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Sample records for period eighteen patients

  1. Muscle pathology in myotonic dystrophy: light and electron microscopic investigation in eighteen patients.

    Science.gov (United States)

    Nadaj-Pakleza, A; Lusakowska, A; Sułek-Piątkowska, A; Krysa, W; Rajkiewicz, M; Kwieciński, H; Kamińska, A

    2011-05-01

    Myotonic dystrophy (DM) is the most common muscular dystrophy in adults. Two known genetic subtypes include DM1 (myotonic dystrophy type 1) and DM2 (myotonic dystrophy type 2). Genetic testing is considered as the only reliable diagnostic criterion in myotonic dystrophies. Relatively little is known about DM1 and DM2 myopathology. Thus, the aim of our study was to characterise light and electron microscopic features of DM1 and DM2 in patients with genetically proven types of the disease. We studied 3 DM1 cases and 15 DM2 cases from which muscle biopsies were taken for diagnostic purposes during the period from 1973 to 2006, before genetic testing became available at our hospital. The DM1 group included 3 males (age at biopsy 15-19). The DM2 group included 15 patients (5 men and 10 women, age at biopsy 26-60). The preferential type 1 fibre atrophy was seen in all three DM1 cases in light microscopy, and substantial central nucleation was present in two biopsies. Electron microscopy revealed central nuclei in all three examined muscle biopsies. No other structural or degenerative changes were detected, probably due to the young age of our patients. Central nucleation, prevalence of type 2 muscle fibres, and the presence of pyknotic nuclear clumps were observed in DM2 patients in light microscopy. Among the ultrastructural abnormalities observed in our DM2 group, the presence of internal nuclei, severely atrophied muscle fibres, and lipofuscin accumulation were consistent findings. In addition, a variety of ultrastructural abnormalities were identified by us in DM2. It appears that no single ultrastructural abnormality is characteristic for the DM2 muscle pathology. It seems, however, that certain constellations of morphological changes might be indicative of certain types of myotonic dystrophy.

  2. Group B streptococcal bacteremia in a major teaching hospital in Malaysia: a case series of eighteen patients.

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    Eskandarian, N; Neela, V; Ismail, Z; Puzi, S M; Hamat, R A; Desa, M N M; Nordin, S A

    2013-09-01

    Group B Streptococcus (GBS) is a leading cause of infections such as meningitis and septicemia in neonates and pregnant women; however the significance of invasive GBS disease has not been clearly defined in non-pregnant adults. We reviewed the hospital records of 18 cases with GBS bacteremia who attended the Universiti Kebangsaan Malaysia Medical Centre from June 2010 to October 2011. We analyzed the clinical findings of both bacteremic adults and neonates and compared them to previous studies of GBS bacteremia. Serotyping was done by latex agglutination test using 10 distinct antisera (Ia, Ib, and II-IX). During the period of 1 year and 4 months, there were 18 patients with GBS bacteremia. Five cases occurred in neonates, one in a parturient woman, and 12 in other adults. All neonates with bacteremia were males and two of them were premature. Septicemia was the most common clinical presentation in neonates. They were treated with intravenous (IV) penicillin G and gentamicin. The adults included nine men (69%) and four women (31%). Their mean age was 60 years and all patients had more than two underlying conditions. The most common clinical syndrome was pneumonia (n=6, 46.5%). The others were peritonitis (n=3, 23.1%), primary bacteremia (n=2, 15.5%), septic arthritis (n=2, 15.5%), skin and soft tissue infection (n=1, 7.7%), meningitis (n=1, 8%), urinary tract infection (n=1, 8%), and intravascular device infection (n=1, 7.7%). Cardiovascular diseases (n=7, 53.8%) were the most common underlying conditions, and diabetes mellitus (n=5, 38.5%) was second. The other co-morbid conditions were hyperlipidemia (n=3, 23.1%), renal disease (n=3, 23.1%), liver disease and/or alcohol abuse (n=3, 23.1%), autoimmune disease or immunosuppressive condition (n=2, 15.5%), malignancy (n=2, 15.5%), respiratory disease (n=1, 8%), and postpartum condition (n=1, 8%), as well as miscellaneous conditions including intravenous drug abuse, HIV infection, and trauma (n=2, 15

  3. Increase in white cell and neutrophil counts during the first eighteen weeks of treatment with clozapine in patients admitted to a long-term psychiatric care inpatient unit.

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    Capllonch, Adrián; de Pablo, Silvia; de la Torre, Alberto; Morales, Ignacio

    Clozapine is an antipsychotic drug that has shown to be more effective than other antipsychotics in the treatment of schizophrenia, but its use is limited due to its side effects, particularly by the risk of causing agranulocytosis. A study was made on the variations in white cell and neutrophil counts in patients treated with clozapine in a Long-term Psychiatric Unit. A retrospective observational study was conducted with a sample of women of our long-term psychiatric care unit who had been treated with clozapine. A study was made on the variations in white cell and neutrophil counts during the first 18 weeks of treatment, as well as the onset of leukopenia, neutropenia, agranulocytosis, and the influence of concomitant drugs. The study included 55 patients on treatment with clozapine. The incidence rate of neutropenia was 1.82% (95% CI; 0.05-10.13). The incidence rate of leukopenia and agranulocytosis was 0%. An increase in white cell and neutrophil counts from baseline to week 3-4 was observed. Only small variations were observed after this time, but the counts remained higher than the initial values. These changes were statistically significant in the white cell count: One-way repeated ANOVA with Greenhouse-Geisser correction F (11.47, 37) = 2.114 (P= .011); and in neutrophils: One-way repeated ANOVA with Greenhouse-Geisser correction F (10.3, 37)=3.312 (P=.0002), and MANOVA F (18, 37)=2.693 (P=.005), ŋ 2 P =0.567. The influence of concomitant drugs (lithium, valproic and biperiden) was not significant on the overall increase found in white cells or neutrophils (MANOVA). Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. [Hypoglycaemic periodic paralysis in hyperthyroidism patients].

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    Kratochvíl, J; Masopust, J; Martínková, V; Charvát, J

    2008-11-01

    Hypokalemic periodic paralysis (HPP) is a rare disorder characterised by acute, potentially fatal atacks of muscle weakness or paralysis. Massive shift of potassium into cells is caused by elevated levels of insulin and catecholamines in the blood. Hypophosphatemia and hypomagnesemia may be also present. Acidobasic status usually is not impaired. HPP occurs as familiar (caused by ion channels inherited defects) or acquired (in patients with hyperthyroidism). On the basis of two clinical cases we present a review of hypokalemic periodic paralysis in hyperthyroid patients. We discuss patogenesis, clinical and laboratory findings as well as the principles of prevention and treatment of this rare disorder.

  5. Survival period after tube feeding in bedridden older patients.

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    Kosaka, Yoichi; Nakagawa-Satoh, Takuma; Ohrui, Takashi; Fujii, Masahiko; Arai, Hiroyuki; Sasaki, Hidetada

    2012-04-01

    We prospectively studied survival periods after tube feeding. Participants were 163 bedridden older patients suffering from dysphagia. A wide range of survival periods after tube feeding were observed within half a year without tube feeding after being bedridden. After this initial period, survival periods after tube feeding were limited to approximately half a year. Survival periods after tube feeding were positively proportional to the length of time patients were free from pneumonia after tube feeding. After tube feeding, patients died from pneumonia within half a year, and the frequency of pneumonia was 3.1 ± 2.7 times (mean ± SD) before death. Survival periods after tube feeding for less than 1 year were primarily determined by being bedridden for more than half a year without tube feeding and once pneumonia occurred; patients who were tube fed did not survive for more than half a year. © 2012 Japan Geriatrics Society.

  6. NOSOCOMIAL INFECTIONS IN PATIENTS WITH UROLITHIASIS IN THE POSTOPERATIVE PERIOD

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    F. S. Sadulloev

    2015-01-01

    Full Text Available Abstract:Objective: To determine the most frequent causative agents of nosocomial infection in patients with urolithiasis in the postoperative period.Material and Methods. The study is based on the results of comprehensive studies conducted in 122 patients with nosocomial urinary tract infection, detected in 823 patients with urolithiasis treated by various methods. A cohort of 823 patients is isolated from 2688 patients treated without at admission signs of infections in the urinary tract for the period 2011–2014. All patients were treated at the Urological department of Avicenna Tajik State Medical University in the Republican Clinical Center of Urology. Main results. By the method of randomly selected 823 medical records of patients with urolithiasis various operations we carried out with 122 patients revealed cases of nosocomial infections. The diagnosis of nosocomial infections on the basis of established symptomatic urinary tract infection, asymptomatic bacteriuria or the presence of wound infection, use during the hospital stay for treatment of antibiotics, antiseptics, physiotherapy and other therapies. The incidence of nosocomial infections was studied in dependence with the severity of the underlying disease, the volume of surgical, invasive, endoscopic and other urological procedures, the timing and frequency of tests, the proportion of individual clinical manifestations in the overall structure of urinary tract infections, sex and age of patients.Conclusions. The leading microflora causing nosocomial infection in patients with urolithiasis in all treatments are gram-negative microorganisms, including prevailing E.coli (24,0%.

  7. 29 CFR 779.508 - Eighteen-year minimum.

    Science.gov (United States)

    2010-07-01

    ... RETAILERS OF GOODS OR SERVICES Other Provisions Which May Affect Retail Enterprises Child Labor Provisions... 29 Labor 3 2010-07-01 2010-07-01 false Eighteen-year minimum. 779.508 Section 779.508 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR STATEMENTS OF GENERAL...

  8. Anaesthetic management of a patient with familial normokalaemic periodic paralysis.

    LENUS (Irish Health Repository)

    Walsh, F

    2012-02-03

    PURPOSE: We describe the anaesthetic management of a patient with the autosomal dominant inherited disease, normokalaemic periodic paralysis. The disease results in intermittent bouts of limb and respiratory muscular weakness in association with hypothermia, stress, prolonged fasting or exercise. Unlike hypokalaemic and hyperkalaemic periodic paralysis, the more common variants of the disease, normokalaemic periodic paralysis is not accompanied by alterations in the plasma potassium concentration. CLINICAL FEATURES: A five-year-old boy presented for emergency scrotal exploration. He had a family history of periodic paralysis and had experienced previous episodes of weakness, two of which had required hospitalization for respiratory distress. On admission there was no evidence of weakness and serum potassium concentration was 4.2 mMol.L-1. A spinal anaesthetic was performed and the procedure was uncomplicated by muscle paralysis above the level of the spinal block. CONCLUSION: Avoidance of known precipitating factors and judicious use of neuromuscular blocking drugs has been advocated in patients with this disorder presenting for surgery. In appropriate circumstances, spinal anaesthesia represents a useful option in patients with normokalaemic periodic paralysis.

  9. Avaliação isocinética de 18 pacientes do sexo masculino submetidos à correção cirúrgica da luxação acromioclavicular aguda com seguimento mínimo de dois anos Isokinetic evaluation of eighteen male patients submitted to surgical corretion of acute acromioclavicular luxation with a minimum two-year follow-up

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    Flavio Almeida Salles

    2002-06-01

    Full Text Available Foram estudados 18 pacientes submetidos ao tratamento cirúrgico de luxação acromioclavicular aguda do grau III da classificação de ALLMAN-TOSSY, todos do sexo masculino com idade média de 36 anos, foram avaliados sob o ponto de vista isocinético com tempo de evolução variando de 24 até 127 meses. A avaliação isocinética foi realizada através de um dinamômetro computadorizado marca CYBEX® modelo 6000 na velocidade angular de 60º/segundo e demonstrou resultados significantes no movimento de abdução no plano neutro, com déficit no pico de torque do lado operado, quando comparado com o lado contra-lateral. Quando comparados os ombros com e sem subluxação, os com subluxação demonstraram défcit no trabalho total tanto na adução quanto na abdução no plano neutro.Eighteen male patients, mean age 36 years, submitted to surgical treatment of ALLMAN-TOSSY grade III acute acromioclavicular luxation were studied. They were isokinetically evaluated during an evolution period ranging from 24 to 127 months. The isokinetic evaluation was carried out with a Cybex® 6000 computerized dynamometer, at a 60º/s angular speed, showing significant results in vertical abduction, with a deficit in peak torque in the operated on shoulder as compared to the contralateral side. When the groups with and without subluxation were compared a deficit in total work was observed in the group with subluxation both in adduction and abduction.

  10. Results of TRT after eighteen months: our experience.

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    Baracca, Giovanna N; Forti, Stella; Crocetti, Andrea; Fagnani, Enrico; Scotti, Alberto; Del Bo, Luca; Ambrosetti, Umberto

    2007-05-01

    The aim of this study was to evaluate the efficacy of TRT in patients suffering from tinnitus. The tinnitus disorder affects about 10-15% of the population and, in one person out of a hundred, it is a disabling disorder. TRT treatment is based on Jastreboff's neurophysiological model. TRT consists of two parts: counselling, and sound therapy by means of dedicated hearing aids and sound generators. It proved to be useful to reduce the symptoms related to tinnitus. Jastreboff's structured interviews were proposed to a sample of 51 patients with tinnitus belonging to the I-II-III-IV classes according to Jastreboff. These patients were treated for 18 months. Sixty-eight percent of patients reported a reduction in the symptoms related to tinnitus, such as sleep disturbance, problems in concentration, and inability to relax. A percentage (64.7%) of patients thought that their quality of life was improved. Patients who had suffered from tinnitus for less than one year achieved significantly better results than patients who had suffered for a longer period of time. TRT is an effective tool in the treatment of tinnitus.

  11. [Tarantism in Spain in the eighteen century: latrodectism and suggestion].

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    Corral-Corral, I; Corral-Corral, C

    2016-10-16

    Tarantism is the disease caused by the bite of the tarantula, in which the music tarantella triggers an involuntary dance. It is known in Italy since the sixteenth century. To analyze the tarantism reported in Spain at the end of the eighteenth century, with special attention to its neurological aspects, and to propose its medical and psychopathological explanation. An epidemic of people affected by the tarantula bite occurred in Spain in 1782. Spanish doctors described appropriately the clinical effects, identical to those produced by the bite of the spider black widow (Latrodectus tredecimguttatus), which was at that time identified as a tarantula. The cases reported by Francisco Xavier Cid cured with the involuntary dance triggered by the tarantella, as was described in Italy since the sixteenth century. Our interpretation is that this curative effect of dance in Spain was induced by suggestion. In Spanish patients there were no behavioral disturbances, periodic recurrences or collective involvement as those reported by Italian authors, which suggest an hysterical phenomenon, probably a continuation of the dancing mania of the Middle Age. Tarantism reported in Spain in the eighteenth century includes two different phenomena: the systemic symptoms produced by the tarantula bite, which is actually latrodectism, and the curative effect of the tarantella, explained by suggestion. The psychiatric disturbances, with a hysterical nature, falsely associated to the tarantula bite, observed in Italy, were not present among the Spanish cases of tarantism in the eighteenth century.

  12. Metabolic observations during the treatment of obese patients by periods of total starvation

    NARCIS (Netherlands)

    Riet, H.G. van; Schwarz, F.; Kinderen, P.J. der; Veeman, W.

    Ten very obese female patients were treated by periods of total starvation lasting 10 days each. In the interval between these starvation periods, a diet of 600 calories was given. Twenty-one periods were completed, 6 patients went through 3 periods each. The fasting was generally well tolerated;

  13. Eighteen years experience of granulocyte donations-acceptable donor safety?

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    Axdorph Nygell, Ulla; Sollén-Nilsson, Agneta; Lundahl, Joachim

    2015-10-01

    Granulocyte transfusions are given to patients with life-threatening infections, refractory to treatment. The donors are stimulated with corticosteroids ± granulocyte colony stimulating factor (G-CSF). However, data regarding the donors' safety is sparse. The objective was therefore to evaluate short- and long-term adverse events (AE) in G-CSF stimulated donors. All consecutive granulocyte donors from 1994 to 2012 were identified through our registry. From the donation records, the number of aphereses, stimulation therapy, AE, blood values post donation, and recent status were evaluated. One hundred fifty-four volunteer donors were mobilized for 359 collections. Age at first granulocyte donation was 43 years (median; range 19-64 years). Follow-up was 60 months (median; range 0-229 months). The dose of G-CSF per collection was 3.8 ug/kg body weight (median; range 1.6-6.0 ug/kg). Sedimentation agent was HES. Short-term AE were mild. Blood values 4 weeks post donation with minor reductions/elevations mostly resolved in later donations. Fourteen donors were excluded from the registry due to hypertension (4), diabetes (2), atrial flutter (1), breast carcinoma (1), urethral carcinoma in situ (1), MGUS (1), thrombosis (1), anaphylaxis (1), primary biliary cirrhosis (1), and unknown (1). Three donors are deceased due to diabetes, acute myocardial infarction, and unknown cause. All excluded/deceased donors except one were excluded/died at least 6 months after first granulocyte donation. No serious short-term AE were observed. Due to the variability of diagnoses among excluded/deceased donors, we propose that it is less likely that granulocyte donations have a causative impact on these donors' exclusion or death. © 2014 Wiley Periodicals, Inc.

  14. Myocardial Revascularization in Dyalitic Patients: In-Hospital Period Evaluation

    International Nuclear Information System (INIS)

    Miranda, Matheus; Hossne, Nelson Américo Jr.; Branco, João Nelson Rodrigues; Vargas, Guilherme Flora; Fonseca, José Honório de Almeida Palma da; Pestana, José Osmar Medina de Abreu; Juliano, Yara; Buffolo, Enio

    2014-01-01

    Coronary artery bypass grafting currently is the best treatment for dialytic patients with multivessel coronary disease, but hospital morbidity and mortality related to procedure is still high. Evaluate results and in-hospital outcomes of coronary artery bypass grafting in dialytic patients. Retrospective unicentric study including 50 consecutive and not selected dialytic patients, who underwent coronary artery bypass grafting in a tertiary university hospital from 2007 to 2012. High prevalence of cardiovascular risk factors was observed (100% hypertensive, 68% diabetic and 40% dyslipidemic). There was no intra-operative death and 60% of the procedures were performed off-pump. There were seven (14%) in-hospital deaths. Postoperative infection, previous heart failure, cardiopulmonary bypass, abnormal ventricular function and surgical re-exploration were associated with increased mortality. Coronary artery bypass grafting is feasible to dialytic patients although high in-hospital morbidity and mortality. It is necessary better understanding about metabolic aspects to plan adequate interventions

  15. Myocardial Revascularization in Dyalitic Patients: In-Hospital Period Evaluation

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    Miranda, Matheus, E-mail: matheus10miranda@gmail.com; Hossne, Nelson Américo Jr.; Branco, João Nelson Rodrigues; Vargas, Guilherme Flora; Fonseca, José Honório de Almeida Palma da; Pestana, José Osmar Medina de Abreu [Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP (Brazil); Juliano, Yara [Universidade de Santo Amaro, São Paulo, SP (Brazil); Buffolo, Enio [Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP (Brazil)

    2014-02-15

    Coronary artery bypass grafting currently is the best treatment for dialytic patients with multivessel coronary disease, but hospital morbidity and mortality related to procedure is still high. Evaluate results and in-hospital outcomes of coronary artery bypass grafting in dialytic patients. Retrospective unicentric study including 50 consecutive and not selected dialytic patients, who underwent coronary artery bypass grafting in a tertiary university hospital from 2007 to 2012. High prevalence of cardiovascular risk factors was observed (100% hypertensive, 68% diabetic and 40% dyslipidemic). There was no intra-operative death and 60% of the procedures were performed off-pump. There were seven (14%) in-hospital deaths. Postoperative infection, previous heart failure, cardiopulmonary bypass, abnormal ventricular function and surgical re-exploration were associated with increased mortality. Coronary artery bypass grafting is feasible to dialytic patients although high in-hospital morbidity and mortality. It is necessary better understanding about metabolic aspects to plan adequate interventions.

  16. [Selected ethical problems of oncologic patients during the terminal period].

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    Iwaszczyszyn, J; Kwiecińska, A

    2001-01-01

    Patient suffering from terminal disease is depended on his environment more than any other one. He often suffers from nervous break down, anxiety and fear and he is usually unprotected from the environment. Fast development of medical science and its technicisation can lead towards dehumanization and lack of psychological and spiritual care, which should be based on clear ethical principles. Main lines of ethical principles of Health Service which are included in Deontological Code of Physicians and Collection of ethical principles for a qualified nurse are the main rules how to proceed as to fulfill the rule: "benefit of a patient is the superior law." According to its speciality Palliative Medicine introduces also four general ethical principles: 1. Patient will is a rule of treatment. 2. The principle of proportion--benefits from the treatment should be higher than losses and suffering from iatrogenic acting. 3. The principle of equality--stop taking a cure does not differ from not undertaking treatment. 4. The principle of relativity--life is not an absolute good, death is not an absolute evil. Holistic acts of Palliative Medicine determines also specific ethical attitudes, especially in the following: 1. Communication between a therapist and a patient and his family (interpersonal attitudes). 2. Procedures how to lessen suffering and its interpretation according to culture, tradition and religion ("nonsense and significance of suffering"). 3. Negation of euthanasia. 4. Spiritual, psychological and social care of patients.

  17. Impaired driving simulation in patients with Periodic Limb Movement Disorder and patients with Obstructive Sleep Apnea Syndrome

    NARCIS (Netherlands)

    Gieteling, Esther W.; Bakker, Marije S.; Hoekema, Aarnoud; Maurits, Natasha M.; Brouwer, Wiebo H.; van der Hoeven, Johannes H.

    Background: Excessive daytime sleepiness (EDS) is considered to be responsible for increased collision rate and impaired driving simulator performance in Obstructive Sleep Apnea Syndrome (OSAS) patients. Periodic Limb Movement Disorder (PLMD) patients also frequently report EDS and may also have

  18. Peri-prosthetic fractures around tumor endoprostheses: a retrospective analysis of eighteen cases.

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    Barut, Nicolas; Anract, Philippe; Babinet, Antoine; Biau, David

    2015-09-01

    Tumour hip and knee endoprostheses have become the mainstay for reconstruction of patients with bone tumours. Fixation into host bone has improved over time. However, some patients present with a peri-prosthetic fracture over follow-up. The objective of this study was to analyse the mode of presentation and survival of implant after a peri-prosthetic fracture around a tumour endoprosthesis. Eighteen peri-prosthetic fractures (17 patients) were included. All patients were treated at a tertiary care center. There were 11 (65%) women; the median age at the time of fracture was 38 years old. All implants were cemented and all knee endoprostheses were fixed-hinge. Twelve (67%) fractures occurred after femoral resection and six (33%) fractures after proximal tibial resection. There were three femoral neck fractures (UCS C), three femoral shaft type C fractures, two femoral shaft type B1, one tibial shaft type B2, three tibial shaft type C, three ankle fractures (UCS C) and three patella fractures (UCS F). Two fractures were treated conservatively and 16 were operated on. Only one patient had the implant revised. There were eight (44%) failures over follow-up; none of the conservative treatment failed. The cumulative probability of failure for any reason was 27% (8-52) and 55% (22-79) at five and ten years, respectively. Peri-prosthetic fractures around massive endoprostheses are different from that of standard implants. There are more type C fractures; internal fixation is an attractive option at the time of presentation but the risk of revision over follow-up is high and patients should be informed accordingly.

  19. Stress perception among patients in pre-colonoscopy period and those undergoing chemotherapy treatment

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    Graziela de Souza Alves da Silva

    2015-05-01

    Full Text Available Objective: comparing the perception of stress among patients with colorectal cancer undergoing chemotherapy with those in pre-colonoscopy period. Methods: a comparative descriptive study developed with 144 people receiving chemotherapy and 100 patients in the pre-colonoscopy period, using biosocial and clinical data, Stress Assessment Tool and Perceived Stress Scale. Results: a predominance of females (73%, aged over 65 (50% were predominant for the pre-colonoscopy period patients. In patients receiving chemotherapy, gender parity with ages ranging from 40-64 years (68.1% was observed. Pre-colonoscopy patients showed higher perceived stress compared to those receiving chemotherapy (p <0.001. Conclusion: the phase of diagnostic definition represents greater stress to patients in comparison to period of treatment, even despite the characteristic manifestations of chemotherapy.

  20. Characteristics of primary biliary cirrhosis in Slovenian patients. Analysis of 169 patients in the period from 1984 to 2010

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    Katja Novak

    2012-05-01

    Conclusions: In this first investigation of PBC in Slovenian patients we found that the features and course of PBC differ in some aspects from other patients’ populations in the western countries. The difference in our group of patients was an exceptionally low number of males and the high proportion of asymptomatic patients at the end of the observation period. We speculate that the aetiology of liver diseases in male patients in Slovenia is to frequently assigned to excessive alcohol consumption and that this attitude needs to be changed. The high number of asymptomatic PBC patients at the end of the observation period could be due to the consistent treatment with ursodeoxycholic acid.

  1. Influence of Kinesitherapy on Gait in Patients with Ischemic Stroke in the Chronic Period

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    Danche Vasileva

    2015-10-01

    CONCLUSION: The applied specialized kinesitherapeutic methodology continued later as exercise program at home, which significantly improved gait cadence and speed of movement in patients with ischemic stroke in the chronic period and is with a supportive prolonged exposure.

  2. Safety as experienced by patients themselves: a Finnish survey of the most recent period of care.

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    Sahlström, Merja; Partanen, Pirjo; Turunen, Hannele

    2014-06-01

    We examined patients' experiences of patient safety and participation in promoting safe care during their most recent care period. A survey of patients (N = 175) revealed that treatment, medication, and device safety were mostly experienced as very good or excellent, but responses varied by age and experience. Patients ages 66-75 were most critical of treatment and medication safety. Device safety was rated the worst aspect of safety. Twenty percent of respondents had experienced errors at some time during their care. Patients who had experienced errors and those who were treated at inpatient wards versus a day surgery unit were most critical towards patient participation. Open and transparent error management involving patients is needed to promote treatment, medication, and especially device safety. © 2014 Wiley Periodicals, Inc.

  3. Thyroid cancer patients in the Hospital Nacional de Ninos during the period from 1992 to 2002

    International Nuclear Information System (INIS)

    Rivas Gutierrez, Maria Elena

    2003-01-01

    A descriptive study was conducted on the presentation, management and monitoring of the patients with thyroid cancer in the pediatric population under 12 years, at once of diagnosis, in the Hospital Nacional de Ninos of Costa Rica. It covers the period from 1992 to 2002. The clinical records were revised in retrospect. Information was collected of the patient, risk factors, laboratory tests, initial surgical therapy, treatment with radioiodine and the illness evolution. There were no family histories of thyroid cancer or radiation history of head and neck radiation in any patient. Thyroid ultrasound was performed in all patients. Also it was made a biopsy by fine needle aspiration in 11 (78.5%) patients, 2 patients the diagnosis was made by puncture of adenopia, 5 (45.4.7%) patients were obtained diagnosis of malignancy. Follicular nodule in 2 patients (18.1%) suspected in a patient and benign in 3 (27.2%) patients [es

  4. Nitrogen emissions from broilers measured by mass balance over eighteen consecutive flocks.

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    Coufal, C D; Chavez, C; Niemeyer, P R; Carey, J B

    2006-03-01

    Emission of nitrogen in the form of ammonia from poultry rearing facilities has been an important topic for the poultry industry because of concerns regarding the effects of ammonia on the environment. Sound scientific data is needed to accurately estimate air emissions from poultry operations. Many factors, such as season of the year, ambient temperature and humidity, bird health, and management practices can influence ammonia volatilization from broiler rearing facilities. Precise results are often difficult to attain from commercial facilities, particularly over long periods of time. Therefore, an experiment was conducted to determine nitrogen loss from broilers in a research facility under conditions simulating commercial production for 18 consecutive flocks. Broilers were reared to 40 to 42 d of age and fed diets obtained from a commercial broiler integrator. New rice hulls were used for litter for the first flock, and the same litter was recycled for all subsequent flocks with caked litter removed between flocks. All birds, feeds, and litter materials entering and leaving the facility were quantified, sampled, and analyzed for total nitrogen content. Nitrogen loss was calculated by the mass balance method in which loss was equal to the difference between the nitrogen inputs and the nitrogen outputs. Nitrogen partitioning as a percentage of inputs averaged 15.29, 6.84, 55.52, 1.27, and 21.08% for litter, caked litter, broiler carcasses, mortalities, and nitrogen loss, respectively, over all eighteen flocks. During the production of 18 flocks of broilers on the same recycled litter, the average nitrogen emission rate was calculated to range from 4.13 to 19.74 g of N/ kg of marketed broiler (grams of nitrogen per kilogram) and averaged 11.07 g of N/kg. Nitrogen loss was significantly (P broiler grow-out facilities varies significantly on a flock-to-flock basis.

  5. The validity of a patient-reported adverse drug event questionnaire using different recall periods

    NARCIS (Netherlands)

    de Vries, Sieta T; Haaijer-Ruskamp, Flora M; de Zeeuw, Dick; Denig, Petra

    2014-01-01

    PURPOSE: To assess the validity of a patient-reported adverse drug events (ADEs) questionnaire with a 3-month or 4-week recall period. METHODS: Patients receiving at least one oral glucose-lowering drug were asked to report potential ADEs they experienced related to any drug in a daily diary for a

  6. Safety of vaccinations in patients with cryopyrin-associated periodic syndromes: a prospective registry based study

    NARCIS (Netherlands)

    Jaeger, Veronika K.; Hoffman, Hal M.; van der Poll, Tom; Tilson, Hugh; Seibert, Julia; Speziale, Antonio; Junge, Guido; Franke, Kristina; Vritzali, Eleni; Hawkins, Philip N.; Kuemmerle-Deschner, Jasmin; Walker, Ulrich A.

    2017-01-01

    Pneumococcal, tetanus and influenza vaccinations are recommended for patients with cryopyrin-associated periodic syndromes (CAPS) when treated with immunosuppressive medication. The aim of this publication is to report the safety of pneumococcal and other vaccinations in CAPS patients. All CAPS

  7. Can patients with Parkinson's disease use dry powder inhalers during off periods?

    NARCIS (Netherlands)

    Luinstra, M.; Rutgers, A.W.F.; Dijkstra, H.; Grasmeijer, F.; Hagedoorn, P.; Vogelzang, J.M.J.; Frijlink, H.W.; De Boer, A.H.

    2015-01-01

    Because of its rapid onset of action, pulmonary administration of levodopa is an interesting alternative to oral administration for the rescue treatment of Parkinson's disease patients in an off period. We studied the ability of Parkinson's disease patients to operate a dry powder inhaler (DPI)

  8. Factors influencing the survival period in Japanese patients with sporadic Creutzfeldt-Jakob disease.

    Science.gov (United States)

    Iwasaki, Yasushi; Akagi, Akio; Mimuro, Maya; Kitamoto, Tetsuyuki; Yoshida, Mari

    2015-10-15

    Although Japanese cases of sporadic Creutzfeldt-Jakob disease (sCJD) generally involve longer survival periods compared to those from other countries, details regarding the factors influencing survival are unclear. To determine the influence of certain factors on survival, we retrospectively assessed 51 Japanese MM1-type sCJD patients with respect to background, clinical course, and disease management. No significant differences were found between men and women, tracheotomy and nontracheotomy patients, or patients treated in public and other types of hospitals. Although the survival period of tube-fed patients was significantly longer than that of patients who were not tube fed, survival of patients fed via a nasal tube did not differ significantly from that of gastrostomy-fed patients. The proportion of tube-fed patients was 68.6% (35/51). Disease duration was not significantly associated with age or year of onset. However, it was associated with time from onset to first recognition of myoclonus, first recognition of periodic sharp-wave complexes on electroencephalogram, and progression to the akinetic mutism state. Mechanical ventilation was not performed for any patient. Because the total disease duration increased in cases with a slowly progressive clinical course as a natural outcome, we concluded that the most crucial factor contributing to the prolonged survival of Japanese sCJD patients was tube feeding once the akinetic mutism state had been reached. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Does recall period have an effect on cancer patients' ratings of the severity of multiple symptoms?

    Science.gov (United States)

    Shi, Qiuling; Trask, Peter C; Wang, Xin Shelley; Mendoza, Tito R; Apraku, Winifred A; Malekifar, Maggie; Cleeland, Charles S

    2010-08-01

    Choosing an appropriate recall period for symptom assessment in a clinical trial is dependent on the design and purpose of the trial. To examine the effects of recall on symptom severity ratings by comparing ratings made using 24-hour and seven-day recall periods of the MD Anderson Symptom Inventory (MDASI). Forty-two patients in their third to eighth week of chemoradiation rated their symptoms using the MDASI on two separate occasions (T1 and T2), one week apart. At T1, patients were randomly assigned to rate symptoms using either a 24-hour or a seven-day recall. At T2, patients rated symptoms using the recall period not used at their first visit. Comparing the 24-hour and seven-day recall periods, the correlation coefficient for total symptom severity was 0.888. All correlation coefficients for symptom severity items were >0.7 except for distress (r=0.67). The percentages of moderate to severe symptoms (rated >or=5) were consistent for both recall periods, with no significant difference between recall periods in the prevalence of moderate to severe symptoms. Cronbach alpha coefficients for both 24-hour and seven-day recalls were >0.8. Symptoms from both recall periods were more severe for patients with poorer performance status. Twenty patients were cognitively debriefed; 70% thought that the seven-day recall was "more appropriate" for the MDASI, but 85% did not think that recall period would influence their answers. This study demonstrated that the MDASI in a seven-day recall format has psychometric properties consistent with the 24-hour recall version, which may promote its use in future cancer clinical trials and may inform the choice of recall period when symptoms are outcome measures. Copyright (c) 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  10. Factors influencing period from surgery to discharge in patients with femoral trochanteric fractures

    OpenAIRE

    Shinoda, Soichiro; Mutsuzaki, Hirotaka; Watanabe, Arata; Morita, Hidetaka; Kamioka, Yumiko

    2017-01-01

    [Purpose] The purpose of this study was to investigate factors influencing the period from surgery to discharge in patients with femoral trochanteric fractures. [Subjects and Methods] Sixty patients with femoral trochanteric fractures were investigated retrospectively. Based on the mean period from surgery to discharge (85.6 ± 26.6 days), the patients were divided into two groups: an under-85-day group (range, 29–78 days) and an over-85-day group (87–128 days). Age, gender, fracture type, pre...

  11. The Psychosocial Influences of Waiting Periods on Patients Undergoing Endoscopic Submucosal Dissection.

    Science.gov (United States)

    Nagao, Noriko; Tsuchiya, Aya; Ando, Sae; Arita, Mizue; Toyonaga, Takashi; Miyawaki, Ikuko

    This study aimed to clarify psychosocial influences of waiting periods on patients undergoing endoscopic submucosal dissection for cancer at an advanced medical care facility in Japan. Subjects were consenting patients hospitalized from 2009 to 2010. Qualitative and quantitative data were gathered about patients' characteristics, disease and stage, and waiting period. Qualitative content analysis was used to analyze free statements and interview data. Subjects included 154 patients with an average wait period of 46.28 days for admission. Qualitative analysis revealed the following wait period perceptions. For calmness, results indicated (1) no anxiety, (2) relief based on doctors' positive judgment, (3) whatever happens/no choice, and (4) trust in doctor. For uneasiness, perceptions included (1) the sooner, the better/eagerly waiting, (2) anxiety and concern, and (3) emotional instability. Four waiting period coping types were identified: (1) making phone inquiries, (2) busy and forgot about the medical procedure, (3) relief from anxiety, and (4) unable to function well in daily life. Patients need to be educated about cancer progression and provided an estimated wait time. They also require more information about how to manage daily life such as monitoring factors from the nursing domain including physical condition, digestive symptoms, diet, and exercise.

  12. Anal carcinoma in HIV-infected patients in the period 1995-2009

    DEFF Research Database (Denmark)

    Legarth, Rebecca; Helleberg, Marie; Kronborg, Gitte

    2013-01-01

    Abstract Background: Several studies have demonstrated an increased risk of non-AIDS cancers in HIV patients and, for some cancers, also in relatives of HIV patients. We aimed to estimate (1) the risk of anal carcinoma among HIV patients and their parents, and (2) the mortality after a diagnosis...... 1995-2009, and (2) parents of HIV patients compared with parents of controls for the period 1978-2009. Cancer diagnoses were identified from The Danish Cancer Registry. We further estimated the mortality rate ratios (MRR) of HIV patients compared with controls after the diagnosis of anal carcinoma....... Results: Thirty-six HIV patients versus 8 population controls were diagnosed with anal carcinoma. HIV patients had an increased risk of anal carcinoma (IRR 77.9, 95% CI 36.2-167.7), especially among men who have sex with men (MSM) (IRR 101.4, 95% CI 39.3-261.5). Fathers of HIV patients had an increased...

  13. 78 FR 23827 - Designation of Eighteen Individuals Pursuant to the Sergei Magnitsky Rule of Law Accountability...

    Science.gov (United States)

    2013-04-22

    ... DEPARTMENT OF THE TREASURY Office of Foreign Assets Control Designation of Eighteen Individuals Pursuant to the Sergei Magnitsky Rule of Law Accountability Act of 2012 AGENCY: Office of Foreign Assets... blocked pursuant to the Sergei Magnitsky Rule of Law Accountability Act of 2012 (Pub. L. 112-208, December...

  14. Increased mortality in patients hospitalized with primary hyperparathyroidism during the period 1977-1993 in Denmark

    DEFF Research Database (Denmark)

    Øgard, Christina G; Engholm, Gerda; Almdal, Thomas P

    2004-01-01

    The aim of the present study was to determine whether patients with the incident hospital diagnosis of primary hyperparathyroidism (PHPT) in Denmark during the period 1977-1993 had an increased mortality from cardiovascular disease and cancer compared to the rest of the Danish population. In a ra......The aim of the present study was to determine whether patients with the incident hospital diagnosis of primary hyperparathyroidism (PHPT) in Denmark during the period 1977-1993 had an increased mortality from cardiovascular disease and cancer compared to the rest of the Danish population...

  15. Patients' Experiences of Performing Self-care of Stomas in the Initial Postoperative Period.

    Science.gov (United States)

    Lim, Siew Hoon; Chan, Sally Wai Chi; He, Hong-Gu

    2015-01-01

    With the loss of an important bodily function and the distortion in body image, a stoma patient experiences physical, psychological, and social changes. With limited current studies exploring experiences of patients in the management of their stoma, there is a need to explore their experiences, their needs, and factors that influence their self-management. The aim of this study was to investigate patients' experiences of performing self-care of stomas in the initial postoperative period. This study adopted a descriptive qualitative approach from the interpretive paradigm. Semistructured interviews were conducted with 12 patients 1 month postoperatively in a colorectal ward in a hospital in Singapore. Thematic analysis was applied to the interview data. Five themes were identified: process of acceptance and self-management of stoma, physical limitations, psychological reactions, social support, and need for timely and sufficient stoma preparation and education. This study highlights the importance of health professionals' role in helping patients adjust preoperatively and postoperatively and accept the presence of a stoma. Health professionals need to be aware of the physical, psychological, and social impact of stoma on patients in the initial 30-day postoperative period. Research findings informed the type and level of assistance and support to be offered to patients by nurses and the importance of encouraging patients to be involved in stoma care at an early stage, which will ultimately contribute to effective and independent self-management. Patients can be prepared preoperatively to reduce the psychological and social impact of stoma after creation of their stoma.

  16. The special features of perioperative period in patients after antireflux surgery

    Directory of Open Access Journals (Sweden)

    Александр Юрьевич Усенко

    2015-11-01

    Full Text Available The aim of this work was the study of the special features of intraoperative and early postoperative period course in patients with gastroesophageal reflux disease after antireflux surgery carried out from laparoscopic and traditional laparotomy approach. Materials and methods. There were analyzed the results of examination and surgical treatment of 136 patients with gastroesophageal reflux disease treated at SI A.A. Shalimov “National Institute of surgery and transplantology” NAMSU from 2005 to 2015 year. The main group included 93 patients who underwent laparoscopic surgery, the control one – 43 patients who underwent surgery by traditional open method.There was carried out monitoring of the main parameters of vital functions every three hours after surgery, recovery terms of intestine peristaltic activity, pain syndrome intensity, analyzed the dynamics of changes of the typical GERD complaints, its intensity, the development of early postoperative complications. The results of research. Duration of laparoscopic surgeries did not differ from the open ones but intraoperative hemorrhage and prolonged artificial pulmonary ventilation, postoperative patient day were less than in the control group. At the same time the main parameters of the organism vital functions (systolic and diastolic arterial pressure, respiration rate, heart rate, oxygen blood saturation were better in patients of the main group.In the group of patients operated by laparascopic approach intensity and duration of pain syndrome were less than in patients operated by open approach and also was noticed an early activation and recovery of intestinal peristalsis in these patients.Conclusions. Both laparoscopic and open approaches at antireflux surgeries in early postoperative period are effective. The received data testifies to the less traumatism, less duration of recovery period at videoendoscopic surgeries that by-turn decreases the risk of postoperative complications

  17. Alteration of the oral environment in patients undergoing esophagectomy during the perioperative period

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    Masami Yoshioka

    2013-04-01

    Full Text Available Objective: During the perioperative period, oral ingestion is changed considerably in esophagectomy patients. The aim of this study was to investigate oral environment modifications in patients undergoing esophageal cancer treatments due to changes in dietary intake and swallowing functions. Material and Methods: Thirty patients who underwent operation for removal of esophageal cancer in Tokushima University Hospital were enrolled in this study. Results: It was found that 1 the flow rate of resting saliva decreased significantly at postoperative period by deprived feeding for one week, although it did not recover several days after oral ingestion began, 2 the accumulation of dental plaque and the number of mutans streptococci in saliva decreased significantly after operation, while both increased relatively quick when oral ingestion began, and 3 the swallowing function decreased significantly in the postoperative period. Conclusions: These results suggest that dental professionals should emphasize the importance of oral health care and provide instructions on plaque control to patients during the perioperative period of esophageal cancer treatment.

  18. Retroperitoneal Fibrosis: A Retrospective Clinical Data Analysis of 30 Patients in a 10-year Period

    Directory of Open Access Journals (Sweden)

    Hai-Jiang Zhou

    2015-01-01

    Full Text Available Background: Retroperitoneal fibrosis (RPF is an uncommon disease that is characterized by development of fibrosclerotic tissues involving retroperitoneal structures. This study aimed to investigate the clinical features of 30 patients with RPF in a single center in Beijing in a 10-year period. Methods: We retrospectively analyzed clinical data on demographic characteristics, clinical manifestations, laboratory findings, radiological findings, modalities of treatments, outcomes and prognosis of 30 patients with RPF. Patients were treated in Beijing Chao-Yang Hospital between January 2003 and December 2013. Results: The mean age of patients with RPF was 56.7 ± 14.4 years. Twenty-three patients were men and seven patients were women. Acute phase reactants were elevated in most patients. Rheumatic factor was positive in 4/25 (16.0% patients, and antinuclear antibody was positive in 6/22 (27.3% patients. Elevation of IgG4 was observed in 9/22 (40.9% patients. The most common type was I + III (n = 13, followed by I + II + III (n = 12. Five patients undertook an 18 F-fluoro-deoxy-D-glucose positron emission tomography examination and increased uptake was detected in four patients. Eight patients received combination therapy with glucocorticoids and tamoxifen. Surgical intervention treatments included intraureteral double-J stent implantation (n = 26, percutaneous nephrostomy (n = 2, open ureterolysis and intraperitonealization of the ureters (n = 5 and laparoscopic ureterolysis and intraperitonealization of the ureters (n = 5. Three patients underwent hemodialysis because of renal failure. Conclusions: Clinical characteristics of RPF patients in our study are similar to those previously reported. Steroids and immunosuppressive therapy combined with ureterolysis could be a viable choice of treatment for RPF. More prospective, multi-center studies with a longer follow-up are warranted.

  19. [Thyrotoxic hypokalemic periodic paralysis, an endocrine emergency: clinical and genetic features in 25 patients].

    Science.gov (United States)

    Silva, Magnus R Dias da; Chiamolera, Maria Izabel; Kasamatsu, Teresa S; Cerutti, Janete M; Maciel, Rui M B

    2004-02-01

    Thyrotoxic hypokalemic periodic paralysis (THPP) is a medical emergency characterized by acute attacks of weakness, hypokalemia, and thyrotoxicosis that resolve with the treatment of hyperthyroidism. Attacks are transient, self-limited, associated with hypokalemia and resemble those of familial hypokalemic periodic paralysis (FHPP), an autosomal dominant neurological channelopathy. This study reviews the clinical features and genetic findings of THPP in 25 Brazilian patients. Most patients had weight loss, taquicardia, goiter, tremor, and ophthalmopathy. Most often attacks arose during the night and recovered spontaneously but some patients evolved to total quadriplegia, and few experienced cardiac arrhythmias. All patients had suppressed TSH and elevated T4 and most had positive anti-thyroid antibodies, indicating autoimmunity thyrotoxic etiology. Potassium was low in all patients during the crisis. Prophylactic potassium therapy has not been shown to prevent attacks; however it was useful for curbing the paralysis during the crisis. We identified the mutation R83H in the KCNE3 gene in one sporadic case, and M58V in the KCNE4 gene in one case with family history. Furthermore, we identified other genetic polymorphisms in the CACNA1S, SCN4A, KCNE1, KCNE2, KCNE1L, KCNJ2, KCNJ8 e KCNJ11 genes. We conclude that THPP is the most common treatable cause of acquired periodic paralysis; therefore, it must be included in the differential diagnosis of acute muscle weakness.

  20. The Correlation between Clinical Variables and Sleep Onset Rapid Eye Movement Period Frequencies in Narcoleptic Patients

    Directory of Open Access Journals (Sweden)

    Jin Hwa Jeong

    2010-11-01

    Full Text Available Background and Objective A diagnosis of narcolepsy is defined by less than 8 minutes of mean sleep latency, and two or more sleep onset rapid eye movement periods on the Multiple Sleep Latency Test. This study examined the relationship between the sleep onset rapid eye movement period frequencies during Multiple Sleep Latency Test and narcoleptic symptom severity. Methods From March 2004 to August 2009, 126 patients suffering from excessive daytime sleepiness who visited the Sleep Disorders Clinic of St. Vincent’s Hospital at the Catholic University of Korea were tested by polysomnography and Multiple Sleep Latency Test. Subjects were divided into three groups according to the number of sleep onset rapid eye movement periods that appeared on the Multiple Sleep Latency Test. Symptom severity instruments included the Epworth Sleepiness Scale and the Stanford Center for Narcolepsy Sleep Inventory, and various sleep parameters. In addition, we performed human leukocyte antigen genotyping for human leukocyte antigen-DQB1*0602 on all patients. Results Among the three groups classified by the number of sleep onset rapid eye movement periods during Multiple Sleep Latency Test, we found no significant differences in demographic features, Epworth Sleepiness Scale, and most polysomnographic findings. However, we observed cataplexy, hypnagogic hallucination, sleep paralysis, and human leukocyte antigen-DQB1*0602 positivity more frequently in groups with higher sleep onset rapid eye movement period frequencies. In addition, the proportions of stage II sleep, REM sleep latency from polysomnography, and mean sleep latency and mean REM sleep latency from the Multiple Sleep Latency Test significantly decreased with increasing sleep onset rapid eye movement period frequency. Conclusions In this study, we demonstrated that sleep onset rapid eye movement period frequency during Multiple Sleep Latency Test correlated with sleep architecture, daytime symptom

  1. Periodic variation and its effect on management and prognosis of Korean patients with acute myocardial infarction.

    Science.gov (United States)

    Park, Hyo Eun; Koo, Bon-Kwon; Lee, Wonjae; Cho, Youngjin; Park, Jin Sik; Choi, Ji-Yong; Jeong, Myung-Ho; Kim, Jong Hyun; Chae, Shung Chull; Kim, Young Jo; Nam, Chang-Wook; Lee, Jae-Hwan; Choi, Dong Hoon; Hong, Taek Jong; Chae, Jei Keon; Rhew, Jae Young; Kim, Kee Sik; Kim, Hyo-Soo; Oh, Byung-Hee; Park, Young Bae

    2010-05-01

    The characteristics of the periodic variation in acute myocardial infarction (AMI) and the subsequent effect on management and prognosis have not been fully investigated in a large number of Asian populations. From a prospective, observational multicenter online registry, 4,573 patients diagnosed as AMI in Korea from January to December 2006 were included. The highest incidence of AMI was between 8 a.m. and noon. The number of cases was highest in the winter and lowest in the autumn (13.6 vs 11.4 patients per day, Pworking hours had a shorter time to first medical contact (203+/-288 min) compared with out-of-hours onset (230+/-288 min, P=0.003). In patients who underwent primary angioplasty, out-of hours symptom onset was associated with a greater time delay in both the patient's and the medical facility's response (door-to-balloon time out-of hours vs working hours: 101+/-54 min vs 84+/-44 min, P<0.001). In patients with ST-segment elevation myocardial infarction, symptoms to first medical contact showed a significant relationship to in-hospital mortality (for every 10 min of symptoms to first medical contact, odds ratio 1.006, 95% confidence interval 1.001-1.012, P=0.018) Circadian and periodic variation in AMI exists in Korean patients, which resulted in different patient behavior, hospital management and outcomes.

  2. Incidence of Diabetes Insipidus in Postoperative Period among the Patients Undergoing Pituitary Tumour Surgery.

    Science.gov (United States)

    Kadir, M L; Islam, M T; Hossain, M M; Sultana, S; Nasrin, R; Hossain, M M

    2017-07-01

    Post operative complications after pituitary tumour surgery vary according to procedure. There are several surgical procedures being done such as transcranial, transsphenoidal microsurgical and transsphenoidal endoscopic approaches. One of the commonest complications is diabetes insipidus (DI). Our main objective was to find out the incidence of diabetes insipidus in post operative period among patients undergoing surgical intervention for pituitary tumour in our institute. The presence of diabetes insipidus in the postoperative period was established by measuring serum Na+ concentration, hourly urine output and urinary specific gravity to find out the incidence of diabetes insipidus in postoperative period in relation to age, gender, tumour diameter, function of tumour (i.e., either hormone secreting or not) and operative procedure used for surgical resection of pituitary tumor. As it is the most common postoperative complication so, in this study we tried to find out how many of the patients develop diabetes insipidus in postoperative period following surgical resection of pituitary tumour. This cross sectional type of observational study was carried out in the department of Neurosurgery, BSMMU from May 2014 to October 2015 on 33 consecutive patients who underwent surgical intervention for pituitary tumour for the first time. Data was collected by using a data collection sheet. The incidence of diabetes insipidus was found 23.1% of patients in diabetes insipidus (p=0.073). Regarding tumour size 30.8% and 69.2% of patients developed diabetes insipidus having tumour diameter diabetes insipidus who was operated by transsphenoidal endoscopic approach, 23.1% and 7.7% of patients developed diabetes insipidus who underwent pituitary tumour resection through transsphenoidal microscopic approach and transcranial microscopic approach respectively (p=0.432). 17.6% of patients develop DI having functioning pituitary macroadenoma and 62.5% of patients develop DI having

  3. Diverse Lifestyles and Strategies of Plant Pathogenesis Encoded in the Genomes of Eighteen Dothideomycetes

    Energy Technology Data Exchange (ETDEWEB)

    Ohm, Robin A.; Feau, Nicolas; Henrissat, Bernard; Schoch, Conrad L.; Horwitz, Benjamin A.; Barry, Kerrie W.; Condon, Bradford J.; Copeland, Alex C.; Dhillon, Braham; Glaser, Fabian; Hesse, Cedar N.; Kosti, Idit; LaButti, Kurt; Lindquist, Erika A.; Lucas, Susan; Salamov, Asaf A.; Bradshaw, Rosie E.; Ciuffetti, Lynda; Hamelin, Richard C.; Kema, Gert H. J.; Lawrence, Christopher; Scott, James A.; Spatafora, Joseph W.; Turgeon, B. Gillian; de Wit, Pierre J. G. M.; Zhong, Shaobin; Goodwin, Stephen B.; Grigoriev, Igor V.

    2013-03-05

    The class of Dothideomycetes is one of the largest and most diverse groups of fungi. Many are plant pathogens and pose a serious threat to agricultural crops that are grown for biofuel, food or feed. Most Dothideomycetes have only a single host plant, and related species can have very diverse hosts. Eighteen genomes of Dothideomycetes have currently been sequenced by the Joint Genome Institute and other sequencing centers. Here we describe the results of comparative analyses of the fungi in this group.

  4. Diverse Lifestyles and Strategies of Plant Pathogenesis Encoded in the Genomes of Eighteen Doethideomycetes Fungi

    Energy Technology Data Exchange (ETDEWEB)

    Ohm, Robin A.; Feau, Nicolas; Henrissat, Bernard; Schoch, Conrad L.; Horwitz, Benjamin A.; Barry, Kerrie W.; Condon, Bradford J.; Copeland, Alex C.; Dhillon, Braham; Glaser, Fabien; Hesse, Cedar N.; Kosti, Idit; LaButti, Kurt; Lindquist, Erika A.; Lucas, Susan; Salamov, Asaf A.; Bradshaw, Rosie E.; Ciuffetti, Lynda; Hamelin, Richard C.; Kema, Gert H. J.; Lawrence, Christopher; Scott, James A.; Spatafora, Joseph W.; Turgeon, B. Gillian; de Wit, Pierre J. G. M.; Zhong, Shaobin; Goodwin, Stephen B.; Grigoriev, Igor V.

    2012-03-13

    The class of Dothideomycetes is one of the largest and most diverse groups of fungi. Many are plant pathogens and pose a serious threat to agricultural crops grown for biofuel, food or feed. Most Dothideomycetes have only a single host and related species can have very diverse host plants. Eighteen genomes of Dothideomycetes have currently been sequenced by the Joint Genome Institute and other sequencing centers. Here we describe the results of comparative analyses of the fungi in this group.

  5. Estudio psicosocial en un grupo de pacientes hemofílicos adultos 18 años después de haber sido estudiados en su niñez Psychosocial study of a group of adult hemophilic patients eighteen years after having been studied in their childhood

    Directory of Open Access Journals (Sweden)

    Raúl Martínez Triana

    2002-12-01

    Full Text Available Se estudiaron las características de personalidad, el perfil psicopatológico, los aspectos psicosociales y el conocimiento sobre la enfermedad en 19 pacientes hemofílicos adultos que habían sido evaluados psicológicamente en su niñez. Se utilizó la prueba de los 16 factores de la personalidad, el Inventario Multifacético de la Personalidad de Minnesota, una entrevista psicosocial y una encuesta de conocimiento de la enfermedad. Los sujetos pueden describirse como reservados, emotivos y dependientes. El perfil psicopatológico de este grupo es característico de personas con depresión, tristeza, dificultad para expresar sus sentimientos, inseguridad y necesidad de afecto. El 21 % presentó dificultades para su integración a actividades sociales. El 52 % están casados. Todos tienen al menos 9no. grado. El 78 % tiene vínculo laboral activo. Todos poseen buen dominio de los aspectos esenciales de la enfermedad. En este grupo se observó una situación psicosocial más favorable que la reportada en este tipo de pacientes décadas atrásThe personality traits, the psychopathological profile, the psychosocial aspects and the knowledge about the illness were studied in 19 adult hemophilic patients who had been psychologically evaluated when they were children. Sixteen personality factors test, Minessota´s Personality Many-Sided Inventory, a psychosocial interview and a disease knowledge survey were used in this study. The subjects can be described as reserved, emotional and dependent. The psychopathological profile of this group corresponds to persons with depression, sadness, difficulties in expressing their feelings, unsteadiness and lack of love. 21% showed difficulties to integrate themselves to social activities. 52% are married. All of them have an educational level of 9th grade. 78% are active workers. All of them know very well the fundamental aspects of their disease. A more favorable psychosocial situation was observed in this

  6. Tasks and means of therapeutic exercises in patients with breast cancer in pre- and postoperative periods

    Directory of Open Access Journals (Sweden)

    T. I. Grushina

    2015-01-01

    Full Text Available The mainstay of radical treatment for patients with breast cancer (BC is a surgical intervention: radical mastectomy (RME of different modifications or organ-sparing operations. In the preoperative period, the tasks of therapeutic exercises (TEs are psychological preparation of a patient for active participation in his / her treatment, as well as complete breath training. Classes are done in a group of convalescents, by applying dynamic and static breathing exercises. In the early postoperative period, the tasks of TEs are to prevent hypostatic pneumonia, surgical-site shoulder joint stiffness and to improve systemic and regional blood and lymph circulation. Analysis of 1235 patients who had undergone RME and 212 patients who had radical resection showed that restricted shoulder joint motion due to hand immobilization in an adducted position and late initiation of TEs occurred in 44.6 and 33.5 % of the patients, respectively. Individual TEs classes include breathing exercises, position treatment, and special exercises to restore shoulder joint function and to control posture. Lymphadenectomy and failure to ligate intersected lymphatic vessels lead to inevitable lymphorrhea and seroma. Analysis of 1447 patents indicated that early initiation of TEs failed to affect seroma duration and extent and wound dehiscence. In the latter (that, according to the author»s data, occurs in 3.7 % of cases after RME and in 9.2 % after preoperative radiotherapy, TEs are limited by position treatment until the wound heals or secondary sutures are applied. The tasks of the late postoperative period are recovery of the full range of shoulder joint motion, normal posture, cardiovascular and respiratory adjustments to increased physical exercises, and general tonic exposure. The paper gives TEs sets developed for each period.

  7. [Modern approach to gait restoration in patients in the acute period of cerebral stroke].

    Science.gov (United States)

    Skvortsova, V I; Ivanova, G E; Rumiantseva, N A; Staritsyn, A N; Kovrazhkina, E A; Suvorov, A Iu

    2010-01-01

    An objective of the study was to work out a complex program of gait restoration in patients with stroke using robot-driven mechanized gait trainers. The study included patients in the acute period of stroke (the mean age 59+/-10,4 years) who were not able to walk without assistance; 53 patients of the main group and 25 patients of the control group. The mean interval from the disease onset to the beginning of gait retraining sessions with mechanized gait trainers was 14+/-1,6 days depending on the adequacy of functional probes. The restoration program included everyday 30 minute sessions of exercise therapy. Patients of the main group received 20 min sessions using mechanized gait trainers Motomed Viva 2 and Gait Trainer 1 (GT1) with continuous monitoring of blood pressure and cardiac beat frequency. The number of sessions with GT1 was from 5 to 12, mean 7+/-1 sessions. After the complex restoration treatment, significant positive changes on scales of standing balance, functional categories of gait, Berg, Barthel (p< or =0.01) were observed in patients of the main group compared to controls. All patients of the main group became able to walk with a support or independently. The significant decrease (p< or =0.05) of a number of patients with disorders of proprioceptive sensitivity (from 37,7 to 9,4%) and with ataxia of the low extremities (from 37 to 11,3%) was observed in the main group, while no changes were seen in the control group. It has been concluded that the complex use of reflex kinesitherapy and robot-driven mechanotherapy in patients in the acute period of stroke allows to increase the functional activity and the level of self-service already prior to the discharge from hospital.

  8. Quality of life and mortality assessment in patients with major cardiac events in the postoperative period.

    Science.gov (United States)

    Abelha, Fernando José; Botelho, Miguela; Fernandes, Vera; Barros, Henrique

    2010-01-01

    Cardiovascular complications in the postoperative period are associated with high mortality and morbidity. Few studies have assessed the degree of dependence in these patients and their perception of health. The objective of this study was to assess the mortality and the quality of life in patients who developed major cardiac events (MCE) in the postoperative period. Retrospective study carried out in a Surgical Intensive Care Unit (SICU), between March 2006 and March 2008. The patients were assessed regarding the occurrence of CE. Six months after the hospital discharge, the Short-Form-36 (SF-36) questionnaire was filled out and dependence was assessed in relation to activities of daily living (ADL). The comparisons between independent groups of patients were carried out using Student's t test. The comparison between each variable and the occurrence of CE was carried out by logistic regression and included all patients. Of the 1,280 patients that met the inclusion criteria, 26 (2%) developed MCE. The univariate analysis identified as independent determinants for the development of major cardiac events: ASA physical status, hypertension, ischemic heart disease, congestive heart disease and score of the Revised Cardiac Risk Index (RCRI). The six-month mortality after the SICU discharge was 35%. Of the 17 surviving patients, 13 completed the questionnaires. Thirty-one percent of them reported that their general health was better on the day they answered the questionnaire, when compared to 12 months before. Sixty-nine percent of the patients were dependent in instrumental ADL e 15% in personal ADL. The development of MCE has a significant impact on the duration of hospital stay and mortality rates. Six months after the discharge from the SICU, more than 50% of the patients were dependent in at least one instrumental ADL. Copyright 2010 Elsevier Editora Ltda. All rights reserved.

  9. [Clinical efficiency of Vasonat in neurometabolic therapy of patients with ischemic stroke at early rehabilitation period].

    Science.gov (United States)

    Abasova, G B; Tyksanbaeva, G U; Orazalieva, D B; Kasymova, S K

    2011-01-01

    Research of efficiency and safety of Vasonat has been carried out. 31 patients aged 46-75 years who had had hemispheric athero- thrombotic or hemodynamic schemic stroke with moderate severity and being treated in 2-5-month of early rehabilitation period have been observed. The control group of patients received placebo. Results of the study, 4 weeks treatment using Vasonat in the dosage of 500 mg/day have shown positive effect on common signs of the disease by decreasing headache intensity, dizziness, a nausea, and on focal neurological symptoms by decreasing hemiparesis degree; psychoemotional and mnestic activity (main memory and attention) improved as well. It was more distinct in patients with localization of the stroke in the right hemisphere of the brain. It was also noted more rapid improvement of motion function and quality of life of patients.

  10. GENE EXPRESSION DYNAMICS IN PATIENTS WITH SEVERE THERAPY-RESISTANT ASTHMA DURING TREATMENT PERIOD

    Directory of Open Access Journals (Sweden)

    Ye. S. Kulikov

    2014-01-01

    Full Text Available Introduction: The leading mechanisms and causes of severe therapy resistant asthma are poorly understood. The aim of this study was to define global patterns of gene expression in adults with severe therapy-resistant asthma in dynamic during treatment period.Methods: Performed 24-week prospective interventional study in parallel groups. Severe asthma patients was aposterior divided at therapy sensitive and resistant patients according to ATS criteria. Global transcriptome profile was characterized using the Affymetrix HuGene ST1.0 chip. Cluster analysis was performed.Results and conclusion: According to our data several mechanisms of therapy resistance may be considered: increased levels of nitric oxide and beta2-agonists nitration, dysregulation of endogenous steroids secretion and involvement in the pathogenesis of Staphylococcus aureus. Absence of suppression of gene expression KEGG-pathway “asthma" may reflect the low efficiency or long period of anti-inflammatory therapy effect realization.

  11. [Analysis of fatigue associated to periodic limb movement during sleep in former poliomyelitis patients].

    Science.gov (United States)

    Oliveira, A R; Correa, F I; Correa, J C F; Oliveira, L V F

    2012-01-01

    Following poliomyelitis, patients may experience sleep disorders stemming from periodic limb movement, leading to fatigue and compromised muscle function the following day. To establish the presence or absence of muscle fatigue in these patients using electromyography and relating the data to polysomnographic findings. An analytical cross-sectional study was carried out involving 19 individuals with motor sequelae in the lower limbs stemming from poliomyelitis. Quantitative tests for the assessment of neurophysiological aspects (knee-jerk/Achilles reflexes and peripheral muscle strength of rectus femoris) and a sleep study (standard, level I polysomnography) were administered. A statistically significant difference was detected (p fatigue associated to sleep disorder. Individuals with sequelae from poliomyelitis exhibit sleep disorders that may lead to muscle fatigue. Periodic limb movement may contribute to this phenomenon.

  12. A spatio-temporal synchronization of periodic markets: evidence ...

    African Journals Online (AJOL)

    This study seeks to identify the 'rings' of periodic market days in Akwa Ibom State, using eighteen periodic markets as case study The entire landmass of the state was covered with a network of grids. These grids were numbered and a table of random numbers was used in selecting a target population of eighteen ...

  13. Neurological outcome of patients with cryopyrin-associated periodic syndrome (CAPS).

    Science.gov (United States)

    Mamoudjy, Nafissa; Maurey, Hélène; Marie, Isabelle; Koné-Paut, Isabelle; Deiva, Kumaran

    2017-02-14

    To assess the neurological involvement and outcome, including school and professional performances, of adults and children with cryopyrin-associated periodic syndrome (CAPS). In this observational study, patients with genetically proven CAPS and followed in the national referral centre for autoinflammatory diseases at Bicêtre hospital were assessed. Neurological manifestations, CSF data and MRI results at diagnosis and during follow-up were analyzed. Twenty-four patients (15 adults and 9 children at diagnosis) with CAPS were included. The median age at disease onset was 0 year (birth) [range 0-14], the median age at diagnosis was 20 years [range 0-53] and the mean duration of follow-up was 10.4 ± 2 years. Neurological involvement at diagnosis, mostly headaches and hearing loss, was noted in 17 patients (71%). Two patients of the same family had abnormal brain MRI. A439V mutation is frequently associated with a non-neurological phenotype while R260W mutation tends to be associated with neurological involvement. Eleven adult patients (61%) and 3 children (50%) underwent school difficulties. Neurological involvement is frequent in patients with CAPS and the majority of patients presented difficulties in school performances with consequences in the professional outcome during adulthood. Further studies in larger cohorts of children with CAPS focusing in intellectual efficiency and school performances are necessary.

  14. Thyrotoxic periodic paralysis in a Saudi patient complicated by life-threatening arrhythmia

    International Nuclear Information System (INIS)

    Aldasouqi, Saleh; Bokhari, Samia A; Khan, Patan M; AlZahrani, Ali S

    2009-01-01

    Thyrotoxic periodic paralysis (TPP) is rare in non-Orientals, and sporadic case reports were reported world-wide. Eight cases were reported in Arabs, including 3 Saudis. We present an additional case of TPP in a 38-year-old Saudi man, and review the literature on TPP in Arabs. Our patient presented with complete flaccid quadriplegia, 5 weeks after he was diagnosed with Graves' disease that was treated with carbimazole and propranolol. He was hyperthyroid, and his potassium was extremely low (1.5 mmol/L). During initial evaluation in the emergency room, he developed transient asystole manifested by syncope. He was resuscitated and his hypokalemia was corrected, and he had a full recovery. This case emphasizes the notion that TPP can occur in patients of any ethnic background. The development of serious cardiac complications in our patient underscores the importance of early and correct diagnosis of this potentially life-threatening complication of hyperthyroidism. (author)

  15. An Asymptomatic Foreign Body in the Nose in an Eighteen-Year-Old Patient: Button Battery

    Directory of Open Access Journals (Sweden)

    Merih Onal

    2015-01-01

    Full Text Available Foreign bodies lodged in the upper airway are a common occurrence in children. Many unusual foreign bodies in the nose have been reported as foreign bodies like nuts, plastic toy parts, beads, and so forth. Most of these produce minimal morbidity but button batteries due to their early chemical disintegration require early surgical intervention. Here, we report a case of button battery lodged in the nose for several years with a symptom of nasal obstruction and chronic sinusitis.

  16. Redefining periodic patterns on electroencephalograms of patients with sporadic Creutzfeldt-Jakob disease.

    Science.gov (United States)

    Shin, Jung-Won; Yim, Byeongsoo; Oh, Seung Hun; Kim, Nam Keun; Lee, Sang Kun; Kim, Ok-Joon

    2017-05-01

    We aimed to redefine various periodic patterns (PPs) observed on electroencephalography (EEG) in patients with sporadic Creutzfeldt-Jakob disease (sCJD) using the American Clinical Neurophysiology Society's (ACNS) Criteria. We analyzed EEG data of 23 patients with sCJD were admitted to two university hospitals between August 2005 and September 2015. We classified PPs on EEG data into three types: irregular periodic discharges (PDs) with superimposed rhythmic activities, appearing at a median of 8weeks after onset (w.a.o.); rhythmic sharp-and-wave, at a median of 11w.a.o.; and PDs with biphasic or triphasic morphology, at a median of 17w.a.o. Of 16 patients presenting with PPs, 14 had widespread lesions in both cortical and subcortical areas with clinical stage III at admission, and shorter time intervals for admission to hospital from disease onset than patients without PPs (Patients with PP, 11.6±12.2weeks; without PP, 18.2±8.3weeks; p=0.033). PPs largely presented as three types at different stages of disease progression, and patients who had PPs had more wide spread lesions and rapid disease progression. Our redefinition of PPs demonstrated on EEG using the ACNS criteria may contribute to further understanding of the pathological mechanisms of sCJD, and PPs might be a predictive factor of a rapid sCJD progression. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  17. Gastrointestinal hemorrhage – some epidemiological characteristics of patients in the period 1994–2003

    Directory of Open Access Journals (Sweden)

    Pavel Skok

    2006-12-01

    Full Text Available Background: Gastrointestinal hemorrhage is a frequent medical problem and a significant cause of morbidity and mortality. The aim of this prospective, cohort study, which was carried out at our institution, was to establish the causes of hemorrhage from the digestive tract and mortality during a 10-year period.Patients and methods: The study includes patients with emergency endoscopy of the upper gastrointestinal tract and other diagnostic procedures of the digestive tract due to gastrointestinal hemorrhage between January 1, 1994 and December 31, 2003.Results: 6416 patients were investigated: 2452 women (38.2 % and 3964 men (61.8 %. The average age of our patients was 59.3 years (a 1–106 year span, SD ± 17.2. In 2142 patients (33.4 %, endoscopic investigation of the upper digestive tube revealed signs of acute or traces of previous hemorrhage. Different methods of endoscopic hemostasis were carried out in 1486 cases (23.2 %. Sequelae of ulcer disease were the cause of hemorrhage in 36.4 % of investigated patients. Frequent causes of hemorrhage were also inflammatory, hemorrhagically-erosive changes of the gastric and duodenal mucosa (16.6 %, esophageal reflux disease (11.2 %, ruptured esophageal varices (10.7 %. Less frequent causes of hemorrhage from the upper digestive tract were different tumors (3.8 %, Mallory-Weiss tear (2.9 %, polyps (1.4 % and Dieulafoy lesion (1.3 %. In 13.7 % of patients the cause of hemorrhage was in the large bowel and in 0.4 % in the small intestine. More than half of our patients (53.4 % were aged over 60, 11.4 % older than 80 years. The total mortality of our patients was 9.9 %, the majority of them (8.5 %, were older than 60 years, with concommitant diseases and complications during treatment.Conclusions: In the observed period, sequelae of ulcer disease were the most significant cause of gastrointestinal hemorrhage. Hemorrhages are frequent in elderly patients who usually have significant medical conditions

  18. Effect of 16-hour duty periods on patient care and resident education.

    Science.gov (United States)

    McCoy, Christopher P; Halvorsen, Andrew J; Loftus, Conor G; McDonald, Furman S; Oxentenko, Amy S

    2011-03-01

    To measure the effect of duty periods no longer than 16 hours on patient care and resident education. As part of our Educational Innovations Project, we piloted a novel resident schedule for an inpatient service that eliminated shifts longer than 16 hours without increased staffing or decreased patient admissions on 2 gastroenterology services from August 29 to November 27, 2009. Patient care variables were obtained through medical record review. Resident well-being and educational variables were collected by weekly surveys, end of rotation evaluations, and an electronic card-swipe system. Patient care metrics, including 30-day mortality, 30-day readmission rate, and length of stay, were unchanged for the 196 patient care episodes in the 5-week intervention month compared with the 274 episodes in the 8 weeks of control months. However, residents felt less prepared to manage cross-cover of patients (P = .006). There was a nonsignificant trend toward decreased perception of quality of education and balance of personal and professional life during the intervention month. Residents reported working fewer weekly hours overall during the intervention (64.3 vs 68.9 hours; P = .40), but they had significantly more episodes with fewer than 10 hours off between shifts (24 vs 2 episodes; P = .004). Inpatient hospital services can be staffed with residents working shifts less than 16 hours without additional residents. However, cross-cover of care, quality of education, and time off between shifts may be adversely affected.

  19. Factors influencing period from surgery to discharge in patients with femoral trochanteric fractures

    Science.gov (United States)

    Shinoda, Soichiro; Mutsuzaki, Hirotaka; Watanabe, Arata; Morita, Hidetaka; Kamioka, Yumiko

    2017-01-01

    [Purpose] The purpose of this study was to investigate factors influencing the period from surgery to discharge in patients with femoral trochanteric fractures. [Subjects and Methods] Sixty patients with femoral trochanteric fractures were investigated retrospectively. Based on the mean period from surgery to discharge (85.6 ± 26.6 days), the patients were divided into two groups: an under-85-day group (range, 29–78 days) and an over-85-day group (87–128 days). Age, gender, fracture type, presence of lesser trochanteric displacement, discharge destination, and walking ability were investigated. The relationship between these factors and the period from surgery to discharge was analyzed with logistic regression analysis. [Results] Age and lesser trochanteric displacement were significantly higher in the over-85-day group, and walking ability before fracture and at discharge were significantly lower in the over-85-day group. Logistic regression analysis showed that lesser trochanteric displacement and age were predictors of the length from surgery to discharge. Lesser trochanteric displacement were observed in 87.5% of these. Immediate displacement after surgery occurred in 57.8% of lesser trochanteric fractures, while 26.3% displaced 1 to 3 weeks after surgery. [Conclusion] This study revealed that lesser trochanteric displacement, higher age, and lower walking ability before fracture and at discharge were associated with longer hospitalizations in patients with femoral trochanteric fractures. Lesser trochanteric displacement were observed in 87.5% of lesser trochanteric fractures. These displacements occurred within 3 weeks after surgery in 84.1% of cases. PMID:29200639

  20. Seismic fragility of nuclear power plant components (Phase 2): A fragility handbook on eighteen components

    International Nuclear Information System (INIS)

    Bandyopadhyay, K.K.; Hofmayer, C.H.; Kassir, M.K.; Shteyngart, S.

