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Sample records for positive treatment effect

  1. Effect of position of blades in the treatment of IMRT

    International Nuclear Information System (INIS)

    Perez Azorin, J. F.; Ramos Garcia, L. I.; Ortiz de Zarate Vivanco, R.; Trueba Garayo, I.; Cacicedo, J.; Hoyo, O. del

    2013-01-01

    This paper presents a method of calculation of the positions of each blade measures during treatment for all segments and the subsequent reconstruction of these positions in the planning system on the patient's physical and anatomical data. (Author)

  2. Effect of the positioning of the blades in MRT treatments

    International Nuclear Information System (INIS)

    Ortiz de Zarate Vivanco, R.; Perez Azorin, J. F.; Casquero Ocio, F.; Trueba Garayo, I.

    2013-01-01

    The attenuation of the beams of radiation that cross the treatment table is a verifiable fact that should be incorporated into the planning of the radiation treatments, especially in advanced techniques. (Author)

  3. Positive Effect of Acupuncture and Cupping in Infertility Treatment.

    Science.gov (United States)

    Wang, Jun-Xiang; Yang, Yang; Song, Yue; Ma, Liang-Xiao

    2018-04-01

    Background: Infertility is clinically defined as the failure to conceive after 12 months of unprotected sexual intercourse. Organic disorders and lifestyle factors are highly associated with infertility. Generally, acupuncture and its related methods can be applied for treating infertility, according to the theory of Traditional Chinese Medicine. Successful cases of acupuncture-treated infertility without concomitant use of any medication are rare. This article presents a case of an infertile woman having a favorable response to acupuncture treatment. Case: A 39-year-old Mexican woman presented with infertility following right-side fallopian-tube obstruction. She had no significant physical feelings of discomfort apart from work-related stress. Her syndrome was first diagnosed as Deficiency of Spleen and Kidney Qi, accompanied by obstruction of channels due to accumulation of Dampness. Acupuncture, accompanied by cupping therapy, was primarily practiced for this patient. Results: After 28 treatment sessions, she was finally able to conceive. Conclusions: Acupuncture could help treat infertility. Further large-scale, randomized clinical trials are needed to verify the efficacy of acupuncture for treating female infertility.

  4. Sensitivity of the Positive and Negative Syndrome Scale (PANSS) in Detecting Treatment Effects via Network Analysis.

    Science.gov (United States)

    Esfahlani, Farnaz Zamani; Sayama, Hiroki; Visser, Katherine Frost; Strauss, Gregory P

    2017-12-01

    Objective: The Positive and Negative Syndrome Scale is a primary outcome measure in clinical trials examining the efficacy of antipsychotic medications. Although the Positive and Negative Syndrome Scale has demonstrated sensitivity as a measure of treatment change in studies using traditional univariate statistical approaches, its sensitivity to detecting network-level changes in dynamic relationships among symptoms has yet to be demonstrated using more sophisticated multivariate analyses. In the current study, we examined the sensitivity of the Positive and Negative Syndrome Scale to detecting antipsychotic treatment effects as revealed through network analysis. Design: Participants included 1,049 individuals diagnosed with psychotic disorders from the Phase I portion of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study. Of these participants, 733 were clinically determined to be treatment-responsive and 316 were found to be treatment-resistant. Item level data from the Positive and Negative Syndrome Scale were submitted to network analysis, and macroscopic, mesoscopic, and microscopic network properties were evaluated for the treatment-responsive and treatment-resistant groups at baseline and post-phase I antipsychotic treatment. Results: Network analysis indicated that treatment-responsive patients had more densely connected symptom networks after antipsychotic treatment than did treatment-responsive patients at baseline, and that symptom centralities increased following treatment. In contrast, symptom networks of treatment-resistant patients behaved more randomly before and after treatment. Conclusions: These results suggest that the Positive and Negative Syndrome Scale is sensitive to detecting treatment effects as revealed through network analysis. Its findings also provide compelling new evidence that strongly interconnected symptom networks confer an overall greater probability of treatment responsiveness in patients with

  5. Investigation of source position uncertainties & balloon deformation in MammoSite brachytherapy on treatment effectiveness

    International Nuclear Information System (INIS)

    Bensaleh, S.

    2010-01-01

    The MammoSite ® breast high dose rate brachytherapy is used in treatment of early-stage breast cancer. The tumour bed volume is irradiated with high dose per fraction in a relatively small number of fractions. Uncertainties in the source positioning and MammoSite balloon deformation will alter the prescribed dose within the treated volume. They may also expose the normal tissues in balloon proximity to excessive dose. The purpose of this work is to explore the impact of these two uncertainties on the MammoSite dose distribution in the breast using dose volume histograms and Monte Carlo simulations. The Lyman–Kutcher and relative seriality models were employed to estimate the normal tissues complications associated with the MammoSite dose distributions. The tumour control probability was calculated using the Poisson model. This study gives low probabilities for developing heart and lung complications. The probability of complications of the skin and normal breast tissues depends on the location of the source inside the balloon and the volume receiving high dose. Incorrect source position and balloon deformation had significant effect on the prescribed dose within the treated volume. A 4 mm balloon deformation resulted in reduction of the tumour control probability by 24%. Monte Carlo calculations using EGSnrc showed that a deviation of the source by 1 mm caused approximately 7% dose reduction in the treated target volume at 1 cm from the balloon surface. In conclusion, accurate positioning of the 192 Ir source at the balloon centre and minimal balloon deformation are critical for proper dose delivery with the MammoSite brachytherapy applicator. On the basis of this study, we suggest that the MammoSite treatment protocols should allow for a balloon deformation of ≤2 mm and a maximum source deviation of ≤1 mm.

  6. The Effect of Vestibular Rehabilitation in the Treatment of Elderly Patients with Benign Paroxysmal Positional Vertigo

    Directory of Open Access Journals (Sweden)

    N. Saki

    2011-04-01

    Full Text Available Introduction & Objective: Vertigo in the elderly is relatively common, but only a few studies are available. Vestibular rehabilitation (VR therapy is an important therapeutic option in treating patients with significant balance deficits. The purpose of this study was to analyze the effect of vestibular rehabilitation on vertigo symptoms in elderly patients with benign paroxysmal positional vertigo (BPPV. Materials & Methods: In a cross sectional analytic design, 46 patients older than 60 years (aged 61 to 72 years with BPPV who referred to the ENT center of Imam Khomeini Hospital, Ahwaz, were studied. After an otologic evaluation, videonystagmography and dizziness handicap inventory (DHI evaluations were performed for each case. Then, vestibular rehabilitation (VR therapy was carried out by means of Epley maneuver. Efficacy of a VRT was tested by comparing pre-treatment with post-treatment VNG and DHI assessments. The data were analyzed by SPSS 16 software. Results: The average age of the patients was 67.28 ± 4.5 years. VR caused normal Hallpike findings in 31 (67.4 % and noticeable reduction in nystagmus amplitudes in 9 patients. We found a significant correlation between nystagmus amplitudes and DHI scores (r=0.77. The mean DHI scores decreased from 53.26±16.12 points to 15.36±9.23 points (p<0.001 at the end of the treatment course. Conclusion: Our investigation revealed that VR plays an important role in reducing vertigo in at-risk elderly patients. Lack of appropriate treatment in this population may cause a serious balance problem (such as bone fracture and long-term handicap that may interfere with their daily activities. (Sci J Hamadan Univ Med Sci 2011;18(1:33-36

  7. Effective Treatment of Solitary Pituitary Metastasis with Panhypopituitarism in HER2-Positive Breast Cancer by Lapatinib.

    Science.gov (United States)

    Park, Youngmok; Kim, Hyemin; Kim, Eui-Hyun; Suh, Chang-Ok; Lee, Soohyeon

    2016-01-01

    Brain metastasis affects one third of patients with HER2-positive breast cancer after treatment with trastuzumab. Surgical resection and radiation therapy are often unsuccessful at accomplishing complete control of metastasis. Lapatinib is presumed to cross the blood-brain barrier, and exhibits clinical activities for treatment of HER2-positive breast cancer. A 43-year-old woman was treated for early breast carcinoma with total mastectomy, axillary lymph-node dissection, and adjuvant chemotherapy with cyclophosphamide plus doxorubicin. After the end of adjuvant trastuzumab therapy, she was diagnosed with panhypopituitarism due to pituitary metastasis. Surgical removal and whole brain radiation therapy were performed, but a portion of viable tumor remained. Only taking lapatinib, the size of the metastatic lesion began to shrink. Trastuzumab may have controlled the micro-metastasis of breast cancer, but it was unable to control its progression to the central nervous system. Lapatinib is a possible option for HER2-positive metastatic breast cancer patients with brain metastasis.

  8. Effects of treatment position and patient immobilization on the variability of patient motion in the treatment of prostate cancer patients

    International Nuclear Information System (INIS)

    Nguyen, A.; Washington, M.; Wyman, B.; Song, P.; Bauml, J.; Tobias, R.; Vaida, F.; Chen, G.; Vijayakumar, S.; Reese, Michael

    1995-01-01

    Purpose/Objective: As dose-escalation is being attempted in the treatment of prostate cancer, uncertainties in patient position due to day-to-day setup has become increasingly critical. We present results from an ongoing study of the variability of patient positioning in prone versus supine treatment positions, as well as with and without immobilization using an aquaplast cast. Materials and Methods: We compared the probability and the amount of day-to-day movement of patients with prostate cancer. Patients were divided into three groups: (a) those treated supine without immobilization, (b) those treated supine and immobilized with an aquaplast cast over the abdomen and pelvis, and (c) those treated prone and similarly immobilized in aquaplast. The three components of patient motion - cephalo-caudad, anterior-posterior, and lateral - were examined separately. Portal films, taken at least once a week during treatment, were compared to simulation films and appropriate changes were made on the next day before treatment. This film record was used in our retrospective analysis of patient motion. To study the probability of movement we carried out a Likelihood Ratio test (LR) on a sample of 43 patients (20, 15, and 8 in treatment positions (a), (b), and (c) respectively). To study the amount of movement, templates with outlines of bony landmarks were generated based on the simulation film and overlaid on the portal film to measure the displacement. Results: Our measurements are summarized in the table below, where the p values for the difference in probability of movement (leftmost three columns) comes from the LR test and the amount of movement (rightmost three columns) is expressed as an average accompanied by a root-mean-square, in millimeters. Conclusions: From the data so far analyzed, patients treated supine and immobilized in an aquaplast cast -- group (b) -- exhibit the lowest probability of cephalo-caudad and anterior-posterior movement. In addition, although

  9. Effects of Bosutinib Treatment on Renal Function in Patients With Philadelphia Chromosome-Positive Leukemias.

    Science.gov (United States)

    Cortes, Jorge E; Gambacorti-Passerini, Carlo; Kim, Dong-Wook; Kantarjian, Hagop M; Lipton, Jeff H; Lahoti, Amit; Talpaz, Moshe; Matczak, Ewa; Barry, Elly; Leip, Eric; Brümmendorf, Tim H; Khoury, H Jean

    2017-10-01

    The purpose of the study was to assess renal function in patients with Philadelphia chromosome-positive leukemias receiving bosutinib or imatinib. Patients received first-line bosutinib (n = 248) or imatinib (n = 251; phase III trial), or second-line or later bosutinib (phase I/II trial; n = 570). Adverse events (AEs) and changes from baseline in estimated glomerular filtration rate (eGFR) and serum creatinine were assessed. Time from the last patient's first dose to data cutoff was ≥ 48 months. Renal AEs were reported in 73/570 patients (13%) receiving second-line or later bosutinib, and in 22/248 (9%) and 16/251 (6%) receiving first-line bosutinib and imatinib, respectively. eGFR in patients receiving bosutinib declined over time with more patients developing Grade ≥ 3b eGFR (570, 24%) compared with first-line bosutinib (26/248, 10%) and imatinib (25/251, 10%); time to Grade ≥ 3b eGFR was shortest with second-line or later bosutinib. Similar proportions of patients receiving second-line or later bosutinib (74/139, 53%), first-line bosutinib (15/26, 58%), and first-line imatinib (15/25, 60%) improved to ≥ 45 mL/min/1.73 m 2 eGFR as of the last follow-up. In a regression analysis, first-line treatment with bosutinib versus imatinib was not a significant predictor of Grade ≥ 3b eGFR. Long-term bosutinib treatment is associated with an apparently reversible decline in renal function with frequency and characteristics similar to renal decline observed with long-term imatinib treatment. Patients with risk factors for Grade ≥ 3b eGFR should be monitored closely. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Mild hypothermia as a treatment for central nervous system injuries: Positive or negative effects.

    Science.gov (United States)

    Darwazeh, Rami; Yan, Yi

    2013-10-05

    Besides local neuronal damage caused by the primary insult, central nervous system injuries may secondarily cause a progressive cascade of related events including brain edema, ischemia, oxida-tive stress, excitotoxicity, and dysregulation of calcium homeostasis. Hypothermia is a beneficial strategy in a variety of acute central nervous system injuries. Mild hypothermia can treat high intra-cranial pressure following traumatic brain injuries in adults. It is a new treatment that increases sur-vival and quality of life for patients suffering from ischemic insults such as cardiac arrest, stroke, and neurogenic fever following brain trauma. Therapeutic hypothermia decreases free radical produc-tion, inflammation, excitotoxicity and intracranial pressure, and improves cerebral metabolism after traumatic brain injury and cerebral ischemia, thus protecting against central nervous system dam-age. Although a series of pathological and physiological changes as well as potential side effects are observed during hypothermia treatment, it remains a potential therapeutic strategy for central nervous system injuries and deserves further study.

  11. Dosimetric effect of images of double field exposure and positioning in radiotherapy of breast treatment

    International Nuclear Information System (INIS)

    Bermudez Luna, R.; Rodriguez Rodriguez, C.; Martin Martin, G.; Lopez Fernandez, A.; Caballero Perea, B.; Ludena Martinez, B.; Prados Losa, R.

    2013-01-01

    The objectives of this study are to quantify the increased dose in white volume and the organ at risk in breast radiotherapy treatment, derived from portals of double-exposure images scheduled for treatment, evaluate dose reduction by passing images of single exposure and consider whether it would be wise to consider this doses in the planning process. (Author)

  12. Effects of respiration on target and critical structure positions during treatment assessed with movie-loop electronic portal imaging

    International Nuclear Information System (INIS)

    Herman, Michael G.; Khadivi, Kevin O.; Kleinberg, Lawrence; Gage, Irene; Abrams, Ross A.

    1997-01-01

    excursions occurred, some portion (exceeding 10%) of the GTV was noted to move beyond the treatment field during the treatment. During tangential breast treatments, increases of up to 20% in treated lung volumes were observed. Conclusions: Diagnostic, simulation and verification images used in radiation therapy are snapshots of dynamic patient anatomy. The magnitude of physiologic motion due to respiration may significantly impact on target volume coverage during the treatment fraction. Movie-loop EPID data recorded during treatments of breast and lung treatments show that while the mean displacements are small, large >3cm displacements and broad standard deviations in target or normal anatomy position exist. The implied effects on decreasing target volume treated or increased normal tissue irradiated will compromise our efforts to deliver dose-escalated, three-dimensional and dynamic radiation therapy

  13. Noradrenergic α1 Receptor Antagonist Treatment Attenuates Positive Subjective Effects of Cocaine in Humans: A Randomized Trial

    Science.gov (United States)

    Newton, Thomas F.; De La Garza, Richard; Brown, Gregory; Kosten, Thomas R.; Mahoney, James J.; Haile, Colin N.

    2012-01-01

    Background Preclinical research implicates dopaminergic and noradrenergic mechanisms in mediating the reinforcing effects of drugs of abuse, including cocaine. The objective of this study was to evaluate the impact of treatment with the noradrenergic α1 receptor antagonist doxazosin on the positive subjective effects of cocaine. Methods Thirteen non-treatment seeking, cocaine-dependent volunteers completed this single-site, randomized, placebo-controlled, within-subjects study. In one study phase volunteers received placebo and in the other they received doxazosin, with the order counterbalanced across participants. Study medication was masked by over-encapsulating doxazosin tablets and matched placebo lactose served as the control. Study medication treatment was initiated at 1 mg doxazosin or equivalent number of placebo capsules PO/day and increased every three days by 1 mg. After receiving 4 mg doxazosin or equivalent number of placebo capsules participants received masked doses of 20 and 40 mg cocaine IV in that order with placebo saline randomly interspersed to maintain the blind. Results Doxazosin treatment was well tolerated and doxazosin alone produced minimal changes in heart rate and blood pressure. During treatment with placebo, cocaine produced dose-dependent increases in subjective effect ratings of “high”, “stimulated”, “like cocaine”, “desire cocaine”, “any drug effect”, and “likely to use cocaine if had access” (p<.001). Doxazosin treatment significantly attenuated the effects of 20 mg cocaine on ratings of “stimulated”, “like cocaine”, and “likely to use cocaine if had access” (p<.05). There were trends for doxazosin to reduce ratings of “stimulated”, “desire cocaine”, and “likely to use cocaine if had access” (p<.10). Conclusions Medications that block noradrenergic α1 receptors, such as doxazosin, may be useful as treatments for cocaine dependence, and should be evaluated further. Trial

  14. Effect of antiviral treatment and host susceptibility on positive selection in hepatitis C virus (HCV).

    Science.gov (United States)

    Jiménez-Hernández, Nuria; Sentandreu, Vicente; Castro, José A; Torres-Puente, Manuela; Bracho, Alma; García-Robles, Inmaculada; Ortega, Enrique; Del Olmo, Juan; Carnicer, Fernando; González-Candelas, Fernando; Moya, Andrés

    2008-02-01

    We have conducted a large sequence study of the E1-E2 and NS5A regions of the HCV, subtypes 1a and b, both in patients previously treated with interferon, and untreated patients, who later responded, or not, to a combination therapy based on interferon plus ribavirin. We have examined the role played by the number of positively selected sites on disease progression and its relationship with several variables such as patients' age, sex and their risk of acquiring the disease. We have detected three groups of patients that respond or not to combination therapy: responders of intermediate age, older non-responders and young non-responders, they possess an increasing average number of positively selected sites in the E1-E2 region, respectively. We conclude that the host's genetic factors play an important role in whether the disease is contained or becomes chronic.

  15. Positive examples of wastewater treatment effectiveness in ‘Natron-Hayat’ Maglaj factory

    Directory of Open Access Journals (Sweden)

    Bušatlić Ilhan

    2017-01-01

    Full Text Available In the paper are described the basic characteristics of wastewaters in the cellulose and paper factory ‘Natron-Hayat’ Maglaj. Particular emphasis is placed on the description of the technological process of wastewater treatment at the ‘Natron-Hayat’ Maglaj factory which is represented in the paper by a technological scheme and represents one of the more complex systems for wastewater treatment. In the experimental part, the results of the efficiency of the wastewater treatment system at the ‘Natron-Hayat’ Maglaj factory were given. It can be said that the basic raw materials for paper production are cellulose fibers and water. The role that water has in the cellulose and paper industry as the solvent, agent for cooking and washing of the produced pulp, indicates the presence of water in almost all stages of cellulose fiber production (Žarković et al., 2004. In accordance with the principles of sustainable development, cellulose and paper industry must face strict regulations on the protection of the environment which includes rationalization of raw material consumption, water, energy and chemicals, with ‘Natron-Hayat’ Maglaj are subjected to the purification before discharging into surface water recipient. The wastewaters from ‘Natron-Hayat’ Maglaj factory are discharged into river Bosna.

  16. Effects of organ motion on proton prostate treatments, as determined from analysis of daily CT imaging for patient positioning.

    Science.gov (United States)

    Maeda, Yoshikazu; Sato, Yoshitaka; Shibata, Satoshi; Bou, Sayuri; Yamamoto, Kazutaka; Tamamura, Hiroyasu; Fuwa, Nobukazu; Takamatsu, Shigeyuki; Sasaki, Makoto; Tameshige, Yuji; Kume, Kyo; Minami, Hiroki; Saga, Yusuke; Saito, Makoto

    2018-05-01

    .0, 7.6, 6.0), (11.8, 8.4, 7.8, 5.2, 6.3), and (9.9, 7.5, 7.8, 5.2, 6.3). PRB matching showed the smallest positional deviations at all portions except for the anterior portion of the prostate and was able to markedly reduce the positional deviations at the posterior portion. The averaged WEL variations at the distal and proximal sides of planning target volumes were estimated 7-9 mm and 4-6 mm, respectively, and showed the increasing of a few millimeters in PC and PRB matching compared to bone matching. In the treatment planning simulation, the DVH values of the rectum in PRB matching were reduced compared to those obtained with other matching strategies. The positional deviations for the prostate on the posterior side and the SVs were smaller by PRB matching than the other strategies and effectively reduced the rectal dose. 3D dose calculations indicate that PRB matching with CT image guidance may do a better job relative to other positioning methods to effectively reduce the rectal complications. The WEL variation was quite large, and the appropriate margin (approx. 10 mm) must be adapted to the proton range in an initial planning to maintain the coverage of target volumes throughout entire treatment. © 2018 American Association of Physicists in Medicine.

  17. Cost-effectiveness analysis of trastuzumab in the adjuvant setting for treatment of HER2-positive breast cancer.

    Science.gov (United States)

    Garrison, Louis P; Lubeck, Deborah; Lalla, Deepa; Paton, Virginia; Dueck, Amylou; Perez, Edith A

    2007-08-01

    Adding trastuzumab to adjuvant chemotherapy provides significant clinical benefit in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer. A cost-effectiveness analysis was performed to assess clinical and economic implications of adding trastuzumab to adjuvant chemotherapy, based upon joint analysis of NSABP B-31 and NCCTG N9831 trials. A Markov model with 4 health states was used to estimate the cost utility for a 50-year-old woman on the basis of trial results through 4 years and estimates of long-term recurrence and death based on a meta-analysis of trials. From 6 years onward, rates of recurrence and death were assumed to be the same in both trastuzumab and chemotherapy-only arms. Incremental costs were estimated for diagnostic and treatment-related costs. Analyses were from payer and societal perspectives, and these analyses were projected to lifetime and 20-year horizons. Over a lifetime, the projected cost of trastuzumab per quality-adjusted life year (QALY; discount rate 3%) gained was 26,417 dollars (range 9,104 dollars-69,340 dollars under multiway sensitivity analysis). Discounted incremental lifetime cost was 44,923 dollars, and projected life expectancy was 3 years longer for patients who received trastuzumab (19.4 years vs 16.4 years). During a 20-year horizon, the projected cost of adding trastuzumab to chemotherapy was 34,201 dollars per QALY gained. Key cost-effectiveness drivers were discount rate, trastuzumab price, and probability of metastasis. The cost-effectiveness result was robust to sensitivity analysis. Trastuzumab for adjuvant treatment of early stage breast cancer was projected to be cost effective over a lifetime horizon, achieving a cost-effectiveness ratio below that of many widely accepted oncology treatments. (c) 2007 American Cancer Society.

  18. [Local ice application in therapy of kinetic limb ataxia. Clinical assessment of positive treatment effects in patients with multiple sclerosis].

    Science.gov (United States)

    Albrecht, H; Schwecht, M; Pöllmann, W; Parag, D; Erasmus, L P; König, N

    1998-12-01

    Upper limb ataxia is one of the most disabling symptoms of patients with multiple sclerosis (MS). There are some clinically tested therapeutic strategies, especially with regard to cerebellar tremor. But most of the methods used for treatment of limb ataxia in physiotherapy and occupational therapy are not systematically evaluated, e.g. the effect of local ice applications, as reported by MS patients and therapists, respectively. We investigated 21 MS patients before and in several steps 1 up to 45 min after cooling the most affected forearm. We used a series of 6 tests, including parts of neurological status and activities of daily living as well. At each step skin temperature and nerve conduction velocity were recorded. All tests were documented by video for later offline analysis. Standardized evaluation was done by the investigators and separately by an independent second team, both of them using numeric scales for quality of performance. After local cooling all patients showed a positive effect, especially a reduction of intentional tremor. In most cases this effect lasted 45 min, in some patients even longer. We presume that a decrease in the proprioceptive afferent inflow-induced by cooling-may be the probable cause of this reduction of cerebellar tremor. Patients can use ice applications as a method of treating themselves when a short-time reduction of intention tremor is required, e.g. for typing, signing or self-catheterization.

  19. Benign paroxysmal positional vertigo treatment

    DEFF Research Database (Denmark)

    West, Niels; Hansen, Søren; Bloch, Sune Land

    2017-01-01

    Benign paroxysmal positional vertigo (BPPV) remains the most frequent cause of vertigo. The TRV chair is a mechanical device suited for optimization of managing complex cases of BPPV. Although the use of repositioning devices in the management of BPPV is increasing, no applicable guide for the TRV...

  20. Lack of body positional effects on paresthesias when stimulating the dorsal root ganglion (DRG) in the treatment of chronic pain.

    Science.gov (United States)

    Kramer, Jeffery; Liem, Liong; Russo, Marc; Smet, Iris; Van Buyten, Jean-Pierre; Huygen, Frank

    2015-01-01

    One prominent side effect from neurostimulation techniques, and in particular spinal cord stimulation (SCS), is the change in intensity of stimulation when moving from an upright (vertical) to a recumbent or supine (horizontal) position and vice versa. It is well understood that the effects of gravity combined with highly conductive cerebrospinal fluid provide the mechanism by which changes in body position can alter the intensity of stimulation-induced paresthesias. While these effects are well established for leads that are placed within the more medial aspects of the spinal canal, little is known about these potential effects in leads placed in the lateral epidural space and in particular within the neural foramina near the dorsal root ganglion (DRG). We prospectively validated a newly developed paresthesia intensity rating scale and compared perceived paresthesia intensities when subjects assumed upright vs. supine bodily positions during neuromodulation of the DRG. On average, the correlation coefficient between stimulation intensity (pulse amplitude) and perceived paresthesia intensity was 0.83, demonstrating a strong linear relationship. No significant differences in paresthesia intensities were reported within subjects when moving from an upright (4.5 ± 0.14) to supine position 4.5 (± 0.12) (p > 0.05). This effect persisted through 12 months following implant. Neuromodulation of the DRG produces paresthesias that remain consistent across body positions, suggesting that this paradigm may be less susceptible to positional effects than dorsal column stimulation. © 2014 International Neuromodulation Society.

  1. Oxidative stress mediated arterial dysfunction in patients with obstructive sleep apnoea and the effect of continuous positive airway pressure treatment

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    Del Ben Maria

    2012-07-01

    Full Text Available Abstract Background Several studies suggest an increase of oxidative stress and a reduction of endothelial function in obstructive sleep apnoea syndrome (OSAS. We assessed the association between OSAS, endothelial dysfunction and oxidative stress. Further aim was to evaluate the effect of nasal continuous positive airway pressure (nCPAP on oxidative stress and arterial dysfunction. Methods We studied 138 consecutive patients with heavy snoring and possible OSAS. Patients underwent unattended overnight home polysomnography. Ten patients with severe OSAS were revaluated after 6 months of nCPAP therapy. To assess oxidative stress in vivo, we measured urinary 8-iso-PGF2α and serum levels of soluble NOX2-derived peptide (sNOX2-dp. Serum levels of nitrite/nitrate (NOx were also determined. Flow-mediated brachial artery dilation (FMD was measured to asses endothelial function. Results Patients with severe OSAS had higher urinary 8-iso-PGF2α (p Conclusions The results of our study indicate that patients with OSAS and cardiometabolic comorbidities have increased oxidative stress and arterial dysfunction that are partially reversed by nCPAP treatment.

  2. Effect of continuous positive airway pressure treatment for obstructive sleep apnoea on visual processing of degraded words.

    Science.gov (United States)

    Proudlove, Katie; Manuel, Ari; Hall, Rachel; Rieu, Romelie; Villarroel, Mauricio; Stradling, John

    2014-01-01

    In a previous uncontrolled study, continuous positive airway pressure (CPAP) therapy for obstructive sleep apnoea (OSA) improved vision in patients with diabetic macular oedema. We investigated whether the above improvement in vision (or visual processing) might have been due to reduced sleepiness, rather than a true improvement in retinal function. Twelve normal control subjects and 20 patients with OSA were tested for their ability to recognise degraded words, by means of a computer programme displaying 5-letter words every 4 s for 10 min, with variable amounts of the bottom half of the word missing; the percentage of the word necessary to achieve correct identification on average half the time was 'hunted' (the test score). All subjects were tested twice, 2-3 weeks apart; the OSA group after the commencement of CPAP. The Epworth Sleepiness Score (ESS) in patients was measured at the same visit. The test score at visit 1 was 26.7% for normal subjects and 31.6% for patients with OSA. At visit 2, the test score was 25.0% for normal subjects and 29.9% for patients with OSA. The groups showed a small and identical improvement over the trial period in the test score, of 1.7% (p = 0.01 and p = 0.03 for the normal and OSA groups, respectively). The group with OSA experienced a drop in ESS of 7.5 (SD 5.5) points following treatment. The small and identical improvement in both groups suggests only a similar learning effect rather than any improvement due to reduced sleepiness.

  3. Lack of body positional effects on paresthesias when stimulating the dorsal root ganglion (DRG) in the treatment of chronic pain

    NARCIS (Netherlands)

    J. Kramer (Jeffery); A.L. Liem (Liong); M. Russo (Marc); I. Smet (Iris); J.P. Van Buyten (Jean-Pierre); F.J.P.M. Huygen (Frank)

    2015-01-01

    textabstractObjectives: One prominent side effect from neurostimulation techniques, and in particular spinal cord stimulation (SCS), is the change in intensity of stimulation when moving from an upright (vertical) to a recumbent or supine (horizontal) position and vice versa. It is well understood

  4. Treatment Effects

    DEFF Research Database (Denmark)

    Heckman, James J.; Lopes, Hedibert F.; Piatek, Rémi

    2014-01-01

    This paper contributes to the emerging Bayesian literature on treatment effects. It derives treatment parameters in the framework of a potential outcomes model with a treatment choice equation, where the correlation between the unobservable components of the model is driven by a low-dimensional v......This paper contributes to the emerging Bayesian literature on treatment effects. It derives treatment parameters in the framework of a potential outcomes model with a treatment choice equation, where the correlation between the unobservable components of the model is driven by a low...... to observe the same person in both the treated and untreated states, but it also turns out to be straightforward to implement. Formulae are provided to compute mean treatment effects as well as their distributional versions. A Monte Carlo simulation study is carried out to illustrate how the methodology can...

  5. Assessment of the tumor load as well as toxic and side effects after herceptin combined with doxorubicin liposome treatment of HER-2 positive breast cance

    Directory of Open Access Journals (Sweden)

    Guo-Quan Wen

    2016-12-01

    Full Text Available Objective: To study the effect of herceptin combined with doxorubicin liposome treatment on tumor load as well as toxic and side effects of HER-2 positive breast cancer. Methods: A total of 138 patients with HER-2 positive breast cancer who received chemotherapy in our hospital between July 2014 and December 2015 were selected as the research subjects and randomly divided into two groups, liposome group received herceptin combined with doxorubicin liposome treatment and control group received herceptin combined with doxorubicin treatment. After 8 weeks of treatment, the content of tumor markers, active molecules and myocardial injury markers in serum as well as the expression levels of immune marker molecules in peripheral blood mononuclear cells were detected. Results: After 8 weeks of treatment, CEA, CA199, CA153, CA125, VEGF, nectin-4, TK-1, PF-4, TSGF, CK, CK-MB, cTnI and cTnT content in serum of liposome group were significantly lower than those of control group, and the fluorescence intensity of CD3, CD4, CD8, CD16, CD19 and CD25 on peripheral blood mononuclear cell surface were significantly higher than those of control group. Conclusions: Herceptin combined with doxorubicin liposome treatment of HER-2 positive breast cancer can more effectively reduce the tumor load and cause less toxic and side effects on the heart and the immune system.

  6. A randomised controlled trial on the effect of mask choice on residual respiratory events with continuous positive airway pressure treatment.

    Science.gov (United States)

    Ebben, Matthew R; Narizhnaya, Mariya; Segal, Alan Z; Barone, Daniel; Krieger, Ana C

    2014-06-01

    It has been found that mask style can affect the amount of continuous positive airway pressure (CPAP) required to reduce an apnoea/hyponoea index (AHI) to mask style to another post titration could affect the residual AHI with CPAP. The purpose of this study was to investigate the differences in residual AHI with CPAP treatment between oronasal and nasal masks. Twenty-one subjects (age mean (M)=62.9, body mass index (BMI) M=29.6 kg/m2) were randomised (14 subjects completed the protocol) to undergo an in-laboratory CPAP titration with either a nasal mask or an oronasal mask. Subjects were then assigned this mask for 3weeks of at-home CPAP use with the optimal treatment pressure determined on the laboratory study (CPAP M=8.4 cm of H2O). At the end of this 3-week period, data were collected from the CPAP machine and the subject was given the other mask to use with the same CPAP settings for the next 3weeks at home (if the nasal mask was given initially, the oronasal one was given later and vice versa). On completion of the second 3-week period, data on residual AHI were again collected and compared with the first 3-week period on CPAP. A Wilcoxon Signed-Rank Test (two-tailed) revealed that residual AHI with CPAP treatment was significantly higher with the oronasal compared with the nasal mask (z = -3.296, pmask, and 50% of the subjects had a residual AHI >10/h in the oronasal mask condition, even though all of these subjects were titrated to an AHI of mask compared with a nasal mask. Switching to an oronasal mask post titration results in an increase in residual AHI with CPAP treatment, and pressure adjustment may be warranted. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Cost and cost-effectiveness of smear-positive tuberculosis treatment by Health Extension Workers in Southern Ethiopia: a community randomized trial.

    Directory of Open Access Journals (Sweden)

    Daniel G Datiko

    Full Text Available UNLABELLED: Treatments by HEWs in the health posts and general health workers at health facility were compared along a community-randomized trial. Costs were analysed from societal perspective in 2007 in US $ using standard methods. We prospectively enrolled smear positive patients, and calculated cost-effectiveness as the cost per patient successfully treated. The total cost for each successfully treated smear-positive patient was higher in health facility ($158.9 compared with community ($61.7. Community-based treatment reduced the total, patient and caregiver cost by 61.2%, 68.1% and 79.8%, respectively. Involving HEWs added a total cost of $8.80 (14.3% of total cost on health service per patient treated in the community. CONCLUSIONS/SIGNIFICANCE: Community-based treatment by HEWs costs only 39% of what treatment by general health workers costs for similar outcomes. Involving HEWs in TB treatment is a cost effective treatment alternative to the health service, to the patients and the family. There is an economic and public health reason to consider involving HEWs in TB treatment in Ethiopia. However, community-based treatment requires initial investment to start its implementation, training and supervision. TRIAL REGISTRATION: ClinicalTrials.gov NCT00803322.

  8. Twenty-five milligrams of clomiphene citrate presents positive effect on treatment of male testosterone deficiency - a prospective study

    Directory of Open Access Journals (Sweden)

    Carlos Teodósio Da Ros

    2012-08-01

    Full Text Available INTRODUCTION: Male testosterone deficiency is associated with bad sexual function and quality of life (QoL. The aim of this study was to determine whether a daily dose of 25 mg clomiphene citrate (CC is effective in stimulating the endogenous testosterone production pathway and to address the applicability of this medication as a therapeutic option for symptomatic hypogonadism. MATERIALS AND METHODS: This was a prospective study. Men with low sexual desire and testosterone levels (T below 400 ng/dL were selected to receive CC. Blood samples were obtained to determine baseline measurements of serum T, estradiol, LH, lipid profile and fasting plasma glucose. Each patient was treated with a daily dose of 25 mg CC for at least 3 months. Patients were asked if they experienced any side effects related to the use of CC and if they experienced any improvement in their sexual profile. Paired samples T-test was utilized to analyze responses to therapy. RESULTS: Our cohort consisted of 125 men with hypogonadism and low libido. Mean age was 62 years (± 11.1 years. Serum T levels ranged from 309 ng/dL (baseline, mean value to 642 ng/dL (3 months after CC initiation, mean value (p < 0.001. Serum cholesterol levels ranged from 197 to 186 mg/dL (p = 0.003. There were no statistically significant differences when comparing pre and post-treatment HDL-Cholesterol, triglycerides, fasting plasma glucose and prolactin. All men reported improvements in the post-treatment QoL scores. No serious adverse events were recorded. CONCLUSIONS: The CC was effective in stimulating the endogenous production of testosterone. A lower level of total cholesterol was verified after three months of treatment. This medication should be considered as a therapeutic option for some patients with symptomatic male testosterone deficiency.

  9. [Effect of Continuous Positive Airway Pressure Treatment on Depression, Anxiety and Perceived Stress Levels in Patients with Obstructive Sleep Apnea Syndrome].

    Science.gov (United States)

    Çelik, Mustafa; Sarıkaya, Yasin; Acar, Mustafa; Kalenderoğlu, Aysun; Doğan, Sedat; Kaskalan, Emin; Karataş, Mehmet

    2016-01-01

    The aim of this study is to determine the effects of continuous positive airway pressure (CPAP) treatment on depression, anxiety, and perceived stress levels and to identify factors predictive of treatment efficacy in patients with obstructive sleep apnea syndrome (OSAS). This study included 51 patients admitted to the Adiyaman University Medical School Otorhinolaryngology Department or Eskisehir Yunus Emre State Hospital between January and September 2014 with one or more complaints including snoring, excessive daytime sleepiness, or apnea witnessed by the partner. Diagnosis of OSAS was made by polysomnography and CPAP treatment was initiated. Depression levels were assessed in all study subjects using the Hospital Anxiety and Depression Scale (HADS) at the start of treatment and at 3 months. Anxiety levels were assessed using both the HADS and the State and Trait Anxiety Inventory (STAI), and perceived stress level was assessed using the Perceived Stress Questionnaire (PSQ). After CPAP treatment, we observed significant decreases in both the Depression and Anxiety Subscales of the HADS, in the Trait Anxiety subscale of the STAI, and in the PSQ. An evaluation of the initial parameters that predict improvements in these scales revealed that snoring time predicted decreases in all scale scores. In OSAS patients CPAP treatment has positive effects on psychological parameters like depression, anxiety, and perceived stress. We suggest that possible psychogenic benefits should be considered when deciding to start CPAP treatment, particularly in patients with pronounced and extended snoring who may also have social problems.

  10. Understanding Antipsychotic Drug Treatment Effects: A Novel Method to Reduce Pseudospecificity of the Positive and Negative Syndrome Scale (PANSS) Factors.

    Science.gov (United States)

    Hopkins, Seth C; Ogirala, Ajay; Loebel, Antony; Koblan, Kenneth S

    2017-12-01

    The Positive and Negative Syndrome Scale (PANSS) is the most widely used efficacy measure in acute treatment studies of schizophrenia. However, interpretation of the efficacy of antipsychotics in improving specific symptom domains is confounded by moderate-to-high correlations among standard (Marder) PANSS factors. The authors review the results of an uncorrelated PANSS score matrix (UPSM) transform designed to reduce pseudospecificity in assessment of symptom change in patients with schizophrenia. Based on a factor analysis of five pooled, placebo-controlled lurasidone clinical trials (N=1,710 patients), a UPSM transform was identified that generated PANSS factors with high face validity (good correlation with standard Marder PANSS factors), and high specificity/orthogonality (low levels of between-factor correlation measuring change during treatment). Between-factor correlations were low at baseline for both standard (Marder) PANSS factors and transformed PANSS factors. However, when measured change in symptom severity was measured during treatment (in a pooled 5-study analysis), there was a notable difference for standard PANSS factors, where changes across factors were found to be highly correlated (factors exhibited pseudospecificity), compared to transformed PANSS factors, where factor change scores exhibited the same low levels of between-factor correlation observed at baseline. At Week 6-endpoint, correlations among PANSS factor severity scores were moderate-to-high for standard factors (0.34-0.68), but continued to be low for the transformed factors (-0.22-0.20). As an additional validity check, we analyzed data from one of the original five pooled clinical trials that included other well-validated assessment scales (MADRS, Negative Symptom Assessment scale [NSA]). In this baseline analysis, UPSM-transformed PANSS factor severity scores (negative and depression factors) were found to correlate well with the MADRS and NSA. The availability of transformed

  11. Tuberculosis treatment among smear positive tuberculosis patients

    International Nuclear Information System (INIS)

    Munir, M.K.; Iqbal, R.; Shabbir, I.; Chaudhry, K

    2012-01-01

    Tuberculosis is a major health problem in many parts of the world. Delay in initiation of the treatment may result in prolonged infectious state, drug resistance, relapse and death. Objectives: To determine the factors responsible for not starting tuberculosis treatment among smear positive tuberculosis patients. Study type, settings and duration: This cross sectional study was done at Pakistan Medical Research Council TB Research Center, King Edward Medical University, Lahore, from fifth March 2010 to fifth December 2010. Patients and Methods: Fifty sputum smear positive patients of tuberculosis who did not register themselves in treatment register and presumably did not initiate anti tuberculosis treatment were contacted using telephone or traced by their home addresses. Once contact was established, they were inquired about the reasons for not starting tuberculosis treatment. Results: Of 50 patients 38(76%)belonged to the lower socio economic class and 12(24%) to the lower middle class. Fourteen patients (28%) were illiterate and 23(46%) had only 8 years of education. Of the 50 cases 41(82%) were taking treatment from traditional healers and 4% did not go back to the DOTS program. Physical condition of the patient, social, domestic and religious issues also played some role in default. Conclusions: Lack of health education and poverty were the main factors responsible for non compliance from treatment. Policy message: Sputum testing sites should have a paramedic who should educate the patients about the benefits of treatment and the dangers of default or partial treatment. (author)

  12. Impact of the type of mask on the effectiveness of and adherence to continuous positive airway pressure treatment for obstructive sleep apnea*

    Science.gov (United States)

    de Andrade, Rafaela Garcia Santos; Piccin, Vivien Schmeling; Nascimento, Juliana Araújo; Viana, Fernanda Madeiro Leite; Genta, Pedro Rodrigues; Lorenzi-Filho, Geraldo

    2014-01-01

    Continuous positive airway pressure (CPAP) is the gold standard for the treatment of obstructive sleep apnea (OSA). Although CPAP was originally applied with a nasal mask, various interfaces are currently available. This study reviews theoretical concepts and questions the premise that all types of interfaces produce similar results. We revised the evidence in the literature about the impact that the type of CPAP interface has on the effectiveness of and adherence to OSA treatment. We searched the PubMed database using the search terms "CPAP", "mask", and "obstructive sleep apnea". Although we identified 91 studies, only 12 described the impact of the type of CPAP interface on treatment effectiveness (n = 6) or adherence (n = 6). Despite conflicting results, we found no consistent evidence that nasal pillows and oral masks alter OSA treatment effectiveness or adherence. In contrast, most studies showed that oronasal masks are less effective and are more often associated with lower adherence and higher CPAP abandonment than are nasal masks. We concluded that oronasal masks can compromise CPAP OSA treatment adherence and effectiveness. Further studies are needed in order to understand the exact mechanisms involved in this effect. PMID:25610507

  13. Impact of the type of mask on the effectiveness of and adherence to continuous positive airway pressure treatment for obstructive sleep apnea.

    Science.gov (United States)

    Andrade, Rafaela Garcia Santos de; Piccin, Vivien Schmeling; Nascimento, Juliana Araújo; Viana, Fernanda Madeiro Leite; Genta, Pedro Rodrigues; Lorenzi-Filho, Geraldo

    2014-01-01

    Continuous positive airway pressure (CPAP) is the gold standard for the treatment of obstructive sleep apnea (OSA). Although CPAP was originally applied with a nasal mask, various interfaces are currently available. This study reviews theoretical concepts and questions the premise that all types of interfaces produce similar results. We revised the evidence in the literature about the impact that the type of CPAP interface has on the effectiveness of and adherence to OSA treatment. We searched the PubMed database using the search terms "CPAP", "mask", and "obstructive sleep apnea". Although we identified 91 studies, only 12 described the impact of the type of CPAP interface on treatment effectiveness (n = 6) or adherence (n = 6). Despite conflicting results, we found no consistent evidence that nasal pillows and oral masks alter OSA treatment effectiveness or adherence. In contrast, most studies showed that oronasal masks are less effective and are more often associated with lower adherence and higher CPAP abandonment than are nasal masks. We concluded that oronasal masks can compromise CPAP OSA treatment adherence and effectiveness. Further studies are needed in order to understand the exact mechanisms involved in this effect.

  14. The effects of CPAP treatment on task positive and default mode networks in obstructive sleep apnea patients: an fMRI study.

    Directory of Open Access Journals (Sweden)

    Olga Prilipko

    Full Text Available INTRODUCTION: Functional magnetic resonance imaging studies enable the investigation of neural correlates underlying behavioral performance. We investigate the effect of active and sham Continuous Positive Airway Pressure (CPAP treatment on working memory function of patients with Obstructive Sleep Apnea Syndrome (OSAS considering Task Positive and Default Mode networks (TPN and DMN. METHODS: An experiment with 4 levels of visuospatial n-back task was used to investigate the pattern of cortical activation in 17 men with moderate or severe OSAS before and after 2 months of therapeutic (active or sub-therapeutic (sham CPAP treatment. RESULTS: Patients with untreated OSAS had significantly less deactivation in the temporal regions of the DMN as compared to healthy controls, but activation within TPN regions was comparatively relatively preserved. After 2 months of treatment, active and sham CPAP groups exhibited opposite trends of cerebral activation and deactivation. After treatment, the active CPAP group demonstrated an increase of cerebral activation in the TPN at all task levels and of task-related cerebral deactivation in the anterior midline and medial temporal regions of the DMN at the 3-back level, associated with a significant improvement of behavioral performance, whereas the sham CPAP group exhibited less deactivation in the temporal regions of Default Mode Network and less Task Positive Network activation associated to longer response times at the 3-back. CONCLUSION: OSAS has a significant negative impact primarily on task-related DMN deactivation, particularly in the medial temporal regions, possibly due to nocturnal hypoxemia, as well as TPN activation, particularly in the right ventral fronto-parietal network. After 2 months of active nasal CPAP treatment a positive response was noted in both TPN and DMN but without compete recovery of existing behavioral and neuronal deficits. Initiation of CPAP treatment early in the course of the

  15. Anti-CagA positivity in duodenal ulcer and functional dyspepsia patients infected with Helicobacter pylori and its effect on the outcome of eradication treatment

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    Yaşar Nazlıgül

    2011-03-01

    Full Text Available Objectives: CagA positive H. pylori strains are considered to be more virulent than other strains. In this study, we aimed to investigate the rate of CagA positivity in duodenal ulcer (DU and functional dyspepsia (FD, and its effect on H. pylori eradication response.Materials and methods: The study was performed on H. pylori positive 60 patients with DU and 50 patients with FD, who underwent upper gastrointestinal endoscopy. H. pylori infection was identified by histology. All patients received a quadriple therapy consisted of esomeprazole 20 mg b.i.d., colloidal bismuth subcitrate 600 mg b.i.d., tetracycline 500 mg q.i.d. and metronidazole 500 mg t.i.d. for 7 days. H.pylori status was rechecked using C14-urea breath test 6 weeks after the end of treatment to confirm cure. Specific IgG antibodies for CagA status were determined by enzyme linked immunosorbent assay.Results: CagA positivities in the patients with DU and FD were calculated respectivily 70% and 68% (P>0.05. H. pylori was eradicated in 85.5% of the patients infected with CagA (+ strains, in 50% of those infected with CagA (- strains (P=0.001. The eradication rates were 95.2% and 55.6% in CagA positive and negative DU subgroups (P=0.001, and 73.5% and 43.8% in CagA positive and negative FD subgroups (P=0.04.Conclusion: CagA positivities were not different in duodenal ulcer and functional dyspepsia. CagA (+ strains was susceptible to the eradication treatment. The titres of serum anti-CagA antibodies may be used in the prediction of eradication outcome, and the modification of eradication therapy.

  16. SU-E-T-346: Effect of Jaw Position On Dose to Critical Structures in 3-D Conformal Radiotherapy Treatment of Pancreatic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Paudel, N; Han, E; Liang, X; Morrill, S; Zhang, X; Hardee, M; Penagaricano, J; Ratanatharathorn, V [Vaneerat, University of Arkansas for Medical Sciences, Little Rock, AR (United States)

    2015-06-15

    Purpose: Three-dimensional conformal therapy remains a valid and widely used modality for pancreatic radiotherapy treatment. It usually meets dose constraints on critical structures. However, careful positioning of collimation jaws can reduce dose to the critical structures. Here we investigate the dosimetric effect of jaw position in MLC-based 3-D conformal treatment planning on critical structures. Methods: We retrospectively selected seven pancreatic cancer patients treated with 3-D conformal radiotherapy. We started with treatment plans (Varian Truebeam LINAC, Eclipse TPS, AAA, 18MV) having both x and y jaws aligned with the farthest extent of the block outline (8mm around PTV). Then we subsequently moved either both x-jaws or all x and y jaws outwards upto 3 cm in 1 cm increments and investigated their effect on average and maximum dose to neighboring critical structures keeping the same coverage to treatment volume. Results: Lateral displacement of both x-jaws by 1cm each increased kidney and spleen mean dose by as much as 1.7% and 1.3% respectively and superior inferior displacement increased liver, right kidney, stomach and spleen dose by as much as 2.1%, 2%, 5.2% and 1.6% respectively. Displacement of all x and y-jaws away by 1cm increased the mean dose to liver, right kidney, left kidney, bowels, cord, stomach and spleen by as much as 4.9%, 5.9%, 2.1%, 2.8%, 7.4%, 10.4% and 4.2% respectively. Percentage increase in mean dose due to 2 and 3cm jaw displacement increased almost linearly with the displaced distance. Changes in maximum dose were much smaller (mostly negligible) than the changes in mean dose. Conclusion: Collimation jaw position affects dose mostly to critical structures adjacent to it. Though treatment plans with MLCs conforming the block margin usually meet dose constraints to critical structures, keeping jaws all the way in, to the edge of the block reduces dose to the critical structures during radiation treatment.

  17. Technical Note: Dosimetric effects of couch position variability on treatment plan quality with an MRI-guided Co-60 radiation therapy machine

    Energy Technology Data Exchange (ETDEWEB)

    Chow, Phillip E., E-mail: pechow@mednet.ucla.edu; Thomas, David H.; Agazaryan, Nzhde; Cao, Minsong; Low, Daniel A.; Yang, Yingli; Steinberg, Michael L.; Lee, Percy; Lamb, James M. [Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California 90095 (United States)

    2016-08-15

    Purpose: Magnetic resonance imaging (MRI) guidance in radiation therapy brings real-time imaging and adaptive planning into the treatment vault where it can account for interfraction and intrafraction movement of soft tissue. The only commercially available MRI-guided radiation therapy device is a three-head {sup 60}Co and MRI system with an integrated treatment planning system (TPS). Couch attenuation of the beam of up to 20% is well modeled in the TPS. Variations in the patient’s day-to-day position introduce discrepancies in the actual couch attenuation as modeled in the treatment plan. For this reason, the authors’ institution avoids plans with beams that pass through or near the couch edges. This study investigates the effects of differential beam attenuation by the couch due to couch shifts in order to determine whether couch edge avoidance restrictions can be lifted. Couch shifts were simulated using a Monte Carlo treatment planning system and ion chamber measurements performed for validation. Methods: A total of 27 plans from 23 patients were investigated. Couch shifts of 1 and 2 cm were introduced in combinations of lateral and vertical directions to simulate patient position variations giving 16 shifted plans per reference plan. The 1 and 2 cm shifts were based on shifts recorded in 320 treatment fractions. Results: Following TG176 recommendations for measurement methods, couch attenuation measurements agreed with TPS modeled attenuation to within 2.1%. Planning target volume D95 changed less than 1% for 1 and 2 cm couch shifts in only the x-direction and less than 3% for all directions. Conclusions: Dosimetry of all plans tested was robust to couch shifts up to ±2 cm. In general, couch shifts resulted in clinically insignificant dosimetric deviations. It is conceivable that in certain cases with large systematic couch shifts and plans that are particularly sensitive to shifts, dosimetric changes might rise to a clinically significant level.

  18. Effect of position of blades in the treatment of IMRT; Efecto del posicionamiento de las laminas en los tratamiento de IMRT

    Energy Technology Data Exchange (ETDEWEB)

    Perez Azorin, J. F.; Ramos Garcia, L. I.; Ortiz de Zarate Vivanco, R.; Trueba Garayo, I.; Cacicedo, J.; Hoyo, O. del

    2013-07-01

    This paper presents a method of calculation of the positions of each blade measures during treatment for all segments and the subsequent reconstruction of these positions in the planning system on the patient's physical and anatomical data. (Author)

  19. The effect of a positive reappraisal coping intervention and problem-solving skills training on coping strategies during waiting period of IUI treatment: An RCT

    Science.gov (United States)

    Ghasemi, Marzieh; Kordi, Masoumeh; Asgharipour, Negar; Esmaeili, Habibollah; Amirian, Maliheh

    2017-01-01

    Background: Waiting period of fertility treatment is stressful, therefore it is necessary to use effective coping strategies to cope with waiting period of intrauterine insemination (IUI) treatment. Objective: The aim of this study was comparing the effect of the positive reappraisal coping intervention (PRCI) with the problem-solving skills training (PSS) on the coping strategies of IUI waiting period, in infertile women referred to Milad Infertility Center in Mashhad. Materials and Methods: In this randomized clinical trial, 108 women were evaluated into three groups. The control group received the routine care, but in PRCI group, two training sessions were held and they were asked to review the coping thoughts cards and fill out the daily monitoring forms during the waiting period, and in PSS group problem-solving skill were taught during 3 sessions. The coping strategies were compared between three groups on the 10th day of IUI waiting period. Results: Results showed that the mean score for problem-focused were significantly different between the control (28.54±9.70), PSS (33.71±9.31), and PRCI (30.74±10.96) (p=0.025) groups. There were significant differences between the PSS group and others groups, and mean emotion-focused were significantly different between the control (32.09±11.65), PSS (29.20±9.88), and PRCI (28.74±7.96) (p=0.036) groups. There were significant differences between the PRCI and the control group (p=0.047). Conclusion: PSS was more effective to increase problem-focused coping strategies than PRCI, therefore it is recommended that this intervention should be used in infertility treatment centers. PMID:29404530

  20. The effect of a positive reappraisal coping intervention and problem-solving skills training on coping strategies during waiting period of IUI treatment: An RCT.

    Science.gov (United States)

    Ghasemi, Marzieh; Kordi, Masoumeh; Asgharipour, Negar; Esmaeili, Habibollah; Amirian, Maliheh

    2017-11-01

    Waiting period of fertility treatment is stressful, therefore it is necessary to use effective coping strategies to cope with waiting period of intrauterine insemination (IUI) treatment. The aim of this study was comparing the effect of the positive reappraisal coping intervention (PRCI) with the problem-solving skills training (PSS) on the coping strategies of IUI waiting period, in infertile women referred to Milad Infertility Center in Mashhad. In this randomized clinical trial, 108 women were evaluated into three groups. The control group received the routine care, but in PRCI group, two training sessions were held and they were asked to review the coping thoughts cards and fill out the daily monitoring forms during the waiting period, and in PSS group problem-solving skill were taught during 3 sessions. The coping strategies were compared between three groups on the 10 th day of IUI waiting period. Results showed that the mean score for problem-focused were significantly different between the control (28.54±9.70), PSS (33.71±9.31), and PRCI (30.74±10.96) (p=0.025) groups. There were significant differences between the PSS group and others groups, and mean emotion-focused were significantly different between the control (32.09±11.65), PSS (29.20±9.88), and PRCI (28.74±7.96) (p=0.036) groups. There were significant differences between the PRCI and the control group (p=0.047). PSS was more effective to increase problem-focused coping strategies than PRCI, therefore it is recommended that this intervention should be used in infertility treatment centers.

  1. The effect of a positive reappraisal coping intervention and problem-solving skills training on coping strategies during waiting period of IUI treatment: An RCT

    Directory of Open Access Journals (Sweden)

    Marzieh Ghasemi

    2017-11-01

    Full Text Available Background: Waiting period of fertility treatment is stressful, therefore it is necessary to use effective coping strategies to cope with waiting period of intrauterine insemination (IUI treatment. Objective: The aim of this study was comparing the effect of the positive reappraisal coping intervention (PRCI with the problem-solving skills training (PSS on the coping strategies of IUI waiting period, in infertile women referred to Milad Infertility Center in Mashhad. Materials and Methods: In this randomized clinical trial, 108 women were evaluated into three groups. The control group received the routine care, but in PRCI group, two training sessions were held and they were asked to review the coping thoughts cards and fill out the daily monitoring forms during the waiting period, and in PSS group problem-solving skill were taught during 3 sessions. The coping strategies were compared between three groups on the 10th day of IUI waiting period. Results: Results showed that the mean score for problem-focused were significantly different between the control (28.54±9.70, PSS (33.71±9.31, and PRCI (30.74±10.96 (p=0.025 groups. There were significant differences between the PSS group and others groups, and mean emotion-focused were significantly different between the control (32.09±11.65, PSS (29.20±9.88, and PRCI (28.74±7.96 (p=0.036 groups. There were significant differences between the PRCI and the control group (p=0.047. Conclusion: PSS was more effective to increase problem-focused coping strategies than PRCI, therefore it is recommended that this intervention should be used in infertility treatment centers.

  2. Towards energy positive wastewater treatment plants.

    Science.gov (United States)

    Gikas, Petros

    2017-12-01

    Energy requirement for wastewater treatment is of major concern, lately. This is not only due to the increasing cost of electrical energy, but also due to the effects to the carbon footprint of the treatment process. Conventional activated sludge process for municipal wastewater treatment may consume up to 60% of the total plant power requirements for the aeration of the biological tank. One way to deal with high energy demand is by eliminating aeration needs, as possible. The proposed process is based on enhanced primary solids removal, based on advanced microsieving and filtration processes, by using a proprietary rotating fabric belt MicroScreen (pore size: 100-300 μm) followed by a proprietary Continuous Backwash Upflow Media Filter or cloth media filter. About 80-90% reduction in TSS and 60-70% reduction in BOD5 has been achieved by treating raw municipal wastewater with the above process. Then the partially treated wastewater is fed to a combination low height trickling filters, combined with encapsulated denitrification, for the removal of the remaining BOD and nitrogen. The biosolids produced by the microsieve and the filtration backwash concentrate are fed to an auger press and are dewatered to about 55% solids. The biosolids are then partially thermally dried (to about 80% solids) and conveyed to a gasifier, for the co-production of thermal (which is partly used for biosolids drying) and electrical energy, through syngas combustion in a co-generation engine. Alternatively, biosolids may undergo anaerobic digestion for the production of biogas and then electric energy. The energy requirements for complete wastewater treatment, per volume of inlet raw wastewater, have been calculated to 0.057 kWh/m 3 , (or 0.087 kWh/m 3 , if UV disinfection has been selected), which is about 85% below the electric energy needs of conventional activated sludge process. The potential for net electric energy production through gasification/co-generation, per volume of

  3. Incidence of neuropsychiatric side effects of efavirenz in HIV-positive treatment-naïve patients in public-sector clinics in the Eastern Cape

    Directory of Open Access Journals (Sweden)

    Razia Gaida

    2016-06-01

    Full Text Available Background: It is acknowledged that almost half of patients initiated on efavirenz will experience at least one neuropsychiatric side effect. Objectives: The aim was to determine the incidence and severity of neuropsychiatric side effects associated with efavirenz use in five public-sector primary healthcare clinics in the Eastern Cape. Method: The study was a prospective drug utilisation study. A total of 126 medical records were reviewed to obtain the required information. After baseline assessment, follow-up reviews were conducted at 4 weeks, 12 weeks and 24 weeks from 2014 to 2015. Results: The participant group was 74.60% female (n = 94, and the average age was 37.57±10.60 years. There were no neuropsychiatric side effects recorded for any patient. After the full follow-up period, there were a total of 49 non-adherent patients and one patient had demised. A non-adherent patient was defined as a patient who did not return to the clinic for follow-up assessment and medication refills 30 days or more after the appointed date. Some patients (n = 11 had sent a third party to the clinic to collect their antiretroviral therapy (ART. The clinic pharmacy would at times dispense a two-month supply of medication resulting in the patient presenting only every two months. Conclusion: Further pharmacovigilance studies need to be conducted to determine the true incidence of these side effects. Healthcare staff must be encouraged to keep complete records to ensure meaningful patient assessments. Patients being initiated on ART need to personally attend the clinic monthly for at least the first 6 months of treatment. Clinic staff should receive regular training concerning ART, including changes made to guidelines as well as reminders of side effects experienced. Keywords: neuropsychiatric; side effects; efavirenz; HIV-positive patients

  4. The effect of obstructive sleep apnea and treatment with continuous positive airway pressure on stroke rehabilitation: rationale, design and methods of the TOROS study

    NARCIS (Netherlands)

    Aaronson, Justine A.; van Bennekom, Coen A. M.; Hofman, Winni F.; van Bezeij, Tijs; van den Aardweg, Joost G.; Groet, Erny; Kylstra, Wytske A.; Schmand, Ben A.

    2014-01-01

    Obstructive sleep apnea is a common sleep disorder in stroke patients. Obstructive sleep apnea is associated with stroke severity and poor functional outcome. Continuous positive airway pressure seems to improve functional recovery in stroke rehabilitation. To date, the effect of continuous positive

  5. Virtual reality for the induction of positive emotions in the treatment of fibromyalgia: a pilot study over acceptability, satisfaction, and the effect of virtual reality on mood.

    Science.gov (United States)

    Herrero, Rocio; García-Palacios, Azucena; Castilla, Diana; Molinari, Guadalupe; Botella, Cristina

    2014-06-01

    One of the most important aspects of fibromyalgia syndrome (FMS) is its impact on quality of life, increasing negative emotions and dysfunctional coping strategies. One of these strategies is to avoid activities, especially meaningful activities, which reduces positive reinforcement. Commencing significant daily activities could enable chronic patients to experience a more fulfilling life. However, the main difficulty found in FMS patients is their willingness to start those activities. Promoting positive emotions could enhance activity management. The aim of this paper is to present a description of a system along with data regarding the acceptability, satisfaction, and preliminary efficacy of a virtual reality (VR) environment for the promotion of positive emotions. The VR environment was especially designed for chronic pain patients. Results showed significant increases in general mood state, positive emotions, motivation, and self-efficacy. These preliminary findings show the potential of VR as an adjunct to the psychological treatment of such an important health problem as chronic pain.

  6. Curative effect of continuous positive airway pressure on treatment of patients with obstructive sleep apnea hypopnea syndrome and hypertension: A Meta-analysis

    Directory of Open Access Journals (Sweden)

    Bi-fang MIAO

    2016-12-01

    Full Text Available Objective  To systematically evaluate the curative effect of continuous positive airway pressure (CPAP on treatment of patients with obstructive sleep apnea hypopnea syndrome (OSAHS and hypertension. Methods  The data were retrieved of randomized controlled trials (RCTs about the curative effect of CPAP on treatment of patients with OSAHS and hypertension from PubMed, Cochrane Library, CNKI, VIP, CBM and WanFang database from inception to Oct. 2015. Literature screening, data extraction and risk bias assessment were performed by two independent reviewers, and meta-analysis was then carried out by using RevMan 5.3 software. Results  A total of 16 RCTs involving 2101 patients were included. Meta-analysis revealed that, compared with the antihypertensive drug therapy alone, CPAP plus antihypertensive drug therapy significantly reduced the daytime systolic pressure [MD=–12.60, 95%CI(–17.68 to –7.52, P<0.00001], nighttime systolic pressure [MD=–21.90, 95%CI(–25.94 to –17.86, P<0.00001] and nighttime diastolic pressure [MD=–11.90, 95%CI(–15.44 to –8.36, P<0.00001], while created no significant difference in daytime diastolic pressure, 24-h mean systolic pressure and 24-h mean diastolic pressure in a following-up less than 12 weeks. Whereas in the following-up no less than 12 weeks, compared with the antihypertensive drug therapy alone, CPAP plus antihypertensive drug therapy significantly reduced the 24-h mean systolic pressure [MD=–7.88, 95%CI(–12.09 to –3.66, P=0.00002], 24-h mean diastolic pressure [MD=–5.14, 95%CI(–6.00 to –4.28, P<0.00001], daytime systolic pressure [MD=–5.89, 95%CI(–8.79 to –2.98, P<0.0001], daytime diastolic pressure [MD=–4.34, 95%CI(–6.32 to –2.36, P<0.0001]; nighttime systolic pressure [MD=–7.06, 95%CI(–11.12 to –2.99, P=0.0007] and nighttime diastolic pressure [MD=–4.49, 95%CI (–7.39 to –1.58, P=0.006]. Conclusions  The current evidences suggest that on the basis

  7. Effect of relative head position on the anesthetic efficacy of inferior alveolar nerve block during endodontic treatment of patients with irreversible pulpitis.

    Science.gov (United States)

    Aggarwal, Vivek; Singla, Mamta; Miglani, Sanjay

    2018-02-01

    The purpose of this prospective randomized single-blind clinical trial was to evaluate the effect of tilting the head on the anesthetic efficacy of inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis. Ninety-two patients were divided into two groups: the first group received IANB and the head was tilted in the direction of the block for 15 min, whereas the second group received IANB and the head was tilted to the opposite side. Access cavity preparation was initiated after 15 min. Success was defined as no pain or faint/weak/mild pain during endodontic access preparation and instrumentation. The anesthetic success rates were analyzed by Pearson chi-square test at 5% significance levels. The same side position and opposite side position yielded 41% and 30% anesthetic success rates, respectively; there was no significant difference between the two sides. Relative head position has no effect on the anesthetic success rate of IANB.

  8. Infliximab Dose Reduction Sustains the Clinical Treatment Effect in Active HLAB27 Positive Ankylosing Spondylitis: A Two-Year Pilot Study

    Directory of Open Access Journals (Sweden)

    Boel Mörck

    2013-01-01

    Full Text Available The rationale of the study was to evaluate the efficacy of infliximab (IFX treatment in patients with ankylosing spondylitis (AS and to determine whether IFX dose reduction and interval extension sustains the treatment effect. Nineteen patients were included and treated with IFX 5 mg/kg every 6 weeks for 56 weeks. All patients concomitantly received MTX with median dose 7.5 mg/weekly. During the second year, the IFX dose was reduced to 3 mg/kg every 8 weeks. Eighteen patients completed the 1-year and 15 patients the 2-year trial. The ≥50% improvement at week 16 from baseline of BASDAI was achieved in 16/19 (84% patients. Significant reductions in BASDAI, BASFI, and BASMI scores, decrease in ESR and CRP, and improvement in SF-36 were observed at weeks 16 and 56. The MRI-defined inflammatory changes in the sacroiliac joints disappeared in 10/15 patients (67% already at 16 weeks. IFX treatment effect was sustained throughout the second year after IFX dose reduction and interval extension. We conclude that IFX treatment is effective in well-established active AS and a dose reduction sustains the treatment effect. These observations are of clinical importance and open the opportunity to reduce the drug costs. This trial is registered with ClinicalTrials.gov NCT01850121.

  9. The effect of obstructive sleep apnea and treatment with continuous positive airway pressure on stroke rehabilitation: rationale, design and methods of the TOROS study

    NARCIS (Netherlands)

    Aaronson, J.A.; van Bennekom, C.A.M.; Hofman, W.F.; van Bezeij, T.; van den Aardweg, J.G.; Groet, E.; Kylstra, W.A.; Schmand, B.A.

    2014-01-01

    BACKGROUND: Obstructive sleep apnea is a common sleep disorder in stroke patients. Obstructive sleep apnea is associated with stroke severity and poor functional outcome. Continuous positive airway pressure seems to improve functional recovery in stroke rehabilitation. To date, the effect of

  10. Renegotiating "best treatment practice" and professional subject positions

    DEFF Research Database (Denmark)

    Søndergaard, Katia Dupret

    the professionals strive for is being able to meet patients as humans rather than meeting them as diagnosed patients. I will explore how situated and local enactments of these treatment ideals, for example dissolving the role of expert have complex constitutive effects and create alternative subject positions...... other. The analysis indicates that an argument of prevention may be a reinforcing motivation factor and possibility of subjectivation for the personnel. A possibility to construct a story about oneself, that facilitates the staff development as self-managing professional, in line with modern management...... strategies, where governing strategies are made invisible, and where management strategies are converted to individual existential projects. A central argument is that the individual ethical project of the introduction of a new treatment approach melts together with psychiatric treatment. There is no longer...

  11. Benign paroxysmal positional vertigo in outpatient practice: Diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    N. V. Bestuzheva

    2014-01-01

    Full Text Available Dizziness is one of the common reasons for visits to physicians of various specialties; the data of foreign investigations show that benign paroxysmal positional vertigo (BPPV is most frequently encountered.Objective: to study the causes of dizziness, to analyze the frequency of BPPV and the efficiency of its treatment in outpatient practice.Patients and methods. The investigation enrolled 80 patients, including 55 (68.7% women and 25 (31.3% men, aged 18 to 75 years (mean age 53.8±12.8 years, who complained of dizziness and sought for medical advice in the Therapeutic-and-Diagnostic Unit, A.Ya. Kozhevnikov Clinic of Nervous System Diseases, I.M. Sechenov First Moscow State Medical University.Results. The most common causes of dizziness in outpatient practice were BPPV (46.2% and postural phobic vertigo (35%. The diagnosis of VPPV, if special positional testing (Dix-Hallpike and McClure-Pagnini tests was carried out, was shown to create no significant difficulties. The diagnosis was not established in the majority (97.5% of the patients; effective treatment was performed in one of the patients. Combined treatment, by performing the positional tests and using betaserc for 2 months, led to complete resolution of positional vertigo in most (97.3% patients.Discussion. The findings indicate the efficiency of examining patients with complaints of dizziness, by using the special otoneurological tests to detect BPPV. The purposeful questioning of patients with BPPV can suspect this disease in the majority of cases. Our investigation shows the high efficiency of rehabilitation maneuvers for BPPV, which agrees well with the data of other authors. Physicians’ poor awareness of BPPV among physicians and the high efficiency of its treatment in outpatient practice are noted.

  12. Effect of continuous positive airway pressure treatment on short-term memory performance over 24 h of sustained wakefulness in patients with obstructive sleep apnea-hypopnea syndrome.

    Science.gov (United States)

    Grenèche, Jérôme; Krieger, Jean; Bertrand, Frédéric; Erhardt, Christine; Maumy, Myriam; Tassi, Patricia

    2013-10-01

    Few studies have examined the impact of continuous positive airway pressure (CPAP) therapy on short-term memory (STM) over sustained wakefulness in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). We have investigated if impaired STM can be reversed by CPAP treatment in a 24-h sustained wakefulness paradigm. Our follow-up study was conducted with repeated-memory tasks within 12 OSAHS patients and 10 healthy controls who underwent three 32-h sessions, one before CPAP (T0) and the second (T3) and the third (T6), after 3 and 6 months of treatment, respectively, for OSAHS patients. Each session included one night of sleep followed by 24h of sustained wakefulness, during which both groups performed STM tasks including both digit span (DS) and Sternberg tasks. Untreated OSAHS patients had no deficit in the forward DS task measuring immediate memory but were impaired in STM, especially working memory assessed by the complex Sternberg task and the backward DS. However, only performance in the latter was improved after 6 months of CPAP treatment. Because the high level of memory scanning required high speed in information processing, persistent impairment on the complex Sternberg task may be attributable to working memory slowing, possibly enhanced by sustained wakefulness. Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.

