUSION The use of CAM in this elderly, debilitated, homebound population was

  15. Angiotensin infusion effects on left ventricular function. Assessment in normal subjects and in patients with coronary disease.

    Science.gov (United States)

    Bianco, J A; Laskey, W K; Makey, D G; Shafer, R B

    1980-02-01

    Radionuclide multigating of the cardiac cycle was employed to assess effects of angiotensin infusion on left ventricular function. In six normal subjects, angiotensin infusion decreased heart rate (HR) from 72 +/- SEM 2 to 57 +/- 2 beats/min (P less than 0.001); while systolic blood pressure (BP) increased from 119 +/- 2 to 178 +/- 1 mm Hg (P less than 0.001), and ejection fraction (EF) declined from 58 +/- 1 to 47 +/- 2 percent (P less than 0.05). In contrast, in 11 normal subjects, supine exercise increased HR and systolic BP by 55 and 49 percent, whereas EF increased from 64 +/- 1 to 71 +/- 1 (P less than 0.001). In ten patients with CAD, angiotensin infusion produced no change in HR, increased systolic BP by 34 percent, and decreased EF by 11 percent. Angiotensin infusion induced left ventricular depression in normal subjects and in patients with CAD. It cannot substitute for exercise in intervention radionuclide ventriculography.

  16. Determination of glycated hemoglobin in patients with advanced liver disease

    Science.gov (United States)

    Lahousen, Theresa; Hegenbarth, Karin; Ille, Rottraut; Lipp, Rainer W.; Krause, Robert; Little, Randie R.; Schnedl, Wolfgang J.

    2004-01-01

    AIM: To evaluate the glycated hemoglobin (HbA 1c) determination methods and to determine fructosamine in patients with chronic hepatitis, compensated cirrhosis and in patients with chronic hepatitis treated with ribavirin. METHODS: HbA1c values were determined in 15 patients with compensated liver cirrhosis and in 20 patients with chronic hepatitis using the ion-exchange high performance liquid chromatography and the immunoassay methods. Fructosamine was determined using nitroblue tetrazolium. RESULTS: Forty percent of patients with liver cirrhosis had HbA1c results below the non-diabetic reference range by at least one HbA1c method, while fructosamine results were either within the reference range or elevated. Twenty percent of patients with chronic hepatitis (hepatic fibrosis) had HbA1c results below the non -diabetic reference range by at least one HbA1c method. In patients with chronic hepatitis treated with ribavirin, 50% of HbA1c results were below the non-diabetic reference using at least one of the HbA1c methods. CONCLUSION: Only evaluated in context with all liver function parameters as well as a red blood count including reticulocytes, HbA 1c results should be used in patients with advanced liver disease. HbA 1c and fructosamine measurements should be used with caution when evaluating long-term glucose control in patients with hepatic cirrhosis or in patients with chronic hepatitis and ribavirin treatment. PMID:15259084

  17. Survey of sexual educational needs in radiation oncology patients

    International Nuclear Information System (INIS)

    Chen, L.; Sweeney, P.; Wallace, G.; Neish, P.; Vijayakumar, S.

    1997-01-01

    Purpose: To assess the knowledge of and need for education about sexuality in oncology patients treated with radiation therapy. Methods and Materials: Patients who received radiation therapy for any disease site were given a self-assessment survey to complete to determine their opinions on sexuality and needs for sexual education. The surveys were given to patients on follow-up visit seen approximately 6 months to 2 years after radiation therapy. All patients were diagnosed with a malignancy and asked to participate on a voluntary basis; confidentiality was ensured by excluding any identifying patient information on the survey form. Respondents were polled with a survey that consisted of 17 questions about their sexual activity. Questions were broadly categorized into the following: definition of sexual activity, frequency of sexual activity prior to and after diagnosis and treatment of cancer, perception of sexual attractiveness, sexual satisfaction in the relationship, patient perception of partner's sexual satisfaction in the relationship, educational needs with regard to sexuality after therapy for cancer, and demographic information. Results: All patients were over age 18, and received radiation therapy as part of the treatment. Patients with all disease sites were included in the survey, regardless of stage or diagnosis. A total of 28 patients completed the survey form, which was approved by our institutional review board. Forty-three percent of patients felt that the cancer diagnosis or treatment effect was the cause of not engaging in sexual intercourse. Fifty percent reported not having the same sexual desire as before the diagnosis of cancer, while 46% reported having the same sexual desire as prior to the diagnosis of cancer. Forty-six percent felt less attractive than before the diagnosis of cancer, while 43% felt the same as before diagnosis. Thirty-six percent of patients received no information with regards to sexuality and cancer, while 18% received

  18. How do patients with inflammatory bowel disease want their biological therapy administered?

    Directory of Open Access Journals (Sweden)