    1991-06-01

    Fragility estimates of seven equipment classes were published in earlier reports. This report presents fragility analysis results from eleven additional equipment categories. The fragility levels are expressed in probabilistic terms. For users' convenience, this concluding report includes a summary of fragility results of all eighteen equipment classes. A set of conversion factors based on judgment is recommended for use of the information for early vintage equipment. The knowledge gained in conducting the Component Fragility Program and similar other programs is expected to provide a new direction for seismic verification and qualification of equipment. 15 refs., 12 tabs

  1. Randomized trial of aromatherapy versus conventional care for breast cancer patients during perioperative periods.

    Science.gov (United States)

    Tamaki, Kentaro; Fukuyama, Akiko Komatsu; Terukina, Shigeharu; Kamada, Yoshihiko; Uehara, Kano; Arakaki, Miwa; Yamashiro, Kazuko; Miyashita, Minoru; Ishida, Takanori; McNamara, Keely May; Ohuchi, Noriaki; Tamaki, Nobumitsu; Sasano, Hironobu

    2017-04-01

    Several studies focused on the effect of aromatherapy on mood, quality of life (QOL), and physical symptoms in patients with cancer. We compared the effects on QOL, vital signs, and sleep quality between aromatherapy and conventional therapy during perioperative periods of the breast cancer patients in this study. Patients were randomly assigned in a 2:1 ratio to receive aromatherapy or usual care. The primary endpoint was QOL, which was assessed using the quality of life questionnaire QLQ-C30, Version 3.0 of the European Organization for Research and Treatment of Cancer (EORTC) Study Group on quality of life. Secondary endpoints included the necessity of hypnotics, vital signs including blood pressure and heart rate and adverse events. In addition, we also summarized the patients' perception of the experience from a free description-type questionnaire. A total of 249 patients had breast cancer surgery and 162 patients gave physician consent and were recruited; 110 were randomly assigned to aromatherapy group (eight patients showed incomplete EORTC QLQ-C30) and 52 to control group (one patient showed incomplete EORTC QLQ-C30). There were no statistically significant differences between the aromatherapy group and control group in the EORTC QLQ-C30 at the surgery day. As for the results of the post-operation day 1, trends for differentiations of physical functioning and role functioning were detected between aromatherapy group and control group, but the differences did not reach statistical significance (p = 0.08 and 0.09). There were no significant differences of systolic and diastolic blood pressures between aromatherapy group and control group (p = 0.82 and 0.68). There was no statistically significant difference in heart rates between aromatherapy group (70.6 ± 11.0 bpm) and control group (71.2 ± 9.8 bpm) (p = 0.73). Likewise, the rate of hypnotic use was not statistically significant (p = 0.10). No adverse events were reported after aromatherapy

  2. Radiation exposure of ventilated trauma patients in intensive care: a retrospective study comparing two time periods.

    Science.gov (United States)

    Yee, Micaela V; Barron, Rochelle A; Knobloch, Tom A; Pandey, Umesh; Twyford, Catherine; Freebairn, Ross C

    2012-08-01

    To describe the cumulative effective dose of radiation that was received during the initial Emergency Department assessment and ICU stay of patients admitted with trauma, who required mechanical ventilation, during two time periods. A retrospective analysis of radiological and clinical data, set in a regional nonurban ICU. Two cohorts (starting 1 January 2004 and 1 January 2009), each comprising 45 adult patients admitted with trauma who were mechanically ventilated in intensive care, were studied. Frequency and type of radiological examinations, demographic information, and clinical data were collated from the radiological database, hospital admission record and Australian Outcomes Research Tool for Intensive Care database. Cumulative effective doses were calculated and expressed as a total dose and average daily dose for each cohort. The median cumulative effective dose per patient (in milliSieverts) increased from 34.59 [interquartile range (IQR) 9.08-43.91] in 2004 to 40.51 (IQR 22.01-48.87) in 2009, P=0.045. An increased number of computed tomography examinations per patient was also observed over the same interval from an average of 2.11 (median 2, IQR 1-3) in 2004 to an average of 2.62 (2, 2-4) in 2009, P=0.046. The radiation exposure of mechanically ventilated trauma patients in intensive care has increased over time. Radiation exposure should be prospectively monitored and staff should be aware of the increased risk resulting from this change in practice.

  3. Clinical effects of blood transfusion during the immediate postoperative period in cardiac surgery patients

    Directory of Open Access Journals (Sweden)

    Vasilis Hatzitolias

    2015-09-01

    Full Text Available Introduction: Blood transfusion is common in patients undergoing cardiac surgery. Aim: Our goal was to investigate the association between blood transfusions in the early postoperative period and complications during Cardiac Intensive Care Unit (CICU stay. Methods: Retrospectively analysis in 874 patients who underwent isolated coronary artery bypass grafting, valve surgery or combined procedures. Patients were allocated to two groups according to the presence (Group A or absence (Group B of blood transfusion during extracorporeal circulation, surgery and CICU stay. Two hundred thirty four patients with preexisting hepatic or blood diseases, atrial fibrillation, emergent surgery or those received autologous blood transfusions were excluded prior to the study. Morbidity was defined as prolonged postoperative mechanical ventilation, mechanical ventilation>7hours, reintubation, use of non-invasive ventilation, postoperative atrial fibrillation and length of hospital stay. Statistical analysis was carried out using Chi-square, Student’s t-test, Relative Risk (RR and logistic regression with statistical significance set at p7 hours (p 7 hours (p<0.01. Conclusions: Blood transfusions seem to associate with certain complications in cardiac surgery patients.

  4. Association of Periodic and Rhythmic Electroencephalographic Patterns With Seizures in Critically Ill Patients.

    Science.gov (United States)

    Rodriguez Ruiz, Andres; Vlachy, Jan; Lee, Jong Woo; Gilmore, Emily J; Ayer, Turgay; Haider, Hiba Arif; Gaspard, Nicolas; Ehrenberg, J Andrew; Tolchin, Benjamin; Fantaneanu, Tadeu A; Fernandez, Andres; Hirsch, Lawrence J; LaRoche, Suzette

    2017-02-01

    Periodic and rhythmic electroencephalographic patterns have been associated with risk of seizures in critically ill patients. However, specific features that confer higher seizure risk remain unclear. To analyze the association of distinct characteristics of periodic and rhythmic patterns with seizures. We reviewed electroencephalographic recordings from 4772 critically ill adults in 3 academic medical centers from February 2013 to September 2015 and performed a multivariate analysis to determine features associated with seizures. Continuous electroencephalography. Association of periodic and rhythmic patterns and specific characteristics, such as pattern frequency (hertz), Plus modifier, prevalence, and stimulation-induced patterns, and the risk for seizures. Of the 4772 patients included in our study, 2868 were men and 1904 were women. Lateralized periodic discharges (LPDs) had the highest association with seizures regardless of frequency and the association was greater when the Plus modifier was present (58%; odds ratio [OR], 2.00, P rhythmic delta activity (LRDA) were associated with seizures in a frequency-dependent manner (1.5-2 Hz: GPDs, 24%,OR, 2.31, P = .02; LRDA, 24%, OR, 1.79, P = .05; ≥ 2 Hz: GPDs, 32%, OR, 3.30, P rhythmic delta activity compared with no periodic or rhythmic pattern (13%, OR, 1.18, P = .26). Higher prevalence of LPDs and GPDs also conferred increased seizure risk (37% frequent vs 45% abundant/continuous, OR, 1.64, P = .03 for difference; 8% rare/occasional vs 15% frequent, OR, 2.71, P = .03, vs 23% abundant/continuous, OR, 1.95, P = .04). Patterns associated with stimulation did not show an additional risk for seizures from the underlying pattern risk (P > .10). In this study, LPDs, LRDA, and GPDs were associated with seizures while generalized rhythmic delta activity was not. Lateralized periodic discharges were associated with seizures at all frequencies with and without Plus modifier, but LRDA and GPDs were associated with

  5. Drug correction of intestinal motility disorders in intensive care in the postoperative period in surgical patients

    Directory of Open Access Journals (Sweden)

    Novitskaya-Usenko L.V.

    2015-03-01

    Full Text Available Aim: improving the results of the complex treatment of patients with surgical pathology of abdominal organs by improving prevention and treatment of motor-evacuation disorders of the gastrointestinal tract in the postoperative period. Results: the article presents data on the use of metoclopramide, L- ar¬ginine, simethicone for the prevention of postoperative dysmotility development. It is proved that L-arginine use reduces the effects of peripheral vasospasm by improving microcirculation of the intestinal wall and this leads to a more rapid recovery of motor-evacuation function of the gastrointestinal tract.

  6. Impaired cytokine responses in patients with cryopyrin-associated periodic syndrome (CAPS).

    Science.gov (United States)

    Haverkamp, M H; van de Vosse, E; Goldbach-Mansky, R; Holland, S M

    2014-09-01

    Cryopyrin-associated periodic syndrome (CAPS) is characterized by dysregulated inflammation with excessive interleukin (IL)-1β activation and secretion. Neonatal-onset multi-system inflammatory disease (NOMID) is the most severe form. We explored cytokine responses in 32 CAPS patients before and after IL-1β blocking therapy. We measured cytokines produced by activated peripheral blood monuclear cells (PBMCs) from treated and untreated CAPS patients after stimulation for 48 h with phytohaemagglutinin (PHA), PHA plus IL-12, lipopolysaccharide (LPS) or LPS plus interferon (IFN)-γ. We measured IL-1β, IL-6, IL-10, tumour necrosis factor (TNF), IL-12p70 and IFN-γ in the supernatants. PBMCs from three untreated CAPS patients were cultured in the presence of the IL-1β blocker Anakinra. Fifty healthy individuals served as controls. CAPS patients had high spontaneous production of IL-1β, IL-6, TNF and IFN-γ by unstimulated cells. However, stimulation indexes (SIs, ratio of stimulated to unstimulated production) of these cytokines to PHA and LPS were low in NOMID patients compared to controls. Unstimulated IL-10 and IL-12p70 production was normal, but up-regulation after PHA and LPS was also low. LPS plus IFN-γ inadequately up-regulated the production of IL-1β, IL-6, TNF and IL-10 in CAPS patients. In-vitro but not in-vivo treatment with Anakinra improved SIs by lowering spontaneous cytokine production. However, in-vitro treatment did not improve the low stimulated cytokine levels. Activating mutations in NLRP3 in CAPS are correlated with poor SIs to PHA, LPS and IFN-γ. The impairment in stimulated cytokine responses in spite of IL-1β blocking therapy suggests a broader intrinsic defect in CAPS patients, which is not corrected by targeting IL-1β. © 2014 British Society for Immunology.

  7. Impact of Complete Parenteral Nutrition on Metabolic Processes in Cancer Patients in the Early Postoperative Period

    Directory of Open Access Journals (Sweden)

    O. A. Obukhova

    2011-01-01

    Full Text Available Objective: to estimate blood glucose levels during complete parenteral nutrition (CPN, by using the three-in-one system with a high glucose level. Subjects and methods. Thirty adult patients without diabetes mellitus (including 18 men were examined. Twelve and 18 patients were operated on for colonic and gastric cancers, respectively. CPN (Oliclinomel No. 7 — 1000, 1500 ml; glucose, 240 g in 1500 ml, Baxter, Belgium was carried out at the Surgery Department in the early postoperative period (3-5 postoperative days with stable hemodynamics and no organ dysfunction (acute respiratory, renal, hepatic failure. The preparation was administered at a rate of about 83 ml/h over 18 hours. Insulin was not used. Serum glucose concentrations were measured before the study and then for 24 hours at an interval of 6 hours. Results. Glucose concentrations were not found to exceed the allowable values in the majority of patients during CPN at the given rate. In 5 (16.7% patients, short-term glucose increases up to 13.3 mmol/l were corrected, by decreasing the infusion rate. There was no hypoglycemia or other complications during CPN. Conclusion. Our findings suggest that three-in-one parenteral feeding is safe and causes no metabolic disturbances if simple principles are followed, the basic ones of which are to observe the intake of an adequate total dose and the rate of administration of nutrients. Key words: parenteral feeding, hyperglycemia, metabolic disturbances.

  8. Application of fast track surgery in elderly patients during perioperative period of laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    ZHANG Yong

    2014-12-01

    Full Text Available ObjectiveTo investigate the safety and superiority of fast track surgery (FTS in elderly patients during the perioperative period of laparoscopic cholecystectomy (LC. MethodsThe clinical data of 124 elderly patients who underwent LC at the Department of General Surgery in our institution between January 2010 and March 2014 were assessed, with 62 cases assigned to FTS group and 62 cases to conventional method group. Anal exhaust time, feeding time, off-bed activity time, and length of hospital stay were compared between the two groups, and postoperative results and adverse reactions were recorded. Continuous data were analyzed using the independent-samples t test, and categorical data were compared using the chi-square test. Results Compared with the control method group, patients in the FTS group showed earlier postoperative anal exhaust, feeding, and off-bed activity, a shorter length of hospital stay, and a lower incidence of postoperative cardiovascular and cerebrovascular complications (P<0.05. ConclusionFTS is an effective approach to accelerate rehabilitation in elderly patients after LC.

  9. Application of forgetful analgesia induction in induction period in patients with obstructive jaundice

    Directory of Open Access Journals (Sweden)

    Wei DU

    2014-03-01

    Full Text Available Objective To observe the effect of forgetful analgesia induction and tracheal intubation on the hemodynamic changes in induction period in patients with obstructive jaundice, and explore a safe method for anesthesia induction and tracheal intubation. Methods Sixty patients with obstructive jaundice undergoing elective abdominal operation in General Hospital of PLA from February, 2013 to August, 2013 were involved in the present study. Participants included 36 male and 24 female patients, aging 19-65 years (mean 42±5 years, weighing 47-73 kg (mean 54±6 kg, with ASA Ⅰ-Ⅱ. These 60 patients were randomly divided into forgetful analgesia induction-tracheal intubation group (group A, n=30 and rapid induction-tracheal intubation group (group B, n=30. The heart rate (HR, mean arterial pressure (MAP, pulse oxygen saturation (SpO2 at the time point of before induction (T0, before intubation (T1, at the moment of intubation (T2 and 3 min after intubation (T3 were determined in both groups. Administration times of ephedrine hydrochloride and atropine was recorded in both groups. Results There was no significant difference in HR, MAP, SpO2 before and after induction in group A. In the patients of group B, the HR increased and MAP decreased after induction compared with those before induction (P<0.05, and the change of SpO2 was not significant. Ephedrine hydrochloride and atropine were administrated in both groups, and the cases and times of ephedrine hydrochloride administration were more in group B than in group A (P<0.05. Conclusion The forgetful analgesia induction-tracheal intubation could effectively control the stress response and reduce the fluctuation in hemodynamics during induction of anesthesia in patients with obstructive jaundice. DOI: 10.11855/j.issn.0577-7402.2014.02.15

  10. Nutrition for the pediatric surgical patient: approach in the peri-operative period

    Directory of Open Access Journals (Sweden)

    Falcão Mário Cícero

    2002-01-01

    Full Text Available Nutrition is essential for maintenance of physiologic homeostasis and growth. Hypermetabolic states lead to a depletion of body stores, with decreased immunocompetence and increased morbidity and mortality. The purpose of this paper is to provide an update regarding the provision of appropriate nutrition for the pediatric surgical patient, emphasizing the preoperative and postoperative periods. Modern nutritional support for the surgical patient comprises numerous stages, including assessment of nutritional status, nutritional requirements, and nutritional therapy. Nutritional assessment is performed utilizing the clinical history, clinical examination, anthropometry, and biochemical evaluation. Anthropometric parameters include body weight, height, arm and head circumference, and skinfold thickness measurements. The biochemical evaluation is conducted using determinations of plasma levels of proteins, including album, pre-albumin, transferrin, and retinol-binding protein. These parameters are subject to error and are influenced by the rapid changes in body composition in the peri-operative period. Nutritional therapy includes enteral and/or parenteral nutrition. Enteral feeding is the first choice for nutritional therapy. If enteral feeding is not indicated, parenteral nutrition must be utilized. In all cases, an individualized, adequate diet (enteral formula or parenteral solution is obligatory to decrease the occurrence of overfeeding and its undesirable consequences.

  11. Application of Ranibizumab at perioperative period of compound trabeculectomy in patients with neovascular glaucoma

    Directory of Open Access Journals (Sweden)

    Su-Ying Qin

    2016-01-01

    Full Text Available AIM:To observe the effect of intravitreal injection of Ranibizumab at perioperative period of compound trabeculectomy on iris neovascularization, intraocular pressure(IOPfor patients with neovascular glaucoma(NVG.METHODS:Intravitreal injection of ranibizumab, compound trabeculectomy and panretinal photocoagulation were given to 38 patients(38 eyeswith neovascular glaucoma, which could not be controlled by drugs, from January 2013 to January 2014 in Anyang Eye Hospital. Iris neovascularization, IOP and changes of visual acuity were observed before and after treatments. The patients were followed up for 6mo after treatments.RESULTS: Seven days after intravitreal injection, 36 cases(94.74%had complete regression of iris neovascularization. Two cases(5.26%had regression of small blood vessels in the iris, a little thick blood vessels were remained. At 1mo after compound trabeculectomy, iris neovascularization in all patients were subsided; at 3mo after treatments, the iris neovascularization in 8 patients(21.05%were performed again, and accepted intravitreal injection of ranibizumab again. Six months after the first treatments, all patients showed no iris neovascularization. The mean IOP before injection was 42.82±10.29mmHg. At 5d after the drug injection was 39.13±9.71mmHg. Before and after the drug injection, change of IOP was not statistically significant(q=2.65, P>0.05. At 1wk,1,3 and 6mo after compound trabeculectomy, IOP was 10.53±1.81mmHg, 10.11±1.73mmHg, 11.29±2.49mmHg, 12.58±3.01mmHg,which decreased significantly(q=23.15,23.46,22.61,21.68, all Pq=20.51,20.81,19.96,19.04, all PCONCLUSION: Intravitreal injection of ranibizumab at perioperative period of compound trabeculectomy can effectively improve the success rate of the surgeries and reduce risk of complications, and the effect is certainly safe.

  12. Periodic Granulocyte Count Measuring Is Useful for Detecting Asymptomatic Agranulocytosis in Antithyroid Drug-Treated Patients with Graves' Disease.

    Science.gov (United States)

    Nakamura, Hirotoshi; Ide, Akane; Kudo, Takumi; Nishihara, Eijun; Ito, Mitsuru; Miyauchi, Akira

    2016-12-01

    Finding agranulocytosis (AG) at an early stage is important to improve outcome, but periodic granulocyte count monitoring is not generally recommended for patients with Graves' disease, because AG develops suddenly. At the Kuma Hospital, Graves' patients under antithyroid drug (ATD) treatment in an outpatient clinic have a granulocyte count examination during each visit, and if it is Graves' disease were 131 I-radioisotope therapy (19 patients), thyroidectomy (2 patients), inorganic iodine (1 patient), or another ATD (1 patient). Among the 33 GP patients, 31 (94%), including 20 asymptomatic cases, were discovered during periodic granulocyte count monitoring. Most of them stopped ATD, and other treatments for Graves' disease were selected. Periodic monitoring of granulocyte counts is useful for identifying AG and GP patients with no or minimum infection symptoms.

  13. Is Period3 Genotype Associated With Sleep and Recovery in Patients With Disorders of Consciousness?

    Science.gov (United States)

    Bedini, Gloria; Bersano, Anna; Sebastiano, Davide Rossi; Sattin, Davide; Ciaraffa, Francesca; Tosetti, Valentina; Brenna, Greta; Franceschetti, Silvana; Ciusani, Emilio; Leonardi, Matilde; Vela-Gomez, Jesus; Boncoraglio, Giorgio B; Parati, Eugenio A

    2016-06-01

    Background Sleep evaluation is increasingly being used as prognostic tool in patients with disorders of consciousness, but, surprisingly, the role of Period3 (Per3) gene polymorphism has never been evaluated. Objective The aim of this study was to investigate the contribution of Per3 genotype on sleep quantity and consciousness recovery level in patients with disorders of consciousness (DOC). Methods In this observational study, we evaluated 71 patients with DOC classified as vegetative state/unresponsive wakefulness syndrome or minimally conscious state. Demographic and clinical data were collected and a standardised diagnostic workup, including a polysomnographic record, was applied. After informed consent provided by proxy, genomic DNA was obtained and Per3 polymorphism was analysed by polymerase chain reaction to identify 5/5, 4/5, or 4/4 genotype. Results Per3(5/5) genotype was found in 12.7% of our DOC patients. The median total Coma Recovery Scale-revised score in Per3(5/5) carriers was significantly higher than 4/4 genotype (10, range 5-16 vs 7, range 4-11; post hoc P = .036). Moreover, total sleep time seemed to be higher in 5/5 genotype (5/5, 221 minutes, range 88-515 minutes; 4/4, 151.5 minutes, range 36-477 minutes; and 4/5, 188 minutes, range 44-422 minutes). Conclusion For the first time we have shown a possible association between Per3 polymorphism and consciousness recovery level in DOC patients. Even though the exact molecular mechanism has not been defined, we speculate that its effect is mediated by higher total sleep time and slow wave sleep, which would improve the preservation of main cerebral connections. © The Author(s) 2015.

  14. A spatio-temporal synchronization of periodic markets: Evidence ...

    African Journals Online (AJOL)

    This study seeks to identify the 'rings' of periodic market days in Akwa Ibom State, using eighteen ... numbers was used in selecting a target population of eighteen communities in the hinterland of the state. ... The rural/traditional markets deal on low order goods and are mainly agricultural ... AJOL African Journals Online.

  15. Nonconvulsive status epilepticus associated with periodic lateralized epileptiform discharges in a patient with syphilis

    Directory of Open Access Journals (Sweden)

    Xin Yu

    2016-09-01

    Full Text Available Nonconvulsive status epilepticus (NCSE has been increasingly recognized as a cause of impaired level of consciousness in the ICU and emergency rooms. The confirmation of NCSE is largely based on the EEG, given the nonspecific and pleomorphic clinical manifestations. Debate remains over electroencephalograms (EEG criteria for NCSE. Periodic lateralized epileptiform discharges (PLEDs, have sparked controversy with regard to being part of the ictal vs. interictal spectrum. We report a case of a patient with syphilis who had cognitive decline and damaged consciousness with PLEDs and T2 hyperintensity at temporal and occipital lobe in MRI. After antiepileptic treatment only, his consciousness improved markedly together with the EEG in few days, while the change of MRI was still serious. In this case PLEDs is the sign of NCSE and change of MRI is limbic encephalitis (LE. This report discusses the association of PLEDs and NCSE, and supports the concept of PLEDs as an ictal pattern in some condition.

  16. Atraumatic diplaced bilateral femoral neck fracture in a patient with hypophosphatemic rickets in postpartum period: A missed diagnosis

    Directory of Open Access Journals (Sweden)

    Erdal Uzun

    2016-01-01

    Conclusion: For patients with bone metabolic diseases and/or the patients in pregnancy and postpartum period, preventive measures should be increased to reduce the risk of pathologic fracture. Admitting to the hospital physicians must be more careful about detecting fractures in these patients.

  17. An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department

    Energy Technology Data Exchange (ETDEWEB)

    Jofre, M J; Sierralta, M P [Military Hospital Nuclear Medicine Department, Santiago (Chile); Del Campo, G; Ide, A; Wiener, R [Department of Endocrinology of the Military Hospital, Santiago (Chile)

    2002-09-01

    An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department. Since the beginning of Nuclear Medicine, the thyroid gland has been an important subject for study. In the fifties, the complimentary use of 131 radioiodine after differentiated thyroid carcinoma (DTC) surgery was postulated. The aim of the study was to analyze our experience of the management of patients with DTC. Material and methods: An 18-year retrospective analysis was made including 109 patients with previous diagnosis of DTC, 90 % females, mean age 47 +/- 17 y.o. (range: 19-85 y.o). Tumoral histology was 67 % papillary, 28 % follicular and 5% non-determined in the medical record. First doses of 131 radioiodine were between 50 and 200 mCi. In all, 156 radioiodine doses were given and 6 patients received 4 doses or more, with total doses between 300 and 570 mCi. Results: The distribution of first and total radioiodine doses is presented in the table below. Of the group of patients who received a first radioiodine dose of less than 100 mCi post surgery, 79% were treated before 1990. Those who received 150mCi or more had cervical ganglionar compromise, trachea invasion or subtotal thyroidectomy. In 50% of the patients who received 4 or more doses, the first two doses were 50 mCi. It is important to mention that there was one patient who received 8 radioiodine doses in 4 years , seven of them were 50 mCi ( total dose 438 mCi). This patient presented trachea and larynx invasion in the early stages, with a persistent focus in the left supraclavicular region. She later developed pulmonary fibrosis, for which she was treated with complimentary radiotherapy (30 Gy), before dying. Distribution of radioiodine doses is presented. Conclusion: It is important to emphasize the validity of a first 131 radioiodine dose after surgery of DTC patients of 100 mCi or more, to obtain the ablation of the remaining thyroid tissue. This

  18. An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department

    International Nuclear Information System (INIS)

    Jofre, M.J.; Sierralta, M.P.; Del Campo, G.; Ide, A.; Wiener, R.

    2002-01-01

    An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department. Since the beginning of Nuclear Medicine, the thyroid gland has been an important subject for study. In the fifties, the complimentary use of 131 radioiodine after differentiated thyroid carcinoma (DTC) surgery was postulated. The aim of the study was to analyze our experience of the management of patients with DTC. Material and methods: An 18-year retrospective analysis was made including 109 patients with previous diagnosis of DTC, 90 % females, mean age 47 +/- 17 y.o. (range: 19-85 y.o). Tumoral histology was 67 % papillary, 28 % follicular and 5% non-determined in the medical record. First doses of 131 radioiodine were between 50 and 200 mCi. In all, 156 radioiodine doses were given and 6 patients received 4 doses or more, with total doses between 300 and 570 mCi. Results: The distribution of first and total radioiodine doses is presented in the table below. Of the group of patients who received a first radioiodine dose of less than 100 mCi post surgery, 79% were treated before 1990. Those who received 150mCi or more had cervical ganglionar compromise, trachea invasion or subtotal thyroidectomy. In 50% of the patients who received 4 or more doses, the first two doses were 50 mCi. It is important to mention that there was one patient who received 8 radioiodine doses in 4 years , seven of them were 50 mCi ( total dose 438 mCi). This patient presented trachea and larynx invasion in the early stages, with a persistent focus in the left supraclavicular region. She later developed pulmonary fibrosis, for which she was treated with complimentary radiotherapy (30 Gy), before dying. Distribution of radioiodine doses is presented. Conclusion: It is important to emphasize the validity of a first 131 radioiodine dose after surgery of DTC patients of 100 mCi or more, to obtain the ablation of the remaining thyroid tissue. This

  19. [Dietary prevention of protein-energy malnutrition during early postoperative period in elderly patients with gastroduodenal diseases].

    Science.gov (United States)

    Baranovskiĭ, A Iu; Protopopova, O B

    2012-01-01

    The modified diet of postoperative rehabilitation program in elderly patients with gastroduodenal ulcers and prognosis of development of protein-energy malnutrition (PEM) is presented. It is shown that early initiated special diet in postoperative period, blocks mechanisms of malnutrition and can significantly improve the functional status of the small intestine and activate, thus, membrane digestion, which leads to normalization of all types of metabolism in elderly patients. In comparison with control group, where 72% of patients in postoperative period had malnutrition, malnutrition in the study group revealed a mild degree in only 17.3% of patients.

  20. Early response to sibutramine in patients not meeting current label criteria: preliminary analysis of SCOUT lead-in period

    DEFF Research Database (Denmark)

    Caterson, Ian; Coutinho, Walmir; Finer, Nick

    2010-01-01

    pulse rate increases; median 1.5 bpm (nonconformers) vs. 3.0 bpm (conformers). There was a low incidence of serious adverse events (conformers: 1.0%; nonconformers: 2.8%) and ~93% of patients in both groups completed the 6-week period. The SCOUT lead-in period evaluating weight management...

  1. Anakinra use during pregnancy in patients with cryopyrin-associated periodic syndromes (CAPS).

    Science.gov (United States)

    Chang, Zenas; Spong, Catherine Y; Jesus, Adriana A; Davis, Michael A; Plass, Nicole; Stone, Deborah L; Chapelle, Dawn; Hoffmann, Patrycja; Kastner, Daniel L; Barron, Karyl; Goldbach-Mansky, Raphaela T; Stratton, Pamela

    2014-11-01

    Objective: To describe the pregnancy course and outcome, and use of anakinra, a recombinant selective IL-1 receptor blocker, during pregnancy in patients with cryopyrin-associated periodic syndromes (CAPS), including familial cold auto-inflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS) and neonatal onset multi-system inflammatory disease (NOMID). Methods: Women currently enrolled in natural history protocols (NCT00059748, and/or NCT00069329 under IND) who have been pregnant were included. Subjects underwent a structured, standardized interview with regards to maternal health, pregnancy and fetal outcomes. Medical records were reviewed. Results: Nine women (four with FCAS, one with MWS and four with NOMID) reported one to four pregnancies, each resulting in a total of fifteen FCAS, three MWS, and six NOMID pregnancies. Six births from FCAS mothers and three births from NOMID mothers occurred while patients were receiving anakinra. If a woman became pregnant while taking anakinra, the pre-pregnancy anakinra dose was continued. Anakinra dose was increased during one twin pregnancy. No preterm births or serious complications of pregnancy were observed. One fetus of the twin pregnancy had renal agenesis and suffered fetal demise. Genetic testing showed the deceased twin carried the same NLRP3 c.785T>C, p.V262A mutation as the mother. The other twin is healthy and mutation negative. Conclusions: Anakinra was continued during pregnancy in women with CAPS and provided significant, persistent CAPS symptom relief while continuing to prevent the long-term sequelae of CAPS. Anakinra was well tolerated. Although a causal relation between anakinra and renal agenesis seems unlikely, further safety data are needed.

  2. Energy metabolism of thoracic surgical patients in the early postoperative period. Effect of posture.

    Science.gov (United States)

    Brandi, L S; Bertolini, R; Janni, A; Gioia, A; Angeletti, C A

    1996-03-01

    To determine the effect of elective thoracic surgery on energy metabolism and gas exchange and to evaluate whether the 30-degree sitting position would affect these variables. Prospective, unblinded, controlled study. Surgical ICU in a university hospital. Twenty-two adult patients undergoing elective pulmonary resection. Posture change from supine to 30-degree sitting position. Oxygen consumption (VO2), carbon dioxide production (VCO2), respiratory quotient (RQ), and energy expenditure (EE) were measured by means of computerized indirect calorimetry before and after surgery. Heart rate and respiratory frequency were measured continuously during gas exchange measurement. Blood gases were analyzed with an automated blood gas analyzer. Preoperatively, altering position did not affect energy metabolism, gas exchange, and cardiopulmonary variables. Postoperatively, the measured EE was 116% of the expected value. Mean EE and VO2 values for each position were higher than the preoperative values for the corresponding postures (pMean percent increases in EE, VO2, and VCO2 were significantly lower in the 30-degree sitting position than in the supine position (EE: 7.9+/-2.7% vs 14.4+/-2.3%; pexchange for each position were worse than the preoperative values for the corresponding postures (pMean arterial pressure, heart rate, and respiratory frequency for each position were higher than the preoperative values for the corresponding postures (pmean values of these variables occurred between the two positions postoperatively. The early postoperative period of patients undergoing elective thoracic surgery is characterized by a condition of impaired gas exchange and by a hypermetabolic state. Hypermetabolism can be partly mitigated by assuming the 30-degree sitting position.

  3. The Stability of DSM Personality Disorders over Twelve to Eighteen Years

    Science.gov (United States)

    Nestadt, Gerald; Di, Chongzhi; Samuels, J F; Bienvenu, O J; Reti, I M; Costa, P; Eaton, William W; Bandeen-Roche, Karen

    2009-01-01

    Background Stability of personality disorders is assumed in most nomenclatures; however, the evidence for this is limited and inconsistent. The aim of this study is to investigate the stability of DSM-III personality disorders in a community sample of eastern Baltimore residents unselected for treatment. Methods Two hundred ninety four participants were examined on two occasions by psychiatrists using the same standardized examination twelve to eighteen years apart. All the DSM-III criteria for personality disorders were assessed. Item-response analysis was adapted into two approaches to assess the agreement between the personality measures on the two occasions. The first approach estimated stability in the underlying disorder, correcting for error in trait measurement, and the second approach estimated stability in the measured disorder, without correcting for item unreliability. Results Five of the ten personality disorders exhibited moderate stability in individuals: antisocial, avoidant, borderline, histrionic, and schizotypal. Associated estimated ICCs for stability of underlying disorder over time ranged between approximately 0.4 and 0.7–0.8. A sixth disorder, OCPD, exhibited appreciable stability with estimated ICC of approximately 0.2–0.3. Dependent, narcissistic, paranoid, and schizoid disorders were not demonstrably stable. Conclusions The findings suggest that six of the DSM personality disorder constructs themselves are stable, but that specific traits within the DSM categories are both of lesser importance than the constructs themselves and require additional specification. PMID:19656527

  4. Cardiorespiratory interactions during periodic breathing in awake chronic heart failure patients.

    Science.gov (United States)

    Pinna, G D; Maestri, R; Mortara, A; La Rovere, M T

    2000-03-01

    We applied spectral techniques to the analysis of cardiorespiratory signals [instantaneous lung volume (ILV), instantaneous tidal volume (ITV), arterial O(2) saturation (Sa(O(2))) at the ear, heart rate (HR), systolic (SAP), and diastolic (DAP) arterial pressure] during nonapneic periodic breathing (PB) in 29 awake chronic heart failure (CHF) patients and estimated the timing relationships between respiratory and slow cardiovascular (cardiorespiratory interactions during PB and 2) to test the hypothesis of a central vasomotor origin of PB. All cardiovascular signals were characterized by a dominant (>/=84% of total power) oscillation at the frequency of PB (mean +/- SE: 0.022 +/- 0.0008 Hz), highly coherent (>/=0.89), and delayed with respect to ITV (ITV-HR, 2.4 +/- 0.72 s; ITV-SAP, 6.7 +/- 0.65 s; ITV-DAP, 3.2 +/- 0.61 s; P cardiorespiratory rhythm led by the ventilatory oscillation and suggest that 1) the cyclic increase in inspiratory drive and cardiopulmonary reflexes and 2) mechanical effects of PB-induced changes in intrathoracic pressure are the more likely sources of the HR and blood pressure oscillations, respectively. The timing relationship between ITV and blood pressure signals excludes the possibility that PB represents the effect of a central vasomotor rhythm.

  5. Analysis of obese patients' medical conditions in the pre and postoperative periods of bariatric surgery.

    Science.gov (United States)

    Rêgo, Anderson DA Silva; Zulin, Aline; Scolari, Sandro; Marcon, Sônia Silva; Radovanovic, Cremilde Aparecida Trindade

    2017-01-01

    to compare the clinical conditions of obese patients in the pre and postoperative period of bariatric surgery. we carried out a descriptive, retrospective, quantitative study by consulting the charts of 134 patients who underwent bariatric surgery in the period from 2009 to 2014. We collected the data between September and November 2015. We performed a descriptive statistical analysis and comparative analysis of anthropometric, metabolic, biochemical and clinical variables, considering six months before and after surgery. the majority of the patients were female (91.8%), with a higher prevalence (35%) in the age group 18-29 years old, complete high-school education (65.6%) and grade III obesity (60.4%). Six months after surgery, weight and lipid profile reduction were significant in both genders, but the impact on biochemical, anthropometric, metabolic and clinical parameters was significant only in female subjects, with a reduction in morbidities associated with obesity, such as arterial hypertension, diabetes mellitus, dyslipidemia and metabolic syndrome and in the use of drugs to control them. bariatric surgery was effective in weight loss, with improvements in anthropometric, metabolic and biochemical parameters and in the reduction of morbidities associated with obesity. comparar as condições clínicas de pacientes obesos em período pré e pós-operatório de cirurgia bariátrica. estudo descritivo, retrospectivo, de abordagem quantitativa, por meio de consulta ao prontuário de 134 pacientes submetidos à cirurgia bariátrica no período de 2009 a 2014. Os dados foram coletados entre os meses de setembro e novembro de 2015. Foi realizada análise estatística descritiva e comparativa das variáveis antropométricas, metabólicas, bioquímicas e clínicas, considerando seis meses antes e após a cirurgia. a maioria dos pacientes era do sexo feminino (91,8%), com maior prevalência (35%) na faixa etária de 18 aos 29 anos, com ensino médio completo (65

  6. [Superficial mycoses in patients from Anzoátegui state, Venezuela, period 2002-2012].

    Science.gov (United States)

    Lemus-Espinoza, Druvic; Teresa Maniscalchi, María; Villarroel, Oskarina; Bónoli, Stefano B; Wahab, Fadi; García, Oswaldo

    2014-12-01

    Superficial fungal diseases that affect the skin and its appendages are frequently seen in basic triage and in dermatology services. These diseases are distributed in Venezuela with an incidence of 92.9%. The aim of this study was to determine the genera and species that cause dermatomycoses in residents of Anzoátegui state, Venezuela, during the period 2002-2012. A total of 4257 patients with a presumptive diagnosis of superficial mycoses were studied, with ages from 7 months to 79 years. The overall prevalence was 30.9%. The most frequent were dermatophytosis (44.7%). M. canis produced 148 cases of tinea capitis. Three dermatophytic agents represented 95% of all cases, with a significant predominance of T. mentagrophytes with 50%. Candidosis occurred in 28.4%. C. albicans, and the C. parapsilosis complex, were responsible for 80% of the cases. The other species identified were C. tropicalis (n = 41, 11.0%), C. glabrata (n = 10, 2.7%), C. guilliermondii (n = 6, 1.6%), C. krusei (n = 4, 1.1%). Pityriasis versicolor occurred in 22.4% of the cases studied, and less frequently were present onychomycosis produced by a non dermatophytic mold: Fusarium oxysporum (n = 34, 65.4%), Aspergillus terreus (n=16, 30.8%) and Scytalidium dimidiatum (n=2; 3.8%). Rare cases of Trichosporon onychomycosis (0.5%) and one case of black tinea were also found. Health education in the population is recommended to promote measures to prevent transmission of these fungi and prevent the spread of this silent public health problem.

  7. Eighteen-point abobotulinum toxin a upper face rejuvenation: an eye plastic perspective on 845 subjects.

    Science.gov (United States)

    Kashkouli, Mohsen Bahmani; Amani, Afsaneh; Jamshidian-Tehrani, Mansooreh; Yousefi, Sahar; Jazayeri, Anis Alsadat

    2014-01-01

    To report the method and results of 18-point Abobotulinum toxin A (ABO-BTA, Dysport) upper face rejuvenation on 845 subjects. In a retrospective chart review, all subjects (the first cycle of injection) with ABO-BTA upper face rejuvenation from 2003 to 2009 were included. Excluded were subjects with facial spastic disorders, injection after upper face lifting, and aberrant regeneration of facial nerves. Upper face rejuvenation included 18 points of injection at forehead creases (4), frown lines (5), bunny line (1), crow's feet (4 on both sides), and lower eyelid crease (4 on both sides). They were revisited in 10 to 14 days for assessment of the effects and possible touch-up injection. Demographics, year of injection, topical anesthetic usage, touch-up injection, and adverse effects (AE) were recorded. There were 845 subjects (85.8% women) whose age was below 40 in 49.3%. All but 68 (8%) were happy with the touch-up visit, 10 to 14 days after injection. Touch-up injection was performed in 8% of subjects mainly for the eyebrow asymmetry. AE (22/845, 2.6%) were bruise (15/845, 1.8%), blepharoptosis (3/845, 0.3%), remained eyebrow asymmetry after touch-up injection (2/845, 0.2%), and headache (2/845, 0.2%). They were significantly more in subjects with touch-up injection, younger than 40 years, and in the first and second year of experience (especially for the bruise). Eighteen-point ABO-BTA upper face rejuvenation had a low rate of AE in this series in which majority was bruise at the lateral canthal area. They were significantly more in the first years of experience, subjects younger than 40, and who had touch-up injections.

  8. 75 FR 68401 - Duncan Smith and Gerald Altizer-Continuance in Control Exemption-Eighteen Thirty Group, LLC and...

    Science.gov (United States)

    2010-11-05

    ... DEPARTMENT OF TRANSPORTATION Surface Transportation Board [Docket No. FD 35436] Duncan Smith and..., LLC Duncan Smith and Gerald Altizer (collectively applicants), noncarrier individuals, have filed a... carriers. Mr. Smith owns 80% of Eighteen Thirty and 75% of Georges Creek. Mr. Altizer owns a 20% interest...

  9. Prognostic EEG patterns in patients resuscitated from cardiac arrest with particular focus on Generalized Periodic Epileptiform Discharges (GPEDs).

    Science.gov (United States)

    Milani, P; Malissin, I; Tran-Dinh, Y R; Deye, N; Baud, F; Lévy, B I; Kubis, N

    2014-04-01

    We assessed clinical and early electrophysiological characteristics, in particular Generalized Periodic Epileptiform Discharges (GPEDs) patterns, of consecutive patients during a 1-year period, hospitalized in the Intensive Care Unit (ICU) after resuscitation following cardiac arrest (CA). Consecutive patients resuscitated from cardiac arrest (CA) with first EEG recordings within 48hours were included. Clinical data were collected from hospital records, in particular therapeutic hypothermia. Electroencephalograms (EEGs) were re-analyzed retrospectively. Sixty-two patients were included. Forty-two patients (68%) were treated with therapeutic hypothermia according to international guidelines. Global mortality was 74% but not significantly different between patients who benefited from therapeutic hypothermia compared to those who did not. All the patients who did not have an initial background activity (36/62; 58%) died. By contrast, initial background activity was present in 26/62 (42%) and among these patients, 16/26 (61%) survived. Electroencephalography demonstrated GPEDs patterns in 5 patients, all treated by therapeutic hypothermia and antiepileptic drugs. One of these survived and showed persistent background activity with responsiveness to benzodiazepine intravenous injection. Patients presenting suppressed background activity, even when treated by hypothermia, have a high probability of poor outcome. Thorough analysis of EEG patterns might help to identify patients with a better chance of survival. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  10. Clinical evaluation of the treatment in male patient with thyrotoxic periodic paralysis: 131I treatment compared with antithyroid drug therapy

    International Nuclear Information System (INIS)

    Su Li; Chen Jing; Zhao Ming

    2007-01-01

    Objective: To evaluate clinical efficacy of 131 I treatment for thyrotoxic periodic paralysis. Methods: 100 male patients with thyrotoxic periodic paralysis were divided equally into two groups, and treated with 131 I or antithyroid drugs (ATD). They were followed up regularly for 3 years with the cure rate, the incidence of hypothyroidism, the recurrence tree of thyrotoxic periodic paralysis and the side effects, which included granulocytopenia, liver function damage and skin rash from medicinal herbs resource. Results: The cure rate of 131 I therapy and ATD therapy for thyrotoxic periodic paralysis is 80% and 52%, respectively. And there is significant difference between them (χ 2 =8.73, P 2 =18.92, P 2 =11.11, P 131 I therapy has a higher incidence of hypothyroidism (χ = 6.35, P 131 I is preferable to effectively control the recurrent attacks of thyrotoxic periodic paralysis. (authors)

  11. Arius and the Three Hundred and Eighteen Orthodox Fathers in the Ethiopian Tradition

    Directory of Open Access Journals (Sweden)

    Jacques-Noël Pérès

    2015-04-01

    Full Text Available What do today’s Ethiopian Christians think about Arius and what do they think about his theology? Naturally, recent studies concerning this topic are terra incognita to them. Arius continues to represent for them the typical arch-heretic. This author bases his study on his research of the Senkessar (the Ethiopian Synaxarion, the Ethiopian liturgical tradition, a number of other texts, as well as the Ethiopian tradition of sacred art. All this permits him to define the image of Arius in today’s Ethiopian Church. The Ethiopian national epos known as the Kebra Nagast or Glory of the Kings places Arius in the company of Nestorius and Ibo of Edessa. For the Ethiopian church which does not accept the Council of Chalcedon, both of these represent hated dia-physite heretics. By associating Arius with them, he becomes the founder of the dia-physite heresy — a movement which historically occurred only after his time and with which he actually had little or nothing to do. In the Ethiopian Synaxarion, Arius is juxtaposed with such heroes of the Ethiopian faith as Peter, Alexander, and Timothy of Alexandria, Athanasius the Great, and the fathers of the Council of Nicaea. Naturally, here just as in the Kebra, Arius is once again portrayed as the arch-heretic, whose teaching represents a pernicious catastrophe for the Orthodox faith. He is compared with Sabellius, Macedonius, Nestorius, and even Mani. He is demonized to the extent that he is actually called a devil. In the Anaphora of the Three Hundred and Eighteen, Arius is not mentioned by name, but the anaphora in question does contain an attack on his heresy. It would seem that the Ethiopian authors make no attempt to even understand the logic which Arius used to define his position. They simply reject it without discussion. The Ethiopian tradition likewise portrays Arius as a new Judas, pointing out similar details in the way both of these figures met their fi nal end. A particular

  12. Hypokalaemic Periodic Paralysis in a Patient with Subclinical Hyperthyroidism: A Rare Case

    OpenAIRE

    Hegde, Swati; Shaikh, Mohammed Aslam; Gummadi, Thejaswi

    2016-01-01

    Thyrotoxic Periodic Paralysis (TPP) is an uncommon disorder. Though many cases of hypokalaemic periodic paralysis are reported in overt hyperthyroidism, hypokalaemic paralysis in subclinical hyperthyroidism is very rare. Subclinical hyperthyroidism is characterised by circulating TSH levels below reference range and normal thyroid hormone levels. We describe a case of 32-year-old Asian male who presented to the emergency department with acute onset weakness and hypokalaemia with no previous h...

  13. [Correlation between social support and quality of life in patients with breast cancer at different periods of treatment].

    Science.gov (United States)

    Yang, L; Song, W P; Chen, Z L; Wang, Y; Chen, Y Y; Hua, Y H; Chen, M; Zou, W B

    2017-03-23

    Objective: To analyze the differences between the social support for breast cancer patients and healthy female, and to explore the correlation between social support and quality of life (QOL) in the patients. Methods: From January 2013 to December 2014, 101 patients with operable breast cancer treated at Xinyu City People's Hospital were recruited as the experimental group. They completed questionnaires in the preoperative, postoperative chemoradiotherapy and rehabilitation periods, respectively.101 healthy female volunteers recruited from the community were included as control group, whose age and level of education were matched with those of the experimental group.The general questionnaire including basic information, disease conditions and other projects, perceived social support scale (PSSS), quality of life of breast cancer patients (FACT-B) were applied to evaluate the general situation, social support and QOL of the subjects. The differences in PSSS scores between the experimental and control groups were compared. The correlation between PSSS score and FACT-B score in the experimental group was analyzed. SPSS 18.0 software was used for statistical analysis. Results: The general situations of the experimental and control groups were comparable (all P >0.05). The rates of the total social support score ≥50 in the experimental and control groups were not significantly different (93.6% vs. 94.7%, P =0.067). Compared with that of the control group (23.2±4.8), the scores of family support in the experimental group in preoperative, postoperative chemoradiotherapy and rehabilitation periods were statistically higher (25.6±3.2, 24.2±4.2 and 24.0±3.4, respectively, P =0.034). The social support scores of patients with different demographic characteristics were different. Among the demographic characteristics, years of education and place of residence had the largest impact. The scores of social support in patients with longer education years and living in the

  14. Early response to sibutramine in patients not meeting current label criteria: preliminary analysis of SCOUT lead-in period

    DEFF Research Database (Denmark)

    Caterson, Ian; Coutinho, Walmir; Finer, Nick

    2010-01-01

    The Sibutramine Cardiovascular Outcomes (SCOUT) trial protocol defines a patient population predominantly outside current European Union label criteria. This article explores responses to sibutramine during the 6-week, single-blind, lead-in period between patients who conformed to the label...... requirements ("conformers") and those who did not ("nonconformers"). SCOUT is an ongoing, randomized, double-blind, placebo-controlled outcome trial in overweight/obese patients at high risk of a cardiovascular event. In total, 10,742 patients received sibutramine and weight management during the lead...... with sibutramine confirms its good tolerability and efficacy in patients who meet current label criteria. Preliminary data from high-risk patients for whom sibutramine is currently contraindicated suggest a low discontinuation rate and few serious adverse events but confirmation from the SCOUT outcome data...

  15. Análise do pólen em dezoito cultivares de macieira Pollen analysis of eighteen apple cultivars

    Directory of Open Access Journals (Sweden)

    Fernando Antonio Campo Dall'Orto

    1985-01-01

    Full Text Available Como subsídio essencial ao projeto de melhoramento genético da macieira (Malus spp. por hibridação e ao conhecimento da polinização natural nas condições do Estado de São Paulo, efetuaram-se estudos sobre a quantidade e a viabilidade do pólen existente em dezoito cultivares de maior interesse no momento. Constatou-se que, entre os cultivares mais utilizados nos cruzamentos, Anna, Brasil, Dulcina, Ein Shemer, Gala, Rainha e Valinhense, juntamente com as novas seleções - IAC 170-1 e IAC 570-38 - foram os que se apresentaram mais ricos de pólen, com número superior a 50.000 grãos por flor. Quanto à viabilidade polínica desse material estudado, a germinação situou-se em níveis bastante satisfatórios - quase sempre maior que 50% - mesmo quando se armazenou o pólen por um período de 70 dias, em ambiente frio (-1ºC em dessecadores.Aiming to find out variations in pollen quantity and viability in eighteen apple cultivars, analysis of "in vitro" germination was performed to contribute - as a parameter for genetic breeding by hybridization and as a pollination basis. The apple cultivars or selections recommended for commercial planting, at the mild climate conditions prevailing in the State of São Paulo, Brasil, and most utilized in crosses, are nowadays the following: Anna, Brasil, Dulcina, Ein Shemer, Gala, Rainha, Valinhense, IAC 170-1 and IAC 570-38. These cultivars presented more than 50 thousand pollen grains per one flower. The germination index observed (also an indicator of pollen viability was higher than 50 percent in great number of materials, indicating that the pollen of the apple plant, well prepared, can be stored in a cold and dry environment (a desiccator at -1ºC during a period of about 70 days.

  16. Effect of a period of aquatic exercise therapy on the quality of life, anxiety and depression in patients with hemophilia

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    Mehdi Kargarfard

    2011-07-01

    Full Text Available Introduction: Muscle-Skeletal disorders are the most common problems in hemophilia patients that can affect the quality of life and psychological factors in these patients. The aim of this study was to evaluate the effect of a period of aquatic exercise therapy on the quality of life, depression and anxiety in hemophilia patients. Materials and Methods: In a semi-experimental study, 20 patients who referred to Isfahan Sayedo-Shohada hospital voluntarily were selected and then randomly in two experimental (n=10 and control (n=10 groups. Subjects of aquatic exercise therapy group started their activity in water for 8 weeks, 3 sessions per week about45 to 60 minutes, while the control group was only followed-up and during this period they did not experience any exercise. The quality of life, depression and anxiety variables of patients were measured by standard questionnaires in the beginning and end of eight week aquatic exercise therapy. Results: The results showed significant improvement in quality of life, depression and anxiety variables in aquatic exercise therapy group patients, compared with the control group after 8 week aquatic exercise therapy (p<0.05. Conclusion: Results of this study showed that aquatic exercise therapy can be used as an effective and helpful method to prevent and treat hemophilia patients because it leads to improve multi-dimensional variable quality of life, depression and anxiety in hemophilia patients .

  17. Benefits of oral administration of an electrolyte solution interrupting a prolonged preoperatory fasting period in pediatric patients.

    Science.gov (United States)

    Moyao-García, D; Corrales-Fernández, M A; Blanco-Rodríguez, G; Sánchez-Hernández, E; Nava-Ocampo, A A

    2001-03-01

    The aim of this study was to evaluate the benefits of an oral isosmolar solution of electrolytes (ISE) administered to interrupt a prolonged fasting period in children undergoing an elective surgical procedure under general anesthesia. Forty unpremedicated children aged 3 to 12 years, ASA I, undergoing a surgical procedure requiring general anesthesia were assigned randomly to 1 of 2 groups. Group 1 consisted of patients with an overnight fasting period for milk and solids of at least 8 hours. In group 2, patients under a similar fasting period received a volume of 4 mL/kg of an oral ISE 3 hours before completing the fasting period. After anesthetic induction, blood glucose level (BGL) was quantified, and patients underwent an endoscopic examination to obtain the gastric content to determine the residual gastric volume (RGV) and pH levels. In group 1, the RGV was 0.78 +/- 0.44 mL/kg, pH was 1.75 +/- 0.38, and BGL was 86.4 +/- 14.5. In group 2, the RGV was 0.40 +/- 0.29 mL/kg, pH was 3.18 +/- 0.61, and BGL was 85.1 +/- 12.6. Only RGV and pH were significantly different between groups. A prolonged fasting period interrupted with oral ISE administration resulted in an RGV of low risk, without counterbalancing a potential fasting-induced hypoglycemia.

  18. Morbidity and mortality in the antiphospholipid syndrome during a 5-year period: a multicentre prospective study of 1000 patients

    DEFF Research Database (Denmark)

    Cervera, R; Khamashta, M A; Shoenfeld, Y

    2008-01-01

    OBJECTIVES: To identify the main causes of morbidity and mortality in patients with antiphospholipid syndrome (APS) during a 5-year period and to determine clinical and immunological parameters with prognostic significance. METHODS: The clinical and immunological features of a cohort of 1000 pati...

  19. Decreasing incidence of foot ulcer among patients with type 1 and type 2 diabetes in the period 2001-2014

    DEFF Research Database (Denmark)

    Rasmussen, A.; Almdal, T.; Nielsen, A. Anker

    2017-01-01

    Aim: Diabetic foot ulcer (DFU) is a serious complication to diabetes. The aim was to study the incidence of first DFU among patients with type 1 (T1DM) and type 2 diabetes (T2DM), stratified according to etiology: neuropathic, neuro-ischemic or ischemic, over a period of 14 years (2001–2014). Met...

  20. Computer Vision Syndrome in Eleven to Eighteen-Year-Old Students in Qazvin

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    Khalaj

    2015-08-01

    Full Text Available Background Prolonged use of computers can lead to complications such as eye strain, eye and head aches, double and blurred vision, tired eyes, irritation, burning and itching eyes, eye redness, light sensitivity, dry eyes, muscle strains, and other problems. Objectives The aim of the present study was to evaluate visual problems and major symptoms, and their associations among computer users, aged between 11 and 18 years old, residing in the Qazvin city of Iran, during year 2010. Patients and Methods This cross-sectional study was done on 642 secondary to pre university students who had referred to the eye clinic of Buali hospital of Qazvin during year 2013. A questionnaire consisting of demographic information and 26 questions on visual effects of the computer was used to gather information. Participants answered all questions and then underwent complete eye examinations and in some cases cycloplegic refraction. Visual acuity (VA was measured with a logMAR in six meters. Refraction errors were determined using an auto refractometer (Potece and Heine retinoscope. The collected data was then analyzed using the SPSS statistical software. Results The results of this study indicated that 63.86% of the subjects had refractive errors. Refractive errors were significantly different in children of different genders (P < 0.05. The most common complaints associated with the continuous use of computers were eyestrain, eye pain, eye redness, headache, and blurred vision. The most prevalent (81.8% eye-related problem in computer users was eyestrain and the least prevalent was dry eyes (7.84%. In order to reduce computer related problems 54.2% of the participants suggested taking enough rest, 37.9% recommended use of computers only for necessary tasks, while 24.4% and 19.1% suggested the use of monitor shields and proper working distance, respectively. Conclusions Our findings revealed that using computers for prolonged periods of time can lead to eye

  1. [Possibilities of magnetic-laser therapy in comprehensive treatment of patients with brain concussion in acute period].

    Science.gov (United States)

    Zubkova, O V; Samosiuk, I Z; Polishchuk, O V; Shul'ga, N M; Samosiuk, N I

    2012-01-01

    The efficacy of magnetic-laser therapy used according to the method developed by us was studied in patients having the brain concussion (BC) in an acute period. The study was based on the dynamics of values of the evoked vestibular potentials and the disease clinical course. It was shown that following the magnetic-laser therapy in combination with traditional pharmacotherapy in BC acute period, the statistically significant positive changes were registered in the quantitative characteristics of the evoked vestibular brain potentials that correlated with the dynamics of the disease clinical course. The data obtained substantiate the possibility of using the magnetic-laser therapy in patients with a mild craniocereblal injury in an acute period.

  2. Aetiology of low Vision Amongst Patients Attending the Eye Clinic of ...

    African Journals Online (AJOL)

    A prospective clinic based study involving 66 patients of both sexes and ages between 3 and 87yr seen at the newly established low vision clinic of the Aminu Kano Teaching Hospital, Kano, Nigeria over an eighteen-month period (March 2007-September 2008) was undertaken. The objective was to assess the causes of ...

  3. Efficiency of insulin analogs in young patients with type 1 diabetes mellitus debut during pubertal period

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    Lyubov' Leonidovna Bolotskaya

    2009-09-01

    Full Text Available Aim. To identify factors responsible for the early development of microvascular complications in patients with type 1 diabetes mellitus (DM1and to evaluate dependence of their prevalence on the type of insulin. Materials and methods. The study carried out from May 2002 to November 2007 included a random sample of patients with DM1 over 10 years in duration(n=5895, 100%, >=20 years from the Central, Volga, Ural, Siberian, North-West and Southern federal districts. All patients underwentexamination of eye fundus and feet, measurement of microalbuminuria, creatinine, urea, serum lipid spectrum and HbА1с. Results. Mean HbА1с level in patients of group 1 (using insulin analogs was significantly lower than in group 2 (using homan insulin (Me 8,5?0,2%;9,7?0,4% SD* respectively p>0,01. Mean daily insulin dose in group 1 and 2 was >1,0 and

  4. Dynamic of oxidative and nitrosative stress markers during the convalescent period of stroke patients undergoing rehabilitation.

    Science.gov (United States)

    Manolescu, Bogdan Nicolae; Berteanu, M; Oprea, E; Chiriac, N; Dumitru, L; Vladoiu, S; Popa, O; Ianas, O

    2011-07-01

    Stroke patients have a redox imbalance, a consequence of both the cerebrovascular event and the associated pathological conditions. Our study was aimed to investigate the dynamic of some oxidative and nitrosative markers during the convalescent phase of postacute stroke patients undergoing rehabilitation. We assessed thiol, advanced oxidation protein product, protein carbonyl, 3-nitro-l-tyrosine, ceruloplasmin and oxidized LDL concentrations, as well as gamma-glutamyltranspeptidase (GGT) activity in 20 patients at the beginning of the hospitalization and at the discharge moment, respectively, and 24 apparently healthy controls. We found significantly increased values for GGT (P = 0.04), ceruloplasmin (P = 0.01) and protein carbonyl (P = 0.04) in stroke patients at the hospitalization moment when compared with healthy controls, while total thiols were significantly decreased (P = 0.002). Rehabilitation was associated with a significant decrease of protein carbonyl (P = 0.03) and oxidized LDL particle concentrations (P = 0.03), as well as GGT activity (P = 0.02). At the hospitalization moment, both GGT and ceruloplasmin were significantly negatively correlated with non-proteic thiols (r = -0.44, P = 0.049, and r = -0.53, P = 0.015, respectively) and significantly positively with protein carbonyls (r = +0.80, P stroke patients, and the possible benefits of an antioxidant-based therapy for the recovery of these patients.

  5. Improving the Quality of Care for Patients Diagnosed With Glioma During the Perioperative Period

    Science.gov (United States)

    Riblet, Natalie B.V.; Schlosser, Evelyn M.; Homa, Karen; Snide, Jennifer A.; Jarvis, Lesley A.; Simmons, Nathan E.; Sargent, David H.; Mason, Linda P.; Cooney, Tobi J.; Kennedy, Nancy L.; Fadul, Camilo E.

    2014-01-01

    Purpose: Although there is agreement on the oncologic management of patients with glioma, few guidelines exist to standardize other aspects of care, including supportive care. Methods: A quality improvement (QI) project was chartered to improve the care provided to patients with glioma. A multidisciplinary team was convened and identified 10 best-practice measures. Using a plan-do-study-act framework, the team brainstormed and implemented various improvement interventions between June 2011 and October 2012. Statistical process control charts were used to evaluate progress. A dashboard of quality measures was generated to allow for ongoing measurement and reporting. Results: The retrospective assessment phase consisted of 43 patients with diagnosis of glioma. A manual medical record review for these patients showed that compliance with 10 best-practice measures ranged from 23% to 100%. Several factors contributed to less-than-ideal process performance, including poor communication among disciplines and lack of familiarity with the larger system of care. After implementing improvement interventions, performance was measured in 96 consecutive patients with glioma. The proportion of patients who met criteria for 10 practice measures significantly improved (pre-QI work, 63%; post-QI work, 85%; P = .003). The largest improvement was observed in the measure assessing for preoperative notification of the neuro-oncology program (pre-QI work, 39%; post-QI work, 97%; P sustaining process improvements. PMID:25294392

  6. [Nursing care in perioperative period in patients with intenstinal stomia exposure].

    Science.gov (United States)

    Szewczyk, Joanna; Bajon, Anna

    2009-05-01

    Despite of enormous advance in minimally invasive surgery which is almost scarless nowadays, there is still very important emotional issue for patients connected with each surgical procedure. One of the most stressful surgical procedures for patients is the one which ends up with stomia exposure. The main objective of this article is to point out very the important factor which leads to decrease the number of complications, speeds up recovery and acceptation of the stomia by patients. This factor is known as a professional nursing care. It consists of physical and psychical preoperative preparation and postoperative care for patients. Special care in early postoperative 24h is crucial for preventing from development of any complications. That is why the nursing personnel is obliged to monitor vital signs very carefully. Complex preparation and postoperative care leads to diminish significantly the number of complications, facilitates cooperation with patients and also influences the increase of sense of safety and trust to medical personnel. Patients with stomia who were under professional nursing staff supervision achieve full recovery and higher quality of life considerably earlier.

  7. Effect of lifestyle on asthma control in Japanese patients: importance of periodical exercise and raw vegetable diet.

    Science.gov (United States)

    Iikura, Motoyasu; Yi, Siyan; Ichimura, Yasunori; Hori, Ai; Izumi, Shinyu; Sugiyama, Haruhito; Kudo, Koichiro; Mizoue, Tetsuya; Kobayashi, Nobuyuki

    2013-01-01

    The avoidance of inhaled allergens or tobacco smoke has been known to have favorable effects on asthma control. However, it remains unclear whether other lifestyle-related factors are also related to asthma control. Therefore, a comprehensive study to examine the associations between various lifestyle factors and asthma control was conducted in Japanese asthmatic patients. The study subjects included 437 stable asthmatic patients recruited from our outpatient clinic over a one-year period. A written, informed consent was obtained from each participant. Asthma control was assessed using the asthma control test (ACT), and a structured questionnaire was administered to obtain information regarding lifestyle factors, including tobacco smoking, alcohol drinking, physical exercise, and diet. Both bivariate and multivariate analyses were conducted. The proportions of total control (ACT = 25), well controlled (ACT = 20-24), and poorly controlled (ACT smoking status and alcohol drinking were not associated with asthma control. On the other hand, younger age (smoking, periodical exercise (> 3 metabolic equivalents-h/week), and raw vegetable intake (> 5 units/week) were significantly associated with good asthma control by bivariate analysis. Younger age, periodical exercise, and raw vegetable intake were significantly associated with good asthma control by multiple linear regression analysis. Periodical exercise and raw vegetable intake are associated with good asthma control in Japanese patients.

  8. Eighteen microsatellite loci in Salix arbutifolia (Salicaceae) and cross-species amplification in Salix and Populus species.

    Science.gov (United States)

    Hoshikawa, Takeshi; Kikuchi, Satoshi; Nagamitsu, Teruyoshi; Tomaru, Nobuhiro

    2009-07-01

    Salix arbutifolia is a riparian dioecious tree species that is of conservation concern in Japan because of its highly restricted distribution. Eighteen polymorphic loci of dinucleotide microsatellites were isolated and characterized. Among these, estimates of the expected heterozygosity ranged from 0.350 to 0.879. Cross-species amplification was successful at 9-13 loci among six Salix species and at three loci in one Populus species. © 2009 Blackwell Publishing Ltd.

  9. Increased arterial stiffness parameters in panic disorder patients in long term treatment period.

    Science.gov (United States)

    Yanartas, Omer; Sunbul, Murat; Senkal, Zeynep; Durmus, Erdal; Kivrak, Tarik; Subasi, Nilufer; Karaer, Gulhan; Ergun, Serhat; Sari, Ibrahim; Sayar, Kemal

    2016-01-01

    The relationship between mental stress and cardiovascular disease has been shown in several studies. Panic disorder (PD) is also associated with cardiovascular disease due to increased risk of myocardial infarction. The aim of this study is to evaluate the association between arterial stiffness parameters and depression/anxiety scores in patients with PD. The study population consisted of 25 patients with PD and 25 age-sex-matched healthy controls. Depression and anxiety levels were evaluated by Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI), respectively. Determination of arterial stiffness parameters was conducted using a Mobil-O-Graph arteriograph system that detected signals from the brachial artery. While baseline characteristics were similar between two groups, BDI and BAI scores were significantly higher in patients with PD (p < 0.005). The pulse wave velocity (PWV) and Augmentation Index (AIx) were also significantly higher in patients with PD (p = 0.001, p = 0.006). There was a moderate correlation between PWV and AIx with BAI scores (r = 0.442, p = 0.001, r = 0.441, p = 0.001). AIx was also positively correlated with BDI scores (r = 0.415, p = 0.03). We demonstrated a significant relationship between arterial stiffness parameters and anxiety/depression scores in patients with PD who receive antidepressant treatment.

  10. Patterns of hospital admission with epistaxis for 26,725 patients over an 18-year period in Wales, UK

    Science.gov (United States)

    Fishpool, SJC; Tomkinson, A

    2012-01-01

    INTRODUCTION Epistaxis is the one of the most common otorhinolaryngology emergencies. This study examined the age and sex distribution of all patients admitted with epistaxis to National Health Service (NHS) hospitals in Wales, UK, over a period of 18 years and 9 months. METHODS The Patient Episode Database for Wales was examined for all patient admissions with a diagnosis of epistaxis between April 1991 and December 2009. The age and sex of these patients was recorded and the proportion of the underlying population affected was calculated by comparing admission rates to the population data derived from the 1991 and 2001 national population censuses for Wales. RESULTS A total of 26,725 patients were admitted to NHS hospitals in Wales with epistaxis over the period studied. The proportion of the population admitted with epistaxis increased from the age of 40 onwards. For all ages except patients in the 10–14 years group, a higher proportion of the male population was admitted with epistaxis than the comparable female population. This discrepancy was most pronounced between the ages of 15 and 49 years, with the female-to-male ratio of hospital admissions with epistaxis being 0.55. These ages (15 and 49 years) approximate the average age of menarche and menopause respectively in the UK. CONCLUSIONS Women of menstrual age have fewer hospital admissions with epistaxis. This may be due to oestrogens providing protection to the nasal vasculature (as they do to other areas of the vascular tree). PMID:23131225

  11. Effects of Orthostatism and Hemodialysis on Mean Heart Period and Fractal Heart Rate Properties of Chronic Renal Failure Patients.

    Science.gov (United States)

    Echeverría, Juan C; Infante, Oscar; Pérez-Grovas, Héctor; González, Hortensia; José, Marco V; Lerma, Claudia

    2017-11-01

    The aim of this work was to evaluate the short-term fractal index (α 1 ) of heart rate variability (HRV) in chronic renal failure (CRF) patients by identifying the effects of orthostatism and hemodialysis (HD), and by evaluating the correlation between α 1 and the mean RR interval from sinus beats (meanNN). HRV time series were derived from ECG data of 19 CRF patients and 20 age-matched healthy subjects obtained at supine and orthostatic positions (lasting 5 min each). Data from CRF patients were collected before and after HD. α 1 was calculated from each time series and compared by analysis of variance. Pearson's correlations between meanNN and α 1 were calculated using the data from both positions by considering three groups: healthy subjects, CRF before HD and CRF after HD. At supine position, α 1 of CRF patients after HD (1.17 ± 0.30) was larger (P renal disease condition in itself. In conclusion, as in healthy subjects, α 1 of CRF patients correlates with meanNN after HD (indicating a more irregular-like HRV behavior at slower heart rates). This suggests that CRF patients with stable blood pressure preserve a regulatory adaptability despite a shifted setting point of the heart period (i.e., higher heart rate) in comparison with healthy subjects. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  12. [Intensity of negative symptoms, working memory and executive functions disturbances in schizophrenic patients in partial remission period].

    Science.gov (United States)

    Hintze, Beata; Borkowska, Alina

    2011-01-01

    The aim of the study was to assess the correlation between the level of working memory and executive functions impairment in schizophrenic subjects in their partial remission period and the intensity of psychopathological symptoms measured by PANSS scale. 45 patients with schizophrenia were included in the study (28 male and 17 female), aged 18-46 (mean 27 +/- 7) years during partial remission of psychopathological symptoms (PANSS partial remission period, the significant dysfunctions of working memory and executive functions show association with negative (not positive) schizophrenic symptoms.

  13. The Presence of Periodic Limb Movement Disorder in a Patient with Diabetes Mellitus and Optic Atrophy (Wolfram Syndrome

    Directory of Open Access Journals (Sweden)

    Bo Seong Kwon

    2014-12-01

    Full Text Available Wolfram syndrome (WFS is characterized by diabetes insipidus, diabetes mellitus, optic atrophy, and deafness (DIDMOAD, together known as DIDMOAD. This syndrome is a rare autosomal recessive neurodegenerative disorder and typically begins wtih insulin-dependent diabetes mellitus. Periodic limb movement disorder (PLMD is characterized by periodic episodes of repetitive, highly stereotyped, limb movement during sleep, which results in disturbed sleep. Its pathophysiology is unclear. It is associated with many conditions, but we were unable to find a previous report regarding WFS accompanied by PLMD. We therefore report, for the first time, about a patient with WFS presenting with PLMD and discuss its pathomechanism with a literature review.

  14. Quality of life of patients with haemoglobinopathies in periods of economic austerity

    Directory of Open Access Journals (Sweden)

    Maria Tsironi

    2014-12-01

    Full Text Available The concept of quality of life (QoL encompasses a broad spectrum of meaning that is variously influenced by individual, natural and psychological conditions. The chronic diseases deteriorate patients physical health and their health related quality of life.

  15. Intestinal stoma in patients with colorectal cancer from the perspective of 20-year period of clinical observation.

    Science.gov (United States)

    Banaszkiewicz, Zbigniew; Woda, Łukasz P; Zwoliński, Tomasz; Tojek, Krzysztof; Jarmocik, Paweł; Jawień, Arkadiusz

    2015-01-01

    Intestinal stoma is a procedure most often performed in patients with colorectal cancer. To identify the percentage of patients with colorectal cancer in which the intestinal stoma was performed. We retrospectively analysed 443 patients treated during a 20-year period (1994-2013) due to colorectal cancer, in which the intestinal stoma was made during the first surgical intervention. In the second analysed decade, a significant decrease in the percentage of created stomas, definitive stomas in particular, was observed. Stomas were made significantly more often in patients with a tumour located in the rectum, the left half of the colon, and in patients undergoing urgent surgeries. An increased incidence of intestinal stomas was associated with a higher severity of illness and higher proportion of unresectable and non-radical procedures. The definitive stomas were significantly more often made in men and in patients with tumours located in the rectum, whereas temporary stomas were created significantly more often in patients undergoing urgent operations. In the last decade (2004-2013) the number of intestinal stomas in patients operated due to colorectal cancer was significantly reduced.

  16. The comparative characteristic of extra- and intracranial hemodynamics in patients with traumatic brain injury in the long-term period

    Directory of Open Access Journals (Sweden)

    Shkolnyk V.M.

    2017-04-01

    Full Text Available Traumatic brain injury (TBI remains an actual problem of modern medicine, as well as of economic and social sectors. Vascular factor plays a leading role in forming of the clinical presentation of the disease in the long-term period of TBI. The aim of the study was to clarify the characteristics of hemodynamic changes at different levels of cerebral blood supply (main extra- and intracranial arteries and level of cerebral vessels depending on the severity of TBI. We examined 100 patients in the long-term period of mild, moderate and severe TBI. All patients underwent rheoencephalography, ultrasound duplex scanning of the main arteries of the head and neck with transcranial dopplerography and functional test with visual load. Extracranial vascular changes in the long-term period of TBI are characterized by significant increase of carotid intima-media thickness and the diameters of right internal carotid artery and left internal carotid artery together with the severity of TBI. The qualitative analysis of linear blood flow velocity reveals the decrease in the number of patients with a compensatory reaction in the form of its acceleration in the middle cerebral artery with increasing TBI severity but the number of patients with reduced linear blood flow velocity increases. Abnormal autoregulation of the cerebral circulation and reduction of vascular reactivity was established in the majority of patients of all groups. In addition, the incidence of vascular disturbances increased from 1st to 3rd group. According to the results of rheoencephalography, we detected prevailing spastic changes of the curve in all groups of patients. The degree of disturbances manifestations increases with the severity of TBI.

  17. Negative and positive childhood experiences across developmental periods in psychiatric patients with different diagnoses – an explorative study

    Directory of Open Access Journals (Sweden)

    Schauer Margarete

    2004-11-01

    Full Text Available Abstract Background A high frequency of childhood abuse has often been reported in adult psychiatric patients. The present survey explores the relationship between psychiatric diagnoses and positive and negative life events during childhood and adulthood in psychiatric samples. Methods A total of 192 patients with diagnoses of alcohol-related disorders (n = 45, schizophrenic disorders (n = 52, affective disorders (n = 54, and personality disorders (n = 41 completed a 42-item self-rating scale (Traumatic Antecedents Questionnaire, TAQ. The TAQ assesses personal positive experiences (competence and safety and negative experiences (neglect, separation, secrets, emotional, physical and sexual abuse, trauma witnessing, other traumas, and alcohol and drugs abuse during four developmental periods, beginning from early childhood to adulthood. Patients were recruited from four Psychiatric hospitals in Germany, Switzerland, and Romania; 63 subjects without any history of mental illness served as controls. Results The amount of positive experiences did not differ significantly among groups, except for safety scores that were lower in patients with personality disorders as compared to the other groups. On the other side, negative experiences appeared more frequently in patients than in controls. Emotional neglect and abuse were reported in patients more frequently than physical and sexual abuse, with negative experiences encountered more often in late childhood and adolescence than in early childhood. The patients with alcohol-related and personality disorders reported more negative events than the ones with schizophrenic and affective disorders. Conclusions The present findings add evidence to the relationship between retrospectively reported childhood experiences and psychiatric diagnoses, and emphasize the fact that a emotional neglect and abuse are the most prominent negative experiences, b adolescence is a more 'sensitive' period for negative

  18. A Retrospective Audit of Dental Treatment Provided to Special Needs Patients under General Anesthesia During a Ten-Year Period.

    Science.gov (United States)

    Mallineni, Sreekanth Kumar; Yiu, Cynthia Kar Y

    The purpose of this study was to perform a comprehensive audit of dental treatment provided to special needs patients (SNP) under general anesthesia (GA) over a ten-year period. Special needs patients who received dental treatment under GA as an in-patient at Queen Mary Hospital, Hong Kong SAR during the time period January 2002 and December 2011 were included in the study. The study population was divided into three groups, based on age (12 years). One-way ANOVA was used to evaluate the effect of "age group" on duration of treatment, post-recovery time, treatment procedures and utilization of different restorative materials. Kappa statistics were used for intra-examiner reliability. A total of 275 patients (174 males and 101 females) were included in the study. The mean age of the patients at the time they received GA was 12.37±10.18 years. Dental procedures performed were mostly restorative in nature (47%). The >12 years group had significantly shorter treatment duration (pdifference in post-operative recovery time was observed among the three age groups (p>0.05). The group received significantly less preventive, but more restorative procedures (pgroup (puse of composite restorations was significantly higher in the group; while amalgam restorations were more frequently used in the >12 years group (Page (page, had longer treatment time under GA. Composite restorations and stainless steel crowns were more frequently used in the primary dentition and amalgam restorations were more frequently employed in the permanent dentition.