  13. Detention and positioning system for patient Treatment with conventional radiotherapy

    International Nuclear Information System (INIS)

    Hueso Bernad, Nuria; Tirado Porcar, Miriam; Del Castillo Arres, M. Jose; Broseta Tormos, M. Mercedes; Franch Martinez, Silvia; Suarez Dieguez, Raquel; Roures Ramos, M.Teresa

    2009-01-01

    The first step in what we call in radiotherapy S imulation and Planning o f radiation, is the correct choice of patient position and methods to use for this position is maintained along both the simulation and planning as the radiation treatment. The choice of position is directly linked to the choice of immobilizer to be used. (Author)

  14. The effect of patient position and field configuration on lung volume in the treatment of advanced carcinoma of the breast or lung volumes in breast techniques - a case study

    International Nuclear Information System (INIS)

    Floyd, J.L.

    1989-01-01

    The position of the patient together with the configuration of the treatment fields play an important role in the volume of lung irradiated in breast techniques. These factors are even more important when the staging of the disease is advanced. A comparison of lung volumes is made with the patient in three treatment positions, and the effect of beam angling is demonstrated. A method of calculating the approximated lung volume from port films is proposed, together with a comparative analysis of the data obtained. Clinical decisions affecting technical considerations are examined. 6 refs., 5 figs

  15. Link Between Positive Clinician-Conveyed Expectations of Treatment Effect and Pain Reduction in Knee Osteoarthritis, Mediated by Patient Self-Efficacy.

    Science.gov (United States)

    Hsiao-Wei Lo, Grace; Balasubramanyam, Ajay S; Barbo, Andrea; Street, Richard L; Suarez-Almazor, Maria E

    2016-07-01

    A prior knee osteoarthritis (OA) trial found that provider-conveyed expectations for treatment success were associated with pain improvement. We hypothesized this relationship was mediated by patient self-efficacy, since expectations of improvement may enhance one's ability to control health behaviors, and therefore health. Our aim was to examine whether self-efficacy was a mediator of the relationship observed in this trial. A secondary analysis of a 3-arm (traditional acupuncture, sham acupuncture, and wait list) trial for knee OA was conducted. Those in the acupuncture groups were equally randomized to acupuncturists trained to communicate a high or neutral expectation of treatment success (e.g., using language conveying high or unclear likelihood that acupuncture would reduce knee pain). A modified Arthritis Self-Efficacy Questionnaire and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale were administered. Linear regression analyses were used to examine whether patient self-efficacy mediated the relationship between provider communication style and knee pain at 3 months. High-expectation provider communication was associated with patient self-efficacy, β coefficient of 0.14 (95% confidence interval [95% CI] 0.01, 0.28). Self-efficacy was associated with WOMAC pain, β coefficient of -9.29 (95% CI -11.11, -7.47), while controlling for the provider communication style. The indirect effect a × b of -1.36 for high versus neutral expectation (bootstrap 95% CI -2.80, -0.15; does not include 0), supports the conclusion that patient self-efficacy mediates the relationship between provider-communicated expectations of treatment effects and knee pain. Our findings suggest that clinician-conveyed expectations can enhance the benefit of treatments targeting knee OA symptoms, mediated by improved patient self-efficacy. © 2016, American College of Rheumatology.

  16. Positive effects of creating mandalas

    OpenAIRE

    Toroš, Maja

    2016-01-01

    The purpose of the present master’s thesis is to examine the psychological effects of creating mandalas and to give recommendations for a better use of the mandalas in the practice of art assistance in order to help in this way others and oneself. Mandalas are sacred symbols, used in Hinduism and Buddhist religion practices as tools for meditation and concentration. They are geometrical representations of the creation of the cosmos and schemas of all that was created. Jung sat the foundations...

  17. Daptomycin treatment in Gram-positive vascular graft infections

    Directory of Open Access Journals (Sweden)

    Francisco Arnaiz de las Revillas

    2018-03-01

    Full Text Available Background: Daptomycin is a bactericidal antibiotic approved for the treatment of skin and soft tissue infections and right-side endocarditis. However, there is a lack of published data outlining its usefulness in vascular graft infections (VGI. The aim of this study was to describe the clinical experience of daptomycin use in the treatment of VGI caused by Gram-positive bacteria. Methods: This was a retrospective cohort study of patients diagnosed with VGI receiving daptomycin at a tertiary care hospital during the period January 2010 to December 2012. Results: Of a total 1066 consecutive patients who had undergone vascular grafts (VG, 25 were diagnosed with VGI. Fifteen of these patients (11 prosthetic VG, three autologous VG, one both types received daptomycin (median dose 6.7 mg/kg/day, range 4.1–7.1 mg/kg/day; median age 69 years, range 45–83 years; 80% male. The infected bypass was removed in 13 cases. The most common reason for selecting daptomycin was kidney failure (53%. The Gram-positive organisms isolated were coagulase-negative Staphylococcus (n = 10, Staphylococcus aureus (n = 3 (two methicillin-resistant S. aureus, Enterococcus faecium (n = 2, and Enterococcus faecalis (n = 1. The mean follow-up was 69 months (interquartile range 48–72 months. Ten patients (66.7% achieved complete healing of the VGI. A recurrence of the infection was observed in 100% of patients in whom the bypass was not removed. Among patients who did not achieve complete healing, one needed a supracondylar amputation and one died as a consequence of infection. Five patients received treatment with rifampicin in addition to daptomycin and they were all cured. Conclusions: The use of daptomycin and surgery for Gram-positive VGI was effective and well tolerated, and this may be a good alternative for the treatment of VGI in patients with peripheral arterial disease in whom renal insufficiency is common. Keywords: Daptomycin, Gram-positive, Vascular

  18. Why HIV Positive Patients on Antiretroviral Treatment and/or ...

    African Journals Online (AJOL)

    Why HIV Positive Patients on Antiretroviral Treatment and/or Cotrimoxazole Prophylaxis Use Traditional Medicine: Perceptions of Health Workers, Traditional Healers and Patients: A Study in Two Provinces of South Africa.

  19. Positive synergistic effect of the reuse and the treatment of hazardous waste on pyrometallurgical process of lead recovery from waste lead-acid batteries

    Directory of Open Access Journals (Sweden)

    Marija Štulović

    2014-09-01

    Full Text Available Modification and optimization of the pyrometallurgical process of lead recovering from the waste lead-acid batteries have been studied in this paper. The aim of this research is to develop a cleaner production in the field of the secondary lead metallurgy. Lead smelting process with the addition of flux (sodium(I-carbonate and reducing agents (coke, iron has been followed. The modified smelting process with the addition of hazardous waste (activated carbon as alternative reducing agents has shown positive results on the quality of the secondary lead, the generated slag and the process gases. Filtration efficiency of the gases, the return of baghouse dust to the process and use of oxygen burners have positive effect on the environment protection and energy efficiency. Optimization of the recycling process has been based on the properties of the slag. Stabilization of slag is proposed in the furnace with addition of waste dust from the recycling of cathode ray tube (CRT monitors. Phosphorus compounds from dust reduce leachability of toxic elements from the generated slag. Reduction the slag amount and its hazardous character through the elimination of migratory heavy metals and valorization of useful components have been proposed in the patented innovative device - cylindrical rotating washer/separator.

  20. The representitativeness of patient position during the first treatment fractions

    DEFF Research Database (Denmark)

    Bertelsen, Anders; Nielsen, Morten; Westberg, Jonas

    2009-01-01

    BACKGROUND: During external radiotherapy daily or even weekly image verification of the patient position might be problematic due to the resulting workload. Therefore it has been customary to perform image verification only at the first treatment fraction. In this study it is investigated whether...... the patient position uncertainty at the initial three treatment fractions is representative for the uncertainty throughout the treatment course. METHODS: Seventy seven patients were treated using Elekta Synergy accelerators. The patients were immobilized during treatment by use of a customized VacFix bag...... and a mask of AquaPlast. Cone beam CT (CBCT) scans were performed at fractions 1, 2, and 3 and at the 10th and 20th treatment fractions. Displacements in patient position, translational and rotational, have been measured by an image registration of the CBCT and the planning CT scan. The displacements data...

  1. Factors associated with the effectiveness of plasma exchange for the treatment of NMO-IgG-positive neuromyelitis optica spectrum disorders.

    Science.gov (United States)

    Lim, Young-Min; Pyun, So Young; Kang, Bong-Hui; Kim, Jimin; Kim, Kwang-Kuk

    2013-08-01

    To identify factors associated with plasma exchange response in neuromyelitis optica (NMO) spectrum disorders, the clinical and magnetic resonance imaging (MRI) features of 31 NMO-IgG-positive patients receiving plasma exchange for steroid-resistant exacerbations were analyzed. Functional improvement was observed in 65% of the patients. A lower baseline Expanded Disability Status Scale score was associated with favorable response (p = 0.040). Patients without cord atrophy had a higher success rate than patients with atrophy (p = 0.016). Levels of NMO-IgG did not differ between responders and non-responders before and after plasma exchange. In conclusion, a minimal pre-existing disability is the primary determinant of the effectiveness of plasma exchange.

  2. Orthotic treatment of positional brachycephaly associated with osteogenesis imperfecta.

    Science.gov (United States)

    Matarazzo, Carolina G; Schreen, Gerd; Lago-Rizzardi, Camilla D do; Peccin, Maria Stella; Pinto, Fernando Cg

    2017-12-01

    Osteogenesis imperfecta is an inherited disorder of the connective tissue characterized primarily by fractures with no or small causal antecedents and extremely variable clinical presentation. The disorder requires a global and, therefore, multidisciplinary therapeutic approach that should aim, among other aspects, at the prevention and treatment of deformities resulting from osteogenesis imperfecta. Due to limitations related to bony deformities, it can be difficult to place these infants in a variety of positions that would help remediate skull deformities, so a cranial orthosis becomes the therapy of choice. The aim of this study was to demonstrate the results obtained during treatment with a cranial remolding orthosis (helmet) in babies with osteogenesis imperfecta. Case Description and Methods: For the first time in the scientific literature, this study describes the use of a cranial orthosis for the treatment of infants with osteogenesis imperfecta. Both children had severe asymmetrical brachycephaly documented by laser digital scanning and were submitted to treatment with a cranial remolding orthosis. Outcomes and Conclusion: The study showed that there was a significant improvement in cranial proportion and symmetry, with a reduction in the cephalic index at reevaluation. It is concluded that the orthotic therapy is an effective therapeutic modality to improve the proportion and minimize the asymmetry in children with osteogenesis imperfecta. Clinical relevance The clinical relevance of such a description is that children with osteogenesis imperfecta may have numerous deformities and minimizing them can be an important factor. This report showed a beneficial result as the orthotic therapy modality improved the proportions and minimized the asymmetry. This treatment offers too high levels of satisfaction to parents and brings these children closer to normal indices.

  3. Diagnosis and Treatment of Benign Paroxysmal Positional Vertigo

    Directory of Open Access Journals (Sweden)

    Muhammed Dagkiran

    2015-12-01

    Full Text Available Benign paroxysmal positional vertigo is the cause of peripheral vertigo, which only takes seconds posed by certain head and body position and led to severe attacks of vertigo. Therefore, it is a disturbance that causes a continuous fear of fall and anxiety in some patients. Although benign paroxysmal positional vertigo is the most common cause of peripheral vertigo, it may cause unnecessary tests, treatment costs and the loss of labor due to the result of the delay in the diagnosis and treatment stages. Diagnosis and treatment of this disease is easy. High success rates can be achieved with appropriate repositioning maneuvers after taking a detailed medical history and accurate assessment of accompanying nystagmus. The aim of this paper was to review the updated information about benign paroxysmal positional vertigo. [Archives Medical Review Journal 2015; 24(4.000: 555-564

  4. The Role of Positive Emotion and Contributions of Positive Psychology in Depression Treatment: Systematic Review

    Science.gov (United States)

    Santos, Veruska; Paes, Flavia; Pereira, Valeska; Arias-Carrión, Oscar; Silva, Adriana Cardoso; Carta, Mauro Giovanni; Nardi, Antonio Egidio; Machado, Sergio

    2013-01-01

    The present study aims to conduct a systematic review of the literature by checking the impact of positive emotion in the treatment of depression and on the use of strategies of positive psychology which involves positive emotion to treat and reduce symptoms of depression. For this purpose, we conducted searches in databases ISI Web of Knowledge, PsycINFO and PubMed and found a total of 3400 studies. After inclusion application and exclusion criteria, 28 articles remained, presented and discussed in this study. The studies have important relations between humor and positive emotion as well as a significant improvement in signs and symptoms of depression using differents strategies of positive psychology. Another relevant aspect is the preventative character of the proposed interventions by positive psychology by the fact that increase well-being and produce elements such as resilience and coping resources that reduce the recurrent relapses in the treatment of depression. The strategies of positive psychology, such as increasing positive emotions, develop personal strengths: seeking direction, meaning and engagement for the day-to-day life of the patients, appear as potentially tools for the prophylaxis and treatment of depression, helping to reduce signs and symptoms as well as for prevention of relapses. PMID:24358052

  5. Effect of the positioning of the blades in MRT treatments; Efecto del posicionamiento de las laminas en los tratamientos de IMRT

    Energy Technology Data Exchange (ETDEWEB)

    Ortiz de Zarate Vivanco, R.; Perez Azorin, J. F.; Casquero Ocio, F.; Trueba Garayo, I.

    2013-07-01

    The attenuation of the beams of radiation that cross the treatment table is a verifiable fact that should be incorporated into the planning of the radiation treatments, especially in advanced techniques. (Author)

  6. Emotional Effects of Positive Forms of Communication

    Directory of Open Access Journals (Sweden)

    Светлана Валентиновна Ионова

    2015-12-01

    Full Text Available The article discusses the problem of emotional significance of a positive form of speech. Based on the methodology of emotions linguistics, linguoecology, communicative linguistics and the methods of description, comparison and discourse analysis, the author distinguishes some types of speech situations that demonstrate visible differences between positive expression of emotions and their content and the pragmatic effect. The difference between the notions of “positive communication” and “positive form of communication” is demonstrated. Special attention is given to the following types of positive emotional communication: tolerant emotional communication, emotional emphasis, emotional neglect, and emotional tabooing. The utterances in situations of real and textual communication demonstrate negative effects of statements expressed in a positive form and identify the specifics of positive forms of emotional communication in comparison with rational communication.

  7. Fish oil prevents excessive accumulation of subcutaneous fat caused by an adverse effect of pioglitazone treatment and positively changes adipocytes in KK mice

    Directory of Open Access Journals (Sweden)

    Yuzuru Iizuka

    Full Text Available Pioglitazone, a thiazolidinedione (TZD, is widely used as an insulin sensitizer in the treatment of type 2 diabetes. However, body weight gain is frequently observed in TZD-treated patients. Fish oil improves lipid metabolism dysfunction and obesity. In this study, we demonstrated suppression of body weight gain in response to pioglitazone administration by combination therapy of pioglitazone and fish oil in type 2 diabetic KK mice. Male KK mice were fed experimental diets for 8 weeks. In safflower oil (SO, safflower oil/low-dose pioglitazone (S/PL, and safflower oil/high-dose pioglitazone (S/PH diets, 20% of calories were provided by safflower oil containing 0%, 0.006%, or 0.012% (wt/wt pioglitazone, respectively. In fish oil (FO, fish oil/low-dose pioglitazone (F/PL, and fish oil/high-dose pioglitazone (F/PH diets, 20% of calories were provided by a mixture of fish oil and safflower oil. Increased body weight and subcutaneous fat mass were observed in the S/PL and S/PH groups; however, diets containing fish oil were found to ameliorate these changes. Hepatic mRNA levels of lipogenic enzymes were significantly decreased in fish oil-fed groups. These findings demonstrate that the combination of pioglitazone and fish oil decreases subcutaneous fat accumulation, ameliorating pioglitazone-induced body weight gain, through fish oil-mediated inhibition of hepatic de novo lipogenesis. Keywords: Fish oil, Pioglitazone, Adverse effect

  8. Nasal continuous positive airway pressure treatment: current realities and future.

    Science.gov (United States)

    Berthon-Jones, M; Lawrence, S; Sullivan, C E; Grunstein, R

    1996-11-01

    Nasal continuous positive airway pressure (CPAP) is a highly effective treatment for obstructive sleep apnea syndrome. The apnea/hypopnea index (AHI) is reduced 10-fold, but the patient dropout rate is up to 30%, and usage is typically 20/hour were recruited, with written informed consent. Subjects slept for a diagnostic night, followed by a treatment night, in the laboratory, using the AutoSet system with full polysomnographic monitoring of respiratory and sleep variables. Arousals were scored using ASDA criteria. Hypopneas were scored when there was a 50% reduction in ventilation for > 10 seconds, associated with a 4% drop in oxygen saturation. For comparison, the ASDA arousal index in 16 normal subjects (without nasal CPAP) is provided. Results are given as mean +/- standard error of the mean. AHI was reduced from 55 +/- 3 to 1.5 +/- 0.35 events/hour (p < 0.0001). The arousal index was reduced from 65 +/- 3 to 18 +/- 2 events/hour (p < 0.0001), identical to the value in the 16 healthy normal subjects. There was a 158% +/- 21% increase in slow-wave sleep (p = 0.01) and a 186% +/- 27% increase in rapid eye movement sleep (p = 0.013). The AutoSet self-adjusting nasal CPAP system adequately treats obstructive sleep apnea syndrome on the first night under laboratory conditions.

  9. Emotional Effects of Positive Forms of Communication

    OpenAIRE

    Светлана Валентиновна Ионова

    2015-01-01

    The article discusses the problem of emotional significance of a positive form of speech. Based on the methodology of emotions linguistics, linguoecology, communicative linguistics and the methods of description, comparison and discourse analysis, the author distinguishes some types of speech situations that demonstrate visible differences between positive expression of emotions and their content and the pragmatic effect. The difference between the notions of “positive communication” and “pos...

  10. Positive regulatory effects of perioperative probiotic treatment on postoperative liver complications after colorectal liver metastases surgery: a double-center and double-blind randomized clinical trial.

    Science.gov (United States)

    Liu, Zhihua; Li, Chao; Huang, Meijin; Tong, Chao; Zhang, Xingwei; Wang, Lei; Peng, Hui; Lan, Ping; Zhang, Peng; Huang, Nanqi; Peng, Junsheng; Wu, Xiaojian; Luo, Yanxing; Qin, Huanlong; Kang, Liang; Wang, Jianping

    2015-03-20

    Colorectal liver metastases (CLM) occur frequently and postoperative intestinal infection is a common complication. Our previous study showed that probiotics could decrease the rate of infectious complications after colectomy for colorectal cancer. To determine the effects of the perioperative administration of probiotics on serum zonulin levels which is a marker of intestinal permeability and the subsequent impact on postoperative infectious complications in patients with CLM. 150 patients with CLM were randomly divided into control group (n = 68) and probiotics group (n = 66). Probiotics and placebo were given orally for 6 days preoperatively and 10 days postoperatively to control group and probiotics group respectively. We used the local resection for metastatic tumor ,while for large tumor, the segmental hepatectomy. Postoperative outcome were recorded. Furthermore, complications in patients with normal intestinal barrier function and the relation with serum zonulin were analyzed to evaluate the impact on the liver barrier dysfunction. The incidence of infectious complications in the probiotics group was lower than control group. Analysis of CLM patients with normal postoperative intestinal barrier function paralleled with the serum zonulin level. And probiotics could also reduce the concentration of serum zonulin (P = 0.004) and plasma endotoxin (P zonulin level, the rate of postoperative septicemia and maintain the liver barrier in patients undergoing CLM surgery. we propose a new model about the regulation of probiotics to liver barrier via clinical regulatory pathway. We recommend the preoperative oral intake of probiotics combined with postoperative continued probiotics treatment in patients who undergo CLM surgery. ChiCTR-TRC- 12002841 . 2012/12/21.

  11. Natalizumab treatment for multiple sclerosis: updates and considerations for safer treatment in JCV positive patients

    Directory of Open Access Journals (Sweden)

    Luiz Henrique da Silva Nali

    2014-12-01

    Full Text Available Natalizumab is currently one of the best options for treatment of patients with Multiple Sclerosis who have failed traditional prior therapies. However, prolonged use, prior immunosuppressive therapy and anti-JCV antibody status have been associated with increased risk of developing progressive multifocal leukoencephalopathy (PML. The evaluation of these conditions has been used to estimate risks of PML in these patients, and distinct (sometimes extreme approaches are used to avoid the PML onset. At this time, the biggest issue facing the use of Natalizumab is how to get a balance between the risks and the benefits of the treatment. Hence, strategies for monitor JCV-positive patients undergoing Natalizumab treatment are deeply necessary. To illustrate it, we monitored JCV/DNA in blood and urine of a patient receiving Natalizumab for 12 months. We also bring to discussion the effectiveness of the current methods used for risk evaluation, and the real implications of viral reactivation.

  12. Adjuvant Trastuzumab Therapy for Early HER2-Positive Breast Cancer in Iran: A Cost-Effectiveness and Scenario Analysis for an Optimal Treatment Strategy

    NARCIS (Netherlands)

    A. Ansaripour (Amir); C.A. Uyl-de Groot (Carin); W.K. Redekop (Ken)

    2017-01-01

    textabstractIntroduction: Clinical guidelines have recommended a 1-year trastuzumab regimen as standard care for early human epidermal growth factor receptor 2 (HER2)-positive breast cancer; however, this recommendation can have a dramatic impact on total drug expenditures in middle-income countries

  13. On the relative contributions of positive reinforcement and escape extinction in the treatment of food refusal.

    OpenAIRE

    Piazza, Cathleen C; Patel, Meeta R; Gulotta, Charles S; Sevin, Bari M; Layer, Stacy A

    2003-01-01

    We compared the effects of positive reinforcement alone, escape extinction alone, and positive reinforcement with escape extinction in the treatment of the food and fluid refusal of 4 children who had been diagnosed with a pediatric feeding disorder. Consumption did not increase when positive reinforcement was implemented alone. By contrast, consumption increased for all participants when escape extinction was implemented, independent of the presence or absence of positive reinforcement. Howe...

  14. Positive Side Effects in the Treatment of SIB Using the Self-Injurious Behavior Inhibiting System (SIBIS): Implications for Operant and Biochemical Explanations of SIB.

    Science.gov (United States)

    Linscheid, Thomas R.; And Others

    1994-01-01

    The rate of self-injurious head hitting in an eight-year old with severe/profound mental retardation was reduced using contingent electric shock delivered via the Self Injurious Behavior Inhibiting System. An improved affective state and increased interaction with the environment were documented. Treatment gains were maintained at one-year…

  15. Positive effects of melatonin treatment on the reproductive performance of young border leicester rams mated to merino ewes in spring: preliminary observations.

    Science.gov (United States)

    Kleemann, D O; Kelly, J M; Arney, L J; Farley, I L; Tilbrook, A J; Walker, S K

    2014-12-01

    Poor reproductive performance of Merino ewe flocks when mated to Border Leicester rams during spring may be due to seasonality of the Border Leicester breed. Two approaches were taken to test this assumption. Six young (12 months old) or six mixed-age (12, 24 and ≥36 months old) Border Leicester rams were either treated or not treated with melatonin implants (2 × 2 design) 6 weeks before the four groups of rams were each put with approximately 300 Merino ewes for an 8-week mating period. Implants were inserted in early September (experiment 1). The second approach was to yard or not yard ewes and mixed-age rams on several occasions during the first 3 weeks of the mating period (experiment 2). Pregnancy rate and twinning percentage were assessed by ultrasonography. In experiment 1, melatonin treatment in young rams increased (p pregnancy rate from 5.0% to 92.6%, but mixed-age rams did not respond (90.7% vs 89.5% for melatonin and non-melatonin treatments, respectively). Twinning rate was similar (p > 0.05) for ewes mated to either melatonin or non-melatonin-treated young rams (36.8% vs 40.0%, respectively), whereas melatonin significantly improved (p melatonin treatment, scrotal circumference was greater (p pregnancy rate compared with non-yarded counterparts (89.5% vs 65.5%). Twinning rate was not affected (37.7% vs 36.1%, respectively). In summary, melatonin treatment of Border Leicester rams significantly improved flock reproductive performance in spring due to improved pregnancy rates with young rams and improved litter size with mixed-age rams. © 2014 Commonwealth of Australia.

  16. Relationship between aldosterone and the metabolic syndrome in patients with obstructive sleep apnea hypopnea syndrome: effect of continuous positive airway pressure treatment.

    Directory of Open Access Journals (Sweden)

    Antonia Barceló

    Full Text Available BACKGROUND: Metabolic syndrome (MS occurs frequently in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS. We hypothesized that aldosterone levels are elevated in OSAHS and associated with the presence of MS. METHODS: We studied 66 patients with OSAHS (33 with MS and 33 without MS and 35 controls. The occurrence of the MS was analyzed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III clinical criteria. Measurements of plasma renin activity (PRA, aldosterone, aldosterone:PRA ratio, creatinine, glucose, triglycerides, cholesterol and HDL cholesterol were obtained at baseline and after CPAP treatment. RESULTS: Aldosterone levels were associated with the severity of OSAHS and higher than controls (p = 0.046. Significant differences in aldosterone levels were detected between OSAHS patients with and without MS (p = 0.041. A significant reduction was observed in the aldosterone levels in patients under CPAP treatment (p = 0.012. CONCLUSION: This study shows that aldosterone levels are elevated in OSAHS in comparison to controls, and that CPAP therapy reduces aldosterone levels. It also shows that aldosterone levels are associated with the presence of metabolic syndrome, suggesting that aldosterone excess might predispose or aggravate the metabolic and cardiovascular complications of OSAHS. TRIAL REGISTRATION: The study is not a randomized controlled trial and was not registered.

  17. Effect of Positive Training on Positive Psychological States (Character Strengths of Female High School Students

    Directory of Open Access Journals (Sweden)

    Ali Farnam

    2017-05-01

    Full Text Available psychological states of female students in second and third grades of high school. The research method was quasi-experimental with pre-test, post-test and follow-up. The sample consisted of forty students selected randomly in two groups (twenty students in each group. To collect data, Positive Psychological State Inventory (Rajaei, Khuy Nzhad and Nesaei was used. The experimental group received ninety minute positive training sessions (for two months and the control group did not receive treatment. The results of analysis  of covariance showed that positive training had positive effects on positive psychological states (trust in God, optimism, self-efficacy, duty, sense of control, targeted, hope, satisfaction with life, meaningful life, pleasant, sociability, self-esteem and self-worth, sense of peace, gratitude, and forgiveness among adolescents  both in the post  and follow-up tests

  18. On the relative contributions of positive reinforcement and escape extinction in the treatment of food refusal.

    Science.gov (United States)

    Piazza, Cathleen C; Patel, Meeta R; Gulotta, Charles S; Sevin, Bari M; Layer, Stacy A

    2003-01-01

    We compared the effects of positive reinforcement alone, escape extinction alone, and positive reinforcement with escape extinction in the treatment of the food and fluid refusal of 4 children who had been diagnosed with a pediatric feeding disorder. Consumption did not increase when positive reinforcement was implemented alone. By contrast, consumption increased for all participants when escape extinction was implemented, independent of the presence or absence of positive reinforcement. However, the addition of positive reinforcement to escape extinction was associated with beneficial effects (e.g., greater decreases in negative vocalizations and inappropriate behavior) for some participants.

  19. Treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia.

    Science.gov (United States)

    Milone, Jorge H; Enrico, Alicia

    2009-12-01

    The presence of the Philadelphia chromosome is a poor prognosis factor in acute lymphoblastic leukemia (ALL), in both children and adults. Using molecular techniques of the gen bcr/abl, it is possible to detect the abnormality, in up to the 40% of adult patients. The unsatisfactory results with conventional chemotherapy schemes have determined the intensification of the treatments and the consideration of allogenic bone marrow transplants as the best therapeutic instance. The development of tyrosine kinase inhibitors have become a therapeutic improvement in the treatment of Philadelphia chromosome-positive ALL, being combined with chemotherapy schemes, only in a selected group of patients, even in therapeutic programs that include transplant.

  20. Serial position effects in mild cognitive impairment.

    Science.gov (United States)

    Howieson, Diane B; Mattek, Nora; Seeyle, Adriana M; Dodge, Hiroko H; Wasserman, Dara; Zitzelberger, Tracy; Jeffrey, Kaye

    2011-03-01

    Mild cognitive impairment (MCI) is often associated with the preclinical phase of Alzheimer's disease (AD). Special scoring of word-list recall data for serial position has been suggested to improve discrimination of normal aging from dementia. We examined serial position effects in word-list recall for MCI participants compared to Alzheimer patients and controls. Individuals with MCI, like Alzheimer patients, had a diminished primacy effect in recalling words from a list. No alternative scoring system was better than standard scoring of word-list recall in distinguishing MCI patients from controls. Retention weighted scoring improved the discrimination of MCI and AD groups.

  1. A randomized controlled trial of positioning treatments in infants with positional head shape deformities.

    Science.gov (United States)

    Hutchison, B Lynne; Stewart, Alistair W; De Chalain, Tristan B; Mitchell, Edwin A

    2010-10-01

    Randomized controlled trials of treatment for deformational plagiocephaly and brachycephaly have been lacking in the literature. Infants (n = 126) presenting to a plagiocephaly clinic were randomized to either positioning strategies or to positioning plus the use of a Safe T Sleep™ positioning wrap. Head shape was measured using a digital photographic technique, and neck function was assessed. They were followed up at home 3, 6 and 12 months later. There was no difference in head shape outcomes for the two treatment groups after 12 months of follow-up, with 42% of infants having head shapes in the normal range by that time. Eighty per cent of children showed good improvement. Those that had poor improvement were more likely to have both plagiocephaly and brachycephaly and to have presented later to clinic. Most infants improved over the 12-month study period, although the use of a sleep positioning wrap did not increase the rate of improvement. © 2010 The Author(s)/Journal Compilation © 2010 Foundation Acta Paediatrica.

  2. Positional Accuracy Assessment for Effective Shoreline Change ...

    African Journals Online (AJOL)

    Michael

    2016-06-01

    Jun 1, 2016 ... as backdrop in GIS environment. Positional error of ... integrated dataset obviously bore the cumulative effect of the input datasets. ... change. The shoreline, which is the interface between land ... modelling, which enables future shoreline change trend to ..... as gaps due to cloud cover and limitation of the.

  3. Positive mood effects on delay discounting.

    Science.gov (United States)

    Hirsh, Jacob B; Guindon, Alex; Morisano, Dominique; Peterson, Jordan B

    2010-10-01

    Delay discounting is the process by which the value of an expected reward decreases as the delay to obtaining that reward increases. Individuals with higher discounting rates tend to prefer smaller immediate rewards over larger delayed rewards. Previous research has indicated that personality can influence an individual's discounting rates, with higher levels of Extraversion predicting a preference for immediate gratification. The current study examined how this relationship would be influenced by situational mood inductions. While main effects were observed for both Extraversion and cognitive ability in the prediction of discounting rates, a significant interaction was also observed between Extraversion and positive affect. Extraverted individuals were more likely to prefer an immediate reward when first put in a positive mood. Extraverts thus appear particularly sensitive to impulsive, incentive-reward-driven behavior by temperament and by situational factors heightening positive affect. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  4. Comparison of The Effects of A Positive Reappraisal Coping Intervention and Problem-Solving Skills Training on Depression during The Waiting Period of The Result of Intrauterine Insemination Treatment: A Randomized Control Trial.

    Science.gov (United States)

    Ghasemi Gojani, Marzieh; Kordi, Masoumeh; Asgharipour, Negar; Esmaeili, Habibollah

    2018-04-01

    The outcomes of fertility treatments are unpredictable, and levels of depressive symptoms increase in patients during the waiting period of the result of intrauterine insemination (IUI) treatment. The aim of this study was to compare the effects of a positive reappraisal coping intervention (PRCI) and problem-solving skills training (PSS) on depression during the waiting period of the result of IUI Treatment. This randomized control clinical trial was done among 108 women undergoing IUI treatment. In the control group, the women received routine care. In the PRCI group, women attended two training sessions and were asked to complete coping thoughts cards and fill out daily monitoring forms during the waiting period. In the PSS group, PSS were taught over three sessions. The depression was measured by the beck depression inventory. On the 10 th th day of the IUI waiting period, there were significant differences between the control group (21.42 ± 11.42) and the PSS group (12.52 ± 8.05) and PRCI groups (13.14 ± 9.7) (P<0.001), but no significant difference between the PRCI group and the PSS group. According to the results of this randomized control trial there is no difference between a PRCI and PSS on depression during the waiting period of the result of IUI treatment. This suggests that both interventions can be used to help infertile women combat depression during the waiting period of the result of fertility treatments (Registration number: IRCT2016020926490N1). Copyright© by Royan Institute. All rights reserved.

  5. Developing and implementing a positive behavioral reinforcement intervention in prison-based drug treatment: Project BRITE.

    Science.gov (United States)

    Burdon, William M; St De Lore, Jef; Prendergast, Michael L

    2011-09-01

    Within prison settings, the reliance on punishment for controlling inappropriate or noncompliant behavior is self-evident. What is not so evident is the similarity between this reliance on punishment and the use of positive reinforcements to increase desired behaviors. However, seldom do inmates receive positive reinforcement for engaging in prosocial behaviors or, for inmates receiving drug treatment, behaviors that are consistent with or support their recovery. This study provides an overview of the development and implementation of a positive behavioral reinforcement intervention in male and female prison-based drug treatment programs. The active involvement of institutional staff, treatment staff, and inmates enrolled in the treatment programs in the development of the intervention along with the successful branding of the intervention were effective at promoting support and participation. However, these factors may also have ultimately impacted the ability of the randomized design to reliably demonstrate the effectiveness of the intervention.

  6. Stereotactic Target point Verification in Actual Treatment Position of Radiosurgery

    International Nuclear Information System (INIS)

    Yun, Hyong Geun; Lee, Hyun Koo

    1995-01-01

    Purpose : Authors tried to enhance the safety and accuracy of radiosurgery by verifying stereotactic target point in actual treatment position prior to irradiation. Materials and Methods : Before the actual treatment, several sections of anthropomorphic head phantom were used to create a condition of unknown coordinated of the target point. A film was sand witched between the phantom sections and punctured by sharp needle tip. The tip of the needle represented the target point. The head phantom was fixed to the stereotactic ring and CT scan was done with CT localizer attached to the ring. After the CT scanning, the stereotactic coordinates of the target point were determined. The head phantom was secured to accelerator's treatment couch and the movement of laser isocenter to the stereotactic coordinates determined by CT scanning was performed using target positioner. Accelerator's anteroposterior and lateral portal films were taken using angiographic localizers. The stereotactic coordinates determined by analysis of portal films were compared with the stereotactic coordinates previously determined by CT scanning. Following the correction of discrepancy, the head phantom was irradiated using a stereotactic technique of several arcs. After the irradiation, the film which was sand witched between the phantom sections was developed and the degree of coincidence between the center of the radiation distribution with the target point represented by the hole in the film was measured. In the treatment of actual patients, the way of determining the stereotactic coordinates with CT localizers and angiographic localizers between two sets of coordinates, we proceeded to the irradiation of the actual patient. Results : In the phantom study, the agreement between the center of the radiation distribution and the localized target point was very good. By measuring optical density profiles of the sand witched film along axes that intersected the target point, authors could confirm

  7. Comparison of The Effects of A Positive Reappraisal Coping Intervention and Problem-Solving Skills Training on Depression during The Waiting Period of The Result of Intrauterine Insemination Treatment: A Randomized Control Trial

    Directory of Open Access Journals (Sweden)

    Marzieh Ghasemi gojani, , ,

    2018-01-01

    Full Text Available Background The outcomes of fertility treatments are unpredictable, and levels of depressive symptoms increase in patients during the waiting period of the result of intrauterine insemination (IUI treatment. The aim of this study was to compare the effects of a positive reappraisal coping intervention (PRCI and problem-solving skills training (PSS on depression during the waiting period of the result of IUI Treatment. Materials and Methods This randomized control clinical trial was done among 108 women undergoing IUI treat- ment. In the control group, the women received routine care. In the PRCI group, women attended two training sessions and were asked to complete coping thoughts cards and fill out daily monitoring forms during the waiting period. In the PSS group, PSS were taught over three sessions. The depression was measured by the beck depression inventory. Results On the 10th day of the IUI waiting period, there were significant differences between the control group (21.42 ± 11.42 and the PSS group (12.52 ± 8.05 and PRCI groups (13.14 ± 9.7 (P<0.001, but no significant difference between the PRCI group and the PSS group. Conclusion According to the results of this randomized control trial there is no difference between a PRCI and PSS on depression during the waiting period of the result of IUI treatment. This suggests that both interventions can be used to help infertile women combat depression during the waiting period of the result of fertility treatments (Registration number: IRCT2016020926490N1.

  8. Photoelectric effect photon beam position monitors

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    Stability of the electron orbit is of critical importance at the NSLS. Many experimenters utilizing the NSLS photon beams can take full advantage of the small transverse dimensions of the source only if the electron orbit variation is kept below 10 to 20% of the transverse electron bunch size. Clearly the first step in a program to stabilize the orbit is to develop position monitors with the required sensitivity, reliability and dynamic range. Of great importance are monitors detecting the photon beams themselves, and also monitors measuring the position of the electron beam. In this section the authors discuss photon beam position monitors utilizing the photoelectric effects, and in the following section the use of capacitively coupled pick-up electrodes to detect electron beam position will be described. In what follows they shall proceed to consider two generic types of monitor geometries (1) Gap monitors, which are designed with the idea that the fringes of the synchrotron radiation will be measured, and the hot or fundamental beam will pass through the monitor unimpeded. (2) Area monitors, which are comprised of two triangular elements nested together similar to the electrodes of a split ion chamber or the diodes described by Siddons and Kraner or Mitsuhashi et al

  9. Positive communication paradigm decreases early recurrence in clubfoot treatment.

    Science.gov (United States)

    Morin, Matthew L; Hoopes, Daniel M; Szalay, Elizabeth A

    2014-03-01

    The Ponseti method has become the treatment standard for idiopathic clubfoot. Deformity recurrence is most commonly attributed to premature abandonment of the requisite abduction orthosis. A study in 2009 from our center revealed a high rate of deformity recurrence in our patient population. It was surmised that the importance of bracing to maintain correction had not been adequately communicated to some families, especially Native Americans. As a result, the principal investigator developed a different communication protocol for parents of infants. All children treated for clubfoot at the University of New Mexico Carrie Tingley Hospital, Albuquerque, NM, from 2008 to 2010 were reviewed. They were compared with a historical control group from this institution, the subjects of the 2009 study, and were analyzed for the rate of recurrence and Pirani score improvement. Our study cohort comprised 69 infants (104 clubfeet), all of whom were treated with the new communication style. The recurrence rate for the new communication paradigm was 2.88% compared with 18.2% in the control group (Pgroup compared with 3.5 in the control group (P=0.001). Native American recurrence was zero in the treatment group and 41% in the control group (P=0.011). A positive, rather than a negative communication style, emphasis on the brace as the most important aspect of treatment, and a more culturally sensitive family education paradigm, resulted in a lower rate of deformity recurrence when treating children with clubfeet using the Ponseti method. Level III.

  10. Comparison of supine and prone positions for percutaneous nephrolithotomy in treatment of staghorn stones.

    Science.gov (United States)

    Gökce, Mehmet İlker; Ibiş, Arif; Sancı, Adem; Akıncı, Aykut; Bağcı, Uygar; Ağaoğlu, Eylül Asya; Süer, Evren; Gülpınar, Ömer

    2017-12-01

    Percutaneous nephrolithotomy (PNL) is the primary treatment modality for management of staghorn stones. PNL in supine position has important advantages over prone positon. However, studies comparing prone and supine positions for PNL in staghorn stone patients have conflicting results, and the aim of the current study was to compare prone and supine positions for PNL in staghorn stone cases. Data of patients underwent PNL for staghorn stones in supine or prone position by a single urologist were collected prospectively. The supine and prone position groups were compared for stone free rate (SFR) and complication rates. All patients were evaluated with NCCT for evaluation of SFR. Chi-square test was used to compare categorical variables and Student t test was applied for continuous variables of the treatment groups. The groups were similar for demographic and stone-related characteristics. Multi-caliceal and intercostal access was more common in prone position. Operation duration was significantly shorter and hemoglobin drop was significantly less in supine group. SFR was 64.1 and 60.4% in the supine and prone groups, respectively (p = 0.72). Complication rates were similar in the two groups but Clavien III complications were observed in two patients in the prone group. PNL in supine position is an effective treatment for management of staghorn stones. The need for multi-caliceal and intercostal puncture is less when combined with retrograde intrarenal surgery. PNL in supine position should be considered as primary treatment option in staghorn stone cases.

  11. Oral treatment with a rattlesnake native polypeptide crotamine efficiently inhibits the tumor growth with no potential toxicity for the host animal and with suggestive positive effects on animal metabolic profile.

    Science.gov (United States)

    Campeiro, Joana D; Marinovic, Marcelo P; Carapeto, Fernando Cintra; Dal Mas, Caroline; Monte, Gabriela Guilherme; Carvalho Porta, Lucas; Nering, Marcela B; Oliveira, Eduardo B; Hayashi, Mirian A F

    2018-02-01

    The efficacy of crotamine as antitumoral was first demonstrated by daily intraperitoneal (IP) injections of low doses of this toxin in an animal model bearing melanoma tumors. Significant inhibition of tumor growth and increased lifespan of mice bearing tumor was also noticed after 21 consecutive days of this daily IP administration of crotamine. However, due to the limited acceptance of treatments by IP route in clinical conditions, herein, we evaluated the antitumor effect of this native polypeptide employing the oral route. The efficacy of crotamine in inhibiting the melanoma growth in vivo, even after passing through the gastrointestinal tract of the animal, was confirmed here. In addition, biochemical biomarkers and also histopathological analysis showed both the absence of any potential toxic effects in tissues or organs of the animal in which the highest accumulation of crotamine is expected. Interestingly, a reduction of weight gain was observed mainly in animals with tumor treated with crotamine by IP route, but not by oral administration. Albeit, oral administered crotamine was able to significantly decrease the body weight gain of healthy animals without tumor. Taking advantage of this same experimental animal models receiving crotamine by oral route, it was possible to show metabolic changes as the increased capacity of glucose clearance, which was accompanied by a reduction of the total cholesterol, and by increased high-density lipoprotein levels, both observed mainly in the absence of tumor. Triglycerides and low-density lipoprotein were also significantly decreased, but only in the absence of tumor. Taken together, these data suggest a clear trend for metabolic positive effects and mischaracterize unhealthy condition of animals, with or without tumors, treated with crotamine for 21 days. In addition, this study confirmed the efficacy of crotamine administered by oral route as antitumor agent, which besides the additional advantage of

  12. Describing treatment effects to patients.

    Science.gov (United States)

    Moxey, Annette; O'Connell, Dianne; McGettigan, Patricia; Henry, David

    2003-11-01

    To examine the impact of different presentations of equivalent information (framing) on treatment decisions faced by patients. A systematic review of the published literature was conducted. English language publications allocating participants to different frames were retrieved using electronic and bibliographic searches. Two reviewers examined each article for inclusion, and assessed methodological quality. Study characteristics were tabulated and where possible, relative risks (RR; 95% confidence intervals) were calculated to estimate intervention effects. Thirty-seven articles, yielding 40 experimental studies, were included. Studies examined treatment (N = 24), immunization (N = 5), or health behavior scenarios (N = 11). Overall, active treatments were preferred when outcomes were described in terms of relative rather than absolute risk reductions or number needed to treat. Surgery was preferred to other treatments when treatment efficacy was presented in a positive frame (survival) rather than a negative frame (mortality) (relative risk [RR] = 1.51, 95% confidence interval [CI], 1.39 to 1.64). Framing effects were less obvious for immunization and health behavior scenarios. Those with little interest in the behavior at baseline were influenced by framing, particularly when information was presented as gains. In studies judged to be of good methodological quality and/or examining actual decisions, the framing effect, although still evident, was less convincing compared to the results of all included studies. Framing effects varied with the type of scenario, responder characteristics, scenario manipulations, and study quality. When describing treatment effects to patients, expressing the information in more than one way may present a balanced view to patients and enable them to make informed decisions.

  13. Impact of HBV DNA detection methods on evaluating the clinical effect of PEG-IFNɑ-2b in treatment of HBeAg-positive chronic hepatitis B: a comparative analysis

    Directory of Open Access Journals (Sweden)

    GUO Chunxia

    2017-04-01

    Full Text Available ObjectiveTo investigate the impact of different HBV DNA detection methods on evaluating the clinical effect of PEG-IFNɑ-2b in the treatment of HBeAg-positive chronic hepatitis B (CHB. MethodsA total of 83 CHB patients who were admitted to Tianjin Second People′s Hospital from September 2014 to January 2016 and treated with PEG-IFNɑ-2b for less than 24 weeks with clearance for the first time detected by HBV DNA low-sensitivity method (the lower limit of detection was 500 IU/ml and negative results within 36 weeks obtained by low-sensitivity detection. Among these patients, 33 patients with negative results within 36 weeks obtained by high-sensitivity detection (the lower limit of detection was 20 IU/ml were enrolled in negative group, and 50 with positive results were enrolled in positive group. The reductions in HBeAg and HBsAg and HBeAg seroconversion rate at 12, 24, and 36 weeks were compared between the two groups. The independent-samples t test was used for comparison of normally distributed continuous data between groups, the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsAt 12, 24, and 36 weeks after negative results were obtained by HBV DNA low-sensitivity detection, the negative group had a significant reduction in HBeAg than the positive group [12 weeks: 0.32 (0.16-0.92 log10 COI vs 014 (0.01-0.30 log10 COI, Z=-3.061, P=0.002; 24 weeks: 0.44 (0.19-1.15 log10 COI vs 0.16 (0.04-0.35 log10 COI, Z=-3.043, P=0.002; 36 weeks: 0.51 (0.36-1.21 log10 COI vs 0.24 (0.10-0.46 log10 COI, Z=-3.880, P<0.001]. At 12 weeks after negative results were obtained by HBV DNA low-sensitivity detection, there was no significant difference in the reduction in HBsAg (P=0.067, while at 24 and 36 weeks, the negative group had a significant reduction in HBsAg than the positive group [24 weeks: 0

  14. Using modeling and vicarious reinforcement to produce more positive attitudes toward mental health treatment.

    Science.gov (United States)

    Buckley, Gary I; Malouff, John M

    2005-05-01

    In this study, the authors evaluated the effectiveness of a video, developed for this study and using principles of cognitive learning theory, to produce positive attitudinal change toward mental health treatment. The participants were 35 men and 45 women who were randomly assigned to watch either an experimental video, which included 3 positive 1st-person accounts of psychotherapy or a control video that focused on the psychological construct of self. Pre-intervention, post-intervention, and 2-week follow-up levels of attitude toward mental health treatment were measured using the Attitude Toward Seeking Professional Help Scale (E. H. Fischer & J. L. Turner, 1970). The experimental video group showed a significantly greater increase in positive attitude than did the control group. These results support the effectiveness of using the vicarious reinforcement elements of cognitive learning theory as a basis for changing attitudes toward mental health treatment.

  15. Malingering, coaching, and the serial position effect.

    Science.gov (United States)

    Suhr, Julie A

    2002-01-01

    The normal pattern of performance on list-learning tasks is to recall more words from the beginning (primacy) and end (recency) of the list. This pattern is also seen in patients with closed head injury, but malingerers tend to recall less words from the beginning of word lists, leading to a suppressed primacy effect. The present study examined this pattern on both learning trials and delayed recall of the Auditory Verbal Learning Test (AVLT) in 34 persons performing with normal effort, 38 naive malingerers, 33 warned malingerers, and 29 head-injured patients. Both malingering groups had lower scores on the primacy portion of the list during learning trials, while normals and head-injured patients had normal serial position curves. During delayed recall, normals and head-injured patients did better than the two malingering groups on middle and recency portions of the list. Findings suggest that the serial position effect during learning trials may be a useful pattern of performance to watch for when suspicious of malingering.

  16. Natural organic matter removal by ion exchange at different positions in the drinking water treatment lane

    Directory of Open Access Journals (Sweden)

    A. Grefte

    2013-01-01

    Full Text Available To guarantee a good water quality at the customers tap, natural organic matter (NOM should be (partly removed during drinking water treatment. The objective of this research was to improve the biological stability of the produced water by incorporating anion exchange (IEX for NOM removal. Different placement positions of IEX in the treatment lane (IEX positioned before coagulation, before ozonation or after slow sand filtration and two IEX configurations (MIEX® and fluidized IEX (FIX were compared on water quality as well as costs. For this purpose the pre-treatment plant at Loenderveen and production plant Weesperkarspel of Waternet were used as a case study. Both, MIEX® and FIX were able to remove NOM (mainly the HS fraction to a high extent. NOM removal can be done efficiently before ozonation and after slow sand filtration. The biological stability, in terms of assimilable organic carbon, biofilm formation rate and dissolved organic carbon, was improved by incorporating IEX for NOM removal. The operational costs were assumed to be directly dependent of the NOM removal rate and determined the difference between the IEX positions. The total costs for IEX for the three positions were approximately equal (0.0631 € m−3, however the savings on following treatment processes caused a cost reduction for the IEX positions before coagulation and before ozonation compared to IEX positioned after slow sand filtration. IEX positioned before ozonation was most cost effective and improved the biological stability of the treated water.

  17. Clinical update on linezolid in the treatment of Gram-positive bacterial infections

    Science.gov (United States)

    Ager, Sally; Gould, Kate

    2012-01-01

    Gram-positive pathogens are a significant cause of morbidity and mortality in both community and health care settings. Glycopeptides have traditionally been the antibiotics of choice for multiresistant Gram-positive pathogens but there are problems with their use, including the emergence of glycopeptide-resistant strains, tissue penetration, and achieving and monitoring adequate serum levels. Newer antibiotics such as linezolid, a synthetic oxazolidinone, are available for the treatment of resistant Gram-positive bacteria. Linezolid is active against a wide range of Gram-positive bacteria and has been generally available for the treatment of Gram-positive infections since 2000. There are potential problems with linezolid use, including its bacteriostatic action and the relatively high incidence of reported adverse effects, particularly with long-term use. Long-term use may also be complicated by the development of resistance. However, linezolid has been shown to be clinically useful in the treatment of several serious infections where traditionally bacteriocidal agents have been required and many of its adverse effects are reversible on cessation. It has also been shown to be a cost-effective treatment option in several studies, with its high oral bioavailability allowing an early change from intravenous to oral formulations with consequent earlier patient discharge and lower inpatient costs. PMID:22787406

  18. Cost-effectiveness analysis of dolutegravir plus backbone compared with raltegravir plus backbone, darunavir+ritonavir plus backbone and efavirenz/tenofovir/emtricitabine in treatment naïve and experienced HIV-positive patients

    Directory of Open Access Journals (Sweden)

    Restelli U

    2017-06-01

    Full Text Available Umberto Restelli,1,2 Giuliano Rizzardini,3,4 Andrea Antinori,5 Adriano Lazzarin,6 Marzia Bonfanti,1 Paolo Bonfanti,7 Davide Croce1,2 1Centre for Research on Health Economics, Social and Health Care Management, LIUC – Università Cattaneo, Castellanza, Varese, Italy; 2School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 3First and Second Divisions of Infectious Diseases, “Luigi Sacco” Hospital, Milan, Italy; 4School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 5National Institute for Infectious Diseases “L Spallanzani”, Rome, 6Department of Infectious Diseases, San Raffaele Scientific Institute, 7Department of Infectious and Tropical Diseases, A Manzoni Hospital, Lecco, Italy Background: In January 2014, the European Medicines Agency issued a marketing authorization for dolutegravir (DTG, a second-generation integrase strand transfer inhibitor for HIV treatment. The study aimed at determining the incremental cost-effectiveness ratio (ICER of the use of DTG+backbone compared with raltegravir (RAL+backbone, darunavir (DRV+ritonavir(r+backbone and efavirenz/tenofovir/emtricitabine (EFV/TDF/FTC in HIV-positive treatment-naïve patients and compared with RAL+backbone in treatment-experienced patients, from the Italian National Health Service’s point of view.Materials and methods: A published Monte Carlo Individual Simulation Model (ARAMIS-DTG model was used to perform the analysis. Patients pass through mutually exclusive health states (defined in terms of diagnosis of HIV with or without opportunistic infections [OIs] and cardiovascular disease [CVD] and successive lines of therapy. The model considers costs (2014 and quality of life per monthly cycle in a lifetime horizon. Costs and quality-adjusted life years (QALYs are dependent on OI, CVD, AIDS events, adverse events and antiretroviral therapies.Results: In

  19. Positive Reinforcement and Logical Consequences in the Treatment of Classroom Encopresis.

    Science.gov (United States)

    Lyon, Mark A.

    1984-01-01

    A child with a diagnosis of mild mental retardation was treated for encopresis. Positive reinforcement procedures for continence and logical consequences for soiling were effective in accomplishing complete continence during the final phase of treatment. An ABCDA design with a decelerating rate of reinforcement was utilized to assess treatment…

  20. Positive expiratory pressure - Common clinical applications and physiological effects.

    Science.gov (United States)

    Fagevik Olsén, Monika; Lannefors, Louise; Westerdahl, Elisabeth

    2015-03-01

    Breathing out against resistance, in order to achieve positive expiratory pressure (PEP), is applied by many patient groups. Pursed lips breathing and a variety of devices can be used to create the resistance giving the increased expiratory pressure. Effects on pulmonary outcomes have been discussed in several publications, but the expected underlying physiology of the effect is seldom discussed. The aim of this article is to describe the purpose, performance, clinical application and underlying physiology of PEP when it is used to increase lung volumes, decrease hyperinflation or improve airway clearance. In clinical practice, the instruction how to use an expiratory resistance is of major importance since it varies. Different breathing patterns during PEP increase or reduce expiratory flow, result in movement of EPP centrally or peripherally and can increase or decrease lung volume. It is therefore necessary to give the right instructions to obtain the desired effects. As the different PEP techniques are being used by diverse patient groups it is not possible to give standard instructions. Based on the information given in this article the instructions have to be adjusted to give the optimal effect. There is no consensus regarding optimal treatment frequency and number of cycles included in each treatment session and must also be individualized. In future research, more precise descriptions are needed about physiological aims and specific instructions of how the treatments have been performed to assure as good treatment quality as possible and to be able to evaluate and compare treatment effects. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Position of anticholinergic drugs in the treatment of childhood asthma

    Directory of Open Access Journals (Sweden)

    Stojković-Anđelković Anđelka

    2010-01-01

    Full Text Available Anticholinergic drugs block muscarinic effect of acetylcholine on the receptors of postjunctional membranes and so inhibit the answer of the postganglionic parasympathetic nerve. The loss of M2 muscarinic receptors function occurs in asthmatics and it contributes to bronchial hyperresponsiveness and it is not a chronic feature of asthma, instead it characterizes asthma exacerbation. The loss of M2 muscarinic receptor function in children and adults happens during antigen bronchoprovocation or during exposition of asthmatics to ozone. After inhalation, ipratropium bromide (IB can be found in a small quantity in circulation and it links less readily to muscarinic receptors on airway smooth muscles as related to its absorption after intravenous application. In the stepwise approach of asthma inhaled anticholinergics is recommended if the symptoms of the disease cannot be adequately controlled by a regular inhalation of antiinflammatory drugs with β2-agonist and oral steroids. The improvement of the airway inspiratory capacity is more elevated than the improvement of FEV1 after inhalation of IB. IB has similar effect as salbutamol and it is recommended to control a stable chronic obstructive disease. During our numerous investigations and up-to-date experience in the usage of 5-7 μg/kg/body mass of IB repeated every 4-6 hours in combination with salbutamol, we did not notice adverse effects of the drug in infants. IB is recommended for hospital treatment of children. .

  2. Positive effects of radiation on forest production

    International Nuclear Information System (INIS)

    Gonzalez J, J.; De la Cruz O, A.; Aguilar, M. A.; Caxnajoy, P. A.; Salceda S, V.

    2009-10-01

    The deforestation is a world problem and due to of increment of seed demand and seedling of good quality, was realized a work about the production improvement on commercial or forest trees for the Mexico State. It was combined the use of two techniques: the plant tissue culture and ionizing application. It was utilized seed of Pinus hartwegii collected and valued previously by ProBosque, with them were formed homogeneous lots that were irradiated to dose of 0, 30, 45, 60, 75, 90 and 105 Gy into irradiator Gammacel-220 and later were decontaminated and cultivated in vitro. The seeds-planting were placed in a growth room with temperature and controlled light. After 10 cultivation days was obtained germination among 87-100% without observing the induction of negative changes in none of treatments. After 21 days already developed the embryos completely, modifications were presented in some structures. With these was possible to determine the lethal dose mean that oscillates between 100 and 105 Gy; since to dose bigger than 100 Gy more of 75% of individuals or seedlings present the phenols formation inducing the material lost by oxidation starting from day 32. Also, it is observed that applied doses between the 30 and 90 Gy do not affect or modify the embryogenesis in Pinus hartwegii but if the structures formation and seedling size since after 12 development days it is possible to appreciate to dose of 90, 75 and 45 Gy the presence of a primary radicular system, same that is observed after 22 development days in the witness. Another observation was that to dose of 45 and 90 Gy the leafs presents bigger elongation increasing the seedlings size on 22% in comparison with the witness. We can say that the doses understood between 45 and 90 Gy affect in a positive way the hormonal production of Pinus hartwegii seedlings and that the dose of 90 Gy accelerates the rhizogenes process and it increases the seedling size allowing to diminish the production time of Pinus hartwegii

  3. Single-position Hall effect measurements

    DEFF Research Database (Denmark)

    2014-01-01

    A method for determining a distance (Y) between a first position on and an electrical boundary (34) of a test sample by a multi-point probe comprising four contact elements, comprising: contacting the test sample with the four contact elements (20,22,24,26) at the first position, applying a magne...

  4. A comparison of ventilatory prostate movement in four treatment positions

    International Nuclear Information System (INIS)

    Dawson, Laura A.; Litzenberg, Dale W.; Brock, Kristy K.; Sanda, Martin; Sullivan, Molly; Sandler, Howard M.; Balter, James M.

    2000-01-01

    Purpose: To ensure target coverage during radiotherapy, all sources of geometric uncertainty in target position must be considered. Movement of the prostate due to breathing has not traditionally been considered in prostate radiotherapy. The purpose of this study is to report the influence of patient orientation and immobilization on prostate movement due to breathing. Methods and Materials: Four patients had radiopaque markers implanted in the prostate. Fluoroscopy was performed in four different positions: prone in alpha cradle, prone with an aquaplast mold, supine on a flat table, and supine with a false table under the buttocks. Fluoroscopic movies were videotaped and digitized. Frames were analyzed using 2D-alignment software to determine the extent of movement of the prostate markers and the skeleton for each position during normal and deep breathing. Results: During normal breathing, maximal movement of the prostate markers was seen in the prone position (cranial-caudal [CC] range: 0.9-5.1 mm; anterior-posterior [AP] range: up to 3.5 mm). In the supine position, prostate movement during normal breathing was less than 1 mm in all directions. Deep breathing resulted in CC movements of 3.8-10.5 mm in the prone position (with and without an aquaplast mold). This range was reduced to 2.0-7.3 mm in the supine position and 0.5-2.1 mm with the use of the false table top. Deep breathing resulted in AP skeletal movements of 2.7-13.1 mm in the prone position, whereas AP skeletal movements in the supine position were negligible. Conclusion: Ventilatory movement of the prostate is substantial in the prone position and is reduced in the supine position. The potential for breathing to influence prostate movement, and thus the dose delivered to the prostate and normal tissues, should be considered when positioning and planning patients for conformal irradiation

  5. Evidence-based treatments for the asymptomatic HIV- positive ...

    African Journals Online (AJOL)

    banzi

    ty of the women attending antenatal clin- ics are healthy and therefore ... a decrease in the patient's risk of falling ill from opportunistic .... 10% risk in those who are tuberculin-. n e g a t i v e . In summary. • There is grade-A evidence that. HIV-positive patients who are tuberculin skin-positive benefit from anti-TB prophylaxis.

  6. Endocrine Society of Australia position statement on male hypogonadism (part 2): treatment and therapeutic considerations.

    Science.gov (United States)

    Yeap, Bu B; Grossmann, Mathis; McLachlan, Robert I; Handelsman, David J; Wittert, Gary A; Conway, Ann J; Stuckey, Bronwyn Ga; Lording, Douglas W; Allan, Carolyn A; Zajac, Jeffrey D; Burger, Henry G

    2016-09-05

    Part 1 of this position statement dealt with the assessment of male hypogonadism, including the indications for testosterone therapy. This article, Part 2, focuses on treatment and therapeutic considerations for male hypogonadism and identifies key questions for future research. Key points and recommendations are:Excess cardiovascular events have been reported in some but not all studies of older men without pathological hypogonadism who were given testosterone treatment. Additional studies are needed to clarify whether testosterone therapy influences cardiovascular risk.Testosterone is the native hormone that should be replaced in men being treated for pathological hypogonadism. Convenient and cost-effective treatment modalities include depot intramuscular injection and transdermal administration (gel, cream or liquid formulations).Monitoring of testosterone therapy is recommended for efficacy and safety, focusing on ameliorating symptoms, restoring virilisation, avoiding polycythaemia and maintaining or improving bone mineral density.Treatment aims to relieve an individual's symptoms and signs of androgen deficiency by administering standard doses and maintaining circulating testosterone levels within the reference interval for eugonadal men.Evaluation for cardiovascular disease and prostate cancer risks should be undertaken as appropriate for eugonadal men of similar age. Nevertheless, when there is a reasonable possibility of substantive pre-existing prostate disease, digital rectal examination and prostate-specific antigen testing should be performed before commencing testosterone treatment.Changes in management as result of the position statement: Treatment aims to relieve symptoms and signs of androgen deficiency, using convenient and effective formulations of testosterone. Therapy should be monitored for efficacy and safety.

  7. Neratinib for the treatment of HER2-positive early stage breast cancer.

    Science.gov (United States)

    Echavarria, Isabel; López-Tarruella, Sara; Márquez-Rodas, Iván; Jerez, Yolanda; Martin, Miguel

    2017-08-01

    Despite the advances in the treatment of HER2-positive breast cancer, resistance to actual chemotherapeutic regimens eventually occurs. Neratinib, an orally available pan-inhibitor of the ERBB family, represents an interesting new option for early-stage HER2-positive breast cancer. Areas covered: In this article, the development of neratinib, with a special focus on its potential value in the treatment of early-stage HER2-positive breast cancer, has been reviewed. For this purpose, a literature search was conducted, including preclinical studies, early-phase trials in advanced cancer with neratinib in monotherapy and in combination, and phase II and large phase III trials in the early setting. Management of neratinib-induced toxicity, future perspectives for the drug, and ongoing trials are also discussed in this review. Expert commentary: Neratinib is emerging as a promising oral drug for the treatment of HER2-positive breast cancer. Although FDA and EMA approval is derived from the extended adjuvant treatment, this setting may not be the ideal scenario to obtain the beneficial effects of neratinib. Confirmatory data in the neoadjuvant setting and subgroup analysis from the ExTENET trial might bring some light into the best setting for neratinib therapy. Data from confirmatory trials in the metastatic setting are also required.

  8. What good are positive emotions for treatment? Trait positive emotionality predicts response to Cognitive Behavioral Therapy for anxiety.

    Science.gov (United States)

    Taylor, Charles T; Knapp, Sarah E; Bomyea, Jessica A; Ramsawh, Holly J; Paulus, Martin P; Stein, Murray B

    2017-06-01

    Cognitive behavioral therapy (CBT) is empirically supported for the treatment of anxiety disorders; however, not all individuals achieve recovery following CBT. Positive emotions serve a number of functions that theoretically should facilitate response to CBT - they promote flexible patterns of information processing and assimilation of new information, encourage approach-oriented behavior, and speed physiological recovery from negative emotions. We conducted a secondary analysis of an existing clinical trial dataset to test the a priori hypothesis that individual differences in trait positive emotions would predict CBT response for anxiety. Participants meeting diagnostic criteria for panic disorder (n = 28) or generalized anxiety disorder (n = 31) completed 10 weekly individual CBT sessions. Trait positive emotionality was assessed at pre-treatment, and severity of anxiety symptoms and associated impairment was assessed throughout treatment. Participants who reported a greater propensity to experience positive emotions at pre-treatment displayed the largest reduction in anxiety symptoms as well as fewer symptoms following treatment. Positive emotions remained a robust predictor of change in symptoms when controlling for baseline depression severity. Initial evidence supports the predictive value of trait positive emotions as a prognostic indicator for CBT outcome in a GAD and PD sample. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Diversity management: the treatment of HIV-positive employees.

    Science.gov (United States)

    Yap, Matthew H T; Ineson, Elizabeth M

    2012-01-01

    Socio-demographic dimensions such as age, gender, sexual orientation, race and ethnicity are commonly included in diversity studies. With a view to helping Asian hospitality managers to manage HIV-positive employees in their workplaces through diversity management (DM) theory, this research extends the boundaries of previous diversity studies by considering Human Immunodeficiency Virus (HIV) infection as a diverse characteristic. Both quantitative and qualitative primary data were collected from purposively selected Asian hospitality managers through postal questionnaire and follow-up telephone interviews. Transformed raw data were analysed using summary statistics and template analysis. Asian hospitality managers agreed that DM would be appropriate in the management of HIV-positive employees and that it could generate substantial benefits for employees and employers. However, they believe that the successful adoption and implementation of DM is not easy; it requires training and, ideally, the recruitment of experienced directors. Nevertheless, Asian hospitality managers are confident that implementing DM to manage HIV-positive employees can enhance tolerance, improve understanding and promote equality. The purposive sampling technique and the small number of respondents have impacted the external validity of the study. However, this exploratory study initiates an equality discussion to include HIV-positive employees in DM discourse beyond antidiscrimination legislation. It also supplements the sparse literature addressing HIV-positive employees in the Asian hospitality workplace. Asian hospitality managers are advised to understand and employ DM to treat HIV-positive employees fairly to overcome hospitality workplace marginalisation, discrimination and stigmatisation.

  10. Positional Accuracy Assessment for Effective Shoreline Change ...

    African Journals Online (AJOL)

    Ghana Mining Journal ... Data quality may be expressed in terms of several indicators such as attributes, temporal or positional accuracies. ... It is concluded that for the purpose of shoreline change analysis, such as shoreline change trends, large scale data sources should be used where possible for accurate ...

  11. Subjective visual vertical after treatment of benign paroxysmal positional vertigo

    Directory of Open Access Journals (Sweden)

    Maristela Mian Ferreira

    Full Text Available Abstract Introduction: Otolith function can be studied by testing the subjective visual vertical, because the tilt of the vertical line beyond the normal range is a sign of vestibular dysfunction. Benign paroxysmal positional vertigo is a disorder of one or more labyrinthine semicircular canals caused by fractions of otoliths derived from the utricular macula. Objective: To compare the subjective visual vertical with the bucket test before and immediately after the particle repositioning maneuver in patients with benign paroxysmal positional vertigo. Methods: We evaluated 20 patients. The estimated position where a fluorescent line within a bucket reached the vertical position was measured before and immediately after the particle repositioning maneuver. Data were tabulated and statistically analyzed. Results: Before repositioning maneuver, 9 patients (45.0% had absolute values of the subjective visual vertical above the reference standard and 2 (10.0% after the maneuver; the mean of the absolute values of the vertical deviation was significantly lower after the intervention (p < 0.001. Conclusion: There is a reduction of the deviations of the subjective visual vertical, evaluated by the bucket test, immediately after the particle repositioning maneuver in patients with benign paroxysmal positional vertigo.

  12. Treatment outcome of tb/hiv positive and negative smear positive ...

    African Journals Online (AJOL)

    Background: In our previous study we found that half of the patients treated at the Nylon District Hospital tuberculosis (TB) treatment centre were seropositive. HIV does not only fuel the number of tuberculosis (TB) cases worldwide but it is also at least in part, responsible for the non-achievement of the 85% cure rate target.

  13. Maintenance plasma exchange treatment for muscle specific kinase antibody positive myasthenia gravis patients.

    Science.gov (United States)

    Yamada, Chisa; Teener, James W; Davenport, Robertson D; Cooling, Laura

    2015-10-01

    Anti-muscle specific kinase antibody positive myasthenia gravis (MuSK MG) is often characterized by a relatively severe and progressive course, refractoriness to standard myasthenia gravis (MG) medications, and an increased risk of myasthenic crisis. We report here successful management of three MuSK MG patients using maintenance therapeutic plasma exchange (TPE) treatment for up to 4.5 years. The study was a 5-year retrospective review of all MG patients treated with TPE between 2008 and 2013 at University of Michigan. Inclusion criteria of MuSK MG were positive for anti-MuSK antibodies and a diagnosis of MuSK MG by staff neurologists. Patient data included age, gender, diagnostic testing results, medications, and the dates and response to TPE treatments. A total of 153 MG patients underwent at least one course of TPE between 2008 and 2013. A total of 12 patients (7.8%) were positive for anti-MuSK antibodies. Patients were predominantly female (83.3%) and a median age of onset was 46-years old. Three MuSK MG patients were successfully managed with maintenance TPE. Maintenance TPE may be an effective option for MuSK MG patients. The key of successful maintenance treatment at our institution has been to tailor the TPE frequency for each individual, and to modify the treatment interval in conjunction with medical management. © 2014 Wiley Periodicals, Inc.

  14. Delay in treatment seeking of smear positive tuberculous patients

    International Nuclear Information System (INIS)

    Bhatti, A.T.; Zahid, M.

