Acute hand and wrist injuries sustained during recreational mountain biking: a prospective study.

Science.gov (United States)

Bush, Kevin; Meredith, Steve; Demsey, Daniel

2013-12-01

Recreational mountain biking continues to increase in popularity and is a significant source of traumatic injury, including injuries to the hand and wrist. A prospective survey of all hand and wrist injuries sustained while participating in recreational mountain biking presenting to the emergency department at the Municipality of Whistler and the District of Squamish was conducted over a 12-month consecutive period. An analysis of 765 unique emergency department visits with 1,079 distinct injuries was performed. Of these injuries, 511 were sustained to the upper limb. Injury to the metacarpal and metacarpal phalangeal joints was the most common hand injury (52) followed by proximal phalanx and proximal interphalangeal joint (20). Mountain biking is a frequent source of a variety of upper limb trauma, and preventative efforts are necessary to minimize the burden of these injuries.

The acute and preventative treatment of episodic migraine

Directory of Open Access Journals (Sweden)

Sarah Miller

2012-01-01

Full Text Available Episodic migraine is a common debilitating condition with significant worldwide impact. An effective management plan must include acute treatment to relieve the pain and potential disability associated with the attacks and may also include preventative treatments with an aim of decreasing attack frequency and severity in the longer term. Acute treatments must be limited to a maximum of 2-3 days a week to prevent medication overuse headache and focus on simple analgesia, non-steroidal anti-inflammatory drugs and triptans. Preventative treatments are numerous and should be considered when migraine attacks are frequent and or disabling, acute medication is failing, in special circumstances such as hemiplegic migraines or if the patient requests them. All preventative medications must be given at therapeutic doses for at least 6-8 weeks before an adequate trial can be judged ineffective. The most important factor in choosing drugs is the patient and the clinical features of their attack and treatment should be tailored to these. Relative co-morbidities will influence drug choice, as will the side effect profile and the efficacy of the drug. First line preventative drugs include ß-blockers, amitriptyline and anti-epileptic drugs such as topiramate and valproate. Drugs with lower efficacy or poorer side effect profiles include selective serotonin reuptake inhibitors (SSRIs, calcium channel antagonists, gabapentin and herbal medicines.

Acute toxicity of zinc to several aquatic species native to the Rocky Mountains.

Science.gov (United States)

Brinkman, Stephen F; Johnston, Walter D

2012-02-01

National water-quality criteria for the protection of aquatic life are based on toxicity tests, often using organisms that are easy to culture in the laboratory. Species native to the Rocky Mountains are poorly represented in data sets used to derive national water-quality criteria. To provide additional data on the toxicity of zinc, several laboratory acute-toxicity tests were conducted with a diverse assortment of fish, benthic invertebrates, and an amphibian native to the Rocky Mountains. Tests with fish were conducted using three subspecies of cutthroat trout (Colorado River cutthroat trout Oncorhynchus clarkii pleuriticus, greenback cutthroat trout O. clarkii stomias, and Rio Grande cutthroat trout O. clarkii virginalis), mountain whitefish (Prosopium williamsoni), mottled sculpin (Cottus bairdi), longnose dace (Rhinichthys cataractae), and flathead chub (Platygobio gracilis). Aquatic invertebrate tests were conducted with mayflies (Baetis tricaudatus, Drunella doddsi, Cinygmula sp. and Ephemerella sp.), a stonefly (Chloroperlidae), and a caddis fly (Lepidostoma sp.). The amphibian test was conducted with tadpoles of the boreal toad (Bufo boreas). Median lethal concentrations (LC(50)s) ranged more than three orders of magnitude from 166 μg/L for Rio Grande cutthroat trout to >67,000 μg/L for several benthic invertebrates. Of the organisms tested, vertebrates were the most sensitive, and benthic invertebrates were the most tolerant.

Network analysis reveals distinct clinical syndromes underlying acute mountain sickness.

Directory of Open Access Journals (Sweden)

David P Hall

Full Text Available Acute mountain sickness (AMS is a common problem among visitors at high altitude, and may progress to life-threatening pulmonary and cerebral oedema in a minority of cases. International consensus defines AMS as a constellation of subjective, non-specific symptoms. Specifically, headache, sleep disturbance, fatigue and dizziness are given equal diagnostic weighting. Different pathophysiological mechanisms are now thought to underlie headache and sleep disturbance during acute exposure to high altitude. Hence, these symptoms may not belong together as a single syndrome. Using a novel visual analogue scale (VAS, we sought to undertake a systematic exploration of the symptomatology of AMS using an unbiased, data-driven approach originally designed for analysis of gene expression. Symptom scores were collected from 292 subjects during 1110 subject-days at altitudes between 3650 m and 5200 m on Apex expeditions to Bolivia and Kilimanjaro. Three distinct patterns of symptoms were consistently identified. Although fatigue is a ubiquitous finding, sleep disturbance and headache are each commonly reported without the other. The commonest pattern of symptoms was sleep disturbance and fatigue, with little or no headache. In subjects reporting severe headache, 40% did not report sleep disturbance. Sleep disturbance correlates poorly with other symptoms of AMS (Mean Spearman correlation 0.25. These results challenge the accepted paradigm that AMS is a single disease process and describe at least two distinct syndromes following acute ascent to high altitude. This approach to analysing symptom patterns has potential utility in other clinical syndromes.

Influence of Acute Normobaric Hypoxia on Hemostasis in Volunteers with and without Acute Mountain Sickness

Directory of Open Access Journals (Sweden)

Marc Schaber

2015-01-01

Full Text Available Introduction. The aim of the present study was to investigate whether a 12-hour exposure in a normobaric hypoxic chamber would induce changes in the hemostatic system and a procoagulant state in volunteers suffering from acute mountain sickness (AMS and healthy controls. Materials and Methods. 37 healthy participants were passively exposed to 12.6% FiO2 (simulated altitude hypoxia of 4,500 m. AMS development was investigated by the Lake Louise Score (LLS. Prothrombin time, activated partial thromboplastin time, fibrinogen, and platelet count were measured and specific methods (i.e., thromboelastometry and a thrombin generation test were used. Results. AMS prevalence was 62.2% (LLS cut off of 3. For the whole group, paired sample t-tests showed significant increase in the maximal concentration of generated thrombin. ROTEM measurements revealed a significant shortening of coagulation time and an increase of maximal clot firmness (InTEM test. A significant increase in maximum clot firmness could be shown (FibTEM test. Conclusions. All significant changes in coagulation parameters after exposure remained within normal reference ranges. No differences with regard to measured parameters of the hemostatic system between AMS-positive and -negative subjects were observed. Therefore, the hypothesis of the acute activation of coagulation by hypoxia can be rejected.

Probiotics for preventing acute upper respiratory tract infections.

Science.gov (United States)

Hao, Qiukui; Dong, Bi Rong; Wu, Taixiang

2015-02-03

Probiotics may improve a person's health by regulating their immune function. Some trials have shown that probiotic strains can prevent respiratory infections. Even though the previous version of our review showed benefits of probiotics for acute upper respiratory tract infections (URTIs), several new studies have been published. To assess the effectiveness and safety of probiotics (any specified strain or dose), compared with placebo, in the prevention of acute URTIs in people of all ages, at risk of acute URTIs. We searched CENTRAL (2014, Issue 6), MEDLINE (1950 to July week 3, 2014), EMBASE (1974 to July 2014), Web of Science (1900 to July 2014), the Chinese Biomedical Literature Database, which includes the China Biological Medicine Database (from 1978 to July 2014), the Chinese Medicine Popular Science Literature Database (from 2000 to July 2014) and the Masters Degree Dissertation of Beijing Union Medical College Database (from 1981 to July 2014). We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov for completed and ongoing trials on 31 July 2014. Randomised controlled trials (RCTs) comparing probiotics with placebo to prevent acute URTIs. Two review authors independently assessed the eligibility and quality of trials, and extracted data using the standard methodological procedures expected by The Cochrane Collaboration. We included 13 RCTs, although we could only extract data to meta-analyse 12 trials, which involved 3720 participants including children, adults (aged around 40 years) and older people. We found that probiotics were better than placebo when measuring the number of participants experiencing episodes of acute URTI (at least one episode: odds ratio (OR) 0.53; 95% confidence interval (CI) 0.37 to 0.76, P value school absence (OR 0.10; 95% CI 0.02 to 0.47, very low quality evidence). Probiotics and placebo were similar when measuring the rate ratio of episodes of acute

Prevention of acute chemotherapy-induced nausea and vomiting: the role of palonosetron

International Nuclear Information System (INIS)

Bajetta, Emilio; Pusceddu, Sara; Guadalupi, Valentina; Ducceschi, Monika; Celio, Luigi

2009-01-01

Prevention of nausea and vomiting is the main goal of antiemetic treatment in cancer patients scheduled to receive chemotherapy. To prevent acute emesis, antiemetics should be administered just before chemotherapy and patients should be protected for up to 24 hours after chemotherapy initiation. The emetogenic potential of chemotherapeutic agents guides clinicians towards the most appropriate antiemetic prophylaxis. Current guidelines recommend the use of 5-HT 3 receptor antagonist (RA) either alone or in combination with dexamethasone and/or a neurokinin-1 RA both in the acute and delayed phases. The second-generation 5-HT 3 RA palonosetron exhibits a longer half-life and a higher binding affinity than older antagonists. Palonosetron has been approved by the FDA for the prevention of chemotherapy-induced nausea and vomiting (CINV) in patients scheduled to receive either moderately (MEC) or highly emetogenic chemotherapy (HEC) and for the prevention of delayed CINV in patients receiving MEC. The present review will discuss the role of palonosetron in the prevention of acute CINV

Increased cerebral output of free radicals during hypoxia: implications for acute mountain sickness?

DEFF Research Database (Denmark)

Bailey, Damian M; Taudorf, Sarah; Berg, Ronan M G

2009-01-01

This study examined whether hypoxia causes free radical-mediated disruption of the blood-brain barrier (BBB) and impaired cerebral oxidative metabolism and whether this has any bearing on neurological symptoms ascribed to acute mountain sickness (AMS). Ten men provided internal jugular vein...... paramagnetic resonance spectroscopy and ozone-based chemiluminescence were employed for direct detection of spin-trapped free radicals and nitric oxide metabolites. Neuron-specific enolase (NSE), S100beta, and 3-nitrotyrosine (3-NT) were determined by ELISA. Hypoxia increased the arterio-jugular venous...... concentration difference (a-v(D)) and net cerebral output of lipid-derived alkoxyl-alkyl free radicals and lipid hydroperoxides (P

Prophylactic Acetaminophen or Ibuprofen Results in Equivalent Acute Mountain Sickness Incidence at High Altitude: A Prospective Randomized Trial.

Science.gov (United States)

Kanaan, Nicholas C; Peterson, Alicia L; Pun, Matiram; Holck, Peter S; Starling, Jennifer; Basyal, Bikash; Freeman, Thomas F; Gehner, Jessica R; Keyes, Linda; Levin, Dana R; O'Leary, Catherine J; Stuart, Katherine E; Thapa, Ghan B; Tiwari, Aditya; Velgersdyk, Jared L; Zafren, Ken; Basnyat, Buddha

2017-06-01

Recent trials have demonstrated the usefulness of ibuprofen in the prevention of acute mountain sickness (AMS), yet the proposed anti-inflammatory mechanism remains unconfirmed. Acetaminophen and ibuprofen were tested for AMS prevention. We hypothesized that a greater clinical effect would be seen from ibuprofen due to its anti-inflammatory effects compared with acetaminophen's mechanism of possible symptom reduction by predominantly mediating nociception in the brain. A double-blind, randomized trial was conducted testing acetaminophen vs ibuprofen for the prevention of AMS. A total of 332 non-Nepali participants were recruited at Pheriche (4371 m) and Dingboche (4410 m) on the Everest Base Camp trek. The participants were randomized to either acetaminophen 1000 mg or ibuprofen 600 mg 3 times a day until they reached Lobuche (4940 m), where they were reassessed. The primary outcome was AMS incidence measured by the Lake Louise Questionnaire score. Data from 225 participants who met inclusion criteria were analyzed. Twenty-five participants (22.1%) in the acetaminophen group and 18 (16.1%) in the ibuprofen group developed AMS (P = .235). The combined AMS incidence was 19.1% (43 participants), 14 percentage points lower than the expected AMS incidence of untreated trekkers in prior studies at this location, suggesting that both interventions reduced the incidence of AMS. We found little evidence of any difference between acetaminophen and ibuprofen groups in AMS incidence. This suggests that AMS prevention may be multifactorial, affected by anti-inflammatory inhibition of the arachidonic-acid pathway as well as other analgesic mechanisms that mediate nociception. Additional study is needed. Copyright © 2017 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

A randomized study of the prevention of acute graft-versus-host disease

International Nuclear Information System (INIS)

Ramsay, N.K.C.; Kersey, J.H.; Robison, L.L.; McGlave, P.B.; Woods, W.G.; Krivit, W.; Kim, T.H.; Goldman, A.I.; Nesbit, M.E. Jr.

1982-01-01

Acute graft-versus-host disease is a major problem in allogeneic bone-marrow transplantation. We performed a randomized study to compare the effectiveness of two regimens in the prevention of acute graft-versus-host disease. Thirty-five patients received methotrexate alone, and 32 received methotrexate, antithymocyte globulin, and prednisone. Of the patients who received methotrexate alone, 48 percent had acute graft-versus-host disease, as compared with 21 per cent of those who received methotrexate, antithymocyte globulin, and prednisone (P = 0.01). The age of the recipient was a significant factor in the development of acute graft-versus-host disease: Older patients had a higher incidence of the disease (P = 0.001). We conclude that the combination of methotrexate, antithymocyte globulin, and prednisone significantly decreased the incidence of acute graft-versus-host disease and should be used to prevent this disorder in patients receiving allogeneic marrow transplants

Cochrane Commentary: Probiotics For Prevention of Acute Upper Respiratory Infection.

Science.gov (United States)

Quick, Melissa

2015-01-01

Probiotics may improve a person's health by regulating their immune function. Some trials have shown that probiotic strains can prevent respiratory infections. Even though the previous version of our review showed benefits of probiotics for acute upper respiratory tract infections (URTIs), several new studies have been published. To assess the effectiveness and safety of probiotics (any specified strain or dose), compared with placebo, in the prevention of acute URTIs in people of all ages, who are at risk of acute URTIs. We searched CENTRAL (2014, Issue 6), MEDLINE (1950 to July week 3, 2014), EMBASE (1974 to July 2014), Web of Science (1900 to July 2014), the Chinese Biomedical Literature Database, which includes the China Biological Medicine Database (from 1978 to July 2014), the Chinese Medicine Popular Science Literature Database (from 2000 to July 2014) and the Masters Degree Dissertation of Beijing Union Medical College Database (from 1981 to July 2014). We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov for completed and ongoing trials on 31 July 2014. Randomised controlled trials (RCTs) comparing probiotics with placebo to prevent acute URTIs. Two review authors independently assessed the eligibility and quality of trials, and extracted data using the standard methodological procedures expected by The Cochrane Collaboration. We included 13 RCTs, although we could only extract data to meta-analyze 12 trials, which involved 3720 participants including children, adults (aged around 40 years) and older people. We found that probiotics were better than placebo when measuring the number of participants experiencing episodes of acute URTI [at least one episode: odds ratio (OR): 0.53; 95% CI = 0.37-0.76, P school absence (OR: 0.10; 95% CI = 0.02-0.47, very low quality evidence). Probiotics and placebo were similar when measuring the rate ratio of episodes of acute URTI (rate ratio: 0

Effects of escitalopram in prevention of depression in patients with acute coronary syndrome (DECARD)

DEFF Research Database (Denmark)

Hansen, Baiba Hedegaard; Hanash, Jamal Abed; Rasmussen, Alice

2012-01-01

Depression is a major problem in patients after acute coronary syndrome (ACS) with negative impact on survival and quality of life. No studies have examined prevention of post-ACS depression. We examined whether treatment with escitalopram can prevent post-ACS depression.......Depression is a major problem in patients after acute coronary syndrome (ACS) with negative impact on survival and quality of life. No studies have examined prevention of post-ACS depression. We examined whether treatment with escitalopram can prevent post-ACS depression....

Eliminating Plasmodium falciparum in Hainan, China: a study on the use of behavioural change communication intervention to promote malaria prevention in mountain worker populations.

Science.gov (United States)

He, Chang-hua; Hu, Xi-min; Wang, Guang-ze; Zhao, Wei; Sun, Ding-wei; Li, Yu-chun; Chen, Chun-xiang; Du, Jian-wei; Wang, Shan-qing

2014-07-13

In the island of Hainan, the great majority of malaria cases occur in mountain worker populations. Using the behavioral change communication (BCC) strategy, an interventional study was conducted to promote mountain worker malaria prevention at a test site. This study found the methods and measures that are suitable for malaria prevention among mountain worker populations. During the Plasmodium falciparum elimination stage in Hainan, a representative sampling method was used to establish testing and control sites in areas of Hainan that were both affected by malaria and had a relatively high density of mountain workers. Two different methods were used: a BCC strategy and a conventional strategy as a control. Before and after the intervention, house visits, core group discussions, and structural surveys were utilized to collect qualitative and quantitative data regarding mountain worker populations (including knowledge, attitudes, and practices [KAPs]; infection status; and serological data), and these data from the testing and control areas were compared to evaluate the effectiveness of BCC strategies in the prevention of malaria. In the BCC malaria prevention strategy testing areas, the accuracy rates of malaria-related KAP were significantly improved among mountain worker populations. The accuracy rates in the 3 aspects of malaria-related KAP increased from 37.73%, 37.00%, and 43.04% to 89.01%, 91.53%, and 92.25%, respectively. The changes in all 3 aspects of KAP were statistically significant (p 0.05). Furthermore, in the testing areas, both the percentage testing positive in the serum malaria indirect fluorescent antibody test (IFAT) and the number of people inflicted decreased more significantly than in the control sites (p strategy significantly improved the ability of mountain workers in Hainan to avoid malarial infection. Educational and promotional materials and measures were developed and selected in the process, and hands-on experience was gained that

Antibiotic therapy for preventing infections in people with acute stroke.

Science.gov (United States)

Vermeij, Jan-Dirk; Westendorp, Willeke F; Dippel, Diederik Wj; van de Beek, Diederik; Nederkoorn, Paul J

2018-01-22

Stroke is the main cause of disability in high-income countries and ranks second as a cause of death worldwide. Infections occur frequently after stroke and may adversely affect outcome. Preventive antibiotic therapy in the acute phase of stroke may reduce the incidence of infections and improve outcome. In the previous version of this Cochrane Review, published in 2012, we found that antibiotics did reduce the risk of infection but did not reduce the number of dependent or deceased patients. However, included studies were small and heterogeneous. In 2015, two large clinical trials were published, warranting an update of this Review. To assess the effectiveness and safety of preventive antibiotic therapy in people with ischaemic or haemorrhagic stroke. We wished to determine whether preventive antibiotic therapy in people with acute stroke:• reduces the risk of a poor functional outcome (dependency and/or death) at follow-up;• reduces the occurrence of infections in the acute phase of stroke;• reduces the occurrence of elevated body temperature (temperature ≥ 38° C) in the acute phase of stroke;• reduces length of hospital stay; or• leads to an increased rate of serious adverse events, such as anaphylactic shock, skin rash, or colonisation with antibiotic-resistant micro-organisms. We searched the Cochrane Stroke Group Trials Register (25 June 2017); the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 5; 25 June 2017) in the Cochrane Library; MEDLINE Ovid (1950 to 11 May 2017), and Embase Ovid (1980 to 11 May 2017). In an effort to identify further published, unpublished, and ongoing trials, we searched trials and research registers, scanned reference lists, and contacted trial authors, colleagues, and researchers in the field. Randomised controlled trials (RCTs) of preventive antibiotic therapy versus control (placebo or open control) in people with acute ischaemic or haemorrhagic stroke. Two review authors independently selected

Prevention of Acute Rheumatic Fever and Rheumatic Heart Disease

Science.gov (United States)

... Patient Page Prevention of Acute Rheumatic Fever and Rheumatic Heart Disease Mariana Mirabel , Kumar Narayanan , Xavier Jouven , Eloi Marijon ... regurgitant ) valves. Over time, there is progressive damage (rheumatic heart disease, RHD) that may lead to heart failure, stroke, ...

Acute high-altitude sickness

Directory of Open Access Journals (Sweden)

Andrew M. Luks

2017-02-01

Full Text Available At any point 1–5 days following ascent to altitudes ≥2500 m, individuals are at risk of developing one of three forms of acute altitude illness: acute mountain sickness, a syndrome of nonspecific symptoms including headache, lassitude, dizziness and nausea; high-altitude cerebral oedema, a potentially fatal illness characterised by ataxia, decreased consciousness and characteristic changes on magnetic resonance imaging; and high-altitude pulmonary oedema, a noncardiogenic form of pulmonary oedema resulting from excessive hypoxic pulmonary vasoconstriction which can be fatal if not recognised and treated promptly. This review provides detailed information about each of these important clinical entities. After reviewing the clinical features, epidemiology and current understanding of the pathophysiology of each disorder, we describe the current pharmacological and nonpharmacological approaches to the prevention and treatment of these diseases.

Prevention of acute chemotherapy-induced nausea and vomiting: the role of palonosetron

Directory of Open Access Journals (Sweden)

Emilio Bajetta

2009-08-01

Full Text Available Emilio Bajetta, Sara Pusceddu, Valentina Guadalupi, Monika Ducceschi, Luigi CelioMedical Oncology Unit 2, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, ItalyAbstract: Prevention of nausea and vomiting is the main goal of antiemetic treatment in cancer patients scheduled to receive chemotherapy. To prevent acute emesis, antiemetics should be administered just before chemotherapy and patients should be protected for up to 24 hours after chemotherapy initiation. The emetogenic potential of chemotherapeutic agents guides clinicians towards the most appropriate antiemetic prophylaxis. Current guidelines recommend the use of 5-HT3 receptor antagonist (RA either alone or in combination with dexamethasone and/or a neurokinin-1 RA both in the acute and delayed phases. The second-generation 5-HT3RA palonosetron exhibits a longer half-life and a higher binding affinity than older antagonists. Palonosetron has been approved by the FDA for the prevention of chemotherapy-induced nausea and vomiting (CINV in patients scheduled to receive either moderately (MEC or highly emetogenic chemotherapy (HEC and for the prevention of delayed CINV in patients receiving MEC. The present review will discuss the role of palonosetron in the prevention of acute CINV.Keywords: antiemetics, chemotherapy, nausea, vomiting, serotonin-receptor antagonists, palonosetron

Efficacy of Residence at Moderate Versus Low Altitude on Reducing Acute Mountain Sickness in Men Following Rapid Ascent to 4300 m

Science.gov (United States)

2013-01-01

reduced AMS after rapid ascent to high altitude. Key Words: acute mountain sickness, hypobaric hypoxia, acclimatization, fluid balance, ventilatory...response to hypoxia Introduction Altitude acclimatization refers to a series of phys-iologic responses to prolonged exposure to hypobaric hypoxia in low...Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts. 2Center for Aerospace and Hyperbaric Medicine

Literature review: use of xylitol for prevention of acute otitis media

Directory of Open Access Journals (Sweden)

Pereira, Agnes de Fátima Faustino

2009-03-01

Full Text Available Introduction: Xylitol is a sugar naturally found in various vegetables and fruits. Studies have demonstrated that the xylitol can be used as new preventive method for acute otitis media (AOM. Objective: To clarify the possible mechanisms of xylitol actions to inhibit the growth of otopathogenic bacteria and to describe researches that contribute for the discussion about the feasibility of the use of this sugar in the prevention of AOM. Method: Literature review based on scientific articles selected by means of the medical databases: MEDLINE, Cochrane, PubMed (MeSH and Web of Science. Results: Studies have demonstrated the efficacy of xylitol to prevent the AOM, when it is administered five times a day in chewing gum. However, this sugar is not so effective in the prevention of AOM during upper airways infections. Final Comments: Xylitol seems to be an effective strategy in prevention of acute otitis media. However, new studies are necessary to establish ideal doses, frequencies and vehicles for the correct administration of the sugar, which allows for its utilization in the public health system.

Mountain Biking Injuries.

Science.gov (United States)

Ansari, Majid; Nourian, Ruhollah; Khodaee, Morteza

With the increasing popularity of mountain biking, also known as off-road cycling, and the riders pushing the sport into extremes, there has been a corresponding increase in injury. Almost two thirds of acute injuries involve the upper extremities, and a similar proportion of overuse injuries affect the lower extremities. Mountain biking appears to be a high-risk sport for severe spine injuries. New trends of injury patterns are observed with popularity of mountain bike trail parks and freeride cycling. Using protective gear, improving technical proficiency, and physical fitness may somewhat decrease the risk of injuries. Simple modifications in bicycle-rider interface areas and with the bicycle (bike fit) also may decrease some overuse injuries. Bike fit provides the clinician with postural correction during the sport. In this review, we also discuss the importance of race-day management strategies and monitoring the injury trends.

Analysis of Surgical Success in Preventing Recurrent Acute Exacerbations in Chronic Pancreatitis

Science.gov (United States)

Nealon, William H.; Matin, Sina

2001-01-01

Objective To determine whether surgical intervention prevents recurrent acute exacerbations in chronic pancreatitis (CP). Summary Background Data The primary goal of surgical intervention in the treatment of CP has been relief of chronic unrelenting abdominal pain. A subset of patients with CP have intermittent acute exacerbations, often with increasing frequency and often unrelated to ongoing ethanol abuse. Little data exist regarding the effectiveness of surgery to prevent acute attacks. Methods From 1985 to 1999, all patients identified with a diagnosis of CP were recruited to participate in an ongoing program of serial clinic visits and functional and clinical evaluations. Patients were offered surgery using standard criteria. Data were gathered regarding ethanol abuse, pain, narcotic use, and recurrent acute exacerbations requiring hospital admission before and after surgery. Patients were broadly categorized as having severe unrelenting pain alone (group 1), severe pain with intermittent acute exacerbations (group 2), and intermittent acute exacerbations only (group 3). Results Two hundred fifty-nine patients were recruited. One hundred eighty-five patients underwent 199 surgical procedures (124 modified Puestow procedure [LPJ], 29 distal pancreatectomies [DP], and 46 pancreatic head resections [PHR; 14 performed after failure of LPJ]). There were no deaths. The complication rate was 4% for LPJ, 15% for DP, and 27% for PHR. Ethanol abuse was causative in 238 patients (92%). Mean follow-up was 81 months. There were 104 patients in group 1 (86 who underwent surgery), 71 patients in group 2 (64 who underwent surgery), and 84 in group 3 (49 who underwent surgery). No patient without surgery had spontaneous resolution of symptoms. Postoperative pain relief (freedom from narcotic analgesics) was achieved in 153 of 185 patients (83%) overall: 106 of 124 (86%) for LPJ, 19 of 29 (67%) for DP, and 42 of 46 (91%) for PHR. The mean rate of acute exacerbations was 6.3 �

Altered free radical metabolism in acute mountain sickness: implications for dynamic cerebral autoregulation and blood-brain barrier function

DEFF Research Database (Denmark)

Bailey, D M; Evans, K A; James, P E

2008-01-01

We tested the hypothesis that dynamic cerebral autoregulation (CA) and blood-brain barrier (BBB) function would be compromised in acute mountain sickness (AMS) subsequent to a hypoxia-mediated alteration in systemic free radical metabolism. Eighteen male lowlanders were examined in normoxia (21% O...... developed clinical AMS (AMS+) and were more hypoxaemic relative to subjects without AMS (AMS-). A more marked increase in the venous concentration of the ascorbate radical (A(*-)), lipid hydroperoxides (LOOH) and increased susceptibility of low-density lipoprotein (LDL) to oxidation was observed during...

A Review of Nutrition-Specific and Nutrition-Sensitive Approaches to Preventing Moderate Acute Malnutrition

International Nuclear Information System (INIS)

Mucha, Noreen; Jimenez, Michelle; Stone-Jimenez, Maryanne; Brown, Rebecca

2014-01-01

Full text: Recent literature reviews have demonstrated the limited efficacy of targeted supplementary feeding programmes aimed at both treating and preventing moderate acute malnutrition (MAM), with high rates of defaulting, low coverage and high associated costs. There is a growing interest in a) reviewing and improving protocols / tools for the management of acute malnutrition and b) increasing the quality and variety of products available for the treatment / prevention of moderate acute malnutrition. There is however, varying evidence on the impact of nutritional products aimed at preventing or treating acute malnutrition, or on the comparative efficacy of different products. Following several literature reviews and operational research with varying results, there is increasing consensus that MAM should be tackled not only through products, and that clearer guidance should be provided on broader preventive strategies, such as optimal infant and young child feeding (IYCF) and caregiving practices, optimal maternal nutrition, counselling, social protection, food security and livelihoods, and water, sanitation and hygiene (WASH). The CMAM Forum has commissioned Technical Briefs which aim to summarise current thinking and practice relating to preventive approaches to MAM, looking at the role of both nutrition-specific and nutrition-sensitive interventions. The work is being launched in January 2014 and results will be available for presentation at the IAEA MAM Symposium in May 2014. The briefs aim to provide: • An overview of approaches to preventing MAM across different sectors (e.g. agriculture, health, IYCF, social protection, water and sanitation) and in different contexts. • A review of current knowledge including: – Evidence from systematic and literature reviews. – Existing approaches and practice for prevention of MAM. – Current guidance on making programmatic choices relating to MAM prevention interventions and decision-making frameworks. �

Age as a risk factor for acute mountain sickness upon rapid ascent to 3,700 m among young adult Chinese men

Directory of Open Access Journals (Sweden)

Tang XG

2014-08-01

Full Text Available Xu-gang Tang,1 Ji-hang Zhang,1 Jun Qin,1 Xu-bin Gao,1 Qian-ning Li,2 Jie Yu,1 Xiao-han Ding,1 Lan Huang1 1Institute of Cardiovascular Diseases, 2Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing, People’s Republic of China Background: The aim of this study was to explore the relationship between age and acute mountain sickness (AMS when subjects are exposed suddenly to high altitude.Methods: A total of 856 young adult men were recruited. Before and after acute altitude exposure, the Athens Insomnia Scale score (AISS was used to evaluate the subjective sleep quality of subjects. AMS was assessed using the Lake Louise scoring system. Heart rate (HR and arterial oxygen saturation (SaO2 were measured.Results: Results showed that, at 500 m, AISS and insomnia prevalence were higher in older individuals. After acute exposure to altitude, the HR, AISS, and insomnia prevalence increased sharply, and the increase in older individuals was more marked. The opposite trend was observed for SaO2. At 3,700 m, the prevalence of AMS increased with age, as did severe AMS, and AMS symptoms (except gastrointestinal symptoms. Multivariate logistic regression analysis showed that age was a risk factor for AMS (adjusted odds ratio [OR] 1.07, 95% confidence interval [CI] 1.01–1.13, P<0.05, as well as AISS (adjusted OR 1.39, 95% CI 1.28–1.51, P<0.001.Conclusion: The present study is the first to demonstrate that older age is an independent risk factor for AMS upon rapid ascent to high altitude among young adult Chinese men, and pre-existing poor subjective sleep quality may be a contributor to increased AMS prevalence in older subjects. Keywords: acute mountain sickness, age, Athens Insomnia Scale, rapid ascent, sleep

Prevention of depression in patients with acute coronary syndrome (DECARD) randomized trial

DEFF Research Database (Denmark)

Hjorthøj, Carsten Rygaard; Hansen, Baiba Hedegaard; Hanash, Jamal Abed

2015-01-01

.02-0.99) ) than in the full sample of patients (HR = 0.20 (0.04-0.90) ), although not statistically significant. CONCLUSIONS: The SF-36 may be too broad an outcome measure in trials or treatments that seek to prevent depression following acute coronary syndrome. The SF-36 may, however, indicate who is more likely......AIM: Escitalopram may prevent depression following acute coronary syndrome. We sought to estimate the effects of escitalopram on self-reported health and to identify subgroups with higher efficacy. METHODS: This is a secondary analysis of a 12-month double-blind clinical trial randomizing non-depressed...... acute coronary syndrome patients to escitalopram (n = 120) or matching placebo (n = 120). The main outcomes were mean scores on Short Form 36 Health Survey (SF-36) domains, and diagnosis of depression was adjusted for baseline SF-36 scores. RESULTS: Escitalopram did not yield different SF-36...

Antibiotic therapy for preventing infections in people with acute stroke

NARCIS (Netherlands)

Vermeij, Jan-Dirk; Westendorp, Willeke F.; Dippel, Diederik Wj; van de Beek, Diederik; Nederkoorn, Paul J.

2018-01-01

Stroke is the main cause of disability in high-income countries and ranks second as a cause of death worldwide. Infections occur frequently after stroke and may adversely affect outcome. Preventive antibiotic therapy in the acute phase of stroke may reduce the incidence of infections and improve

Antibiotic therapy for preventing infections in patients with acute stroke

NARCIS (Netherlands)

Westendorp, Willeke F.; Vermeij, Jan-Dirk; Vermeij, Frederique; den Hertog, Heleen M.; Dippel, Diederik W. J.; van de Beek, Diederik; Nederkoorn, Paul J.

2012-01-01

Background Stroke is the main cause of disability in high income countries and ranks second as a cause of death worldwide. Infections occur frequently after stroke and may adversely affect outcome. Preventive antibiotic therapy in the acute phase of stroke may reduce infections and improve outcome.

Acute Kidney Injury by Radiographic Contrast Media: Pathogenesis and Prevention

Science.gov (United States)

Faga, Teresa; Pisani, Antonio; Michael, Ashour

2014-01-01

It is well known that iodinated radiographic contrast media may cause kidney dysfunction, particularly in patients with preexisting renal impairment associated with diabetes. This dysfunction, when severe, will cause acute renal failure (ARF). We may define contrast-induced Acute Kidney Injury (AKI) as ARF occurring within 24–72 hrs after the intravascular injection of iodinated radiographic contrast media that cannot be attributed to other causes. The mechanisms underlying contrast media nephrotoxicity have not been fully elucidated and may be due to several factors, including renal ischaemia, particularly in the renal medulla, the formation of reactive oxygen species (ROS), reduction of nitric oxide (NO) production, and tubular epithelial and vascular endothelial injury. However, contrast-induced AKI can be prevented, but in order to do so, we need to know the risk factors. We have reviewed the risk factors for contrast-induced AKI and measures for its prevention, providing a long list of references enabling readers to deeply evaluate them both. PMID:25197639

Recent advances in the treatment of colonic diverticular disease and prevention of acute diverticulitis

Science.gov (United States)

Elisei, Walter; Tursi, Antonio

2016-01-01

The incidence of diverticulosis and diverticular disease of the colon is increasing worldwide. Although the majority of patients remains asymptomatic long-life, the prevalence of diverticular disease of the colon, including acute diverticulitis, is substantial and is becoming a significant burden on National Health Systems in terms of direct and indirect costs. Focus is now being drawn on identifying the correct therapeutic approach by testing various treatments. Fiber, non-absorbable antibiotics and probiotics seem to be effective in treating symptomatic and uncomplicated patients, and 5-aminosalicylic acid might help prevent acute diverticulitis. Unfortunately, robust evidence on the effectiveness of a medical strategy to prevent acute diverticulitis recurrence is still lacking. We herein provide a concise review on the effectiveness and future perspectives of these treatments. PMID:26752946

Mountain biking injuries: an update.

Science.gov (United States)

Kronisch, Robert L; Pfeiffer, Ronald P

2002-01-01

This article reviews the available literature regarding injuries in off-road bicyclists. Recent progress in injury research has allowed the description of several patterns of injury in this sport. Mountain biking remains popular, particularly among young males, although sales and participation figures have decreased in the last several years. Competition in downhill racing has increased, while cross-country racing has decreased somewhat in popularity. Recreational riders comprise the largest segment of participants, but little is known about the demographics and injury epidemiology of noncompetitive mountain cyclists. Most mountain bikers participating in surveys reported a history of previous injuries, but prospective studies conducted at mountain bike races have found injury rates of bike racing the risk of injury may be higher for women than men. Minor injuries such as abrasions and contusions occur frequently, but are usually of little consequence. Fractures usually involve the torso or upper extremities, and shoulder injuries are common. Head and face injuries are not always prevented by current helmet designs. Fatal injuries are rare but have been reported. Improvements in safety equipment, rider training and racecourse design are suggested injury prevention measures. The authors encourage continued research in this sport.

Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update

Science.gov (United States)

Anderson, Deverick J.; Podgorny, Kelly; Berríos-Torres, Sandra I.; Bratzler, Dale W.; Dellinger, E. Patchen; Greene, Linda; Nyquist, Ann-Christine; Saiman, Lisa; Yokoe, Deborah S.; Maragakis, Lisa L.; Kaye, Keith S.

2014-01-01

PURPOSE Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their surgical site infection (SSI) prevention efforts. This document updates “Strategies to Prevent Surgical Site Infections in Acute Care Hospitals,”1 published in 2008. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.2 PMID:24799638

Treatment of diverticular disease of the colon and prevention of acute diverticulitis: a systematic review.

Science.gov (United States)

Maconi, Giovanni; Barbara, Giovanni; Bosetti, Cristina; Cuomo, Rosario; Annibale, Bruno

2011-10-01

Diverticular disease of the colon is a common disorder, characterized by recurrent symptoms and complications such as diverticulitis, requiring hospital admissions and surgery. This study aimed to systematically review the evidence for medical therapy of diverticular disease in reducing symptoms and preventing acute diverticulitis. MEDLINE and Embase databases (1966 to February 2010). The studies selected were prospective clinical trials on uncomplicated diverticular disease of the colon. Four investigators independently reviewed articles, extracted data, and assessed study quality according to standardized criteria. The main outcomes measured were improvement in symptoms, complete remission of symptoms, and prevention of acute diverticulitis. We identified 31 studies, including 6 placebo-controlled trials. The methodological quality of these studies was suboptimal. Only 10 trials provided a detailed description of the patient history, 8 assessed symptoms by the use of a validated questionnaire, and 14 appropriately defined inclusion and exclusion criteria. Only one long-term double-blind placebo-controlled study was identified. This reported a significant improvement in symptoms and greater prevalence of symptom-free patients at 1 year with fiber plus rifaximin in comparison with fiber alone. The efficacy of treatment in preventing acute diverticulitis was evaluated in 11 randomized trials. Four trials compared rifaximin plus fiber vs fiber alone and failed to show a significant difference between treatments. However, cumulative data from these trials revealed a significant benefit following rifaximin and fiber (1-year rate of acute diverticulitis: 11/970 (1.1%) vs 20/690 (2.9%); P = .012), but with a number needed to treat of 57, to prevent an attack of acute diverticulitis. : Heterogeneity of the study design, patients' characteristics, regimens and combination of studied treatment, and outcome reporting precluded the pooling of results and limited

Leukostasis: Management to Prevent Crisis in Acute Leukemia
.