  19. Choroidal Thickness Changes in the Acute Attack Period in Patients with Familial Mediterranean Fever.

    Science.gov (United States)

    Gundogan, Fatih C; Akay, Fahrettin; Uzun, Salih; Ozge, Gokhan; Toyran, Sami; Genç, Halil

    2016-01-01

    The aim of this study was to evaluate choroidal thickness changes during acute attacks of familial Mediterranean fever (FMF). Fifty patients with FMF and 50 healthy controls were included. Choroidal thickness of each participant was measured at the foveola and horizontal nasal and temporal quadrants at 500-µm intervals to 1,500 µm from the foveola using spectral-domain optical coherence tomography. White blood cell count, erythrocyte sedimentation rate (ESR) and serum levels of fibrinogen and C-reactive protein (CRP) were evaluated. The clinical findings (peritonitis, arthritis and pleuritis) were noted. Choroidal thickness was significantly thicker at all measurement points in FMF patients compared to healthy controls during an acute attack (p 0.05). Increased choroidal thickness in the acute phase of FMF is possibly related to the inflammatory edematous changes in the choroid. © 2015 S. Karger AG, Basel.

  20. Mitral restenosis in the early postoperative period of a patient with systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    Pomerantzeff Pablo Maria Alberto

    1999-01-01

    Full Text Available A forty eight year old woman, who had undergone mitral comissurotomy and subsequently developed early restenosis, presented with major comissural fusion and verrucous lesions on the cuspid edges of the mitral valve, with normal subvalvar apparatus. Patient did well for the first six months after surgery when she began to present dyspnea on light exertion. A clinical diagnosis of restenosis was made, which was confirmed by an echocardiogram and cardiac catheterization. She underwent surgery, and a stenotic mitral valve with verrucous lesions suggesting Libman-Sacks' endocarditis was found. Because the diagnosis of systemic lupus erythematosus (SLE had not been confirmed at that time, a bovine pericardium bioprosthesis (FISICS-INCOR was implanted. The patient did well in the late follow-up and is now in NYHA Class I .

  1. Mitral restenosis in the early postoperative period of a patient with systemic lupus erythematosus.

    Science.gov (United States)

    Pomerantzeff, P M; Corrêa, J D; Brandão, C M; de Assis, R V; Jatene, A D

    1999-04-01

    A forty-eight year old woman, who had undergone mitral comissurotomy and subsequently developed early restenosis, presented with major comissural fusion and verrucous lesions on the cuspid edges of the mitral valve, with normal subvalvar apparatus. Patient did well for the first six months after surgery when she began to present dyspnea on light exertion. A clinical diagnosis of restenosis was made, which was confirmed by an echocardiogram and cardiac catheterization. She underwent surgery, and a stenotic mitral valve with verrucous lesions suggesting Libman-Sacks' endocarditis was found. Because the diagnosis of systemic lupus erythematosus (SLE) had not been confirmed at that time, a bovine pericardium bioprosthesis (FISICS-INCOR) was implanted. The patient did well in the late follow-up and is now in NYHA Class I.

  2. [A Chinese patient with pernicious anemia; a medical experience from the Indonesian period].

    Science.gov (United States)

    Zuidema, P J

    1996-03-09

    On May 19th 1952 a 64-year-old Chinese man was admitted to a hospital at Yogyakarta (Indonesia) on account of a sawing noise in both ears and some soreness of the tongue. He had macrocytic anemia (haemoglobin: 3.7 mmol/l) and the tongue showed some smooth patches. A presumptive diagnosis of pernicious anaemia was confirmed by gastric analysis which revealed a histamine fast achlorhydria. On treatment with vitamin B12 the noise in the ears rapidly disappeared and there was a characteristic rise in reticulocytes and haemoglobin content. After 3 years the patient died of inoperable gastric carcinoma. There probably was a hereditary component as in a 54-year-old cousin, who also suffered (and died) from gastric carcinoma, gastric analysis showed a histamine fast achlorhydria. The patient is the first case of pernicious anaemia described in a Chinese resident of Indonesia. A survey of the literature revealed that until now pernicious anaemia has been recorded in 31 Chinese patients, in chronological order from the following countries: U.S (1945), Indonesia (1954), Singapore (1967), Hong-Kong (1969) and China (1990). In the autochthonous Chinese population no case has yet been reported.

  3. Evaluation of long-term patient satisfaction and experience with the Baha(®) bone conduction implant

    DEFF Research Database (Denmark)

    Rasmussen, Jacob; Olsen, Steen Østergaard; Nielsen, Lars Holme

    2012-01-01

    Objective: Evaluate long-term patient satisfaction with bone-anchored hearing aids (the Baha(R), now referred to by Cochlear as a 'bone conduction implant') in our hospital clinic spanning the eighteen-year period from the inception of our Baha program. The researchers further wished to analyse t...

  4. Recurrent bleeding after arterial embolization in patients with hemoptysis : Comparison of angiographic findings and relapsing period

    International Nuclear Information System (INIS)

    Park, Sung Keun; Choi, Seok Jin; Choi, Gi Bok; Kim, Hae Yeon; Park, Auh Whan; Juhn, Jae Ryang; Cha, Seong Sook

    2001-01-01

    To describe the angiographic findings of patients with recurrent hemoptysis after bronchial artery embolization (BAE) according to the point at which relapse occurred. From 125 patients who underwent BAE due to hemoptysis between 1996 and 2000, we selected 18 of 23 who underwent additional BAE due to recurrent bleeding after initial BAE. Depending on the point at which relapse occurred, they were divided into two groups (I and ll, according to whether additional BAE was performed within two weeks of initial BAE or more than two weeks after this) We retrospectively compared the two groups in terms of angiographic findings, number of embolized arteries, and character of feeding arteries at initial and additional BAE. Nine patients in group I (additional BAE: n=10) and nine in group ll (additional BAE: n=13) were admitted for recurrent hemoptysis within two weeks of initial BAE and more than two weeks after this, respectively. In group I (n=29) and ll(n=31), angiography demonstrated two direct and 27 indirect, and two direct and 29 indirect signs of hemorrhage, respectiveIy. No statistically significant differences were observed (x 2 =0.005, ρ=0.945). Among the embolized feeder ressels in group I (n=30) there were 20 bronchial artery and 10 non bronchial systemic collaterals, while for group ll (n=35), the corresponding totals were 21 and 14. Again, no statistically significant differences were encountered(x 2 =0.308; ρ=0.579). In group I, feeders were newly developed in one case(10%), previously embolized in five(50%), and missed in four(40%), while in group two the corresponding figures were none, twelve(92.3%), and one(7.7%) No significant differences were noted, though the incidence of previously embolized feeders in Group ll was very high (x 2 =5.383, ρ=0.068). Among patients in whom hemoptysis after BAE recurred at different times, the angiographic findings and number of embolized arteries were not significantly different, but differences in the nature of the

  5. Effect of lifestyle on asthma control in Japanese patients: importance of periodical exercise and raw vegetable diet.

    Directory of Open Access Journals (Sweden)

    Motoyasu Iikura

    Full Text Available BACKGROUND: The avoidance of inhaled allergens or tobacco smoke has been known to have favorable effects on asthma control. However, it remains unclear whether other lifestyle-related factors are also related to asthma control. Therefore, a comprehensive study to examine the associations between various lifestyle factors and asthma control was conducted in Japanese asthmatic patients. METHODS: The study subjects included 437 stable asthmatic patients recruited from our outpatient clinic over a one-year period. A written, informed consent was obtained from each participant. Asthma control was assessed using the asthma control test (ACT, and a structured questionnaire was administered to obtain information regarding lifestyle factors, including tobacco smoking, alcohol drinking, physical exercise, and diet. Both bivariate and multivariate analyses were conducted. RESULTS: The proportions of total control (ACT = 25, well controlled (ACT = 20-24, and poorly controlled (ACT 3 metabolic equivalents-h/week, and raw vegetable intake (> 5 units/week were significantly associated with good asthma control by bivariate analysis. Younger age, periodical exercise, and raw vegetable intake were significantly associated with good asthma control by multiple linear regression analysis. CONCLUSIONS: Periodical exercise and raw vegetable intake are associated with good asthma control in Japanese patients.

  6. The declined levels of inflammatory cytokines related with weaning rate during period of septic patients using ventilators.

    Science.gov (United States)

    Yang, Chao-Huei; Hsiao, Jung-Lung; Wu, Ming-Feng; Lu, Mei-Hua; Chang, Hui-Ming; Ko, Wang-Sheng; Chiou, Ya-Ling

    2018-02-01

    Approximately 50% of patients with sepsis-induced acute lung injury and acute respiratory distress syndrome require mechanical ventilation. Patients with extended mechanical ventilator use routinely develop reinfections, which increases hospital stay, mortality, and health care cost. Some studies have pointed out inflammatory factors concentrations can affect ventilator weaning, but do not indicate changed inflammatory factors related to ventilator weaning during using ventilators. This study aimed to investigate during period of septic patients using ventilators, the inflammatory cytokines concentrations related with weaning rate. Blood was collected from 35 septic patients before and during ventilator use on days 1, 7, 14, and 21 (or weaning). 58.3% (N = 20) of septic patients with mechanical ventilators were weaned successfully within 21 days (ventilator weaned group, VW), 16.7% (N = 6) did not wean within 21 days (ventilator dependent group, VD), and 25% died (death group) in hospital. Before ventilator use, higher C-reactive protein (CRP), IL-6, and IL-8 levels were measured in the death group than in all other groups (P ventilator use, CRP, IL-6, and IL-8 concentrations declined significantly in VW and VD patients (P ventilators weaning successfully such as disease control, nutritional status, and so on. The declined levels of serum inflammatory cytokines, especially IL-6, improved inflammation status might be one factor of successfully weaning during septic patients on ventilators. © 2016 John Wiley & Sons Ltd.

  7. Morbidity and mortality in the antiphospholipid syndrome during a 10-year period: a multicentre prospective study of 1000 patients.

    Science.gov (United States)

    Cervera, R; Serrano, R; Pons-Estel, G J; Ceberio-Hualde, L; Shoenfeld, Y; de Ramón, E; Buonaiuto, V; Jacobsen, S; Zeher, M M; Tarr, T; Tincani, A; Taglietti, M; Theodossiades, G; Nomikou, E; Galeazzi, M; Bellisai, F; Meroni, P L; Derksen, R H W M; de Groot, P G D; Baleva, M; Mosca, M; Bombardieri, S; Houssiau, F; Gris, J-C; Quéré, I; Hachulla, E; Vasconcelos, C; Fernández-Nebro, A; Haro, M; Amoura, Z; Miyara, M; Tektonidou, M; Espinosa, G; Bertolaccini, M L; Khamashta, M A

    2015-06-01

    To assess the prevalence of the main causes of morbi-mortality in the antiphospholipid syndrome (APS) during a 10-year-follow-up period and to compare the frequency of early manifestations with those that appeared later. In 1999, we started an observational study of 1000 APS patients from 13 European countries. All had medical histories documented when entered into the study and were followed prospectively during the ensuing 10 years. 53.1% of the patients had primary APS, 36.2% had APS associated with systemic lupus erythematosus and 10.7% APS associated with other diseases. Thrombotic events appeared in 166 (16.6%) patients during the first 5-year period and in 115 (14.4%) during the second 5-year period. The most common events were strokes, transient ischaemic attacks, deep vein thromboses and pulmonary embolism. 127 (15.5%) women became pregnant (188 pregnancies) and 72.9% of pregnancies succeeded in having one or more live births. The most common obstetric complication was early pregnancy loss (16.5% of the pregnancies). Intrauterine growth restriction (26.3% of the total live births) and prematurity (48.2%) were the most frequent fetal morbidities. 93 (9.3%) patients died and the most frequent causes of death were severe thrombosis (36.5%) and infections (26.9%). Nine (0.9%) cases of catastrophic APS occurred and 5 (55.6%) of them died. The survival probability at 10 years was 90.7%. Patients with APS still develop significant morbidity and mortality despite current treatment. It is imperative to increase the efforts in determining optimal prognostic markers and therapeutic measures to prevent these complications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. The effect of the apneic period on the respiratory physiology of patients undergoing intubation in the ED.

    Science.gov (United States)

    West, Jason R; Scoccimarro, Anthony; Kramer, Cody; Caputo, Nicholas D

    2017-09-01

    We sought to examine the physiological impact the apneic period has on the respiratory physiology of patients undergoing intubation in the emergency department and whether DAO, the delivery of 15L oxygen by nasal cannula during apnea, can affect the development of respiratory acidosis. This was a prospective observational cohort study conducted at an urban academic level 1 trauma center. A convenience sample of 100 patients was taken. Timed data collection forms were completed during the periintubation period. We report the mean ABG and end-tidal CO2 (EtCO2) values between those with normal and prolonged apnea times (>60s) and between those who received DAO and those who did not. 100 patients met our inclusion criteria. There were no significant differences in the pre-RSI ABG values between those who received DAO and those who did not and between those with apnea times less than or >60s. Only in the group of patients with apnea times >60s did significant changes in respiratory physiology occur. DAO did not alter the trend in respiratory acidosis during the periintubation period. EtCO2 increased as apnea times were prolonged, and DAO altered this trend. Post-RSI EtCO2 increased as apnea times were prolonged. DAO may alter this trend. Statistically significant changes in pH and PaCO2 (mean differences of 0.15 and 12.5, respectively) occurred in the group of patients who had mean apnea times of >60s but not in those with apnea times <60s. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Monteggia fracture dislocation equivalents - analysis of eighteen cases treated by open reduction and internal fixation

    Directory of Open Access Journals (Sweden)

    Singh Ajay Pal

    2012-02-01

    Full Text Available 【Abstract】 Objective: Monteggia fracture dislocation equivalent, though already described by Bado, is still an unclassified entity. We aimed to retrospectively analyze 18 cases of Monteggia variants and discuss the injury mechanisms, management, and outcome along with a review of the literature. Methods: A retrospective record of Monteggia fracture dislocation (2003-2008 was reviewed from medical record department of our institute. Classic Monteggia fracture dislocation, children below 12 years or adults over 50 years, as well as open grade II & III cases were excluded from this study. Monteggia variant inclusion criteria included fracture of the proximal ulna together with a fracture of the radial head or neck and skeletal maturity. Totally 26 patients were identified with Monteggia variants and 18 were available for follow-up, including 11 males and 7 females with the mean age of 35 years. The ulna fracture was treated by compression plating along with tension band wiring. Radial head/neck was reconstructed in 12 patients while excised in 6 patients. Results: Follow-up ranged from 1-4 years, mean 2.6 years. Patients were assessed clinicoradiologically. Mayo Elbow Performance Score was employed to assess the outcomes. At final follow-up, the results were excellent in 10 patients, good in 4, fair in 2 and poor in 2. Mean range of motion of the elbow was 20°, 116°, 50° and 55° for extension, flexion, pronation and supination, respectively. Two patients had complications in the form of heterotopic ossification and stiffness of the elbow. One nonunion ulna, primarily treated by tension band wiring, was managed by refixation with locking reconstruction plate and bone grafting. Bone grafting was only required in this patient for nonunion. Another patient had implants removed on his request. The results in our series closely correlated with extent of intraarticular damage, coronoid fracture and comminuted fractures. Conclusions: Monteggia

  10. Eighteen cases of wheat allergy and wheat-dependent exercise-induced urticaria/anaphylaxis sensitized by hydrolyzed wheat protein in soap.

    Science.gov (United States)

    Kobayashi, Tomoko; Ito, Tomonobu; Kawakami, Hiroshi; Fuzishiro, Kanzan; Hirano, Hirofumi; Okubo, Yukari; Tsuboi, Ryoji

    2015-08-01

    Glupearl 19S, an acid-hydrolyzed wheat protein (HWP), is used widely in Japan as a moisturizing ingredient in facial soaps. Since 2010, there has been an increasing number of reports of contact urticaria and wheat allergy resulting from the use of products containing this substance. Sixty-one patients who had used HWP-containing facial soap visited our hospital. Thirty-five of these experienced urticaria or anaphylaxis after consuming wheat-containing food. Eighteen of the 35 patients tested positive to 0.01% Glupearl 19S solution. Wheat-specific IgE and serum gluten-specific IgE were higher in the patients with HWP allergy than in non-HWP allergy patients. Among the patients who tested positive to Glupearl 19S on the skin prick test, nine experienced HWP-wheat-dependent exercise-induced anaphylaxis, and four experienced food-dependent anaphylaxis. Moreover, four of these patients not only experienced food-dependent anaphylaxis but also a worsening of the symptoms during exercise. The clinical symptomology was so variable that the patients were classified into six groups. We found that patients with HWP allergy tended to manifest symptoms of both HWP-wheat-dependent exercise-induced anaphylaxis and contact urticaria. The etiology of hydrolyzed wheat protein allergy is unknown. Patients with a history of these symptoms need to be informed about the risk of consuming wheat-containing foods and the importance of excluding such items from their diet. © 2015 The International Society of Dermatology.

  11. Effect of different anesthesia methods on plasma neuropeptides levels during the peri-operative period in surgical patients with hypertension

    International Nuclear Information System (INIS)

    Li Hong; He Haomin; Tian Xiaoping

    2003-01-01

    Objective: To explore the effect of different anesthesia methods on the levels of plasma neuropeptides during the peri-operative period in patients with hypertension. Methods: Ninety hypertensive patients undergoing upper abdominal operations were randomly allocated to equal divided epidural anesthesia, general anesthesia and combined Groups. Plasma neuropeptide Y(NPY) concentrations were measured before anesthesia, at 15 min after anesthesia, 20 min after operation and 10 min after completion of the operation. Results: BP, HR and NPY were significantly changed in both E group and G group after anesthesia and operation (compared vs before anesthesia, p<0.01). BP, HR and NPY were significantly changed in C group after operation compared with those in both E and G group (p<0.05) . Conclusion: The combined anesthesia method is effective in inhibits the stress response during upper abdominal operation in the hypertensive patients

  12. Periodical assessment of genitourinary and gastrointestinal toxicity in patients who underwent prostate low-dose-rate brachytherapy

    International Nuclear Information System (INIS)

    Tanaka, Nobumichi; Asakawa, Isao; Anai, Satoshi; Hirayama, Akihide; Hasegawa, Masatoshi; Konishi, Noboru; Fujimoto, Kiyohide

    2013-01-01

    To compare the periodical incidence rates of genitourinary (GU) and gastrointestinal (GI) toxicity in patients who underwent prostate low-dose-rate brachytherapy between the monotherapy group (seed implantation alone) and the boost group (in combination with external beam radiation therapy (EBRT)). A total of 218 patients with a median follow-up of 42.5 months were enrolled. The patients were divided into 2 groups by treatment modality, namely, the monotherapy group (155 patients) and the boost group (63 patients). The periodical incidence rates of GU and GI toxicity were separately evaluated and compared between the monotherapy group and the boost group using the National Cancer Institute - Common Terminology Criteria for Adverse Events, version 3.0. To elucidate an independent factor among clinical and postdosimetric parameters to predict grade 2 or higher GU and GI toxicity in the acute and late phases, univariate and multivariate logistic regression analyses were carried out. Of all patients, 78.0% showed acute GU toxicity, and 7.8% showed acute GI toxicity, while 63.8% showed late GU toxicity, and 21.1% showed late GI toxicity. The incidence rates of late GU and GI toxicity were significantly higher in the boost group. Multivariate analysis showed that the International Prostate Symptom Score (IPSS) before seed implantation was a significant parameter to predict acute GU toxicity, while there were no significant predictive parameters for acute GI toxicity. On the other hand, combination with EBRT was a significant predictive parameter for late GU toxicity, and rectal volume (mL) receiving 100% of the prescribed dose (R100) was a significant predictive parameter for late GI toxicity. The boost group showed higher incidence rates of both GU and GI toxicity. Higher IPSS before seed implantation, combination with EBRT and a higher R100 were significant predictors for acute GU, late GU and late GI toxicity

  13. Non-Hodgkin's lymphomas in Turkey: eighteen years' experience at the Hacettepe University.

    Science.gov (United States)

    Barista, I; Tekuzman, G; Firat, D; Baltali, E; Kansu, E; Kars, A; Ozisik, Y; Ruacan, S; Uzunalimoğlu, B; Karaağaoğlu, E

    1994-12-01

    In this retrospective study, 470 patients with non-Hodgkin's lymphoma (NHL) who had been followed in the Hacettepe University Medical Oncology Department between 1973 and 1990, were evaluated to establish their epidemiologic, clinical and therapeutic characteristics. Out of 470 patients, 302 (62.2%) were male and 168 (37.8%) were female. The ages ranged from 16 to 85, with a median of 44 years. Constitutional symptoms were present in 46.4% of the patients. According to the Working Formulation, low, intermediate, and high-grade lymphomas comprised 33.4%, 54.9%, and 12.7%, respectively. The most common extranodal presentation was gastrointestinal. The chemotherapy regimens most commonly used were CVP (cyclophosphamide, vincristine, prednisone), BCNOP (bleomycin, cyclophosphamide, mitoxantrone, vincristine, prednisone), CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) and CHOP-Bleo (cyclophosphamide, doxorubicin, vincristine, prednisone, bleomycin). The response rates and the survival figures attained with these regimens were not statistically significantly different (P > 0.05). In the Cox multivariate model, pathologic grade, leukopenia, responsiveness to chemotherapy, bone marrow involvement and age were the important factors influencing the disease-free survival, while responsiveness to chemotherapy, age, presence of constitutional symptoms, pathologic grade, extranodal presentation and stage were the important factors influencing the overall survival. The distribution of NHL according to grade and stage was similar to that in western societies, while constitutional symptoms and lymphomas of the small intestine including immunoproliferative small intestinal disease were more common in Turkey.

  14. Non‐Hodgkin's Lymphomas in Turkey: Eighteen Years’Experience at the Hacettepe University

    Science.gov (United States)

    Barista, Ibrahim; Tekuzman, Gülten; Firat, Dinçer; Baltali, Esmen; Kansu, Emin; Kars, Ayse; Özisik, Yavuz; Ruacan, Sevket; Uzunalimoglu, Bedri; Karaagaoglu, Ergun

    1994-01-01

    In this retrospective study, 470 patients with non‐Hodgkin's lymphoma (NHL) who had been followed in the Hacettepe University Medical Oncology Department between 1973 and 1990, were evaluated to establish their epidemiologic, clinical and therapeutic characteristics. Out of 470 patients, 302 (62.2%) were male and 168 (37.8%) were female. The ages ranged from 16 to 85, with a median of 44 years. Constitutional symptoms were present in 46.4% of the patients. According to the Working Formulation, low, intermediate, and high‐grade lymphomas comprised 33.4%, 54.9%, and 12.7%, respectively. The most common extranodal presentation was gastrointestinal. The chemotherapy regimens most commonly used were CVP (cyclophosphamide, vincristine, prednisone), BCNOP (bleomycin, cyclophosphamide, mitoxantrone, vincristine, prednisone), CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) and CHOP‐Bleo (cyclophosphamide, doxorubicin, vincristine, prednisone, bleomycin). The response rates and the survival figures attained with these regimens were not statistically significantly different (P > 0.05). In the Cox multivariate model, pathologic grade, leukopenia, responsiveness to chemotherapy, bone marrow involvement and age were the important factors influencing the disease‐free survival, while responsiveness to chemotherapy, age, presence of constitutional symptoms, pathologic grade, extranodal presentation and stage were the important factors influencing the overall survival. The distribution of NHL according to grade and stage was similar to that in western societies, while constitutional symptoms and lymphomas of the small intestine including immunoproliferative small intestinal disease were more common in Turkey. PMID:7531679

  15. Molecular epidemiology of enterovirus and parechovirus infections according to patient age over a 4-year period in Spain.

    Science.gov (United States)

    Cabrerizo, María; Díaz-Cerio, María; Muñoz-Almagro, Carmen; Rabella, Núria; Tarragó, David; Romero, María Pilar; Pena, María José; Calvo, Cristina; Rey-Cao, Sonia; Moreno-Docón, Antonio; Martínez-Rienda, Inés; Otero, Almudena; Trallero, Gloria

    2017-03-01

    The epidemiology and clinical association of enterovirus (EV) and parechovirus (HPeV) infections, as well as the type-distribution-according-to-age, were determined during a 4-year study period in Spain. During 2010-2013, a total of 21,832 clinical samples were screened for EV and the detection frequency was 6.5% (1,430). Of the total EV-negative samples, only 1,873 samples from 2011 to 2013 were available for HPeV testing. HPeV was detected in 42 (2%) of them. Positive samples were genotyped using PCR and sequencing. EV infections occurred in all age groups of patients: neonates (17%), children 28 days to 2 years (29%), children 2-14 years (40%), and adults (14%). Thirty-four different EV types were identified. HPeV infections were detected exclusively in infants 2 years and adults (P < 0.05). Clinically, meningitis was associated with EV (P < 0.01) whereas, encephalitis was more frequent in HPeV-infected patients. CV-B types were associated with myocarditis (90%; P < 0.05) and EV species A with hand-foot-mouth-disease/atypical exanthema (88%; P < 0.05). J. Med. Virol. 89:435-442, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  16. Comparison of nevirapine plasma concentrations between lead-in and steady-state periods in Chinese HIV-infected patients.

    Directory of Open Access Journals (Sweden)

    Huijuan Kou

    Full Text Available To investigate the potential of nevirapine 200 mg once-daily regimen and evaluate the influence of patient characteristics on nevirapine concentrations.This was a prospective, multicentre cohort study with 532 HIV-infected patients receiving nevirapine as a part of their initial antiretroviral therapy. Plasma samples were collected at trough or peak time at the end of week 2 (lead-in period and week 4, 12, 24, 36, and 48 (steady-state period, and nevirapine concentrations were determined using a validated HPLC method. Potential influencing factors associated with nevirapine concentrations were evaluated using univariate and multivariate logistic regression.A total of 2348 nevirapine plasma concentrations were collected, including 1510 trough and 838 peak values. The median nevirapine trough and peak concentration during the lead-in period were 4.26 µg/mL (IQR 3.05-5.61 and 5.07 µg/mL (IQR 3.92-6.44 respectively, which both exceeded the recommended thresholds of nevirapine plasma concentrations. Baseline hepatic function had a moderate effect on median nevirapine trough concentrations at week 2 (4.25 µg/mL v.s. 4.86 µg/mL, for ALT <1.5 × ULN and ≥ 1.5 × ULN, respectively, P = 0.045. No significant difference was observed in median nevirapine trough concentration between lead-in and steady-state periods in patients with baseline ALT and AST level ≥ 1.5 × ULN (P = 0.171, P = 0.769, which was different from the patients with ALT/AST level <1.5ULN. The median trough concentrations were significantly higher in HIV/HCV co-infected patients than those without HCV at week 48 (8.16 µg/mL v.s. 6.15 µg/mL, P = 0.004.The 200 mg once-daily regimen of nevirapine might be comparable to twice-daily in plasma pharmacokinetics in Chinese population. Hepatic function prior to nevirapine treatment and HIV/HCV coinfection were significantly associated with nevirapine concentrations.

  17. The Use of β-blockers in Patients with Ventricular Ectopic Heartbeat in the Early and Distant Postinfarction Period

    Directory of Open Access Journals (Sweden)

    N. M. Kulayets

    2017-10-01

    Full Text Available Aim: to increase the effectiveness of patients after Q-, QS- myocardial infarction rehabilitation, based on the study of clinical, instrumental and biochemical changes in cases of cardiac arrhythmias, and development on this basis of new approaches to treatment. Materials and Methods. The clinical, instrumental and biochemical examinations were carried out for 70 patients who had Q-, QS-myocardial infarction (MI with a ventricular ectopic heartbeat on the regenerative period since the acute coronary syndrome development in 1, 3, and 6 months. The features of the ventricular ectopic heartbeat course in patients with myocardial infarction against the backdrop of sotalol and carvedilol use and influence of applied treatment on the clinical and pathogenetical features of patients’ functional recovery in early and distant (prolonged postinfarction period were analyzed. Results. Analyzing the dynamics of coronary artery disease clinical manifestations in patients with ventricular arrhythmia (VA with myocardial infarction against the backdrop of sotalol and carvedilol treatment it has been noted a marked decrease in anginal chest pain manifestation, feeling of palpitations, disruption of the heart, shortness of breath, feeling of breath shortness, etc. in all groups of patients. The positive effect of therapy had been increasing since the 3 week during the 3-month long treatment. Results of heart rate Holter monitoring have shown a marked antiarrhythmic effect of metoprolol, carvedilol and sotalol. In particular, in all groups of patients the frequency of VA reduced by half, the percentage of high grade VA decreased namely pair and group arrhythmia, ventricular bigeminy. Assessment of hemodynamic parameters in the process of patients with ST treatment has represented the marked trend and a further significant increase in ejection fraction and other contractile dysfunction forms correction. This positive trend was the most relevant in the application

  18. State estimation and optimal long period clinical treatment of HIV seropositive patients

    Directory of Open Access Journals (Sweden)

    Juliana M. Grégio

    2009-03-01

    Full Text Available Optimal control theory provides a very interesting quantitative method that can be used to assist the decision making process in several areas of application, such as engineering, biology, economics and sociology. The main idea is to determine the values of the manipulated variables, such as drug doses, so that some cost function is minimized, subject to physical constraints. In this work, the cost function reflects the number of CD4+T cells, viral particles and the drug doses. It is worth noticing that high drug doses are related to more intense side-effects, apart from the impact on the actual cost of the treatment. In a previous paper by the authors, the LQR - Linear Quadratic Regulator approach was proposed for the computation of long period maintenance doses for the drugs, which turns out to be of state feedback form. However, it is not practical to determine all the components of the state vector, due to the fact that infected and uninfected CD4+T cells are not microscopically distinguishable. In order to overcome this difficulty, this work proposes the use of Extended Kalman Filter to estimate the state, even though, because of the nonlinear nature of the involved state equations, the separation principle may not be valid. Extensive simulations were then carried out to investigate numerically if the control strategy consisting of the feedback of estimated states yielded satisfactory clinical results.A teoria de controle ótimo apresenta um método quantitativo muito interessante que pode ajudar no processo de tomada de decisão em algumas áreas de aplicação, tais como engenharia, biologia, economia e sociologia. A principal idéia é determinar os valores das variáveis controladas, tais como doses de medicamentos, onde alguma função-custo é minimizada, sujeito às restrições físicas. Neste trabalho, a função-custo reflete o número de células CD4+T, partículas virais e doses de medicamentos. É fato que altas dosagens de

  19. Bacterial spectrum and susceptibility patterns of pathogens in adult febrile neutropenic patients: a comparison between two time periods

    International Nuclear Information System (INIS)

    Zahid, K.F.; Hafeez, H.; Afzal, A.

    2009-01-01

    The aim of this study was to study trends in bacterial spectrum and susceptibility patterns of pathogens in adult febrile neutropenic patients during two time periods. We retrospectively reviewed the medical records of 379 adult oncology patients admitted with chemotherapy induced febrile neutropenia at our institute during years 2003 and 2006. A total of 151 organisms were isolated during the two calendar years. Gram negative bacteria accounted for 57.6% of organisms, while gram positive organisms accounted for 42.3% of the total isolates. The most common organisms were: Escherichia coli (23.1%), Staphylococcus epidermidis (13.9%), Pseudomonas aeruginosa (12.5%) and Staphylococcus aureus (7.9%). The number of gram positive isolates showed an increase from 35% in 2003 to 47.2% in 2006 (p=0.13). During each calendar year, Staphylococcus epidermidis and Staphylococcus aureus were 100% susceptible to vancomycin and 33% strains of Staphylococcus aureus were methicillin resistant. Escherichia coli and Pseudomonas aeruginosa strains were highly sensitive to piperacillin/tazobactam and amikacin during both time periods. Resistance of Pseudomonas aeruginosa strains to ciprofloxacin increased from 0% in 2003 to 50% in 2006 (p=0.03). Gram negative organisms are the predominant organisms in adult febrile neutropenic patients at our institute. Initial empirical therapy with piperacillin/tazobactam seems appropriate to cover most gram negative pathogens while vancomycin to be added for suspected gram positive infections. During the two calendar years resistance of Pseudomonas aeruginosa strains to ciprofloxacin has significantly increased. (author)

  20. [An approach to the patients with cryopyrin-associated periodic syndrome (CAPS) : a new biologic response modifier, canakinumab].

    Science.gov (United States)

    Yokota, Shumpei; Kikuchi, Masako; Nozawa, Tomo; Kizawa, Toshiatsu; Kanetaka, Taichi; Miyamae, Takako; Mori, Masa-aki; Nishikomori, Ryohta; Takata, Hidetoshi; Heike, Toshio; Hara, Toshiro; Imagawa, Tomoyuki

    2012-01-01

    Cryopyrin-associated periodic syndrome (CAPS) comprises a group of rare, but severe, autoinflammatory syndrome, and includes 3 distinct conditions, familial cold autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS), and neonatal-onset multisystem inflammatory disease (MONID). These syndromes are characterized by urticarial-like rash, periodic fever, central nervous system inflammation, an arthropathy, and the risk of amyloidosis. About 20% die by age 20 years in the most severe cases. The disease is associated with mutations in the NLRP3 gene that encodes for the protein cryopyrin, a component of the inflammasome complex that regulates the production and secretion of IL-1β. Canakinumab is a human IgG monoclonal antibody targeting IL-1β. The clinical trials of canakinumab for patients with CAPS in both western countries and Japan were well-tolerated in most patients, and provided significant advantages over existing competitive therapies. Although no serious adverse effects have been reported, the frequencies of common infectious diseases including nasopharyngitis, upper respiratory tract infections, and gastroenteritis were reported presumably due to the blockade of proinflammatory cytokine, IL-1β. For us pediatrician, it will be important to be more careful for infectious diseases to provide the maximum safety of canakinumab for these patients.

  1. An assessment of twelve- versus eighteen-month cycles for PWRs

    International Nuclear Information System (INIS)

    Momsen, B.F.; Dale, R.

    1983-01-01

    This paper discusses the technical and economic factors involved in 18-month cycles for Zion pressurized water reactors (PWRs). The technical factors are divided into the factors that define input to the economic analysis and factors that are combined with the economic results in the final decisionmaking process. The economic analysis was performed by using a Present Value of the Revenue Requirements (PVRR) method and a complementary cash flow examination. The PVRR analysis examined total costs associated with both the 12- and 18-month cycles. The only significant technical problem that was identified was the relatively low new fuel enrichment limit of 3.2 w/o U 235 . The economic analysis demonstrated that 18-month cycles yielded significant PVRR savings over the 15-year study period. The economic benefits of 18-month cycles decreased as the fuel cost increased, the operating capacity factor decreased, the refueling outage length decreased, the differential 18-month cycle outage length increased, the replacement power cost decreased, and the escalation rate decreased

  2. The effects of music intervention on the emotion, haemodynamics and endocrine hormone level of senile patients during the perianesthesia period

    Directory of Open Access Journals (Sweden)

    Liang Feng

    2017-01-01

    Full Text Available Purpose: to explore the effects of music intervention on haemodynamics and endocrine hormone level of senile patients. Methods: choosing ASA II-III level and selecting 60 senile patients performed with intraspinal anesthesia; randomly dividing them into the intervention group and control group with 30 cases in each group. Both the two groups of patients completed the SAS before entering the operating room. When the patients of the intervention group entered the operating room, selected music would be played in a continuous loop immediately till the end of the operation while the doctors of the control group just told the patient to relax without music or other special treatment. Recording and comparing the SAS scores, SBP, HR and salivary cortisol concentration of the two groups before and after intervention. Results: the SAS scores, SBP, HR and salivary cortisol concentration of the intervention group were significantly decreased compared with the value before intervention and the differences within and between the groups were significant (P < 0.05. Conclusion: music intervention can effectively reduce the preoperative anxiety, ease intranperative tension and maintain the stability of hemodynamics, so it is beneficial for senile parents to live through the perianesthesia period.

  3. Comparison of serum oxidant and antioxidant parameters in familial Mediterranean fever patients (FMF) with attack free period.

    Science.gov (United States)

    Şahin, Ali; Erten, Şükran; Altunoğlu, Alpaslan; Işıkoğlu, Semra; Neşelioğlu, Salim; Ergin, Merve; Atalay, Hacı Veli; Erel, Özcan

    2014-01-01

    Familial Mediterranean fever (FMF) is an autoinflammatory, autosomal recessive, inherited disease characterized by recurrent self-limiting attacks of serosal surfaces. The imbalance of oxidants/antioxidants may play a role in such attacks. In this study, we aimed to evaluate the relationship between serum paraoxonase (PON1) activity, PON1 phenotype, and other parameters in patients with FMF and healthy controls. A total of 120 FMF patients with an attack-free period (AFP) and 65 healthy subjects were included in this study. The serum PON1 activity, stimulated paraoxonase (SPON) activity, PON1 phenotype (representing Q192R polymorphism; QQ, QR, RR), arylesterase activity, total oxidant status (TOS), total antioxidant capacity (TAC), oxidative stress index (OSI), advanced oxidative protein products (AOPP), total thiols (TTL), and ischemia-modified albumin (IMA) and cystatin-c (CYS-C) levels were measured. For the QQ phenotype, the median TTL and AOPP levels of the control group were 264.50 (57.75) mol/L and 21.26 (21.17) mmol/L, respectively, whereas the median TTL, AOPP levels of the patients were 309.00 (47.00) mol/L and 12.98 (6.96) mmol/L, respectively. There was a statistically significant difference between the patients and controls with the QQ phenotype in terms of TTL and AOPP (pantioxidant parameters were similar among the patients during AFP and the controls.

  4. Effect of probucol combined with atorvastatin adjuvant therapy on serum indexes of acute cerebral infarction patients during rehabilitation period

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    Li Zhang

    2016-06-01

    Full Text Available Objective: To analyze the effect of probucol combined with atorvastatin adjuvant therapy on serum indexes of acute cerebral infarction patients in rehabilitation period. Methods: A total of 102 patients with acute cerebral infarction were treated in our hospital from August 2011 to June 2015, were confirmed by magnetic resonance imaging and were randomly divided into observation group 51 cases and control group 51 cases according to the order of hospitalization. Control group received atorvastatin treatment alone, observation group received probucol combined with atorvastatin adjuvant therapy, and then differences in levels of serum CXCL16, HMGB1, CD40L and Fibulin-5, P-selectin, NPY, CGRP, visfatin and others, chemokines and inflammation-related factors, vascular endothelial cells and fibrinolytic function, etc were compared between two groups after treatment. Results: Serum CXCL16, HMGB1, CD40L and Fibulin-5 levels of observation group after treatment were lower than those of control group; serum P-selectin, NPY, visfatin, UCH-L1, sVCAM-1 and SAA levels of observation group after treatment were lower than those of control group while CGRP level was higher than that of control group; serum CCL-19, CCL-21, YKL-40, IL-33 and IL- 18 values of observation group after treatment were lower than those of control group; serum vWF, PAI-1 and plasminogen levels of observation group after treatment were lower than those of control group while 6-K-PGF1α and tPA levels were higher than those of control group. Conclusions: Probucol combined with atorvastatin adjuvant therapy for acute cerebral infarction patients in rehabilitation period can effectively optimize patients’ general status and avoid re-infarction in recovery period, and it has positive clinical significance.

  5. Eighteen cases of small breast cancer: a comparative study of mammography, CT scan and pathology

    International Nuclear Information System (INIS)

    Wu Yaopan; Lin Haogao; Cai Peiqiang; Ouyang Yi; Zhang Weizhang; Lu Bingui

    2003-01-01

    Objective: To improve the early diagnosis of breast cancer through a study of the mammography and CT findings of small breast cancer. Methods: The mammography and CT findings of 18 cases of small breast cancer (φ≤2.0 cm in diameter) were studied and compared with pathological results. Results: The diagnostic accuracy of CT and mammography was 83% and 61%, respectively. There was a statistical difference between both modalities (P<0.05), CT scan was superior to mammography. However, there was no difference between them when assessing the lesion arising in F-type breast. In detecting breast fine cluster of calcification, the sensitivity of mammography was better than CT scan. Conclusion: The patient suspected of small breast cancer should take mammography as the first evaluation. CT scan is reserved for the further investigation. The mammography combined with CT scan can improve the early diagnostic rate of breast cancer

  6. [The complex approach to the rehabilitation of post-stroke patients with movement disorders in the early rehabilitation period].

    Science.gov (United States)

    Khabirov, F A; Khaĭbullin, T I; Grigor'eva, O V

    2011-01-01

    We studied 110 patients, aged 34-71 years, in the early rehabilitation period after stroke who were admitted to a rehabilitation neurologic department of Kazan. The rehabilitation approach was based on the combination of several methods: kinesitherapy, transcranial magnetic stimulation and cerebrolysin treatment. This complex reanimation allowed to achieve the marked functional restoration of movement abilities in many cases that was correlated with the normalization of brain bioelectric activity (the increase of alpha-rhythm spectral power, the decrease of slow-wave EEG components). The combined use of these three methods was more effective than a combination of any two of them.

  7. Clinical monitoring of tooth wear progression in patients over a period of one year using CAD/CAM

    OpenAIRE

    Ahmed, Khaled E.; Whitters, John; Ju, Xiangyang; Pierce, S. Gareth; MacLeod, Charles N.; Murray, Colin A.

    2017-01-01

    Purpose: The aim of this study was to clinically monitor the progression of tooth wear over a period of 1 year in a cohort of referred tooth wear patients through the use of a computer-aided design/ computer-assisted manufacture (CAD/CAM) scanner and a standardized scanning/assessment methodology. Materials and Methods: Polyether impressions were made of 11 participants (130 teeth) at baseline and at 1 year. Impressions were poured in type IV dental stone and the anterior teeth were 3D scanne...

  8. Evaluation of the Appropriate Washout Period Following Fan Therapy for Dyspnea in Patients With Advanced Cancer: A Pilot Study.

    Science.gov (United States)

    Kako, Jun; Morita, Tatsuya; Yamaguchi, Takuhiro; Sekimoto, Asuko; Kobayashi, Masamitsu; Kinoshita, Hiroya; Ogawa, Asao; Zenda, Sadamoto; Uchitomi, Yosuke; Inoguchi, Hironobu; Matsushima, Eisuke

    2018-02-01

    To clarify the duration required for dyspnea to return to baseline severity after fan therapy, to evaluate whether fan-to-legs therapy or no fan therapy would be a suitable control therapy, and to investigate changes in patients' face surface temperature after fan therapy. In this pilot study, all participants received 3 interventions in the following order: no fan, fan to legs, and fan to face. Participants used a fan for 5 minutes, and they scored their dyspnea at 10-minute intervals for 60 minutes or until the score had returned to its baseline value, whichever occurred first. Nine patients with advanced cancer admitted to a palliative care unit were included; they had dyspnea at rest and rated its severity as at least 3 points on a 0- to 10-point numerical rating scale. Descriptive statistics and the Wilcoxon signed rank test were used to analyze the data. All patients completed the study. Of the 9 participants, 6 experienced a clinical benefit from using a fan to their faces. Of these patients, only 2 participants' (2 of 6) dyspnea scores returned to baseline by the end of the 60-minute assessment period after exposure to fan-to-face therapy. In fan-to-legs and no fan settings, there was no change in the dyspnea scores. There were significant differences between the baseline face surface temperature and that after fan-to-face and fan-to-legs settings. When using a crossover design to investigate the effect of fan therapy on dyspnea, 1 hour is an insufficient washout period.

  9. [Notification of incidents related to patient safety in hospitals in Catalonia, Spain during the period 2010-2013].

    Science.gov (United States)

    Oliva, Glòria; Alava, Fernando; Navarro, Laura; Esquerra, Miquel; Lushchenkova, Oksana; Davins, Josep; Vallès, Roser

    2014-07-01

    The aim of this paper is to discover the aggregated results of a general notification system for incidents related to patient safety implemented in Catalan hospitals from 2010 to 2013. Observational study describing the incidents notified from January 2010 to December 2013 from all hospitals in Catalonia forming part of the project to create operational patient safety management units. The Patient Safety Notification and Learning System (SiNASP) was used. This makes it possible to classify incidents depending on the area where they occur, the type of incident notified, the consequences, the seriousness according to the Severity Assessment Code (SAC) and the profession of the notifying party, as the principal variables. The system was accessed via the Internet (SiNASP portal). Access was voluntary and anonymous or with a name given and later removed. During the study period, notification of a total of 5,948 incidents came from 22-29 hospitals. 5,244 of the incidents were handled by the centres and these are the ones analysed in the study. 64% (3,380) affected patients, 18% (950) created a situation capable of causing an incident and 18% (914) did not affect patients. 26% of incidents that affected patients (864) caused some kind of harm. Most incidents occurred during hospitalisation (54%) and in casualty (15%), followed by the ICU (9%) and the surgical block (8%). The most frequent notifying parties were nurses (71%) followed by doctors (15%) and pharmacists (9%). In terms of severity, most incidents were classified as low-risk (37%) or incidents that did not affect the patient (36%). However, 40 cases (0.76%) of extreme risk should be highlighted. In terms of the types of incident notified, most were due to a medication error (26.8%), followed by falls (16.3%) and patient identification (10.6%). The majority of notifications were incidents that affected patients and, of these, 26% caused harm. In general, they occurred in hospitalisation units and notification was

  10. [Prevalence of Hypothyroidism in Major Psychiatric Disorders in Hospitalised Patients in Montserrat Hospital During the period March to October 2010].

    Science.gov (United States)

    Vargas Navarro, Pedro; Ibañez Pinilla, Edgar Antonio; Galeano España, Alejandra; Noguera Bravo, Ana María; Milena Pantoja, Sandra; Suárez Acosta, Ana María

    Hypothyroidism results from inadequate production of thyroid hormone. It is known that there is a relationship between the major psychiatric disorders and hypothyroidism. To determine the prevalence of hypothyroidism in patients admitted due to major psychiatric disorders in Montserrat Hospital during the period from March to October 2010. A descriptive cross-sectional study was conducted on 105 patients admitted to Montserrat Hospital with a primary diagnosis of major psychiatric disorder (major depression, bipolar affective disorder, generalised panic disorder, panic disorder, mixed anxiety-depressive disorder, and schizophrenia) in the aforementioned period. Thyroid Stimulating Hormone (TSH) was performed to assess the evidence of hypothyroidism. The overall prevalence of hypothyroidism was found to be 10.5% (95% CI; 5%-16%). It was 12.5% in anxiety disorder, 11.1% in depressive disorder, with a lower prevalence of 10.3% for bipolar disorder, and 9.9% for schizophrenia. The overall prevalence of hypothyroidism was found to be less than in the general population, which is between 4.64% and 18.5%, and hypothyroidism was found in disorders other than depression. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  11. Dynamics of the liver stiffness value using transient elastography during the perioperative period in patients with valvular heart disease.

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    Young Eun Chon

    Full Text Available Liver congestion due to heart failure in patients with valvular heart disease (VHD can result in an overestimate of the liver stiffness (LS as assessed by transient elastography (TE. This prospective pilot study investigated the dynamics of LS during the perioperative valve operation period.Thirty-two patients who underwent a valve operation (case and 12 who underwent a varicose vein operation (control were prospectively enrolled. LS and cardiologic parameters at three time points [baseline, post-operative day (POD7, and POD90] were collected.LS at three time points were consistently higher in the case group than those in the control group, although all participants did not show evidence of underlying chronic liver disease (all P<0.05. In the case group, LS at POD7 increased slightly from the LS at baseline (median 7.9→8.4 kPa, P = 0.816, whereas LS at POD90 decreased significantly from the LS at POD7 (median 8.4→6.0 kPa; P = 0.026. LS was significantly correlated with N-terminal-pro brain natriuretic peptide (NT-proBNP (ρ = 0.412, left ventricular ejection fraction (ρ = -0.494, and central venous pressure during the operation (ρ = 0.555 at baseline (all P<0.05. LS was significantly correlated with NT-proBNP (ρ = 0.526 and right ventricular pressure (ρ = 0.572 at POD7, whereas LS was significantly correlated with NT-proBNP (ρ = 0.590 at POD90 (all P<0.05.LS can be overestimated in patients with VHD due to hepatic congestion. However, LS can be dynamically reversed during the perioperative period reflecting the restoration of cardiac function after a successful operation.

  12. Frequency of and Factors Associated With Obstructive Sleep Apnea and Periodic Limb Movements in Stroke and TIA Patients.

    Science.gov (United States)

    Gadodia, Gaurav; Rangaraju, Srikant; Raza, Syed A; Razzak, Ammar; Marmarchi, Labib; Davis, Brittaine; Henriquez, Laura; Trotti, Lynn M; Rye, David; Nahab, Fadi

    2018-03-01

    Obstructive sleep apnea (OSA) and periodic limb movements (PLMs) have been associated with an increased risk of cardiovascular disease. There is limited data on the relationship between OSA and PLMs with atrial fibrillation and resistant hypertension in stroke and transient ischemic attack (TIA) patients. Consecutive stroke and TIA patients referred by a vascular neurologist for diagnostic polysomnography (PSG) from September 1, 2012 to August 31, 2015 were included in a retrospective analysis. Baseline clinical characteristics, PSG results and outcomes were collected to identify the frequency of and factors associated with PLMs (mild 5 to 10/h; severe ≥15/h), PLM arousals (≥5/h) and moderate-severe OSA (apna-hypopnea Index ≥15) including atrial fibrillation and resistant hypertension. Among 103 patients (mean age, 60±15 y; 50% female; 61% nonwhites; 77% ischemic stroke; 23% resistant hypertension) who underwent PSG, 20% had mild PLMs, 28% had severe PLMs, 14% had PLM arousals, and 22% had moderate-severe OSA. Factors associated with moderate-severe OSA included older age (odds ratio, 1.06; 95% confidence interval, 1.02-1.11) and presence of atrial fibrillation (odds ratio, 4.26; 95% confidence interval, 1.17-15.44). Nonwhite race was associated with lower likelihood of mild and severe PLMs, whereas female sex was associated with lower likelihood of PLM arousals. OSA and PLMs were not associated with resistant hypertension. A significant number of stroke and TIA patients who underwent PSG have PLMs and moderate-severe OSA. Stroke and TIA patients with atrial fibrillation are more likely to have moderate-severe OSA and may benefit from PSG evaluation.

  13. Cerebrospinal Fluid Biomarkers in the Diagnosis of Creutzfeldt-Jakob Disease in Slovak Patients: over 10-Year Period Review.

    Science.gov (United States)

    Koscova, Silvia; Zakova Slivarichova, Dana; Tomeckova, Ivana; Melicherova, Katarina; Stelzer, Martin; Janakova, Alzbeta; Kosorinova, Dana; Belay, Girma; Mitrova, Eva

    2017-10-01

    Creutzfeldt-Jakob disease is a rare, but rapidly progressive, up to now untreatable and fatal neurodegenerative disorder. Clinical diagnosis of Creutzfeldt-Jakob disease (CJD) is difficult; however, it can be facilitated by suitable biomarkers. Aim of the present study is to compare levels of cerebrospinal fluid biomarkers (total tau protein, phosphorylated-tau protein, protein 14-3-3 and amyloid beta) in Slovak population of CJD suspect cases, retrospectively in over a 10-year period. One thousand three hundred sixty-four CSF samples from patients with suspect CJD, forming a homogenous group in terms of geographical as well as of equal transport conditions, storage and laboratory processing, were analysed. Definite diagnosis of Creutzfeldt-Jakob disease was confirmed in 101 patients with genetic form, and 60 patients with its sporadic form of the disease. Specificity of protein 14-3-3 and total tau in both forms CJD was similar (87 % for P14-3-3/85 % for total tau), sensitivity to P 14-3-3 and total tau was higher in sporadic Creutzfeldt-Jakob disease (sCJD) (90/95 %) than in genetic Creutzfeldt-Jakob disease (gCJD) (89/74 %). As expected, the total tau levels were significantly higher in CJD patients than in controls, but there was also significant difference between gCJD and sCJD (levels in gCJD were lower; p = 0.003). There was no significant difference in p-tau and Aβ 1-42 levels neither between both CJD forms nor between CJD patients and control group.

  14. Family functioning and its predictors among disaster bereaved individuals in China: eighteen months after the Wenchuan Earthquake.

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    Xiaoyi Cao

    Full Text Available BACKGROUND: The 2008 Wenchuan earthquake in China resulted in great loss of life and property, and previous studies have focused on psychopathological symptoms in survivors after disasters. This study examined perceived family functioning and its predictors in disaster bereaved individuals eighteen months after the 2008 Wenchuan earthquake. METHODOLOGY/FINDINGS: This was a cross-sectional study of a convenience sample of 264 bereaved individuals. The instruments used in the study included Family APGAR Index, Family Adaptability and Cohesion Evaluation ScaleãÀ, Emotional and Social Loneliness Scale, and a range of items eliciting demographic characteristics and disaster-related variables. The results indicated that the rates of moderate family dysfunction and severe family dysfunction in bereaved individuals were 37.1% and 12.9%, respectively. Less financial loss during the earthquake was a significant predictor for positive family function. Better self-rated health status after the earthquake was significantly related to positive family function, cohesion, and adaptability. Scores on family cohesion and adaptability in bereaved individuals from extended or nuclear families were significantly higher than those from single-parent families. The ability to give birth to another baby of bereaved parents was a significant predictor for positive family function and cohesion. Poorer family function, cohesion and adaptability were significantly related to greater loneliness. CONCLUSIONS/SIGNIFICANCE: This study found a high prevalence of family dysfunction in bereaved individuals eighteen months after the 2008 Wenchuan earthquake. Strategies can be designed to facilitate post-disaster recovery, particularly for the bereaved at high risk for family dysfunction. The study provides useful information for post-disaster rebuilding and relief work.

  15. Hepatitis C genotype distribution in patient and blood donor samples in South Africa for the period 2008-2012.

    Science.gov (United States)

    Prabdial-Sing, N; Chirwa, T; Thaver, J; Smuts, H; Vermeulen, M; Suchard, M; Puren, A J

    2016-11-01

    There are limited molecular epidemiological studies of hepatitis C at a national level in South Africa. The introduction of newer treatment modalities for hepatitis C requires knowledge of the genotypes as these may have different prognostic and therapeutic implications. This retrospective study describes genotype distributions of patients attending specialist clinics and a blood donor group studied during the period 2008-2012 in South Africa. Residual samples from diagnostic viral load testing from specialist clinics in South Africa (n=941) and from the South African National Blood Service (n=294) were analysed quantitatively by real-time PCR and genotyped using the Versant line probe assay or sequencing. Genotype 1 was predominant in blood donors (34%), whilst genotype 5a was prevalent in patients (36%). In the blood donor group, genotype 4 was detected for the first time. Genotype 2 was rare in the patient group and not detected in blood donors. Genotype 1 was the predominant genotype in the younger age groups (less than 30 years), whereas genotype 5a was found at higher proportions in the older age groups for both the patient and blood donor groups, comprising more than 60% of genotypes in those older than 50 years. Genotypes 1 and 5 were at highest proportions across all provinces compared to other genotypes. In blood donors, genotype 1 was predominant among Caucasians (43%) and genotype 5a among Blacks (54%). Such information is required for planning the impact on the health sector with regard to newly emerging therapies for hepatitis C and burden of disease. © 2016 John Wiley & Sons Ltd.

  16. RHEOLOGICAL PROPERTIES OF BLOOD AT PATIENTS WITH BOWEL OBSTRUCTION OF TUMORAL GENESIS IN THE EARLY POSTOPERATIVE PERIOD

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    V. V. Maslyakov

    2014-01-01

    Full Text Available Introduction. Microcirculation plays an important role in early postoperative period in colorectal cancer patients. At the same time the question connected with studying of rheological properties of blood as one of microcirculation indicators in literature it studied insufficiently.Materials and methods. We studied rheological properties of blood in 30 patients operated for bowel obstruction caused by right colon cancer. 17 (56,7 % patients were male, 13 (43,3 % – female. Average age was 57 ± 3 years. Time from the moment of manifestation of the first clinical signs before admission to a hospital and the beginnings of carrying out medical and diagnostic actions was 12 ± 0,5 h. The stage of a disease was T3N0–1M0. The group of comparison consisted of 20 healthy volunteers of the same age. Changes of a rheology of blood were measured by means of the accounting of viscosity of blood, change of an index of deformation and aggregation of erythrocytes. Studying of viscosity of blood was carried out by means of the rotational viscometer at shift speeds: 200; 100; 150; 50 and 20 MPas. Measures were conducted at the time of receipt, on the first, third, fifth, seventh and tenth postoperative day.Results. In patients with bowel impassability at the time of receipt the increase in indicators of viscosity of blood is noted at all speeds of the shift, analyzed indicators increase by the third postoperative day, decrease on the seventh and are partially restored for the tenth postoperative days. Complications developed in 16,6 % of cases, in all cases – pneumonia. By comparison of the obtained laboratory data to a clinical picture it is established that complications developed on 3–5th postoperative days.

  17. Early rehabilitation after surgery program versus conventional care during perioperative period in patients undergoing laparoscopic assisted total gastrectomy

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    Manash Ranjan Sahoo

    2014-01-01

    Full Text Available Objective: To evaluate the safety and efficacy of early rehabilitation after surgery program (ERAS in patients undergoing laparoscopic assisted total gastrectomy. Materials And Methods: This is a study where 47 patients who are undergoing lap assisted total gastrectomy are selected. Twenty-two (n = 22 patients received enhanced recovery programme (ERAS management and rest twenty-five (n = 25 conventional management during the perioperative period. The length of postoperative hospital stay, time to passage of first flatus, intraoperative and postoperative complications, readmission rate and 30 day mortality is compared. Serum levels of C-reactive protein pre-operatively and also on post-op day 1 and 3 are compared. Results: Postoperative hospital stay is shorter in ERAS group (78 ± 26 h when compared to conventional group (140 ± 28 h. ERAS group passed flatus earlier than conventional group (37 ± 9 h vs. 74 ± 16 h. There is no significant difference in complications between the two groups. Serum levels of CRP are significantly low in ERAS group in comparison to conventional group. [d1 (52.40 ± 10.43 g/L vs. (73.07 ± 19.32 g/L, d3 (126.10 ± 18.62 g/L vs. (160.72 ± 26.18 g/L]. Conclusion: ERAS in lap-assisted total gastrectomy is safe, feasible and efficient and it can ameliorate post-operative stress and accelerate postoperative rehabilitation in patients with gastric cancer. Short term follow up results are encouraging but we need long term studies to know its long term benefits.

  18. Quarterly RCRA Groundwater Monitoring Data for the Period July through September 2006

    Energy Technology Data Exchange (ETDEWEB)

    Hartman, Mary J.

    2007-02-01

    This report provides information about RCRA groundwater monitoring for the period July through September 2006. Eighteen Resource Conservation and Recovery Act (RCRA) sites were sampled during the reporting quarter.

  19. Antimicrobial susceptibility of bacteria, isolated from patients treated at Jesenice General hospital in the period between 2004 and 2006

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    Helena Ribič

    2007-11-01

    Full Text Available Background: Antimicrobial resistance of bacteria is still one of the mayor problems in medicine. In the year 2006, microbiologists of the Institute of Public Health Kranj together with clinicians and pharmacist of Jesenice General Hospital prepared the programm of antimicrobial resistance surveillance of patients treated in the hospital. Some of the results are presented in this article.Methods: In the retrospective study, bacterial strains, isolated from different samples were analysed. The strains were isolated and studied during the routine work of microbiology laboratory of IPH Kranj in the period between 2004 and 2006.Results: The most frequently isolated bacteria from haemocultures was Escherichia coli (35.4 %. In the years 2004 and 2006, susceptibility of strains for ciprofloxacin was 95.7 % and 97.2 %, for parenteral cefuroxime (95.7 % and 94.4 %, for cefotaxime and gentamicin in both years 100 %. Susceptibility of E. coli strains from urine samples in patients from the department for internal medicine was in 2004 and 2006 for co-amoxiclav 88.5 % and 70.1 %, for co-trimoxazole 60.3 % and 81.3 %, for cefaclor 94.9 % and 89.7 %, for ciprofloxacin 83.3 % and 82.2 %. Among strains of Staphylococcus aureus, 100 % were sensitive to vancomycin and 99.3 % to linezolid in 2006. Among methicillin susceptible strains, sensitivity to erythromycin, clindamycin and ciprofloxacin lowered slightely in the three years period; in 2006 it was 87.6 %, 90.6 % and 89.1 %. Susceptibility of strains Pseudomonas aeruginosa was in 2006 similar comparing to 2004; it was 92 % for ceftazidime, 75 % for gentamicin, 64.6 % for ciprofloxacin and 96 % for imipenem. Among strains of Acinetobacter spp., sensitivity rate to ciprofloxacin, ceftazidime, piperacillin with tazobactam and gentamicin significantly fell in the year 2005 and stayed low in 2006.Conclusions: The results of antimicrobial susceptibility surveillance and trends of susceptibility are intended to guide

  20. Long term management of patients with cryopyrin-associated periodic syndromes (CAPS: focus on rilonacept (IL-1 Trap

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    Leigh D Church

    2008-10-01

    Full Text Available Leigh D Church1, Sinisa Savic2, Michael F McDermott21Department of Rheumatology, Division of Immunity, Infection and Inflammation, Institute for Biomedical Research, The University of Birmingham, Birmingham, UK; 2Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, Wellcome Trust Brenner Building, University of Leeds, Leeds, UKAbstract: Cryopyrin-associated periodic syndromes (CAPS are a group of inherited inflammatory disorders consisting of familial cold-induced autoinflammatory syndrome (FCAS, Muckle-Wells syndrome (MWS, and neonatal-onset multisystem inflammatory disease (NOMID; also known as chronic infantile neurologic, cutaneous, articular [CINCA] syndrome. These rare disorders are associated with heterozygous mutations in the NLRP3 (CIAS1 gene, which encodes the protein NALP3 or cryopyrin, and inflammation driven by excessive production of the cytokine interleukin-1β (IL-1β. Amyloidosis is a serious complication with 25% of MWS patients developing amyloidosis, with occasional fatal consequences, whilst up to 20% of CINCA/NOMID patients die from various complications, before reaching the early adulthood. In some CINCA/NOMID adult survivors amyloidosis can also occur. Prior to the discovery of the CIAS1 gene mutations and the advent of IL-1 targeted therapy, treatment was aimed at suppressing inflammation, with limited success. The selective blockade of IL-1β, with anakinra (IL-1 receptor antagonist, not only provided supportive evidence for the role of IL-1β in CAPS, but also demonstrated the efficacy of targeting IL-1β for treatment of these conditions. In February, 2008, ‘Orphan Drug’ approval from the Food and Drug Administration (FDA for rilonacept (IL-1 Trap/Arcalyst™, Regeneron Pharmaceuticals, Inc was given for the treatment of two CAPS disorders, FCAS and MWS in adults and children 12 years and older, making rilonacept the first therapy approved for the treatment of CAPS.Keywords: cryopyrin

  1. Efficacy of drainage blood reinfusion in early postoperative period after total hip arthroplasty in patients with rheumatoid arthritis

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    N B Shelokova

    2008-01-01

    Full Text Available To study effect of drainage blood reinfusion in early postoperative period (EPP after total hip arthroplasty (THA in patients with rheumatoid arthritis (RA. Material and methods. Primary THA was performed in 51 RA pts with hip damage (49 female, 2 male aged from 26 to 68 years. 42 THA were performed with “Endosystems and Implants” (ESI endoprosthesis, and 21 — with “Mathys” endoprosthesis. The pts were divided into two groups. Standard infusion-transfusion therapy with donor blood components was performed in group 1 pts (n=26 to compensate blood loss in EPP. In group 2 pts (n=25 drainage blood reinfusion was done with active aspiration system Handy Vac TM ATS (Unomedical. Group 1 pts had more prominent circulatory and neurologic disturbances in EPP: hypodynamic variant of circulation with elevation of peripheral vascular resistance till 5-7 day of postoperative period, prominent hypersympathicotonia and a large number of posttransfusion reactions. Evaluation of hemodynamic and vegetative disturbances showed advantage of blood loss compensation and vegetative disturbances normalization with drainage blood reinfusion in EPP after THA in comparison with standard pts management.

  2. Long term management of patients with cryopyrin-associated periodic syndromes (CAPS): focus on rilonacept (IL-1 Trap).

    Science.gov (United States)

    Church, Leigh D; Savic, Sinisa; McDermott, Michael F

    2008-12-01

    Cryopyrin-associated periodic syndromes (CAPS) are a group of inherited inflammatory disorders consisting of familial cold-induced autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS), and neonatal-onset multisystem inflammatory disease (NOMID; also known as chronic infantile neurologic, cutaneous, articular [CINCA] syndrome). These rare disorders are associated with heterozygous mutations in the NLRP3 (CIAS1) gene, which encodes the protein NALP3 or cryopyrin, and inflammation driven by excessive production of the cytokine interleukin-1beta (IL-1beta). Amyloidosis is a serious complication with 25% of MWS patients developing amyloidosis, with occasional fatal consequences, whilst up to 20% of CINCA/NOMID patients die from various complications, before reaching the early adulthood. In some CINCA/NOMID adult survivors amyloidosis can also occur. Prior to the discovery of the CIAS1 gene mutations and the advent of IL-1 targeted therapy, treatment was aimed at suppressing inflammation, with limited success. The selective blockade of IL-1beta, with anakinra (IL-1 receptor antagonist), not only provided supportive evidence for the role of IL-1beta in CAPS, but also demonstrated the efficacy of targeting IL-1beta for treatment of these conditions. In February, 2008, 'Orphan Drug' approval from the Food and Drug Administration (FDA) for rilonacept (IL-1 Trap/Arcalyst(), Regeneron Pharmaceuticals, Inc) was given for the treatment of two CAPS disorders, FCAS and MWS in adults and children 12 years and older, making rilonacept the first therapy approved for the treatment of CAPS.

  3. Analysis of the Indicence and Survival of Female Breast Cancer Patients in Beijing Over a 20-Year Period

    Institute of Scientific and Technical Information of China (English)

    Qijun Wang; Weixing Zhu; Xiumei Xing; Chenxu Qu

    2006-01-01

    OBJECTIVE To provide evidence for breast cancer prevention and control through epidemiological analysis of the incidence, mortality and survival rate of female breast cancer patients in Beijing.METHODS The female registration data in the Beijing urban area from 1982 to 2001 were retrospectively reviewed. The incidence, mortality and survival rate of female breast cancer patients were analyzed using routine and life-table statistical methods.RESULTS During the period of 1982 to 2001, there was a trend of an average annual increase of female breast cancer incidence of 4.6% in urban Beijing, and of 4.9% in the world-population standardized incidence.The epidemiological features of urban Beijing female breast cancer showed:(1)The incidence distribution of different age groups from 25 to 80 years elevated with two peaks at ages of 45~ and 70~ years; (2)There was an elevation in each age group over the last 20 years; (3)The incidence rate at ages of 35 to 64 reached 95.3/105, causing breast cancer to become the number one cancer in females. The changes in the survival rate showed the following: the 5-year observed survival rate (OSR)increased from 62.0% in 1982~1983 to 68.7% in 1987~1988, and the relative-survival rate (RSR) increased from 66.3% to 74.2%. The 10-year OSR and RSR in 1987~1988 were 60.3% and 65.1%, and at 15 years 57.5% and 61.3%, respectively. The mortality rate of breast cancer patients fluctuated from 8 to 10 per 105 population over the 20 years of study.CONCLUSION There is a trend of an annual increase in female breast cancer in Beijing. The 5-year survival is being improved gradually while the mortality remains stable. The results demonstrate that the principles of "early prevention, diagnosis and treatment" for breast cancer are effective in Beijing.

  4. [Effects of combined action of radon baths and transcranial magnetotherapy on cerebral circulation in patients in an intermediate period of a mild craniocerebral trauma].

    Science.gov (United States)

    Moliavchikova, O V; Cherevashchenko, L A; Grinzaĭd, Iu M; Aĭvazov, V N; Zhuravlev, M E

    2007-01-01

    The authors propose combined therapy improving cerebral circulation in patients in an intermediate period of a mild craniocerebral trauma. The combination consists of radon baths and transcranial magnetotherapy which raise blood volume filling, relieve vascular resistance, improve venous outflow.

  5. Prediction of Mesiodistal Width of Unerupted Lateral Incisors, Canines and Premolars in Orthodontic Patients in Early Mixed Dentition Period

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Toodehzaeim

    2017-01-01

    Full Text Available Objectives: Proper diagnosis and prevention of malocclusion are superior to treatment. Discrepancy between arch length and tooth size in mixed dentition period is a condition requiring timely diagnosis. Estimating the mesiodistal width of unerupted teeth according to the size of erupted ones can lead to earlier diagnosis of malocclusion. On the other hand, the best timing for serial extractions is before the eruption of lateral incisors. The aim of this study was to present prediction formulas for mesiodistal width of unerupted lateral incisors, canines and premolars in an Iranian population based on the width of erupted permanent mandibular central incisors and maxillary first molars.Materials and Methods: A total of 120 dental models (60 males, 60 females of orthodontic patients between 11-25 years were evaluated in Yazd city. The measurements were made by a digital caliper on the widest mesiodistal width of teeth at the interproximal contacts. Data were analyzed to calculate the prediction equation.Results: The prediction equation in the upper jaw was y=0.57x+10.82 for males, y=0.7x+6.37 for females and y=0.64x+8.46 for both sexes. The equation for the lower jaw was y=0.76x+2.86 for males, y=0.74x+3.53 for females and y=0.77x+2.7 for both sexes.Conclusions: The prediction equations suggested in this study can predict the mesiodistal width of unerupted lateral incisors, canines and premolars in an Iranian population in early mixed dentition period without taking radiographs.Keywords: Dentition, Mixed; Dentition, Permanent; Tooth, Unerupted

  6. Nutritional follow-up of patients with ulcerative colitis during periods of intestinal inflammatory activity and remission

    Directory of Open Access Journals (Sweden)

    Juliana Ripoli

    2010-03-01

    Full Text Available CONTEXT: Ulcerative colitis is an inflammatory bowel disease involving superficial inflammation of the mucosa of the colon, rectum, and anus, sometimes including the terminal ileum. When in clinical activity, the disease is characterized by various daily evacuations containing blood, mucus and/or pus alternating periods of remission. OBJECTIVE: To compare nutritional parameters (dietary, biochemical and anthropometric among patients with ulcerative colitis followed up on an outpatient basis over a period of 1 year and during periods of intestinal inflammatory activity and remission. METHODS: Sixty-five patients were studied over a period of 1 year and divided into two groups: group 1 with inflammatory disease activity (n = 24, and group 2 without disease activity (n = 41. Anthropometric measures, biochemical parameters, quantitative food intake, and qualitative food frequency were analyzed. RESULTS: A significant reduction in body mass index and weight and in the intake of energy, proteins, lipids, calcium, iron and phosphorus was observed in the group with inflammatory activity (group 1 when compared to the period of clinical remission. The most affected food groups were cereals, legumes, oils, and fats. In contrast, in group 2 significant differences in triceps and sub scapular skin fold thickness, total protein, hemoglobin and hematocrit were observed between the first and final visit. Calcium and vitamin B6 intake, as well as the consumption of legumes, meat and eggs, and sugar and sweets, was significantly higher than on the first visit. CONCLUSION: Patients with ulcerative colitis followed up on an outpatient basis tend to be well nourished. However, the nutritional aspects studied tend to worsen during the period of inflammatory disease activity.CONTEXTO: A retocolite ulcerativa inespecífica compreende uma das doenças inflamatórias intestinais, com características de inflamação superficial da mucosa do cólon, reto, ânus, podendo

  7. Sertraline and periodic limb movements during sleep: an 8-week open-label study in depressed patients with insomnia.

    Science.gov (United States)

    Zhang, Bin; Hao, Yanli; Jia, Fujun; Li, Xueli; Ren, Yanzhen; Zhou, Ping; Liu, Wuhan; Wing, Yun Kwok

    2013-12-01

    Previous studies have reported that selective serotonin reuptake inhibitors (SSRIs) might induce or exacerbate periodic limb movements during sleep (PLMS). However, most of these studies were retrospective and cross-sectional studies with small sample sizes on a selective SSRI, fluoxetine. Because different SSRIs have different pharmacologic profiles, it was not certain if other SSRIs also might lead to PLMS. Data were taken from an open-label 8-week trial of sertraline in depressive patients with insomnia (n=31). Depressed patients were administered sertraline 50mg at 8:00am on the first day, and the dosage was subsequently titrated up to a maximum of 200mg daily during the 8-week trial. All participants were tested by repeated polysomnography (PSG) (baseline, first day, 14th day, 28th day, and 56th day). Periodic leg movements (PLM) were visually counted and the PLM index (PLMI) was calculated. PLMS was defined as PLMI ⩾5, and significant PLMS was defined as PLMI ⩾15. Compared with baseline (PLMI, 3.6±1.5), all PLMI indices increased on the immediate administration of sertraline on the first day (PLMI, 5.1±3.9). From the 14th day onward, PLMI became stable and significantly higher than baseline and the first day (8.7±3.1 on the 14th day, 8.3±3.7 on the 28th day, and 8.5±3.6 on the 56th day; F[11.81]; P=.003). The clinical responses and PSG characteristics continuously improved during the 8-week trial. The PLMS group (PLMI ⩾5) had a higher arousal index (AI) than the non-PLMS group on the 14th day (9.4±5.5 vs 5.2±3.7; t test, 4.22; P=.03) and the 56th day (8.1±5.5 vs 4.3±3.7; z score, 3.11; P=.04); albeit, there was no significant clinical disturbances in the PLMS group. PLMS were increased during sertraline treatment, but only a few of the PLMS reached the significant level. This effect of sertraline on PLMS might be dosage dependent. Although the sertraline-induced PLMS did not seem to cause significant clinical disturbance, the PLMS group (PLMI

  8. [Evaluation of immunosuppressive treatment on homocystein levels in patients after kidney transplantation during a 2 year observation period].

    Science.gov (United States)

    Aksamit, Dariusz; Janda, Katarzyna; Kuźniewski, Marek; Krzanowski, Marcin; Ignacak, Ewa; Betkowska-Prokop, Alina; Chowaniec, Eve; Sułowicz, Wladysław

    2012-01-01

    The aim of the study was to evaluate the influence of the type of prescribed immunosuppression: cyclosporine A (CsA) vs. tacrolimus (Tac) on remote homocystein levels in patients (pts) after kidney transplantation (Ktx). The study included 51 pts (17 F, 34 M) aged 15 to 62 years (mean 38.1) after cadaver Ktx. The mean observation period equaled 21.2 months (6 -24); while total observation period was 90 personlyears. Before Ktx, 46 pts were treated with maintenance hemodialysis (HD), while 5 by peritoneal dialysis (PD). After Ktx, patients had immunosuppression prescribed according to the following schemes: prednisone (P) + CsA + azathioprine (AZA) - 12 pts; P + CsA + mycophenolate mofetil (MMF) -26 pts; P + Tac + MMF - 11 pts; and P + Tac + AZA - 2 pts. Hcy level was measured using high performance liquid chromatography (HPLC). Serum creatinine level was measured by standard method using the Hitachi 917 analyzer. Creatinine clearance was calculated based on the Cockcroft-Gault formula. Patient's blood was drawn before Ktx and 3, 6, 9, 12,15, 18, 21 and 24 months post procedure. Delayed graft function (DGF) after Ktx was diagnosed in 29 pts (56.9%) and this group required from 4 to 28 HD sessions (mean 14 sessions). Hcy level did not significantly differ between pts requiring (29 pts) and not requiring (22 pts) HD treatment after Ktx. It was also noted that the number of performed HD sessions did not significantly correlate with Hcy levels 24 months after Ktx (R =0.04, p=0.81). No relationship was found (non-parametric Spearman test) between the drop in Hcy level 3 months after Ktx as compare with value before Ktx and ischemia time (R=0.09, p=0.49), number of compatible HLA A and B (R=0.07, p=0.63), and DR antigens (R=0.09, p=0.51). Decrease in Hcy level (before Ktx and 24 months after Ktx) did not significantly correlate with the above parameters, respectively: R=-0.14, p=0.40; R=0.06, p=0.73; R=0.12, p=0.45; R=0.11, p=0.50. Decrease in Hcy level (before Ktx and 3

  9. Usefulness of routine periodic fasting to lower risk of coronary artery disease in patients undergoing coronary angiography.