    2010-01-01

    To assess and identify the causes and circumstances leading to delays in health seeking and diagnosis of tuberculosis patients as they often present with advance disease resulting in increased morbidity and mortality. Settings Department of Tuberculosis, DOTS clinic DHQ Hospital, Vehari. Methodology One (author) inspiration diagnosed smear positive pulmonary tuberculosis patients were included. Information was gathered through interviews and from TB-01 card. Results Maximum patients were in age group of 16-40 years. Median patient delay was 4-6 months; jobless, homeless personnel had longer delay. The main reason for delay was that the symptoms were not considered serious enough. Delay in presentation of smear positive cases may be due to the lack of awareness of patients and the incompetence of some health workers. Training and supervision of staff and awareness campaigns targeted at the population and involvement of private sector will improve TB control in Vehari. (author)

  15. Anti-TNFα Treatment for HLA-B27-Positive Ankylosing Spondylitis-Related Uveitis.

    Science.gov (United States)

    Kim, Mirinae; Won, Jae-Yon; Choi, Seung Yong; Ju, Ji Hyeon; Park, Young-Hoon

    2016-10-01

    To assess the long-term efficacy of the most widely used anti-tumor necrosis factor alpha (TNFα) agents for treatment of HLA-B27-positive ankylosing spondylitis (AS)-related uveitis. Retrospective cohort study. The medical records of 143 patients with HLA-B27-positive AS who visited Seoul St. Mary's Hospital and were taking an anti-TNFα agent for at least 1 year were studied. Subjects were divided into 3 groups according to anti-TNFα treatment: Group 1 (infliximab, 66), Group 2 (adalimumab, 45), and Group 3 (etanercept, 32). Mean age was 41.0 ± 13.0 years, and 97 patients (67.8%) were male. Mean follow-up period was 70.6 ± 37.9 months. In cases of active ocular inflammation at the onset of anti-TNFα treatment, patients showed improved activity of uveitis after 24.0 ± 15.0 days (Group 1), 17.9 ± 6.0 days (Group 2), and 25.9 ± 18.0 days (Group 3). After the anti-TNFα treatment, 71 of 94 patients (32 [76.2%] in Group 1, 26 [78.8%] in Group 2, and 13 [68.4%] in Group 3) remained without uveitis relapse. A reduction in the number of systemic medications was achieved in 129 patients (90.2%). Twenty-eight cases of minor side effects were observed, and 4 cases were tuberculosis leading to discontinuation of anti-TNFα treatment. Infliximab, adalimumab, and etanercept were effective for treating and reducing the number of uveitis relapses in HLA-B27-positive AS. However, the risk of serious infections was noted, so ophthalmologists should consider the possibility that prolonged use of biologic agents may result in systemic side effects. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. New developments in the treatment of HER2-positive breast cancer

    Directory of Open Access Journals (Sweden)

    Nahta R

    2012-05-01

    Full Text Available Rita NahtaDepartments of Pharmacology and Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USAAbstract: Approximately 20%–30% of metastatic breast cancers show increased expression of the human epidermal growth factor receptor-2 (HER2 tyrosine kinase. Two HER2-specific therapies are currently approved for clinical treatment of patients with HER2-overexpressing metastatic breast cancer. Trastuzumab is a monoclonal antibody against HER2 and is approved for first-line treatment of HER2-positive metastatic breast cancer. Lapatinib is a small molecule dual inhibitor of epidermal growth factor receptor and HER2 tyrosine kinases, and is approved for trastuzumab-refractory disease. Although trastuzumab is a highly effective therapy for patients with HER2-overexpressing metastatic breast cancer, a significant number of patients in the initial clinical trials of trastuzumab monotherapy showed resistance to trastuzumab-based therapy. Further, among those who did respond, the initial trials indicated that the median time to progression was less than 1 year. Similarly, lapatinib is effective in a subset of trastuzumab-refractory cases, but the majority of patients display resistance. This review discusses the multiple molecular mechanisms of resistance that have been proposed in the literature. In addition, novel agents that are being tested for efficacy against HER2-positive breast cancer, including the antibodies pertuzumab and trastuzumab-DM1 and the immunotoxin affitoxin, are reviewed. The introduction of trastuzumab has revolutionized the clinical care of patients with HER2-positive metastatic breast cancer and has resulted in dramatic reductions in recurrences of early-stage HER2-positive breast cancer. The development and implementation of gene- and protein-based assays that measure potential molecular predictors of trastuzumab resistance will allow individualization of HER2-targeted therapeutic approaches

  17. National Emphysema Treatment Trial redux: accentuating the positive.

    Science.gov (United States)

    Sanchez, Pablo Gerardo; Kucharczuk, John Charles; Su, Stacey; Kaiser, Larry Robert; Cooper, Joel David

    2010-09-01

    Under the Freedom of Information Act, we obtained the follow-up data of the National Emphysema Treatment Trial (NETT) to determine the long-term outcome for "a heterogeneous distribution of emphysema with upper lobe predominance," postulated by the NETT hypothesis to be optimal candidates for lung volume reduction surgery. Using the NETT database, we identified patients with heterogeneous distribution of emphysema with upper lobe predominance and analyzed for the first time follow-up data for those receiving lung volume reduction surgery and those receiving medical management. Furthermore, we compared the results of the NETT reduction surgery group with a previously reported consecutive case series of 250 patients undergoing bilateral lung volume reduction surgery using similar selection criteria. Of the 1218 patients enrolled, 511 (42%) conformed to the NETT hypothesis selection criteria and received the randomly assigned surgical or medical treatment (surgical = 261; medical = 250). Lung volume reduction surgery resulted in a 5-year survival benefit (70% vs 60%; P = .02). Results at 3 years compared with baseline data favored surgical reduction in terms of residual volume reduction (25% vs 2%; P George Respiratory Questionnaire quality of life score (12 points vs 0 points; P < .001). For the 513 patients with a homogeneous pattern of emphysema randomized to surgical or medical treatment, lung volume reduction surgery produced no survival advantage and very limited functional benefit. Patients most likely to benefit from lung volume reduction surgery have heterogeneously distributed emphysema involving the upper lung zones predominantly. Such patients in the NETT trial had results nearly identical to those previously reported in a nonrandomized series of similar patients undergoing lung volume reduction surgery. 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  18. [Treatment of supine position-related obstructive sleep apnea with smartphone applications].

    Science.gov (United States)

    Haas, D; Birk, R; Maurer, J T; Hörmann, K; Stuck, B A; Sommer, J U

    2017-02-01

    Positional obstructive sleep apnea (POSA) is common in mild and moderate forms of obstructive sleep apnea (OSA). Two smartphone applications (apps) professing to avoid the supine position (SP) are available: for Android the "Apnea Sleep Position Trainer" and for iOS the "SomnoPose-Sleep Position Monitor". The smartphone needs to be attached to the chest to recognize SP, which then triggers a vibration alarm. This is intended to encourage the patient to change position and the vibration stops as soon as SP is left. These apps, however, have not yet undergone a systematic evaluation. Adult patients with polysomnographically diagnosed POSA were invited to participate in the study. POSA was defined as an apnea-hypopnea index (AHI) in SP >10, with AHI in a lateral position sleep time and to an overall AHI smartphone apps have the capability to prevent PS in POSA patients and can potentially offer a cost-effective option in the treatment of POSA.

  19. Community Work Programme has positive and negative effects on ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-08-03

    Aug 3, 2016 ... ... has positive and negative effects on social bonds in South African communities ... to contribute to positive social cohesion and to prevent violence. ... including shared values and identity, feelings of belonging, civic pa.

  20. Predictors of experiences of discrimination and positive treatment in people with mental health problems: findings from an Australian national survey.

    Science.gov (United States)

    Reavley, Nicola J; Morgan, Amy J; Jorm, Anthony F

    2017-03-01

    The aim of the study was to assess the factors predicting experiences of avoidance, discrimination and positive treatment in people with mental health problems. In 2014, telephone interviews were carried out with 5220 Australians aged 18+, 1381 of whom reported a mental health problem or scored highly on a symptom screening questionnaire. Questions covered experiences of avoidance, discrimination and positive treatment by friends, spouse, other family, workplace, educational institution and others in the community; as well as disclosure of mental health problems. Avoidance, discrimination and positive treatment scores were calculated by counting the number of domains in which each occurred. Predictors of avoidance, discrimination and positive treatment were modelled with negative binomial regression analyses. After adjusting for the effects of other predictors in multivariate analyses, symptom severity and a diagnosis of 'any other disorder' (most commonly psychotic disorders or eating disorders) predicted experiences of both avoidance and discrimination but not positive treatment. Disclosing a mental health problem in more settings was also associated with higher rates of avoidance and discrimination, but also with positive treatment. Disclosure of mental health problems to others may increases experiences of discrimination, but may also increase experiences of positive treatment. These findings can help to inform decision making by people with mental health problems about disclosure, particularly in the case of more severe or low-prevalence disorders.

  1. Positive effects of massage therapy on a patient with narcolepsy.

    Science.gov (United States)

    Hill, Robyn; Baskwill, Amanda

    2013-01-01

    The purpose of this case report was to investigate the effects of massage therapy on the sleep patterns of a woman with narcolepsy. The 23-year-old woman's primary symptoms included excessive daytime sleepiness and periodic leg movements (PLM), which were associated with her diagnoses of both narcolepsy and cataplexy. Five 45-minute massage therapy treatments were administered over a five-week period. The patient's sleep patterns were recorded each week before the treatment. A final measurement was recorded in the sixth week. The sleep patterns were monitored using the Leeds Sleep Evaluation Questionnaire, which included ten visual analogue scales. The results of this case report included an improvement in getting to sleep by 148%, an improvement in quality of sleep by 1100%, an improvement in awake following sleep by 121%, and an improvement in behaviour following wakening by 28% using the Leeds Sleep Evaluation Questionnaire. This case report suggests that massage therapy had a positive effect on this patient with narcolepsy. Further research is needed to investigate the effects of massage therapy on narcolepsy and sleep patterns.

  2. Clinical effects of prior trastuzumab on combination eribulin mesylate plus trastuzumab as first-line treatment for human epidermal growth factor receptor 2 positive locally recurrent or metastatic breast cancer: results from a Phase II, single-arm, multicenter study

    Directory of Open Access Journals (Sweden)

    Puhalla S

    2016-12-01

    Full Text Available Shannon Puhalla,1 Sharon Wilks,2 Adam M Brufsky,1 Joyce O’Shaughnessy,3 Lee S Schwartzberg,4 Erhan Berrak,5 James Song,5 Linda Vahdat6 1Department of Hematology and Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, 2Department of Hematology Oncology, US Oncology-Cancer Care Centers of South Texas, San Antonio, TX, 3Department of Medical Oncology, Texas Oncology-Baylor Charles A. Sammons Cancer Center US Oncology, Dallas, TX, 4Department of Hematology/Oncology, West Cancer Center, University of Tennessee Health Science Center, Memphis, TN, 5Department of Medical Affairs, Formerly of Eisai Inc., Woodcliff Lake, NJ, 6Department of Medicine, Weill Cornell Medical College, New York, NY, USA Abstract: Eribulin mesylate, a novel nontaxane microtubule dynamics inhibitor in the halichondrin class of antineoplastic drugs, is indicated for the treatment of patients with metastatic breast cancer who previously received ≥2 chemotherapy regimens in the metastatic setting. Primary data from a Phase II trial for the first-line combination of ­eribulin plus trastuzumab in human epidermal growth factor receptor 2 positive patients showed a 71% objective response rate and tolerability consistent with the known profile of these agents. Here, we present prespecified analyses of efficacy of this combination based on prior trastuzumab use. Patients received eribulin mesylate 1.4 mg/m2 (equivalent to 1.23 mg/m2 eribulin [expressed as free base] intravenously on days 1 and 8 plus trastuzumab (8 mg/kg intravenously/cycle 1, then 6 mg/kg on day 1 of each 21-day cycle. Objective response rates, progression-free survival, and tolerability were assessed in patients who had and had not received prior adjuvant or neoadjuvant (neo/adjuvant trastuzumab treatment. Fifty-two patients (median age: 59.5 years received eribulin/trastuzumab for a median treatment duration of ~31 weeks; 40.4% (n=21 had been previously treated with neo/adjuvant trastuzumab prior to

  3. Continuous positive airway pressure treatment increases bronchial reactivity in obstructive sleep apnea patients.

    Science.gov (United States)

    Korczynski, Piotr; Gorska, Katarzyna; Przybylowski, Tadeusz; Bielicki, Piotr; Zielinski, Jan; Chazan, Ryszarda

    2009-01-01

    The effects of continuous positive airway pressure (CPAP) treatment on the function of the lower airways are poorly understood. One of the methods used to determine the influence of positive pressure breathing on lower airways is the bronchial hyperreactivity test. Some authors report that CPAP increases bronchial hyperreactivity, while others report decreases. To assess the influence of CPAP treatment on bronchial reactivity and the effects of bronchial hyperreactivity on compliance to CPAP treatment. The study group consisted of 101 obstructive sleep apnea syndrome patients (88 men and 13 women) with a mean age of 51 ± 11 years, mean apnea-hypopnea index of 53 ± 20 and mean body mass index of 32.6 ± 5.4. Patients were randomly assigned to a treatment group that received 3 weeks of CPAP therapy (group 1) or to a nontreatment control group (group 2). Pulmonary function tests and the methacholine bronchial provocation test were performed at baseline and 3 weeks later. There were no statistically significant differences between treated and control groups in anthropometry and polysomnography variables. At baseline, bronchial hyperreactivity was found in 6 patients from group 1 and 5 patients from group 2. A significant increase in bronchial reactivity was observed after CPAP treatment. Log PC20M decreased from 1.38 ± 0.30 at baseline to 1.26 ± 0.50 (p bronchial hyperreactivity during CPAP treatment were characterized by significantly lower FEV1, FVC and MEF50 values. CPAP produces statistically significant bronchial hyperreactivity. However, there were no clinical symptoms and it is not necessary to withdraw previous therapies. Copyright © 2009 S. Karger AG, Basel.

  4. SU-E-J-15: Automatically Detect Patient Treatment Position and Orientation in KV Portal Images

    Energy Technology Data Exchange (ETDEWEB)

    Qiu, J [Washington University in St Louis, Taian, Shandong (China); Yang, D [Washington University School of Medicine, St Louis, MO (United States)

    2015-06-15

    Purpose: In the course of radiation therapy, the complex information processing workflow will Result in potential errors, such as incorrect or inaccurate patient setups. With automatic image check and patient identification, such errors could be effectively reduced. For this purpose, we developed a simple and rapid image processing method, to automatically detect the patient position and orientation in 2D portal images, so to allow automatic check of positions and orientations for patient daily RT treatments. Methods: Based on the principle of portal image formation, a set of whole body DRR images were reconstructed from multiple whole body CT volume datasets, and fused together to be used as the matching template. To identify the patient setup position and orientation shown in a 2D portal image, the 2D portal image was preprocessed (contrast enhancement, down-sampling and couch table detection), then matched to the template image so to identify the laterality (left or right), position, orientation and treatment site. Results: Five day’s clinical qualified portal images were gathered randomly, then were processed by the automatic detection and matching method without any additional information. The detection results were visually checked by physicists. 182 images were correct detection in a total of 200kV portal images. The correct rate was 91%. Conclusion: The proposed method can detect patient setup and orientation quickly and automatically. It only requires the image intensity information in KV portal images. This method can be useful in the framework of Electronic Chart Check (ECCK) to reduce the potential errors in workflow of radiation therapy and so to improve patient safety. In addition, the auto-detection results, as the patient treatment site position and patient orientation, could be useful to guide the sequential image processing procedures, e.g. verification of patient daily setup accuracy. This work was partially supported by research grant from

  5. SU-E-J-15: Automatically Detect Patient Treatment Position and Orientation in KV Portal Images

    International Nuclear Information System (INIS)

    Qiu, J; Yang, D

    2015-01-01

    Purpose: In the course of radiation therapy, the complex information processing workflow will Result in potential errors, such as incorrect or inaccurate patient setups. With automatic image check and patient identification, such errors could be effectively reduced. For this purpose, we developed a simple and rapid image processing method, to automatically detect the patient position and orientation in 2D portal images, so to allow automatic check of positions and orientations for patient daily RT treatments. Methods: Based on the principle of portal image formation, a set of whole body DRR images were reconstructed from multiple whole body CT volume datasets, and fused together to be used as the matching template. To identify the patient setup position and orientation shown in a 2D portal image, the 2D portal image was preprocessed (contrast enhancement, down-sampling and couch table detection), then matched to the template image so to identify the laterality (left or right), position, orientation and treatment site. Results: Five day’s clinical qualified portal images were gathered randomly, then were processed by the automatic detection and matching method without any additional information. The detection results were visually checked by physicists. 182 images were correct detection in a total of 200kV portal images. The correct rate was 91%. Conclusion: The proposed method can detect patient setup and orientation quickly and automatically. It only requires the image intensity information in KV portal images. This method can be useful in the framework of Electronic Chart Check (ECCK) to reduce the potential errors in workflow of radiation therapy and so to improve patient safety. In addition, the auto-detection results, as the patient treatment site position and patient orientation, could be useful to guide the sequential image processing procedures, e.g. verification of patient daily setup accuracy. This work was partially supported by research grant from

  6. Palbociclib as a first-line treatment in oestrogen receptor-positive, HER2-negative, advanced breast cancer not cost-effective with current pricing: a health economic analysis of the Swiss Group for Clinical Cancer Research (SAKK).

    Science.gov (United States)

    Matter-Walstra, K; Ruhstaller, T; Klingbiel, D; Schwenkglenks, M; Dedes, K J

    2016-07-01

    Endocrine therapy continues to be the optimal systemic treatment for metastatic ER(+)HER2(-) breast cancer. The CDK4/6 inhibitor palbociclib combined with letrozole has recently been shown to significantly improve progression-free survival. Here we examined the cost-effectiveness of this regimen for the Swiss healthcare system. A Markov cohort simulation based on the PALOMA-1 trial (Finn et al. in Lancet Oncol 16:25-35, 2015) was used as the clinical course. Input parameters were based on summary trial data. Costs were assessed from the Swiss healthcare system perspective. Adding palbociclib to letrozole (PALLET) compared to letrozole monotherapy was estimated to cost an additional CHF342,440 and gain 1.14 quality-adjusted life years, resulting in an incremental cost-effectiveness ratio (ICER) of CHF301,227/QALY gained. In univariate sensitivity analyses, no tested variation in key parameters resulted in an ICER below a willingness-to-pay threshold of CHF100,000/QALY. PALLET had a 0 % probability of being cost-effective in probabilistic sensitivity analyses. Lowering PALLET's price by 75 % resulted in an ICER of CHF73,995/QALY and a 73 % probability of being cost-effective. At current prices, PALLET would cost the Swiss healthcare system an additional CHF155 million/year. Palbociclib plus letrozole cannot be considered cost-effective for the first-line treatment of patients with metastatic breast cancer in the Swiss healthcare system.

  7. Augmenting one-session treatment of children's specific phobias with attention training to positive stimuli.

    Science.gov (United States)

    Waters, Allison M; Farrell, Lara J; Zimmer-Gembeck, Melanie J; Milliner, Ella; Tiralongo, Evelin; Donovan, Caroline L; McConnell, Harry; Bradley, Brendan P; Mogg, Karin; Ollendick, Thomas H

    2014-11-01

    This study examined the efficacy of combining two promising approaches to treating children's specific phobias, namely attention training and one 3-h session of exposure therapy ('one-session treatment', OST). Attention training towards positive stimuli (ATP) and OST (ATP+OST) was expected to have more positive effects on implicit and explicit cognitive mechanisms and clinical outcome measures than an attention training control (ATC) condition plus OST (ATC+OST). Thirty-seven children (6-17 years) with a specific phobia were randomly assigned to ATP+OST or ATC+OST. In ATP+OST, children completed 160 trials of attention training responding to a probe that always followed the happy face in happy-angry face pairs. In ATC+OST, the probe appeared equally often after angry and happy faces. In the same session, children completed OST targeting their phobic situation/object. Clinical outcomes included clinician, parent and child report measures. Cognitive outcomes were assessed in terms of change in attention bias to happy and angry faces and in danger and coping expectancies. Assessments were completed before and after treatment and three-months later. Compared to ATC+OST, the ATP+OST condition produced (a) significantly greater reductions in children's danger expectancies about their feared situations/object during the OST and at three-month follow-up, and (b) significantly improved attention bias towards positive stimuli at post-treatment, which in turn, predicted a lower level of clinician-rated phobia diagnostic severity three-months after treatment. There were no significant differences between ATP+OST and ATC+OST conditions in clinician, parent, or child-rated clinical outcomes. Training children with phobias to focus on positive stimuli is effective in increasing attention towards positive stimuli and reducing danger expectancy biases. Studies with larger sample sizes and a stronger 'dose' of ATP prior to the OST may reveal promising outcomes on clinical measures

  8. Use of the prone position in radiation treatment for women with early stage breast cancer

    International Nuclear Information System (INIS)

    Algan, Oezer; Fowble, Barbara; McNeeley, Shawn; Fein, Douglas

    1998-01-01

    Purpose: The prone position has been advocated for women with large pendulous breasts undergoing breast-conserving treatment with radiation therapy. However, there is no information in the literature regarding the coverage of the target volume with this technique. The purpose of this study was to evaluate the effectiveness of the prone treatment position in including at least the biopsy cavity with a 2-cm margin. Methods and Materials: Eleven consecutive patients who underwent CT simulation in the prone position were included in this study. Patients underwent CT simulation in the prone position using a flat platform containing an aperture for the breast to hang through in a dependent fashion. CT slices were 5-mm thick taken at 3-mm intervals. The biopsy cavity was localized and outlined on sequential CT images using the surgical clips (when present) as well as the residual seroma. A 2-cm margin was included around the biopsy cavity to define the minimal target volume (mTV). Lateral fields were used for treatment planning. The beam arrangements were considered adequate if the mTV was totally included in the lateral fields. Results: Median age of the patient population was 55 years. Bra sizes ranged from 36A-44DD. The majority of patients had mammographically detected T1 lesions. Median volume of the biopsy cavity was 48 cm 3 . Five of 11 (45%) patients underwent reexcision of the biopsy cavity, and 6 of 11 (55%) had surgical clips placed in the biopsy cavity. Overall, 8 of 11 (73%) patients did not have the entire mTV included in the lateral opposed tangential fields in the prone position. This was especially true in patients whose biopsy cavity extended down to the chest wall. There were no other clinical factors that could predict for the adequacy of coverage in the prone position. Conclusion: Special attention must be paid to the location of the surgical clips to determine the proximity of the biopsy cavity to the chest wall, or CT simulation should be performed

  9. POSITIVE study: physical exercise program in non-operable lung cancer patients undergoing palliative treatment.

    Science.gov (United States)

    Wiskemann, Joachim; Hummler, Simone; Diepold, Christina; Keil, Melanie; Abel, Ulrich; Steindorf, Karen; Beckhove, Philipp; Ulrich, Cornelia M; Steins, Martin; Thomas, Michael

    2016-07-19

    Patients with advanced stage non-small cell lung cancer (NSCLC) or small cell lung cancer (SCLC) often experience multidimensional impairments, affecting quality of life during their course of disease. In lung cancer patients with operable disease, several studies have shown that exercise has a positive impact on quality of life and physical functioning. There is limited evidence regarding efficacy for advanced lung cancer patients undergoing palliative treatment. Therefore, the POSITIVE study aims to evaluate the benefit of a 24-week exercise intervention during palliative treatment in a randomized controlled setting. The POSITIVE study is a randomized, controlled trial investigating the effects of a 24-week exercise intervention during palliative treatment on quality of life, physical performance and immune function in advanced, non-operable lung cancer patients. 250 patients will be recruited in the Clinic for Thoracic Diseases in Heidelberg, enrolment begun in November 2013. Main inclusion criterion is histologically confirmed NSCLC (stage IIIa, IIIb, IV) or SCLC (Limited Disease-SCLC, Extensive Disease-SCLC) not amenable to surgery. Patients are randomized into two groups. Both groups receive weekly care management phone calls (CMPCs) with the goal to assess symptoms and side effects. Additionally, one group receives a combined resistance and endurance training (3x/week). Primary endpoints are quality of life assessed by the Functional Assessment of Cancer Therapy for patients with lung cancer (FACT-L, subcategory Physical Well-Being) and General Fatigue measured by the Multidimensional Fatigue Inventory (MFI-20). Secondary endpoints are physical performance (maximal voluntary isometric contraction, 6-min walk distance), psychosocial (depression and anxiety) and immunological parameters and overall survival. The aim of the POSITIVE trial is the evaluation of effects of a 24-week structured and guided exercise intervention during palliative treatment stages

  10. Aerobic exercise decreases the positive-reinforcing effects of cocaine.

    Science.gov (United States)

    Smith, Mark A; Schmidt, Karl T; Iordanou, Jordan C; Mustroph, Martina L

    2008-11-01

    Aerobic exercise can serve as an alternative, non-drug reinforcer in laboratory animals and has been recommended as a potential intervention for substance abusing populations. Unfortunately, relatively little empirical data have been collected that specifically address the possible protective effects of voluntary, long-term exercise on measures of drug self-administration. The purpose of the present study was to examine the effects of chronic exercise on sensitivity to the positive-reinforcing effects of cocaine in the drug self-administration procedure. Female rats were obtained at weaning and immediately divided into two groups. Sedentary rats were housed individually in standard laboratory cages that permitted no exercise beyond normal cage ambulation; exercising rats were housed individually in modified cages equipped with a running wheel. After 6 weeks under these conditions, rats were surgically implanted with venous catheters and trained to self-administer cocaine on a fixed-ratio schedule of reinforcement. Once self-administration was acquired, cocaine was made available on a progressive ratio schedule and breakpoints were obtained for various doses of cocaine. Sedentary and exercising rats did not differ in the time to acquire cocaine self-administration or responding on the fixed-ratio schedule of reinforcement. However, on the progressive ratio schedule, breakpoints were significantly lower in exercising rats than sedentary rats when responding was maintained by both low (0.3mg/kg/infusion) and high (1.0mg/kg/infusion) doses of cocaine. In exercising rats, greater exercise output prior to catheter implantation was associated with lower breakpoints at the high dose of cocaine. These data indicate that chronic exercise decreases the positive-reinforcing effects of cocaine and support the possibility that exercise may be an effective intervention in drug abuse prevention and treatment programs.

  11. Understanding placebo, nocebo, and iatrogenic treatment effects.

    Science.gov (United States)

    Bootzin, Richard R; Bailey, Elaine T

    2005-07-01

    Placebo and nonplacebo treatments have both positive and negative effects on patient outcomes. To better understand the patterning of treatment effects, three specific interventions will be discussed that are reported to produce more harm than benefit: critical incident stress debriefing, group therapy for adolescents with conduct disorders, and psychotherapy for dissociative identity disorder. In each case, there is an interaction between mechanisms thought to underlie both placebo and specific treatment effects. Mechanisms hypothesized to underlie placebo and nocebo effects include patient expectancy, self-focused attention to symptoms, motivation to change, and sociocultural role-enactment cues. In the three treatments discussed, specific mechanisms interact with nonspecific mechanisms to produce iatrogenic effects. To advance knowledge, it is important both to specify the theory of treatment and its expected outcomes and to put the theory to test. Only with attention to the empirical findings from programmatic research of specific and nonspecific effects and their interaction is it possible to improve the outcomes of treatment beyond the status quo.

  12. A Novel, Aqueous Surface Treatment To Thermally Stabilize High Resolution Positive Photoresist Images*

    Science.gov (United States)

    Grunwald, John J.; Spencer, Allen C.

    1986-07-01

    The paper describes a new approach to thermally stabilize the already imaged profile of high resolution positive photoresists such as ULTRAMAC" PR-914. ***XD-4000, an aqueous emulsion of a blend of fluorine-bearing compounds is spun on top of the developed, positive photoresist-imaged wafer, and baked. This allows the photoresist to withstand temperatures up to at least 175 deg. C. while essentially maintaining vertical edge profiles. Also, adverse effects of "outgassing" in harsh environments, ie., plasma and ion implant are greatly minimized by allowing the high resolution imaged photoresist to be post-baked at "elevated" temperatures. Another type of product that accomplishes the same effect is ***XD-4005, an aqueous emulsion of a high temperature-resistant polymer. While the exact mechanism is yet to be identified, it is postulated that absorption of the "polymeric" species into the "skin" of the imaged resist forms a temperature resistant "envelope", thereby allowing high resolution photoresists to also serve in a "high temperature" mode, without reticulation, or other adverse effects due to thermal degradation. SEM's are presented showing imaged ULTRAMAC" PR-914 and ULTRAMAC" **EPA-914 geometries coated with XD-4000 or XD-4005 and followed by plasma etched oxide,polysilicon and aluminum. Selectivity ratios are compared with and without the novel treatment and are shown to be significantly better with the treatment. The surface-treated photoresist for thermal resistance remains easily strippable in solvent-based or plasma media, unlike photoresists that have undergone "PRIST" or other gaseous thermal stabilization methods.

  13. Development of a Simple Radioactive marker System to Reduce Positioning Errors in Radiation Treatment

    International Nuclear Information System (INIS)

    William H. Miller; Dr. Jatinder Palta

    2007-01-01

    The objective of this research is to implement an inexpensive, quick and simple monitor that provides an accurate indication of proper patient position during the treatment of cancer by external beam X-ray radiation and also checks for any significant changes in patient anatomy. It is believed that this system will significantly reduce the treatment margin, provide an additional, independent quality assurance check of positioning accuracy prior to all treatments and reduce the probability of misadministration of therapeutic dose

  14. Effective orbital volume and eyeball position: an MRI study.

    Science.gov (United States)

    Detorakis, Efstathios T; Drakonaki, Eleni; Papadaki, Efrosini; Pallikaris, Ioannis G; Tsilimbaris, Miltiadis K

    2010-10-01

    Previous studies have examined factors affecting the position of the eyeball to the orbit. This study examined the role of effective orbital volume (EOV), defined as the difference between orbital and eyeball volume, as a determinant of eyeball position, using MRI scans. Forty-six patients were recruited from the Department of Ophthalmology of the University Hospital of Heraklion, Crete Greece. Patients with a history of orbital disease were excluded. Distances between eyeball poles and orbital landmarks were measured in T1 weighted transverse, sagittal and coronal orbital images. The protrusion of the eyeball in the sagittal and transverse planes was recorded. The volume of the eyeball and bony orbit, the EOV, the volume of the extraocular muscles as well as clinical information (age, gender, Hertel exophthalmometry) were also recorded. EOV was significantly associated with orbital volume but not with eyeball volume. EOV was also significantly associated with transverse and sagittal globe protrusions. Females displayed significantly lower orbital and eyeball volumes as well as EOV than males but higher transverse globe protrusion than males. Variations in EOV are associated with orbital volume rather than with eyeball volume. EOV is associated with globe protrusion and may be taken into account in the planning of various procedures, including orbital decompression, treatment of enophthalmos or the size of orbital implants following enucleation.

  15. Orthodontic informed consent considering information load and serial position effect.

    Science.gov (United States)

    Pawlak, Caroline E; Fields, Henry W; Beck, F Michael; Firestone, Allen R

    2015-03-01

    Previous research has demonstrated that current methods of informed consent are relatively ineffective as shown by poor recall and comprehension by adolescent patients and their parents. The purpose of this study was to determine whether adding a short videotape presentation reiterating the issues related to informed consent to a modified informed consent document that emphasizes a limited number of core and patient-specific custom "chunks" at the beginning of an informed consent presentation improved the recall and comprehension of the risks, benefits, and alternatives of orthodontic treatment. A second objective was to evaluate the current related data for recommendable practices. Seventy patient-parent pairs were randomly divided into 2 groups. The intervention group (group A) patients and parents together reviewed a customized slide show and a short videotape presentation describing the key risks of orthodontic treatment. Group B followed the same protocol without viewing the videotape. All patients and parents were interviewed independently by research assistants using an established measurement tool with open-ended questions. Interviews were transcribed and scored for the appropriateness of responses using a previously established codebook. Lastly, the patients and parents were given 2 reading literacy tests, 1 related to health and 1 with general content followed by the self-administered demographic and psychological state questionnaires. There were no significant differences between the groups for sociodemographic variables. There were no significant differences between the groups for overall recall and comprehension; recall and comprehension for the domains of treatment, risk, and responsibility; and recall and comprehension for core, general, and custom items. The positional effects were limited in impact. When compared with previous studies, these data further demonstrate the benefit of improved readability and audiovisual supplementation with the

  16. Social position, gender role, and treatment adherence among Colombian women living with HIV/AIDS: social determinants of health approach.

    Science.gov (United States)

    Arrivillaga, Marcela; Ross, Michael; Useche, Bernardo; Alzate, Martha Lucia; Correa, Diego

    2009-12-01

    To assess and analyze the associations between adherence to treatment and social position in women living with HIV/AIDS. A cross-sectional, descriptive, correlational study among 269 Colombian women was conducted. Participants completed three questionnaires: a socio-demographic and clinical characteristics survey, a treatment adherence scale, and a social position survey. Women of low social position had a significantly higher probability of low treatment adherence (OR = 5.651, P effect on adherence. A general model considering the variables 'type of national health care plan' ('contributive,' 'subsidized,' or, in the case of vinculadas or the uninsured, 'none'); 'having HIV-positive children'; and 'level of viral load' was statistically reliable in predicting study participants' treatment adherence. Membership in the subsidized plan or being uninsured had a greater effect on the probability of low adherence than membership in the contributive plan (OR = 3.478, P 400 copies/ml were more likely to have low adherence than women without those characteristics (OR = 2.395, P = 0.0274 and OR = 2.178, P = 0.0050, respectively). Improving women's adherence to HIV/AIDS treatment in Colombia would require eliminating barriers to national health care system and comprehensive health care services and implementing programs that take into account women's role as maternal caregivers The findings underscore the need to integrate variables related to gender inequality and social position in treatment adherence analysis, as advocated in the social determinants of health approach.

  17. Combination therapies for the treatment of HER2-positive breast cancer: current and future prospects.

    Science.gov (United States)

    Brandão, Mariana; Pondé, Noam F; Poggio, Francesca; Kotecki, Nuria; Salis, Mauren; Lambertini, Matteo; de Azambuja, Evandro

    2018-05-24

    HER2-positive disease is an aggressive subtype of breast cancer that has been revolutionized by anti-HER2 directed therapies. Multiple drugs have been developed and are currently in clinical use, including trastuzumab, lapatinib, pertuzumab, T-DM1, and neratinib, alone or combined in 'dual HER2-blockade' regimens. Areas covered: A comprehensive literature review was performed regarding the current state and the future of combination regimens containing anti-HER2 agents, focusing on their efficacy, toxicity, and cost-effectiveness. Expert commentary: The combination of trastuzumab/pertuzumab is approved in all disease settings, while trastuzumab/neratinib is approved in the adjuvant setting and trastuzumab/lapatinib in metastatic disease. Meanwhile, as breast cancer biology and resistance mechanisms become clearer, combinations with drugs like PI3K/Akt/mTOR inhibitors, CDK4/6 inhibitors, anti-PD(L)1 antibodies, endocrine therapy, and new anti-HER2 agents (panHER and HER2 tyrosine kinase inhibitors, bispecific antibodies, anti-HER3 antibodies, and antibody-drug conjugates) are being extensively tested in clinical trials. More specific strategies for the 'triple-positive' (estrogen receptor-positive/HER2-positive) disease are also being explored. However, there is an urgent need for the development of predictive biomarkers for a better tailoring of anti-HER2 directed therapy. This is the only way to further improve clinical outcomes and quality of life and to decrease costs and toxicities of unnecessary treatments.

  18. Wheel running decreases the positive reinforcing effects of heroin.

    Science.gov (United States)

    Smith, Mark A; Pitts, Elizabeth G

    2012-01-01

    The purpose of this study was to examine the effects of voluntary wheel running on the positive reinforcing effects of heroin in rats with an established history of drug self-administration. Rats were assigned to sedentary (no wheel) and exercise (wheel) conditions and trained to self-administer cocaine under positive reinforcement contingencies. Rats acquiring cocaine self-administration were then tested with various doses of heroin during daily test sessions. Sedentary rats self-administered more heroin than exercising rats, and this effect was greatest at low and moderate doses of heroin. These data suggest that voluntary wheel running decreases the positive reinforcing effects of heroin.

  19. Differential effectiveness of placebo treatments

    DEFF Research Database (Denmark)

    Meissner, Karin; Fässler, Margrit; Rücker, Gerta

    2013-01-01

    IMPORTANCE When analyzing results of randomized clinical trials, the treatment with the greatest specific effect compared with its placebo control is considered to be the most effective one. Although systematic variations of improvements in placebo control groups would have important implications...... relevant sources through February 2012 and contacted the authors to identify randomized clinical trials on the prophylaxis of migraine with an observation period of at least 8 weeks after randomization that compared an experimental treatment with a placebo control group. We calculated pooled random-effects...... and sham surgery are associated with higher responder ratios than oral pharmacological placebos. Clinicians who treat patients with migraine should be aware that a relevant part of the overall effect they observe in practice might be due to nonspecific effects and that the size of such effects might differ...

  20. Treatment of gram-positive deep sternal wound infections in cardiac surgery -experiences with daptomycin-

    Directory of Open Access Journals (Sweden)

    Coskun Kasim O

    2011-09-01

    Full Text Available Abstract The reported incidence of deep sternal wound infection (DSWI after cardiac surgery is 0.4-5% with Staphylococcus aureus being the most common pathogen isolated from infected wound sternotomies and bacteraemic blood cultures. This infection is associated with a higher morbidity and mortality than other known aetiologies. Little is reported about the optimal antibiotic management. The aim of the study is to quantify the application of daptomycin treatment of DSWI due to gram-positive organisms post cardiac surgery. We performed an observational analysis in 23 cases of post sternotomy DSWI with gram-positive organisms February 2009 and September 2010. When the wound appeared viable and the microbiological cultures were negative, the technique of chest closure was individualised to the patient. The incidence of DSWI was 1.46%. The mean dose of daptomycin application was 4.4 ± 0.9 mg/kg/d and the average duration of the daptomycin application was 14.47 ± 7.33 days. In 89% of the patients VAC therapy was used. The duration from daptomycin application to sternal closure was 18 ± 13.9 days. The parameters of infection including, fibrinogen (p = 0.03, white blood cell count (p = 0.001 and C-reactive protein (p = 0.0001 were significantly reduced after daptomycin application. We had no mortality and wound healing was successfully achieved in all patients. Treatment of DSWI due to gram-positive organisms with a daptomycin-containing antibiotic regimen is safe, effective and promotes immediate improvement of local wound conditions. Based on these observations, daptomycin may offer a new treatment option for expediting surgical management of DSWI after cardiac surgery.

  1. Stigma, social support, and treatment adherence among HIV-positive patients in Chiang Mai, Thailand.

    Science.gov (United States)

    Li, Michael Jonathan; Murray, Jordan Keith; Suwanteerangkul, Jiraporn; Wiwatanadate, Phongtape

    2014-10-01

    Our study assessed the influence of HIV-related stigma on treatment adherence among people living with HIV in Chiang Mai, Thailand, and whether social support had a moderating effect on this relationship. We recruited 128 patients living with HIV from Sansai Hospital, a community hospital in Chiang Mai, Thailand, and collected data through structured interviews. All forms of HIV-related stigma considered in this study (personalized experience, disclosure, negative self-image, and public attitudes) were negatively correlated with adherence to anti-retroviral regimens. Multiple linear regression indicated that total HIV-related stigma was more predictive of treatment adherence than any individual stigma type, after adjusting for socio-demographic and health characteristics. Tests of interaction showed that social support did not appear to moderate the association between HIV stigma and treatment adherence. Our findings suggest that community and government efforts to improve public perceptions about people living with HIV might promote treatment adherence behaviors among HIV-positive patients.

  2. Whole plant extracts versus single compounds for the treatment of malaria: synergy and positive interactions.

    Science.gov (United States)

    Rasoanaivo, Philippe; Wright, Colin W; Willcox, Merlin L; Gilbert, Ben

    2011-03-15

    In traditional medicine whole plants or mixtures of plants are used rather than isolated compounds. There is evidence that crude plant extracts often have greater in vitro or/and in vivo antiplasmodial activity than isolated constituents at an equivalent dose. The aim of this paper is to review positive interactions between components of whole plant extracts, which may explain this. Narrative review. There is evidence for several different types of positive interactions between different components of medicinal plants used in the treatment of malaria. Pharmacodynamic synergy has been demonstrated between the Cinchona alkaloids and between various plant extracts traditionally combined. Pharmacokinetic interactions occur, for example between constituents of Artemisia annua tea so that its artemisinin is more rapidly absorbed than the pure drug. Some plant extracts may have an immunomodulatory effect as well as a direct antiplasmodial effect. Several extracts contain multidrug resistance inhibitors, although none of these has been tested clinically in malaria. Some plant constituents are added mainly to attenuate the side-effects of others, for example ginger to prevent nausea. More clinical research is needed on all types of interaction between plant constituents. This could include clinical trials of combinations of pure compounds (such as artemisinin + curcumin + piperine) and of combinations of herbal remedies (such as Artemisia annua leaves + Curcuma longa root + Piper nigum seeds). The former may enhance the activity of existing pharmaceutical preparations, and the latter may improve the effectiveness of existing herbal remedies for use in remote areas where modern drugs are unavailable.

  3. Positive Psychotherapy for Smoking Cessation: Treatment Development, Feasibility and Preliminary Results.

    Science.gov (United States)

    Kahler, Christopher W; Spillane, Nichea S; Day, Anne; Clerkin, Elise; Parks, Acacia; Leventhal, Adam M; Brown, Richard A

    2014-01-01

    Low positive and high negative affect predict low rates of smoking abstinence among smokers making a quit attempt. Positive Psychotherapy can both increase positive affect and decrease negative affect and therefore may be a useful adjunct to behavioral smoking counseling. The purpose of the present study was to assess the feasibility and acceptability of a Positive Psychotherapy for Smoking Cessation (PPT-S) intervention that integrates standard smoking cessation counseling with nicotine patch and a package of positive psychology interventions. We delivered PPT-S to 19 smokers who were low in positive affect at baseline. Rates of session attendance and satisfaction with treatment were high, and most participants reported using and benefiting from the positive psychology interventions. Almost one-third of participants (31.6%) sustained smoking abstinence for 6 months after their quit date. Future studies to assess the relative efficacy of PPT-S compared to standard smoking cessation treatment are warranted.

  4. Comfort as a determiner of treatment position in radiotherapy of the male pelvis

    International Nuclear Information System (INIS)

    Cox, J.; Davison, A.

    2005-01-01

    Purpose: A comfortable treatment position in radiotherapy may promote patient stability and contribute to the best possible patient experience. Patients receiving radical radiotherapy for prostate cancer lie supine or prone, but little evaluation has been made of the comfort of these positions. The purpose of this research was to evaluate the comfort of the prone and supine positions and to assess any influence of feelings of anxiety. Methods: Self-reported comfort and anxiety levels were measured using visual analogue scales in the first and last weeks of treatment for patients receiving radical prostatic radiotherapy. The subjects were from two hospitals, 23 routinely treated lying prone and 21 routinely treated lying supine. Six subjects from each group were interviewed in the first week of treatment. Results: Comfort levels were high and no significant difference was found between treatment positions or between the first and last weeks of treatment. Anxiety levels were low with no significant variation according to position or week of treatment. Little correlation was seen between reported anxiety and comfort levels. Interview data supported the quantitative findings. Supine subjects indicated the need for lateral elbow support to improve feelings of stability. Conclusions: For radiotherapy of male patients without pain or other complicating factors, selection between the prone and supine positions may be made without considering comfort. Supine patients should be provided with lateral elbow support. Further research is indicated into the comfort of these positions for females and the phenomenon of low reported anxiety in male cancer patients

  5. Effects of micronutrients on oxidative stress in HIV positive patients ...

    African Journals Online (AJOL)

    Micronutrient supplementation was therefore shown to reduce oxidative stress in HIV positive patients on HAART and could possibly be very helpful as an adjunct in the treatment of this disease. Key Words: Antiretroviral, micronutrients, malondialdehyde, ART naïve, reactive oxygen species, supplementation.

  6. Positivity Effect Specific to Older Adults with Subclinical Memory Impairment

    Science.gov (United States)

    Leal, Stephanie L.; Noche, Jessica A.; Murray, Elizabeth A.; Yassa, Michael A.

    2016-01-01

    Numerous studies have suggested that older adults preferentially remember positive information ("positivity effect"), however others have reported mixed results. One potential source of conflict is that aging is not a unitary phenomenon and individual differences exist. We modified a standard neuropsychological test to vary emotional…

  7. Brain metastasis in human epidermal growth factor receptor 2-positive breast cancer: from biology to treatment

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Tae Ryool [Dept. of Radiation Oncology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon (Korea, Republic of); Kim, In Ah [Dept. of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2016-03-15

    Overexpression of human epidermal growth factor receptor 2 (HER2) is found in about 20% of breast cancer patients. With treatment using trastuzumab, an anti-HER2 monoclonal antibody, systemic control is improved. Nonetheless, the incidence of brain metastasis does not be improved, rather seems to be increased in HER2-positive breast cancer. The mainstay treatment for brain metastases is radiotherapy. According to the number of metastatic lesions and performance status of patients, radiosurgery or whole brain radiotherapy can be performed. The concurrent use of a radiosensitizer further improves intracranial control. Due to its large molecular weight, trastuzumab has a limited ability to cross the blood-brain barrier. However, small tyrosine kinase inhibitors such as lapatinib, has been noted to be a promising agent that can be used as a radiosensitizer to affect HER2-positive breast cancer. This review will outline general management of brain metastases and will focus on preclinical findings regarding the radiosensitizing effect of small molecule HER2 targeting agents.

  8. Fertility effects of cancer treatment.

    Science.gov (United States)

    Marsden, Donald E; Hacker, Neville

    2003-01-01

    Cancer sufferers are a subfertile group, and most treatments have the potential to adversely affect gonadal function. As cancer treatment becomes more effective and survival rates improve there are more cancer survivors in the reproductive age group for whom parenting is an important consideration. This article outlines the effects on fertility of cancer treatments and techniques to minimise the risk of infertility. The overall prospects for younger cancer sufferers to either retain their fertility or have genetic offspring is now better than ever before, due to advances in assisted reproductive technology, the appropriate use of fertility sparing surgery and other techniques to reduce the toxicity of therapy on the reproductive organs. These advances raise new moral and ethical concerns that must be considered before advising cancer sufferers of the options for preserving reproductive capacity.

  9. Symptoms of insomnia among patients with obstructive sleep apnea before and after two years of positive airway pressure treatment.

    Science.gov (United States)

    Björnsdóttir, Erla; Janson, Christer; Sigurdsson, Jón F; Gehrman, Philip; Perlis, Michael; Juliusson, Sigurdur; Arnardottir, Erna S; Kuna, Samuel T; Pack, Allan I; Gislason, Thorarinn; Benediktsdóttir, Bryndis

    2013-12-01

    To assess the changes of insomnia symptoms among patients with obstructive sleep apnea (OSA) from starting treatment with positive airway pressure (PAP) to a 2-y follow-up. Longitudinal cohort study. Landspitali--The National University Hospital of Iceland. There were 705 adults with OSA who were assessed prior to and 2 y after starting PAP treatment. PAP treatment for OSA. All patients underwent a medical examination along with a type 3 sleep study and answered questionnaires on health and sleep before and 2 y after starting PAP treatment. The change in prevalence of insomnia symptoms by subtype was assessed by questionnaire and compared between individuals who were using or not using PAP at follow-up. Symptoms of middle insomnia were most common at baseline and improved significantly among patients using PAP (from 59.4% to 30.7%, P insomnia tended to persist regardless of PAP treatment, and symptoms of late insomnia were more likely to improve among patients not using PAP. Patients with symptoms of initial and late insomnia at baseline were less likely to adhere to PAP (odds ratio [OR] 0.56, P = 0.007, and OR 0.53, P insomnia. Symptoms of initial and late insomnia, however, tended to persist regardless of positive airway pressure treatment and had a negative effect on adherence. Targeted treatment for insomnia may be beneficial for patients with obstructive sleep apnea comorbid with insomnia and has the potential to positively affect adherence to positive airway pressure.

  10. Gram-positive rods prevailing in teeth with apical periodontitis undergoing root canal treatment.

    Science.gov (United States)

    Chávez de Paz, L E; Molander, A; Dahlén, G

    2004-09-01

    To identify Gram-positive rods from root canals of teeth with apical periodontitis and to examine their associations with other species. Consecutive root canal samples (RCSs) from 139 teeth undergoing root canal treatment were analyzed prospectively for cultivable microbes. Gram-positive rods in the first RCS submitted after chemo-mechanical preparation were categorised to genus level by selective media and gas-liquid chromatography (GLC), and identified to species level by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). Associations between organisms were measured by odds ratios (OR). In the first samples submitted a total of 158 Gram-positive rods, 115 Gram-positive cocci, 26 Gram-negative rods and 9 Gram-negative cocci, were identified. At genus levels Gram-positive rods were classified into: Lactobacillus spp. (38%), Olsenella spp. (18%), Propionibacterium spp. (13%), Actinomyces spp. (12%), Bifidobacterium spp. (13%) and Eubacterium spp. (6%). The most frequent species were Olsenella uli, Lactobacillus paracasei and Propionibacterium propionicum. In subsequent samples taken during treatment, Gram-positive rods were also identified, although the number of strains was considerably reduced. Positive associations were observed between members of the genus lactobacilli and Gram-positive cocci (OR>2). Olsenella uli and Lactobacillus spp. predominated over other Gram-positive rods. A possible association exists between Lactobacillus spp. and Gram-positive cocci in root canals of teeth with apical periodontitis receiving treatment.

  11. Put reading first: Positive effects of direct instruction and scaffolding ...

    African Journals Online (AJOL)

    Put reading first: Positive effects of direct instruction and scaffolding for ESL learners struggling with reading. ... are intended to open up for debate a topic of critical importance to the country's education system. ... AJOL African Journals Online.

  12. Combination Immunotherapy for the Treatment of High-Risk HER2-Positive Breast Cancer

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-14-1-0109 TITLE: Combination Immunotherapy for the Treatment of High-Risk HER2-Positive Breast Cancer PRINCIPAL INVESTIGATOR...Elizabeth A. Mittendorf, MD, PhD CONTRACTING ORGANIZATION: University of Texas MD Anderson Cancer Center Houston, TX 77030 REPORT DATE: October...CONTRACT NUMBER Combination Immunotherapy for the Treatment of High-Risk HER2-Positive Breast Cancer 5b. GRANT NUMBER W81XWH-14-1-0109 5c. PROGRAM

  13. Sleeping Well Trial: Increasing the effectiveness of treatment with continuous positive airway pressure using a weight management program in overweight adults with obstructive sleep apnoea-A stepped wedge randomised trial protocol.

    Science.gov (United States)

    Truby, Helen; Edwards, Bradley A; O'Driscoll, Denise M; Young, Alan; Ghazi, Ladan; Bristow, Claire; Roem, Kerryn; Bonham, Maxine P; Murgia, Chiara; Day, Kaitlin; Haines, Terry P; Hamilton, Garun S

    2018-05-24

    The majority of adults diagnosed with obstructive sleep apnoea (OSA) are overweight or obese. Continuous positive airway pressure (CPAP) is the most common effective therapy for OSA. However, adherence declines over time with only 50% of patients prescribed CPAP continuing to use it long term. Furthermore, a recent prospective analysis indicated that those more adherent with CPAP therapy have enhanced weight gain trajectories which in turn may negatively impact their OSA. The Sleeping Well Trial aims to establish whether the timing of starting a lifestyle weight loss intervention impacts on weight trajectory in those with moderate-severe OSA treated at home with CPAP, while testing the potential for smart phone technology to improve adherence with lifestyle interventions. A stepped wedge design with randomisation of individuals from 1 to 6 months post-enrolment, with 5 months of additional prospective follow up after completion of the stepped wedge. This design will investigate the effect of the 6-month lifestyle intervention on people undergoing CPAP on body weight, body composition and health-related quality of life. This trial tests whether the timing of supporting the patient through a weight loss intervention is important in obtaining the maximum benefit of a lifestyle change and CPAP usage, and identify how best to support patients through this critical period. The protocol (v1) is registered prospectively with the International Clinical Trials Registry (CTR) ACTRN12616000203459 (public access). Any amendments to protocol will be documented via the CTR. Recruitment commenced in March 2016 with data collection scheduled to finish by May 2018. © 2018 Dietitians Association of Australia.

  14. Going positive: The effects of negative and positive advertising on candidate success and voter turnout

    Directory of Open Access Journals (Sweden)

    Liam C Malloy

    2016-01-01

    Full Text Available Given the depth of research on negative advertising in campaigns, scholars have wondered why candidates continue to attack their opponents. We build on this research by considering real-world campaign contexts in which candidates are working in competition with each other and have to react to the decisions of the opposing campaign. Our results suggest that it is never efficacious for candidates to run attack ads, but running positive ads can increase a candidate’s margin of victory. These results are conditioned by two factors: candidates must both stay positive and out-advertise their opponent. Second, the effects of positive advertising are strongest in areas where the candidate is losing or winning by a large margin—areas where they might be tempted to not advertise at all.

  15. Medical Cannabis and the Treatment of Obstructive Sleep Apnea: An American Academy of Sleep Medicine Position Statement.

    Science.gov (United States)

    Ramar, Kannan; Rosen, Ilene M; Kirsch, Douglas B; Chervin, Ronald D; Carden, Kelly A; Aurora, R Nisha; Kristo, David A; Malhotra, Raman K; Martin, Jennifer L; Olson, Eric J; Rosen, Carol L; Rowley, James A

    2018-03-30

    The diagnosis and effective treatment of obstructive sleep apnea (OSA) in adults is an urgent health priority. Positive airway pressure (PAP) therapy remains the most effective treatment for OSA, although other treatment options continue to be explored. Limited evidence citing small pilot or proof of concept studies suggest that the synthetic medical cannabis extract dronabinol may improve respiratory stability and provide benefit to treat OSA. However, side effects such as somnolence related to treatment were reported in most patients, and the long-term effects on other sleep quality measures, tolerability, and safety are still unknown. Dronabinol is not approved by the United States Food and Drug Administration (FDA) for treatment of OSA, and medical cannabis and synthetic extracts other than dronabinol have not been studied in patients with OSA. The composition of cannabinoids within medical cannabis varies significantly and is not regulated. Synthetic medical cannabis may have differential effects, with variable efficacy and side effects in the treatment of OSA. Therefore, it is the position of the American Academy of Sleep Medicine (AASM) that medical cannabis and/or its synthetic extracts should not be used for the treatment of OSA due to unreliable delivery methods and insufficient evidence of effectiveness, tolerability, and safety. OSA should be excluded from the list of chronic medical conditions for state medical cannabis programs, and patients with OSA should discuss their treatment options with a licensed medical provider at an accredited sleep facility. Further research is needed to understand the functionality of medical cannabis extracts before recommending them as a treatment for OSA. Copyright © 2018 American Academy of Sleep Medicine. All rights reserved.

  16. Contextual effect of positive intergroup contact on outgroup prejudice

    Science.gov (United States)

    Christ, Oliver; Schmid, Katharina; Lolliot, Simon; Swart, Hermann; Stolle, Dietlind; Tausch, Nicole; Al Ramiah, Ananthi; Wagner, Ulrich; Vertovec, Steven; Hewstone, Miles

    2014-01-01

    We assessed evidence for a contextual effect of positive intergroup contact, whereby the effect of intergroup contact between social contexts (the between-level effect) on outgroup prejudice is greater than the effect of individual-level contact within contexts (the within-level effect). Across seven large-scale surveys (five cross-sectional and two longitudinal), using multilevel analyses, we found a reliable contextual effect. This effect was found in multiple countries, operationalizing context at multiple levels (regions, districts, and neighborhoods), and with and without controlling for a range of demographic and context variables. In four studies (three cross-sectional and one longitudinal) we showed that the association between context-level contact and prejudice was largely mediated by more tolerant norms. In social contexts where positive contact with outgroups was more commonplace, norms supported such positive interactions between members of different groups. Thus, positive contact reduces prejudice on a macrolevel, whereby people are influenced by the behavior of others in their social context, not merely on a microscale, via individuals’ direct experience of positive contact with outgroup members. These findings reinforce the view that contact has a significant role to play in prejudice reduction, and has great policy potential as a means to improve intergroup relations, because it can simultaneously impact large numbers of people. PMID:24591627

  17. Contextual effect of positive intergroup contact on outgroup prejudice.

    Science.gov (United States)

    Christ, Oliver; Schmid, Katharina; Lolliot, Simon; Swart, Hermann; Stolle, Dietlind; Tausch, Nicole; Al Ramiah, Ananthi; Wagner, Ulrich; Vertovec, Steven; Hewstone, Miles

    2014-03-18

    We assessed evidence for a contextual effect of positive intergroup contact, whereby the effect of intergroup contact between social contexts (the between-level effect) on outgroup prejudice is greater than the effect of individual-level contact within contexts (the within-level effect). Across seven large-scale surveys (five cross-sectional and two longitudinal), using multilevel analyses, we found a reliable contextual effect. This effect was found in multiple countries, operationalizing context at multiple levels (regions, districts, and neighborhoods), and with and without controlling for a range of demographic and context variables. In four studies (three cross-sectional and one longitudinal) we showed that the association between context-level contact and prejudice was largely mediated by more tolerant norms. In social contexts where positive contact with outgroups was more commonplace, norms supported such positive interactions between members of different groups. Thus, positive contact reduces prejudice on a macrolevel, whereby people are influenced by the behavior of others in their social context, not merely on a microscale, via individuals' direct experience of positive contact with outgroup members. These findings reinforce the view that contact has a significant role to play in prejudice reduction, and has great policy potential as a means to improve intergroup relations, because it can simultaneously impact large numbers of people.

  18. 30. effects of anxiety on neurocognitive performance in hiv positive ...

    African Journals Online (AJOL)

    Esem

    poor treatment compliance, disease progression leading. 1 ... deficits associated with HIV related anxiety and determine effects of ..... And Boys With And Without Attention Deficit. Hyperactivity Disorder Differ Neuropsychologically. In Preteen ...

  19. Dosimetric effect of images of double field exposure and positioning in radiotherapy of breast treatment; Efecto dosimetrico de las imagenes de doble exposicion de campo y posicionamiento en tratamientos de radioterapia de mama

    Energy Technology Data Exchange (ETDEWEB)

    Bermudez Luna, R.; Rodriguez Rodriguez, C.; Martin Martin, G.; Lopez Fernandez, A.; Caballero Perea, B.; Ludena Martinez, B.; Prados Losa, R.

    2013-07-01

    The objectives of this study are to quantify the increased dose in white volume and the organ at risk in breast radiotherapy treatment, derived from portals of double-exposure images scheduled for treatment, evaluate dose reduction by passing images of single exposure and consider whether it would be wise to consider this doses in the planning process. (Author)

  20. Pregnancy in HIV-Positive Patients: Effects on Vaginal Flora

    Directory of Open Access Journals (Sweden)

    Cristina Vallone

    2012-01-01

    Full Text Available A high proportion of HIV-infected pregnant women present pathogenic organisms in their lower genital tract. This has been associated with the development of postpartum morbility, HIV transmission to the partner and offspring, and other gynaecological conditions, such as cervical dysplasia or cancer. Vaginal flora alterations can range from 47% in Western countries to 89% in Africa in pregnant HIV-positive patients, much higher than about 20% of the general population. Pathogen organism retrieval is high. As peripartum complications due to vaginal infections seem higher in HIV-positive patients, accurate investigation and treatment of such infections are strongly mandatory.

  1. Brine treatment, smoking and storage techniques: their effects on the ...

    African Journals Online (AJOL)

    Journal of Food Technology in Africa ... Brine treatment, smoking and storage techniques: their effects on the microbial quality of smoked mackerel. ... off odour development, softening of the fish and positively affected personal preference.

  2. The role of negative and positive memories in fear of dental treatment

    DEFF Research Database (Denmark)

    Staugaard, Søren Risløv; Jøssing, Marit; Krohn, Christina

    2017-01-01

    is influenced by memories of positive and negative childhood experiences with dental care. More specifically, we predicted that the emotional impact, sense of reliving, rehearsal, and belief in the accuracy of a negative treatment memory would be associated with increased dental fear, while positive treatment...... memories would show the opposite relation. Methods One hundred thirty-six young adults leaving childhood dental care responded to a online measures of dental fear, the most negative and most positive memory of dental treatment, and symptoms of posttraumatic stress disorder. Results Negative memories...... of events that involved pain and dentist behaviors such as impatience or scolding were frequently described and significantly associated with dental fear and symptoms of posttraumatic stress. Positive memories were more frequent, but did not show a consistent relationship with dental fear. Conclusions...

  3. Nasal Oxytocin Treatment Biases Dogs’ Visual Attention and Emotional Response toward Positive Human Facial Expressions

    Directory of Open Access Journals (Sweden)

    Sanni Somppi

    2017-10-01

    Full Text Available The neuropeptide oxytocin plays a critical role in social behavior and emotion regulation in mammals. The aim of this study was to explore how nasal oxytocin administration affects gazing behavior during emotional perception in domestic dogs. Looking patterns of dogs, as a measure of voluntary attention, were recorded during the viewing of human facial expression photographs. The pupil diameters of dogs were also measured as a physiological index of emotional arousal. In a placebo-controlled within-subjects experimental design, 43 dogs, after having received either oxytocin or placebo (saline nasal spray treatment, were presented with pictures of unfamiliar male human faces displaying either a happy or an angry expression. We found that, depending on the facial expression, the dogs’ gaze patterns were affected selectively by oxytocin treatment. After receiving oxytocin, dogs fixated less often on the eye regions of angry faces and revisited (glanced back at more often the eye regions of smiling (happy faces than after the placebo treatment. Furthermore, following the oxytocin treatment dogs fixated and revisited the eyes of happy faces significantly more often than the eyes of angry faces. The analysis of dogs’ pupil diameters during viewing of human facial expressions indicated that oxytocin may also have a modulatory effect on dogs’ emotional arousal. While subjects’ pupil sizes were significantly larger when viewing angry faces than happy faces in the control (placebo treatment condition, oxytocin treatment not only eliminated this effect but caused an opposite pupil response. Overall, these findings suggest that nasal oxytocin administration selectively changes the allocation of attention and emotional arousal in domestic dogs. Oxytocin has the potential to decrease vigilance toward threatening social stimuli and increase the salience of positive social stimuli thus making eye gaze of friendly human faces more salient for dogs. Our

  4. Insomnia complaints in lean patients with obstructive sleep apnea negatively affect positive airway pressure treatment adherence.

    Science.gov (United States)

    Eysteinsdottir, Bjorg; Gislason, Thorarinn; Pack, Allan I; Benediktsdottir, Bryndís; Arnardottir, Erna S; Kuna, Samuel T; Björnsdottir, Erla

    2017-04-01

    The objective of this study was to evaluate the determinants of long-term adherence to positive airway pressure treatment among patients with obstructive sleep apnea, with special emphasis on patients who stop positive airway pressure treatment within 1 year. This is a prospective long-term follow-up of subjects in the Icelandic Sleep Apnea Cohort who were diagnosed with obstructive sleep apnea between 2005 and 2009, and started on positive airway pressure treatment. In October 2014, positive airway pressure adherence was obtained by systematically evaluating available clinical files (n = 796; 644 males, 152 females) with moderate to severe obstructive sleep apnea (apnea-hypopnea index ≥15 events per h). The mean follow-up time was 6.7 ± 1.2 years. In total, 123 subjects (15.5%) returned their positive airway pressure device within the first year, 170 (21.4%) returned it later and 503 (63.2%) were still using positive airway pressure. The quitters within the first year had lower body mass index, milder obstructive sleep apnea, less sleepiness, and more often had symptoms of initial and late insomnia compared with long-term positive airway pressure users at baseline. Both initial and late insomnia were after adjustment still significantly associated with being an early quitter among subjects with body mass index insomnia are associated with early quitting on positive airway pressure among non-obese subjects. © 2016 European Sleep Research Society.

  5. Immobilization and positioning systems for treatment of patients with image-guided radiation therapy and intensity modulated radiation therapy)

    International Nuclear Information System (INIS)

    Hueso Bernad, M. Nuria; Suarez Dieguez, Raquel; Roures Ramos, M. Teresa; Broseta Tormos, M.Mercedes; Tirado Porcar, Miriam M; Del Castillo Arres, Jose; Franch Martinez, Silvia

    2009-01-01

    For adequate reproduction of daily patient positioning during treatment we use a 3-coordinate system alignment. The first set of axes would be the system of light (laser). - The second coordinate system is recognized by marks on the skin patient and / or immobilization systems. The third set of alignment refers to alignment of coordinates volume to try to locate the isocenter use Guided Radiotherapy Imaging when applied technologies with Intensity Modulated Radiotherapy treatment fields tend to be very small so it made individual protection and immobilization systems such as thermoplastic masks, vacuum sealed bags exterotaxicos conjugated systems and immobilization systems carbon fiber results by combining these immobilization and positioning systems can ensure effective treatment volume to be treated. There is no perfect immobilization system. However the choice of pool of qualified stun makes treatment more precise. (author)

  6. Whole plant extracts versus single compounds for the treatment of malaria: synergy and positive interactions

    Directory of Open Access Journals (Sweden)

    Wright Colin W

    2011-03-01

    Full Text Available Abstract Background In traditional medicine whole plants or mixtures of plants are used rather than isolated compounds. There is evidence that crude plant extracts often have greater in vitro or/and in vivo antiplasmodial activity than isolated constituents at an equivalent dose. The aim of this paper is to review positive interactions between components of whole plant extracts, which may explain this. Methods Narrative review. Results There is evidence for several different types of positive interactions between different components of medicinal plants used in the treatment of malaria. Pharmacodynamic synergy has been demonstrated between the Cinchona alkaloids and between various plant extracts traditionally combined. Pharmacokinetic interactions occur, for example between constituents of Artemisia annua tea so that its artemisinin is more rapidly absorbed than the pure drug. Some plant extracts may have an immunomodulatory effect as well as a direct antiplasmodial effect. Several extracts contain multidrug resistance inhibitors, although none of these has been tested clinically in malaria. Some plant constituents are added mainly to attenuate the side-effects of others, for example ginger to prevent nausea. Conclusions More clinical research is needed on all types of interaction between plant constituents. This could include clinical trials of combinations of pure compounds (such as artemisinin + curcumin + piperine and of combinations of herbal remedies (such as Artemisia annua leaves + Curcuma longa root + Piper nigum seeds. The former may enhance the activity of existing pharmaceutical preparations, and the latter may improve the effectiveness of existing herbal remedies for use in remote areas where modern drugs are unavailable.

  7. Selective control of attention supports the positivity effect in aging.

    Directory of Open Access Journals (Sweden)

    Laura K Sasse

    Full Text Available There is emerging evidence for a positivity effect in healthy aging, which describes an age-specific increased focus on positive compared to negative information. Life-span researchers have attributed this effect to the selective allocation of cognitive resources in the service of prioritized emotional goals. We explored the basic principles of this assumption by assessing selective attention and memory for visual stimuli, differing in emotional content and self-relevance, in young and old participants. To specifically address the impact of cognitive control, voluntary attentional selection during the presentation of multiple-item displays was analyzed and linked to participants' general ability of cognitive control. Results revealed a positivity effect in older adults' selective attention and memory, which was particularly pronounced for self-relevant stimuli. Focusing on positive and ignoring negative information was most evident in older participants with a generally higher ability to exert top-down control during visual search. Our findings highlight the role of controlled selectivity in the occurrence of a positivity effect in aging. Since the effect has been related to well-being in later life, we suggest that the ability to selectively allocate top-down control might represent a resilience factor for emotional health in aging.

  8. Selective control of attention supports the positivity effect in aging.

    Science.gov (United States)

    Sasse, Laura K; Gamer, Matthias; Büchel, Christian; Brassen, Stefanie

    2014-01-01

    There is emerging evidence for a positivity effect in healthy aging, which describes an age-specific increased focus on positive compared to negative information. Life-span researchers have attributed this effect to the selective allocation of cognitive resources in the service of prioritized emotional goals. We explored the basic principles of this assumption by assessing selective attention and memory for visual stimuli, differing in emotional content and self-relevance, in young and old participants. To specifically address the impact of cognitive control, voluntary attentional selection during the presentation of multiple-item displays was analyzed and linked to participants' general ability of cognitive control. Results revealed a positivity effect in older adults' selective attention and memory, which was particularly pronounced for self-relevant stimuli. Focusing on positive and ignoring negative information was most evident in older participants with a generally higher ability to exert top-down control during visual search. Our findings highlight the role of controlled selectivity in the occurrence of a positivity effect in aging. Since the effect has been related to well-being in later life, we suggest that the ability to selectively allocate top-down control might represent a resilience factor for emotional health in aging.

  9. Time perspective and positivity effects in Alzheimer's disease.

    Science.gov (United States)

    Bohn, Linzy; Kwong See, Sheree T; Fung, Helene H

    2016-09-01

    This study tested whether time perspective, a central tenant of socioemotional selectivity theory (Carstensen, 2006), moderates positivity effects in emotional memory. To provide measures of time perspective, young (YA; M = 22.48 years), young-old (YO; M = 67.56 years), old-old adults (OO; M = 80.24 years), and participants with moderate severity Alzheimer's disease (PAD; M = 84.28 years) completed a line task and reported subjective age. As expected, YA, YO, and OO reported successively more constrained future time perspectives. PAD showed distortion in time perspective, envisioning a future comparable with the YO, although closer matched in chronological age to OO adults. To evince positivity effects, participants were oriented to pairs of emotional images and were then tested for memory (recall and recognition) of the images. Recall and recognition memory for the images indicated an age-related advantage for positive over negative material (positivity effects). Time perspective, however, did not moderate these age effects. In memory performance, PAD were more comparable with OO adults with whom they shared a similar chronological age, rather than YO adults, who had a corresponding time perspective. These results suggest that age correlates that are shared by PAD and OO, such as reduced processing resources, rather than time perspective, may drive the age associated positivity effects. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  10. Position-dependent Effects of Polylysine on Sec Protein Transport*

    Science.gov (United States)

    Liang, Fu-Cheng; Bageshwar, Umesh K.; Musser, Siegfried M.

    2012-01-01

    The bacterial Sec protein translocation system catalyzes the transport of unfolded precursor proteins across the cytoplasmic membrane. Using a recently developed real time fluorescence-based transport assay, the effects of the number and distribution of positive charges on the transport time and transport efficiency of proOmpA were examined. As expected, an increase in the number of lysine residues generally increased transport time and decreased transport efficiency. However, the observed effects were highly dependent on the polylysine position in the mature domain. In addition, a string of consecutive positive charges generally had a more significant effect on transport time and efficiency than separating the charges into two or more charged segments. Thirty positive charges distributed throughout the mature domain resulted in effects similar to 10 consecutive charges near the N terminus of the mature domain. These data support a model in which the local effects of positive charge on the translocation kinetics dominate over total thermodynamic constraints. The rapid translocation kinetics of some highly charged proOmpA mutants suggest that the charge is partially shielded from the electric field gradient during transport, possibly by the co-migration of counter ions. The transport times of precursors with multiple positively charged sequences, or “pause sites,” were fairly well predicted by a local effect model. However, the kinetic profile predicted by this local effect model was not observed. Instead, the transport kinetics observed for precursors with multiple polylysine segments support a model in which translocation through the SecYEG pore is not the rate-limiting step of transport. PMID:22367204

  11. Position-dependent effects of polylysine on Sec protein transport.

    Science.gov (United States)

    Liang, Fu-Cheng; Bageshwar, Umesh K; Musser, Siegfried M

    2012-04-13

    The bacterial Sec protein translocation system catalyzes the transport of unfolded precursor proteins across the cytoplasmic membrane. Using a recently developed real time fluorescence-based transport assay, the effects of the number and distribution of positive charges on the transport time and transport efficiency of proOmpA were examined. As expected, an increase in the number of lysine residues generally increased transport time and decreased transport efficiency. However, the observed effects were highly dependent on the polylysine position in the mature domain. In addition, a string of consecutive positive charges generally had a more significant effect on transport time and efficiency than separating the charges into two or more charged segments. Thirty positive charges distributed throughout the mature domain resulted in effects similar to 10 consecutive charges near the N terminus of the mature domain. These data support a model in which the local effects of positive charge on the translocation kinetics dominate over total thermodynamic constraints. The rapid translocation kinetics of some highly charged proOmpA mutants suggest that the charge is partially shielded from the electric field gradient during transport, possibly by the co-migration of counter ions. The transport times of precursors with multiple positively charged sequences, or "pause sites," were fairly well predicted by a local effect model. However, the kinetic profile predicted by this local effect model was not observed. Instead, the transport kinetics observed for precursors with multiple polylysine segments support a model in which translocation through the SecYEG pore is not the rate-limiting step of transport.