Science.gov (United States)

Blackburn, Lisa M; Brown, Shelly; Munyon, Aimee; Orovets, Michelle

2017-12-01

Hyperleukocytosis, a peripheral white blood cell count greater than 100,000/mm3,is most commonly seen in patients with newly diagnosed or relapsed acute lymphoblastic leukemia and acute myeloid leukemia. Leukostasis is a reduction in blood flow related to hyperviscosity. Hyperleukocytosis, causing leukostasis, is an oncologic emergency and requires an exacting assessment and rapid response with appropriate intervention to prevent morbidity and mortality in the first week after diagnosis. The objectives of this article are to equip oncology nurse to identify patients with hyperleukocytosis and to provide nursing interventions that will ensure safe, quality care. A case study is used to demonstrate key concepts that are critical in early assessment, identification, and treatment of patients with leukostasis.
. Oncology nurses well versed in the pathophysiology, clinical presentation, and management of leukostasis can make a significant contribution to the safe management of patients with cancer.

Plant invasions in mountains: Global lessons for better management

Science.gov (United States)

McDougall, K.L.; Khuroo, A.A.; Loope, L.L.; Parks, C.G.; Pauchard, A.; Reshi, Z.A.; Rushworth, I.; Kueffer, C.

2011-01-01

Mountains are one of few ecosystems little affected by plant invasions. However, the threat of invasion is likely to increase because of climate change, greater anthropogenic land use, and continuing novel introductions. Preventive management, therefore, will be crucial but can be difficult to promote when more pressing problems are unresolved and predictions are uncertain. In this essay, we use management case studies from 7 mountain regions to identify common lessons for effective preventive action. The degree of plant invasion in mountains was variable in the 7 regions as was the response to invasion, which ranged from lack of awareness by land managers of the potential impact in Chile and Kashmir to well-organized programs of prevention and containment in the United States (Hawaii and the Pacific Northwest), including prevention at low altitude. In Australia, awareness of the threat grew only after disruptive invasions. In South Africa, the economic benefits of removing alien plants are well recognized and funded in the form of employment programs. In the European Alps, there is little need for active management because no invasive species pose an immediate threat. From these case studies, we identify lessons for management of plant invasions in mountain ecosystems: (i) prevention is especially important in mountains because of their rugged terrain, where invasions can quickly become unmanageable; (ii) networks at local to global levels can assist with awareness raising and better prioritization of management actions; (iii) the economic importance of management should be identified and articulated; (iv) public acceptance of management programs will make them more effective; and (v) climate change needs to be considered. We suggest that comparisons of local case studies, such as those we have presented, have a pivotal place in the proactive solution of global change issues. ?? International Mountain Society.

High altitude headache and acute mountain sickness at moderate elevations in a military population during battalion-level training exercises.

Science.gov (United States)

Norris, Jacob N; Viirre, Erik; Aralis, Hilary; Sracic, Michael K; Thomas, Darren; Gertsch, Jeffery H

2012-08-01

Few studies have evaluated high altitude headache (HAH) and acute mountain sickness (AMS) in military populations training at moderate (1,500-2,500 m) to high altitudes (>2,500 m). In the current study, researchers interviewed active duty personnel training at Marine Corps Mountain Warfare Training Center. Participants were asked about HAH and AMS symptoms, potential risk factors, and medications used. In a sample of 192 U.S. Navy and Marine Corps personnel, 14.6% reported AMS (Lake Louise Criteria > or = 3) and 28.6% reported HAH. Dehydration and recent arrival at altitude (defined as data collected on days 2-3) were significantly associated with AMS; decreased sleep allowance was significantly associated with HAH. Although ibuprofen/Motrin users were more likely to screen positive for AMS, among AMS-positive participants, ibuprofen/Motrin users had decreased likelihood of reporting robust AMS relative to non-ibuprofen/Motrin users (p altitude. Further, ibuprofen/Motrin may be a reasonable treatment for the symptoms of AMS and HAH, although further study is warranted.

Novel drugs in the management of acute mountain sickness and high altitude pulmonary edema

Directory of Open Access Journals (Sweden)

Sikri G

2015-12-01

Full Text Available Gaurav Sikri, Anirban Bhattacharya Department of Physiology, Armed Forces Medical College, Wanowarie, Pune, IndiaWe read with great interest the review article titled “Wilderness medicine at high altitude: recent developments in the field” by Shah et al.1 The authors have comprehensively summarized the recent advances in the field of high altitude medicine relevant to sports and travel medicine. However, Shah et al have described potential drugs for management of high-altitude illnesses, such as acute mountain sickness (AMS, high altitude cerebral edema, and high altitude pulmonary edema (HAPE as one group under the section “Novel drug treatment for AMS”. The pathophysiologies of these two sets of diseases (AMS/high altitude cerebral edema as one and HAPE as another set are different2 and hence it would have been nice to have had the novel drugs described separately to elucidate the therapeutic approach for the two different classes of diseases.View original paper by Shah et al.

A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates.

Science.gov (United States)

Yokoe, Deborah S; Anderson, Deverick J; Berenholtz, Sean M; Calfee, David P; Dubberke, Erik R; Ellingson, Katherine D; Gerding, Dale N; Haas, Janet P; Kaye, Keith S; Klompas, Michael; Lo, Evelyn; Marschall, Jonas; Mermel, Leonard A; Nicolle, Lindsay E; Salgado, Cassandra D; Bryant, Kristina; Classen, David; Crist, Katrina; Deloney, Valerie M; Fishman, Neil O; Foster, Nancy; Goldmann, Donald A; Humphreys, Eve; Jernigan, John A; Padberg, Jennifer; Perl, Trish M; Podgorny, Kelly; Septimus, Edward J; VanAmringe, Margaret; Weaver, Tom; Weinstein, Robert A; Wise, Robert; Maragakis, Lisa L

2014-08-01

Since the publication of "A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals" in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. They are the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

Relationship between oxygen delivery and its compensatory factors and acute mountain sickness

Directory of Open Access Journals (Sweden)

Ming LI

2013-03-01

Full Text Available Objective 　To investigate the changes in oxygen delivery (DO2 to the body and brain and its compensatory factors to acute hypoxia and their relation to acute mountain sickness (AMS. Methods 　One hundred and forty-seven participants were recruited from Chinese young men who had lived in plain all along arrived in Tibet by flight. All of them were asked to complete an AMS questionnaire within 48h after arrival. The resting heart rate (HR, blood pressure (BP, cardiac output (CO, oxygen saturation (SaO2, stroke volume (SV and blood flow velocity in the middle cerebral artery (MCAv were measured one week before departure from the plain and within 48h after arrival in Tibet. AMS was diagnosed according to Louis Lake Score System (LLS, and the results were then statistically analyzed. Results 　AMS was diagnosed in eighty-six subjects (58.5%. After exposure to hypoxia, SaO2 was decreased by 10% and was negatively correlated with AMS score. Systemic DO2, CO and HR were increased by 19%, 32.5% and 31.7%, respectively, and were positively correlated with AMS, while the SV remained unchanged. MCAv accelerated by 10%, and that of AMS subjects was higher than of non-AMS ones. The cerebral DO2 (DO2C was maintained because the MCAv matched with SaO2 changes. The middle cerebral artery resistance units (RMCA decreased obviously with an increase in MBP, and RMCA in AMS subjects was lower than that in non-AMS ones. HR and MCAv, the key compensation factors of DO2, were used as the objective evaluation indices, in collaboration of HR≥85 beat/min and MCAv≥66cm/s, could be a better means to evaluate AMS, with a positive predictive value of 82.4% and specificity of 90.2%. Conclusions 　DO2 and its compensatory factors may play a key role in the regulation response to acclimatize to acute hypoxia. Among them, HR and MCAv may relate to the mechanism of AMS development, and indirectly reflect the compensation level to oxygen debt, implying that HR and MCAv are

Mountain biking injuries requiring trauma center admission: a 10-year regional trauma system experience.

Science.gov (United States)

Kim, Peter T W; Jangra, Dalbhir; Ritchie, Alec H; Lower, Mary Ellen; Kasic, Sharon; Brown, D Ross; Baldwin, Greg A; Simons, Richard K

2006-02-01

Mountain biking has become an increasingly popular recreational and competitive sport with increasingly recognized risks. The purpose of this study was to review a population based approach to serious injuries requiring trauma center admission related to mountain biking, identify trends and develop directions for related injury prevention programs. Three trauma centers in the Greater Vancouver area exclusively serve a major mountain bike park and the North Shore Mountains biking trails. The Trauma Registries and the patient charts were reviewed for mountain bike injuries from 1992 to 2002. The data were analyzed according to demographics, distribution, and severity of injuries, and need for operative intervention. Findings were reviewed with injury prevention experts and regional and national mountain-biking stakeholders to provide direction to injury prevention programs. A total of 1,037 patients were identified as having bicycling-related injuries. Of these, 399 patients sustained 1,092 injuries while mountain biking. There was a threefold increase in the incidence of mountain biking injuries over a 10-year period. Young males were most commonly affected. Orthopedic injuries were most common (46.5%) followed by head (12.2%), spine (12%), chest (10.3%), facial (10.2%), abdominal (5.4%), genitourinary (2.2%), and neck injuries (1%). High operative rate was observed: 38% of injuries and 66% of patients required surgery. One patient died from his injuries. Injury prevention programs were developed and successfully engaged the target population. Mountain biking is a growing cause of serious injuries. Young males are principally at risk and serious injuries result from intended activity and despite protective equipment. Injury prevention programs were developed to address these concerns.

Mountain biking. Breezy ups and traumatic downs

International Nuclear Information System (INIS)

Schueller, G.

2010-01-01

For more than two decades the popularity of mountain biking as a national pastime as well as a competitive sport has been undiminished. However, its related risks are not monitored as closely as those, for example, of skiing. The injuries caused by mountain biking are specific and cannot be compared with those caused by other cycling sports. This is due not only to the characteristics of the terrain but also to the readiness to assume a higher risk compared to cycle racing. The particular value of radiology is in the acute trauma setting. Most often musculoskeletal lesions must be examined and digital radiography and MRI are the most useful techniques. Severe trauma of the cranium, face, spine, thorax and abdomen are primarily evaluated with CT, particularly in dedicated trauma centers. Therefore, radiology can play a role in the rapid diagnosis and optimal treatment of the trauma-related injuries of mountain biking. Thus, the unnecessarily high economical damage associated with mountain biking can be avoided. (orig.) [de

[Mountain biking : Breezy ups and traumatic downs].

Science.gov (United States)

Schueller, G

2010-05-01

For more than two decades the popularity of mountain biking as a national pastime as well as a competitive sport has been undiminished. However, its related risks are not monitored as closely as those, for example, of skiing. The injuries caused by mountain biking are specific and cannot be compared with those caused by other cycling sports. This is due not only to the characteristics of the terrain but also to the readiness to assume a higher risk compared to cycle racing.The particular value of radiology is in the acute trauma setting. Most often musculoskeletal lesions must be examined and digital radiography and MRI are the most useful techniques. Severe trauma of the cranium, face, spine, thorax and abdomen are primarily evaluated with CT, particularly in dedicated trauma centers. Therefore, radiology can play a role in the rapid diagnosis and optimal treatment of the trauma-related injuries of mountain biking. Thus, the unnecessarily high economical damage associated with mountain biking can be avoided.

Prediction and Prevention of Acute Kidney Injury after Cardiac Surgery

Directory of Open Access Journals (Sweden)

Su Rin Shin

2016-01-01

Full Text Available The incidence of acute kidney injury after cardiac surgery (CS-AKI ranges from 33% to 94% and is associated with a high incidence of morbidity and mortality. The etiology is suggested to be multifactorial and related to almost all aspects of perioperative management. Numerous studies have reported the risk factors and risk scores and novel biomarkers of AKI have been investigated to facilitate the subclinical diagnosis of AKI. Based on the known independent risk factors, many preventive interventions to reduce the risk of CS-AKI have been tested. However, any single preventive intervention did not show a definite and persistent benefit to reduce the incidence of CS-AKI. Goal-directed therapy has been considered to be a preventive strategy with a substantial level of efficacy. Many pharmacologic agents were tested for any benefit to treat or prevent CS-AKI but the results were conflicting and evidences are still lacking. The present review will summarize the current updated evidences about the risk factors and preventive strategies for CS-AKI.

Mountain biking injuries: a review.

Science.gov (United States)

Carmont, Michael R

2008-01-01

Mountain biking is a fast, exciting adventure sport with increasing numbers of participants and competitions. A search of PubMed, Medline, CINAHL, DH data, and Embase databases was performed using the following keywords: mountain, biking and injuries. This revealed 2 review articles, 17 case controlled studies, 4 case series and 5 case reports. This review summarises the published literature on mountain biking injuries, discusses injury frequency and common injury mechanisms. Riders are quick to adopt safety measures. Helmet usage is now increasingly common and handlebar adaptations have been discontinued. Although the sport has a reputation for speed and risk with research and awareness, injury prevention measures are being adopted making the sport as safe as possible.

Patients' preferences for headache acute and preventive treatment.

Science.gov (United States)

Mitsikostas, Dimos D; Belesioti, Ioanna; Arvaniti, Chryssa; Mitropoulou, Euthymia; Deligianni, Christina; Kasioti, Elina; Constantinidis, Theodoros; Dermitzakis, Manolis; Vikelis, Michail

2017-10-06

We aimed to explore patients' preferences for headache treatments with a self-administered questionnaire including the Q-No questionnaire for nocebo. Questionnaires from 514 outpatients naïve to neurostimulation and monoclonal antibodies were collected. Patients assessed that the efficacy of a treatment is more important than safety or route of administration. They preferred to use an external neurostimulation device for both acute (67.1%) and preventive treatment (62.8%). Most patients preferred to take a pill (86%) than any other drug given parenterally for symptomatic pharmaceutical treatment. For preventive pharmaceutical treatment, most patients preferred to take a pill once per day (52%) compared to an injection either subcutaneously or intravenously each month (9% and 4%), or three months (15% and 11%). 56.6% of all participants scored more than 15 in Q-No questionnaire indicating potential nocebo behaviors that contributed significantly in their choices. These patient preferences along with efficacy and safety data may help physicians better choose the right treatment for the right person.

Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis.

Science.gov (United States)

Doherty, Cailbhe; Bleakley, Chris; Delahunt, Eamonn; Holden, Sinead

2017-01-01

Ankle sprains are highly prevalent with high risk of recurrence. Consequently, there are a significant number of research reports examining strategies for treating and preventing acute and recurrent sprains (otherwise known as chronic ankle instability (CAI)), with a coinciding proliferation of review articles summarising these reports. To provide a systematic overview of the systematic reviews evaluating treatment strategies for acute ankle sprain and CAI. Overview of intervention systematic reviews. Individuals with acute ankle sprain/CAI. The primary outcomes were injury/reinjury incidence and function. 46 papers were included in this systematic review. The reviews had a mean score of 6.5/11 on the AMSTAR quality assessment tool. There was strong evidence for bracing and moderate evidence for neuromuscular training in preventing recurrence of an ankle sprain. For the combined outcomes of pain, swelling and function after an acute sprain, there was strong evidence for non-steroidal anti-inflammatory drugs and early mobilisation, with moderate evidence supporting exercise and manual therapy techniques. There was conflicting evidence regarding the efficacy of surgery and acupuncture for the treatment of acute ankle sprains. There was insufficient evidence to support the use of ultrasound in the treatment of acute ankle sprains. For the treatment of acute ankle sprain, there is strong evidence for non-steroidal anti-inflammatory drugs and early mobilisation, with moderate evidence supporting exercise and manual therapy techniques, for pain, swelling and function. Exercise therapy and bracing are supported in the prevention of CAI. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Age as a risk factor for acute mountain sickness upon rapid ascent to 3,700 m among young adult Chinese men.

Science.gov (United States)

Tang, Xu-Gang; Zhang, Ji-hang; Qin, Jun; Gao, Xu-bin; Li, Qian-ning; Yu, Jie; Ding, Xiao-han; Huang, Lan

2014-01-01

The aim of this study was to explore the relationship between age and acute mountain sickness (AMS) when subjects are exposed suddenly to high altitude. A total of 856 young adult men were recruited. Before and after acute altitude exposure, the Athens Insomnia Scale score (AISS) was used to evaluate the subjective sleep quality of subjects. AMS was assessed using the Lake Louise scoring system. Heart rate (HR) and arterial oxygen saturation (SaO2) were measured. Results showed that, at 500 m, AISS and insomnia prevalence were higher in older individuals. After acute exposure to altitude, the HR, AISS, and insomnia prevalence increased sharply, and the increase in older individuals was more marked. The opposite trend was observed for SaO2. At 3,700 m, the prevalence of AMS increased with age, as did severe AMS, and AMS symptoms (except gastrointestinal symptoms). Multivariate logistic regression analysis showed that age was a risk factor for AMS (adjusted odds ratio [OR] 1.07, 95% confidence interval [CI] 1.01-1.13, Psleep quality may be a contributor to increased AMS prevalence in older subjects.

ALMA to Help Solving Acute Mountain Sickness Mystery

Science.gov (United States)

2007-04-01

, family and social isolation, commuting, intermittent high altitude exposure and other environmental challenges such as low temperatures. "An adequate acclimatisation to 2500m altitude requires around two weeks, and we can thus speculate that going to 5000m would require more than one month to achieve complete acclimatisation," said Professor Juan Silva Urra, from the University of Antofagasta. However, short and long term effects of regular commuting between sea level and high altitude have scarcely been studied in biomedical terms. Scientifically based guidelines for appropriate preventive handling and care under these conditions are lacking and the new study will help bridging this gap. Among the studies to be done, some involve continuous monitoring of the human body through portable devices, including measurements of hormone levels and application of psychometric tests. All measurements at 5000m will be carried out on a voluntary basis, under strict safety protocols, with the presence of a doctor from the investigation team, paramedic personnel form ALMA and an ambulance. The symptoms of Acute Mountain Sickness are headache, sicknesses, gastrointestinal inconveniences, fatigue and insomnia that, depending on their intensities, decrease the capacity to carry out the most routine activities. The valuable data collected will enhance our knowledge of human physiology in extreme environments, generating recommendations that will improve wellbeing and health not only in high-altitude observatories, but also in mining and Antarctic personnel. "We are pleased that ALMA is contributing to other disciplines, like medicine, even before the antennas begin to explore the universe," said Felix Mirabel, ESO's representative in Chile. "This outstanding long-term research that will provide crucial information of human physiology to experts worldwide, has been made possible thanks to the combined effort of Chilean and European universities, in collaboration with ALMA". The Atacama

Awareness and prevalence of acute mountain sickness and prevalence of obstructive airflow limitation among Nepalese porters: A cross-sectional study in Khumbu Valley, Nepal

OpenAIRE

Parajuli, Ranjan

2009-01-01

Background: Acute mountain sickness is a major public health problem in high altitudes. Similarly, anecdotal evidence suggests that there is high prevalence of tobacco smoking among this group though prevalence of obstructive airflow limitation is not known. Objectives: The main aims of the study were to measure the awareness of AMS and report the prevalence of AMS and obstructive lung diseases in high altitude Nepalese porters. Setting: This study was done with bases in Namche Bazaar (...

ASSESSMENT OF EFFICACY IN APPLICATION OF TOPICAL IMMUNOLOGIC RESPONSE MODIFIER FOR PREVENTION OF INFLUENZA AND ACUTE RESPIRATORY INFECTIONS IN CHILDREN

Directory of Open Access Journals (Sweden)

I.N. Lytkina

2009-01-01

Full Text Available The purpose of this work was to assess the efficacy of bacterial lysate for prevention of acute respiratory infections. The article provides results of monitoring children in the orphanage who were administered the medication of this group as a prophylactic drug against acute respiratory infections. Children also from orphanages who were not administered the medication were selected as a control group. It was found that out of 80 children who underwent preventive treatment, only 26 children fell ill, while out of 80 children in the control group so did 78 orphans. The results achieved allowed the topical immunologic response modifier to be recommended as a general preventive medication for wide use in children in the period of seasonal respiratory infection incidence rate pickup.Key words: influenza, acute respiratory infections, preventive treatment, children.

Metalloproteinase inhibition prevents acute respiratory distress syndrome.

Science.gov (United States)

Carney, D E; McCann, U G; Schiller, H J; Gatto, L A; Steinberg, J; Picone, A L; Nieman, G F

2001-08-01

The acute respiratory distress syndrome (ARDS) occurs in patients with clearly identifiable risk factors, and its treatment remains merely supportive. We postulated that patients at risk for ARDS can be protected against lung injury by a prophylactic treatment strategy that targets neutrophil-derived proteases. We hypothesized that a chemically modified tetracycline 3 (COL-3), a potent inhibitor of neutrophil matrix metalloproteinases (MMPs) and neutrophil elastase (NE) with minimal toxicity, would prevent ARDS in our porcine endotoxin-induced ARDS model. Yorkshire pigs were anesthetized, intubated, surgically instrumented for hemodynamic monitoring, and randomized into three groups: (1) control (n = 4), surgical instrumentation only; (2) lipopolysaccharide (LPS) (n = 4), infusion of Escherichia coli lipopolysaccharide at 100 microg/kg; and (3) COL-3 + LPS (n = 5), ingestion of COL-3 (100 mg/kg) 12 h before LPS infusion. All animals were monitored for 6 h following LPS or sham LPS infusion. Serial bronchoalveolar lavage (BAL) samples were analyzed for MMP concentration by gelatin zymography. Lung tissue was fixed for morphometric assessment at necropsy. LPS infusion was marked by significant (P decrement in arterial oxygen partial pressure (P(a)O(2)) (LPS = 66 +/- 15 mm Hg, Control = 263 +/- 25 mm Hg) 6 h following LPS or sham LPS infusion, respectively. Pretreatment with COL-3 reduced the above pathophysiological changes 6 h following LPS infusion (P(plat) = 18.5 +/- 1.7 mm Hg, P(a)O(2) = 199 +/- 35 mm Hg; P = NS vs control). MMP-9 and MMP-2 concentration in BAL fluid was significantly increased between 2 and 4 h post-LPS infusion; COL-3 reduced the increase in MMP-9 and MMP-2 concentration at all time periods. Morphometrically LPS caused a significant sequestration of neutrophils and monocytes into pulmonary tissue. Pretreatment with COL-3 ameliorated this response. The wet/dry lung weight ratio was significantly greater (P single prophylactic treatment with COL

Acute allergic reaction to oral quinine for malarial prevention: A case report

Directory of Open Access Journals (Sweden)

Sora Yasri

2016-01-01

Full Text Available Quinine is a classical antimalarial drug that is used worldwide. It is also used for pre-exposure of malaria before visiting to the jungle in the endemic area of malaria. In this article, the authors reported a case of acute allergic reaction to oral quinine for malarial prevention.

MEDEX2015: Greater Sea-Level Fitness Is Associated with Lower Sense of Effort During Himalayan Trekking Without Worse Acute Mountain Sickness.

Science.gov (United States)

Rossetti, Gabriella M K; Macdonald, Jamie H; Smith, Matthew; Jackson, Anna R; Callender, Nigel; Newcombe, Hannah K; Storey, Heather M; Willis, Sebastian; van den Beukel, Jojanneke; Woodward, Jonathan; Pollard, James; Wood, Benjamin; Newton, Victoria; Virian, Jana; Haswell, Owen; Oliver, Samuel J

2017-06-01

Rossetti, Gabriella M.K., Jamie H. Macdonald, Matthew Smith, Anna R. Jackson, Nigel Callender, Hannah K. Newcombe, Heather M. Storey, Sebastian Willis, Jojanneke van den Beukel, Jonathan Woodward, James Pollard, Benjamin Wood, Victoria Newton, Jana Virian, Owen Haswell, and Samuel J. Oliver. MEDEX2015: Greater sea-level fitness is associated with lower sense of effort during Himalayan trekking without worse acute mountain sickness. High Alt Med Biol. 18:152-162, 2017.-This study examined the complex relationships of fitness and hypoxic sensitivity with submaximal exercise responses and acute mountain sickness (AMS) at altitude. Determining these relationships is necessary before fitness or hypoxic sensitivity tests can be recommended to appraise individuals' readiness for altitude. Forty-four trekkers (26 men; 18 women; 20-67 years) completed a loaded walking test and a fitness questionnaire in normoxia to measure and estimate sea-level maximal aerobic capacity (maximum oxygen consumption [[Formula: see text]O 2max ]), respectively. Participants also completed a hypoxic exercise test to determine hypoxic sensitivity (cardiac, ventilatory, and arterial oxygen saturation responses to acute hypoxia, fraction of inspired oxygen [Fio 2 ] = 0.112). One month later, all participants completed a 3-week trek to 5085 m with the same ascent profile. On ascent to 5085 m, ratings of perceived exertion (RPE ascent ), fatigue by Brunel Mood Scale, and AMS were recorded daily. At 5085 m, RPE during a fixed workload step test (RPE fixed ) and step rate during perceptually regulated exercise (STEP RPE35 ) were recorded. Greater sea-level [Formula: see text]O 2max was associated with, and predicted, lower sense of effort (RPE ascent ; r = -0.43; p sea-level fitness reported less effort during simulated and actual trekking activities, had better mood (less fatigue), and chose a higher step rate during perceptually regulated exercise, but did not suffer from worse AMS

Optimising secondary prevention in the acute period following a TIA of ischaemic origin.

Science.gov (United States)

Heron, Neil

2016-01-01

Transient ischaemic attacks (TIAs) are highly prevalent conditions, with at least 46 000 people per year in the UK having a TIA for the first time. TIAs are a warning that the patient is at risk of further vascular events and the 90-day risk of vascular events following a TIA, excluding events within the first week after diagnosis when the risk is highest, can be as high as 18%. Immediate assessment of patients with TIA, either at accident and emergency, general practice and/or TIA clinics, is therefore required to address secondary prevention and prevent further vascular events. This article addresses the need for optimising secondary prevention in the acute period following a TIA of ischaemic origin to reduce the risk of further vascular events as per recent Cochrane review advice and presents a novel project, Stroke Prevention Rehabilitation Intervention Trial of Exercise (SPRITE), to do this. One novel way to tackle vascular risk factors and promote secondary prevention in patients with TIA could be to adapt a cardiac rehabilitation programme for these patients. SPRITE, a feasibility and pilot study (ClinicalTrials.gov Identifier: NCT02712385) funded by the National Institute for Health Research, is attempting to adapt a home-based cardiac rehabilitation programme, 'The Healthy Brain Rehabilitation Manual', for use in the acute period following a TIA. The use of cardiac rehabilitation programmes post-TIA requires further research, particularly within the primary care setting.

Curcumin Prevents Acute Neuroinflammation and Long-Term Memory Impairment Induced by Systemic Lipopolysaccharide in Mice

Directory of Open Access Journals (Sweden)

Vincenzo Sorrenti

2018-03-01

Full Text Available Systemic lipopolysaccharide (LPS induces an acute inflammatory response in the central nervous system (CNS (“neuroinflammation” characterized by altered functions of microglial cells, the major resident immune cells of the CNS, and an increased inflammatory profile that can result in long-term neuronal cell damage and severe behavioral and cognitive consequences. Curcumin, a natural compound, exerts CNS anti-inflammatory and neuroprotective functions mainly after chronic treatment. However, its effect after acute treatment has not been well investigated. In the present study, we provide evidence that 50 mg/kg of curcumin, orally administered for 2 consecutive days before a single intraperitoneal injection of a high dose of LPS (5 mg/kg in young adult mice prevents the CNS immune response. Curcumin, able to enter brain tissue in biologically relevant concentrations, reduced acute and transient microglia activation, pro-inflammatory mediator production, and the behavioral symptoms of sickness. In addition, short-term treatment with curcumin, administered at the time of LPS challenge, anticipated the recovery from memory impairments observed 1 month after the inflammatory stimulus, when mice had completely recovered from the acute neuroinflammation. Together, these results suggest that the preventive effect of curcumin in inhibiting the acute effects of neuroinflammation could be of value in reducing the long-term consequences of brain inflammation, including cognitive deficits such as memory dysfunction.

Injuries in mountain biking.

Science.gov (United States)

Gaulrapp, H; Weber, A; Rosemeyer, B

2001-01-01

Despite still growing attraction mountain biking as a matter of sports traumatology still lacks relevant data based on large cross-sectional surveys. To obtain an overview of risk factors, types, and main body sites of injuries occurring in mountain biking we assessed the results of a questionnaire answered by 3873 athletes. A total of 8133 single lesions were reported by 3474 athletes, 36% of whom regularly participated in competitions. The incidence of injuries in mountain biking is comparable to that in other outdoor sports, the majority of injuries being minor. Mountain biking athletes were found to have an overall injury risk rate of 0.6% per year and 1 injury per 1000 h of biking. The main risk factors included slippery road surface, cyclist's poor judgement of the situation, and excessive speed, representing personal factors that could be altered by preventive measures. Of all injuries 14% were due to collision with some part of the bike, especially the pedals and the handlebar. While 75% of the injuries were minor, such as skin wounds and simple contusions, 10% were so severe that hospitalization was required. A breakdown of the injuries according to body site and frequency of occurrence is presented.

Long-term secondary prevention of acute myocardial infarction (SEPAT) - guidelines adherence and outcome.

Science.gov (United States)

Ergatoudes, Constantinos; Thunström, Erik; Rosengren, Annika; Björck, Lena; Bengtsson Boström, Kristina; Falk, Kristin; Fu, Michael

2016-11-17

A number of registry studies have reported suboptimal adherence to guidelines for cardiovascular prevention during the first year after acute myocardial infarction (AMI). However, only a few studies have addressed long-term secondary prevention after AMI. This study evaluates prevention guideline adherence and outcome of guideline-directed secondary prevention in patients surviving 2 years after AMI. Patients aged 18-85 years at the time of their index AMI were consecutively identified from hospital discharge records between July 2010 and December 2011 in Gothenburg, Sweden. All patients who agreed to participate in the study (16.2%) were invited for a structured interview, physical examinations and laboratory analysis 2 years after AMI. Guideline-directed secondary preventive goals were defined as optimally controlled blood pressure, serum cholesterol, glucose, regular physical activity, smoking cessation and pharmacological treatment. The mean age of the study cohort (n = 200) at the index AMI was 63.0 ± 9.7 years, 79% were men. Only 3.5% of the cohort achieved all six guideline-directed secondary preventive goals 2 years after infarction. LDL therapy was used by 97% of the patients, beta-blockers by 83.0%, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers by 76.5% and statins by 88.5%. During follow-up, non-fatal adverse cardiovascular events (cardiac hospitalization, recurrent acute coronary syndrome, angina pectoris, new percutaneous coronary intervention, new onset of atrial fibrillation, post-infarct heart failure, pacemaker implantation, stroke/transient ischemic attack (TIA), cardiac surgery and cardiac arrest) occurred in 47% of the cohort and readmission due to cardiac causes in 30%. Our data showed the failure of secondary prevention in our daily clinical practice and high rate of non-fatal adverse cardiovascular events 2 years after AMI.

СHILDREN OF MEGAPOLISES WHO FALL ILL FREQUENTLY: ACUTE RESPIRATORY INFECTION PREVENTION AND TREATMENT

Directory of Open Access Journals (Sweden)

R.M. Torshkhoeva

2006-01-01

Full Text Available The article is devoted to prevention and treatment of acute respiratory diseases children of megapolises who fall ill frequently. The authors prove the thesis that children falling ill frequently and residing in mega cities, and not only in Russia, have a similar immune status, according to which not only therapeutic but also preventive immunomodulatory treatment courses must be administered to them.Key words: frequently ill children, bacterial immunomodulation, cytokinic status.

[Reduction of in-hospital mortality and improved secondary prevention after acute myocardial infarction. First results from the registry of secondary prevention after acute myocardial infarction (SAMI)].

Science.gov (United States)

Tebbe, U; Messer, C; Stammwitz, E; The, G S; Dietl, J; Bischoff, K-O; Schulten-Baumer, U; Tebbenjohanns, J; Gohlke, H; Bramlage, P

2007-07-30

In hospital mortality of acute myocardial infarction (AMI) has been reduced due to the availability of better therapeutic strategies. But there is still a gap between mortality rates in randomised trials and daily clinical practice. Thus, it was aim of the present registry to document the course and outcome of patients with AMI and to improve patient care by implementing recent guidelines. In a nationwide registry study in hospitals in Germany with a cardiology unit or an internal medicine department data on consecutive patients were recorded for six to twelve months at admission, discharge and during a follow-up of one year. From 02/2003 until 10/2004 a total of 5,353 patients with acute myocardial infarction (65.7 % male, mean age of 67.6 +/- 17.7 years; 55.1 % of them with ST elevation myocardial infarction (STEMI) were included in the registry. Of the patients with STEMI, 76.6 % underwent acute intervention, 37.1 % had thrombolysis, 69.7 % percutaneous transluminal coronary angioplasty (PTCA). 40.0 % of those with non-Stemi (NSTEMI) had an acute intervention, 6.6 % thrombolysis, 73.5 % PTCA. Recommended secondary prevention consisted of ASS (93.2 %), beta-blockers (93.0 %), CSE-inhibitors (83.5 %), ACE-inhibitors (80.9 %) and clopidogrel (74.0 %). In-hospital mortality was 10.5 % (STEMI) and 7.4 % (NSTEMI). The 9 % mortality among patients with acute myocardial infarction treated in the hospitals participating in the SAMI registry is low compared to that in similar collectives. The high number of patients who had thrombofibrinolysis and coronary interventions as well as the early initiation of drug therapy contributed to these results. Medical treatment in the prehospital phase of these patients remains still insufficient and to a substantial extent contributes to the mortality of acute myocardial infarction.

Visual analog scale (VAS) for assessment of acute mountain sickness (AMS) on Aconcagua.

Science.gov (United States)

Van Roo, Jon D; Lazio, Matthew P; Pesce, Carlos; Malik, Sanjeev; Courtney, D Mark

2011-03-01

The Lake Louise AMS Self-Report Score (LLSelf) is a commonly used, validated assessment of acute mountain sickness (AMS). We compared LLSelf and visual analog scales (VAS) to quantify AMS on Aconcagua (6962 m). Prospective observational cohort study at Plaza de Mulas base camp (4365 m), Aconcagua Provincial Park, Argentina. Volunteers climbing in January 2009 were enrolled at base camp and ascended at their own pace. They completed the LLSelf, an overall VAS [VAS(o)], and 5 individual VAS [VAS(i)] corresponding to the items of the LLSelf when symptoms were maximal. Composite VAS [VAS(c)] was calculated as the sum of the 5 VAS(i). A total of 127 volunteers consented to the study. Response rate was 52.0%. AMS occurred in 77.3% of volunteers, while 48.5% developed severe AMS. Median (interquartile range, IQR) LLSelf was 4 (3-7). Median (IQR) VAS(o) was 36 mm (23-59). VAS(o) was linear and correlated with LLSelf: slope = 6.7 (95% CI: 4.4-9.0), intercept = 3.0 (95% CI: -10.0-16.1), ρ = 0.71, τ = 0.55, R(2) = 0.45, p gold standard for the diagnosis of AMS. Copyright © 2011 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Effectiveness of recommended drug classes in secondary prevention of acute coronary syndrome in France

NARCIS (Netherlands)

Bezin, Julien; Groenwold, Rolf; Ali, Sanni; Lassalle, Régis; De Boer, Anthonius; Moore, Nicholas; Klungel, Olaf; Pariente, Antoine

Background: Guidelines for cardiovascular secondary prevention are based on evidence from relatively old clinical trials and need to be evaluated in daily clinical practice. Objectives: To evaluate effectiveness of the recommended drug classes after an acute coronary syndrome (ACS) for secondary

Nutritional advice for prevention of acute pancreatitis: review of current opinion

Directory of Open Access Journals (Sweden)

Lowe ME

2012-12-01

Full Text Available Mark E Lowe, Wednesday A SevillaDivision of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USAAbstract: Pancreatitis is inflammation of the pancreas that can be acute and self-limiting or, in a small percentage of patients, recurrent. Patients with recurrent episodes of acute pancreatitis (RAP often progress to chronic pancreatitis. Pancreatitis in all forms causes significant economic and social burdens. Prevention of RAP may decrease those burdens and halt progression to chronic disease. Unfortunately, no therapy has proven effective at altering the course of RAP. While enteral nutritional therapy plays an important role in the treatment of acute pancreatitis during episodes, nutritional advice provided to patients in an attempt to prevent recurrent episodes has not proven effective in most cases. Discontinuing alcohol consumption and treating dyslipidemia with diet and medication can help patients with these issues. In patients whose pancreatitis is associated with celiac disease or eosinophilic gastroenteritis, a gluten-free diet and avoidance of food allergens can be effective in stopping RAP. Advice to take pancreatic enzyme replacement therapy, lose weight, control diabetes, decrease dietary sucrose, decrease dietary fat or avoid monosodium glutamate has little to no evidence of efficacy. Some studies suggest that an antioxidant cocktail may decrease the frequency of RAP and the intensity of chronic pain, but the evidence is weak. Nutritional therapy may have a role in the treatment of patients with RAP. At present, there are no clear guidelines for nutritional advice to give these patients. More studies are needed to identify nutritional interventions that will benefit patients with RAP.Keywords: pancreatitis, nutrition, pancreatic enzyme replacement therapy, antioxidants, herbal supplements

Elevated plasma cholecystokinin at high altitude: metabolic implications for the anorexia of acute mountain sickness.