    Science.gov (United States)

    Horne, Benjamin D; May, Heidi T; Anderson, Jeffrey L; Kfoury, Abdallah G; Bailey, Beau M; McClure, Brian S; Renlund, Dale G; Lappé, Donald L; Carlquist, John F; Fisher, Patrick W; Pearson, Robert R; Bair, Tami L; Adams, Ted D; Muhlestein, Joseph B

    2008-10-01

    Coronary artery disease (CAD) is common and multifactorial. Members of the Church of Jesus Christ of Latter-day Saints (LDS, or Mormons) in Utah may have lower cardiac mortality than other Utahns and the US population. Although the LDS proscription of smoking likely contributes to lower cardiac risk, it is unknown whether other shared behaviors also contribute. This study evaluated potential CAD-associated effects of fasting. Patients (n(1) = 4,629) enrolled in the Intermountain Heart Collaborative Study registry (1994 to 2002) were evaluated for the association of religious preference with CAD diagnosis (> or = 70% coronary stenosis using angiography) or no CAD (normal coronaries, <10% stenosis). Consequently, another set of patients (n(2) = 448) were surveyed (2004 to 2006) for the association of behavioral factors with CAD, with routine fasting (i.e., abstinence from food and drink) as the primary variable. Secondary survey measures included proscription of alcohol, tea, and coffee; social support; and religious worship patterns. In population 1 (initial), 61% of LDS and 66% of all others had CAD (adjusted [including for smoking] odds ratio [OR] 0.81, p = 0.009). In population 2 (survey), fasting was associated with lower risk of CAD (64% vs 76% CAD; OR 0.55, 95% confidence interval 0.35 to 0.87, p = 0.010), and this remained after adjustment for traditional risk factors (OR 0.46, 95% confidence interval 0.27 to 0.81, p = 0.007). Fasting was also associated with lower diabetes prevalence (p = 0.048). In regression models entering other secondary behavioral measures, fasting remained significant with a similar effect size. In conclusion, not only proscription of tobacco, but also routine periodic fasting was associated with lower risk of CAD.

  10. Usefulness of Routine Periodic Fasting to Lower Risk of Coronary Artery Disease among Patients Undergoing Coronary Angiography

    Science.gov (United States)

    Horne, Benjamin D.; May, Heidi T.; Anderson, Jeffrey L.; Kfoury, Abdallah G.; Bailey, Beau M.; McClure, Brian S.; Renlund, Dale G.; Lappé, Donald L.; Carlquist, John F.; Fisher, Patrick W.; Pearson, Robert R.; Bair, Tami L.; Adams, Ted D.; Muhlestein, Joseph B.

    2008-01-01

    Coronary artery disease (CAD) is common and multi-factorial. Members of the Church of Jesus Christ of Latter-day Saints (LDS, or Mormons) in Utah may have lower cardiac mortality than other Utahns and the US population. While the LDS proscription of smoking likely contributes to lower cardiac risk, it is unknown whether other shared behaviors also contribute. This study evaluated potential CAD-associated effects of fasting. Patients (N1=4,629) enrolled in the Intermountain Heart Collaborative Study registry (1994-2002) were evaluated for association of religious preference with CAD diagnosis (≥70% coronary stenosis on angiography) or no CAD (normal coronaries, <10% stenosis). Consequently, another set of patients (N2=448) were surveyed (2004-2006) for association of behavioral factors with CAD, with the primary variable being routine fasting (i.e., abstinence from food and drink). Secondary survey measures included proscription of alcohol, tea, and coffee, social support, and religious worship patterns. In population 1 (initial), 61% of LDS and 66% of all others had CAD (adjusted [including for smoking]: odds ratio [OR]=0.81; p=0.009). In population 2 (survey), fasting was associated with lower risk of CAD (64% vs. 76% CAD; OR=0.55, CI=0.35, 0.87; p=0.010) and this remained after adjustment for traditional risk factors (OR=0.46, CI=0.27, 0.81; p=0.007). Fasting was also associated with lower diabetes prevalence (p=0.048). In regression models entering other secondary behavioral measures, fasting remained significant with similar effect size. In conclusion, not only proscription of tobacco, but also routine periodic fasting was associated with lower risk of CAD. PMID:18805103

  11. Molecular analysis of the eighteen most frequent mutations in the BRCA1 gene in 63 Chilean breast cancer families

    Directory of Open Access Journals (Sweden)

    LILIAN JARA

    2004-01-01

    Full Text Available BRCA1 gene mutations account for nearly all families with multiple cases of both early onset breast and/or ovarian cancer and about 30% of hereditary breast cancer. Although to date more than 1,237 distinct mutations, polymorphisms, and variants have been described, several mutations have been found to be recurrent in this gene. We have analyzed 63 Chilean breast/ovarian cancer families for eighteen frequent BRCA1 mutations. The analysis of the five exons and two introns in which these mutations are located was made using mismatch PCR assay, ASO hybridization assay, restriction fragment analysis, allele specific PCR assay and direct sequentiation techniques. Two BRCA1 mutations (185delAG and C61G and one variant of unknown significance (E1250K were found in four of these families. Also, a new mutation (4185delCAAG and one previously described polymorphism (E1038G were found in two other families. The 185delAG was found in a 3.17 % of the families and the others were present only in one of the families of this cohort. Therefore these mutations are not prominent in the Chilean population. The variant of unknown significance and the polymorphism detected could represent a founder effect of Spanish origin

  12. “To Sing with the Spirit:” Psalms, Hymns and the Spirituality of Late Eighteen Century American Presbyterians

    Directory of Open Access Journals (Sweden)

    William Harrison Taylor

    2013-12-01

    Full Text Available This paper contends that the contemporary discussion among theologians regarding the relationship between theology and spirituality can offer new insight into the eighteenth century religious world. This theological discussion has wrestled with, among other things, the questions of whether theology and spirituality are mutually exclusive and what exactly their relationship looks like. Resoundingly, theologians such as Alister McGrath, J. I. Packer, and Sandra Schneiders have concluded that any separation of the two represents a false dichotomy within Christianity. Accordingly, Christians are called to “the quest for a fulfilled and authentic Christian existence, involving the bringing together of the fundamental ideas of Christianity and the whole experience of living on the basis of, and within, the scope of the Christian faith.” Sound theology, then, necessitates living by the Spirit and vice versa. The benefit of this theological position for religious history lies in its reevaluation of the common categorization of Christians as either theologically or spiritually focused. By heeding the call of contemporary theologians and blurring these lines of distinction, historians can afford eighteen century American Christians the chance to better define themselves. Considered in this light, the actions of the Presbyterians, for instance, are freed from the manipulative “social control” framework as one of the “establishmentarian” churches. Instead, the Presbyterians reveal characteristics generally reserved for the democratically charged “sectarians,” such as a robust spiritual life compelled by music.

  13. Radiographic and 2-D echocardiographic findings in eighteen cats experimentally exposed to D. immitis via mosquito bites

    International Nuclear Information System (INIS)

    Selcer, B.A.; Newell, S.M.; Mansour, A.E.; McCall, J.W.

    1996-01-01

    Eighteen cats were exposed to Dirofilaria immitis infected mosquitoes. Thoracic radiography was performed prior to exposure and at 5, 7, and 9 month intervals following exposure. Immunologic testing for adult heartworm antigen was performed on days 168, 195, 210, 224, 237, 254 and 271 post infection. Necropsies were performed on all cats. Adult heartworms were found in 61% of the exposed cats. Radiographic findings in heartworm positive cats included bronchointerstitial lung disease, lobar pulmonary arterial enlargement and pulmonary hyperinflation. In most heartworm positive cats, lobar arterial enlargement resolved as the disease progressed while pulmonary hyperinflation progressively became more common. Pulmonary patterns in heartworm positive cats remained abnormal throughout the study while abnormal pulmonary patterns resolved in over 50% of the heartworm negative cats. Cardiomegaly was seen in less than 50% of the cats with adult heartworms at necropsy. This study suggests that the radiographic appearance of heartworm disease is variable and radiographic changes are dependent on the time post infection at which cats are evaluated. Echocardiographic examinations were randomly performed on 16 of 18 cats. Heartworms were identified in 7 cats. No false positive identifications were made. Persistent pulmonary disease accompanied by resolving vascular disease in heartworm cats with pulmonary hyperinflation may be difficult to distinguish from cats with feline allergic lung. Echocardiograms may be helpful in identifying adult heartworms in cats in which the radiographic signs or immunodiagnostic data are insufficient to provide a diagnosis

  14. An appraisal of eighteen commonly consumed edible plants as functional food based on their antioxidant and starch hydrolase inhibitory activities.

    Science.gov (United States)

    Lee, Yian Hoon; Choo, Candy; Watawana, Mindani I; Jayawardena, Nilakshi; Waisundara, Viduranga Y

    2015-11-01

    Eighteen edible plants were assessed for their antioxidant potential based on oxygen radical absorbance capacity (ORAC), 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity, total phenolics, vitamin C content and various lipophilic antioxidants. The inhibitory activities of the plant extracts against the enzymatic activities of α-amylase and α-glucosidase were also evaluated. The antioxidant and starch hydrolase activities of the plants varied widely across a single batch of analysis. The ORAC and DPPH radical scavenging EC50 values varied between 298 and 1984 Trolox equivalents g(-1) fresh weight and between 91 and 533 mg kg(-1) fresh weight, respectively. The total phenolics and vitamin C contents varied between 32 and 125 mg gallic acid equivalents g(-1) fresh weight and between 96 and 285 µg g(-1) fresh weight, respectively. All the plants contained neoxanthin, violaxanthin, and α- and β-carotene in varying amounts. Coccinia grandis, Asparagus racemosus, Costus speciosus, Amaranthus viridis and Annona muricata displayed the highest inhibitory activities against starch hydrolases. They were the most efficient against the breakdown of seven starches exposed to the two enzymes as well. Overall, the edible plants were observed to display a high antioxidant potential with starch hydrolase inhibitory properties, which were beneficial in their being recognized as functional food. © 2014 Society of Chemical Industry.

  15. Level of anxiety versus self-care in the preoperative and postoperative periods of total laryngectomy patients.

    Science.gov (United States)

    Almonacid, Clara Inés Flórez; Ramos, Alfredo Jurado; Rodríguez-Borrego, María-Aurora

    2016-06-14

    estimate the prevalence of anxiety in laryngectomy patients in the pre and postoperative periods and its relation with the self-care level. observational research of 40 patients with stage IV laryngeal cancer. Three observations took place: in the preoperative phase, at seven and at 14 days after the surgery; between June 2010 and December 2012. Two self-care levels were defined: self-sufficient and needing help for activities of daily living and treatment-related activities. To assess the anxiety levels, Zigmond's hospital anxiety scale (1983) was used. in the preoperative and postoperative phases, the patients presented high levels of anxiety. Concerning self-care, on average, self-sufficient patients presented lower levels of anxiety than patients who needed help to accomplish activities of daily living and activities deriving from the surgery, without significant differences. anxiety is present at all times in laryngectomy patients and the reduction of the self-care deficit seems to decrease it, without putting a permanent end to it. estimar a prevalência de ansiedade do paciente laringectomizado no pré-operatório e pós-operatório e sua relação com o nível de autocuidado. pesquisa observacional de 40 pacientes com câncer da laringe estágio IV. Foram realizadas 3 observações: no pré-operatório, a 7 e 14 dias pós-operatório, no período de junho de 2010 a dezembro de 2012. Dois níveis de autocuidado foram definidos: autossuficientes e precisar ajuda para as atividades da vida diária e relacionadas ao tratamento. Para avaliar a ansiedade, foi utilizada a escala de ansiedade hospitalar de Zigmond (1983). no pré-operatório e pós-operatório, os pacientes apresentaram níveis elevados de ansiedade. Com relação ao autocuidado, os pacientes autossuficientes apresentaram na média níveis inferiores de ansiedades que os pacientes que precisavam de ajuda para realizar as atividades da vida diária y as derivadas da cirurgia, sem chegar a ser

  16. Comparison between dopaminergic agents and physical exercise as treatment for periodic limb movements in patients with spinal cord injury.

    Science.gov (United States)

    De Mello, M T; Esteves, A M; Tufik, S

    2004-04-01

    Randomized controlled trial of physical exercise and dopaminergic agonist in persons with spinal cord injury and periodic leg movement (PLM). The objective of the present study was to compare the effectiveness of physical exercise and of a dopaminergic agonist in reducing the frequency of PLM. Centro de Estudos em Psicobiologia e Exercício. Universidade Federal de São Paulo, Brazil. A total of 13 volunteers (mean age: 31.6+/-8.3 years) received L-DOPA (200 mg) and benserazide (50 mg) 1 h before sleeping time for 30 days and were then submitted to a physical exercise program on a manual bicycle ergometer for 45 days (3 times a week). Both L-DOPA administration (35.11-19.87 PLM/h, P<0.03) and physical exercise (35.11-18.53 PLM/h, P<0.012) significantly reduced PLM; however, no significant difference was observed between the two types of treatment. The two types of treatment were found to be effective in the reduction of PLM; however, physical exercise is indicated as the first treatment approach, while dopaminergic agonists or other drugs should only be recommended for patients who do not respond to this type of treatment.

  17. Gait and balance deterioration over a 12-month period in multiple sclerosis patients with EDSS scores ≤ 3.0.

    Science.gov (United States)

    Galea, Mary P; Cofré Lizama, L Eduardo; Butzkueven, Helmut; Kilpatrick, Trevor J

    2017-01-01

    It is not currently known whether gait and balance measures are responsive to deterioration of motor function in multiple sclerosis (MS) patients with low EDSS scores (≤3.0). The aim of this study was to quantify MS-related gait and balance deterioration over a 12-month period. Thirty-eight participants with MS (33 female, mean age: 41.1 ± 8.3 years), mean time since diagnosis 2.2 ± 4.1 years, EDSS score ≤3.0 and without clinical evidence of gait deterioration, were recruited. Participants performed walking trials and Functional and Lateral Reach Tests. Kinematics of the ankle and knee, and electromyography of the tibialis anterior and medial gastrocnemius muscles were also measured. Three participants reported relapses with worsening EDSS scores and 4 non-relapsing participants had worse EDSS scores at 12 months. There were significant decreases in mean gait speed, stride length and balance scores, and a significant increase in double support. Marked changes in ankle kinematics, with decreased medial gastrocnemius activity were observed. Gait and balance performance of non-disabled RRMS participants may progressively decline, even in the absence of both acute clinical relapse and change in clinical status measured by the EDSS.

  18. Patient-reported outcomes in patients with overactive bladder treated with mirabegron and tolterodine in a prospective, double-blind, randomized, two-period crossover, multicenter study (PREFER).

    Science.gov (United States)

    Herschorn, Sender; Staskin, David; Tu, Le Mai; Fialkov, Jonathan; Walsh, Terry; Gooch, Katherine; Schermer, Carol R

    2018-04-19

    The PREFER study was an assessment of medication tolerability, treatment preference and symptom improvement during treatment with mirabegron (M) and tolterodine (T) extended release (ER) in patients with overactive bladder (OAB). In this analysis of PREFER, patient-reported outcomes (PROs) were assessed during treatment. PREFER was a two-period, 8-week crossover, double-blind, phase IV study (NCT02138747) of treatment-naïve adults with OAB ≥3 months randomized to 1 of 4 treatment sequences (M/T; T/M; M/M; T/T), separated by a 2-week washout. Tolterodine ER was dosed at 4 mg for 8 weeks and mirabegron was dosed at 25 mg for 4 weeks then increased to 50 mg for the next 4 weeks. At each visit, PROs related to treatment satisfaction, quality of life and symptom bother were assessed using the OAB Satisfaction (OAB-S; 3 independent scales/5 single-item overall assessments), OAB-q (total health-related QoL [HRQoL] and subscales [Sleep, Social, Coping, Concern] and Symptom Bother scale) and Patient Perception of Bladder Condition (PPBC) questionnaires. Responder rates were reported for OAB-q subscales based on a minimal important difference (MID; ≥ 10-point improvement) and OAB-S Medication Tolerability score ≥ 90. In total, 358 randomized patients received ≥1 dose of double-blind study medication and completed ≥1 post-baseline value (OAB-S scale, OAB-q, PPBC): M/T (n = 154), T/M (n = 144), M/M (n = 30) or T/T (n = 30). At end of treatment (EoT), mirabegron and tolterodine ER were associated with similar mean improvements in 7 of the 8 OAB-S scores investigated, OAB-q scales and PPBC. A higher percentage of patients achieved clinically relevant improvements (MID) in OAB-q scales and OAB-S Medication Tolerability score during treatment with mirabegron than tolterodine ER. On average, patients with OAB experienced improvements in treatment satisfaction, HRQoL and symptom bother that were of a similar magnitude during treatment with

  19. Eighteen-Year Cryopreservation Does Not Negatively Affect the Pluripotency of Human Embryos: Evidence from Embryonic Stem Cell Derivation

    Science.gov (United States)

    Rungsiwiwut, Ruttachuk; Numchaisrika, Pranee; Ahnonkitpanit, Vichuda; Isarasena, Nipan; Virutamasen, Pramuan

    2012-01-01

    Abstract Human embryonic stem (hES) cells are considered to be a potential source for the therapy of human diseases, drug screening, and the study of developmental biology. In the present study, we successfully derived hES cell lines from blastocysts developed from frozen and fresh embryos. Seventeen- to eighteen-year-old frozen embryos were thawed, cultured to the blastocyst stage, and induced to form hES cells using human foreskin fibroblasts. The Chula2.hES cell line and the Chula4.hES and Chula5.hES cell lines were derived from blastocysts developed from frozen and fresh embryos, respectively. The cell lines expressed pluripotent markers, including alkaline phosphatase (AP), Oct3/4, stage-specific embryonic antigen (SSEA)-4, and tumor recognition antigen (TRA)-1-60 and TRA-1-81 as detected with immunocytochemistry. The real-time polymerase chain reaction (RT-PCR) results showed that the cell lines expressed pluripotent genes, including OCT3/4, SOX2, NANOG, UTF, LIN28, REX1, NODAL, and E-Cadherin. In addition, the telomerase activities of the cell lines were higher than in the fibroblast cells. Moreover, the cell lines differentiated into all three germ layers both in vitro and in vivo. The cell lines had distinct identities, as revealed with DNA fingerprinting, and maintained their normal karyotype after a long-term culture. This study is the first to report the successful derivation of hES cell lines in Thailand and that frozen embryos maintained their pluripotency similar to fresh embryos, as shown by the success of hES cell derivation, even after years of cryopreservation. Therefore, embryos from prolonged cryopreservation could be an alternative source for embryonic stem cell research. PMID:23514952

  20. The impact of "Ramadan fasting period" on total and differential white blood cells, haematological indices, inflammatory biomarker, respiratory symptoms and pulmonary function tests of healthy and asthmatic patients.

    Science.gov (United States)

    Askari, V R; Alavinezhad, A; Boskabady, M H

    2016-01-01

    There is no conclusive evidence regarding the effect of fasting on different features in asthmatic patients. In the present study, the effect of Ramadan fasting in asthmatic patients and healthy control was studied. Haematological indices, inflammatory mediators, pulmonary function tests (PFT) and respiratory symptoms were evaluated in 15 asthmatic patients compared to 14 healthy matched control group before and after the one-month fasting period in Ramadan. The change in each parameter from the beginning to the end of Ramadan was calculated and referred to as "variation during Ramadan". The values of MCH, MCHC in both groups and monocyte counts in asthmatic patients, were significantly increased but platelet count was reduced in asthmatic and controls respectively compared to pre-Ramadan fasting period (Pfasting month (Pfasting month in both groups were non-significantly higher compared to pre-fasting values except FVC. Respiratory symptoms in asthmatic patients were non-significantly but wheeze-o was significantly reduced after Ramadan fasting period in asthma group (Pfasting period between two groups, although reduction of hs-CRP in asthmatic group was non-significantly higher than control group. These results show that Ramadan fasting period has no negative impact on asthma and may have some positive effect on asthma severity with regard to reduction of hs-CRP concentration and chest wheeze. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  1. An approach to combining parallel and cross-over trials with and without run-in periods using individual patient data.

    Science.gov (United States)

    Tvete, Ingunn F; Olsen, Inge C; Fagerland, Morten W; Meland, Nils; Aldrin, Magne; Smerud, Knut T; Holden, Lars

    2012-04-01

    In active run-in trials, where patients may be excluded after a run-in period based on their response to the treatment, it is implicitly assumed that patients have individual treatment effects. If individual patient data are available, active run-in trials can be modelled using patient-specific random effects. With more than one trial on the same medication available, one can obtain a more precise overall treatment effect estimate. We present a model for joint analysis of a two-sequence, four-period cross-over trial (AABB/BBAA) and a three-sequence, two-period active run-in trial (AB/AA/A), where the aim is to investigate the effect of a new treatment for patients with pain due to osteoarthritis. Our approach enables us to separately estimate the direct treatment effect for all patients, for the patients excluded after the active run-in trial prior to randomisation, and for the patients who completed the active run-in trial. A similar model approach can be used to analyse other types of run-in trials, but this depends on the data and type of other trials available. We assume equality of the various carry-over effects over time. The proposed approach is flexible and can be modified to handle other designs. Our results should be encouraging for those responsible for planning cost-efficient clinical development programmes.

  2. Clinical outcomes with olanzapine long-acting injection: impact of the 3-hour observation period on patient satisfaction and well-being

    Directory of Open Access Journals (Sweden)

    Anand E

    2016-10-01

    Full Text Available Ernie Anand,1 Lovisa Berggren,2 John Landry,3 Ágoston Tóth,4 Holland C Detke5 1Neuroscience Medical Affairs, Eli Lilly & Company Ltd, Windlesham, UK; 2Global Statistical Sciences, Lilly Deutschland GmbH, Bad Homburg, Germany; 3Global Statistical Sciences, Eli Lilly Canada Inc., Toronto, ON, Canada; 4Neuroscience, Lilly Hungary, Budapest, Hungary; 5Psychiatry and Pain Disorders, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA Background: The objective of the present analysis is to determine the impact of the 3-hour observation period for olanzapine long-acting injection (LAI on patient satisfaction and well-being by comparing data collected before and after its implementation. Methods: This is a post hoc analysis of patients treated with olanzapine LAI in 1 a 6-month fixed-dose randomized controlled trial and/or 2 a 6-year open-label safety study. This analysis was limited to patients with schizophrenia who were treated with olanzapine LAI consistent with the approved indication and dosing recommendations of the European Union Summary of Product Characteristics (N=966. Of the 966 patients, the analysis further focused only on those patients who received both 1 at least one injection before the implementation of the 3-hour observation period and 2 at least one injection after implementation of the 3-hour observation period (N=487. Patient satisfaction was assessed with the three-item Patient Satisfaction with Medication Questionnaire-Modified. Responses were averaged across all postbaseline visits occurring before (ie, without the implementation of the 3-hour observation period and across all postbaseline visits occurring after (ie, with the implementation of the 3-hour observation period. In addition, the rate of postinjection delirium/sedation syndrome events was calculated. Results: There was no meaningful change after implementation of the 3-hour observation period in satisfaction (before: mean [SD] =4.0 [1.02] and

  3. Oil fatty acid composition of eighteen Mediterranean olive varieties cultivated under the arid conditions of Boughrara (southern Tunisia

    Directory of Open Access Journals (Sweden)

    Zarrouk, Mokhtar

    2009-12-01

    Full Text Available In this study, eighteen olive varieties, originating from Spain, France, Italy, Greece and Algeria, and maintained at the olive experimental station of Boughrara (arid region of Tunisia were evaluated for their oil yield and fatty acid composition. The analysis of variance revealed significant differences among varieties for all traits (p En este estudio, dieciocho variedades de aceituna procedentes de España, de Francia, de Italia, de Grecia y de Argelia, cultivadas en la estación experimental del olivo de Boughrara (región árida de Túnez, fueron evaluadas para el rendimiento en aceite y la composición de ácidos grasos. El análisis de la varianza mostró diferencias significativas entre todas las variedades (p < 0.01. El análisis de “clusters” jerárquico clasificó las variedades en tres grandes grupos. El primer grupo incluía un subgrupo compuesto por siete variedades de aceituna Changlot Real, Koroneiki, Verdial de Vélez- Málaga, Coratina, Lechín de Granada, Cornezuelo y Leccino, que se caracterizan por su alto rendimiento en aceite, alto contenido en oleico y bajo contenido en ácidos palmítico y linoleico. Las composiciones de ácidos grasos de aceites provenientes de estas variedades se conforman con estándares internacionales y son mejores si las comparamos con la de Chemlali (el cultivo más abundante en Túnez. Finalmente, los ácidos grasos mayoritarios (palmítico (C16:0, oleico (C18:1 y linoleico (C18:2 de nueve de los aceites de oliva virgen estudiados fueron comparados con los de las mismas variedades cultivadas en sus áreas originarias. A excepción de los aceites Koroneiki y Olivière que mostraron una composición de ácidos grasos inalterable y del aceite Cornezuelo en el que se observó un aumento del nivel de ácido oleico y un descenso del nivel de ácido linoleico, la mayoría de los aceites mostró disminución de ácido oleico y aumento de los porcentajes de ácido palmítico y linoleico, compar

  4. Low-frequency rTMS with language therapy over a 3-month period for sensory-dominant aphasia: case series of two post-stroke Japanese patients.

    Science.gov (United States)

    Kakuda, Wataru; Abo, Masahiro; Uruma, Go; Kaito, Nobuyoshi; Watanabe, Motoi

    2010-01-01

    To examine the safety and feasibility of therapeutic application of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with language therapy for post-stroke patients with sensory-dominant aphasia. Two post-stroke Japanese patients with sensory-dominant aphasia were studied. In both patients, 10 sessions of 20-minute low-frequency rTMS with 1 Hz to the Wernicke's area were provided throughout 6-day hospitalization, followed by weekly outpatient rTMS treatment for 3 months. The language therapy was also provided through the period of in- and out-patient treatment. Language function was evaluated using the Token test and the Standard Language Test of Aphasia (SLTA) at the start and end of the in-patient treatment and the end of the outpatient treatment. The therapeutic protocol was well tolerated throughout the in- and out-patient treatments, without any adverse effects. The scores of the Token test and certain sub-categories of SLTA increased in both patients after the in-patient rTMS treatment. Persistent improvement of the score was noted over the 3-month post-discharge period. The proposed protocol of long-term application of low-frequency rTMS to the Wernicke's area and language therapy is considered a safe and feasible therapeutic approach for post-stroke patients with sensory-dominant aphasia.

  5. Therapeutic efficiency of decimeter range waves and their effect on cerebral circulation in patients during recovery period after surgery performed on intracranial arteries

    Energy Technology Data Exchange (ETDEWEB)

    Danilova, D.P.; Strelkova, N.I.; Streltsova, E.N.

    The goal of this work was to evaluate the therapeutic effect of an electromagnetic field in the decimeter range on focal neurologic symptoms and cerebral circulation in patients recovering from surgery on intracranial arteries. This treatment led to regression of focal neurologic symptoms and improved cerebral circulation in 86.3% of patients who tolerated this procedure rather well. This approach was recommended as a method of choice for rehabilitative treatment during the postsurgical period. 7 references, 1 figure.

  6. Concern for pain in the pre-operative period- is the internet being used for information by patients?

    Science.gov (United States)

    Kurup, Viji; Dabu-Bondoc, Susan; Senior, Audrey; Dai, Feng; Hersey, Denise; Vadivelu, Nalini

    2014-02-01

    This study was conducted to provide information regarding prevalence of pain, type of provider managing pain, and use of Internet for information regarding pain, among patients coming for presurgical anesthesia consultation at a major academic institution. With IRB approval, patients were invited to participate in a voluntary and anonymous 14 question survey given to them when they presented for anesthesia consultation prior to their surgical procedure. The qualitative/categorical data were summarized by number (percentage [%]) and analyzed by Chi-square test or Fisher's exact test as appropriate. All data analyses were performed using the statistical software SAS, v9.2. A total of 1039 patients were asked to complete the survey and 670 patients returned their responses (response rate = 64.5%). 83% of patients had a history of prior surgery. 57% were concerned about postoperative pain. 30% of patients had chronic pain for more than 3 months pre-operatively. 16% of patients had looked online for information regarding pain. Pain physicians were involved in pain management only in 3.8% of these patients. Patients are presenting for surgery with significant pre-operative pain issues. Knowing this information pre-operatively will help healthcare personnel manage postsurgical pain more effectively. Patients are also using the Internet to obtain information regarding pain. As providers, there may be value to directing patients to reliable information online during consultation. As all physicians will eventually be managing chronic pain in their patients, pain education should be given priority in medical school curriculum. © 2013 World Institute of Pain.

  7. Incidence of peri-implant mucositis and peri-implantitis in edentulous patients with an implant-retained mandibular overdenture during a 10-year follow-up period

    NARCIS (Netherlands)

    Meijer, Henny J. A.; Raghoebar, Gerry M.; de Waal, Yvonne C. M.; Vissink, Arjan

    2014-01-01

    Objectives: The aim of this sub-analysis of two prospective studies was to assess the incidence of peri-implant mucositis and peri-implantitis in fully edentulous patients with an implant-retained mandibular overdenture during a 10-year follow-up period. Material and Methods: One hundred and fifty

  8. Evaluation of cephalometric changes in patients with class III malocclusion in mixed dentition period following face mask therapy and slow maxillary expansion

    Directory of Open Access Journals (Sweden)

    Ahmad Akhondi MS.

    2008-11-01

    Full Text Available "nBackground and Aim: Among different treatments of patients with Class III malocclusion , orthopedic protraction of maxilla has been known as an effective method in mixed dentition period. The aim of this study was to evaluate the cephalometric changes of Cl III patients in mixed dentition period following face mask therapy and slow maxillary expansion. "nMaterials and Methods: This was a before-after study which was conducted on 10 children in mixed dentition period, who had class III malocclusion and maxillary deficiency according to the Stiener and Mc Namara's analysis. The patients were all treated by protraction face mask and slow maxillary expansion. The cephalometric changes of maxilla , mandible and dental relations during the treatment were analyzed by Paired sample T Test. P<0.05 was considered as the level of significant. "nResults: The overjet increasement was 1.7mm. Co. ANS distance improvement was 5.6mm, Ptm.ANS distance increasing was 3mm, and ultimately improvement of Gf.s distance was 1.5mm which were all statistically significant (p<0.05. "nConclusion: Based on the results of this study, face mask therapy with slow maxillary expansion is able to improve the horizotal position of maxilla, in patients with Cl III malocclusion , in mixed dentition period.

  9. Is Heart Period Variability Associated with the Administration of Lifesaving Interventions in Individual Prehospital Trauma Patients with Normal Standard Vital Signs?

    Science.gov (United States)

    2010-08-01

    heart period variability as an indicator of mortality in intensive care unit patients many hours before death. Similarly, re- cent studies using data...the Department of Health and Kinesiology (CAR), The University of Texas at San Antonio, San An- tonio, TX; U.S. Army Institute of Surgical Research (CAR

  10. Prognostic factors for weight loss over 1-year period in patients recently diagnosed with mild Alzheimer Disease

    DEFF Research Database (Denmark)

    Hansen, M.L.; Waldorff, F.B.; Waldemar, G.

    2011-01-01

    The aim of the study was to identify prognostic factors for weight loss in patients recently diagnosed with mild Alzheimer disease (AD), with special emphasis on the patients' social participation and living arrangements. The data used in this study was part of the Danish Alzheimer Intervention...

  11. ISOLATION OF THE GENOME SEQUENCE STRAIN MYCOBACTERIUM AVIUM 104 FROM MULTIPLE PATIENTS OVER A 17-YEAR PERIOD

    Science.gov (United States)

    The genome sequence strain 104 of the opportunistic pathogen Mycobacterium avium was isolated form an adult AIDS patient in Southern California in 1983. Isolates of non-paratuberculosis M. avium from 207 other patients in Southern California and elsewhere were examined for genoty...

  12. Mental functioning in patients with rheumatoid arthritis over an eleven years follow-up period: the role of comorbidity

    NARCIS (Netherlands)

    Hoek, van den J.; Roorda, L.D.; Boshuizen, H.C.; Bos, van den G.A.; Hees, van J.; Rupp, I.; Tijhuis, G.; Dekker, J.

    2012-01-01

    Background Mental functioning is reported as an important outcome measure in patients with Rheumatoid Arthritis (RA). Patients show lower mental functioning scores than the general population (1). A factor that has great impact on the overall health outcomes is comorbidity (2). Both somatic and

  13. Diagnostic and interventional radiology in the post-operative period and follow-up of patients after rectal resection with coloanal anastomosis

    International Nuclear Information System (INIS)

    Severini, A.; Civelli, E.M.; Uslenghi, E.; Cozzi, G.; Salvetti, M.; Milella, M.; Gallino, G.; Bonfanti, G.; Belli, F.; Leo, E.

    2000-01-01

    Surgical treatment of carcinoma of the distal third of the rectum with anal sphincter preservation is increasingly used in accredited cancer centers. This study aimed to evaluate the diagnostic usefulness of radiological investigations in the management of patients who had undergone resection with coloanal anastomosis for carcinoma of the rectum, in the immediate post-operative period, during closure of the protective colostomy and in the follow-up of symptomatic recanalized patients. A total of 175 patients who had undergone total rectal resection with end-to-side anastomosis for carcinoma of the distal third of the rectal ampulla, most of whom had received postoperative radiotherapy, were evaluated radiologically. In the postoperative period radiological investigation was ordered only for symptomatic patients to detect pathology of the anastomosis and the pouch sutures and was used direct film abdominal radiography and contrast-enhanced radiography of the rectal stump with a water-soluble radio-opaque agent. Before closure of the colostomy, 2 months after rectal excision or approximately 4 months after if postoperative radiotherapy was given, the anastomosis and pouch of all patients, even asymptomatic ones, were studied with water-soluble contrast enema to check for normal canalization. In the follow-up after recanalization radiological examinations were done to complete the study of the large intestine if the endoscopist was not able to examine it up to the cecum. Of the 175 patients examined radiologically during the postoperative period and/or subsequent follow-up, 95 showed no pathological findings. Seventy-nine patients had fistulas of the coloanal anastomosis or the pouch, 23 of which supplied a presacral collection. In the absence of severe sepsis, the only therapeutic measures were systemic antibiotics and washing of the surgical catheters to maintain efficient operation. In 2 patients in whom transanal drainage was performed radiologically the fistula

  14. Diagnostic and interventional radiology in the post-operative period and follow-up of patients after rectal resection with coloanal anastomosis

    Energy Technology Data Exchange (ETDEWEB)

    Severini, A.; Civelli, E.M.; Uslenghi, E.; Cozzi, G.; Salvetti, M.; Milella, M. [Department of Radiology, National Cancer Institute of Milan, via Venezian 1, I-23100 Milan (Italy); Gallino, G.; Bonfanti, G.; Belli, F.; Leo, E. [Department of Surgery, National Cancer Institute of Milan, via Venezian 1, I-23100 Milan (Italy)

    2000-07-01

    Surgical treatment of carcinoma of the distal third of the rectum with anal sphincter preservation is increasingly used in accredited cancer centers. This study aimed to evaluate the diagnostic usefulness of radiological investigations in the management of patients who had undergone resection with coloanal anastomosis for carcinoma of the rectum, in the immediate post-operative period, during closure of the protective colostomy and in the follow-up of symptomatic recanalized patients. A total of 175 patients who had undergone total rectal resection with end-to-side anastomosis for carcinoma of the distal third of the rectal ampulla, most of whom had received postoperative radiotherapy, were evaluated radiologically. In the postoperative period radiological investigation was ordered only for symptomatic patients to detect pathology of the anastomosis and the pouch sutures and was used direct film abdominal radiography and contrast-enhanced radiography of the rectal stump with a water-soluble radio-opaque agent. Before closure of the colostomy, 2 months after rectal excision or approximately 4 months after if postoperative radiotherapy was given, the anastomosis and pouch of all patients, even asymptomatic ones, were studied with water-soluble contrast enema to check for normal canalization. In the follow-up after recanalization radiological examinations were done to complete the study of the large intestine if the endoscopist was not able to examine it up to the cecum. Of the 175 patients examined radiologically during the postoperative period and/or subsequent follow-up, 95 showed no pathological findings. Seventy-nine patients had fistulas of the coloanal anastomosis or the pouch, 23 of which supplied a presacral collection. In the absence of severe sepsis, the only therapeutic measures were systemic antibiotics and washing of the surgical catheters to maintain efficient operation. In 2 patients in whom transanal drainage was performed radiologically the fistula

  15. Temporal trends and associated factors for pre-hospital and in-hospital delays of stroke patients over a 16-year period: the Athens study.

    Science.gov (United States)

    Papapanagiotou, Panagiotis; Iacovidou, Nicoletta; Spengos, Konstantinos; Xanthos, Theodoros; Zaganas, Ioannis; Aggelina, Afrodite; Alegakis, Athanasios; Vemmos, Konstantinos

    2011-01-01

    The management and outcome of acute ischemic stroke changed dramatically after the introduction of intravenous thrombolysis. However, relatively few patients have received thrombolytic treatment, mainly due to pre-hospital and/or in-hospital delays. Although the causes of these delays have been adequately studied, their change over a long period has not. All acute first-ever stroke patients (n = 2,746) presenting to our academic center from 1993 to 2008 were prospectively documented in a computerized stroke data bank. The time from symptoms onset to presentation at the emergency room and to acquisition of a brain CT was calculated. Time trends over this period as well as the factors affecting them were analyzed. The final study cohort consisted of 2,326 acute stroke patients after excluding 302 patients with an unknown time of stroke onset and 118 who suffered a stroke during hospitalization for another illness. Over the 16-year period, the median time from stroke onset to presentation at the emergency room decreased significantly from 3.15 h (interquartile range 1.30-10.30) to 2.00 h (range 1.00-4.00) (p best early management of acute stroke patients. Copyright © 2010 S. Karger AG, Basel.

  16. Retrievable Guenther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep venous thrombosis in perinatal period

    Energy Technology Data Exchange (ETDEWEB)

    Koecher, Martin [Department of Radiology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic)], E-mail: martin.kocher@seznam.cz; Krcova, Vera [Department of Hematooncology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic); Cerna, Marie [Department of Radiology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic); Prochazka, Martin [Department of Obstetrics and Gynaecology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic)

    2009-04-15

    Objectives: To evaluate the feasibility and efficacy of the retrievable Guenther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep vein thrombosis in the perinatal period and to discuss the technical demands associated with the filter's implantation and retrieval. Methods: Between 1996 until 2007, eight women (mean age 27.4 years, range 20-42 years) with acute deep iliofemoral venous thrombosis in the perinatal period of pregnancy and increased risk of pulmonary embolism during delivery were indicated for retrievable Guenther Tulip Vena Cava Filter implantation. All filters were inserted and removed under local anesthesia from the jugular approach. Results: The Guenther Tulip Vena Cava Filter was implanted suprarenally in all patients on the day of caesarean delivery. In follow-up cavograms performed just before planned filter removal, no embolus was seen in the filter in any patient. In all patients the filter was retrieved without complications on the 12th day after implantation. Conclusions: Retrievable Guenther Tulip Vena Cava Filters can be inserted and removed in patients during the perinatal period without major complications.

  17. Retrievable Guenther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep venous thrombosis in perinatal period

    International Nuclear Information System (INIS)

    Koecher, Martin; Krcova, Vera; Cerna, Marie; Prochazka, Martin

    2009-01-01

    Objectives: To evaluate the feasibility and efficacy of the retrievable Guenther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep vein thrombosis in the perinatal period and to discuss the technical demands associated with the filter's implantation and retrieval. Methods: Between 1996 until 2007, eight women (mean age 27.4 years, range 20-42 years) with acute deep iliofemoral venous thrombosis in the perinatal period of pregnancy and increased risk of pulmonary embolism during delivery were indicated for retrievable Guenther Tulip Vena Cava Filter implantation. All filters were inserted and removed under local anesthesia from the jugular approach. Results: The Guenther Tulip Vena Cava Filter was implanted suprarenally in all patients on the day of caesarean delivery. In follow-up cavograms performed just before planned filter removal, no embolus was seen in the filter in any patient. In all patients the filter was retrieved without complications on the 12th day after implantation. Conclusions: Retrievable Guenther Tulip Vena Cava Filters can be inserted and removed in patients during the perinatal period without major complications.

  18. Retrievable Günther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep venous thrombosis in perinatal period.

    Science.gov (United States)

    Köcher, Martin; Krcova, Vera; Cerna, Marie; Prochazka, Martin

    2009-04-01

    To evaluate the feasibility and efficacy of the retrievable Günther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep vein thrombosis in the perinatal period and to discuss the technical demands associated with the filter's implantation and retrieval. Between 1996 until 2007, eight women (mean age 27.4 years, range 20-42 years) with acute deep iliofemoral venous thrombosis in the perinatal period of pregnancy and increased risk of pulmonary embolism during delivery were indicated for retrievable Günther Tulip Vena Cava Filter implantation. All filters were inserted and removed under local anesthesia from the jugular approach. The Günther Tulip Vena Cava Filter was implanted suprarenally in all patients on the day of caesarean delivery. In follow-up cavograms performed just before planned filter removal, no embolus was seen in the filter in any patient. In all patients the filter was retrieved without complications on the 12th day after implantation. Retrievable Günther Tulip Vena Cava Filters can be inserted and removed in patients during the perinatal period without major complications.

  19. Thyrotoxic periodic paralysis

    OpenAIRE

    Rojith Karandode Balakrishnan; Suresh Rama Chandran; Geetha Thirumalnesan; Nedumaran Doraisamy

    2011-01-01

    This article aims at highlighting the importance of suspecting thyrotoxicosis in cases of recurrent periodic flaccid paralysis; especially in Asian men to facilitate early diagnosis of the former condition. A case report of a 28 year old male patient with recurrent periodic flaccid paralysis has been presented. Hypokalemia secondary to thyrotoxicosis was diagnosed as the cause of the paralysis. The patient was given oral potassium intervention over 24 hours. The patient showed complete recove...

  20. Prognostic factors for weight loss over 1-year period in patients recently diagnosed with mild Alzheimer Disease

    DEFF Research Database (Denmark)

    Hansen, Marie-Louise H; Waldorff, Frans B; Waldemar, Gunhild

    2011-01-01

    The aim of the study was to identify prognostic factors for weight loss in patients recently diagnosed with mild Alzheimer disease (AD), with special emphasis on the patients' social participation and living arrangements. The data used in this study was part of the Danish Alzheimer Intervention......%. Furthermore, the results suggested a trend that for men, living alone was a risk factor for losing weight, whereas for women living with somebody was associated with a higher risk. However, further studies are pertinent within this area. As weight loss is a predictor of mortality in patients with AD...

  1. Factors associated with emergency services use in Taiwanese advanced cancer patients receiving palliative home care services during out-of-hours periods: a retrospective medical record study.

    Science.gov (United States)

    Kao, Yee-Hsin; Liu, Yao-Ting; Koo, Malcolm; Chiang, Jui-Kun

    2018-03-12

    For patients receiving palliative home care, the need to visit the emergency department is considered to be an indicator of poor quality care. The situation can be particularly distressing when it occurs outside of normal hours of palliative home care service. The aim of this study was to investigate the factors for emergency department use during out-of-hours periods of palliative home care service among advanced cancer patients in Taiwan. This case-control study was based on a retrospective medical chart review (January 2010 to December 2012) of advanced cancer patients who were receiving palliative home care in a community hospital in south Taiwan. The use of emergency medical services by these patients was dichotomized into either normal hours (8 a.m. to midnight, Monday to Friday, excluding public holidays) of palliative home care or outside normal hours. Logistic regression analyses were performed to evaluate factors associated with emergency services use during out-of-hours period of palliative home care. Of the 94 patients receiving palliative home care, 65 had used emergency services at least once during the 3-year study period. Of these 65 patients, 40% used emergency services during out-of-hours of palliative home care. Patients with distressing conditions (defined as the occurrence of any two conditions of dyspnea, change of consciousness, or gastrointestinal bleeding) were significantly more likely to use emergency services during out-of-hours of palliative home care. Patients at risk of developing dyspnea, change of consciousness, or gastrointestinal bleeding should be provided with relevant information regarding these symptoms and signs.

  2. Program of home telemonitoring in patients with cystic fibrosis over a period of 2 years: a contribution to the rationalization of care.

    Science.gov (United States)

    Bella, S; Murgia, F; Cotognini, C; Alghisi, F; Montemitro, E

    2013-01-01

    In present study we tested the possible presence of a saving for Italian National Health Service (INHS) when using telemonitoring in the follow-up at home of patients with Cystic Fibrosis (CF), in the aim to assess the possible role of Telemedicine in rationalization of hospital admissions. We performed an economic analysis of the costs incurred by the INHS for patients with CF followed at home by telemonitoring, recalled to hospital under suspicion or diagnosis of acute pulmonary recurrence. We calculated, for 19 patients retrieved in the period of the study, a total saving compared to traditional home care of € 132.144,91 in 24 months, corresponding to € 3.303,62/year/patient. The presence of an economic advantage for the INHS is confirmed once again, although not significant. The data from this study are encouraging regarding the possible role of telemedicine in the organization of homecare of CF patients.

  3. Withdrawal of corticosteroids in inflammatory bowel disease patients after dependency periods ranging from 2 to 45 years: a proposed method.

    LENUS (Irish Health Repository)

    Murphy, S J

    2012-02-01

    BACKGROUND: Even in the biologic era, corticosteroid dependency in IBD patients is common and causes a lot of morbidity, but methods of withdrawal are not well described. AIM: To assess the effectiveness of a corticosteroid withdrawal method. METHODS: Twelve patients (10 men, 2 women; 6 ulcerative colitis, 6 Crohn\\'s disease), median age 53.5 years (range 29-75) were included. IBD patients with quiescent disease refractory to conventional weaning were transitioned to oral dexamethasone, educated about symptoms of the corticosteroid withdrawal syndrome (CWS) and weaned under the supervision of an endocrinologist. When patients failed to wean despite a slow weaning pace and their IBD remaining quiescent, low dose synthetic ACTH stimulation testing was performed to assess for adrenal insufficiency. Multivariate analysis was performed to assess predictors of a slow wean. RESULTS: Median durations for disease and corticosteroid dependency were 21 (range 3-45) and 14 (range 2-45) years respectively. Ten patients (83%) were successfully weaned after a median follow-up from final wean of 38 months (range 5-73). Disease flares occurred in two patients, CWS in five and ACTH testing was performed in 10. Multivariate analysis showed that longer duration of corticosteroid use appeared to be associated with a slower wean (P = 0.056). CONCLUSIONS: Corticosteroid withdrawal using this protocol had a high success rate and durable effect and was effective in patients with long-standing (up to 45 years) dependency. As symptoms of CWS mimic symptoms of IBD disease flares, gastroenterologists may have difficulty distinguishing them, which may be a contributory factor to the frequency of corticosteroid dependency in IBD patients.

  4. Significant survival improvement of patients with recurrent breast cancer in the periods 2001-2008 vs. 1992-2000

    Directory of Open Access Journals (Sweden)

    Nishimura Sumiko

    2011-03-01

    Full Text Available Abstract Background It is unclear whether individualized treatments based on biological factors have improved the prognosis of recurrent breast cancer. The purpose of this study is to evaluate the survival improvement of patients with recurrent breast cancer after the introduction of third generation aromatase inhibitors (AIs and trastuzumab. Methods A total of 407 patients who received first diagnosis of recurrent breast cancer and treatment at National Kyushu Cancer Center between 1992 and 2008 were retrospectively evaluated. As AIs and trastuzumab were approved for clinical use in Japan in 2001, the patients were divided into two time cohorts depending on whether the cancer recurred before or after 2001. Cohort A: 170 patients who were diagnosed between 1992 and 2000. Cohort B: 237 patients who were diagnosed between 2001 and 2008. Tumor characteristics, treatments, and outcome were compared. Results Fourteen percent of cohort A and 76% of cohort B received AIs and/or trastuzumab (P Conclusions The prognosis of patients with recurrent breast cancer was improved over time following the introduction of AIs and trastuzumab and the survival improvement was apparent in HR- and/or HER-2-positive tumors.

  5. The prevalence of vitamin D deficiency in consecutive new patients seen over a 6-month period in general rheumatology clinics.

    LENUS (Irish Health Repository)

    Haroon, Muhammad

    2012-02-01

    The objectives of this study are to assess: (a) the prevalence of vitamin D deficiency among new patients attending rheumatology outpatient departments, (b) the age profile of these low vitamin D patients and (c) whether any diagnostic category had a particularly high number of vitamin D-deficient patients. All new patients seen consecutively in general rheumatology clinics between January to June 2007 inclusive were eligible to partake in this study, and 231 out of 264 consented to do so. Parathyroid hormone, 25-hydroxyvitamin D, creatinine, calcium, phosphate, albumin and alkaline phosphatase levels were measured. We defined vitamin D deficiency as <\\/=53 nmol\\/l and severe deficiency as <\\/=25 nmol\\/l. Overall, 70% of 231 patients had vitamin D deficiency, and 26% had severe deficiency. Sixty-five percent of patients aged >\\/=65 and 78% of patients aged <\\/=30 years had low vitamin D levels. Vitamin D deficiency in each diagnostic category was as follows: (a) inflammatory joint diseases\\/connective tissue diseases (IJD\\/CTD), 69%; (b) soft tissue rheumatism, 77%; (c) osteoarthritis, 62%; (d) non-specific musculoskeletal back pain, 75% and (e) osteoporosis, 71%. Seasonal variation of vitamin D levels was noted in all diagnostic groups apart from IJD\\/CTD group, where the degree of vitamin D deficiency persisted from late winter to peak summer. Very high prevalence of vitamin D deficiency was noted in all diagnostic categories (p = 0.006), and it was independent of age (p = 0.297). The results suggest vitamin D deficiency as a possible modifiable risk factor in different rheumatologic conditions, and its role in IJD\\/CTD warrants further attention.

  6. Recommendations for diagnosis and treatment planning, and treatment during the pregnancy, postpartum and breastfeeding period in patients with antiphospholipid syndrome

    Directory of Open Access Journals (Sweden)

    Lidia Ostanek

    2014-03-01

    Full Text Available The antiphospholipid syndrome (APS is an interdisciplinary condition with a clinical picture in which thrombotic complications and obstetric failures play the most significant role. It has been demonstrated on the basis of multicentre clinical observations that the most common pregnancy-related complications in the course of APS include: recurrent miscarriage in the first trimester of pregnancy, pregnancy loss in the second and third trimester of pregnancy, early preeclampsia and preterm delivery. Any APS female patient planning a pregnancy should be advised about the risk of complications which may occur in the course of pregnancy. The treatment of pregnant APS patients should be conducted by a multidisciplinary team including specialists in rheumatology, obstetrics, and in justified cases also in haematology. The most important element of the pregnant APS patient management is secondary thromboprophylaxis with low dose aspirin and heparins. The introduction of hydroxychloroquine is recommended in patients with systemic lupus erythematosus. The visits should take place every 4 weeks and starting from week 26–28 of pregnancy every 1–2 weeks. The patients should be strictly monitored for signs of preeclampsia and/or thrombosis.

  7. Examining the social status, risk factors and lifestyle changes of tuberculosis patients in Sri Lanka during the treatment period: a cross-sectional study.

    Science.gov (United States)

    Senanayake, Madapathage Gayan Buddhika; Wickramasinghe, Sumudu Indika; Samaraweera, Sudath; De Silva, Pubudu; Edirippulige, Sisira

    2018-01-01

    Tuberculosis (TB) is a major global health problem, commonly seen in underdeveloped countries. The probability of contracting the disease is significantly higher among the economically vulnerable and the socially disadvantaged. Risk factors associated with TB can also change over time. In the Sri Lankan context, no study has explored how these factors impact patients. Therefore, we aimed to explore social status, associated risk factors and lifestyle changes during the treatment period of TB patients attending a tertiary respiratory center in Colombo, Sri Lanka. The descriptive cross-sectional study was conducted in 2011. The study population consisted of diagnosed tuberculosis patients above the age of 15 years. Patient records were retrieved from the TB patient registry for the Colombo district. Systematic sampling was used to identify patients to be invited to the study. An interviewer-administered questionnaire was used for data collection. Data were collected on social status (example, level of education, employment, and income), associated risk factors (example, smoking and alcohol consumption, contact history, narcotic drug use) and lifestyle changes during treatment (example, employment status, social interactions). The analysis included a logistic regression model to explore the association between social status and risk factors. The total number of patients included in the study was 425. Tuberculosis was found to be strongly prevalent among participants from the lower socio-economic status. It was also common in participants with a low level of education, unemployed, if employed, those who are engaged in unskilled employment and have low levels of income. Risk factors associated with the patients were smoking, alcohol consumptions, narcotic drug use, imprisonment, close contact history with active TB patients and chronic medical conditions. Changes in employment and the reduction of social-interactions were the main lifestyle changes of the participants

  8. Effects of combination of whey protein intake and rehabilitation on muscle strength and daily movements in patients with hip fracture in the early postoperative period.

    Science.gov (United States)

    Niitsu, Masaya; Ichinose, Daisuke; Hirooka, Taku; Mitsutomi, Kazuhiko; Morimoto, Yoshitaka; Sarukawa, Junichiro; Nishikino, Shoichi; Yamauchi, Katsuya; Yamazaki, Kaoru

    2016-08-01

    Elderly patients can be at risk of protein catabolism and malnutrition in the early postoperative period. Whey protein includes most essential amino acids and stimulates the synthesis of muscle protein. The purpose of this study was to investigate the effect of resistance training in combination with whey protein intake in the early postoperative period. We randomized patients to a whey protein group or a control group. The former group received 32.2 g of whey protein pre- and post-rehabilitation in the early postoperative period for two weeks. Outcomes were knee extension strength on either side by Biodex 4.0, and the ability of transfer, walking, toilet use and stair use by the Barthel Index (BI). We performed initial and final assessments in the second and tenth rehabilitation sessions. A total of 38 patients were recruited: 20 in the whey protein group and 18 in the control group. Participants in the whey protein group showed significantly greater improvement in knee extension strength in the operated limb compared with the control group (F = 6.11, P = 0.02). The non-operated limb also showed a similar tendency (F = 3.51, P = 0.07). The abilities of transfer, walking and toilet use showed greater improvements in the whey protein group than in the control group by BI (P patients with hip fracture. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  9. Influence of different fasting periods on P-31-MR-spectroscopy of the liver in normals and patients with liver metastases

    International Nuclear Information System (INIS)

    Brinkmann, G.; Melchert, U.H.; Muhle, C.; Brossmann, J.; Link, J.; Reuter, M.; Heller, M.

    1996-01-01

    The purpose of this study was to determine the influence of different fasting periods on the in vivo P-31MR spectroscopy of the healthy liver and patients with liver metastases. Image-guided localized P-31-MRS was performed in 24 patients with liver metastases and in 20 healthy volunteers. The spectra were obtained with a whole body scanner operating at 1.5 T using a surface coil. The P-31-MRS was performed after a fasting period of 3-5 h (group 1) and after overnight fasting (group 2). The PME/β-NTP, PDE/β-NTP and Pi/β-NTP were calculated from P-31-MR spectra and were compared in relation to the nutrition status of the volunteers and patients. The PME/β-NTP and PDE/β-NTP were significantly increased in spectra of patients with metastases. There were no significant changes in the ratios of phosphorus metabilites in healthy liver tissue or in liver metastases after a fasting period of 3-5 h as compared with overnight fasting. (orig.)

  10. Silent hepatic lesions detected with computed tomography in aplastic anemia patients administered androgens for a long period

    International Nuclear Information System (INIS)

    Yamagishi, Morihisa; Hiraoka, Atsunobu; Uchino, Haruto.

    1982-01-01

    Macroscopic liver lesions were investigated with the use of computed tomography (CT) and radionuclide imaging (RN) in 15 aplastic anemia patients who were administered anabolic steroids for over one year and who showed no apparent physical and biochemical sign of liver tumor. In 3 patients, CT scans showed radiolucent areas in the liver. Contrast enhancements revealed these lesions to be well vascularized, suggesting they were not cysts but probably tumors. RN imaging could not demonstrate any definite space occupying lesions. Total dose of AS administered to each of the three patients exceeded 30,000 mg. It was felt that attention should be paid to the possible development of hepatic tumor when the dose of AS administered exceeds 30,000 mg. (author)

  11. Silent hepatic lesions detected with computed tomography in aplastic anemia patients administered androgens for a long period

    Energy Technology Data Exchange (ETDEWEB)

    Yamagishi, Morihisa (Shiga Univ., Otsu (Japan)); Hiraoka, Atsumobu; Uchino, Haruto

    1982-07-01

    Macroscopic liver lesions were investigated with the use of computed tomography (CT) and radionuclide imaging (RN) in 15 aplastic anemia patients who were administered anabolic steroids for over one year and who showed no apparent physical and biochemical sign of liver tumor. In 3 patients, CT scans showed radiolucent areas in the liver. Contrast enhancements revealed these lesions to be well vascularized, suggesting they were not cysts but probably tumors. RN imaging could not demonstrate any definite space occupying lesions. Total dose of AS administered to each of the three patients exceeded 30,000 mg. It was felt that attention should be paid to the possible development of hepatic tumor when the dose of AS administered exceeds 30,000 mg.

  12. Variability of blood pressure and blood glucose during perioperative period for patients with secondary neovascular glaucoma after silicone oil removed in PDR

    Directory of Open Access Journals (Sweden)

    Fu-Lin Gao

    2015-06-01

    Full Text Available AIM:To research blood pressure and blood glucose variability during peroperative period for patients with secondary neovasular glaucoma(NVGafter silicone oil removed in proliferative diabetic retinaopathy(PDR.METHODS: Totally, 271 patients(271 eyesundergone surgery of vitrectomy and silicon-oil tamponade combined with cataract were respective analyzed. Fourteen patients(14 eyeswith secondary NVG after silicon oil removed and randomly controlled group of no NVG according with ages, operation method in the same time were studied. The blood pressure and blood glucose variability during peroperative period was analyzed, and did comparison after excluded contralateral eye. The complications of 271 patients were surveyed in following-up period 1~12mo. The incidence of NVG, the time, blood pressure, blood glucose and glycated hemoglobin(Hbc%variability during peroperative period was statisticed and compared by software of SPSS 11.0.RESULTS: Fourteen eyes(5.2%of 271 cases was with secondary NVG(female: 4 eyes, 28.6%; male: 10 eyes, 71.4%, average ages was 57.07 years(49~68 years. NVG presented in the 107~ 135d after vitrectomy and 7~45d(average 31.78dafter silicon-oil removed. Diabetes mellitus was 10~15(average 13.2a. In NVG group, the variability of blood glucose was 4.0~10.2mmol/L(mean 8.52±3.24mmol/L, variable coefficient was 0.48. In NNVG group, the variability of blood glucose was 5.0~8.2mmol/L(mean 7.22±0.24mmol/L, variable coefficient was 0.43. It was significantly difference in comparison in variable coefficient(PPPPCONCLUSION: There are significant variability on fasting blood glucose, daytime SBP and night DBP during perioperative in PDR patients with secondary NVG. It might be occurred 1wk after silicone oil removal surgery.

  13. Problem Periods

    Science.gov (United States)

    ... ovary syndrome. Read our information on PCOS for teens , and see your doctor if you think you may have PCOS. Major weight loss. Girls who have anorexia will often stop having periods. When to see ...

  14. Non-Hodgkin's Lymphoma of the Stomach: Treatment Outcomes for 57 Patients Over a 20-Year Period

    Directory of Open Access Journals (Sweden)

    Ching-Liang Ho

    2005-01-01

    Conclusion: Clinical stage is the most important factor predicting the long-term survival of patients with gastric NHL. Surgery may still be necessary in cases of failed gastroscopic diagnosis. In early-stage gastric NHL, non-surgical treatment seems able to achieve the aims of improved long-term survival and, in some instances, cure.

  15. Does the declining prevalence of Helicobacter pylori unmask patients with idiopathic peptic ulcer disease? Trends over an 8 year period

    NARCIS (Netherlands)

    Arents, NLA; Thijs, JC; van Zwet, AA; Kleibeuker, JH

    Objectives Recent studies have suggested that the prevalence of Helicobacter pylori infection in patients with ulcer disease who were not using non-steroidal anti-inflammatory drugs (NSAIDs) has been overestimated. The decreasing prevalence of H. pylori could lead to a relative increase in the

  16. Type-D personality is a stable taxonomy in post-MI patients over an 18-month period

    DEFF Research Database (Denmark)

    Martens, Elisabeth J; Kupper, Nina; Pedersen, Susanne S.

    2007-01-01

    type-D personality comprises a risk factor for adverse prognosis in patients with cardiovascular disease (CVD). However, concerns that type-D personality may not be a stable personality taxonomy and that progression of CVD may contribute to the manifestation of type-D personality have been voiced...

  17. Tracking Central Hypovolemia with ECG in Humans: Cautions for the Use of Heart Period Variability in Patient Monitoring

    Science.gov (United States)

    2010-06-01

    US Army Institute of Surgical Research, Fort Sam Houston, Texas; and †Department of Health and Kinesiology , The University of Texas at San Antonio...higher in trauma patients both in prehospital and intensive care unit settings, suggesting that these metrics may not be useful for reliable and

  18. Characterization of patients diagnosed with central precocious puberty starting treatment with leuprolide acetate, at the Hospital Nacional de Ninos in the period January 2004 to December 2009

    International Nuclear Information System (INIS)

    Viquez Viquez, Natalia

    2013-01-01

    Clinical characteristics and laboratory and cabinet findings (hormone levels, bone age, pelvic ultrasound) were determined in a sample of 39 patients diagnosed with central precocious puberty (CPP) who started treatment with leuprolide acetate (LPA). The cross-sectional observational study was developed at the Hospital Nacional de Ninos 'Dr. Carlos Saenz Herrera' during the period 2004 and 2009. The chronological age of patients with CPP was specified at the time of diagnosis and to start treatment with LPA. Epidemiological characteristics (sex, origin) were described in patients with CPP. Bone age with respect to chronological age was identified in patients with CPP. Sexual maturity of patients with CPP was established by the Tanner scale. The hormone levels of estrogen, testosterone, luteinizing hormone and follicle stimulating hormone were specified in patients with CPP. The etiology was determined in patients with CPP treated with LPA. The adverse effects of treatment with LPA were described. Anthropometric measurements were detailed. The heredo-familial antecedents of precocious puberty were established in patients with diagnosis of CPP. The size of the pelvic organs was evaluated by pelvic ultrasound [es

  19. Depressive disorder in the last phase of life in patients with cardiovascular disease, cancer, and COPD: data from a 20-year follow-up period in general practice.

    Science.gov (United States)

    Warmenhoven, Franca; Bor, Hans; Lucassen, Peter; Vissers, Kris; van Weel, Chris; Prins, Judith; Schers, Henk

    2013-05-01

    Depression is assumed to be common in chronically ill patients during their last phase of life and is associated with poorer outcomes. The prevalence of depression is widely varying in previous studies due to the use of different terminology, classification, and assessment methods. To explore the reported incidence of depressive disorder, as registered in the last phase of life of patients who died from cardiovascular disease, cancer or COPD, in a sample of primary care patients. A historic cohort study, using a 20-year period registration database of medical records in four Dutch general practices (a dynamic population based on the Continuous Morbidity Registration database). Medical history of the sample cohort was analysed for the diagnosis of a new episode of depressive disorder and descriptive statistics were used. In total 982 patients were included, and 19 patients (1.9%) were diagnosed with a new depressive disorder in the last year of their life. The lifetime prevalence of depressive disorder in this sample was 8.2%. The incidence of depressive disorder in the last phase of life is remarkably low in this study. These data were derived from actual patient care in general practice. Psychiatric diagnoses were made by GPs in the context of both patient needs and delivered care. A broader concept of depression in general practice is recommended to improve the diagnosis and treatment of mood disorders in patients in the last phase of life.

  20. Radiographic cephalometric study using Ricketts analysis for dentoskeletal patterns evaluation of patients having class II, division I malocclusion treated during mixed dentition period

    International Nuclear Information System (INIS)

    Motta e Albuquerque, Carmen da.

    1988-01-01

    In the specialized literature about the use of extra oral forces in the treatment of the Class II malocclusion one can observe that it has been used more and more, with the objective of achieving teeth improvement and bone as well. It is proposed to evaluate the extent of the orthodontic/orthopedic modifications and their influence in the facial pattern of patients with those malocclusions, treated during the mixed dentition period. A sample of 32 patients of both sexes, leucoderms, with Class II, division I malocclusion, between 7 and 14 years old, were studied employing a cephalometric radiographic method for evaluation. (author). 94 refs., 11 figs., 15 tabs

  1. Social-occupational rehabilitation of patients with Hodgkin's disease in a long-term period after irradiation

    International Nuclear Information System (INIS)

    Bajsogolov, G.D.; Shishkin, I.P.

    1983-01-01

    Some data on 239 patients with Hodkin disease in a long-term (5-12 yrs.) remission achieved with radiotherapy, have been analysed. The number of married persons and the number of children in a family were less, and the number of divorces equal to indices determined during mass screening of population. The rates of morbidity with a less of capacity to work were consistent with control values. Most of the patients (90.3%) after therapy resumed their work the nature of which was mainly the same (88.6%). In expert medical evaluation of the working capacity there are no reliable criteria. It should proceed from the completeness of remission and the nature of the pathological process

  2. Do We Need a Diet Therapy to Manage Patients with Chronic Kidney Disease in the Predialysis Period?

    OpenAIRE

    S.V. Kushnirenko

    2014-01-01

    The article examines the criteria for diagnosis of chronic kidney disease and the feasibility of diet therapy in combination with keto-analogues of essential amino acids at predialysis stage. It is proved that additional administration to the patients with predialysis chronic kidney disease of keto-analogues of essential amino acids enhances the metabolic beneficial effects of low-protein diet, promotes normalization of the amino acid composition of the blood and correction of metabolic acido...

  3. [TRANSOSSEOUS OSTEOSYNTHESIS OF LOWER EXTREMITIES BONES FRACTURES AND QUALITY OF LIFE OF PATIENTS IN THE TREATMENT PERIOD].

    Science.gov (United States)

    Dyusupov, A; Dyusupov, A; Manarbekov, E; Bukatov, A; Serikbaev, A

    2018-02-01

    The aim of the study is a comparative analysis of the quality of life in the treatment of fractures of the bones of the lower extremities of various localizations using transosseous and submerged osteosynthesis. We examined 397 patients with injuries of the lower segment of the lower extremity (patellar fractures - 81, multiple bones fractures of the tibia - 84 and fractures of the ankles, accompanied by a dislocation of the foot - 232). Patients were distributed in the subgroups depending on the treatment. The main group was performed using transosseous osteosynthesis, the comparison group - submerged osteosynthesis. The quality of life was examined using a general questionnaire SF-36 and specialized KOOS (with patella fractures) and FOAS (fractures of the bones of the lower leg and ankles). In patients with all localizations of fractures the quality of life was exceeded in the subgroups of the transosseous osteosynthesis group over the parameters of the comparison group. The most significant differences with the use of specialized questionnaires were revealed 6-9 months after trauma with a tendency to leveling to the end of the study (1 year). A more pronounced excess of the quality of life in the main group was seen in fractures of the shin bones. The study of the quality of life allows us to recommend the use of transosseous osteosynthesis for the treatment of lower segment of the lower limb bone fractures.

  4. Evaluation of the Usefulness of Restricted Respiratory Period at the Time of Radiotherapy for Non-Small Cell Lung Cancer Patient

    Energy Technology Data Exchange (ETDEWEB)

    Park, So Yeon; Ahn, Jong Ho; Kim, Yung Il; Kim, Jin Man; Choi, Byung Ki; Pyo, Hong Ryul; Song, Ki Won [Dept. of Radiation Oncology, Samsung Medical Center, Seoul (Korea, Republic of); Suh, Jung Min [Dept. of Radiological Science, Daewon University Colloge, Jecheon (Korea, Republic of)

    2012-09-15

    It is essential to minimize the movement of tumor due to respiratory movement at the time of respiration controlled radiotherapy of non-small cell lung cancer patient. Accordingly, this Study aims to evaluate the usefulness of restricted respiratory period by comparing and analyzing the treatment plans that apply free and restricted respiration period respectively. After having conducted training on 9 non-small cell lung cancer patients (tumor n=10) from April to December 2011 by using 'signal monitored-breathing (guided- breathing)' method for the 'free respiratory period' measured on the basis of the regular respiratory period of the patents and 'restricted respiratory period' that was intentionally reduced, total of 10 CT images for each of the respiration phases were acquired by carrying out 4D CT for treatment planning purpose by using RPM and 4-dimensional computed tomography simulator. Visual gross tumor volume (GTV) and internal target volume (ITV) that each of the observer 1 and observer 2 has set were measured and compared on the CT image of each respiratory interval. Moreover, the amplitude of movement of tumor was measured by measuring the center of mass (COM) at the phase of 0% which is the end-inspiration (EI) and at the phase of 50% which is the end-exhalation (EE). In addition, both observers established treatment plan that applied the 2 respiratory periods, and mean dose to normal lung (MDTNL) was compared and analyzed through dose-volume histogram (DVH). Moreover, normal tissue complication probability (NTCP) of the normal lung volume was compared by using dose-volume histogram analysis program (DVH analyzer v.1) and statistical analysis was performed in order to carry out quantitative evaluation of the measured data. As the result of the analysis of the treatment plan that applied the 'restricted respiratory period' of the observer 1 and observer 2, there was reduction rate of 38.75% in the 3-dimensional

  5. Evaluation of the Usefulness of Restricted Respiratory Period at the Time of Radiotherapy for Non-Small Cell Lung Cancer Patient

    International Nuclear Information System (INIS)

    Park, So Yeon; Ahn, Jong Ho; Kim, Yung Il; Kim, Jin Man; Choi, Byung Ki; Pyo, Hong Ryul; Song, Ki Won; Suh, Jung Min

    2012-01-01

    It is essential to minimize the movement of tumor due to respiratory movement at the time of respiration controlled radiotherapy of non-small cell lung cancer patient. Accordingly, this Study aims to evaluate the usefulness of restricted respiratory period by comparing and analyzing the treatment plans that apply free and restricted respiration period respectively. After having conducted training on 9 non-small cell lung cancer patients (tumor n=10) from April to December 2011 by using 'signal monitored-breathing (guided- breathing)' method for the 'free respiratory period' measured on the basis of the regular respiratory period of the patents and 'restricted respiratory period' that was intentionally reduced, total of 10 CT images for each of the respiration phases were acquired by carrying out 4D CT for treatment planning purpose by using RPM and 4-dimensional computed tomography simulator. Visual gross tumor volume (GTV) and internal target volume (ITV) that each of the observer 1 and observer 2 has set were measured and compared on the CT image of each respiratory interval. Moreover, the amplitude of movement of tumor was measured by measuring the center of mass (COM) at the phase of 0% which is the end-inspiration (EI) and at the phase of 50% which is the end-exhalation (EE). In addition, both observers established treatment plan that applied the 2 respiratory periods, and mean dose to normal lung (MDTNL) was compared and analyzed through dose-volume histogram (DVH). Moreover, normal tissue complication probability (NTCP) of the normal lung volume was compared by using dose-volume histogram analysis program (DVH analyzer v.1) and statistical analysis was performed in order to carry out quantitative evaluation of the measured data. As the result of the analysis of the treatment plan that applied the 'restricted respiratory period' of the observer 1 and observer 2, there was reduction rate of 38.75% in the 3-dimensional direction movement of the tumor in

  6. Variations in steroid hormone receptor content throughout age and menopausal periods, and menstrual cycle in breast cancer patients

    International Nuclear Information System (INIS)

    Nikolic-Vukosavljevic, D.; Vasiljevic, N.; Brankovic-Magic, M.; Polic, D.

    1996-01-01

    Variations in steroid hormone receptor contents throughout age and menopausal periods define three breast carcinoma groups: younger pre-menopausal carcinomas (aged up to 45), middle-aged carcinomas (aged up to 45), middle-aged carcinomas (pre-, peri-, and postmenopausal aged 45-59) and older postmenopausal carcinomas (aged over 59). Age-related steroid hormone receptor contents within pre-menopausal and postmenopausal carcinoma groups are characterized by the important increase of both receptor contents, while menopausal-related steroid hormone receptor contents within middle-aged carcinoma group (aged 45-59) are characterized by the important decrease of progesterone receptor content and estrogen receptor functionality. No variations in steroid hormone receptor contents throughout menstrual cycle within the follicular and the luteal phases were obtained. The important cycle within the follicular and the luteal phases were obtained. The important decrease of estrogen receptor content in the mid-cycle phase versus the peri-menstrual phase was found. Variations in steroid hormone receptor contents throughout age and menopausal periods, as well as throughout menstrual cycle could nod be associated with variations in the blood steroid hormone concentrations. However, important association between steroid hormone receptor contents and the blood steroid hormone concentrations was found within the luteal phase carcinoma group and within older postmenopausal carcinoma group. It is interesting that within carcinoma group with the highest concentration of progesterone, progesterone receptor content increases with an increase of the ration of estradiol and progesterone blood concentrations, while within carcinoma group with the lowest steroid hormone concentration and the highest content of estrogen receptor content, estrogen receptor content decreases with an increase of either the blood estradiol concentration or the ratio of the blood estradiol and progesterone blood

  7. Importance of cutaneous silent period in fibromyalgia and its relationship with disease characteristics, psychological disorders and quality of life of patients.

    Science.gov (United States)

    Umay, Ebru; Ulas, Umit; Unlu, Ece; Akgun, Hakan; Cakci, Aytul; Odabasi, Zeki

    2013-01-01

    Cutaneous silent period (CSP) is an inhibitory spinal protective reflex and its afferents consist of A-delta nerve fibers. We aimed to evaluate patients with fibromyalgia (FM) and healthy controls to determine any differences between the groups in terms of CSP duration and latency, and if present, to determine whether there is any relationship with disease characteristics, psychological disorders and quality of life. Thirty-two patients with FM and 32 healthy volunteers were included in the study. The patient and control groups were compared in terms of CSP latency and duration in both upper and lower extremities. Disease characteristics, psychological disorders and quality of life of patients were assessed using the Fibromyalgia Impact Questionnaire (FIQ) and Short Form-36 (SF-36). Patients with CSP measurements equal to or lower than those of the control group were compared with those with higher values than controls in terms of disease characteristics, psychological status and quality of life. Significantly prolonged CSP latencies in both upper and lower extremities were determined in patients compared to controls. We found that prolongation of CSP latency in the lower extremity is associated with disease severity and functional disability. CSP latencies in both upper and lower extremities in patients with FM are longer than in healthy volunteers. Moreover, prolongation of CSP latency in the lower extremity is associated with disease severity and physical functional disability.