  12. The role of negative and positive memories in fear of dental treatment.

    Science.gov (United States)

    Risløv Staugaard, Søren; Jøssing, Marit; Krohn, Christina

    2017-12-01

    Most young adults transition from childhood dental care to adult dental care without problems. However, a substantial minority leaves childhood dental care with considerable fear of dental treatment. In the present study, we hypothesized that fear of dental treatment in the young adult is influenced by memories of positive and negative childhood experiences with dental care. More specifically, we predicted that the emotional impact, sense of reliving, rehearsal, and belief in the accuracy of a negative treatment memory would be associated with increased dental fear, while positive treatment memories would show the opposite relation. One hundred thirty-six young adults leaving childhood dental care responded to a online measures of dental fear, the most negative and most positive memory of dental treatment, and symptoms of posttraumatic stress disorder. Negative memories of events that involved pain and dentist behaviors such as impatience or scolding were frequently described and significantly associated with dental fear and symptoms of posttraumatic stress. Positive memories were more frequent, but did not show a consistent relationship with dental fear. The importance of negative memories suggests an avenue for intervention against dental fear that focuses on restructuring those memories to emphasize positive aspects. © 2016 American Association of Public Health Dentistry.

  13. Impact on reproducibility of the treatment position by improving immobilization device in image guided radiation therapy

    International Nuclear Information System (INIS)

    Morita, Yuko; Sasaki, Junichi; Shiomi, Hiroya; Oh, Ryoongjin; Inoue, Toshihiko; Tajiri, Shingo

    2012-01-01

    The immobilization device for treatment becomes important to obtain fixation and reproducibility of the treatment position. It was confirmed that reproducibility of the treatment position obtains higher accuracy by the method of using immobilization device. We divided into three terms by the methods of immobilization. An infrared reflective marker performs the setup of a position at the start of treatment, and setup of the patient in a fixed implement is performed by ExacTrac. Difference between coordinates of the immobilization device and the patient position was calculated by the vector in three directions. We estimated the position error index (PE index ) by using the square root of the sum of square of each vectors, and evaluated the amount of differences of patient position at three terms. Mean and standard deviation of index values were 9.53±7.21, 8.50±5.93, and 6.42±3.80 at each three terms. With every passing year, the amount of gap and difference of the patient fixation has decreased. By the improvement of the use of the immobilization device, gap and difference of fixation has decreased. Accordingly, we could obtain better accuracy of fixation. (author)

  14. [MINIMALLY INVASIVE TREATMENT OF POSTERIOR CRUCIATE LIGAMENT AVULSION FRACTURE IN A FLOPPY LATERAL POSITION].

    Science.gov (United States)

    Zhao, Junchao; Wang, Hao

    2016-09-08

    To conclude the effectiveness of arthroscopy combined with Burks and SchaVer's approach in the treatment of posterior cruciate ligament (PCL) avulsion fractures in a floppy lateral position. Between May 2010 and March 2014, 21 patients with PCL avulsion fractures were treated. There were 13 males and 8 females, aged 21 to 62 years (mean, 39.1 years). The causes included traffic accident injury in 10 cases, sports injury in 5 cases, and falling injury from height in 6 cases. The time from injury to hospital was 1-6 days (mean, 2.5 days). The results of posterior drawer test were all positive, and the results of anterior drawer test and lateral stress test were all negative. The Lysholm score was 28.0±5.5 before operation. And the American Orthopaedic Foot and Ankle Society (IKDC) score was 46.2±7.6 before operation. According to Meyer standards for fractures classification, 11 cases were rated as type II and 10 cases as type III. Arthroscopy was used to inspect and treat the intra-articular lesions, then avulsion fracture was fixed by Burks and SchaVer's approach in lateral position. Postoperative functional exercises were performed. Primary healing of incision was obtained, without nerve and vascular injury or joint infection. All patients were followed up 18-36 months (mean, 27.2 months). The X-ray films of the knee joint showed good fractures reduction and healing at 3 months after operation. The results of posterior drawer test and reverse Lachman test were negative. The knee range of motion was recovered to normal level. At last follow-up, the Lysholm score of the knee joint was significantly improved to 90.9±1.4 from preoperative one ( t =54.584, P =0.000), and the IKDC score was significantly increased to 90.5±5.3 from preoperative one ( t =15.638, P =0.000), including 19 cases of grade A and 2 cases of grade B. A combination of arthroscopy and Burks and SchaVer's approach for the treatment of PCL avulsion fractures in a floppy lateral position has the

  15. Treatment of sleep-disordered breathing with positive airway pressure devices: technology update

    Directory of Open Access Journals (Sweden)

    Johnson KG

    2015-10-01

    Full Text Available Karin Gardner Johnson, Douglas Clark Johnson Department of Medicine, Baystate Medical Center, Springfield, MA, USA Abstract: Many types of positive airway pressure (PAP devices are used to treat sleep-disordered breathing including obstructive sleep apnea, central sleep apnea, and sleep-related hypoventilation. These include continuous PAP, autoadjusting CPAP, bilevel PAP, adaptive servoventilation, and volume-assured pressure support. Noninvasive PAP has significant leak by design, which these devices adjust for in different manners. Algorithms to provide pressure, detect events, and respond to events vary greatly between the types of devices, and vary among the same category between companies and different models by the same company. Many devices include features designed to improve effectiveness and patient comfort. Data collection systems can track compliance, pressure, leak, and efficacy. Understanding how each device works allows the clinician to better select the best device and settings for a given patient. This paper reviews PAP devices, including their algorithms, settings, and features. Keywords: BiPAP, CPAP, iVAPS, AVAPS, ASV, positive pressure respiration, instrumentation, treatment algorithm

  16. Chewing and Attention: A Positive Effect on Sustained Attention

    Science.gov (United States)

    Onozuka, Minoru

    2015-01-01

    Chewing is crushing food not only to aid swallowing and digestion, but also to help stress relief and regulate cognitive function, especially in attention. It is well known that chewing gum is used for sleepiness prevention during work, learning, and driving, suggesting a link between chewing and sustained attention. We hypothesized that chewing elevates attention and/or alertness, leading to improvements in cognitive performance. We carried out a systematic review of the PubMed database. We inspected the attributes of effects on attention in studies investigating the effects of chewing on attention or alertness conducted with pre-post design in healthy subjects, except elderly. We identified 151 references, 22 of which were included: 14 (64%) showed positive attributes of effects on attention, 1 (5%) showed negative attributes of effects on attention, 5 (23%) showed both positive and negative attributes of effects on attention, and 2 (9%) showed no significant attributes of effects on attention. Thus, positive attributes of effects of chewing on attention, especially on sustained attention, were shown in over half of the reports. These effects also appeared with improvement in mood and stress relief and were influenced by time-on-task effect. Further studies are needed, but chewing could be useful for modifying cognitive function. PMID:26075234

  17. Chewing and Attention: A Positive Effect on Sustained Attention

    Directory of Open Access Journals (Sweden)

    Yoshiyuki Hirano

    2015-01-01

    Full Text Available Chewing is crushing food not only to aid swallowing and digestion, but also to help stress relief and regulate cognitive function, especially in attention. It is well known that chewing gum is used for sleepiness prevention during work, learning, and driving, suggesting a link between chewing and sustained attention. We hypothesized that chewing elevates attention and/or alertness, leading to improvements in cognitive performance. We carried out a systematic review of the PubMed database. We inspected the attributes of effects on attention in studies investigating the effects of chewing on attention or alertness conducted with pre-post design in healthy subjects, except elderly. We identified 151 references, 22 of which were included: 14 (64% showed positive attributes of effects on attention, 1 (5% showed negative attributes of effects on attention, 5 (23% showed both positive and negative attributes of effects on attention, and 2 (9% showed no significant attributes of effects on attention. Thus, positive attributes of effects of chewing on attention, especially on sustained attention, were shown in over half of the reports. These effects also appeared with improvement in mood and stress relief and were influenced by time-on-task effect. Further studies are needed, but chewing could be useful for modifying cognitive function.

  18. Chewing and attention: a positive effect on sustained attention.

    Science.gov (United States)

    Hirano, Yoshiyuki; Onozuka, Minoru

    2015-01-01

    Chewing is crushing food not only to aid swallowing and digestion, but also to help stress relief and regulate cognitive function, especially in attention. It is well known that chewing gum is used for sleepiness prevention during work, learning, and driving, suggesting a link between chewing and sustained attention. We hypothesized that chewing elevates attention and/or alertness, leading to improvements in cognitive performance. We carried out a systematic review of the PubMed database. We inspected the attributes of effects on attention in studies investigating the effects of chewing on attention or alertness conducted with pre-post design in healthy subjects, except elderly. We identified 151 references, 22 of which were included: 14 (64%) showed positive attributes of effects on attention, 1 (5%) showed negative attributes of effects on attention, 5 (23%) showed both positive and negative attributes of effects on attention, and 2 (9%) showed no significant attributes of effects on attention. Thus, positive attributes of effects of chewing on attention, especially on sustained attention, were shown in over half of the reports. These effects also appeared with improvement in mood and stress relief and were influenced by time-on-task effect. Further studies are needed, but chewing could be useful for modifying cognitive function.

  19. Viewing-position effects in the Stroop task: Initial fixation position modulates Stroop effects in fully colored words.

    Science.gov (United States)

    Perret, Patrick; Ducrot, Stéphanie

    2010-08-01

    In two experiments that we conducted with adult (Experiment 1) and child (Experiment 2) participants, we experimentally controlled the eyes' first fixation in the word using a variable viewing-position technique in a classical all-letter-coloring Stroop procedure. We explored the impact of initial-fixation position (optimal viewing position [OVP] vs. end of the word) on the magnitude of Stroop effects (both interference and facilitation). The results showed that both interference and facilitation effects were reduced when the first fixation was located at the end of the word rather than at the OVP. These data make a new contribution to the study of the role of low-level processes in Stroop effects and add support to the growing body of research indicating that oculomotor processes can act as moderators of cognitive processes in the determination of Stroop effects.

  20. Effect of Positive Psychotherapy in Depression Symptoms and Character Strengths in Cancer Affected Patients

    Directory of Open Access Journals (Sweden)

    R Khodabakhash

    2015-05-01

    Full Text Available The purpose of this research was to study the effect of positive psychotherapy on depression symptoms and character strengths in cancer affected patients. Based on a quasi-experimental design by available sampling, 58 cancer patients were investigated. 30 patients were assigned in two groups: 15 patients in positive psychotherapy group (treatment and 15 patients as control group. In the present research, Oxford Happiness-Depression Questionnaire (OHDQ and Values In Action Inventory of Strengths (VIA-IS were used. The results showed that the positive psychotherapy was effective in reducing depression, increasing the character strengths and virtues, improving meaningful, pleasant and engaged life of cancer patients.

  1. Metrical analysis of disc-condyle relation with different splint treatment positions in patients with TMJ disc displacement

    Directory of Open Access Journals (Sweden)

    Mu-Qing Liu

    Full Text Available Abstract Objective: To evaluate the effect of bite positions characterizing different splint treatments (anterior repositioning and stabilization splints on the disc-condyle relation in patients with TMJ disc displacement with reduction (DDwR, using magnetic resonance imaging (MRI. Material and Methods: 37 patients, with a mean age of 18.8±4.3 years (7 male and 30 females and diagnosed with DDwR based on the RDC/TMD, were recruited. MRI metrical analysis of the spatial changes of the disc/condyle, as well as their relationships, was done in three positions: maximum intercuspation (Position 1, anterior repositioning splint position (Position 2, and stabilization splint position (Position 3. Disc/condyle coordinate measurements and disc condyle angles were determined and compared. Results: In Position 1, the average disc-condyle angle was 53.4° in the 60 joints with DDwR, while it was −13.3° with Position 2 and 30.1° with Position 3. The frequency of successful "disc recapture" with Position 2 was significantly higher (58/60, 96.7% than Position 3 (20/60, 33.3%. In Positions 2 and 3, the condyle moved forward and downward while the disc moved backward. The movements were, however, more remarkable with Position 2. Conclusions: Anterior repositioning of the mandible improves the spatial relationship between the disc and condyle in patients with DDwR. In addition to anterior and inferior movement of the condyle, transitory posterior movement of the disc also occurred.

  2. Successful Omalizumab treatment in HIV positive patient with chronic spontaneous urticaria: a case report.

    Science.gov (United States)

    Iemoli, E; Niero, F; Borgonovo, L; Cossu, M V; Piconi, S

    2017-03-01

    We described a case of a 56 year old homosexual HIV positive man who presented a history of CSU since one year (2012). All the allergologic, immunologic and microbiologic tests to evaluate the pathogenesis of wheals resulted negative. Therefore in June 2015 we decided to start therapy with Omalizumab while the patient kept on effective antiretroviral therapy with 310 cells/mm3 TCD4 counts and undetectable HIV viremia. After two monthly subcutaneuous injection of 150 mg of Omalizumab the patient had no more urticarial symptoms. UAS7 (Urticaria Activity Score over 7 days) and Cu-Q2oL (chronic urticarial quality of life questionnaire) dropped respectively to 14 from 42 and to 0 from 40 with increase of TCD4 counts while viral load remained undetectable. In November 2015, i.e. 4 months after the end of Omalizumab therapy, the patient was still asymptomatic with persistent effective immune-virological response to antiretroviral therapy. This case report confirms the excellent tolerability and efficacy of anti-IgE therapy in the treatment of spontaneous chronic urticarial even in an immunodepressed patient for HIV infection. Omalizumab therapy shows a remarkable clinical success and had no effect on peripheral TCD4 counts and HIV viral load.

  3. The Coo Effect in the International Brand Positioning Strategy

    Directory of Open Access Journals (Sweden)

    Barbara Kobuszewski Volles

    2016-12-01

    Full Text Available Abstract Purpose: This study aims to develop a model in order to understand how Chinese companies strategically position their brands, considering the causes of the country of origin (COO effect, when going through the process of internationalization. Design/methodology/approach: The study approach a qualitative case study that incorporates two different Chinese companies with subsidiaries settled in Brazil. It was conducted depth interviews with different components of the studied firms. Findings: In this way, it was developed a model that try to explain the positive and/or negative effect of general attributes from China (labor market, institution framework and education on the brand positioning divers (value preposition, points of leverage, primary target and image reinforcement, which influences on the cost-benefit strategy approach of the brands when positioning internationally. Research limitations/implications: Considering that this research is a qualitative study of two Chinese companies, further qualitative and quantitative studies would be fruitful to the validity of the presented model. Originality/value: In order to contribute to the academic field, it was found that this research present a unique model considering different causes of the COO effect that might affect the international branding positioning.

  4. The theory behind the age-related positivity effect

    Directory of Open Access Journals (Sweden)

    Andrew E Reed

    2012-09-01

    Full Text Available The positivity effect refers to an age-related trend that favors positive over negative stimuli in cognitive processing. Relative to their younger counterparts, older people attend to and remember more positive than negative information. Since the effect was initially identified and the conceptual basis articulated (Mather & Carstensen, 2005 scores of independent replications and related findings have appeared in the literature. Over the same period, a number of investigations have failed to observe age differences in the cognitive processing of emotional material. When findings are considered in theoretical context, a reliable pattern of evidence emerges that helps to refine conceptual tenets. In this article we articulate the operational definition and theoretical foundations of the positivity effect and review the empirical evidence based on studies of visual attention, memory, decision-making, and neural activation. We conclude with a discussion of future research directions with emphasis on the conditions where a focus on positive information may benefit and/or impair cognitive performance in older people.

  5. The Effects of Positive or Neutral Communication during Acupuncture for Relaxing Effects: A Sham-Controlled Randomized Trial

    Directory of Open Access Journals (Sweden)

    Annelie Rosén

    2016-01-01

    Full Text Available Introduction. The link between patient-clinician communication and its effect on clinical outcomes is an important clinical issue that is yet to be elucidated. Objective. Investigating if communication type (positive or neutral about the expected treatment outcome affected (i participants’ expectations and (ii short-term relaxation effects in response to genuine or sham acupuncture and investigating if expectations were related to outcome. Methods. Healthy volunteers (n=243, mean age of 42 were randomized to one treatment with genuine or sham acupuncture. Within groups, participants were randomized to positive or neutral communication, regarding expected treatment effects. Visual Analogue Scales (0–100 millimeters were used to measure treatment expectations and relaxation, directly before and after treatment. Results. Participants in the positive communication group reported higher treatment expectancy, compared to the neutral communication group (md 12 versus 6 mm, p=0.002. There was no difference in relaxation effects between acupuncture groups or between communication groups. Participants with high baseline expectancy perceived greater improvement in relaxation, compared to participants with low baseline levels (md 27 versus 15 mm, p=0.022. Conclusion. Our data highlights the importance of expectations for treatment outcome and demonstrates that expectations can be effectively manipulated using a standardized protocol that in future research may be implemented in clinical trials.

  6. Determination of tolerances in the positioning of the treatment table from an image-guided system

    International Nuclear Information System (INIS)

    Perez Moreno, J. M.; Zucca Aparicio, D.; Fernandez leton, P.; Garcia Ruiz-Zorrilla, J.; Minanbres Moro, A.

    2011-01-01

    The use of techniques of image-guided radiotherapy (TGRT) aims to reduce the uncertainties associated with patient positioning. One of the techniques more recent development is the cone beam CT (CBCT), consisting of the acquisition of volumetric images of the patient by a detector integrated into the linear accelerator. By analyzing the results of all sessions of treatment to all patients in which the positioning has been carried out with image-guided system MV CBCT have been determined tolerance tables for translational coordinates of the table treatment based on pathology and immobilization system used. (Author)

  7. Investigations on uncertainties in patient positioning for prostate treatment with EPID

    International Nuclear Information System (INIS)

    Bakai, A.; Nuesslin, F.; Paulsen, F.; Plasswilm, L.; Bamberg, M.

    2002-01-01

    Background: Conformal radiotherapy techniques as used in prostate treatment allow to spare normal tissue by conforming the radiation fields to the shape of the planning target volume (PTV). To be able to fully utilize the advantages of these techniques correct patient positioning is an important prerequisite. This study employing an electronic portal imaging device (EPID) investigated the positioning uncertainties that occur in the pelvic region for different patient positioning devices. Patients and Methods: 15 patients with prostate cancer were irradiated with or without rectal balloon/pelvic mask at a linear accelerator with multileaf collimator (MLC). For each patient multiple portal images were taken from different directions and compared to the digitally reconstructed radiographs (DRRs) of the treatment planning system and to simulation films (Table 1, Figure 1). Results: In spite of different positioning devices, all patients showed comparable total positioning uncertainties of 4.0 mm (lateral), 4.5 mm (cranio-caudal) and 1.7 mm (dorso-ventral). The lateral positioning error was reduced for the pelvic mask patients while the cranio-caudal error increased (Table 2, Figure 2). A systematic and a random component sum up to the total positioning error, and a good estimate of the magnitudes of the two is possible from six to eight portal images (Figure 3). Conclusions: With a small number of portal images it is possible to find out the systematic and random positioning error of a patient. Knowledge of the random error can be used to resize the treatment margin which is clinically relevant since this error differs greatly for different patients (Figure 4). Image analysis with EPID is convenient, yet has some problems. For example, one only gets indirect information on the movement of the ventral rectum wall. The successful operation of positioning devices, although, needs further improvement - especially if one focuses on IMRT. (orig.) [de

  8. Automatic detection of patient identification and positioning errors in radiotherapy treatment using 3D setup images

    OpenAIRE

    Jani, Shyam

    2015-01-01

    The success of modern radiotherapy treatment depends on the correct alignment of the radiation beams with the target region in the patient. In the conventional paradigm of image-guided radiation therapy, 2D or 3D setup images are taken immediately prior to treatment and are used by radiation therapy technologists to localize the patient to the same position as defined from the reference planning CT dataset. However, numerous reports in the literature have described errors during this step, wh...

  9. The Effectiveness of CASAs in Achieving Positive Outcomes for Children.

    Science.gov (United States)

    Litzelfelner, Pat

    2000-01-01

    Evaluated effectiveness of court-appointed special advocates (CASAs) in achieving positive outcomes for children in the child welfare system, using data from court and CASA program files on 200 children. Found that CASAs may have reduced the number of placements and court continuances children experienced. More services were provided to children…

  10. The Positive Effects of Cognitive Learning Styles in ELT Classes

    Science.gov (United States)

    Yagcioglu, Ozlem

    2016-01-01

    In the EFL, ESL, ESP and in the ELT classes, students are taught their courses with different kinds of methods and approaches. Cognitive learning styles are the most essential styles in foreign language education. In this paper, the positive effects of cognitive learning styles will be handled. The benefits of these styles will be highlighted.…

  11. Divergent Effects of Different Positive Emotions on Moral Judgment

    Science.gov (United States)

    Strohminger, Nina; Lewis, Richard L.; Meyer, David E.

    2011-01-01

    Positive emotions are often treated as relatively similar in their cognitive-behavioral effects, and as having unambiguously beneficial consequences. For example, Valdesolo and DeSteno (2006) reported that a humorous video made people more prone to choose a utilitarian solution to a moral dilemma. They attributed this finding to increased positive…

  12. Quantitative analysis of the errors positioning of a multi leaf collimator for volumetric arcoterapia treatments

    International Nuclear Information System (INIS)

    Gomez Gonzalez, N.; Garcia Repiso, S.; Martin Rincon, C.; Cons Perez, N.; Saez Beltran, M.; Delgado Aparicio, J. M.; Perez alvarez, M. E.; Verde Velasco, J. M.; Ramos Pacho, J. A.; Sena Espinel, E. de

    2013-01-01

    The precision in the positioning of the multi leaf collimation system of a linear accelerator is critical, especially in treatments of IMRT, where small mistakes can cause relevant dosimetry discrepancies regarding the calculated plan. To assess the accuracy and repeatability of the blades positioning can be used controls, including the one known as fence test whose image pattern allows you to find anomalies in a visual way. The objective of this study is to develop a method which allows to quantify the positioning errors of the multi leaf collimator from this test. (Author)

  13. Positive EtG findings in hair as a result of a cosmetic treatment.

    Science.gov (United States)

    Sporkert, Frank; Kharbouche, Hicham; Augsburger, Marc P; Klemm, Clementine; Baumgartner, Markus R

    2012-05-10

    In a case of a driving ability assessment, hair analysis for ethyl glucuronide (EtG) was requested by the authorities. The person concerned denied alcohol consumption and did not present any clinical sign of alcoholism. However, EtG was found in concentrations of up to 910pg/mg in hair from different sampling dates suggesting an excessive drinking behavior. The person declared to use a hair lotion on a regularly base. To evaluate a possible effect of the hair lotion, prospective blood and urine controls as well as hair sampling of scalp and pubic hair were performed. The traditional clinical biomarkers of ethanol consumption, CDT and GGT, were inconspicuous in three blood samples taken. EtG was not detected in all collected urine samples. The hair lotion was transmitted to our laboratory. The ethanol concentration in this lotion was determined with 35g/L. The EtG immunoassay gave a positive result indicating EtG, which could be confirmed by GC-MS/MS-NCI. In a follow-up experiment the lotion was applied to the hair of a volunteer over a period of six weeks. After this treatment, EtG could be measured in the hair at a concentration of 72pg/mg suggesting chronic and excessive alcohol consumption. Overnight incubation of EtG free hair in the lotion yielded an EtG concentration of 140pg/mg. In the present case, the positive EtG hair findings could be interpreted as the result of an EtG containing hair care product. To our knowledge, the existence of such a product has not yet been reported, and it is exceptionally unusual to find EtG in cosmetics. Therefore, external sources for hair contamination should always be taken into account when unusual cosmetic treatment is mentioned. In those cases, it is recommended to analyze the hair product for a possible contamination with EtG. The analysis of body hair can help to reveal problems occurring from cosmetic treatment of head hair. As a consequence, the assessment of drinking behavior should be based on more than one

  14. The Effect of Relaxation and Positive Self-Talk on Symptoms of Premenstrual Syndrome

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    Kimiyaee Asadi

    2016-05-01

    Full Text Available Background Premenstrual syndrome (PMS is characterized by recurrent, moderate-to-severe affective, physical, and behavioral symptoms that develop during the luteal menstrual cycle and disappear within a few days of menstruation. Objectives This article aims to identify the effects of relaxation, positive self-talk, and a combination of relaxation and positive self-talk on premenstrual syndrome. Methods In this quasi-experimental study, 80 women with PMS disorder were selected using a simple random sampling method, in Hamadan, west of Iran. They were randomly divided into four groups. The first and second groups underwent positive self-talk and relaxation, respectively. The third group experienced positive self-talk and relaxation at the same time. The fourth group did not receive any treatment. The duration of treatment was 8 one-hour sessions. Data were collected using a PMS symptom severity questionnaire. All groups were followed up for six months after the intervention. Finally, data analysis was performed using SPSS version 18 for ANCOVA and Bonferroni tests. Results The results showed that compared to the control group, relaxation (23.2 and positive self-talk (21.25 treatment methods alone can reduce PMS (P < 0.001. On the other hand, a combined (relaxation + positive self-talk treatment method (13.75 was more effective in reducing PMS compared to relaxation or positive self-talk alone. Conclusions It seems that psychological therapy based on relaxation and positive self-talk can be significantly effective in reducing PMS.

  15. Incidence of neuropsychiatric side effects of efavirenz in HIV-positive ...

    African Journals Online (AJOL)

    2016-06-30

    Jun 30, 2016 ... HIV-positive treatment-naïve patients in public-sector ... current depression or other mental disorders would increase ... medication and the importance of adherence is discussed ..... neuropsychiatric side effects, substance abuse and emotional ... All authors contributed towards the conceptualisation and.

  16. POSITIVE AND NEGATIVE EFFECTS ANALYSIS IN ABUSE OF DOMINANCE

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    Mihai MĂRGINEAN

    2017-12-01

    Full Text Available Abuse of a dominant position is a threat to the functioning of the free market. This is the reason why we have proposed to highlight the impact of this particular anti-competitive practice in the European Union area. The aim of this paper is to present, from a theoretical and practical approach, the implications and the effects of this type of behavior and also to highlight the main actors in this process. In order to achieve these goals, we will use the content analysis to compress the effects of the abuse of dominant position in two categories: positive and negative effects. The historical method to emphasize the historical origins of the concepts and institutions involved. The comparative method will be used to nominate specific features, concepts or institutions that we will analyze and also it will help us to analyze the evolution that have occurred over time in terms of their development and to highlight certain advantages or disadvantages in terms of choice of competition policy on the abuse of a dominant position. In this paper we will notice that both the companies and the market itself are facing with companies that use anti-competitive since 1900. These kind of practices are harmful both for competition and for consumers, so that should not be allowed to expand. In this context, the European Commission imposed a set of rules that all operators must comply in order to protect, maintain and stimulate competition in the Single Market and to promote fair competition.

  17. Changes in the Position of Mandibular Third Molars Following Extraction and Non-Extraction Orthodontic Treatments

    Directory of Open Access Journals (Sweden)

    Maryam Poosti

    2012-09-01

    Full Text Available Introduction: Impaction of third molars can be associated with a number of sequelae, each requiring a different type of treatment. The purpose of this study was to assess the changes in the position of lower third molars following extraction and non-extraction orthodontic treatments. Methods: Pre- and post-treatment panoramic radiographs of 26 class I malocclusion patients (4 male and 22 female who were treated on a non-extraction basis were compared with those of 30 class I malocclusion patients (5 male and 25 female who received orthodontic treatment following the extraction of all first premolars. In each group, the lower third molar angulations and their distance from the lower border of the mandible were assessed. Results: Paired t-tests and independent t-tests detected significant changes in the position of the lower third molars in the extraction group. Both the left and right molars became more upright and their distance from the lower border of the mandible increased. Similar changes were only seen in the position of the right mandibular third molars in the non-extraction group. Conclusion: Tooth extractions can bring about favorable changes in the position of mandibular third molars and possibly reduce their incidence of impaction.

  18. Changes in the Position of Mandibular Third Molars Following Extraction and Non-Extraction Orthodontic Treatments

    Directory of Open Access Journals (Sweden)

    Maryam Poosti

    2013-01-01

    Full Text Available Introduction: Impaction of third molars can be associated with a number of sequelae, each requiring a different type of treatment. The purpose of this study was to assess the changes in the position of lower third molars following extraction and non-extraction orthodontic treatments. Methods: Pre- and post-treatment panoramic radiographs of 26 class I malocclusion patients (4 male and 22 female who were treated on a non-extraction basis were compared with those of 30 class I malocclusion patients (5 male and 25 female who received orthodontic treatment following the extraction of all first premolars. In each group, the lower third molar angulations and their distance from the lower border of the mandible were assessed. Results: Paired t-tests and independent t-tests detected significant changes in the position of the lower third molars in the extraction group. Both the left and right molars became more upright and their distance from the lower border of the mandible increased. Similar changes were only seen in the position of the right mandibular third molars in the non-extraction group. Conclusion: Tooth extractions can bring about favorable changes in the position of mandibular third molars and possibly reduce their incidence of impaction

  19. The History of Behavioral Treatments in Autism: From the Punitive to the Positive

    Science.gov (United States)

    Suppo, Jennifer L.

    2017-01-01

    The behavioral treatments for persons diagnosed with autism have evolved from those that included punitive components to those that are now based upon principles of positive behavior supports. The proceeding document provides an historical overview of relevant behavioral approaches, including the type of approach and the quality of involvement and…

  20. The effectiveness of stuttering treatments in Germany.

    Science.gov (United States)

    Euler, Harald A; Lange, Benjamin P; Schroeder, Sascha; Neumann, Katrin

    2014-03-01

    Persons who stutter (PWS) should be referred to the most effective treatments available, locally or regionally. A prospective comparison of the effects of the most common stuttering treatments in Germany is not available. Therefore, a retrospective evaluation by clients of stuttering treatments was carried out. The five most common German stuttering treatments (231 single treatment cases) were rated as to their perceived effectiveness, using a structured questionnaire, by 88 PWS recruited through various sources. The participants had received between 1 and 7 treatments for stuttering. Two stuttering treatments (stuttering modification, fluency shaping) showed favorable and three treatments (breathing therapy, hypnosis, unspecified logopedic treatment) showed unsatisfactory effectiveness ratings. The effectiveness ratings of stuttering modification and fluency shaping did not differ significantly. The three other treatments were equally ineffective. The differences between the effective and ineffective treatments were of large effect sizes. The typical therapy biography begins in childhood with an unspecified logopedic treatment administered extensively in single and individual sessions. Available comparisons showed intensive or interval treatments to be superior to extensive treatments, and group treatments to be superior to single client treatments. The stuttering treatment most often prescribed in Germany, namely a weekly session of individual treatment by a speech-language pathologist, usually with an assorted package of mostly unknown components, is of limited effectiveness. Better effectiveness can be expected from fluency shaping or stuttering modification approaches, preferably with an intensive time schedule and with group sessions. Readers will be able to: (a) discuss the five most prevalent stuttering treatments in Germany; (b) summarize the effectiveness of these treatments; and (c) describe structural treatment components that seem to be preferable

  1. Effectiveness of cryotherapy treatment for cervical intraepithelial neoplasia.

    Science.gov (United States)

    Luciani, Silvana; Gonzales, Miguel; Munoz, Sergio; Jeronimo, Jose; Robles, Sylvia

    2008-05-01

    To assess the effectiveness of cryotherapy treatment delivered by general practitioners in primary care settings, as part of a screen-and-treat approach for cervical cancer prevention. Women aged between 25 and 49 years residing in San Martin, Peru, who were positive on visual inspection screening were treated, if eligible, with cryotherapy following biopsy. At 12 months post cryotherapy treatment the participants were evaluated for treatment effectiveness and examined by visual inspection and Papanicolaou test and, if positive, referred to a gynecologist for colposcopy and biopsy. Cryotherapy treatment was performed for 1398 women; of these, 531 (38%) had a histology result of cervical intraepithelial neoplasia (CIN). Cryotherapy effectively cured CIN in 418 (88%) women, including 49 (70%) women with a baseline diagnosis of CIN 3. Cryotherapy is an effective treatment for cervical precancerous lesions; it can easily be administered by general practitioners in primary care settings following visual inspection screening.

  2. HPV Positive Head and Neck Cancers: Molecular Pathogenesis and Evolving Treatment Strategies

    Directory of Open Access Journals (Sweden)

    Rüveyda Dok

    2016-03-01

    Full Text Available Head and neck squamous cell carcinoma (HNSCC is a highly heterogeneous disease that is the result of tobacco and/or alcohol abuse or infection with high-risk Human papillomaviruses. Despite the fact that HPV positive HNSCC cancers form a distinct clinical entity with better treatment outcome, all HNSCC are currently treated uniformly with the same treatment modality. At present, biologic basis of these different outcomes and their therapeutic influence are areas of intense investigation. In this review, we will summarize the molecular basis for this different outcome, novel treatment opportunities and possible biomarkers for HPV positive HNSCC. In particular, the focus will be on several molecular targeted strategies that can improve the chemoradiation response by influencing DNA repair mechanisms.

  3. A Positive Generation Effect on Memory for Auditory Context.

    Science.gov (United States)

    Overman, Amy A; Richard, Alison G; Stephens, Joseph D W

    2017-06-01

    Self-generation of information during memory encoding has large positive effects on subsequent memory for items, but mixed effects on memory for contextual information associated with items. A processing account of generation effects on context memory (Mulligan in Journal of Experimental Psychology: Learning, Memory, and Cognition, 30(4), 838-855, 2004; Mulligan, Lozito, & Rosner in Journal of Experimental Psychology: Learning, Memory, and Cognition, 32(4), 836-846, 2006) proposes that these effects depend on whether the generation task causes any shift in processing of the type of context features for which memory is being tested. Mulligan and colleagues have used this account to predict various negative effects of generation on context memory, but the account also predicts positive generation effects under certain circumstances. The present experiment provided a critical test of the processing account by examining how generation affected memory for auditory rather than visual context. Based on the processing account, we predicted that generation of rhyme words should enhance processing of auditory information associated with the words (i.e., voice gender), whereas generation of antonym words should have no effect. These predictions were confirmed, providing support to the processing account.

  4. Differential effects of arousal in positive and negative autobiographical memories.

    Science.gov (United States)

    Ford, Jaclyn Hennessey; Addis, Donna Rose; Giovanello, Kelly S

    2012-01-01

    Autobiographical memories are characterised by a range of emotions and emotional reactions. Recent research has demonstrated that differences in emotional valence (positive vs. negative emotion) and arousal (the degree of emotional intensity) differentially influence the retrieved memory narrative. Although the mnemonic effects of valence and arousal have both been heavily studied, it is currently unclear whether the effects of emotional arousal are equivalent for positive and negative autobiographical events. In the current study, multilevel models were used to examine differential effects of emotional valence and arousal on the richness of autobiographical memory retrieval both between and within subjects. Thirty-four young adults were asked to retrieve personal autobiographical memories associated with popular musical cues and to rate the valence, arousal and richness of these events. The multilevel analyses identified independent influences of valence and intensity upon retrieval characteristics at the within- and between-subject levels. In addition, the within-subject interactions between valence and arousal highlighted differential effects of arousal for positive and negative memories. These findings have important implications for future studies of emotion and memory, highlighting the importance of considering both valence and arousal when examining the role emotion plays in the richness of memory representation.

  5. The Treatment Effectiveness Assessment (TEA

    Directory of Open Access Journals (Sweden)

    Ling W

    2013-09-01

    Full Text Available Walter Ling,1 David Farabee,1 Dagmar Liepa,2 Li-Tzy Wu3 1Integrated Substance Abuse Programs, University of California, Los Angeles, CA, 2Valley Care Medical Center, Panorama City, CA, 3Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC, USA We have been surprised and gratified by the readers’ responses to our article, The Treatment Effectiveness Assessment (TEA: an efficient, patient-centered instrument for evaluating progress in recovery from addiction, which was published in December 2012.1 In the six months since that time, we have received numerous questions and observations about the article, and about the TEA instrument. Respondents were clinicians: physicians, counselors, therapists, nurses; as well as administrators and policy makers.  View original paper by Ling W, Farabee D, Liepa D, Wu LT. 

  6. Effect of intrauterine position on the radiosensitivity of rat embryos

    International Nuclear Information System (INIS)

    Ward, W.F.; Aceto, H. Jr.; Karp, C.H.

    1977-01-01

    Rats were exposed to gamma rays or helium ions on one of days 4 to 9 of gestation. Embryonic survival was recorded as a function of intrauterine position at autopsy on day 20 of gestation. Embryos located at the ovarian and cervical ends of the uterus experienced higher rates of mortality than did their littermates located at the middle of the uterine horn. This effect was observed in litters exposed to both radiation modalities on all days studied. The influence of intrauterine position on embryonic survival was directly proportional to radiation dose and to the number of fetuses occupying the uterus horn. Under the least advantageous conditions (i.e., a crowded uterine horn exposed to a moderately high radiation dose), the cervical embryo's probability of survival was less than half that of the litter as a whole. A disproportionately high rate of embryonic mortality at the cervical position was also observed in litters irradiated under hypoxic conditions, suggesting that the non-random distribution of radiation effect was not the result of variations in oxygen concentration within the uterus. In contrast, there was no indication that intrauterine position influenced the distribution of gross morphologic abnormalities in irradiated litters

  7. Coping with Cosmetic Effects of Cancer Treatment

    Science.gov (United States)

    ... Search English Español Coping With Cosmetic Effects of Cancer Treatment KidsHealth / For Parents / Coping With Cosmetic Effects of Cancer Treatment What's in this article? Hair Loss Skin Problems ...

  8. A Faraday effect position sensor for interventional magnetic resonance imaging.

    Science.gov (United States)

    Bock, M; Umathum, R; Sikora, J; Brenner, S; Aguor, E N; Semmler, W

    2006-02-21

    An optical sensor is presented which determines the position and one degree of orientation within a magnetic resonance tomograph. The sensor utilizes the Faraday effect to measure the local magnetic field, which is modulated by switching additional linear magnetic fields, the gradients. Existing methods for instrument localization during an interventional MR procedure often use electrically conducting structures at the instruments that can heat up excessively during MRI and are thus a significant danger for the patient. The proposed optical Faraday effect position sensor consists of non-magnetic and electrically non-conducting components only so that heating is avoided and the sensor could be applied safely even within the human body. With a non-magnetic prototype set-up, experiments were performed to demonstrate the possibility of measuring both the localization and the orientation in a magnetic resonance tomograph. In a 30 mT m(-1) gradient field, a localization uncertainty of 1.5 cm could be achieved.

  9. Estimating the effect of treatment rate changes when treatment benefits are heterogeneous: antibiotics and otitis media.

    Science.gov (United States)

    Park, Tae-Ryong; Brooks, John M; Chrischilles, Elizabeth A; Bergus, George

    2008-01-01

    Contrast methods to assess the health effects of a treatment rate change when treatment benefits are heterogeneous across patients. Antibiotic prescribing for children with otitis media (OM) in Iowa Medicaid is the empirical example. Instrumental variable (IV) and linear probability model (LPM) are used to estimate the effect of antibiotic treatments on cure probabilities for children with OM in Iowa Medicaid. Local area physician supply per capita is the instrument in the IV models. Estimates are contrasted in terms of their ability to make inferences for patients whose treatment choices may be affected by a change in population treatment rates. The instrument was positively related to the probability of being prescribed an antibiotic. LPM estimates showed a positive effect of antibiotics on OM patient cure probability while IV estimates showed no relationship between antibiotics and patient cure probability. Linear probability model estimation yields the average effects of the treatment on patients that were treated. IV estimation yields the average effects for patients whose treatment choices were affected by the instrument. As antibiotic treatment effects are heterogeneous across OM patients, our estimates from these approaches are aligned with clinical evidence and theory. The average estimate for treated patients (higher severity) from the LPM model is greater than estimates for patients whose treatment choices are affected by the instrument (lower severity) from the IV models. Based on our IV estimates it appears that lowering antibiotic use in OM patients in Iowa Medicaid did not result in lost cures.

  10. Method effects: the problem with negatively versus positively keyed items.

    Science.gov (United States)

    Lindwall, Magnus; Barkoukis, Vassilis; Grano, Caterina; Lucidi, Fabio; Raudsepp, Lennart; Liukkonen, Jarmo; Thøgersen-Ntoumani, Cecilie

    2012-01-01

    Using confirmatory factor analyses, we examined method effects on Rosenberg's Self-Esteem Scale (RSES; Rosenberg, 1965) in a sample of older European adults. Nine hundred forty nine community-dwelling adults 60 years of age or older from 5 European countries completed the RSES as well as measures of depression and life satisfaction. The 2 models that had an acceptable fit with the data included method effects. The method effects were associated with both positively and negatively worded items. Method effects models were invariant across gender and age, but not across countries. Both depression and life satisfaction predicted method effects. Individuals with higher depression scores and lower life satisfaction scores were more likely to endorse negatively phrased items.

  11. Effects of positive end-expiratory pressure on renal function.

    Science.gov (United States)

    Järnberg, P O; de Villota, E D; Eklund, J; Granberg, P O

    1978-01-01

    The effects were studied positive end-expiratory pressure (PEEP) on renal function in eight patients with acute respiratory failure, requiring mechanical ventilation. On application of PEEP + 10 cm H2O, central venous pressure increased, systolic blood pressure decreased, urine flow and PAH-clearance were reduced, while inulin clearance remained stable. There was a marked increase in fractional sodium reabsorption and a concurrent decrease in fractional osmolal excretion. Fractional free-water clearance and the ratio UOsm/POsm did change.

  12. THE POSITIVE EFFECTS OF COGNITIVE LEARNING STYLES IN ELT CLASSES

    OpenAIRE

    Ozlem Yagcioglu

    2016-01-01

    In the EFL, ESL, ESP and in the ELT classes, students are taught their courses with different kinds of methods and approaches. Cognitive learning styles are the most essential styles in foreign language education. In this paper, the positive effects of cognitive learning styles will be handled. The benefits of these styles will be highlighted. Games on cognitive learning styles will be explained. Sample classroom activities will be shared. Useful books, videos and websites on cognitive learni...

  13. Determinants of compliance with nasal continuous positive airway pressure treatment applied in a community setting.

    Science.gov (United States)

    Ball, E M.; Banks, M B.

    2001-05-01

    Objectives: To assess determinants of nasal continuous positive airway pressure (CPAP) compliance when applied in a community setting.Background: One-third of obstructive sleep apnea patients eventually refuse CPAP therapy. Treatment outcomes may be improved by identifying predictors of CPAP failure, including whether management by primary care physicians without sleep consultation affects results.Methods: Polysomnogram, chart review, and questionnaire results for regular CPAP users (n=123) were compared with those returning the CPAP machine (n=26).Results: Polysomnographic data and the presence of multiple sleep disorders were only modestly predictive of CPAP compliance. Striking differences in questionnaire responses separated CPAP users from non-users, who reported less satisfaction with all phases of their diagnosis and management. Rates of CPAP use were not significantly different between patients managed solely by their primary care physician or by a sleep consultant.Conclusions: Polysomnographic findings are unlikely to identify eventual CPAP non-compliers in a cost-effective fashion. Improvements in sleep apnea management may result from addressing the role of personality factors and multiple sleep disorders in determining compliance. In this practice setting, management by primary care physicians did not significantly degrade CPAP compliance.

  14. EFFECT OF BODY POSITIONS ON INTRA OCULAR PRESSURE

    Directory of Open Access Journals (Sweden)

    Rajendra

    2015-09-01

    Full Text Available BACKGROUND: Intra Ocular Pressure (IOP can be altered by changing body position. Very few studies are available in the Indian subjects. AIM: To study the effect of changes in the body position from upright posture to supine to head down tilt of - 60 0 . MATERIALS AND M ETHODS: The study group consisted of 60 subjects, 35 boys and 25 girls in the age group of 18 to 24 years, with no ocular pathology were chosen. Independent measurements of the IOP of each eye were obtained. Keelar Pulsair air impulse tonometer was used in all the subjects for IOP measurement. IOP was measured in the department of Ophthalmology, Teaching Hospital between 10AM to 12 Noon. STATISTICAL ANALYSIS : were done using Student’s paired ‘t’ test. RESULTS: The change of IOP (Increased induced by the change of position between the means of IOP’s for the sitting and supine positions was 2.789±1.03 mm Hg of all subjects, 2.825±0.226 mm Hg in males and 2.739±0.089 mm Hg in females and between the supine and in clined - 60 ⁰ position was 4.971±0.914 mm Hg of all subjects, 4.703±0.816mm Hg in males and 5.346±1.098 mm Hg in females. CONCLUSION: It is apparent that, the IOP is significantly higher in the supine than in the sitting and in the inclined than in the supin e positions. The difference was statistically significant (P<0.001.

  15. Patient position alters attenuation effects in multipinhole cardiac SPECT.

    Science.gov (United States)

    Timmins, Rachel; Ruddy, Terrence D; Wells, R Glenn

    2015-03-01

    Dedicated cardiac cameras offer improved sensitivity over conventional SPECT cameras. Sensitivity gains are obtained by large numbers of detectors and novel collimator arrangements such as an array of multiple pinholes that focus on the heart. Pinholes lead to variable amounts of attenuation as a source is moved within the camera field of view. This study evaluated the effects of this variable attenuation on myocardial SPECT images. Computer simulations were performed for a set of nine point sources distributed in the left ventricular wall (LV). Sources were placed at the location of the heart in both an anthropomorphic and a water-cylinder computer phantom. Sources were translated in x, y, and z by up to 5 cm from the center. Projections were simulated with and without attenuation and the changes in attenuation were compared. A LV with an inferior wall defect was also simulated in both phantoms over the same range of positions. Real camera data were acquired on a Discovery NM530c camera (GE Healthcare, Haifa, Israel) for five min in list-mode using an anthropomorphic phantom (DataSpectrum, Durham, NC) with 100 MBq of Tc-99m in the LV. Images were taken over the same range of positions as the simulations and were compared based on the summed perfusion score (SPS), defect width, and apparent defect uptake for each position. Point sources in the water phantom showed absolute changes in attenuation of ≤8% over the range of positions and relative changes of ≤5% compared to the apex. In the anthropomorphic computer simulations, absolute change increased to 20%. The changes in relative attenuation caused a change in SPS of position-dependent changes were removed with attenuation correction. Translation of a source relative to a multipinhole camera caused only small changes in homogeneous phantoms with SPS changing position-dependent changes in attenuation.

  16. Positive effects of vegetation: Urban heat island and green roofs

    International Nuclear Information System (INIS)

    Susca, T.; Gaffin, S.R.; Dell'Osso, G.R.

    2011-01-01

    This paper attempts to evaluate the positive effects of vegetation with a multi-scale approach: an urban and a building scale. Monitoring the urban heat island in four areas of New York City, we have found an average of 2 deg. C difference of temperatures between the most and the least vegetated areas, ascribable to the substitution of vegetation with man-made building materials. At micro-scale, we have assessed the effect of surface albedo on climate through the use of a climatological model. Then, using the CO 2 equivalents as indicators of the impact on climate, we have compared the surface albedo, and the construction, replacement and use phase of a black, a white and a green roof. By our analyses, we found that both the white and the green roofs are less impactive than the black one; with the thermal resistance, the biological activity of plants and the surface albedo playing a crucial role. - Highlights: → The local morphology and the scarcity of vegetation in NYC core determines its UHI. → We introduce the evaluation of the effects of the surface albedo on climate change. → We use it to compare a black roof with a white and a green one. → Surface albedo has a crucial role in the evaluation of the environmental loads of the roofs. → Vegetation has positive effects on both the urban and the building scale. - Vegetation has positive effects both on an urban scale, mitigating the urban heat island effect; and on a building scale, where albedo, thermal insulation and biological activity of plants play a crucial role.

  17. Position displacement effect on the doses in the peripheral head regions

    International Nuclear Information System (INIS)

    Kortesniemi, M.; Seppaelae, T.; Bjugg, H.; Seren, T.; Kotiluoto, P.; Auterinen, I.; Parkkinen, R.; Savolainen, S.

    2000-01-01

    Patient positioning is a challenging task in BNCT-treatments due to the use of multiple fields and a static horizontal beam construction. Positioning accuracy of 5 mm is required for acceptable dose delivery within appropriate limits of dose uncertainty (up to 10% of point dose in target volume). The aim of this study was to determine if a patient head position creating a clear gap between the beam port and the head would have a significant effect on the doses to the peripheral regions of the head, e.g. to the eyes. The gamma dose rates were measured in a water filled ellipsoidal phantom with an ionisation chamber (IC). Mn activation wires were used to determine the Mn-55(n, γ) reaction rates. Twelve measurement points were chosen in the phantom and two phantom positions were applied. According to this study the 35 mm position change and the resulting gap has an obvious effect on the peripheral doses in BNCT. The Mn activation reaction rates were on the average 80% higher in the deviation position than in the reference position. Increasing depth from the surface inside the phantom diminished the gamma dose difference between the two positions. Scattering environment changes with position displacement and resulting gap causes differences in neutron fluences and gamma doses. (author)

  18. Atmospheric pressure loading effects on Global Positioning System coordinate determinations

    Science.gov (United States)

    Vandam, Tonie M.; Blewitt, Geoffrey; Heflin, Michael B.

    1994-01-01

    Earth deformation signals caused by atmospheric pressure loading are detected in vertical position estimates at Global Positioning System (GPS) stations. Surface displacements due to changes in atmospheric pressure account for up to 24% of the total variance in the GPS height estimates. The detected loading signals are larger at higher latitudes where pressure variations are greatest; the largest effect is observed at Fairbanks, Alaska (latitude 65 deg), with a signal root mean square (RMS) of 5 mm. Out of 19 continuously operating GPS sites (with a mean of 281 daily solutions per site), 18 show a positive correlation between the GPS vertical estimates and the modeled loading displacements. Accounting for loading reduces the variance of the vertical station positions on 12 of the 19 sites investigated. Removing the modeled pressure loading from GPS determinations of baseline length for baselines longer than 6000 km reduces the variance on 73 of the 117 baselines investigated. The slight increase in variance for some of the sites and baselines is consistent with expected statistical fluctuations. The results from most stations are consistent with approximately 65% of the modeled pressure load being found in the GPS vertical position measurements. Removing an annual signal from both the measured heights and the modeled load time series leaves this value unchanged. The source of the remaining discrepancy between the modeled and observed loading signal may be the result of (1) anisotropic effects in the Earth's loading response, (2) errors in GPS estimates of tropospheric delay, (3) errors in the surface pressure data, or (4) annual signals in the time series of loading and station heights. In addition, we find that using site dependent coefficients, determined by fitting local pressure to the modeled radial displacements, reduces the variance of the measured station heights as well as or better than using the global convolution sum.

  19. Position of the American Dietetic Association: Nutrition intervention in the treatment of anorexia nervosa, bulimia nervosa, and other eating disorders.

    Science.gov (United States)

    2006-12-01

    It is the position of the American Dietetic Association that nutrition intervention, including nutritional counseling, by a registered dietitian (RD) is an essential component of the team treatment of patients with anorexia nervosa, bulimia nervosa, and other eating disorders during assessment and treatment across the continuum of care. Diagnostic criteria for eating disorders provide important guidelines for identification and treatment. However, it is thought that a continuum of disordered eating may exist that ranges from persistent dieting to subthreshold conditions and then to defined eating disorders, which include anorexia nervosa, bulimia nervosa, and binge eating disorder. Understanding the complexities of eating disorders, such as influencing factors, comorbid illness, medical and psychological complications, and boundary issues, is critical in the effective treatment of eating disorders. The nature of eating disorders requires a collaborative approach by an interdisciplinary team of psychological, nutritional, and medical specialists. The RD is an integral member of the treatment team and is uniquely qualified to provide medical nutrition therapy for the normalization of eating patterns and nutritional status. RDs provide nutritional counseling, recognize clinical signs related to eating disorders, and assist with medical monitoring while cognizant of psychotherapy and pharmacotherapy that are cornerstones of eating disorder treatment. Specialized resources are available for RDs to advance their level of expertise in the field of eating disorders. Further efforts with evidenced-based research must continue for improved treatment outcomes related to eating disorders along with identification of effective primary and secondary interventions.

  20. Foot positioning instruction, initial vertical load position and lifting technique: effects on low back loading.

    Science.gov (United States)

    Kingma, Idsart; Bosch, Tim; Bruins, Louis; van Dieën, Jaap H

    2004-10-22

    This study investigated the effects of initial load height and foot placement instruction in four lifting techniques: free, stoop (bending the back), squat (bending the knees) and a modified squat technique (bending the knees and rotating them outward). A 2D dynamic linked segment model was combined with an EMG assisted trunk muscle model to quantify kinematics and low back loading in 10 subjects performing 19 different lifting movements, using 10.5 kg boxes without handles. When lifting from a 0.05 m height with the feet behind the box, squat lifting resulted in 19.9% (SD 8.7%) higher net moments (p squat and stoop lifts, as well as the interaction with lifting height, could to a large extent be explained by changes in the horizontal L5/S1 intervertebral joint position relative to the load, the upper body acceleration, and lumbar flexion. Rotating the knees outward during squat lifts resulted in moments and compression forces that were smaller than in squat lifting but larger than in stoop lifting. Shear forces were small ( < 300 N) at the L4/L5 joint and substantial (1100 - 1400 N) but unaffected by lifting technique at the L5/S1 joint. The present results show that the effects of lifting technique on low back loading depend on the task context.

  1. Refractory Positional Vertigo With Apogeotropic Horizontal Nystagmus After Labyrinthitis: Surgical Treatment and Identification of Dysmorphic Ampullae.

    Science.gov (United States)

    Ahmed, Sameer; Heidenreich, Katherine D; McHugh, Jonathan B; Altschuler, Richard A; Carender, Wendy J; Telian, Steven A

    2015-09-01

    To describe the rationale, intraoperative details, and histopathologic findings discovered when treating an unusual case of apogeotropic horizontal canal positional vertigo with a transmastoid labyrinthectomy. A single case report. Therapeutic. Resolution of apogeotropic nystagmus and improvement of positional vertigo. The apogeotropic variant of horizontal canal positional vertigo can be a difficult entity to treat. This report describes a patient who developed profound sensorineural hearing loss and vertigo after an acute left labyrinthitis. Ten months later, she developed vertigo with apogeotropic positional nystagmus involving the left horizontal semicircular canal. Particle repositioning maneuvers and vestibular physical therapy were unsuccessful. In addition, she developed intermittent positional vertigo affecting the ipsilateral vertical semicircular canals. Given the persistence of her vertigo, multiple canal involvement, and patient preference for definitive treatment, a transmastoid labyrinthectomy was performed. Intraoperatively, the ampulla of the horizontal canal as well as that of the other canals was grossly abnormal as later confirmed on histology. After surgery, her apogeotropic nystagmus and vertigo resolved, and her balance ability gradually improved to a highly functional level. This case illustrates a unique form of positional vertigo that developed and persisted after acute labyrinthitis. Conservative measures were unsuccessful and a transmastoid labyrinthectomy documented dense inflammatory tissue involving all three ampullae. We postulate that the post-labyrinthitic inflammatory changes resulted in mass loading of the membranous ampullae, causing abnormal nystagmus patterns and positional vertigo, which resolved after the labyrinthectomy.

  2. Hepatitis C virus reinfection incidence and treatment outcome among HIV-positive MSM.

    Science.gov (United States)

    Martin, Thomas C S; Martin, Natasha K; Hickman, Matthew; Vickerman, Peter; Page, Emma E; Everett, Rhiannon; Gazzard, Brian G; Nelson, Mark

    2013-10-23

    Liver disease secondary to hepatitis C virus (HCV) infection in the context of HIV infection is one of the leading non-AIDS causes of death. Sexual transmission of HCV infection among HIV-positive MSM appears to be leading to increased reports of acute HCV infection. Reinfection after successful treatment or spontaneous clearance is reported among HIV-positive MSM but the scale of reinfection is unknown. We calculate and compare HCV reinfection rates among HIV-positive MSM after spontaneous clearance and successful medical treatment of infection. Retrospective analysis of HIV-positive MSM with sexually acquired HCV who subsequently spontaneously cleared or underwent successful HCV treatment between 2004 and 2012. Among 191 individuals infected with HCV, 44 were reinfected over 562 person-years (py) of follow-up with an overall reinfection rate of 7.8/100 py [95% confidence interval (CI) 5.8-10.5]. Eight individuals were subsequently reinfected a second time at a rate of 15.5/100 py (95% CI 7.7-31.0). Combining all reinfections, 20% resulted in spontaneous clearance and treatment sustained viral response rates were 73% (16/22) for genotypes one and four and 100% (2/2) for genotypes two and three. Among 145 individuals with a documented primary infection, the reinfection rate was 8.0 per 100 py (95% CI 5.7-11.3) overall, 9.6/100 py (95% CI 6.6-14.1) among those successfully treated and 4.2/100 py (95% CI 1.7-10.0) among those who spontaneously cleared. The secondary reinfection rate was 23.2/100 py (95% CI 11.6-46.4). Despite efforts at reducing risk behaviour, HIV-positive MSM who clear HCV infection remain at high risk of reinfection. This emphasizes the need for increased sexual education, surveillance and preventive intervention work.

  3. Tenofovir treatment in an unselected cohort of highly antiretroviral experienced HIV positive patients

    DEFF Research Database (Denmark)

    Lerbaek, A; Kristiansen, Thomas Birk; Katzenstein, TL

    2004-01-01

    Tenofovir treatment in an unselected cohort of highly antiretroviral experienced HIV positive patients.Lerbaek A, Kristiansen TB, Katzenstein TL, Mathiesen L, Gerstoft J, Nielsen C, Larsen K, Nielsen JO, Obel N, Laursen AL, Nielsen SD. Department of Infectious Diseases, Hvidovre Hospital......, HIV-RNA levels and genotypic resistance were determined at baseline and after 3 and 6 months. After initiation of tenofovir treatment, a mean decrease in HIV-RNA for all 34 patients was observed (-0.43 log1o copies/ml (+/- 1.22) and -0.49 log10 copies/ml (+/- 1.36) after 3 and 6 months, respectively......, respectively). After initiation of tenofovir treatment, no significant increases in CD4 count were observed. All new NRTI-associated mutations could be explained by the background treatment. In conclusion, we observed a significant decrease in HIV-RNA only when tenofovir was prescribed, in conjunction...

  4. Emerging treatments for HER2-positive early-stage breast cancer: focus on neratinib.

    Science.gov (United States)

    Kourie, Hampig Raphael; El Rassy, Elie; Clatot, Florian; de Azambuja, Evandro; Lambertini, Matteo

    2017-01-01

    Over the last decades, a better understanding of breast cancer heterogeneity provided tools for a biologically based personalization of anticancer treatments. In particular, the overexpression of the human epidermal growth factor receptor 2 (HER2) by tumor cells provided a specific target in these HER2-positive tumors. The development of the monoclonal antibody trastuzumab, and its approval in 1998 for the treatment of patients with metastatic disease, radically changed the natural history of this aggressive subtype of breast cancer. These findings provided strong support for the continuous research in targeting the HER2 pathway and implementing the development of new anti-HER2 targeted agents. Besides trastuzumab, a series of other anti-HER2 agents have been developed and are currently being explored for the treatment of breast cancer patients, including those diagnosed with early-stage disease. Among these agents, neratinib, an oral tyrosine kinase inhibitor that irreversibly inhibits HER1, HER2, and HER4 at the intracellular level, has shown promising results, including when administered to patients previously exposed to trastuzumab-based treatment. This article aims to review the available data on the role of the HER2 pathway in breast cancer and on the different targeted agents that have been studied or are currently under development for the treatment of patients with early-stage HER2-positive disease with a particular focus on neratinib.

  5. Invisible Support: Effects on the Provider's Positive and Negative Affect.

    Science.gov (United States)

    König, Claudia; Stadler, Gertraud; Knoll, Nina; Ochsner, Sibylle; Hornung, Rainer; Scholz, Urte

    2016-07-01

    Social support that goes unnoticed by receivers (i.e. invisible support) seems to be most beneficial for the receivers' well-being. The providers' well-being, however, has been neglected so far. This study examines how invisible support is related to the providers' well-being and whether this association is dependent on the providers' relationship satisfaction. Overall, 97 non-smoking partners of smokers who were about to quit smoking were examined. Invisible support was assessed dyadically: partners' reports on smoking-specific provided social support together with smokers' reports on received support were assessed at baseline. Partners' relationship satisfaction was also assessed at baseline. Partners' positive and negative affect were measured at baseline and six-week follow-up. No main effects of invisible instrumental or emotional support occurred. However, partners' relationship satisfaction moderated the association between invisible instrumental support and change in partners' negative and positive affect: For partners with lower relationship satisfaction more invisible instrumental support was related to increased negative affect and decreased positive affect, whereas for partners with higher relationship satisfaction the inverse effects occurred. The study's results emphasise that invisible instrumental support might have emotional costs for the providers. Relationship satisfaction seems to serve as a protective factor. © 2016 The International Association of Applied Psychology.

  6. Self-treatment of benign paroxysmal positional vertigo with DizzyFix, a new dynamic visual device.

    Science.gov (United States)

    Brehmer, Detlef

    2010-09-01

    Benign paroxysmal positional vertigo is one of the most common disorders of the vestibular system. It is characterized by episodes of recurrent vertigo triggered by head movements or position changes associated with nystagmus. There is scientific evidence that in the majority of cases this condition responds well to the particle repositioning maneuver (PRM) correctly performed by the physician. However, the PRM needs to be repeated in approximately 30% of the cases. Although the maneuver is simple, patients often find it difficult to perform correctly as self-treatment, with the result that it fails to bring about an improvement in the symptoms. DizzyFix (Clearwater Clinical Limited, Canada) is the name given to a new dynamic visual device designed to provide a visual representation of the PRM based on the canalith theory. The DizzyFiX consists of a specially curved acrylic tube containing a nontoxic viscous fluid and a bead, the purpose of which is to help the patient and the inexperienced physician to perform the PRM correctly. A randomized clinical trial has shown that it reliably enables the maneuver to be performed correctly, and a study investigating the effectiveness of patient self-treatment of benign paroxysmal positional vertigo with the device in comparison with standard office treatment revealed both techniques to be equally effective. The device has now been approved by the US FDA.

  7. Positive emotional change: mediating effects of forgiveness and spirituality.

    Science.gov (United States)

    Levenson, Michael R; Aldwin, Carolyn M; Yancura, Loriena

    2006-01-01

    We evaluated the efficacy of an emotional education program that seeks to reduce the intergenerational transmission of negative interaction patterns by increasing forgiveness and spirituality. We examined both reduction of psychological symptoms and increase in positive psychological outcomes over the course of a year, as well as the mediators of this change. At baseline, the sample consisted of 99 participants and 47 waiting list controls. Comparisons of scores from baseline (Time 1) to one week after the Hoffman Quadrinity Process (Time 2) showed large declines in negative affect (depressive symptoms) and increases in both positive outcomes (mastery, empathy, emotional intelligence, life satisfaction, forgiveness, and spiritual experience) and health and well-being. Over the course of a year, most of these gains were sustained, in comparison with the control group. Further, increases in forgiveness and spirituality mediated the effect of program participation on depressive symptoms.

  8. Linezolid: a promising option in the treatment of Gram-positives.

    Science.gov (United States)

    Zahedi Bialvaei, Abed; Rahbar, Mohammad; Yousefi, Mehdi; Asgharzadeh, Mohammad; Samadi Kafil, Hossein

    2017-02-01

    Linezolid, an oxazolidinone antimicrobial agent that acts by inhibiting protein synthesis in a unique fashion, is used in the treatment of community-acquired pneumonia, skin and soft-tissue infections and other infections caused by Gram-positive bacteria including VRE and methicillin-resistant staphylococci. Currently, linezolid resistance among these pathogens remains low, commonly linezolid susceptibility testing for this important agent and should be taken into account when considering its therapeutic use. Considering the importance of linezolid in the treatment of infections caused by Gram-positive bacteria, this review was undertaken to optimize the clinical use of this antibiotic. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. [Selection of access and positioning for operative treatment of pelvic injuries. Decision-making strategies].

    Science.gov (United States)

    Ossendorf, C; Hofmann, A; Rommens, P M

    2013-03-01

    Surgical treatment of pelvic ring injuries requires in-depth knowledge of the topographic anatomy of the pelvic bones, joints and soft tissue structures. A wide range of stabilizing techniques is available including bridging plate osteosynthesis, iliosacral compression screw osteosynthesis and transpubic positioning screws. In this article the different treatment strategies with the respective surgical approaches and patient positioning for pelvic ring fractures and combined lesions of the pelvic ring and acetabulum are presented. Pelvic ring lesions with rotational instability are approached from the anterior and occasionally from both the anterior and posterior based on the amount and localization of the instability. In vertically unstable lesions the most unstable part must be addressed first by reduction and fixation of the dislocated part to the axial skeleton. In combined fractures of the pelvis and acetabulum dorsal stabilization is carried out first.

  10. [Effects of a Positive Psychotherapy Program on Positive Affect, Interpersonal Relations, Resilience, and Mental Health Recovery in Community-Dwelling People with Schizophrenia].

    Science.gov (United States)

    Kim, Jinhee; Na, Hyunjoo

    2017-10-01

    Recently, the interest in positive psychotherapy is growing, which can help to encourage positive relationships and develop strengths of people. This study was conducted to investigate the effects of a positive psychotherapy program on positive affect, interpersonal relations, resilience, and mental health recovery in community-dwelling people with schizophrenia. The research was conducted using a randomized control group pretest-posttest design. A total of 57 adults with schizophrenia participated in this study. The study participants in experimental group received a positive psychotherapy program (n=28) and the participants in control group received only the usual treatment in community centers (n=29). The positive psychotherapy program was provided for 5 weeks (of 10 sessions, held twice/week, for 60 minutes). The study outcomes included positive affect, interpersonal relations, resilience, and mental health recovery. The collected data were analyzed using repeated measures ANOVA for examining study hypothesis. Results showed that interpersonal relations (F=11.83, p=.001) and resilience (F=9.62, p=.003) significantly increased in the experimental group compared to the control group. Although experimental group showed a slight increase in positive affect, it was not significant. The study findings confirm that the positive psychotherapy program is effective for improving interpersonal relations and resilience of community-dwelling people with schizophrenia. Based on the findings, we believe that the positive psychotherapy program would be acceptable and helpful to improve recovery of mental health in schizophrenia. © 2017 Korean Society of Nursing Science

  11. Releasing the constraints on aphasia therapy: the positive impact of gesture and multimodality treatments.

    Science.gov (United States)

    Rose, Miranda L

    2013-05-01

    There is a 40-year history of interest in the use of arm and hand gestures in treatments that target the reduction of aphasic linguistic impairment and compensatory methods of communication (Rose, 2006). Arguments for constraining aphasia treatment to the verbal modality have arisen from proponents of constraint-induced aphasia therapy (Pulvermüller et al., 2001). Confusion exists concerning the role of nonverbal treatments in treating people with aphasia. The central argument of this paper is that given the state of the empirical evidence and the strong theoretical accounts of modality interactions in human communication, gesture-based and multimodality aphasia treatments are at least as legitimate an option as constraint-based aphasia treatment. Theoretical accounts of modality interactions in human communication and the gesture production abilities of individuals with aphasia that are harnessed in treatments are reviewed. The negative effects on word retrieval of restricting gesture production are also reviewed, and an overview of the neurological architecture subserving language processing is provided as rationale for multimodality treatments. The evidence for constrained and unconstrained treatments is critically reviewed. Together, these data suggest that constraint treatments and multimodality treatments are equally efficacious, and there is limited support for constraining client responses to the spoken modality.

  12. Regulation of positive and negative emotion: Effects of sociocultural context

    Directory of Open Access Journals (Sweden)

    Sara A. Snyder

    2013-07-01

    Full Text Available Previous research has demonstrated that the use of emotion regulation strategies can vary by sociocultural context. In a previous study, we reported changes in the use of two different emotion regulation strategies at an annual alternative cultural event, Burning Man (McRae, Heller, John, & Gross, 2011. In this sociocultural context, as compared to home, participants reported less use of expressive suppression (a strategy generally associated with maladaptive outcomes, and greater use of cognitive reappraisal (a strategy associated with adaptive outcomes. What remained unclear was whether these changes in self-reported emotion regulation strategy use were characterized by changes in the regulation of positive emotion, negative emotion, or both. We addressed this issue in the current study by asking Burning Man participants separate questions about positive and negative emotion. Using multiple datasets, we not only replicated our previous findings, but also found that the decreased use of suppression is primarily driven by reports of decreased suppression of positive emotion at Burning Man. By contrast, the reported increased use of reappraisal is not characterized by differential reappraisal of positive and negative emotion at Burning Man. Moreover, we observed novel individual differences in the magnitude of these effects. The contextual changes in self-reported suppression that we report are strongest for men and younger participants. For those who had previously attended Burning Man, we observed lower levels of self-reported suppression in both sociocultural contexts: Burning Man and home. These findings have implications for understanding the ways in which certain sociocultural contexts may decrease suppression, and possibly minimize its associated maladaptive effects.

  13. Treatment Adherence and Outcomes of Antiretroviral Agents in HIV Positive Patients

    International Nuclear Information System (INIS)

    Tahir, N. B.; Uddin, Q. T.

    2014-01-01

    Objective: To describe the treatment outcomes in terms of adherence, outcomes and side effects of antiretroviral (ARV) agents. Study Design: An observational study. Place and Duration of Study: Teaching Hospital of Khyber Medical University, Institute of Medical Sciences, Kohat, from February 2007 to December 2012. Methodology: Human Immunodeficiency Virus (HIV) positive patients, taking 1st line ARV agents for at least 6 months were included. Adherence was calculated by self report on asking the number of doses missed in last 30 days. ARVs were provided on monthly basis. Adherence data was noted over a period of 6 months. ARVs outcomes were recorded in the form of adherence, CD4 count, functional status of the patient, change in weight, further transmission of the disease, number of hospital admissions and deaths. Adverse Drug Reactions (ARDs) to ARVs were assessed clinically and by laboratory markers. Mean and standard deviation were calculated for numerical variables while frequencies and percentages were calculated for categorical variables. Results: Total number of patients included in this study were 107. Out of them, 66.4% were males and 33.6% were females. The mean age was 39.9 +- 13.80 years. Patients taking AZT/3TC/NVP, AZT/3TC/EFZ, D4T/3TC/NVP, D4T/3TC/EFZ, TNF/3TC/NVP or EFZ were 49.5%, 22.4%, 10.3%, 4.7% and 13% respectively. Most adverse affects were observed in 10 days to 90 days of initiation of therapy. Rash was observed in 71 (66.4%) patients, anaemia in 4 (3.7%) patients while only one patient (0.93%) had nausea / vomiting. Thirty (28%) patients reported no side effects. Out of 107 patients, 98 (91.5%) were alive whereas 9 (8.4%) died at the end of the study period. Twelve patients had one hospital admission (11.21%) whereas 9 (8.4%) patients had two admissions during the study period. The first mean CD4 was 325.27 cells /mcL whereas mean last CD4 count was 389.86 cells/mcL. Conclusion: ARVs have very satisfactory outcomes in HIV/AIDS patients

  14. Algorithm for the treatment of type 2 diabetes: a position statement of Brazilian Diabetes Society

    OpenAIRE

    Lerario, Antonio C; Chacra, Antonio R; Pimazoni-Netto, Augusto; Malerbi, Domingos; Gross, Jorge L; Oliveira, Jos? EP; Gomes, Marilia B; Santos, Raul D; Fonseca, Reine MC; Betti, Roberto; Raduan, Roberto

    2010-01-01

    Abstract The Brazilian Diabetes Society is starting an innovative project of quantitative assessment of medical arguments of and implementing a new way of elaborating SBD Position Statements. The final aim of this particular project is to propose a new Brazilian algorithm for the treatment of type 2 diabetes, based on the opinions of endocrinologists surveyed from a poll conducted on the Brazilian Diabetes Society website regarding the latest algorithm proposed by American Diabetes Associatio...