Science.gov (United States)

Bailey, D M; Davies, B; Milledge, J S; Richards, M; Williams, S R; Jordinson, M; Calam, J

2000-01-01

The aims of the present study were to measure the satiety neuropeptide cholecystokinin (CCK) in humans at terrestrial high altitude to investigate its possible role in the pathophysiology of anorexia, cachexia, and acute mountain sickness (AMS). Nineteen male mountaineers aged 38 +/- 12 years participated in a 20 +/- 5 day trek to Mt. Kanchenjunga basecamp (BC) located at 5,100 m, where they remained for 7 +/- 5 days. Subjects were examined at rest and during a maximal exercise test at sea-level before/after the expedition (SL1/SL2) and during the BC sojourn. There was a mild increase in Lake Louise AMS score from 1.1 +/- 1.2 points at SL1 to 2.3 +/- 2.3 points by the end of the first day at BC (P anorexia on Day 2 compared with those with a normal appetite. While there was no relationship between the increase in CCK and AMS score at BC, a more pronounced increase in resting CCK was observed in subjects with AMS (> or =3 points at the end of Day 1 at BC) compared with those without (+98.9 +/- 1.4 pmol/L(-1) vs. +67.6 +/- 37.2 pmol/L(-1), P < 0.05). Caloric intake remained remarkably low during the stay at BC (8.9 +/- 1.4 MJ.d(-1)) despite a progressive decrease in total body mass (-4.5 +/- 2.1 kg after 31 +/- 13 h at BC, P < 0.05 vs. SL1/SL2), which appeared to be due to a selective loss of torso adipose tissue. These findings suggest that the satiogenic effects of CCK may have contributed to the observed caloric deficit and subsequent cachexia at high altitude despite adequate availability of palatable foods. The metabolic implications of elevated CCK in AMS remain to be elucidated.

Risk and Protective Factors for Sudden Cardiac Death During Leisure Activities in the Mountains: An Update.

Science.gov (United States)

Burtscher, Martin

2017-08-01

Annually, more than 100 million tourists with widely varying health and fitness status are attracted by the mountainous areas around the world. Whereas mountaineering activities may contribute to the well established beneficial effects of regular exercise, for certain individuals these activities are also associated with a relatively high risk of death. This manuscript presents an updated overview of risk and protective factors for sudden cardiac death during leisure activities in the mountains. Sudden cardiac death (SCD) has been proven to be the most frequent cause of non traumatic death in males aged over 34 years, e.g. during mountain hiking, cross country skiing or downhill skiing. Risk factors for cardiovascular diseases and, in particular, prior myocardial infarction, are the most important risk factors for SCD, predominantly relevant in downhill skiers. The unusual physical exertion on the first day at altitude, the late morning hours and the prolonged abstinence from food and fluid intake during exercise at altitude are most important triggers. Acute hypoxia may represent a trigger for SCD on the one hand but might also evoke beneficial effects by preconditioning on the other hand. The identification of high-risk subjects and SCD triggers, evidence-based therapy of treatable risk factors, the appropriate individual preparation by physical training, and considering behavioural aspects, especially at the beginning of the physically active altitude sojourn will help to prevent SCD and increase the health benefits generated by mountaineering activities. Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

The Effect of Local Irradiation in Prevention and Reversal of Acute Rejection of Transplanted Kidney with High-dose Steroid Pulse

International Nuclear Information System (INIS)

Kim, I. H.; Ha, S. W.; Park, C. I.; Kim, S. T.

1986-01-01

From 1979 to 1984, 39 local allograft irradiations were given to 29 patients: 10 irradiations were administered for prevention and 29 for reversal of acute rejection of transplanted kidney. Three doses of 150 cGy every other day were combined with high-dose of methylprednisolone pulse (1 gm/day) for 3 days. For prevention of acute rejection, local irradiation was delivered on the days 1, 3, and 5 after the transplantation, and for reversal, irradiation started after the diagnosis of acute rejection. Eight out of 10 patients irradiated for prevention had acute allograft rejection, and, what is more, there was no surviving graft at 15 months after transplantation. Reversal of acute rejection was achieved in 71%. When the pre-irradiation level of serum creatinine was below 5.5 mg%, the reversal rate was 93%, but above 5.5 mg% the reversal rate was only 17% (p<0.01). Reirradiation after failure was not successful. Among 15 reversed patients, 7 (47%) had subsequent rejection (s). The functional graft survivals at 6 month, 1, 2, and 3 year were 70%, 65%, 54%, and 65%, respectively. Therapeutic irradiation resulted in better graft survival when serum creatinine was below 5.5 mg% (p<0.001) or when irradiation started within 15 days after the diagnosis of acute rejection (p<0.001)

Association between body water status and acute mountain sickness.

Directory of Open Access Journals (Sweden)

Hannes Gatterer

Full Text Available PURPOSE: The present study determined the association between body fluid variation and the development of acute mountain sickness (AMS in adults. METHODS: Forty-three healthy participants (26 males and 17 females, age: 26 ± 6 yr, height: 174 ± 9 cm, weight: 68 ± 12 kg were passively exposed at a FiO2 of 12.6% (simulated altitude hypoxia of 4500 m, PiO2 = 83.9 mmHg for 12-h. AMS severity was assessed using the Lake Louise Score (LLS. Food and drink intakes were consumed ad libitum and measured; all urine was collected. Before and after the 12-h exposure, body weight and plasma osmolality were measured and whole-body bioimpedance analysis was performed. RESULTS: The overall AMS incidence was 43% (38% males, 50% females. Participants who developed AMS showed lower fluid losses (3.0 ± 0.9 vs. 4.5 ± 2.0 ml/kg/h, p = 0.002, a higher fluid retention (1.9 ± 1.5 vs. 0.6 ± 0.8 ml/kg/h, p = 0.022, greater plasma osmolality decreases (-7 ± 7 vs. -2 ± 5 mOsm/kg, p = 0.028 and a larger plasma volume expansion (11 ± 10 vs. 1 ± 15%, p = 0.041 compared to participants not developing AMS. Net water balance (fluid intake--fluid loss and the amount of fluid loss were strong predictors whether getting sick or not (Nagelkerkes r(2 = 0.532. The LLS score was related to net water balance (r = 0.358, p = 0.018, changes in plasma osmolality (r = -0.325, p = 0.033 and sodium concentration (r = -0.305, p = 0.047. Changes in the impedance vector length were related to weight changes (r = -0.550, p<0.001, fluid intake (r = -0.533, p<0.001 and net water balance (r = -0.590, p<0.001. CONCLUSIONS: Participants developing AMS within 12 hours showed a positive net water balance due to low fluid loss. Thus measures to avoid excess fluid retention are likely to reduce AMS symptoms.

The ventilatory response to hypoxia: how much is good for a mountaineer?

OpenAIRE

Milledge, J. S.

1987-01-01

Methods for measuring the ventilatory response to hypoxia (HVR) are reviewed. The criteria for success as a high altitude mountaineer are defined as freedom from acute mountain sickness (AMS) and ability to perform well at extreme altitude. The evidence for a brisk HVR being protective against AMS and associated with successful high altitude performance is reviewed. The contrary evidence of blunted HVR in high altitude residence and some elite climbers is discussed. The effect of a brisk HVR ...

Kawasaki disease following Rocky Mountain spotted fever: a case report.

Science.gov (United States)

Bal, Aswine K; Kairys, Steven W

2009-07-06

Kawasaki disease is an idiopathic acute systemic vasculitis of childhood. Although it simulates the clinical features of many infectious diseases, an infectious etiology has not been established. This is the first reported case of Kawasaki disease following Rocky Mountain spotted fever. We report the case of a 4-year-old girl who presented with fever and petechial rash. Serology confirmed Rocky Mountain spotted fever. While being treated with intravenous doxycycline, she developed swelling of her hands and feet. She had the clinical features of Kawasaki disease which resolved after therapy with intravenous immune globulin (IVIG) and aspirin. This case report suggests that Kawasaki disease can occur concurrently or immediately after a rickettsial illness such as Rocky Mountain spotted fever, hypothesizing an antigen-driven immune response to a rickettsial antigen.

Treatment and prevention of hepatic failure in acute biliary pancreatitis in patients with diabetes mellitus

Directory of Open Access Journals (Sweden)

S.I. Savoliuk

2017-10-01

Full Text Available Background. The purpose of the study was to evaluate the effectiveness of traditional and optimized programs for integrated treatment and prevention of clinical and laboratory manifestations of hepatic dysfunction in acute biliary pancreatitis in patients with diabetes mellitus by observing the dynamics of markers of cytopathic hypoxia, erythron system and iron metabolism. Materials and methods. The work is based on the analysis of the results of the comprehensive treatment of 122 patients with acute biliary pancreatitis against the background of diabetes mellitus. Laboratory analysis was performed to monitor markers of cytopathic hypoxia, erythron system and iron metabolism depending on the morphological form of acute pancreatitis and the effectiveness of optimized and traditional treatment. Results. The interstitial form of acute biliary pancreatitis in diabetes mellitus is characterized by significant changes in the dynamics of carbonyl groups, the content of arginine and adenosine deamination on the background of physiological fluctuations of the remaining markers of cytopathic hypoxia, and the signs of a distinct functional iron deficiency state in the form of microcytosis and hypochromia were detected. The emergence of pancreatic parenchyma necrosis of different planes, depending on the morphological form of acute biliary pancreatitis, is accompanied by reliable evidence of an absolute iron deficiency state of varying intensity and negative dynamics of indicators of endothelial dysfunction with a separate form. In patients with widespread necrotizing acute biliary pancreatitis, the pathological changes in the systemic metabolism are associated with the catabolism of purine nucleotides — the growth of xanthine and hypoxanthine levels. The stage of decompensation of systemic disorders of homeostasis is observed in patients with subtotal-total forms, when additional increase in the concentrations of enzymes responsible for utilization of

ZFX Controls Propagation and Prevents Differentiation of Acute T-Lymphoblastic and Myeloid Leukemia

Directory of Open Access Journals (Sweden)

Stuart P. Weisberg

2014-02-01

Full Text Available Tumor-propagating cells in acute leukemia maintain a stem/progenitor-like immature phenotype and proliferative capacity. Acute myeloid leukemia (AML and acute T-lymphoblastic leukemia (T-ALL originate from different lineages through distinct oncogenic events such as MLL fusions and Notch signaling, respectively. We found that Zfx, a transcription factor that controls hematopoietic stem cell self-renewal, controls the initiation and maintenance of AML caused by MLL-AF9 fusion and of T-ALL caused by Notch1 activation. In both leukemia types, Zfx prevents differentiation and activates gene sets characteristic of immature cells of the respective lineages. In addition, endogenous Zfx contributes to gene induction and transformation by Myc overexpression in myeloid progenitors. Key Zfx target genes include the mitochondrial enzymes Ptpmt1 and Idh2, whose overexpression partially rescues the propagation of Zfx-deficient AML. These results show that distinct leukemia types maintain their undifferentiated phenotype and self-renewal by exploiting a common stem-cell-related genetic regulator.

Stevia Prevents Acute and Chronic Liver Injury Induced by Carbon Tetrachloride by Blocking Oxidative Stress through Nrf2 Upregulation

Science.gov (United States)

Ramos-Tovar, Erika; Hernández-Aquino, Erika; Casas-Grajales, Sael; Buendia-Montaño, Laura D.; Tsutsumi, Víctor

2018-01-01

The effect of stevia on liver cirrhosis has not been previously investigated. In the present study, the antioxidant and anti-inflammatory properties of stevia leaves were studied in male Wistar rats with carbon tetrachloride- (CCl4-) induced acute and chronic liver damage. Acute and chronic liver damage induced oxidative stress, necrosis, and cholestasis, which were significantly ameliorated by stevia. Chronic CCl4 treatment resulted in liver cirrhosis, as evidenced by nodules of hepatocytes surrounded by thick bands of collagen and distortion of the hepatic architecture, and stevia significantly prevented these alterations. Subsequently, the underlying mechanism of action of the plant was analyzed. Our study for the first time shows that stevia upregulated Nrf2, thereby counteracting oxidative stress, and prevented necrosis and cholestasis through modulation of the main proinflammatory cytokines via NF-κB inhibition. These multitarget mechanisms led to the prevention of experimental cirrhosis. Given the reasonable safety profile of stevia, our results indicated that it may be useful for the clinical treatment of acute and chronic liver diseases. PMID:29849889

High-Altitude Illnesses: Physiology, Risk Factors, Prevention, and Treatment

Directory of Open Access Journals (Sweden)

Andrew T. Taylor

2011-01-01

Full Text Available High-altitude illnesses encompass the pulmonary and cerebral syndromes that occur in non-acclimatized individuals after rapid ascent to high altitude. The most common syndrome is acute mountain sickness (AMS which usually begins within a few hours of ascent and typically consists of headache variably accompanied by loss of appetite, nausea, vomiting, disturbed sleep, fatigue, and dizziness. With millions of travelers journeying to high altitudes every year and sleeping above 2,500 m, acute mountain sickness is a wide-spread clinical condition. Risk factors include home elevation, maximum altitude, sleeping altitude, rate of ascent, latitude, age, gender, physical condition, intensity of exercise, pre-acclimatization, genetic make-up, and pre-existing diseases. At higher altitudes, sleep disturbances may become more profound, mental performance is impaired, and weight loss may occur. If ascent is rapid, acetazolamide can reduce the risk of developing AMS, although a number of high-altitude travelers taking acetazolamide will still develop symptoms. Ibuprofen can be effective for headache. Symptoms can be rapidly relieved by descent, and descent is mandatory, if at all possible, for the management of the potentially fatal syndromes of high-altitude pulmonary and cerebral edema. The purpose of this review is to combine a discussion of specific risk factors, prevention, and treatment options with a summary of the basic physiologic responses to the hypoxia of altitude to provide a context for managing high-altitude illnesses and advising the non-acclimatized high-altitude traveler.

Kawasaki disease following Rocky Mountain spotted fever: a case report

Directory of Open Access Journals (Sweden)

Bal Aswine K

2009-07-01

Full Text Available Abstract Introduction Kawasaki disease is an idiopathic acute systemic vasculitis of childhood. Although it simulates the clinical features of many infectious diseases, an infectious etiology has not been established. This is the first reported case of Kawasaki disease following Rocky Mountain spotted fever. Case presentation We report the case of a 4-year-old girl who presented with fever and petechial rash. Serology confirmed Rocky Mountain spotted fever. While being treated with intravenous doxycycline, she developed swelling of her hands and feet. She had the clinical features of Kawasaki disease which resolved after therapy with intravenous immune globulin (IVIG and aspirin. Conclusion This case report suggests that Kawasaki disease can occur concurrently or immediately after a rickettsial illness such as Rocky Mountain spotted fever, hypothesizing an antigen-driven immune response to a rickettsial antigen.

Managing Rocky Mountain spotted fever.

Science.gov (United States)

Minniear, Timothy D; Buckingham, Steven C

2009-11-01

Rocky Mountain spotted fever is caused by the tick-borne bacterium Rickettsia rickettsii. Symptoms range from moderate illness to severe illness, including cardiovascular compromise, coma and death. The disease is prevalent in most of the USA, especially during warmer months. The trademark presentation is fever and rash with a history of tick bite, although tick exposure is unappreciated in over a third of cases. Other signature symptoms include headache and abdominal pain. The antibiotic therapy of choice for R. rickettsii infection is doxycycline. Preventive measures for Rocky Mountain spotted fever and other tick-borne diseases include: wearing long-sleeved, light colored clothing; checking for tick attachment and removing attached ticks promptly; applying topical insect repellent; and treating clothing with permethrin.

Comparative effectiveness of recommended versus less intensive drug combinations in secondary prevention of acute coronary syndrome

NARCIS (Netherlands)

Bezin, Julien; Groenwold, Rolf; Ali, M Sanni; Lassalle, Régis; Robinson, Philip; de Boer, Anthonius; Moore, Nicholas; Klungel, Olaf H; Pariente, Antoine

2017-01-01

PURPOSE: The secondary prevention treatment for acute coronary syndrome (ACS) is based on the combined use of drugs from four therapeutic classes (beta-blockers, antiplatelet agents, statins, and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers). The objective of this study

Comparative effectiveness of recommended versus less intensive drug combinations in secondary prevention of acute coronary syndrome

NARCIS (Netherlands)

Bezin, Julien; Groenwold, Rolf H H; Ali, M. Sanni; Lassalle, Régis; Robinson, Philip; de Boer, A.; Moore, Nicholas; Klungel, Olaf H.; Pariente, Antoine

Purpose: The secondary prevention treatment for acute coronary syndrome (ACS) is based on the combined use of drugs from four therapeutic classes (beta-blockers, antiplatelet agents, statins, and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers). The objective of this study

Preventive PCI versus culprit lesion stenting during primary PCI in acute STEMI: a systematic review and meta-analysis

Science.gov (United States)

Pandit, Anil; Aryal, Madan Raj; Aryal Pandit, Aashrayata; Hakim, Fayaz Ahmad; Giri, Smith; Mainali, Naba Raj; Sharma, Prashant; Lee, Howard R; Fortuin, F David; Mookadam, Farouk

2014-01-01

Aim The benefit of preventive percutaneous coronary intervention (PCI) in ST elevation myocardial infarction (STEMI) has been shown in randomised trials. However, all the randomised trials are underpowered to detect benefit in cardiac death. We aim to systematically review evidence on the cardiac mortality benefit of preventive PCI in patients presenting with acute STEMI in randomised patient populations. Methods PubMed, Scopus, Cochrane and clinicaltrials.gov databases were searched for studies published until 30 September 2013. The studies were limited to randomised clinical trials. Independent observers abstracted the data on outcomes, characteristics and qualities of studies included. Fixed effect model was employed for meta-analysis. Heterogeneity of studies included was analysed using I2 statistics. Results In three randomised clinical trials published, involving 748 patients with acute STEMI and multivessel disease, 416 patients were randomised to preventive PCI and 332 to culprit-only PCI. Patients undergoing preventive PCI had significant lower risk of cardiovascular deaths (pooled OR 0.39, 95% CI 0.18 to 0.83, p=0.01, I2=0%), repeat revascularisation (pooled OR 0.28, 95% CI 0.18 to 0.44, p=0.00001, I2=0%) and non-fatal myocardial infarction (pooled OR 0.38, 95% CI 0.20 to 0.75, p=0.005, I2=0%) compared with culprit-only revascularisation. Conclusions In patients presenting with acute STEMI and significant multivessel coronary artery disease, based on our data, preventive PCI is associated with lower risk of cardiovascular mortality compared with primary PCI of only the culprit artery. This finding needs to be confirmed in larger adequately powered randomised clinical trials. PMID:25332779

Red Wine Prevents the Acute Negative Vascular Effects of Smoking.

Science.gov (United States)

Schwarz, Viktoria; Bachelier, Katrin; Schirmer, Stephan H; Werner, Christian; Laufs, Ulrich; Böhm, Michael

2017-01-01

Moderate consumption of red wine is associated with fewer cardiovascular events. We investigated whether red wine consumption counteracts the adverse vascular effects of cigarette smoking. Participants smoked 3 cigarettes alone or after drinking a titrated volume of red wine. Clinical chemistry, blood counts, plasma cytokine enzyme-linked immunosorbent assays, immunomagnetic separation of CD14 + monocytes for gene expression analysis, fluorescence-activated cell sorting for microparticles, and isolation of circulating mononuclear cells to measure telomerase activity were performed, and urine cotinine levels were quantified. Compared with baseline, leukocytosis (P = .019), neutrophilia (P <.001), lymphopenia (P <.001), and eosinopenia (P = .008) were observed after only smoking. Endothelial and platelet-, monocyte-, and leukocyte-derived microparticles (P <.001 each) were elevated. In monocytes, messenger RNA expression of interleukin (IL)-6 (2.6- ± 0.57-fold), tumor necrosis factor alpha (2.2- ± 0.62-fold), and IL-1b (2.3- ± 0.44-fold) were upregulated, as was IL-6 (1.2 ± 0.12-fold) protein concentration in plasma. Smoking acutely inhibited mononuclear cell telomerase activity. Markers of endothelial damage, inflammation, and cellular aging were completely attenuated by red wine consumption. Cigarette smoke results in acute endothelial damage, vascular and systemic inflammation, and indicators of the cellular aging processes in otherwise healthy nonsmokers. Pretreatment with red wine was preventive. The findings underscore the magnitude of acute damage exerted by cigarette smoking in "occasional lifestyle smokers" and demonstrate the potential of red wine as a protective strategy to avert markers of vascular injury. Copyright © 2016 Elsevier Inc. All rights reserved.

[A fatal case series of Rocky Mountain spotted fever in Sonora, México].

Science.gov (United States)

Delgado-De la Mora, Jesús; Licona-Enríquez, Jesús David; Leyva-Gastélum, Marcia; Delgado-De la Mora, David; Rascón-Alcantar, Adela; Álvarez-Hernández, Gerardo

2018-03-15

Rocky Mountain spotted fever is a highly lethal infectious disease, particularly if specific treatment with doxycycline is given belatedly. To describe the clinical profile of fatal Rocky Mountain spotted fever cases in hospitalized patients in the state of Sonora, México. We conducted a cross-sectional study on a series of 47 deaths caused by Rickettsia rickettsii from 2013 to 2016. The diagnosis of Rocky Mountain spotted fever was confirmed in a single blood sample by polymerase chain reaction (PCR) or by a four-fold increase in immunoglobulin G measured in paired samples analyzed by indirect immunofluorescence. Clinical and laboratory characteristics were compared stratifying subjects into two groups: pediatric and adult. There were no differences in clinical characteristics between groups; petechial rash was the most frequent sign (96%), followed by headache (70%) and myalgia (67%). Although that doxycycline was administered before the fifth day from the onset of symptoms, death occurred in 55% of patients. In clinical laboratory, thrombocytopenia, and biomarkers of liver acute failure and acute kidney failure were the most frequent. Rocky Mountain spotted fever remains as one of the most lethal infectious diseases, which may be related not only to the lack of diagnostic suspicion and delayed administration of doxycycline, but to genotypic characteristics of Rickettsia rickettsii that may play a role in the variability of the fatality rate that has been reported in other geographical regions where the disease is endemic.

Preventive effect of aggressive blood pressure lowering on hematoma enlargement in patients with ultra-acute intracerebral hemorrhage

International Nuclear Information System (INIS)

Nishikawa, Tomofumi; Ueba, Tetsuya; Kajiwara, Motohiro; Iwata, Ryoichi; Yamashita, Kohsuke; Miyamatsu, Naomi

2010-01-01

The preventive effect of aggressive blood pressure lowering on hematoma enlargement was investigated in patients with ultra-acute spontaneous intracerebral hemorrhage (ICH). Retrospective review of 248 patients (145 males, 103 females) with spontaneous ICH treated in our hospital between 2005 and 2008 identified patients with ultra-acute ICH who were directly taken to our institute by ambulance within 3 hours after onset. Patients who could not be assessed twice by computed tomography (CT) within 24 hours after arrival were excluded. Systolic blood pressure (SBP) was aggressively controlled in all patients using intravenous nicardipine to below 140 mmHg as soon as possible after diagnosis of ICH with CT. Hematoma enlargement was defined as increase in volume of more than 33% or more than 12.5 ml in the first 24 hours. Hematoma enlargement was observed in 11 of the 73 patients (15.0%). The time course of SBP change was not significantly different in patients with and without hematoma enlargement. The incidence of hematoma enlargement in patients with ultra-acute ICH in this study was 15.0%, which was lower than that in other series in which blood pressure was not reduced aggressively. This finding suggests that aggressive SBP lowering to below 140 mmHg has a preventive effect on hematoma enlargement in patients with ultra-acute ICH. (author)

2016 updated MASCC/ESMO consensus recommendations : Prevention of acute chemotherapy-induced nausea and vomiting in children

NARCIS (Netherlands)

Dupuis, L. Lee; Sung, Lillian; Molassiotis, Alexander; Orsey, Andrea D.; Tissing, Wim; van de Wetering, Marianne

To update the 2009 recommendations for the prevention of acute chemotherapy-induced emesis in children. We updated the original systematic literature search. Randomized studies were included in the evidence to support this guideline if they were primary studies fully published in full text in

A new network on mountain geomorphosites

Science.gov (United States)

Giusti, Christian

2013-04-01

Since about two decades, the value of geoheritage in mountain areas has been re-discovered in various parts of the Alps (Reynard et al., 2010) and other mountain ranges, and various initiatives (protection of sites worthy of protection, inventories of geomorphosites, geotourist promotion, creation of geoparks, etc.) to conserve or promote mountain geoheritage have been developed. As mountains are recognized as natural areas with a very high geodiversity, and at the same time as areas with a great potential for the development of soft tourism, a new Network on Mountain Geomorphosites was created in October 2012 in conclusion to a workshop organized by the University of Lausanne (Switzerland). The Network is open to all researchers active in geoheritage, geoconservation and geotourism studies in mountain areas. For the first years research will focus on three main issues: - Geoheritage and natural processes: Mountains are very sensitive areas where climate change impacts are very acute and where active geomorphological processes rapidly modify landscapes. It is hypothesized that geoheritage will be highly impacted by global change in the future. Nevertheless, at the moment, very little research is carried out on the evolution of landforms recognized as geoheritage and no specific management measures have been developed. Also, the tourist activities related to geoheritage, especially the trails developed to visit geomorphosites, are sensitive to geomorphological processes in mountain areas in a context of global change, and need, therefore, to be better addressed by geomorphologists. - Geotourism: During the last two decades numerous initiatives have developed geotourism in mountain areas. Nevertheless, studies addressing issues such as the needs of the potential public(s) of geotourism, the evaluation of the quality of the geotourist products developed by scientists and/or local authorities, and the assessment of the economic benefits of geotourism for the regional

Acute D2/D3 dopaminergic agonism but chronic D2/D3 antagonism prevents NMDA antagonist neurotoxicity.

Science.gov (United States)

Farber, Nuri B; Nemmers, Brian; Noguchi, Kevin K

2006-09-15

Antagonists of the N-methyl-D-aspartate (NMDA) glutamate receptor, most likely by producing disinhibtion in complex circuits, acutely produce psychosis and cognitive disturbances in humans, and neurotoxicity in rodents. Studies examining NMDA Receptor Hypofunction (NRHypo) neurotoxicity in animals, therefore, may provide insights into the pathophysiology of psychotic disorders. Dopaminergic D2 and/or D3 agents can modify psychosis over days to weeks, suggesting involvement of these transmitter system(s). We studied the ability of D2/D3 agonists and antagonists to modify NRHypo neurotoxicity both after a one-time acute exposure and after chronic daily exposure. Here we report that D2/D3 dopamine agonists, probably via D3 receptors, prevent NRHypo neurotoxicity when given acutely. The protective effect with D2/D3 agonists is not seen after chronic daily dosing. In contrast, the antipsychotic haloperidol does not affect NRHypo neurotoxicity when given acutely at D2/D3 doses. However, after chronic daily dosing of 1, 3, or 5 weeks, haloperidol does prevent NRHypo neurotoxicity with longer durations producing greater protection. Understanding the changes that occur in the NRHypo circuit after chronic exposure to dopaminergic agents could provide important clues into the pathophysiology of psychotic disorders.

Haemodynamic-guided fluid administration for the prevention of contrast-induced acute kidney injury: the POSEIDON randomised controlled trial.

Science.gov (United States)

Brar, Somjot S; Aharonian, Vicken; Mansukhani, Prakash; Moore, Naing; Shen, Albert Y-J; Jorgensen, Michael; Dua, Aman; Short, Lindsay; Kane, Kevin

2014-05-24

The administration of intravenous fluid remains the cornerstone treatment for the prevention of contrast-induced acute kidney injury. However, no well-defined protocols exist to guide fluid administration in this treatment. We aimed to establish the efficacy of a new fluid protocol to prevent contrast-induced acute kidney injury. In this randomised, parallel-group, comparator-controlled, single-blind phase 3 trial, we assessed the efficacy of a new fluid protocol based on the left ventricular end-diastolic pressure for the prevention of contrast-induced acute kidney injury in patients undergoing cardiac catheterisation. The primary outcome was the occurrence of contrast-induced acute kidney injury, which was defined as a greater than 25% or greater than 0·5 mg/dL increase in serum creatinine concentration. Between Oct 10, 2010, and July 17, 2012, 396 patients aged 18 years or older undergoing cardiac catheterisation with an estimated glomerular filtration rate of 60 mL/min per 1·73 m(2) or less and one or more of several risk factors (diabetes mellitus, history of congestive heart failure, hypertension, or age older than 75 years) were randomly allocated in a 1:1 ratio to left ventricular end-diastolic pressure-guided volume expansion (n=196) or the control group (n=200) who received a standard fluid administration protocol. Four computer-generated concealed randomisation schedules, each with permuted block sizes of 4, were used for randomisation, and participants were allocated to the next sequential randomisation number by sealed opaque envelopes. Patients and laboratory personnel were masked to treatment assignment, but the physicians who did the procedures were not masked. Both groups received intravenous 0·9% sodium chloride at 3 mL/kg for 1 h before cardiac catheterisation. Analyses were by intention to treat. Adverse events were assessed at 30 days and 6 months and all such events were classified by staff who were masked to treatment assignment. This

Flash Flood Type Identification within Catchments in Beijing Mountainous Area

Science.gov (United States)

Nan, W.

2017-12-01

Flash flood is a common type of disaster in mountainous area, Flash flood with the feature of large flow rate, strong flushing force, destructive power, has periodically caused loss to life and destruction to infrastructure in mountainous area. Beijing as China's political, economic and cultural center, the disaster prevention and control work in Beijing mountainous area has always been concerned widely. According to the transport mechanism, sediment concentration and density, the flash flood type identification within catchment can provide basis for making the hazards prevention and mitigation policy. Taking Beijing as the study area, this paper extracted parameters related to catchment morphological and topography features respectively. By using Bayes discriminant, Logistic regression and Random forest, the catchments in Beijing mountainous area were divided into water floods process, fluvial sediment transport process and debris flows process. The results found that Logistic regression analysis showed the highest accuracy, with the overall accuracy of 88.2%. Bayes discriminant and Random forest had poor prediction effects. This study confirmed the ability of morphological and topography features to identify flash flood process. The circularity ratio, elongation ratio and roughness index can be used to explain the flash flood types effectively, and the Melton ratio and elevation relief ratio also did a good job during the identification, whereas the drainage density seemed not to be an issue at this level of detail. Based on the analysis of spatial patterns of flash flood types, fluvial sediment transport process and debris flow process were the dominant hazards, while the pure water flood process was much less. The catchments dominated by fluvial sediment transport process were mainly distributed in the Yan Mountain region, where the fault belts were relatively dense. The debris flow process prone to occur in the Taihang Mountain region thanks to the abundant

Preventive effect of eccentric training on acute hamstring injuries in men's soccer: A cluster-randomized controlled trial

DEFF Research Database (Denmark)

Petersen, Jesper; Thorborg, Kristian; Nielsen, Michael Bachmann

2011-01-01

Background: The incidence of acute hamstring injuries is high in several sports, including the different forms of football. Purpose: The authors investigated the preventive effect of eccentric strengthening of the hamstring muscles using the Nordic hamstring exercise compared with no additional h...

Implementation of pressure ulcer prevention best practice recommendations in acute care: an observational study.

Science.gov (United States)

Barker, Anna Lucia; Kamar, Jeannette; Tyndall, Tamara Jane; White, Lyn; Hutchinson, Anastasia; Klopfer, Nicole; Weller, Carolina

2013-06-01

Pressure ulcers are a common but preventable problem in hospitals. Implementation of best practice guideline recommendations can prevent ulcers from occurring. This 9-year cohort study reports prevalence data from point prevalence surveys during the observation period, and three practice metrics to assess implementation of best practice guideline recommendations: (i) nurse compliance with use of a validated pressure ulcer risk assessment and intervention checklist; (ii) accuracy of risk assessment scoring in usual-care nurses and experienced injury prevention nurses; and (iii) use of pressure ulcer prevention strategies. The prevalence of hospital-acquired pressure ulcers decreased following implementation of an evidence-based prevention programme from 12·6% (2 years preprogramme implementation) to 2·6% (6 years postprogramme implementation) (P pressure ulcer prevention documentation according to best practice guidelines was high (>84%). A sample of 270 patients formed the sample for the study of risk assessment scoring accuracy and use of prevention strategies. It was found usual-care nurses under-estimated patients' risk of pressure ulcer development and under-utilised prevention strategies compared with experienced injury prevention nurses. Despite a significant reduction in prevalence of hospital-acquired pressure ulcers and high documentation compliance, use of prevention strategies could further be improved to achieve better patient outcomes. Barriers to the use of prevention strategies by nurses in the acute hospital setting require further examination. This study provides important insights into the knowledge translation of pressure ulcer prevention best practice guideline recommendations at The Northern Hospital. © 2012 The Authors. International Wound Journal © 2012 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

Preventive Effects of Eccentric Training on Acute Hamstring Muscle Injury in Professional Baseball

Science.gov (United States)

Seagrave, Richard A.; Perez, Luis; McQueeney, Sean; Toby, E. Bruce; Key, Vincent; Nelson, Joshua D.

2014-01-01

Background: Hamstring injuries are the second most common injury causing missed days in professional baseball field players. Recent studies have shown the preventive benefit of eccentric conditioning on the hamstring muscle group in injury prevention. Specifically, Nordic-type exercises have been shown to decrease the incidence of acute hamstring injuries in professional athletes. Purpose: This was a prospective study performed in coordination with a single Major League Baseball (MLB) organization (major and minor league teams) that targeted the effects of Nordic exercises on the incidence of acute hamstring injuries in the professional-level baseball player. Study Design: Prospective cohort study; Level of evidence, 2. Methods: The daily workouts of 283 professional baseball players throughout all levels of a single MLB organization were prospectively recorded. The intervention group participated in the Nordic exercise program and was compared with a randomly selected control group of professional athletes within the organization not participating in the exercise program. The incidence of hamstring injuries in both groups was compared, and the total number of days missed due to injury was compared with the 2 previous seasons. Results: There were 10 hamstring injuries that occurred during the 2012 season among the 283 professional athletes that required removal from play. There were no injuries that occurred in the intervention group (n = 65, 0.00%; P = .0381). The number needed to treat (NNT) to prevent 1 hamstring injury was 11.3. The average repetitions per week of the injured group were assessed at multiple time points (2, 4, 6, and total weeks) prior to injury. There were significantly fewer repetitions per week performed in the injured group at all time points compared with overall average repetitions per week in the noninjured group (P = .0459, .0127, .0164, and .0299, respectively). After beginning the Nordic exercise program, there were 136 total days

Prevention and Intervention Strategies in Acute Pancreatitis

NARCIS (Netherlands)

Besselink, M.G.H.

2008-01-01

Acute pancreatitis is a common, costly, potentially lethal, and poorly understood disease, mostly caused by gallstones. In the past decade the incidence of acute pancreatitis in the Netherlands increased by 50% to over 3400 admissions in 2006, most likely due to an increase of gallstone disease.

Rationale, design and methodology of a double-blind, randomized, placebo-controlled study of escitalopram in prevention of Depression in Acute Coronary Syndrome (DECARD)

DEFF Research Database (Denmark)

Hansen, Baiba Hedegaard; Hanash, Jamal Abed; Rasmussen, Alice

2009-01-01

with acute coronary syndrome. METHODS: Two hundred forty non-depressed patients with acute coronary syndrome are randomized to treatment with either escitalopram or placebo for 1 year. Psychiatric and cardiac assessment of patients is performed to evaluate the possibility of preventing depression. Diagnosis...

A proposal for prevention of acute radiation hazard and social panic regarding orphan sources in Japan

Energy Technology Data Exchange (ETDEWEB)

Takahash, T. [Research Reactor Institute, Kyoto Univ., Osaka (Japan); Kai, M. [Oita Univ., of Nursing and Health Sciences, Oita (Japan); Yamazaki, K. [Chiyoda Technol Corporation, Tokyo (Japan); Gomi, K. [Japan Radioisotope Association, Tokyo (Japan); Nakazato, K. [School of Medicine, Keio univ., Tokyo (Japan); Iida, T. [Nagoya Univ., Nagoya (Japan)

2002-07-01

To respond to an increase of social problems concerning orphan sources in Japan, a working group was formed in the Japan Health Physics Society. In this working group, we investigated how to prevent acute radiation hazard or social panic regarding orphan sources in scrap metal and detection system for orphan sources brought into scrap yards before recycle. For detection system in a scrap yard we conducted an experiment on detectability of monitoring instrument using a radiation source mixed in scrap metal on a truck. The result showed that it was not easy to detect even a high-level source if it was shielded by scrap metal. We also estimated detection limits for radioactive materials in scrap metal by calculation that was validated with experimental data. We summarized present status about orphan sources in Japan and proposed a categorization of orphan sources according to dose rates to deal with unknown sources in a scrap yard. Our report includes some proposals to the government, industry and academic world for preventing acute radiation hazard and social panic.

A proposal for prevention of acute radiation hazard and social panic regarding orphan sources in Japan

International Nuclear Information System (INIS)

Takahash, T.; Kai, M.; Yamazaki, K.; Gomi, K.; Nakazato, K.; Iida, T.