  8. Do We Need a Diet Therapy to Manage Patients with Chronic Kidney Disease in the Predialysis Period?

    Directory of Open Access Journals (Sweden)

    S.V. Kushnirenko

    2014-08-01

    Full Text Available The article examines the criteria for diagnosis of chronic kidney disease and the feasibility of diet therapy in combination with keto-analogues of essential amino acids at predialysis stage. It is proved that additional administration to the patients with predialysis chronic kidney disease of keto-analogues of essential amino acids enhances the metabolic beneficial effects of low-protein diet, promotes normalization of the amino acid composition of the blood and correction of metabolic acidosis, supports the parameters of carbohydrate and lipid metabolism at an optimum level under reduced protein intake, slowing further progression of chronic kidney disease.

  9. Interictal Spect with Tc-99m ECD studies in migraine patients. Role of Spect in the diagnosis of migraine with ura in headache-free periods

    International Nuclear Information System (INIS)

    Gonzalez, F.M.; Martinez, J.J.; Bermudez, M.C.; Fernandez, B.; Delgado, J.; Martin, A.; Padilla, O.; Nieto, R.

    2002-01-01

    Aim: The migraine is one of the neurological alterations more frequent provoking a discharge morbility and big inconveniences the one that endures it. The presence of brain perfusion abnormalities during the pain-free intervals of migraine even is fueling of controversies being so numerous the supporters of its existence as whom they deny it. This study was aimed at assessing the presence of cerebral perfusion abnormalities also during the interictal phase and the role of SPECT with Tc99 ECD on diagnosis of this migrainous patients. Materials And Methods: We studied 20 patients (16 woman and 4 man) with diagnose of migraine with aura during a periods without headache and 20 apareaded controls for age and sex of this patients.Was realized brain spect with 925 MBq Tc99m-ECD on a two heads rotating gamma camera (Piker Axis) equipped with a fan-beam collimator. The images were reconstructed using a filter Mezt and presented in courts in the three axes and reconstruction in three dimensions and later they were analyzed by two observers. Results: We found 14 of the patients (70%) with images of focal hypoperfusion with clear interhemispheric asymmetry while on control groups only two have this find (10%) being this difference statistically significant. The part of the brain more affected was the occipital one, though also they predominated over the more widespread hipocaptations. Conclusion: The brain Spect is a useful technology to identify the patients with migraine, being able to be used in the periods without pain. The boss of perfusion in the patients is the located hypoperfusion and is significantly different from that of the controls, It can be explained by an impaired regional cerebral vascular autoregulation may exist even during headache-free intervals in patients suffering from migraine. Future studies must be realized to determine if it exists relation between the zone of hypoperfusion and the type of present symptomatology in the aura

  10. [The use of a robot-assisted Gait Trainer GT1 in patients in the acute period of cerebral stroke: a pilot study].

    Science.gov (United States)

    Skvortsova, V I; Ivanova, G E; Kovrazhkina, E A; Rumiantseva, N A; Staritsyn, A N; Suvorov, A Iu; Sogomonian, E K

    2008-01-01

    An aim of the study was to evaluate efficacy of using Gait Trainer GT1, a robot-assisted gait trainer with a system of body-weight support, for the rehabilitation of gait in patients in the acute period of cerebral stroke. A main group included 30 patients in the acute period of ischemic and hemorrhage stroke and a control group--20 age- and sex matched patients. Patients of both groups had daily kinesitherapy sessions with a rehabilitator. Patients of the main group had additional sessions on the Gait Trainer GT1 from the moment of functional readiness to adequate orthostatic probe. Efficacy of rehabilitation was assessed in the four following phases: the first verticalization of patient in the standing position, adaptation of patient to the standing position, walking with assistance, independent walking. Muscular power (scores) in all muscles of low extremities, muscle tonus (the Ashfort scale), amplitude of tendinous reflexes on the reflexes scale, sensory disturbances and discoordination syndromes (specially elaborated scales), pathological positions in the axial muscular system and extremities, functional status (a steadiness scale, the Berg balance scale, the Barthel scale, 5 m test) were assessed in each phase. Stabilometry was conducted for objective evaluation of vertical balance function. The duration of sessions on GT1 and a number of exercises were depended on the patient's tolerability to physical activity. Percentage of relief was determined by the ability of a patient to balance in the standing position. Each patient had 8-10 sessions. A significant improvement of the functional status: ability to balance in standing position, walking, increase of self-care skills were observed in both groups. No significant differences in the level of functional improvements were found compared to the control group. However some peculiarities of the rehabilitation of primary neurologic deficit were observed during CT1-trainings: the normalization of muscle tonus

  11. [Evaluation of the interdependence between homocystein and folic acid levels in patients after kidney transplantation during a 2 year observation period].

    Science.gov (United States)

    Janda, Katarzyna; Aksamit, Dariusz; Krzanowski, Marcin; Kuzniewski, Marek; Sułowicz, Władysław

    2013-01-01

    Patients on maintenance dialysis have increased heomocystein (Hcy) serum levels. The aim of the study was to evaluate the interdependence between Hcy and folic acid (FA) levels in renal transplant patients (pts) at various time periods during a two year observation period after kidney transplantation (Ktx). The study included 51 pts (17 F, 34 M) aged 15-62 years (median 38.1) after deceased donors Ktx. Before Ktx, 46 pts were treated with maintenance hemodialysis (HD), while 5 by peritoneal dialysis (PD). The mean observation period equaled 21.2 months (6-24 months); while total observation period was 90 person/years. Hcy level was measured using high performance liquid chromatography (HPLC). FA level was measured using chemiluminesence method (standard methods) using the Immulite 2000 analyzer. Patients blood was drawn before Ktx and 3, 6, 9, 12, 15, 18, 21 and 24 months after procedure. An increased Hcy level (>15 micromol/l) - mean 28.5 +/- 17.8 micromol/l (range from 10.2 micromol/l to 116.8 micromol/I) was noted in the blood of 44 pts before Ktx (86.3% of the examined population). In 31 pts after Ktx (60.8% of the examined population), mean Hcy level remained increased above 15 micromol/I (mean Hcy - 19.2 +/- 5.8 micromol/I). A negative correlation was found between the levels of Hcy and FA directly before Ktx (R= -0.28, p15 micromol/l (36.4 ng/ml vs. 62.5 ng/ml). Statistically significant decrease of Hcy concentration was observed after Ktx as compare with values before procedure, however not reached normal values. Significant decrease of FA concentration after Ktx is most likely associated with the discontinuation of FA supplementation, as well as due to the restoration of the erythropoietic line.

  12. Eighteen years of geochemical monitoring at the oceanic active volcanic island of El Hierro (Canary Islands, Spain)

    Science.gov (United States)

    Asensio-Ramos, María; Alonso, Mar; Sharp, Emerson; Woods, Hannah; Barrancos, José; Pérez, Nemesio M.

    2016-04-01

    We report herein the latest results of a diffuse CO2 efflux survey at El Hierro volcanic system carried out during the summer period of 2015 to constrain the total CO2 output from the studied area a during post-eruptive period. El Hierro Island (278 km2) is the youngest and the SW-most of the Canary Islands. On July 16, 2011, a seismic-volcanic crisis started with the occurrence of more than 11,900 seismic events and significant deformation along the island. On October 10, 2011, the dominant character of seismicity changed dramatically from discrete earthquakes to continuous tremor, a clear indication that magma was rapidly approaching the surface immediately before the onset of the eruption, October 12. Eruption was declared over on 5 March, 2012. In order to monitor the volcanic activity of El Hierro Island, from 1998 to 2015 diffuse CO2 emission studies have been performed at El Hierro volcanic system in a yearly basis (˜600 observation sites) according to the accumulation chamber method. Spatial distribution maps were constructed following the sequential Gaussian simulation (sGs) procedure. To quantify the total CO2 emission from the studied area, 100 simulations for each survey have been performed. During the eruption period, soil CO2 efflux values range from non-detectable (˜0.5 g m-2 d-1) up to 457 g m-2 d-1, reaching in November 27, 2011, the maximum CO2 output estimated value of all time series, 2,398 t d-1, just before the episodes of maximum degassing observed as vigorous bubbling at the sea surface and an increment in the amplitude of the tremor signal. During the 2015 survey, soil CO2 efflux values ranged from non-detectable up to 41 g m-2 d-1. The spatial distribution of diffuse CO2 emission values seemed to be controlled by the main volcano structural features of the island. The total diffuse CO2 output released to atmosphere was estimated at 575 ± 24 t d-1, value slightly higher that the background CO2 emission estimated at 422 t d-1 (Melián et

  13. LIVER FUNCTION CHANGES IN PATIENTS WITH SPONDYLOARTHRITIS TAKING NONSTEROIDAL ANTI-INFLAMMATORY DRUGS OVER A LONG PERIOD: RESULTS OF A 10-YEAR PROGRESS PROSPECTIVE STUDY

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    A. P. Rebrov

    2016-01-01

    Full Text Available Objective: to assess liver function changes in patients with spondyloarthritis (SpA taking NSAIDs regularly over a long period.Patients and methods. The data obtained during a 10-year PROGRESS prospective single-center cohort study of functional status, activity, and comorbidity (including gastrointestinal tract diseases in patients with SpA were analyzed. The data of 363 SpA patients receiving NSAIDs regularly over a long period and followed up for 10 years were also explored. The changes that had occurred over a decade in the liver enzyme levels, the number of discontinued NSAID treatments because of a persistent increase in liver enzyme levels, and the number of prescriptions of hepatoprotective agents were analyzed.Results. For 10 years, 18 patients with SpA discontinued their NSAID intake due to elevated liver enzyme levels (≥3 times greater than the reference value; during that time, the same increase in enzyme levels was observed in 2 healthy individuals (χ2 =1.39; p=0.2. In the patients with SpA as compared to the healthy individuals, the relative risk of abnormal liver function was 1.19 (95% CI, 1.009–1.405; odds ratio was 2.9 (95% CI, 0.65–12.95. There was no increased risk for discontinuation of some NSAIDs, including nimesulide (χ2 =0.03, p=0.85, the frequency of using hepatoprotective drugs was proved to be highest for diclofenac sodium, ibuprofen, nimesulide, and ketoprofen.Conclusion. The regular long-term (as long as 10 years use of NSAIDs to treat SpA is associated with treatment discontinuation because of elevated enzyme levels in every 10 patients. The maximum rate of discontinuation of NSAIDs due to a persistent increase in liver enzyme levels is observed 6–8 years after their regular use, so long-term NSAID therapy requires continuous monitoring of hepatic safety. The longterm intake of nimesulide, as compared with other NSAIDs, is shown to be unassociated with the higher rate of its discontinuation because of

  14. Changes of plasma IL-6 and TNF-α levels during peri-operative period in patients undergoing laser photo-coagulation of greater saphenous varicosities

    International Nuclear Information System (INIS)

    Wang Taihan; Wang Chunxi

    2005-01-01

    Objective: To investigate the plasma levels of IL-6 and TNF-α during peri-operative period in patients undergoing laser photocoagulation of greater saphenous varicosities. Methods: Plasma IL-6 and TNF-α levels were determined with RIA before operation and 1, 3, 7, 14 days post-operatively in 110 patients with greater saphenous vein varicosity undergoing different forms of treatment (intravascular laser photo-coagulation 43, photo-coagulation combined with venous valve repair 35, high ligation and segmental stripping 32). Skin trophic disturbances were present in 56 of the 110 patients. Plasma IL-6 and TNF-α levels were also measured in 33 controls. Results: The plasma IL-6 and TNF-α levels in patients with skin trophic disturbances were significantly higher than those in controls (P<0.01), while levels in patients without skin lesions were not much changed. The plasma IL-6 and TNF-α levels were increased at first and dropped later to approaching pre-operative value by d14 in all the 110 patients after operation, however, the amount of increase was least and the normalization was also soonest in the simple photo-coagulation group, the reverse was true for the conventional operation group. Conclusion: Laser photo-coagulation is least stressful among the three types of operation and magnitude of changes of plasma IL-6 and TNF-α levels correctly reflects the intensity of stress. (authors)

  15. Intravitreal bevacizumab for macular edema due to proton beam radiotherapy: Favorable results shown after eighteen months follow-up

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    Eleni Loukianou

    2010-05-01

    Full Text Available Eleni Loukianou, Dimitrios Brouzas, Eleni Georgopoulou, Chrysanthi Koutsandrea, Michael ApostolopoulosEye Department, University of Athens, Athens, GreecePurpose: To evaluate the safety and efficacy of intravitreal injections of bevacizumab (Avastin® as a treatment option for radiation maculopathy secondary to proton beam radiotherapy for choroidal melanoma.Case: A 61-year-old woman presented with a gradual decrease in left eye visual acuity (VA 29 months after proton beam radiotherapy for choroidal melanoma. On presentation, her best-corrected VA (BCVA was 2/10 in the left eye and the intraocular pressure was 15 mmHg. Fundoscopy revealed cystoid macular edema, intraretinal hemorrhages, epiretinal membrane in the posterior pole, and residual tumor scar with exudative retinal detachment and hard exudates in the periphery of the superotemporal quadrant. A treatment with intravitreal injections of bevacizumab (Avastin® was recommended. The injections were performed on a six-weekly basis.Results: The central retinal thickness prior to the treatment was 458 μm. After the first intravitreal injection of bevacizumab, the retinal thickness at the centre of the fovea was reduced to 322 μm. After the third injection, the central retinal thickness was 359 μm and 18 months after presentation, it reduced to 334 μm. The BCVA increased to 3/10 after the intravitreal injections of bevacizumab and remained stable during the follow-up period. The intraocular pressure was within normal range during the follow-up period.Conclusion: Bevacizumab should be regarded as a treatment option for macular edema due to proton beam radiotherapy for choroidal melanoma. By reducing the central retinal thickness, intravitreal bevacizumab can improve VA or ameliorate further decline caused by radiation maculopathy.Keywords: bevacizumab (Avastin®, choroidal melanoma, macular edema, radiation retinopathy

  16. The consequences' magnitude of the postsurgering period as a factor which determining the direction of rehabilitation in patients after surgical treatment of the vertebral compression syndromes

    Directory of Open Access Journals (Sweden)

    Lazarieva Ye.B.

    2012-11-01

    Full Text Available The difficult multicomponent system of internal and external co-operations of organism of man is considered. Content-analysis of hospital of patients of able to work age charts is conducted (52% men, 48% women. It is set that an osteochondrosis striking the most active group of population in age from 20 to 60 years. The separate group of youth age is selected (1,34 % patients. Influence of age is set on the feature of flow of period of rehabilitation. It is confirmed the presence of reliable cross-correlation connections between the number of the spent years and quality and duration of sleep on 5 days after an operation (r=0,35. This index was estimated in accordance with the questionnaire of Osvestri. A determining value on the specific of flow of postoperational period has the appearance of operative interference and surgical access. These indexes with duration of early postoperational period and terms of stay in permanent establishment have coefficients of correlation scope from 0,75 to 0,92.

  17. The effects of one period of exercise walking program on textured surface on balance in Multiple sclerosis patients

    Directory of Open Access Journals (Sweden)

    Asadi Ghaleni M

    2015-04-01

    Full Text Available Abstract Background: Multiple sclerosis (MS is a chronic progressive disease of the central nervous system with signs and symptoms such as fatigue and balance that are disable. The purpose of this study was to assess the effect of training which instructions focus of attention on postural sway of multiple sclerosis patients. Materials and Methods: The present quasi-experimental study used a pretest-posttest design. The subjects with the age of 27-42, expanded disability status scale 1-4 and were purposefully and voluntarily selected and randomly allocated to the experimental and control groups. Training program for groups was carried out in 3 weeks, five sessions per week, and each session lasted about one hour. Berg Balance Scale was used to measure balance. The data was analyzed by using analysis of independent and dependent sample t-test at a significance level of p≤0.05. Results: The results showed that significant improvements observed in balance (p≤0/05. Also significant differences observed between post hoc scores in the experimental and control groups (p≥0/05. Conclusion: According to research findings, the exercise walking program on textured surface resulted in considerable improvements in balance in multiple sclerosis. Also, the respective specialists can use these exercies as a complementary treatment along with the drug therapy for patiens with multiple sclerosis.

  18. Associations between period 3 gene polymorphisms and sleep- /chronotype-related variables in patients with late-life insomnia.

    Science.gov (United States)

    Mansour, Hader A; Wood, Joel; Chowdari, Kodavali V; Tumuluru, Divya; Bamne, Mikhil; Monk, Timothy H; Hall, Martica H; Buysse, Daniel J; Nimgaonkar, Vishwajit L

    2017-01-01

    A variable number tandem repeat polymorphism (VNTR) in the period 3 (PER3) gene has been associated with heritable sleep and circadian variables, including self-rated chronotypes, polysomnographic (PSG) variables, insomnia and circadian sleep-wake disorders. This report describes novel molecular and clinical analyses of PER3 VNTR polymorphisms to better define their functional consequences. As the PER3 VNTR is located in the exonic (protein coding) region of PER3, we initially investigated whether both alleles (variants) are transcribed into messenger RNA in human fibroblasts. The VNTR showed bi-allelic gene expression. We next investigated genetic associations in relation to clinical variables in 274 older adult Caucasian individuals. Independent variables included genotypes for the PER3 VNTR as well as a representative set of single nucleotide polymorphisms (SNPs) that tag common variants at the PER3 locus (linkage disequilibrium (LD) between genetic variants sleep time and sleep latency, self-rated chronotype, estimated with the Composite Scale (CS), and lifestyle regularity, estimated using the social rhythm metric (SRM). Initially, genetic polymorphisms were individually analyzed in relation to each outcome variable using analysis of variance (ANOVA). Nominally significant associations were further tested using regression analyses that incorporated individual ANOVA-associated DNA variants as potential predictors and each of the selected sleep/circadian variables as outcomes. The covariates included age, gender, body mass index and an index of medical co-morbidity. Significant genetic associations with the VNTR were not detected with the sleep or circadian variables. Nominally significant associations were detected between SNP rs1012477 and CS scores (p = 0.003) and between rs10462021 and SRM (p = 0.047); rs11579477 and average delta power (p = 0.043) (analyses uncorrected for multiple comparisons). In conclusion, alleles of the VNTR are expressed at the

  19. The rationale for sitting elderly patients in hospital out of bed for long periods is medically unsubstantiated and detrimental to their recovery.

    Science.gov (United States)

    Bliss, Mary Rose

    2004-01-01

    The notorious statement by Asher about the dangers of bed rest [Brit Med J 1947; ii: 967-8] which continues to be quoted out of context in leading medical journals today is inapplicable to modern short stay elderly hospital patients and has little medical foundation. 'Blood clotting in the veins' is more likely to result from venous stasis during sitting than from lying down. 'Lime draining from the bones' refers to subjects' spending weeks, not hours, in the horizontal position and similar losses have been shown to occur in healthy people immobilised in chairs for long periods during the day. Constipation is common in sick old people and there is no evidence that 'scybala stacking up the colon' is more likely to occur in bed than in a chair. The 'flesh rotting from the seat', or pressure sores, occur as frequently or more frequently, in sick patients nursed in chairs as in bed. 'Urine leaking from the distended bladder' may be reduced in very debilitated old people sitting in chairs, but at the expense of impaired renal function associated with reduced perfusion in the upright posture and exacerbated incontinence due to a compensatory diuresis at night. The 'spirit evaporating from the soul' today is more likely to afflict old patients who are exhausted by prolonged chair nursing and orthostatic hypotension due to age or illness. Recent studies in intensive care patients have highlighted the hypotension due to vasodilatation which can occur in infection and trauma. There is no evidence that nosocomial pneumonia is reduced by sitting patients out of bed, and lack of sleep is likely to exacerbate infection and delay recovery. Preventing patients from lying down when they feel the need is a violation of their rights and has been shown to be probably as injurious as the Victorian practice of preventing healthy patients from getting up. Physiotherapy is obviously important but patients should be allowed to decide for themselves how long they spend in or out of bed.

  20. Opioids Consumed in the Immediate Post-Operative Period Do Not Influence How Patients Rate Their Experience of Care After Total Hip Arthroplasty.

    Science.gov (United States)

    Etcheson, Jennifer I; Gwam, Chukwuweike U; George, Nicole E; Virani, Sana; Mont, Michael A; Delanois, Ronald E

    2018-04-01

    Patient perception of care, commonly measured with Press Ganey (PG) surveys, is an important metric used to determine hospital and provider reimbursement. However, post-operative pain following total hip arthroplasty (THA) may negatively affect patient satisfaction. As a result, over-administration of opioids may occur, even without marked evidence of pain. Therefore, this study evaluated whether opioid consumption in the immediate postoperative period bears any influence on satisfaction scores after THA. Specifically, this study assessed the correlation between post-operative opioid consumption and 7 PG domains: (1) Overall hospital rating; (2) Communication with nurses; (3) Responsiveness of hospital staff; (4) Communication with doctors; (5) Hospital environment; (6) Pain Management; and (7) Communication about medicines. Our institutional PG database was reviewed for patients who received THA from 2011 to 2014. A total of 322 patients (mean age = 65 years; 61% female) were analyzed. Patient's opioid consumption was measured using a morphine milli-equivalent conversion algorithm. Bivariate correlation analysis assessed the association between opioid consumption and Press-Ganey survey elements. Pearson's r assessed the strength of the association. No correlation was found between total opioid consumption and Overall hospital rating (r = 0.004; P = .710), Communication with nurses (r = 0.093; P = .425), Responsiveness of hospital staff (r = 0.104; P = .381), Communication with doctors (r = 0.009; P = .940), Hospital environment (r = 0.081; P = .485), and Pain management (r = 0.075; P = .536). However, there was a positive correlation between total opioid consumption and "Communication about medicines" (r = 0.262; P = .043). Our report demonstrates that PG patient satisfaction scores are not influenced by post-operative opioid use, with the exception of PG domain, "Communication about medications." These results suggest that opioid medications should be

  1. THE CONSTRUCTION OF PHYSICAL REHABILITATION PROGRAMS IN THE PREOPERATIVE PERIOD FOR PATIENTS THAT WILL REMOVE OF INTERVERTEBRAL DISC’ PROLAPSE IN THE LUMBAR SPINE

    Directory of Open Access Journals (Sweden)

    E.B. Lazarieva

    2014-06-01

    Full Text Available The ineffectiveness of conservative treatment will make the need for surgery in 4-5% of patients suffering from low back pain with hernias of the lumbar and sacral spine. Despite the surgical removal of the source of compressed roots, nerves and blood vessels, require a comprehensive system of rehabilitation therapy in order to eliminate manifestations of disease and relief of disease progression. The aim of the work is to substantiate the general approaches for the using of physical rehabilitation and diagnostics static component of the dynamic stereotype in the preoperative period in patients to remove intervertebral disc prolapse. The materials and methods. There was examined 96 with low back pain. Methods are applied in this research: analysis of a literature, observation methods. Results. In conjunction with the physician was determined "diagnosis for rehabilitation" and "prognosis of the rehabilitation". The formulation of the basis of the diagnosis for rehabilitation was performed through the examination during the rehabilitation (as a taking an anamnestic data, examination and palpation, studies of intact sensory and motor functions, the results of objective research tool. Conclusions. The identification of preserved anatomical and functional entities, the definition of the initial level of compensation for lost functions and forecast further recovery is a fundamental approach to program development in the preoperative period in patients with low back pain aimed at the removal of intervertebral disc herniations.

  2. Patient Survival Periods and Death Causes Following Surgical Treatment of Mammary Gland Tumours Depending on Histological Type of Tumour: Retrospective Study of 221 Cases

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    Jana Lorenzová

    2010-01-01

    Full Text Available This retrospective study evaluated a canine patient group operated on for mammary neoplasms (221 females. After surgical treatment, the animals were divided based on histological findings into groups and subgroups according to the WHO system. In the individual groups and subgroups the length of their survival following a mammary tumour surgery and death causes were followed. Of their total number, 164 tumours were malignant, 39 were benign and 18 were mammary hyperplasias. With regard to malignant tumours, invasive tubular carcinoma (20.81% was identified most frequently; fibroadenoma reached the highest occurrence (10.41% as regards benign tumours. The length of survival in females with malignant tumours ranged from 12 to 37.4 months, depending on histological subtypes. In females with benign mammary neoplasms the length of survival ranged from 39.1 to 59.3 months and in animals with hyperplasia it was 50.2 months. As a result of mammary tumour, 41 females (25% died in the malignant tumour group, none died in the benign tumour group and 2 females (11.1% died in the hyperplasia group. The survival periods in surgically treated patients with mammary tumours were shorter for solid and complex carcinomas, compared to patients affected with the remainder of the histological subtypes. The longest survival period following operation was recorded in the group suffering from adenoma. The least favourable illness prognosis for patients with mammary tumours in respect to linking the death cause to the mammary tumour was for those having invasive papillary carcinoma. The most favourable illness prognosis was for patients with benign tumours and non-invasive tubular carcinoma. A frequent death cause in females with mammary tumours was another illness unrelated to mammary tumours.

  3. Errata Corrige. Orthostatic Reactivity in Patients with Ischemic Stroke in the Chronic Period. http://dx.doi.org/10.3889/oamjms.2015.090.

    Science.gov (United States)

    Vasileva, Danche; Lubenova, Daniela; Mihova, Marija; Grigorova-Petrova, Kristin; Dimitrova, Antoaneta

    2015-09-15

    This study aims to trace the influence of specialized kinesitherapeutic methodology (SKTM) on orthostatic reactivity in patients with ischemic stroke in the chronic period (ISChP). An active orthostatic test is used for the evaluation of the orthostatic reactions. The arterial blood pressure and heart rate were defined in the 10 minutes of supine position, before and after 1, 5 and 10 minutes of active upright position. The orthostatic autoregulation is evaluated four times - at the beginning of the study, on the 10th day, on the 1st month and three months after the start of the KT. The classification by Thulesius was used to separate the patients into two groups depending on the type of their orthostatic reactivity. At the beginning of the study of infringements symptomatic type orthostatic reactivity (SOR) was observed in 24 patients and hypertensive type orthostatic reactivity (HOR) was observed in the remaining 32 patients. Once applied SKTM establish improvement of orthostatic autoregulation for the groups SOR and HOR at the 10th day and the 1st month with a level of significance p <0.05. The applied specialized kinesitherapeutic methodology continued later as an adapted exercise program at home, has significantly improved the orthostatic reactivity in patients with orthostatic dysregulation due to the ISChP.

  4. PRIORITIES IN CONCEPT OF CARDIOVASCULAR RISK FACTORS IN IRRADIATED PATIENTS AT DISTANT PERIOD AFTER CHERNOBYL NUCLEAR DISASTER BASED ON PROSPECTIVE COHORT DATA

    Directory of Open Access Journals (Sweden)

    R. G. Oganov

    2008-01-01

    Full Text Available Aim. To study pathogenetic mechanisms and cardiovascular risk factors prospective cohort study in liquidators of consequences of Chernobyl Nuclear Disaster 13-20 years after an accident.Material and methods. 409 irradiated patients and 224 control patients comparable on the age and gender were involved into two-stage cohort prospective study with 4,5years period of observation. Database included results of standard questionnaires, social and demographic description, education, family status, smoking and alcohol habits, anthropometry, fasting lipids and glucose, blood pressure, ECG, arrhythmias on ECG monitoring, heart rhythm variability, Echocardiography, thyroid ultrasound image, spirometry, transesophageal electrophysiological study of heart conduction system, exercise tests, functional class of ischemic heart disease, stage of arterial hypertension, fatal/nonfatal end-points, as well as neurologist, endocrinologist and cardiologist conclusions. Totally 267 variables were included in the analysis.Results. Spectrum of active cardiovascular risk factors in cohort of irradiated patients was entirely different from this in control patients. Determinative value for irradiated patients was related with night hypersympathetic activity, ANDS syndrome (Autonomic Nervous Dysfunction on hyperSympathetic type and less related with decreased airway conductance in small bronchial tubes.Conclusion. Comparative prospective cohort study in liquidators of consequences of Chernobyl Nuclear Disaster 13-20 years after an accident revealed highly significant new and permanently acting cardiovascular risk factors. These data let to work out appropriate approaches to therapy and prevention of cardiovascular diseases.

  5. [2001 national survey of nosocomial infection prevalence among newborns and under-eighteen children and adolescents in France].

    Science.gov (United States)

    Branger, B

    2005-07-01

    To know nosocomial infections (NI) rates among newborns and hospitalised children according to age and units of hospitalisation, In 2001, the Comité technique des infections nosocomiales (CTIN) initiated a one-day prevalence survey on an arranged date. It was conducted by the 5 centres de coordination de lutte contre les infections nosocomiales (C.CLIN). Paediatric data only were analysed dividing them into 2 groups: newborns (NB) up to 28 days old, whether in maternity, neonatology or intensive care units, and children (CH) from 29 days to 18 years old with separate analysis for surgery, cancer units and intermediate care and rehabilitation centres (ICRC). The survey included 21 596 children under 18 years old: 9136 NB and 12,460 CH, i.e. 7.1% of the total hospital population on that one given day. A total of 2.6% of the patients were infected, with 1.2% of NB and 3.3% of CH. There were 1.09 infections per patient. 456 different microorganisms were responsible for 562 infections, i.e. 81.1%: 18,6% Staphylococcus aureus of which 26.7% were methicillin resistant (MRSA), 21.9% Staphylococcus epidermis, 21.9% enterobacteries, 10.3% Pseudomonas aeruginosa, 4.4% Candida albicans, and 4.2% rotavirus. NB and CH infection factors were studied separately. Selective criteria for hospitalised NB were: gender: male(P infected patients in intensive care units was 7.8% for NB and 16.2% for CH, with 9.6% neonatal, 30.8% heart condition, 26.3% non-specialised units and 14.2% children units. ICRC infection rate was 4.5% while surgery units had a rate of 1.9% with 2.4% orthopaedic, 0.7% children units, 2.0% non-specialised units and 8.1% neurosurgery. The 2001 NI level showed a significant fall from 3.5% in the 1996 survey (all ages) to 2.4%. However, including newborns from private maternity units into the survey may have partly lowered this level. MRSA levels have also dropped from 46% in 1996 to 27% in 2001. It is difficult to compare international data as definitions vary

  6. Wiskott-Aldrich Syndrome With Normal-Sized Platelets in an Eighteen-Month-Old Boy: A Rare Mutation

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    Jayitri Mazumdar

    2015-07-01

    Full Text Available Introduction: Wiskott-Aldrich syndrome (WAS is an X-linked recessive disorder characterized by thrombocytopenia, eczema, and recurrent infections. The disease is usually associated with small defective platelets. Case Presentation: We described an 18-month-old boy who presented with lower gastrointestinal bleeding, eczema, and recurrent infections. There was pancytopenia with normal-sized platelets. In addition, the CD4 count was significantly low and serum IgA and IgE levels were increased. The diagnosis of WAS was confirmed by detecting a mutation of WAS gene, which was due to a deletion mutation resulting in frameshift (c.177DelT. Conclusions: Usually microplatelets with mean platelet volume of 4-5 fL are seen in WAS, but in this case, the patient had normal-sized platelets with a rare mutation of WAS gene. Therefore, high index of clinical suspicion is needed to diagnose WAS.

  7. Effects of active and passive training apparatus combined with rehabilitation training on lower limb function of stroke patients during recovery period

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Stroke patients always spontaneously do some learning and training of motor functions;however, learning and training are not prompt and right, while patients do not have enough activity amounts.Active and passive motor training apparatus is aimed directly at lower limb training so as to stimulate nerve function through stimulating muscular movement. Based on motor mileage, motor time, various power supplies and velocity of active and passive training apparatus, we can understand the training condition and adjust training program.OBJECTIVE: To observe the effects of grade-III rehabilitation training combining with active and passive training apparatus on lower limb function, muscle strength and activity of daily living (ADL) in stroke patients during recovery period.DESIGN: Contrast observation.SETTING: Department of Rehabilitation, Jilin Academic Institute of Traditional Chinese Medicine.PARTICIPANTS: A total of 80 patients with stroke-induced hemiplegia after stabilizing vital signs for 2 weeks were selected from Department of Rehabilitation, Jilin Academic Institute of Traditional Chinese Medicine from January to June 2007. There were 47 males and 33 females, and their ages ranged from 41 to 75 years. All patients met the diagnostic criteria of the Fourth National Cerebrovascular Disease Academic Meeting in 1995 and were diagnosed as cerebral hemorrhage or cerebral infarction through CT or MRI examinations in clinic. Patients and their parents provided the confirmed consent. Based on therapeutic orders of hospitalization, patients were randomly divided into treatment group and control group with 40 patients in each group.METHODS: Patients in the control group received physical therapy and occupational therapy combining with rehabilitative treatment based on grade-Ⅲ rehabilitative treatment program, which was set by the National Cerebrovascular Disease Topic Group. In addition, patients in the treatment group were trained with active and passive

  8. Unexpectedly long incubation period of Plasmodium vivax malaria, in the absence of chemoprophylaxis, in patients diagnosed outside the transmission area in Brazil

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    da Silveira Bressan Clarisse

    2011-05-01

    Full Text Available Abstract Background In 2010, Brazil recorded 3343,599 cases of malaria, with 99.6% of them concentrated in the Amazon region. Plasmodium vivax accounts for 86% of the cases circulating in the country. The extra-Amazonian region, where transmission does not occur, recorded about 566 cases imported from the Amazonian area in Brazil and South America, from Central America, Asia and African countries. Prolonged incubation periods have been described for P. vivax malaria in temperate climates. The diversity in essential biological characteristics is traditionally considered as one possible explanation to the emergence of relapse in malaria and to the differences in the duration of the incubation period, which can also be explained by the use of chemoprophylaxis. Studying the reported cases of P. vivax malaria in Rio de Janeiro, where there is no vector transmission, has made it possible to evaluate the extension of the incubation period and to notice that it may be extended in some cases. Methods Descriptive study of every malaria patients who visited the clinic in the last five years. The mean, standard deviation, median, minimum and maximum of all incubation periods were analysed. Results From the total of 80 patients seen in the clinic during the study time, with confirmed diagnosis of malaria, 49 (63% were infected with P. vivax. Between those, seven had an estimated incubation period varying from three to 12 months and were returned travellers from Brazilian Amazonian states (6 and Indonesia (1. None of them had taken malarial chemoprophylaxis. Conclusions The authors emphasize that considering malaria as a possible cause of febrile syndrome should be a post-travel routine, independent of the time elapsed after exposure in the transmission area, even in the absence of malaria chemoprophylaxis. They speculate that, since there is no current and detailed information about the biological cycle of human malaria plasmodia's in Brazil, it is possible

  9. Description of preoperative risk factors and postoperative complications of radical hysterectomy in patients of Hospital Dr. Rafael Angel Calderon Guardia: period 2000-2006

    International Nuclear Information System (INIS)

    Sosa Quesada, Carlos Ivan; Wang Zuniga, Sylvia

    2008-01-01

    Preoperative risk factors and postoperative complications were determined in patients with radical hysterectomy in gynecologic oncology service of Hospital Rafael Angel Calderon Guardia in 2000-2006. Radical hysterectomy Piver type II and III was carried out among women in the gynecology service. The information derived from the qualitative variables were analyzed using frequency distributions and percentages. The most common preoperative comorbidity has been hypertension, the most frequently encountered complication has been urinary incontinence. Postoperative complications have been located in a period less than three months. [es

  10. Design, implementation, and evaluation of a computerized system to communicate with patients with limited native language proficiency in the perioperative period.

    Science.gov (United States)

    Taicher, Brad M; Alam, Rammy I; Berman, Joshua; Epstein, Richard H

    2011-01-01

    Effective communication with patients having limited proficiency in the native language of anesthesia care providers during the perioperative period is often challenging. We describe how we developed, implemented, and evaluated a computerized system to convey frequently used prerecorded phrases related to perioperative anesthesia care in the languages we most often encounter in such patients. Phrases were chosen through a consensus process among anesthesia department members. These included routine sayings used to inform patients about what they should anticipate, what interventions we are performing, and how they can participate. Common questions requiring a "yes" or "no" answer were also identified. We recorded these phrases using native speakers who were both knowledgeable medically and familiar with the culture of the patients to provide accurate translations. We developed a software application that categorically grouped the phrases and allowed care providers to select a phrase and play the associated sound file to the patient and deployed the program on our touchscreen-enabled anesthesia information management system workstations. A convenience sample of obstetrical patients speaking a Chinese dialect with whom the language program was used were asked to complete an anonymous questionnaire, translated into Chinese, about their experience. Ninety-five percent lower confidence limits (LCLs) were calculated for response proportions. We approached 25 parturients with varying levels of English comprehension, and all agreed to use the language program. Each used it throughout her interaction with the anesthesia care providers during labor and delivery, and all patients completed the survey. Acceptance of the process was high, with all patients indicating that they would like to use it again were they to return for another procedure requiring anesthesia. Eighty-eight percent (LCL = 73%) indicated that having instructions in their native language made them feel more

  11. Implementation experience during an eighteen month intervention to improve paediatric and newborn care in Kenyan district hospitals

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    Wamae Annah

    2009-07-01

    Full Text Available Abstract Background We have conducted an intervention study aiming to improve hospital care for children and newborns in Kenya. In judging whether an intervention achieves its aims, an understanding of how it is delivered is essential. Here, we describe how the implementation team delivered the intervention over 18 months and provide some insight into how health workers, the primary targets of the intervention, received it. Methods We used two approaches. First, a description of the intervention is based on an analysis of records of training, supervisory and feedback visits to hospitals, and brief logs of key topics discussed during telephone calls with local hospital facilitators. Record keeping was established at the start of the study for this purpose with analyses conducted at the end of the intervention period. Second, we planned a qualitative study nested within the intervention project and used in-depth interviews and small group discussions to explore health worker and facilitators' perceptions of implementation. After thematic analysis of all interview data, findings were presented, discussed, and revised with the help of hospital facilitators. Results Four hospitals received the full intervention including guidelines, training and two to three monthly support supervision and six monthly performance feedback visits. Supervisor visits, as well as providing an opportunity for interaction with administrators, health workers, and facilitators, were often used for impromptu, limited refresher training or orientation of new staff. The personal links that evolved with senior staff seemed to encourage local commitment to the aims of the intervention. Feedback seemed best provided as open meetings and discussions with administrators and staff. Supervision, although sometimes perceived as fault finding, helped local facilitators become the focal point of much activity including key roles in liaison, local monitoring and feedback, problem solving

  12. Characterization of patients with esophageal atresia of the Servicio de Cuidados Intensivos Neonatales of the Hospital Nacional de Ninos, during the period from January 2008 to December 2012

    International Nuclear Information System (INIS)

    Ramirez Gutierrez, Hannia

    2013-01-01

    A population of 61 patients discharged of the Servicio de Cuidados Intensivos Neonatales of the Hospital Nacional de Ninos with the diagnosis of esophageal atresia, associated anomalies, medical-surgical management and complications was describing during the period from 2008 to 2012. The patients had complementary studies such as chest x-ray, esophagogram, echocardiogram and gastrointestinal transit. Esophageal atresia can be diagnosed prenatally by ultrasound. According to the study, the absence of prenatal ultrasound data in the files and failure to perform a routine morphological ultrasound to pregnant women to rule out malformations or defects in prenatal care, were considered as possible causes for the poor prenatal diagnosis. The most frequent Gross AE is type C, as noted in world literature. Cardiac malformations are the most frequent. Early and late complications according to the type of surgical approach (extrapleural and transpleural) were compared and described. The most frequent surgical complications were presented in the transpleural surgical approach [es

  13. Weight and blood pressure response to weight management and sibutramine in diabetic and non-diabetic high-risk patients: an analysis from the 6-week lead-in period of the sibutramine cardiovascular outcomes (SCOUT) trial

    DEFF Research Database (Denmark)

    Van Gaal, L F; Caterson, I D; Coutinho, W

    2010-01-01

    To assess treatment responses to sibutramine and weight management in diabetic patients during the lead-in period of the Sibutramine Cardiovascular OUTcomes (SCOUT) trial.......To assess treatment responses to sibutramine and weight management in diabetic patients during the lead-in period of the Sibutramine Cardiovascular OUTcomes (SCOUT) trial....

  14. Correlation between special brain area and blood perfusion in patients with cerebral infarction at convalescent period Feasibility for quantitative determination and estimation of learning and memory function

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Presently, clinic memory scale is used to evaluate learning memory ability in most studies,and the influence of difference in measurement condition of individuals exists.OBJECTIVE: To study the correlation between regional cerebral blood flow (rCBF) perfusion and learning memory function in special brain regions of patients with cerebral infarction at convalescent period,and to try to find out a method which can quantitatively evaluate learning ability.DESIGN: Case observation, and correlation analysis.SETTINGS: Shandong Institute for Behavioral Medicine; the Affiliated Hospital of Jining Medical College.PARTICIPANTS: Totally 70 patients with cerebral infarction admitted to Departtment of Neurology, Jining Medical College between January 2004 and December 2005 were involved. The involved patients, 58 male and 12 female, were averaged (52±3) years, and they were all right handed. They all met the diagnosis criteria instituted by the Fourth National Conference on Cerebrovascular Disease, and were confirmed as cerebral infarction by skull CT or MRI. Informed consents of detected items were obtained from all the patients and relatives.METHODS: When the patients were at convalescent period, their learning and memory ability were measured with" clinic memory scale (set A)". The 18 patients whose total mark over 100 were regarded as good learning memory function group; The 23 cases whose total mark less than 70 were regarded as poor learning memory function group. RCBF of hippocampus, nucleus amygdalae, temporal cortex and prefrontal lobe of patients between two groups were measured and compared by single photon emission computed tomography (SPECT). The total scores of the 18 good learning memory patients and 23 poor learning memory patients were taken as dependent variable Y, and their rCBFs of hippocampus, nucleus amygdale,temporal cortex and prefrontal lobe respectively as independent variable X for linear correlation analysis.MAIN OUTCOME MEASURES

  15. Fertility, pregnancy planning, and pharmacotherapy during the pregnancy, postpartum and breastfeeding period in patients with rheumatoid arthritis and other inflammatory arthropathies

    Directory of Open Access Journals (Sweden)

    Marzena Olesińska

    2014-03-01

    Full Text Available The peak in incidence of the majority of inflammatory arthropathies (IAs is observed in the 2 nd –4 th decades of life. Thus the diseases affect patients at reproductive age. The results of population studies have demonstrated that these diseases can exert effects on the fertility of the patients, family planning, course of pregnancy and further development of the baby. It has also been shown that female patients with IAs, compared with healthy women, less frequently decide to have the first and other babies and the interval between successive pregnancies is longer. The aim of pharmacotherapy in a patient with IA who plans to become pregnant is to effectively inhibit the inflammatory activity and to maintain remission/low activity of the disease during pregnancy and after its termination. Disease-modifying drugs suitable for administration in the preconception period and pregnancy include: chloroquine, hydroxychloroquine, sulfasalazine, azathioprine, ciclosporin A, glucocorticosteroids and non-steroidal anti-inflammatory drugs. The following should not be administered: out of the synthetic disease-modifying drugs – methotrexate, leflunomide, cyclophosphamide and mycophenolate mofetil; and out of biological drugs – abatacept, tocilizumab and rituximab.

  16. Radiation Risk to Patients from Nuclear Medicine Procedures in Camaguey and Ciego de Avila Provinces (Cuba) during the period 2000-2005

    International Nuclear Information System (INIS)

    Brigido Flores, O.; Barreras Caballero, A.

    2015-01-01

    Population radiation dose estimation due to administration of radiopharmaceuticals in Camaguey and Ciego de Avila provinces was carried out using Medical Internal Radiation Dose scheme (MIRD). Data were gathered on the type of radiopharmaceuticals used, the administered activity, the numbers of each kind of examination, and the age and sex of the patients involved during the period 2000 - 2005. The average annual frequency of examinations was estimated to be 3.65 per 1000 population. The results show that imaging nuclear medicine techniques of thyroid and bone explorations with 13.3 and 12.9%, respectively and iodide uptake with 50% are the main techniques implicated in the relative contribution to the total annual effective collective dose which averaged 95 man-Sv for the studied period. Radiation risks for the Camaguey-Ciego de Avila population caused by nuclear medicine examinations in the period studied were calculated: the total number of fatal and non-fatal cancers was 34.2 and the number of serious hereditary disturbance was 7.4 as a result of 24139 nuclear medicine procedures, corresponding to a total detriment of 1.72 per 1000 examination. (Author)

  17. The validity of the PAM-RL device for evaluating periodic limb movements in sleep and an investigation on night-to-night variability of periodic limb movements during sleep in patients with restless legs syndrome or periodic limb movement disorder using this system.

    Science.gov (United States)

    Kobayashi, Mina; Namba, Kazuyoshi; Ito, Eiki; Nishida, Shingo; Nakamura, Masaki; Ueki, Yoichiro; Furudate, Naomichi; Kagimura, Tatsuo; Usui, Akira; Inoue, Yuichi

    2014-01-01

    The status of night-to-night variability for periodic limb movements in sleep (PLMS) has not been clarified. With this in mind, we investigated the validity of PLMS measurement by actigraphy with the PAM-RL device in Japanese patients with suspected restless legs syndrome (RLS) or periodic limb movement disorder (PLMD) and the night-to-night variability of PLMS among the subjects. Forty-one subjects (mean age, 52.1±16.1 years) underwent polysomnography (PSG) and PAM-RL measurement simultaneously. Thereafter, subjects used the PAM-RL at home on four more consecutive nights. The correlation between PLMS index on PSG (PLMSI-PSG) and PLM index on PAM-RL (PLMI-PAM) was 0.781 (PPAM-RL. PAM-RL is thought to be valuable for assessing PLMS even in Japanese subjects. Recording of PAM-RL for three or more consecutive nights may be required to ensure the screening reliability of a patient with suspected pathologically frequent PLMS. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. Thyrotoxic periodic paralysis

    Directory of Open Access Journals (Sweden)

    Rojith Karandode Balakrishnan

    2011-01-01

    Full Text Available This article aims at highlighting the importance of suspecting thyrotoxicosis in cases of recurrent periodic flaccid paralysis; especially in Asian men to facilitate early diagnosis of the former condition. A case report of a 28 year old male patient with recurrent periodic flaccid paralysis has been presented. Hypokalemia secondary to thyrotoxicosis was diagnosed as the cause of the paralysis. The patient was given oral potassium intervention over 24 hours. The patient showed complete recovery after the medical intervention and was discharged after 24 hours with no residual paralysis. Thyrotoxic periodic paralysis (TPP is a complication of thyrotoxicosis, more common amongst males in Asia. It presents as acute flaccid paralysis in a case of hyperthyroidism with associated hypokalemia. The features of thyrotoxicosis may be subtle or absent. Thus, in cases of recurrent or acute flaccid muscle paralysis, it is important to consider thyrotoxicosis as one of the possible causes, and take measures accordingly.

  19. Patient safety incident reports related to traditional Japanese Kampo medicines: medication errors and adverse drug events in a university hospital for a ten-year period.

    Science.gov (United States)

    Shimada, Yutaka; Fujimoto, Makoto; Nogami, Tatsuya; Watari, Hidetoshi; Kitahara, Hideyuki; Misawa, Hiroki; Kimbara, Yoshiyuki

    2017-12-21

    Kampo medicine is traditional Japanese medicine, which originated in ancient traditional Chinese medicine, but was introduced and developed uniquely in Japan. Today, Kampo medicines are integrated into the Japanese national health care system. Incident reporting systems are currently being widely used to collect information about patient safety incidents that occur in hospitals. However, no investigations have been conducted regarding patient safety incident reports related to Kampo medicines. The aim of this study was to survey and analyse incident reports related to Kampo medicines in a Japanese university hospital to improve future patient safety. We selected incident reports related to Kampo medicines filed in Toyama University Hospital from May 2007 to April 2017, and investigated them in terms of medication errors and adverse drug events. Out of 21,324 total incident reports filed in the 10-year survey period, we discovered 108 Kampo medicine-related incident reports. However, five cases were redundantly reported; thus, the number of actual incidents was 103. Of those, 99 incidents were classified as medication errors (77 administration errors, 15 dispensing errors, and 7 prescribing errors), and four were adverse drug events, namely Kampo medicine-induced interstitial pneumonia. The Kampo medicine (crude drug) that was thought to induce interstitial pneumonia in all four cases was Scutellariae Radix, which is consistent with past reports. According to the incident severity classification system recommended by the National University Hospital Council of Japan, of the 99 medication errors, 10 incidents were classified as level 0 (an error occurred, but the patient was not affected) and 89 incidents were level 1 (an error occurred that affected the patient, but did not cause harm). Of the four adverse drug events, two incidents were classified as level 2 (patient was transiently harmed, but required no treatment), and two incidents were level 3b (patient was

  20. Prevalence of Cancers of Female Organs among Patients with Diabetes Type 2 in Kelantan, Malaysia: Observations over an 11 Year Period and Strategies to Reduce the Incidence.

    Science.gov (United States)

    Jalil, Nur Asyilla Che; Zin, Anani Aila Mat; Othman, Nor Hayati

    2015-01-01

    Kelantan is one of the states in Malaysia which has a high prevalence of type 2 diabetes (DM2). Other than with endometrial carcinoma, the association of DM2 with particular female cancers is not known. To determine the proportion of breast, cervical, ovarian and endometrial cancers among females with DM2 diagnosed in Hospital Universiti Sains Malaysia (HUSM) over an 11 year period. All histologically confirmed cases of breast, endometrial, cervical and ovarian carcinomas admitted to the Hospital were included in the study. The patient diabetic status was traced from the hospital medical records. There was a total of 860 cases of breast, cervical, ovarian and endometrial carcinomas over this period. Breast carcinoma was the commonest, accounting for 437/860 (50.8%) followed by cervix, 159/860 (18.5%), ovarian, 143/860 (16.6%) and endometrial carcinomas, 121/860 (14.1%). Out of these, 228/860 (26.5%) were confirmed diabetics. Endometrial carcinoma patients showed the highest proportion being diabetics, 42.1% (51/121), followed by ovarian cancer, 25.9% (37/143), breast carcinoma, 23.6% (103/437) and cervical cancer 23.3% (37/159). There is a significant proportion of DM2 among women with these four cancers, endometrial carcinoma being the highest followed by ovarian, breast and cervical carcinoma. The rising trend of these four cancers is in tandem with an increasing trend of DM2 in the community. In populations where diabetes is prevalent, screening for epithelial cancers should be rigourous. Diabetic clinics should include screening for these cancers among their female patients and gynecology clinics should screen the women they treat for their diabetes status.

  1. Effect of rehabilitation training combined with hyperbaric oxygen therapy on the nerve cytokine secretion and oxidative stress in rehabilitation period of patients with cerebral infarction

    Directory of Open Access Journals (Sweden)

    Ling Kong

    2017-11-01

    Full Text Available Objective: To discuss the influence of rehabilitation training combined with hyperbaric oxygen therapy on the nerve cytokine secretion and oxidative stress in rehabilitation period of patients with cerebral infarction. Methods: A total of 110 patients with cerebral infarction who received rehabilitation therapy in the hospital between January 2015 and May 2017 were divided into routine group (n=55 and hyperbaric oxygen group (n=55 according to random number table. Routine group received regular rehabilitation training, and hyperbaric oxygen group underwent rehabilitation training combined with hyperbaric oxygen therapy. The differences in the serum contents of nerve factors, neurotransmitters and oxidative stress indexes were compared between the two groups at immediately after admission (T0 and after 14 d of treatment (T1. Results: At T0, there was no statistically significant difference in the serum contents of nerve factors, neurotransmitters and oxidative stress indexes between the two groups. At T1, serum nerve factors MBP and NSE contents of hyperbaric oxygen group were lower than those of routine group while NGF content was higher than that of routine group; serum neurotransmitter Glu content was lower than that of routine group while GABA content was higher than that of routine group; serum oxidative stress indexes ROS and LHP contents were lower than those of routine group while CAT and SOD contents were higher than those of routine group. Conclusion: Rehabilitation training combined with hyperbaric oxygen therapy can effectively optimize the nerve function and inhibit the systemic oxidative stress response in rehabilitation period of patients with cerebral infarction.

  2. Time trends of period prevalence rates of patients with inhaled long-acting beta-2-agonists-containing prescriptions: a European comparative database study.

    Directory of Open Access Journals (Sweden)

    Marietta Rottenkolber

    Full Text Available Inhaled, long-acting beta-2-adrenoceptor agonists (LABA have well-established roles in asthma and/or COPD treatment. Drug utilisation patterns for LABA have been described, but few studies have directly compared LABA use in different countries. We aimed to compare the prevalence of LABA-containing prescriptions in five European countries using a standardised methodology.A common study protocol was applied to seven European healthcare record databases (Denmark, Germany, Spain, the Netherlands (2, and the UK (2 to calculate crude and age- and sex-standardised annual period prevalence rates (PPRs of LABA-containing prescriptions from 2002-2009. Annual PPRs were stratified by sex, age, and indication (asthma, COPD, asthma and COPD.From 2002-2009, age- and sex-standardised PPRs of patients with LABA-containing medications increased in all databases (58.2%-185.1%. Highest PPRs were found in men ≥ 80 years old and women 70-79 years old. Regarding the three indications, the highest age- and sex-standardised PPRs in all databases were found in patients with "asthma and COPD" but with large inter-country variation. In those with asthma or COPD, lower PPRs and smaller inter-country variations were found. For all three indications, PPRs for LABA-containing prescriptions increased with age.Using a standardised protocol that allowed direct inter-country comparisons, we found highest rates of LABA-containing prescriptions in elderly patients and distinct differences in the increased utilisation of LABA-containing prescriptions within the study period throughout the five European countries.

  3. A Comparision of the Effect of Sugammadex on the Recovery Period and Postoperative Residual Block in Young Elderly and Middle-Aged Elderly Patients

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    Emine Yazar

    2016-04-01

    Full Text Available Background: The importance of the characteristics of anesthesia and postoperative residual curarization (PORC in the elderly population should be a growing concern in this century. Aims: To investigate the effect of sugammadex on the duration of the recovery from neuromuscular blocking agents and postoperative residual curarization in the young elderly and middle-aged elderly patients who underwent elective laparoscopic cholecystectomy, followed by a train of four (TOF watch monitorization. Study Design: Prospective clinical trial study. Methods: Sixty patients over the age of 65 with American Society of Anesthesiologists I-III were divided into two groups according to their age (65-74 years old and ≥75 years old. Patients received sugammadex (2.0 mg/kg iv at the reappearance of the second twitch of the TOF as an agent for reversal of neuromuscular blockage at the end of surgery. Patients were extubated at the time of TOF ≥0.9. The patients’ TOF responses were evaluated with regards to PORC in at the 5th minute and were followed up for one hour in the recovery room. Reintubation was applied for those patients who developed PORC and had peripheric oxygen saturation <90% despite being given 6 L oxygen per min with a face mask. Results: The onset time of neuromuscular blocking agent and time from T2 to achieve TOF ratio 90% (the duration of sugammadex effect or over were found to be longer in the middle-aged elderly group than in the young elderly group. A statistically significant relationship was found between age and the duration of TOF ratio to reach 0.9 in the same direction. The PORC incidence and rate of reintubation were found to be 1.7% in all patients. Conclusion: In our opinion, it is necessary to remember that the duration of sugammadex effect on the recovery period is prolonged for patients who are aged ≥75 years compared to patients aged between 65-74 years. (ClinicalTrials.gov Identifier: ACTRN12615000758505

  4. Sublingual immunotherapy in patients with house dust mite allergic rhinitis: prospective study of clinical outcomes over a two-year period.

    Science.gov (United States)

    Soh, J Y; Thalayasingam, M; Ong, S; Loo, E X L; Shek, L P; Chao, S S

    2016-03-01

    Sublingual immunotherapy in patients with allergic rhinitis sensitised to house dust mites is safe, but its efficacy is controversial and sublingual immunotherapy with Blomia tropicalis has not yet been studied. This study sought to evaluate the efficacy of sublingual immunotherapy with house dust mite extract in children and adults with house dust mite allergic rhinitis over a period of two years. A prospective observational study was conducted of children and adults diagnosed with house dust mite allergic rhinitis who were treated with sublingual immunotherapy from 2008 to 2012. Total Nasal Symptom Scores, Mini Rhinoconjunctivitis Quality of Life scores and medication usage scores were assessed prospectively. Thirty-nine patients, comprising 24 children and 15 adults, were studied. Total Nasal Symptom Scores and Mini Rhinoconjunctivitis Quality of Life scores dropped significantly at three months into therapy, and continued to improve. Medication usage scores improved at one year into immunotherapy. Sublingual immunotherapy with house dust mite extracts, including B tropicalis, is efficacious as a treatment for patients with house dust mite allergic rhinitis.

  5. The Effect of Four-Week Period of Aerobic Exercise with Cinnamon Consumption on Lipoprotein Indicates and Blood sugar in Diabetic Female Patients (Type 2

    Directory of Open Access Journals (Sweden)

    M Dastani

    2013-01-01

    Full Text Available Introduction: Cinnamon as an herbal medicine has the ability to reduce blood glucose and lipoproteins in diabetic patients. Based on the positive effects of exercise on diabetic patients, the present study was conducted to investigate the effect of Four weeks Period aerobic exercise alongside using cinnamon on lipoprotein parameters and blood glucose in women with type 2 diabetes. Methods: Thirty diabetic women were voluntarily selected and were randomly divided into three groups: 1 aerobic exercise group; 2 aerobic exercise alongside using cinnamon; and 3 control group. Aerobic exercise took four weeks with 60 percent of maximum heart rate. Blood samples were collected at the beginning and end of the study. Results: Blood glucose, the fat percentage and HDL, and the ratio of LDL to HDL in the first group significantly decreased and in the second group increased (P<0.05. Also the first group showed a significant reduction in triglyceride. The only significant change observed in the control group was a significant increase in the level of LDL. Comparing the first and second group, it was observed that in the second group the level of total cholesterol decreased and the ratio of LDL to HDL increased (P<0.05. Conclusion: Using cinnamon alongside aerobic exercise is likely to be beneficial in regulating the concentration of blood glucose and lipids in diabetic patients.

  6. Income and health-related quality of life among prostate cancer patients over a one-year period after radical prostatectomy: a linear mixed model analysis.

    Science.gov (United States)

    Klein, Jens; Lüdecke, Daniel; Hofreuter-Gätgens, Kerstin; Fisch, Margit; Graefen, Markus; von dem Knesebeck, Olaf

    2017-09-01

    To examine income-related disparities in health-related quality of life (HRQOL) over a one-year period after surgery (radical prostatectomy) and its contributory factors in a longitudinal perspective. Evidence of associations between income and HRQOL among patients with prostate cancer (PCa) is sparse and their explanations still remain unclear. 246 males of two German hospitals filled out a questionnaire at the time of acute treatment, 6 and 12 months later. Age, partnership status, baseline disease and treatment factors, physical and psychological comorbidities, as well as treatment factors and adverse effects at follow-up were additionally included in the analyses to explain potential disparities. HRQOL was assessed with the EORTC (European Organisation for Research and Treatment of Cancer) QLQ-C30 core questionnaire and the prostate-specific QLQ-PR25. A linear mixed model for repeated measures was calculated. The fixed effects showed highly significant income-related inequalities regarding the majority of HRQOL scales. Less affluent PCa patients reported lower HRQOL in terms of global quality of life, all functional scales and urinary symptoms. After introducing relevant covariates, some associations became insignificant (physical, cognitive and sexual function), while others only showed reduced estimates (global quality of life, urinary symptoms, role, emotional and social function). In particular, mental disorders/psychological comorbidity played a relevant role in the explanation of income-related disparities. One year after surgery, income-related disparities in various dimensions of HRQOL persist. With respect to economically disadvantaged PCa patients, the findings emphasize the importance of continuous psychosocial screening and tailored interventions, of patients' empowerment and improved access to supportive care.

  7. A prospective, double-blind, randomized, two-period crossover, multicenter study to evaluate tolerability and patient preference between mirabegron and tolterodine in patients with overactive bladder (PREFER study).

    Science.gov (United States)

    Staskin, David; Herschorn, Sender; Fialkov, Jonathan; Tu, Le Mai; Walsh, Terry; Schermer, Carol R

    2018-02-01

    The objective of this study was to assess the tolerability and treatment preference in patients with overactive bladder (OAB) treated with mirabegron or tolterodine. This was a two-period, 8-week crossover, double-blind, phase IV study (PREFER; NCT02138747) in treatment-naive adults with OAB for 3 months or longer randomized to one of four treatment sequences in a 5:5:1:1 ratio (mirabegron/tolterodine, tolterodine/mirabegron, mirabegron/mirabegron, or tolterodine/tolterodine), separated by a washout period of 2 weeks. The primary endpoint was drug tolerability using the Medication Tolerability scale of the OAB Treatment Satisfaction (OAB-S) questionnaire at end of treatment (EoT). Period-by-treatment interactions were analyzed to determine any effect of drug order. Patient preference, change from baseline in OAB symptoms, and treatment-emergent adverse events (TEAEs) were assessed. A total of 358 randomized patients completed the OAB-S Medication Tolerability scale questionnaire at one or more visits after the baseline evaluation. The mean (95% CI) OAB-S Medication Tolerability scores were significantly higher (better tolerability) for mirabegron (86.29 [83.50, 89.08]) than for tolterodine (83.40 [80.59, 86.20]; p = 0.004). The period-by-treatment interaction was not significant (p = 0.955). Improvements in OAB-S Medication Tolerability scores at EoT were more evident in women, patients aged ≥65 years, and in patients without baseline incontinence, and were greater with mirabegron than with tolterodine extended release. There were no significant differences in patient preference or improvements in OAB symptoms. Significant differences in favor of mirabegron were observed for anticholinergic TEAEs (20.4% vs. 27.4%; p = 0.042) and specifically for gastrointestinal disorders (14.7% vs. 22.5%; p = 0.015). Tolerability of mirabegron was significantly higher than that of tolterodine, and patient preference and improvements in OAB symptoms were comparable

  8. Preliminary Evaluation of a New Semi-Closed-Loop Insulin Therapy System Over the Prandial Period in Adult Patients With Type 1 Diabetes

    Science.gov (United States)

    Quemerais, Marie Aude; Doron, Maeva; Dutrech, Florent; Melki, Vincent; Franc, Sylvia; Antonakios, Michel; Charpentier, Guillaume; Hanaire, Helene; Charpentier, Guillaume

    2014-01-01

    There is room for improvement in the algorithms used in closed-loop insulin therapy during the prandial period. This pilot study evaluated the efficacy and safety of the Diabeloop algorithm (model predictive control type) during the postprandial period. This 2-center clinical trial compared interstitial glucose levels over two 5-hour periods (with/without the algorithm) following a calibrated lunch. On the control day, the amount of insulin delivered by the pump was determined according to the patient’s usual parameters. On the test day, 50% or 75% of the theoretical bolus required was delivered, while the algorithm, informed of carbohydrate intake, proposed changes to insulin delivery every 15 minutes using modeling to forecast glucose levels. The primary endpoint was percentage of time spent at near normoglycemia (70-180 mg/dl). Twelve patients with type 1 diabetes (9 men, age 35.6 ± 12.7 years, HbA1c 7.3 ± 0.8%) were included. The percentage of time spent in the target range was 84.5 ± 20.8 (test day) versus 69.2 ± 33.9% (control day, P = .11). The percentage of time spent in hypoglycemia < 70 mg/dl was 0.2 ± 0.8 (test) versus 4.4 ± 8.2% (control, P = .18). Interstitial glucose at the end of the test (5 hours) was 127.5 ± 40.1 (test) versus 146 ± 53.5 mg/dl (control, P = .25). The insulin doses did not differ, and no differences were observed between the 50% and 75% boluses. In a semi-closed-loop configuration with manual priming boluses (25% or 50% reduction), the Diabeloop v1 algorithm was as successful as the manual method in determining the prandial bolus, without any exposure to excessive hypoglycemic risk. PMID:25097057

  9. Why do patients undergoing anterior cruciate ligament reconstruction in Brazil stay in hospital for longer periods than in other countries? Prospective evaluation of 30 patients and presentation of possible discharge criteria

    Directory of Open Access Journals (Sweden)

    Diego Costa Astur

    2013-08-01

    Full Text Available OBJECTIVE: Evaluate a better moment by the medical team and patient to be discharged and relate to possible medical discharge criteria. METHODS: 31 anterior cruciate ligament reconstructed patients under similar conditions prospectively evaluated about the possibility of discharge with 24 and 48 hours after surgery and possibles discharges criteria such as pain, range of motion and capacity quadriceps contraction, besides the use of a validated scale to measure the patient's functional independence. RESULTS: 50% and 6.4% of patients prefer remain hospitalized after 24 and 48 hours of surgery, respectively. The average of the visual analogue scale of pain was 2.63 and 1.76 points, and the range of motion of 79º and 86,7º after 24 and 48 hours, respectively. 100% of patients were able to quadriceps contraction in every evaluated moments. CONCLUSION: In Brazil, possible discharged criteria as pain, range of motion, quad contraction and motor independence motor function scale show that anterior cruciate reconstruction reconstructed patients could be discharged after 24 hours of surgery. However, 50% of patients still prefer to remain hospitalized for longer periods.

  10. Experience acquired over a four-year period using Vichi's scoring system in chest alterations occurring in patients with cystic fibrosis

    International Nuclear Information System (INIS)

    Vichi, G.F.; Jenuso, R.; Pellegrini, T.

    1987-01-01

    The classification of chest alterations in Cystic Fibrosis (CF) and related score proposed by Chrispin and Norman has been widely adopted in Europe and is still applied (although slightly modified) in most European Centres. Brasfield classification instead has been monstly used in the USA. Lately, however, to revise both classifications, the need has been felt, for a more precise correlation to anatomo-radiological data as well as for inclusion of headings which have not been taken into account so far. In 1980 one of the authors (Vichi) worked out a new scoring system for the chest alterations of CF. Results are reported from a follow-up of 15 patients with CF carried out at the FC Center of Meyer Ospedale in Florence from the late 1981 to 1985. The patients underwent periodic checking including determination of clinical scoring system-according to Shwachman and Kulczychi modified by Doershuk-respiratory function tests, chest X-rays evaluated by three radiologists separately, following both Chrispin and Norman and Vichi scoring systems. The latter system has proved to be well correlated to clinical data and to the ordinary pulmonary function tests but it mainly presents a high observer reproducibility

  11. Incubation Period and Early Natural History Events of the Acute Form of Paracoccidioidomycosis: Lessons from Patients with a Single Paracoccidioides spp. Exposure.

    Science.gov (United States)

    Buccheri, Renata; Khoury, Zarifa; Barata, Luis Carlos Barradas; Benard, Gil

    2016-06-01

    Several aspects of the natural history of paracoccidioidomycosis are still poorly understood. Different from the most prevalent, chronic form of the disease, the acute form represents a continuum from the initial respiratory infection to the full-blown disease, thus providing an opportunity to elucidate the pathogenesis of the early phase of this mycosis. We describe, for the first time, two patients with a single time point exposure to Paracoccidioides spp., for whom we were able to determine the time lapsed between exposure to the fungus Paracoccidioides spp. and the onset of signs and symptoms. In case 1, the pulmonary infection was unapparent, and the first manifestations of the acute/subacute form of the disease presented 4 months after Paracoccidioides spp. In case 2, self-limited, non-specific respiratory and systemic symptoms presented 45 days after infection. Thus, our patients confirm that, within a few weeks of infection, Paracoccidioides spp. affects the pulmonary lymphatic system and initially causes no or mild-to-moderate self-limited symptoms, eventually causing abnormalities on a chest X-ray, all of which spontaneously subside. These cases provide some insight into the natural history of this mycosis, the extent of the host exposure to the fungus, and the determination of its incubation period.

  12. Risperidone increases the cortical silent period in drug-naive patients with first-episode schizophrenia: A transcranial magnetic stimulation study.

    Science.gov (United States)

    Ustohal, Libor; Mayerova, Michaela; Hublova, Veronika; Prikrylova Kucerova, Hana; Ceskova, Eva; Kasparek, Tomas

    2017-04-01

    Schizophrenia is accompanied by impaired cortical inhibition, as measured by several markers including the cortical silent period (CSP). It is thought that CSP measures gamma-aminobutyric acid receptors B (GABA B ) mediated inhibitory activity. But the mutual roles of schizophrenia as a disease and the drugs used for the treatment of psychosis on GABA mediated neurotransmission are not clear. We recruited 13 drug-naive patients with first-episode schizophrenia. We used transcranial magnetic stimulation to assess CSP prior to initiating risperidone monotherapy and again four weeks later. At the same time, we rated the severity of psychopathology using the Positive and Negative Syndrome Scale (PANSS). We obtained data from 12 patients who showed a significant increase in CSP, from 134.20±41.81 ms to 162.95±61.98 ms ( p=0.041; Cohen's d=0.544). After the treatment, the PANSS total score was significantly lower, as were the individual subscores ( pschizophrenia demonstrated an association between risperidone monotherapy and an increase in GABA B mediated inhibitory neurotransmission.

  13. Ultrasonographic-arthroscopic correlation in knee injuries in patients operated on at the Hospital Mexico, during the period from January 1, 2010 until December 31, 2010

    International Nuclear Information System (INIS)

    Zamora Lopez, Rafael Angel

    2012-01-01

    Ultrasound is evaluated as a method of diagnosis for intra-articular pathologies of knee, widely used as a means to rule out injuries to the institutional level. The advantages of ultrasound are mentioned: low cost, availability and is a noninvasive method. In order to implement this study has been to create a question about the real utility of ultrasound in the Hospital Mexico, as further support for the correct diagnosis of knee pathology. A search of clinical records of patients was conducted in the orthopedics and traumatology service with diagnosis of gonalgia, to which was conducted a preoperative ultrasound and, subsequently, have been operated at the Hospital by arthroscopy, during the period 1 January 2010 to December 31, 2010. Subsequently, a comprehensive review of the operative notes was performed, ultrasound reports and records, for the purpose of making an analysis and compare the results of both procedures. This paper has clearly demonstrated poor training in musculoskeletal system of the ultrasound operators. A poor correlation was determined between the arthroscopic results against ultrasound. The need to create care protocols to patients with intra-articular pathology of knee was evidenced. (author) [es

  14. Vitamin D and Calcium Addition during Denosumab Therapy over a Period of Four Years Significantly Improves Lumbar Bone Mineral Density in Japanese Osteoporosis Patients

    Directory of Open Access Journals (Sweden)

    Takako Suzuki

    2018-02-01

    Full Text Available This study investigated whether or not vitamin D and calcium supplementation affected bone metabolism and bone mineral density (BMD over a period of four years of denosumab therapy in patients with primary osteoporosis. Patients were divided into a denosumab monotherapy group (22 cases or a denosumab plus vitamin D and calcium supplementation group (combination group, 21 cases. We measured serum bone alkaline phosphatase (BAP, tartrate-resistant acid phosphatase (TRACP-5b, urinary N-terminal telopeptide of type-I collagen (NTX, and BMD of the lumbar 1–4 vertebrae (L-BMD and bilateral hips (H-BMD at baseline and at 12, 24, 36, and 48 months of treatment. There were no significant differences in patient background. Serum BAP, TRACP-5b, and urinary NTX were significantly and comparably inhibited in both groups from 12 to 48 months versus baseline values. L-BMD was significantly increased at every time point in both groups, while H-BMD was significantly increased at every time point in the combination group only. There were significant differences between the groups for L-BMD at 24, 36, and 48 months (P < 0.05 and for H-BMD at 12 months (P < 0.05. Compared with denosumab monotherapy, combination therapy of denosumab plus vitamin D and calcium significantly increased H-BMD at 12 months and L-BMD from 24 to 48 months. These findings indicate that continuous vitamin D and calcium supplementation is important, especially for 12 months to improve H-BMD and from 24 to 48 months to improve L-BMD.

  15. Do MRI Findings Change Over a Period of Up to 1 Year in Patients With Low Back Pain and/or Sciatica?: A Systematic Review.

    Science.gov (United States)

    Panagopoulos, John; Hush, Julia; Steffens, Daniel; Hancock, Mark J

    2017-04-01

    Systematic review OBJECTIVE.: The aim of the study was to investigate whether magnetic resonance imaging (MRI) findings change over a relatively short period of time (sciatica. We also investigated whether there was an association between any change in MRI findings and change in clinical outcomes. MRI offers the potential to identify possible pathoanatomic sources of LBP and/or sciatica; however, the clinical importance of MRI findings remains unclear. Little is known about whether lumbar MRI findings change over the short term and if so whether these changes are associated with changes in clinical outcomes. Medline, EMBASE, and CINAHL databases were searched. Included were cohort studies that performed repeat MRI scans within 12 months in patients with LBP and/or sciatica. Data on study characteristics and change in MRI findings were extracted from included studies. Any data describing associations between change in MRI findings and change in clinical outcomes were also extracted. A total of 12 studies met the inclusion criteria and were included in the review. Pooling was not possible due to heterogeneity of studies and findings. Seven studies reported on changes in disc herniation and reported 15% to 93% of herniations reduced or disappeared in size. Two studies reported on changes in nerve root compression and reported 17% to 91% reduced or disappeared. Only one study reported on the association between change in MRI findings and change in clinical outcomes within 1 year, and found no association. This review found moderate evidence that the natural course of herniations and nerve root compression is favorable over a 1-year period in people with sciatica or LBP. There is a lack of evidence on whether other MRI findings change, and whether changes in MRI findings are associated with changes in clinical outcomes. 1.

  16. Reliability of cortical lesion detection on double inversion recovery MRI applying the MAGNIMS-Criteria in multiple sclerosis patients within a 16-months period.

    Directory of Open Access Journals (Sweden)

    Tobias Djamsched Faizy

    Full Text Available In patients with multiple sclerosis (MS, Double Inversion Recovery (DIR magnetic resonance imaging (MRI can be used to identify cortical lesions (CL. We sought to evaluate the reliability of CL detection on DIR longitudinally at multiple subsequent time-points applying the MAGNIMs scoring criteria for CLs.26 MS patients received a 3T-MRI (Siemens, Skyra with DIR at 12 time-points (TP within a 16 months period. Scans were assessed in random order by two different raters. Both raters separately marked all CLs on each scan and total lesion numbers were obtained for each scan-TP and patient. After a retrospective re-evaluation, the number of consensus CLs (conL was defined as the total number of CLs, which both raters finally agreed on. CLs volumes, relative signal intensities and CLs localizations were determined. Both ratings (conL vs. non-consensus scoring were compared for further analysis.A total number of n = 334 CLs were identified by both raters in 26 MS patients with a first agreement of both raters on 160 out of 334 of the CLs found (κ = 0.48. After the retrospective re-evaluation, consensus agreement increased to 233 out of 334 CL (κ = 0.69. 93.8% of conL were visible in at least 2 consecutive TP. 74.7% of the conL were visible in all 12 consecutive TP. ConL had greater mean lesion volumes and higher mean signal intensities compared to lesions that were only detected by one of the raters (p<0.05. A higher number of CLs in the frontal, parietal, temporal and occipital lobe were identified by both raters than the number of those only identified by one of the raters (p<0.05.After a first assessment, slightly less than a half of the CL were considered as reliably detectable on longitudinal DIR images. A retrospective re-evaluation notably increased the consensus agreement. However, this finding is narrowed, considering the fact that retrospective evaluation steps might not be practicable in clinical routine. Lesions that were not reliably

  17. Cryopyrin-associated periodic syndrome in Australian children and adults: Epidemiological, clinical and treatment characteristics.