  15. Total binding energy of heavy positive ions including density treatment of Darwin and Breit corrections

    International Nuclear Information System (INIS)

    Hill, S.H.; Grout, P.J.; March, N.H.

    1987-01-01

    Previous work on the relativistic Thomas-Fermi treatment of total energies of neutral atoms is first generalised to heavy positive ions. To facilitate quantitative contact with the numerical predictions of Dirac-Fock theory, Darwin and Breit corrections are expressed in terms of electron density, and computed using input again from relativistic Thomas-Fermi theory. These corrections significantly improve the agreement between the two seemingly very different theories. (author)

  16. Emerging treatments for HER2-positive early-stage breast cancer: focus on neratinib

    Directory of Open Access Journals (Sweden)

    Kourie HR

    2017-07-01

    Full Text Available Hampig Raphael Kourie,1 Elie El Rassy,1 Florian Clatot,2,3 Evandro de Azambuja,4 Matteo Lambertini3,4 1Department of Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon; 2Department of Medical Oncology and IRON/U1245, Centre Henri Becquerel, Rouen, France; 3Breast Cancer Translational Research Laboratory, 4Department of Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium Abstract: Over the last decades, a better understanding of breast cancer heterogeneity provided tools for a biologically based personalization of anticancer treatments. In particular, the overexpression of the human epidermal growth factor receptor 2 (HER2 by tumor cells provided a specific target in these HER2-positive tumors. The development of the monoclonal antibody trastuzumab, and its approval in 1998 for the treatment of patients with metastatic disease, radically changed the natural history of this aggressive subtype of breast cancer. These findings provided strong support for the continuous research in targeting the HER2 pathway and implementing the development of new anti-HER2 targeted agents. Besides trastuzumab, a series of other anti-HER2 agents have been developed and are currently being explored for the treatment of breast cancer patients, including those diagnosed with early-stage disease. Among these agents, neratinib, an oral tyrosine kinase inhibitor that irreversibly inhibits HER1, HER2, and HER4 at the intracellular level, has shown promising results, including when administered to patients previously exposed to trastuzumab-based treatment. This article aims to review the available data on the role of the HER2 pathway in breast cancer and on the different targeted agents that have been studied or are currently under development for the treatment of patients with early-stage HER2-positive disease with a particular focus on neratinib. Keywords: breast cancer, HER2-positive, neratinib, early-stage, targeted

  17. Treatment of sleep central apnea with non-invasive mechanical ventilation with 2 levels of positive pressure (bilevel in a patient with myotonic dystrophy type 1

    Directory of Open Access Journals (Sweden)

    Ricardo Tera Akamine

    2014-06-01

    Bi-level positive airway pressure treatment at spontaneous/timed mode showed an improvement in snoring, apneas, and Epworth sleepiness scale decreased from 20 to 10. This case illustrates the beneficial effects of Bi-level positive airway pressure support in central sleep apnea syndrome of a patient with myotonic dystrophy type 1.

  18. Treatment deintensification in human papillomavirus-positive oropharynx cancer: Outcomes from the National Cancer Data Base.

    Science.gov (United States)

    Cheraghlou, Shayan; Yu, Phoebe K; Otremba, Michael D; Park, Henry S; Bhatia, Aarti; Zogg, Cheryl K; Mehra, Saral; Yarbrough, Wendell G; Judson, Benjamin L

    2018-02-15

    The growing epidemic of human papillomavirus-positive (HPV+) oropharyngeal cancer and the favorable prognosis of this disease etiology have led to a call for deintensified treatment for some patients with HPV+ cancers. One of the proposed methods of treatment deintensification is the avoidance of chemotherapy concurrent with definitive/adjuvant radiotherapy. To the authors' knowledge, the safety of this form of treatment de-escalation is unknown and the current literature in this area is sparse. The authors investigated outcomes after various treatment combinations stratified by American Joint Committee on Cancer (AJCC) eighth edition disease stage using patients from the National Cancer Data Base. A retrospective study of 4443 patients with HPV+ oropharyngeal cancer in the National Cancer Data Base was conducted. Patients were stratified into AJCC eighth edition disease stage groups. Multivariate Cox regressions as well as univariate Kaplan-Meier analyses were conducted. For patients with stage I disease, treatment with definitive radiotherapy was associated with diminished survival compared with chemoradiotherapy (hazard ratio [HR], 1.798; P = .029), surgery with adjuvant radiotherapy (HR, 2.563; P = .002), or surgery with adjuvant chemoradiotherapy (HR, 2.427; P = .001). For patients with stage II disease, compared with treatment with chemoradiotherapy, patients treated with a single-modality (either surgery [HR, 2.539; P = .009] or radiotherapy [HR, 2.200; P = .030]) were found to have poorer survival. Among patients with stage III disease, triple-modality therapy was associated with improved survival (HR, 0.518; P = .024) compared with treatment with chemoradiotherapy. Deintensification of treatment from chemoradiotherapy to radiotherapy or surgery alone in cases of HPV+ AJCC eighth edition stage I or stage II disease may compromise patient safety. Treatment intensification to triple-modality therapy for patients with stage III disease may improve survival in

  19. Evaluation of direct membrane filtration and direct forward osmosis as concepts for compact and energy-positive municipal wastewater treatment.

    Science.gov (United States)

    Hey, Tobias; Bajraktari, Niada; Davidsson, Åsa; Vogel, Jörg; Madsen, Henrik Tækker; Hélix-Nielsen, Claus; Jansen, Jes la Cour; Jönsson, Karin

    2018-02-01

    Municipal wastewater treatment commonly involves mechanical, biological and chemical treatment steps to protect humans and the environment from adverse effects. Membrane technology has gained increasing attention as an alternative to conventional wastewater treatment due to increased urbanization. Among the available membrane technologies, microfiltration (MF) and forward osmosis (FO) have been selected for this study due to their specific characteristics, such as compactness and efficient removal of particles. In this study, two treatment concepts were evaluated with regard to their specific electricity, energy and area demands. Both concepts would fulfil the Swedish discharge demands for small- and medium-sized wastewater treatment plants at full scale: (1) direct MF and (2) direct FO with seawater as the draw solution. The framework of this study is based on a combination of data obtained from bench- and pilot-scale experiments applying direct MF and FO, respectively. Additionally, available complementary data from a Swedish full-scale wastewater treatment plant and the literature were used to evaluate the concepts in depth. The results of this study indicate that both concepts are net positive with respect to electricity and energy, as more biogas can be produced compared to that using conventional wastewater treatment. Furthermore, the specific area demand is significantly reduced. This study demonstrates that municipal wastewater could be treated in a more energy- and area-efficient manner with techniques that are already commercially available and with future membrane technology.

  20. False Positive and False Negative Effects on Network Attacks

    Science.gov (United States)

    Shang, Yilun

    2018-01-01

    Robustness against attacks serves as evidence for complex network structures and failure mechanisms that lie behind them. Most often, due to detection capability limitation or good disguises, attacks on networks are subject to false positives and false negatives, meaning that functional nodes may be falsely regarded as compromised by the attacker and vice versa. In this work, we initiate a study of false positive/negative effects on network robustness against three fundamental types of attack strategies, namely, random attacks (RA), localized attacks (LA), and targeted attack (TA). By developing a general mathematical framework based upon the percolation model, we investigate analytically and by numerical simulations of attack robustness with false positive/negative rate (FPR/FNR) on three benchmark models including Erdős-Rényi (ER) networks, random regular (RR) networks, and scale-free (SF) networks. We show that ER networks are equivalently robust against RA and LA only when FPR equals zero or the initial network is intact. We find several interesting crossovers in RR and SF networks when FPR is taken into consideration. By defining the cost of attack, we observe diminishing marginal attack efficiency for RA, LA, and TA. Our finding highlights the potential risk of underestimating or ignoring FPR in understanding attack robustness. The results may provide insights into ways of enhancing robustness of network architecture and improve the level of protection of critical infrastructures.

  1. A topographical map approach to representing treatment efficacy: a focus on positive psychology interventions.

    Science.gov (United States)

    Gorlin, Eugenia I; Lee, Josephine; Otto, Michael W

    2018-01-01

    A recent meta-analysis by Bolier et al. indicated that positive psychology interventions have overall small to moderate effects on well-being, but results were quite heterogeneous across intervention trials. Such meta-analytic research helps condense information on the efficacy of a broad psychosocial intervention by averaging across many effects; however, such global averages may provide limited navigational guidance for selecting among specific interventions. Here, we introduce a novel method for displaying qualitative and quantitative information on the efficacy of interventions using a topographical map approach. As an initial prototype for demonstrating this method, we mapped 50 positive psychology interventions targeting well-being (as captured in the Bolier et al. [2013] meta-analysis, [Bolier, L., Haverman, M., Westerhof, G. J., Riper, H., Smit, F., & Bohlmeijer, E. (2013). Positive psychology interventions: A meta-analysis of randomized controlled studies. BMC Public Health, 13, 83]). Each intervention domain/subdomain was mapped according to its average effect size (indexed by vertical elevation), number of studies providing effect sizes (indexed by horizontal area), and therapist/client burden (indexed by shading). The geographical placement of intervention domains/subdomains was determined by their conceptual proximity, allowing viewers to gauge the general conceptual "direction" in which promising intervention effects can be found. The resulting graphical displays revealed several prominent features of the well-being intervention "landscape," such as more strongly and uniformly positive effects of future-focused interventions (including, goal-pursuit and optimism training) compared to past/present-focused ones.

  2. [Longitudinal genetic effects on mandibular position of female twins from six to twelve years old].

    Science.gov (United States)

    Zhu, Chang-feng; Peng, Jing

    2013-06-01

    To find the longitudinal genetic effects on mandibular position in mixed dentition. The sample used in this study consisted of lateral cephalograms of eighty-nine pairs of female twins in Beijing. With a mixed longitudinal method, the effective twins were 183 pairs(monozygous 110 pairs and dizygous 73 ones). The genetic and environmental effects on mandibular position were analyzed by statistical methods in female twins from six to twelve years old. Statistical comparisons revealed significant (Pchin is the most subjective to environment change, then the mandibular angle, and the condyle is the least. Using N and S as references, the environmental influence on heights showed different order from the most to least changeable: The mandibular angle, the condyle and the chin. In later stage of our observation, the mandibular morphology and growth type might be family inherited. For environmental influences plays important roles on mandibular position, these findings can be used in orthodontic treatment planning.

  3. Patient position alters attenuation effects in multipinhole cardiac SPECT

    International Nuclear Information System (INIS)

    Timmins, Rachel; Ruddy, Terrence D.; Wells, R. Glenn

    2015-01-01

    Purpose: Dedicated cardiac cameras offer improved sensitivity over conventional SPECT cameras. Sensitivity gains are obtained by large numbers of detectors and novel collimator arrangements such as an array of multiple pinholes that focus on the heart. Pinholes lead to variable amounts of attenuation as a source is moved within the camera field of view. This study evaluated the effects of this variable attenuation on myocardial SPECT images. Methods: Computer simulations were performed for a set of nine point sources distributed in the left ventricular wall (LV). Sources were placed at the location of the heart in both an anthropomorphic and a water-cylinder computer phantom. Sources were translated in x, y, and z by up to 5 cm from the center. Projections were simulated with and without attenuation and the changes in attenuation were compared. A LV with an inferior wall defect was also simulated in both phantoms over the same range of positions. Real camera data were acquired on a Discovery NM530c camera (GE Healthcare, Haifa, Israel) for five min in list-mode using an anthropomorphic phantom (DataSpectrum, Durham, NC) with 100 MBq of Tc-99m in the LV. Images were taken over the same range of positions as the simulations and were compared based on the summed perfusion score (SPS), defect width, and apparent defect uptake for each position. Results: Point sources in the water phantom showed absolute changes in attenuation of ≤8% over the range of positions and relative changes of ≤5% compared to the apex. In the anthropomorphic computer simulations, absolute change increased to 20%. The changes in relative attenuation caused a change in SPS of <1.5 for the water phantom but up to 4.2 in the anthropomorphic phantom. Changes were larger for axial than for transverse translations. These results were supported by SPS changes of up to six seen in the physical anthropomorphic phantom for axial translations. Defect width was also seen to significantly increase. The

  4. Treatment of obstructive sleep apnea syndrome with nasal positive airway pressure improves golf performance.

    Science.gov (United States)

    Benton, Marc L; Friedman, Neil S

    2013-12-15

    Obstructive sleep apnea syndrome (OSAS) is associated with impairment of cognitive function, and improvement is often noted with treatment. Golf is a sport that requires a range of cognitive skills. We evaluated the impact of nasal positive airway pressure (PAP) therapy on the handicap index (HI) of golfers with OSAS. Golfers underwent a nocturnal polysomnogram (NPSG) to determine whether they had significant OSAS (respiratory disturbance index > 15). Twelve subjects with a positive NPSG were treated with PAP. HI, an Epworth Sleepiness Scale (ESS), and sleep questionnaire (SQ) were submitted upon study entry. After 20 rounds of golf on PAP treatment, the HI was recalculated, and the questionnaires were repeated. A matched control group composed of non-OSAS subjects was studied to assess the impact of the study construct on HI, ESS, and SQ. Statistical comparisons between pre- and post-PAP treatment were calculated. The control subjects demonstrated no significant change in HI, ESS, or SQ during this study, while the OSAS group demonstrated a significant drop in average HI (11.3%, p = 0.01), ESS, (p = 0.01), and SQ (p = 0.003). Among the more skilled golfers (defined as HI ≤ 12), the average HI dropped by an even greater degree (31.5%). Average utilization of PAP was 91.4% based on data card reporting. Treatment of OSAS with PAP enhanced performance in golfers with this condition. Treatment adherence was unusually high in this study. Non-medical performance improvement may be a strong motivator for selected subjects with OSAS to seek treatment and maximize adherence.

  5. Effects of screening and partner notification on Chlamydia positivity in the United States: a modeling study.

    Science.gov (United States)

    Kretzschmar, Mirjam; Satterwhite, Catherine; Leichliter, Jami; Berman, Stuart

    2012-05-01

    Model impact of increasing screening and partner notification (PN) on chlamydia positivity. We used a stochastic simulation model describing pair formation and dissolution in an age-structured heterosexual population. The model accounts for steady, casual, and concurrent partnerships and a highly sexually active core group. The model used existing sexual behavior data from the United States and was validated using chlamydia positivity data from Region X (Alaska, Idaho, Oregon, Washington). A screening program with a coverage rate of 20% was implemented among women aged 15 to 24 years. After 10 years, we increased screening coverage to 35%, 50%, and 65% and partner treatment rates from 20% to 40% and 55%. Finally, we included male screening (aged 15-24, screening coverage: 20% and 35%, partner treatment: 25% and 40%). We analyzed the effects on chlamydia positivity in women and the frequency of reinfection 6 months after treatment. The model described the decline in positivity observed from 1988 to 1997 in Region X, given screening coverage of 20% and a 25% partner treatment rate. Increasing screening coverage from 35% to 65% resulted in incremental decreases in positivity as did increasing the PN rate; a 23% reduction in positivity was achieved by either increasing screening by 3-fold or PN by 2-fold. Adding male screening to the program had less impact than increasing screening coverage or PN among women. Increased PN and treatment reduced reinfection rates considerably. Increasing efforts in PN may contribute at least as much to control of chlamydia infection as increasing screening coverage rates.

  6. Tenofovir treatment in an unselected cohort of highly antiretroviral experienced HIV positive patients

    DEFF Research Database (Denmark)

    Lerbaek, Anne; Kristiansen, Thomas B; Katzenstein, Terese L

    2004-01-01

    The aim of the present study was to explore the treatment effect of tenofovir as implemented in clinical practice. Data are presented on 34 patients. 11 patients had tenofovir added to a stable anti-retroviral treatment (ART) and 23 patients had drugs other than tenofovir. CD4 counts, HIV......-RNA levels and genotypic resistance were determined at baseline and after 3 and 6 months. After initiation of tenofovir treatment, a mean decrease in HIV-RNA for all 34 patients was observed (-0.43 log1o copies/ml (+/- 1.22) and -0.49 log10 copies/ml (+/- 1.36) after 3 and 6 months, respectively, (p = 0...... initiation of tenofovir treatment, no significant increases in CD4 count were observed. All new NRTI-associated mutations could be explained by the background treatment. In conclusion, we observed a significant decrease in HIV-RNA only when tenofovir was prescribed, in conjunction with other anti...

  7. Energy positive domestic wastewater treatment: the roles of anaerobic and phototrophic technologies

    KAUST Repository

    Shoener, B. D.

    2014-01-01

    The negative energy balance of wastewater treatment could be reversed if anaerobic technologies were implemented for organic carbon oxidation and phototrophic technologies were utilized for nutrient recovery. To characterize the potential for energy positive wastewater treatment by anaerobic and phototrophic biotechnologies we performed a comprehensive literature review and analysis, focusing on energy production (as kJ per capita per day and as kJ m-3 of wastewater treated), energy consumption, and treatment efficacy. Anaerobic technologies included in this review were the anaerobic baffled reactor (ABR), anaerobic membrane bioreactor (AnMBR), anaerobic fluidized bed reactor (AFB), upflow anaerobic sludge blanket (UASB), anaerobic sequencing batch reactor (ASBR), microbial electrolysis cell (MEC), and microbial fuel cell (MFC). Phototrophic technologies included were the high rate algal pond (HRAP), photobioreactor (PBR), stirred tank reactor, waste stabilization pond (WSP), and algal turf scrubber (ATS). Average energy recovery efficiencies for anaerobic technologies ranged from 1.6% (MFC) to 47.5% (ABR). When including typical percent chemical oxygen demand (COD) removals by each technology, this range would equate to roughly 40-1200 kJ per capita per day or 110-3300 kJ m-3 of treated wastewater. The average bioenergy feedstock production by phototrophic technologies ranged from 1200-4700 kJ per capita per day or 3400-13000 kJ m-3 (exceeding anaerobic technologies and, at times, the energetic content of the influent organic carbon), with usable energy production dependent upon downstream conversion to fuels. Energy consumption analysis showed that energy positive anaerobic wastewater treatment by emerging technologies would require significant reductions of parasitic losses from mechanical mixing and gas sparging. Technology targets and critical barriers for energy-producing technologies are identified, and the role of integrated anaerobic and phototrophic

  8. Energy positive domestic wastewater treatment: the roles of anaerobic and phototrophic technologies.

    Science.gov (United States)

    Shoener, B D; Bradley, I M; Cusick, R D; Guest, J S

    2014-05-01

    The negative energy balance of wastewater treatment could be reversed if anaerobic technologies were implemented for organic carbon oxidation and phototrophic technologies were utilized for nutrient recovery. To characterize the potential for energy positive wastewater treatment by anaerobic and phototrophic biotechnologies we performed a comprehensive literature review and analysis, focusing on energy production (as kJ per capita per day and as kJ m(-3) of wastewater treated), energy consumption, and treatment efficacy. Anaerobic technologies included in this review were the anaerobic baffled reactor (ABR), anaerobic membrane bioreactor (AnMBR), anaerobic fluidized bed reactor (AFB), upflow anaerobic sludge blanket (UASB), anaerobic sequencing batch reactor (ASBR), microbial electrolysis cell (MEC), and microbial fuel cell (MFC). Phototrophic technologies included were the high rate algal pond (HRAP), photobioreactor (PBR), stirred tank reactor, waste stabilization pond (WSP), and algal turf scrubber (ATS). Average energy recovery efficiencies for anaerobic technologies ranged from 1.6% (MFC) to 47.5% (ABR). When including typical percent chemical oxygen demand (COD) removals by each technology, this range would equate to roughly 40-1200 kJ per capita per day or 110-3300 kJ m(-3) of treated wastewater. The average bioenergy feedstock production by phototrophic technologies ranged from 1200-4700 kJ per capita per day or 3400-13 000 kJ m(-3) (exceeding anaerobic technologies and, at times, the energetic content of the influent organic carbon), with usable energy production dependent upon downstream conversion to fuels. Energy consumption analysis showed that energy positive anaerobic wastewater treatment by emerging technologies would require significant reductions of parasitic losses from mechanical mixing and gas sparging. Technology targets and critical barriers for energy-producing technologies are identified, and the role of integrated anaerobic and

  9. [Ferrous sulfate in the treatment of iron deficiency anemia: The positions continue].

    Science.gov (United States)

    Dvoretsky, L I

    The paper discusses treatment strategy and tactics for iron deficiency anemia. It gives data on the comparative efficacy of different iron sulfate drugs, their bioavailability, effects on peroxidation processes, and side effects. The paper also considers the clinical significance of a dosage form of iron-containing drugs with a sustained iron release, as well as ways to reduce the frequency and magnitude of side effects when ferrous sulfate is used.

  10. [Techniques and complementary techniques. Complementary treatments: nitric oxide, prone positioning and surfactant].

    Science.gov (United States)

    Martos Sánchez, I; Vázquez Martínez, J L; Otheo de Tejada, E; Ros, P

    2003-11-01

    The management of hypoxic respiratory failure is based on oxygen delivery and ventilatory support with lung-protective ventilation strategies. Better understanding of acute lung injury have led to new therapeutic approaches that can modify the outcome of these patients. These adjunctive oxygenation strategies include inhaled nitric oxide and surfactant delivery, and the use of prone positioning. Nitric oxide is a selective pulmonary vasodilator that when inhaled, improves oxygenation in clinical situations such as persistent pulmonary hypertension of the newborn, pulmonary hypertension associated with congenital heart disease, and acute respiratory distress syndrome (ARDS). When applied early in ARDS, prone positioning improves distribution of ventilation and reduces the intrapulmonary shunt. The surfactant has dramatically decreased mortality caused by hyaline membrane disease in premature newborns, although the results have been less successful in ARDS. Greater experience is required to determine whether the combination of these treatments will improve the prognosis of these patients.

  11. Positive Drinking Consequences Are Associated With Alcohol Use and Alcohol-Related Problems Among Veterans Seeking Treatment for Alcohol Use Disorder.

    Science.gov (United States)

    Morean, Meghan E; Cooney, Judith L

    2015-01-01

    Military service is associated with increased rates of heavy drinking. Widely used clinical practices (e.g., motivational interviewing) indicate that addressing both negative and positive drinking consequences is essential to effective treatment. However, research on effectively assessing positive drinking consequences in a clinical population is absent. The current study (1) evaluated the utility of the Positive Drinking Consequences Questionnaire (PDCQ), a measure previously validated in an undergraduate sample, for use with treatment-seeking veterans, and (2) evaluated relationships between positive drinking consequences and alcohol expectancies, pre-treatment alcohol use, and alcohol-related problems. Ninety-seven veterans seeking treatment for alcohol problems completed an anonymous survey (97.9% male; mean age = 49.76[11.40], 67.0% Caucasian). The PDCQ evidenced a single factor latent structure and internal consistency (Cronbach's alpha = .90). Positive drinking consequences and expectancies were related yet distinct constructs. After controlling for demographic factors, experiencing more positive drinking consequences at program intake was associated with heavier pretreatment drinking (ηp(2) = .10, p = .003) and alcohol-related problems (ηp(2) = .18, p alcohol use (ηp(2) = .12, p = .002) and alcohol-related problems (ηp(2) = .11, p = .003) when expectancies also were included in the model. Positive drinking consequences are assessed reliably by the PDCQ in a clinical sample and appear to play an important role in the drinking behavior of veterans seeking alcohol treatment.

  12. [Benign paroxysmal positional vertigo of the anterior semicircular canal: clinical aspects and treatment].

    Science.gov (United States)

    Lorin, P

    2005-01-01

    To describe the videonystagmographic characteristics and the treatment of the patients reached with a canalolithiasis or a cupulolithiasis of the anterior semicircular canal. Retrospective study concerning patients treated for a Benign Paroxysmal Positional Vertigo (BPPV) of the anterior semicircular canal. Each patient after analysis under videonystagmoscopy (VNS) and under videonystagmography (VNG) was treated by maneuvers. On 462 observations of typical BPPV 6 cases of VPPB of the anterior semicircular canal were treated concerning 5 patients (1.3%). The BPPV of the anterior semicircular canal are rare. We modified our method of diagnosis, and our therapeutic techniques could be validated with the help of the two-dimensional videonystagmography.

  13. Negative index effects from a homogeneous positive index prism

    Science.gov (United States)

    Marcus, Sherman W.; Epstein, Ariel

    2017-12-01

    Cellular structured negative index metamaterials in the form of a right triangular prism have often been tested by observing the refraction of a beam across the prism hypotenuse which is serrated in order to conform to the cell walls. We show that not only can this negative index effect be obtained from a homogeneous dielectric prism having a positive index of refraction, but in addition, for sampling at the walls of the cellular structure, the phase in the material has the illusory appearance of moving in a negative direction. Although many previous reports relied on refraction direction and phase velocity of prism structures to verify negative index design, our investigation indicates that to unambiguously demonstrate material negativity additional empirical evidence is required.

  14. Environmental gram-positive mastitis treatment: in vitro sensitivity and bacteriologic cure.

    Science.gov (United States)

    Cattell, M B; Dinsmore, R P; Belschner, A P; Carmen, J; Goodell, G

    2001-09-01

    A clinical trial was conducted in a large dairy herd to determine the efficacy of intramammary pirlimycin hydrochloride administration during lactation for bacteriologic clearance of gram-positive environmental clinical and subclinical mastitis infections. Quarters infected with environmental streptococci that received pirlimycin therapy (13/28) were 1.8 times more likely to resolve infection than untreated quarters (5/14). The small numbers of quarters infected with coagulase-negative staphylococci resulted in inadequate power to assess treatment differences in cure rate. Although the association was not statistically significant, quarters from cows with sensitive environmental streptococci isolates from composite samples (8/13) resolved infection with treatment at approximately twice the rate of treated quarters with resistant isolates (3/10).

  15. Continuous positive airway pressure and conventional mechanical ventilation in the treatment of meconium aspiration syndrome.

    Science.gov (United States)

    Goldsmith, J P

    2008-12-01

    Meconium aspiration syndrome (MAS) is a complex syndrome that ranges in severity from mild respiratory distress to severe respiratory failure, persistent pulmonary hypertension of the newborn and sometimes death. Understanding of the syndrome's complicated pathophysiology will help determine the appropriate treatment strategy, including the use of continuous positive airway pressure (CPAP), conventional mechanical ventilation (CMV) and other therapies. Approximately 30 to 50% of infants diagnosed with MAS will require CPAP or mechanical ventilation. The optimum modes of ventilation for MAS are not known. Very few studies have been conducted to determine 'best' ventilatory strategies. Despite the introduction, over the last two decades, of innovative ventilatory treatments for this disease (for example, surfactant, high-frequency ventilation, inhaled nitric oxide, extracorporeal membrane oxygenation), the majority of infants can be successfully managed with CPAP or mechanical ventilation alone.

  16. The effect of surface electrical stimulation on vocal fold position.

    Science.gov (United States)

    Humbert, Ianessa A; Poletto, Christopher J; Saxon, Keith G; Kearney, Pamela R; Ludlow, Christy L

    2008-01-01

    Closure of the true and false vocal folds is a normal part of airway protection during swallowing. Individuals with reduced or delayed true vocal fold closure can be at risk for aspiration and may benefit from intervention to ameliorate the problem. Surface electrical stimulation is currently used during therapy for dysphagia, despite limited knowledge of its physiological effects. Prospective single effects study. The immediate physiological effect of surface stimulation on true vocal fold angle was examined at rest in 27 healthy adults using 10 different electrode placements on the submental and neck regions. Fiberoptic nasolaryngoscopic recordings during passive inspiration were used to measure change in true vocal fold angle with stimulation. Vocal fold angles changed only to a small extent during two electrode placements (P vocal fold abduction was 2.4 degrees; while horizontal placements of electrodes in the submental region produced a mean adduction of 2.8 degrees (P = .03). Surface electrical stimulation to the submental and neck regions does not produce immediate true vocal fold adduction adequate for airway protection during swallowing, and one position may produce a slight increase in true vocal fold opening.

  17. [Position of diuretics in the treatment of heart failure in light of current guidelines].

    Science.gov (United States)

    Bury, Krzysztof; Nessler, Jadwiga

    Diuretics are the longest-used drugs in heart failure after digoxin. This is due to their effect on the retention of sodium and an increase in the volume of fluid in the extracellular space secondary to neurohormonal and hemodynamic disorders occurs in heart failure, and their effectiveness in the treatment of symptomatic heart failure. Discontinuation of treatment with diuretics or use them in too small doses is one of the causes of exacerbation or acute heart failure.The effectiveness of most of diuretics does not confirm in the clinical trials, and the indications for their use are often based only on expert opinion. The effect of these drugs on morbidity and mortality in patients with HF was not examined. Diuretics reduce shortness of breath and swelling. For this reasons it is recom-mended to use them in patients with signs and symptoms of fluid retention regardless of the left ventricular ejection fraction.

  18. Brazilian experience in EU-CORE: daptomycin registry and treatment of serious Gram-positive infections

    Directory of Open Access Journals (Sweden)

    Artur Timerman

    Full Text Available OBJECTIVES: To collect data about non-controlled prescribing use of daptomycin and its impact among Brazilian patients with serious Gram positive bacterial infection, as well as the efficacy and safety outcomes. MATERIALS AND METHODS: This is a multi-center, retrospective, non-interventional registry (August 01, 2009 to June 30, 2011 to collect data on 120 patients (44 patients in the first year and 76 patients in the second year who had received at least one dose of commercial daptomycin in Brazil for the treatment of serious Gram-positive bacterial infection. RESULTS: Right-sided endocarditis (15.8%, complicated skin and soft tissue infections (cSSTIwound (15.0% and bacteremia-catheter-related (14.2% were the most frequent primary infections; lung (21.7% was the most common site for infection. Daptomycin was used empirically in 76 (63.3% patients, and methicillin-resistant Staphylococcus aureus (MRSA was the most common suspected pathogen (86.1%. 82.5% of the cultures were obtained prior to or shortly after initiation of daptomycin therapy. Staphylococcus spp. - coagulase negative, MRSA, and methicillin-susceptible S. aureus were the most frequently identified pathogens (23.8%, 23.8% and 12.5%, respectively. The most common daptomycin dose administered for bacteremia and cSSTI was 6 mg/kg (30.6% and 4 mg/kg (51.7%, respectively. The median duration of inpatient daptomycin therapy was 14 days. Most patients (57.1% did not receive daptomycin while in intensive care unit. Carbapenem (22.5% was the most commonly used antibiotic concomitantly. The patients showed clinical improvement after two days (median following the start of daptomycin therapy. The clinical success rate was 80.8% and the overall rate of treatment failure was 10.8%. The main reasons for daptomycin discontinuation were successful end of therapy (75.8%, switched therapy (11.7%, and treatment failure (4.2%. Daptomycin demonstrated a favorable safety and tolerability profile

  19. Positive experience with intrathecal baclofen treatment in children with severe cerebral palsy

    DEFF Research Database (Denmark)

    Overgård, Tinett Martesen; Kjærsgaard-Hansen, Lars; Søe, Morten

    2015-01-01

    INTRODUCTION: Treatment of severe spasticity and dystonia with intrathecal baclofen (ITB) in children has been shown to be effective and has therefore been employed in the Region of Southern Denmark. The aim of this retrospective study was to analyse the efficacy and adverse events since ITB was ...

  20. Effects of Varying Entry Points and Trendelenburg Positioning ...

    African Journals Online (AJOL)

    2018-04-04

    Apr 4, 2018 ... ... made in superior and inferior entry points at supine position at 0° .... Trendelenburg degree, taking all risks into consideration. As a result of our .... patient's position influences the incidence of dysrhythmias during pulmonary.

  1. Positioning the Co-op Program for Maximum Marketing Effectiveness.

    Science.gov (United States)

    Harris, Ronald R.

    1983-01-01

    Examines the concept of positioning, which is the way that individuals perceive and are made aware of a program and believe in its benefit to them and its application to cooperative education programs. Includes a five-step plan for assessing the position of cooperative programs and six ways to implement a positioning strategy. (JOW)

  2. Horizontal canal benign paroxysmal positional vertigo: diagnosis and treatment of 37 patients

    Directory of Open Access Journals (Sweden)

    Eliana Teixeira Maranhão

    2015-06-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV, the most frequent cause of vertigo is associated with high morbidity in the elderly population. The most common form is linked to debris in the posterior semicircular canal. However, there has been an increasing number of reported BPPV cases involving the horizontal canals. The purpose of this article is to highlight the clinical features, diagnosis, and treatment in 37 patients with horizontal canal BPPV; twenty-six with geotropic nystagmus, and eleven with the apogeotropic form. Treatment consisted of the Gufoni manoeuver in eighteen patients (48.6%, the barbecue 360° maneuver in twelve patients (32.4%, both manoeuvers in four patients (10.8%, both manoeuvers plus head shaking in one patient (2.7%, and the Gufoni maneuver plus head shaking in two patients. Cupulolithiasis patients were asked to sleep in a forced prolonged position. We obtained a complete resolution of vertigo and nystagmus in 30 patients (81.0% on the initial visit.

  3. Peptide-Mediated Liposome Fusion: The Effect of Anchor Positioning

    Directory of Open Access Journals (Sweden)

    Niek S. A. Crone

    2018-01-01

    Full Text Available A minimal model system for membrane fusion, comprising two complementary peptides dubbed “E” and “K” joined to a cholesterol anchor via a polyethyleneglycol spacer, has previously been developed in our group. This system promotes the fusion of large unilamellar vesicles and facilitates liposome-cell fusion both in vitro and in vivo. Whilst several aspects of the system have previously been investigated to provide an insight as to how fusion is facilitated, anchor positioning has not yet been considered. In this study, the effects of placing the anchor at either the N-terminus or in the center of the peptide are investigated using a combination of circular dichroism spectroscopy, dynamic light scattering, and fluorescence assays. It was discovered that anchoring the “K” peptide in the center of the sequence had no effect on its structure, its ability to interact with membranes, or its ability to promote fusion, whereas anchoring the ‘E’ peptide in the middle of the sequence dramatically decreases fusion efficiency. We postulate that anchoring the ‘E’ peptide in the middle of the sequence disrupts its ability to form homodimers with peptides on the same membrane, leading to aggregation and content leakage.

  4. A Multicenter Retrospective Review of Prone Position Ventilation (PPV) in Treatment of Severe Human H7N9 Avian Flu.

    Science.gov (United States)

    Xu, Yuanda; Deng, Xilong; Han, Yun; Zhou, Lixin; He, Weiqun; Chen, Sibei; Nong, Lingbo; Huang, Huang; Zhang, Yan; Yu, Tieou; Li, Yimin; Liu, Xiaoqing

    2015-01-01

    Patients with H7N9 avian flu concurrent with severe acute respiratory distress syndrome (ARDS) usually have a poor clinical outcome. Prone position ventilation (PPV) has been shown to improve the prognosis of patients with severe ARDS. This study explored the effects of PPV on the respiratory and circulatory mechanics of H7N9-infected patients with severe ARDS. Individuals admitted to four hospitals designated for H7N9 patients in Guangdong province were treated with PPV, and their clinical data were recorded before and after receiving PPV. Six of 20 critically ill patients in the ICU received PPV. After treatment with 35 PPV sessions, the oxygenation index (OI) values of the six patients when measured post-PPV and post-supine position ventilation (SPV) were significantly higher than those measured pre-PPV (P protective ventilation strategy for use in patients with H7N9 avian flu concurrent with severe ARDS.

  5. Management of patients with hormone receptor–positive breast cancer with visceral disease: challenges and treatment options

    International Nuclear Information System (INIS)

    Harb, Wael A

    2015-01-01

    Endocrine therapy is an important treatment option for women with hormone receptor–positive (HR+) advanced breast cancer (ABC), yet many tumors are either intrinsically resistant or develop resistance to these therapies. Treatment of patients with ABC presenting with visceral metastases, which is associated with a poor prognosis, is also problematic. There is an unmet need for effective treatments for this patient population. Although chemotherapy is commonly perceived to be more effective than endocrine therapy in managing visceral metastases, patients who are not in visceral crisis might benefit from endocrine therapy, avoiding chemotherapy-associated toxicities that might affect quality of life. To improve outcomes, several targeted therapies are being investigated in combination with endocrine therapy for patients with endocrine-resistant, HR+ ABC. Although available data have considered patients with HR+ ABC as a whole, there are promising data from a prespecified analysis of a Phase III study of everolimus (Afinitor ® ), a mammalian target of rapamycin (mTOR) inhibitor, in combination with exemestane (Aromasin ® ) in patients with visceral disease progressing after nonsteroidal aromatase inhibitor therapy. In this review, challenges and treatment options for management of HR+ ABC with visceral disease, including consideration of therapeutic approaches undergoing clinical investigation, will be assessed

  6. Effect of pods' position on the protein content in soybean grains at low latitude

    Directory of Open Access Journals (Sweden)

    Paulo Victor Gomes Sales

    2016-12-01

    Full Text Available Soybean grains have a high protein content, which can vary depending on various factors, as the pods' position throughout the plant. In this sense, aiming to study the effect of pods' position on the main stem of the plant for grades of soybean proteins, It has been accomplished in the years 2010 and 2011, a trial with ten soybean cultivars in the experimental area of the Federal University of Tocantins in Palmas. The experimental area was randomized blocks with 30 treatments and three replications. Treatments were arranged in one a split plot, being allocated in Ten cultivars plots (BRS Valuable, P98Y51, P98Y70, P99R03, M8527RR, M8925RR, M9144RR, M8867RR, and TMG103RR, and the sub plots In the pods' position on the plant (upper third, intermediate, and basal third. According to the results, we can conclude that there is variability among the pods' position. The grains located in the median and apical plant showed a trend of higher protein content. Cultivar P98Y70 showed the highest protein value. In the sampling grain for protein quantitation, it is recommended to use grains of pods located at the same position of the plant.

  7. Growth hormone positive effects on craniofacial complex in Turner syndrome.

    Science.gov (United States)

    Juloski, Jovana; Dumančić, Jelena; Šćepan, Ivana; Lauc, Tomislav; Milašin, Jelena; Kaić, Zvonimir; Dumić, Miroslav; Babić, Marko

    2016-11-01

    Turner syndrome occurs in phenotypic females with complete or partial absence of X chromosome. The leading symptom is short stature, while numerous but mild stigmata manifest in the craniofacial region. These patients are commonly treated with growth hormone to improve their final height. The aim of this study was to assess the influence of long-term growth hormone therapy on craniofacial morphology in Turner syndrome patients. In this cross-sectional study cephalometric analysis was performed on 13 lateral cephalograms of patients with 45,X karyotype and the average age of 17.3 years, who have received growth hormone for at least two years. The control group consisted of 13 Turner syndrome patients naive to growth hormone treatment, matched to study group by age and karyotype. Sixteen linear and angular measurements were obtained from standard lateral cephalograms. Standard deviation scores were calculated in order to evaluate influence of growth hormone therapy on craniofacial components. In Turner syndrome patients treated with growth hormone most of linear measurements were significantly larger compared to untreated patients. Growth hormone therapy mainly influenced posterior face height, mandibular ramus height, total mandibular length, anterior face height and maxillary length. While the increase in linear measurements was evident, angular measurements and facial height ratio did not show statistically significant difference. Acromegalic features were not found. Long-term growth hormone therapy has positive influence on craniofacial development in Turner syndrome patients, with the greatest impact on posterior facial height and mandibular ramus. However, it could not compensate X chromosome deficiency and normalize craniofacial features. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. 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.

  9. Prioritizing Positivity: An Effective Approach to Pursuing Happiness?

    Science.gov (United States)

    Catalino, Lahnna I.; Algoe, Sara B.; Fredrickson, Barbara L.

    2017-01-01

    A decade of research reveals the benefits of positive emotions for mental and physical health; however, recent empirical work suggests the explicit pursuit of happiness may backfire. The present study hypothesized that the pursuit of happiness is not inherently self-defeating; in particular, individuals who seek positivity, as exemplified by how they make decisions about how to organize their day-to-day lives, may be happier. This individual difference is labeled prioritizing positivity. In a community sample of young to older adults (N = 233), prioritizing positivity predicted a host of well-being outcomes (positive emotions, depressive symptomology). In addition, people high in prioritizing positivity have greater resources, and these links are explained by more frequent experiences of positive emotions. In sum, the present study suggests that seeking happiness, although a delicate art, may be a worthwhile pursuit. PMID:25401290

  10. Effectiveness of a positive psychology intervention combined with cognitive behavioral therapy in university students

    Directory of Open Access Journals (Sweden)

    Rosario-Josefa Marrero

    Full Text Available The aim of this study was to design and implement a positive intervention combined with cognitive-behavioral therapy to enhance subjective and psychological well-being and other positive functioning constructs in a convenience sample. Participants analysed were 48 university students (mean age 22.25, 25 assigned nonrandomized to intervention condition and 23 to no-treatment waiting-list control condition. All participants were assessed pre- and post-intervention to test the treatment program effectiveness. Repeated-measures ANCOVAs, controlling baseline differences between the two groups, indicated that the intervention group reported greater social support after the intervention period than the waiting-list control group. Within-group differences were found for happiness, selfacceptance, positive relations with others, optimism, and self-esteem in the intervention group; these differences did not appear in the waiting-list control group. These findings suggest the limited capacity of this intervention program for improving well-being through positive activities combined with cognitive-behavioral therapy. Future research should analyse what kind of activities could be more effective in promoting well-being depending on the characteristics of participants.

  11. Essentials from the 2015 European AIDS Clinical Society (EACS) guidelines for the treatment of adult HIV-positive persons.

    Science.gov (United States)

    Ryom, L; Boesecke, C; Gisler, V; Manzardo, C; Rockstroh, J K; Puoti, M; Furrer, H; Miro, J M; Gatell, J M; Pozniak, A; Behrens, G; Battegay, M; Lundgren, J D

    2016-02-01

    The European AIDS Clinical Society (EACS) guidelines are intended for all clinicians involved in the care of HIV-positive persons, and are available in print, online, and as a free App for download for iPhone and Android. The 2015 version of the EACS guidelines contains major revisions in all sections; antiretroviral treatment (ART), comorbidities, coinfections and opportunistic diseases. Among the key revisions is the recommendation of ART for all HIV-positive persons, irrespectively of CD4 count, based on the Strategic Timing of AntiRetroviral Treatment (START) study results. The recommendations for the preferred and the alternative ART options have also been revised, and a new section on the use of pre-exposure prophylaxis (PrEP) has been added. A number of new antiretroviral drugs/drug combinations have been added to the updated tables on drug-drug interactions, adverse drug effects, dose adjustment for renal/liver insufficiency and for ART administration in persons with swallowing difficulties. The revisions of the coinfection section reflect the major advances in anti-hepatitis C virus (HCV) treatment with direct-acting antivirals with earlier start of treatment in individuals at increased risk of liver disease progression, and a phasing out of interferon-containing treatment regimens. The section on opportunistic diseases has been restructured according to individual pathogens/diseases and a new overview table has been added on CD4 count thresholds for different primary prophylaxes. The diagnosis and management of HIV infection and related coinfections, opportunistic diseases and comorbidities continue to require a multidisciplinary effort for which the 2015 version of the EACS guidelines provides an easily accessable and updated overview. © 2015 British HIV Association.

  12. Spatial variation of electrode position in bioelectrochemical treatment system: Design consideration for azo dye remediation.

    Science.gov (United States)

    Yeruva, Dileep Kumar; Shanthi Sravan, J; Butti, Sai Kishore; Annie Modestra, J; Venkata Mohan, S

    2018-05-01

    In the present study, three bio-electrochemical treatment systems (BET) were designed with variations in cathode electrode placement [air exposed (BET1), partially submerged (BET2) and fully submerged (BET3)] to evaluate azo-dye based wastewater treatment at three dye loading concentrations (50, 250 and 500 mg L -1 ). Highest dye decolorization (94.5 ± 0.4%) and COD removal (62.2 ± 0.8%) efficiencies were observed in BET3 (fully submerged electrodes) followed by BET1 and BET2, while bioelectrogenic activity was highest in BET1 followed by BET2 and BET3. It was observed that competition among electron acceptors (electrode, dye molecules and intermediates) critically regulated the fate of bio-electrogenesis to be higher in BET1 and dye removal higher in BET3. Maximum half-cell potentials in BET3 depict higher electron acceptance by electrodes utilized for dye degradation. Study infers that spatial positioning of electrodes in BET3 is more suitable towards dye remediation, which can be considered for scaling-up/designing a treatment plant for large-scale industrial applications. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. Position Paper on Treatment of Hepatitis C in Romania 2017. Part Two.

    Science.gov (United States)

    Gheorghe, Liana; Sporea, Ioan; Iacob, Speranta; Sirli, Roxana; Trifan, Anca; Diculescu, Mircea; Stanciu, Carol; Pascu, Oliviu; Acalovschi, Monica; Brisc, Ciprian; Cijevschi, Cristina; Gheorghe, Cristian; Spârchez, Zeno; Rogoveanu, Ion; Dobru, Daniela; Dumitrascu, Dan L

    2017-09-01

    Hepatitis C virus (HCV) infection is a common condition with endemic prevalence in some areas of the world. In Romania, the mean prevalence is about 3%. New treatments have become available on the market in recent years and new drugs are in the pipeline. A re-evaluation of HCV therapy was considered mandatory. The Romanian Society of Gastroenterology and Hepatology undertook this task for the practitioners of this country. A group of recognized experts was created who screened the available literature and the major available guidelines. A list of items requiring attention was created and these were discussed and rated. Decisions were taken by consensus. We present here the second part of the Society's recommendations for chronic HCV infection treatment. An agreement between experts was reached regarding the therapy of the special categories of patients infected with HCV, complications and monitoring of the therapy, follow-up of the patients who reached sustained virologic response and re-treatment of the patients with therapy failure. This Position Paper represents a guide for the assessment and the therapy of HCV infection. The recommendations are in concordance with other guidelines but are applied to real-life conditions in Romania.

  14. Effects of Positioning Uncertainty and Breathing on Dose Delivery and Radiation Pneumonitis Prediction in Breast Cancer

    International Nuclear Information System (INIS)

    Mavroidis, Panayiotis; Axelsson, Sofie; Hyoedynmaa, Simo; Rajala, Juha; Pitkaenen, Maunu A.; Lind, Bengt K.; Brahme, Anders

    2002-01-01

    The quality of the radiation therapy delivered in the treatment of breast cancer is susceptible to setup errors and organ motion uncertainties. For 60 breast cancer patients (24 resected with negative node involvement, 13 resected with positive node involvement and 23 ablated) who were treated with three different irradiation techniques, these uncertainties are simulated. The delivered dose distributions in the lung were recalculated taking positioning uncertainty and breathing effects into account. In this way the real dose distributions delivered to the patients are more closely determined. The positioning uncertainties in the anteroposterior (AP) and the craniocaudal (CC) directions are approximated by Gaussian distributions based on the fact that setup errors are random. Breathing is assumed to have a linear behavior because of the chest wall movement during expiration and inspiration. The combined frequency distribution of the positioning and breathing distributions is obtained by convolution. By integrating the convolved distribution over a number of intervals, the positions and the weights of the fields that simulate the original 'effective fields' are calculated. Opposed tangential fields are simulated by a set of 5 pairs of fields in the AP direction and 3 such sets in the CC direction. Opposed AP + PA fields are simulated by a set of 3 pairs of fields in the AP direction and 3 such sets in the CC direction. Single frontal fields are simulated by a set of 5 fields. In radiotherapy for breast cancer, the lung is often partly within the irradiated volume even though it is a sensitive organ at risk. The influence of the deviation in the dose delivered by the original and the adjusted treatment plans on the clinical outcome is estimated by using the relative seriality model and the biologically effective uniform dose concept. Radiation pneumonitis is used as the clinical endpoint for lung complications. The adjusted treatment plans show larger lung

  15. Sample positioning effects in x-ray spectrometry

    International Nuclear Information System (INIS)

    Carpenter, D.

    Instrument error due to variation in sample position in a crystal x-ray spectrometer can easily exceed the total instrumental error. Lack of reproducibility in sample position in the x-ray optics is the single largest source of system error. The factors that account for sample positioning error are described, and many of the details of flat crystal x-ray optics are discussed

  16. Social anxiety and the ironic effects of positive interviewer feedback.

    Science.gov (United States)

    Budnick, Christopher J; Kowal, Marta; Santuzzi, Alecia M

    2015-01-01

    Positive interviewer feedback should encourage positive experiences and outcomes for interviewees. Yet, positive feedback is inconsistent with socially anxious interviewees' negative self-views. Socially anxious interviewees might experience increased self-focus while attempting to reconcile the inconsistency between their self-perceptions and that feedback. This could interfere with successful interview performance. This study used a 3 (feedback: positive, negative, no) × 2 (social anxiety: high, low) between-subjects design. Undergraduate students (N = 88) completed a measure of dispositional social anxiety. They then engaged in a simulated interview with a White confederate trained to adhere to a standardized script. Interviewees received positive, negative, or no interviewer feedback. Each interview was video recorded to code anxiety displays, impression management tactics, and interview success. Following positive feedback, socially anxious interviewees displayed more anxiety, less assertiveness, and received lower success ratings. Among anxious interviewees, increased self-focus provided an indirect path between positive feedback and lower success. Consistent with self-verification theory, anxious interviewees had poorer interview performance following positive feedback that contradicted their negative self-views. Thus, socially anxious interviewees might be at a disadvantage when interviewing, especially following positive feedback. Implications for interviewees and interviewers are discussed.

  17. [Treatment compliance with continuous positive airway pressure device among adults with obstructive sleep apnea (OSA): how many adhere to treatment?].

    Science.gov (United States)

    Sarrell, E Michael; Chomsky, Ofer; Shechter, Dalia

    2013-03-01

    Obstructive sleep apnea syndrome (OSA) afflicts approximately 5% of the adult population and increases with age. The gold standard treatment is with the Continuous Positive Airways Pressure (CPAP) machine. Well-designed prospective trials to elucidate long term compliance with CPAP machine are rare. Assessing compliance and long-term use of CPAP machines among patients with OSA who were referred for treatment with this machine. A 4 years prospective cohort observational study was conducted using telephone interviews of 371 newly diagnosed patients with moderate to severe OSA, who received a specialist recommendation to use the CPAP machine which was bought and adjusted to their use. At the end of the first year, 126 (34%) of the OSA patients used the CPAP machine on a nightly basis (regular users), 120 (32.3%) had not used it at all, and 125 (33.7%) had used it only intermittently. The number of regular users increased between the 1st and 2nd year from 126 (34%), to 163 (44%) (p < 0.07) due to additions from the intermittent users group. The non-users group grew from 120 (32.3%) in the first year, and every year afterwards, up to 221 (59.6%) in the fourth year (p < 0.02). In contrast, there was a significant decrease in the intermittent users group, which declined from 125 (33.7%) in the first year to only 18 (4.8%) in the 4th year (p < 0.005). Most of the patients (92.9%) were males. The average age of the regular users was 59.6 years (+/- 11), which was higher in comparison to 55.9 years (+/- 10.3) for the non-users or 58.9 years (+/- 12.6) among the intermittent users (p = 0.064). There were no statistical differences in co-morbidities or demographics between the three groups. However, the regular users were found to have a higher score in the Epworth Sleepiness Scale (ESS) and a minimal arterial oxygen saturation (SaO2) level lower than the patients in the non-users and intermittent users groups (p = 0.019 and p = 0.03 respectively). Four years follow

  18. Optional contributions have positive effects for volunteering public goods games

    Science.gov (United States)

    Song, Qi-Qing; Li, Zhen-Peng; Fu, Chang-He; Wang, Lai-Sheng

    2011-11-01

    Public goods (PG) games with the volunteering mechanism are referred to as volunteering public goods (VPG) games, in which loners are introduced to the PG games, and a loner obtains a constant payoff but not participating the game. Considering that small contributions may have positive effects to encourage more players with bounded rationality to contribute, this paper introduces optional contributions (high value or low value) to these typical VPG games-a cooperator can contribute a high or low payoff to the public pools. With the low contribution, the logit dynamics show that cooperation can be promoted in a well mixed population comparing to the typical VPG games, furthermore, as the multiplication factor is greater than a threshold, the average payoff of the population is also enhanced. In spatial VPG games, we introduce a new adjusting mechanism that is an approximation to best response. Some results in agreement with the prediction of the logit dynamics are found. These simulation results reveal that for VPG games the option of low contributions may be a better method to stimulate the growth of cooperation frequency and the average payoff of the population.

  19. Mechanisms of hyperthermia induced radiatiosensitization for treatment of human papillomavirus positive tumors

    International Nuclear Information System (INIS)

    Oei, Arlene; Leeuwen, Caspar van; Stalpers, Lukas; Rodermond, Hans; Kok, Petra; Crezee, Hans; Franken, Nicolaas

    2016-01-01

    HPV is associated with cervical cancer, the third most common cancer in women. In over 70% of cervical cancers, the high-risk HPV-types 16 and 18 are found. In these tumors, functionality of p53 is suppressed by the presence of protein E6. Hyperthermia is a clinical application of heat in which tumour temperatures are raised to 40-43°C and combined hyperthermia with radiation is very effective in the treatment of cervical cancer

  20. STIGMA, SOCIAL SUPPORT, AND TREATMENT ADHERENCE AMONG HIV-POSITIVE PATIENTS IN CHIANG MAI, THAILAND

    OpenAIRE

    Li, Michael Jonathan; Murray, Jordan Keith; Suwanteerangkul, Jiraporn; Wiwatanadate, Phongtape

    2014-01-01

    Our study assessed the influence of HIV-related stigma on treatment adherence among people living with HIV in Chiang Mai, Thailand, and whether social support had a moderating effect on this relationship. We recruited 128 patients living with HIV from Sansai Hospital, a community hospital in Chiang Mai, Thailand, and collected data through structured interviews. All forms of HIV-related stigma considered in this study (personalized experience, disclosure, negative self-image, and public attit...

  1. SU-E-P-36: Evaluation of MLC Positioning Errors in Dynamic IMRT Treatments by Analyzing Dynalog Files

    International Nuclear Information System (INIS)

    Olasolo, J; Pellejero, S; Gracia, M; Gallardo, N; Martin, M; Lozares, S; Maneru, F; Bragado, L; Miquelez, S; Rubio, A

    2015-01-01

    Purpose: To assess the accuracy of MLC positioning in Varian linear accelerator, in dynamic IMRT technique, from the analysis of dynalog files generated by the MLC controller. Methods: In Clinac accelerators (pre-TrueBeam technology), control system has an approximately 50ms delay (one control cycle time). Then, the system compares the measured position to the planned position corresponding to the next control cycle. As it has been confirmed by Varian technical support, this effect causes that measured positions appear in dynalogs one cycle out of phase with respect to the planned positions. Around 9000 dynalogs have been analyzed, coming from the three linear accelerators of our center (one Trilogy and two Clinac 21EX) equipped with a Millennium 120 MLC. In order to compare our results to recent publications, leaf positioning errors (RMS and 95th percentile) are calculated with and without delay effect. Dynalogs have been analyzed using a in-house Matlab software. Results: The RMS errors were 0.341, 0.339 and 0.348mm for each Linac; being the average error 0.343 mm. The 95th percentiles of the error were 0.617, 0.607 and 0.625; with an average of 0.617mm. A recent multi-institution study carried out by Kerns et al. found a mean leaf RMS error of 0.32mm and a 95th percentile error value of 0.64mm.Without delay effect, mean leaf RMS errors obtained were 0.040, 0.042 and 0.038mm for each treatment machine; being the average 0.040mm. The 95th percentile error values obtained were 0.057, 0.058 and 0.054 mm, with an average of 0.056mm. Conclusion: Results obtained for the mean leaf RMS error and the mean 95th percentile were consistent with the multi-institution study. Calculated error statistics with delay effect are significantly larger due to the speed proportional and systematic leaf offset. Consequently it is proposed to correct this effect in dynalogs analysis to determine the MLC performance

  2. Potential Positive Effects of Pesticides Application on (Walker (Lepidoptera: Insecta

    Directory of Open Access Journals (Sweden)

    Guo-Qing Yang

    2014-01-01

    Full Text Available In China, the pink stem borer (PSB Sesamia inferens (Walker (Lepidoptera: Noctuidae has become a rice pest in some rice-producing regions. The cause of this shift from secondary to major pest is unknown. The major purpose of this study was to examine the effect of five commonly used pesticides in rice fields on reproduction of PSB and on biochemical substances of rice plants. The results showed that the weight of pupae developed from 1st instar larvae treated with 2 mg/L triazophos and the number of eggs laid by emerged females from the treatment were significantly greater than those of the control, increasing by 26.2% and 47%, respectively. In addition, a nontarget insecticide, pymetrozine 100 mg/L, and a target insecticide, chlorantraniliprole 2 mg/L, stimulated reproduction of PSB. Biochemical measurement showed that foliar sprays of these pesticides resulted in significant reductions of contents of resistant substances, flavonoids and phenolic acids, in rice plants. For example, flavonoids and phenolic acids of rice plants treated with triazophos reduced by 48.5% and 22.4%, respectively, compared to the control. Therefore, we predicted that the application of some pesticides, eg triazophos and chlorantraniliprole, may be the cause of the increase in the population numbers of PSB in rice fields.

  3. Treatment of Dyeing Wastewater by Using Positive Pulsed Corona Discharge to Water Surface

    Science.gov (United States)

    Young, Sun Mok; Hyun, Tae Ahn; Joeng, Tai Kim

    2007-02-01

    This study investigated the treatment of textile-dyeing wastewater by using an electrical discharge technique (positive pulsed corona discharge). The high-voltage electrode was placed above the surface of the wastewater while the ground electrode was submerged in the wastewater. The electrical discharge starting at the tip of the high voltage electrode propagated toward the surface of the wastewater, producing various oxidative radicals and ozone. Oxygen was used as the working gas instead of air to prevent nitrogen oxides from forming. The simulated wastewater was made up with amaranth, which is a kind of azo dye. The results obtained showed that the chromaticity of the wastewater was almost completely removed within an hour. The ultraviolet/visible spectra of the wastewater treated by the electrical discharge revealed that the total hydrocarbon level also decreased significantly.

  4. Treatment of Dyeing Wastewater by Using Positive Pulsed Corona Discharge to Water Surface

    International Nuclear Information System (INIS)

    Mok, Young Sun; Ahn, Hyun Tae; Kim, Joeng Tai

    2007-01-01

    This study investigated the treatment of textile-dyeing wastewater by using an electrical discharge technique (positive pulsed corona discharge). The high-voltage electrode was placed above the surface of the wastewater while the ground electrode was submerged in the wastewater. The electrical discharge starting at the tip of the high voltage electrode propagated toward the surface of the wastewater, producing various oxidative radicals and ozone. Oxygen was used as the working gas instead of air to prevent nitrogen oxides from forming. The simulated wastewater was made up with amaranth, which is a kind of azo dye. The results obtained showed that the chromaticity of the wastewater was almost completely removed within an hour. The ultraviolet/visible spectra of the wastewater treated by the electrical discharge revealed that the total hydrocarbon level also decreased significantly

  5. Evolving landscape of human epidermal growth factor receptor 2-positive breast cancer treatment and the future of biosimilars.

    Science.gov (United States)

    Jackisch, Christian; Lammers, Philip; Jacobs, Ira

    2017-04-01

    Human epidermal growth factor receptor 2-positive (HER2+) breast cancer comprises approximately 15%-20% of all breast cancers and is associated with a poor prognosis. The introduction of anti-HER2 therapy has significantly improved clinical outcomes for patients with HER2+ breast cancer, and multiple HER2-directed agents (ie, trastuzumab, pertuzumab, lapatinib, and ado-trastuzumab emtansine [T-DM1]) are approved for clinical use in various settings. The treatment landscape for patients with HER2+ breast cancer is continuing to evolve. While novel agents and therapeutic strategies are emerging, biologic therapies, particularly trastuzumab, are likely to remain a mainstay of treatment. However, access issues create barriers to the use of biologics, and there is evidence for underuse of trastuzumab worldwide. A biosimilar is a biologic product that is highly similar to a licensed biologic in terms of product safety and effectiveness. Biosimilars of trastuzumab are in development and may soon become available. The introduction of biosimilars may improve access to anti-HER2 therapies by providing additional treatment options and lower-cost alternatives. Because HER2-targeted drugs may be administered for extended periods of time and in combination with other systemic therapies, biosimilars have the potential to result in significant savings for healthcare systems. Herein we review current and emerging treatment options for, and discuss the possible role of biosimilars in, treating patients with HER2+ breast cancer. Copyright © 2017 Authors, Pfizer Inc. Published by Elsevier Ltd.. All rights reserved.

  6. Foot positioning instruction, initial vertical load position and lifting technique: effects on low back loading

    NARCIS (Netherlands)

    Kingma, I.; Bosch, T.; Bruins, L.; van Dieen, J.H.

    2004-01-01

    This study investigated the effects of initial load height and foot placement instruction in four lifting techniques: free, stoop (bending the back), squat (bending the knees) and a modified squat technique (bending the knees and rotating them outward). A 2D dynamic linked segment model was combined

  7. Improved treatment of radiation effects on the skin

    International Nuclear Information System (INIS)

    Wandl, E.O.; Kaercher, K.H.; Wandl-Hainberger, I.

    1985-01-01

    The treatment concept developed by K.H. Kaercher was extended by a therapy using Elasten S cream. In the course of a highvoltage therapy using fast electrons or cobalt-60, interesting aspects in the treatment and progression of the radiation reactions of the skin were established. The dermato-therapeutic principles layed down by K.H. Kaercher with the treatment palette used hitherto, have without doubt invariably proven their value. The exclusive powder treatment, however, may be made more practical by application of the new treatment cream in accordance with the intervals in radiation treatment or as a basic treatment towards the end of therapy. Furthermore it is ideally suited for the care and after-treatment of skin, strained by radiation. It reduces considerably the remaining visible radiation reactions. The treatment with powder and emulsion has for more than 10 years proven effective. After the excellent results of the new cream during radiation treatment, additional positive effects are expected in a long-term trial which will be reported on separately. (orig.) [de

  8. Cost-Effective Fuel Treatment Planning

    Science.gov (United States)

    Kreitler, J.; Thompson, M.; Vaillant, N.

    2014-12-01

    The cost of fighting large wildland fires in the western United States has grown dramatically over the past decade. This trend will likely continue with growth of the WUI into fire prone ecosystems, dangerous fuel conditions from decades of fire suppression, and a potentially increasing effect from prolonged drought and climate change. Fuel treatments are often considered the primary pre-fire mechanism to reduce the exposure of values at risk to wildland fire, and a growing suite of fire models and tools are employed to prioritize where treatments could mitigate wildland fire damages. Assessments using the likelihood and consequence of fire are critical because funds are insufficient to reduce risk on all lands needing treatment, therefore prioritization is required to maximize the effectiveness of fuel treatment budgets. Cost-effectiveness, doing the most good per dollar, would seem to be an important fuel treatment metric, yet studies or plans that prioritize fuel treatments using costs or cost-effectiveness measures are absent from the literature. Therefore, to explore the effect of using costs in fuel treatment planning we test four prioritization algorithms designed to reduce risk in a case study examining fuel treatments on the Sisters Ranger District of central Oregon. For benefits we model sediment retention and standing biomass, and measure the effectiveness of each algorithm by comparing the differences among treatment and no treat alternative scenarios. Our objective is to maximize the averted loss of net benefits subject to a representative fuel treatment budget. We model costs across the study landscape using the My Fuel Treatment Planner software, tree list data, local mill prices, and GIS-measured site characteristics. We use fire simulations to generate burn probabilities, and estimate fire intensity as conditional flame length at each pixel. Two prioritization algorithms target treatments based on cost-effectiveness and show improvements over those

  9. Algorithm for the treatment of type 2 diabetes: a position statement of Brazilian Diabetes Society.

    Science.gov (United States)

    Lerario, Antonio C; Chacra, Antonio R; Pimazoni-Netto, Augusto; Malerbi, Domingos; Gross, Jorge L; Oliveira, José Ep; Gomes, Marilia B; Santos, Raul D; Fonseca, Reine Mc; Betti, Roberto; Raduan, Roberto

    2010-06-08

    The Brazilian Diabetes Society is starting an innovative project of quantitative assessment of medical arguments of and implementing a new way of elaborating SBD Position Statements. The final aim of this particular project is to propose a new Brazilian algorithm for the treatment of type 2 diabetes, based on the opinions of endocrinologists surveyed from a poll conducted on the Brazilian Diabetes Society website regarding the latest algorithm proposed by American Diabetes Association /European Association for the Study of Diabetes, published in January 2009.An additional source used, as a basis for the new algorithm, was to assess the acceptability of controversial arguments published in international literature, through a panel of renowned Brazilian specialists. Thirty controversial arguments in diabetes have been selected with their respective references, where each argument was assessed and scored according to its acceptability level and personal conviction of each member of the evaluation panel.This methodology was adapted using a similar approach to the one adopted in the recent position statement by the American College of Cardiology on coronary revascularization, of which not only cardiologists took part, but also specialists of other related areas.

  10. Bilateral parotitis in a patient under continuous positive airway pressure treatment.

    Science.gov (United States)

    Abdullayev, Ruslan; Saral, Filiz Cosku; Kucukebe, Omer Burak; Sayiner, Hakan Sezgin; Bayraktar, Cem; Akgun, Sadik

    Many conditions such as bacterial and viral infectious diseases, mechanical obstruction due to air and calculi and drugs can cause parotitis. We present a case of unusual bilateral parotitis in a patient under non-invasive continuous positive airway pressure (CPAP) therapy for chronic obstructive pulmonary disease exacerbation in intensive care unit. A 36-year-old patient was admitted to intensive care unit with the diagnosis of chronic obstructive pulmonary disease exacerbation. Antibiotherapy, bronchodilator therapy and non-invasive positive pressure ventilation were applied as treatment regimen. Painless swellings developed on the 3rd day of admission on the right and a day after this on the left parotid glands. Amylase levels were increased and ultrasonographic evaluation revealed bilateral parotitis. No intervention was made and the therapy was continued. The patient was discharged on the 6th day with clinical improvement and regression of parotid swellings without any complications. Parotitis may have occurred after retrograde air flow in the Stensen duct during CPAP application. After the exclusion of possible viral and bacteriological etiologies and possible drug reactions we can focus on this diagnosis. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  11. Algorithm for the treatment of type 2 diabetes: a position statement of Brazilian Diabetes Society

    Directory of Open Access Journals (Sweden)

    Lerario Antonio C

    2010-06-01

    Full Text Available Abstract The Brazilian Diabetes Society is starting an innovative project of quantitative assessment of medical arguments of and implementing a new way of elaborating SBD Position Statements. The final aim of this particular project is to propose a new Brazilian algorithm for the treatment of type 2 diabetes, based on the opinions of endocrinologists surveyed from a poll conducted on the Brazilian Diabetes Society website regarding the latest algorithm proposed by American Diabetes Association /European Association for the Study of Diabetes, published in January 2009. An additional source used, as a basis for the new algorithm, was to assess the acceptability of controversial arguments published in international literature, through a panel of renowned Brazilian specialists. Thirty controversial arguments in diabetes have been selected with their respective references, where each argument was assessed and scored according to its acceptability level and personal conviction of each member of the evaluation panel. This methodology was adapted using a similar approach to the one adopted in the recent position statement by the American College of Cardiology on coronary revascularization, of which not only cardiologists took part, but also specialists of other related areas.

  12. Self-Reported Napping Behavior Change After Continuous Positive Airway Pressure Treatment in Older Adults with Obstructive Sleep Apnea.

    Science.gov (United States)

    Hsieh, Cheng-Fang; Riha, Renata L; Morrison, Ian; Hsu, Chung-Yao

    2016-08-01

    To assess the effect of continuous positive airway pressure (CPAP) on napping behavior in adults aged 60 and older with obstructive sleep apnea-hypopnea syndrome (OSAHS). Retrospective cohort study using questionnaires. Sleep center. Individuals starting CPAP treatment between April 2010 and March 2012 (mean age 65.2 ± 4.7; M:F = 3.9:1; N = 107). All subjects underwent sleep studies, clinical reviews, and CPAP adherence checks and completed a questionnaire regarding CPAP adherence, current employment status, sleep patterns before and after CPAP, and factors affecting their current sleep patterns. CPAP treatment duration was 82.7 ± 30.0 weeks, and objective adherence was 5.4 ± 2.0 hours per night overall. Daytime nap frequency before CPAP treatment was higher in those with a history of stroke or cardiovascular disease. Both sexes had a significant reduction in daytime napping (men, P napping (men, P nap duration (men, P nap duration was associated with younger age (odds ratio (OR) = 0.86, P = .04), a decrease in ESS score (OR = 1.20, P = .03), and longer self-reported daily nap duration at baseline (OR = 31.52, P nap frequency and daily nap duration. Aging or shorter baseline daily nap duration may attenuate this effect. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  13. Positive interaction between prebiotics and thiazolidinedione treatment on adiposity in diet-induced obese mice.

    Science.gov (United States)

    Alligier, Maud; Dewulf, Evelyne M; Salazar, Nuria; Mairal, Aline; Neyrinck, Audrey M; Cani, Patrice D; Langin, Dominique; Delzenne, Nathalie M

    2014-07-01

    To investigate whether inulin-type fructan (ITF) prebiotics could counteract the thiazolidinedione (TZD, PPARγ activator) induced-fat mass gain, without affecting its beneficial effect on glucose homeostasis, in high-fat (HF) diet fed mice. Male C57bl6/J mice were fed a HF diet alone or supplemented with ITF prebiotics (0.2 g/day × mouse) or TZD (30 mg pioglitazone (PIO)/kg body weight × day) or both during 4 weeks. An insulin tolerance test was performed after 3 weeks of treatment. As expected, PIO improved glucose homeostasis and increased adiponectinaemia. Furthermore, it induced an over-expression of several PPARγ target genes in white adipose tissues. ITF prebiotics modulated the PIO-induced PPARγ activation in a tissue-dependent manner. The co-treatment with ITF prebiotics and PIO maintained the beneficial impact of TZD on glucose homeostasis and adiponectinaemia. Moreover, the combination of both treatments reduced fat mass accumulation, circulating lipids and hepatic triglyceride content, suggesting an overall improvement of metabolism. Finally, the co-treatment favored induction of white-to-brown fat conversion in subcutaneous adipose tissue, thereby leading to the development of brite adipocytes that could increase the oxidative capacity of the tissue. ITF prebiotics decrease adiposity and improve the metabolic response in HF fed mice treated with TZD. © 2014 The Obesity Society.