2002-01-01

To respond to an increase of social problems concerning orphan sources in Japan, a working group was formed in the Japan Health Physics Society. In this working group, we investigated how to prevent acute radiation hazard or social panic regarding orphan sources in scrap metal and detection system for orphan sources brought into scrap yards before recycle. For detection system in a scrap yard we conducted an experiment on detectability of monitoring instrument using a radiation source mixed in scrap metal on a truck. The result showed that it was not easy to detect even a high-level source if it was shielded by scrap metal. We also estimated detection limits for radioactive materials in scrap metal by calculation that was validated with experimental data. We summarized present status about orphan sources in Japan and proposed a categorization of orphan sources according to dose rates to deal with unknown sources in a scrap yard. Our report includes some proposals to the government, industry and academic world for preventing acute radiation hazard and social panic

Preventive analgesia

DEFF Research Database (Denmark)

Dahl, Jørgen B; Kehlet, Henrik

2011-01-01

This paper will discuss the concepts of pre-emptive and preventive analgesia in acute and persistent postsurgical pain, based on the most recent experimental and clinical literature, with a special focus on injury-induced central sensitization and the development from acute to chronic pain. Recent...... of preventive analgesia for persistent postoperative pain are promising. However, clinicians must be aware of the demands for improved design of their clinical studies in order to get more conclusive answers regarding the different avenues for intervention. Summary: The concept of preventive analgesia is still...

HLA-haploidentical transplantation with regulatory and conventional T-cell adoptive immunotherapy prevents acute leukemia relapse.

Science.gov (United States)

Martelli, Massimo F; Di Ianni, Mauro; Ruggeri, Loredana; Falzetti, Franca; Carotti, Alessandra; Terenzi, Adelmo; Pierini, Antonio; Massei, Maria Speranza; Amico, Lucia; Urbani, Elena; Del Papa, Beatrice; Zei, Tiziana; Iacucci Ostini, Roberta; Cecchini, Debora; Tognellini, Rita; Reisner, Yair; Aversa, Franco; Falini, Brunangelo; Velardi, Andrea

2014-07-24

Posttransplant relapse is still the major cause of treatment failure in high-risk acute leukemia. Attempts to manipulate alloreactive T cells to spare normal cells while killing leukemic cells have been unsuccessful. In HLA-haploidentical transplantation, we reported that donor-derived T regulatory cells (Tregs), coinfused with conventional T cells (Tcons), protected recipients against graft-versus-host disease (GVHD). The present phase 2 study investigated whether Treg-Tcon adoptive immunotherapy prevents posttransplant leukemia relapse. Forty-three adults with high-risk acute leukemia (acute myeloid leukemia 33; acute lymphoblastic leukemia 10) were conditioned with a total body irradiation-based regimen. Grafts included CD34(+) cells (mean 9.7 × 10(6)/kg), Tregs (mean 2.5 × 10(6)/kg), and Tcons (mean 1.1 × 10(6)/kg). No posttransplant immunosuppression was given. Ninety-five percent of patients achieved full-donor type engraftment and 15% developed ≥grade 2 acute GVHD. The probability of disease-free survival was 0.56 at a median follow-up of 46 months. The very low cumulative incidence of relapse (0.05) was significantly better than in historical controls. These results demonstrate the immunosuppressive potential of Tregs can be used to suppress GVHD without loss of the benefits of graft-versus-leukemia (GVL) activity. Humanized murine models provided insights into the mechanisms underlying separation of GVL from GVHD, suggesting the GVL effect is due to largely unopposed Tcon alloantigen recognition in bone marrow. © 2014 by The American Society of Hematology.

National Guidelines «Acute Kidney Injury: Basic Principles of the Diagnosis, Prevention and Treatment (2015» Part I

Directory of Open Access Journals (Sweden)

A.V. Smirnov

2016-04-01

Full Text Available The main problems of acute kidney injury (AKI are considered. The necessity of introduction of the AKI concept into the practice of national health care is justified. Specific recommendations for the diagnosis, monitoring, prevention and treatment of this dangerous condition are given.

An acute post-rape intervention to prevent substance use and abuse.

Science.gov (United States)

Acierno, Ron; Resnick, Heidi S; Flood, Amanda; Holmes, Melisa

2003-12-01

The trauma of rape is routinely associated with extreme acute distress. Such peri-event anxiety increases risk of developing psychopathology and substance use or abuse post-rape, with the degree of initial distress positively predicting future problems. Unfortunately, the nature of post-rape forensic evidence collection procedures may exacerbate initial distress, thereby potentiating post-rape negative emotional sequelae. Consequently, substance use may increase in an effort to ameliorate this distress. To address this, a two-part video intervention was developed for use in acute post-rape time frames to (a) minimize anxiety during forensic rape examinations, thereby reducing risk of future emotional problems, and (b) prevent increased post-rape substance use and abuse. Pilot study data with 124 rape victims indicated that the low-cost, easily administered intervention was effective in reducing risk of marijuana abuse at 6 weeks. Nonstatistically significant trends also were evident for reduced marijuana use. Trends were also noted in favor of the intervention in the subgroup of women who were actively using substances pre-rape (among pre-rape alcohol users, 28% viewers vs. 43% nonviewers met criteria for post-rape alcohol abuse; among pre-rape marijuana users, the rates of post-marijuana use were 17% vs. 43%).

Acute pancreatitis.

Science.gov (United States)

Talukdar, Rupjyoti; Vege, Santhi S

2015-09-01

To summarize recent data on classification systems, cause, risk factors, severity prediction, nutrition, and drug treatment of acute pancreatitis. Comparison of the Revised Atlanta Classification and Determinant Based Classification has shown heterogeneous results. Simvastatin has a protective effect against acute pancreatitis. Young black male, alcohol, smoldering symptoms, and subsequent diagnosis of chronic pancreatitis are risk factors associated with readmissions after acute pancreatitis. A reliable clinical or laboratory marker or a scoring system to predict severity is lacking. The PYTHON trial has shown that oral feeding with on demand nasoenteric tube feeding after 72 h is as good as nasoenteric tube feeding within 24 h in preventing infections in predicted severe acute pancreatitis. Male sex, multiple organ failure, extent of pancreatic necrosis, and heterogeneous collection are factors associated with failure of percutaneous drainage of pancreatic collections. The newly proposed classification systems of acute pancreatitis need to be evaluated more critically. New biomarkers are needed for severity prediction. Further well designed studies are required to assess the type of enteral nutritional formulations for acute pancreatitis. The optimal minimally invasive method or combination to debride the necrotic collections is evolving. There is a great need for a drug to treat the disease early on to prevent morbidity and mortality.

Faith Moves Mountains: An Appalachian Cervical Cancer Prevention Program

Science.gov (United States)

Schoenberg, Nancy E.; Hatcher, Jennifer; Dignan, Mark B.; Shelton, Brent; Wright, Sherry; Dollarhide, Kaye F.

2009-01-01

Objective To provide a conceptual description of Faith Moves Mountains (FMM), an intervention designed to reduce the disproportionate burden of cervical cancer among Appalachian women. Methods FMM, a community-based participatory research program designed and implemented in collaboration with churches in rural, southeastern Kentucky, aims to increase cervical cancer screening (Pap tests) through a multiphase process of educational programming and lay health counseling. Results We provide a conceptual overview to key elements of the intervention, including programmatic development, theoretical basis, intervention approach and implementation, and evaluation procedures. Conclusions After numerous modifications, FMM has recruited and retained over 400 women, 30 churches, and has become a change agent in the community. PMID:19320612

Dental injuries in mountain biking--a survey in Switzerland, Austria, Germany and Italy.

Science.gov (United States)

Müller, Kathrin E; Persic, Robert; Pohl, Yango; Krastl, Gabriel; Filippi, Andreas

2008-10-01

Mountain biking is considered an extreme sport, causing not only head and neck injuries, but also injuries to every part of the body. Using standardised interview, the aim of this work was to survey the frequency of dental injuries in mountain biking, as well as the behaviour of athletes after experiencing dental trauma, depending on their intensity level. Furthermore, habits of wearing helmets and mouthguards as well as knowledge about the tooth rescue kit were investigated. A total of 423 male mountain bikers from Germany, Italy, Austria and Switzerland were surveyed for this study, including 50 juniors from Switzerland. 27 athletes (5.7%) had endured tooth accidents in mountain biking. Only 246 (52%) were aware of the fact that avulsed teeth can be replanted, and only 30 individuals knew about the tooth rescue kit (6.3%). 71.9% (n=340) were familiar with mouthguards; however, only 21 individuals (4.4%) used mouthguards while mountain biking. The results show that where mountain biking is concerned, more information about prevention is required.

Pressure ulcers and prevention among acute care hospitals in the United States.

Science.gov (United States)

Bergquist-Beringer, Sandra; Dong, Lei; He, Jianghua; Dunton, Nancy

2013-09-01

Most pressure ulcers can be prevented with evidence-based practice. Many studies describe the implementation of a pressure ulcer prevention program but few report the effect on outcomes across acute care facilities. Data on hospital-acquired pressure ulcers and prevention from the National Database of Nursing Quality Indicators 2010 Pressure Ulcer Surveys were linked to hospital characteristics and nurse staffing measures within the data set. The sample consisted of 1,419 hospitals from across the United States and 710,626 patients who had been surveyed for pressure ulcers in adult critical care, step-down, medical, surgical, and medical/surgical units. Hierarchical logistic regression analysis was performed to identify study variables associated with hospital-acquired pressure ulcers among patients at risk for these ulcers. The rate of hospital-acquired pressure ulcers was 3.6% across all surveyed patients and 7.9% among those at risk. Patients who received a skin and pressure ulcer risk assessment on admission were less likely to develop a pressure ulcer. Additional study variables associated with lower hospital-acquired pressure ulcer rates included a recent reassessment of pressure ulcer risk, higher Braden Scale scores, a recent skin assessment, routine repositioning, and Magnet or Magnet-applicant designation. Variables associated with a higher likelihood of hospital-acquired pressure ulcers included nutritional support, moisture management, larger hospital size, and academic medical center status. Results provide empirical support for pressure ulcer prevention guideline recommendations on skin assessment, pressure ulcer risk assessment, and routine repositioning, but the 7.9% rate of hospital-acquired pressure ulcers among at-risk patients suggests room for improvement in pressure ulcer prevention practice.

The plutonium mountain: preventing diversion

International Nuclear Information System (INIS)

Pohling-Brown, Pamela.

1997-01-01

With continued arms-reduction between the USA and the former Soviet Union, surplus nuclear materials, from dismantled weapons, requires handling. A number of risks are identified including occupational safety for workers involved with handling nuclear materials, and environmental protection. Perhaps the most sinister is the extra security needed to ensure that these materials are not diverted to rogue states or terrorist groups, as materials are handled in a larger number of countries. In particular, the author addresses the problem of plutonium reserves, and discusses the role of reprocessing in preventing diversion. (UK)

Suicide risk in placebo-controlled trials of treatment for acute manic episode and prevention of manic-depressive episode

NARCIS (Netherlands)

Storosum, Jitschak G.; Wohlfarth, Tamar; Gispen-de Wied, Christine C.; Linszen, Don H.; Gersons, Berthold P. R.; van Zwieten, Barbara J.; van den Brink, Wim

2005-01-01

Objective: The authors' goal was to investigate whether there is a greater suicide risk in the placebo arms of placebo-controlled studies of active medication for the treatment of acute manic episode and the prevention of manic/depressive episode. If so, this would be a strong ethical argument

Antibiotic prophylaxis after endoscopic therapy prevents rebleeding in acute variceal hemorrhage: a randomized trial.

Science.gov (United States)

Hou, Ming-Chih; Lin, Han-Chieh; Liu, Tsu-Te; Kuo, Benjamin Ing-Tieu; Lee, Fa-Yauh; Chang, Full-Young; Lee, Shou-Dong

2004-03-01

Bacterial infection may adversely affect the hemostasis of patients with gastroesophageal variceal bleeding (GEVB). Antibiotic prophylaxis can prevent bacterial infection in such patients, but its role in preventing rebleeding is unclear. Over a 25-month period, patients with acute GEVB but without evidence of bacterial infection were randomized to receive prophylactic antibiotics (ofloxacin 200 mg i.v. q12h for 2 days followed by oral ofloxacin 200 mg q12h for 5 days) or receive antibiotics only when infection became evident (on-demand group). Endoscopic therapy for the GEVB was performed immediately after infection work-up and randomization. Fifty-nine patients in the prophylactic group and 61 patients in the on-demand group were analyzed. Clinical and endoscopic characteristics of the gastroesophageal varices, time to endoscopic treatment, and period of follow-up were not different between the two groups. Antibiotic prophylaxis decreased infections (2/59 vs. 16/61; P actuarial probability of rebleeding was higher in patients without prophylactic antibiotics (P =.0029). The difference of rebleeding was mostly due to early rebleeding within 7 days (4/12 vs. 21/27, P =.0221). The relative hazard of rebleeding within 7 days was 5.078 (95% CI: 1.854-13.908, P <.0001). The multivariate Cox regression indicated bacterial infection (relative hazard: 3.85, 95% CI: 1.85-13.90) and association with hepatocellular carcinoma (relative hazard: 2.46, 95% CI: 1.30-4.63) as independent factors predictive of rebleeding. Blood transfusion for rebleeding was also reduced in the prophylactic group (1.40 +/- 0.89 vs. 2.81 +/- 2.29 units, P <.05). There was no difference in survival between the two groups. In conclusion, antibiotic prophylaxis can prevent infection and rebleeding as well as decrease the amount of blood transfused for patients with acute GEVB following endoscopic treatment.

The Value Proposition of Prevention: The Impacts of Pure North S’Energy Foundation’s Preventive Care Program on Acute Care Utilization in Alberta

Directory of Open Access Journals (Sweden)

J.C. Herbert Emery

2016-04-01

Full Text Available This analysis of Pure North S’Energy Foundation’s preventive health services shows that the acute health care cost savings of being pro-active, rather than reactive, and averting chronic disease, are significant, immediate and worth pursuing further. Chronic disease, such as cardiovascular maladies, diabetes, cancer and other long-term illnesses, represents the leading cause of disability and death in Canada. An estimated 25 per cent of expenditures in the public health system go towards treating these frequently avoidable diseases. This health-care cost curve, which sees more money expended on fighting the increase of chronic disease, can be bent, so to speak, through prevention services that offer long-term benefits to people’s health. Preventing disease is not just good for individuals, but for the health system in general, as prevention frees up acute care beds for more timely access by those who need them. The concern for health care decision makers struggling to find dollars to meet current health care needs is that investment in prevention is risky compared spending on medical treatment. It is often expressed that the health cost savings of prevention are too far off in the future and there is a lack of convincing evidence that preventive services and interventions will achieve the health gains expected. Pure North offers participants in its eight-year-old program access to a variety of healthcare practitioners, including doctors, naturopaths, nurses, nurse practitioners and dentists. Participants receive lifestyle counselling and dietary supplements aimed at combating vitamin D insufficiency, obesity, insulin resistance and other problems that can lead to chronic disease. Our study found that participants who stay with the program for two years demonstrate significant reductions in their number of visits to emergency rooms and hospitals. Indeed, after just one year in the program, the number of hospital visits was down 27 per cent

Mountains

Science.gov (United States)

Regina M. Rochefort; Laurie L. Kurth; Tara W. Carolin; Robert R. Mierendorf; Kimberly Frappier; David L. Steenson

2006-01-01

This chapter concentrates on subalpine parklands and alpine meadows of southern British Columbia, Washington, Oregon, and western Montana. These areas lie on the flanks of several mountain ranges including the Olympics, the Cascades of Oregon and Washington, and the Coast Mountains in British Columbia.

Evaluating Risk Perception based on Gender Differences for Mountaineering Activity

Science.gov (United States)

Susanto, Novie; Susatyo, Nugroho W. P.; Rizkiyah, Ega

2018-02-01

In average 26 death events in mountaineering per year for the time span from 2003 to 2012 is reported. The number of women dying during the mountaineering is significantly smaller than males (3.5 deaths male for one female death). This study aims to analyze the differences of risk perception based on gender and provide recommendations as education basic to prevent accidents in mountaineering. This study utilizes the Kruskal-Wallis test and the Delphi Method. A total of 200 mountaineer respondents (100 males and 100 females) participated in this study. The independent variable in this study was gender. The dependent variable was risk perception including perception toward the serious accident, perception toward the probability of accident event as well as anxiety level and perception of efficacy and self-efficacy. The study result showed that the risk perception of women is higher than men with significant difference (p-value = 0.019). The recommendations from Delphi method result are by developing a positive mental attitude, showing about the risks that exist in nature, implementing Cognitive Behaviour Therapy (CBT) to raise awareness of the safety of ownself, following the climbing or mountaineer school, and using instructors to give lessons about safety in outdoor activities.

Evaluating Risk Perception based on Gender Differences for Mountaineering Activity

Directory of Open Access Journals (Sweden)

Susanto Novie

2018-01-01

Full Text Available In average 26 death events in mountaineering per year for the time span from 2003 to 2012 is reported. The number of women dying during the mountaineering is significantly smaller than males (3.5 deaths male for one female death. This study aims to analyze the differences of risk perception based on gender and provide recommendations as education basic to prevent accidents in mountaineering. This study utilizes the Kruskal-Wallis test and the Delphi Method. A total of 200 mountaineer respondents (100 males and 100 females participated in this study. The independent variable in this study was gender. The dependent variable was risk perception including perception toward the serious accident, perception toward the probability of accident event as well as anxiety level and perception of efficacy and self-efficacy. The study result showed that the risk perception of women is higher than men with significant difference (p-value = 0.019. The recommendations from Delphi method result are by developing a positive mental attitude, showing about the risks that exist in nature, implementing Cognitive Behaviour Therapy (CBT to raise awareness of the safety of ownself, following the climbing or mountaineer school, and using instructors to give lessons about safety in outdoor activities.

Acute Upper Thermal Limits of Three Aquatic Invasive Invertebrates: Hot Water Treatment to Prevent Upstream Transport of Invasive Species

Science.gov (United States)

Beyer, Jessica; Moy, Philip; de Stasio, Bart

2011-01-01

Transport of aquatic invasive species (AIS) by boats traveling up rivers and streams is an important mechanism of secondary spread of AIS into watersheds. Because physical barriers to AIS movement also prevent navigation, alternate methods for preventing spread are necessary while allowing upstream navigation. One promising approach is to lift boats over physical barriers and then use hot water immersion to kill AIS attached to the hull, motor, or fishing gear. However, few data have been published on the acute upper thermal tolerance limits of potential invaders treated in this manner. To test the potential effectiveness of this approach for a planned boat lift on the Fox River of northeastern WI, USA, acute upper thermal limits were determined for three AIS, adult zebra mussels ( Dreissena polymorpha), quagga mussels ( Dreissena rostriformis bugensis), and spiny water fleas ( Bythotrephes longimanus) from the local area employing temperatures from 32 to 54°C and immersion times from 1 to 20 min. Mortality was determined after immersion followed by a 20-min recovery period. Immersion at 43°C for at least 5 min was required to ensure 100% mortality for all three species, but due to variability in the response by Bythotrephes a 10 min immersion would be more reliable. Overall there were no significant differences between the three species in acute upper thermal limits. Heated water can be an efficient, environmentally sound, and cost effective method of controlling AIS potentially transferred by boats, and our results should have both specific and wide-ranging applications in the prevention of the spread of aquatic invasive species.

Plant invasions in mountains: global lessons for better management

Science.gov (United States)

Keith L. McDougall; Anzar A. Khuroo; Lloyd L. Loope; Catherine G. Parks; Anibal Pauchard; Zafar A. Reshi; Ian Rushworth; Christoph. Kueffer

2011-01-01

Mountains are one of few ecosystems little affected by plant invasions. However, the threat of invasion is likely to increase because of climate change, greater anthropogenic land use, and continuing novel introductions. Preventive management, therefore, will be crucial but can be difficult to promote when more pressing problems are unresolved and predictions are...

Acetazolamide during acute hypoxia improves tissue oxygenation in the human brain.

Science.gov (United States)

Wang, Kang; Smith, Zachary M; Buxton, Richard B; Swenson, Erik R; Dubowitz, David J

2015-12-15

Low doses of the carbonic anhydrase inhibitor acetazolamide provides accelerated acclimatization to high-altitude hypoxia and prevention of cerebral and other symptoms of acute mountain sickness. We previously observed increases in cerebral O2 metabolism (CMRO2 ) during hypoxia. In this study, we investigate whether low-dose oral acetazolamide (250 mg) reduces this elevated CMRO2 and in turn might improve cerebral tissue oxygenation (PtiO2 ) during acute hypoxia. Six normal human subjects were exposed to 6 h of normobaric hypoxia with and without acetazolamide prophylaxis. We determined CMRO2 and cerebral PtiO2 from MRI measurements of cerebral blood flow (CBF) and cerebral venous O2 saturation. During normoxia, low-dose acetazolamide resulted in no significant change in CBF, CMRO2 , or PtiO2 . During hypoxia, we observed increases in CBF [48.5 (SD 12.4) (normoxia) to 65.5 (20.4) ml·100 ml(-1)·min(-1) (hypoxia), P effect was improved cerebral tissue PtiO2 during acute hypoxia [11.4 (2.7) (hypoxia) to 16.5 (3.0) mmHg (hypoxia + acetazolamide), P effect, low-dose acetazolamide is effective at the capillary endothelium, and we hypothesize that local interruption in cerebral CO2 excretion accounts for the improvements in CMRO2 and ultimately in cerebral tissue oxygenation during hypoxia. This study suggests a potentially pivotal role of cerebral CO2 and pH in modulating CMRO2 and PtiO2 during acute hypoxia. Copyright © 2015 the American Physiological Society.

Chronic mitochondrial uncoupling treatment prevents acute cold-induced oxidative stress in birds.

Science.gov (United States)

Stier, Antoine; Massemin, Sylvie; Criscuolo, François

2014-12-01

Endotherms have evolved two major types of thermogenesis that allow them to actively produce heat in response to cold exposure, either through muscular activity (i.e. shivering thermogenesis) or through futile electro-chemical cycles (i.e. non-shivering thermogenesis). Amongst the latter, mitochondrial uncoupling is of key importance because it is suggested to drive heat production at a low cost in terms of oxidative stress. While this has been experimentally shown in mammals, the oxidative stress consequences of cold exposure and mitochondrial uncoupling are clearly less understood in the other class of endotherms, the birds. We compared metabolic and oxidative stress responses of zebra finches chronically treated with or without a chemical mitochondrial uncoupler (2,4-dinitrophenol: DNP), undergoing an acute (24 h) and a chronic (4 weeks) cold exposure (12 °C). We predicted that control birds should present at least a transient elevation of oxidative stress levels in response to cold exposure. This oxidative stress cost should be more pronounced in control birds than in DNP-treated birds, due to their lower basal uncoupling state. Despite similar increase in metabolism, control birds presented elevated levels of DNA oxidative damage in response to acute (but not chronic) cold exposure, while DNP-treated birds did not. Plasma antioxidant capacity decreased overall in response to chronic cold exposure. These results show that acute cold exposure increases oxidative stress in birds. However, uncoupling mitochondrial functioning appears as a putative compensatory mechanism preventing cold-induced oxidative stress. This result confirms previous observations in mice and underlines non-shivering thermogenesis as a putative key mechanism for endotherms in mounting a response to cold at a low oxidative cost.

Recent population trends of mountain goats in the Olympic Mountains, Washington

Science.gov (United States)

Jenkins, Kurt J.; Happe, Patricia J.; Beirne, Katherine F.; Hoffman, Roger A.; Griffin, Paul C.; Baccus, William T.; Fieberg, John

2012-01-01

Mountain goats (Oreamnos americanus) were introduced in Washington's Olympic Mountains during the 1920s. The population subsequently increased in numbers and expanded in range, leading to concerns by the 1970s over the potential effects of non-native mountain goats on high-elevation plant communities in Olympic National Park. The National Park Service (NPS) transplanted mountain goats from the Olympic Mountains to other ranges between 1981 and 1989 as a means to manage overabundant populations, and began monitoring population trends of mountain goats in 1983. We estimated population abundance of mountain goats during 18–25 July 2011, the sixth survey of the time series, to assess current population status and responses of the population to past management. We surveyed 39 sample units, comprising 39% of the 59,615-ha survey area. We estimated a population of 344 ± 72 (90% confidence interval [CI]) mountain goats in the survey area. Retrospective analysis of the 2004 survey, accounting for differences in survey area boundaries and methods of estimating aerial detection biases, indicated that the population increased at an average annual rate of 4.9% since the last survey. That is the first population growth observed since the cessation of population control measures in 1990. We postulate that differences in population trends observed in western, eastern, and southern sections of the survey zone reflected, in part, a variable influence of climate change across the precipitation gradient in the Olympic Mountains.

Prevention of deep venous thrombosis in patients with acute spinal cord injuries: use of rotating treatment tables

International Nuclear Information System (INIS)

Becker, D.M.; Gonzalez, M.; Gentili, A.; Eismont, F.; Green, B.A.

1987-01-01

A randomized clinical trial of 15 patients with acute spinal cord injuries was performed to test the hypothesis that rotating treatment tables prevent deep venous thrombosis in this population. Four of 5 control (nonrotated) patients developed distal and proximal thrombi, assessed by 125 I fibrinogen leg scans and impedance plethysmography. In comparison, only 1 of 10 treated (rotated) patients developed both distal and proximal thrombosis. These results suggest but do not prove that rotating treatment tables prevent the development of proximal deep venous thrombosis in spinal cord-injured patients. Larger clinical trials are needed to confirm this heretofore undocumented benefit of rotating treatment tables

Pharmacotherapy in Patients after Acute Myocardial Infarction - the Basis for Effective Secondary Prevention. Data from a Pilot Registry in the Czech Republic

Czech Academy of Sciences Publication Activity Database

Grünfeldová, H.; Tomečková, Marie; Monhart, Z.; Faltus, Václav; Peleška, Jan

2007-01-01

Roč. 30 (2007), s. 372-372 ISSN 1420-4096. [Central European Meeting on Hypertension and Cardiovascular Disease Prevention. 11.10.2007-13.10.2007, Kraków] R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : acute myocardial ifraction * pilot registry * secondary prevention Subject RIV: FA - Cardiovascular Disease s incl. Cardiotharic Surgery

Advances in global mountain geomorphology

Science.gov (United States)

Slaymaker, Olav; Embleton-Hamann, Christine

2018-05-01

Three themes in global mountain geomorphology have been defined and reinforced over the past decade: (a) new ways of measuring, sensing, and analyzing mountain morphology; (b) a new emphasis on disconnectivity in mountain geomorphology; and (c) the emergence of concerns about the increasing influence of anthropogenic disturbance of the mountain geomorphic environment, especially in intertropical mountains where population densities are higher than in any other mountain region. Anthropogenically induced hydroclimate change increases geomorphic hazards and risks but also provides new opportunities for mountain landscape enhancement. Each theme is considered with respect to the distinctiveness of mountain geomorphology and in relation to important advances in research over the past decade. The traditional reliance on the high energy condition to define mountain geomorphology seems less important than the presence of unique mountain landforms and landscapes and the distinctive ways in which human activity and anthropogenically induced hydroclimate change are transforming mountain landscapes.

Impact of Infection Prevention and Control Initiatives on Acute Respiratory Infections in a Pediatric Long-Term Care Facility.

Science.gov (United States)

Murray, Meghan T; Jackson, Olivia; Cohen, Bevin; Hutcheon, Gordon; Saiman, Lisa; Larson, Elaine; Neu, Natalie

2016-07-01

We evaluated the collective impact of several infection prevention and control initiatives aimed at reducing acute respiratory infections (ARIs) in a pediatric long-term care facility. ARIs did not decrease overall, though the proportion of infections associated with outbreaks and average number of cases per outbreak decreased. Influenza rates decreased significantly. Infect Control Hosp Epidemiol 2016;37:859-862.

[Rocky mountain spotted fever: report of two cases].

Science.gov (United States)

Martínez-Medina, Miguel Angel; Padilla-Zamudio, Guillermo; Solís-Gallardo, Lilia Patricia; Guevara-Tovar, Marcela

2005-01-01

Rocky Mountain spotted fever (RMSF) is an acute febrile illness caused by infection with Ricketsia Rickettsii, characterized by the presence of petechial rash. Even though the etiology, clinical characteristics and availability of effective antibiotics are known, RMSF related deaths have a prevalence of 4%. In its early stages RMFS can resemble many others infectious conditions and the diagnosis can be difficult. The present paper reports two patients with RMSF; these cases underscore the importance of prompt diagnosis and appropriate antimicrobial therapy, and consider RMSF as a differential diagnosis in any patient who develops fever and rash in an endemic area.

Sucralfate versus mesalazine versus hydrocortisone in the prevention of acute radiation proctitis during conformal radiotherapy for prostate carcinoma. A randomized study.

Science.gov (United States)

Sanguineti, Giuseppe; Franzone, Paola; Marcenaro, Michela; Foppiano, Franca; Vitale, Vito

2003-07-01

To assess whether the topical use of steroids or 5-aminosalicylic acid (5-ASA) is superior to sucralfate in preventing acute rectal toxicity during three-dimensional conformal radiotherapy (3DCRT) to 76 Gy. Patients undergoing 3DCRT for prostate carcinoma at our institution were offered to be randomized to sucralfate 3 g in 15 ml suspension enema (Antepsin, mesalazine 4 g gel enema (Enterasyn, or hydrocortisone 100 mg foam enema (Colifoam. Randomization was blind to the treating physician but not to the patient. Sucralfate was chosen as control arm. Topical treatment had to be performed once daily, starting on day 1 of 3DCRT. Acute rectal toxicity was scored weekly according to RTOG criteria. Time to occurrence of grade 2+ acute rectal toxicity was taken as endpoint. The trial was opened in August 1999, and after the first 24 patients had been treated, arm 2 was discontinued because of eight patients receiving mesalazine, seven actually developed acute rectal toxicity (five patients grade 3 and two patients grade 2). Until May 2001, 134 consecutive patients were randomly assigned to sucralfate (63 patients), mesalazine (eight patients) or hydrocortisone (63 patients). The cumulative incidence of acute rectal toxicity at the end of treatment by arm is 61.9 +/- 6.1%, 87.5 +/- 11.7%, and 52.4 +/- 6.2% for arms 1, 2, and 3, respectively. The difference between the mesalazine group and the sucralfate group is highly significant (hazard ratio [HR] 2.5, 95% confidence interval [CI] 1.1-5.7; p = 0.03). At both uni- and multivariate analysis taking into account several patients and treatment covariates, the difference between hydrocortisone and sucralfate is not significant (HR 0.7, 95% CI 0.5-1.2; p = 0.2). Topical mesalazine is contraindicated during radiotherapy. Hydrocortisone enema is not superior to sucralfate in preventing acute rectal toxicity.

Zingiber officinale Roscoe prevents acetaminophen-induced acute hepatotoxicity by enhancing hepatic antioxidant status.

Science.gov (United States)

Ajith, T A; Hema, U; Aswathy, M S

2007-11-01

A large number of xenobiotics are reported to be potentially hepatotoxic. Free radicals generated from the xenobiotic metabolism can induce lesions of the liver and react with the basic cellular constituents - proteins, lipids, RNA and DNA. Hepatoprotective activity of aqueous ethanol extract of Zingiber officinale was evaluated against single dose of acetaminophen-induced (3g/kg, p.o.) acute hepatotoxicity in rat. Aqueous extract of Z. officinale significantly protected the hepatotoxicity as evident from the activities of serum transaminase and alkaline phosphatase (ALP). Serum glutamate pyruvate transaminase (SGPT), serum glutamate oxaloacetate transaminase (SGOT) and ALP activities were significantly (pHepatic lipid peroxidation was enhanced significantly (pofficinale (200 and 400mg/kg, p.o.) prior to acetaminophen significantly declines the activities of serum transaminases and ALP. Further the hepatic antioxidant status was enhanced in the Z. officinale plus acetaminophen treated group than the control group. The results of the present study concluded that the hepatoprotective effect of aqueous ethanol extract of Z. officinale against acetaminophen-induced acute toxicity is mediated either by preventing the decline of hepatic antioxidant status or due to its direct radical scavenging capacity.

CLOSTRIDIUM DIFFICILE INFECTION IN ACUTE CARE HOSPITALS: SYSTEMATIC REVIEW AND BEST PRACTICES FOR PREVENTION

Science.gov (United States)

Louh, Irene K.; Greendyke, William G.; Hermann, Emilia A.; Davidson, Karina W.; Falzon, Louise; Vawdrey, David K.; Shaffer, Jonathan A.; Calfee, David P.; Furuya, E. Yoko; Ting, Henry H.

2017-01-01

Objective Prevention of Clostridium difficile infection (CDI) in acute care hospitals is a priority for hospitals and clinicians. We performed a qualitative systematic review to update the evidence on interventions to prevent CDI published since 2009. Design We searched Ovid, MEDLINE, EMBASE, The Cochrane Library, CINAHL, ISI Web of Knowledge, and grey literature databases from January 1, 2009 to August 1, 2015. Setting We included studies performed in acute care hospitals. Patients or participants We included studies conducted on hospitalized patients that investigated the impact of specific interventions on CDI rates. Interventions We used the QI-Minimum Quality Criteria Set (QI-MQCS) to assess the quality of included studies. Interventions were grouped thematically: environmental disinfection, antimicrobial stewardship, hand hygiene, chlorhexidine bathing, probiotics, bundled approaches, and others. A meta-analysis was performed when possible. Results Of 3236 articles screened, 261 met the criteria for full-text review and 46 studies were ultimately included. The average quality rating was 82% on the QI-MQCS. The most effective interventions, resulting in a 45% to 85% reduction in CDI, included daily to twice daily disinfection of high-touch surfaces (including bed rails) and terminal cleaning of patient rooms with chlorine-based products. Bundled interventions and antimicrobial stewardship showed promise for reducing CDI rates. Chlorhexidine bathing and intensified hand hygiene practices were not effective for reducing CDI rates. Conclusions Daily and terminal cleaning of patient rooms using chlorine-based products were most effective in reducing CDI rates in hospitals. Further studies are needed to identify the components of bundled interventions that reduce CDI rates. PMID:28300019

Prevention and Therapy of Acute Kidney Injury in the Developing World

Directory of Open Access Journals (Sweden)

Vijay Kher

2017-07-01

Full Text Available Timely recognition of patients at risk or with possible acute kidney injury (AKI is essential for early intervention to minimize further damage and improve outcome. Initial management of patients with suspected and persistent AKI should include thorough clinical assessment of all patients with AKI to identify reversible factors, including fluid volume status, potential nephrotoxins, and an assessment of the underlying health of the kidney. Based on these assessments, early interventions to provide appropriate and adequate fluid resuscitation while avoiding fluid overload, removal of nephrotoxins, and adjustment of drug doses according to the level of kidney function derangement are important. The judicious use of diuretics for fluid overload and/or in cardiac decompensated patients and introduction of early enteral nutritional support need to be considered to improve outcomes in AKI. Although these basic principles are well recognized, their application in clinical practice in low resource settings is often limited due to lack of education, availability of resources, and lack of trained personnel, which limits access to care. We report the consensus recommendations of the 18th Acute Dialysis Quality Initiative meeting in Hyderabad, India, on strategies to evaluate patients with suspected AKI and initiate measures for prevention and management to improve outcomes, particularly in low resource settings. These recomendations provide a framework for caregivers, who are often primary care physicians, nurses, and other allied healthcare personnel, to manage patients with AKI in resource poor countries.

Rocky Mountain spotted fever in Mexico: past, present, and future.

Science.gov (United States)

Álvarez-Hernández, Gerardo; Roldán, Jesús Felipe González; Milan, Néstor Saúl Hernández; Lash, R Ryan; Behravesh, Casey Barton; Paddock, Christopher D

2017-06-01

Rocky Mountain spotted fever, a tick-borne zoonosis caused by Rickettsia rickettsii, is among the most lethal of all infectious diseases in the Americas. In Mexico, the disease was first described during the early 1940s by scientists who carefully documented specific environmental determinants responsible for devastating outbreaks in several communities in the states of Sinaloa, Sonora, Durango, and Coahuila. These investigators also described the pivotal roles of domesticated dogs and Rhipicephalus sanguineus sensu lato (brown dog ticks) as drivers of epidemic levels of Rocky Mountain spotted fever. After several decades of quiescence, the disease re-emerged in Sonora and Baja California during the early 21st century, driven by the same environmental circumstances that perpetuated outbreaks in Mexico during the 1940s. This Review explores the history of Rocky Mountain spotted fever in Mexico, current epidemiology, and the multiple clinical, economic, and social challenges that must be considered in the control and prevention of this life-threatening illness. Copyright © 2017 Elsevier Ltd. All rights reserved.

Propagation prevention: a complementary mechanism for "lung protective" ventilation in acute respiratory distress syndrome.

Science.gov (United States)

Marini, John J; Gattinoni, Luciano

2008-12-01

To describe the clinical implications of an often neglected mechanism through which localized acute lung injury may be propagated and intensified. Experimental and clinical evidence from the medical literature relevant to the airway propagation hypothesis and its consequences. The diffuse injury that characterizes acute respiratory distress syndrome is often considered a process that begins synchronously throughout the lung, mediated by inhaled or blood-borne noxious agents. Relatively little attention has been paid to possibility that inflammatory lung injury may also begin focally and propagate sequentially via the airway network, proceeding mouth-ward from distal to proximal. Were this true, modifications of ventilatory pattern and position aimed at geographic containment of the injury process could help prevent its generalization and limit disease severity. The purposes of this communication are to call attention to this seldom considered mechanism for extending lung injury that might further justify implementation of low tidal volume/high positive end-expiratory pressure ventilatory strategies for lung protection and to suggest additional therapeutic measures implied by this broadened conceptual paradigm.