    Science.gov (United States)

    Mehr, Sam; Allen, Roger; Boros, Christina; Adib, Navid; Kakakios, Alyson; Turner, Paul J; Rogers, Maureen; Zurynski, Yvonne; Singh-Grewal, Davinder

    2016-09-01

    Cryopyrin-associated periodic syndromes (CAPS) encapsulate three auto-inflammatory conditions, ranging in severity from mild (familial cold auto-inflammatory syndrome: FCAS), moderate (Muckle-Wells syndrome: MWS) and severe (neonatal onset multi-inflammatory disorder: NOMID). We aimed to describe the epidemiology, clinical features and outcomes of Australian children and adults with CAPS. Patients were identified and clinical data collected through a questionnaire sent during 2012-2013 to clinicians reporting to the Australian Paediatric Surveillance Unit and subscribing to the Australasian Societies for Allergy/Immunology, Rheumatology and Dermatology. Eighteen cases of CAPS were identified (8 NOMID; 8 MWS, 2 FCAS); 12 in children <18 years of age. The estimated population prevalence of CAPS was 1 per million persons. Diagnostic delay was frequent, particularly in those with milder phenotypes (median diagnostic delay in MWS/FCAS 20.6 years compared with NOMID 2.1 years; P = 0.04). Common presenting features included urticaria (100%), periodic fever (78%), arthralgia (72%) and sensorineural hearing loss (61%). Almost all (90%) MWS patients had a family member similarly affected compared with none in the NOMID group (P = 0.004). A significant proportion of patients on anti-interleukin (IL)-1 therapy (n = 13) no longer had systemic inflammation. Only 50% with sensorineural hearing loss had hearing restored on anti-IL-1 therapy. Although CAPS are rare, patients often endured prolonged periods of systemic inflammation. This is despite almost all MWS patients having family members with similar symptoms and children with NOMID presenting with chronic infantile urticaria associated with multi-system inflammation. Hearing loss in NOMID/MWS was frequent, and reversible in only 50% of cases. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  18. Distribution of Parasites Detected in Stool Samples of Patients Admitted to Our Parasitology Laboratory during a Three-Year Period between 2012 and 2014.

    Science.gov (United States)

    Selek, Mehmet Burak; Bektöre, Bayhan; Karagöz, Ergenekon; Baylan, Orhan; Özyurt, Mustafa

    2016-09-01

    Parasitic diseases are among the major public health issues worldwide. A number of tests are available for diagnosis, but the sentivity and specifity of these tests are assumed to be insufficient. Nevertheless, the most common diagnostic method is microscopic examination. In this study, we aimed to introduce the distribution of parasites detected in stool samples of patients admitted to our laboratory on the basis of parameters such as, age, and gender during a 3-year period between 2012 and 2014. In total, 6757 stool samples were included in the study. After macroscopic examination, wet mounts of all samples were examined under a light microscope using ×100 and ×400 magnification lenses. Wet mounts were prepared with physiological saline and Lugol's iodine. Parasites were detected in 3.7% (252) of the samples, while no parasites were detected in 96.3% (6505) of the samples. The distribution of intestinal parasites was as follows: Blastocystis hominis (63.5%), Giardia intestinalis (26.2%), Taenia sp. (4.8%), Enterobius vermicularis (2.4%), Entamoeba histolytica/dispar (1.6%), and Hymenolepis nana (1.6%). When the burden of intestinal parasites on public health is considered, they are still a major health issue in Turkey. The frequency of parasitic diseases can be reduced by the education of individuals and implementation of effective diagnostic methods, treatments, and preventive measures.

  19. Experience in diagnosis and treatment of patients with breast neoplasm in the 'Hospital Ramon Gonzalez Coro' in the period 2006-2008

    International Nuclear Information System (INIS)

    Ruiz Lorente, Raiza; Hernandez Duran, Daisy; Rubio, Maria Caridad

    2009-01-01

    Breast cancer remains one of the most malignant common in Cuba and the world. The existence of screening programs through active investigation in healthy women has allowed the diagnostic stage more precocious, this coupled with the new modalities of treatment and testing has current clinical knowledge of the clinical stages diagnosis in very early stages and achieve a free range of events and better survival in cases diagnosed, but despite be shown that it is preventable and curable cancer has not been achieved in our country reduce mortality is now among the first 4 causes of cancer death in women and the incidence has continued increasing during the last decades. In this paper a study retrospective longitudinal descriptive in patients with breast cancer at the Hospital Ramon Gonzalez Coro in the period for January 2006 to December 2008.Se treated at this stage a total of 132 cases with histologically confirmed breast cancer. It stage as diagnostic and therapeutic guidelines in force and sets out results of treatments with an interval of an event-free 92.7%. (Author)

  20. Molecular findings from influenza A(H1N1pdm09 detected in patients from a Brazilian equatorial region during the pandemic period

    Directory of Open Access Journals (Sweden)

    Maria José Couto Oliveira

    2014-11-01

    Full Text Available After the World Health Organization officially declared the end of the first pandemic of the XXI century in August 2010, the influenza A(H1N1pdm09 virus has been disseminated in the human population. In spite of its sustained circulation, very little on phylogenetic data or oseltamivir (OST resistance is available for the virus in equatorial regions of South America. In order to shed more light on this topic, we analysed the haemagglutinin (HA and neuraminidase (NA genes of influenza A(H1N1pdm09 positive samples collected during the pandemic period in the Pernambuco (PE, a northeastern Brazilian state. Complete HA sequences were compared and amino acid changes were related to clinical outcome. In addition, the H275Y substitution in NA, associated with OST resistance, was investigated by pyrosequencing. Samples from PE were grouped in phylogenetic clades 6 and 7, being clustered together with sequences from South and Southeast Brazil. The D222N/G HA gene mutation, associated with severity, was found in one deceased patient that was pregnant. Additionally, the HA mutation K308E, which appeared in Brazil in 2010 and was only detected worldwide the following year, was identified in samples from hospitalised cases. The resistance marker H275Y was not identified in samples tested. However, broader studies are needed to establish the real frequency of resistance in this Brazilian region.

  1. Bicalutamide 150 mg in addition to standard care for patients with early non-metastatic prostate cancer: updated results from the Scandinavian Prostate Cancer Period Group-6 Study after a median follow-up period of 7.1 years

    DEFF Research Database (Denmark)

    Iversen, Peter; Johansson, Jan-Erik; Lodding, Pär

    2006-01-01

    The Early Prostate Cancer (EPC) programme is evaluating the efficacy and tolerability of bicalutamide following standard care (radiotherapy, radical prostatectomy or watchful waiting) in patients with localized (T1-2, N0/Nx) or locally advanced (T3-4, any N; or any T, N + ) non-metastatic prostat...

  2. Efficacy and safety of teneligliptin add-on to insulin monotherapy in Japanese patients with type 2 diabetes mellitus: a 16-week, randomized, double-blind, placebo-controlled trial with an open-label period.

    Science.gov (United States)

    Kadowaki, Takashi; Kondo, Kazuoki; Sasaki, Noriyuki; Miyayama, Kyoko; Yokota, Shoko; Terata, Ryuji; Gouda, Maki

    2017-09-01

    To assess the efficacy and safety of teneligliptin as add-on to insulin monotherapy in patients with type 2 diabetes mellitus (T2DM). In a 16-week, double-blind period, 148 Japanese T2DM patients with inadequate glycemic control with insulin and diet/exercise therapies were randomized to placebo or teneligliptin 20 mg. In a subsequent 36-week, open-label period, all patients received teneligliptin once daily. The primary outcome measure was change in HbA1c at the end of the double-blind period. The difference between placebo and teneligliptin in change in HbA1c in the double-blind period (least squares mean ± SE) was -0.80% ± 0.11%; teneligliptin was superior (ANCOVA, P 1). The HbA1c-lowering effect of teneligliptin was maintained throughout the open-label period. The incidence of adverse events was 53.5% with placebo and 44.2% with teneligliptin in the double-blind period, 66.7% in the placebo/teneligliptin group in the open-label period, and 77.9% in the teneligliptin/teneligliptin group over both double-blind/open-label periods. The incidence of hypoglycemic symptoms was 11.1% in the placebo/teneligliptin group in the open-label period and 27.3% in the teneligliptin/teneligliptin group over both double-blind/open-label periods. Teneligliptin was effective and well tolerated in Japanese T2DM patients with inadequate glycemic control. NCT02081599.

  3. Indonesia Cohort of IO HAT Study to Evaluate Diabetes Management, Control, and Complications in Retrospective and Prospective Periods Among Insulin-Treated Patients with Type 1 and Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Achmad Rudijanto

    2018-04-01

    Full Text Available Background: hypoglycemia is a major adverse event of insulin therapy for diabetes mellitus patients. The study was conducted to evaluate the incidence of hypoglycemia among insulin treated patients with type 1 diabetes mellitus (T1DM or type 2 diabetes mellitus (T2DM in the Indonesian cohort. Methods: this Indonesian cohort study consisted of retrospective and prospective evaluation of hypoglycemic episodes, using International Operations Hypoglycemia Assessment Tool (IO HAT in 374 patients with diabetes (T1DM; n=17 or T2DM; n=357. The patients of ≥18 years of age and treated with insulin for >12 months were selected for this study (ClinicalTrials.gov number: NCT02306681. Results: a total of 374 patients were enrolled in this study and completed SAQ1. All patients with T1DM (17 [100%], and 347 (97.2% patients with T2DM completed SAQ2. Almost all the patients in the 4-week prospective period reported at least one hypoglycemic event (T1DM 100%, T2DM 99.4% and the incidence rate of any hypoglycemia was 67.5 events per patient-year (PPY and 25.7 events PPY for T1DM and T2DM patients, respectively. Among patients with T1DM and T2DM, 5.9% and 36.4%, respectively, did not know what hypoglycemia was at baseline, also high proportion of patients had impaired hypoglycemic awareness in the study (82.4% and 62.7%, respectively. Conclusion: overall, high proportion of patients reported hypoglycemic events in the prospective period indicating under reporting during the retrospective period due to recall bias. Therefore, there is a need for patient education program to improve the awareness of hypoglycemia in diabetes patient in Indonesia.

  4. Epidemiological and radiological profile of patients with gastric cancer studied by gastroduodenal series in the Servicio de Radiologia of the Hospital San Juan de Dios during the period January 2009 to December 2009

    International Nuclear Information System (INIS)

    Loria Mendez, Mildred

    2011-01-01

    The epidemiological and radiological characteristics are described in patients with gastric cancer studied by gastroduodenal series in the Servicio de Radiologia of the Hospital San Juan de Dios, during the period January to December 2009. The cumulative incidence is estimated in patients with gastric cancer. The study population is identified according to sex, age and provenance. Radiographic findings and stage of the gastric cancer patients are described [es

  5. Refractory epilepsy treated by hemispherectomy, experience, retrospective analysis and results on the casuistry of patients treated at the Hospital Nacional de Ninos Dr. Carlos Saenz Herrera, in the period between the years 1993-2014

    International Nuclear Information System (INIS)

    Murillo Alvarez, Ricardo

    2015-01-01

    A retrospective analysis is realized on the casuistry of patients treated with hemispherectomy in the Hospital Nacional de Ninos Dr. Carlos Saenz Herrera, in the period between the years 1993-2014. The bases of refractory epilepsy and the need of surgery as therapeutic are reviewed in patients treated. The hemispherectomies are quantified in the period between 1993-2014. The results obtained of the work carried at the Unidad de Monitoreo y Cirugia de Epilepsia from Hospital Nacional de Ninos is analyzed in the group of patients. The improvement in quality of life is documented in patients treated with hemispherectomy. Reduction in the amount of drugs used and suppression of subsequent seizures to surgery are determined in patients [es

  6. Global survival in patients with glioblastoma treated with hypofractionated radiation therapy at Hospital Mexico of Costa Rica during the period from January 2010 to February 2013

    International Nuclear Information System (INIS)

    Ramirez Zamora, Juliana

    2014-01-01

    Survival is analyzed in patients with glioblastoma treated with hypofractionated radiation therapy at Hospital Mexico. The characteristics of the patients are determined within the study. Survival is stableshed in patients who have received hypofractionated regimen. Functional status according to ECOG scale and Karnofsky index is known prior to radiotherapy. The degree of resection to which these patients were submitted is diagnosed before being referred to radiotherapy. The RPA scale adapted from the EORTC of patients is related to overall survival. The mean survival time of the patients have been 5,8 months, and a greater overall survival in the first 6 months. Survival has been more favorable for patients with predicted RPA IV, those older than 60 years and with a degree of complete resection [es

  7. Glaucoma in patients with uveitis.

    OpenAIRE

    Panek, W C; Holland, G N; Lee, D A; Christensen, R E

    1990-01-01

    The records of 100 patients (161 eyes) with uveitis were reviewed retrospectively to determine the prevalence of increased intraocular pressure, the forms of uveitis most commonly associated with glaucoma, and the forms that require specific glaucoma therapy. Secondary glaucoma was present in 23 patients (31 eyes): three of 24 patients with acute uveitis (three eyes, 12% of acute uveitis patients) and 20 of 76 patients with chronic uveitis (28 eyes, 26% of chronic uveitis patients). Eighteen ...

  8. Clinical characteristics and outcome of patients diagnosed with psychogenic nonepileptic seizures: a 5-year review.

    LENUS (Irish Health Repository)

    O'Sullivan, S S

    2012-02-03

    OBJECTIVE: The goal of this article was to describe the clinical characteristics and outcomes of patients diagnosed with psychogenic nonepileptic seizures (PNES). METHODS: We conducted a retrospective review of patients diagnosed with PNES in a 5-year period. RESULTS: Fifty patients with PNES were identified, giving an estimated incidence of 0.91\\/100,000 per annum. Thirty-eight were included for review, 15 of whom were male (39%). Eighteen patients had been diagnosed with epilepsy as well as PNES (47%). We demonstrated a gender difference in our patients, with males having higher seizure frequencies, more antiepileptic drug use, and a longer interval before diagnosis of PNES. Females were diagnosed with other conversion disorders more often than males. Impaired social function was observed in PNES, as was resistance to psychological interventions with a subsequent poor response to treatments. CONCLUSIONS: PNES remains a difficult condition to treat, and may affect males in proportions higher than those described in previous studies.

  9. Evolution of periodicity in periodical cicadas.

    Science.gov (United States)

    Ito, Hiromu; Kakishima, Satoshi; Uehara, Takashi; Morita, Satoru; Koyama, Takuya; Sota, Teiji; Cooley, John R; Yoshimura, Jin

    2015-09-14

    Periodical cicadas (Magicicada spp.) in the USA are famous for their unique prime-numbered life cycles of 13 and 17 years and their nearly perfectly synchronized mass emergences. Because almost all known species of cicada are non-periodical, periodicity is assumed to be a derived state. A leading hypothesis for the evolution of periodicity in Magicicada implicates the decline in average temperature during glacial periods. During the evolution of periodicity, the determinant of maturation in ancestral cicadas is hypothesized to have switched from size dependence to time (period) dependence. The selection for the prime-numbered cycles should have taken place only after the fixation of periodicity. Here, we build an individual-based model of cicadas under conditions of climatic cooling to explore the fixation of periodicity. In our model, under cold environments, extremely long juvenile stages lead to extremely low adult densities, limiting mating opportunities and favouring the evolution of synchronized emergence. Our results indicate that these changes, which were triggered by glacial cooling, could have led to the fixation of periodicity in the non-periodical ancestors.

  10. A retrospective analysis of 44 patients with granuloma annulare during an 11-year period from a tertiary medical center in south Taiwan

    Directory of Open Access Journals (Sweden)

    Yu-Wen Cheng

    2016-09-01

    Conclusion: In contrast to the reported studies, the incidence of GA showed a bimodal age incidence with slight male preponderance. Our patients had higher prevalence of diabetes mellitus than the general Taiwanese population but had no increase in incidence of dyslipidemia. Whether patients received treatment or not does not affect the disease outcome. Overall, children have better prognosis than adults.

  11. Complications and renal functional deterioration in patients with co ...

    African Journals Online (AJOL)

    E. Sharma

    2016-07-26

    Jul 26, 2016 ... (CCS) [7] with scores varying from 2 to 7. Eleven patients had CCS of 2, twelve patients had CCS of 3, nineteen patients had CCS of. 4, eighteen patients had CCS of 5, seven patients had CCS of 6 and one patient had CCS of 7 (Chart 1). Partial nephrectomy was done laparoscopically, hilar clamping.

  12. Clinical Features and Genetic Background of the Periodic Fever Syndrome with Aphthous Stomatitis, Pharyngitis, and Adenitis: A Single Center Longitudinal Study of 81 Patients

    Directory of Open Access Journals (Sweden)

    Daša Perko

    2015-01-01

    Full Text Available PFAPA syndrome is the most common autoinflammatory disorder in childhood with unknown etiology. The aim of our study was clinical evaluation of PFAPA patients from a single tertiary care center and to determine whether variations of AIM2, MEFV, NLRP3, and MVK genes are involved in PFAPA pathogenesis. Clinical and laboratory data of consecutive patients with PFAPA syndrome followed up at the University Children’s Hospital, Ljubljana, were collected from 2008 to 2014. All four genes were PCR amplified and directly sequenced. Eighty-one patients fulfilled criteria for PFAPA syndrome, 50 (63% boys and 31 (37% girls, with mean age at disease onset of 2.1 ± 1.5 years. Adenitis, pharyngitis, and aphthae were present in 94%, 98%, and 56%, respectively. Family history of recurrent fevers in childhood was positive in 78%. Nineteen variants were found in 17/62 (27% patients, 4 different variants in NLRP3 gene in 13 patients, and 6 different variants in MEFV gene in 5 patients, and 2 patients had 2 different variants. No variants of clinical significance were found in MVK and AIM2 genes. Our data suggest that PFAPA could be the result of multiple low-penetrant variants in different genes in combination with epigenetic and environmental factors leading to uniform clinical picture.

  13. The Role of Post-Resuscitation Electrocardiogram in Patients With ST-Segment Changes in the Immediate Post-Cardiac Arrest Period.

    Science.gov (United States)

    Kim, Youn-Jung; Min, Sun-Yang; Lee, Dong Hun; Lee, Byung Kook; Jeung, Kyung Woon; Lee, Hui Jai; Shin, Jonghwan; Ko, Byuk Sung; Ahn, Shin; Nam, Gi-Byoung; Lim, Kyoung Soo; Kim, Won Young

    2017-03-13

    The authors aimed to evaluate the role of post-resuscitation electrocardiogram (ECG) in patients showing significant ST-segment changes on the initial ECG and to provide useful diagnostic indicators for physicians to determine in which out-of-hospital cardiac arrest (OHCA) patients brain computed tomography (CT) should be performed before emergency coronary angiography. The usefulness of immediate brain CT and ECG for all resuscitated patients with nontraumatic OHCA remains controversial. Between January 2010 and December 2014, 1,088 consecutive adult nontraumatic patients with return of spontaneous circulation who visited the emergency department of 3 tertiary care hospitals were enrolled. After excluding 245 patients with obvious extracardiac causes, 200 patients were finally included. The patients were categorized into 2 groups: those with ST-segment changes with spontaneous subarachnoid hemorrhage (SAH) (n = 50) and those with OHCA of suspected cardiac origin group (n = 150). The combination of 4 ECG characteristics including narrow QRS (<120 ms), atrial fibrillation, prolonged QTc interval (≥460 ms), and ≥4 ST-segment depressions had a 66.0% sensitivity, 80.0% specificity, 52.4% positive predictive value, and 87.6% negative predictive value for predicting SAH. The area under the receiver-operating characteristic curves in the post-resuscitation ECG findings was 0.816 for SAH. SAH was observed in a substantial number of OHCA survivors (25.0%) with significant ST-segment changes on post-resuscitation ECG. Resuscitated patients with narrow QRS complex and any 2 ECG findings of atrial fibrillation, QTc interval prolongation, or ≥4 ST-segment depressions may help identify patients who need brain CT as the next diagnostic work-up. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  14. Effect of patient's age on the profitability of inpatient cardiac catheterization: a contribution margin analysis of frequently performed procedures over a 5-year period.

    Science.gov (United States)

    Plehn, Gunnar; Butz, Thomas; Maagh, Petra; Meissner, Axel

    2017-01-18

    Due to a continuing age shift in the German society hospital providers are concerned about the additional costs associated with the treatment of elderly patients. It is not clear if cardiac catheterization in aged patients leads to higher resource utilization and if DRG-revenues do compensate for this factor. Procedure-related and administrative data of all patients who underwent cardiac catheterization at a tertiary heart center between 2007 and 2011 were collected and analyzed. Then a profitability analysis was performed by comparing the case related variable costs with the Diagnosis-related group (DRG) per case revenues. A particular emphasis was placed on a comparative analysis of identical clusters of procedures. The most frequently performed catheterization procedure (n = 1800) was associated with significantly higher material expenditure in very old patients (178 ± 48 €) than in old (171 ± 28; p = 0.001) and young patients (172 ± 39; p = 0.046). Furthermore, radiation time and the length of hospital stay were increased in very old patients (3.5 ± 3.8 min and 6.2 ± 4.8 days) compared to old (2.7 ± 2.8 min and 4.6 ± 3.8 days; p < 0.001) and young patients (2.5 ± 2.5 min and 4.5 ± 3.9 days; p < 0.001). Due to higher DRG revenues very old patients achieved higher absolute contribution margins (2065 ± 1033 €) than old (1804 ± 1902 €; p < 0.001) and young patients (1771 ± 902 €; p < 0.001). However, the contribution margins per day were significantly smaller (440 ± 226 €) than those in old (488 ± 234 €; p = 0.001) and young patients (484 ± 206 €; p = 0.001). Catheterization of very old patients is related to lower contribution margins per day despite higher material and time expenditures. Since efforts to reduce the length of hospital stay of these patients are limited, this may result in a competitive disadvantage of hospitals which

  15. Tolerability of sibutramine during a 6-week treatment period in high-risk patients with cardiovascular disease and/or diabetes: a preliminary analysis of the Sibutramine Cardiovascular Outcomes (SCOUT) Trial

    DEFF Research Database (Denmark)

    Maggioni, A.P.; Caterson, I.; Coutinho, W.

    2008-01-01

    Uncertainties about the cardiovascular safety of sibutramine led to the SCOUT trial that is investigating sibutramine plus weight management in high-risk, overweight/obese patients. A 6-week lead-in period during which all patients received sibutramine permitted an initial assessment...... of tolerability. A total of 10,742 patients received sibutramine and 3.1% of these discontinued due to an adverse event; issues affecting more than 10 patients were drug intolerance, headache, insomnia, nausea, dry mouth, and constipation-, tachycardia-, and hypertension-related events. Serious adverse events......, most commonly associated with the System Organ Class, Cardiac disorders, were reported by 2.7% of patients; however, the majority was not considered sibutramine-related. Adverse events relating to high blood pressure and/or pulse rate, whether reported as adverse events leading to discontinuation...

  16. Experience of severe desaturation during anesthetic induction period in an obese adult patient with Prader-Willi syndrome -A case report-.

    Science.gov (United States)

    Choi, Joon Woo; Kim, Eun-Ju; Min, Byung Woo; Ban, Jong Seouk; Lee, Sang Gon; Lee, Ji-Hyang

    2012-02-01

    Prader-Willi syndrome is characterized by infantile hypotonia, childhood-onset obesity, short stature, mental retardation, hyperphagia, hypogonadism. After infantile hypotonia phase, patient is prone to morbid obesity due to hyperphagia. Complications associated with morbid obesity are recognized as the main risk factors for death the lifespan of patients with Prader-Willi syndrome. We experienced desaturation and bronchospasm during arteriovenous fistula surgery in an obese adult with Prader-Willi syndrome.

  17. Clinical outcome during the peri-operative (thyroidectomy) period of severely hyperthyroid patients with normalized pre-operative free-T4 levels: Importance of I-131 therapy as a part of pre-operative preparation

    International Nuclear Information System (INIS)

    Siguan-Crisaldo, M.A.L.; Mercado-Asis, L.B.

    2005-01-01

    Thyroidectomy is performed for hyperthyroidism on patients who do not respond to or are not compliant with medical therapy and in patients with very large goiters causing compressive symptoms. All thyrotoxic patients undergoing thyroidectomy usually are first treated with anti-thyroid drugs to normalize free thyroid hormone levels and render them euthyroid before surgery in order to prevent complications particularly thyroid storm and circulatory collapse. In this case series, we describe the clinical outcome during the perioperative (thyroidectomy) period of three severely hyperthyroid patients, two females and one male, with ages ranging from 13 to 38 years. All patients had grade III goiter, and only one had exophthalmos. The mean duration of goiter was 3.6 years. All of them were given preoperative treatment consisting of propylthiouracil (PTU) at 450-600 mg/day; iodone, 3 tablets daily and propranolol at 30-120 mg/day for one month. All of them had normalized preoperative thyroid function tests. In addition to the preoperative medications mentioned above, all three patients received radioactive iodine therapy before surgery. The first two patients received relatively low doses of 8.0 and 7.5 mCi of I-131 respectively. Unfortunately the first patient had supraventricular tachycardia (SVT), post skin cutting and the other one went into thyroid storm. The third patient who received a cumulative dose of 23.5 mCi of I-131 before surgery had an uneventful postoperative course. It is concluded that normalization of thyroid hormone parameters, especially free T4 is not sufficient for an uneventful and uncomplicated peri-thyroidectomy period in severely hyperthyroid patients with large goiters. Effective radioactive iodine therapy might prove to be helpful in inducing thyroid tissue fibrosis, thus leading to true clinical euthyroidism and excellent clinical course postoperatively. (author)

  18. A pilot study to compare the cerebral hemodynamics between patients with obstructive sleep apnea syndrome (OSA) and periodic limb movement syndrome (PLMS) during nocturnal sleep with near-infrared spectroscopy (NIRS)

    Science.gov (United States)

    Zhang, Zhongxing; Schneider, Maja; Laures, Marco; Fritschi, Ursula; Hügli, Gordana; Lehner, Isabella; Qi, Ming; Khatami, Ramin

    2014-03-01

    Obstructive sleep apnea syndrome (OSA) and periodic limb movement in sleep syndrome (PLMS) are two common sleep disorders. Previous studies showed that OSA and PLMS share common features, such as increased cardio-vascular risk, both apnea events and limb movements occur periodically, they are usually associated with cortical arousals, and both of them can induce declines in peripheral oxygen saturation measured with pulse oximetry. However, the question whether apnea events and limb movements also show similar characteristics in cerebral hemodynamic and oxygenation has never been addressed. In this pilot study, we will first time compare the cerebral hemodynamic changes induced by apnea events and limb movements in patients with OSA (n=4) and PLMS (n=4) with NIRS. In patients with OSA, we found periodic oscillations in HbO2, HHb, and blood volume induced by apnea/hypopnea events, HbO2 and HHb showed reverse changing trends. By contrast, the periodic oscillations linked to limb movements were only found in HbO2 and blood volume in patients with PLMS. These findings of different cerebral hemodynamics patterns between apnea events and limb movements may indicate different regulations of nervous system between these two sleep disorders.

  19. A revision of Metaleptobasis Calvert (Odonata: Coenagrionidae) with seven synonymies and the description of eighteen new species from South America.

    Science.gov (United States)

    Von Ellenrieder, Natalia

    2013-11-25

    Examination of over 1,400 specimens of the neotropical genus Metaleptobasis Calvert, 1907, including primary types or paratypes of 18 of the 20 currently available species names and large series of specimens including pairs in tandem and copula, allowed me to unequivocally associate older names with species, distinguish between specific and intraspecific variability, associate both sexes for each species, and recognize the existence of female polymorphism. As a result, seven names are found to be junior synonyms: Metaleptobasis mauritia Williamson, 1915 junior synonym of M. bicornis (Selys, 1877), M. manicaria Williamson, 1915 and M. fernandezi Rácenis, 1955 junior synonyms of M. diceras (Selys, 1877), M. westfalli Cumming, 1954 junior synonym of M. foreli Ris, 1915, and M. tetragena Calvert, 1947, M. weibezahni Rácenis, 1955, and M. incisula De Marmels, 1989 junior synonyms of M. brysonima Williamson, 1915. Lectotypes are designated for M. amazonica and Leptobasis diceras. Eighteen new species of Metaleptobasis are described: M. brevicauda (Holotype ♂, Peru, Huánuco Dep., Shapajilla, jungle, 11 v 1939, F. Woytkowski leg., in UMMZ); M. falcifera (Holotype ♂, Peru, Madre De Dios Dep., Pakitza, Reserved Zone, Manu National Park, T2 to R2 to T1 to base camp, 11°55'48''S, 71°15'18''W, 250 m, 17 ix 1989, J.A. Louton leg., in USNM); M. furcifera (Holotype ♂, Peru, Loreto Dep., Iquitos, iii 1936, G.G. Klug leg., in BMNH); M. gabrielae (Holotype ♂, Peru, Loreto Dep., Tamshiyacu-Tahuayo Reserve, forest interior (4°23'40''S, 73°14'56''W), 27 vii 2009, T. Faasen leg., in RMNH); M. guillermoi (Holotype ♂, Peru, Loreto Dep., Yarinacocha, temporary forest stream (8°17'S, 74°37'W, 145 m), 2 vi 1972, D.L. Pearson leg., in FSCA); M. inermis (Holotype ♂, Brazil, Pará State, Jacareacanga, vii 1969, F.R. Barbosa leg., in UMMZ); M. leniloba (Holotype ♂, Peru, Loreto Dep., Pacaya-Samiria National Reserve, Santa Luisa trail (5°15'S, 74°40'W), 10 vi 2008, C

  20. Radiation risk to the patient: a case study involving multiple diagnostic X ray exposures given over a period of 25 years

    International Nuclear Information System (INIS)

    Rainbow, A.J.; McMaster Univ., Hamilton, ON; Roginski, P.; McGeen, W.

    1992-01-01

    The cumulative somatic dose index (SDI) for a number of diagnostic X ray examinations was made for a 60 year old male. The history of diagnostic X ray exposure for this patient from 1957 to 1983 showed 29 diagnostic X ray examinations including more than 100 films and 15 minutes of fluoroscopy. The total cumulative SDI to this patient was 214 mGy (about 21 rad). More than half this dose, 142 mGy, was contributed from upper GI and barium enema examinations which used fluoroscopy, with 88 mGy from the fluoroscopy alone. Using the recently revised risk coefficient for fatal cancer following whole-body irradiation of adult workers recommended by the International Commission on Radiological Protection in 1990, the authors estimate a 0.9% cancer morality risk to this patient resulting from the 29 diagnostic X ray examinations. (author)

  1. Longitudinal proxy measurements in multiple sclerosis: patient-proxy agreement on the impact of MS on daily life over a period of two years

    Directory of Open Access Journals (Sweden)

    Thompson Alan J

    2008-02-01

    Full Text Available Abstract Background The use of self-report measurements in clinical settings is increasing. However, in patients with limitations that interfere with reliable self-assessment such as cognitive impairment or mood disturbances, as may be the case in multiple sclerosis (MS, data collection might be problematic. In these situations, information obtained from proxy respondents (e.g. partners may replace self-ratings. The aim of this study was to examine the value of proxy ratings at separate points in time and to assess patient-proxy agreement on possible changes in disease impact of MS. Methods Fifty-six MS patients and their partners completed the Multiple Sclerosis Impact Scale (MSIS-29 at baseline and follow-up, two years later. Patient-proxy agreement was assessed at both time points by calculating intraclass correlation coefficients (ICCs, exact and global agreement and the mean directional differences between groups. Agreement of change over time was assessed by calculating ICCs between change scores. In parallel, global ratings of both patients and proxy respondents of the extent to which the patient had improved or deteriorated over the past two years were collected to validate possible changes on the MSIS-29. Results At both time points, agreement on the physical scale was higher than agreement on the psychological scale (ICCs at baseline were 0.81 for the physical scale and 0.72 for the psychological scale; at follow-up, the ICC values were 0.86 and 0.65 respectively. At follow-up, statistically significant mean differences between patients and proxies were noted for the physical scale (-4.8 ± 12.7, p = 0.006 and the psychological scale (-8.9 ± 18.8, p = 0.001. Agreement between change scores on the MSIS-29 was fair (ICC Conclusion Proxy respondents could act as a reliable source of information in cross-sectional studies. Moreover, results suggested that agreement on change over time might be better for proxy respondents compared to

  2. Profile of the geriatric patient treated in the Unidad de Incontinencia Urinaria del Hospital Nacional de Geriatria y Gerontologia 'Dr. Raul Blanco Cervantes' in the period from January 1, 2012 to June 30, 2013

    International Nuclear Information System (INIS)

    Garita Cordero, Andrea

    2014-01-01

    The elderly adult patient is characterized in the Unidad de Incontinencia Urinaria of the Hospital Nacional de Geriatria 'Dr. Raul Blanco Cervantes', during the period between January 1, 2012 and June 30, 2013. The total revision was 513 clinical records of patients treated for the first time in the Urinary Incontinence Unit in the established period. 228 of the cases were excluded. A final sample of 285 patients aged 76 years on average is studied, the predominance is the female sex and the state is widowhood, schooling is Aged 6 and residing in San Jose. In addition, partial dependent patients BLFA (Basic Life Activities) and IALF (Instrumental Activities of Life) are included, in normal cognitive condition according to schooling by MMSE (Mini Mental State Examination) and with risk of depression. As comorbidity they have presented mainly AHT (Arterial hypertension), DM (Diabetes Mellitus) and depression with associated obesity. The patients studied have consumed at least 2 medications simultaneously and usually have had a previous surgical history. Women who have had gynecological obstetric records of pregnancies and births were found to be unrelated to some type of incontinence. Patients have presented defects of the pelvic floor, such as cystocele and rectocele, in men increased prostate size. The most prevalent urinary incontinence has been the mixed, finding association by gender, in women is given more mixed urinary incontinence, followed by stress urinary incontinence; In men, urgent urinary incontinence and urinary incontinence due to overflow. Patients are sent to treatment with electrostimulation of pelvic floor and completed sessions, have shown an improvement in incontinence and quality of life. A more detailed evaluation of the older adult and to evaluate urinary incontinence could give greater results of the capture of patients with positive repercussion in the patient's quality of life. (author) [es

  3. The weight lowering effect of sibutramine and its impact on serum lipids in cardiovascular high risk patients with and without type 2 diabetes mellitus - an analysis from the SCOUT lead-in period

    Directory of Open Access Journals (Sweden)

    James Philip T

    2010-02-01

    Full Text Available Abstract Background Obesity, type 2 diabetes mellitus (T2D and unhealthy blood lipid profile are strongly associated with the risk of developing cardiovascular disease (CVD. We examined whether blood lipid changes with short term administration of the weight lowering drug, sibutramine and lifestyle modification in obese and overweight high-risk patients was associated with T2D status at screening. Methods The Sibutramine Cardiovascular OUTcomes (SCOUT trial included obese and overweight patients at increased risk of cardiovascular events. All patients received guidance on diet and exercise plus once-daily 10 mg sibutramine during the 6-week, single blind lead-in period. Multivariable regression models were used to investigate factors associated with changes in lipid levels during the first four weeks of treatment. Results A total of 10 742 patients received at least one dose of sibutramine during the 6-week lead-in period of SCOUT. After four weeks, patients experienced mean reductions in low density lipoprotein (LDL-C 0.19 mmol/L, high density lipoprotein (HDL-C 0.019 mmol/L, very low density lipoprotein (VLDL-C 0.08 mmol/L, total cholesterol (TC 0.31 mmol/L and triglycerides 0.24 mmol/L (p 2 decrease in BMI in patients with T2D was associated with -0.09 mmol/L in LDL-C (P Conclusion Short term weight management with sibutramine therapy in obese or overweight high-risk patients induced significant mean reductions for all lipids. Those without T2D benefited most. Patients with hyperlipidaemia and the less obese patients also had greater falls in LDL-C and TC during weight loss. The trial is registered at ClinicalTrial.gov number: NCT00234832.

  4. Longitudinal proxy measurements in multiple sclerosis: patient-proxy agreement on the impact of MS on daily life over a period of two years

    NARCIS (Netherlands)

    van der Linden, F.A.H.; Kragt, J.J.; van Bon, M.; Klein, M.; Thompson, A.J.; van der Ploeg, H.M.; Polman, C.H.; Uitdehaag, B.M.J.

    2008-01-01

    Background: The use of self-report measurements in clinical settings is increasing. However, in patients with limitations that interfere with reliable self-assessment such as cognitive impairment or mood disturbances, as may be the case in multiple sclerosis (MS), data collection might be

  5. Is a home based video teleconcltation setup cost effective for lowering HBA1C for patients with type-2 diabetes over a six-month period?

    DEFF Research Database (Denmark)

    Sall Jensen, Morten; Rasmussen, Ole Winther

    OBJECTIVES: A RCT assessed the effectiveness and costs of a home based video teleconsultation (HVT) setup to lower HbA1c in patients with type-2 diabetes against usual out-patient treatment on the hospital. The HVT equipment was delivered to the patients by the hospital. This analysis shows...... the potential incremental cost-effectiveness ratio (ICER) of using a HVT setup on six-months health care effects and costs. METHODS: The study effectiveness outcome was HbA1c level in mmol/l. The economic analysis was performed with a spreadsheet decision tree model with a Danish hospital payer’s direct cost...... perspective. Cost data were based on study measured time consumption pr. HVT, consultations at out-patient clinic, HVT-equipment, -subscription, -support costs, and hospital operating cost. Medicine costs weren’t included in the model. Model output included the cost of a 1 mmol/l point reduction of HbA1c...

  6. Effect of Intravitreal Injection of Bevacizumab on Acute Central Serous Chorioretinopathy Patients who Visited Feiz Hospital during 2014–2015 Period

    Directory of Open Access Journals (Sweden)

    Mohamad Reza Akhlaghi

    2017-01-01

    Full Text Available Background: Aim of this clinical trial is the evaluation of the effect of intravitreal injection of bevacizumab on acute central serous chorioretinopathy (CSC. Materials and Methods: In a nonrandomized clinical trial, 36 CSC eyes (with <1-month disease history were examined. Initially, all the patients underwent posterior and anterior segment examinations as well as complete eye examination to evaluate the best spectacle-corrected visual acuity (BSCVA. Then, optical coherence tomography was performed to confirm the diagnosis. The patients were divided to the two groups each of 18 subjects, which 18 patients received intravitreal injection of bevacizumab (1.25 mg and the rest of them did not receive any treatment (control group. The patients were health checked by the end of the 1st and 3rd months. Significance level was considered as P < 0.05. Results: In the BSCVA, no significant difference in visual improvement was observed in baseline vision compared to each other (P = 0.481. There was also no significant difference in the vision of intervention and control groups 1 and 3 months after injection (P = 0.379 and P = 0.557. A significant decrement existed in the intervention group compared with the control group in the maximum central macular thickness at 1 month after injection (P = 0.001; however, the difference was not significant when comparing the two groups at baseline and 3 months after injection (P = 0.925 and P = 0.338. Conclusion: In general, according to the results of this study, intravitreal injection of bevacizumab was not effective in improvement of patients with acute CSC, although it had no side effects.

  7. Effect of Intravitreal Injection of Bevacizumab on Acute Central Serous Chorioretinopathy Patients Who Visited Feiz Hospital during 2014–2015 Period

    Science.gov (United States)

    Akhlaghi, Mohamad Reza; Nasrollahi, Cobra; Namgar, Seyed Mohamad; Kianersi, Farzan; Dehghani, Ali Reza; Arefpour, Reza

    2017-01-01

    Background: Aim of this clinical trial is the evaluation of the effect of intravitreal injection of bevacizumab on acute central serous chorioretinopathy (CSC). Materials and Methods: In a nonrandomized clinical trial, 36 CSC eyes (with the patients underwent posterior and anterior segment examinations as well as complete eye examination to evaluate the best spectacle-corrected visual acuity (BSCVA). Then, optical coherence tomography was performed to confirm the diagnosis. The patients were divided to the two groups each of 18 subjects, which 18 patients received intravitreal injection of bevacizumab (1.25 mg) and the rest of them did not receive any treatment (control group). The patients were health checked by the end of the 1st and 3rd months. Significance level was considered as P the BSCVA, no significant difference in visual improvement was observed in baseline vision compared to each other (P = 0.481). There was also no significant difference in the vision of intervention and control groups 1 and 3 months after injection (P = 0.379 and P = 0.557). A significant decrement existed in the intervention group compared with the control group in the maximum central macular thickness at 1 month after injection (P = 0.001); however, the difference was not significant when comparing the two groups at baseline and 3 months after injection (P = 0.925 and P = 0.338). Conclusion: In general, according to the results of this study, intravitreal injection of bevacizumab was not effective in improvement of patients with acute CSC, although it had no side effects. PMID:29142888

  8. [Conditional probability analysis between tinnitus and comorbidities in patients attending the National Rehabilitation Institute-LGII in the period 2012-2013].

    Science.gov (United States)

    Gómez Toledo, Verónica; Gutiérrez Farfán, Ileana; Verduzco-Mendoza, Antonio; Arch-Tirado, Emilio

    Tinnitus is defined as the conscious perception of a sensation of sound that occurs in the absence of an external stimulus. This audiological symptom affects 7% to 19% of the adult population. The aim of this study is to describe the associated comorbidities present in patients with tinnitus usingjoint and conditional probability analysis. Patients of both genders, diagnosed with unilateral or bilateral tinnitus, aged between 20 and 45 years, and had a full computerised medical record, were selected. Study groups were formed on the basis of the following clinical aspects: 1) audiological findings; 2) vestibular findings; 3) comorbidities such as, temporomandibular dysfunction, tubal dysfunction, otosclerosis and, 4) triggering factors of tinnitus noise exposure, respiratory tract infection, use of ototoxic and/or drugs. Of the patients with tinnitus, 27 (65%) reported hearing loss, 11 (26.19%) temporomandibular dysfunction, and 11 (26.19%) with vestibular disorders. When performing the joint probability analysis, it was found that the probability that a patient with tinnitus having hearing loss was 2742 0.65, and 2042 0.47 for bilateral type. The result for P (A ∩ B)=30%. Bayes' theorem P (AiB) = P(Ai∩B)P(B) was used, and various probabilities were calculated. Therefore, in patients with temporomandibulardysfunction and vestibular disorders, a posterior probability of P (Aі/B)=31.44% was calculated. Consideration should be given to the joint and conditional probability approach as tools for the study of different pathologies. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  9. Correction of estimates of retention in care among a cohort of HIV-positive patients in Uganda in the period before starting ART: a sampling-based approach.

    Science.gov (United States)

    Nyakato, Patience; Kiragga, Agnes N; Kambugu, Andrew; Bradley, John; Baisley, Kathy

    2018-04-20

    The aim of this study was to use a sampling-based approach to obtain estimates of retention in HIV care before initiation of antiretroviral treatment (ART), corrected for outcomes in patients who were lost according to clinic registers. Retrospective cohort study of HIV-positive individuals not yet eligible for ART (CD4 >500). Three urban and three rural HIV care clinics in Uganda; information was extracted from the clinic registers for all patients who had registered for pre-ART care between January and August 2015. A random sample of patients who were lost according to the clinic registers (>3 months late to scheduled visit) was traced to ascertain their outcomes. The proportion of patients lost from care was estimated using a competing risks approach, first based on the information in the clinic records alone and then using inverse probability weights to incorporate the results from tracing. Cox regression was used to determine factors associated with loss from care. Of 1153 patients registered for pre-ART care (68% women, median age 29 years, median CD4 count 645 cells/µL), 307 (27%) were lost according to clinic records. Among these, 195 (63%) were selected for tracing; outcomes were ascertained in 118 (61%). Seven patients (6%) had died, 40 (34%) were in care elsewhere and 71 (60%) were out of care. Loss from care at 9 months was 30.2% (95% CI 27.3% to 33.5%). After incorporating outcomes from tracing, loss from care decreased to 18.5% (95% CI 13.8% to 23.6%). Estimates of loss from HIV care may be too high if based on routine clinic data alone. A sampling-based approach is a feasible way of obtaining more accurate estimates of retention, accounting for transfers to other clinics. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Patterns recurrence of gastric cancer in patients treated with adjuvant chemoradiation in the Servicio de Oncologia Medica of Hospital Rafael Angel Calderon Guardia in the period 2006 and 2010

    International Nuclear Information System (INIS)

    Campos Vallejos, Arturo

    2013-01-01

    The pattern of relapse is described in patients with gastric cancer who received adjuvant chemoradiation at the Servicio de Oncologia Medica of Hospital Rafael Angel Calderon Guardia in the period 2006-2010. The evolution of the disease is described. Types of relapse are explained in gastric cancer patients who received chemotherapy-adjuvant radiotherapy. The magnitude of the problem is identified by the calculation of incidence, survival and mortality. Patients with adenocarcinoma type gastric cancer, resected in curative R0 and treated with adjuvant chemotherapy / radiotherapy (QT/RT) were analyzed. The variables of age, sex, functional status (according to ECOG), tumor characteristics, staging (TNM), type of surgery, type of nodal dissection, period between surgery and postoperative therapy were used for a descriptive analysis. Survival analysis is performed using Kaplan - Meier curves from the date of surgery until the date of death or the last control. The online biostat and biomates programs are used to process information. Lymph node dissection has a significant impact on patient survival, as well as the duration of chemotherapy treatment, the presence of positive lymph nodes and other features such as the presence of seal ring cells and lymphovascular invasion. More radical ganglionic dissections and more effective treatments can achieve better results in patient survival [es

  11. Treatment of the glottic squamous cell carcinoma in stages T1-T2, N0: surgery versus radiotherapy: retrospective study of 50 patients attended at the Hospital Mexico in the period 2005 to 2011

    International Nuclear Information System (INIS)

    Diaz Munoz, Angie

    2014-01-01

    Recurrence rates are compared in patients with glottic cancer in early stages, treated with surgery and/or radiotherapy. The study was composed by all patients diagnosed with glottic cancer in the Servicio de Otorrinolaringologia from Hospital Mexico, in early stages during the period 2005 to 2011. The local and locoregional recurrence rates are determined. Differences in recurrence rates are analyzed. Factors associated to higher recurrence rates are identified. Treatment with radiotherapy has had statistically a higher proportion of local recurrence than treatment with surgery [es

  12. Clinical response to anti-TNFα therapy in patients with rheumatoid arthritis faulted or intolerance in non-biological DMARD in the Hospital San Juan de Dios in the period January 2006 to December 2011

    International Nuclear Information System (INIS)

    Salas Mena, Claudio

    2014-01-01

    Various clinical studies are performed globally using anti-TNFα therapy and has proven its clinical effectiveness in the management of rheumatoid arthritis patients, that have failed or have presented intolerance to the use of non-biological DMARDs. The clinical response to treatment of anti-TNFα was determined in patients with rheumatoid arthritis who have presented without respond, have showed intolerance or secondary effects to DMARDs no biological, in the Servicio de Reumatologia del Hospital San Juan de Dios, in the period January 2006 to December 2011. Study has been descriptive, retrospective, observational, by reviewing dossiers of patients with rheumatoid arthritis to initiate anti-TNFα therapy where has valued the DAS28 and initial VES, then at 6 months and 12 months after starting treatment. In the period analyzed, 47 patients evaluated with traditional DMARD failure who have received anti-TNFα therapy, according to DAS28, 32 patients were cataloged as severe activity and 15 of them with moderate activity. A total of 41 patients have used etanercept, with adalimumab 6 patients. The DAS28 initial average was 5,63 in all patients, 6,16 in the subgroup of patients with severe activity, and 4,49 in the subgroup of moderate activity. After 6 months of treatment, the DAS28 has descended to 3,25 in all patients, with 3,67 in the subgroup of severe clinical activity, and 2,35 in the subgroup of moderate clinical activity. One year after treatment values DAS28 have been 3,13 for all patients, 3,53 in severe activity and 2,28 in the subgroup of activity clinical moderate. In all groups and subgroups of patients, difference was demonstrated statistically significant at p less than 0,05. Between the subgroups of patients according to clinical activity is keeped without significant difference, or the type of anti-TNFα therapy employed. The anti-TNFα therapy has proven to be effective for improvement of clinical activity of rheumatoid arthritis, regardless of

  13. Reproducibility over a 1-month period of 1H-MR spectroscopic imaging NAA/Cr ratios in clinically stable multiple sclerosis patients.

    Science.gov (United States)

    Mostert, J P; Blaauw, Y; Koch, M W; Kuiper, A J; Hoogduin, J M; De Keyser, J

    2008-08-01

    N-acetylaspartate/creatine (NAA/Cr) ratios, assessed with proton magnetic resonance spectroscopy, are increasingly used as a surrogate marker for axonal dysfunction and degeneration in multiple sclerosis (MS). The purpose of this study was to test short-time reproducibility of NAA/Cr ratios in patients with clinically stable MS. In 35 MS patients we analysed NAA/Cr ratios obtained with (1)H-MR spectroscopic imaging at the centrum semiovale either with lateral ventricles partially included (group 1; n=15) or more cranially with no ventricles included (group 2; n=20). To test short-term reproducibility of the NAA/Cr measurements, patients were scanned twice 4 weeks apart. We determined mean NAA/Cr and Cho/Cr ratios of 12 grey matter and 24 white matter voxels. Mean NAA/Cr ratios of both the white and grey matter did not change after 4 weeks. Overall 4-week reproducibility of the NAA/Cr ratio, expressed as coefficient of variation, was 4.8% for grey matter and 3.5% for white matter. Reproducibility of cranial scanning of the ventricles was slightly better than with cerebrospinal fluid included. Our study shows good short-term reproducibility of NAA/Cr ratio measurements in the centrum semiovale, which supports the reliability of this technique for longitudinal studies.

  14. Study on the change of gastrointestinal hormones and Th1/Th2 indexes of patients with gastric cancer during the perioperative period

    Directory of Open Access Journals (Sweden)

    Yu-Jie Liu

    2016-01-01

    Full Text Available Objective: To investigate the effect of intra-aortic balloon counterpulsation combined with percutaneous coronary intervention (PCI in the prognosis of acute myocardial infarction patients complicated with cardiogenic shock. Methods: A total of 78 cases of acute myocardial infarction patients complicated with cardiogenic shock were enrolled for study and randomly divided into two groups, observation group received intra-aortic balloon counterpulsation combined with PCI therapy and control group received PCI therapy. Then heart function, nerve function, kidney function and humoral indicators of two groups were compared. Results: (1 target organ function: 3 d after treatment, serum CK-MB, cTnT, cTnI, NSE, VILIP1 and NMDA-R contents as well as urinary albumin / creatinine ratio, 24 h urinary microalbumin content, LVESD and LVEDD of observation group were lower than those of control group, LVEF and glomerular filtration rate were higher than those of control group; (2 humoral indicators: 6, 12, 24 and 48 h after treatment, serum NT-proBNP and PCT contents of both groups showed decreasing trend and serum NT-proBNP and PCT contents of observation group were lower than those of control group. Conclusions: Intra-aortic balloon counterpulsation combined with PCI can improve the prognosis of acute myocardial infarction patients complicated with cardiogenic shock, specifically manifested as protecting target organ function, reducing cardiac stress and relieving inflammation.

  15. Epidural Analgesia in the Postoperative Period

    National Research Council Canada - National Science Library

    Mathsen, Curtis

    2001-01-01

    .... This descriptive study was conducted to determine which surgical patients experienced the most analgesia with the fewest side effects when receiving epidural analgesia in the postoperative period...

  16. Autoinflammatory Diseases with Periodic Fevers.

    Science.gov (United States)

    Sag, Erdal; Bilginer, Yelda; Ozen, Seza

    2017-07-01

    One purpose of this review was to raise awareness for the new autoinflammatory syndromes. These diseases are increasingly recognized and are in the differential diagnosis of many disease states. We also aimed to review the latest recommendations for the diagnosis, management, and treatment of these patients. Familial Mediterranean fever (FMF), cryopyrin-associated periodic syndrome (CAPS), tumor necrosis factor receptor-associated periodic fever syndrome (TRAPS), and hyperimmunoglobulinemia D and periodic fever syndrome/mevalonate kinase deficiency (HIDS/MVKD) are the more common autoinflammatory diseases that are characterized by periodic fevers and attacks of inflammation. Recently much collaborative work has been done to understand the characteristics of these patients and to develop recommendations to guide the physicians in the care of these patients. These recent recommendations will be summarized for all four diseases. FMF is the most common periodic fever disease. We need to further understand the pathogenesis and the role of single mutations in the disease. Recently, the management and treatment of the disease have been nicely reviewed. CAPS is another interesting disease associated with severe complications. Anti-interleukin-1 (anti-IL-1) treatment provides cure for these patients. TRAPS is characterized by the longest delay in diagnosis; thus, both pediatricians and internists should be aware of the characteristic features and the follow-up of these patients. HIDS/MVKD is another autoinflammatory diseases characterized with fever attacks. The spectrum of disease manifestation is rather large in this disease, and we need further research on biomarkers for the optimal management of these patients.

  17. Tolerability of sibutramine during a 6-week treatment period in high-risk patients with cardiovascular disease and/or diabetes: a preliminary analysis of the Sibutramine Cardiovascular Outcomes (SCOUT) Trial.

    Science.gov (United States)

    Maggioni, Aldo P; Caterson, Ian; Coutinho, Walmir; Finer, Nick; Gaal, Luc Van; Sharma, Arya M; Torp-Pedersen, Christian; Bacher, Peter; Shepherd, Gillian; Sun, Rui; James, Philip

    2008-11-01

    Uncertainties about the cardiovascular safety of sibutramine led to the SCOUT trial that is investigating sibutramine plus weight management in high-risk, overweight/obese patients. A 6-week lead-in period during which all patients received sibutramine permitted an initial assessment of tolerability. A total of 10,742 patients received sibutramine and 3.1% of these discontinued due to an adverse event; issues affecting more than 10 patients were drug intolerance, headache, insomnia, nausea, dry mouth, and constipation-, tachycardia-, and hypertension-related events. Serious adverse events, most commonly associated with the System Organ Class, Cardiac disorders, were reported by 2.7% of patients; however, the majority was not considered sibutramine-related. Adverse events relating to high blood pressure and/or pulse rate, whether reported as adverse events leading to discontinuation, or serious adverse events were reported by less than 0.2% of patients. No serious or individual events leading to discontinuation occurred in more than 25 patients. There were 15 (0.1%) deaths; 10 were attributed to a cardiovascular cause. Discontinuations for adverse events were lower than anticipated. Serious adverse events generally reflected sibutramine's known pharmacology or were related to cardiac disorders already present in this high-risk population. When compared with epidemiological data, overall mortality rate was low and sibutramine was well tolerated in this mainly off-label population. No new safety issues were detected.

  18. The Meaning of Using «The Quality of Life Assessment of Growth Hormone Deficiency in Adults» Questionnaire in Patients with Non-Functional Pituitary Adenomas and Various Tumors of Chiasmosellar Area in Pre- and Postoperative Period

    Directory of Open Access Journals (Sweden)

    Yu.M. Urmanova

    2014-10-01

    Full Text Available The authors have examined 136 patients with growth hormone deficiency (GHD of various origins (pituitary tumors and ischemic heart disease — comparison group. The investigation of the quality of life on the basis of GHD questionnaire «Quality of Life Assessment of Growth Hormone Deficiency in Adults» (QoL-AGHDA in 136 patients showed, that in all groups the average score was higher than normal one (normal < 11, and most significantly it was observed in patients of first, third and fourth groups and second subgroup of the fifth group. Reliable correlation between low basal levels of somatotropic hormone (STH, insulin-like growth factor-1 (IGF-1 of blood plasma and average score by GHD questionnaire QoL-AGHDA was found in the first, second, third, and fourth groups of the second subgroup of the fifth group of patients, that confirms high efficacy of using GHD questionnaire QoL-AGHDA in patients with GHD of various origins. 36 patients in 3 months after transnasal hypophysectomy reported reliable increase in the average score by GHD questionnaire on the background of decreased levels of STH and IGF-1. This shows that in the early postoperative period in patients the severity of hypopituitarism increases and the question of the prescription of hormone replacement therapy arises.

  19. Effects of oral carbohydrate with amino acid solution on the metabolic status of patients in the preoperative period: a randomized, prospective clinical trial.

    Science.gov (United States)

    Tsutsumi, Rie; Kakuta, Nami; Kadota, Takako; Oyama, Takuro; Kume, Katsuyoshi; Hamaguchi, Eisuke; Niki, Noriko; Tanaka, Katsuya; Tsutsumi, Yasuo M

    2016-10-01

    Enhanced recovery after surgery is increasingly desired nowadays, and preoperative nutrient intake may be beneficial for this purpose. In this study, we investigated whether the intake of preoperative carbohydrate with amino acid (ONS) solution can improve starvation status and lipid catabolism before the induction of anesthesia. This randomized, prospective clinical trial included 24 patients who were divided into two groups before surgery under general anesthesia: a control group, comprising patients who fasted after their last meal the day before surgery (permitted to drink only water), and an ONS group, comprising patients who consumed ONS solution 2 h before surgery. Biochemical markers, the respiratory quotient, and psychosomatic scores were assessed at the initiation of anesthesia. Compared with the control group, the ONS group showed significantly lower serum free fatty acid levels [control group: 828 (729, 1004) µEq/L, ONS group: 479 (408, 610) µEq/L, P = 0.0002, median (25th, 75th percentile)] and total ketone bodies [control group: 119 (68, 440) µmol/L, ONS group: 40 [27, 64] µmol/L, P = 0.037]. In addition, analysis using the Visual Analog Scale showed higher preoperative scores for anxiety, hunger, and thirst for the control group, with no differences in any other measure of subjective well-being between groups. The results of this study suggest that preoperative ONS intake improves lipid catabolism and starvation status before the induction of anesthesia. Furthermore, it can provide better preoperative mental health compared with complete fasting.

  20. Severe hypothyroidism presenting as myxedema coma in the postoperative period in a patient taking sunitinib: case report and review of literature.

    Science.gov (United States)

    Lele, Abhijit V; Clutter, Sarah; Price, Eleana; De Ruyter, Martin L

    2013-02-01

    The case of a 62-year-old Caucasian woman who underwent urgent hip hemiarthroplasty for repair of a pathological fracture is reported. The patient's medical history was significant for renal cell carcinoma, cerebellar metastases, and sunitinib-induced hypothyroidism. Her intraoperative course was complicated by profound hypothermia, bradycardia, augmentation of neuromuscular blockade, delayed emergence, failure of postoperative extubation, and need for mechanical ventilation. The intensive care course was significant for hypothermia requiring forced-air warming, treatment with intravenous thyroxine (T4), and hemodynamic supportive care. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Changes in T-cell subpopulations and cytokine network during early period of ibrutinib therapy in chronic lymphocytic leukemia patients: the significant decrease in T regulatory cells number.

    Science.gov (United States)

    Podhorecka, Monika; Goracy, Aneta; Szymczyk, Agnieszka; Kowal, Malgorzata; Ibanez, Blanca; Jankowska-Lecka, Olga; Macheta, Arkadiusz; Nowaczynska, Aleksandra; Drab-Urbanek, Elzbieta; Chocholska, Sylwia; Jawniak, Dariusz; Hus, Marek

    2017-05-23

    B cell receptor (BCR) stimulation signal plays an important role in the pathogenesis of chronic lymphocytic leukemia (CLL), and kinase inhibitors directed toward the BCR pathway are now the promising anti-leukemic drugs. Ibrutinib, a Bruton tyrosine kinase inhibitor, demonstrates promising clinical activity in CLL. It is reported that ibrutinib, additionally to directly targeting leukemic cells, also inhibits the interactions of these cells with T cells, macrophages and accessory cells. Assessment of these mechanisms is important because of their non -direct anti-leukemic effects and to identify possible side effects connected with long-term drug administration.The aim of this study was to assess the in vivo effects of ibrutinib on T-cell subpopulations and cytokine network in CLL. The analysis was performed on a group of 19 patients during first month of ibrutinib therapy. The standard multicolor flow cytometry and cytometric bead array methods were used for assessment of T-cell subsets and cytokines/chemokines, respectively.The data obtained indicates that Ibrutinib treatment results in changes in T-cell subpopulations and cytokine network in CLL patients. Particularly, a significant reduction of T regulatory cells in peripheral blood was observed. By targeting these populations of T cells Ibrutinib can stimulate rejection of tumor cells by the immune system.

  2. Labour pain with remifentanil patient-controlled analgesia versus epidural analgesia : a randomised equivalence trial

    NARCIS (Netherlands)

    Logtenberg, Slm; Oude Rengerink, K; Verhoeven, C J; Freeman, L M; van den Akker, Esa; Godfried, M B; van Beek, E; Borchert, Owhm; Schuitemaker, N; van Woerkens, Ecsm; Hostijn, I; Middeldorp, J M; van der Post, J A; Mol, B W

    OBJECTIVE: To distinguish satisfaction with pain relief using remifentanil patient-controlled analgesia (RPCA) compared with epidural analgesia (EA) in low-risk labouring women. DESIGN: Randomised controlled equivalence trial. SETTING: Eighteen midwifery practices and six hospitals in the

  3. Genomic characterization of adenovirus serotype 7 isolated in Brazil from acute respiratory disease patients during the period from 1980 to 1991

    Directory of Open Access Journals (Sweden)

    MORAES Marcia T.B.

    1997-01-01

    Full Text Available Forty isolates of adenovirus type 7 were analized by restriction enzyme digestion with BamHI, SmaI, EcoRI and HindIII. These isolates were obtained from acute respiratory disease patients during the years 1980 to 1991. Only two genomic types were found: Ad7b and Ad7e, with Ad7b (87.5% being more frequent than Ad7e (12.5%. The genomic type Ad7e appeared in the years 1980, 1981 and 1983. Ad7b appeared in 1982 and it was the only genomic type found from 1984 to 1991. Both genomic types were responsible for lower (LRTI and upper (URTI respiratory tract infection, but the proportion LRTI/URTI is higher for Ad7b (25/6 than for Ad7e (1/4.

  4. The effect of single low-dose dexamethasone on blood glucose concentrations in the perioperative period: a randomized, placebo-controlled investigation in gynecologic surgical patients.

    Science.gov (United States)

    Murphy, Glenn S; Szokol, Joseph W; Avram, Michael J; Greenberg, Steven B; Shear, Torin; Vender, Jeffery S; Gray, Jayla; Landry, Elizabeth

    2014-06-01

    The effect of single low-dose dexamethasone therapy on perioperative blood glucose concentrations has not been well characterized. In this investigation, we examined the effect of 2 commonly used doses of dexamethasone (4 and 8 mg at induction of anesthesia) on blood glucose concentrations during the first 24 hours after administration. Two hundred women patients were randomized to 1 of 6 groups: Early-control (saline); Early-4 mg (4 mg dexamethasone); Early-8 mg (8 mg dexamethasone); Late-control (saline); Late-4 mg (4 mg dexamethasone); and Late-8 mg (8 mg dexamethasone). Blood glucose concentrations were measured at baseline and 1, 2, 3, and 4 hours after administration in the early groups and at baseline and 8 and 24 hours after administration in the late groups. The incidence of hyperglycemic events (the number of patients with at least 1 blood glucose concentration >180 mg/dL) was determined. Blood glucose concentrations increased significantly over time in all control and dexamethasone groups (from median baselines of 94 to 102 mg/dL to maximum medians ranging from 141 to 161.5 mg/dL, all P < 0.001). Blood glucose concentrations did not differ significantly between the groups receiving dexamethasone (either 4 or 8 mg) and those receiving saline at any measurement time. The incidence of hyperglycemic events did not differ in any of the early (21%-28%, P = 0.807) or late (13%-24%, P = 0.552) groups. Because blood glucose concentrations during the first 24 hours after administration of single low-dose dexamethasone did not differ from those observed after saline administrations, these results suggest clinicians need not avoid using dexamethasone for nausea and vomiting prophylaxis out of concerns related to hyperglycemia.

  5. Auditing the frequency and the clinical and economic impact of testing for Fabry disease in patients under the age of 70 with a stroke admitted to Saint Vincent's University Hospital over a 6-month period.

    Science.gov (United States)

    Lambe, J; Noone, I; Lonergan, R; Tubridy, N

    2018-02-01

    Fabry disease is an X-linked recessive lysosomal storage disorder that provokes multi-organ morbidity, including early-onset stroke. Worldwide prevalence may be greater than previously estimated, with many experiencing first stroke prior to diagnosis of Fabry disease. The aim of this study is to screen a cohort of stroke patients under 70 years of age, evaluating the clinical and economic efficacy of such a broad screening programme for Fabry disease. All stroke patients under 70 years of age who were entered into the Saint Vincent's University Hospital stroke database over a 6-month period underwent enzyme analysis and/or genetic testing as appropriate for Fabry disease. Patients' past medical histories were analysed for clinical signs suggestive of Fabry disease. Cost-effectiveness analysis of testing was performed and compared to overall economic impact of young stroke in Ireland. Of 22 patients tested for Fabry disease, no new cases were detected. Few clinical indicators of Fabry disease were identified at the time of testing. Broad screening programmes for Fabry disease are highly unlikely to offset the cost of testing. The efficacy of future screening programmes will depend on careful selection of an appropriate patient cohort of young stroke patients with multi-organ morbidity and a positive family history.

  6. Stability of personality traits over a five-year period in Swedish patients with schizophrenia spectrum disorder and non-psychotic individuals: a study using the Swedish universities scales of personality.

    Science.gov (United States)

    Fagerberg, Tomas; Söderman, Erik; Petter Gustavsson, J; Agartz, Ingrid; Jönsson, Erik G

    2018-02-27

    Personality is considered as an important aspect in persons with psychotic disorders. Several studies have investigated personality in schizophrenia. However, no study has investigated stability of personality traits exceeding three years in patients with schizophrenia. This study aims to investigate the stability of personality traits over a five-year period among patients with schizophrenia and non-psychotic individuals and to evaluate case-control differences. Patients with psychotic disorders (n = 36) and non-psychotic individuals (n = 76) completed Swedish universities Scales of Personality (SSP) at two occasions five years apart. SSP scores were analysed for effect of time and case-control differences by multiple analysis of covariance (MANCOVA) and within-subjects correlation. MANCOVA within-subjects analysis did not show any effect of time. Thus, SSP mean scale scores did not significantly vary during the five-year interval. Within subject correlations (Spearman) ranged 0.30-0.68 and 0.54-0.75 for the different SSP scales in patients and controls, respectively. Patients scored higher than controls in SSP scales Somatic Trait Anxiety, Psychic Trait Anxiety, Stress Susceptibility, Lack of Assertiveness, Detachment, Embitterment, and Mistrust. The stability of the SSP personality trait was reasonably high among patients with psychotic disorder, although lower than among non-psychotic individuals, which is in accordance with previous research.

  7. Metabolic control and chronic complications during a 3-year follow-up period in a cohort of type 2 diabetic patients attended in primary care in the Community of Madrid (Spain).

    Science.gov (United States)

    Arrieta, Francisco; Piñera, Marbella; Iglesias, Pedro; Nogales, Pedro; Salinero-Fort, Miguel Angel; Abanades, Juan Carlos; Botella-Carretero, José Ignacio; Calañas, Alfonso; Balsa, José Antonio; Zamarrón, Isabel; Rovira, Adela; Vázquez, Clotilde

    2014-01-01

    Our aim was to analyze both metabolic control and chronic complications of type 2 diabetes mellitus (T2D) patients regularly attended in primary care during a 3 years of follow-up in the Community of Madrid (Spain). From 2007 to 2010 we prospectively included 3268 patients with T2D attended by 153 primary care physicians from 51 family health centers. An prospective cohort study with annual evaluation over 3 years to the same population was performed. We measured the goals of control in diabetic patients and the incidence of chronic complications of diabetes during the study period. A significant decrease in serum glucose levels (143±42mg/dl vs 137±43mg/dl, p1.2% vs 7.02±1.2%, p191.4±38mg/dl vs 181.5±36mg/dl, p114.7±31mg/dl vs 105.5±30mg/dl, p144.5±93mg/dl vs 138±84mg/dl, p14mg/dl vs 49.9±16mg/dl, pdiabetic complications throughout the study period was low, with a incidence of coronary heart disease of 6.2%, peripheral arterial disease 3%, ischemic stroke 2.8%, diabetic foot 11.2%, nephropathy 5.9%, retinopathy 4.5%, and neuropathy 3%. Metabolic control in T2D patients attended in primary care in the Community of Madrid throughout 3 years is adequate and is accompanied by low percent of chronic diabetic complications during this period of follow-up. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  8. Evaluation of long-term patient satisfaction and experience with the Baha(®) bone conduction implant

    DEFF Research Database (Denmark)

    Rasmussen, Jacob; Olsen, Steen Østergaard; Nielsen, Lars Holme

    2012-01-01

    Objective: Evaluate long-term patient satisfaction with bone-anchored hearing aids (the Baha(R), now referred to by Cochlear as a 'bone conduction implant') in our hospital clinic spanning the eighteen-year period from the inception of our Baha program. The researchers further wished to analyse...... the various factors leading to patient satisfaction/dissatisfaction with their Baha. We developed a new questionnaire to obtain a comprehensive impression of individual patient practices, general satisfaction, and experiences with their Baha in respect to time spent using Baha, sound quality, annoyance from...... noise disturbance, ease of communication, cosmetic appearance, and satisfaction with the Baha amongst patient relatives, an aspect not previously investigated. Design: The study design was retrospective and executed as a postal questionnaire. The questionnaire was developed by the authors of this paper...

  9. Recurrent skin and soft tissue infections in HIV-infected patients during a 5-year period: incidence and risk factors in a retrospective cohort study.

    Science.gov (United States)

    Hemmige, Vagish; McNulty, Moira; Silverman, Ethan; David, Michael Z

    2015-10-26

    Skin and soft tissue infections (SSTIs) are common in the era of community-associated methicillin resistant Staphylococcus aureus among HIV-infected patients. Recurrent infections are frequent. Risk factors for recurrence after an initial SSTI have not been well-studied. Retrospective cohort study, single center, 2005-2009. Paper and electronic medical records were reviewed by one of several physicians. Subjects with initial SSTI were followed until the time of SSTI recurrence. Standard descriptive statistics were calculated to describe the characteristics of subjects who did and did not develop a recurrent SSTI. Kaplan-Meier methods were used to estimate the risk of recurrent SSTI. A Cox regression model was developed to identify predictors of SSTI recurrence. 133 SSTIs occurred in 87 individuals. 85 subjects were followed after their initial SSTI, of whom 30 (35.3 %) had a recurrent SSTI in 118.3 person-years of follow-up, for an incidence of second SSTI of 253.6 SSTIs/1000 person-years (95 % CI 166.8-385.7). The 1-year Kaplan-Meier estimated risk of a second SSTI was 29.2 % (95 % CI 20.3-41.0 %), while the 3-year risk was 47.0 % (95 % CI 34.4-61.6 %). Risk factors for recurrent SSTI in a multivariable Cox regression model were non-hepatitis liver disease (HR 3.44; 95 % CI 1.02-11.5; p = 0.05), the presence of an intravenous catheter (HR 6.50; 95 % CI 1.47-28.7; p = 0.01), and a history of intravenous drug use (IVDU) (HR 2.80; 95 % CI 1.02-7.65; p = 0.05); African-American race was associated with decreased risk of recurrent SSTI (HR 0.12; 95 % CI 0.04-0.41; p < 0.01). Some evidence was present for HIV viral load ≥ 1000 copies/mL as an independent risk factor for recurrent SSTI (HR 2.21; 95 % CI 0.99-4.94; p = 0.05). Hemodialysis, currently taking HAART, CD4+ count, trimethoprim-sulfamethoxazole or azithromycin use, initial SSTI type, diabetes mellitus, incision and drainage of the original SSTI, or self-report of being a man who has sex with men were not

  10. The Periodic Pyramid

    Science.gov (United States)

    Hennigan, Jennifer N.; Grubbs, W. Tandy

    2013-01-01

    The chemical elements present in the modern periodic table are arranged in terms of atomic numbers and chemical periodicity. Periodicity arises from quantum mechanical limitations on how many electrons can occupy various shells and subshells of an atom. The shell model of the atom predicts that a maximum of 2, 8, 18, and 32 electrons can occupy…

  11. Book Reviews in Periodicals.

    Science.gov (United States)

    Ettelt, Harold J.

    All recent issues of periodicals found which contain indexed book reviews are listed in this compilation from Drake Memorial Library at the New York State University at Brockport. The periodicals are listed by 29 subject headings in this informal guide designed to be used at Drake Library. The number of reviews in the periodical in a recent year…

  12. Using Electromagnetic Microwave Field Combined With Laserotherapy in Postoperative Period of Patients With Purulent-Inflammatory Diseases of the Hand in Outpatient Clinic

    International Nuclear Information System (INIS)

    Rabenok, L.; Grimalsky, V.; Juarez R, D.

    2008-01-01

    The results of a treatment of 51 patients with purulent-inflammatory diseases of the hand in outpatient clinic are analyzed; a new method of treatment using electromagnetic (EM) microwave field combined with laserotherapy was applied. A portable apparatus was used that operates in the millimeter (mm) wave range in 4 regimes of an intensity 2-10 mW/cm 2 and a red laser of 0.65 μm wavelength of a low intensity 10-15 mW/cm 2 . A peculiarity of the method was an absence of any antibacterial medicine. An exposure of an influence was 10 min. The total course included 5-7 applications. An influence of low intensity EM radiation was started 15-20 min before the operation. The action was to the center of purulent inflammation and to the biological active points of acupuncture (G14, E36). Starting from the first day since the operation, the low intensity EM radiation was applied to the biological active points combined with laserotherapy to the wound in the sedative regime (the repetition rate 9-10 Hz) during 10 min. Clinical symptomatology, radiographic findings, the results of microbiologic, morphologic studies were analyzed as well and were satisfactory (without any complications)

  13. Safety and Effectiveness of Percutaneously Inserted Peritoneal Ports Compared to Surgically Inserted Ports in a Retrospective Study of 87 Patients with Ovarian Carcinoma over a 10-Year Period

    International Nuclear Information System (INIS)

    Woodley-Cook, Joel; Tarulli, Emidio; Tan, Kong T.; Rajan, Dheeraj K.; Simons, Martin E.