  14. An Investigation of the Effectiveness of Family-Centred Positive Behaviour Support of Young Children with Disabilities

    Science.gov (United States)

    Chu, Szu-Yin

    2015-01-01

    Positive Behaviour Intervention and Support (PBIS) is an evidence-based approach that has been proven to be effective in remediating problem behaviours in children. The purpose of this study was to evaluate the effectiveness of the family-centred PBIS approach when involving Taiwanese families in the treatment of off-task and non-compliant…

  15. Foot positioning instruction, initial vertical load position and lifting technique: effects on low back loading

    OpenAIRE

    Kingma, I.; Bosch, T.; Bruins, L.; van Dieen, J.H.

    2004-01-01

    This study investigated the effects of initial load height and foot placement instruction in four lifting techniques: free, stoop (bending the back), squat (bending the knees) and a modified squat technique (bending the knees and rotating them outward). A 2D dynamic linked segment model was combined with an EMG assisted trunk muscle model to quantify kinematics and low back loading in 10 subjects performing 19 different lifting movements, using 10.5 kg boxes without handles. When lifting from...

  16. Impact of Treatment Integrity on Intervention Effectiveness

    Science.gov (United States)

    Fryling, Mitch J.; Wallace, Michele D.; Yassine, Jordan N.

    2012-01-01

    Treatment integrity has cogent implications for intervention effectiveness. Understanding these implications is an important, but often neglected, undertaking in behavior analysis. This paper reviews current research on treatment integrity in applied behavior analysis. Specifically, we review research evaluating the relation between integrity…

  17. Natural history of treatment-emergent central sleep apnea on positive airway pressure: A systematic review.

    Science.gov (United States)

    Nigam, Gaurav; Riaz, Muhammad; Chang, Edward T; Camacho, Macario

    2018-01-01

    Treatment-emergent central sleep apnea (TECSA) is observed in some patients when they are treated with positive airway pressure (PAP) after significant resolution of the preexisting obstructive events in patients with obstructive sleep apnea. The objective of this study was to systematically review the literature for studies describing the natural history of TECSA. PubMed, Medline, Scopus, Web of Science, and Cochran Library databases were searched through June 29, 2017. Five studies were identified that discussed the natural history of TECSA. TECSA developed in 3.5%-19.8% of PAP-treated patients. Treatment-persistent central sleep apnea (TPCSA), representing protracted periods of PAP therapy-related central apneas, was noted in 14.3%-46.2% of patients with TECSA. Delayed-TECSA (D-TECSA) represents an anomalous TECSA entity appearing weeks to months after initial PAP therapy. D-TECSA was observed in 0.7%-4.2% of OSA patients undergoing PAP treatment (after at least 1 month). In patients with TECSA, a higher apnea-hypopnea index (AHI) and central apnea index at their baseline study or a higher residual AHI at their titration study may be associated with an increased likelihood of conversion to TPCSA. Overall, TECSA developed in 3.5%-19.8% of PAP-treated patients with OSA. The vast majority will experience complete resolution of central apneas over a few weeks to months. Unfortunately, about a third of patients with TECSA may continue to exhibit persistence of central sleep apnea on reevaluation. A small proportion may experience D-TECSA after few weeks to several months of initial exposure to PAP therapy.

  18. Mineralizing urban net-zero water treatment: Field experience for energy-positive water management.

    Science.gov (United States)

    Wu, Tingting; Englehardt, James D

    2016-12-01

    An urban net-zero water treatment system, designed for energy-positive water management, 100% recycle of comingled black/grey water to drinking water standards, and mineralization of hormones and other organics, without production of concentrate, was constructed and operated for two years, serving an occupied four-bedroom, four-bath university residence hall apartment. The system comprised septic tank, denitrifying membrane bioreactor (MBR), iron-mediated aeration (IMA) reactor, vacuum ultrafilter, and peroxone or UV/H 2 O 2 advanced oxidation, with 14% rainwater make-up and concomitant discharge of 14% of treated water (ultimately for reuse in irrigation). Chemical oxygen demand was reduced to 12.9 ± 3.7 mg/L by MBR and further decreased to below the detection limit (treatment. The process produced a mineral water meeting 115 of 115 Florida drinking water standards that, after 10 months of recycle operation with ∼14% rainwater make-up, had a total dissolved solids of ∼500 mg/L, pH 7.8 ± 0.4, turbidity 0.12 ± 0.06 NTU, and NO 3 -N concentration 3.0 ± 1.0 mg/L. None of 97 hormones, personal care products, and pharmaceuticals analyzed were detected in the product water. For a typical single-home system with full occupancy, sludge pumping is projected on a 12-24 month cycle. Operational aspects, including disinfection requirements, pH evolution through the process, mineral control, advanced oxidation by-products, and applicability of point-of-use filters, are discussed. A distributed, peroxone-based NZW management system is projected to save more energy than is consumed in treatment, due largely to retention of wastewater thermal energy. Recommendations regarding design and operation are offered. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Effect of socioeconomic position on patient outcome after hysterectomy

    DEFF Research Database (Denmark)

    Daugbjerg, Signe B; Cesaroni, Giulia; Ottesen, Bent

    2014-01-01

    OBJECTIVE: To investigate the association between socioeconomic position (assessed by education, employment and income) and complications following hysterectomy and assess the role of lifestyle, co-morbidity and clinical conditions on the relationship. DESIGN: Register-based cohort study. SETTING...... significantly higher odds of complications following hysterectomy compared with women with a high socioeconomic position. Unhealthy lifestyle and presence of co-morbidity in women with low socioeconomic position partially explains the differences in complications.......OBJECTIVE: To investigate the association between socioeconomic position (assessed by education, employment and income) and complications following hysterectomy and assess the role of lifestyle, co-morbidity and clinical conditions on the relationship. DESIGN: Register-based cohort study. SETTING...... and employed women. Furthermore, unemployed women had higher odds of hospitalization >4 days than women in employment. Lifestyle factors (smoking and body mass index) and co-morbidity status seemed to explain most of the social differences. However, an association between women with less than high school...

  20. Effects of nursing position on transformational leadership practices.

    Science.gov (United States)

    Herman, Susan; Gish, Mary; Rosenblum, Ruth

    2015-02-01

    This study sought to identify significant differences in nursing leadership strengths by position title. Recent reports show aspects of transformational leadership (TL) related to position, age, and educational level. This study focuses on differentiating the strength of leadership practices across the range of nursing management positions. The Leadership Practices Inventory-Self-assessment survey, and a variety of demographic questions, were used to anonymously poll voluntary members of the Association of California Nurse Leaders. Nursing positions of director level and above were strongest in leadership practices. Those at manager and below were identified as needing additional leadership development. LPI-S subscales Enable Others to Act and Model the Way were strongest. Those at the manager level and below will benefit most from additional education and training. Even upper levels of management would gain from enhancing the LPI practices of Challenge the Process and Inspire a Shared Vision.

  1. Positive emotions and the social broadening effects of Barack Obama.

    Science.gov (United States)

    Ong, Anthony D; Burrow, Anthony L; Fuller-Rowell, Thomas E

    2012-10-01

    Past experiments have demonstrated that the cognitive broadening produced by positive emotions may extend to social contexts. Building on this evidence, we hypothesized that positive emotions triggered by thinking about Barack Obama may broaden and expand people's sense of self to include others. Results from an expressive-writing study demonstrated that African American college students prompted to write about Obama immediately prior to and after the 2008 presidential election used more plural self-references, fewer other-references, and more social references. Mediation analyses revealed that writing about Obama increased positive emotions, which in turn increased the likelihood that people thought in terms of more-inclusive superordinate categories (we and us rather than they and them). Implications of these findings for the role of positive emotions in perspective-taking and intergroup relations are considered.

  2. Prone positioning ventilation for treatment of acute lung injury and acute respiratory distress syndrome.

    Science.gov (United States)

    Lan, Mei-juan; He, Xiao-di

    2009-08-01

    Patients who are diagnosed with acute lung injury/acute respiratory distress syndrome (ALI/ARDS) usually have ventilation-perfusion mismatch, severe decrease in lung capacity, and gas exchange abnormalities. Health care workers have implemented various strategies in an attempt to compensate for these pathological alterations. By rotating patients with ALI/ARDS between the supine and prone position, it is possible to achieve a significant improvement in PaO2/FiO2, decrease shunting and therefore improve oxygenation without use of expensive, invasive and experimental procedures. Prone positioning is a safe and effective way to improve ventilation when conventional strategies fail to initiate a patient response. Because a specific cure for ARDS is not available, the goal is to support the patients with therapies that cause the least amount of injury while the lungs have an opportunity to heal. Based on current data, a trial of prone positioning ventilation should be offered to the patients who have ALI/ARDS in the early course of the disease. Published studies exhibit substantial heterogeneity in clinical results, suggesting that an adequately sized study optimizing the duration of proning ventilation strategy is warranted to enable definitive conclusions to be drawn.

  3. The Correlation of Initial Sputum Smear Positivity on Treatment Failure of Category 1 Therapy for Pulmonary Tuberculosis

    Directory of Open Access Journals (Sweden)

    Puput Dyah Ayu

    2016-11-01

    Full Text Available Tuberculosis is an infectious disease and is an important public health problem. Based on data from East Java Province Health Department reported that number of tuberculosis patient in Surabaya is the highest in East Java on year 2014. Early identification and good treatment based on the result of sputum identification are the strategy use to control tuberculosis widespread. So that why, microscopic observation to identify acid fast bacilli (AFB is the fundamental stage to determine recovery treatment. Initial sputum smear positivity is necessary to determine infectious graded. The objectives of the study were to identify of initial sputum smear positivity on treatment failure of category 1 therapy for pulmonary tuberculosis in RS Paru Surabaya year 2011-2014. This study used case control method with quantitative approach. Forty two samples were taken from secondary data. Case group is 21 samples who have treatment failure and control group is 21 successful treatment. Samples were selected by simple random sampling. The chi square correlation showed that highly positive initial smear (p = 0,045; OR = 5,4 have correlated and risk factor to treatment failure on category 1 therapy for pulmonary tuberculosis. The conclusion is patient’s high positive sputum smear initially correlated to treatment failure on category 1 therapy for pulmonary tuberculosis in RS Paru Surabaya year 2011–2014. Keywords: initial sputum smear positivity, treatment failure,, category 1 therapy for pulmonary tuberculosis

  4. Radiosensitivity and effect of hypoxia in HPV positive head and neck cancer cells

    International Nuclear Information System (INIS)

    Sørensen, Brita Singers; Busk, Morten; Olthof, Nadine; Speel, Ernst-Jan; Horsman, Michael R.; Alsner, Jan; Overgaard, Jens

    2013-01-01

    Background and purpose: HPV associated Head and Neck Squamous Cell Carcinoma (HNSCC) represents a distinct subgroup of HNSCC characterized by a favorable prognosis and a distinct molecular biology. Previous data from the randomized DAHANCA 5 trial indicated that HPV positive tumors did not benefit from hypoxic modifications by Nimorazole during radiotherapy, whereas a significant benefit was observed in the HPV negative tumors. However, more studies have demonstrated equal frequencies of hypoxic tumors among HPV-positive and HPV-negative tumors. The aim of the present study was to determine radiosensitivity, the impact of hypoxia and the effect of Nimorazole in HPV positive and HPV negative cell lines. Materials and method: The used cell lines were: UDSCC2, UMSCC47 and UPCISCC90 (HPV positive) and FaDu DD , UTSCC33 and UTSCC5 (HPV negative). Cells were cultured under normoxic or hypoxic conditions, and gene expression levels of previously established hypoxia induced genes were assessed by qPCR. Cells were irradiated with various doses under normoxia, hypoxia or hypoxia +1 mM Nimorazole, and the clonogenic survival was determined. Results: The HPV positive and HPV negative cell lines exhibited similar patterns of upregulation of hypoxia induced genes in response to hypoxia. The HPV positive cell lines were up to 2.4 times more radiation sensitive than HPV negative cell lines. However, all HPV positive cells displayed the same response to hypoxia in radiosensitivity, with an OER in the range 2.3–2.9, and a sensitizer effect of Nimorazole of 1.13–1.29, similar to HPV negative cells. Conclusions: Although HPV positive cells had a markedly higher radiosensitivity compared to HPV negative cells, they displayed the same relative radioresistance under hypoxia and the same relative sensitizer effect of Nimorazole. The clinical observation that HPV positive patients do not seem to benefit from Nimorazole treatment is not due to inherent differences in hypoxia sensitivity

  5. Position Statement: Drug Holiday in Osteoporosis Treatment with Bisphosphonates in South Korea

    Science.gov (United States)

    Lee, Seung Hun; Gong, Hyun Sik; Kim, Tae-Hee; Park, Si Young; Shin, Jung-Ho; Cho, Sun Wook

    2015-01-01

    Bisphosphonates have been widely used in the treatment of osteoporosis with robust data from many placebo-controlled trials demonstrating its efficacy in fracture risk reduction over 3 to 5 years of treatment. Although bisphosphonates are generally safe and well tolerated, concerns have emerged about the adverse effects related to its long-term use, including osteonecrosis of the jaw and atypical femur fractures. Because bisphosphonates are incorporated into the skeleton and continue to exert an anti-resorptive effect for a period of time after the discontinuation of drugs, the concept of a "drug holiday" has emerged, whereby the risk of adverse effects might be decreased while the patient still benefits from anti-fracture efficacy. As randomized clinical trial evidence is not yet available on who may qualify for a drug holiday, there is considerable controversy regarding the selection of candidates for the drug holiday and monitoring during a drug holiday, both of which should be based on individual assessments of risk and benefit. This statement will provide suggestions for clinicians in South Korea on the identification of possible candidates and monitoring during a bisphosphonate drug holiday. PMID:26713307

  6. The Effect of Positive Affect on the Memory of Pain.

    Science.gov (United States)

    Bąbel, Przemysław

    2017-06-01

    The aim of the study was to assess the accuracy of the memory of experimentally induced pain and the affect that accompanies experimentally induced pain. Sixty-two healthy female volunteers participated in the study. In the first phase of the study, the participants received three pain stimuli and rated pain intensity, pain unpleasantness, state anxiety, and their positive and negative affect. About a month later, in the second phase of the study, the participants were asked to rate the pain intensity, pain unpleasantness, state anxiety, and the emotions they had felt during the first phase of the study. Both recalled pain intensity and recalled pain unpleasantness were found to be underestimated. Although the positive affect that accompanied pain was remembered accurately, recalled negative affect was overestimated and recalled state anxiety was underestimated. Experienced pain, recalled state anxiety, and recalled positive affect accounted for 44% of the total variance in predicting recalled pain intensity and 61% of the total variance in predicting recalled pain unpleasantness. Together with recent research findings on the memory of other types of pain, the present study supports the idea that pain is accompanied by positive as well as negative emotions, and that positive affect influences the memory of pain. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  7. The effect of motivation and positive affect on ego depletion: Replenishment versus release mechanism.

    Science.gov (United States)

    Zhu, Ze; Li, Jian; Zhang, Bo; Li, Ye; Zhang, Houcan

    2017-12-01

    In this study, 2 experiments were conducted to investigate whether motivation and positive affect can alleviate ego depletion and to elucidate their possible mechanisms. In Experiment 1, a crossing-out-letter task was adapted to reach an ego depletion state for Chinese participants. Participants were then randomly assigned to the extrinsic motivation group, the positive affect group or the depletion control group. After the experimental treatment, a dumbbell task was used to measure participants' remaining self-regulatory resources. The results showed that participants in the motivation and positive affect groups performed better on the dumbbell task than participants in the depletion control group. Experiment 2 was similar to Experiment 1 except that participants were asked to perform an additional unexpected dumbbell task after a neutral video following the above procedure. The results of Experiment 1 were replicated; however, participants' performance on the additional dumbbell task differed. The positive affect group performed better than the depletion control group, indicating an increase in self-regulatory resources and thus supporting the replenishment effect of positive affect. No significant difference was found between the motivation group and the depletion control group. © 2015 International Union of Psychological Science.

  8. Gel pillow designed specifically for obstructive sleep apnea treatment with continuous positive airway pressure.

    Science.gov (United States)

    Salvaggio, Adriana; Lo Bue, Anna; Isidoro, Serena Iacono; Romano, Salvatore; Marrone, Oreste; Insalaco, Giuseppe

    2016-01-01

    To determine whether the use of a gel pillow with side cutouts designed to accommodate a continuous positive airway pressure (CPAP) mask and reduce head temperature improves the efficacy of and adherence to auto-CPAP therapy. Twenty-three consecutive CPAP-naïve patients with obstructive sleep apnea were enrolled in the study. Patients were given an auto-CPAP machine with an appropriate CPAP mask and were instructed to use CPAP for 15 nights. They were instructed to sleep with their own pillow (the control pillow) from nights 1 to 5 and with either a foam pillow or a gel pillow, both of which had side cutouts, for 5 consecutive nights each, in random order. After night 15, auto-CPAP machine data were downloaded and patients rated their satisfaction with each pillow on a visual analog scale. Twenty-two patients completed the protocol. The pressures administered, residual apnea-hypopnea index, air leaks, and mean duration of CPAP use did not differ among the periods during which each pillow was used. Patients were significantly more satisfied with the gel pillow than with the control pillow and the foam pillow (p = 0.022 and p = 0.004, respectively), their level of satisfaction with the gel pillow correlating significantly with excessive daytime sleepiness (r2 = 0.19; p = 0.0443). Among obstructive sleep apnea patients treated with nasal CPAP, the use of a gel pillow with side cutouts appears to have no impact on treatment effectiveness. Nevertheless, such patients seem to prefer a gel pillow over other types of pillows. Determinar se o uso de um travesseiro de gel com recortes laterais para acomodar a máscara de continuous positive airway pressure (CPAP, pressão positiva contínua nas vias aéreas) e diminuir a temperatura em torno da cabeça melhora a eficácia do tratamento com auto-CPAP e a adesão dos pacientes ao tratamento. Foram incluídos no estudo 23 pacientes consecutivos com apneia obstrutiva do sono que nunca haviam recebido tratamento com CPAP. Os

  9. Bio-oss in Treatment of Furcation Class II Deffects and Comparison with Coronally Positioned Flap

    Directory of Open Access Journals (Sweden)

    Ak.Khoshkhoo Nejad

    2004-09-01

    Full Text Available Statement of Problem: Among periodontal defects, the furcation involvement represents one of the most chalenging scenarios due to the difficulty of achieving a predictable improvement regardless of the type of periodontal therapy. Moreover, the presence of furcation involvement has been demonstrated to considerably affect tooth prognosis. Thus, treatment of furcation defects is a challenge in clinical periodontics. The aim of periodontal treatment is not only to control infection but also to regenerate periodontal tissues lost as a consequence of periodontal disease.Purpose: The purpose of this study was to compare Bio-oss (Bo, an anorganic bovine bone Xenograft, in combination with coronally positioned flap to open flap debridment surgery with coronally positiond flap alone in human mandibular class II furcation defects.Materials and Methods: In this clinical trial and interventional study 24 furcations, which provided 12 pairs of similar periodontal defects were evaluated. Each defect was randomly assigned to treatment with Bio-Oss in combination coronally positioned flap or open flap debridment and coronally positioned flap alone. Following basic therapy, baseline measurements were recorded including probing depth (PDD, clinical attachment level (CAL,gingival recession (REC, keratinized gingiva (KG and closed horizontal probing depth(CHPD. After 6 months, all sites were re-entered and hard tissue measurements were recorded.Hard tissue measurements were performed during surgery to determine open horizontal probing depth (OHPD and open vertical probing depth (OVPD. The data was analyzed using t-test paired sample.Results: Vertical probing depth reduction of 3.17±1.32 mm and horizontal probing depth reduction of 4.42±1.02 mm were noted for the BO group, with 2.87±0.83 mm and 2.31±0.49 mm reductions, respectively, noted for CPF alone. Both surgical procedures resulted in statistically significant probing depth reduction and gain clinical

  10. Positive Effekte eines Kuraufenthaltes auf menopausale Beschwerden // Positive Effects of Health Cure on Menopausal Complaints

    Directory of Open Access Journals (Sweden)

    Foisner W

    2016-01-01

    Full Text Available 100 patients in menopause were recruited in an open duo-centre study during a health cure for musculoskeletal system to investigate if health cure is able to achieve additive effects on menopausal afflictions. Patients were differentiated in pre-, periand postmenopausal stadium due to their hormonal state (TSH, estradiol, LH, FSH. Survey dates were admission, discharge, 3, 6, 9, 12 months. MRS (Menopause Rating Scale and HADS-D (Hospital Anxiety and Depression Scale – German version were used as main outcome parameters.brThe analysis revealed that beside the total score also the subscale of both questionnaires improved during the cure. This “success of cure” lasted over a period of 6 months. Afterwards the values approached to the initial situation. Indeed all subscales stayed beyond baseline during the whole study.brThe results of the present investigation may be concluded as a temporary improvement of discomforts, life quality and psyche of peri- and postmenopausal women due to inpatient health cure. p bKurzfassung/b: Während eines Kurheilverfahrens zu Beschwerden des Stütz- und Bewegungsapparates wurden in einer offenen Duo-Center-Studie 100 Patientinnen in der Menopause rekrutiert, um zu untersuchen, ob der Kuraufenthalt additive Effekte auf menopausale Beschwerden besitzt. Anhand eines Hormonstatus (TSH, Estradiol, LH, FSH wurden die Patientinnen in die Menopause-Stadien prä-, peri- und postmenopausal eingeteilt. Erhebungszeitpunkte: Aufnahme, Entlassung, 3, 6, 9 und 12 Monate. Die „Menopause Rating Scale“ (MRS und die „Hospital Anxiety and Depression Scale – deutsche Version“ (HADS-D wurden als Haupt-Outcomeparameter herangezogen.brDie Auswertung ergab, dass sich neben dem Gesamtscore auch die Teilskalen der beiden Fragebögen während des Kuraufenthaltes verbesserten. Dieser „Kurerfolg“ hielt über einen Zeitraum von 6 Monaten an, danach näherten sich die Werte wieder der Ausgangssituation. Alle Teilscores blieben über dem

  11. Self-Efficacy and Short-Term Adherence to Continuous Positive Airway Pressure Treatment in Children.

    Science.gov (United States)

    Xanthopoulos, Melissa S; Kim, Ji Young; Blechner, Michael; Chang, Ming-Yu; Menello, Mary Kate; Brown, Christina; Matthews, Edward; Weaver, Terri E; Shults, Justine; Marcus, Carole L

    2017-07-01

    Infants, children, and adolescents are increasingly being prescribed continuous positive airway pressure (CPAP) for treatment of obstructive sleep apnea syndrome (OSAS), yet adherence is often poor. The purpose of this study was to examine the relationship between caregiver and patient-reported health cognitions about CPAP prior to starting CPAP and CPAP adherence at 1 month. We hypothesized that greater caregiver-reported self-efficacy would be positively associated with CPAP adherence in children. We also evaluated patient-reported self-efficacy and caregiver- and patient-reported risk perception and outcome expectations as they related to adherence, as well as how demographic factors influenced these relationships. A pediatric modification of the Self-Efficacy Measure for Sleep Apnea Questionnaire was administered to children and adolescents with OSAS-prescribed CPAP and their caregivers during the clinical CPAP-initiation visit. The primary outcome variable for adherence was the average total minutes of CPAP usage across all days from the date that CPAP was initiated to 31 days later. Unadjusted ordinary least-square regression showed a significant association between caregiver-reported self-efficacy and adherence (p = .007), indicating that mean daily CPAP usage increased by 48.4 minutes when caregiver-reported self-efficacy increased by one point (95% confidence interval 13.4-83.4 minutes). No other caregiver- or patient-reported cognitive health variables were related to CPAP use. This study indicates that caregiver CPAP-specific self-efficacy is an important factor to consider when starting youth on CPAP therapy for OSAS. Employing strategies to improve caregiver self-efficacy, beginning at CPAP initiation, may promote CPAP adherence. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  12. SU-E-J-115: Graticule for Verification of Treatment Position in Neutron Therapy.

    Science.gov (United States)

    Halford, R; Snyder, M

    2012-06-01

    Until recently the treatment verification for patients undergoing fast neutron therapy at our facility was accomplished through a combination of neutron beam portal films aligned with a graticule mounted on an orthronormal x-ray tube. To eliminate uncertainty with respect to the relative positions of the x-ray graticule and the therapy beam, we have developed a graticule which is placed in the neutron beam itself. For a graticule to be visible on the portal film, the attenuation of the neutron beam by the graticule landmarks must be significantly greater than that of the material in which the landmarks are mounted. Various materials, thicknesses, and mounting points were tried to gain the largest contrast between the graticule landmarks and the mounting material. The final design involved 2 inch steel pins of 0.125 inch diameter captured between two parallel plates of 0.25 inch thick clear acrylic plastic. The distance between the two acrylic plates was 1.625 inches, held together at the perimeter with acrylic sidewall spacers. This allowed the majority of length of the steel pins to be surrounded by air. The pins were set 1 cm apart and mounted at angles parallel to the divergence of the beam dependent on their position within the array. The entire steel pin and acrylic plate assembly was mounted on an acrylic accessory tray to allow for graticule alignment. Despite the inherent difficulties in attenuating fast neutrons, our simple graticule design produces the required difference of attenuation between the arrays of landmarks and the mounting material. The graticule successfully provides an in-beam frame of reference for patient portal verification. © 2012 American Association of Physicists in Medicine.

  13. Presence of Anxiety and Depression Symptoms Affects the First Time Treatment Efficacy and Recurrence of Benign Paroxysmal Positional Vertigo.

    Science.gov (United States)

    Wei, Wei; Sayyid, Zahra N; Ma, Xiulan; Wang, Tian; Dong, Yaodong

    2018-01-01

    To investigate the possible effects of anxiety and/or depression symptoms on the treatment outcomes and recurrence of benign paroxysmal positional vertigo (BPPV). This is a retrospective study conducted at a single institution. 142 consecutive patients diagnosed with idiopathic BPPV at the Department of Otology in Shengjing Hospital of China Medical University between October 2016 and July 2017 were retrospectively reviewed. 127 patients were finally included in this study. Zung self-rating anxiety scale (SAS) and Zung self-rating depression scale (SDS) were used to evaluate the presence of anxiety and/or depression, respectively, in our BPPV patients. A significant score (at or above 50 for SAS and 53 for SDS) represents the presence of clinically significant symptoms. Two-tailed Student's t -test, χ 2 test, and logistic regression analysis were used as appropriate. A p value less than 0.05 was considered statistically significant. The prevalence of anxiety and/or depression symptoms in BPPV patients in the present study was 49.61%. The effectiveness of the first time canalith repositioning maneuver (CRM) was 70.08%. With weekly follow-up treatments of CRM, the success rate increased to 97.64% by 1 month. The total recurrence rate at 6-month follow-up post-cure was 14.17%. Holding all other variables constant, patients with psychiatric symptoms (Relative-risk ratio: 3.160; p  = 0.027) and patients with non-posterior semicircular canal (PSC) involvement (Relative-risk ratio: 7.828, p  = 0.013) were more likely to experience residual dizziness (RD) even after effective CRM treatment. Psychiatric symptoms (Relative-risk ratio: 6.543; p  = 0.001) and female gender (Relative-risk ratio: 4.563; p  = 0.010) are risk factors for the failure of first time CRM. In addition, BPPV patients with psychiatric symptoms (Odds ratio: 9.184, p  = 0.008) were significantly more likely to experience recurrences within the first 6 months after a successful

  14. Presence of Anxiety and Depression Symptoms Affects the First Time Treatment Efficacy and Recurrence of Benign Paroxysmal Positional Vertigo

    Directory of Open Access Journals (Sweden)

    Wei Wei

    2018-03-01

    Full Text Available ObjectivesTo investigate the possible effects of anxiety and/or depression symptoms on the treatment outcomes and recurrence of benign paroxysmal positional vertigo (BPPV.MethodsThis is a retrospective study conducted at a single institution. 142 consecutive patients diagnosed with idiopathic BPPV at the Department of Otology in Shengjing Hospital of China Medical University between October 2016 and July 2017 were retrospectively reviewed. 127 patients were finally included in this study. Zung self-rating anxiety scale (SAS and Zung self-rating depression scale (SDS were used to evaluate the presence of anxiety and/or depression, respectively, in our BPPV patients. A significant score (at or above 50 for SAS and 53 for SDS represents the presence of clinically significant symptoms. Two-tailed Student’s t-test, χ2 test, and logistic regression analysis were used as appropriate. A p value less than 0.05 was considered statistically significant.ResultsThe prevalence of anxiety and/or depression symptoms in BPPV patients in the present study was 49.61%. The effectiveness of the first time canalith repositioning maneuver (CRM was 70.08%. With weekly follow-up treatments of CRM, the success rate increased to 97.64% by 1 month. The total recurrence rate at 6-month follow-up post-cure was 14.17%. Holding all other variables constant, patients with psychiatric symptoms (Relative-risk ratio: 3.160; p = 0.027 and patients with non-posterior semicircular canal (PSC involvement (Relative-risk ratio: 7.828, p = 0.013 were more likely to experience residual dizziness (RD even after effective CRM treatment. Psychiatric symptoms (Relative-risk ratio: 6.543; p = 0.001 and female gender (Relative-risk ratio: 4.563; p = 0.010 are risk factors for the failure of first time CRM. In addition, BPPV patients with psychiatric symptoms (Odds ratio: 9.184, p = 0.008 were significantly more likely to experience recurrences within the first 6

  15. Modification of First-line Antiretroviral Therapy in Treatment-naive, HIV Positive Patients

    Directory of Open Access Journals (Sweden)

    Smita Shenoy

    2017-10-01

    Full Text Available Introduction: Modification of initial Antiretroviral Therapy (ART program is an important issue in HIV infected patients as the number of ART regimens available is limited. Hence, there is a need to understand the factors that affect modification and therefore, the durability of the initial antiretroviral regimen. Aim: To study the type of modification of first line ART in treatment-naive HIV positive patients and factors influencing it. Materials and Methods: A retrospective observational study was carried out in the HIV clinic of a tertiary care hospital, using data obtained from the case records of the subjects who were initiated on ART between January 2012 to December 2014. Data on patient baseline characteristics, proportion of patients who required modification, type and time of modification was collected. The determinants of time to modification were analysed using Chi-square test. Binomial logistic regression was utilized to assess independent risk factors for change in regimen. Results: Out of 200 case records analysed, 54 patients had to undergo a modification in their initial regimen. The mean age of patients was 44.68 ± 11.31 years. Majority of the patients were males. The most common reason for modification was Adverse Drug Reactions (ADRs (79.63% followed by treatment failure (9.25%. In 85.18% cases, modification involved substitution. Occurrence of ADRs and non-tenofovir based first-line regimens were associated with higher likelihood of substitution in regimen (p<0.05. The median time (IQR to modification was 173 (152.25, 293.50 days. Conclusion: ADRs and the use of non-tenofovir based regimens resulted in significantly higher rates of modification of antiretroviral therapy. There should be monitoring of patients on ART to detect ADRs at the earliest and to obtain increased use of single tablet containing tenofovir based regimen to improve durability of first line regimens.

  16. Cost of vitamin K antagonist anticoagulant treatment in patients with metallic prosthetic valve in mitral position.

    Science.gov (United States)

    Ene, Gabriela; Garcia Raso, Aránzazu; Gonzalez-Dominguez Weber, Almudena; Hidalgo-Vega, Álvaro; Llamas, Pilar

    2016-01-01

    The initiation of oral anticoagulation therapy after valve replacement surgery requires strict monitoring because these patients are at high risk for the development of thrombotic complications and present an increased risk of bleeding. The aim of this study was to examine the total healthcare costs of oral anticoagulant treatment with vitamin K antagonists in patients with metallic prosthetic valves in the mitral position. Data from clinical records were used in the study including international normalized ratio results, number of medical visits, type of anticoagulant, use of rescue medication and hospital admissions from related complications. The drug cost was calculated based on the official Spanish Ministry of Health price list. Monitoring expenses were included in the cost of the medical supplies used in the procedures. Hospitalization costs were calculated using the diagnosis-related group price for each case. We collected data from 151 patients receiving oral anticoagulation therapy with vitamin K antagonist who were diagnosed with mitral prosthesis (n = 90), mitro-aortic prosthesis (n = 57), and mitral and tricuspid prosthesis (n = 4). The total direct healthcare cost was €15302.59, with a mean total cost per patient per year of €1558.15 (±2774.58) consisting of 44.38 (±42.30) for drug cost, €71.41 (±21.43) for international normalized ratio monitoring, €429.52 (±126.87) for medical visits, €26.31 (±28.38) for rescue medication and €986.53 (±2735.68) for related complications. Most direct healthcare costs associated with the sampled patients arose from the specialist-care monitoring required for treatment. Good monitoring is inversely related to direct healthcare costs.

  17. Cost of vitamin K antagonist anticoagulant treatment in patients with metallic prosthetic valve in mitral position

    Directory of Open Access Journals (Sweden)

    Gabriela Ene

    2016-08-01

    Full Text Available Background: The initiation of oral anticoagulation therapy after valve replacement surgery requires strict monitoring because these patients are at high risk for the development of thrombotic complications and present an increased risk of bleeding. Objectives: The aim of this study was to examine the total healthcare costs of oral anticoagulant treatment with vitamin K antagonists in patients with metallic prosthetic valves in the mitral position. Methods: Data from clinical records were used in the study including international normalized ratio results, number of medical visits, type of anticoagulant, use of rescue medication and hospital admissions from related complications. The drug cost was calculated based on the official Spanish Ministry of Health price list. Monitoring expenses were included in the cost of the medical supplies used in the procedures. Hospitalization costs were calculated using the diagnosis-related group price for each case. Results: We collected data from 151 patients receiving oral anticoagulation therapy with vitamin K antagonist who were diagnosed with mitral prosthesis (n = 90, mitro-aortic prosthesis (n = 57, and mitral and tricuspid prosthesis (n = 4. The total direct healthcare cost was €15302.59, with a mean total cost per patient per year of €1558.15 (±2774.58 consisting of 44.38 (±42.30 for drug cost, €71.41 (±21.43 for international normalized ratio monitoring, €429.52 (±126.87 for medical visits, €26.31 (±28.38 for rescue medication and €986.53 (±2735.68 for related complications. Conclusion: Most direct healthcare costs associated with the sampled patients arose from the specialist-care monitoring required for treatment. Good monitoring is inversely related to direct healthcare costs.

  18. Effects of Negative and Positive Evidence on Adult Word Learning

    Science.gov (United States)

    Strapp, Chehalis M.; Helmick, Augusta L.; Tonkovich, Hayley M.; Bleakney, Dana M.

    2011-01-01

    This study compared negative and positive evidence in adult word learning, predicting that adults would learn more forms following negative evidence. Ninety-two native English speakers (32 men and 60 women [M[subscript age] = 20.38 years, SD = 2.80]), learned nonsense nouns and verbs provided within English frames. Later, participants produced…

  19. Endocarditis : Effects of routine echocardiography during Gram-positive bacteraemia

    NARCIS (Netherlands)

    Vos, F J; Bleeker-Rovers, C P; Sturm, P D; Krabbe, P F M; van Dijk, A P J; Oyen, W J G; Kullberg, B J

    2011-01-01

    BACKGROUND: Despite firm recommendations to perform echocardiography in high-risk patients with Gram-positive bacteraemia, routine echocardiography is not embedded in daily practice in many settings. The aim of this study was to evaluate whether a regime including routine echocardiography results in

  20. Lack of immunomodulating effect of disulfiram on HIV positive patients

    DEFF Research Database (Denmark)

    Hørding, M; Gøtzsche, P C; Bygbjerg, Ib Christian

    1990-01-01

    Disulfiram (Antabuse (R)) is metabolized to two molecules of diethyldithiocarbamate, which has been reported to be an immunomodulating agent. In a double blind trial, 15 HIV antibody positive homosexual men were given daily doses of 100 mg or 400 mg of disulfiram or placebo, for 4 weeks. All had...

  1. Antitumour effects of combined radio- and parvovirotherapy in N-Ras-positive tumour cells

    International Nuclear Information System (INIS)

    Angelova, A.; Galabov, A.; Rommelaere, J.; Raykov, Z.

    2007-01-01

    Many innovative approaches have attempted to challenge the dominant position of surgery, chemotherapy and radiotherapy as the major therapeutic modalities to treat cancer. However, only recently some new agents have appeared that achieve effects comparable to the ones of these established treatments. A novel class of such therapeutics consists of oncolytic viruses with several main representatives, namely adeno-, herpes, reo- and parvovirus. The latter class of anticancer agents has proven to be quite effective in many preclinical models and is now considered for a phase I clinical trial in patients with glioma and pancreatic cancer. An important question to be answered is whether virotherapy can be combined with standard treatments to achieve an enhanced antitumor effect still at a low level of toxicity. Here we present data concerning the application of irradiation together with H-1PV parvovirus infection comparing their toxic effects on normal and Ras -transformed fibroblasts. This proved to be a potent combination achieving high level of synergistic toxicity on transformed cells at doses, which did not affect the viability of normal human fibroblasts. This strategy holds promise to become a part of the clinical treatment of radioresistant tumours. (authors)

  2. Effectiveness of Positive Psychotherapy in Improving Opiate Addicts’ Quality of Life

    Directory of Open Access Journals (Sweden)

    P Porzoor

    2016-02-01

    Full Text Available Objective: This study was aimed to assess the effectiveness of positive psychotherapy based on quality of life in improving opiate addicts’ quality of life. Method: A quasi experimental research design long with control group and pre-test, post-test and follow-up was employed for the conduct of this study. All the opiate addicts referring to treatment centers of Ardebil city in 2013 constituted the statistical population of the study and the number of 36 participants was selected as the sample via purposive sampling and randomly assigned into experimental and control groups. Quality-of-life-based psychotherapy was conducted on the experimental group in 8 sessions while the control group received no intervention. Quality of life questionnaire was used for data collection purposes. Results: The results suggested the effectiveness of the intervention in quality of life. Conclusion: This intervention, which is formed from the combination positive psychology and cognitive-behavioral approach, can be used as an effective treatment method.

  3. Advances in surface treatments: Technology, applications, effects

    International Nuclear Information System (INIS)

    Niku-Lari, A.

    1987-01-01

    An international handbook has been produced to include all aspects of residual stresses, including the theoretical background, effects of residual stresses, measurement and calculation and quantitative assessment of residual stress effects. Techniques for altering residual stresses, particularly surface treatments, are discussed. Up to date information on the state of the art is presented. (UK)

  4. Conventional treatment of functional constipation has a positive impact on the behavioural difficulties in children with and without faecal incontinence

    DEFF Research Database (Denmark)

    Modin, Line; Jakobsen, Ida Skytte; Jakobsen, Marianne Skytte

    2016-01-01

    AIM: Constipation studies have only evaluated behavioural difficulties in children with faecal incontinence. This study evaluated changes in behavioural difficulties in childhood with functional constipation (FC) with and without faecal incontinence, based on treatment outcomes. METHODS: Children...... treatment of FC had a positive impact on behavioural difficulties in constipated children with and without faecal incontinence. This study highlights the importance of proactive detection and treatment of FC in paediatric patients....

  5. Plants used in Guatemala for the treatment of respiratory diseases. 1. Screening of 68 plants against gram-positive bacteria.

    Science.gov (United States)

    Caceres, A; Alvarez, A V; Ovando, A E; Samayoa, B E

    1991-02-01

    Respiratory ailments are important causes of morbidity and mortality in developing countries. Ethnobotanical surveys and literature reviews conducted in Guatemala during 1986-88 showed that 234 plants from 75 families, most of them of American origin, have been used for the treatment of respiratory ailments. Three Gram-positive bacteria causing respiratory infections (Staphylococcus aureus, Streptococcus pneumoniae and Streptococcus pyogenes) were used to screen 68 of the most commonly used plants for activity. Twenty-eight of these (41.2%) inhibited the growth of one or more of the bacteria tested. Staphylococcus aureus was inhibited by 18 of the plant extracts, while 7 extracts were effective against Streptococcus pyogenes. Plants of American origin which exhibited antibacterial activity were: Gnaphalium viscosum, Lippia alba, Lippia dulcis, Physalis philadelphica, Satureja brownei, Solanum nigrescens and Tagetes lucida. These preliminary in vitro results provide scientific basis for the use of these plants against bacterial respiratory infections.

  6. Positional changes of maxillary central incisors following orthodontic treatment using single-crown implants as fixed reference markers

    DEFF Research Database (Denmark)

    Brahem Ben, Elissa; Holm, Bente; Sonnesen, L

    2017-01-01

    OBJECTIVES: This follow-up study (1) compares tooth displacement of central incisors in patients with and without pre-implant orthodontic treatment and (2) investigates whether sex, age, or orthodontic retention have an effect on tooth displacement after the insertion of single-crown implants...... during baseline examinations after prosthetic rehabilitation and at the final follow-up examination at least 5 years later. A total of 114 dental casts were digitalized and aligned using a software program to measure changes in the positions of the central incisors. RESULTS: After a follow-up period......, and there were no significant correlations with patient age or sex. CONCLUSION: The majority of patients had minor vertical (60%) or horizontal (67%) tooth displacement of the central incisors (0.25-0.75 mm) after a minimum follow-up period of 5 years. This study found no significant differences in tooth...

  7. Clinical characteristics and treatment outcomes for benign paroxysmal positional vertigo comorbid with hypertension.

    Science.gov (United States)

    Tan, Jun; Deng, Yuxiao; Zhang, Tianyu; Wang, Menghong

    2017-05-01

    Patients with BPPV comorbid with hypertension (h-BPPV) tend to receive a delayed diagnosis of BPPV. Comorbidity with hypertension did not influence the efficacy of the repositioning maneuver; however, comorbidity with hypertension was associated with an increased recurrence rate of BPPV. To determine the clinical characteristics and outcomes of h-BPPV, as well as the clinical differences between h-BPPV and idiopathic BPPV (i-BPPV). The authors reviewed the medical records of 41 consecutive patients with h-BPPV (the h-BPPV group) from March to December 2014 and 47 patients with i-BPPV (the i-BPPV group) during the same period. There were no significant differences in age, sex ratio, or the affected side between the h-BPPV and i-BPPV groups. The proportion of patients reporting an initial episode of positional vertigo was significantly lower in the h-BPPV group (51.22% vs 74.47%; p = .024). Patients in the h-BPPV group reported a longer median episode duration than did those in the i-BPPV group (60 days vs 15 days; p = .017). The results of treatment using repositioning maneuvers were similar between the two groups. At follow-up, 13 patients in the h-BPPV group were diagnosed with recurrent BPPV compared with six in the i-BPPV group (p = .031).

  8. Design, building and test of one prototype and four final position sensor assemblies: Hall effect position sensors

    Science.gov (United States)

    1976-01-01

    This report covers the development of a three channel Hall effect position sensing system for the commutation of a three phase dc torquer motor. The effort consisted of the evaluation, modification and re-packaging of a commercial position sensor and the design of a target configuration unique to this application. The resulting design meets the contract requirements and, furthermore, the test results indicate not only the practicality and versatility of the design, but also that there may be higher limits of resolution and accuracy achievable.

  9. The Benefit of Mirtazapine in the Treatment of Progressive Multifocal Leukoencephalopathy in a Young HIV-positive Patient

    Science.gov (United States)

    Miranda, Jorge; Sandoval, Hugo; Ramos-Duran, Luis; Tonarelli, Silvina B.

    2018-01-01

    Highly active antiretroviral therapy is well-established in the treatment of human immunodeficiency virus (HIV)-positive patients. Nonadherence with therapy regimens often leads to the occurrence of opportunistic infections that further complicate treatment and challenge the treating physician. We report a young HIV-positive patient who suffered from progressive multifocal leukoencephalopathy caused by the human John Cunningham virus and showed objective clinical improvement after adding mirtazapine to the treatment regimen, an observation that is supported by the emerging literature. PMID:29497578

  10. Investigation of positive roles of hydrogen plasma treatment for interface passivation based on silicon heterojunction solar cells

    International Nuclear Information System (INIS)

    Zhang, Liping; Liu, Wenzhu; Liu, Jinning; Shi, Jianhua; Meng, Fanying; Liu, Zhengxin; Guo, Wanwu; Bao, Jian

    2016-01-01

    The positive roles of H 2 -plasma treatment (HPT) have been investigated by using different treatment procedures in view of the distinctly improved passivation performance of amorphous-crystalline silicon heterojunctions (SHJs). It has been found that a hydrogenated amorphous silicon thin film and crystalline silicon (a-Si:H/c-Si) interface with a high stretching mode (HSM) is detrimental to passivation. A moderate pre-HPT introduces atomic H, which plays an effective tuning role in decreasing the interfacial HSM; unfortunately, an epitaxial layer is formed. Further improvement in passivation can be achieved in terms of increasing the HSM of a-Si:H film treated by appropriate post-HPT based on the a-Si:H thickness. The minority carrier lifetime of crystalline wafers can be improved by treated films containing a certain quantity of crystallites. The microstructure factor R and the maximum intensity of the dielectric function ε 2max have been found to be critical microstructure parameters that describe high-quality a-Si:H passivation layers, which are associated with the amorphous-to-microcrystalline transition phase induced by multi-step HPT. Finally, the open circuit voltage and conversion efficiency of the SHJ solar cell can be improved by implementing an effective HPT process. (paper)

  11. Treatment of Type 2 Diabetes: From "Guidelines" to "Position Statements" and Back: Recommendations of the Israel National Diabetes Council.

    Science.gov (United States)

    Mosenzon, Ofri; Pollack, Rena; Raz, Itamar

    2016-08-01

    Given the increased prevalence of type 2 diabetes worldwide, most patients are treated by their primary health care team (PHCT). PHCTs need guidance in choosing the best treatment regimen for patients, since the number of glucose-lowering agents (GLAs) is rapidly increasing, as is the amount of clinical data regarding these drugs. The American Diabetes Association/European Association for the Study of Diabetes Position Statement emphasizes the importance of personalized treatment and lists drug efficacy, risk of hypoglycemia, effect on weight, side effects, and cost as important parameters to consider when choosing GLAs. The suggested Israeli guidelines refocus earlier international recommendations from 2012 and 2015, based on emerging data from cardiovascular outcome trials as well as what we believe are important issues for patient care (i.e., durability, hypoglycemia risk, and weight gain). © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  12. Effectiveness of Otolith Repositioning Maneuvers and Vestibular Rehabilitation exercises in elderly people with Benign Paroxysmal Positional Vertigo: a systematic review

    OpenAIRE

    Ribeiro, Karyna Figueiredo; Oliveira, Bruna Steffeni; Freitas, Raysa V.; Ferreira, Lidiane M.; Deshpande, Nandini; Guerra, Ricardo O.

    2018-01-01

    Abstract Introduction Benign Paroxysmal Positional Vertigo is highly prevalent in elderly people. This condition is related to vertigo, hearing loss, tinnitus, poor balance, gait disturbance, and an increase in risk of falls, leading to postural changes and quality of life decreasing. Objective To evaluate the outcomes obtained by clinical trials on the effectiveness of Otolith Repositioning Maneuver and Vestibular Rehabilitation exercises in the treatment of Benign Paroxysmal Positional Ve...

  13. Positive Effects of Negative Publicity: When Negative Reviews Increase Sales

    OpenAIRE

    Jonah Berger; Alan T. Sorensen; Scott J. Rasmussen

    2010-01-01

    Can negative information about a product increase sales, and if so, when? Although popular wisdom suggests that "any publicity is good publicity," prior research has demonstrated only downsides to negative press. Negative reviews or word of mouth, for example, have been found to hurt product evaluation and sales. Using a combination of econometric analysis and experimental methods, we unify these perspectives to delineate contexts under which negative publicity about a product will have posit...

  14. Positioning SGLT2 Inhibitors/Incretin-Based Therapies in the Treatment Algorithm.

    Science.gov (United States)

    Wilding, John P H; Rajeev, Surya Panicker; DeFronzo, Ralph A

    2016-08-01

    Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are the most recent addition to the therapeutic options available for the treatment of type 2 diabetes and became available after the introduction of incretin-based therapies, dipeptidyl peptidase 4 inhibitors and glucagon-like peptide 1 receptor agonists (GLP-1 RAs). These agents have potential advantages with regard to their weight loss-promoting effect, low risk of hypoglycemia, reduction in blood pressure, and reduction in cardiovascular events in high-risk patients (with empagliflozin). Apart from these clinically important outcomes, they may also correct core defects present in type 2 diabetes (i.e., improvement in β-cell function and insulin sensitivity). They do, however, have some adverse effects, notably, nausea with GLP-1 RAs and genital tract infections and potential for volume depletion with SGLT2i. Whether incretin-based therapies are associated with an increased risk of pancreatitis is unclear. Most recently, diabetic ketoacidosis has been reported with SGLT2i. Therefore, a key clinical question in relation to guidelines is whether these clinical advantages, in the context of the adverse effect profile, outweigh the additional cost compared with older, more established therapies. This article reviews the therapeutic rationale for the use of these newer drugs for diabetes treatment, considers their place in current guidelines, and discusses how this may change as new data emerge about their long-term efficacy and safety from ongoing outcome trials. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  15. Comparison between epleys maneuvre and prochlorperazine maleate in treatment of benign paroxysmal positional vertigo

    International Nuclear Information System (INIS)

    Niazi, K.O.K.; Dastgir, M.

    2015-01-01

    The objective is to compare the efficacy of Epley's maneuver and vestibular sedative, prochlorperazine maleate in the management of benign paroxysmal positional vertigo (BPPV). Study Design: Randomized Control Trial. Place and Duration of Study: ENT department, Combined Military Hospital, Rawalpindi from 1st May 2011 to 1st November 2011. Patients and Methods: After consent, 60 patients of BPPV fulfilling the inclusion criteria were randomly allotted two groups. Group A was treated with Epley's maneuver (n=30) while group B with prochlorperazine maleate (n=30). Outcomes were analyzed on disappearance of vertigo at follow-up examination. Results: 24 (80%) cases managed by Epley's maneuver showed relief of symptoms while only 14 (47%) treated by rochlorperazine maleate showed recovery after 15 days. Conclusion: Epley's maneuver was more effective than vestibular sedatives like prochlorperazine maleate in treating patients of BPPV. (author)

  16. Treatment of sleep-disordered breathing with positive airway pressure devices: technology update.

    Science.gov (United States)

    Johnson, Karin Gardner; Johnson, Douglas Clark

    2015-01-01

    Many types of positive airway pressure (PAP) devices are used to treat sleep-disordered breathing including obstructive sleep apnea, central sleep apnea, and sleep-related hypoventilation. These include continuous PAP, autoadjusting CPAP, bilevel PAP, adaptive servoventilation, and volume-assured pressure support. Noninvasive PAP has significant leak by design, which these devices adjust for in different manners. Algorithms to provide pressure, detect events, and respond to events vary greatly between the types of devices, and vary among the same category between companies and different models by the same company. Many devices include features designed to improve effectiveness and patient comfort. Data collection systems can track compliance, pressure, leak, and efficacy. Understanding how each device works allows the clinician to better select the best device and settings for a given patient. This paper reviews PAP devices, including their algorithms, settings, and features.

  17. Analytical and numerical studies of positive ion beam expansion for surface treatment applications

    Science.gov (United States)

    Lounes-Mahloul, Soumya; Bendib, Abderrezeg; Oudini, Noureddine

    2018-01-01

    The aim of this work is to study the expansion in vacuum, of a positive ion beam with the use of one dimensional (1D) analytic model and a two dimensional Particle-In-Cell (2D-PIC) simulation. The ion beam is extracted and accelerated from preformed plasma by an extraction system composed of two polarized parallel perforated grids. The results obtained with both approaches reveal the presence of a potential barrier downstream the extraction system which tends to reflect the ion flux. The dependence of the critical distance for which all extracted ions are reflected, is investigated as a function of the extracted ion beam current density. In particular, it is shown that the 1D model recovers the well-known Child-Langmuir law and that the 2D simulation presents a significant discrepancy with respect to the 1D prediction. Indeed, for a given value of current density, the transverse effects lead to a greater critical distance.

  18. Neural effects of positive and negative incentives during marijuana withdrawal.

    Directory of Open Access Journals (Sweden)

    Francesca M Filbey

    Full Text Available In spite of evidence suggesting two possible mechanisms related to drug-seeking behavior, namely reward-seeking and harm avoidance, much of the addiction literature has focused largely on positive incentivization mechanisms associated with addiction. In this study, we examined the contributing neural mechanisms of avoidance of an aversive state to drug-seeking behavior during marijuana withdrawal. To that end, marijuana users were scanned while performing the monetary incentive delay task in order to assess positive and negative incentive processes. The results showed a group x incentive interaction, such that marijuana users had greater response in areas that underlie reward processes during positive incentives while controls showed greater response in the same areas, but to negative incentives. Furthermore, a negative correlation between withdrawal symptoms and response in the amygdala during negative incentives was found in the marijuana users. These findings suggest that although marijuana users have greater reward sensitivity and less harm avoidance than controls, that attenuated amygdala response, an area that underlies fear and avoidance, was present in marijuana users with greater marijuana withdrawal symptoms. This is concordant with models of drug addiction that involve multiple sources of reinforcement in substance use disorders, and suggests the importance of strategies that focus on respective mechanisms.

  19. Effect of continuous positive airway pressure ventilation on prethrombotic state in patients with obstructive sleep apnea-hypopnea syndrome

    International Nuclear Information System (INIS)

    Guo Dianbao; Chen Xiangkun; Sheng Chunyong; Zhang Yingying

    2009-01-01

    To investigate the prethrombotic state (PTS) in patients with obstructive sleep apnea syndrome (OS-AS) and the effect of continuous positive airway pressure ventilation (CPAP) on their PTS, the blood samples of 49 patients with OSAS were taken before treatment and on day 30 after treatment respectively. The platelet aggregation ( PAG), P-selections, endothdlin-1 (ET-1) and plasma vom willebrand factor (vWF) in 49 patients and 42 health controls were detected by radioimmunoassay and enzyme-immunoassay. The results showed that the PAG, P-selections, ET-1 and vWF in patients with OSAS before treatment were significantly higher than those after treatment and in control group (P 0.05). The results indicate that there were PTS in most patients with OSAS before treatment. The activity of platelet could be corrected, and the function of endotheliocyte could be repaired after CPAP treatment. It had certain effect in lightening the clinical symptoms. (authors)

  20. Comparison of Radiation Treatment Plans for Breast Cancer between 3D Conformal in Prone and Supine Positions in Contrast to VMAT and IMRT Supine Positions

    Science.gov (United States)

    Bejarano Buele, Ana Isabel

    The treatment regimen for breast cancer patients typically involves Whole Breast Irradiation (WBI). The coverage and extent of the radiation treatment is dictated by location of tumor mass, breast tissue distribution, involvement of lymph nodes, and other factors. The current standard treatment approach used at our institution is a 3D tangential beam geometry, which involves two fields irradiating the breast, or a four field beam arrangement covering the whole breast and involved nodes, while decreasing the dose to organs as risk (OARs) such as the lung and heart. The coverage of these targets can be difficult to achieve in patients with unfavorable thoracic geometries, especially in those cases in which the planning target volume (PTV) is extended to the chest wall. It is a well-known fact that exposure of the heart to ionizing radiation has been proved to increase the subsequent rate of ischemic heart disease. In these cases, inverse planned treatments have become a proven alternative to the 3D approach. The goal of this research project is to evaluate the factors that affect our current techniques as well as to adapt the development of inverse modulated techniques for our clinic, in which breast cancer patients are one of the largest populations treated. For this purpose, a dosimetric comparison along with the evaluation of immobilization devices was necessary. Radiation treatment plans were designed and dosimetrically compared for 5 patients in both, supine and prone positions. For 8 patients, VMAT and IMRT plans were created and evaluated in the supine position. Skin flash incorporation for inverse modulated plans required measurement of the surface dose as well as an evaluation of breast volume changes during a treatment course. It was found that prone 3D conformal plans as well as the VMAT and IMRT plans are generally superior in sparing OARs to supine plans with comparable PTV coverage. Prone setup leads to larger shifts in breast volume as well as in

  1. Barriers to condom purchasing: Effects of product positioning on reactions to condoms.

    Science.gov (United States)

    Scott-Sheldon, Lori A J; Glasford, Demis E; Marsh, Kerry L; Lust, Sarah A

    2006-12-01

    Correct and consistent condom use has been promoted as a method to prevent sexually transmitted infections including HIV. Yet research has repeatedly shown that people fail to use condoms consistently. One influence on the pervasive lack of condom use that has received relatively little attention is the context in which consumers are exposed to condoms (i.e., how condoms are displayed in retail settings). In this paper we present two studies explored variations in condom shelf placement and its effects on people's condom attitudes and acquisition. Study 1 explored the shelf placement of condoms in 59 retail outlets in Connecticut, USA and found that condoms were typically located in areas of high visibility (e.g., next to the pharmacy counter) and on shelves adjacent to feminine hygiene and disease treatment products. In Study 2, 120 heterosexual undergraduate students at the University of Connecticut were randomly assigned to evaluate condoms adjacent to sensual, positive, neutral, or negative products and found that overall men reported more positive attitudes and acquired more condoms when exposed to condoms in a sensual context compared to women in the same condition. Among women, condom attitudes were more positive in the context of neutral products; condom acquisition was strongest for women exposed to condoms in the positive aisles. These results suggest a gender-specific approach to condom promotion. Implications of these studies for HIV prevention, public health, and condom marketing strategies are discussed.

  2. Effects of positive and negative delusional ideation on memory.

    Science.gov (United States)

    Sugimori, Eriko; Tanno, Yoshihiko

    2010-04-01

    We investigated the relationship between levels of delusional ideation (whether positive or negative delusions) and the activation and distortion of memory by using pairs of positive and negative adjectives describing personality traits where those adjectives had similar meanings. We presented one of each pair of adjectives in the learning phase. Immediately after the learning phase in Experiment 1, we asked whether each adjective had been presented. Participants with high (positive or negative) delusional ideation were more likely to indicate that they had learned adjectives that they had not actually learned. This finding suggested that non-learned positive (or negative) adjectives that were associated with learned negative (or positive) adjectives were more likely to be activated in participants prone to positive (or negative) delusional ideation. However, in Experiment 2, two forced-choice tests were conducted immediately after the learning phase. In this context, participants, regardless of their proneness to delusional ideation, could almost always correctly distinguish what had and had not been presented, suggesting that the activation of learned items was still stronger than that for non-learned items in the immediate test. As time passed, the proportion of false alarms for positive or negative adjectives was higher in the two forced-choice tests among those with high proneness to (positive or negative) delusional ideation, suggesting that participants with delusional ideation were increasingly likely to depend on internal conditions for retrieval over time. Nous avons examiné la relation entre les niveaux d'idéation illusoire (qu'elle soit positive ou négative) et l'activation et la distorsion de la mémoire, en utilisant des paires d'adjectifs positifs et négatifs à significations similaires décrivant des traits de personnalité. Nous avons présenté un membre de chaque paire d'adjectifs lors d'une phase d'apprentissage. Dans une première exp

  3. Positive effects of Religious and Spiritual Coping on Bereavement

    Directory of Open Access Journals (Sweden)

    Laura Yoffe

    2015-09-01

    Full Text Available Antonovsky (1987 coined the term “salutogenesis” in opposition to “pathogenesis”, with the intention to point out to cientific researchers ways and mechanisms that could promote health, well -being and life satisfaction. The area of the Psychology of Religion and Spirituality began both in Europe and in the United States at the beginning of the twenth century. The research done in this field -since the last two decades- has focused on the relationships between religion, spirituality and health; and on the ways in which religious people cope with negative life events. We could think this area as a complementary one to the Positive Psychology; as both share certain common points of view about health, coping and well-being. In the field of the Psychology of Religion and Spirituality, Pargament and Koenig (1997 used the term “coping” -coined by Lazarus and Folkman (1986- referring to different styles of “religious coping” as “ways and mechanism by which religious people apply their religious beliefs and behaviours to prevent and /or moderate negative consequences of stressful life events, in order to solve their problems as well”. Each religion promotes ways to overcome negative life events, such as the death of loved ones. By using faith, prayers, meditations, religious rituals and beliefs about life, death and afterlife, religious persons try to cope with their grief and enhance positive feelings of emotional ,mental and spiritual well-being. Clergy of different religions are trained in religious practices, knowledge and skills to provide social support to those ones who face pain and loss. Religious groups can provide different types of emotional, practical, intelectual and spiritual support that can help diminish feelings of loneliness and grief. Being and feeling part of a religious community can promote ways to reconect to life and positive feelings that can help to overcome the grief of the death of loved ones and make

  4. Positional changes of maxillary central incisors following orthodontic treatment using single-crown implants as fixed reference markers.

    Science.gov (United States)

    Brahem, E B; Holm, B; Sonnesen, L; Worsaae, N; Gotfredsen, K

    2017-12-01

    This follow-up study (1) compares tooth displacement of central incisors in patients with and without pre-implant orthodontic treatment and (2) investigates whether sex, age, or orthodontic retention have an effect on tooth displacement after the insertion of single-crown implants. Fifty-seven patients - thirty-seven with (test group) and twenty without pre-implant orthodontic treatment (control group) - were rehabilitated with 89 single-crown implants in the upper maxilla. Clinical and radiographic data, clinical photographs, and dental casts were collected during baseline examinations after prosthetic rehabilitation and at the final follow-up examination at least 5 years later. A total of 114 dental casts were digitalized and aligned using a software program to measure changes in the positions of the central incisors. After a follow-up period of at least five years, 87% of the central incisors measured in the test group were displaced >0.25 mm vertically compared with 70% in the control group. Seventy-eight percent of the test group teeth had moved >0.25 mm horizontally compared with 55% in the control group. These differences were not significant, and there were no significant correlations with patient age or sex. The majority of patients had minor vertical (60%) or horizontal (67%) tooth displacement of the central incisors (0.25-0.75 mm) after a minimum follow-up period of 5 years. This study found no significant differences in tooth displacement comparing patients with and without pre-implant orthodontic treatment. No significant effect of sex, age, orthodontic retention, or implant location was observed on tooth displacement. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. SARS: systematic review of treatment effects.

    Directory of Open Access Journals (Sweden)

    Lauren J Stockman

    2006-09-01

    Full Text Available BACKGROUND: The SARS outbreak of 2002-2003 presented clinicians with a new, life-threatening disease for which they had no experience in treating and no research on the effectiveness of treatment options. The World Health Organization (WHO expert panel on SARS treatment requested a systematic review and comprehensive summary of treatments used for SARS-infected patients in order to guide future treatment and identify priorities for research. METHODS AND FINDINGS: In response to the WHO request we conducted a systematic review of the published literature on ribavirin, corticosteroids, lopinavir and ritonavir (LPV/r, type I interferon (IFN, intravenous immunoglobulin (IVIG, and SARS convalescent plasma from both in vitro studies and in SARS patients. We also searched for clinical trial evidence of treatment for acute respiratory distress syndrome. Sources of data were the literature databases MEDLINE, EMBASE, BIOSIS, and the Cochrane Central Register of Controlled Trials (CENTRAL up to February 2005. Data from publications were extracted and evidence within studies was classified using predefined criteria. In total, 54 SARS treatment studies, 15 in vitro studies, and three acute respiratory distress syndrome studies met our inclusion criteria. Within in vitro studies, ribavirin, lopinavir, and type I IFN showed inhibition of SARS-CoV in tissue culture. In SARS-infected patient reports on ribavirin, 26 studies were classified as inconclusive, and four showed possible harm. Seven studies of convalescent plasma or IVIG, three of IFN type I, and two of LPV/r were inconclusive. In 29 studies of steroid use, 25 were inconclusive and four were classified as causing possible harm. CONCLUSIONS: Despite an extensive literature reporting on SARS treatments, it was not possible to determine whether treatments benefited patients during the SARS outbreak. Some may have been harmful. Clinical trials should be designed to validate a standard protocol for dosage

  6. The Effects of a School-Wide Positive Behavior Intervention Support Program on the Intrinsic Motivation of Third Grade Students

    Science.gov (United States)

    Amis, Sarah Anne

    2013-01-01

    This research project sought to determine the effects of a School-Wide Positive Behavior Intervention Support program (SWPBIS) on the intrinsic motivation of third grade students in regard to student achievement, student behavior, and teacher perception. Students of two intermediate schools served as the treatment group and control group, and were…

  7. Effectiveness of the Triple P Positive Parenting Program on behavioral problems in children: A meta-analysis

    NARCIS (Netherlands)

    de Graaf, I.; Speetjens, P.; Smit, F.; de Wolff, M.; Tavecchio, L.

    2008-01-01

    The Triple P Positive Parenting Program is a multilevel parenting program to prevent and offer treatment for severe behavioral, emotional, and developmental problems in children. The aim of this meta-analysis is to assess the effectiveness of Triple P Level 4 interventions in the management of

  8. Decreasing the Burden of Side Effects Through Positive Message Framing: an Experimental Proof-of-Concept Study.

    Science.gov (United States)

    Wilhelm, Marcel; Rief, Winfried; Doering, Bettina K

    2018-05-21

    Informing patients about treatment side effects increases the occurrence and intensity of side effects. Since the obligatory informed consent procedure in drug treatments requires transparency and nocebo research suggests that the informed consent of a drug leads to an increased occurrence of the mentioned side effects, the aim of this proof of concept study was to determine the effect of two different framings of informed consent on the occurrence, intensity, and perceived threat of side effects. Healthy male participants (n = 80) were randomized to one of two framing groups. The positive framing group was informed that the common side effect dizziness was a sign that the drug had started to work, while the neutral framing group was told that dizziness is an unpleasant but well-known side effect. Side effects were measured after the administration of metoprolol, an antihypertensive agent. Post hoc moderator analyses investigated the effect of pre-existing negative beliefs about the general harm of medication on the framing manipulation. Metoprolol-specific drug-attributed side effects were rated significantly less threatening in the positive framing group. The between-group effect size (Cohen's d) was small (d = 0.38, p = 0.049). Exploratory post hoc moderator analyses suggest that participants who believed that medication is a source of harmful effects benefited from positive framing, compared to neutral framing of drug-attributed side effects. Positive framing was partially effective in decreasing specific side effect measures, particularly among participants with a tendency to believe that medicine is harmful. Informed consent procedures should therefore be personalized, focusing on patients with negative treatment beliefs.

  9. Estimating scaled treatment effects with multiple outcomes.

    Science.gov (United States)

    Kennedy, Edward H; Kangovi, Shreya; Mitra, Nandita

    2017-01-01

    In classical study designs, the aim is often to learn about the effects of a treatment or intervention on a single outcome; in many modern studies, however, data on multiple outcomes are collected and it is of interest to explore effects on multiple outcomes simultaneously. Such designs can be particularly useful in patient-centered research, where different outcomes might be more or less important to different patients. In this paper, we propose scaled effect measures (via potential outcomes) that translate effects on multiple outcomes to a common scale, using mean-variance and median-interquartile range based standardizations. We present efficient, nonparametric, doubly robust methods for estimating these scaled effects (and weighted average summary measures), and for testing the null hypothesis that treatment affects all outcomes equally. We also discuss methods for exploring how treatment effects depend on covariates (i.e., effect modification). In addition to describing efficiency theory for our estimands and the asymptotic behavior of our estimators, we illustrate the methods in a simulation study and a data analysis. Importantly, and in contrast to much of the literature concerning effects on multiple outcomes, our methods are nonparametric and can be used not only in randomized trials to yield increased efficiency, but also in observational studies with high-dimensional covariates to reduce confounding bias.

  10. Musical hallucinations: review of treatment effects

    Directory of Open Access Journals (Sweden)

    Jan eCoebergh

    2015-06-01

    Full Text Available AbstractBackground: Despite an increased scientific interest in musical hallucinations throughout the past 25 years, treatment protocols are still lacking. This may well be due to the fact that musical hallucinations have multiple causes, and that published cases are relatively rare.Objective: To review the effects of published treatment methods for musical hallucinations.Methods: A literature search yielded 175 articles discussing a total number of 516 cases, of which 147 articles discussed treatment in 276 individuals. We analysed the treatment results in relation to the aetiological factor considered responsible for the mediation of the musical hallucinations, i.e., idiopathic/hypoacusis, psychiatric disorder, brain lesion and other pathology, epilepsy or intoxication.Results: Musical hallucinations can disappear without intervention. When hallucinations are bearable, patients can be reassured without any other treatment. However, in other patients musical hallucinations are so disturbing that treatment is indicated. Distinct aetiological groups appear to respond differently to treatment. In the hypoacusis group, treating the hearing impairment can yield significant improvement and coping strategies (e.g. more acoustic stimulation are frequently helpful. Pharmacological treatment methods can also be successful, with antidepressants being more helpful than antiepileptics (which are still better than antipsychotics. The limited use of acetylcholinesterase inhibitors has looked promising. Musical hallucinations occurring as part of a psychiatric disorder tend to respond well to psychopharmacological treatments targeting the underlying disorder. Musical hallucinations experienced in the context of brain injuries and epilepsy tend to respond well to antiepileptics, but their natural course is often benign, irrespective of any pharmacological treatment. When intoxication is the main aetiological factor, it is important to stop or switch the

  11. Three-dimensional intrafractional movement of prostate measured during real-time tumor-tracking radiotherapy in supine and prone treatment positions

    International Nuclear Information System (INIS)

    Kitamura, Kei; Shirato, Hiroki; Seppenwoolde, Yvette; Onimaru, Rikiya; Oda, Makoto; Fujita, Katsuhisa; Shimizu, Shinichi; Shinohara, Nobuo; Harabayashi, Toru; Miyasaka, Kazuo

    2002-01-01

    affected by the respiratory cycle and is influenced by bowel movement in the prone position. Conclusion: The results of this study have confirmed that internal organ motion is less frequent in the supine position than in the prone position in the treatment of prostate cancer. RTRT would be useful in reducing uncertainty due to the effects of the respiratory cycle, especially in the prone position

  12. Cordycepin enhances Epstein-Barr virus lytic infection and Epstein-Barr virus-positive tumor treatment efficacy by doxorubicin.

    Science.gov (United States)

    Du, Yinping; Yu, Jieshi; Du, Li; Tang, Jun; Feng, Wen-Hai

    2016-07-01

    The consistent latent presence of Epstein-Barr virus (EBV) in tumor cells offers potential for virus-targeted therapies. The switch from the latent form of EBV to the lytic form in tumor cells can lead to tumor cell lysis. In this study, we report that a natural small molecule compound, cordycepin, can induce lytic EBV infection in tumor cells. Subsequently, we demonstrate that cordycepin can enhance EBV reactivating capacity and EBV-positive tumor cell killing ability of low dose doxorubicin. The combination of cordycepin and doxorubicin phosphorylates CCAAT/enhancer binding protein β (C/EBPβ) through protein kinase C (PKC)-p38 mitogen activated protein kinases (p38 MAPK) signaling pathway, and C/EBPβ is required for the activation of lytic EBV infection. Most importantly, an in vivo experiment demonstrates that the combination of cordycepin and doxorubicin is more effective in inhibiting tumor growth in SCID mice than is doxorubicin alone. Our findings establish that cordycepin can enhance the efficacy of conventional chemotherapy for treatment of EBV-positive tumors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Impact of educational strategies in positioning Samarium-153 EDTMP as a treatment for metastatic bone pain

    International Nuclear Information System (INIS)

    Seminario, C.; Morales, R.; Castro, M.; Cano, R.A.; Mendoza, G.