Assessing climate change impacts on water resources in remote mountain regions

Science.gov (United States)

Buytaert, Wouter; De Bièvre, Bert

2013-04-01

From a water resources perspective, remote mountain regions are often considered as a basket case. They are often regions where poverty is often interlocked with multiple threats to water supply, data scarcity, and high uncertainties. In these environments, it is paramount to generate locally relevant knowledge about water resources and how they impact local livelihoods. This is often problematic. Existing environmental data collection tends to be geographically biased towards more densely populated regions, and prioritized towards strategic economic activities. Data may also be locked behind institutional and technological barriers. These issues create a "knowledge trap" for data-poor regions, which is especially acute in remote and hard-to-reach mountain regions. We present lessons learned from a decade of water resources research in remote mountain regions of the Andes, Africa and South Asia. We review the entire tool chain of assessing climate change impacts on water resources, including the interrogation and downscaling of global circulation models, translating climate variables in water availability and access, and assessing local vulnerability. In global circulation models, mountain regions often stand out as regions of high uncertainties and lack of agreement of future trends. This is partly a technical artifact because of the different resolution and representation of mountain topography, but it also highlights fundamental uncertainties in climate impacts on mountain climate. This problem also affects downscaling efforts, because regional climate models should be run in very high spatial resolution to resolve local gradients, which is computationally very expensive. At the same time statistical downscaling methods may fail to find significant relations between local climate properties and synoptic processes. Further uncertainties are introduced when downscaled climate variables such as precipitation and temperature are to be translated in hydrologically

Comparison of participants and non-participants in a randomized study of prevention of depression in patients with acute coronary syndrome

DEFF Research Database (Denmark)

Hansen, Baiba; Hanash, Jamal A.; Rasmussen, Alice

2011-01-01

Background: The prevalence of depression and anxiety in patients after acute coronary syndrome (ACS) is higher than in the general population. In a study on prevention of post-ACS depression, more than half of eligible patients declined participation. Aims: The aim of this study was to evaluate...

Neuromuscular training with injury prevention counselling to decrease the risk of acute musculoskeletal injury in young men during military service: a population-based, randomised study

Directory of Open Access Journals (Sweden)

Suni Jaana

2011-04-01

Full Text Available Abstract Background The rapidly increasing number of activity-induced musculoskeletal injuries among adolescents and young adults is currently a true public health burden. The objective of this study was to investigate whether a neuromuscular training programme with injury prevention counselling is effective in preventing acute musculoskeletal injuries in young men during military service. Methods The trial design was a population-based, randomised study. Two successive cohorts of male conscripts in four companies of one brigade in the Finnish Defence Forces were first followed prospectively for one 6-month term to determine the baseline incidence of injury. After this period, two new successive cohorts in the same four companies were randomised into two groups and followed prospectively for 6 months. Military service is compulsory for about 90% of 19-year-old Finnish men annually, who comprised the cohort in this study. This randomised, controlled trial included 968 conscripts comprising 501 conscripts in the intervention group and 467 conscripts in the control group. A neuromuscular training programme was used to enhance conscripts' motor skills and body control, and an educational injury prevention programme was used to increase knowledge and awareness of acute musculoskeletal injuries. The main outcome measures were acute injuries of the lower and upper limbs. Results In the intervention groups, the risk for acute ankle injury decreased significantly compared to control groups (adjusted hazards ratio (HR = 0.34, 95% confidence interval (95% CI = 0.15 to 0.78, P = 0.011. This risk decline was observed in conscripts with low as well as moderate to high baseline fitness levels. In the latter group of conscripts, the risk of upper-extremity injuries also decreased significantly (adjusted HR = 0.37, 95% CI 0.14 to 0.99, P = 0.047. In addition, the intervention groups tended to have less time loss due to injuries (adjusted HR = 0.55, 95% CI 0

Preventing acute malnutrition among young children in crises: a prospective intervention study in Niger.

Science.gov (United States)

Langendorf, Céline; Roederer, Thomas; de Pee, Saskia; Brown, Denise; Doyon, Stéphane; Mamaty, Abdoul-Aziz; Touré, Lynda W-M; Manzo, Mahamane L; Grais, Rebecca F

2014-09-01

Finding the most appropriate strategy for the prevention of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) in young children is essential in countries like Niger with annual "hunger gaps." Options for large-scale prevention include distribution of supplementary foods, such as fortified-blended foods or lipid-based nutrient supplements (LNSs) with or without household support (cash or food transfer). To date, there has been no direct controlled comparison between these strategies leading to debate concerning their effectiveness. We compared the effectiveness of seven preventive strategies-including distribution of nutritious supplementary foods, with or without additional household support (family food ration or cash transfer), and cash transfer only-on the incidence of SAM and MAM among children aged 6-23 months over a 5-month period, partly overlapping the hunger gap, in Maradi region, Niger. We hypothesized that distributions of supplementary foods would more effectively reduce the incidence of acute malnutrition than distributions of household support by cash transfer. We conducted a prospective intervention study in 48 rural villages located within 15 km of a health center supported by Forum Santé Niger (FORSANI)/Médecins Sans Frontières in Madarounfa. Seven groups of villages (five to 11 villages) were allocated to different strategies of monthly distributions targeting households including at least one child measuring 60 cm-80 cm (at any time during the study period whatever their nutritional status): three groups received high-quantity LNS (HQ-LNS) or medium-quantity LNS (MQ-LNS) or Super Cereal Plus (SC+) with cash (€38/month [US$52/month]); one group received SC+ and family food ration; two groups received HQ-LNS or SC+ only; one group received cash only (€43/month [US$59/month]). Children 60 cm-80 cm of participating households were assessed at each monthly distribution from August to December 2011. Primary endpoints were SAM

Mountain goat abundance and population trends in the Olympic Mountains, Washington, 2011

Science.gov (United States)

Jenkins, Kurt; Happe, Patricia; Griffin, Paul C.; Beirne, Katherine; Hoffman, Roger; Baccus, William

2011-01-01

We conducted an aerial helicopter survey between July 18 and July 25, 2011, to estimate abundance and trends of introduced mountain goats (Oreamnos americanus) in the Olympic Mountains. The survey was the first since we developed a sightability correction model in 2008, which provided the means to estimate the number of mountain goats present in the surveyed areas and not seen during the aerial surveys, and to adjust for undercounting biases. Additionally, the count was the first since recent telemetry studies revealed that the previously defined survey zone, which was delineated at lower elevations by the 1,520-meter elevation contour, did not encompass all lands used by mountain goats during summer. We redefined the lower elevation boundary of survey units before conducting the 2011 surveys in an effort to more accurately estimate the entire mountain goat population. We surveyed 39 survey units, comprising 39 percent of the 59,615-hectare survey area. We estimated a mountain goat population of 344±44 (standard error, SE) in the expanded survey area. Based on this level of estimation uncertainty, the 95-percent confidence interval ranged from 258 to 430 mountain goats at the time of the survey. To permit comparisons of mountain goat populations between the 2004 and 2011 surveys, we recomputed population estimates derived from the 2004 survey using the newly developed bias correction methods, and we computed the 2004 and 2011 surveys based on comparable survey zone definitions (for example, using the boundaries of the 2004 survey). The recomputed estimates of mountain goat populations were 217±19 (SE) in 2004 and 303±41(SE) in 2011. The difference between the current 2011 population estimate (344±44[SE]) and the recomputed 2011 estimate (303±41[SE]) reflects the number of mountain goats counted in the expanded lower elevation portions of the survey zone added in 2011. We conclude that the population of mountain goats has increased in the Olympic Mountains at

Surface pressure drag for hydrostatic two-layer flow over axisymmetric mountains

Energy Technology Data Exchange (ETDEWEB)

Leutbecher, M.

2000-07-01

The effect of partial reflections on surface pressure drag is investigated for hydrostatic gravity waves in two-layer flow with piecewise constant buoyancy frequency. The variation of normalized surface pressure drag with interface height is analyzed for axisymmetric mountains. The results are compared with the familiar solution for infinitely long ridges. The drag for the two-layer flow is normalized with the drag of one-layer flow, which has the buoyancy frequency of the lower layer. An analytical expression for the normalized drag of axisymmetric mountains is derived from linear theory of steady flow. Additionally, two-layer flow over finite-height axisymmetric mountains is simulated numerically for flow with higher stability in the upper layer. The temporal evolution of the surface pressure drag is examined in a series of experiments with different interface and mountain heights. The focus is on the linear regime and the nonlinear regime of nonbreaking gravity waves. The dispersion of gravity waves in flow over isolated mountains prevents that the entire wave spectrum is in resonance at the same interface height, which is the case in hydrostatic flow over infinitely long ridges. In consequence, the oscillation of the normalized drag with interface height is smaller for axisymmetric mountains than for infinitely long ridges. However, even for a reflection coefficient as low as 1/3 the drag of an axisymmetric mountain can be amplified by 50% and reduced by 40%. The nonlinear drag becomes steady in the numerical experiments in which no wave breaking occurs. The steady state nonlinear drag agrees quite well with the prediction of linear theory if the linear drag is computed for a slightly lowered interface. (orig.)

THE EFFECTIVENESS OF A NATURAL PREPARATION IN THE TREATMENT AND PREVENTION OF INFLUENZA AND OTHER ACUTE RESPIRATORY DISEASES IN CHILDREN

Directory of Open Access Journals (Sweden)

O. V. Shamsheva

2017-01-01

Full Text Available The results of application of the drug of natural origin (Aflubin with immunomodulating, anti-inflammatory, detoxifying effect in complex treatment of influenza and acute respiratory infections in children are presented. The inclusion of Aflubin in the complex treatment of diseases contributed to reducing the severity and duration of intoxication, reducing the duration of catarrhal phenomena, preventing the development of secondary bacterial complications. Relative simplicity of the drug (drops at affordable cost, therapeutic and preventive efficacy in all age groups ensure its high compliance. 

Prebiotics in healthy infants and children for prevention of acute infectious diseases: a systematic review and meta-analysis.

Science.gov (United States)

Lohner, Szimonetta; Küllenberg, Daniela; Antes, Gerd; Decsi, Tamás; Meerpohl, Joerg J

2014-08-01

Prebiotics, defined as nondigestible dietary ingredients resistant to gastric acidity and fermented by the intestinal flora, are used to positively influence the composition of intestinal flora, thereby promoting health benefits. The objective of this systematic review was to assess the efficacy of prebiotics in the prevention of acute infectious diseases in children. A systematic literature search was conducted using the Ovid Medline, Scopus, Web of Science, and Cochrane Library's Central databases. Finally, five randomized controlled trials, all of them investigating infants and children 0-24 months of age, were included in the review. Pooled estimates from three studies revealed a statistically significant decrease in the number of infectious episodes requiring antibiotic therapy in the prebiotic group as compared with the placebo group (rate ratio 0.68; 95% confidence interval 0.61-0.77). Studies available indicate that prebiotics may also be effective in decreasing the rate of overall infections in infants and children 0-24 months of age. Further studies in the age group 3-18 years are required to determine whether prebiotics can be considered for the prevention of acute infectious diseases in the older pediatric population. © 2014 International Life Sciences Institute.

[PREVENTION AND CORRECTION OF PULMONARY COMPLICATIONS FOR SEVERE ACUTE PANCREATITIS].

Science.gov (United States)

Fedorkiv, M B

2015-06-01

Increased of proinflammatory cytokines levels, including interleukin-8 (IL-8) and tumor necrosis factor-alpha (TNF-alpha) on severe acute pancreatitis causes vasodilatation, increased permeability of the wall, accumulation of fluid in lung tissue and pleural sinuses. Transudate from acute parapancreatyc clusters of hot liquid and abdomen falls into the chest cavity through microscopic defects in the diaphragm due to the formation of pathological pleural-peritoneal connections or the relevant pressure gradient between the abdominal and pleural cavities. Remediation and removal of acute parapancreatyc clusters combined with the use of a multicomponent drug infusion therapy Cytoflavin provide a reduction in the frequency of pulmonary complications of acute pancreatitis from 48.3 to 31.0%. Use of the drug Cytoflavin reduces the severity of endogenous intoxication and mortality from acute lung injury from 12.9 to 6.1%.

Clostridium Difficile Infection in Acute Care Hospitals: Systematic Review and Best Practices for Prevention.

Science.gov (United States)

Louh, Irene K; Greendyke, William G; Hermann, Emilia A; Davidson, Karina W; Falzon, Louise; Vawdrey, David K; Shaffer, Jonathan A; Calfee, David P; Furuya, E Yoko; Ting, Henry H

2017-04-01

OBJECTIVE Prevention of Clostridium difficile infection (CDI) in acute-care hospitals is a priority for hospitals and clinicians. We performed a qualitative systematic review to update the evidence on interventions to prevent CDI published since 2009. DESIGN We searched Ovid, MEDLINE, EMBASE, The Cochrane Library, CINAHL, the ISI Web of Knowledge, and grey literature databases from January 1, 2009 to August 1, 2015. SETTING We included studies performed in acute-care hospitals. PATIENTS OR PARTICIPANTS We included studies conducted on hospitalized patients that investigated the impact of specific interventions on CDI rates. INTERVENTIONS We used the QI-Minimum Quality Criteria Set (QI-MQCS) to assess the quality of included studies. Interventions were grouped thematically: environmental disinfection, antimicrobial stewardship, hand hygiene, chlorhexidine bathing, probiotics, bundled approaches, and others. A meta-analysis was performed when possible. RESULTS Of 3,236 articles screened, 261 met the criteria for full-text review and 46 studies were ultimately included. The average quality rating was 82% according to the QI-MQCS. The most effective interventions, resulting in a 45% to 85% reduction in CDI, included daily to twice daily disinfection of high-touch surfaces (including bed rails) and terminal cleaning of patient rooms with chlorine-based products. Bundled interventions and antimicrobial stewardship showed promise for reducing CDI rates. Chlorhexidine bathing and intensified hand-hygiene practices were not effective for reducing CDI rates. CONCLUSIONS Daily and terminal cleaning of patient rooms using chlorine-based products were most effective in reducing CDI rates in hospitals. Further studies are needed to identify the components of bundled interventions that reduce CDI rates. Infect Control Hosp Epidemiol 2017;38:476-482.

Prevention of Moderate Acute Malnutrition (MAM) Positive Deviance Hearth (PDH) Approach in Burundi

International Nuclear Information System (INIS)

Madagasha, Aristide; Tse, Carmen; Baik, Diane

2014-01-01

Full text: Background and Objectives: PDH approach utilizes local resources and solutions to rehabilitate and prevent future malnutrition in children under five. Although PDH focuses on addressing underweight, PDH includes children with MAM and may have potential to address and prevent MAM where community-based management of acute malnutrition (CMAM), specifically targeted supplementary feeding component, may not be appropriate. The objectives are: 1) to assess the effectiveness of PDH to reduce moderate and severe underweight in participant children as well as prevent malnutrition in younger siblings of participant children; and 2) to assess PDH’s effectiveness for treatment and prevention of MAM in ten villages in Burundi. Methods: Starting September to November 2012, PDH was implemented by trained community volunteers in the ten villages. A “positive deviant” inquiry identified local practices that positively impact child nutritional status. These practices were transferred to families of malnourished children through experiential learning during 12 days of “Hearth” sessions. Two weeks of home visits followed Hearth. Mid-upper arm circumference of participant children (n = 70) were measured on the first day of Hearth, with appropriate referral for cases of severe acute malnutrition. Weights of children were assessed at Day 1 (n = 94), 12 (n = 94), 30 (n = 74) and one year after the start of Hearth (n = 92). Weight gain of children at Day 12 and 30 were compared with standard weight gains for PDH (200-250 grams for Day 12 and 400 grams for Day 30). Younger siblings were also weighed at the one year follow-up (n = 73). Results: Mean weight-for-age z-scores (WAZ) of the children improved from -3.1±0.2 to -1.1±0.1 (p<0.001), showing sustained catch-up growth at home. Almost all children achieved the standard weight gain on Day 12 and Day 30 (92.6% (87/94) and 98.6% (73/74), respectively). Within one year, severe and moderate underweight decreased from 77

Sucralfate versus mesalazine versus hydrocortisone in the prevention of acute radiation proctitis during conformal radiotherapy for prostate carcinoma. A randomized study

International Nuclear Information System (INIS)

Sanguineti, G.; Franzone, P.; Marcenaro, M.; Vitale, V.; Foppiano, F.

2003-01-01

Purpose: To assess whether the topical use of steroids or 5-aminosalicylic acid (5-ASA) is superior to sucralfate in preventing acute rectal toxicity during three-dimensional conformal radiotherapy (3DCRT) to 76 Gy. Patients and Methods: Patients undergoing 3DCRT for prostate carcinoma at our institution were offered to be randomized to sucralfate 3 g in 15 ml suspension enema (Antepsin trademark ), mesalazine 4 g gel enema (Enterasyn trademark), or hydrocortisone 100 mg foam enema (Colifoam trademark ). Randomization was blind to the treating physician but not to the patient. Sucralfate was chosen as control arm. Topical treatment had to be performed once daily, starting on day 1 of 3DCRT. Acute rectal toxicity was scored weekly according to RTOG criteria. Time to occurrence of grade 2+ acute rectal toxicity was taken as endpoint. Results: The trial was opened in August 1999, and after the first 24 patients had been treated, arm 2 was discontinued because of eight patients receiving mesalazine, seven actually developed acute rectal toxicity (five patients grade 3 and two patients grade 2). Until May 2001, 134 consecutive patients were randomly assigned to sucralfate (63 patients), mesalazine (eight patients) or hydrocortisone (63 patients). The cumulative incidence of acute rectal toxicity at the end of treatment by arm is 61.9 ± 6.1%, 87.5 ± 11.7%, and 52.4 ± 6.2% for arms 1, 2, and 3, respectively. The difference between the mesalazine group and the sucralfate group is highly significant (hazard ratio [HR] 2.5, 95% confidence interval [CI] 1.1-5.7; p = 0.03). At both uni- and multivariate analysis taking into account several patients and treatment covariates, the difference between hydrocortisone and sucralfate is not significant (HR 0.7, 95% CI 0.5-1.2; p = 0.2). Conclusion: Topical mesalazine is contraindicated during radiotherapy. Hydrocortisone enema is not superior to sucralfate in preventing acute rectal toxicity. (orig.)

Sucralfate versus mesalazine versus hydrocortisone in the prevention of acute radiation proctitis during conformal radiotherapy for prostate carcinoma. A randomized study

Energy Technology Data Exchange (ETDEWEB)

Sanguineti, G.; Franzone, P.; Marcenaro, M.; Vitale, V. [Dept. of Radiation Oncology, National Inst. for Cancer Research, Genova (Italy); Foppiano, F. [Dept. of Physics, National Inst. for Cancer Research, Genova (Italy)

2003-07-01

Purpose: To assess whether the topical use of steroids or 5-aminosalicylic acid (5-ASA) is superior to sucralfate in preventing acute rectal toxicity during three-dimensional conformal radiotherapy (3DCRT) to 76 Gy. Patients and Methods: Patients undergoing 3DCRT for prostate carcinoma at our institution were offered to be randomized to sucralfate 3 g in 15 ml suspension enema (Antepsin {sup trademark}), mesalazine 4 g gel enema (Enterasyn trademark), or hydrocortisone 100 mg foam enema (Colifoam {sup trademark}). Randomization was blind to the treating physician but not to the patient. Sucralfate was chosen as control arm. Topical treatment had to be performed once daily, starting on day 1 of 3DCRT. Acute rectal toxicity was scored weekly according to RTOG criteria. Time to occurrence of grade 2+ acute rectal toxicity was taken as endpoint. Results: The trial was opened in August 1999, and after the first 24 patients had been treated, arm 2 was discontinued because of eight patients receiving mesalazine, seven actually developed acute rectal toxicity (five patients grade 3 and two patients grade 2). Until May 2001, 134 consecutive patients were randomly assigned to sucralfate (63 patients), mesalazine (eight patients) or hydrocortisone (63 patients). The cumulative incidence of acute rectal toxicity at the end of treatment by arm is 61.9 {+-} 6.1%, 87.5 {+-} 11.7%, and 52.4 {+-} 6.2% for arms 1, 2, and 3, respectively. The difference between the mesalazine group and the sucralfate group is highly significant (hazard ratio [HR] 2.5, 95% confidence interval [CI] 1.1-5.7; p = 0.03). At both uni- and multivariate analysis taking into account several patients and treatment covariates, the difference between hydrocortisone and sucralfate is not significant (HR 0.7, 95% CI 0.5-1.2; p = 0.2). Conclusion: Topical mesalazine is contraindicated during radiotherapy. Hydrocortisone enema is not superior to sucralfate in preventing acute rectal toxicity. (orig.)

Will Parents Participate in and Comply with Programs and Regimens Using Xylitol for Preventing Acute Otitis Media in Their Children?

Science.gov (United States)

Danhauer, Jeffrey L.; Johnson, Carole E.; Baker, Jason A.; Ryu, Jung A.; Smith, Rachel A.; Umeda, Claire J.

2015-01-01

Purpose: Antiadhesive properties in xylitol, a natural sugar alcohol, can help prevent acute otitis media (AOM) in children by inhibiting harmful bacteria from colonizing and adhering to oral and nasopharyngeal areas and traveling to the Eustachian tube and middle ear. This study investigated parents' willingness to use and comply with a regimen…

Annual Copper Mountain Conferences on Multigrid and Iterative Methods, Copper Mountain, Colorado

International Nuclear Information System (INIS)

McCormick, Stephen F.

2016-01-01

This project supported the Copper Mountain Conference on Multigrid and Iterative Methods, held from 2007 to 2015, at Copper Mountain, Colorado. The subject of the Copper Mountain Conference Series alternated between Multigrid Methods in odd-numbered years and Iterative Methods in even-numbered years. Begun in 1983, the Series represents an important forum for the exchange of ideas in these two closely related fields. This report describes the Copper Mountain Conference on Multigrid and Iterative Methods, 2007-2015. Information on the conference series is available at http://grandmaster.colorado.edu/~copper/

Annual Copper Mountain Conferences on Multigrid and Iterative Methods, Copper Mountain, Colorado

Energy Technology Data Exchange (ETDEWEB)

McCormick, Stephen F. [Front Range Scientific, Inc., Lake City, CO (United States)

2016-03-25

This project supported the Copper Mountain Conference on Multigrid and Iterative Methods, held from 2007 to 2015, at Copper Mountain, Colorado. The subject of the Copper Mountain Conference Series alternated between Multigrid Methods in odd-numbered years and Iterative Methods in even-numbered years. Begun in 1983, the Series represents an important forum for the exchange of ideas in these two closely related fields. This report describes the Copper Mountain Conference on Multigrid and Iterative Methods, 2007-2015. Information on the conference series is available at http://grandmaster.colorado.edu/~copper/.

Reconnaissance and economic geology of Copper Mountain metamorphic complex, Owl Creek Mountains, Wyoming

International Nuclear Information System (INIS)

Hausel, W.D.

1983-01-01

The Copper Mountain metamorphic complex lies within a westerly trending belt of Precambrian exposures known as the Owl Creek Mountains uplift. The metamorphic complex at Copper Mountain is part of a larger complex known as the Owl Creek Mountains greenstone belt. Until more detailed mapping and petrographic studies can be completed, the Copper Mountain area is best referred to as a complex, even though it has some characteristics of a greestone belt. At least three episodes of Precambrian deformation have affected the supracrustals, and two have disturbed the granites. The final Precambrian deformation event was preceded by a weak thermal event expressed by retrogressive metamorphism and restricted metasomatic alteration. During this event, a second phase of pegmatization was accompanied by hydrothermal solutions. During the Laramide orogeny, Copper Mountain was again modified by deformation. Laramide deformation produced complex gravity faults and keystone grabens. Uranium deposits were formed following major Laramide deformation. The genesis of these deposits is attributable to either the leaching of granites or the leaching of overlying tuffaceous sediments during the Tertiary. Production of metals and industrial minerals has been limited, although some gold, copper, silver, tungsten, beryl, feldspar, and lithium ore have been shipped from Copper Mountain. A large amount of uranium was produced from the Copper Mountain district in the 1950s

Communication strategies in acute health care: evaluation within the context of infection prevention and control.

Science.gov (United States)

Edwards, R; Sevdalis, N; Vincent, C; Holmes, A

2012-09-01

Communication in healthcare settings has recently received significant attention in the literature. However, there continues to be a large gap in current understanding of the effectiveness of different communication channels used in acute healthcare settings, particularly in the context of infection prevention and control (IPC). To explore and evaluate the main communication channels used within hospitals to communicate with healthcare workers (HCWs) and to propose practical recommendations. Critical review of the main communication channels used within acute health care to communicate information to HCWs, and analysis of their impact on practice. The analysis covers verbal communications, standardization via guidelines, education and training, electronic communications and marketing strategies. Traditional communication channels have not been successful in changing and sustaining best practice in IPC, but newer approaches (electronic messages and marketing) also have pitfalls. A few simple recommendations are made in relation to the development, implementation and evaluation of communications to HCWs; top-down vs bottom-up communications; and the involvement of HCWs, particularly ward personnel. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Yucca Mountain and The Environment

International Nuclear Information System (INIS)

NA

2005-01-01

The Yucca Mountain Project places a high priority on protecting the environment. To ensure compliance with all state and federal environmental laws and regulations, the Project established an Environmental Management System. Important elements of the Environmental Management System include the following: (1) monitoring air, water, and other natural resources; (2) protecting plant and animal species by minimizing land disturbance; (3) restoring vegetation and wildlife habitat in disturbed areas; (4) protecting cultural resources; (5) minimizing waste, preventing pollution, and promoting environmental awareness; and (6) managing of hazardous and non-hazardous waste. Reducing the impacts of Project activities on the environment will continue for the duration of the Project

Homeopathic medicinal products for preventing and treating acute respiratory tract infections in children.

Science.gov (United States)

Hawke, Kate; van Driel, Mieke L; Buffington, Benjamin J; McGuire, Treasure M; King, David

2018-04-09

Acute respiratory tract infections (ARTIs) are common and may lead to complications. Most children experience between three and six ARTIs each year. Although these infections are self limiting, the symptoms can be distressing. Many treatments are used to control symptoms and shorten the duration of illness. They often have minimal benefit and may lead to adverse effects. Oral homeopathic medicinal products could play a role in the treatment of ARTIs for children if evidence for effectiveness is established. To assess the effectiveness and safety of oral homeopathic medicinal products compared with placebo or conventional therapy to prevent and treat acute respiratory tract infections in children. We searched CENTRAL (2017, Issue 11), which contains the Cochrane Acute Respiratory Infections Specialised Register, MEDLINE (1946 to 27 November 2017), Embase (2010 to 27 November 2017), CINAHL (1981 to 27 November 2017), AMED (1985 to December 2014), CAMbase (searched 29 March 2018), British Homeopathic Library (searched 26 June 2013 - no longer operating). We also searched the WHO ICTRP and ClinicalTrials.gov trials registers (29 March 2018), checked references, and contacted study authors to identify additional studies. Double-blind, randomised controlled trials (RCTs) or double-blind cluster-RCTs comparing oral homeopathy medicinal products with identical placebo or self selected conventional treatments to prevent or treat ARTIs in children aged 0 to 16 years. We used standard methodological procedures expected by Cochrane. We included eight RCTs of 1562 children receiving oral homeopathic medicinal products or a control treatment (placebo or conventional treatment) for upper respiratory tract infections (URTIs). Four treatment studies examined the effect on recovery from URTIs, and four studies investigated the effect on preventing URTIs after one to three months of treatment and followed up for the remainder of the year. Two treatment and two prevention studies

Bone Marrow-Derived Mesenchymal Stem Cells Repaired but Did Not Prevent Gentamicin-Induced Acute Kidney Injury through Paracrine Effects in Rats

OpenAIRE

Reis, Luciana A.; Borges, Fernanda T.; Simões, Manuel J.; Borges, Andrea A.; Sinigaglia-Coimbra, Rita; Schor, Nestor

2012-01-01

This study evaluated the effects of bone marrow-derived mesenchymal stem cells (BMSCs) or their conditioned medium (CM) on the repair and prevention of Acute Kidney Injury (AKI) induced by gentamicin (G). Animals received daily injections of G up to 20 days. On the 10(th) day, injections of BMSCs, CM, CM+trypsin, CM+RNase or exosome-like microvesicles extracted from the CM were administered. In the prevention groups, the animals received the BMSCs 24 h before or on the 5(th) day of G treatmen...

Acute adrenal insufficiency: an aide-memoire of the critical importance of its recognition and prevention.

Science.gov (United States)

Gargya, A; Chua, E; Hetherington, J; Sommer, K; Cooper, M

2016-03-01

Adrenal crisis is a life-threatening emergency that causes significant excess mortality in patients with adrenal insufficiency. Delayed recognition by medical staff of an impending adrenal crisis and failure to give timely hydrocortisone therapy within the emergency department continue to be commonly encountered, even in metropolitan teaching hospitals. Within the authors' institutions, several cases of poorly handled adrenal crises have occurred over the last 2 years. Anecdotal accounts from members of the Addison's support group suggest that these issues are common in Australia. This manuscript is a timely reminder for clinical staff on the critical importance of the recognition, treatment and prevention of adrenal crisis. The manuscript: (i) outlines a case and the clinical outcome of sub-optimally managed adrenal crisis, (ii) summarises the clinical features and acute management of adrenal crisis, (iii) provides recommendations on the prevention of adrenal crisis and (iv) provides guidance on the management of 'sick days' in patients with adrenal insufficiency. © 2016 Royal Australasian College of Physicians.

Mountaineering-induced bilateral plantar paresthesia.

Science.gov (United States)

Henderson, Kyle K; Parker, Justine; Heinking, Kurt P

2014-07-01

Flat feet (pes planus) have been implicated in multiple musculoskeletal complaints, which are often exacerbated by lack of appropriate arch support or intense exercise. To investigate the efficacy of osteopathic manipulative treatment (OMT) on a patient (K.K.H.) with mountaineering-induced bilateral plantar paresthesia and to assess the association of pes planus with paresthesia in members of the mountaineering expedition party that accompanied the patient. A patient history and physical examination of the musculoskeletal system were performed. The hindfoot, midfoot, forefoot, big toe, and distal toes were evaluated for neurologic function, specifically pin, vibration, 10-g weight sensitivity, and 2-point discrimination during the 4-month treatment period. To determine if OMT could augment recovery, the patient volunteered to use the contralateral leg as a control, with no OMT performed on the sacrum or lower back. To determine if pes planus was associated with mountaineering-induced paresthesia, a sit-to-stand navicular drop test was performed on members of the expedition party. Osteopathic manipulative treatment improved fibular head motion and muscular flexibility and released fascial restrictions of the soleus, hamstring, popliteus, and gastrocnemius. The patient's perception of stiffness, pain, and overall well-being improved with OMT. However, OMT did not shorten the duration of paresthesia. Of the 9 expedition members, 2 experienced paresthesia. Average navicular drop on standing was 5.1 mm for participants with no paresthesia vs 8.9 mm for participants with paresthesia (t test, Pparesthesia. Early diagnosis of pes planus and treatment with orthotics (which may prevent neuropathies)--or, less ideally, OMT after extreme exercise--should be sought to relieve tension and discomfort. © 2014 The American Osteopathic Association.

Shift in U.S. payer responsibility for the acute care of violent injuries after the Affordable Care Act: Implications for prevention.

Science.gov (United States)

Coupet, Edouard; Karp, David; Wiebe, Douglas J; Kit Delgado, M

2018-03-28

Investment in violence prevention programs is hampered by lack of clearly identifiable stakeholders with a financial stake in prevention. We determined the total annual charges for the acute care of injuries from interpersonal violence and the shift in financial responsibility for these charges after the Medicaid expansion from the Affordable Care Act in 2014. We analyzed all emergency department (ED) visits from 2009 to 2014 with diagnosis codes for violent injury in the Nationwide Emergency Department Sample (NEDS). We used sample weights to estimate total charges with adjusted generalized linear models to estimate charges for the 15% of ED visits with missing charge data. We then calculated the share attributable by payer and determined the difference in proportion by payer from 2013 to 2014. Between 2009 and 2013, the uninsured accounted for 28.2-31.3% of annual charges for the acute care of violent injury, while Medicaid was responsible for a similar amount (29.0-31.0%). In 2014, there were $10.7 billion in total charges for violent injury. Medicaid assumed the greatest share, 39.8% (95% CI: 38.0-41.5%, $3.5-5.1 billion), while the uninsured accounted for 23.6% (95% CI: 22.2-24.9%, $2.0-3.0 billion), and Medicare accounted for 7.8% (95% CI: 7.7-8.0%, $0.7-1.0 billion). After Medicaid expansion, taxpayers are now accountable for nearly half of the $10.7 billion in annual charges for the acute care of violent injury in the U.S. These findings highlight the benefit to state Medicaid programs of preventing interpersonal violence. Published by Elsevier Inc.

Risk factors for acute renal failure: inherent and modifiable risks.

Science.gov (United States)

Leblanc, Martine; Kellum, John A; Gibney, R T Noel; Lieberthal, Wilfred; Tumlin, James; Mehta, Ravindra

2005-12-01

Our purpose is to discuss established risk factors in the development of acute renal failure and briefly overview clinical markers and preventive measures. Findings from the literature support the role of older age, diabetes, underlying renal insufficiency, and heart failure as predisposing factors for acute renal failure. Diabetics with baseline renal insufficiency represent the highest risk subgroup. An association between sepsis, hypovolemia, and acute renal failure is clear. Liver failure, rhabdomyolysis, and open-heart surgery (especially valve replacement) are clinical conditions potentially leading to acute renal failure. Increasing evidence shows that intraabdominal hypertension may contribute to the development of acute renal failure. Radiocontrast and antimicrobial agents are the most common causes of nephrotoxic acute renal failure. In terms of prevention, avoiding nephrotoxins when possible is certainly desirable; fluid therapy is an effective prevention measure in certain clinical circumstances. Supporting cardiac output, mean arterial pressure, and renal perfusion pressure are indicated to reduce the risk for acute renal failure. Nonionic, isoosmolar intravenous contrast should be used in high-risk patients. Although urine output and serum creatinine lack sensitivity and specificity in acute renal failure, they remain the most used parameters in clinical practice. There are identified risk factors of acute renal failure. Because acute renal failure is associated with a worsening outcome, particularly if occurring in critical illness and if severe enough to require renal replacement therapy, preventive measures should be part of appropriate management.

Atypical Rocky Mountain spotted fever with polyarticular arthritis.

Science.gov (United States)

Chaudhry, Muhammad A; Scofield, Robert Hal

2013-11-01

Rocky Mountain spotted fever (RMSF) is an acute, serious tick borne illness caused by Rickettsia rickettsi. Frequently, RMSF is manifested by headache, a typical rash and fever but atypical disease is common, making diagnosis difficult. Inflammatory arthritis as a manifestation is rare. The purpose of this study is to describe a patient with serologically proven RMSF who presented in an atypical manner with inflammatory arthritis of the small joints of the hands and to review the previously reported patients with rickettsial infection and inflammatory arthritis. An 18-year-old woman presented with a rash that began on the distal extremities and spread centrally, along with hand pain and swelling. She had tenderness and swelling of the metacarpophlangeal joints on examination in addition to an erythematosus macular rash and occasional fever. Acute and convalescent serology demonstrated R rickettsi infection. She was successfully treated with doxycycline. Inflammatory arthritis is a rare manifestation of RMSF or other rickettsial infection with 8 previously reported patients, only 1 of whom had RMSF. Physician must have a high index of suspicion for RMSF because of atypical presentations.

Severe acute pancreatitis : Improving outcome

NARCIS (Netherlands)

van Brunschot, S.

2018-01-01

This thesis contains results of 8 years of clinical research performed to improve the treatment of patients with acute pancreatitis. The first part of this thesis focusses on diagnostics and the prevention of complications. The applicability of the revised Atlanta classification for acute

Effectiveness and Value of Prophylactic 5-Layer Foam Sacral Dressings to Prevent Hospital-Acquired Pressure Injuries in Acute Care Hospitals: An Observational Cohort Study.

Science.gov (United States)

Padula, William V

The purpose of this study was to examine the effectiveness and value of prophylactic 5-layer foam sacral dressings to prevent hospital-acquired pressure injury rates in acute care settings. Retrospective observational cohort. We reviewed records of adult patients 18 years or older who were hospitalized at least 5 days across 38 acute care hospitals of the University Health System Consortium (UHC) and had a pressure injury as identified by Patient Safety Indicator #3 (PSI-03). All facilities are located in the United States. We collected longitudinal data pertaining to prophylactic 5-layer foam sacral dressings purchased by hospital-quarter for 38 academic medical centers between 2010 and 2015. Longitudinal data on acute care, hospital-level patient outcomes (eg, admissions and PSI-03 and pressure injury rate) were queried through the UHC clinical database/resource manager from the Johns Hopkins Medicine portal. Data on volumes of dressings purchased per UHC hospital were merged with UHC data. Mixed-effects negative binomial regression was used to test the longitudinal association of prophylactic foam sacral dressings on pressure injury rates, adjusted for hospital case-mix and Medicare payments rules. Significant pressure injury rate reductions in US acute care hospitals between 2010 and 2015 were associated with the adoption of prophylactic 5-layer foam sacral dressings within a prevention protocol (-1.0 cases/quarter; P = .002) and changes to Medicare payment rules in 2014 (-1.13 cases/quarter; P = .035). Prophylactic 5-layer foam sacral dressings are an effective component of a pressure injury prevention protocol. Hospitals adopting these technologies should expect good value for use of these products.

Design and Implementation of Distress Prevention System using a Beacon

Directory of Open Access Journals (Sweden)

Lee Imsu

2016-01-01

Full Text Available It was proven that human accidents due to mountain climbing occupy large proportion of recently occurred man-made disasters. This paper designed and implemented an application that tells users about a variety of accidents that frequently occur in mountain and shows dynamic information about mountain climbing. It designed ‘distress prevention system using beacon’. When using beacon, it can dynamically express information without using GPS. It has advantage of supporting BLE and has little Smartphone battery consumption. The application was developed based on Android as a prototype. We expect that the application developed in this paper can contribute to the protection of precious lives by helping quick rescue in case of emergency such as distress. Manager of mountain can control data regarding the mountain climbing accident where the related functions are provided through view and user authority setup in DBMS.