    2016-01-01

    PurposePlacement of peritoneal ports has become a favorable technique for direct chemotherapy infusion in treating peritoneal metastases from ovarian cancer. We aim to outline an approach to the percutaneous insertion of peritoneal ports and to characterize success and complication rates compared to surgically inserted ports.Materials and MethodsRetrospective analysis was collected from 87 patients who had peritoneal port insertion (28 inserted surgically and 59 percutaneously) for treatment of peritoneal metastases from ovarian cancer from July 2004 to July 2014. Complications were classified according to the SIR Clinical Practice Guidelines as major or minor.ResultsTechnical success rates for surgically and percutaneously inserted ports were 100 and 96.7 %, respectively (p = 0.44), with the two percutaneous failures successful at a later date. There were no major complications in either group. Minor complication rates for surgically versus percutaneously inserted ports were 46.4 versus 22.0 %, respectively (p = 0.02). The infection rate for surgically inserted versus percutaneously inserted ports was 14.3 and 0 %, respectively (p = 0.002). The relative risk of developing a complication from percutaneous peritoneal port insertion without ascites was 3.4 (p = 0.04). For percutaneously inserted ports, the mean in-room procedure time was 81 ± 1.3 min and mean fluoroscopy time was 5.0 ± 4.5 min.ConclusionPercutaneously inserted peritoneal ports are a safe alternative to surgically inserted ports, demonstrating similar technical success and lower complication rates.

  14. Interrelation of melatonin with quality of life and personality properties of patients with endometrial pathology in the late reproductive and premenopausal period

    Directory of Open Access Journals (Sweden)

    S. M. Korniyenko

    2017-08-01

    Full Text Available The aim of the work is to investigate the relationship of melatonin with the quality of life and the profile of the personality of women of late reproductive and premenopausal age with the pathology of the endometrium. Materials and methods. 45 women aged 36-55 years with endometrial diseases were examined. All patients underwent hysteroscopy. The personality profile was assessed using the FPI test. To study the quality of life, the SF-36 questionnaire was used. The data was processed using the Spearman rank correlation. Results. As a result of the correlation analysis of data on melatonin concentration and SF-36 scales, our study found that the value of melatonin did not affect the quality of life associated with health. However, if we evaluate trends, then the highest of the reduced correlation coefficients is of some interest. It's about role physical functioning. The correlation coefficients of the melatonin index and the scales of the FPI questionnaire looked as follows: all significant correlation coefficients had a negative sign, that is, the personality properties corresponding to these coefficients were associated with a low concentration of melatonin. The ordering of the FPI scales by decreasing the significance of the correlation coefficients helped to identify the personal profile of hypomelatoninemia in the examined women. First of all, he was characterized by high levels of depressiveness and emotional lability. Conclusions. In the psychopathological structure of the personality of women of late reproductive and pre-menopausal age with endometrial pathology burdened with hypomelatoninemia, depressive and emotional lability is predominate. Reducing the secretion of melatonin is also associated with increased spontaneous aggressiveness, neuroticism and irritability.

  15. Safety and Effectiveness of Percutaneously Inserted Peritoneal Ports Compared to Surgically Inserted Ports in a Retrospective Study of 87 Patients with Ovarian Carcinoma over a 10-Year Period

    Energy Technology Data Exchange (ETDEWEB)

    Woodley-Cook, Joel, E-mail: jwoodleycook@gmail.com [The Scarborough Hospital, Vascular and Interventional Radiology, Department of Diagnostic Imaging (Canada); Tarulli, Emidio; Tan, Kong T.; Rajan, Dheeraj K.; Simons, Martin E. [University of Toronto, Vascular and Interventional Radiology, Department of Medical Imaging, University Health Network (Canada)

    2016-11-15

    PurposePlacement of peritoneal ports has become a favorable technique for direct chemotherapy infusion in treating peritoneal metastases from ovarian cancer. We aim to outline an approach to the percutaneous insertion of peritoneal ports and to characterize success and complication rates compared to surgically inserted ports.Materials and MethodsRetrospective analysis was collected from 87 patients who had peritoneal port insertion (28 inserted surgically and 59 percutaneously) for treatment of peritoneal metastases from ovarian cancer from July 2004 to July 2014. Complications were classified according to the SIR Clinical Practice Guidelines as major or minor.ResultsTechnical success rates for surgically and percutaneously inserted ports were 100 and 96.7 %, respectively (p = 0.44), with the two percutaneous failures successful at a later date. There were no major complications in either group. Minor complication rates for surgically versus percutaneously inserted ports were 46.4 versus 22.0 %, respectively (p = 0.02). The infection rate for surgically inserted versus percutaneously inserted ports was 14.3 and 0 %, respectively (p = 0.002). The relative risk of developing a complication from percutaneous peritoneal port insertion without ascites was 3.4 (p = 0.04). For percutaneously inserted ports, the mean in-room procedure time was 81 ± 1.3 min and mean fluoroscopy time was 5.0 ± 4.5 min.ConclusionPercutaneously inserted peritoneal ports are a safe alternative to surgically inserted ports, demonstrating similar technical success and lower complication rates.

  16. Canakinumab (ACZ885, a fully human IgG1 anti-IL-1β mAb) induces sustained remission in pediatric patients with cryopyrin-associated periodic syndrome (CAPS).

    Science.gov (United States)

    Kuemmerle-Deschner, Jasmin B; Ramos, Eduardo; Blank, Norbert; Roesler, Joachim; Felix, Sandra D; Jung, Thomas; Stricker, Kirstin; Chakraborty, Abhijit; Tannenbaum, Stacey; Wright, Andrew M; Rordorf, Christiane

    2011-02-28

    Cryopyrin-associated periodic syndrome (CAPS) represents a spectrum of three auto-inflammatory syndromes, familial cold auto-inflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS), and neonatal-onset multisystem inflammatory disease/chronic infantile neurological cutaneous and articular syndrome (NOMID/CINCA) with etiology linked to mutations in the NLRP3 gene resulting in elevated interleukin-1β (IL-1β) release. CAPS is a rare hereditary auto-inflammatory disease, which may start early in childhood and requires a life-long treatment. Canakinumab, a fully human anti-IL-1β antibody, produces sustained selective inhibition of IL-1β. This study was conducted to assess the efficacy, safety, and pharmacokinetics of canakinumab in the treatment of pediatric CAPS patients. Seven pediatric patients (five children and two adolescents) with CAPS were enrolled in a phase II, open-label study of canakinumab in patients with CAPS. Canakinumab was administered at a dose of 2 mg/kg subcutaneously (s.c.) (for patients with body weight ≤ 40 kg) or 150 mg s.c. (for patients with body weight > 40 kg) with re-dosing upon each relapse. The primary efficacy variable was time to relapse following achievement of a complete response (defined as a global assessment of no or minimal disease activity and no or minimal rash and values for serum C-reactive protein (CRP) and/or serum amyloid A (SAA) within the normal range, CAPS. ClinicalTrials.gov: NCT00487708.

  17. Sigmoid Volvulus Complicating Postpartum Period

    Directory of Open Access Journals (Sweden)

    Kelsey E. Ward

    2017-01-01

    Full Text Available Background. Sigmoid volvulus is a rare complication of pregnancy and the puerperium. Case. A 19-year-old patient, gravida 1 para 0 at 41 0/7 weeks of gestation, admitted for late-term induction of labor underwent an uncomplicated primary low transverse cesarean delivery for arrest of descent. Her postoperative period was complicated by sudden onset of abdominal pain and the ultimate diagnosis of sigmoid volvulus. Conclusion. Prompt surgical evaluation of an acute abdomen in the postpartum period is essential; delayed diagnosis and treatment can lead to significant maternal morbidity and mortality.

  18. In a world without faith and dominated by ambition: Representations of Brazil and the Portuguese in the First Half of the Eighteen Century European Travel Literature

    Directory of Open Access Journals (Sweden)

    Domingues, Ângela

    2012-12-01

    Full Text Available As part of a reflection on Atlantic history, I intend to reread the travel literature written by Europeans who stayed briefly at the Brazilian shore, so as to learn about the Portuguese empire -and particularly Brazil- from the inside and understand how the Portuguese and Luso-Brazilians of the colony were perceived. Travelers registered their impressions based on their own principles, and in some cases exaggerated the cultural differences they observed. This rereading makes it possible to evaluate the differences between a Europe constituted by nations, kingdoms and empires, and Mediterranean Europe. The travel literature, which did not have Brazil as final destination, could have disproportionate and unsuspected repercussions. The accounts showed Portugal and its colonies as similar to Spain and very different from the rest of Europe, at a period of affirmation of the national States and aggressive imperial external policies aimed at the South Atlantic.Desde una reflexión en torno a la historia atlántica, pretendo releer la literatura de viajes escrita por europeos que permanecieron brevemente en el litoral brasileño, para así conocer el Imperio Portugués -y muy particularmente Brasil- desde adentro y comprender cómo eran percibidos los portugueses y luso-brasileños de la colonia. Los viajeros registraban sus impresiones a partir de sus propios principios, exagerando en algunos casos las diferencias culturales observadas. Esta relectura permite evaluar las diferencias entre una Europa constituida por naciones, reinos e imperios; y la Europa Mediterránea. La literatura de viajes, cuyo destino final no era Brasil, podía tener repercusiones desproporcionadas e insospechadas. Los relatos mostraban a Portugal y sus colonias similar a España y muy diferente del resto de Europa, en un período de afirmación de los estados nacionales y agresivas políticas externas imperialista que apuntaban al Atlántico Sur.

  19. Percentage of pathological complete response in patients with rectal cancer that received neoadjuvant therapy with chemotherapy and radiotherapy at the Servicio de Radioterapia from Hospital Mexico, in the period from January 2009 to December 2013

    International Nuclear Information System (INIS)

    Lopez Mena, Stephanie

    2015-01-01

    Percentage of pathologic complete response is determined in patients with rectal cancer, treated with neoadjuvant chemotherapy and radiotherapy, in the Servicio de Radioterapia from Hospital Mexico, in the period between January 2009 and December 2013. Tumor histology is determined. The distance of the tumor is identified with respect to the anal margin. The correlation between the TNM staging and the response received in this type of neoadjuvant therapy is described. Radiotherapy dose used in each case is described. Different schemes of chemotherapy used are characterized. The acute side effects most common are determined in the study population [es

  20. Analysis of the Anxiety and Depression for Patients with Type 2 Diabetic Retinopathy in Different Period%不同时期2型糖尿病视网膜病变患者焦虑抑郁分析

    Institute of Scientific and Technical Information of China (English)

    刘奎香; 贺庆娟; 李廷

    2014-01-01

    Objective To study the anxiety and depression status of patients with type 2 diabetic retinopathy in different period. Methods Experimental group (patients with proliferative diabetic retinopathy)and control group (patients with non-proliferative diabetic retinopathy ) were all patients to our hospital,each group had 50 people. Cross-sectional survey about Hamilton rating scalefor anxiety (HAMA) and depression self-rating scale (HAMD)were carried out,then do statistical analysis. Results Patients with proliferative diabetic retinopathy got higher scores higher in anxiety depression test than that who with non-proliferative diabetic retinopathy. And the dif erence has statistical significance.Conclusion Higher at ention should be paid to psychological treatment for patients with proliferative diabetic retinopathy,and early intervention treatment of diabetic retinopathy for patients with non-proliferative diabetic retinopathy.%目的探讨非增殖期与增殖期糖尿病病变患者的焦虑抑郁心理状态。方法试验组及对照组均取于我院就诊的患有增殖期及非增殖期糖尿病视网膜病变的患者,各50例,对其进行焦虑及抑郁自评量表调查并对结果进行统计分析。结果增殖期糖尿病视网膜病变患者焦虑抑郁得分较非增殖期患者明显增高,差异有统计学意义。结论应重视对增殖期糖尿病视网膜病变患者的心理治疗及非增殖期糖尿病视网膜病变患者的早期干预治疗。

  1. The incidence and risk of developing a second primary esophageal cancer in patients with oral and pharyngeal carcinoma: a population-based study in Taiwan over a 25 year period

    International Nuclear Information System (INIS)

    Lee, Kuan-Der; Lu, Chang-Hsien; Chen, Ping-Tsung; Chan, Chunghuang Hubert; Lin, Jen-Tsun; Huang, Cih-En; Chen, Chih-Cheng; Chen, Min-Chi

    2009-01-01

    The incidence of oral and pharyngeal (including oral cavity, oropharynx and hypopharynx) carcinoma increases rapidly in Asia and South Pacific because of betel quid chewing. Thus far, large-scale epidemiological studies are not available yet to stratify these patients by their risks of developing a second primary cancer in the digestive tract including esophagus, stomach, colon, and rectum. A population-based study was conducted using the database from the Taiwan National Cancer Registry for the period 1979-2003. We quantified standardized incidence ratios (SIRs) and cumulative incidence of second primary cancers among 33,787 patients with initial diagnoses of oral and pharyngeal carcinoma. Among these four digestive tract organs, the esophagus was the only site of second cancer with excess risk in patients with oral and pharyngeal carcinoma. The incidence and risk of developing a second primary esophageal cancer differed by the site of the primary index tumor, most frequently seen in hypopharyngeal cancer (71/4,218 = 1.68%, SIR = 22.76, 95% CI 17.77-28.70), followed by oropharyngeal cancer (30/3,403 = 0.88%, SIR = 14.29, 95% CI 9.64-20.39) and the least in oral cavity cancer (99/26,166 = 0.38%, SIR = 5.57, 95% CI 4.53-6.78). In addition, the risk was extraordinarily high for patients with a follow-up interval ≤ 1 year and those with first primary cancer diagnosed at age ≤50. These patients may justify more close surveillance. The present study represents the first population-based study in Asia attempting to stratify the patients of oral and pharyngeal carcinoma by their risk of developing a second esophageal cancer. It helps identify patients at high risk and tailor the application of intense follow-up surveillance to the estimated risk in each individual case

  2. Manual lymphatic drainage and therapeutic ultrasound in liposuction and lipoabdominoplasty post-operative period

    Directory of Open Access Journals (Sweden)

    Igor F. B. Masson

    2014-01-01

    Full Text Available Background: Physiotherapy in the plastic surgery post-operative (PO is essential to provide means for an adequate and fast recovery as it restores function through the use of physiotherapeutic procedures. Aim: The aim of the following study is to verify the effects of the association between the manual lymphatic drainage and the therapeutic ultrasound on pain, oedema and the tissue fibrosis in liposuction and lipoabdominoplasty PO. Design: This is a clinical trial prospective. Materials and Methods: Eighteen women aged between 18 and 60 years participated in this study, in the late PO period following lipoabdominoplasty or liposuction in the abdomen, flanks and lower trunk, which showed tissue fibrosis of the flanks and abdomen regions. They were divided into two groups: Liposuction group and lipoabdominoplasty group. A total of twelve sessions of therapeutic ultrasound followed by the manual lymphatic drainage were performed. The patients were assessed with regard to pain, oedema and tissue fibrosis in different moments: Initial assessment, during assessment and final assessment through the application of the protocol of evaluation of cysts fibrosis levels. Statistical Analysis: The test of equality for two proportions and the confidence interval test for mean to evaluate the distribution of variables. The significance level adopted for statistical tests was 5% (P < 0.05. Results: There was a statistically significant reduction of pain, swelling and tissue fibrosis in both groups. Conclusion: the association between manual lymphatic drainage and the therapeutic ultrasound reduced the swelling and the tissue fibrosis and made pain disappear in liposuction and lipoabdominoplasty PO period.

  3. A retrospective data acquisition and evaluation on the characterization and prognosis for 776 patients with differentiated thyroid carcinomas in the Klinik und Poliklinik fuer Nuklearmedizin der Universitaet zu Koeln in the period from 1990 to 2005

    International Nuclear Information System (INIS)

    Meixner, Markus

    2011-01-01

    The author describes the retrospective data acquisition and evaluation on the characterization and prognosis for 776 patients (average age 40:1 years) with differentiated thyroid carcinomas in the Klinik und Poliklinik fuer Nuklearmedizin der Universitaet zu Koeln in the period from 1990 to 2005. The methodology includes patient-relevant data, examination data, imaging techniques and biochemical tests. Clinically important differences were found for papillary and follicular thyroid carcinoma. Further differences concern the localization of metastases. The author discusses the prognostic significance of the primary tumor radius in comparison with the so-called TNM classification for papillary and follicular thyroid carcinomas. It is concluded that the new version of the TNM classification offers only slight advantages with respect to the former version. It was also shown that the primary tumor size is adequate for prognostic estimations.

  4. Painful menstrual periods

    Science.gov (United States)

    Menstruation - painful; Dysmenorrhea; Periods - painful; Cramps - menstrual; Menstrual cramps ... into two groups, depending on the cause: Primary dysmenorrhea Secondary dysmenorrhea Primary dysmenorrhea is menstrual pain that ...

  5. Middle Helladic Period

    DEFF Research Database (Denmark)

    Sarri, Kalliopi

    1999-01-01

    and their quality was improved considerably toward the end of this period. The profound cultural innovations of the Middle Helladic period were initially interpreted as a result of violent population movement and troubles provoked by the coming of the first Indo-European races. However, this matter does no more...... Helladic period is considered as a period of economic and social decline it was the time during which the mainland features merged with the insular influence, that is all the Aegean elements which led to the creation of the Mycenaean civilization were mixed in a creative way....

  6. TIME COURSE OF STRUCTURAL AND FUNCTIONAL CHANGES IN THE MYOCARDIAL ARTERIES OF PATIENTS WITH RHEUMATOID ARTHRITIS TREATED WITH METHOTREXATE AND HYDROXYCHLOROQUINE DURING A 4-YEAR FOLLOW-UP PERIOD

    Directory of Open Access Journals (Sweden)

    A. V. Petrov

    2016-01-01

    Full Text Available Many patients with rheumatoid arthritis (RA develop myocardial damage that is frequently latent and usually manifests itself as congestive heart failure and arrhythmias in the late period of the disease.Objective: to comparatively study the time course of clinical, structural, and functional changes in the myocardium in RA patients taking methotrexate (MTX and a combination of MTX and hydroxychloroquine (HC during a 4-year follow-up period.Subjects and methods. Clinical data and echocardiographic, carotid artery ultrasonographic, and Holter electrocardiogram (ECG monitoring readings were analyzed in 83 patients with RA with disease duration of < 10 years, who had received MTX (n = 44 or a combination of MTX and HC (n = 39 for 4 years. RA activity remained low (DAS28 ≤ 3.1 during the follow-up period.Results and discussion. Over 4 years, the RA patients showed significant increases in left ventricular mass index (from 106.20 [98.14; 112.44] to 114.23 [109.12; 131.19], in the rate of eccentric left ventricular hypertrophy (from 22.9 to 40.9%, frequent supraventricular extrasystoles (from 13.3 to 22.8%, different types of premature ventricular contractions (from 14.2 to 26.2%, paroxysmal ventricular tachycardia (from 1.2 to 3.6%, intraventricular conduction disturbances (from 3.6 to 14.4%, and first-degree atrioventricular block (from 2.4 to 4.8%, as well as atherosclerotic plaques in the carotid arteries (from 6.0 to 10.8% (p < 0.05. During combined therapy with MTX and HC, the increase in the rate of eccentric left ventricular hypertrophy, high-grade premature ventricular contractions, and right bundle-branch block was not so great as that during MTX monotherapy (5.1 and 29.6%; 5.1 and 18.2%; 2.6 and 11.4%, respectively.Conclusion. There is evidence that HC intake has a positive impact on myocardial structural and functional parameters in RA patients.

  7. BCNU wafer placement with temozolomide (TMZ) in the immediate postoperative period after tumor resection followed by radiation therapy with TMZ in patients with newly diagnosed high grade glioma: final results of a prospective, multi-institutional, phase II trial.

    Science.gov (United States)

    Burri, Stuart H; Prabhu, Roshan S; Sumrall, Ashley L; Brick, Wendy; Blaker, Brian D; Heideman, Brent E; Boltes, Peggy; Kelly, Renee; Symanowski, James T; Wiggins, Walter F; Ashby, Lynn; Norton, H James; Judy, Kevin; Asher, Anthony L

    2015-06-01

    Temozolomide (TMZ) and BCNU have demonstrated anti-glioma synergism in preclinical models. We report final data from a prospective, multi-institutional study of BCNU wafers and early TMZ followed by radiation therapy with TMZ in patients with newly diagnosed malignant glioma. 65 patients were consented in 4 institutions, and 46 patients (43 GBM, 3 AA) were eligible for analysis. After resection and BCNU wafer placement, TMZ began on day four postoperatively. Radiation and TMZ (RT/TMZ) were then administered, followed by monthly TMZ at 200 mg/m2 for the first 26 patients, which was reduced to 150 mg/m2 for the remaining 20 patients. Non-hematologic toxicities were minimal. Nine of 27 patients (33 %) who received 200 mg/m2 TMZ, but only 1 of 20 (5 %) who received 150 mg/m2, experienced grade 3/4 thrombocytopenia. Median progression free survival (PFS) and overall survival (OS) period was 8.5 and 18 months, respectively. The 1-year OS rate was 76 %, which is a significant improvement compared with the historical control 1-year OS rate of 59 % (p = 0.023). However, there was no difference in 1-year OS compared with standard RT/TMZ (p = 0.12) or BCNU wafer followed by RT/TMZ (p = 0.87) in post hoc analyses. Early post-operative TMZ can be safely administered with BCNU wafers following resection of malignant glioma at the 150 mg/m2 dose level. Although there was an OS benefit compared to historical control, there was no indication of benefit for BCNU wafers and early TMZ in addition to standard RT/TMZ or early TMZ in addition to regimens of BCNU wafers followed by RT/TMZ.

  8. On some periodicity effects

    DEFF Research Database (Denmark)

    Sorokin, Sergey V.

    2015-01-01

    The talk is concerned with the modelling of wave propagation in and vibration of periodic elastic structures. Although analysis of wave-guide properties of infinite periodic structures is a well establish research subject, some issues have not yet been fully addressed in the literature. The aim o...

  9. The Living Periodic Table

    Science.gov (United States)

    Nahlik, Mary Schrodt

    2005-01-01

    To help make the abstract world of chemistry more concrete eighth-grade students, the author has them create a living periodic table that can be displayed in the classroom or hallway. This display includes information about the elements arranged in the traditional periodic table format, but also includes visual real-world representations of the…

  10. Periods and Nori motives

    CERN Document Server

    Huber, Annette

    2017-01-01

    This book casts the theory of periods of algebraic varieties in the natural setting of Madhav Nori’s abelian category of mixed motives. It develops Nori’s approach to mixed motives from scratch, thereby filling an important gap in the literature, and then explains the connection of mixed motives to periods, including a detailed account of the theory of period numbers in the sense of Kontsevich-Zagier and their structural properties. Period numbers are central to number theory and algebraic geometry, and also play an important role in other fields such as mathematical physics. There are long-standing conjectures about their transcendence properties, best understood in the language of cohomology of algebraic varieties or, more generally, motives. Readers of this book will discover that Nori’s unconditional construction of an abelian category of motives (over fields embeddable into the complex numbers) is particularly well suited for this purpose. Notably, Kontsevich's formal period algebra represents a to...

  11. [Analysis of the effectiveness of the spa and health resort-based treatment of the patients presenting with broncho-pulmonary pathology at the southern coast of the Crimea depending on the period of flowering of Mediterranean Cypress (Cupressus sempervirens)].

    Science.gov (United States)

    Savchenko, V M; Belyaeva, S N; Govorun, M I; Pirogova, M E

    The objective of the present study was to evaluate the influence of pollen of Mediterranean Cypress (Cupressus sempervirens) on the effectiveness of the spa and health resort-based treatment (SHRT) of the patients with broncho-pulmonary pathology at the southern coast of the Crimea (SCC). This article presents the results of the analysis of the data on 122 patients presenting with broncho-pulmonary pathology who received SHRT under the conditions of the Southern Coast of the Crimea. Fifty one (41.8%) of these patients suffered from chronic obstructive pulmonary disease and 71 (58.2%) ones had bronchial asthma. The whole group was comprised of 44 men (36.1%) and 78 women (63.9%). The average (median) age of the patients was 55.8 years. All the participants of the study underwent the comprehensive examination including the general medical and physical examination, complete blood count, the study of sputum cytology and immunological properties of blood including the standard characteristics, IgE and lysozyme levels), evaluation of the respiratory and locomotor (physical) functions with the use of the 6-minute walking test. The aeropollenological study of the aerial environment of the southern coast of the Crimea in the region of Yalta showed that the «bloom» of the Mediterranean Cypress occurs during the period from February till April inclusive. The highest concentrations of cypress pollen are observed in March and early April. The overall effectiveness of SHRT for the patients with broncho-pulmonary pathology arriving for the treatment at the southern coast of the Crimea from other Crimean localities does not depend on the period of «flowering» (the presence of pollen in the air) of the Mediterranean Cypress. In these patients, the termination of the spa and health resort-based treatment during the «flowering» of the Mediterranean Cypress resulted in nothing more than a strained adaptive response manifested as the altered blood leukocyte count. Such reaction

  12. Mean-periodic functions

    Directory of Open Access Journals (Sweden)

    Carlos A. Berenstein

    1980-01-01

    Full Text Available We show that any mean-periodic function f can be represented in terms of exponential-polynomial solutions of the same convolution equation f satisfies, i.e., u∗f=0(μ∈E′(ℝn. This extends to n-variables the work of L. Schwartz on mean-periodicity and also extends L. Ehrenpreis' work on partial differential equations with constant coefficients to arbitrary convolutors. We also answer a number of open questions about mean-periodic functions of one variable. The basic ingredient is our work on interpolation by entire functions in one and several complex variables.

  13. Painful periods (dysmenorrhea) (image)

    Science.gov (United States)

    Primary dysmenorrhea is a normal cramping of the lower abdomen caused by hormone-induced uterine contractions before the period. Secondary dysmenorrhea may be caused by abnormal conditions such as ...

  14. Vaginal bleeding between periods

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003156.htm Vaginal bleeding between periods To use the sharing features ... this page, please enable JavaScript. This article discusses vaginal bleeding that occurs between a woman's monthly menstrual ...

  15. Super periodic potential

    Science.gov (United States)

    Hasan, Mohammd; Mandal, Bhabani Prasad

    2018-04-01

    In this paper we introduce the concept of super periodic potential (SPP) of arbitrary order n, n ∈I+, in one dimension. General theory of wave propagation through SPP of order n is presented and the reflection and transmission coefficients are derived in their closed analytical form by transfer matrix formulation. We present scattering features of super periodic rectangular potential and super periodic delta potential as special cases of SPP. It is found that the symmetric self-similarity is the special case of super periodicity. Thus by identifying a symmetric fractal potential as special cases of SPP, one can obtain the tunnelling amplitude for a particle from such fractal potential. By using the formalism of SPP we obtain the close form expression of tunnelling amplitude of a particle for general Cantor and Smith-Volterra-Cantor potentials.

  16. Establishing contract periods

    International Nuclear Information System (INIS)

    Huffman, F.C.

    1978-01-01

    The lead time for executing the Adjustable Fixed-Commitment (AFC) contract and exceptions which may be considered are discussed. The initial delivery period is also discussed. Delays, deferrals, and schedule adjustment charges are finally considered

  17. The Periodic Table CD.

    Science.gov (United States)

    Banks, Alton J.; Holmes, Jon L.

    1995-01-01

    Describes the characteristics of the digitized version of The Periodic Table Videodisc. Provides details about the organization of information and access to the data via Macintosh and Windows computers. (DDR)

  18. Setting the Periodic Table.

    Science.gov (United States)

    Saturnelli, Annette

    1985-01-01

    Examines problems resulting from different forms of the periodic table, indicating that New York State schools use a form reflecting the International Union of Pure and Applied Chemistry's 1984 recommendations. Other formats used and reasons for standardization are discussed. (DH)

  19. Supersymmetrically transformed periodic potentials

    OpenAIRE

    C, David J. Fernandez

    2003-01-01

    The higher order supersymmetric partners of a stationary periodic potential are studied. The transformation functions associated to the band edges do not change the spectral structure. However, when the transformation is implemented for factorization energies inside of the forbidden bands, the final potential will have again the initial band structure but it can have bound states encrusted into the gaps, giving place to localized periodicity defects.

  20. Depression in pregnancy and postpartum period.

    Science.gov (United States)

    Sood, Mamta; Sood, A K

    2003-01-01

    This prospective study was carried out in a service hospital, with the aim to study the prevalence and incidence of depression in pregnancy and postpartum period. Eighty Four consecutive patients attending the antenatal outpatient in the Obstetrics & Gynaecology department in their last trimester of pregnancy were recruited for the study. They were assessed on Beck Depression Inventory thrice viz. during third trimester of pregnancy, within 3 days of delivery (early postpartum period) & within 4-8 weeks of delivery (late postpartum period).The prevalence of depression was 8.3%, 20% and 12.8% respectively at three ratings. The incidence was 16% and 10% in the early & late postpartum period respectively. Further analysis revealed that depression in pregnancy correlated significantly with depression in early postpartum period, but not with late postpartum period. Depression in early postpartum period correlated with depression in late postpartum period.These findings have implications for early detection and care of women at risk for developing depression.

  1. Eighteen Years of Safe Storage and Counting

    Energy Technology Data Exchange (ETDEWEB)

    Moren, Richard J. [Mission Support Alliance; Morton, M. [Polestar Technical Services, INC

    2016-03-28

    The purpose of this paper is to share the status and condition of the six reactor buildings at the Hanford Site in Washington State that are in this SAFSTOR condition (for between 4 and 18 years as of summer of 2016).

  2. The world in eighteen lessons: Christopher Williams

    NARCIS (Netherlands)

    Berrebi, S.

    2011-01-01

    Conceptual photographer Christopher Williams is a real artist's artist. Ever since he moved to Germany, his measured work, which both reveres and examines the art of photography, has more and more easily found its way into European art institutes, such as this spring at Museum Dhondt-Dhaenens in

  3. Agronomic characterization of eighteen cucurbitaceae cultivars used ...

    African Journals Online (AJOL)

    SARAH

    2014-09-30

    Sep 30, 2014 ... Faculty of Sciences and Technology at Abdou Moumouni. University of ..... information on seeds form highlighted lying seeds (ratio less than 1) for all .... ERP- value. -. 0.0926. 0.7146. FLO -. 0.3711. 0.1295. 0.1499. 0.5528.

  4. Identification and characterization of eighteen polymorphic ...

    Indian Academy of Sciences (India)

    Author Affiliations. Fei Xiong1 Hong-Yan Liu1 Xin-Bin Duan2 Da-Qing Chen2. College of Life Sciences, Jianghan University, Wuhan 430056, People's Republic of China; Yangtze River Fisheries Research Institute, Chinese Academy of Fishery Sciences, Wuhan 430223, People's Republic of China ...

  5. Training course for eighteen teachers at CERN

    CERN Multimedia

    Laurianne Noemie Trimoulla

    2015-01-01

    From 8 to 10 December, 18 teachers from all over France attended a three-day training course on matter, organised by the LAMAP Foundation (Fondation La main à la pâte, see here) and hosted by CERN and S'Cool Lab. The LAMAP Foundation, set up by Georges Charpak in 1995, aims to help primary school teachers use the investigative process to instil the scientific spirit in their pupils.      Fired by curiosity and eager to learn, the teachers were introduced to the many and varied activities on offer at CERN, including the cloud chamber experiment, the Masterclass programme and the "Be a physicist" learning scheme. They particularly enjoyed their tours of Microcosm, the Synchrocyclotron and the ATLAS visitor centre, which stimulated many questions. They are eagerly looking forward to passing on their newly found knowledge to their pupils and perhaps even inspiring some to take up a career in physics! Last but not least, they were treat...

  6. Eighteen polymorphic microsatellites for domestic pigeon Columba ...

    Indian Academy of Sciences (India)

    certain parasites which cause health problems in humans and domestic animals ... The genomic DNA was isolated using standard protocol as described by ..... panel of polymorphic microsatellite markers in Himalayan monal. Lophophorus ...

  7. Air stacking: effects on pulmonary function in patients with spinal muscular atrophy and in patients with congenital muscular dystrophy,

    Directory of Open Access Journals (Sweden)

    Tanyse Bahia Carvalho Marques

    2014-10-01

    Full Text Available OBJECTIVE: Respiratory complications are the main causes of morbidity and mortality in patients with neuromuscular disease (NMD. The objectives of this study were to determine the effects that routine daily home air-stacking maneuvers have on pulmonary function in patients with spinal muscular atrophy (SMA and in patients with congenital muscular dystrophy (CMD, as well as to identify associations between spinal deformities and the effects of the maneuvers. METHODS: Eighteen NMD patients (ten with CMD and eight with SMA were submitted to routine daily air-stacking maneuvers at home with manual resuscitators for four to six months, undergoing pulmonary function tests before and after that period. The pulmonary function tests included measurements of FVC; PEF; maximum insufflation capacity (MIC; and assisted and unassisted peak cough flow (APCF and UPCF, respectively with insufflations. RESULTS: After the use of home air-stacking maneuvers, there were improvements in the APCF and UPCF. In the patients without scoliosis, there was also a significant increase in FVC. When comparing patients with and without scoliosis, the increases in APCF and UPCF were more pronounced in those without scoliosis. CONCLUSIONS: Routine daily air-stacking maneuvers with a manual resuscitator appear to increase UPCF and APCF in patients with NMD, especially in those without scoliosis.

  8. Stigma Among California's Medical Marijuana Patients

    OpenAIRE

    Satterlund, Travis D.; Lee, Juliet P.; Moore, Roland S.

    2015-01-01

    The enactment of California's Proposition 215 stipulates that patients may use marijuana for medical reasons, provided that it is recommended by a physician. Yet, medical marijuana patients risk being stigmatized for this practice. This paper examines the way in which medical marijuana patients perceive and process stigma, and how it affects their interactions and experiences with others. Eighteen semi-structured interviews of medical marijuana patients were carried out using a semi-structure...

  9. Improving anxiety regulation in patients with breast cancer at the beginning of the survivorship period: a randomized clinical trial comparing the benefits of single-component and multiple-component group interventions.

    Science.gov (United States)

    Merckaert, Isabelle; Lewis, Florence; Delevallez, France; Herman, Sophie; Caillier, Marie; Delvaux, Nicole; Libert, Yves; Liénard, Aurore; Nogaret, Jean-Marie; Ogez, David; Scalliet, Pierre; Slachmuylder, Jean-Louis; Van Houtte, Paul; Razavi, Darius

    2017-08-01

    To compare in a multicenter randomized controlled trial the benefits in terms of anxiety regulation of a 15-session single-component group intervention (SGI) based on support with those of a 15-session multiple-component structured manualized group intervention (MGI) combining support with cognitive-behavioral and hypnosis components. Patients with nonmetastatic breast cancer were randomly assigned at the beginning of the survivorship period to the SGI (n = 83) or MGI (n = 87). Anxiety regulation was assessed, before and after group interventions, through an anxiety regulation task designed to assess their ability to regulate anxiety psychologically (anxiety levels) and physiologically (heart rates). Questionnaires were used to assess psychological distress, everyday anxiety regulation, and fear of recurrence. Group allocation was computer generated and concealed till baseline completion. Compared with patients in the SGI group (n = 77), patients attending the MGI group (n = 82) showed significantly reduced anxiety after a self-relaxation exercise (P = .006) and after exposure to anxiety triggers (P = .013) and reduced heart rates at different time points throughout the task (P = .001 to P = .047). The MGI participants also reported better everyday anxiety regulation (P = .005), greater use of fear of recurrence-related coping strategies (P = .022), and greater reduction in fear of recurrence-related psychological distress (P = .017) compared with the SGI group. This study shows that an MGI combining support with cognitive-behavioral techniques and hypnosis is more effective than an SGI based only on support in improving anxiety regulation in patients with breast cancer. Copyright © 2016 John Wiley & Sons, Ltd.

  10. [The analysis of the judicial practice of treating the civil lawsuits concerning the inadequate dental health service appeals launched by the patients in the Russian Federation during the period from 1993 to 2017].

    Science.gov (United States)

    Andreeva, S N; Gusarov, A A; Fetisov, V A

    2018-01-01

    The objective of the present study was to elucidate the characteristic features and peculiarities in the dynamic of the civil legal proceedings concerning the quality of the stomatological aid to the population of the Russian Federation during the period from 1993 to 2017. We have undertaken the analysis of the official sources containing the court reports on the statements of claim launched by the patients. The study gave evidence of the currently well apparent sustained tendency toward the increase in the number of such civil lawsuits. The probabilities of legal proceedings in connection with the unfavourable outcomes of the dental treatment are roughly identical in all areas of the stomatological practice. The maximum number of the respective civil lawsuits arise from the claims of the patients against the dental surgeons employed by the healthcare settings designated as the limited liability companies. The majority of the statements of case coming from the patients contain the demanding financial claims for the compensation of the moral damage. It is concluded that the aforementioned tendencies in the strategy of the development of the stomatological aid for the population of the Russian Federation dictate the necessity of the priority development of the quality standards (including the clinical guidelines, protocols, etc.) designed to improve the medical assistance for the patients presenting with dental problems, the modernization of the validated methods for the evaluation of the effectiveness of the stomatological aid for the population, the implementation of the measures needed to introduce the mechanisms of professional liability insurance into the routine stomatological practice. These measures are believed to allow to meet the demand of the population of this country for the high-quality stomatological services.

  11. Bioequivalence of Liposome-Entrapped Paclitaxel Easy-To-Use (LEP-ETU) formulation and paclitaxel in polyethoxylated castor oil: a randomized, two-period crossover study in patients with advanced cancer.

    Science.gov (United States)

    Slingerland, Marije; Guchelaar, Henk-Jan; Rosing, Hilde; Scheulen, Max E; van Warmerdam, Laurence J C; Beijnen, Jos H; Gelderblom, Hans

    2013-12-01

    Preclinical studies comparing paclitaxel formulated with polyethoxylated castor oil with the sonicated formulation of liposome-entrapped paclitaxel (LEP) have demonstrated that LEP was associated with reduced toxicity while maintaining similar efficacy. Preliminary studies on the pharmacokinetics in patients support earlier preclinical data, which suggested that the LEP Easy-to-Use (LEP-ETU) formulation and paclitaxel formulated with castor oil may have comparable pharmacokinetic properties. Our objectives were: (1) to determine bioequivalence of paclitaxel pharmaceutically formulated as LEP-ETU (test) and paclitaxel formulated with castor oil (reference); and (2) to assess the tolerability of LEP-ETU following intravenous administration. Patients with advanced cancer were studied in a randomized, 2-period crossover bioequivalence study. Patients received paclitaxel 175 mg/m(2) administered as an intravenous infusion over 180 minutes, either as a single-treatment cycle of the test formulation followed by a single-treatment cycle of the reference formulation, or vice versa. Thirty-two of 58 patients were evaluable and were included in the analysis for bioequivalence. Mean total paclitaxel Cmax values for the test and reference formulations were 4955.0 and 5108.8 ng/mL, respectively. Corresponding AUC0-∞ values were 15,853.8 and 18,550.8 ng·h/mL, respectively. Treatment ratios of the geometric means were 97% (90% CI, 91%-103%) for Cmax and 84% (90% CI, 80%-90%) for AUC0-∞. These results met the required 80% to 125% bioequivalence criteria. The most frequently reported adverse events after LEP-ETU administration were fatigue, alopecia, and myalgia. At the studied dose regimen, LEP-ETU showed bioequivalence with paclitaxel formulated with polyethoxylated castor oil. © 2013 Elsevier HS Journals, Inc. All rights reserved.

  12. Periodic table of elements

    International Nuclear Information System (INIS)

    Fluck, E.; Heumann, K.G.

    1985-01-01

    Following a recommendation by the International Union for Pure and Applied Chemistry (IUPAC), the groups of the periodic table shall be numbered from 1 to 18, instead of I to VIII as before. The recommendations has been approved of by the Committee on Nomenclature of the American Chemical Society. The new system abandons the distinction between main groups (a) and auxiliary groups (b), which in the past frequently has been the reason for misunderstandings between European and American chemists, due to different handling. The publishing house VCH Verlagsgesellschaft recently produced a new periodic table that shows the old and the new numbering system together at a glance, so that chemists will have time to get familiar with the new system. In addition the new periodic table represents an extensive data compilation arranged by elements. The front page lists the chemical properties of elements, the back page their physical properties. (orig./EF) [de

  13. Periodically poled silicon

    Science.gov (United States)

    Hon, Nick K.; Tsia, Kevin K.; Solli, Daniel R.; Khurgin, Jacob B.; Jalali, Bahram

    2010-02-01

    Bulk centrosymmetric silicon lacks second-order optical nonlinearity χ(2) - a foundational component of nonlinear optics. Here, we propose a new class of photonic device which enables χ(2) as well as quasi-phase matching based on periodic stress fields in silicon - periodically-poled silicon (PePSi). This concept adds the periodic poling capability to silicon photonics, and allows the excellent crystal quality and advanced manufacturing capabilities of silicon to be harnessed for devices based on χ(2)) effects. The concept can also be simply achieved by having periodic arrangement of stressed thin films along a silicon waveguide. As an example of the utility, we present simulations showing that mid-wave infrared radiation can be efficiently generated through difference frequency generation from near-infrared with a conversion efficiency of 50% based on χ(2) values measurements for strained silicon reported in the literature [Jacobson et al. Nature 441, 199 (2006)]. The use of PePSi for frequency conversion can also be extended to terahertz generation. With integrated piezoelectric material, dynamically control of χ(2)nonlinearity in PePSi waveguide may also be achieved. The successful realization of PePSi based devices depends on the strength of the stress induced χ(2) in silicon. Presently, there exists a significant discrepancy in the literature between the theoretical and experimentally measured values. We present a simple theoretical model that produces result consistent with prior theoretical works and use this model to identify possible reasons for this discrepancy.

  14. Hereditary periodic fever syndromes

    NARCIS (Netherlands)

    McDermott, MF; Frenkel, J

    Hereditary periodic fever syndromes are defined by recurrent attacks of generalised inflammation for which no infectious or auto-immune cause can be identified. For most of these disorders, the molecular basis has recently been elucidated. This has opened the prospect of novel therapeutic

  15. Almost periodic Schroedinger operators

    International Nuclear Information System (INIS)

    Bellissard, J.; Lima, R.

    1984-01-01

    These lectures are devoted to recent developments in the theory of almost-periodic Schroedinger Operators. We specially describe the algebraic point of view, with applications to gap-labelling theorems. Particular models are also presented which exhibit various spectral properties. (orig.)

  16. Astrophysical implications of periodicity

    International Nuclear Information System (INIS)

    Muller, R.A.

    1988-01-01

    Two remarkable discoveries of the last decade have profound implications for astrophysics and for geophysics. These are the discovery by Alvarez et al., that certain mass extinctions are caused by the impact on the earth of a large asteroid or comet, and the discovery by Raup and Sepkoski that such extinctions are periodic, with a cycle time of 26 to 30 million years. The validity of both of these discoveries is assumed and the implications are examined. Most of the phenomena described depend not on periodicity, but just on the weaker assumption that the impacts on the earth take place primarily in showers. Proposed explanations for the periodicity include galactic oscillations, the Planet X model, and the possibility of Nemesis, a solar companion star. These hypotheses are critically examined. Results of the search for the solar companion are reported. The Deccan flood basalts of India have been proposed as the impact site for the Cretaceous impact, but this hypotheisis is in contradiction with the conclusion of Courtillot et al., that the magma flow began during a period of normal magnetic field. A possible resolution of this contradiction is proposed

  17. Periodic Table of Students.

    Science.gov (United States)

    Johnson, Mike

    1998-01-01

    Presents an exercise in which an eighth-grade science teacher decorated the classroom with a periodic table of students. Student photographs were arranged according to similarities into vertical columns. Students were each assigned an atomic number according to their placement in the table. The table is then used to teach students about…

  18. A Modern Periodic Table.

    Science.gov (United States)

    Herrenden-Harker, B. D.

    1997-01-01

    Presents a modern Periodic Table based on the electron distribution in the outermost shell and the order of filling of the sublevels within the shells. Enables a student to read off directly the electronic configuration of the element and the order in which filling occurs. (JRH)

  19. Prosthetic Management of Patients Presenting with Juvenile ...

    African Journals Online (AJOL)

    Eighteen were referred for prosthetic replacement. Their age ranged between 18 and 36 years. A total of 24 removable partial dentures were fabricated, 17[70.8%] were kennedy class III type, of which 11[64.7%] had the bounded saddle located in the anterior segment. Majority 8[44.4%] of the patients had 2-4 teeth replaced ...

  20. Diagnósticos de enfermagem do paciente no período pós-operatório imediato Nursing diagnoses of the patient in the immediate post-operative period

    Directory of Open Access Journals (Sweden)

    Lídia Aparecida Rossi

    2000-06-01

    Full Text Available O objetivo deste estudo foi identificar os diagnósticos de enfermagem mais freqüentes de pacientes em pós-operatório imediato. Foi elaborada uma ficha de avaliação pós-anestésica do período pós-operatório que foi utilizada em 28 pacientes nas primeiras duas horas em que permaneceram em centro de recuperação pós-anestésica. Os diagnósticos de enfermagem foram estabelecidos com base na Taxionomia I dos Diagnósticos de Enfermagem da North American Nursing Diagnosis Association -NANDA. Foram identificados os seguintes diagnósticos: risco para injúria (100,0%, risco para infecção (92,8%, senso-percepção alterada (89,2%, risco para aspiração (82,1%, mobilidade física prejudicada (71,4%, integridade tissular prejudicada (82,1% e hipotermia (67,8%.The aim of this study was to identify the nursing diagnoses that are more f requent in patients in immediate post-operative period. Data were collected and recorded on specially cards, through evaluation of 28 patients in the f irst two hours af ter the admission of the patient. The nursing diagnoses were set by one of the authors, based on Taxonomy I, proposed by North American Nursing Diagnosis Association - NANDA. The diagnoses that occurred mostly were: Risk for injury (100,0%, Risk for inf ection (92,8% , Sensory perceptual al terations (89,2% , Risk for aspiration (82,1% , Impaired physical mobility (71,4%, Impaired tissue integrity (82,1% and Hypothermia (67,8%.

  1. Your First Period

    Science.gov (United States)

    ... your menstrual flow. They come in different sizes, styles, and thicknesses. Some have extra material on the ... Bulletins Patient Education Green Journal Clinical Updates Practice Management Coding Health Info Technology Professional Liability Managing Your ...

  2. Effect of Nigella sativa supplementation over a one-year period on lipid levels, blood pressure and heart rate in type-2 diabetic patients receiving oral hypoglycemic agents: nonrandomized clinical trial.

    Science.gov (United States)

    Badar, Ahmed; Kaatabi, Huda; Bamosa, Abdullah; Al-Elq, Abdulmohsen; Abou-Hozaifa, Bodour; Lebda, Fatma; Alkhadra, Akram; Al-Almaie, Sameeh

    2017-01-01

    Diabetic patients with hypertension and dyslipidemia are at a high risk of cardiovascular complications. To determine the effect of Nigella sativa supplementation on the lipid profile, mean arterial pressure, and heart rate in persons with type 2 diabetes on oral hypoglycemic agents (OHA). Single-blind, nonrandomized. Diabetes clinic of a university hospital in Saudi Arabia. Type-2 diabetic patients were recruited by purposive sampling and assigned to treatment or control at the discretion of the investigator with the patient blinded to treatment. Before the in.tervention and every 3 months thereafter until the end of the treatment period, the following parameters were measured: triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and body mass index (BMI). Results at the baseline and each subsequent visit were compared between the two groups. Lipid and cardiovascular parameters, and BMI. Fifty-seven patients were assigned to receive N sativa 2 g daily for one year and 57 were assigned to receive an identical regimen of placebo, along with OHA. A significant decrease in HDL-C and increase in the TC/HDL-C and LDL-C/HDL-C ratios were seen in the control group. The N sativa group had a signifi.cant decline in TC, LDL-C, TC/HDL-C and LDL-C/HDL-C ratios, compared with the respective baseline data and the control group. HDL-C was significantly elevated in the N sativa group. The control group showed a significant elevation in MAP. The N sativa group had a significant reduction in SBP, DBP, MAP and HR and a significant decrease in DBP, MAP and HR as compared with the control group. N sativa supplementation improves total cholesterol, mean arterial pressure and heart rate in type 2 diabetes patients on oral hypoglycemic agents. There were 9 subjects in each group lost to follow up

  3. Optimal glucose management in the perioperative period.

    Science.gov (United States)

    Evans, Charity H; Lee, Jane; Ruhlman, Melissa K

    2015-04-01

    Hyperglycemia is a common finding in surgical patients during the perioperative period. Factors contributing to poor glycemic control include counterregulatory hormones, hepatic insulin resistance, decreased insulin-stimulated glucose uptake, use of dextrose-containing intravenous fluids, and enteral and parenteral nutrition. Hyperglycemia in the perioperative period is associated with increased morbidity, decreased survival, and increased resource utilization. Optimal glucose management in the perioperative period contributes to reduced morbidity and mortality. To readily identify hyperglycemia, blood glucose monitoring should be instituted for all hospitalized patients. Published by Elsevier Inc.

  4. Thyrotoxic periodic paralysis

    International Nuclear Information System (INIS)

    Ferreiro, J.E.; Arguelles, D.J.; Rams, H. Jr.

    1986-01-01

    A case of thyrotoxic periodic paralysis is reported in a Hispanic man with an unusual recurrence six weeks after radioactive iodine treatment. Thyrotoxic periodic paralysis has now been well characterized in the literature: it occurs primarily in Orientals with an overwhelming male preponderance and a higher association of specific HLA antigens. Clinical manifestations include onset after high carbohydrate ingestion or heavy exertion, with progressive symmetric weakness leading to flaccid paralysis of the extremities and other muscle groups, lasting several hours. If hypokalemia is present, potassium administration may help abort the attack. Although propranolol can be efficacious in preventing further episodes, the only definitive treatment is establishing a euthyroid state. The pathophysiology is still controversial, but reflects altered potassium and calcium dynamics as well as certain morphologic characteristics within the muscle unit itself

  5. The effect of Saccharomyces boulardii in patients eligible for liver transplantation.

    Science.gov (United States)

    Liboredo, Juliana Costa; Ferrari, Maria de Lourdes Abreu; Vilela, Eduardo Garcia; Lima, Agnaldo Soares; Correia, Maria Isabel Toulson Davisson

    2014-09-12

    The aim of this study was to evaluate the influence of Saccharomyces boulardii on the intestinal permeability, laboratory parameters and MELD and Child-Pugh severity scores in cirrhotic patients eligible for liver transplantation. Eighteen patients followed in a Transplant Outpatient Clinic were evaluated immediately before the beginning of treatment, after a 30-day period of treatment period with probiotics and at the end of the second study month (after a thirty-day period without probiotics). Fifteen healthy controls also underwent the intestinal permeability test (lactulose/mannitol). Before the probiotic, the median lactulose/ mannitol ratio was greater in the cirrhotic patients (0.0209, range 0.0012-0.1984) compared to the healthy controls (0.0030, range 0.0020-0.0013) (p boulardii, there was no improvement in intestinal permeability or significant differences in the laboratory parameters for the three evaluations. Patients eligible for liver transplants presented with increased intestinal permeability compared to healthy controls. A thirty-day treatment with S. boulardii did not improve this intestinal permeability or the severity scores, nor did it impact the laboratory parameters. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  6. Study of the efficiency of AgCl, In2O3, Ga2O3, NaF, LiF and SrF2 as spectrographic carriers in the quantitative analysis of eighteen microcompound elements in uranium

    International Nuclear Information System (INIS)

    Gomes, R.P.; Lordello, A.R.; Abrao, A.

    1977-01-01

    A comparative study of the efficiency of some spectrochemical carriers (AgCl, In 2 O 3 , Ga 2 O 3 , NaF, LiF and SrF 2 ) is presented for the quantitative spectrographic analysis of Ag, Al, B, Bi, Cd, Cr, Cu, Fe, Mg, Mn, Mo, Ni, P, Pb, Si, Sn, V and Zn in uranium and its compounds. The volatility behaviour of the eighteen elements was verified by means of the moving plate technique for each of the mentioned carriers. The final aim was the selection of the carriers for the determination of trace amounts of the impurities. The best results were obtained with 4% In 2 O 3 , 6% AgCl and 6% NaF in a U 3 O 8 matrix. The sensitivities for some elements were extended to fractions of p.p.m. The precision, accuracy and acceptability of the method were calculated for all elements. The total error values are approximately in the range of 16-45% [pt

  7. Polysheroidal periodic functions

    International Nuclear Information System (INIS)

    Truskova, N.F.

    1985-01-01

    Separation of variables in the Helmholtz N-dimensional (N≥4) equation in polyspheroidal coordinate systems leads to the necessity of solving equations going over into equations for polyspheroidal periodic functions used for solving the two-centre problem in quantum mechanics, the three-body problem with Coulomb interaction, etc. For these functions the expansions are derived in terms of the Jacobi polynomials and Bessel functions. Their basic properties, asymptotics are considered. The algorithm of their computer calculations is developed. The results of numerical calculations are given

  8. Deciphering Periodic Methanol Masers

    Science.gov (United States)

    Stecklum, Bringfried; Caratti o Garatti, Alessio; Henning, Thomas; Hodapp, Klaus; Hopp, Ulrich; Kraus, Alex; Linz, Hendrik; Sanna, Alberto; Sobolev, Andrej; Wolf, Verena

    2018-05-01

    Impressive progress has been made in recent years on massive star formation, yet the involved high optical depths even at submm/mm wavelengths make it difficult to reveal its details. Recently, accretion bursts of massive YSOs have been identified to cause flares of Class II methanol masers (methanol masers for short) due to enhanced mid-IR pumping. This opens a new window to protostellar accretion variability, and implies that periodic methanol masers hint at cyclic accretion. Pinning down the cause of the periodicity requires joint IR and radio monitoring. We derived the first IR light curve of a periodic maser host from NEOWISE data. The source, G107.298+5.639, is an intermediate-mass YSO hosting methanol and water masers which flare every 34.5 days. Our recent joint K-band and radio observations yielded first but marginal evidence for a phase lag between the rise of IR and maser emission, respectively, and revealed that both NEOWISE and K-band light curves are strongly affected by the light echo from the ambient dust. Both the superior resolution of IRAC over NEOWISE and the longer wavelengths compared to our ground-based imaging are required to inhibit the distractive contamination by the light echo. Thus, we ask for IRAC monitoring of G107 to cover one flare cycle, in tandem with 100-m Effelsberg and 2-m Wendelstein radio and NIR observations to obtain the first high-quality synoptic measurements of this kind of sources. The IR-maser phase lag, the intrinsic shape of the IR light curves and their possible color variation during the cycle allow us to constrain models for the periodic maser excitation. Since methanol masers are signposts of intermediate-mass and massive YSOs, deciphering their variability offers a clue to the dynamics of the accretion-mediated growth of massive stars and their feedback onto the immediate natal environment. The Spitzer light curve of such a maser-hosting YSO would be a legacy science product of the mission.

  9. Prophylactic transabdominal amnioinfusion in oligohydramnios for preterm premature rupture of membranes: increase of amniotic fluid index during latency period.

    Science.gov (United States)

    Garzetti, G G; Ciavattini, A; De Cristofaro, F; La Marca, N; Arduini, D

    1997-01-01

    This study was designed to: (i) evaluate the effect of amnioinfusion on the latency period in patients with oligohydramnios for preterm premature rupture of membranes, and (ii) to investigate the relationship between changes in the amniotic fluid index and fetal heart rate short-term variability by computerized Hewlett-Packard cardiotocography, longitudinally estimated before and after prophylactic amnioinfusion. All singleton pregnancies with prolonged premature rupture of membranes after 25 weeks of gestation and seen at the Institute of Obstetrics and Gynecology, University of Ancona (Italy), between January 1994 and June 1995 were included in the study. Transabdominal amnioinfusion with 150-350 ml warmed normal saline (25-50 ml/min) was performed at weekly intervals. Amniotic fluid volume was assessed ultrasonographically by means of the four-quadrant technique on a weekly basis before and after each amnioinfusion, as well as the short-term variability by a Hewlett-Packard computerized cardiotocographic system. 18 women were enrolled and underwent prophylactic transabdominal amnioinfusion at weekly intervals until delivery. Eighteen controls, who did not undergo prophylactic amnioinfusion, were recruited from our 1992-1993 series and included in the study. The median interval between premature rupture of membranes and delivery was 3.0 weeks (range 1-8 weeks), with an average delivery age of 33.0 weeks (range 27-36 weeks). The latency period was significantly longer in patients who underwent prophylactic amnioinfusion (mean +/- SD, 4.1 +/- 1.7 weeks) than in controls(1.7 +/- 1.0 weeks; p amnioinfusion. A direct relationship was observed between the amniotic fluid index and short-term variability (linear regression analysis r = 0.54, p = 0.04). The mean values of fetal movements recorded by computerized tomography during the 20 min of observation significantly increased after amnioinfusion in comparison with those before it (2.6 +/- 0.9 and 0.9 +/- 0

  10. Steady-state kinetics and dynamics of morphine in cancer patients

    DEFF Research Database (Denmark)

    Christrup, Lona Louring; Sjøgren, P; Jensen, N H

    1999-01-01

    Eighteen patients suffering from chronic pain due to cancer completed a balanced, double-blind, double-dummy, two period cross-over trial comparing the pharmacokinetics (PK) and pharmacodynamics (PD) of morphine and its metabolites, morphine-3-glucuronide and morphine-6-glucuronide, after...... samples for analysis of morphine, morphine-3-glucuronide, and morphine-6-glucuronide were obtained. Pain intensity, sedation, and continuous reaction time (CRT) were assessed. No significant differences could be demonstrated in AUC/dose, Cmin, Cmax or fluctuation index values between the two treatments...... and the variability in the data, the statistical power of the test was only 0.074. The risk of a type II error is 0.926. These data demonstrate the PK and PD similarities and differences between CR and IR morphine. They suggest that there may be a relationship between Tmax (determined by absorption rate) and sedation...

  11. Acute effect of weight loss on levels of total bilirubin in obese, cardiovascular high-risk patients: an analysis from the lead-in period of the Sibutramine Cardiovascular Outcome trial

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Weeke, Peter; Fosbøl, Emil Loldrup

    2009-01-01

    Low levels of bilirubin are associated with an increased risk of cardiovascular adverse events. Weight reduction is known to reduce several cardiovascular risk factors, but effects on bilirubin levels have not been reported. We studied the response of weight loss therapy with sibutramine and life......Low levels of bilirubin are associated with an increased risk of cardiovascular adverse events. Weight reduction is known to reduce several cardiovascular risk factors, but effects on bilirubin levels have not been reported. We studied the response of weight loss therapy with sibutramine...... and lifestyle change on levels of total bilirubin in an overweight or obese, cardiovascular high-risk population. Data from the first 4 weeks of the lead-in period of the Sibutramine Cardiovascular Outcome study were analyzed. A total of 10 198 patients provided body weight measurements before and after 4 weeks...... of sibutramine treatment (10 mg daily), of whom 1059 (10.4%) gained weight, 1467 (13.7%) lost greater than 0% to 1%, 2492 (23.2%) lost greater than 1% to 2%, 2280 (21.2%) lost greater than 2% to 3%, 1498 (13.9%) lost greater than 3% to 4%, and 1402 (13.1%) lost greater than 4% of their initial weight...

  12. Experience with polyclonal immunoglobulin therapy in poly trauma patients with severe sepsis

    International Nuclear Information System (INIS)

    Janjua, S.K.; Hussain, R.M.; Mohsin, S.T.; Iqbal, A.; Mishwani, A.H.

    2011-01-01

    To evaluate the effects of intravenous immunoglobulin therapy on progression of severe sepsis in patients of poly trauma. Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital Peshawar from June 2008 to Dec 2009. Patients and Methods: Forty six patients of poly trauma with severe sepsis were included. Along with the standard management i.e., surgical management, fluid resuscitation, antibiotics, analgesics, ionotropic, ventilatory and nutritional support, IVIG 5% (intravenous immunoglobulin) was infused over a period of 6 hours and repeated for three consecutive days. Sequential Organ Failure Assessment (SOFA) score was used to assess the progress in all the patients. Results: At the time of enrolment mean SOFA score was 5.41+- 1.127 and on the 15 day it was 1.62 +- 2.24, mean age was 39.21+10.26 years. Thirty four patients (73.91%) developed gram negative sepsis and eighteen patients (39.13%) developed septic shock. Mean duration of stay in ICU and on ventilatory support was 20.80+9.61 and 10.52 + 5.52 days respectively. Thirty five days mortality rate of these patients was 30.43%. Conclusion: The IVIG administration, when used along with the standard management appears to improve significantly the prognosis in patients of poly trauma with severe sepsis. (author)

  13. Periodically modulated dark states

    Science.gov (United States)

    Han, Yingying; Zhang, Jun; Zhang, Wenxian

    2018-04-01

    Phenomena of electromagnetically induced transparency (PEIT) may be interpreted by the Autler-Townes Splitting (ATS), where the coupled states are split by the coupling laser field, or by the quantum destructive interference (QDI), where the atomic phases caused by the coupling laser and the probe laser field cancel. We propose modulated experiments to explore the PEIT in an alternative way by periodically modulating the coupling and the probe fields in a Λ-type three-level system initially in a dark state. Our analytical and numerical results rule out the ATS interpretation and show that the QDI interpretation is more appropriate for the modulated experiments. Interestingly, dark state persists in the double-modulation situation where control and probe fields never occur simultaneously, which is significant difference from the traditional dark state condition. The proposed experiments are readily implemented in atomic gases, artificial atoms in superconducting quantum devices, or three-level meta-atoms in meta-materials.

  14. A periodic table for cancer.

    Science.gov (United States)

    Epstein, Richard J

    2015-01-01

    Cancers exhibit differences in metastatic behavior and drug sensitivity that correlate with certain tumor-specific variables such as differentiation grade, growth rate/extent and molecular regulatory aberrations. In practice, patient management is based on the past results of clinical trials adjusted for these biomarkers. Here, it is proposed that treatment strategies could be fine-tuned upfront simply by quantifying tumorigenic spatial (cell growth) and temporal (genetic stability) control losses, as predicted by genetic defects of cell-cycle-regulatory gatekeeper and genome-stabilizing caretaker tumor suppressor genes, respectively. These differential quantifications of tumor dysfunction may in turn be used to create a tumor-specific 'periodic table' that guides rational formulation of survival-enhancing anticancer treatment strategies.

  15. [Childhood periodic syndromes].

    Science.gov (United States)

    Cuvellier, J-C; Lépine, A

    2010-01-01

    This review focuses on the so-called "periodic syndromes of childhood that are precursors to migraine", as included in the Second Edition of the International Classification of Headache Disorders. Three periodic syndromes of childhood are included in the Second Edition of the International Classification of Headache Disorders: abdominal migraine, cyclic vomiting syndrome and benign paroxysmal vertigo, and a fourth, benign paroxysmal torticollis is presented in the Appendix. The key clinical features of this group of disorders are the episodic pattern and intervals of complete health. Episodes of benign paroxysmal torticollis begin between 2 and 8 months of age. Attacks are characterized by an abnormal inclination and/or rotation of the head to one side, due to cervical dystonia. They usually resolve by 5 years. Benign paroxysmal vertigo presents as sudden attacks of vertigo, accompanied by inability to stand without support, and lasting seconds to minutes. Age at onset is between 2 and 4 years, and the symptoms disappear by the age of 5. Cyclic vomiting syndrome is characterized in young infants and children by repeated stereotyped episodes of pernicious vomiting, at times to the point of dehydration, and impacting quality of life. Mean age of onset is 5 years. Abdominal migraine remains a controversial issue and presents in childhood with repeated stereotyped episodes of unexplained abdominal pain, nausea and vomiting occurring in the absence of headache. Mean age of onset is 7 years. Both cyclic vomiting syndrome and abdominal migraine are noted for the absence of pathognomonic clinical features but also for the large number of other conditions to be considered in their differential diagnoses. Diagnostic criteria, such as those of the Second Edition of the International Classification of Headache Disorders and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, have made diagnostic approach and management easier. Their diagnosis

  16. Nonparametric Inference for Periodic Sequences

    KAUST Repository

    Sun, Ying; Hart, Jeffrey D.; Genton, Marc G.

    2012-01-01

    the periodogram, a widely used tool for period estimation. The CV method is computationally simple and implicitly penalizes multiples of the smallest period, leading to a "virtually" consistent estimator of integer periods. This estimator is investigated both

  17. Significance of abnormal myocardial perfusion scintigraphy in young adult patients with SLE

    International Nuclear Information System (INIS)

    Zakavi, S.R.; Kakhki, V.R.D.; Sadeghi, R.; Jokar, M.H.; Khazaei, G.

    2009-01-01

    Detection of subclinical coronary artery disease (CAD) is a potential challenge in patients with systemic lupus erythematosus (SLE) and it is suggested that myocardial perfusion single photon emission computerized tomography (SPECT) is more sensitive than exercise test in this setting. However, the significance of perfusion abnormalities in SLE patients is not well known. In this study, we evaluated the prognostic significance of myocardial perfusion defects in patients with SLE. Patients with proven diagnosis of SLE admitted to the hospital due to noncardiac problems with no history of CAD were studied. All patients underwent 99m Tc-methoxyisobutylisonitrile (MIBI) myocardial perfusion scan using dipyridamole as pharmacological stress. All patients were followed up by reviewing patients file in lupus clinic and any minor or major cardiac events were recorded. Eighteen female and two male patients with mean age of 28.2±12.05 years were included. Six patients had mild reversible perfusion defects with mean summed difference score of 2.5±1.0. Pattern of reverse redistribution (reverse fill-in) was noted in three patients. Eleven patients had normal myocardial perfusion. Hypokinesia was noted in three patients on gated images. One patient with abnormal perfusion died 21 days after imaging due to on-cardiac cause. Nineteen patients were followed for a mean time of 39.2±16.0 months. No major or minor cardiac events were noted during follow-up. Three patients (one with abnormal perfusion) had at least one readmission during follow-up period. Our study showed that myocardial perfusion abnormalities are fairly frequent in SLE patients but the defects are generally mild and do not advocate an adverse prognosis. (author)

  18. Clinical characteristics of pigment dispersion syndrome in Chinese patients.

    Science.gov (United States)

    Qing, G; Wang, N; Tang, X; Zhang, S; Chen, H

    2009-08-01

    To report clinical findings and characteristics of pigment dispersion syndrome (PDS) in Chinese patients. PDS suspects with any one of the following signs: corneal endothelial pigmentation, iris transillumination defects (ITDs), pigment granule dusting on anterior iris surface, posterior iris bowing, trabecular meshwork (TM) pigmentation, and lenticular or zonular pigmentation were evaluated for PDS at the glaucoma specialty clinic at Beijing Tongren Eye Centre. Diagnosis of PDS required at least two of the following signs: Krukenberg spindle, moderate-to-heavy TM pigmentation (>or=Scheie II) and any degree of lenticular and/or zonular pigmentation. Eighteen patients (12 males and six females) were identified as having PDS during a 1-year period, with mean age of 35.5+/-7.0 years (range, 22-49). All but two eyes from two patients had myopia of -0.5 D or greater, with mean spherical equivalent power of -5.20+/-5.80 D (range, -24.75+/-0.5). The average IOP at initial diagnosis was 33.7+/-10.5 mm Hg (range, 16-56). Fifteen patients (83.3%) were found to have pigmentary glaucoma at their initial diagnosis. All patients showed homogenous increased TM pigmentation as well as lenticular and/or zonular pigmentation. 61.1% of patients (11 of 18) had Krukenberg spindle. None of the patients exhibited spoke-like midperipheral ITDs except for trace-isolated transillumination in both eyes of the two patients. The most common clinical findings in Chinese PDS patients include homogeneous TM pigmentation and pigment granule dusting on lens zonules and/or posterior peripheral lens surface. ITDs are uncommon in Chinese patients with PDS.

  19. Episodic spontaneous hypothermia: a periodic childhood syndrome.

    Science.gov (United States)

    Ruiz, Cynthia; Gener, Blanca; Garaizar, Carmen; Prats, José M

    2003-04-01

    Episodic spontaneous hypothermia is an infrequent disorder, with unknown pathogenic mechanisms. A systemic cause or underlying brain lesion has not been found for the disease. We report four new patients, 3-9 years old, with episodic hypothermia lower than 35 degrees C, marked facial pallor, and absent shivering. The episodes could last a few hours or four days, and recurred once a week or every 2-3 months. Two patients also demonstrated bradycardia, mild hypertension, and somnolence during the events; in one of them, profuse sweating was also a feature, and all four presented with either headache, a periodic childhood syndrome, or both (recurrent abdominal pain, cyclic vomiting, or vertigo). Three patients reported a family history of migraine. Neurologic examination, endocrine function, and imaging studies were normal. Migraine prophylactic therapy was of moderate efficacy. Spontaneous resolution was observed in one patient. The clinical characteristics of the syndrome allow for its inclusion as a childhood periodic syndrome related to migraine.

  20. Testing periodically integrated autoregressive models

    NARCIS (Netherlands)

    Ph.H.B.F. Franses (Philip Hans); M.J. McAleer (Michael)

    1997-01-01

    textabstractPeriodically integrated time series require a periodic differencing filter to remove the stochastic trend. A non-periodic integrated time series needs the first-difference filter for similar reasons. When the changing seasonal fluctuations for the non-periodic integrated series can be

  1. A Web-based Game for Teaching Facial Expressions to Schizophrenic Patients.

    Science.gov (United States)

    Gülkesen, Kemal Hakan; Isleyen, Filiz; Cinemre, Buket; Samur, Mehmet Kemal; Sen Kaya, Semiha; Zayim, Nese

    2017-07-12

    Recognizing facial expressions is an important social skill. In some psychological disorders such as schizophrenia, loss of this skill may complicate the patient's daily life. Prior research has shown that information technology may help to develop facial expression recognition skills through educational software and games. To examine if a computer game designed for teaching facial expressions would improve facial expression recognition skills of patients with schizophrenia. We developed a website composed of eight serious games. Thirty-two patients were given a pre-test composed of 21 facial expression photographs. Eighteen patients were in the study group while 14 were in the control group. Patients in the study group were asked to play the games on the website. After a period of one month, we performed a post-test for all patients. The median score of the correct answers was 17.5 in the control group whereas it was 16.5 in the study group (of 21) in pretest. The median post-test score was 18 in the control group (p=0.052) whereas it was 20 in the study group (pgames may be used for the purpose of educating people who have difficulty in recognizing facial expressions.

  2. A study at Manchester Dental Hospital, of the compliance of IV sedation patients and their escorts.

    Science.gov (United States)

    Lightfoot, Kate

    2014-01-01

    Oral surgery, under intravenous sedation, is carried out on a daily basis at Manchester Dental Hospital. This essay discusses the background of conscious sedation in the dental setting and looks at the compliance of patients (and escorts) when having intravenous sedation. The patient journey, from pre-operative assessment through to treatment is considered. Hospital instructions indicate an obligation for patients to attend with a responsible adult (eighteen or over) who remains with them throughout their treatment, escorts them home,and arranges their care for the next twenty-four hours. By following these instructions the patient should receive optimal care. Two questionnaires were devised and given to patients/escorts to assess their compliance with Manchester Dental Hospital postoperative protocols. 100% compliance was the set standard, with results presented as pie charts. This work began during the undergraduate summer vacation of 2012 and continued over a five-month period. Initial results suggested that compliance was generally good but certain improvements could be made. Suggestions for future development are presented. These aim to give clarity to all patients/escorts and their specific roles in the anticipated treatment.

  3. Baseline MELD score predicts hepatic decompensation during antiviral therapy in patients with chronic hepatitis C and advanced cirrhosis.

    Directory of Open Access Journals (Sweden)

    Georg Dultz

    Full Text Available In patients with advanced liver cirrhosis due to chronic hepatitis C virus (HCV infection antiviral therapy with peginterferon and ribavirin is feasible in selected cases only due to potentially life-threatening side effects. However, predictive factors associated with hepatic decompensation during antiviral therapy are poorly defined.In a retrospective cohort study, 68 patients with HCV-associated liver cirrhosis (mean MELD score 9.18 ± 2.72 were treated with peginterferon and ribavirin. Clinical events indicating hepatic decompensation (onset of ascites, hepatic encephalopathy, upper gastrointestinal bleeding, hospitalization as well as laboratory data were recorded at baseline and during a follow up period of 72 weeks after initiation of antiviral therapy. To monitor long term sequelae of end stage liver disease an extended follow up for HCC development, transplantation and death was applied (240 weeks, ± SD 136 weeks.Eighteen patients (26.5% achieved a sustained virologic response. During the observational period a hepatic decompensation was observed in 36.8%. Patients with hepatic decompensation had higher MELD scores (10.84 vs. 8.23, p14, respectively. Baseline MELD score was significantly associated with the risk for transplantation/death (p<0.001.Our data suggest that the baseline MELD score predicts the risk of hepatic decompensation during antiviral therapy and thus contributes to decision making when antiviral therapy is discussed in HCV patients with advanced liver cirrhosis.

  4. Concurrent hypokalemic periodic paralysis and bipolar disorder

    Directory of Open Access Journals (Sweden)

    Chia-Lin Lin

    2015-01-01

    Full Text Available Primary periodic paralysis is a rare autosomal dominant disorder of ion-channel dysfunction, manifested by episodic flaccid paresis secondary to abnormal sarcolemma excitability. Membrane destabilization involving Na, K-ATPase has been hypothesized to be a biological etiology of the bipolar disorder (BD and the mechanisms underlying lithium therapy have been linked to it. To date, there has been only one reported case of BD comorbid with periodic paralysis. Herein, we reported another case of concurrent bipolar mania and hypokalemic periodic paralysis (HPP, one special form of periodic paralysis. Consistent with the previous case, our patient responded well to lithium treatment for both bipolar mania and HPP. This might provide some support to the hypothesis that the therapeutic effects of lithium in both BD and HPP could be due to the correction of the underlying common pathophysiology.

  5. Periodic feedback stabilization for linear periodic evolution equations

    CERN Document Server

    Wang, Gengsheng

    2016-01-01

    This book introduces a number of recent advances regarding periodic feedback stabilization for linear and time periodic evolution equations. First, it presents selected connections between linear quadratic optimal control theory and feedback stabilization theory for linear periodic evolution equations. Secondly, it identifies several criteria for the periodic feedback stabilization from the perspective of geometry, algebra and analyses respectively. Next, it describes several ways to design periodic feedback laws. Lastly, the book introduces readers to key methods for designing the control machines. Given its coverage and scope, it offers a helpful guide for graduate students and researchers in the areas of control theory and applied mathematics.

  6. The redoubtable ecological periodic table

    Science.gov (United States)

    Ecological periodic tables are repositories of reliable information on quantitative, predictably recurring (periodic) habitat–community patterns and their uncertainty, scaling and transferability. Their reliability derives from their grounding in sound ecological principle...