    2005-01-01

    , which has finished in December 2004. Three television spots were delivered to public: 'Hello, Doctor', which has a morning audience and in two interviews in news programs, with high rating performance. Five interviews were given in radio programs, one of them was for a feminine audience, three for general public and the other two with national impact. In every program a web page, an e-mail and a telephone number were given for consultation. In Nuclear Medicine Centers in Lima telephone calls have been received since the beginning of the campaign every day, up to date. In a year, a monthly conference was delivered to physicians. Samarium EDTMP treatment increased substantially after the campaign. The more significant means in mass media for changing management were patient education, continuous meetings with specialists and one of the television spots used ('Hello, doctor'), which continues to be delivered in the closed circuit TV network of the social security system. We conclude that repetitive educational strategies have a positive impact in delivering radiopharmaceuticals for bone pain palliation to patients with bone metastases

  14. [Undesired treatment effects in behavior group therapy: Frequency and spectrum].

    Science.gov (United States)

    Linden, M; Walter, M; Fritz, K; Muschalla, B

    2015-11-01

    Psychotherapy not only has positive but also negative effects, which is especially true for group psychotherapy due to psychodynamic and interactional processes. Using the UE-G questionnaire 71 patients who participated in cognitive behavioral group psychotherapy reported on negative experiences in the context of the group therapy. The answers were then validated in a qualitative interview. Of the patients 98.6% reported about at least one negative experience and 43.7% about severe or extremely severe negative experiences. Most prominent was the induction of hopelessness and demoralization by what patients saw and heard from other patients in the group. Burdensome and therefore undesired treatment effects are regularly seen in group psychotherapy, because of treatment or patient related factors. In any case they must be taken into account during treatment, in the training of group psychotherapists and in quality control.

  15. [Intraabdominal fat redistribution in long-term continuous positive airway pressure treatment in obstructive sleep apnea patients].

    Science.gov (United States)

    Català, Raquel; Ferré, Raimón; Sangenís, Sandra; Cabré, Anna; Hernández-Flix, Salvador; Masana, Lluís

    2016-06-03

    Obesity is the main risk factor for obstructive sleep apnoea (OSA). The aim was to evaluate the long-term effect of continuous positive airway pressure (CPAP) on intraabdominal fat distribution in OSA patients. Fifty OSA patients with and 35 without CPAP treatment criteria were followed-up for 2 years. Visceral and subcutaneous adipose tissue (VAT and SAT) and preaortic intraabdominal fat (PIF) were assessed by sonography. In the non CPAP treated group, SAT and VAT mean values didn't change, while a significantly PIF growth was observed (55.19 [23.44] vs. 63.45 [23.94] mm, P=.021). In the CPAP treated group, VAT and PIF mean were not changed, while SAT decreased significantly (11.29 [5.69] vs. 10.47 [5.71] mm, P=.012). Long-term CPAP treatment produces intraabdominal fat redistribution and is associated with an anthropometric profile of lower cardiovascular risk in OSA patients. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  16. The effects of betahistine in addition to epley maneuver in posterior canal benign paroxysmal positional vertigo.

    Science.gov (United States)

    Guneri, Enis Alpin; Kustutan, Ozge

    2012-01-01

    The purpose of this study is to evaluate the effects of betahistine in addition to Epley maneuver on the quality of life of patients with posterior semicircular canal benign paroxysmal positional vertigo (BPPV) of the canalithiasis type. Double-blind, randomized, controlled clinical trial. Academic university hospital. Seventy-two patients were enrolled in the study. The first group was treated with Epley maneuver only. The second group received placebo drug 2 times daily for 1 week in addition to Epley maneuver, and the third group received 24 mg betahistine 2 times daily for 1 week in addition to Epley maneuver. The effectiveness of the treatments was assessed in each group as well as between them by analyzing and comparing data of 4 different vertigo symptom scales. Epley maneuver, alone or combined with betahistine or placebo, was found to be very effective with a primary success rate of 86.2%. The symptoms were significantly reduced in group 3 patients overall, and those patients younger or older than 50 years of age who had hypertension, with symptom onset <1 month, and with attack duration of less than a minute did significantly better with the combination of betahistine 48 mg daily. Betahistine in addition to Epley maneuver is more effective than Epley maneuver alone or combined with placebo with regard to improvement of symptoms in certain patients. However, future clinical studies covering more patients to investigate the benefit of medical treatments in addition to Epley maneuver are needed.

  17. The effect of trigger point management by positional release therapy on tension type headache.

    Science.gov (United States)

    Ghanbari, Ali; Rahimijaberi, Abbas; Mohamadi, Marzieh; Abbasi, Leila; Sarvestani, Fahimeh Kamali

    2012-01-01

    The aim of this study was to compare the effectiveness of trigger points' management by Positional Release Therapy (PRT) and routine medical therapy in treatment of Tension Type Headache. Tension Type Headache is the most frequent headache with the basis of myofascial and trigger point disorders. PRT is an indirect technique that treats trigger points. 30 Patients with active trigger points in cervical muscles entered to the study. They were randomly assigned to PRT or medical therapy group. Headache frequency, intensity and duration and tablet count were recorded by use of a daily headache diary. Sensitivity of trigger points was assessed by numeric pain intensity and by use of a digital force gauge (FG 5020). Both groups showed significant reduction in headache frequency and duration and tablet count after treatment phase. However, the reduction of study variables was persisted only in PRT group after follow up phase. There was no significant reduction in headache intensity, neither in PRT and nor in medication group. Sensitivity of trigger points was significantly reduced. In comparison of the two study groups, there was no significant difference in headache frequency, intensity, duration and tablet count (p> 0.05). Both procedures were equally effective according to the study. Thus, PRT can be a treatment choice for patients with T.T.H.

  18. An effective immunotherapy regimen for VGKC antibody-positive limbic encephalitis.

    Science.gov (United States)

    Wong, S H; Saunders, M D; Larner, A J; Das, K; Hart, I K

    2010-10-01

    Voltage-gated potassium channel antibody-positive limbic encephalitis (VGKC+LE) frequently improves with immunotherapy, although the optimum regimen is unknown. The effectiveness of a combination immunomodulatory regimen was tested in consecutive VGKC+LE patients. This was an open-label prospective study of nine VGKC+LE patients. All patients had plasma exchange (50 ml/kg), intravenous immunoglobulin (2 g/kg) and intravenous methylprednisolone (1 g×3), followed by maintenance oral prednisolone (1 mg/kg/day). Mycophenolate (2 g/day) was used in the first three patients. Assessments included serial clinical, cognitive, brain MRI and VGKC antibody testing. Within 1 week, seizures and hyponatraemia remitted in all affected patients. Cognitive function improved in all patients within 3 months. MRI appearances improved substantially within 9 months, with remission of inflammation in the majority of patients. All achieved immunological remission with normal VGKC antibody titres within 1-4 months. Major adverse events of therapy included one septicaemia and one thrombosis on plasma exchange and one death from sepsis after incidental bowel surgery. One patient remains in remission after 40 months of follow up, 26 months after being off all treatment. Our immunotherapy regimen was effective for the treatment of the clinical, cognitive and immunological features of VGKC+LE. Radiological improvement was seen in the majority. Pending randomised controlled trials, this regimen is proposed for the treatment of VGKC+LE.

  19. Effect of a hybrid maneuver in treating posterior canal benign paroxysmal positional vertigo.

    Science.gov (United States)

    Badawy, Wanees M A; Gad El-Mawla, Ebtessam K; Chedid, Ahmed E F; Mustafa, Ahmed H A

    2015-02-01

    Benign paroxysmal positional vertigo (BPPV) is the most common disorder of the vestibular system of the inner ear, which is a vital part of maintaining balance. Although the efficacy of the Epley maneuver-also known as the canalith repositioning maneuver (CRM)-is well established, data comparing CRM versus a hybrid treatment are lacking. The purpose of this study was to determine the effect of a hybrid treatment, the Gans repositioning maneuver (GRM) either with or without postmaneuver restrictions, compared with CRM on treatment of posterior canal BPPV (PC-BPPV). Study design was a randomized controlled trial. A total of 45 patients (30 males and 15 females) with unilateral PC-BPPV were randomly allocated to one of three equal groups on the basis of the date of the first visit with matched assignment for gender: a GRMR group (GRM with postmaneuver restrictions), a GRM group, and a CRM group. Patients received weekly administration of the maneuver until resolution of symptoms. The Dix-Hallpike test was performed before treatment at every appointment, and finally after 1 mo from the last maneuver. Nystagmus duration and vertigo intensity were recorded. The supine roll test was performed in case the Dix-Hallpike test was negative to test otoconial migration. Data were analyzed with repeated-measures analysis of variance, paired t-tests with a Bonferroni correction, and the Spearman rank correlation coefficient. All patients showed improvement within the groups, and PC-BPPV symptoms were resolved by an average of 2, 1.7, and 1.6 maneuvers for GRMR, GRM, and CRM, respectively, with no statistical differences among the three groups (p > 0.05). Only two patients had recurrence, and one patient had horizontal BPPV at 1 mo follow-up. We demonstrated that the GRM as a new treatment is effective in treating PC-BPPV with no benefits to postmaneuver restrictions. American Academy of Audiology.

  20. Experiences of discrimination and positive treatment in people with mental health problems: Findings from an Australian national survey.

    Science.gov (United States)

    Reavley, Nicola J; Jorm, Anthony F

    2015-10-01

    Stigma and discrimination are central concerns for people with mental health problems. The aim of the study was to carry out a national survey in order to assess experiences of avoidance, discrimination and positive treatment in people with mental health problems. In 2014, telephone interviews were carried out with 5220 Australians aged 18+, 1381 of whom reported a mental health problem or scored highly on a symptom screening questionnaire. Questions covered experiences of avoidance, discrimination and positive treatment by friends, spouse, other family, workplace, educational institution and others in the community. In most domains, respondents reported more positive treatment experiences than avoidance or discrimination. Friends and family were more likely to avoid the person than to discriminate. The results can provide input into the design of anti-discrimination interventions and further empower people with mental health problems as they advocate for change in the area of discrimination. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  1. Positive effects of bisphosphonates on bone and muscle in a mouse model of Duchenne muscular dystrophy.

    Science.gov (United States)

    Yoon, Sung-Hee; Sugamori, Kim S; Grynpas, Marc D; Mitchell, Jane

    2016-01-01

    Patients with Duchenne muscular dystrophy are at increased risk of decreased bone mineral density and bone fracture as a result of inactivity. To determine if antiresorptive bisphosphonates could improve bone quality and their effects on muscle we studied the Mdx mouse, treated with pamidronate during peak bone growth at 5 and 6 weeks of age, and examined the outcome at 13 weeks of age. Pamidronate increased cortical bone architecture and strength in femurs with increased resistance to fracture. While overall long bone growth was not affected by pamidronate, there was significant inhibition of remodeling in metaphyseal trabecular bone with evidence of residual calcified cartilage. Pamidronate treatment had positive effects on skeletal muscle in the Mdx mice with decreased serum and muscle creatine kinase and evidence of improved muscle histology and grip strength. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. A Multicenter Retrospective Review of Prone Position Ventilation (PPV in Treatment of Severe Human H7N9 Avian Flu.

    Directory of Open Access Journals (Sweden)

    Yuanda Xu

    Full Text Available Patients with H7N9 avian flu concurrent with severe acute respiratory distress syndrome (ARDS usually have a poor clinical outcome. Prone position ventilation (PPV has been shown to improve the prognosis of patients with severe ARDS. This study explored the effects of PPV on the respiratory and circulatory mechanics of H7N9-infected patients with severe ARDS.Individuals admitted to four hospitals designated for H7N9 patients in Guangdong province were treated with PPV, and their clinical data were recorded before and after receiving PPV.Six of 20 critically ill patients in the ICU received PPV. After treatment with 35 PPV sessions, the oxygenation index (OI values of the six patients when measured post-PPV and post-supine position ventilation (SPV were significantly higher than those measured pre-PPV (P < 0.05.The six patients showed no significant differences in their values for respiratory rate (RR, peak inspiratory pressure (PIP, tidal volume (TV or arterial partial pressure of carbon dioxide (PaCO2 when compared pre-PPV, post-PPV, and post-SPV. Additionally, there were no significant differences in the mean values for arterial pressure (MAP, cardiac index (CI, central venous pressure (CVP, heart rate (HR, lactic acid (LAC levels or the doses of norepinephrine (NE administered when compared pre-PPV, post-PPV, and post-SPV.PPV provided improved oxygenation that was sustained after returning to a supine position, and resulted in decreased carbon dioxide retention. PPV can thus serve as an alternative lung protective ventilation strategy for use in patients with H7N9 avian flu concurrent with severe ARDS.

  3. Neurocognitive Effects of Treatment for Childhood Cancer

    Science.gov (United States)

    Butler, Robert W.; Haser, Jennifer K.

    2006-01-01

    We review research on the neuropsychological effects that central nervous system (CNS) cancer treatments have on the cognitive abilities of children and adolescents. The authors focus on the two most common malignancies of childhood: leukemias and brain tumors. The literature review is structured so as to separate out earlier studies, generally…

  4. Evaluating the Effectiveness Of Postfire Rehabilitation Treatments

    Science.gov (United States)

    Peter R. Robichaud; Jan L. Beyers; Daniel G. Neary

    2000-01-01

    Spending on postfire emergency watershed rehabilitation has increased during the past decade. A west-wide evaluation of USDA Forest Service burned area emergency rehabilitation (BAER) treatment effectiveness was undertaken as a joint project by USDA Forest Service Research and National Forest System staffs. This evaluation covers 470 fires and 321 BAER projects, from...

  5. Theoretical approach towards increasing effectiveness of palatal surgery in obstructive sleep apnea: role for concomitant positional therapy?

    Science.gov (United States)

    van Maanen, J P; Witte, B I; de Vries, N

    2014-05-01

    The aims of this study are to evaluate the effect of palatal surgery (uvulopalatopharyngoplasty (UPPP) or Z-palatoplasty (ZPP)) with or without (+/-) concomitant radiofrequent ablation of the base of the tongue (RFTB) on body position-specific apnea-hypopnea index (AHI) values in patients with obstructive sleep apnea (OSA) and to compare this treatment outcome to the theoretical effect of (addition of) positional therapy (PT). Retrospective analysis of pre- and posttreatment polysomnographies in 139 patients who had undergone UPPP/ZPP +/- RFTB was performed. Hypothetical evaluation of the effects of (addition of) ideal PT on AHI in positional OSA (POSA) patients was carried out. Median AHI significantly decreased from 18.0 to 11.2 (p effect of body position needs to be taken into account. PT, either as monotherapy or in addition to surgery, theoretically has shown to improve treatment results dramatically in POSA patients. Prospective, controlled trials focusing on the effects of this combination of treatments should further evaluate this hypothetical conclusion.

  6. Positioning for Effectiveness: Applying Marketing Concepts to Distance Education.

    Science.gov (United States)

    Levenburg, Nancy

    1997-01-01

    Demonstrates how colleges can use distance education to attract and retain a "critical mass" of learners for distance programs. Explores alternative ways to view distance education market opportunities and determine which avenues to pursue. Suggests how to be more effective in all aspects of distance education programs. (13 citations) (YKH)

  7. Effects of window position on natural cross ventilation in vernacular ...

    African Journals Online (AJOL)

    Among the most effective architectures is vernacular architecture of Mazandaran whose incorporation in nature is so delicate that appears to be an essential part of it. Paying more attention to vernacular architecture and promoting it can be helpful in reducing energy consumption. Increasing use of fossil fuels in heating and ...

  8. Evaluating the effectiveness of brand-positioning strategies from a consumer perspective

    DEFF Research Database (Denmark)

    Fuchs, Christoph; Diamantopoulos, Adamantios

    2010-01-01

    - The findings should guide brand managers in selecting the most appropriate positioning strategies for their brands in high-involvement markets such as the automobile market. Originality/value - The study sheds initial light on the overall relative effectiveness of major positioning strategies. The study......Purpose - The purpose of the paper is to explore empirically the overall relative effectiveness of alternative positioning strategies from a consumer perspective. Design/methodology/approach - Two studies (within- and between-subjects design) are conducted aimed at evaluating the positioning...... of positioning strategy used affects the positioning success of a brand. More specifically, the study confirms normative arguments about the overall relative effectiveness of main positioning strategies by revealing that benefit-based positioning and surrogate (user) positioning generally outperform feature...

  9. A phase II trial for the optimisation of treatment position in the radiation therapy of prostate cancer

    DEFF Research Database (Denmark)

    O'Neill, L.; Armstrong, J.; Buckney, S.

    2008-01-01

    Background: Patient immobilisation and position are important contributors to the reproducibility and accuracy of radiation therapy. In addition the choice of position can alter the external contour of the treated area and has the potential to alter the spatial relationship between internal organs...... was reduced to 5 mm. The outer circumference of the bladder, rectal wall, small bowel (when present) was drawn along with femoral heads. 3D conformal treatment plans were computed using Helax TMS version 6.1B. A 3-field treatment technique was employed with energy of 10/15 MV. The prescribed dose was 70 Gy...

  10. Side effects of endobronchial laser treatment

    Energy Technology Data Exchange (ETDEWEB)

    Dierkesmann, R.; Huzly, A.

    1985-03-01

    Side effects that have occurred in over 250 endobronchial laser treatments are reported. The laser has been used in severe tracheal and in bronchial obstructions. In two cases significant bleeding had to be treated with tamponade. In one patient an emphysema of the mediastinum developed, in 2 further patients a small pneumothorax. Perforation of the airway was not detected and no special treatment was necessary. Three patients with life-threatening tracheal stenoses and one patient with severe stenosis of both the mainstem bronchi due to metastasis in the bifurcation lymph node had a large defect in the tracheal or bronchial wall with a deep necrosis five to twelve weeks after laser treatment; all these patients had extensive radiotherapy in addition. One patient died due to severe respiratory insufficiency, probably caused by smoke intoxication. After the laser treatment, rubber-like fibrin-rich plaques may develop, which can lead to life-threatening obstructions of the airway. It is recommended that laser bronchoscopy should be performed with the rigid bronchoscope. After treatment of tracheal lesion an endoscopic check must be performed within 24 hours. The combination of laser treatment and radiotherapy seems to involve a certain risk of large defects in the bronchial wall due to necrosis of the tumor.

  11. Dabrafenib: a new opportunity for the treatment of BRAF V600-positive melanoma

    Directory of Open Access Journals (Sweden)

    Banzi M

    2016-05-01

    Full Text Available Maria Banzi,1 Simona De Blasio,2 Aimilios Lallas,3 Caterina Longo,2 Elvira Moscarella,2 Roberto Alfano,4 Giuseppe Argenziano5 1Department of Medical Oncology, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy; 2Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy; 3First Department of Dermatology, Aristotle University, Thessaloniki, Greece; 4Department of Anesthesiology, Surgery and Emergency, 5Dermatology Unit, Second University of Naples, Naples, Italy Abstract: Prior to 2011, the 1-year survival rates for patients suffering from advanced or metastatic melanoma was as low as 33%, with a median overall survival of about 9 months. Several chemotherapeutic regimens have been applied, either as monochemotherapy or as polychemotherapy, overall not resulting in an improvement of progression-free or overall survival. Novel insights into the epidemiology and biology of melanoma allowed the development of newer therapies. The discovery of mutations in BRAF, a part of the mitogen-activated protein kinase, allowed the development of two BRAF inhibitors, vemurafenib and dabrafenib, which significantly improved the outcome of metastatic melanoma treatment. This article reviews the mechanism of action, efficacy, and safety profile of dabrafenib. An in-depth knowledge of this medication will encourage clinicians to select the appropriate therapeutic strategy for each patient, as well as to prevent or adequately manage side effects, optimizing, thus, the drug’s applicability. Keywords: melanoma, BRAF, target therapy, dabrafenib, melanoma survival

  12. Combined treatment with progesterone and magnesium sulfate positively affects traumatic brain injury in immature rats.

    Science.gov (United States)

    Uysal, Nazan; Baykara, Basak; Kiray, Muge; Cetin, Ferihan; Aksu, Ilkay; Dayi, Ayfer; Gurpinar, Tugba; Ozdemir, Durgul; Arda, M Nuri

    2013-01-01

    It is well known that head trauma results in damage in hippocampal and cortical areas of the brain and impairs cognitive functions. The aim of this study is to explore the neuroprotective effect of combination therapy with magnesium sulphate (MgSO4) and progesterone in the 7-days-old rat pups subjected to contusion injury. Progesterone (8 mg/kg) and MgSO4 (150 mg/kg) were injected intraperitoneally immediately after induction of traumatic brain injury. Half of groups were evaluated 24 hours later, the remaining animals 3 weeks after trauma or sham surgery. Anxiety levels were assessed with open field activity and elevated plus maze; learning and memory performance were evaluated with Morris Water maze in postnatal 27 days. Combined therapy with progesterone and magnesium sulfate significantly attenuated trauma-induced neuronal death, increased brain VEGF levels and improved spatial memory deficits that appear later in life. Brain VEGF levels were higher in rats that received combined therapy compared to rats that received either medication alone. Moreover, rats that received combined therapy had reduced hipocampus and prefrontal cortex apoptosis in the acute period. These results demonstrate that combination of drugs with different mechanisms of action may be preferred in the treatment of head trauma.

  13. [Effect of body image in adolescent orthodontic treatment].

    Science.gov (United States)

    Minghui, Peng; Jing, Kang; Xiao, Deng

    2017-10-01

    This study was designed to probe the psychological factors adolescent orthodontic patients, the role of body image and self-esteem in the whole process of orthodontic treatment and the impact on the efficacy and satisfaction of orthodontic. Five hundred and twenty-eight patients were selected in this study. The Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN-AC) , Rosenberg Self-Esteem Scale (SES), Negative Physical Self-General (NPS-G) and other body analysis scale study after orthodontic lasted 18-24 months were used to investigate the role of body image in adolescent orthodontic treatment. Esthetic evaluation of patients teeth after correction had been significantly improved, patient self-evaluation difference IOTN-AC doctor evaluation, Psychosocial Impact of Dental Aesthetics Questionnaire-tooth confidence, aesthetic concerns, psychological impact and social function were significantly improved. The improvement of the dental aesthetics component (T2 when doctors evaluate IOTN-AC) was positively correlated with the evaluation of the efficacy, and was significantly negatively correlated with the negative emotions of patients at baseline. Negative body image-dental dissatisfied-cognitive component and the affective component, the overall negative body image and negative emotions can predict patient satisfaction with treatment efficacy. Orthodontic treatment not only improves the self-aesthetic evaluation of adolescent patients, but also has a positive effect on the mental health of adolescent patients.

  14. Does Subjective Left-Right Position Have a Causal Effect on Support for Redistribution?

    DEFF Research Database (Denmark)

    Jæger, Mads Meier

    characteristics as instruments for left-right position, can be used to estimate the causal effect of left-right position on support for redistribution. I analyze data on Sweden, Germany, and Norway from the two first waves of the European Social Survey and find first that left-right position is endogenous...... to support for redistribution, and second consistent with theory, that a causal effect of left-right position on support for redistribution exists which is stronger than previously shown....

  15. Effects of Patellar Taping on the Patella Position in Presence of Quadriceps Contraction in 20-40 Year-Old Women With Patellofemoral Pain Syndrome Using MRI

    Directory of Open Access Journals (Sweden)

    Mahboobeh Banejad

    2016-06-01

    Discussion: Kinesio taping plus quadriceps contraction reduced the PFCA and LPFA. Patellar taping is effective in the correction of the patellar position in contracted quadriceps. Therefore, both neuromuscular and mechanical effects of patellar taping affect the patellar position over a long period. The combination of patellar taping and exercise reduced pain and improved activity faster than either of the treatment alone.

  16. Effects contributing to positive coolant void reactivity in CANDU

    International Nuclear Information System (INIS)

    Whitlock, J.J.; Garland, W.J.; Milgram, M.S.

    1995-01-01

    The lattice cell code WIMS-AECL (Ref. 3) is used to model a typical CANDU lattice cell, using nominal geometric bucklings, the PIJ option, and 69-group Winfrith library. The effect of cell voiding is modeled as a 100% instantaneous removal of coolant from the lattice. This is conservative because of the neglect of time dependence and partial core voiding, considered more plausible in CANDU. Results are grouped into three spectral groups: fast neutrons (0.821 to 10 MeV), epithermal neutrons (0.625 eV to 0.821 MeV), and thermal neutrons (<0.625 eV)

  17. A new kind of shape-stabilized PCMs with positive temperature coefficient (PTC) effect

    International Nuclear Information System (INIS)

    Cheng, Wen-long; Wu, Wan-fan; Song, Jia-liang; Liu, Yi; Yuan, Shuai; Liu, Na

    2014-01-01

    Highlights: • A new kind of shape-stabilized PCMs with PTC effect is first prepared. • It provides a potential means for the thermal control of the electronic devices. • The switching temperature of the materials is about 25 °C. • The most appropriate component of the material is found out by experimental study. • The NTC effect of the new PCMs is eliminated effectively by heat treatment. - Abstract: A new kind of shape-stabilized phase change materials (PCMs) with positive temperature coefficient (PTC) effect was prepared in this paper. The materials were prepared by adding graphite powder (GP) to the paraffin/low density polyethylene (LDPE) composite and the PTC characteristic was found by adjusting the component ratio of the material. Then the physical structures and thermal properties of the materials were investigated and the effect of various GP mass fractions and paraffin/LDPE mass proportions on the PTC behavior of the materials was studied experimentally. The results showed that the switching temperature of the materials was about 25 °C (room temperature) which approached to the first phase change temperature of paraffin dispersed in the materials. The PTC behavior of the materials was the best when the GP mass fraction and the mass proportion of LDPE/paraffin were 40 wt% and 30:70, respectively. Furthermore, the negative temperature coefficient (NTC) effect of the materials could be eliminated effectively with heat treatment. This new kind of materials is different from the former PTC materials which the switching temperatures focus on high temperature ranges. It makes up for the defect of previous materials that the switching temperatures only range in high temperature rather than room temperature and provides a potential means for the thermal control of the electronic devices or other room temperature thermal control applications

  18. Effect of Ankle Positioning During Hamstring Stretches for Improving Straight Leg Hip Flexion Motion.

    Science.gov (United States)

    Laudner, Kevin G; Benjamin, Peter J; Selkow, Noelle M

    2016-03-01

    To compare the effects of stretching the hamstrings with the ankle in either a plantar-flexed (PF) or dorsiflexed (DF) position for improving straight leg hip flexion range of motion (ROM) over a 4-week period. Randomized, single-blinded, pretest, posttest design. Athletic training facility. Each limb of 34 asymptomatic individuals (15 males, 19 females) was randomly assigned to one of the 3 groups. Twenty-four limbs received hamstring stretches with the ankle in DF, 24 limbs received hamstring stretches with the ankle in PF, and 20 limbs received no stretch (control). Ankle position (PF, DF) during hamstring stretching. We measured pretest and posttest passive straight leg hip flexion ROM with the test ankle in a neutral position. For the intervention groups, the test limb was passively stretched with the ankle held in end range DF or PF for their respective group. Each stretch was held for 30 seconds for a total of 3 applications. Two treatment sessions were completed per week for a total of 4 weeks. The control limbs received no stretching during the 4-week period. We conducted 1-way analyses of covariance to determine significant changes in ROM between groups (P hamstrings in either PF or DF improve straight leg hip ROM compared with a control group. The results of this study should be considered by clinicians when determining the optimal stretching techniques aimed at increasing hamstring length.

  19. Toxic Stress: Effects, Prevention and Treatment

    Directory of Open Access Journals (Sweden)

    Hillary A. Franke

    2014-11-01

    Full Text Available Children who experience early life toxic stress are at risk of long-term adverse health effects that may not manifest until adulthood. This article briefly summarizes the findings in recent studies on toxic stress and childhood adversity following the publication of the American Academy of Pediatrics (AAP Policy Report on the effects of toxic stress. A review of toxic stress and its effects is described, including factors of vulnerability, resilience, and the relaxation response. An integrative approach to the prevention and treatment of toxic stress necessitates individual, community and national focus.

  20. Effect of the transpalatal arch during extraction treatment.

    Science.gov (United States)

    Zablocki, Heather L; McNamara, James A; Franchi, Lorenzo; Baccetti, Tiziano

    2008-06-01

    The transpalatal arch (TPA) can be used as an adjunct during orthodontic treatment to help control the movement of the maxillary first molars in 3 dimensions, including producing molar rotation and uprighting, maintaining transverse dimensions posteriorly during treatment, and maintaining leeway spaces during the transition of the dentition. The purpose of this retrospective cephalometric study was to test an additional function of the TPA: its ability to enhance orthodontic anchorage during extraction treatment. Records consisting of pretreatment and posttreatment cephalograms were gathered from several orthodontic practices that used an .018 x .025-in preangulated appliance. All patients were white and had 4 first premolars extracted as part of their treatment protocol. Patients were treated either with or without a TPA of the soldered Goshgarian design. Patients were excluded if headgear or any other auxiliary anchorage device beside the TPA was used during treatment. Matched samples of 30 patients were identified based on sex, age at the start of treatment, treatment duration, and cervical vertebral maturation stage. Statistical comparisons were made with nonparametric statistical tests. Analysis of the changes from pretreatment to posttreatment for the TPA and the no-TPA groups showed no statistically significant differences in any of the variables examined. The net difference for both vertical and mesial movement of the maxillary first molar in relation to the maxilla between the 2 groups was 0.4 mm, with the no-TPA group in a more downward and forward position. Although the usefulness of the TPA for the abovementioned functions is not negated, it does not provide a significant effect on either the anteroposterior or the vertical position of the maxillary first molars during extraction treatment.

  1. Temperature effects on interaction of positive ions with plastic detectors

    International Nuclear Information System (INIS)

    Mendoza Anaya, D.

    1992-01-01

    The range of heavy charged particles in matter is dependent mainly on two groups of parameters, one related to the particle characteristics (charge z, mass m, energy E) and the other characterized by the stopping medium (charge z, density ρ). Those two groups are enough to describe the particle energy lost, which is related to the residual range. Research on charge particles registration using solid state nuclear track detectors (SSNTD), probe that environmental parameters affect the stabilization and formation of the tracks. One of those, is the temperature detector which shows an important effect during the irradiation on the characteristics of the tracks produced. In order to study the dependence of track geometry as a function of irradiation temperature, some SSNTD (CR 39 type) were irradiated with α particles and fission fragments. Results of this work show the existence of irradiation temperature effect on the track geometry. It is observed a reduction of length and diameters, as temperature increases. For low irradiation temperatures, there is a reduction of the track geometry, as compared with environmental temperature. (Author)

  2. Pregnancy failure in patients with obstetric antiphospholipid syndrome with conventional treatment: the influence of a triple positive antibody profile.

    Science.gov (United States)

    Latino, J O; Udry, S; Aranda, F M; Perés Wingeyer, S D A; Fernández Romero, D S; de Larrañaga, G F

    2017-08-01

    Conventional treatment of obstetric antiphospholipid syndrome fails in approximately 20-30% of pregnant women without any clearly identified risk factor. It is important to identify risk factors that are associated with these treatment failures. This study aimed to assess the impact of risk factors on pregnancy outcomes in women with obstetric antiphospholipid syndrome treated with conventional treatment. We carefully retrospectively selected 106 pregnancies in women with obstetric antiphospholipid syndrome treated with heparin + aspirin. Pregnancy outcomes were evaluated according to the following associated risk factors: triple positivity profile, double positivity profile, single positivity profile, history of thrombosis, autoimmune disease, more than four pregnancy losses, and high titers of anticardiolipin antibodies and/or anti-βeta-2-glycoprotein-I (aβ2GPI) antibodies. To establish the association between pregnancy outcomes and risk factors, a single binary logistic regressions analysis was performed. Risk factors associated with pregnancy loss with conventional treatment were: the presence of triple positivity (OR = 5.0, CI = 1.4-16.9, p = 0.01), high titers of aβ2GPI (OR = 4.4, CI = 1.2-16.1, p = 0.023) and a history of more than four pregnancy losses (OR = 3.5, CI = 1.2-10.0, p = 0.018). The presence of triple positivity was an independent risk factor associated with gestational complications (OR = 4.1, CI = 1.2-13.9, p = 0.02). Our findings reinforce the idea that triple positivity is a categorical risk factor for poor response to conventional treatment.

  3. Assessment of blood gas parameters and the degree of inflammation in noninvasive positive pressure ventilation combined with aminophylline treatment of COPD complicated with type II respiratory failure

    Directory of Open Access Journals (Sweden)

    Jin-Ru Zhang

    2016-10-01

    Full Text Available Objective: To analyze the effect of noninvasive positive pressure ventilation combined with aminophylline therapy on blood gas parameters and the degree of inflammation in patients with COPD and type II respiratory failure. Methods: A total of 80 patients with COPD and type Ⅱ respiratory failure were randomly divided into observation group and control group (n=40, control group received symptomatic treatment + aminophylline treatment, observation group received symptomatic treatment + aminophylline + noninvasive positive pressure ventilation treatment, and then differences in blood gas parameters, pulmonary function parameters, hemorheology parameters and inflammatory factor levels were compared between two groups of patients after treatment. Results: Radial artery pH and PO2 values of observation group after treatment were higher than those of control group while PCO2, Cl- and CO2CP values were lower than those of control group; pulmonary function parameters FVC, FEV1, FEF25-75, MMF, PEF and FRC values of observation group after treatment were higher than those of control group; whole blood viscosity (150 s- and 10 s-, plasma viscosity, fibrinogen, erythrocyte aggregation index and erythrocyte rigidity index values in peripheral venous blood of observation group after treatment were lower than those of control group; serum IL-17, IL-33, TREM-1, sICAM-1 and PGE2 levels of observation group after treatment were lower than those of control group. Conclusion: Noninvasive positive pressure ventilation combined with aminophylline can optimize the respiratory function of patients with COPD and type II respiratory failure and improve blood gas parameters and the degree of inflammation.

  4. The effect of positive and negative message framing on short term continuous positive airway pressure compliance in patients with obstructive sleep apnea.

    Science.gov (United States)

    Pengo, Martino F; Czaban, Marcin; Berry, Marc P; Nirmalan, Prajeshan; Brown, Richard; Birdseye, Adam; Woroszyl, Asia; Chapman, Julia; Kent, Brian D; Hart, Nicholas; Rossi, Gian Paolo; Steier, Joerg

    2018-01-01

    Continuous positive airway pressure (CPAP), the best available treatment for obstructive sleep apnea (OSA), requires long-term compliance to be effective. Behavioral interventions may be used to improve adherence to CPAP. We aimed to investigate whether positive or negative message framing impacts on CPAP compliance in patients with OSA, when compared to standard care. Consenting patients with confirmed OSA were randomly allocated to receive along with their CPAP either positively or negatively framed messages (Pos; Neg), or standard care (Con). Standardized motivational messages were read out to patients during an initial teaching session and through weekly telephone calls. Patients' compliance data were reviewed 2 and 6 weeks following CPAP initiation. We randomized 112 patients to groups that were matched for age, BMI, and OSA severity. The positively framed group (Pos) showed greater CPAP usage after 2 weeks (total use 53.7±31.4 hours) as compared to the negatively framed and the control group (35.6±27.4 and 40.8±33.5 hours, Pframed groups (Pos n=5; Neg n=8; Con n=11; Pframed messages can improve CPAP adherence in patients with OSA in the short-term; however, strategies for implementing its long-term use need to be developed.

  5. Effects of particle's off-axis position, shape, orientation and entry position on resistance changes of micro Coulter counting devices

    International Nuclear Information System (INIS)

    Qin, Zhenpeng; Zhe, Jiang; Wang, Guo-Xiang

    2011-01-01

    With the recent advance in micro/nano-fabrication technology, micro Coulter counters have been widely used in detecting and characterizing micro- and nanoscale objects. In this paper, the electrical resistance change during translocation of a non-conducting particle through a channel is studied numerically. The numerical results are validated by proven analytical results available in the literature. The effects of particle's off-axis position, shape and orientation, and entry position are studied for particles with a large dynamic range. From the numerical results, a new fitted correlation is proposed that can accurately predict the resistance change caused by off-axis spherical particles regardless of their size. The shape and orientation effects of the electrical resistance change are studied by changing the axis ratio of spheroid particles and their orientation angles. Results show that a particle's shape and orientation have a significant influence on the resistance change. Simulation of an entry effect indicates that a particle starts to induce a resistance change before it enters the channel and still causes a resistance change even after the particle exits the channel completely. This study will offer some guidelines in designing and implementing Coulter counting devices and experiments, and provide insights into explaining experimental results

  6. Releasing the Constraints on Aphasia Therapy: The Positive Impact of Gesture and Multimodality Treatments

    Science.gov (United States)

    Rose, Miranda L.

    2013-01-01

    Purpose: There is a 40-year history of interest in the use of arm and hand gestures in treatments that target the reduction of aphasic linguistic impairment and compensatory methods of communication (Rose, 2006). Arguments for constraining aphasia treatment to the verbal modality have arisen from proponents of constraint-induced aphasia therapy…

  7. Beyond the treatment effect: Evaluating the effects of patient preferences in randomised trials.

    Science.gov (United States)

    Walter, S D; Turner, R; Macaskill, P; McCaffery, K J; Irwig, L

    2017-02-01

    The treatments under comparison in a randomised trial should ideally have equal value and acceptability - a position of equipoise - to study participants. However, it is unlikely that true equipoise exists in practice, because at least some participants may have preferences for one treatment or the other, for a variety of reasons. These preferences may be related to study outcomes, and hence affect the estimation of the treatment effect. Furthermore, the effects of preferences can sometimes be substantial, and may even be larger than the direct effect of treatment. Preference effects are of interest in their own right, but they cannot be assessed in the standard parallel group design for a randomised trial. In this paper, we describe a model to represent the impact of preferences on trial outcomes, in addition to the usual treatment effect. In particular, we describe how outcomes might differ between participants who would choose one treatment or the other, if they were free to do so. Additionally, we investigate the difference in outcomes depending on whether or not a participant receives his or her preferred treatment, which we characterise through a so-called preference effect. We then discuss several study designs that have been proposed to measure and exploit data on preferences, and which constitute alternatives to the conventional parallel group design. Based on the model framework, we determine which of the various preference effects can or cannot be estimated with each design. We also illustrate these ideas with some examples of preference designs from the literature.

  8. The Positive Effect of Realia in EFL Classes

    Directory of Open Access Journals (Sweden)

    Emine Bala

    2015-09-01

    Full Text Available There are many ways generated by the linguists to teach the language items in EFL classroom; however, bringing ̳realia‘ into the classroom is one of the most effective ways to create an enjoyable class atmosphere and acquire the target language efficiently. Especially, low-level students may suffer from obtaining what teacher presents because they have no chance to synthesize what they learn in the class with real life situations. Using real objects and materials gives students opportunity to experience real life in the class atmosphere and this may facilitate and accelerate their learning process. Accordingly, using visuals stimulates students to maintain studying on the language because practicing the topic with visuals assists students to get involved in more powerful learning. This study illustrates an investigation based on a 20-question exam paper whether getting support from realia augments the students‘ success in the examination or not. Two elementary-level EFL classes took part in this project. Looking at the results, the students who were taught with realia showed more success compared to the others who were not taught with visuals during teaching.

  9. US: developments in the treatment of HIV-positive prisoners in two states.

    Science.gov (United States)

    Gibson, Katie

    2005-08-01

    Legal actions have been launched in Alabama and Mississippi to address living conditions and medical care of HIV-positive prisoners in state prisons. These were the only two states to allow complete segregation of HIV-positive prisoners in state prisons into the 1990s. The two cases highlight the ways in which the courts have been involved in supervising prison conditions in the United States.

  10. Recall of symptoms and treatment of syphilis and yaws by healthy blood donors screening positive for syphilis in Kumasi, Ghana

    Directory of Open Access Journals (Sweden)

    Francis Sarkodie

    2016-09-01

    Conclusions: A small proportion of confirmed seroreactive donors in this sample had any recall of symptoms or treatment for yaws or syphilis. These data suggest that clinical questioning adds little further information to the current screening algorithm. The relative contribution of yaws and syphilis to frequent positive tests in endemic areas remains speculative.

  11. Reactivation of tuberculosis during immunosuppressive treatment in a patient with a positive QuantiFERON-RD1 test

    DEFF Research Database (Denmark)

    Ravn, Pernille; Munk, Martin E; Andersen, Ase Bengaard

    2004-01-01

    A patient with polymyositis developed tuberculosis during immunosuppressive treatment. Tuberculin Skin Test and chest X-ray failed to demonstrate latent tuberculosis, whereas a blood sample that was tested with a modified QuantiFERON-TB-assay, using the recombinant ESAT-6 and CFP-10, was positive...

  12. Investigating the effects of strategic positioning for development of modern banking services

    Directory of Open Access Journals (Sweden)

    Vahid Anvar Keivi

    2014-05-01

    Full Text Available During the past few years, there have been tremendous changes on banking services and many bank customers are able to do their daily banking activities using recent advances of technology such as internet banking, telephone banking, etc. In this paper, we present an empirical investigation on the effects of strategic positioning for development of modern banking services. The proposed study designs a questionnaire in Likert scale and distributes it among some 385 randomly selected people who live in Tehran in 2013. The questionnaire consists of seven factors including property positioning, advantage positioning, consumer positioning, user positioning, competitive advantage positioning, quality positioning and merchandise category positioning. Using Spearman correlation as well as stepwise regression technique, the study has determined positive and meaningful relationships between different components of strategy positioning development of modern banking services.

  13. Efficacy and mechanism of action of the tyrosine kinase inhibitors gefitinib, lapatinib and neratinib in the treatment of HER2-positive breast cancer: preclinical and clinical evidence.

    Science.gov (United States)

    Segovia-Mendoza, Mariana; González-González, María E; Barrera, David; Díaz, Lorenza; García-Becerra, Rocío

    2015-01-01

    An increasing number of tumors, including breast cancer, overexpress proteins of the epidermal growth factor receptor (EGFR) family. The interaction between family members activates signaling pathways that promote tumor progression and resistance to treatment. Human epidermal growth factor receptor type II (HER2) positive breast cancer represents a clinical challenge for current therapy. It has motivated the development of novel and more effective therapeutic EGFR family target drugs, such as tyrosine kinase inhibitors (TKIs). This review focuses on the effects of three TKIs mostly studied in HER2- positive breast cancer, lapatinib, gefitinib and neratinib. Herein, we discuss the mechanism of action, therapeutic advantages and clinical applications of these TKIs. To date, TKIs seem to be promising therapeutic agents for the treatment of HER2-overexpressing breast tumors, either as monotherapy or combined with other pharmacological agents.

  14. Effective treatment strategies against Ebola virus

    Directory of Open Access Journals (Sweden)

    Amina Yaqoob

    2015-08-01

    Full Text Available Ebola virus (EBOV, a member of order Mononegavirales is most famous for causing the endemics of hemorrhagic fever in different countries of the world. Various effective treatment for EBOV are available presently but different clinical trials and experimental studies on animal models are ongoing for this purpose. Results from different studies showed that selective vaccines and therapeutic drugs have potential to interfere the viral life events within host cell in order to inhibit its replication. Various pre-clinical trials in this regard are proved successful on non-human primates (NHPs and found to be significant in inhibiting EBOV infections. It is the need of hour to develop effective vaccines against Ebola virus to combat this problem as soon as possible. The present article is a brief review on potential treatment strategies against Ebola virus.

  15. The profile and treatment outcomes of sputum smear positive pulmonary tuberculosis re-treatment cases, in a district medical college of West Bengal, India

    Directory of Open Access Journals (Sweden)

    Abinash Agarwala

    2014-01-01

    Full Text Available Background: In a high tuberculosis (TB burden county like India with different regional demography, knowledge about patient profile has a pivotal role in determining and identifying the factors associated with poor treatment outcomes among TB re-treatment cases. Aim: The aim was to describe the demography and clinical characteristics of TB re-treatment cases and to evaluate the factors associated with poor treatment outcomes among those patients. Settings and Design: A prospective longitudinal cohort study was carried out at chest medicine outdoor from February, 2011 to 2014 in a district medical college of West Bengal, India. Materials and Methods: Sputum smear positive re-treatment pulmonary TB patients attending our chest medicine outdoor during the 3 years study period were evaluated for demographic and clinical characteristics on the basis of previous treatment history and records at the beginning of the study. Patients were followed-up during the 8 months treatment period (Category II treatment regimen under Revised National TB Control Program. At the end of the study period, treatment outcomes were analyzed and factors associated with poor treatment outcomes were identified. Statistical Analysis: All variables were described by proportions, and differences between independent groups were compared using the Chi-square test and Fisher′s exact test, as applicable. Results: Among 74 patients, re-treatment was successful in 75.7% of relapse case, 66.7% of loss to follow-up cases and 53.8% of failure cases. Re-treatment failure was higher (38.5% in treatment failure cases compare to relapse cases (10.8% and initial loss to follow-up cases (16.7%. Young age, male, unmarried, employed who work outside appears to be the risk factors for loss to follow-up. Low body mass index, treatment from the private sector, history of alcoholism, radiological cavitory lesion, larger duration of previous treatment, lesser gap from previous treatment has

  16. Changes of hyoid bone position following treatment of class II div1 malocclusion with Farmand functional appliance

    Directory of Open Access Journals (Sweden)

    Yassaei S

    2007-01-01

    Full Text Available Background and Aim: Unlike other bones of the head and neck, hyoid bone has no bony articulations. It is connected to mandible, cranium and pharynx through muscles and ligaments. During treatment with functional appliance in patients with class II div1 malocclusion, mandible is positioned in inferior and anterior direction. Regarding the relation between hyoid and mandibular bone, alterations of hyoid bone position can be a result of functional appliance therapy. The aim of this study was to evaluate the changes of hyoid bone position following treatment with Farmand functional appliance in patients with class II div 1 malocclusion. Materials and Methods: In this before-after clinical trial, 28 patients with class II div 1 malocclusion which were under treatment with Farmand functional appliance for 11 months were selected. Facial growth in vertical, normal or horizontal direction was determined by cephalometric measurement. Data were analyzed with Paired-t test to compare the differences of mean values pre and post treatment. Variance analysis was used to compare the three growth patterns. P<0.05 was considered as the limit of significance. Results: Hyoid bone shifted significantly forward in horizontal dimension (P<0.01 and non-significantly upward in vertical dimension. There was no significant difference among the three studied groups with respect to hyoid bone position alterations in horizontal dimension but significant difference was observed between horizontal and vertical growth pattern in vertical dimension (P<0.05. There was significant correlation between decrease of ANB angle and forward movement of hyoid bone. Conclusion: Based on the results of this study, treatment with Farmand functional appliance (Fa II leads to significant alterations in the position and anterior displacement of the hyoid bone.

  17. Energy positive domestic wastewater treatment: the roles of anaerobic and phototrophic technologies

    KAUST Repository

    Shoener, B. D.; Bradley, I. M.; Cusick, R. D.; Guest, J. S.

    2014-01-01

    The negative energy balance of wastewater treatment could be reversed if anaerobic technologies were implemented for organic carbon oxidation and phototrophic technologies were utilized for nutrient recovery. To characterize the potential for energy

  18. Proportion of false-positive lesions at interim and end-of-treatment FDG-PET in lymphoma as determined by histology: Systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Adams, Hugo J.A., E-mail: h.j.a.adams@gmail.com; Kwee, Thomas C.

    2016-11-15

    Purpose: To systematically review and meta-analyze the proportion of false-positive lesions at interim and end-of-treatment {sup 18}F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in lymphoma using biopsy as reference standard. Materials and methods: Medline was searched for original studies. Methodological quality of included studies was evaluated, and results were meta-analytically summarized using random effects (in case of interstudy heterogeneity [I{sup 2} ≤ 50%]) or fixed effects (in case of no interstudy heterogeneity [I{sup 2} > 50%]). Results: Eleven studies, comprising 139 patients who underwent biopsy of an FDG-avid lesion during or after completion of antilymphoma treatment, were included. Overall methodological quality was moderate. The proportion of false-positive results among all biopsied FDG-avid lesions at PET performed during of after completion of treatment ranged between 7.7% and 90.5% (the vast majority was due to inflammatory changes), with a weighted summary proportion (random effects, I{sup 2} = 75.7%) of 55.7% (95% confidence interval [CI]: 32.6–76.6%). There were no available studies on interim FDG-PET in Hodgkin lymphoma. The pooled summary false-positive proportions were 83.0% (95% CI: 72.0%–90.2%) for interim FDG-PET in non-Hodgkin lymphoma (fixed effects, I{sup 2} = 27.7%), 23.1% (95% CI: 4.7%–64.5%) for end-of-treatment FDG-PET in Hodgkin lymphoma (random effects; I{sup 2} = 67.1%), and 31.5% (95% CI: 3.9%–83.9%) for end-of-treatment FDG-PET in non-Hodgkin lymphoma (random effects, I{sup 2} = 68.3%). Conclusion: Both interim and end-of-treatment FDG-PET scans in patients with lymphoma suffer from a very high number of false-positive FDG-avid lesions. This finding, in combination with the previously reported high number of false-negative FGD-PET scans for residual disease detection, suggests that the role of interim and end-of-treatment FDG-PET should be reconsidered.

  19. Use of positive pressure in preoperative and intraoperative of bariatric surgery and its effect on the time of extubation

    Directory of Open Access Journals (Sweden)

    Letícia Baltieri

    2015-04-01

    Full Text Available BACKGROUND AND OBJECTIVE: To investigate the influence of intraoperative and preoperative positive pressure in the time of extubation in patients undergoing bariatric surgery. METHOD: Randomized clinical trial, in which 40 individuals with a body mass index between 40 and 55 kg/m2, age between 25 and 55 years, nonsmokers, underwent bariatric surgery type Roux-en-Y gastric bypass by laparotomy and with normal preoperative pulmonary function were randomized into the following groups: G-pre (n = 10: individuals who received treatment with noninvasive positive pressure before surgery for 1 h; G-intra (n = 10: individuals who received positive end-expiratory pressure of 10 cm H2O throughout the surgical procedure; and G-control (n = 20: not received any preoperative or intraoperative intervention. Following were recorded: time between induction of anesthesia and extubation, between the end of anesthesia and extubation, duration of mechanical ventilation, and time between extubation and discharge from the post-anesthetic recovery. RESULTS: There was no statistical difference between groups. However, when applied to the Cohen coefficient, the use of positive end-expiratory pressure of 10 cm H2O during surgery showed a large effect on the time between the end of anesthesia and extubation. About this same time, the treatment performed preoperatively showed moderate effect. CONCLUSION: The use of positive end-expiratory pressure of 10 cm H2O in the intraoperative and positive pressure preoperatively, influenced the time of extubation of patients undergoing bariatric surgery.

  20. Clinical features and effect of antiviral therapy on anti-liver/kidney microsomal antibody type 1 positive chronic hepatitis C.

    Science.gov (United States)

    Ferri, Silvia; Muratori, Luigi; Quarneti, Chiara; Muratori, Paolo; Menichella, Rita; Pappas, Georgios; Granito, Alessandro; Ballardini, Giorgio; Bianchi, Francesco B; Lenzi, Marco

    2009-06-01

    Anti-liver/kidney microsomal antibody type 1 (anti-LKM1), a serological marker of type 2 autoimmune hepatitis, is also detected in a small proportion of patients with hepatitis C. This study aimed to evaluate clinical features and effect of antiviral therapy in patients with hepatitis C who are anti-LKM1 positive. Sixty consecutive anti-LKM1 positive and 120 age and sex-matched anti-LKM1 negative chronic hepatitis C patients were assessed at diagnosis and during follow-up. Of these, 26 anti-LKM1 positive and 72 anti-LKM1 negative received antiviral therapy. Anti-LKM1 was detected by indirect immunofluorescence and immunoblot. Number of HCV-infected hepatocytes and intrahepatic CD8+ lymphocytes was determined by immunohistochemistry. At diagnosis anti-LKM1 positive patients had higher IgG levels and more intrahepatic CD8+ lymphocytes (p 0.022 and 0.046, respectively). Viral genotypes distribution and response to therapy were identical. Hepatic flares during antiviral treatment only occurred in a minority of patients in concomitance with anti-LKM1 positivity. Immune system activation is more pronounced in anti-LKM1 positive patients with hepatitis C, possibly representing the expression of autoimmune mechanisms of liver damage. Antiviral treatment is as beneficial in these patients as in anti-LKM1 negative patients, and the rare necroinflammatory flares are effectively controlled by corticosteroids, allowing subsequent resumption of antiviral therapy.

  1. The company you keep: Effects of leader and teams network position on performance

    NARCIS (Netherlands)

    Vernet, A; Deichmann, D.; Moser, C.

    2016-01-01

    In this paper we argue that leaders positively influence team performance through their positions in a collaboration network. We propose also that the leader’s effect on team performance is moderated by the position of the team in the larger collaboration network. We distinguish between brokerage

  2. Investigating the effects of tea, water and a positive affect induction on mood and creativity

    NARCIS (Netherlands)

    Einöther, S.J.L.; Baas, M.; Rowson, M.; Giesbrecht, T.

    2015-01-01

    Positive affect has been shown to be predictive of improved creativity. This study investigated the immediate effect of the tea experience on positive affect and creativity, compared to both a neutral and positive control condition. Regular tea drinkers (N = 150) were allocated to three conditions:

  3. The Upward Spiral of Adolescents' Positive School Experiences and Happiness: Investigating Reciprocal Effects over Time

    Science.gov (United States)

    Stiglbauer, Barbara; Gnambs, Timo; Gamsjager, Manuela; Batinic, Bernad

    2013-01-01

    In line with self-determination theory and Fredrickson's (2001) broaden-and-build theory of positive emotions, this study adopts a positive perspective on students' school experiences and their general psychological functioning. The reciprocal effects of positive school experiences and happiness, a dimension of affective well-being, are examined…

  4. Strategy for personalized treatment of human papillomavirus-positive oropharyngeal squamous cell carcinoma

    International Nuclear Information System (INIS)

    Mizumachi, Takatsugu; Hatakeyama, Hiromitsu; Kano, Satoshi; Sakashita, Tomohiro; Suzuki, Seigo; Homma, Akihiro; Oridate, Nobuhiko; Fukuda, Satoshi

    2011-01-01

    We performed a retrospective analysis of the association between tumor HPV status and the demographic and clinicopathological parameters of 83 patients with oropharyngeal squamous cell carcinoma at Hokkaido University Hospital, Japan, between 1998 and 2010. The parameters included age, gender, tumor subsite, Tumor-Node-Metastasis (TNM) stage, and overall survival. HPV status was established by multiplex polymerase chain reaction analysis. Of the 83 oropharyngeal cancers, 22 were positive for HPV-16, two for HPV-18, and one for HPV-35 and HPV-58. Kaplan-Meier survival analysis showed improved overall survival rates in patients with HPV-positive tumors (p=0.0024) compared with HPV-negative tumors. Of the 51 patients who received chemoradiotherapy, HPV-positive patients experienced better overall survival than HPV-negative patients (p=0.0024). HPV status is a significantly favorable prognostic factor in oropharyngeal cancer in Japan. (author)

  5. Psoriasis: characteristics, psychosocial effects and treatment options.

    LENUS (Irish Health Repository)

    Ryan, Sheila

    2012-02-01

    Psoriasis is a complex chronic non-infectious inflammatory skin disease with a variety of different presentations. The classic presentation is of well-defined red plaques with silver scale. The characteristic scale makes the disorder highly visible and intrusive on the patient\\'s lifestyle. The visible nature of the disease ensures that psoriasis has both physical and psychosocial effects. In normal skin, epidermal cell reproduction and proliferation takes 28 days. In psoriasis this process is considerably accelerated to approximately 4 days, resulting in the deposit of immature cells on the skin. While the exact cause of this process is unknown, certain environmental and genetic factors are known to be triggers. Disease management depends on disease severity, psychosocial effects and the patient\\'s lifestyle. To effectively treat this disease the nurse must be skilled in psoriasis management, and in patient education and motivation. This article reviews the characteristics, aetiology, psychosocial effects and treatment strategies of psoriasis.

  6. Effectiveness of improved treatment of inflamatory bowel disiseases in infants

    Directory of Open Access Journals (Sweden)

    Marushko RV

    2015-01-01

    Full Text Available Actually is required to improve the treatment of chronic inflammatory bowel disease in infants on the principles of safety of therapeutic interventions and the impact on the basic pathogenetic mechanisms involved in the formation of the pathology of the bowel. Purpose — to evaluate the effectiveness of improved treatment of chronic non"specific non"ulcered colitis in infants using functional foods (pro", prebiotics, omega-3 long chain polyunsaturated fatty acids, L-carnitine, hepatoprotectors and alternative formulas. Patients and methods. A total of 114 infants (from 9 months up to 3 years of life with chronic non-specific non-ulcerated (unidentified colitis were studded. Researched the effectiveness of improved treatment using pro-, prebiotics, omega-3 long chain polyunsaturated fatty acids, L-carnitine, hepatoprotectors and semi-elemental formula of chronic non-specific non-ulcerated colitis on the basis of clinical and laboratory research methods, including bacteriological and immunological (TNF-α, ITF in serum, SIgA in coprofiltrates. Were used chronic non-specific non-ulcerated colitis activity index and the index of endoscopic changes of the intestinal mucosa during the treatment in infants. Results. It is shown that the use of functional foods as multiprobiotics, prebiotics, omega-3 polyunsaturated fatty acids and enhancing cellular energy provitamins as well as hepatoprotectors and alternative formulas in the treatment of chronic colitis in infants contributes to a significant improvement in the results of chronic non-specific non-ulcerated colitis treatment, more rapidly elimination of main symptoms and increase the number of positive results of treatment in infants with chronic non-specific non-ulcerated colitis (80.4% versus 55.2%. Conclusions. Results of the study allow us to recommend the use of elaborated improved treatment in infants with chronic non-specific non-ulcerated colitis on different levels of child healthcare.

  7. Which technology to select for primary focal treatment of prostate cancer?-European Section of Urotechnology (ESUT) position statement.

    Science.gov (United States)

    Ganzer, Roman; Arthanareeswaran, Vinodh Kumar Adithyaa; Ahmed, Hashim U; Cestari, Andrea; Rischmann, Pascal; Salomon, Georg; Teber, Dogu; Liatsikos, Evangelos; Stolzenburg, Jens-Uwe; Barret, Eric

    2018-05-09

    With growing interest in focal therapy (FT) of prostate cancer (PCa) there is an increasing armamentarium of treatment modalities including high-intensity focused ultrasound (HIFU), cryotherapy, focal laser ablation (FLA), irreversible electroporation (IRE), vascular targeted photodynamic therapy (VTP), focal brachytherapy (FBT) and stereotactic ablative radiotherapy (SABR). Currently there are no clear recommendations as to which of these technologies are appropriate for individual patient characteristics. Our intention was to review the literature for special aspects of the different technologies that might be of advantage depending on individual patient and tumour characteristics. The current literature on FT was screened for the following factors: morbidity, repeatability, tumour risk category, tumour location, tumour size and prostate volume and anatomical issues. The ESUT expert panel arrived at consensus regarding a position statement on a structured pathway for available FT technologies based on a combination of the literature and expert opinion. Side effects were low across different studies and FT modalities with urinary continence rates of 90-100% and erectile dysfunction between 5 and 52%. Short to medium cancer control based on post-treatment biopsies were variable between ablative modalities. Expert consensus suggested that posterior lesions are better amenable to FT using HIFU. Cryotherapy provides best possible outcomes for anterior tumours. Apical lesions, when treated with FBT, may yield the least urethral morbidity. Further prospective trials are required to assess medium to long term disease control of different ablative modalities for FT. Amongst different available FT modalities our ESUT expert consensus suggests that some may be better for diffe`rent tumour locations. Tumour risk, tumour size, tumour location, and prostate volume are all important factors to consider and might aid in designing future FT trials.

  8. Effect of a standardized treatment regime for infection after osteosynthesis.

    Science.gov (United States)

    Hellebrekers, Pien; Leenen, Luke P H; Hoekstra, Meriam; Hietbrink, Falco

    2017-03-09

    Infection after osteosynthesis is an important complication with significant morbidity and even mortality. These infections are often caused by biofilm-producing bacteria. Treatment algorithms dictate an aggressive approach with surgical debridement and antibiotic treatment. The aim of this study is to analyze the effect of such an aggressive standardized treatment regime with implant retention for acute, existing regime consisted of implant retention, thorough surgical debridement, and immediate antibiotic combination therapy with rifampicin. The primary outcome was success. Success was defined as consolidation of the fracture and resolved symptoms of infection. Culture and susceptibility testing were performed to identify bacteria and resistance patterns. Univariate analysis was conducted on patient-related factors in association with primary success and antibiotic resistance. Forty-nine patients were included for analysis. The primary success rate was 63% and overall success rate 88%. Factors negatively associated with primary success were the following: Gustilo classification (P = 0.023), higher number of debridements needed (P = 0.015), inability of primary closure (P = 0.017), and subsequent application of vacuum therapy (P = 0.030). Adherence to the treatment regime was positively related to primary success (P = 0.034). The described treatment protocol results in high success rates, comparable with success rates achieved in staged exchange in prosthetic joint infection treatment.

  9. Gender moderates valence effects on the late positive potential to emotional distracters

    OpenAIRE

    Syrjänen, Elmeri

    2013-01-01

    Attention is captured more strongly by emotional pictures than by neutral pictures. This allocation of attention to emotional pictures is commonly indexed by the late positive potential (LPP), an event-related potential (ERP) that is larger for negative and positive pictures than for neutral pictures. However, findings are mixed in regards to valence effects, that is, whether the LPP is larger for negative pictures than for positive pictures (negativity bias) or vice versa (positivity bias). ...

  10. Somato-Visceral Effects in the Treatment of Dysmenorrhea: Neuromuscular Manual Therapy and Standard Pharmacological Treatment.

    Science.gov (United States)

    Barassi, Giovanni; Bellomo, Rosa Grazia; Porreca, Annamaria; Di Felice, Piera Attilia; Prosperi, Loris; Saggini, Raoul

    2018-03-01

    This study aims to verify whether neuromuscular therapy (NMT) or pharmacology therapy (PT) is more effective for reducing symptoms in women affected by primary dysmenorrhea and the effects associated with each treatment. A controlled, randomized, single-blind clinical trial within the framework of the chair of physical medicine and rehabilitation of the University "G. d'Annunzio" of Chieti-Pescara. The study was conducted on a sample of 60 women suffering from primary dysmenorrhea. Subjects were randomly divided in two groups (A and B). Group A was treated with NMT and group B with PT. Group B was given ibuprofen or naproxen because they are considered the best painkillers for this condition. Group A was treated with 8 neuromuscular manual lumbosacral and abdominal therapy sessions twice per week for 4 weeks. Results were analyzed at the beginning (T0) and end (T1) of the study with a menstrual distress questionnaire, brief pain inventory, and visual analogue scale. Twenty patients from Group A were selected for evaluation of their maintenance of the eventual improvement that was detected in T1 at follow-up (T2). Both therapies had significant short-term effects in reducing the perception and duration of pain. However, NMT appears to give more improvements in the duration of pain. NMT had a long-term effect on perception of pain because patients conserved the positive effects of treatment after 4 weeks. NMT also had a long-term effect on duration of pain because patients conserved benefits of treatment, but this improvement started to decrease after 4 weeks. In the treatment of primary dysmenorrhea, NMT represents a valid therapeutic alternative method to PT. NMT is free from potential adverse effects of analgesics, is noninvasive, and is easy to perform.

  11. Treatment of graphite felt by modified Hummers method for the positive electrode of vanadium redox flow battery

    International Nuclear Information System (INIS)

    Wu, Xiaoxin; Xu, Hongfeng; Shen, Yang; Xu, Pengcheng; Lu, Lu; Fu, Jie; Zhao, Hong

    2014-01-01

    A novel and highly effective treatment based on modified Hummers method was firstly used to improve the electrochemical activity of graphite felt as the positive electrode in all-vanadium redox flow battery (VRFB). The graphite felt was treated by the modified Hummers method and characterized by Fourier transform infrared spectroscopy and scanning electron microscopy. The electrochemical performance of the prepared electrode was evaluated through cyclic voltammetry and electrochemical impedance spectroscopy. Results show that graphite felt treated by modified Hummers method exhibits excellent electrocatalytic activity and reaction rate to vanadium redox couples. In our research, the hydrogen electrode and H 2 replaced the graphite felt and V 2+ /V 3+ couple in the negative side in the VRFB performance test. The coulombic, voltage, and energy efficiencies of the VRFB with the as-prepared electrodes at 50 mA cm −2 are 95.0%, 81.3%, and 77.2%, respectively. These values are much higher than those of the cell-assembled graphite felt electrodes that were conventionally and thermally treated. The graphite felt treated by the modified Hummers method carries more hydrophilic groups, such as–OH, on its defects, which is advantageous in facilitating the redox reaction of vanadium ions, thereby improving the operation efficiency of the vanadium redox flow battery

  12. Socioeconomic position, treatment, and survival of non-Hodgkin lymphoma in Denmark--a nationwide study

    DEFF Research Database (Denmark)

    Frederiksen, Birgitte Lidegaard; Dalton, Susanne Oksbjerg; Osler, Merete

    2012-01-01

    Not all patients have benefited equally from the advances in non-Hodgkin lymphoma (NHL) survival. This study investigates several individual-level markers of socioeconomic position (SEP) in relation to NHL survival, and explores whether any social differences could be attributed to comorbidity...

  13. Topical 5-fluorouracil treatment of anal intraepithelial neoplasia in human immunodeficiency virus-positive men

    NARCIS (Netherlands)

    Richel, O.; Wieland, U.; de Vries, H. J. C.; Brockmeyer, N. H.; van Noesel, C.; Potthoff, A.; Prins, J. M.; Kreuter, A.

    2010-01-01

    Background Anal intraepithelial neoplasia (AIN), a human papillomavirus (HPV) induced potential precursor lesion of anal cancer, is frequent among human immunodeficiency virus (HIV)-positive men who have sex with men (MSM). So far, only a few prospective studies have been performed on the topical

  14. Vinblastine, rituximab and HAART, treatment of an HIV -positive patient with multicentric Castleman's disease

    NARCIS (Netherlands)

    van Aalderen, M. C.; Brinkman, K.; van den Berk, G. E. L.; Terpstra, W. E.

    2010-01-01

    An HIV-positive man from Somalia presented with severe malaise, weight loss, relapsing fever, lymphadenopathy and splenomegaly. An FDG-PET-scan-guided lymph node biopsy revealed the characteristic histological features of the plasma cell variant of Castleman's disease. A high HHV-8 viral load was

  15. Asymmetric inhibitory treatment effects in multilingual aphasia.

    Science.gov (United States)

    Goral, Mira; Naghibolhosseini, Maryam; Conner, Peggy S

    2013-01-01

    Findings from recent psycholinguistic studies of bilingual processing support the hypothesis that both languages of a bilingual are always active and that bilinguals continually engage in processes of language selection. This view aligns with the convergence hypothesis of bilingual language representation. Furthermore, it is hypothesized that when bilinguals perform a task in one language they need to inhibit their other, nontarget language(s) and that stronger inhibition is required when the task is performed in the weaker language than in the stronger one. The study of multilingual individuals who acquire aphasia resulting from a focal brain lesion offers a unique opportunity to test the convergence hypothesis and the inhibition asymmetry. We report on a trilingual person with chronic nonfluent aphasia who at the time of testing demonstrated greater impairment in her first acquired language (Persian) than in her third, later learned language (English). She received treatment in English followed by treatment in Persian. An examination of her connected language production revealed improvement in her grammatical skills in each language following intervention in that language, but decreased grammatical accuracy in English following treatment in Persian. The increased error rate was evident in structures that are used differently in the two languages (e.g., auxiliary verbs). The results support the prediction that greater inhibition is applied to the stronger language than to the weaker language, regardless of their age of acquisition. We interpret the findings as consistent with convergence theories that posit overlapping neuronal representation and simultaneous activation of multiple languages and with proficiency-dependent asymmetric inhibition in multilinguals.

  16. Bergamot (Citrus bergamia) Essential Oil Inhalation Improves Positive Feelings in the Waiting Room of a Mental Health Treatment Center: A Pilot Study.

    Science.gov (United States)

    Han, Xuesheng; Gibson, Jacob; Eggett, Dennis L; Parker, Tory L

    2017-05-01

    Mental health issues have been increasingly recognized as public health problems globally. Their burden is projected to increase over the next several decades. Additional therapies for mental problems are in urgent need worldwide due to the limitations and costs of existing healthcare approaches. Essential oil aromatherapy can provide a cost-effective and safe treatment for many mental problems. This pilot study observed the effects of bergamot essential oil inhalation on mental health and well-being, as measured by the Positive and Negative Affect Scale, in a mental-health treatment center located in Utah, USA. Fifty-seven eligible participants (50 women, age range: 23-70 years) were included for analysis. Fifteen minutes of bergamot essential oil exposure improved participants' positive feelings compared with the control group (17% higher). Unexpectedly, more participants participated in experimental periods rather than control periods, suggesting even brief exposure to essential oil aroma may make people more willing to enroll in clinical trials. This study provides preliminary evidence of the efficacy and safety of bergamot essential oil inhalation on mental well-being in a mental health treatment center, suggesting that bergamot essential oil aromatherapy can be an effective adjunct treatment to improve individuals' mental health and well-being. © 2017 The Authors. Phytotherapy Research published by John Wiley & Sons Ltd. © 2017 The Authors. Phytotherapy Research published by John Wiley & Sons Ltd.

  17. Plasma apelin levels in obstructive sleep apnea and the effect of continuous positive airway pressure therapy.

    Science.gov (United States)

    Henley, David E; Buchanan, Fiona; Gibson, Rosemary; Douthwaite, Jennie A; Wood, Susan A; Woltersdorf, Wolfram W; Catterall, James R; Lightman, Stafford L

    2009-10-01

    Apelin is a peptide hormone with cardiovascular and glucose homeostasis properties, and obstructive sleep apnea (OSA) is complicated by cardiovascular and metabolic comorbidities. Plasma apelin has not been previously assessed in OSA. We investigated the response of plasma apelin to a 2-h 75 g oral glucose tolerance test (OGTT) and the effect of 3 months compliant continuous positive airway pressure (CPAP) therapy in 15 obese males with newly diagnosed OSA. Plasma apelin and serum cortisol were recorded 10 minutely, while serum insulin and glucose were measured 30 minutely. Ten subjects had plasma apelin measured at intervals across a 24-h period to investigate for circadian variation in apelin levels, and this was repeated following 3 months compliant CPAP therapy. Fasting (0.342+/-0.038 vs 0.288+/-0.024 ng/ml, P=0.04), 30 min (0.399+/-0.035 vs 0.312+/-0.036 ng/ml, P=0.007) and 120 min (0.402+/-0.030 vs 0.259+/-0.024 ng/ml, P<0.001) apelin levels were reduced following CPAP. The area under curve for apelin OGTT response was lower post-CPAP (44.1+/-3.3 vs 35.8+/-2.3 ng/ml per min, P<0.001). Mean OGTT apelin levels showed a significant treatment effect (P=0.006) and a time effect (P<0.001), and the effect of time was different pre- versus post-CPAP (P=0.005). No significant variability in apelin levels existed across the 24-h period at diagnosis. Lower levels were evident overnight following treatment (P=0.004). Improvements in insulin and glucose parameters and reduced cortisol levels were found post-CPAP. In summary, untreated OSA was associated with elevated plasma apelin levels, altered apelin secretory dynamics in response to oral glucose and lack of an apparent circadian variability, which was restored following CPAP.