Reservoirs on the mountain rivers and their safety

Directory of Open Access Journals (Sweden)

Ts.Z. Basilashvili

2016-06-01

Full Text Available Water resource issues and problems in the world's developing countries, present special challenges, as development of these countries significantly depends on the utilization of water resources. Georgia nestled between the Black Sea, Russia, and Turkey, and surrounded by the Caucasus Mountains, occupies a unique geographic space, which gives it strategic importance far beyond its size. Though blessed by its rich hydro resources, Georgia due to its uneven distribution, experiences some problems as the demand on water frequently doesn't coincide with water provision. As a result it causes acute deficit situation. Due to the global warming of the climate, it is expected that the fresh water amount will decrease in Georgia. This is why it is necessary to approach the use of water resources in a complex way by means of water reservoirs, which will enable attaining of a large economic effect. In the mountainous conditions filling of reservoirs take place in spring time, when snow and glaciers melt. In Georgia as in mountainous country, abundant rains take place, thus causing catastrophic flooding on rivers. In summer and winter water amount decreases 10 times and irrigation, water provision and energy production is impeded. Thus, the lack of water just like the excess amount of water causes damage. This is why it is needed to forecast water amount in water reservoirs for different periods of the year. But in a complex, mountainous terrain operative data of hydrometeorology is not sufficient for application of modern mathematical methods. We have elaborated multiple-factor statistical model for a forecast, which by means of different mathematical criteria and methods can simultaneously research the increase of the timeliness of forecasts and the level of their precision. We have obtained methodologies for short and long term forecasts of inflowing water properties in Georgia's main water reservoirs to further plan optimally and regulate water resources

Efficacy of atorvastatin on the prevention of contrast-induced acute kidney injury: a meta-analysis

Directory of Open Access Journals (Sweden)

Liu L

2018-03-01

Full Text Available Ling-Yun Liu,1 Yang Liu,2 Mei-Yan Wu,2 Yan-Yan Sun,3 Fu-Zhe Ma2 1Department of Andrology, 2Department of Nephrology, the First Hospital of Jilin University, 3Department of Nephrology, the Fourth Hospital of Jilin University, Changchun, China Background: Results of studies on the efficacy of atorvastatin pretreatment on reducing the prevalence of contrast-induced acute kidney injury (CIAKI in patients undergoing coronary angiography (CAG or percutaneous coronary intervention (PCI have been controversial.Objective: We undertook a meta-analysis to evaluate the efficacy of atorvastatin on contrast-induced nephropathy (CIN after CAG or PCI.Materials and methods: We undertook a systematic search of electronic databases (PubMed, Embase, and the Cochrane Library up to June 2017. A meta-analysis was carried out including randomized controlled trials (RCTs that compared atorvastatin pretreatment with pretreatment with a low-dose statin or placebo for CIAKI prevention in patients undergoing CAG. The main endpoint was CIN prevalence.Results: Nine RCTs were included in our meta-analysis. Atorvastatin pretreatment reduced the prevalence of CIN significantly (odds ratio [OR] 0.46; 95% confidence interval [95% CI] 0.27–0.79; p=0.004. The benefit of high-dose atorvastatin pretreatment was consistent when compared with the control group (OR 0.45; 95% CI 0.21–0.95; p=0.04.Conclusion: At high doses, atorvastatin pretreatment was associated with a significant reduction in the prevalence of CIAKI in patients undergoing CAG. Pretreatment with high-dose atorvastatin could be employed to prevent CIAKI. Keywords: atorvastatin, contrast-induced acute kidney injury, coronary angiography, percutaneous coronary intervention, contrast-induced nephropathy, meta-analysis

Knowledge, perceptions, and practices of methicillin-resistant Staphylococcus aureus transmission prevention among health care workers in acute-care settings.

Science.gov (United States)

Seibert, Dorothy J; Speroni, Karen Gabel; Oh, Kyeung Mi; DeVoe, Mary C; Jacobsen, Kathryn H

2014-03-01

Health care workers (HCWs) play a critical role in prevention of health care-associated infections such as methicillin-resistant Staphylococcus aureus (MRSA), but glove and gown contact precautions and hand hygiene may not be consistently used with vulnerable patients. A cross-sectional survey of MRSA knowledge, attitudes/perceptions, and practices among 276 medical, nursing, allied health, and support services staff at an acute-care hospital in the eastern United States was completed in 2012. Additionally, blinded observations of hand hygiene behaviors of 104 HCWs were conducted. HCWs strongly agreed that preventive behaviors reduce the spread of MRSA. The vast majority reported that they almost always engage in preventive practices, but observations of hand hygiene found lower rates of adherence among nearly all HCW groups. HCWs who reported greater comfort with telling others to take action to prevent MRSA transmission were significantly more likely to self-report adherence to recommended practices. It is important to reduce barriers to adherence with preventive behaviors and to help all HCWs, including support staff who do not have direct patient care responsibilities, to translate knowledge about MRSA transmission prevention methods into consistent adherence of themselves and their coworkers to prevention guidelines. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

YUCCA MOUNTAIN SITE DESCRIPTION

International Nuclear Information System (INIS)

Simmons, A.M.

2004-01-01

The ''Yucca Mountain Site Description'' summarizes, in a single document, the current state of knowledge and understanding of the natural system at Yucca Mountain. It describes the geology; geochemistry; past, present, and projected future climate; regional hydrologic system; and flow and transport within the unsaturated and saturated zones at the site. In addition, it discusses factors affecting radionuclide transport, the effect of thermal loading on the natural system, and tectonic hazards. The ''Yucca Mountain Site Description'' is broad in nature. It summarizes investigations carried out as part of the Yucca Mountain Project since 1988, but it also includes work done at the site in earlier years, as well as studies performed by others. The document has been prepared under the Office of Civilian Radioactive Waste Management quality assurance program for the Yucca Mountain Project. Yucca Mountain is located in Nye County in southern Nevada. The site lies in the north-central part of the Basin and Range physiographic province, within the northernmost subprovince commonly referred to as the Great Basin. The basin and range physiography reflects the extensional tectonic regime that has affected the region during the middle and late Cenozoic Era. Yucca Mountain was initially selected for characterization, in part, because of its thick unsaturated zone, its arid to semiarid climate, and the existence of a rock type that would support excavation of stable openings. In 1987, the United States Congress directed that Yucca Mountain be the only site characterized to evaluate its suitability for development of a geologic repository for high-level radioactive waste and spent nuclear fuel

Human impacts to mountain streams

Science.gov (United States)

Wohl, Ellen

2006-09-01

Mountain streams are here defined as channel networks within mountainous regions of the world. This definition encompasses tremendous diversity of physical and biological conditions, as well as history of land use. Human effects on mountain streams may result from activities undertaken within the stream channel that directly alter channel geometry, the dynamics of water and sediment movement, contaminants in the stream, or aquatic and riparian communities. Examples include channelization, construction of grade-control structures or check dams, removal of beavers, and placer mining. Human effects can also result from activities within the watershed that indirectly affect streams by altering the movement of water, sediment, and contaminants into the channel. Deforestation, cropping, grazing, land drainage, and urbanization are among the land uses that indirectly alter stream processes. An overview of the relative intensity of human impacts to mountain streams is provided by a table summarizing human effects on each of the major mountainous regions with respect to five categories: flow regulation, biotic integrity, water pollution, channel alteration, and land use. This table indicates that very few mountains have streams not at least moderately affected by land use. The least affected mountainous regions are those at very high or very low latitudes, although our scientific ignorance of conditions in low-latitude mountains in particular means that streams in these mountains might be more altered than is widely recognized. Four case studies from northern Sweden (arctic region), Colorado Front Range (semiarid temperate region), Swiss Alps (humid temperate region), and Papua New Guinea (humid tropics) are also used to explore in detail the history and effects on rivers of human activities in mountainous regions. The overview and case studies indicate that mountain streams must be managed with particular attention to upstream/downstream connections, hillslope

Preventing Acute Malnutrition among Young Children in Crises: A Prospective Intervention Study in Niger

Science.gov (United States)

Langendorf, Céline; Roederer, Thomas; de Pee, Saskia; Brown, Denise; Doyon, Stéphane; Mamaty, Abdoul-Aziz; Touré, Lynda W.-M.; Manzo, Mahamane L.; Grais, Rebecca F.

2014-01-01

Background Finding the most appropriate strategy for the prevention of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) in young children is essential in countries like Niger with annual “hunger gaps.” Options for large-scale prevention include distribution of supplementary foods, such as fortified-blended foods or lipid-based nutrient supplements (LNSs) with or without household support (cash or food transfer). To date, there has been no direct controlled comparison between these strategies leading to debate concerning their effectiveness. We compared the effectiveness of seven preventive strategies—including distribution of nutritious supplementary foods, with or without additional household support (family food ration or cash transfer), and cash transfer only—on the incidence of SAM and MAM among children aged 6–23 months over a 5-month period, partly overlapping the hunger gap, in Maradi region, Niger. We hypothesized that distributions of supplementary foods would more effectively reduce the incidence of acute malnutrition than distributions of household support by cash transfer. Methods and Findings We conducted a prospective intervention study in 48 rural villages located within 15 km of a health center supported by Forum Santé Niger (FORSANI)/Médecins Sans Frontières in Madarounfa. Seven groups of villages (five to 11 villages) were allocated to different strategies of monthly distributions targeting households including at least one child measuring 60 cm–80 cm (at any time during the study period whatever their nutritional status): three groups received high-quantity LNS (HQ-LNS) or medium-quantity LNS (MQ-LNS) or Super Cereal Plus (SC+) with cash (€38/month [US$52/month]); one group received SC+ and family food ration; two groups received HQ-LNS or SC+ only; one group received cash only (€43/month [US$59/month]). Children 60 cm–80 cm of participating households were assessed at each monthly distribution from

Preventing acute malnutrition among young children in crises: a prospective intervention study in Niger.

Directory of Open Access Journals (Sweden)

Céline Langendorf

2014-09-01

Full Text Available BACKGROUND: Finding the most appropriate strategy for the prevention of moderate acute malnutrition (MAM and severe acute malnutrition (SAM in young children is essential in countries like Niger with annual "hunger gaps." Options for large-scale prevention include distribution of supplementary foods, such as fortified-blended foods or lipid-based nutrient supplements (LNSs with or without household support (cash or food transfer. To date, there has been no direct controlled comparison between these strategies leading to debate concerning their effectiveness. We compared the effectiveness of seven preventive strategies-including distribution of nutritious supplementary foods, with or without additional household support (family food ration or cash transfer, and cash transfer only-on the incidence of SAM and MAM among children aged 6-23 months over a 5-month period, partly overlapping the hunger gap, in Maradi region, Niger. We hypothesized that distributions of supplementary foods would more effectively reduce the incidence of acute malnutrition than distributions of household support by cash transfer. METHODS AND FINDINGS: We conducted a prospective intervention study in 48 rural villages located within 15 km of a health center supported by Forum Santé Niger (FORSANI/Médecins Sans Frontières in Madarounfa. Seven groups of villages (five to 11 villages were allocated to different strategies of monthly distributions targeting households including at least one child measuring 60 cm-80 cm (at any time during the study period whatever their nutritional status: three groups received high-quantity LNS (HQ-LNS or medium-quantity LNS (MQ-LNS or Super Cereal Plus (SC+ with cash (€38/month [US$52/month]; one group received SC+ and family food ration; two groups received HQ-LNS or SC+ only; one group received cash only (€43/month [US$59/month]. Children 60 cm-80 cm of participating households were assessed at each monthly distribution from August to

A phase III randomized, placebo-controlled, double-blind study of misoprostol rectal suppositories to prevent acute radiation proctitis in patients with prostate cancer

International Nuclear Information System (INIS)

Hille, Andrea; Schmidberger, Heinz; Hermann, Robert M.; Christiansen, Hans; Saile, Bernhard; Pradier, Olivier; Hess, Clemens F.

2005-01-01

Purpose: Acute radiation proctitis is the most relevant complication of pelvic radiation and is still mainly treated supportively. Considering the negative impact of acute proctitis symptoms on patients' daily activities and the potential relationship between the severity of acute radiation injury and late damage, misoprostol was tested in the prevention of acute radiation-induced proctitis. Methods and Materials: A total of 100 patients who underwent radiotherapy for prostate cancer were entered into this phase III randomized, placebo-controlled, double-blind study with misoprostol or placebo suppositories. Radiation-induced toxicity was evaluated weekly during radiotherapy using the Common Toxicity Criteria. Results: Between the placebo and the misoprostol groups, no significant differences in proctitis symptoms occurred: 76% of patients in each group had Grade 1 toxicity, and 26% in the placebo group and 36% in the misoprostol group had Grade 2 toxicity. No differences were found in onset or symptom duration. Comparing the peak incidence of patients' toxicity symptoms, significantly more patients experienced rectal bleeding in the misoprostol group (p = 0.03). Conclusion: Misoprostol given as a once-daily suppository did not decrease the incidence and severity of radiation-induced acute proctitis and may increase the incidence of acute bleeding

Prevention and Therapeutic Effects and Mechanisms of Tanshinone IIA Sodium Sulfonate on Acute Liver Injury Mice Model

Directory of Open Access Journals (Sweden)

Lunjie Lu

2016-01-01

Full Text Available Tanshinone IIA sodium sulfonate (TSS is a water-soluble derivative of tanshinone IIA, which is the main pharmacologically active component of Salvia miltiorrhiza. This study aimed to verify the preventive and therapeutic effects of TSS and its combined therapeutic effects with magnesium isoglycyrrhizinate (MI in D-galactosamine- (D-Gal- induced acute liver injury (ALI in mice. The potential regulatory mechanisms of TSS on ALI were also examined. Our results may provide a basis for the development of novel therapeutics for ALI.

Multimodal Preincisional Premedication to Prevent Acute Pain After Cholecystectomy

Directory of Open Access Journals (Sweden)

Dawood Aghamohammadi

2012-09-01

Full Text Available Introduction: Postoperative pain as an important medical concern is usually treated by opioids which also are of various inevitable side effects. The aim of this study was to assess the efficacy of multimodal preincisional premedication on preventing post-cholecystectomy acute pain. Methods: In a randomized clinical trial, sixty patients undergoing open cholecystectomy were randomized into two groups. Before anesthesia induction, Diclofenac suppository (100 mg and oral Clonidine (0.2 mg were administered in the first group. Immediately before operation, patients received Ketamine (1 mg/kg IV while the control group received placebo. The site of incision was infiltrated by the surgeon with 20 mL Bupivacaine 0.25% in both groups. Anesthesia induction and maintenance were similar in both groups. The severity of pain was recorded 2, 4, 6, 12, 24 and 48 hours after operation according to Visual Analogue Scale. Results: The severity of pain at two defined stages (6 and 12 hours later was significantly less in the intervention group than the control group (P<0.005. The average pain severity score was less than the control group (P<0.005. Conclusion: In our study, the administration of Clonidine, Diclofenac and Ketamine and bupivacaine infiltration to the site of incision, altogether was associated with a significant decrease in pain score and opioid requirement after cholecystectomy in comparison to bupivacaine infiltration to the site of incision.

YUCCA MOUNTAIN SITE DESCRIPTION

Energy Technology Data Exchange (ETDEWEB)

A.M. Simmons

2004-04-16

The ''Yucca Mountain Site Description'' summarizes, in a single document, the current state of knowledge and understanding of the natural system at Yucca Mountain. It describes the geology; geochemistry; past, present, and projected future climate; regional hydrologic system; and flow and transport within the unsaturated and saturated zones at the site. In addition, it discusses factors affecting radionuclide transport, the effect of thermal loading on the natural system, and tectonic hazards. The ''Yucca Mountain Site Description'' is broad in nature. It summarizes investigations carried out as part of the Yucca Mountain Project since 1988, but it also includes work done at the site in earlier years, as well as studies performed by others. The document has been prepared under the Office of Civilian Radioactive Waste Management quality assurance program for the Yucca Mountain Project. Yucca Mountain is located in Nye County in southern Nevada. The site lies in the north-central part of the Basin and Range physiographic province, within the northernmost subprovince commonly referred to as the Great Basin. The basin and range physiography reflects the extensional tectonic regime that has affected the region during the middle and late Cenozoic Era. Yucca Mountain was initially selected for characterization, in part, because of its thick unsaturated zone, its arid to semiarid climate, and the existence of a rock type that would support excavation of stable openings. In 1987, the United States Congress directed that Yucca Mountain be the only site characterized to evaluate its suitability for development of a geologic repository for high-level radioactive waste and spent nuclear fuel.

MOUNTAIN TOURISM INTERCONNECTIONS. VARIATION OF MOUNTAIN TOURIST FLOW IN SUCEAVA COUNTY

Directory of Open Access Journals (Sweden)

George CHEIA

2013-12-01

Full Text Available Mountain tourism, in addition to one of the most common types of tourism, is generated by a complex of factors and at the same time, triggers a series of processes involving tourism phenomenon, especially the environment where it is taking place. This paper aims to discuss some of these causal factors, and the relationship between this type of tourism and the tourist area itself (1. By using SPSS analytical methods , it can be practically demonstrated the impact of mountain tourist flow in spas (2 and mountain resorts (3 in Suceava county.

[Rocky Mountain spotted fever in Mexican children: Clinical and mortality factors].

Science.gov (United States)

Álvarez-Hernández, Gerardo; Candia-Plata, María Del Carmen; Delgado-de la Mora, Jesús; Acuña-Meléndrez, Natalia Haydeé; Vargas-Ortega, Anabel Patricia; Licona-Enríquez, Jesús David

2016-06-01

Characterize clinical manifestations and predictors of mortality in children hospitalized for spotted fever. Cross-sectional study in 210 subjects with a diagnosis of Rocky Mountain spotted fever (RMSF) in a pediatric hospital in Sonora, from January 1st, 2004 to June 30th, 2015. Data were analyzed using descriptive statistics and multivariate logistic regression. An upward trend was observed in RMSF morbidity and mortality. Fatality rate was 30%.Three predictors were associated with risk of death: delay ≥ 5 days at the start of doxycycline (ORa= 2.95, 95% CI 1.10-7.95), acute renal failure ((ORa= 8.79, 95% CI 3.46-22.33) and severe sepsis (ORa= 3.71, 95% CI 1.44-9.58). RMSF causes high mortality in children, which can be avoided with timely initiation of doxycycline. Acute renal failure and severe sepsis are two independent predictors of death in children with RMSF.

Transfusion-related acute lung injury: Current understanding and preventive strategies

NARCIS (Netherlands)

Vlaar, A. P. J.

2012-01-01

Transfusion-related acute lung injury (TRALI) is the most serious complication of transfusion medicine. TRALI is defined as the onset of acute hypoxia within 6 hours of a blood transfusion in the absence of hydrostatic pulmonary oedema. The past decades have resulted in a better understanding of the

Oral Astragalus (Huang qi) for preventing frequent episodes of acute respiratory tract infection in children.

Science.gov (United States)

Su, Guobin; Chen, Xiankun; Liu, Zhuangzhu; Yang, Lihong; Zhang, La; Stålsby Lundborg, Cecilia; Wen, Zehuai; Guo, Xinfeng; Qin, Xindong; Liang, Jueyao; Liu, Xusheng

2016-12-01

Acute respiratory tract infections (ARTIs) are common in children and can involve both upper and lower airways. Many children experience frequent ARTI episodes or recurrent respiratory tract infections (RRTIs) in early life, which creates challenges for paediatricians, primary care physicians, parents and carers of children.In China, Astragalus (Huang qi), alone or in combination with other herbs, is used by Traditional Chinese Medicine (TCM) practitioners in the form of a water extract, to reduce the risk of ARTIs; it is believed to stimulate the immune system. Better understanding of the therapeutic mechanisms of Astragalus may provide insights into ARTI prevention, and consequently reduced antibiotic use. To assess the effectiveness and safety of oral Astragalus for preventing frequent episodes of acute respiratory tract infections (ARTIs) in children in community settings. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 12, 2015), MEDLINE (Ovid) (1946 to 31 December 2015), Embase (Elsevier) (1974 to 31 December 2015), AMED (Ovid) (1985 to 31 December 2015), Chinese National Knowledge Infrastructure (CNKI) (1979 to 31 December 2015) and Chinese Scientific Journals full text database (CQVIP) (1989 to 31 December 2015), China Biology Medicine disc (CBM 1976 to 31 December 2015) and Wanfang Data Knowledge Service Platform (WanFang) (1998 to 31 December 2015). We included randomised controlled trials (RCTs) comparing oral Astragalus as a sole Chinese herbal preparation with placebo to prevent frequent episodes of ARTIs in children. We used standard Cochrane methodological procedures for this review. We assessed search results to identify relevant studies. We planned to extract data using standardised forms. Disagreements were to be resolved through discussion. Risk of bias was to be assessed using the Cochrane 'Risk of bias' tool. We planned to use mean difference (MD) or standardised mean difference (SMD) for continuous data and risk

Will parents participate in and comply with programs and regimens using xylitol for preventing acute otitis media in their children?

Science.gov (United States)

Danhauer, Jeffrey L; Johnson, Carole E; Baker, Jason A; Ryu, Jung A; Smith, Rachel A; Umeda, Claire J

2015-04-01

Antiadhesive properties in xylitol, a natural sugar alcohol, can help prevent acute otitis media (AOM) in children by inhibiting harmful bacteria from colonizing and adhering to oral and nasopharyngeal areas and traveling to the Eustachian tube and middle ear. This study investigated parents' willingness to use and comply with a regimen of xylitol for preventing AOM in their preschool- and kindergarten-aged children. An Internet questionnaire was designed and administered to parents of young children in preschool and kindergarten settings. Most parents were unaware of xylitol's use for AOM and would not likely comply with regimens for preventing AOM in their children; however, parents having previous knowledge of xylitol and whose children had a history of AOM would be more likely to do so. Generally, most of these parents did not know about xylitol and probably would not use it to prevent ear infections. Unfortunately, these results parallel earlier findings for teachers and schools, which present obstacles for establishing ear infection prevention programs using similar protocols for young children. The results showed that considerable education and age-appropriate vehicles for administering xylitol are needed before establishing AOM prevention programs in schools and/or at home.

Tick testing as a method of controlling Rocky Mountain spotted fever.

Science.gov (United States)

Sacks, J J; Pinner, T A; Parker, R L

1983-01-01

In South Carolina, 1974-1980, only two matches were found between 536 Rocky Mountain spotted fever (RMSF) cases and 965 individuals who submitted ticks that tested rickettsial antigen positive. In neither case did the positive test prevent RMSF. Tick rickettsial positivity rates varied inversely with human RMSF attack rates in different geographic areas. A physician survey established it as unlikely that RMSF occurred in positive tick submitters (PTS), and that although not recommended, 34 per cent of asymptomatic PTS received prophylactic treatment. Only 18 per cent of positive ticks were engorged. Tick testing appears ineffective in preventing RMSF. PMID:6869643

The effect of electrical stimulation in combination with Bobath techniques in the prevention of shoulder subluxation in acute stroke patients.

Science.gov (United States)

Fil, Ayla; Armutlu, Kadriye; Atay, Ahmet Ozgur; Kerimoglu, Ulku; Elibol, Bulent

2011-01-01

To examine the efficiency of electrical stimulation in combination with Bobath techniques in the prevention of inferior and anterior shoulder subluxation in acute stroke patients. A prospective randomized controlled trial. Intensive care unit and inpatient clinics of neurology in a university hospital. Forty-eight patients with acute stroke, divided equally into control and study groups. Subjects in both groups were treated in accordance with the Bobath concept during the early hospitalization period. In addition to Bobath techniques, electrical stimulation was also applied to the supraspinatus muscle, mid and posterior portions of the deltoid muscle of patients in the study group. Two radiological methods were used to measure the horizontal, vertical and total asymmetry and vertical distance values of the shoulder joint. Motor functions of the arm were evaluated with the Motor Assessment Scale. The hospitalization period was 12.62 ± 2.24 days for the control group and 11.66 ± 1.88 days for the study group. Shoulder subluxation occurred in 9 (37.5%) subjects in the control group, whereas it was not observed in the study group. All shoulder joint displacement values were higher in the control group than in the study group (horizontal asymmetry P = 0.0001, vertical asymmetry P = 0.0001, total asymmetry P = 0.0001, vertical range P = 0.002). Application of electrical stimulation combined with the Bobath approach proved to be efficient in preventing inferior and anterior shoulder subluxation in the acute stages of stroke.

Palonosetron for the prevention of nausea and vomiting in children with acute lymphoblastic leukemia treated with high dose methotrexate

DEFF Research Database (Denmark)

Nadaraja, Sambavy; Mamoudou, Aissata Diop; Thomassen, Harald

2012-01-01

High dose methotrexate (HD-MTX), used in the treatment of children with acute lymphoblastic leukemia (ALL), is moderately emetogenic. First generation 5-HT(3) receptor antagonists are effective prophylactic agents but require multiple administrations. Palonosetron has a half life of 36-42 hours...... of palonosetron (5 µg/kg) for the prevention of chemotherapy-induced nausea and vomiting in children 18 years of age with ALL treated with HD-MTX, 5 g/m(2)....

Prevention of acute malnutrition

DEFF Research Database (Denmark)

de Pee, Saskia; Grais, Rebecca; Fenn, Bridget

2015-01-01

of cash or food, enables households to better meet the food, health, and other needs of household members and may increase resilience; water, sanitation, and hygiene (WASH) and health interventions help prevent and address illness and hence reduce wasting risk. The contributions of specific interventions...... "best possible" treatment, can provide evidence about what works, to what extent, at what cost, and under which circumstances. Programs should address the most important causes in given contexts, be feasible to implement at scale, and assess implementation, coverage, and outcomes....

Sodium Bicarbonate Versus Sodium Chloride for Preventing Contrast-Associated Acute Kidney Injury in Critically Ill Patients: A Randomized Controlled Trial.

Science.gov (United States)

Valette, Xavier; Desmeulles, Isabelle; Savary, Benoit; Masson, Romain; Seguin, Amélie; Sauneuf, Bertrand; Brunet, Jennifer; Verrier, Pierre; Pottier, Véronique; Orabona, Marie; Samba, Désiré; Viquesnel, Gérald; Lermuzeaux, Mathilde; Hazera, Pascal; Dutheil, Jean-Jacques; Hanouz, Jean-Luc; Parienti, Jean-Jacques; du Cheyron, Damien

2017-04-01

To test whether hydration with bicarbonate rather than isotonic sodium chloride reduces the risk of contrast-associated acute kidney injury in critically ill patients. Prospective, double-blind, multicenter, randomized controlled study. Three French ICUs. Critically ill patients with stable renal function (n = 307) who received intravascular contrast media. Hydration with 0.9% sodium chloride or 1.4% sodium bicarbonate administered with the same infusion protocol: 3 mL/kg during 1 hour before and 1 mL/kg/hr during 6 hours after contrast medium exposure. The primary endpoint was the development of contrast-associated acute kidney injury, as defined by the Acute Kidney Injury Network criteria, 72 hours after contrast exposure. Patients randomized to the bicarbonate group (n = 151) showed a higher urinary pH at the end of the infusion than patients randomized to the saline group (n = 156) (6.7 ± 2.1 vs 6.2 ± 1.8, respectively; p 0.99) were also similar between the saline and bicarbonate groups, respectively. Except for urinary pH, none of the outcomes differed between the two groups. Among ICU patients with stable renal function, the benefit of using sodium bicarbonate rather than isotonic sodium chloride for preventing contrast-associated acute kidney injury is marginal, if any.

YUCCA MOUNTAIN PROJECT - A BRIEFING -

International Nuclear Information System (INIS)

2003-01-01

This report has the following articles: Nuclear waste--a long-term national problem; Spent nuclear fuel; High-level radioactive waste; Radioactivity and the environment; Current storage methods; Disposal options; U.S. policy on nuclear waste; The focus on Yucca Mountain; The purpose and scope of the Yucca Mountain Project; The approach for permanently disposing of waste; The scientific studies at Yucca Mountain; The proposed design for a repository at Yucca Mountain; Natural and engineered barriers would work together to isolate waste; Meticulous science and technology to protect people and the environment; Licensing a repository; Transporting waste to a permanent repository; The Environmental Impact Statement for a repository; Current status of the Yucca Mountain Project; and Further information available on the Internet

Mountain Weather and Climate, Third Edition

Science.gov (United States)

Hastenrath, Stefan

2009-05-01

For colleagues with diverse interests in the atmosphere, glaciers, radiation, landforms, water resources, vegetation, human implications, and more, Mountain Weather and Climate can be a valuable source of guidance and literature references. The book is organized into seven chapters: 1, Mountains and their climatological study; 2,Geographical controls of mountain meteorological elements; 3, Circulation systems related to orography; 4, Climatic characteristics of mountains; 5, Regional case studies; 6, Mountain bioclimatology; and 7, Changes in mountain climates. These chapters are supported by l78 diagrams and photographs, 47 tables, and some 2000 literature references. The volume has an appendix of units and energy conversion factors and a subject index, but it lacks an author index.

Rocky Mountain spotted fever in Mexican children: Clinical and mortality factors.

Directory of Open Access Journals (Sweden)

Gerardo Álvarez-Hernández

2016-05-01

Full Text Available Objective. Characterize clinical manifestations and predictors of mortality in children hospitalized for spotted fever. Materials and methods. Cross-sectional study in 210 subjects with a diagnosis of Rocky Mountain spotted fever (RMSF in a pediatric hospital in Sonora, from January 1st, 2004 to June 30th, 2015. Data were analyzed using descriptive statistics and multivariate logistic regression. Results. An upward trend was observed in RMSF morbidity and mortal- ity. Fatality rate was 30%. Three predictors were associated with risk of death: delay ≥ 5 days at the start of doxycycline (ORa = 2.95, 95% CI 1.10-7.95, acute renal failure ((ORa = 8.79, 95% CI 3.46-22.33 and severe sepsis (ORa = 3.71, 95% CI 1.44-9.58. Conclusions. RMSF causes high mortality in children, which can be avoided with timely initiation of doxycycline. Acute renal failure and severe sepsis are two independent predictors of death in children with RMSF.

Prevention of pressure ulcers in patients undergoing sub-acute rehabilitation after severe brain injury

DEFF Research Database (Denmark)

Sachs, Marianne Brostrup; Wolffbrandt, Mia Moth; Poulsen, Ingrid

2018-01-01

OBJECTIVE: The aim of this study was to uncover efforts made by healthcare professionals to prevent pressure ulcers (PUs) in patients with severe brain injury undergoing treatment at a sub-acute rehabilitation department. BACKGROUND: PUs is a major burden for patients and also generate considerable...... healthcare costs. PUs are, nevertheless, prevalent in both secondary and primary care. DESIGN: In this qualitative study, we performed 24-hour observation on four patients undergoing rehabilitation for severe brain injury. An observation guide was developed inspired by the Braden Scale and Spradley's theory...... that patients' rehabilitation days be planned in such a manner that activities, mobilisation and training are conducted throughout the day and evening. We also recommend that professional staff are encouraged to seek information about the former life of patients with severe brain injury. This article...

Yucca Mountain digital database

International Nuclear Information System (INIS)

Daudt, C.R.; Hinze, W.J.

1992-01-01

This paper discusses the Yucca Mountain Digital Database (DDB) which is a digital, PC-based geographical database of geoscience-related characteristics of the proposed high-level waste (HLW) repository site of Yucca Mountain, Nevada. It was created to provide the US Nuclear Regulatory Commission's (NRC) Advisory Committee on Nuclear Waste (ACNW) and its staff with a visual perspective of geological, geophysical, and hydrological features at the Yucca Mountain site as discussed in the Department of Energy's (DOE) pre-licensing reports

Intravenous immunoglobulin prevents murine antibody-mediated acute lung injury at the level of neutrophil reactive oxygen species (ROS production.

Directory of Open Access Journals (Sweden)

John W Semple

Full Text Available Transfusion-related acute lung injury (TRALI is a leading cause of transfusion-associated mortality that can occur with any type of transfusion and is thought to be primarily due to donor antibodies activating pulmonary neutrophils in recipients. Recently, a large prospective case controlled clinical study of cardiac surgery patients demonstrated that despite implementation of male donors, a high incidence of TRALI still occurred and suggested a need for additional interventions in susceptible patient populations. To examine if intravenous immunoglobulin (IVIg may be effective, a murine model of antibody-mediated acute lung injury that approximates human TRALI was examined. When BALB/c mice were injected with the anti-major histocompatibility complex class I antibody 34-1-2s, mild shock (reduced rectal temperature and respiratory distress (dyspnea were observed and pre-treatment of the mice with 2 g/kg IVIg completely prevented these symptoms. To determine IVIg's usefulness to affect severe lung damage, SCID mice, previously shown to be hypersensitive to 34-1-2s were used. SCID mice treated with 34-1-2s underwent severe shock, lung damage (increased wet/dry ratios and 40% mortality within 2 hours. Treatment with 2 g/kg IVIg 18 hours before 34-1-2s administration completely protected the mice from all adverse events. Treatment with IVIg after symptoms began also reduced lung damage and mortality. While the prophylactic IVIg administration did not affect 34-1-2s-induced pulmonary neutrophil accumulation, bone marrow-derived neutrophils from the IVIg-treated mice displayed no spontaneous ROS production nor could they be stimulated in vitro with fMLP or 34-1-2s. These results suggest that IVIg prevents murine antibody-mediated acute lung injury at the level of neutrophil ROS production and thus, alleviating tissue damage.

Prevention: Exercise

Medline Plus

Full Text Available ... Training for the Elderly Other Back Pack Safety Pregnancy and Back Pain Preventing Osteoporosis Back Pain Basics ... increases your back pain after five repetitions, or causes acute pain, you should stop doing it. Transverse ...

Prevention: Exercise

Medline Plus

Full Text Available ... A SPECIALIST Prevention Strengthening Exercise Committee Exercise Committee Core Strengthening Many popular forms of exercise focus on ... acute pain, you should stop doing it. Transverse Core Strengthening This strengthens the muscles that cross from ...

Recreational mountain biking injuries.

Science.gov (United States)

Aitken, S A; Biant, L C; Court-Brown, Charles M

2011-04-01

Mountain biking is increasing in popularity worldwide. The injury patterns associated with elite level and competitive mountain biking are known. This study analysed the incidence, spectrum and risk factors for injuries sustained during recreational mountain biking. The injury rate was 1.54 injuries per 1000 biker exposures. Men were more commonly injured than women, with those aged 30-39 years at highest risk. The commonest types of injury were wounding, skeletal fracture and musculoskeletal soft tissue injury. Joint dislocations occurred more commonly in older mountain bikers. The limbs were more commonly injured than the axial skeleton. The highest hospital admission rates were observed with head, neck and torso injuries. Protective body armour, clip-in pedals and the use of a full-suspension bicycle may confer a protective effect.

Lung injury in acute pancreatitis: mechanisms, prevention, and therapy.

LENUS (Irish Health Repository)

Shields, Conor J

2012-02-03

Lung injury is the most pertinent manifestation of extra-abdominal organ dysfunction in pancreatitis. The propensity of this retroperitoneal inflammatory condition to engender a diffuse and life-threatening lung injury is significant. Approximately one third of patients will develop acute lung injury and acute respiratory distress syndrome, which account for 60% of all deaths within the first week. The variability in the clinical course of pancreatitis renders it a vexing entity and makes demonstration of the efficacy of any specific intervention difficult. The distinct pathologic entity of pancreatitis-associated lung injury is reviewed with a focus on etiology and potential therapeutic maneuvers.

Acute antibody-mediated rejection in pancreas and kidney transplantation

NARCIS (Netherlands)

Kort, Hanneke de

2013-01-01

In this thesis, acute rejection after kidney, simultaneous pancreas and kidney (SPKT), and islets of Langerhans transplantation was addressed. The focus is on acute antibody-mediated rejection (AMR) after transplantation and on a potential strategy using cellular immune modulation to prevent acute

Rocky Mountain spotted fever

Science.gov (United States)

... spotted fever on the foot Rocky Mountain spotted fever, petechial rash Antibodies Deer and dog tick References McElligott SC, Kihiczak GG, Schwartz RA. Rocky Mountain spotted fever and other rickettsial infections. In: Lebwohl MG, Heymann ...

Developing an intervention to prevent acute kidney injury: using the Plan, Do, Study, Act (PDSA) service improvement approach.

Science.gov (United States)

Byrne, Jo; Xu, Gang; Carr, Sue

2015-03-01

In the UK, recent National Institute for Health and Care Excellence guidelines for acute kidney injury point to the need for interventions to help prevent this condition. Effective medicines management is of prime importance in reducing the risk of AKI. Part of this challenge is to increase patients' awareness of their medicines and the possible need to temporarily withhold certain medications when acutely unwell. The objectives were to use a service improvement approach (the Plan, Do, Study, Act cycle) to develop an intervention and to evaluate current delivery of acute kidney injury management and to test and generate new ideas relating to patients' needs. A postal feedback form sent to a random sample of over 200 patients with chronic kidney disease. The feedback form collected information on: what patients know about acute kidney injury and managing medicines; where patients get their information from; whether patients want more information and where from; and what patients feel about self-managing their medicines. Completed feedback forms were received from 113 participants. Of these, 92% said they had received no advice, 77% of respondents wanted more advice but only 17% said they would feel comfortable to stop their own medication without medical consent. The PDSA cycle offered a very useful framework to evaluate the current service delivery and to test and generate new ideas for the development of an AKI intervention. Our findings highlighted that the current service is limited and more robust research is needed. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Man-induced transformation of mountain meadow soils of Aragats mountain massif (Armenia)

Science.gov (United States)

Avetisyan, M. H.

2018-01-01

The article considers issues of degradation of mountain meadow soils of the Aragats mountain massif of the Republic of Armenia and provides the averaged research results obtained for 2013 and 2014. The present research was initiated in the frames of long-term complex investigations of agroecosystems of Armenia’s mountain massifs and covered sod soils of high mountain meadow pasturelands and meadow steppe grasslands lying on southern slope of Mt. Aragats. With a purpose of studying the peculiarities of migration and transformation of flows of major nutrients namely carbon, nitrogen, phosphorus in study mountain meadow and meadow steppe belts of the Aragats massif we investigated water migration of chemical elements and regularities of their leaching depending on different belts. Field measurement data have indicated that organic carbon and humus in a heavily grazed plot are almost twice as low as on a control site. Lysimetric data analysis has demonstrated that heavy grazing and illegal deforestation have brought to an increase in intrasoil water acidity. The results generated from this research support a conclusion that a man’s intervention has brought to disturbance of structure and nutrient and water regimes of soils and loss of significant amounts of soil nutrients throughout the studied region.