  7. Survival in adult patients with diagnosis of high-grade glioma located in the central nervous system, who were treated with radiotherapy and temozolamide at Hospital Mexico during the period from January 2009 to December 2011

    International Nuclear Information System (INIS)

    Chaves Porras, Jorge Alvaro

    2013-01-01

    The impact of survival is determined by the incorporation of the chemotherapeutic temozolamide into the therapy regimen of patients with high grade gliomas. Overall survival is determined in patients with high grade gliomas. The investigation is performed with the total of patients with high grade gliomas, with treatment of radiotherapy and temozolamide. Progression-free survival is determined in the population with high-grade gliomas at Hospital Mexico, from January 2009 to December 2011. The diagnosis of glioblastoma is given in 86% and astrocytoma grade III in 14% of the cases. The concomitance of radiotherapy with temozolomide is received by 33 of 37 patients. Seventy-six percent of patients completed the 6 cycles of adjuvant therapy. The overall survival rate was 14.39 months. Patients with grade III gliomas have had a better prognosis [es

  8. Radiological clinical correlation of pulmonary and extrapulmonary tuberculosis with CD4 T lymphocyte counts in patients with V.I.H. in the San Juan de Dios Hospital during the period 2004 to the first half of 2009

    International Nuclear Information System (INIS)

    Campos Fallas, Christian

    2010-01-01

    The association between radiographic presentation of tuberculosis (TB), pulmonary and extrapulmonary, and the count of CD4 T lymphocytes in patients infected with Human Immunodeficiency Virus (HIV), are investigated. The order has been to achieve a diagnosis and isolation early of coinfected patients. A retrospective analysis was performed of the clinical history, chest radiograph, CD4 T lymphocyte count of 25 HIV-infected patients with documented pulmonary or extrapulmonary tuberculosis diagnosis. 18 patients diagnosed (72%) with radiologic atypical skipper, 14 of them with significant immunosuppression (TB patients with CD4 T count <200 / mm 3 ), while only 6 (24%) with radiologic typical skipper of TB was associated with negative sputum smears (p=0.06). In HIV patients with CD4 T lymphocyte counts T <200 / mm 3 , no respiratory symptoms and atypical radiographic pattern, may be suspected active TB, even with negative sputum smears. (Author) [es

  9. Peripheral neuropathy due to therapy with paclitaxel, gemcitabine, and cisplatin in patients with advanced ovarian cancer.

    NARCIS (Netherlands)

    Verstappen, C.C.P.; Postma, T.J.; Hoekman, K.; Heimans, J.J.

    2003-01-01

    BACKGROUND: To evaluate the peripheral neuropathic changes induced by combination chemotherapy including paclitaxel (taxol), gemcitabine and cisplatin (TGC regimen). PATIENTS AND METHODS: Eighteen patients with primary or recurrent ovarian cancer were treated with paclitaxel 150 or 110 mg/m2,

  10. State of immune system in patients with cancer of the esophagus and proximal section of the stomach with passage on esophagus in the process of combined treatment and in delayed periods

    International Nuclear Information System (INIS)

    Kamenets, L.Ya.; Redkousova, S.F.; Kirkilevskij, S.I.; Mitrofanova, L.Yu.; Polinskaya, V.I.; Zamotaeva, G.A.

    1987-01-01

    Results of studying the state of immune system in 108 patients with cancer of the esophagus and in 194 patients with gastroesophagous cancer of the third stage without metastases and recurrences in the process of combined treatment and 12 months after it are presented. It is shown that shifts in the state of cellular and humoral immunity in these patients are intensified with the radiation and surgical treatment

  11. Possible Association between Serum Matrix Metalloproteinase-9 (MMP-9) Levels and Relapse in Depressed Patients following Electroconvulsive Therapy (ECT).

    Science.gov (United States)

    Shibasaki, Chiyo; Itagaki, Kei; Abe, Hiromi; Kajitani, Naoto; Okada-Tsuchioka, Mami; Takebayashi, Minoru

    2018-03-01

    Matrix metalloproteinases are involved in neuroinflammatory processes, which could underlie depression. Serum levels of MMP-9 and MMP-2 in depressed patients are significantly altered following electroconvulsive therapy, but an association between altered matrix metalloproteinases after successful ECT and possible relapse has yet to be investigated. Serum was obtained twice, before and immediately after a course of electroconvulsive therapy, from 38 depressed patients. Serum was also collected, once, from two groups of age- and gender-matched healthy controls, 40 volunteers in each group. Possible associations between levels of matrix metalloproteinases and relapse during a 1-year follow-up period were analyzed. Excluding patients who did not respond to electroconvulsive therapy and patients lost to follow-up, data from 28 patients were evaluated. Eighteen of the patients (64.3%) relapsed within 1 year. In the group that did not relapse, serum levels of MMP-9 were significantly decreased after a course of electroconvulsive therapy, but not in the group that relapsed. No association between MMP-2 and relapse was observed. The degree of change in serum MMP-9 change could be associated with relapse following electroconvulsive therapy in depressed patients. © The Author 2017. Published by Oxford University Press on behalf of CINP.

  12. Periodic waves in nonlinear metamaterials

    International Nuclear Information System (INIS)

    Liu, Wen-Jun; Xiao, Jing-Hua; Yan, Jie-Yun; Tian, Bo

    2012-01-01

    Periodic waves are presented in this Letter. With symbolic computation, equations for monochromatic waves are studied, and analytic periodic waves are obtained. Factors affecting properties of periodic waves are analyzed. Nonlinear metamaterials, with the continuous distribution of the dielectric permittivity obtained, are different from the ones with the discrete distribution. -- Highlights: ► Equations for the monochromatic waves in transverse magnetic polarization have been studied. ► Analytic periodic waves for the equations have been obtained. ► Periodic waves are theoretically presented and studied in the nonlinear metamaterials.

  13. Nonparametric Inference for Periodic Sequences

    KAUST Repository

    Sun, Ying

    2012-02-01

    This article proposes a nonparametric method for estimating the period and values of a periodic sequence when the data are evenly spaced in time. The period is estimated by a "leave-out-one-cycle" version of cross-validation (CV) and complements the periodogram, a widely used tool for period estimation. The CV method is computationally simple and implicitly penalizes multiples of the smallest period, leading to a "virtually" consistent estimator of integer periods. This estimator is investigated both theoretically and by simulation.We also propose a nonparametric test of the null hypothesis that the data have constantmean against the alternative that the sequence of means is periodic. Finally, our methodology is demonstrated on three well-known time series: the sunspots and lynx trapping data, and the El Niño series of sea surface temperatures. © 2012 American Statistical Association and the American Society for Quality.

  14. Suicide attempts and clinical features of bipolar patients

    OpenAIRE

    Berkol, Tongu? D.; ?slam, Serkan; K?rl?, Ebru; P?narba??, Rasim; ?zy?ld?r?m, ?lker

    2016-01-01

    Objectives: To identify clinical predictors of suicide attempts in patients with bipolar disorder. Methods: This study included bipolar patients who were treated in the Psychiatry Department, Haseki Training and Research Hospital, Istanbul, Turkey, between 2013 and 2014; an informed consent was obtained from the participants. Two hundred and eighteen bipolar patients were assessed by using the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition...

  15. Positive periodic solutions of delayed periodic Lotka-Volterra systems

    International Nuclear Information System (INIS)

    Lin Wei; Chen Tianping

    2005-01-01

    In this Letter, for a general class of delayed periodic Lotka-Volterra systems, we prove some new results on the existence of positive periodic solutions by Schauder's fixed point theorem. The global asymptotical stability of positive periodic solutions is discussed further, and conditions for exponential convergence are given. The conditions we obtained are weaker than the previously known ones and can be easily reduced to several special cases

  16. Photolysis of Periodate and Periodic Acid in Aqueous Solution

    DEFF Research Database (Denmark)

    Sehested, Knud; Kläning, U. K.

    1978-01-01

    The photochemistry of periodate and periodic acid in aqueous solution was studied (i) by quantum yield measurements at low light intensity (ii) by flash photolysis, and (iii) by photolysis of glassy samples at 77 K. The photochemical studies were supplemented with pulse radiolysis studies...... of aqueous periodate solutions and with kinetic studies using stopped-flow technique. In strongly alkaline solution the photodecomposition of periodate proceeds via formation of O– and IVI. At pH solution O3 P is formed in a small...

  17. Availability of 111In-labeled platelet scintigraphy in patients with postinfarction left ventricular aneurysm

    International Nuclear Information System (INIS)

    Tsuda, Takatoshi; Kubota, Masahiro; Iwakubo, Akifumi

    1989-01-01

    Eighteen patients with postinfarction left ventricular aneurysm (LVA) were examined with indium-111-labeled autologous platelet scintigraphy to identify intracardiac thrombi and to investigate the effect of antithrombotic agents on thrombogenesitiy within the LVA. Indium-111-platelet scintigraphy had a sensitivity of 60% and a specificity of 100% in detecting LVA mural thrombi. Among 6 patients showing false-negative scintigraphic studies, 4 was managed on antiplatelet therapy. Of 9 patients showing active platelet deposition on initial study, including 8 not receiving antiplatelet therapy, 5 were treated with tichlopidine (300 mg/day) for 29.8±5.0 days. For the 5 patients, 2 had resolution and the 3 others had interruption of intraaneurysmal deposition in the second platelet study. For one patient receiving the third platelet study after warfarin therapy, it took two weeks to completely interrupt platelet deposition within the LVA. ECG gated radionuclide ventriculography and thallium-201 myocardial SPECT were also performed to assess left ventricular wall motion of left ventricular ejection fraction (LVEF) and myocardial blood perfusion. Thallium-201 SPECT showed apical or anteroapical perfusion defects. Radionuclide ventriculography pinpointed all 18 apical and anteroseptal aneurysms. A comparison between the thrombus positive group and the thrombus negative group revealed no statistical differences in LVEF and the period from the last myocardial infarction to the initial platelet scanning. These results suggest that indium-111 labeled platelet scintigraphy may be useful for identifying active left ventricular mural thrombi and for judging antiplatelet and anticoagulant therapy. (Namekawa, K)

  18. Availability of /sup 111/In-labeled platelet scintigraphy in patients with postinfarction left ventricular aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Tsuda, Takatoshi; Kubota, Masahiro; Iwakubo, Akifumi and others

    1989-03-01

    Eighteen patients with postinfarction left ventricular aneurysm (LVA) were examined with indium-111-labeled autologous platelet scintigraphy to identify intracardiac thrombi and to investigate the effect of antithrombotic agents on thrombogenesitiy within the LVA. Indium-111-platelet scintigraphy had a sensitivity of 60% and a specificity of 100% in detecting LVA mural thrombi. Among 6 patients showing false-negative scintigraphic studies, 4 was managed on antiplatelet therapy. Of 9 patients showing active platelet deposition on initial study, including 8 not receiving antiplatelet therapy, 5 were treated with tichlopidine (300 mg/day) for 29.8+-5.0 days. For the 5 patients, 2 had resolution and the 3 others had interruption of intraaneurysmal deposition in the second platelet study. For one patient receiving the third platelet study after warfarin therapy, it took two weeks to completely interrupt platelet deposition within the LVA. ECG gated radionuclide ventriculography and thallium-201 myocardial SPECT were also performed to assess left ventricular wall motion of left ventricular ejection fraction (LVEF) and myocardial blood perfusion. Thallium-201 SPECT showed apical or anteroapical perfusion defects. Radionuclide ventriculography pinpointed all 18 apical and anteroseptal aneurysms. A comparison between the thrombus positive group and the thrombus negative group revealed no statistical differences in LVEF and the period from the last myocardial infarction to the initial platelet scanning. These results suggest that indium-111 labeled platelet scintigraphy may be useful for identifying active left ventricular mural thrombi and for judging antiplatelet and anticoagulant therapy. (Namekawa, K).

  19. MR imaging in the neonatal period

    International Nuclear Information System (INIS)

    Aida, Noriko; Inuzuka, Michiko; Odagiri, Kunio

    1994-01-01

    We reviewed 118 MR examinations in the neonatal period to define its indication, problem, and usefulness. The patients were 58 term infants under 28 days of age and 46 preterm infants under 46 week of their post conceptional age. Almost all patients were examined under sedation. We used pulse wave monitoring and respiration was monitored only by observing the chest motion. Hot water bags were used in some cases to keep the patient warm. No serious accidents or sequelae occurred, although a very few patients had a brief apnea attacks during sedation and some developed hypothermia after the examination. The MR provided many useful information such as basal ganglial lesions after perinatal asphyxia and multiplaner demonstration of the CN5 anomalies which no other modality could. The detection rate of abnormality in the study was about 65%. Although MR studies in the neonatal period have many difficulties to be overcome including sedation, maintenance of body temperature and monitoring, they can demonstrate useful information that are helpful for their early treatment and care. Thus we believe that the MR study should be performed in a more positive manner in a variety of clinical setting in the neonatal period. (author)

  20. MR imaging in the neonatal period

    Energy Technology Data Exchange (ETDEWEB)

    Aida, Noriko; Inuzuka, Michiko; Odagiri, Kunio (Kanagawa Children' s Medical Center (Japan))

    1994-01-01

    We reviewed 118 MR examinations in the neonatal period to define its indication, problem, and usefulness. The patients were 58 term infants under 28 days of age and 46 preterm infants under 46 week of their post conceptional age. Almost all patients were examined under sedation. We used pulse wave monitoring and respiration was monitored only by observing the chest motion. Hot water bags were used in some cases to keep the patient warm. No serious accidents or sequelae occurred, although a very few patients had a brief apnea attacks during sedation and some developed hypothermia after the examination. The MR provided many useful information such as basal ganglial lesions after perinatal asphyxia and multiplaner demonstration of the CN5 anomalies which no other modality could. The detection rate of abnormality in the study was about 65%. Although MR studies in the neonatal period have many difficulties to be overcome including sedation, maintenance of body temperature and monitoring, they can demonstrate useful information that are helpful for their early treatment and care. Thus we believe that the MR study should be performed in a more positive manner in a variety of clinical setting in the neonatal period. (author).

  1. From Periodic Properties to a Periodic Table Arrangement

    Science.gov (United States)

    Besalú, Emili

    2013-01-01

    A periodic table is constructed from the consideration of periodic properties and the application of the principal components analysis technique. This procedure is useful for objects classification and data reduction and has been used in the field of chemistry for many applications, such as lanthanides, molecules, or conformers classification.…

  2. Periodic instantons and scattering amplitudes

    International Nuclear Information System (INIS)

    Khlebnikov, S.Yu.; Rubakov, V.A.; Tinyakov, P.G.

    1991-04-01

    We discuss the role of periodic euclidean solutions with two turning points and zero winding number (periodic instantons) in instanton induced processes below the sphaleron energy E sph . We find that the periodic instantons describe certain multiparticle scattering events leading to the transitions between topologically distinct vacua. Both the semiclassical amplitudes and inital and final states of these transitions are determined by the periodic instantons. Furthermore, the corresponding probabilities are maximal among all states of given energy. We show that at E ≤ E sph , the periodic instantons can be approximated by infinite chains of ordinary instantons and anti-instantons, and they naturally emerge as deformations of the zero energy instanton. In the framework of 2d abelian Higgs model and 4d electroweak theory we show, however, that there is not obvious relation between periodic instantons and two-particle scattering amplitudes. (orig.)

  3. Nonoperative management for patients with grade IV blunt hepatic trauma

    Directory of Open Access Journals (Sweden)

    Zago Thiago

    2012-08-01

    Full Text Available Abstract Introduction The treatment of complex liver injuries remains a challenge. Nonoperative treatment for such injuries is increasingly being adopted as the initial management strategy. We reviewed our experience, at a University teaching hospital, in the nonoperative management of grade IV liver injuries with the intent to evaluate failure rates; need for angioembolization and blood transfusions; and in-hospital mortality and complications. Methods This is a retrospective analysis conducted at a single large trauma centre in Brazil. All consecutive, hemodynamically stable, blunt trauma patients with grade IV hepatic injury, between 1996 and 2011, were analyzed. Demographics and baseline characteristics were recorded. Failure of nonoperative management was defined by the need for surgical intervention. Need for angioembolization and transfusions, in-hospital death, and complications were also assessed Results Eighteen patients with grade IV hepatic injury treated nonoperatively during the study period were included. The nonoperative treatment failed in only one patient (5.5% who had refractory abdominal pain. However, no missed injuries and/or worsening of bleeding were observed during the operation. None of the patients died nor need angioembolization. No complications directly related to the liver were observed. Unrelated complications to the liver occurred in three patients (16.7%; one patient developed a tracheal stenosis (secondary to tracheal intubation; one had pleural effusion; and one developed an abscess in the pleural cavity. The hospital length of stay was on average 11.56 days. Conclusions In our experience, nonoperative management of grade IV liver injury for stable blunt trauma patients is associated with high success rates without significant complications.

  4. Nonoperative management for patients with grade IV blunt hepatic trauma.

    Science.gov (United States)

    Zago, Thiago Messias; Tavares Pereira, Bruno Monteiro; Araujo Calderan, Thiago Rodrigues; Godinho, Mauricio; Nascimento, Bartolomeu; Fraga, Gustavo Pereira

    2012-08-22

    The treatment of complex liver injuries remains a challenge. Nonoperative treatment for such injuries is increasingly being adopted as the initial management strategy. We reviewed our experience, at a University teaching hospital, in the nonoperative management of grade IV liver injuries with the intent to evaluate failure rates; need for angioembolization and blood transfusions; and in-hospital mortality and complications. This is a retrospective analysis conducted at a single large trauma centre in Brazil. All consecutive, hemodynamically stable, blunt trauma patients with grade IV hepatic injury, between 1996 and 2011, were analyzed. Demographics and baseline characteristics were recorded. Failure of nonoperative management was defined by the need for surgical intervention. Need for angioembolization and transfusions, in-hospital death, and complications were also assessed Eighteen patients with grade IV hepatic injury treated nonoperatively during the study period were included. The nonoperative treatment failed in only one patient (5.5%) who had refractory abdominal pain. However, no missed injuries and/or worsening of bleeding were observed during the operation. None of the patients died nor need angioembolization. No complications directly related to the liver were observed. Unrelated complications to the liver occurred in three patients (16.7%); one patient developed a tracheal stenosis (secondary to tracheal intubation); one had pleural effusion; and one developed an abscess in the pleural cavity. The hospital length of stay was on average 11.56 days. In our experience, nonoperative management of grade IV liver injury for stable blunt trauma patients is associated with high success rates without significant complications.

  5. Role of ascorbic acid in reduction of the incidence of the atrial fibrillation in patients under B-blocker and undergoing coronary artery bypass graft operation in early post-operative period

    Directory of Open Access Journals (Sweden)

    Moataz E. Rezk, MD

    2017-09-01

    Conclusions: The incidence of post CABG AF, intensive care unit stay, need for inotropic support and ventilator stay were decreased by patients intake of vitamin C in combination with β -blockers pre-operatively.

  6. Do Physicians Respond to Web-Based Patient Ratings? An Analysis of Physicians' Responses to More Than One Million Web-Based Ratings Over a Six-Year Period.

    Science.gov (United States)

    Emmert, Martin; Sauter, Lisa; Jablonski, Lisa; Sander, Uwe; Taheri-Zadeh, Fatemeh

    2017-07-26

    Physician-rating websites (PRWs) may lead to quality improvements in case they enable and establish a peer-to-peer communication between patients and physicians. Yet, we know little about whether and how physicians respond on the Web to patient ratings. The objective of this study was to describe trends in physicians' Web-based responses to patient ratings over time, to identify what physician characteristics influence Web-based responses, and to examine the topics physicians are likely to respond to. We analyzed physician responses to more than 1 million patient ratings displayed on the German PRW, jameda, from 2010 to 2015. Quantitative analysis contained chi-square analyses and the Mann-Whitney U test. Quantitative content techniques were applied to determine the topics physicians respond to based on a randomly selected sample of 600 Web-based ratings and corresponding physician responses. Overall, physicians responded to 1.58% (16,640/1,052,347) of all Web-based ratings, with an increasing trend over time from 0.70% (157/22,355) in 2010 to 1.88% (6377/339,919) in 2015. Web-based ratings that were responded to had significantly worse rating results than ratings that were not responded to (2.15 vs 1.74, PWeb to patient ratings differ significantly from nonresponders regarding several characteristics such as gender and patient recommendation results (PWeb to patient ratings. This is likely because of (1) the low awareness of PRWs among physicians, (2) the fact that only a few PRWs enable physicians to respond on the Web to patient ratings, and (3) the lack of an active moderator to establish peer-to-peer communication. PRW providers should foster more frequent communication between the patient and the physician and encourage physicians to respond on the Web to patient ratings. Further research is needed to learn more about the motivation of physicians to respond or not respond to Web-based patient ratings. ©Martin Emmert, Lisa Sauter, Lisa Jablonski, Uwe Sander

  7. Holonomic systems for period mappings

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Jingyue, E-mail: jychen@brandeis.edu [Department of Mathematics, Brandeis University, Waltham, MA 02454 (United States); Huang, An, E-mail: anhuang@math.harvard.edu [Department of Mathematics, Harvard University, Cambridge, MA 02138 (United States); Lian, Bong H., E-mail: lian@brandeis.edu [Department of Mathematics, Brandeis University, Waltham, MA 02454 (United States)

    2015-09-15

    Period mappings were introduced in the sixties [4] to study variation of complex structures of families of algebraic varieties. The theory of tautological systems was introduced recently [7,8] to understand period integrals of algebraic manifolds. In this paper, we give an explicit construction of a tautological system for each component of a period mapping. We also show that the D-module associated with the tautological system gives rise to many interesting vanishing conditions for period integrals at certain special points of the parameter space.

  8. Microprocessor controlled digital period meter

    International Nuclear Information System (INIS)

    Keefe, D.J.; McDowell, W.P.; Rusch, G.K.

    1980-01-01

    A microprocessor controlled digital period meter has been developed and tested operationally on a reactor at Argonne National Laboratory. The principle of operation is the mathematical relationship between asymptotic periods and pulse counting circuitry. This relationship is used to calculate and display the reactor periods over a range of /plus or minus/1 second to /plus or minus/999 seconds. The time interval required to update each measurement automatically varies from 8 seconds at the lowest counting rates to 2 seconds at higher counting rates. The paper will describe hardware and software design details and show the advantages of this type of Period Meter over the conventional circuits. 1 ref

  9. Prognosis following cancer surgery during holiday periods.

    Science.gov (United States)

    Lagergren, Jesper; Mattsson, Fredrik; Lagergren, Pernilla

    2017-11-15

    Surgery is the mainstay curative treatment in most cancer. We aimed to test the new hypothesis that cancer surgery performed during holiday periods is associated with worse long-term prognosis than for non-holiday periods. This nationwide Swedish population-based cohort study included 228,927 patients during 1997-2014 who underwent elective resectional surgery for a cancer where the annual number of resections was over 100. The 16 eligible cancer sites were grouped into 10 cancer groups. The exposure, holiday periods, was classified as wide (14-weeks) or narrow (7-weeks). Surgery conducted inside versus outside holiday periods was compared regarding overall disease-specific (main outcome) and overall all-cause (secondary outcome) mortality. Cox regression provided hazard ratios (HR) with 95% confidence intervals (CI) adjusted for age, sex, comorbidity, hospital volume, calendar period and tumor stage. Surgery conducted during wide and narrow holiday periods were associated with increased HRs of disease-specific mortality for cancer of the breast (HR 1.08, 95% CI 1.03-1.13 and HR 1.06, 95% CI 1.01-1.12) and possibly of cancer of the liver-pancreas-bile ducts (HR 1.09, 95% CI 0.99-1.20 and HR 1.12, 95% CI 0.99-1.26). Sub-groups with cancer of the colon-rectum, head-and-neck, prostate, kidney-urine bladder and thyroid also experienced statistically significantly worse prognosis following surgery conducted during holiday periods. No influence of surgery during holiday was detected for cancer of the esophagus-stomach, lung or ovary-uterus. All-cause HRs were similar to the disease-specific HRs. The prognosis following cancer surgery might not be fully maintained during holiday periods for all cancer sites. © 2017 UICC.

  10. The frequency of alcoholism in patients with advanced cancer admitted to an acute palliative care unit and a home care program.

    Science.gov (United States)

    Mercadante, Sebastiano; Porzio, Giampiero; Caruselli, Amanda; Aielli, Federica; Adile, Claudio; Girelli, Nicola; Casuccio, Alessandra

    2015-02-01

    Cancer patients with a history of alcoholism may be problematic. The frequency of alcoholism among patients with advanced cancer has never been reported in Italy or other European countries. The aim of this prospective study was to determine the frequency of alcoholism, assessed with a simple and validated instrument, among patients with advanced cancer who were referred to two different palliative care settings: an acute inpatient palliative care unit (PCU) of a comprehensive cancer center in a metropolitan area and a home care program (HCP) in a territorial district, localized in the mountains of Italy. A consecutive sample of patients admitted to an inpatient PCU and to an HCP was assessed for a period of eight months. Each patient who agreed to be interviewed completed the Cut down, Annoyed, Guilty, Eye-opener (CAGE) questionnaire. Patients were then interviewed informally to gather information about their history with alcohol. In total, 443 consecutive patients were surveyed; data from 249 to 194 patients were collected in the PCU and HCP, respectively, in the eight-month period. The mean age was 66.4 (SD 12.7) years, and 207 were males. The mean Karnofsky level was 54.2 (SD 14.6). Eighteen patients were CAGE positive (4.06%). Males (Pearson Chi-squared, P = 0.027) and younger patients (analysis of variance test, P = 0.009) were more likely to be CAGE positive. Informal interviews revealed that 17 patients (3.83%) were alcoholics or had a history of alcoholism, and that alcoholism was strongly correlated with CAGE (Pearson Chi-squared, P alcoholism. As CAGE patients express more symptom distress, it is important to detect this problem with a simple tool that has a high sensitivity and specificity and is easy to use even in patients with advanced disease. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  11. Phase II study of tailored S-1 monotherapy with a 1-week interval after a 2-week dosing period in elderly patients with advanced non-small cell lung cancer.

    Science.gov (United States)

    Goto, Hisatsugu; Okano, Yoshio; Machida, Hisanori; Hatakeyama, Nobuo; Ogushi, Fumitaka; Haku, Takashi; Kanematsu, Takanori; Urata, Tomoyuki; Kakiuchi, Soji; Hanibuchi, Masaki; Sone, Saburo; Nishioka, Yasuhiko

    2018-01-01

    S-1 is an oral fluoropyrimidine that is active in the treatment of non-small cell lung cancer (NSCLC); however, an optimal treatment schedule and appropriate dose adjustments of S-1 in elderly patients have not yet been established. We conducted a phase II trial to evaluate the efficacy and safety of a 2-week S-1 monotherapy treatment followed by a 1-week interval as a first-line treatment of elderly NSCLC patients, by adjusting the dose based on the individual creatinine clearance (Ccr) and body surface area (BSA). The primary endpoint was the disease control rate. Forty patients were enrolled. The disease control and response rates were 89.5% (95% confidence interval [CI] = 79.8-99.2) and 7.9% (95% CI = 0.0-16.4), respectively. The median progression-free survival and overall survival times were 4.4 months (95% CI = 4.2-8.5) and 17.0 months (95% CI = 11.2-18.7), respectively. Neutropenia, anorexia, hyponatremia, hypokalemia, and pneumonia of grade ≥ 3 occurred in 5.0%, 7.5%, 5.0%, 2.5%, and 2.5% of patients, respectively. Among the patient-reported outcomes, most of the individual factors in the patients' quality of life, including upper intestine-related symptoms improved with the treatment, except for dyspnea, which slightly albeit continuously worsened throughout the study. In elderly patients with previously untreated advanced NSCLC, a 2-week S-1 monotherapy treatment, tailored to both the Ccr and BSA, with a 1-week interval was well tolerated and demonstrated promising efficacy. This study was registered at the University Hospital Medical Information Network (UMIN) Center (ID: UMIN000002035), Japan. Copyright © 2017 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

  12. Forward Period Analysis Method of the Periodic Hamiltonian System.

    Directory of Open Access Journals (Sweden)

    Pengfei Wang

    Full Text Available Using the forward period analysis (FPA, we obtain the period of a Morse oscillator and mathematical pendulum system, with the accuracy of 100 significant digits. From these results, the long-term [0, 1060] (time unit solutions, ranging from the Planck time to the age of the universe, are computed reliably and quickly with a parallel multiple-precision Taylor series (PMT scheme. The application of FPA to periodic systems can greatly reduce the computation time of long-term reliable simulations. This scheme provides an efficient way to generate reference solutions, against which long-term simulations using other schemes can be tested.

  13. Anticoagulation period in idiopathic venous thromboembolism

    International Nuclear Information System (INIS)

    Farraj, Rami S.

    2004-01-01

    The period of anticoagulation of a first episode of idiopathic venous thromboembolism has been 6 months. It is unclear if such patients would benefit from longer treatment, as there appears to be an increased risk of recurrence after anticoagulation is stopped. In a randomized prospective study of 64 patients admitted to King Hussein Medical city, Amman, Jordan, who developed a first episode of venous thromboembolism, 32 patients were given warfarin for 24-months, while 32 patients stopped anticoagulation after completion of 6-months of therapy. Our goal was to determine the effects of extended anticoagulation on rates of recurrence of symptomatic venous thromboembolism and bleeding. The patients were followed for 12-months after stopping anticoagulation. After 24-months, 7 of the 32 patients (21%) who had standard anticoagulation for 6-months had a recurrent episode of thromboembolism compared to one of the 32 patients who received anticoagulation for 24 months (3%). Extended warfarin therapy for 24-months has resulted in an absolute risk reduction of 0.1% (p<0.05). This translates into 8 patients having to be treated for 24-months to avoid one recurrence without increasing the risk of major bleeding. Two patients in each group (6%) had major nonfatal bleeding, all 4 bleeding episodes occurring within the first 3-months of anticoagulation. After 36-months of follow up, the recurrence rate of extended warfarin therapy was only 3 patients (9%), which is a 43% relative reduction in recurrence of thromboembolism compared to standard therapy for 6-months. Patients with first episodes of idiopathic venous thromboembolism have an increased risk of recurrent venous thromboembolism and should be treated with oral anticoagulants for longer than 6-months, probably 24-months. (author)

  14. Detecting periodicities with Gaussian processes

    Directory of Open Access Journals (Sweden)

    Nicolas Durrande

    2016-04-01

    Full Text Available We consider the problem of detecting and quantifying the periodic component of a function given noise-corrupted observations of a limited number of input/output tuples. Our approach is based on Gaussian process regression, which provides a flexible non-parametric framework for modelling periodic data. We introduce a novel decomposition of the covariance function as the sum of periodic and aperiodic kernels. This decomposition allows for the creation of sub-models which capture the periodic nature of the signal and its complement. To quantify the periodicity of the signal, we derive a periodicity ratio which reflects the uncertainty in the fitted sub-models. Although the method can be applied to many kernels, we give a special emphasis to the Matérn family, from the expression of the reproducing kernel Hilbert space inner product to the implementation of the associated periodic kernels in a Gaussian process toolkit. The proposed method is illustrated by considering the detection of periodically expressed genes in the arabidopsis genome.

  15. Scheduling periodic tasks with slack

    NARCIS (Netherlands)

    Korst, J.H.M.; Aarts, E.H.L.; Lenstra, J.K.

    1997-01-01

    We consider the problem of nonpreemptively scheduling periodic tasks on a minimum number of identical processors, assuming that some slack is allowed in the time between successive executions of a periodic task. We prove that the problem is NP-hard in the strong sense. Necessary and sufficient

  16. Rationalization of Comet Halley's periods

    Science.gov (United States)

    Belton, Michael J. S.

    1990-01-01

    The sense of long axis orientation of Comet Halley during the Vega 1 encounter must be reversed from that deduced by Sagdeev et al. (1986) in order to harmonize the comet nucleus' Vega/Giotto-observed orientations with periodicities extracted from time-series brightness data. It is also demonstrated that Vega/Giotto observations can be satisfied by either a 2.2- or 3.7-day long-axis free precession period. A novel Fourier algorithm is used to reanalyze five independent data sets; strong evidence is adduced for periods harmonically related to a 7.4-day period. The preferred candidate models for Halley's nuclear rotation are characterized by a long-axis precession period of 3.7 days.

  17. Orbital periods of recurrent novae

    International Nuclear Information System (INIS)

    Schaefer, B.E.

    1990-01-01

    The class of recurrent novae (RN) with thermonuclear runaways contains only three systems (T Pyx, U Sco, and V394 CrA), for which no orbital periods are known. This paper presents a series of photometric observations where the orbital periods for all three systems are discovered. T Pyx is found to have sinusoidal modulation with an amplitude of 0.08 mag and a period of 2.3783 h (with a possible alias of 2.6403 h). U Sco is found to be an eclipsing system with an eclipse amplitude of roughly 1.5 mag and an orbital period of 1.2344 days. V394 CrA is found to have sinusoidal modulation with an amplitude of 0.5 mag and a period of 0.7577 days. Thus two out of three RN with thermonuclear runaways (or five out of six for all RN) have evolved companions. 16 refs

  18. Unstable Angina Treatment in Various Periods of Geomagnetic Activity

    Science.gov (United States)

    Parshina, S. S.; Tokayeva, L. K.; Afanasiyeva, T. N.; Samsonov, S. N.; Petrova, V. D.; Dolgova, E. M.; Manykina, V. I.; Vodolagina, E. S.

    In 145 patients with unstable angina (UA) there was analized an efficiency of a drug therapy at different types of heliogeophysical activity (HA) during the 23th solar cycle. 83 patients were examined at the period of a lower HA (Kp-index 16,19±0,18), and 62 patients - at the period of a higher HA (Kp-index 17,25±0,21, p<0,05). Baseline severity of patients' condition with UA at the moment of hospitalization at the studied periods did not differ, but the effectiveness of the therapy depended on the period of HA. At the period of a higher HA antianginal effect was stronger than at the lower period of HA (2,27±0,16 points and 1,75±0,12 points, p<0,05), and the need in nitroglycerin on the background of a drug therapy disappeared for 5-7 days quicker than at the period of a lower HA. Maximal hypotensive effect at a higher HA was achieved quicker - on the 3rd day of the treatment, and at a lower HA - only up to hospital discharge (p<0,05). Blood viscosity did not normalize in both of the studied periods, but in small vessels there was noted a decrease of a BV (p<0,05). So, at a higher HA the effectiveness of a drug therapy in patients with UA is higher than at the period of a lower HA.

  19. Chaos to periodicity and periodicity to chaos by periodic perturbations in the Belousov-Zhabotinsky reaction

    International Nuclear Information System (INIS)

    Li Qianshu; Zhu Rui

    2004-01-01

    A three-variable model of the Belousov-Zhabotinsky reaction system subject to external sinusoidal perturbations is investigated by means of frequency spectrum analysis. In the period-1 window of the model, the transitions from periodicity to chaos are observed; in the chaotic window, the transitions from chaos to periodicity are found. The former might be understood by the circle map of two coupled oscillators, and the latter is partly explained by the resonance between the main frequency of the chaos and the frequency of the external periodic perturbations

  20. Effect of cognitive stimulation in patients with mild congenital deterioration, in the reduction of progression to dementia, in the Clinica de la Memoria, Hospital Nacional de Geriatria y Gerontologia, during the period from September 2008 to September 2013

    International Nuclear Information System (INIS)

    Giangiulio Lobo, Andrea

    2014-01-01

    The efficacy of cognitive stimulation in the progression to dementia is verified in patients with mild cognitive impairment, from the Clinica de Memoria of the Hospital Nacional de Geriatria y Gerontologia, between September 2008 and September 2013. A sample of 190 patients of the Metropolitan Area, the majority of female, complete primary, with self-care, aged 70 to 79 years are selected. The investigated group has had a history of hypertension, diabetes mellitus to a lesser extent and some degree of associated sensory deficit. The evolution time of memory loss presented is 2.6 years at the time of the medical evaluation. The most common cognitive impairment in the study has been the multiple dominion amnesia, followed by the non-amnesic dominion multiple. The etiology has leaded the degenerative, followed by vascular and thirdly the deficit of vitamin B12. Patients with mild cognitive impairment almost half of the cases have had neuro-behavioral disorder, being the depression most frequent, followed by anxiety and apathy. Patients have been partial independent in ABVD and dependent on AIVD. Absenteeism to dating has existed both in Clinica de Memoria; but mainly to the appointment with psychology. During the study it is determined that the deterioration was developed without progress to dementia, relatives have reported cognitive stability in more than half of the cases, only 18 patients have progressed to dementia. In the process only 29 patients have concluded and were reevaluated; without being able to demonstrate that the cognitive stimulation delays the cognitive deterioration to the dementia, but nevertheless; this result is given without unduly discrediting cognitive stimulation as a non-pharmacological measure for the prevention and delaying of dementia. (author) [es

  1. Motor unit properties of biceps brachii in chronic stroke patients assessed with high-density surface EMG

    NARCIS (Netherlands)

    Kallenberg, L.A.C.; Hermens, Hermanus J.

    2009-01-01

    The aim of this study was to investigate motor unit (MU) characteristics of the biceps brachii in post-stroke patients, using high-density surface electromyography (sEMG). Eighteen chronic hemiparetic stroke patients took part. The Fugl-Meyer score for the upper extremity was assessed. Subjects

  2. Endothelin-1 and -3 plasma concentrations in patients with cirrhosis: role of splanchnic and renal passage and liver function

    DEFF Research Database (Denmark)

    Gerbes, A L; Møller, S; Gülberg, V

    1995-01-01

    of splanchnic and renal passage and of liver function on plasma concentrations of endothelin-1 (ET-1) and endothelin-3 (ET-3) in patients with cirrhosis compared with controls. Eighteen patients with cirrhosis and 8 normotensive controls of similar age were investigated. Arterial and venous plasma samples were...

  3. [Comparison of clinical and histological diagnosis in kidney post-transplantation period].

    Science.gov (United States)

    de Castro, M C; Chocair, P R; Saldanha, L B; Nahas, W; Arap, S; Sabbaga, E; Ianhez, L E

    1998-01-01

    To assess the agreement between clinical and histopathological diagnosis in a renal transplantation center, 40 episodes of acute renal failure were studied. Kidney biopsies were performed at the moment that a clinical diagnosis was made by the staff. Nineteen episodes of acute tubular necrosis (ATN), eighteen episodes of acute cellular rejection (ACR), 2 humoral rejections and 1 acute cyclosporin nephrotoxicity episodes were diagnosed. ATN episodes were confirmed by renal biopsy in 84.21%, ACR episodes in 83.33%, humoral rejections in 100%. Renal biopsy showed ATN in the occurrence of clinical cyclosporin nephrotoxicity. Total agreement was 82.5%. There is a good relationship between clinical and histopathological diagnosis in the post-transplantation period. Diagnostic mistakes occurred mainly when oliguria was present.

  4. Iraqi architecture in mogul period

    Directory of Open Access Journals (Sweden)

    Hasan Shatha

    2018-01-01

    Full Text Available Iraqi architecture have many periods passed through it until now, each on from these periods have it is architectural style, also through time these styles interacted among us, to creating kind of space forming, space relationships, and architectural elements (detailed treatments, the research problem being from the multi interacted architectural styles causing some of confused of general characteristic to every style, that we could distinguish by it. Research tries to study architecture style through Mogul Conquest to Baghdad. Aim of research follow main characteristic for this architectural style in the Mogul periods on the level of form, elements, and treatments. Research depending on descriptive and analytical all buildings belong to this period, so from analyzing there style by, general form for building, architectural elements, and it architectural treatment, therefore; repeating this procedures to every building we get some similarities, from these similarities we can making conclusion about pure characteristic of the style of these period. Other side, we also discover some Dissimilar in the building periods, these will lead research to make what interacting among styles in this period, after all that we can drew clearly main characteristic of Architectural Style for Mogul Conquest in Baghdad

  5. Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2018; Amendments to Special Enrollment Periods and the Consumer Operated and Oriented Plan Program. Final rule.

    Science.gov (United States)

    2016-12-22

    This final rule sets forth payment parameters and provisions related to the risk adjustment program; cost-sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges and State-based Exchanges on the Federal platform. It also provides additional guidance relating to standardized options; qualified health plans; consumer assistance tools; network adequacy; the Small Business Health Options Programs; stand-alone dental plans; fair health insurance premiums; guaranteed availability and guaranteed renewability; the medical loss ratio program; eligibility and enrollment; appeals; consumer-operated and oriented plans; special enrollment periods; and other related topics.

  6. The significance of preoperative CT during arterial portography in surgical treatment of patients with hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Hayashi, Takafumi; Suzuki, Kazunori; Konishi, Ichiro; Sato, Naoki; Yamashiro, Yutaka; Yamaguchi, Yumi; Hirooka, Yasuaki; Kaibara, Nobuaki

    1999-01-01

    This study was designed to elucidate the significance of preoperative computed tomography during arterial portography (CTAP) in surgical treatment of hepatocellular carcinoma (HCC). Eighteen patients with HCC whose minute lesions had been pointed out by CTAP preoperatively (CTAP positive group) were compared with another eight patients with HCC having postoperative recurrence in a region at where no tumors had been detected by preoperative CTAP (CTAP negative group) for preoperative location of tumor and postoperative pattern of recurrence. In the CTAP positive group, 11 patients had recurrence and the remaining seven patients had not. Disease-free periods up to recurrences were 8.7 months in an average in the 11 CTAP positive patients and 16.6 months in the CTAP-negative group, showing a significantly shorter interval in the CTAP positive patients. In recurred cases from the CTAP positive group, tumors identified by imaging procedures other than CTAP were solitary in four and multiple in seven cases, while all solitary in non-recurred cases. In the recurred CTAP positive cases, actual recurrence occurred in the same segment where a tumor had been pointed out by CTAP alone in five out of six cases of solitary recurrence; or involved the same segment where CTAP detected tumor (s) in four out of five cases of multiple recurrence. It is indicated that the possibility of postoperative recurrence of HCC is high in cases having minute lesions visualized by CTAP alone in addition to multiple lesions visualized by imaging procedures other than CTAP. We think that periodical imaging methods including CTAP are required for HCC patients. (author)

  7. Use of the low air loss bed system in treatment of burns patients.

    Science.gov (United States)

    Leeder, C J

    1979-01-01

    When a person is confined to bed, whatever the reason, small areas of soft tissues are compressed between the skeleton and the supporting surfaces. Transient circulatory disturbances resulting in epidermis to dermis damage or finally deep penetrating necrosis involving subcutaneous tissues, fascia muscle and bone may result. In the case of the severely burned patient who has already sustained gross trauma, any further destruction of tissues is to be avoided at all costs. The Low Air Loss Bed System offers many advantages in the care and management of the burns patient. There is a definite saving of nursing time by rendering unnecessary constant attention to the patient for preventative skin care, positioning, bed pan etc. The nurse is then able to devote her time positively to the more involved needs of the patient and family. It will also provide for periods of rest that are so often lacking, especially in the initial stages of treatment. The patient does not have to be kept on a rigid regime of Q2H turning. He is turned only for wound care, physio- and general body cleansing. His position may be contoured without having to touch him circumferentially. Any lifting and positioning necessary is easier for staff members due to the design of the unit, and more comfortable for the patient. Over a period of two years, eighteen patients with varying extent and degree of burn injuries were treated on the bed. This paper will describe the mechanical operation of the bed and experiences with nursing management and monitoring of the system.

  8. The Periodic Table in Croatia

    Directory of Open Access Journals (Sweden)

    Raos, N.

    2011-12-01

    Full Text Available The Croatian (Yugoslav Academy of Sciences and Arts was the first academy to elect D. I. Mendeleev as its honorary member (1882, whereas the periodic table of the elements has been taught regularly at the Zagreb University since 1888. The early interest of Croatian chemists in the periodic table should be attributed primarily to their pan-Slavic attitude, particularly as proof that Slavic people were able to produce "their own Newtons" (M. V. Lomonosov and D. I. Mendeleev. Such enthusiastic views, however, did not help in analyzing the contribution of Mendeleev and other scientists to the discovery and development of the periodic table of the elements.

  9. Is employment-focused case management effective for patients with substance use disorders? Results from a controlled multi-site trial in Germany covering a 2-years-period after inpatient rehabilitation.

    Science.gov (United States)

    Saal, Susanne; Forschner, Lukas; Kemmann, Dietmar; Zlatosch, Jacqueline; Kallert, Thomas W

    2016-08-05

    Substance use disorders are associated with unemployment. An employment-focused case management (CMRE) has been conceptualised as a specific intervention to help substance use disorder patients return to competitive employment immediately after inpatient rehabilitation. This study investigated the effect of the intervention on return to work of persons with substance use disorders. The study was conducted in four German inpatient rehabilitation departments, and included unemployed patients (aged between 18 and 63 years) with a main clinical diagnosis of ICD-10 F10-19 disorders. Six weeks before discharge, patients were randomly allocated to CMRE or standard care (SC) using a quasi-randomised approach. The primary outcome measure was integration into competitive employment 24 months after discharge from rehabilitation. Secondary outcome domains were abstinence, duration of employment, proportion of publicly funded employment, satisfaction with life, precarious housing situation and precarious financial situation, and use of follow-up services. Outcome measures were assessed 6 weeks and 1-2 days prior to discharge, and 12 and 24 months after discharge from rehabilitation. One hundred sixty patients were allocated into the CMRE group and 160 patients into the control group. 267 resp. 179 participants could be included in the analyses performed for the 12-, and the 24-months follow-up assessments. At the study endpoint the rate of integration into the primary labour market was 35.6 % in the CMRE group and 41.2 % in the control group, respectively (Relative Risk 0.92, 95 % CI, 0.47; 1.79). There was a significantly higher proportion in the CMRE group, however, which immediately after discharge linked with services of the Federal Employment Agency or Job Centres. There were no statistically significant differences in other outcomes between the groups. Compared to SC, the additional specific CMRE intervention did not result in superior effects on return to work

  10. Evidence-based provisional clinical classification criteria for autoinflammatory periodic fevers

    NARCIS (Netherlands)

    Federici, Silvia; Sormani, Maria Pia; Ozen, Seza; Lachmann, Helen J; Amaryan, Gayane; Woo, Patricia; Koné-Paut, Isabelle; Dewarrat, Natacha; Cantarini, Luca; Insalaco, Antonella; Uziel, Yosef; Rigante, Donato; Quartier, Pierre; Demirkaya, Erkan; Herlin, Troels; Meini, Antonella; Fabio, Giovanna; Kallinich, Tilmann; Martino, Silvana; Butbul, Aviel Yonatan; Olivieri, Alma; Kuemmerle-Deschner, Jasmin; Neven, Benedicte; Simon, Anna; Ozdogan, Huri; Touitou, Isabelle; Frenkel, Joost; Hofer, Michael; Martini, Alberto; Ruperto, Nicolino; Gattorno, Marco

    2015-01-01

    The objective of this work was to develop and validate a set of clinical criteria for the classification of patients affected by periodic fevers. Patients with inherited periodic fevers (familial Mediterranean fever (FMF); mevalonate kinase deficiency (MKD); tumour necrosis factor

  11. Topological imprint for periodic orbits

    International Nuclear Information System (INIS)

    Martín, Jesús San; Moscoso, Ma José; Gómez, A González

    2012-01-01

    The more self-crossing points an orbit has the more complex it is. We introduce the topological imprint to characterize crossing points and focus on the period-doubling cascade. The period-doubling cascade topological imprint determines the topological imprint for orbits in chaotic bands. In addition, there is a closer link between this concept and the braids studied by Lettelier et al (2000 J. Phys. A: Math. Gen. 33 1809–25). (paper)

  12. Analysis of ultrasounds performed on patients of the waiting list at the Radiology Service of the Hospital San Juan de Dios, in the period from June to November 2013

    International Nuclear Information System (INIS)

    Lopez-Vallejo Guzman, Carolina; Saborio Ramirez, Ana Isabel; Sanchez Gonzalez, Juan Carlos

    2013-01-01

    A descriptive analysis of 451 ultrasounds performed at the Servicio de Radiologia of the Hospital San Juan de Dios during June to November 2013 was carried out. The age group, gender, reference area, type of ultrasound, delivery diagnosis and final diagnosis were used as variables. The data was obtained through a direct interview with the patient. A greater percentage of users were women (80%) because the requests in 26% correspond to breast ultrasounds. A predominant age range of 51 to 60 years was identified. Most of the patients examined were referred from peripheral clinics attached to the hospital. Abdominal pain was exposed as the main reason for consultation. No pathology was identified among the majority of the final diagnoses obtained by the studies performed [es

  13. Minimum period and the gap in periods of Cataclysmic binaries

    International Nuclear Information System (INIS)

    Paczynski, B.; Sienkiewicz, R.

    1983-01-01

    The 81 minute cutoff to the orbital periods of hydrogen-rich cataclysmic binaries is consistent with evolution of those systems being dominated by angular momentum losses due to gravitational radiation. Unfortunately, many uncertainties, mainly poorly known atmospheric opacities below 2000 K, make is physically impossible to verify the quadrupole formula for gravitational radiation by using the observed cutoff at 81 minutes. The upper boundary of the gap in orbital periods observed at about 3 hours is almost certainly due to enhanced angular momentum losses from cataclysmic binaries which have longer periods. The physical mechanism of those losses is not identified, but a possible importance of stellar winds is pointed out. The lower boundary of the gap may be explained with the oldest cataclysmic binaries, whose periods evolved past the minimum at 81 minutes and reached the value of 2 hours within about 12 x 10 9 years after the binary had formed. Those binaries should have secondary components of only 0.02 solar masses, and their periods could be used to estimate ages of the oldest cataclysmic stars, and presumably the age of Galaxy. An alternative explanation for the gap requires that binaries should be detached while crossing the gap. A possible mechanism for this phenomenon is discussed. It requires the secondary components to be about 0.2 solar masses in the binaries just below the gap

  14. Profile of the elderly patient with the diagnosis of pulmonary thromboembolism admitted to the Hospital Nacional de Geriatria y Gerontologia during the period of 2008-2012: relationship with functional status, comorbidities and mortality

    International Nuclear Information System (INIS)

    Gutierrez Jimenez, Irene

    2013-01-01

    The profile of the elderly with the diagnosis of pulmonary thromboembolism admitted to the Hospital Nacional de Geriatria y Gerontologia during 2008-2012, was described through a retrospective and descriptive study. 44 cases were analyzed, in which a greater frequency of pulmonary embolism (PE) was documented in females and a higher incidence as age increased. The most frequent concomitant chronic pathologies in patients hospitalized with PE were cardiovascular conditions. Dyspnea was the most frequent symptom in elderly patients with PE and the findings in cabinet studies were nonspecific, due to the multiple underlying medical conditions. Low molecular weight heparins were preferred for the management of PE and it could be concluded that the probability of dying differs significantly according to the treatment, being lower in the group that received the heparins. A worse functional state was related to a higher frequency of PE cases and mortality for these, although the relationship was not significant. The associated lethality was PE, since a large percentage of the patients with the diagnosis presented hemodynamic collapse during the course of the picture. (author) [es

  15. Circumferential resection margin (CRM) positivity after MRI assessment and adjuvant treatment in 189 patients undergoing rectal cancer resection.

    Science.gov (United States)

    Simpson, G S; Eardley, N; McNicol, F; Healey, P; Hughes, M; Rooney, P S

    2014-05-01

    The management of rectal cancer relies on accurate MRI staging. Multi-modal treatments can downstage rectal cancer prior to surgery and may have an effect on MRI accuracy. We aim to correlate the findings of MRI staging of rectal cancer with histological analysis, the effect of neoadjuvant therapy on this and the implications of circumferential resection margin (CRM) positivity following neoadjuvant therapy. An analysis of histological data and radiological staging of all cases of rectal cancer in a single centre between 2006 and 2011 were conducted. Two hundred forty-one patients had histologically proved rectal cancer during the study period. One hundred eighty-two patients underwent resection. Median age was 66.6 years, and male to female ratio was 13:5. R1 resection rate was 11.1%. MRI assessments of the circumferential resection margin in patients without neoadjuvant radiotherapy were 93.6 and 88.1% in patients who underwent neoadjuvant radiotherapy. Eighteen patients had predicted positive margins following chemoradiotherapy, of which 38.9% had an involved CRM on histological analysis. MRI assessment of the circumferential resection margin in rectal cancer is associated with high accuracy. Neoadjuvant chemoradiotherapy has a detrimental effect on this accuracy, although accuracy remains high. In the presence of persistently predicted positive margins, complete resection remains achievable but may necessitate a more radical approach to resection.

  16. Commuting periodic operators and the periodic Wigner function

    International Nuclear Information System (INIS)

    Zak, J

    2004-01-01

    Commuting periodic operators (CPO) depending on the coordinate x-hat and the momentum p-hat operators are defined. The CPO are functions of the two basic commuting operators exp(i x-hat 2π/a) and exp(i/h p-hat a), with a being an arbitrary constant. A periodic Wigner function (PWF) w(x, p) is defined and it is shown that it is applicable in a normal expectation value calculation to the CPO, as done in the original Wigner paper. Moreover, this PWF is non-negative everywhere, and it can therefore be interpreted as an actual probability distribution. The PWF w(x, p) is shown to be given as an expectation value of the periodic Dirac delta function in the phase plane. (letter to the editor)

  17. Nanopublication beyond the sciences: the PeriodO period gazetteer

    Directory of Open Access Journals (Sweden)

    Patrick Golden

    2016-02-01

    Full Text Available The information expressed in humanities datasets is inextricably tied to a wider discursive environment that is irreducible to complete formal representation. Humanities scholars must wrestle with this fact when they attempt to publish or consume structured data. The practice of “nanopublication,” which originated in the e-science domain, offers a way to maintain the connection between formal representations of humanities data and its discursive basis. In this paper we describe nanopublication, its potential applicability to the humanities, and our experience curating humanities nanopublications in the PeriodO period gazetteer.

  18. Comparative study of thyrotoxic periodic paralysis from idiopathic hypokalemic periodic paralysis: An experience from India

    Directory of Open Access Journals (Sweden)

    J Kalita

    2012-01-01

    Full Text Available Objective: There is paucity of reports on thyrotoxic periodic paralysis (TPP from India. We report the patients with TPP and compare them with idiopathic hypokalemic periodic paralysis (IHPP. Materials and Methods: Patients with hypokalemic periodic paralysis (HPP treated during the past 11 years were evaluated retrospectively. Their demographic parameters, family history, clinical features, precipitating factors, severity of weakness, laboratory parameters and rapidity of recovery were recorded. The demographic, clinical and laboratory parameters of TPP and IHPP were compared. Results: During the study period, we managed 52 patients with HPP; nine (17.3% of whom had TPP and 27 (52% had IHPP. The demographic, precipitating factors, number of attacks and severity of limb weakness were similar between the TPP and IHPP groups, except in the IHPP group, bulbar weakness was present in four and respiratory paralysis in six, needing artificial ventilation in two patients. Serum potassium was significantly lower in TPP (2.21 ± 0.49 compared with IHPP (2.67 ± 0.59, P = 0.04. Four patients with TPP had subclinical thyrotoxicosis and two had subclinical hyperthyroidism. Rebound hyperkalemia occurred in both TPP and IHPP (three versus eight patients. The recovery was faster in IHPP (26.7 ± 15.4 h compared with TPP (34.0 ± 14.0 h, but was statistically insignificant. Conclusion: TPP constitutes 17.3% of HPP, and absence of clinical features of thyrotoxicosis and subclinical hyperthyroidism in TPP is not uncommon. Clinical features, demographic profile and rebound hyperkalemia are similar in both TPP and IHPP. The serum potassium level is significantly low in the TPP compared with the IHPP group.

  19. [Vaginitis and vaginosis. Comparison of two periods].

    Science.gov (United States)

    Ceruti, M; Canestrelli, M; Piantelli, G; Amone, F; Condemi, V; De Paolis, P; Ludovici, G; Somenzi, P

    1993-10-01

    Vaginitis is the most frequent gynecological disease. It is characterized by objective and subjective signs of inflammation and differs from bacterial vaginosis (BV) which is an abnormal condition of the vaginal ecosystem caused by the excessive growth of aerobic and anaerobic flora normally present in the vagina with an increased risk of pelvic inflammatory disease (PID). The authors report the results of a study carried out at the Centre for Gynecological Infections at the Clinic of Obstetrics and Gynecology of the University of Parma. 828 patients were enrolled in the study during the period 1985-86 and 1559 patients during the two-year period 1991-92. The aim of the study was to evaluate variations in epidemiological data for vaginitis and bacterial vaginosis in the two periods examined. No significant changes were observed (p > 0.05) with regard to the prevalence of Ca, Tv and BV forms. On the other hand, there was a significant reduction (p vaginitis and BV showed a reduction of other microorganisms and an increase in negative vaginal swabs in adults (> 20 years old).

  20. Periodic testing in operative action

    International Nuclear Information System (INIS)

    Larm, T.

    2005-01-01

    Periodic testing forms a remarkable part of the regular work tasks of the shift crew. Testing is generally carried out beside the daily monitoring and control work. Even remarkable plant related differences may occur in the procedures and routines used in periodic testing. The goal is still always the same, to regularly ensure that the systems and equipment are in working order according to their design. This presentation studies with examples the execution and scope of periodic testing as well as the routines and procedures used in the testing in Loviisa power plant. The presentation is based on the testing procedures of Loviisa power plant and the aim is not to compare them to the procedures of other plants. The scope of periodic testing has increased and the routines and procedures have been developed as the operation experience has increased. The assessment of the need of periodic testing and the consideration of the practical execution possibilities should be a part of the plant's planning phase as a part of the planning process. (orig.)

  1. The Correlation between Individual and Environmental Hygiene and Pioderma Incidence An Analytical Observational Study in Pyoderma Patient in Islamic Sultan Agung Hospital during the Period August to December 2010

    Directory of Open Access Journals (Sweden)

    Iis Aisyah Sutisna

    2011-06-01

    Design and Methods: The study type was analytic observational with case control design. The sample consisted of 30 respondents RSI patients Sultan Agung for case group and 30 persons as control group is the neighbors of patients who have similar characteristics and are not suffering pyoderma. The data used are secondary data from medical records and primary data from questionnaires filled out by respondents, then the data were analyzed with chi-square and to determine the correlation power there was used a contingency coefficient test. Results: It was found that the good and the bad individual hygene for the case group were 3.3% and 66.7% respectively, while for the control group the good and bad individual hygene were 80.0% and 20.0% respectively. Chi-square test resulted in p=0,000 with contingency coefisien of 0.426. It was found that the good and the bad environmental hygene for the case group were 56.7% and 43.3% respectively, while for the control group the good and bad environmental hygene were 83.3% and 16.3% respectively. Chi-square test resulted in p=0,024 with contingency coefisien of 0.27. Conclusion: There was a significant correlation between the personal and environmental hygiene and poderma insicence at the RSI Sultan Agung with a moderate relationship between individual hygiene and weak relationship between environmental hygene (Sains Medika, 3(1:24-30.

  2. Improved nonparametric inference for multiple correlated periodic sequences

    KAUST Repository

    Sun, Ying; Hart, Jeffrey D.; Genton, Marc G.

    2013-01-01

    cross-validation method to the temperature data obtained from multiple ice cores, investigating the periodicity of the El Niño effect. Our methodology is also illustrated by estimating patients' cardiac cycle from different physiological signals

  3. Implicit and Explicit Memory for Affective Passages in Temporal Lobectomy Patients

    Science.gov (United States)

    Burton, Leslie A.; Rabin, Laura; Vardy, Susan Bernstein; Frohlich, Jonathan; Porter, Gwinne Wyatt; Dimitri, Diana; Cofer, Lucas; Labar, Douglas

    2008-01-01

    Eighteen temporal lobectomy patients (9 left, LTL; 9 right, RTL) were administered four verbal tasks, an Affective Implicit Task, a Neutral Implicit Task, an Affective Explicit Task, and a Neutral Explicit Task. For the Affective and Neutral Implicit Tasks, participants were timed while reading aloud passages with affective or neutral content,…

  4. Inflation from periodic extra dimensions

    Energy Technology Data Exchange (ETDEWEB)

    Higaki, Tetsutaro [Department of Physics, Keio University, Kanagawa 223-8522 (Japan); Tatsuta, Yoshiyuki, E-mail: thigaki@rk.phys.keio.ac.jp, E-mail: y_tatsuta@akane.waseda.jp [Department of Physics, Waseda University, Tokyo 169-8555 (Japan)

    2017-07-01

    We discuss a realization of a small field inflation based on string inspired supergravities. In theories accompanying extra dimensions, compactification of them with small radii is required for realistic situations. Since the extra dimension can have a periodicity, there will appear (quasi-)periodic functions under transformations of moduli of the extra dimensions in low energy scales. Such a periodic property can lead to a UV completion of so-called multi-natural inflation model where inflaton potential consists of a sum of multiple sinusoidal functions with a decay constant smaller than the Planck scale. As an illustration, we construct a SUSY breaking model, and then show that such an inflaton potential can be generated by a sum of world sheet instantons in intersecting brane models on extra dimensions containing orbifold. We show also predictions of cosmic observables by numerical analyzes.

  5. Periodicity, the Canon and Sport

    Directory of Open Access Journals (Sweden)

    Thomas F. Scanlon

    2015-10-01

    Full Text Available The topic according to this title is admittedly a broad one, embracing two very general concepts of time and of the cultural valuation of artistic products. Both phenomena are, in the present view, largely constructed by their contemporary cultures, and given authority to a great extent from the prestige of the past. The antiquity of tradition brings with it a certain cachet. Even though there may be peripheral debates in any given society which question the specifics of periodization or canonicity, individuals generally accept the consensus designation of a sequence of historical periods and they accept a list of highly valued artistic works as canonical or authoritative. We will first examine some of the processes of periodization and of canon-formation, after which we will discuss some specific examples of how these processes have worked in the sport of two ancient cultures, namely Greece and Mesoamerica.

  6. Periodicity and repeatability in data

    Science.gov (United States)

    Southwood, D.

    Using magnetic data from the first two years in Saturn orbit, the basic periodicity of apparent is examined with the aim of elucidating the `cam' shaft model of Espinosa et al. (2003) identifying the nature of the `cam' and giving a definitive period for its rotation. An initial hypothesis, supported by the spectral analysis of analysis of the first 8 months in orbit Gianpieri et al. (2006), is made that the source of the period is linked to something inside the planet and therefore that the source inertia means that the period effectively does not change over the 2 years. Moreover one expects that the source phase is fixed. Using this approach, not only can the period identified by spectral analysis (647.1 + 0.6 min.) be verified but also by phase analysis between successive passes over the 2 years the period can be refined to 647.6 + 0.1 min. The signal itself is remarkably reproducible from pass to pass. It appears in all three components of the field and its polarisation is unambiguously not attributable to direct detection of an internal field. Not only does the signal not decay rapidly with distance from the planet, but although it has the m=1 symmetry of a tilted dipole, the field lines diverge from the planet indicating an exterior source. This feature led to the `cam' model. The polarisation and comparisons of passes with different latitude profiles show a surprising north-south symmetry in the azimuthal field. The absence of asymmetry with respect to the magnetic equator rules out a direct magnetospheric-ionospheric interaction source. Accordingly, it is proposed that the basic `cam' effect is generated by a single hemisphere anomaly which creates hemisphere to hemisphere field aligned currents. The existence of Saturn phase related anomaly appears to produce a basic asymmetry in the inner magnetosphere that sets the phase of both an inflowing and outflowing sector in a rotating circulation system.

  7. A cloud-based home health care information sharing system to connect patients with home healthcare staff -A case report of a study in a mountainous region.

    Science.gov (United States)

    Nomoto, Shinichi; Utsumi, Momoe; Sasayama, Satoshi; Dekigai, Hiroshi

    2017-01-01

    We have developed a cloud system, the e-Renraku Notebook (e-RN) for sharing of home care information based on the concept of "patient-centricity". In order to assess the likelihood that our system will enhance the communication and sharing of information between home healthcare staff members and home-care patients, we selected patients who were residing in mountainous regions for inclusion in our study. We herein report the findings.Eighteen staff members from 7 medical facilities and 9 patients participated in the present study.The e-RN was developed for two reasons: to allow patients to independently report their health status and to have staff members view and respond to the information received. The patients and staff members were given iPads with the pre-installed applications and the information being exchanged was reviewed over a 54-day period.Information was mainly input by the patients (61.6%), followed by the nurses who performed home visits (19.9%). The amount of information input by patients requiring high-level nursing care and their corresponding staff member was significantly greater than that input by patients who required low-level of nursing care.This patient-centric system in which patients can independently report and share information with a member of the healthcare staff provides a sense of security. It also allows staff members to understand the patient's health status before making a home visit, thereby giving them a sense of security and confidence. It was also noteworthy that elderly patients requiring high-level nursing care and their staff counterpart input information in the system significantly more frequently than patients who required low-level care.

  8. An improved test for periodicity

    International Nuclear Information System (INIS)

    Davies, S.R.

    1990-01-01

    I discuss two widely used methods of testing for periodicity, phase dispersion minimization and epoch-folding. Using an analysis of variance approach, I demonstrate the close relationship between these two methods. I also show that the significance test sometimes used in phase dispersion minimization is statistically inaccurate, and that the test used in epoch-folding is an approximation valid only for large sample sizes. I propose a new test statistic, applicable to either epoch-folding or PDM, which is statistically sound for all sample sizes, and which is also more sensitive to periodicity than the test statistics previously used with these two methods. (author)

  9. Hydrogen purification by periodic adsorption

    Energy Technology Data Exchange (ETDEWEB)

    Barg, Christian; Secchi, Argimiro R.; Trierweiler, Jorge O. [Rio Grande do Sul Univ., Porto Alegre, RS (Brazil). Dept. de Engenharia Quimica]. E-mail: cbarg@enq.ufrgs.br; arge@enq.ufrgs.br; jorge@enq.ufrgs.br

    2000-07-01

    The periodic adsorption processes have been widely used for industrial applications, mainly because it spends less energy than the usual gas separation processes, like the cryogenic distillation. The largest commercial application of periodic adsorption processes is the pressure swing adsorption (PSA) applied to hydrogen purification. Although its wide use in the chemical and petrochemical industry, there are no reports in the open literature about complete modeling studies of a complex commercial unit, with multiple adsorbents and multiple beds and several feed components. This study has as objective the modeling, optimization and dynamical analysis of an industrial PSA unit for hydrogen purification. (author)

  10. Availability of periodically tested systems

    International Nuclear Information System (INIS)

    Signoret, J.P.

    1979-01-01

    There is at the present time a need in accurate models to asess the availability of periodically tested stand-by systems. This paper shows how to improve the well known 'saw-tooth curve' model in order to take into account various reliability parameters. A model is developed to assess the pointwise and the mean availabilities of periodically tested stand-by systems. Exact and approxination formulae are given. In addition, the model developed herein leads to optimize the test interval in order to minimize the mean unavailability. A safety diesel in a nuclear power plant is given as an example

  11. Effects of digoxin and. beta. -methyldigoxin on the heart rate of decompensated patients with atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, K E; Johansson, B W; Ledermann, H; von Schenck, H; Thorell, J I [Lund Univ. (Sweden). Clinical Pharmacological Lab.; Allmaenna Sjukhuset, Malmoe (Sweden). Heat Lab.; Allmaenna Sjukhuset, Malmoe (Sweden). Dept. of Clinical Chemistry)

    1977-02-01

    Eighteen patients with atrial fibrillation were given digoxin 0.13 mg twice daily for 3 weeks and ..beta..-methyldigoxin 0.10 mg twice daily for another 3 weeks. At the end of each 3 week period an exercise test was performed and the effects on the heart rate of the two drugs were compared. No difference in heart rate was obtained at rest, wheareas the heart rate after 6 min of exercise was higher during treatment with digoxin (131 beats/min) than when the patients were taking ..beta..-methyldigoxin (124 beats/min). There were no significant differences between digoxin and ..beta..-methyldigoxin in their effects on the ECT (R-R intervals, T-wave, Q-T duration). The plasma concentrations of the two glycosides were determined by radioimmunoassay and by /sup 86/Rb-uptake inhibition assay. Comparable plasma concentration values (1.0 ng/ml for digoxin, 1.1 ng/ml for ..beta..-methyldigoxin, mean values) were obtained by radioimmunoassay, but the /sup 86/Rb-technique gave significantly higher values (mean 1.5 ng/ml) for ..beta..-methyldigoxin. It is concluded that ..beta..-methyldigoxin is equal to digoxin for producing slowing of the heart rate in patients with atrial fibrillation.

  12. Hemorrhage is the most common cause of neonatal mortality in patients with sacrococcygeal teratoma.

    Science.gov (United States)

    Kremer, Marijke E B; Wellens, Lianne M; Derikx, Joep P M; van Baren, Robertine; Heij, Hugo A; Wijnen, Marc H W A; Wijnen, René M H; van der Zee, David C; van Heurn, L W Ernest

    2016-11-01

    A small percentage of neonates with sacrococcygeal teratoma die shortly after birth from hemorrhagic complications. The incidence of and risk factors associated with hemorrhagic mortality are unknown. In this multicenter study we determined the incidence of early death in neonates born with SCT and evaluated potential risk factors for hemorrhagic mortality. 235 children with SCT treated from 1970 to 2010 in the Netherlands were retrospectively included. The following candidate risk factors for hemorrhagic mortality were examined: sex, prematurity, Altman type, tumor volume, tumor histology, necessity of emergency operation and time of diagnosis. Eighteen patients (7.7%) died at a median age of 163.5days (range 1.7-973days). Nine patients died of a malignancy. Nine others (3.8%) died postnatally (age 1-27days), six even within two days after birth. In seven of these nine patients death was related to tumor-hemorrhage and/or circulatory failure. Risk factors for hemorrhagic mortality were prematurity, tumor volume>1000cm 3 and performance of an emergency operation. Hemorrhagic mortality of neonates with SCT is relatively high (3.8%) representing almost 70% of the overall mortality in the neonatal period. High-output cardiac failure, internal tumor hemorrhage and perioperative bleeding were the most common causes of early death and were all strongly associated with larger tumor sizes. II (Retrospective study). Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Possible Rivaroxaban Failure during the Postpartum Period.

    Science.gov (United States)

    Rudd, Kelly M; Winans, Amanda R McFee; Panneerselvam, Narmadha

    2015-11-01

    Rivaroxaban, a factor Xa inhibitor, is a direct-acting oral anticoagulant (DOAC) indicated for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and for reducing the risk of DVT and PE recurrence. To our knowledge, no data are presently available to guide DOAC dosing in the postpartum period when pharmacokinetic and pharmacodynamic changes induced by pregnancy have an impact on drug clearance and increase hypercoagulability for a period of 6-8 weeks after delivery. We describe the case of a 35-year-old postpartum woman who presented to the emergency department with a diagnosis of a new multiple segmental PE 5 days after starting rivaroxaban therapy for a diagnosis of DVT. No precipitating cause, including noncompliance, was identified as a source of thrombosis embolization or extension. The patient was admitted, a heparin infusion was started for the management of PE, and rivaroxaban was discontinued. She was transitioned to enoxaparin 1 mg/kg (90 mg) subcutaneously every 12 hours the next day, bridged to warfarin, and discharged home on the overlapping regimen with close follow-up by the pharmacist-managed outpatient Anticoagulation Management Service. To our knowledge, this is the first case report of potential failure associated with rivaroxaban therapy in the postpartum period, possibly due to pharmacokinetic alterations seen in the postpartum period contributing to decreased drug exposure, yielding reduced anticoagulant efficacy. Clinicians should carefully weigh the risks and benefits of DOAC therapy in postpartum patients or other special populations requiring anticoagulation therapy. This report also highlights the need for further research identifying the impact of pharmacokinetic changes induced by special populations and the need to develop monitoring assays for such clinical situations. © 2015 Pharmacotherapy Publications, Inc.

  14. Periodic and quasiperiodic revivals in periodically driven interacting quantum systems

    Science.gov (United States)

    Luitz, David J.; Lazarides, Achilleas; Bar Lev, Yevgeny

    2018-01-01

    Recently it has been shown that interparticle interactions generically destroy dynamical localization in periodically driven systems, resulting in diffusive transport and heating. In this Rapid Communication we rigorously construct a family of interacting driven systems which are dynamically localized and effectively decoupled from the external driving potential. We show that these systems exhibit tunable periodic or quasiperiodic revivals of the many-body wave function and thus of all physical observables. By numerically examining spinless fermions on a one-dimensional lattice we show that the analytically obtained revivals of such systems remain stable for finite systems with open boundary conditions while having a finite lifetime in the presence of static spatial disorder. We find this lifetime to be inversely proportional to the disorder strength.

  15. Cosmophysical periods in European history

    International Nuclear Information System (INIS)

    Vladimirskij, B.M.; Kislovskij, L.D.

    1995-01-01

    In social systems there are rhythms synchronised by cosmical periods. These rhythms have partly biological origin. Some natural cycles also might influence upon historical processes (as such as climatic and epidemical). The analysis of the literature shows that there is rhythmic component in European history where solar activity cycles -11 and 340 years are presented. 17 refs., 2 tabs

  16. Genius of the periodic table

    International Nuclear Information System (INIS)

    1969-01-01

    'Isn't it the work of a genius!' exclaimed Academician V.I. Spitsyn, USSR, a member of the Scientific Advisory Committee when talking to an Agency audience in January. His listeners shared his enthusiasm. Academician Spitsyn was referring to the first formulation a hundred years ago by Professor Dmitry I. Mendeleyev of the Periodic Law of Elements. (author)

  17. Glass Waveguides for Periodic Poling

    DEFF Research Database (Denmark)

    Fage-Pedersen, Jacob; Jacobsen, Rune Shim; Kristensen, Martin

    2005-01-01

    Planar silica-based waveguide devices have been developed for second-harmonic generation by poling with periodic electrodes. We show that detrimental charge transport can occur along interfaces, but with proper choice of fabrication, high-quality devices are obtained....

  18. Periodic linear differential stochastic processes

    NARCIS (Netherlands)

    Kwakernaak, H.

    1975-01-01

    Periodic linear differential processes are defined and their properties are analyzed. Equivalent representations are discussed, and the solutions of related optimal estimation problems are given. An extension is presented of Kailath and Geesey’s [1] results concerning the innovations representation

  19. Model selection in periodic autoregressions

    NARCIS (Netherlands)

    Ph.H.B.F. Franses (Philip Hans); R. Paap (Richard)

    1994-01-01

    textabstractThis paper focuses on the issue of period autoagressive time series models (PAR) selection in practice. One aspect of model selection is the choice for the appropriate PAR order. This can be of interest for the valuation of economic models. Further, the appropriate PAR order is important

  20. Periodic progress report, 6 months

    DEFF Research Database (Denmark)

    Juhl, Thomas Winther; Nielsen, Jakob Skov

    This is the first progress report of the BriteEuram project named "High Power Laser Cutting for Heavy Industry" ("Powercut"). The report contains a summary of the objectives of the first period, an overview of the technical progress, a comparison between the planed and the accomplished work...

  1. A comparison of two clinical correlation models used for real-time tumor tracking of semi-periodic motion: A focus on geometrical accuracy in lung and liver cancer patients

    International Nuclear Information System (INIS)

    Poels, Kenneth; Dhont, Jennifer; Verellen, Dirk; Blanck, Oliver; Ernst, Floris; Vandemeulebroucke, Jef; Depuydt, Tom; Storme, Guy; De Ridder, Mark

    2015-01-01

    Purpose: A head-to-head comparison of two clinical correlation models with a focus on geometrical accuracy