  18. Evaluation of treatment effects by ranking

    DEFF Research Database (Denmark)

    Halekoh, U; Kristensen, K

    2008-01-01

    In crop experiments measurements are often made by a judge evaluating the crops' conditions after treatment. In the present paper an analysis is proposed for experiments where plots of crops treated differently are mutually ranked. In the experimental layout the crops are treated on consecutive...... plots usually placed side by side in one or more rows. In the proposed method a judge ranks several neighbouring plots, say three, by ranking them from best to worst. For the next observation the judge moves on by no more than two plots, such that up to two plots will be re-evaluated again...... in a comparison with the new plot(s). Data from studies using this set-up were analysed by a Thurstonian random utility model, which assumed that the judge's rankings were obtained by comparing latent continuous utilities or treatment effects. For the latent utilities a variance component model was considered...

  19. The Institution Image and Trust and Their Effect on the Positive Word of Mouth

    Directory of Open Access Journals (Sweden)

    Soni Harsono

    2014-04-01

    Full Text Available In marketing, it is important to see how competitive a university is. Among public universities (PTN and private universities (PTS, it shows a very competitive situation recently. To overcome this problem, it requires shaping up the institution image and trust for increasing the positive word of mouth among students. This study aims to determine the effect of the institution image, trust both partially and simultaneously on the positive word of mouth by the students of private universities in Surabaya with their accreditation levels of A, B and C. The sample consists of students from six colleges with accreditation ratings A, B, and C totaling 125 students. Accidental sampling technique was done using a sampling technique of multiple regression analysis with SPSS version 17. It shows, for the college with accreditation category C, the image of the institution both partially and simulta-neously has significant positive effect on the positive word of mouth. For the college accreditation category B, the image of the institution and trust simultaneously has significant positive effect on the positive word of mouth and, finally, trust in accreditation category A has significant positive effect on the positive word of mouth and the institution image and trust simultaneously have significant positive effect on the positive word of mouth.

  20. CNS effects following the treatment of malignancy

    International Nuclear Information System (INIS)

    Rane, N.; Quaghebeur, G.

    2012-01-01

    Corporeal and central nervous system (CNS) axis chemotherapy and radiotherapy have long been used for the effective treatment and prophylaxis of CNS, body malignancies, and leukaemias. However, they are not without their problems. Following the proliferation of magnetic resonance neuroimaging in recent years it has become clear that the spectrum of toxicity that these therapies produce ranges from subclinical white matter changes to overt brain necrosis. The effects are both direct and indirect and via different pathological mechanisms. Chronic and progressive changes can be detected many years after the initial intervention. In addition to leucoencephalopathic changes, grey matter changes are now well described. Changes may be difficult to distinguish from tumour recurrence, though may be reversible and remediable, and are thus very important to differentiate. In this review toxic effects are classified and their imaging appearances discussed, with reference to specific syndromes.

  1. A randomised controlled trial of positive memory training for the treatment of depression within schizophrenia

    NARCIS (Netherlands)

    Steel, C.; van der Gaag, M.; Korrelboom, K.; Simon, J.; Phiri, P.; Baksh, M.F.; Wykes, T.; Rose, D.; Hardcastle, M.; Enright, S.; Evans, G.; Kingdon, D.

    2015-01-01

    Background: Depression is highly prevalent within individuals diagnosed with schizophrenia, and is associated with an increased risk of suicide. There are no current evidence based treatments for low mood within this group. The specific targeting of co-morbid conditions within complex mental health

  2. Early treatment of idiopathic respiratory distress syndrome using binasal continuous positive airway pressure

    DEFF Research Database (Denmark)

    Kamper, J; Ringsted, C

    1990-01-01

    out of 25 infants with a birth weight less than or equal to 1500 g and in 53 out of 60 infants with a birth weight greater than 1500 g. Seven infants developed pneumothorax during CPAP treatment. Seventy-four infants survived, all without bronchopulmonary dysplasia. At the age of 1.5-4.5 years...

  3. A randomised controlled trial of positive memory training for the treatment of depression within schizophrenia

    NARCIS (Netherlands)

    Steel, Craig; van der Gaag, Mark; Korrelboom, Kees; Simon, Judit; Phiri, Peter; Baksh, M. Fazil; Wykes, Til; Rose, Diana; Rose, Suzanna; Hardcastle, Mark; Enright, Simon; Evans, Gareth; Kingdon, David

    2015-01-01

    Background Depression is highly prevalent within individuals diagnosed with schizophrenia, and is associated with an increased risk of suicide. There are no current evidence based treatments for low mood within this group. The specific targeting of co-morbid conditions within complex mental health

  4. False Positive Functional Analysis Results as a Contributor of Treatment Failure during Functional Communication Training

    Science.gov (United States)

    Mann, Amanda J.; Mueller, Michael M.

    2009-01-01

    Research has shown that functional analysis results are beneficial for treatment selection because they identify reinforcers for severe behavior that can then be used to reinforce replacement behaviors either differentially or noncontingently. Theoretically then, if a reinforcer is identified in a functional analysis erroneously, a well researched…

  5. Urine Osmolality in Treatment-naïve HIV-positive Subjects in ...

    African Journals Online (AJOL)

    2017-03-01

    Mar 1, 2017 ... commonly evaluated in routine clinical practice and in human ... the variables and urine osmolality and the strength of variables to ... function, and weight were common in treatment-naïve HIV subjects who had ... Nigeria, underweight and obesity, urine osmolality ..... associated with a salt-losing syndrome.

  6. Differential Effects of Positive versus Negative Self-Involving Counselor Responses.

    Science.gov (United States)

    Remer, Pam; And Others

    1983-01-01

    Investigated the effects of positive and negative counselor disclosure using typescripts of hypothetical counseling interviews. Results indicated impact of condition was mixed, with each having some desirable effects. (PAS)

  7. Positive or negative Poynting effect? The role of adscititious inequalities in hyperelastic materials

    KAUST Repository

    Mihai, L. A.; Goriely, A.

    2011-01-01

    Motivated by recent experiments on biopolymer gels whereby the reverse of the usual (positive) Poynting effect was observed, we investigate the effect of the so-called 'adscititious inequalities' on the behaviour of hyperelastic materials subject

  8. Tinea capitis in the form of concentric rings in an HIV positive adult on antiretroviral treatment

    Directory of Open Access Journals (Sweden)

    Kirti Narang

    2012-01-01

    Full Text Available Dermatophyte infection may present in the form of concentric rings caused by Trichophyton concentricum, known as Tinea Imbricata. In immunosuppressed patients, there are reports of lesions in the form of concentric rings caused by dermatophytes other than Trichophyton concentricum too, mostly by Trichophyton tonsurans, known as Tinea indesiciva or Tinea pseudoimbricata. We report a case of tinea capitis in a HIV-positive adult woman on antiretroviral therapy, who presented with concentric rings of papules and pustules with slight scaling on the scalp along with diffuse thinning of hair. Both Potassium hydroxide mount and culture showed the presence of Dermatophytes. Tinea capitis is considered rare in adults, but new cases are being reported in immunocompromised as well as in immunocompetent patients. The pertinent features of this case are: HIV-positive adult female on antiretroviral therapy, presenting with tinea capitis in the form of concentric rings; culture from the lesion grew Microsporum audouinii; responding to oral Terbinafine.

  9. The effects of an edgeline on speed and lateral position: a meta-analysis

    NARCIS (Netherlands)

    van Driel, Cornelie J.G.; Davidse, Ragnhild J.; van Maarseveen, Martin F.A.M.

    2004-01-01

    This paper presents a meta-analysis of studies that have evaluated the effects of an edgeline on speed and lateral position of motorised road users. Together with many other study characteristics, 41 estimates of the effects of an edgeline on speed and 65 on lateral position were extracted from the

  10. The effect of positive end-expiratory pressure on pulse pressure ...

    African Journals Online (AJOL)

    The effect of positive end-expiratory pressure on pulse pressure variation. FJ Smith, M Geyser, I Schreuder, PJ Becker. Abstract. Objectives: To determine the effect of different levels of positive end-expiratory pressure (PEEP) on pulse pressure variation (PPV). Design: An observational study. Setting: Operating theatres of a ...

  11. Effect of Continuous Positive Airway Pressure on Stroke Rehabilitation: A Pilot Randomized Sham-Controlled Trial

    Science.gov (United States)

    Khot, Sandeep P.; Davis, Arielle P.; Crane, Deborah A.; Tanzi, Patricia M.; Li Lue, Denise; Claflin, Edward S.; Becker, Kyra J.; Longstreth, W.T.; Watson, Nathaniel F.; Billings, Martha E.

    2016-01-01

    Study Objectives: Obstructive sleep apnea (OSA) predicts poor functional outcome after stroke and increases the risk for recurrent stroke. Less is known about continuous positive airway pressure (CPAP) treatment on stroke recovery. Methods: In a pilot randomized, double-blind, sham-controlled trial, adult stroke rehabilitation patients were assigned to auto-titrating or sham CPAP without diagnostic testing for OSA. Change in Functional Independence Measure (FIM), a measure of disability, was assessed between rehabilitation admission and discharge. Results: Over 18 months, 40 patients were enrolled and 10 withdrew from the study: 7 from active and 3 from sham CPAP (p > 0.10). For the remaining 30 patients, median duration of CPAP use was 14 days. Average CPAP use was 3.7 h/night, with at least 4 h nightly use among 15 patients. Adherence was not influenced by treatment assignment or stroke severity. In intention-to-treat analyses (n = 40), the median change in FIM favored active CPAP over sham but did not reach statistical significance (34 versus 26, p = 0.25), except for the cognitive component (6 versus 2.5, p = 0.04). The on-treatment analyses (n = 30) yielded similar results (total FIM: 32 versus 26, p = 0.11; cognitive FIM: 6 versus 2, p = 0.06). Conclusions: A sham-controlled CPAP trial among stroke rehabilitation patients was feasible in terms of recruitment, treatment without diagnostic testing and adequate blinding—though was limited by study retention and CPAP adherence. Despite these limitations, a trend towards a benefit of CPAP on recovery was evident. Tolerance and adherence must be improved before the full benefits of CPAP on recovery can be assessed in larger trials. Citation: Khot SP, Davis AP, Crane DA, Tanzi PM, Li Lue D, Claflin ES, Becker KJ, Longstreth WT, Watson NF, Billings ME. Effect of continuous positive airway pressure on stroke rehabilitation: a pilot randomized sham-controlled trial. J Clin Sleep Med 2016;12(7):1019–1026. PMID

  12. Continuous Positive Airway Pressure (CPAP)

    Science.gov (United States)

    ... ENT Doctor Near You Continuous Positive Airway Pressure (CPAP) Continuous Positive Airway Pressure (CPAP) Patient Health Information ... relations staff at newsroom@entnet.org . What Is CPAP? The most common and effective nonsurgical treatment for ...

  13. Reactivation of tuberculosis during immunosuppressive treatment in a patient with a positive QuantiFERON-RD1 test

    DEFF Research Database (Denmark)

    Ravn, Pernille; Munk, Martin E; Andersen, Ase Bengaard

    2004-01-01

    A patient with polymyositis developed tuberculosis during immunosuppressive treatment. Tuberculin Skin Test and chest X-ray failed to demonstrate latent tuberculosis, whereas a blood sample that was tested with a modified QuantiFERON-TB-assay, using the recombinant ESAT-6 and CFP-10, was positive...... indicating that this patient was latently infected before immunosuppressive therapy. This case indicates the risk of progressing from latent to active tuberculosis given that the subject is RD1 responsive, and we believe that preventive anti-tuberculous treatment could have prevented this case...

  14. Evaluation of direct membrane filtration and direct forward osmosis as concepts for compact and energy-positive municipal wastewater treatment

    DEFF Research Database (Denmark)

    Hey, Tobias; Bajraktari, Niada; Davidsson, Åsa

    2018-01-01

    electricity, energy and area demands. Both concepts would fulfil the Swedish discharge demands for small- and medium-sized wastewater treatment plants at full scale: (1) direct MF and (2) direct FO with seawater as the draw solution. The framework of this study is based on a combination of data obtained from...... positive with respect to electricity and energy, as more biogas can be produced compared to that using conventional wastewater treatment. Furthermore, the specific area demand is significantly reduced. This study demonstrates that municipal wastewater could be treated in a more energy- and area...

  15. Reactivation of tuberculosis during immunosuppressive treatment in a patient with a positive QuantiFERON-RD1 test

    DEFF Research Database (Denmark)

    Ravn, Pernille; Munk, Martin E; Andersen, Ase Bengaard

    2004-01-01

    A patient with polymyositis developed tuberculosis during immunosuppressive treatment. Tuberculin Skin Test and chest X-ray failed to demonstrate latent tuberculosis, whereas a blood sample that was tested with a modified QuantiFERON-TB-assay, using the recombinant ESAT-6 and CFP-10, was positive...... indicating that this patient was latently infected before immunosuppressive therapy. This case indicates the risk of progressing from latent to active tuberculosis given that the subject is RD1 responsive, and we believe that preventive anti-tuberculous treatment could have prevented this case...... of tuberculosis. We suggest that RD1 based tests are evaluated further in immunocompromised patients....

  16. PP087. Deep trial secondary analysis: Digoxin immune fab fragment treatment has additional benefits in endogenous digitalis-like factor positive preeclamptic women.

    Science.gov (United States)

    Graves, S W; Hopoate-Sitake, M; Johnston, A; Buckalew, V; Lam, G; Mason, L; Adair, D

    2012-07-01

    A double blinded placebo controlled clinical trial of a commercial digoxin immune Fab fragment (DIF) in preeclamptic (PE) women provided some benefit to treated subjects (1). In that study DIF, relative to placebo, prevented a decline in CrCl and lowered levels of endogenous digitalis-like factor (EDLF) activity as measured by sodium pump inhibition (SPI). However, some PE subjects had undetectable EDLF. The hypothesis tested was that only PE women with measureable EDLF would respond to DIF treatment and analysis of EDLF positive women might reveal treatment effects masked by inclusion of EDLF negative, and hence non-responding, PE women. Accordingly, analyses of DIF effects in EDLF positive PE women were conducted. Patient characteristics and study design have been published (1). In these subanalyses, subjects were considered to be EDLF positive if their plasma inhibited red cell sodium pump mediated Rb uptake. All analyses were redone for the EDLF positive subgroup by Covance Inc as in the original trial. Continuous data were analyzed by ANCOVA. Categorical data were analyzed by Barnard Exact Test. 45 subjects (23 DIF, 22 placebo) had baseline SPI evaluated. Of these 22% had undetectable SPI. EDLF positive PE women showed greater and more significant reductions of SPI in response to DIF at each time point (12, 24, 48 hr treatment) than in the original analysis. Subjects with undetectable EDLF showed no significant change in response to DIF or placebo. For CrCl, EDLF positive PE women showed greater and more significant preservation of CrCl compared with original analyses. Subjects absent EDLF showed deterioration of CrCl with or without DIF. Among EDLF positive PE women DIF treated women had significantly less maternal pulmonary edema (p=0.035) and significantly less intraventricular hemorrhage in their infants (p=0.015). There was the suggestion of reductions in the incidence of other maternal and neonatal abnormalities. These data indicate that EDLF positive PE

  17. Individually dosed omalizumab: an effective treatment for severe peanut allergy.

    Science.gov (United States)

    Brandström, J; Vetander, M; Lilja, G; Johansson, S G O; Sundqvist, A-C; Kalm, F; Nilsson, C; Nopp, A

    2017-04-01

    Treatment with omalizumab has shown a positive effect on food allergies, but no dosages are established. Basophil allergen threshold sensitivity (CD-sens) can be used to objectively measure omalizumab treatment efficacy and correlates with the outcome of double-blind placebo-controlled food challenge to peanut. To evaluate whether individualized omalizumab treatment monitored by CD-sens could be an effective intervention for suppression of allergic reactions to peanut. Severely peanut allergic adolescents (n = 23) were treated with omalizumab for 8 weeks, and CD-sens was analysed before and after. Based on whether CD-sens was suppressed after 8 weeks, the patients either were subject to a peanut challenge or received eight more weeks with increased dose of omalizumab, followed by peanut challenge or another 8-week cycle of omalizumab. IgE and IgE-antibodies to peanut and its components were analysed before treatment. After individualized omalizumab treatment (8-24 weeks), all patients continued with an open peanut challenge with no (n = 18) or mild (n = 5) objective allergic symptoms. Patients (n = 15) needing an elevated omalizumab dose (ED) to suppress CD-sens had significantly higher CD-sens values at baseline 1.49 (0.44-20.5) compared to those (n = 8) who managed with normal dose (ND) 0.32 (0.24-5.5) (P omalizumab, monitored by CD-sens, is an effective and safe treatment for severe peanut allergy. The ratio of IgE-ab to storage protein Ara h 2/IgE as well as CD-sens to peanut may predict the need of a higher omalizumab dose. Clinical trials numbers: EudraCT; 2012-005625-78, ClinicalTrials.gov; NCT02402231. © 2016 John Wiley & Sons Ltd.

  18. Diagnosis and treatment of hypoparathyroidism: a position statement from the Brazilian Society of Endocrinology and Metabolism.

    Science.gov (United States)

    Maeda, Sergio Setsuo; Moreira, Carolina Aguiar; Borba, Victória Zeghbi Cochenski; Bandeira, Francisco; Farias, Maria Lucia Fleiuss de; Borges, João Lindolfo Cunha; Paula, Francisco José Albuquerque de; Vanderlei, Felipe Augusto Brasileiro; Montenegro, Fábio Luiz de Menezes; Santos, Rodrigo Oliveira; Ferraz-de-Souza, Bruno; Lazaretti-Castro, Marise

    2018-02-01

    Objective To present an update on the diagnosis and treatment of hypoparathyroidism based on the most recent scientific evidence. Materials and methods The Department of Bone and Mineral Metabolism of the Sociedade Brasileira de Endocrinologia e Metabologia (SBEM; Brazilian Society of Endocrinology and Metabolism) was invited to prepare a document following the rules set by the Guidelines Program of the Associação Médica Brasileira (AMB; Brazilian Medical Association). Relevant papers were retrieved from the databases MEDLINE/PubMed, LILACS, and SciELO, and the evidence derived from each article was classified into recommendation levels according to scientific strength and study type. Conclusion An update on the recent scientific literature addressing hypoparathyroidism is presented to serve as a basis for the diagnosis and treatment of this condition in Brazil.

  19. Outcome correlation of smear-positivity but culture-negativity during standard anti-tuberculosis treatment in Taiwan.

    Science.gov (United States)

    Chao, Wen-Cheng; Huang, Yi-Wen; Yu, Ming-Chih; Yang, Wen-Ta; Lin, Chou-Jui; Lee, Jen-Jyh; Huang, Ruay-Ming; Shieh, Chi-Chang; Chien, Shun-Tien; Chien, Jung-Yien

    2015-02-18

    The appearance of smear-positivity but culture-negativity (SPCN) for acid-fast bacilli among sputum specimen is frequently found in pulmonary tuberculosis (TB) patients during treatment. This study aimed to investigate clinical risk factors, impacts on treatment course, and relapse pattern associated with sputum SPCN. We retrospectively enrolled 800 patients with culture-proven pulmonary TB who were receiving standard treatment and follow-up at six TB-referral hospitals in Taiwan between January 2006 and December 2007. Relevant patient characteristics and chemotherapy data were analyzed for associations with incidence of SPCN. Data from patients who relapsed within 3 years after completing treatment were analyzed for associations with SPCN during treatment. Of the 800 subjects, 111 (13.8%) had sputum SPCN during treatment. Three factors were found to predict the development of SPCN; namely, high initial acid-fast staining grading (OR, 3.407; 95% CI, 2.090-5.553), cavitation on chest-X ray films (OR, 2.217; 95% CI, 1.359-3.615), and smoking (OR, 1.609; 95% CI, 1.006-2.841). Patients with SPCN had longer treatment duration (rifampicin: 284 ± 91 vs. 235 ± 69 days, P <0.001; isoniazid: 289 ± 90 vs. 234 ± 69 days, P < 0.001) than those without SPCN. Finally, the rate of relapse within 3 years of completing treatment was similar for groups with/without SPCN (2.7%, 3/111 vs. 1.0%, 7/689, respectively; P = 0.15). In conclusion, severity of infection was a major risk factor for SPCN during treatment; however, the relapse rate within 3 years of completing treatment was not affected by the appearance of SPCN.

  20. Some positive effects of pine oil on brain tissue in streptozotocin-induced diabetic rats

    International Nuclear Information System (INIS)

    Demir, E.; Keser, S.; Yilmiz, O.

    2016-01-01

    Pine oil has antiseptic, expectorant and antioxidant properties and has been used for treatment of rheumatism, respiratory and urinary system and skin diseases. We aimed to determine protective effects of pine oil (PO) on the lipid-soluble vitamins, cholesterol, GSH, total protein, MDA, fatty acid levels of brain tissue of the streptozotocin-induced diabetic rats. Rats were randomly divided into three groups: Control (C), streptozotocin (STZ), streptozotocin+pine oil (PO) groups. Streptozotocin was injected intraperitoneally single dose (65 mg/kg) to the STZ and PO groups for inducing of diabetes. To the PO group 1 mg/kg dose pine oil was intraperitoneally injected every next day. While the GSH and total protein were significantly decreased in the Streptozotocin (STZ) group, their levels were protected in PO group. MDA level was significantly increased in STZ group, its level significantly decreased in the PO group. Our results showed that PO has a positive effect on the GSH, total protein, and MDA levels in the brain tissue of diabetic rats. The PO and STZ administrations were affected by levels of some important fatty acids. The decrease in the MDA level and observed protecting effects can be attributed to PO extract, because it contains some important phytochemical constituents. (author)

  1. The effect of loving-kindness meditation on positive emotions: a meta-analytic review.

    Science.gov (United States)

    Zeng, Xianglong; Chiu, Cleo P K; Wang, Rong; Oei, Tian P S; Leung, Freedom Y K

    2015-01-01

    While it has been suggested that loving-kindness meditation (LKM) is an effective practice for promoting positive emotions, the empirical evidence in the literature remains unclear. Here, we provide a systematic review of 24 empirical studies (N = 1759) on LKM with self-reported positive emotions. The effect of LKM on positive emotions was estimated with meta-analysis, and the influence of variations across LKM interventions was further explored with subgroup analysis and meta-regression. The meta-analysis showed that (1) medium effect sizes for LKM interventions on daily positive emotions in both wait-list controlled RCTs and non-RCT studies; and (2) small to large effect sizes for the on-going practice of LKM on immediate positive emotions across different comparisons. Further analysis showed that (1) interventions focused on loving-kindness had medium effect size, but interventions focused on compassion showed small effect sizes; (2) the length of interventions and the time spent on meditation did not influence the effect sizes, but the studies without didactic components in interventions had small effect sizes. A few individual studies reported that the nature of positive emotions and individual differences also influenced the results. In sum, LKM practice and interventions are effective in enhancing positive emotions, but more studies are needed to identify the active components of the interventions, to compare different psychological operations, and to explore the applicability in clinical populations.

  2. The effect of loving-kindness meditation on positive emotions: a meta-analytic review

    Directory of Open Access Journals (Sweden)

    Xianglong eZENG

    2015-11-01

    Full Text Available While it has been suggested that loving-kindness meditation (LKM is an effective practice for promoting positive emotions, the empirical evidence in the literature remains unclear. Here, we provide a systematic review of 24 empirical studies (N = 1759 on LKM with self-reported positive emotions. The effect of LKM on positive emotions was estimated with meta-analysis, and the influence of variations across LKM interventions was further explored with subgroup analysis and meta-regression. The meta-analysis showed that (1 medium effect sizes for LKM interventions on daily positive emotions in both wait-list controlled RCTs and non-RCT studies; and (2 small to large effect sizes for the on-going practice of LKM on immediate positive emotions across different comparisons. Further analysis showed that (1 interventions focused on loving-kindness had medium effect size, but interventions focused on compassion showed small effect sizes; (2 the length of interventions and the time spent on meditation did not influence the effect sizes, but the studies without didactic components in interventions had small effect sizes. A few individual studies reported that the nature of positive emotions and individual differences also influenced the results. In sum, LKM practice and interventions are effective in enhancing positive emotions, but more studies are needed to identify the active components of the interventions, to compare different psychological operations, and to explore the applicability in clinical populations.

  3. Effect of patient position on the lordosis and scoliosis of patients with degenerative lumbar scoliosis.

    Science.gov (United States)

    Fei, Han; Li, Wei-Shi; Sun, Zhuo-Ran; Jiang, Shuai; Chen, Zhong-Qiang

    2017-08-01

    This study aimed to analyze the effect of patient positions on the lordosis and scoliosis of patients with degenerative lumbar scoliosis (DLS).Seventy-seven patients with DLS were retrospectively analyzed. We measured lordosis and Cobb's angle on preoperative upright x-rays and magnetic resonance imagings in supine position. The lordosis and scoliosis of surgical segments in intraoperative prone position were measured on intraoperative radiographs of 20 patients to compare with that in standing position. Paired t tests were performed to investigate the parameters of the sample.From standing to supine position the whole lordosis increased (29.2 ± 15.7 degree vs. 34.9 ± 11.2 degree), and the whole scoliosis decreased (24.3 ± 11.8 degree vs. 19.0 ± 10.5 degree); 53 of 77 (68.8%) cases had increased lordosis, and 67 of 77 (87%) cases had decreased scoliosis. The lordosis of surgical segments in standing position had no difference with that in intraoprerative prone position. But in changing from supine/standing position to intraoprerative prone position, the scoliosis of surgical segments decreased (14.7 ± 9.4 degree vs. 11.4 ± 7.0 degree; 19.0 ± 11.8 degree vs. 11.4 ± 7.0 degree, respectively), and 18 of 20 (90%) cases had decreased scoliosis in intraoperative prone position than that in standing position.Compared with standing position in DLS patients, supine position increased lordosis and reduced scoliosis, and intraoperative prone position reduced scoliosis significantly. When evaluating the severity of DLS and making preoperative surgical plans, lumbar lordosis in supine position should also be evaluated in addition to upright x-ray, and the effects of different positions should be taken into consideration to reduce deviation.

  4. The effect of mechanical stress on lateral-effect position-sensitive detector characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, H.A. [Department of Information Technology and Media, Mid-Sweden University, SE-85170 Sundsvall (Sweden)]. E-mail: Henrik.Andersson@miun.se; Mattsson, C.G. [Department of Information Technology and Media, Mid-Sweden University, SE-85170 Sundsvall (Sweden); Thungstroem, G. [Department of Information Technology and Media, Mid-Sweden University, SE-85170 Sundsvall (Sweden); Lundgren, A. [SiTek Electro Optics, Ogaerdesvaegen 13A 433 30 Partille (Sweden); Nilsson, H.-E. [Department of Information Technology and Media, Mid-Sweden University, SE-85170 Sundsvall (Sweden)

    2006-07-01

    Position-sensitive detectors (PSDs) are widely used in noncontact measurement systems. In order to minimize the size of such systems, interest has increased in mounting the PSD chip directly onto printed circuit boards (PCBs). Stress may be induced in the PSD because of the large differences in thermal expansion coefficients, as well as the long-term geometrical stability of the chip packaging. Mechanical stress has previously been shown to have an effect on the performance of semiconductors. The accuracy, or linearity, of a lateral effect PSD is largely dependent on the homogeneity of the resistive layer. Variations of the resistivity over the active area of the PSD will result in an uneven distribution of photo-generated current, and hence an error in the readout position. In this work experiments were performed to investigate the influence of anisotropic mechanical stress in terms of nonlinearity. PSD chips of 60x3 mm active area were subjected, respectively, to different amounts of compressive and tensile stress to determine the influence on the linearity.

  5. Improved treatment of global positioning system force parameters in precise orbit determination applications

    Science.gov (United States)

    Vigue, Y.; Lichten, S. M.; Muellerschoen, R. J.; Blewitt, G.; Heflin, M. B.

    1993-01-01

    Data collected from a worldwide 1992 experiment were processed at JPL to determine precise orbits for the satellites of the Global Positioning System (GPS). A filtering technique was tested to improve modeling of solar-radiation pressure force parameters for GPS satellites. The new approach improves orbit quality for eclipsing satellites by a factor of two, with typical results in the 25- to 50-cm range. The resultant GPS-based estimates for geocentric coordinates of the tracking sites, which include the three DSN sites, are accurate to 2 to 8 cm, roughly equivalent to 3 to 10 nrad of angular measure.

  6. Legacy of road salt: Apparent positive larval effects counteracted by negative postmetamorphic effects in wood frogs.

    Science.gov (United States)

    Dananay, Kacey L; Krynak, Katherine L; Krynak, Timothy J; Benard, Michael F

    2015-10-01

    Road salt runoff has potentially large effects on wetland communities, but is typically investigated in short-term laboratory trials. The authors investigated effects of road salt contamination on wood frogs (Rana sylvatica) by combining a field survey with 2 separate experiments. The field survey tested whether wood frog larval traits were associated with road salt contamination in natural wetlands. As conductivity increased, wood frog larvae were less abundant, but those found were larger. In the first experiment of the present study, the authors raised larvae in outdoor artificial ponds under 4 salt concentrations and measured larval vital rates, algal biomass, and zooplankton abundance. Salt significantly increased larval growth, algal biomass, and decreased zooplankton abundance. In the second experiment, the authors raised larvae to metamorphosis in the presence and absence of salt contamination and followed resulting juvenile frogs in terrestrial pens at high and low densities. Exposure to road salt as larvae caused juvenile frogs to have greater mortality in low-density terrestrial environments, possibly because of altered energy allocation, changes in behavior, or reduced immune defenses. The present study suggests that low concentrations of road salt can have positive effects on larval growth yet negative effects on juvenile survival. These results emphasize the importance of testing for effects of contaminants acting through food webs and across multiple life stages as well as the potential for population-level consequences in natural environments. © 2015 SETAC.

  7. Weightbath hydrotraction treatment: application, biomechanics, and clinical effects

    Directory of Open Access Journals (Sweden)

    Márta Kurutz

    2010-04-01

    Full Text Available Márta Kurutz1, Tamás Bender21Department of Structural Mechanics, Budapest University of Technology and Economics, Hungary; 2Department of Physical Medicine, Polyclinic and Hospital of the Hospitaller Brothers of St. John of God, Budapest, Medical University of Szeged, HungaryBackground and purpose: Weightbath hydrotraction treatment (WHT is a simple noninvasive effective method of hydro- or balneotherapy to stretch the spine or lower limbs, applied successfully in hospitals and health resort sanitaria in Hungary for more than fifty years. This study aims to introduce WHT with its biomechanical and clinical effects. History, development, equipment, modes of application, biomechanics, spinal traction forces and elongations, indications and contraindications of WHT are precented.Subjects and methods: The calculation of traction forces acting along the spinal column during the treatment is described together with the mode of suspension and the position of extra weight loads applied. The biomechanics of the treatment are completed by in vivo measured elongations of lumbar segments using a special underwater ultrasound measuring method. The clinical effects, indications, and contraindications of the treatment are also presented.Results: In the underwater cervical suspension of a human body, approximately 25 N stretching load occurs in the cervical spine, and about 11 N occurs in the lumbar spine. By applying extra weights, the above tensile forces along the spinal column can be increased. Thus, the traction effect can be controlled by applying such loads during the treatment. Elongations of segments L3–L4, L4–L5, and L5–S1 were measured during the usual WHT of patients suspended cervically in water for 20 minutes, loaded by 20–20 N lead weights on the ankles. The mean initial elastic elongations of spinal segments were about 0.8 mm for patients aged under 40 years, 0.5 mm between 40–60 years, and 0.2 mm for patients over 60 years. The mean

  8. Residual position errors of lymph node surrogates in breast cancer adjuvant radiotherapy: Comparison of two arm fixation devices and the effect of arm position correction

    International Nuclear Information System (INIS)

    Kapanen, Mika; Laaksomaa, Marko; Skyttä, Tanja; Haltamo, Mikko; Pehkonen, Jani; Lehtonen, Turkka; Kellokumpu-Lehtinen, Pirkko-Liisa; Hyödynmaa, Simo

    2016-01-01

    Residual position errors of the lymph node (LN) surrogates and humeral head (HH) were determined for 2 different arm fixation devices in radiotherapy (RT) of breast cancer: a standard wrist-hold (WH) and a house-made rod-hold (RH). The effect of arm position correction (APC) based on setup images was also investigated. A total of 113 consecutive patients with early-stage breast cancer with LN irradiation were retrospectively analyzed (53 and 60 using the WH and RH, respectively). Residual position errors of the LN surrogates (Th1-2 and clavicle) and the HH were investigated to compare the 2 fixation devices. The position errors and setup margins were determined before and after the APC to investigate the efficacy of the APC in the treatment situation. A threshold of 5 mm was used for the residual errors of the clavicle and Th1-2 to perform the APC, and a threshold of 7 mm was used for the HH. The setup margins were calculated with the van Herk formula. Irradiated volumes of the HH were determined from RT treatment plans. With the WH and the RH, setup margins up to 8.1 and 6.7 mm should be used for the LN surrogates, and margins up to 4.6 and 3.6 mm should be used to spare the HH, respectively, without the APC. After the APC, the margins of the LN surrogates were equal to or less than 7.5/6.0 mm with the WH/RH, but margins up to 4.2/2.9 mm were required for the HH. The APC was needed at least once with both the devices for approximately 60% of the patients. With the RH, irradiated volume of the HH was approximately 2 times more than with the WH, without any dose constraints. Use of the RH together with the APC resulted in minimal residual position errors and setup margins for all the investigated bony landmarks. Based on the obtained results, we prefer the house-made RH. However, more attention should be given to minimize the irradiation of the HH with the RH than with the WH.

  9. [Silvicultural treatments and their selection effects].

    Science.gov (United States)

    Vincent, G

    1973-01-01

    Selection can be defined in terms of its observable consequences as the non random differential reproduction of genotypes (Lerner 1958). In the forest stands we are selecting during the improvements-fellings and reproduction treatments the individuals surpassing in growth or in production of first-class timber. However the silvicultural treatments taken in forest stands guarantee a permanent increase of forest production only in such cases, if they have been taken with respect to the principles of directional (dynamic) selection. These principles require that the trees determined for further growing and for forest regeneration are selected by their hereditary properties, i.e. by their genotypes.For making this selection feasible, our study deals with the genetic parameters and gives some examples of the application of the response, the selection differential, the heritability in the narrow and in the broad sense, as well as of the genetic and genotypic gain. On the strength of this parameter we have the possibility to estimate the economic success of several silvicultural treatments in forest stands.The mentioned examples demonstrate that the selection measures of a higher intensity will be manifested in a higher selection differential, in a higher genetic and genotypic gain and that the mentioned measures show more distinct effects in the variable populations - in natural forest - than in the population characteristic by a smaller variability, e.g. in many uniform artificially established stands.The examples of influences of different selection on the genotypes composition of population prove that genetics instructs us to differentiate the different genotypes of the same species and gives us at the same time a new criterions for evaluating selectional treatments. These criterions from economic point of view is necessary to consider in silviculture as advantageous even for the reason that we can judge from these criterions the genetical composition of forest stands

  10. Effects of Triclabendazole and Al bendazole on treatment of Fascioliasis

    International Nuclear Information System (INIS)

    Mawoad, M.A.F.; Amin, M.M.; Elnashar, D. E.

    2010-01-01

    Fascioliasis is a zoonotic disease caused by the trematode Fasciola hepatica, a liver fluke. It affect numerous species mainly ruminants. Its usual hosts are sheep or cattle, in which it causes a disease of economic importance. The prevalence of human infection has been reported worldwide. The present study was designed to evaluate the comparative efficacy of different anthelmintic drugs against Fasciola hepatica infestation. Twenty parasite-free rabbits were divided into four groups, group I: non-infected non- treated rabbits, kept as negative control. Rabbits of group II, III and IV were intended for infection with 20 Fasciola hepatica metacercariae per animal. Group II received no treatment and kept as positive control. Animals of group III administered Triclabendazole (TCBZ) treatment orally in a single dose (0.45 mg/Kg b. wt.) 60 days after infection. Consistent with group III, animals of group IV administered a bendazole (ABZ) treatment orally in a single dose (0.52 mg/Kg b.wt.) The comparisons between the anthelmintic efficacy of TCBZ and ABZ were done throughout (1): parasitological evaluation of egg counts; (2): biochemical evaluation of serum AST and ALT; (3): histopathological examination of liver and (4): scanning electron microscope of host worms. Data represented showed that the egg count was highly significant reduced in rabbits treated with TCBZ as compared with those of positive control group. But, rabbits treated with ABZ revealed slightly reduction as compared with those of positive control group. Also, the results illustrated that infection of rabbits with Fasciola hepatica induced a highly significant increased in serum (AST and ALT) activities compared to control group. In response to treatment with TCBZ and ABZ, it was revealed a significant decrease in the enzyme activity of both serum AST and ALT levels compared to those of control negative group as well as control positive group. However, histopathological examination showed a significant

  11. Changes in anteroposterior position and inclination of the maxillary incisors after surgical-orthodontic treatment of skeletal class III malocclusions.

    Science.gov (United States)

    Zou, Bingshuang; Zhou, Yang; Lowe, Alan A; Li, Huiqi; Pliska, Benjamin

    2015-12-01

    The purpose of this study was to evaluate and compare the anteroposterior (AP) position and inclination of the maxillary incisors in subjects with class I normal occlusion and a harmonious profile with patients with skeletal class III malocclusions, and to investigate the changes in maxillary incisor inclination and AP position after surgical-orthodontic treatment in class III patients. Sixty-five subjects (35 female and 30 male; mean age: 21.8 ± 3.89 years) with normal profiles and class I skeletal and dental patterns were selected as a control sample. Sixty-seven patients (38 female and 29 male; mean age: 21.3 ± 3.31 years) with skeletal and dental class III malocclusions who sought surgical-orthodontic treatment were used as the study sample. Subjects were asked to smile and profile photographs were taken with the head in a natural position and the maxillary central incisors and the forehead in full view; cephalograms were taken and superimposed on the profile pictures according to the outline of the forehead and nose. Forehead inclination, maxillary incisor facial inclination and the AP position of the maxillary central incisor relative to the forehead (FAFFA) were measured on the integrated images and statistical analyses were performed. In both groups, there were no significant male/female differences in either the maxillary central incisor inclination or AP position. Female subjects had a significantly steeper forehead inclination compared with males (P 0.05). In the control group, 84.6% had the facial axial point (FA) of their maxillary central incisors positioned between lines through the forehead facial axis (FFA) point and the glabella. In the study group, however, 79.1% had the maxillary central incisors positioned posterior to the line through the FFA point and the difference with the control group was statistically significant (P 0.05). With the integrated radiograph-photograph method, the lateral cephalogram was reoriented, which makes it possible

  12. Optimization of linezolid treatment regimens for Gram-positive bacterial infections based on pharmacokinetic/pharmacodynamic analysis.

    Science.gov (United States)

    Yang, Minjie; Zhang, Jing; Chen, Yuancheng; Liang, Xiaoyu; Guo, Yan; Yu, Jicheng; Zhu, Demei; Zhang, Yingyuan

    2017-01-01

    To optimize linezolid treatment regimens for Gram-positive bacterial infections based on pharmacokinetic/pharmacodynamic analysis. The minimum inhibitory concentration (MIC) distribution of 572 Gram-positive strains from patients with clinically confirmed infections was analyzed. Using the Monte Carlo simulation method, the cumulative fraction of response and probability of target attainment were determined for linezolid regimens of 600 mg q.12h and q.8h Results: Linezolid dosage of 600 mg q.12h yielded >90% cumulative fraction of response and probability of target attainment for staphylococcal infections with an MIC of ≤1 mg/l, enterococcal infections with higher MIC values required 600 mg q.8h. Linezolid 600 mg q.12h is still the clinically recommended empirical dosage for Gram-positive bacterial infections. However, as bacterial MICs increase, 600 mg q.8h may be required to achieve better efficacy.

  13. Positional accommodative intraocular lens power error induced by the estimation of the corneal power and the effective lens position

    Directory of Open Access Journals (Sweden)

    David P Piñero

    2015-01-01

    Full Text Available Purpose: To evaluate the predictability of the refractive correction achieved with a positional accommodating intraocular lenses (IOL and to develop a potential optimization of it by minimizing the error associated with the keratometric estimation of the corneal power and by developing a predictive formula for the effective lens position (ELP. Materials and Methods: Clinical data from 25 eyes of 14 patients (age range, 52-77 years and undergoing cataract surgery with implantation of the accommodating IOL Crystalens HD (Bausch and Lomb were retrospectively reviewed. In all cases, the calculation of an adjusted IOL power (P IOLadj based on Gaussian optics considering the residual refractive error was done using a variable keratometric index value (n kadj for corneal power estimation with and without using an estimation algorithm for ELP obtained by multiple regression analysis (ELP adj . P IOLadj was compared to the real IOL power implanted (P IOLReal , calculated with the SRK-T formula and also to the values estimated by the Haigis, HofferQ, and Holladay I formulas. Results: No statistically significant differences were found between P IOLReal and P IOLadj when ELP adj was used (P = 0.10, with a range of agreement between calculations of 1.23 D. In contrast, P IOLReal was significantly higher when compared to P IOLadj without using ELP adj and also compared to the values estimated by the other formulas. Conclusions: Predictable refractive outcomes can be obtained with the accommodating IOL Crystalens HD using a variable keratometric index for corneal power estimation and by estimating ELP with an algorithm dependent on anatomical factors and age.

  14. SU-F-T-303: Quantification of MLC Positioning Accuracy in VMAT Delivery of Head and Neck Cancer Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Li, X; Yang, F [University Of Miami, Miami, FL (United States)

    2016-06-15

    Purpose: Knowing MLC leaf positioning error over the course of treatment would be valuable for treatment planning, QA design, and patient safety. The objective of the current study was to quantify the MLC positioning accuracy for VMAT delivery of head and neck treatment plans. Methods: A total of 837 MLC log files were collected from 14 head and neck cancer patients undergoing full arc VMAT treatment on one Varian Trilogy machine. The actual and planned leaf gaps were extracted from the retrieved MLC log files. For a given patient, the leaf gap error percentage (LGEP), defined as the ratio of the actual leaf gap over the planned, was evaluated for each leaf pair at all the gantry angles recorded over the course of the treatment. Statistics describing the distribution of the largest LGEP (LLGEP) of the 60 leaf pairs including the maximum, minimum, mean, Kurtosis, and skewness were evaluated. Results: For the 14 studied patients, their PTV located at tonsil, base of tongue, larynx, supraglottis, nasal cavity, and thyroid gland with volume ranging from 72.0 cm{sup 3} to 602.0 cm{sup 3}. The identified LLGEP differed between patients. It ranged from 183.9% to 457.7% with a mean of 368.6%. For the majority of the patients, the LLGEP distributions peaked at non-zero positions and showed no obvious dependence on gantry rotations. Kurtosis and skewness, with minimum/maximum of 66.6/217.9 and 6.5/12.6, respectively, suggested relatively more peaked while right-skewed leaf error distribution pattern. Conclusion: The results indicate pattern of MLC leaf gap error differs between patients of lesion located at similar anatomic site. Understanding the systemic mechanisms underlying these observed error patterns necessitates examining more patient-specific plan parameters in a large patient cohort setting.

  15. The facilitating effect of positive emotions during an emotional Stroop task.

    Science.gov (United States)

    Liu, Xingyu; Yang, Yisheng; Jiang, Songxiu; Li, Jie

    2018-05-08

    Prior research has shown that negative emotions, even though task irrelevant, are capable of delaying a participant's response to the color in which a negative emotional word is presented, a phenomenon known as the 'emotional Stroop effect'. However, relatively little is known about whether positive emotions have a similar or an opposite effect. The current study sets out to confirm the facilitating effect of positive emotions on color naming, which is predicted by Barbara Fredrickson's 'broaden and build' theory. Our results indicate that positive emotions did facilitate such processing in both of the study's experiments. We also found a significant difference in early posterior negativity amplitudes between positive and neutral stimuli, which was related to the 'fast effect'. Overall, the study's findings suggest that positive emotions can be detected quickly and automatically, and that this kind of prioritizing facilitates the ongoing cognitive processing.

  16. [SEMERGEN positioning for the treatment of alcohol disorders in primary care].

    Science.gov (United States)

    Arbesú, José Ángel; Gual, Antoni; Casquero, Rafael; Bobes, Julio; Ortega, Patricia

    2015-12-01

    The present manuscript is based on the recommendations of a panel of health care professionals, including several experts in primary health care, psychiatry and addictions. The participants are recognized specialists in the treatment of alcohol use disorder. The panel met in Barcelona on 2015 April 22 with the aims of evaluating the current management of alcohol use disorder in primary health care and developing a strategy to address this problem, basing on the evidence and the recommendations of the scientific societies and national and international organizations. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Rural y Generalista (SEMERGEN). All rights reserved.

  17. Effectiveness of prehospital continuous positive airway pressure in the management of acute pulmonary edema.

    Science.gov (United States)

    Hubble, Michael W; Richards, Michael E; Jarvis, Roger; Millikan, Tori; Young, Dwayne

    2006-01-01

    To compare the effectiveness of continuous positive airway pressure (CPAP) with standard pharmacologic treatment in the management of prehospital acute pulmonary edema. Using a nonrandomized control group design, all consecutive patients presenting to two participating emergency medical services (EMS) systems with a field impression of acute pulmonary edema between July 1, 2004, and June 30, 2005, were included in the study. The control EMS system patients received standard treatment with oxygen, nitrates, furosemide, morphine, and, if indicated, endotracheal intubation. The intervention EMS system patients received CPAP via face mask at 10 cm H2O in addition to standard therapy. Ninety-five patients received standard therapy, and 120 patients received CPAP and standard therapy. Intubation was required in 8.9% of CPAP-treated patients compared with 25.3% in the control group (p = 0.003), and mortality was lower in the CPAP group than in the control group (5.4% vs. 23.2%; p = 0.000). When compared with the control group, the CPAP group had more improvement in respiratory rate (-4.55 vs. -1.81; p = 0.001), pulse rate (-4.77 vs. 0.82; p = 0.013), and dyspnea score (-2.11 vs. -1.36; p = 0.008). Using logistic regression to control for potential confounders, patients receiving standard treatment were more likely to be intubated (odds ratio, 4.04; 95% confidence interval, 1.64 to 9.95) and more likely to die (odds ratio, 7.48; 95% confidence interval, 1.96 to 28.54) than those receiving standard therapy and CPAP. The prehospital use of CPAP is feasible, may avert the need for endotracheal intubation, and may reduce short-term mortality.

  18. Effects of continuous positive airway pressure on hemorheology and serum inflammatory factors in patients with obstructive sleep apnea hypopnea syndrome

    Directory of Open Access Journals (Sweden)

    Ye-Jun Liu

    2016-02-01

    Full Text Available Objective: To investigate the effects of continuous positive airway pressure (CPAP on hemorheology and serum inflammatory factors in patients with obstructive sleep apnea hypopnea syndrome (OSAHS. Methods: A total of 87 patients with moderate and severe OSAHS from Department of Otolaryngology-Head and Neck Surgery of South Central Hospital of Wuhan University and Qianjiang Central Hospital were selected as research objects in the treatment group, while 37 healthy individuals were chosen as objects in the control group. The changes of hemorheology indexes including hematocrit (HCT, whole blood viscosity, platelet aggregation (PAG and endothelin (ET as well as serum inflammatory factors including interleukin-6 (IL-6, IL-18 and tumor necrosis factor-α (TNF-α were measured in the control group and the treatment group, and comparisons involving these indexes were made between the two groups. Results: Before treatment, the hemorheology indexes HCT, whole blood viscosity (high, medium and low sheer rates, PAG and ET as well as the inflammatory factors IL-6, IL-18 and TNF-α levels were significantly higher than those in the control group; after CPAP treatment, all these indexed mentioned above in the treatment group were significantly decreased compared with before treatment. Conclusion: CPAP treatment has a reliable therapeutic effect on OSAHS patients, which can obviously improve the hemorheology and largely reduce the inflammatory response.

  19. Continuous positive airway pressure for the treatment of obstructive sleep apnea.

    Science.gov (United States)

    Nurwidya, Fariz; Susanto, Agus Dwi; Juzar, Dafsah A; Kobayashi, Isao; Yunus, Faisal

    2016-01-01

    Obstructive sleep apnea (OSA) is a recurrent episode of partial or complete upper airway obstruction during sleep despite ongoing respiratory efforts and is implicated as the risk factor of cardiovascular disease. The OSA syndrome is typified by recurring partial or total occlusion of the pharynx, sleep fragmentation, episodes of gasping, and, eventually, daytime sleepiness. If it is left untreated, OSA syndrome can cause hypertension, coronary artery disease congestive heart disease, insulin resistance and death. In this review, we describe the pathogenesis and diagnosis of OSA. We also focused on the continuous positive airway pressure (CPAP) as the main therapy for OSA. CPAP has been shown to provide benefit for not only respiratory system, but also for cardiovascular system and metabolic system. Finally, we discussed briefly about the issue of adherence of using CPAP that could contribute to lower compliant in patient with OSA.

  20. Positional variability of a tandem applicator system in HDR brachytherapy for primary treatment of cervix cancer. Analysis of the anatomic pelvic position and comparison of the applicator positions during five insertions

    International Nuclear Information System (INIS)

    Wulf, J.; Popp, K.; Oppitz, U.; Baier, K.; Flentje, M.

    2004-01-01

    Purpose: evaluation of the inter- and intraindividual applicator variability of multiple high-dose-rate (HDR) brachytherapy applications for primary treatment of cancer of the uterine cervix. Material and methods: retrospective analysis of 460 pairs of orthogonal X-ray films for conventional treatment in 92 patients with five intrauterine applications using an HDR tandem applicator. Measurement of the position of the applicator origin relative to a bony reference system in three dimensions. Evaluation of the differences of the applicator position in all 460 applications (interindividual variability), of the five applications in a single patient (intraindividual variability) and of the intraindividual variability relative to the applicator position at the first application. Results: the position of the applicator origin in the pelvis ranged from 23 mm cranial and 55 mm caudal to the top of femoral heads, 23 mm right and 27 mm left to the pelvic midline, and 6-53 mm dorsal to the mid of the femoral heads. Standard deviation (SD) of interindividual applicator variability was 12.9 mm (minimum/maximum -55/+23 mm, mean -13.6 mm) in longitudinal, 5.1 mm (-27/+23 mm, mean 1.6 mm) in lateral, and 7.6 mm (6/53 mm, mean 26 mm) in anterior-posterior [AP] direction. SD of intraindividual variability was 5.5 mm (-21/+23 mm, mean 0 mm) in longitudinal, 2.5 mm (-17/+19 mm, mean 0 mm) in lateral, and 4.2 mm (-15/+18 mm, mean 0 mm) in AP direction compared to intraindividual variability relative to the first insertion with an SD of 8.9 mm (-23/+36 mm, mean 2.8 mm) in longitudinal, 4.0 mm (-11/+23 mm, mean 0 mm) in lateral, and 6.8 mm (-27/+17 mm, mean -0.8 mm) in AP direction. Conclusion: intraindividual applicator variability is significantly smaller than interindividual variability. Applicator-related procedures such as midline shielding or dose matching of tele- and brachytherapy should be performed with information on at least one individual applicator position. (orig.)

  1. Positional variability of a tandem applicator system in HDR brachytherapy for primary treatment of cervix cancer. Analysis of the anatomic pelvic position and comparison of the applicator positions during five insertions

    Energy Technology Data Exchange (ETDEWEB)

    Wulf, J.; Popp, K.; Oppitz, U.; Baier, K.; Flentje, M. [Dept. of Radiotherapy, Univ. of Wuerzburg (Germany)

    2004-04-01

    Purpose: evaluation of the inter- and intraindividual applicator variability of multiple high-dose-rate (HDR) brachytherapy applications for primary treatment of cancer of the uterine cervix. Material and methods: retrospective analysis of 460 pairs of orthogonal X-ray films for conventional treatment in 92 patients with five intrauterine applications using an HDR tandem applicator. Measurement of the position of the applicator origin relative to a bony reference system in three dimensions. Evaluation of the differences of the applicator position in all 460 applications (interindividual variability), of the five applications in a single patient (intraindividual variability) and of the intraindividual variability relative to the applicator position at the first application. Results: the position of the applicator origin in the pelvis ranged from 23 mm cranial and 55 mm caudal to the top of femoral heads, 23 mm right and 27 mm left to the pelvic midline, and 6-53 mm dorsal to the mid of the femoral heads. Standard deviation (SD) of interindividual applicator variability was 12.9 mm (minimum/maximum -55/+23 mm, mean -13.6 mm) in longitudinal, 5.1 mm (-27/+23 mm, mean 1.6 mm) in lateral, and 7.6 mm (6/53 mm, mean 26 mm) in anterior-posterior [AP] direction. SD of intraindividual variability was 5.5 mm (-21/+23 mm, mean 0 mm) in longitudinal, 2.5 mm (-17/+19 mm, mean 0 mm) in lateral, and 4.2 mm (-15/+18 mm, mean 0 mm) in AP direction compared to intraindividual variability relative to the first insertion with an SD of 8.9 mm (-23/+36 mm, mean 2.8 mm) in longitudinal, 4.0 mm (-11/+23 mm, mean 0 mm) in lateral, and 6.8 mm (-27/+17 mm, mean -0.8 mm) in AP direction. Conclusion: intraindividual applicator variability is significantly smaller than interindividual variability. Applicator-related procedures such as midline shielding or dose matching of tele- and brachytherapy should be performed with information on at least one individual applicator position. (orig.)

  2. Successful Resection of G719X-Positive Pleomorphic Carcinoma after Afatinib Treatment

    Directory of Open Access Journals (Sweden)

    Daisuke Nakamura

    2017-11-01

    Full Text Available We report a case of pleomorphic carcinoma with exon 18 mutation (G719X of the epidermal growth factor receptor (EGFR, which showed good response to afatinib and resulted in successful resection. To our knowledge, this is the first report on the use of afatinib for pleomorphic carcinoma followed by the surgical resection. The patient was a 59-year-old woman, who visited our hospital because chest computed tomography showed a 28 × 28-mm nodule in the left upper lobe. Bronchoscopy was performed and the histological findings of transbronchial biopsy revealed adenosquamous carcinoma positive for G719X mutation in exon 18 of the EGFR. Since fluorodeoxyglucose (FDG-positron emission tomography/computed tomography revealed a positive accumulation in the bilateral hilar and mediastinal lymph nodes, the disease was diagnosed as cT1bN3M0, stage IIIB. After 3 months of afatinib therapy, FDG accumulation in primary tumor was almost gone. However, FDG accumulation in lymph nodes remained unchanged. Video-assisted thoracic surgery was planned for further diagnostic information and left upper lobectomy with mediastinal lymph node dissection was performed. The resected tumor included adenocarcinoma, squamous cell carcinoma, and spindle cell components, without lymph node metastasis. Thus, the disease was diagnosed as pleomorphic carcinoma (pT2aN0M0, stage IB. All components in the resected specimen had the same G719X mutation in exon 18 of the EGFR. The patient has shown no signs of recurrence at 1 year after the operation. The present case indicates the possibility of minor EGFR mutations in pleomorphic carcinoma and successful outcome by the use of afatinib and surgical resection.

  3. Positive effects of tertiary centres for amyotrophic lateral sclerosis on outcome and use of hospital facilities.

    Science.gov (United States)

    Chiò, A; Bottacchi, E; Buffa, C; Mutani, R; Mora, G

    2006-08-01

    To evaluate the effects of tertiary centres for amyotrophic lateral sclerosis (ALS) on ALS outcome and the use of hospital facilities. The study was based on the data of an epidemiological, prospective, population-based register on ALS (Piemonte and Valle d'Aosta Register for amyotrophic lateral sclerosis, PARALS). The 221 patients recruited between 1995 and 1996 were prospectively followed up for outcome and use of hospital-based services. In all, 97 patients were followed up by tertiary ALS centres and 124 by general neurological clinics. Patients followed up by tertiary ALS centres were found to be 4 years younger and underwent percutaneous endoscopic gastronomy and non-invasive positive-pressure ventilation more often. Patients followed up by tertiary ALS centres were found to have a considerably longer median survival time (1080 v 775 days), even when stratifying by age, site of onset and respiratory function at diagnosis. In Cox multivariate analysis, attending a tertiary ALS centre was observed to be an independent positive prognostic factor. Moreover, patients attending a tertiary ALS centre were admitted to hospital less often (1.2 v 3.3) and were more frequently admitted for planned interventions. Conversely, patients followed up by general neurological clinics were more frequently admitted for acute events. Also, the hospital stay was considerably shorter for patients attending tertiary ALS centres (5.8 v 12.4 days). Improved survival was seen in patients with ALS attending tertiary ALS centres, independently from all other known prognostic factors, possibly through a better implementation of supportive treatments. Moreover, because of these centres, the hospitalisation rate was markedly reduced, thus offering a cost-effective service to patients with ALS and to the community as a whole.

  4. The effect of patient position on dose in radiation therapy of liver cancer

    International Nuclear Information System (INIS)

    Jung, Won Seok; Shin, Ryung Mi; Oh, Jeong Hun; Jeong, Geon A; Jo, Jun Young; Kim, Gi Chul; Choi, Tae Kyu; Kim, Ju Ho; Kim, Young Jae

    2014-01-01

    To analyze tumors movement and volume change from changing position in order to minimize movement caused by breathing. We conducted survey of 14 patients with HCC(Hepatocellular carcinoma). Patient immobilization device was made in two ways(Supine position, prone position) and from image acquisition, tumors movement, volume and dose are analyzed. The mean movement of target(LR, Left-right) in supine position and prone position was 2.76±1.25 mm, 2.21±0.93 mm. AP(Anterior-posterior) and SI(Superior-inferior) was 4.02±1.63 mm, 11.56±3.08 mm, and 3.36±1.17 mm, 7.45±1.96 mm. Treatment volume was decreased and normal liver volume was increased in prone position. We could reduce the margin of the treatment volume by minimizing the movement of liver caused by breathing. Especially in prone position, it is considered to be able to decrease the movement of the liver and increase normal liver volume

  5. The effect of patient position on dose in radiation therapy of liver cancer

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Won Seok; Shin, Ryung Mi; Oh, Jeong Hun; Jeong, Geon A; Jo, Jun Young; Kim, Gi Chul; Choi, Tae Kyu [Dept. of Radiation Oncology, Kyunghee College Hospital, Seoul (Korea, Republic of); Kim, Ju Ho [Dept. of Radiation Oncology, Yonsei Cancer Center, Seoul (Korea, Republic of); Kim, Young Jae [Dept. of Radiation Technology, Daegu Health College, Daegu (Korea, Republic of)

    2014-06-15

    To analyze tumors movement and volume change from changing position in order to minimize movement caused by breathing. We conducted survey of 14 patients with HCC(Hepatocellular carcinoma). Patient immobilization device was made in two ways(Supine position, prone position) and from image acquisition, tumors movement, volume and dose are analyzed. The mean movement of target(LR, Left-right) in supine position and prone position was 2.76±1.25 mm, 2.21±0.93 mm. AP(Anterior-posterior) and SI(Superior-inferior) was 4.02±1.63 mm, 11.56±3.08 mm, and 3.36±1.17 mm, 7.45±1.96 mm. Treatment volume was decreased and normal liver volume was increased in prone position. We could reduce the margin of the treatment volume by minimizing the movement of liver caused by breathing. Especially in prone position, it is considered to be able to decrease the movement of the liver and increase normal liver volume.

  6. Positive Education for Young Children: Effects of a Positive Psychology Intervention for Preschool Children on Subjective Well Being and Learning Behaviors

    OpenAIRE

    Anat Shoshani; Michelle Slone

    2017-01-01

    Despite the flourishing in recent years in applications of positive psychology in the field of education, there is a paucity of research investigating positive psychology interventions for preschool children. The present study examined the effects of a positive psychology-based intervention conducted in Israel on children’s subjective well-being, mental health and learning behaviors. Twelve preschool classrooms of 3–6.5 year-olds were randomly assigned to a positive psychology intervention co...

  7. Recommendations for treatment of hypothyroidism with levothyroxine and levotriiodothyronine: a 2016 position statement of the Italian Society of Endocrinology and the Italian Thyroid Association.

    Science.gov (United States)

    Biondi, B; Bartalena, L; Chiovato, L; Lenzi, A; Mariotti, S; Pacini, F; Pontecorvi, A; Vitti, P; Trimarchi, F

    2016-12-01

    Levothyroxine (L-T4) is recommended as lifelong replacement therapy for hypothyroidism. Recent clinical and experimental data support the addition of levotriiodothyronine (L-T3) treatment in some selected hypothyroid patients when their symptoms persist and their quality of life remains impaired despite adequate L-T4 monotherapy. An increase in L-T3 prescriptions has been recently observed in Italy due to availability of different L-T3 formulations, making it possible to clinicians to prescribe L-T3 alone or in combination with L-T4. The aim of the present position statement was to define the correct clinical indications, schedule, duration of treatment and contraindications of combined treatment with L-T4 and L-T3 in hypothyroid patients in an attempt to guide clinicians and to avoid potential adverse effects of overtreatment.

  8. Capecitabine and its role in the treatment of advanced HER2 positive breast cancer

    International Nuclear Information System (INIS)

    Barilla, R.; Sycova-Mila, Z.; Andrasina, I.

    2011-01-01

    Metastatic breast cancer is the leading cause of death from cancer among women worldwide. Approximately 20 % women with breast cancer that over express HER2, considered to be strong predictor for disease progression and death, are at greater risk than women whose tumors do not over express HER2. It represents an important therapeutic target in this population. We currently have 2 registered targeted drugs in this setting (trastuzumab and lapatinib) and others are being investigated in clinical trials (pertuzumab, neratinib etc.). (5, 6) The treatment of intensively pretreated breast cancer is essentially palliative with the aim of providing antitumor activity and prolonging survival but without significant deterioration in quality of life. Despite the era of targeted therapies in several cancer types with certainty we cannot omit cytotoxic chemotherapy in these patients. (author)

  9. Effects of insertion speed and trocar stiffness on the accuracy of needle position for brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    McGill, Carl S.; Schwartz, Jonathon A.; Moore, Jason Z.; McLaughlin, Patrick W.; Shih, Albert J. [Biomedical Engineering Department, University of Michigan, Ann Arbor, Michigan 48109 (United States); Department of Mechanical and Nuclear Engineering, The Pennsylvania State University, State College, Pennsylvania 16802 (United States); Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan 48109 (United States); Biomedical Engineering Department, University of Michigan, Ann Arbor, Michigan 48109 and Mechanical Engineering Department, University of Michigan, Ann Arbor, Michigan 48109 (United States)

    2012-04-15

    Purpose: In prostate brachytherapy, accurate positioning of the needle tip to place radioactive seeds at its target site is critical for successful radiation treatment. During the procedure, needle deflection leads to seed misplacement and suboptimal radiation dose to cancerous cells. In practice, radiation oncologists commonly use high-speed hand needle insertion to minimize displacement of the prostate as well as the needle deflection. Effects of speed during needle insertion and stiffness of trocar (a solid rod inside the hollow cannula) on needle deflection are studied. Methods: Needle insertion experiments into phantom were performed using a 2{sup 2} factorial design (2 parameters at 2 levels), with each condition having replicates. Analysis of the deflection data included calculating the average, standard deviation, and analysis of variance (ANOVA) to find significant single and two-way interaction factors. Results: The stiffer tungsten carbide trocar is effective in reducing the average and standard deviation of needle deflection. The fast insertion speed together with the stiffer trocar generated the smallest average and standard deviation for needle deflection for almost all cases. Conclusions: The combination of stiff tungsten carbide trocar and fast needle insertion speed are important to decreasing needle deflection. The knowledge gained from this study can be used to improve the accuracy of needle insertion during brachytherapy procedures.

  10. MDEP Generic Common Position No DICWG-01. Common position on the treatment of common cause failure caused by software within digital safety systems

    International Nuclear Information System (INIS)

    2013-01-01

    Common cause failures (CCF)2 have been a significant safety concern for nuclear power plant systems. The increasing dependence on software-in safety systems for nuclear power plants has increased the safety significance of CCF caused by software, when software in redundant channels or portions of safety systems has some common dependency. For example, the effect of systematic failures can lead to a loss of safety in many ways: unwanted actuations, a safety function is not provided when needed. Therefore, nuclear power plants should be systematically protected from the effects of common cause failures caused by software in DI and C safety systems. Software for nuclear power plant safety systems should be of the high quality necessary to help assure against the loss of safety (i.e. developed with high-quality engineering practices, commensurate quality assurance applied, with continuous improvement through corrective actions based on lessons learned from operating experience). However, demonstrating adequate software quality only through verification and validation activities and controls on the development process has proved to be problematic. Therefore, this common position provides guidance for the assessment of the potential for CCF for software. It is recognized that programmable logic devices do not execute software in the conventional sense; however, the application development process using these devices have many similarities with software development, and the deficiencies that may be introduced during the application development process may induce errors in the programmable logic devices that can result in common cause failures of these devices of a type similar to software common cause failure. Although deficiencies with the potential to give rise to software common cause failures can be introduced at all phases of the software life cycle, this common position will only consider the potential for software common cause failures within digital safety system

  11. An experimental study of the effect of green positioning on brand attitude

    OpenAIRE

    PATRIK HARTMANN; VANESSA APAOLAZA IBÁÑEZ; F. JAVIER FORCADA SAIZ

    2004-01-01

    Reducing the environmental impact of a product or its manufacturing process not necessarily limits the company’s activities. In the context of a green branding strategy, it might as well open new business opportunities. Ecological positioning provides a strategic tool for the active implementation of green brands. The empirical study shows that more positive attitudes are developed towards a brand positioned by environmental attributes and that these effects vary as a result of the implementa...

  12. Automatic beam position control at Los Alamos Spallation Radiation Effects Facility (LASREF)

    International Nuclear Information System (INIS)

    Oothoudt, M.; Pillai, C.; Zumbro, M.

    1997-01-01

    Historically the Los Alamos Spallation Radiation Effects Facility (LASREF) has used manual methods to control the position of the 800 kW, 800 MeV proton beam on targets. New experiments, however, require more stringent position control more frequently than can be done manually for long periods of time. Data from an existing harp is used to automatically adjust steering magnets to maintain beam position to required tolerances

  13. Cost-effectiveness of positive contrast and nuclear arthrography in patients who underwent total hip arthroplasty

    International Nuclear Information System (INIS)

    Swan, J.S.; Braunstein, E.M.; Capello, W.; Wellman, H.

    1989-01-01

    The authors have compared the cost effectiveness of contrast arthrography (CA) and nuclear arthrography (NA), in which In-111 chloride is injected with the contrast material, of total hip arthroplasties. Their series included 48 cases of surgically proved loose femoral components. The cost per true-positive result was obtained by taking the total cost of the examinations in surgically proved cases and dividing by the number of true-position cases. The cost of CA was $297 and the cost of NA was $335. For CA, the cost per true positive was $1,018, and for the NA the cost per true positive was $946. In spite of higher initial cost, NA is more cost effective than CA on a cost per true-positive case basis. NA is cost effective in evaluating hip arthroplasties in which there is suspicion of a loose femoral component

  14. Feedback enhances the positive effects and reduces the negative effects of multiple-choice testing.

    Science.gov (United States)

    Butler, Andrew C; Roediger, Henry L

    2008-04-01

    Multiple-choice tests are used frequently in higher education without much consideration of the impact this form of assessment has on learning. Multiple-choice testing enhances retention of the material tested (the testing effect); however, unlike other tests, multiple-choice can also be detrimental because it exposes students to misinformation in the form of lures. The selection of lures can lead students to acquire false knowledge (Roediger & Marsh, 2005). The present research investigated whether feedback could be used to boost the positive effects and reduce the negative effects of multiple-choice testing. Subjects studied passages and then received a multiple-choice test with immediate feedback, delayed feedback, or no feedback. In comparison with the no-feedback condition, both immediate and delayed feedback increased the proportion of correct responses and reduced the proportion of intrusions (i.e., lure responses from the initial multiple-choice test) on a delayed cued recall test. Educators should provide feedback when using multiple-choice tests.

  15. Trastuzumab after Chemotherapy Is Effective in HER2-Positive Breast Cancer

    Science.gov (United States)

    Treatment with trastuzumab for 1 year following standard chemotherapy improved disease-free survival in women with HER2-positive early breast cancer, according to 4-year follow-up results of the Herceptin Adjuvant (HERA) trial reported February 25, 2011,

  16. The effect of emphasis and position on word identification by adult cochlear implant listeners

    DEFF Research Database (Denmark)

    Morris, David Jackson; Magnusson, Lennart; Jönsson, Radoslava

    2013-01-01

    sentence framework. It was found that emphasised stimuli were not identified more accurately than unemphasised stimuli. A regression analysis revealed a significant main effect for words drawn from the initial position in a sentence, however there was no interaction between original word position...

  17. Serial Position Effects in the Identification of Letters, Digits, and Symbols

    Science.gov (United States)

    Tydgat, Ilse; Grainger, Jonathan

    2009-01-01

    In 6 experiments, the authors investigated the form of serial position functions for identification of letters, digits, and symbols presented in strings. The results replicated findings obtained with the target search paradigm, showing an interaction between the effects of serial position and type of stimulus, with symbols generating a distinct…

  18. The Effects of Positive and Negative Mood on Cognition and Motivation in Multimedia Learning Environment

    Science.gov (United States)

    Liew, Tze Wei; Tan, Su-Mae

    2016-01-01

    The Cognitive-Affective Theory of Learning with Media framework posits that the multimedia learning process is mediated by the learner's mood. Recent studies have shown that positive mood has a facilitating effect on multimedia learning. Though literature has shown that negative mood encourages an individual to engage in a more systematic,…

  19. Drug Repositioning for Effective Prostate Cancer Treatment.

    Science.gov (United States)

    Turanli, Beste; Grøtli, Morten; Boren, Jan; Nielsen, Jens; Uhlen, Mathias; Arga, Kazim Y; Mardinoglu, Adil

    2018-01-01

    Drug repositioning has gained attention from both academia and pharmaceutical companies as an auxiliary process to conventional drug discovery. Chemotherapeutic agents have notorious adverse effects that drastically reduce the life quality of cancer patients so drug repositioning is a promising strategy to identify non-cancer drugs which have anti-cancer activity as well as tolerable adverse effects for human health. There are various strategies for discovery and validation of repurposed drugs. In this review, 25 repurposed drug candidates are presented as result of different strategies, 15 of which are already under clinical investigation for treatment of prostate cancer (PCa