Chronic and acute adenosine A2A receptor blockade prevents long-term episodic memory disruption caused by acute cannabinoid CB1 receptor activation.

Science.gov (United States)

Mouro, Francisco M; Batalha, Vânia L; Ferreira, Diana G; Coelho, Joana E; Baqi, Younis; Müller, Christa E; Lopes, Luísa V; Ribeiro, Joaquim A; Sebastião, Ana M

2017-05-01

Cannabinoid-mediated memory impairment is a concern in cannabinoid-based therapies. Caffeine exacerbates cannabinoid CB 1 receptor (CB 1 R)-induced memory deficits through an adenosine A 1 receptor-mediated mechanism. We now evaluated how chronic or acute blockade of adenosine A 2A receptors (A 2A Rs) affects long-term episodic memory deficits induced by a single injection of a selective CB 1 R agonist. Long-term episodic memory was assessed by the novel object recognition (NOR) test. Mice received an intraperitoneal (i.p.) injection of the CB 1 /CB 2 receptor agonist WIN 55,212-2 (1 mg/kg) immediately after the NOR training, being tested for novelty recognition 24 h later. Anxiety levels were assessed by the Elevated Plus Maze test, immediately after the NOR. Mice were also tested for exploratory behaviour at the Open Field. For chronic A 2A R blockade, KW-6002 (istradefylline) (3 mg/kg/day) was administered orally for 30 days; acute blockade of A 2A Rs was assessed by i.p. injection of SCH 58261 (1 mg/kg) administered either together with WIN 55,212-2 or only 30 min before the NOR test phase. The involvement of CB 1 Rs was assessed by using the CB 1 R antagonist, AM251 (3 mg/kg, i.p.). WIN 55,212-2 caused a disruption in NOR, an action absent in mice also receiving AM251, KW-6002 or SCH 58261 during the encoding/consolidation phase; SCH 58251 was ineffective if present during retrieval only. No effects were detected in the Elevated Plus maze or Open Field Test. The finding that CB 1 R-mediated memory disruption is prevented by antagonism of adenosine A 2A Rs, highlights a possibility to prevent cognitive side effects when therapeutic application of CB 1 R drugs is desired. Copyright © 2017 Elsevier Ltd. All rights reserved.

Rocky Mountain Spotted Fever

Science.gov (United States)

... with facebook share with twitter share with linkedin Rocky Mountain Spotted Fever Credit: CDC A male cayenne tick, Amblyomma cajennense, ... and New Mexico. Why Is the Study of Rocky Mountain Spotted Fever a Priority for NIAID? Tickborne diseases are becoming ...

Perioperative acute renal failure.

LENUS (Irish Health Repository)

Mahon, Padraig

2012-02-03

PURPOSE OF REVIEW: Recent biochemical evidence increasingly implicates inflammatory mechanisms as precipitants of acute renal failure. In this review, we detail some of these pathways together with potential new therapeutic targets. RECENT FINDINGS: Neutrophil gelatinase-associated lipocalin appears to be a sensitive, specific and reliable biomarker of renal injury, which may be predictive of renal outcome in the perioperative setting. For estimation of glomerular filtration rate, cystatin C is superior to creatinine. No drug is definitively effective at preventing postoperative renal failure. Clinical trials of fenoldopam and atrial natriuretic peptide are, at best, equivocal. As with pharmacological preconditioning of the heart, volatile anaesthetic agents appear to offer a protective effect to the subsequently ischaemic kidney. SUMMARY: Although a greatly improved understanding of the pathophysiology of acute renal failure has offered even more therapeutic targets, the maintenance of intravascular euvolaemia and perfusion pressure is most effective at preventing new postoperative acute renal failure. In the future, strategies targeting renal regeneration after injury will use bone marrow-derived stem cells and growth factors such as insulin-like growth factor-1.

[Prevention and Treatment of Common Acute Adverse Effects With Antipsychotic Use in Adults With Schizophrenia Diagnosis].

Science.gov (United States)

Arenas Borrero, Álvaro Enrique; Gómez Restrepo, Carlos; Bohórquez Peñaranda, Adriana Patricia; Vélez Traslaviña, Ángela; Castro Díaz, Sergio Mario; Jaramillo González, Luis Eduardo; García Valencia, Jenny

2014-01-01

To determine the most adequate strategies for the prevention and treatment of the acute adverse effects of the use of antipsychotics. A clinical practice guideline was elaborated under the parameters of the Methodological Guide of the Ministerio de Salud y Protección Social to identify, synthesize and evaluate the evidence and make recommendations about the treatment and follow-up of adult patients with schizophrenia. A systematic literature search was carried out. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. The non-pharmacological interventions such as nutritional counseling by a nutritionist, exercise and psychotherapy are effective in preventing weight gain with the use of antipsychotics. (Kg Weight reduction in DM of -3.05 (-4.16, -1.94)). The antipsychotic change from olanzapine to aripiprazole showed weight loss and decreased BMI (decreased weight in KG DM -3.21 (-9.03, -2.61). The use of beta blockers was ineffective in reducing akathisia induced by antipsychotic; using as outcome the 50% reduction of symptoms of akathisia comparing beta-blockers with placebo RR was 1.4 (0.59, 1.83). It is recommended to make psychotherapeutic accompaniment and nutrition management of overweight for patients with weight gain. If these alternatives are ineffective is suggested to change the antipsychotic or consider starting metformin. For the management of drug-induced akathisia it is recommended to decrease the dose of the drug and the addition of lorazepam. It is recommended using 5mg biperiden IM or trihexyphenidyl 5mg orally in case of secondary acute dystonia and for the treatment of antipsychotic-induced parkinsonism to decrease the dose of antipsychotic or consider using 2 - 4mg/day of biperiden or diphenhydramine 50mg once daily. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Prolonged nerve block by microencapsulated bupivacaine prevents acute postoperative pain in rats.

Science.gov (United States)

Ohri, Rachit; Blaskovich, Phillip; Wang, Jeffrey Chi-Fei; Pham, Lan; Nichols, Gary; Hildebrand, William; Costa, Daniel; Scarborough, Nelson; Herman, Clifford; Strichartz, Gary

2012-01-01

To minimize acute postoperative pain, a new formulation of slowly released bupivacaine was developed. Bupivacaine was microencapsulated at 60% (wt/wt) in poly-lactide-co-glycolide polymers and characterized for physicochemical properties and bupivacaine release kinetics. This formulation was injected around the rat sciatic nerve to produce an antinociceptive effect to toe pinch. Mechanical hyperalgesia following lateral plantar paw incision in rats was assessed for 7 to 14 days when the bupivacaine slow-release formulation was placed at the ipsilateral sciatic nerve and compared with the hyperalgesia that developed with various controls. Bupivacaine was released in vitro at a relatively constant rate over a period of ≈ 72 to 96 hours. Complete antinociception, shown as no response to toe pinch, lasted for 23 ± 7 hours, with a half-recovery time of 42 ± 8 hours after sciatic nerve injection of 0.4 mL of the microspheres delivering 34 mg of bupivacaine. Solutions of 0.5% (wt/vol) bupivacaine-HCl (0.1 mL) produced complete antinociception for less than 2 hours and recovery half-times of 2 hours. Postincisional mechanical hyperalgesia, shown by increased withdrawal responses to von Frey filaments, was absent for 24 hours and was lower than control for 96 hours, when the sciatic nerve was blocked by bupivacaine microspheres, whereas the 0.5% bupivacaine solution reduced postincisional pain for only 4 hours. Corresponding to its far greater functional blocking time, the microsphere-bupivacaine formulation was able to significantly reduce postoperative pain below control levels for up to 4 days. These findings of several days of postoperative pain relief, for an injectable formulation containing a single active agent, present an improved and potentially promising therapy to prevent acute pain after surgery.

Medical and Indirect Costs Associated with a Rocky Mountain Spotted Fever Epidemic in Arizona, 2002–2011

Science.gov (United States)

Drexler, Naomi A.; Traeger, Marc S.; McQuiston, Jennifer H.; Williams, Velda; Hamilton, Charlene; Regan, Joanna J.

2015-01-01

Rocky Mountain spotted fever (RMSF) is an emerging public health issue on some American Indian reservations in Arizona. RMSF causes an acute febrile illness that, if untreated, can cause severe illness, permanent sequelae requiring lifelong medical support, and death. We describe costs associated with medical care, loss of productivity, and death among cases of RMSF on two American Indian reservations (estimated population 20,000) between 2002 and 2011. Acute medical costs totaled more than $1.3 million. This study further estimated $181,100 in acute productivity lost due to illness, and $11.6 million in lifetime productivity lost from premature death. Aggregate costs of RMSF cases in Arizona 2002–2011 amounted to $13.2 million. We believe this to be a significant underestimate of the cost of the epidemic, but it underlines the severity of the disease and need for a more comprehensive study. PMID:26033020

Mantle Subduction and Uplift of Intracontinental Mountains: A Case Study from the Chinese Tianshan Mountains within Eurasia.

Science.gov (United States)

Li, Jinyi; Zhang, Jin; Zhao, Xixi; Jiang, Mei; Li, Yaping; Zhu, Zhixin; Feng, Qianwen; Wang, Lijia; Sun, Guihua; Liu, Jianfeng; Yang, Tiannan

2016-06-29

The driving mechanism that is responsible for the uplift of intracontinental mountains has puzzled geologists for decades. This study addresses this issue by using receiver function images across the Chinese Tianshan Mountains and available data from both deep seismic profiles and surface structural deformation. The near-surface structural deformation shows that the Tianshan crust experienced strong shortening during the Cenozoic. The receiver function image across the Tianshan Mountains reveals that the lithosphere of the Junggar Basin to the north became uncoupled along the Moho, and the mantle below the Moho subducted southwards beneath the northern part of the Tianshan Mountains, thereby thickening the overlying crust. Similar deep structures, however, are not observed under the Tarim Basin and the adjacent southern Tianshan Mountains. This difference in the deep structures correlates with geomorphological features in the region. Thus, a new model of mantle subduction, herein termed M-type subduction, is proposed for the mountain-building processes in intracontinental compressional settings. The available geomorphological, geological and seismic data in the literatures show that this model is probably suitable for other high, linear mountains within the continent.

Acute incidents during anaesthesia

African Journals Online (AJOL)

management of acute incidents and the prevention of ... High or total (complete) spinal blocks in obstetric .... Pain and opioid analgesics lead to delayed ... Step up postoperative care and use ... recognise suprasternal and supraclavicular.

Medical and Indirect Costs Associated with a Rocky Mountain Spotted Fever Epidemic in Arizona, 2002-2011.

Science.gov (United States)

Drexler, Naomi A; Traeger, Marc S; McQuiston, Jennifer H; Williams, Velda; Hamilton, Charlene; Regan, Joanna J

2015-09-01

Rocky Mountain spotted fever (RMSF) is an emerging public health issue on some American Indian reservations in Arizona. RMSF causes an acute febrile illness that, if untreated, can cause severe illness, permanent sequelae requiring lifelong medical support, and death. We describe costs associated with medical care, loss of productivity, and death among cases of RMSF on two American Indian reservations (estimated population 20,000) between 2002 and 2011. Acute medical costs totaled more than $1.3 million. This study further estimated $181,100 in acute productivity lost due to illness, and $11.6 million in lifetime productivity lost from premature death. Aggregate costs of RMSF cases in Arizona 2002-2011 amounted to $13.2 million. We believe this to be a significant underestimate of the cost of the epidemic, but it underlines the severity of the disease and need for a more comprehensive study. © The American Society of Tropical Medicine and Hygiene.

A sightability model for mountain goats

Science.gov (United States)

Rice, C.G.; Jenkins, K.J.; Chang, W.-Y.

2009-01-01

Unbiased estimates of mountain goat (Oreamnos americanus) populations are key to meeting diverse harvest management and conservation objectives. We developed logistic regression models of factors influencing sightability of mountain goat groups during helicopter surveys throughout the Cascades and Olympic Ranges in western Washington during summers, 20042007. We conducted 205 trials of the ability of aerial survey crews to detect groups of mountain goats whose presence was known based on simultaneous direct observation from the ground (n 84), Global Positioning System (GPS) telemetry (n 115), or both (n 6). Aerial survey crews detected 77 and 79 of all groups known to be present based on ground observers and GPS collars, respectively. The best models indicated that sightability of mountain goat groups was a function of the number of mountain goats in a group, presence of terrain obstruction, and extent of overstory vegetation. Aerial counts of mountain goats within groups did not differ greatly from known group sizes, indicating that under-counting bias within detected groups of mountain goats was small. We applied HorvitzThompson-like sightability adjustments to 1,139 groups of mountain goats observed in the Cascade and Olympic ranges, Washington, USA, from 2004 to 2007. Estimated mean sightability of individual animals was 85 but ranged 0.750.91 in areas with low and high sightability, respectively. Simulations of mountain goat surveys indicated that precision of population estimates adjusted for sightability biases increased with population size and number of replicate surveys, providing general guidance for the design of future surveys. Because survey conditions, group sizes, and habitat occupied by goats vary among surveys, we recommend using sightability correction methods to decrease bias in population estimates from aerial surveys of mountain goats.

Moderate acute malnutrition: uncovering the known and unknown for more effective prevention and treatment.

Science.gov (United States)

Wegner, Christopher William; Loechl, Cornelia; Mokhtar, Najat

2015-03-01

With a fast-approaching post-Millennium Development Goal era, there is an urgent need to boost global investment in efforts to reduce child malnutrition. Critical to the management of moderate malnutrition, and therefore to the new Sustainable Development Goals, is addressing severe acute malnutrition (SAM) and moderate acute malnutrition (MAM). Despite the considerable difference in the approximate number of children affected by MAM (33 million) compared with SAM (19 million), there is currently no standardized approach to the management of MAM. In partnership with Valid International, the World Food Programme, and the Micronutrient Initiative, the International Atomic Energy Agency hosted the International Symposium on Understanding Moderate Malnutrition in Children for Effective Interventions in Vienna, Austria, 26-29 May 2014. This symposium focused on the management (prevention and treatment) of MAM in children. The symposium convened over 350 participants from 63 countries, the majority of whom represented governments responding to moderate malnutrition in their populations, nearly 70 national and international organizations from the United Nations and nongovernmental sectors, and universities from around the world, as well as donor governments and private-sector entities. The symposium was structured around nine sessions over a 3-day period, progressing from a global analysis of the scale of the problem to recent research findings relevant to designing effective interventions. This Supplement contains a series of papers that summarize the symposium sessions and other fundamental aspects important to improving the management of moderate malnutrition in children.

Subjective assessment of acute mountain sickness: investigating the relationship between the Lake Louise Self-Report, a visual analogue scale and psychological well-being scales.

Science.gov (United States)

Frühauf, Anika; Burtscher, Martin; Pocecco, Elena; Faulhaber, Martin; Kopp, Martin

2016-01-01

There is an ongoing discussion how to assess acute mountain sickness (AMS) in real life conditions. Next to more-item scales with a cut off like the Lake Louise Self-Report (LLS), some authors suggested to use visual analog scales (VAS) to assess AMS. This study tried to contribute to this question using VAS items used for the Subjective Ratings of Drug Effects, including an additional single item for AMS. Furthermore, we investigated if instruments developed to assess psychological well-being might predict AMS assessed via LLS or VAS. 32 (19 Female) adult persons with known AMS susceptibility filled in questionnaires (Feeling Scale, Felt Arousal Scale, Activation Deactivation Check List, LLS, VAS) at a height of 3650 m above sea level. Correlation and regression analysis suggest a moderate to high relationship between the LLS score and the VAS items, including one VAS item asking for the severity of AMS, as well as psychological well-being. In conclusion, using VAS items to assess AMS can be a more precise alternative to questionnaires like LLS, for people knowledgeable with AMS. Furthermore, researchers should be aware that psychological well-being might be an important parameter influencing the assessment of AMS.

Heart rate variability changes at 2400 m altitude predicts acute mountain sickness on further ascent at 3000-4300 m altitudes

Directory of Open Access Journals (Sweden)

Heikki Mikael Karinen

2012-08-01

Full Text Available ObjectiveIf the body fails to acclimatize at high altitude, acute mountain sickness (AMS may result. For the early detection of AMS, changes in cardiac autonomic function measured by heart rate variability (HRV may be more sensitive than clinical symptoms alone. The purpose of this study was to ascertain if the changes in HRV during ascent are related to AMS.MethodsWe followed Lake Louise Score (LLS, arterial oxygen saturation at rest (R-SpO2 and exercise (Ex-SpO2 and HRV parameters daily in 36 different healthy climbers ascending from 2400 m to 6300 m altitudes during five different expeditions.ResultsAfter an ascent to 2400 m, standard deviation (RMSSD2 min, high-frequency power (HF2 min of HRV were 17-51 % and Ex-SpO2 was 3% lower in those climbers who suffered from AMS at 3000- 4300 m than in those only developing AMS later (≥ 5000 m or not at all (all p < 0.01. At the altitude of 2400 m RMSSD2 min ≤ 30 ms and Ex-SpO2 ≤ 91% both had 92% sensitivity for AMS if ascent continued without extra acclimatization days.ConclusionsChanges in supine HRV parameters at 2400 m were related to AMS at 3000-4300 m Thus, diverse analyses of HRV could offer potential markers for identifying the climbers at risk for AMS.

Diagnosis, Prevention and Management of Postoperative ...

African Journals Online (AJOL)

Diagnosis, Prevention and Management of Postoperative Pulmonary Edema. ... period or it can be negative pressure pulmonary edema (NPPE). NPPE is an important clinical entity in immediate post.extubation period and occurs due to acute upper airway obstruction and creation of acute negative intrathoracic pressure.

Acute Pancreatitis in Children

Science.gov (United States)

... a feeding tube or an IV to prevent malnutrition and improve healing. Does my child have to ... Acute Pancreatitis in Children Chronic Pancreatitis in Children Childhood Inherited Disorders Pancreatic Cancer Pancreatic Cancer Risks and ...

Prevention of subsequent exercise-induced periinfarct ischemia by emergency coronary angioplasty in acute myocardial infarction: comparison with intracoronary streptokinase

International Nuclear Information System (INIS)

Fung, A.Y.; Lai, P.; Juni, J.E.; Bourdillon, P.D.; Walton, J.A. Jr.; Laufer, N.; Buda, A.J.; Pitt, B.; O'Neill, W.W.

1986-01-01

To compare the efficacy of emergency percutaneous transluminal coronary angioplasty and intracoronary streptokinase in preventing exercise-induced periinfarct ischemia, 28 patients presenting within 12 hours of the onset of symptoms of acute myocardial infarction were prospectively randomized. Of these, 14 patients were treated with emergency angioplasty and 14 patients received intracoronary streptokinase. Recatheterization and submaximal exercise thallium-201 single photon emission computed tomography were performed before hospital discharge. Periinfarct ischemia was defined as a reversible thallium defect adjacent to a fixed defect assessed qualitatively. Successful reperfusion was achieved in 86% of patients treated with emergency angioplasty and 86% of patients treated with intracoronary streptokinase (p = NS). Residual stenosis of the infarct-related coronary artery shown at predischarge angiography was 43.8 +/- 31.4% for the angioplasty group and 75.0 +/- 15.6% for the streptokinase group (p less than 0.05). Of the angioplasty group, 9% developed exercise-induced periinfarct ischemia compared with 60% of the streptokinase group (p less than 0.05). Thus, patients with acute myocardial infarction treated with emergency angioplasty had significantly less severe residual coronary stenosis and exercise-induced periinfarct ischemia than did those treated with intracoronary streptokinase. These results suggest further application of coronary angioplasty in the management of acute myocardial infarction

The origins of mountain geoecology

Directory of Open Access Journals (Sweden)

Ives, Jack D.

2012-05-01

Full Text Available Mountain geoecology, as a sub-discipline of Geography, stems from the life and work of Carl Troll who, in turn, was inspired by the philosophy and mountain travels of Alexander von Humboldt. As founding chair of the IGU Commission on High-Altitude Geoecology (1968, Troll laid the foundations for inter-disciplinary and international mountain research. The paper traces the evolution of the Commission and its close links with the UNESCO Man and Biosphere Programme (1972- and the United Nations University’s mountain Project (1978-. This facilitated the formation of a major force for inclusion of a mountain chapter in AGENDA 21 during the 1992 Rio de Janeiro Herat Summit (UNCED and the related designation by the United Nations of 2002 as the International Year of Mountains. In this way, mountain geoecology not only contributed to worldwide mountain research but also entered the political arena in the struggle for sustainable mountain development and the well-being of mountain people.La geoecología de montaña, como sub-disciplina de la Geografía, entronca con la vida y trabajo de Carl Troll, quien, a su vez, fue inspirado por la filosofía y viajes de Alexander von Humboldt. Como presidente fundador de la comisión de la UGI sobre High Altitude Geoecology (1968, Troll colocó las bases para la investigación interdisciplinar e internacional de las montañas. Este trabajo presenta la evolución de la Comisión y sus estrechas relaciones con el Programa Hombre y Biosfera de UNESCO (1972- y con el Proyecto de montaña de la Universidad de Naciones Unidas (1978-. Esto facilitó la inclusión de un capítulo sobre la montaña en AGENDA 21 durante la Cumbre de la Tierra de Río de Janeiro (UNCED, y la consiguiente designación de 2002 como el Año Internacional de las Montañas por parte de Naciones Unidas. En este sentido, la geoecología de montaña no sólo contribuyó a la investigación de las montañas del mundo sino que también empujó a la pol

Anticoagulants for secondary prevention after acute myocardial infarction: lessons from the past decade

NARCIS (Netherlands)

Atar, D.; Bode, C.; Stuerzenbecher, A.; Verheugt, F.W.A.

2014-01-01

The impact of an acute coronary syndrome (ACS) event, such as an acute myocardial infarction (MI), is not limited to the acute management phase; patients face an elevated risk of residual atherothrombotic events that commonly requires chronic management for months or even years. Significant advances

Use of escitalopram to prevent depression and cognitive impairments in the acute phase of stroke

Directory of Open Access Journals (Sweden)

Dina Rustemovna Khasanova

2013-01-01

Full Text Available The purpose of the study was to comparatively analyze the rate of post-stroke depression and cognitive impairments in escitalopram (cipralex-treated and untreated (control patients. Emotional and affective cognitive symptoms, neurological deficit, and day-to-day activity were evaluated over time 1, 3, and 6 months after treatment. The results of the study indicated that escitalopram used to prevent depression in the acute phase of stroke provided a good effect. This drug caused a prompter recovery of cognitive impairments and reduced the pace of development of neurodegenerative disorders underlying the post-stroke 2D (depression and dementia syndrome. The study group was recorded to have more favorable functional outcomes of stroke and patient mobility indicators associated with lower disability rates.

Methotrexate: an option for preventing the recurrence of acute anterior uveitis.

Science.gov (United States)

Muñoz-Fernández, S; García-Aparicio, A M; Hidalgo, M V; Platero, M; Schlincker, A; Bascones, M L; Pombo, M; Morente, P; Sanpedro, J; Martín-Mola, E

2009-05-01

To evaluate the efficacy of methotrexate (MTX) in preventing the recurrence of acute anterior uveitis (AAU). This prospective, open, longitudinal study included patients from June 2002 to March 2005 who had either three or more episodes of AAU in the previous year, or a recurrence of AAU within 3 months before starting the trial. We excluded uveitis of infectious origin, masquerade syndromes, and patients with contraindications to MTX. The response criteria were defined as an absence of symptoms and the presence of a normal ophthalmologic examination. The study outcome compared the number of flare-ups of uveitis over an MTX-treated for 1 year to the number of flare-ups of the same group during the previous year without MTX. A total of 571 patients with uveitis were evaluated during the period of the study, and 10 fulfilled the inclusion criteria. One patient refused the treatment, and nine completed the study. The mean number of recurrences in the pre-MTX year was 3.4 (SD: 0.52), which was significantly reduced to 0.89 (SD: 1.17) in the year of treatment (P=0.011). MTX treatment seems to reduce the number of flare-ups in patients with recurrent AAU.

Protection of the Mountain Ridgelines Utilizing GIS

Science.gov (United States)

Lee, S.; Lee, M.

2013-12-01

Korean peninsula is characterized by numerous hills and mountains. The longest mountain ridgeline starting from Mt. Baekdusan to Mt. Jirisan is called Baekdudaegan which is similar to the continental divide or topographical watershed. In this study, GIS data, such as remotesensing images, national digital map, and watershed map, are used to analyze Korean mountain ridgelines structure and one Baekdudaegan data and nine Ridgelines are extracted. When extracted Baekdudaegan and other Ridgelines are overlaid on geologic maps, granite and gneiss are main components on the mountain ridgelines. The main mountain ridgelines are considered as the spiritual heritage overlapped in the land in Korea. As the environmental state is relatively better than those of other region in Korea, so many mountain ridgelines are legally protected by national legislation. The mountain ridgelines has hierarchical system; Baekdudaegan, Jeongmaek, Gimaek and Jimaek etc. according to their scale and total lengths of ridgelines. As only part of mountain ridgelines are currently protected by law or managed in environmental impact assessment (EIA) procedure, we think that most part of them should be under protection. Considering the environmental state of the ridgelines, we think that some protective measures should be set up nearby 1 km on both sides of them. If there goes a development plan or project near the main mountain ridgelines, topographical change index (TCI) and topographical scale index (TSI) etc. are to be applied in EIA. This study intends: firstly, to analyze the topological characteristics of the Korean mountain ridgelines using GIS, secondly, to analyze the geological characteristics of nearby mountain ridgelines, and lastly, to find a way to utilize the results on EIA.

Phytogeography of the tropical north-east African mountains

Directory of Open Access Journals (Sweden)

I. Friis

1983-11-01

Full Text Available The tropical north-east African mountains are tentatively divided into four phytochoria, the formal rank of which is not defined. The division is based on patterns of distribution and endemism in the region. The recognition of a distinct Afromontane phytochorion is now well established (Chapman & White, 1970; Werger, 1978; White, 1978. However, there is still very little information on the phytogeography of the individual mountains or mountain systems. This study hopes to fill a little of the gap by analysing distribution patterns and patterns of endemism in the flora of the tropical north-east African mountains. The north-east African mountain system is the largest in tropical Africa (see e.g. map in White, 1978. At the core of this system is the large Ethiopian massif, around which are located various mountains and mountain chains. These include the Red Sea Hills in the Sudan, the mountain chain in northern Somalia, the south-west Arabian mountains, and the Imatong mountains of south-east Sudan. The latter are often referred to the East African mountain system (White, 1978 but. as I will point out later, they also have a close connection with the south-west highlands of Ethiopia. The paper presents some results of my study of the mountain flora of tropical north-east Africa, particularly the forest species. Where no source is indicated, the data are from my own unpublished studies.

Management of Multi-Casualty Incidents in Mountain Rescue: Evidence-Based Guidelines of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM).

Science.gov (United States)

Blancher, Marc; Albasini, François; Elsensohn, Fidel; Zafren, Ken; Hölzl, Natalie; McLaughlin, Kyle; Wheeler, Albert R; Roy, Steven; Brugger, Hermann; Greene, Mike; Paal, Peter

2018-02-15

Blancher, Marc, François Albasini, Fidel Elsensohn, Ken Zafren, Natalie Hölzl, Kyle McLaughlin, Albert R. Wheeler III, Steven Roy, Hermann Brugger, Mike Greene, and Peter Paal. Management of multi-casualty incidents in mountain rescue. High Alt Med Biol. 00:000-000, 2018. Multi-Casualty Incidents (MCI) occur in mountain areas. Little is known about the incidence and character of such events, and the kind of rescue response. Therefore, the International Commission for Mountain Emergency Medicine (ICAR MEDCOM) set out to provide recommendations for the management of MCI in mountain areas. Details of MCI occurring in mountain areas related to mountaineering activities and involving organized mountain rescue were collected. A literature search using (1) PubMed, (2) national mountain rescue registries, and (3) lay press articles on the internet was performed. The results were analyzed with respect to specific aspects of mountain rescue. We identified 198 MCIs that have occurred in mountain areas since 1956: 137 avalanches, 38 ski lift accidents, and 23 other events, including lightning injuries, landslides, volcanic eruptions, lost groups of people, and water-related accidents. General knowledge on MCI management is required. Due to specific aspects of triage and management, the approach to MCIs may differ between those in mountain areas and those in urban settings. Mountain rescue teams should be prepared to manage MCIs. Knowledge should be reviewed and training performed regularly. Cooperation between terrestrial rescue services, avalanche safety authorities, and helicopter crews is critical to successful management of MCIs in mountain areas.

Mountain cedar allergens found in nonpollen tree parts.

Science.gov (United States)

Goetz, D W; Goetz, M A; Whisman, B A

1995-09-01

Mountain cedar (Juniperus ashei) pollen is the principal aeroallergen in south central Texas from late December through February. The major mountain cedar allergen is a 40-kD glycoprotein, gp40. To identify allergens in mountain cedar wood, leaves, and berries and to detect mountain cedar allergen in smoke from burning male or female trees. SDS-PAGE plus mountain cedar human sIgE and monoclonal antibody immunoblots identified mountain cedar allergens within pollen and nonpollen tree part extracts. IgE immunoblots identified a single wood allergen at 36 kD and three berry allergens at 36, 26-27, and 21 kD, in addition to known pollen allergens. Mountain cedar monoclonal antibody bound an allergen epitope present not only on 40, 33, and 28-kD pollen allergens, but also on 36 and 32-kD wood allergens, and the 26-27-kD berry allergen. Immunoblot studies detected no mountain cedar allergen in leaves and no allergen in smoke from burning male and female trees. Allergens constituted a much smaller percentage of extractable protein in wood and berries than in pollen. Mountain cedar berry allergen content is too small to give credence to the ingestion of berries as a folk medicine treatment of mountain cedar pollinosis. In addition, while smoke from burning mountain cedar trees may be irritating, it contains no allergens that could cause allergic rhinoconjunctivitis.

Effets cardiovasculaires d'un bloqueur calcique en hypoxie d'altitude

DEFF Research Database (Denmark)

Dugas, L; Dubray, C; Herry, J P

1995-01-01

High altitude pulmonary oedema can be successfully treated and prevented by calcium channel blockers. Moreover, calcium entering in the cells could explain the congestive phenomena of acute mountain sickness (AMS). These findings led us to study the action of a calcium channel blocker, isradipine...

Effectiveness differences of ranitidine and omeprazole in prevention of stress ulcer and its effect on pneumonia occurrence and outcome of acute stroke patients

Science.gov (United States)

Batubara, C. A.; Ritarwan, K.; Rambe, A. S.

2018-03-01

Stress ulcer is one ofacute stroke complications. Giving ranitidine or omeprazole may prevent stress ulcer, but may increase the occurrence of pneumonia. Thus, it will affect the outcome of acute stroke. The method was experimental with a randomized control-group pretest - posttest design. This study divided the subjects into two groups, ranitidine 300mg and omeprazole 20mg group.We observed the patients whether stress ulcer or pneumonia occurred during hospitalization. Then, we measured the outcome by the National Institutes of Health Stroke Scaleand modified Rankin Scale. There were 32 subjects in this study. Only 1 (3.1%) subject suffered stress ulcer, and 3 (3.1%) suffered pneumonia in ranitidine group. Moreover, 2 (6.2%) subjects suffered pneumonia in omeprazole group. The differences were not significant between the two groups (p = 0.31 and p = 0.54). There was no significant effect and difference effect on the administration of both medications to the outcome at day 14. These results indicate that ranitidine and omeprazole have anequal effectiveness in the prevention of stress ulcer and also have equal effect on the occurrence of pneumonia, and both have no effect on the outcome of acute stroke patients.

Acute medication overuse in headache

Directory of Open Access Journals (Sweden)

Abouch Valenty Krymchantovscki

2004-03-01

Full Text Available Primary headache patients frequently overuse analgesics. Acute medication overuse plays an important role in the transformation of episodic into chronic headaches. The sudden discontinuation of analgesic and migraine prevention introduction are the main issues in the management of chronic daily headache patients. Educational strategies for those who do not overuse acute medications and an agressive approach to those overusing are fundamental for the efficacy of the primary frequent headache treatment.

Using Acute Flaccid Paralysis Surveillance as a Platform for Vaccine-Preventable Disease Surveillance.

Science.gov (United States)

Wassilak, Steven G F; Williams, Cheryl L; Murrill, Christopher S; Dahl, Benjamin A; Ohuabunwo, Chima; Tangermann, Rudolf H

2017-07-01

Surveillance for acute flaccid paralysis (AFP) is a fundamental cornerstone of the global polio eradication initiative (GPEI). Active surveillance (with visits to health facilities) is a critical strategy of AFP surveillance systems for highly sensitive and timely detection of cases. Because of the extensive resources devoted to AFP surveillance, multiple opportunities exist for additional diseases to be added using GPEI assets, particularly because there is generally 1 district officer responsible for all disease surveillance. For this reason, integrated surveillance has become a standard practice in many countries, ranging from adding surveillance for measles and rubella to integrated disease surveillance for outbreak-prone diseases (integrated disease surveillance and response). This report outlines the current level of disease surveillance integration in 3 countries (Nepal, India, and Nigeria) and proposes that resources continue for long-term maintenance in resource-poor countries of AFP surveillance as a platform for surveillance of vaccine-preventable diseases and other outbreak-prone diseases. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Assessment and prevention of acute health effects of weather conditions in Europe, the PHEWE project: background, objectives, design

Directory of Open Access Journals (Sweden)

Anderson Hugh

2007-04-01

Full Text Available Abstract Background The project "Assessment and prevention of acute health effects of weather conditions in Europe" (PHEWE had the aim of assessing the association between weather conditions and acute health effects, during both warm and cold seasons in 16 European cities with widely differing climatic conditions and to provide information for public health policies. Methods The PHEWE project was a three-year pan-European collaboration between epidemiologists, meteorologists and experts in public health. Meteorological, air pollution and mortality data from 16 cities and hospital admission data from 12 cities were available from 1990 to 2000. The short-term effect on mortality/morbidity was evaluated through city-specific and pooled time series analysis. The interaction between weather and air pollutants was evaluated and health impact assessments were performed to quantify the effect on the different populations. A heat/health watch warning system to predict oppressive weather conditions and alert the population was developed in a subgroup of cities and information on existing prevention policies and of adaptive strategies was gathered. Results Main results were presented in a symposium at the conference of the International Society of Environmental Epidemiology in Paris on September 6th 2006 and will be published as scientific articles. The present article introduces the project and includes a description of the database and the framework of the applied methodology. Conclusion The PHEWE project offers the opportunity to investigate the relationship between temperature and mortality in 16 European cities, representing a wide range of climatic, socio-demographic and cultural characteristics; the use of a standardized methodology allows for direct comparison between cities.

Sodium bicarbonate infusion for prevention of acute kidney injury: no evidence for superior benefit, but risk for harm?

Science.gov (United States)

Schiffl, Helmut

2015-02-01

The best "treatment" of acute kidney injury (AKI) is prevention. Patients who are at high risk of AKI should have an assessment of their volume status and receive appropriate volume expansion. The most effective type of intravenous fluid remains unclear. Innumerable studies have compared sodium bicarbonate and isotonic saline and have combined fluid hydration with pharmacological interventions, particularly N-acetyl-cysteine. However, abundant systematic reviews and meta-analyses have provided conflicting conclusions and have recognized a significant degree of heterogeneity between studies and publication bias. Most studies comparing intravenous sodium bicarbonate and saline were small. They often enrolled patients with a low risk for AKI, yielding low serious events (renal replacement therapy), and used different protocols for administration of fluids. Based on current literature, intravenous sodium bicarbonate does not seem to be more efficient than saline for the prevention of contrast-media-induced AKI, cardiac surgery-associated AKI, pigment nephropathy or septic AKI. However, some cohort studies or prospective randomized trials did track and report serious adverse events, such as higher rates of AKI or higher in-hospital mortality. At present, it should be concluded that the use of intravenous sodium bicarbonate administration to prevent AKI should be evaluated further in multicenter randomized double-blind trials rather than adopted into routine clinical practice.

Mountain-Scale Coupled Processes (TH/THC/THM)

International Nuclear Information System (INIS)

Dixon, P.

2004-01-01

The purpose of this Model Report is to document the development of the Mountain-Scale Thermal-Hydrological (TH), Thermal-Hydrological-Chemical (THC), and Thermal-Hydrological-Mechanical (THM) Models and evaluate the effects of coupled TH/THC/THM processes on mountain-scale UZ flow at Yucca Mountain, Nevada. This Model Report was planned in ''Technical Work Plan (TWP) for: Performance Assessment Unsaturated Zone'' (BSC 2002 [160819], Section 1.12.7), and was developed in accordance with AP-SIII.10Q, Models. In this Model Report, any reference to ''repository'' means the nuclear waste repository at Yucca Mountain, and any reference to ''drifts'' means the emplacement drifts at the repository horizon. This Model Report provides the necessary framework to test conceptual hypotheses for analyzing mountain-scale hydrological/chemical/mechanical changes and predict flow behavior in response to heat release by radioactive decay from the nuclear waste repository at the Yucca Mountain site. The mountain-scale coupled TH/THC/THM processes models numerically simulate the impact of nuclear waste heat release on the natural hydrogeological system, including a representation of heat-driven processes occurring in the far field. The TH simulations provide predictions for thermally affected liquid saturation, gas- and liquid-phase fluxes, and water and rock temperature (together called the flow fields). The main focus of the TH Model is to predict the changes in water flux driven by evaporation/condensation processes, and drainage between drifts. The TH Model captures mountain-scale three dimensional (3-D) flow effects, including lateral diversion at the PTn/TSw interface and mountain-scale flow patterns. The Mountain-Scale THC Model evaluates TH effects on water and gas chemistry, mineral dissolution/precipitation, and the resulting impact to UZ hydrological properties, flow and transport. The THM Model addresses changes in permeability due to mechanical and thermal disturbances in

Geology of Gable Mountain-Gable Butte Area

International Nuclear Information System (INIS)

Fecht, K.R.