    Lindsay Hannah

    2010-01-01

    Full Text Available Abstract Background Infliximab is usually administered by two monthly intravenous (iv infusions, therefore requiring visits to hospital. Adalimumab is administered by self subcutaneous (sc injections every other week. Both of these anti-TNF drugs appear to be equally efficacious in the treatment of Crohn's Disease and therefore the decision regarding which drug to choose will depend to some extent on patient choice, which may be based on the mode of administration. The aims of this study were to compare preferences in Inflammatory Bowel Disease (IBD patients for two currently available anti-TNF agents and the reasons for their choices. Methods An anonymous questionnaire was distributed to IBD patients who had attended the Gastroenterology service (Ulster Hospital, Dundonald, Belfast, N. Ireland. UK between January 2007 and December 2007. The patients were asked in a hypothetical situation if the following administering methods of anti-TNF drugs (intravenous or subcutaneous were available, which drug route of administration would they choose. Results One hundred and twenty-five patients fulfilled the inclusion criteria and were issued questionnaires, of these 78 questionnaires were returned (62 percent response. The mean age of respondent was 44 years. Of the total number of respondents, 33 patients (42 percent preferred infliximab and 19 patients (24 percent preferred adalimumab (p = 0.07. Twenty-six patients (33 percent did not indicate a preference for either biological therapy and were not included in the final analysis. The commonest reason cited for those who chose infliximab (iv was: "I do not like the idea of self-injecting," (67 percent. For those patients who preferred adalimumab (sc the commonest reason cited was: "I prefer the convenience of injecting at home," (79 percent. Of those patients who had previously been treated with an anti-TNF therapy (n = 10, all infliximab six patients stated that they would prefer infliximab if given

  19. Prostate health index and prostate cancer gene 3 score but not percent-free Prostate Specific Antigen have a predictive role in differentiating histological prostatitis from PCa and other nonneoplastic lesions (BPH and HG-PIN) at repeat biopsy.

    Science.gov (United States)

    De Luca, Stefano; Passera, Roberto; Fiori, Cristian; Bollito, Enrico; Cappia, Susanna; Mario Scarpa, Roberto; Sottile, Antonino; Franco Randone, Donato; Porpiglia, Francesco

    2015-10-01

    To determine if prostate health index (PHI), prostate cancer antigen gene 3 (PCA3) score, and percentage of free prostate-specific antigen (%fPSA) may be used to differentiate asymptomatic acute and chronic prostatitis from prostate cancer (PCa), benign prostatic hyperplasia (BPH), and high-grade prostate intraepithelial neoplasia (HG-PIN) in patients with elevated PSA levels and negative findings on digital rectal examination at repeat biopsy (re-Bx). In this prospective study, 252 patients were enrolled, undergoing PHI, PCA3 score, and %fPSA assessments before re-Bx. We used 3 multivariate logistic regression models to test the PHI, PCA3 score, and %fPSA as risk factors for prostatitis vs. PCa, vs. BPH, and vs. HG-PIN. All the analyses were performed for the whole patient cohort and for the "gray zone" of PSA (4-10ng/ml) cohort (171 individuals). Of the 252 patients, 43 (17.1%) had diagnosis of PCa. The median PHI was significantly different between men with a negative biopsy and those with a positive biopsy (34.9 vs. 48.1, Pprostatitis and PCa was moderate, although it extended to a good range of threshold probabilities (40%-100%), whereas that from using %fPSA was negligible: this pattern was reported for the whole population as for the "gray zone" PSA cohort. In front of a good diagnostic performance of all the 3 biomarkers in distinguishing negative biopsy vs. positive biopsy, the clinical benefit of using the PCA3 score and PHI to estimate prostatitis vs. PCa was comparable. PHI was the only determinant for prostatitis vs. BPH, whereas no biomarkers could differentiate prostate inflammation from HG-PIN. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Patient perceptions of factors leading to spasmodic dysphonia: a combined clinical experience of 350 patients.

    Science.gov (United States)

    Childs, Lesley; Rickert, Scott; Murry, Thomas; Blitzer, Andrew; Sulica, Lucian

    2011-10-01

    Spasmodic dysphonia (SD) is an idiopathic voice disorder that is characterized by either a strained, strangled voice quality or a breathy voice with aphonic segments of connected speech. It has been suggested that environmental factors play a role in triggering the onset. Clinical observation suggests that some patients associate onset with specific events or factors while others do not. The purpose of this study was to examine a large database of SD patients to determine if specific triggers are associated with the onset of SD. Retrospective chart review. A total of 350 charts of patients with SD were identified and were categorized as either "sudden onset" or "gradual onset." One hundred sixty-nine recalled their circumstances surrounding onset. Forty-five percent of these patients described the onset as sudden. Patient perceptions of inciting events in the sudden onset group were identified 77% of the time and 2% of the time in the gradual onset group. The most common factors identified were stress (42%), upper respiratory infection (33%), and pregnancy and parturition (10%). Thirty-five percent of SD patients perceive their disorder to have a sudden onset with identified inciting events. This prevalence raises questions regarding possible behavioral and environmental factors surrounding the onset of this disorder. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.