1978-09-01

Gable Mountain and Gable Butte are two ridges which form the only extensive outcrops of the Columbia River Basalt Group in the central portion of the Pasco Basin. The Saddle Mountains Basalt and two interbedded sedimentary units of the Ellensburg Formation crop out on the ridges. These include, from oldest to youngest, the Asotin Member (oldest), Esquatzel Member, Selah Interbed, Pomona Member, Rattlesnake Ridge Interbed, and Elephant Mountain Member (youngest). A fluvial plain composed of sediments from the Ringold and Hanford (informal) formations surrounds these ridges. The structure of Gable Mountain and Gable Butte is dominated by an east-west-trending major fold and northwest-southeast-trending parasitic folds. Two faults associated with the uplift of these structures were mapped on Gable Mountain. The geomorphic expression of the Gable Mountain-Gable Butte area resulted from the comlex folding and subsequent scouring by post-basalt fluvial systems

Causal Chains Arising from Climate Change in Mountain Regions: the Core Program of the Mountain Research Initiative

Science.gov (United States)

Greenwood, G. B.

2014-12-01

Mountains are a widespread terrestrial feature, covering from 12 to 24 percent of the world's terrestrial surface, depending of the definition. Topographic relief is central to the definition of mountains, to the benefits and costs accruing to society and to the cascade of changes expected from climate change. Mountains capture and store water, particularly important in arid regions and in all areas for energy production. In temperate and boreal regions, mountains have a great range in population densities, from empty to urban, while tropical mountains are often densely settled and farmed. Mountain regions contain a wide range of habitats, important for biodiversity, and for primary, secondary and tertiary sectors of the economy. Climate change interacts with this relief and consequent diversity. Elevation itself may accentuate warming (elevationi dependent warming) in some mountain regions. Even average warming starts complex chains of causality that reverberate through the diverse social ecological mountain systems affecting both the highlands and adjacent lowlands. A single feature of climate change such as higher snow lines affect the climate through albedo, the water cycle through changes in timing of release , water quality through the weathering of newly exposed material, geomorphology through enhanced erosion, plant communities through changes in climatic water balance, and animal and human communities through changes in habitat conditions and resource availabilities. Understanding these causal changes presents a particular interdisciplinary challenge to researchers, from assessing the existence and magnitude of elevation dependent warming and monitoring the full suite of changes within the social ecological system to climate change, to understanding how social ecological systems respond through individual and institutional behavior with repercussions on the long-term sustainability of these systems.

Rationale treatment and preventive measures for correction of bone structure in children with acute leukemia, exposed to ionizing radiation due to the Chornobyl accident

International Nuclear Information System (INIS)

Bebeshko, V.G.; Bruslova, K.M.; Tsvjetkova, N.M.; Kopilova, O.V.; Belyingyio, T.O.; Berezovs'kij, S.Ya.; Petrun'ko, M.P.; Boyars'kij, V.G.; Polyans'ka, V.M.; Pushkar'ova, T.Yi.; Myishchenko, L.P.; Volodyina, T.T.

2014-01-01

A reduction of bone densitometry, calcium and cortisol levels and increase of serum alkaline phosphatase and urine oxyproline were found in children with acute leukemia in acute I phase and during the chemotherapy. In the period of remission the majority of patients did not differ from the comparison group. The signs of osteopenic syndrome that require monitoring of the bone structure status were revealed in 10.0 % of children of the comparison group. Radiation doses of leukemia patients were 3.66 ± 0.11 mSv. No relationship between radiation dose and indicators that reflect the state of the bone tissue structures has been established. The use of complex health care measures in children with acute leukemia in remission, contributed to the positive effect of 62.0 %. Worser effect was observed in patients with an unfavorable course of the disease. Results of the study of bone tissue metabolism prove fore a change in the organic and mineral matrix in patients with acute leukemia exposed to ionizing radiation as a result of the Chornobyl NPP accident, and persons without hematologic diseases, and the need for treatment and prevention

Mountains as early warning indicators of climate change

Science.gov (United States)

Williams, M. W.

2015-12-01

The panoramic splendor and complexity of mountain environments have inspired and challenged humans for centuries. These areas have been variously perceived as physical structures to be conquered, as sites of spiritual inspiration, and as some of the last untamed natural places on Earth. In our time, the perception that "mountains are forever" may provide solace to those seeking stability in a rapidly changing world. However, changes in the hydrology and in the abundance and species composition of the native flora and fauna of mountain ecosystems are potential bellwethers of global change, because these systems have a propensity to amplify environmental changes within specific portions of this landscape. Mountain areas are thus sentinels of climate change. We are seeing effects today in case histories I present from the Himalaya's, Andes, Alps, and Rocky Mountains. Furthermore, these ecosystem changes are occurring in mountain areas before they occur in downstream ecosystems. Thus, mountains are early warning indicators of perturbations such as climate change. The sensitivity of mountain ecosystems begs for enhanced protection and worldwide protection. Our understanding of the processes that control mountain ecosystems—climate interactions, snowmelt runoff, biotic diversity, nutrient cycling—is much less developed compared to downstream ecosystems where human habitation and development has resulted in large investments in scientific knowledge to sustain health and agriculture. To address these deficiencies, I propose the formation of an international mountain research consortium.

Acute abdominal pain: Advances in diagnosis and management

NARCIS (Netherlands)

Gans, S.L.

2015-01-01

The term acute abdominal pain refers to non-traumatic abdominal pain of rapid onset with duration of less than five days. Acute abdominal pain can be divided in urgent and non-urgent conditions. Urgent causes require treatment within 24 hours to prevent serious complications whereas for non-urgent

Potential Risk Assessment of Mountain Torrent Disasters on Sloping Fields in China

Science.gov (United States)

GAO, X.

2017-12-01

China's sloping fields have the problems of low production and serious soil erosion, and mountain torrent disasters will bring more serious soil and water loss to traditional extensive exploitation of sloping field resources. In this paper, China's sloping fields were classified into three grades, such as slightly steep, steep and very steep grade. According to the geological hazards prevention and control regulation, the historical data of China's mountain torrent disasters were spatially interpolated and divided into five classes, such as extremely low, low, middle, high and extremely high level. And the risk level map of mountain torrents was finished in ArcGIS. By using overlaying analysis on sloping fields and risk level map, the potential risk regionalization map of sloping fields in various slope grades was obtained finally. The results shows that the very steep and steep sloping fields are mainly distributed in the first or second stage terraces in China. With the increase of hazard risk level, the area of sloping fields decreases rapidly and the sloping fields in extremely low and low risk levels of mountain torrents reach 98.9%. With the increase of slope grade, the area of sloping fields in various risk levels also declines sharply. The sloping fields take up approximately 60 65% and 26 30% in slightly steep and steep grade areas separately at different risk level. The risk regionalization map can provide effective information for returning farmland to forests or grassland and reducing water and soil erosion of sloping fields in the future.

Extinction of Harrington's mountain goat

International Nuclear Information System (INIS)

Mead, J.I.; Martin, P.S.; Euler, R.C.; Long, A.; Jull, A.J.T.; Toolin, L.J.; Donahue, D.J.; Linick, T.W.

1986-01-01

Keratinous horn sheaths of the extinct Harrington's mountain goat, Oreamnos harringtoni, were recovered at or near the surface of dry caves of the Grand Canyon, Arizona. Twenty-three separate specimens from two caves were dated nondestructively by the tandem accelerator mass spectrometer (TAMS). Both the TAMS and the conventional dates indicate that Harrington's mountain goat occupied the Grand Canyon for at least 19,000 years prior to becoming extinct by 11,160 +/- 125 radiocarbon years before present. The youngest average radiocarbon dates on Shasta ground sloths, Nothrotheriops shastensis, from the region are not significantly younger than those on extinct mountain goats. Rather than sequential extinction with Harrington's mountain goat disappearing from the Grand Canyon before the ground sloths, as one might predict in view of evidence of climatic warming at the time, the losses were concurrent. Both extinctions coincide with the regional arrival of Clovis hunters

Clinical profile and predictors of fatal Rocky Mountain spotted fever in children from Sonora, Mexico.

Science.gov (United States)

Alvarez-Hernandez, Gerardo; Murillo-Benitez, Coral; Candia-Plata, Maria del Carmen; Moro, Manuel

2015-02-01

Rocky Mountain spotted fever (RMSF) is an increasingly important cause of preventable mortality in children in Sonora, Mexico. Although early treatment with tetracycline has shown to prevent fatal outcome, the disease remains a life-threatening condition, particularly for children. This study describes the clinical factors associated with pediatric mortality due to RMSF in Sonora, in order to guide healthcare practices. This is a retrospective analysis of 104 children consecutively hospitalized at the major pediatric hospital of Sonora, diagnosed with RMSF between January 2004 and December 2013. Descriptive statistics and multiple logistic regression were used to identify risk factors for fatal outcome. The case fatality ratio in this cohort was 20.2%. Children were hospitalized after a median of 6 days from onset of symptoms including fever (100%), rash involving palms and soles (88.5%) and headache (79.8%); 90.4% of fatal cases had low platelet counts (<50,000/μL) and 33.3% showed serum creatinine concentrations above the normal value. Acute kidney injury increased mortality, odds ratio (OR(adj)) = 4.84, 95% confidence interval (CI): 1.2-16.2, as well as delay in treatment (≥ 5th day from onset) with doxycycline, OR(adj) = 2.62, 95% CI: 1.24-5.52 and hemorrhage, OR(adj) = 6.11, 95% CI: 1.89-19.69. RMSF is a public health problem in Sonora. Clinically, fatal cases differ from non-fatal cases in renal function and hemorrhagic manifestations, although these findings may occur too late for a timely intervention. First-line providers must be educated to harbor a timely suspicion of RMSF, and should provide empiric treatment with doxycycline when febrile patients first present for care.

THE MOUNTAIN REGIONS IN CONTEXT OF STRATEGY 2020

Directory of Open Access Journals (Sweden)

ANTONESCU Daniela

2014-07-01

Full Text Available The mountain regions in Romania and European Union represent a special territory of interest, with a huge economic, social, environmental and cultural potential. More, mountain area is considerate a natural-economic region and constitutes an important objective for regional development policy. The main sectors of mountain area are presented in agriculture and tourism fields that lead the key role in safeguarding the sensitive eco-system and thereby maintaining the general living and working space.Mountain areas should have a specific policy defined by the sustainable development principle, which meets the needs of the present without compromising the opportunities of future generations. The specific mountain policy aims to reduce the imbalance between favored and disadvantaged mountain regions, permanently marked by natural, economic, social, cultural and environmental constraints. In previous programming period, mountain regions among have profited from the intensive regional support, in specially, for constructing of and connecting them to fresh water and waste water networks, in particular for increasing of life quality. In context of 2020 Strategy, the Member States will concentrate investments on a small number of thematic objectives. In advanced regions, 60 % of funds will used for only two of these objectives (competitiveness of SME and research/innovation. The all less developed regions will received about 50% of Structural Funds In Romania, mountain representing 29.93% out of the total national surface and 20.14% from UAA (Utilised Agricultural Area of total national. The mountain territory has around 20% of the national population and is overlapping almost 100% with the Carpathian Mountains. Due to these conditions, Romania's regional development policy must take into account the specificities of mountain area, the problems they faced, and the requirements of 2020 Strategy.This paper presents the main aspects to be taken into account

Sustainability and Mountain Tourism: The Millennial’s Perspective

Directory of Open Access Journals (Sweden)

Alessandro Bonadonna

2017-07-01

Full Text Available Evidence from several studies illustrates the different points of view through which sustainability and mountains have been studied over the years. Nowadays, interest in Millennials is increasing but no research has compared Millennials and sustainability in the mountain context. This study aims at defining sustainability with reference to Millennial perception of both winter and summer mountain sports. By analysing data gathered from a sample of 2292 Millennials (Piedmont area, the authors confirm their high degree of sensitivity towards sustainable issues and, above all, discover that there are differences in the sustainable perception Millennials have of both mountain winter and summer sports. More specifically, Millennial perception is deeply influenced by the place where they are used to living―mountains or cities―and by their gender. From a managerial point of view, results have direct implications on the administrators of mountain institutions who can implement appropriate initiatives in order to correctly sensitise Millennials towards mountain sports. Moreover, from a theoretical perspective, the study opens a new scenario on two important topics linked to sustainability, namely Millennials and mountain sports.

Anticoagulant therapy and outcomes in patients with prior or acute heart failure and acute coronary syndromes: Insights from the APixaban for PRevention of Acute ISchemic Events 2 trial.

Science.gov (United States)

Cornel, Jan H; Lopes, Renato D; James, Stefan; Stevens, Susanna R; Neely, Megan L; Liaw, Danny; Miller, Julie; Mohan, Puneet; Amerena, John; Raev, Dimitar; Huo, Yong; Urina-Triana, Miguel; Gallegos Cazorla, Alex; Vinereanu, Dragos; Fridrich, Viliam; Harrington, Robert A; Wallentin, Lars; Alexander, John H

2015-04-01

Clinical outcomes and the effects of oral anticoagulants among patients with acute coronary syndrome (ACS) and either a history of or acute heart failure (HF) are largely unknown. We aimed to assess the relationship between prior HF or acute HF complicating an index ACS event and subsequent clinical outcomes and the efficacy and safety of apixaban compared with placebo in these populations. High-risk patients were randomly assigned post-ACS to apixaban 5.0 mg or placebo twice daily. Median follow-up was 8 (4-12) months. The primary outcome was cardiovascular death, myocardial infarction, or stroke. The main safety outcome was thrombolysis in myocardial infarction major bleeding. Heart failure was reported in 2,995 patients (41%), either as prior HF (2,076 [28%]) or acute HF (2,028 [27%]). Patients with HF had a very high baseline risk and were more often managed medically. Heart failure was associated with a higher rate of the primary outcome (prior HF: adjusted hazard ratio [HR] 1.73, 95% CI 1.42-2.10, P acute HF: adjusted HR 1.65, 95% CI 1.35-2.01, P acute HF: adjusted HR 2.52, 95% CI 1.82-3.50). Patients with acute HF also had significantly higher rates of thrombolysis in myocardial infarction major bleeding (prior HF: adjusted HR 1.22, 95% CI 0.65-2.27, P = .54, acute HF: adjusted HR 1.78, 95% CI 1.03-3.08, P = .04). There was no statistical evidence of a differential effect of apixaban on clinical events or bleeding in patients with or without prior HF; however, among patients with acute HF, there were numerically fewer events with apixaban than placebo (14.8 vs 19.3, HR 0.76, 95% CI 0.57-1.01, interaction P = .13), a trend that was not seen in patients with prior HF or no HF. In high-risk patients post-ACS, both prior and acute HFs are associated with an increased risk of subsequent clinical events. Apixaban did not significantly reduce clinical events and increased bleeding in patients with and without HF; however, there was a tendency toward fewer clinical

Acute Central Nervous System Complications in Pediatric Acute Lymphoblastic Leukemia.

Science.gov (United States)

Baytan, Birol; Evim, Melike Sezgin; Güler, Salih; Güneş, Adalet Meral; Okan, Mehmet

2015-10-01

The outcome of childhood acute lymphoblastic leukemia has improved because of intensive chemotherapy and supportive care. The frequency of adverse events has also increased, but the data related to acute central nervous system complications during acute lymphoblastic leukemia treatment are sparse. The purpose of this study is to evaluate these complications and to determine their long term outcome. We retrospectively analyzed the hospital reports of 323 children with de novo acute lymphoblastic leukemia from a 13-year period for acute neurological complications. The central nervous system complications of leukemic involvement, peripheral neuropathy, and post-treatment late-onset encephalopathy, and neurocognitive defects were excluded. Twenty-three of 323 children (7.1%) suffered from central nervous system complications during acute lymphoblastic leukemia treatment. The majority of these complications (n = 13/23; 56.5%) developed during the induction period. The complications included posterior reversible encephalopathy (n = 6), fungal abscess (n = 5), cerebrovascular lesions (n = 5), syndrome of inappropriate secretion of antidiuretic hormone (n = 4), and methotrexate encephalopathy (n = 3). Three of these 23 children (13%) died of central nervous system complications, one from an intracranial fungal abscess and the others from intracranial thrombosis. Seven of the survivors (n = 7/20; 35%) became epileptic and three of them had also developed mental and motor retardation. Acute central neurological complications are varied and require an urgent approach for proper diagnosis and treatment. Collaboration among the hematologist, radiologist, neurologist, microbiologist, and neurosurgeon is essential to prevent fatal outcome and serious morbidity. Copyright © 2015 Elsevier Inc. All rights reserved.

AHP 35: An Abandoned Mountain Deity

Directory of Open Access Journals (Sweden)

Limusishiden (Li Dechun 李得春

2015-02-01

Full Text Available Lasizi are cairns where mountain deities dwell, and the same word also refers to the deities that dwell in these cairns. There are many lasizi in Tu areas in Huzhu Tu Autonomous County, Haidong Municipality, Qinghai Province. The most famous are: Chileb, located in the north part of both Danma Town and Donggou Township Durizang, located in the northern part of Wushi Town Lawa, located atop a mountain on the border between Danma Town and Wushi Town. The mountain is referred to as Lawa Lasizi. Lawa Village is located at the foot of Lawa Lasizi's west side, which is within Danma Town territory. Tughuan Village is located at the foot of Lawa Lasizi's east side, which belongs is within Wushi Town jurisdiction. Sughua, located atop a mountain on the border between Danma Town and Dongshan Township. The mountain is locally known as Sughua Lasizi. Qighaan Dawa Village is located at the foot of Sughua Lasizi's west side, which is part of Dongshan Township. Sughua Village is located at the foot of Sughua Lasizi's east side, which is part of belongs Danma Town. Walighuan, located atop a mountain in Hongyazigou Township and Sunduu, located on the border between Songduo and Bazha (two autonomous Tibetan townships in Huzhu County and Ledu Region. ...

Biomarkers of Acute Stroke Etiology (BASE) Study Methodology.

Science.gov (United States)

Jauch, Edward C; Barreto, Andrew D; Broderick, Joseph P; Char, Doug M; Cucchiara, Brett L; Devlin, Thomas G; Haddock, Alison J; Hicks, William J; Hiestand, Brian C; Jickling, Glen C; June, Jeff; Liebeskind, David S; Lowenkopf, Ted J; Miller, Joseph B; O'Neill, John; Schoonover, Tim L; Sharp, Frank R; Peacock, W Frank

2017-05-05

Acute ischemic stroke affects over 800,000 US adults annually, with hundreds of thousands more experiencing a transient ischemic attack. Emergent evaluation, prompt acute treatment, and identification of stroke or TIA (transient ischemic attack) etiology for specific secondary prevention are critical for decreasing further morbidity and mortality of cerebrovascular disease. The Biomarkers of Acute Stroke Etiology (BASE) study is a multicenter observational study to identify serum markers defining the etiology of acute ischemic stroke. Observational trial of patients presenting to the hospital within 24 h of stroke onset. Blood samples are collected at arrival, 24, and 48 h later, and RNA gene expression is utilized to identify stroke etiology marker candidates. The BASE study began January 2014. At the time of writing, there are 22 recruiting sites. Enrollment is ongoing, expected to hit 1000 patients by March 2017. The BASE study could potentially aid in focusing the initial diagnostic evaluation to determine stroke etiology, with more rapidly initiated targeted evaluations and secondary prevention strategies.Clinical Trial Registration Clinicaltrials.gov NCT02014896 https://clinicaltrials.gov/ct2/show/NCT02014896?term=biomarkers+of+acute+stroke+etiology&rank=1.

N-Acetyl Cysteine does not prevent liver toxicity from chronic low dose plus sub-acute high dose paracetamol exposure in young or old mice

Science.gov (United States)

Kane, Alice-Elizabeth; Huizer-Pajkos, Aniko; Mach, John; McKenzie, Catriona; Mitchell, Sarah-Jayne; de Cabo, Rafael; Jones, Brett; Cogger, Victoria; Le Couteur, David G; Hilmer, Sarah-Nicole

2016-01-01

Paracetamol is an analgesic commonly used by people of all ages, which is well documented to cause severe hepatotoxicity with acute over-exposures. The risk of hepatotoxicity from non-acute paracetamol exposures is less extensively studied, and this is the exposure most common in older adults. Evidence on the effectiveness of N-acetyl cysteine (NAC) for non-acute paracetamol exposures, in any age group, is lacking. This study aimed to examine the effect of long-term exposure to therapeutic doses of paracetamol and sub-acute paracetamol over-exposure, in young and old mice, and to investigate whether NAC was effective at preventing paracetamol hepatotoxicity induced by these exposures. Young and old male C57BL/6 mice were fed a paracetamol-containing (1.33g/kg food) or control diet for 6 weeks. Mice were then dosed orally 8 times over 3 days with additional paracetamol (250mg/kg) or saline, followed by either one or two doses of oral NAC (1200mg/kg) or saline. Chronic low-dose paracetamol exposure did not cause hepatotoxicity in young or old mice, measured by serum alanine aminotransferase (ALT) elevation, and confirmed by histology and a DNA fragmentation assay. Sub-acute paracetamol exposure caused significant hepatotoxicity in young and old mice, measured by biochemistry (ALT) and histology. Neither a single nor double dose of NAC protected against this toxicity from sub-acute paracetamol in young or old mice. This finding has important clinical implications for treating toxicity due to different paracetamol exposure types in patients of all ages, and implies a need to develop new treatments for sub-acute paracetamol toxicity. PMID:26821200

Mountains: top down.

Science.gov (United States)

Woodwell, George M

2004-11-01

Mountainous regions offer not only essential habitat and resources, including water, to the earth's more than 6 billion inhabitants, but also insights into how the global human habitat works, how it is being changed at the moment as global climates are disrupted, and how the disruption may lead to global biotic and economic impoverishment. At least 600 million of the earth's more than 6 billion humans dwell in mountainous regions. Such regions feed water into all the major rivers of the world whose valleys support most of the rest of us. At least half of the valley dwellers receive part or all of their water from montane sources, many from the melt water of glaciers, others from the annual snow melt. Glaciers are retreating globally as the earth warms as a result of human-caused changes in the composition of the atmosphere. Many are disappearing, a change that threatens municipal water supplies virtually globally. The warming is greatest in the higher latitudes where the largest glaciers such as those of Greenland and the Antarctic Continent have become vulnerable. The melting of ice in the northern hemisphere raises serious concerns about the continued flow of the Gulf Stream and the possibility of massive climatic changes in Scandinavia and northern Europe. Mountains are also biotic islands in the sea life, rich in endemism at the ecotype level. The systematic warming of the earth changes the environment out from under these genetically specialized strains (ecotypes) which are then maladapted and vulnerable to diseases of all types. The process is systematic impoverishment in the pattern conspicuous on mountain slopes with increasing exposure to climatic extremes. It is seen now in the increased mortality and morbidity of plants as climatic changes accumulate. The seriousness of the global climatic disruption is especially clear in any consideration of mountains. It can and must be addressed constructively despite the adamancy of the current US administration.

Mountain home known geothermal resource area: an environmental analysis

Energy Technology Data Exchange (ETDEWEB)

Spencer, S.G.; Russell, B.F. (eds.)

1979-09-01

The Mountain Home KGRA encompasses an area of 3853 hectares (ha) at the foot of the Mount Bennett Hills in Elmore County, Idaho. The site is associated with an arid climate and high winds that generate an acute dust problem. The KGRA lies adjacent to the northwest-southeast trending fault zone that reflects the northern boundary of the western Snake River Plain graben. Data indicate that a careful analysis of the subsidence potential is needed prior to extensive geothermal development. Surface water resources are confined to several small creeks. Lands are utilized for irrigated farmlands and rangeland for livestock. There are no apparent soil limitations to geothermal development. Sage grouse and mule deer are the major species of concern. The potential of locating significant heritage resources other than the Oregon Trail or the bathhouse debris appears to be relatively slight.

A Comment on “Management for Mountain Pine Beetle Outbreak Suppression: Does Relevant Science Support Current Policy?”

Directory of Open Access Journals (Sweden)

Christopher J. Fettig

2014-04-01

Full Text Available There are two general approaches for reducing the negative impacts of mountain pine beetle, Dendroctonus ponderosae Hopkins, on forests. Direct control involves short-term tactics designed to address current infestations by manipulating mountain pine beetle populations, and includes the use of fire, insecticides, semiochemicals, sanitation harvests, or a combination of these treatments. Indirect control is preventive, and designed to reduce the probability and severity of future infestations within treated areas by manipulating stand, forest and/or landscape conditions by reducing the number of susceptible host trees through thinning, prescribed burning, and/or alterations of age classes and species composition. We emphasize that “outbreak suppression” is not the intent or objective of management strategies implemented for mountain pine beetle in the western United States, and that the use of clear, descriptive language is important when assessing the merits of various treatment strategies.

MOUNTAIN TOURISM-PLEASURE AND NECESSITY

Directory of Open Access Journals (Sweden)

Gabriela Corina SLUSARIUC

2015-07-01

Full Text Available Tourism has a more and more important role in the economic development of many countries. Mountain tourism is an anti-stress solutions and a type of disconnection from the citadel life style through replacing some activities of media consuming type, games and virtual socializing with therapy through movement, the physical activity being an essential dimension in assuring the high life quality. Mountaineering is searched for: practicing winter sports, its invigorating and comforting, relaxing role, medical spa treatments practicing hiking, alpinism. Mountain tourism generates increased economic benefits for the surrounding areas, improves the life quality of the local communities and can assure the prosperity of some disadvantaged areas, being able to be a remedy for unindustrialised regions. Mountain tourism contributes to the economic development of the region and also to satisfying spiritual and psychological needs of the people, representing a necessity for a touristic area and a pleasure for tourist consumers.

Allodynia Is Associated With Initial and Sustained Response to Acute Migraine Treatment: Results from the American Migraine Prevalence and Prevention Study.

Science.gov (United States)

Lipton, Richard B; Munjal, Sagar; Buse, Dawn C; Bennett, Alix; Fanning, Kristina M; Burstein, Rami; Reed, Michael L

2017-07-01

In a population sample of persons with migraine treating with a single category of acute migraine medication, to identify rates and factors associated with acute treatment outcomes, including 2-hour pain freedom (2hPF), 24-hour pain response (24hPR), and 24-hour sustained pain response (24hSPR). Key predictors include acute treatment type (triptans and other medication categories), the influence of allodynia on response to medication, and the interaction between medication category and presence of allodynia in response to treatment among people with migraine. Cutaneous allodynia was previously associated with inadequate 2hPF, 24hPR, and 24hSPR (sustained response at 24 hours among those with adequate 2hPF) among people with migraine in the American Migraine Prevalence and Prevention (AMPP) Study. The AMPP Study obtained data from a representative US sample of persons with migraine by mailed questionnaire. The 2006 survey included 8233 people with migraine aged 18 or over who completed the Migraine Treatment Optimization Questionnaire (mTOQ). mTOQ was used to assess acute treatment outcomes including 2hPF, 24hPR, and 24hSPR. Eligible individuals used only a single category of acute prescription migraine treatments (n  =  5236, 63.6%). This sample was stratified into 5 categories of type of acute prescription headache medication used (triptans, nonsteroidal anti-inflammatory drugs, barbiturate-combinations, opioids, and opioid combinations and ergot alkaloids). Separate binary logistic regression models evaluated: (1) triptans vs other medication types; (2) presence of allodynia vs no allodynia; and (3) the interaction of medication category with allodynia. Sociodemographic variables, health insurance status, over-the-counter and preventive medication use were included as covariates. Odds ratios (OR) and 95% confidence intervals (CI) were generated for each acute treatment outcome. Among eligible participants, the mean age was 46 years, and 82.5% were women

Dynamics of myeloid cell populations during relapse-preventive immunotherapy in acute myeloid leukemia.

Science.gov (United States)

Rydström, Anna; Hallner, Alexander; Aurelius, Johan; Sander, Frida Ewald; Bernson, Elin; Kiffin, Roberta; Thoren, Fredrik Bergh; Hellstrand, Kristoffer; Martner, Anna

2017-08-01

Relapse of leukemia in the postchemotherapy phase contributes to the poor prognosis and survival in patients with acute myeloid leukemia (AML). In an international phase IV trial (ClinicalTrials.gov; NCT01347996), 84 patients with AML in first complete remission who had not undergone transplantation received immunotherapy with histamine dihydrochloride (HDC) and low-dose IL-2 with the aim of preventing relapse. The dynamics of myeloid cell counts and expression of activation markers was assessed before and after cycles of immunotherapy and correlated with clinical outcome in terms of relapse risk and survival. During cycles, a pronounced increase in blood eosinophil counts was observed along with a reduction in monocyte and neutrophil counts. A strong reduction of blood monocyte counts during the first HDC/IL-2 treatment cycle predicted leukemia-free survival. The HDC component of the immunotherapy exerts agonist activity at histamine type 2 receptors (H2Rs) that are expressed by myeloid cells. It was observed that the density of H 2 R expression in blood monocytes increased during cycles of immunotherapy and that high monocyte H 2 R expression implied reduced relapse risk and improved overall survival. Several other activation markers, including HLA-DR, CD86, and CD40, were induced in monocytes and dendritic cells during immunotherapy but did not predict clinical outcome. In addition, expression of HLA-ABC increased in all myeloid populations during therapy. A low expression of HLA-ABC was associated with reduced relapse risk. These results suggest that aspects of myeloid cell biology may impact clinical benefit of relapse-preventive immunotherapy in AML. © Society for Leukocyte Biology.

Personal and professional profile of mountain medicine physicians.

Science.gov (United States)

Peters, Patrick

2003-01-01

The purpose of this study was to define and describe the personal and professional profile of mountain medicine physicians including general physical training information and to include a detailed overview of the practice of mountain sports. A group of physicians participating in a specialized mountain medicine education program filled out a standardized questionnaire. The data obtained from this questionnaire were first analyzed in a descriptive way and then by statistical methods (chi2 test, t test, and analysis of variance). Detailed results have been provided for gender, age, marital status, general training frequency and methods, professional status, additional medical qualifications, memberships in professional societies and alpine clubs, mountain sports practice, and injuries sustained during the practice of mountain sports. This study has provided a detailed overview concerning the personal and professional profile of mountain medicine physicians. Course organizers as well as official commissions regulating the education in mountain medicine will be able to use this information to adapt and optimize the courses and the recommendations/requirements as detailed by the UIAA-ICAR-ISMM (Union Internationale des Associations Alpinistes, International Commission for Alpine Rescue, International Society for Mountain Medicine).

[New approaches in neurosurgery and hyperbaric medicine--the importance of preventive and industrial medicine].

Science.gov (United States)

Kohshi, K; Munaka, M; Abe, H; Tosaki, T

1999-12-01

Neurosurgical patients have been mainly treated by surgical procedures over the past decades. In addition, hyperbaric oxygen (HBO) therapy in neurosurgery has been used in patients with ischemic cerebrovascular diseases, head trauma, spinal damage, postoperative brain edema and others. However, the main therapeutic methods for neurosurgical diseases have changed dramatically due to developments in radiological techniques, such as radiosurgery and intravascular surgery. With changes in therapeutic methods, HBO therapy may become a very important treatment option for neurosurgical patients. For example, HBO therapy combined with radiotherapy (UOEH regimen) and anticoagulant therapy appear to be very effective in the treatments of malignant brain tumors and ischemic cerebrovascular diseases, respectively. On the other hand, medical examinations under hyper- and hypobaric environments have not yet been fully studied in the central nervous system compared to those in the cardiopulmonary systems. Moreover, the mechanisms of cerebral lesions in decompression sickness and acute mountain sickness remain unclear. Clinical neurologic approaches are very important in these fields. Hence, clinicians and researchers skilled in both neurosurgery and hyperbaric medicine will be required for advanced treatment and preventive and industrial medicine.

Depression following acute coronary syndrome

DEFF Research Database (Denmark)

Joergensen, Terese Sara Hoej; Maartensson, Solvej; Ibfelt, Else Helene

2016-01-01

PURPOSE: Depression is common following acute coronary syndrome, and thus, it is important to provide knowledge to improve prevention and detection of depression in this patient group. The objectives of this study were to examine: (1) whether indicators of stressors and coping resources were risk...... factors for developing depression early and later after an acute coronary syndrome and (2) whether prior depression modified these associations. METHODS: The study was a register-based cohort study, which includes 87,118 patients with a first time diagnosis of acute coronary syndrome during the period...... 2001-2009 in Denmark. Cox regression models were used to analyse hazard ratios (HRs) for depression. RESULTS: 1.5 and 9.5 % develop early (≤30 days) and later (31 days-2 years) depression after the acute coronary syndrome. Among all patients with depression, 69.2 % had first onset depression, while 30...

Psychological Care, Patient Education, Orthotics, Ergonomics and Prevention Strategies for Neck Pain

DEFF Research Database (Denmark)

Gross, Anita R; Kaplan, Faith; Huang, Stacey

2013-01-01

To conduct an overview on psychological interventions, orthoses, patient education, ergonomics, and 1⁰/2⁰ neck pain prevention for adults with acute-chronic neck pain.......To conduct an overview on psychological interventions, orthoses, patient education, ergonomics, and 1⁰/2⁰ neck pain prevention for adults with acute-chronic neck pain....

Mountains of Our Future Earth: Defining Priorities for Mountain Research—A Synthesis From the 2015 Perth III Conference

Directory of Open Access Journals (Sweden)

Erin H. Gleeson

2016-11-01

Full Text Available The Perth conferences, held every 5 years in Perth, Scotland, bring together people who identify as mountain researchers and who are interested in issues related to global change in mountain social-ecological systems. These conferences provide an opportunity to evaluate the evolution of research directions within the mountain research community, as well as to identify research priorities. The Future Earth Strategic Research Agenda provides a useful framework for evaluating the mountain research community's progress toward addressing global change and sustainability challenges. Using a process originally set up to analyze contributions to the 2010 conference, the abstracts accepted for the 2015 conference in the context of the Future Earth framework were analyzed. This revealed a continued geographic underrepresentation in mountain research of Africa, Latin America, and South and Southeast Asia but a more even treatment of biophysical and social science themes than in 2010. It also showed that the Perth conference research community strongly focused on understanding system processes (the Dynamic Planet theme of the Future Earth research agenda. Despite the continued bias of conference contributions toward traditional observation- and conservation-oriented research, survey results indicate that conference participants clearly believe that transdisciplinary, transformative research is relevant to mountains. Of the 8 Future Earth focal challenges, those related to safeguarding natural assets, promoting sustainable land use, increasing resilience and understanding the water-energy-food nexus received considerable attention. The challenges related to sustainable consumption, decarbonizing socioeconomic systems, cities, and health were considerably less well represented, despite their relevance to mountain socioeconomic systems. Based on these findings, we outline a proposal for the future directions of mountain research.

Reasons for decision in the matter of Trans Mountain Pipeline Inc. (formerly Terasen Pipelines (Trans Mountain) Inc.) : tariffs

International Nuclear Information System (INIS)

2007-01-01

In 2006 and 2007 Terasen Pipelines (Trans Mountain) Inc. (now Trans Mountain Pipeline Inc.) submitted a series of applications to the National Energy Board for revisions to the Trans Mountain Tariffs. They were filed in response to apportionment concerns on the Trans Mountain pipeline. Four of the applications involved pronounced and contentious changes to the capacity allocation procedures on the pipeline system. For ease of reference, the Board amalgamated its 4 decisions on these applications into a single document. A map of the Trans Mountain pipeline system as a whole was presented along with a detailed map indicating the delivery locations served by the system in the lower mainland of British Columbia and the state of Washington. The issues considered by the Board in each of these decisions included capacity allocation for Westridge Dock; capacity allocations to export destinations; common carriage requirements; and the need for creating a new barge subcategory. Relevant sections of the National Energy Board Act referred to in the decisions were highlighted. This document also listed the Trans Mountain Tariffs that have introduced notable revisions to the capacity allocation procedures on the system since September 2003. 16 refs., 2 figs., 3 appendices

Separating Trends in Whitebark Pine Radial Growth Related to Climate and Mountain Pine Beetle Outbreaks in the Northern Rocky Mountains, USA

Directory of Open Access Journals (Sweden)

Saskia L. van de Gevel

2017-06-01

Full Text Available Drought and mountain pine beetle (Dendroctonus ponderosae Hopkins outbreaks have affected millions of hectares of high-elevation conifer forests in the Northern Rocky Mountains during the past century. Little research has examined the distinction between mountain pine beetle outbreaks and climatic influence on radial growth in endangered whitebark pine (Pinus albicaulis Engelm. ecosystems. We used a new method to explore divergent periods in whitebark pine radial growth after mountain pine beetle outbreaks across six sites in western Montana. We examined a 100-year history of mountain pine beetle outbreaks and climate relationships in whitebark pine radial growth to distinguish whether monthly climate variables or mountain pine outbreaks were the dominant influence on whitebark pine growth during the 20th century. High mortality of whitebark pines was caused by the overlapping effects of previous and current mountain pine beetle outbreaks and white pine blister rust infection. Wet conditions from precipitation and snowpack melt in the previous summer, current spring, and current summer benefit whitebark pine radial growth during the following growing season. Whitebark pine radial growth and climate relationships were strongest in sites less affected by the mountain pine beetle outbreaks or anthropogenic disturbances. Whitebark pine population resiliency should continue to be monitored as more common periods of drought will make whitebark pines more susceptible to mountain pine beetle attack and to white pine blister rust infection.

Mountaineering Tourism

Directory of Open Access Journals (Sweden)

Patrick Maher

2016-08-01

Full Text Available Reviewed: Mountaineering Tourism Edited by Ghazali Musa, James Higham, and Anna Thompson-Carr. Abingdon, United Kingdom: Routledge, 2015. xxvi + 358 pp. Hardcover. US$ 145.00. ISBN 978-1-138-78237-2.

Acute kidney injury: Global health alert

Directory of Open Access Journals (Sweden)

Philip Kam Tao Li

2013-01-01

Full Text Available Acute kidney injury (AKI is increasingly prevalent in developing and developed countries and is associated with severe morbidity and mortality. Most etiologies of AKI can be prevented by interventions at the individual, community, regional and in-hospital levels. Effective measures must include community-wide efforts to increase an awareness of the devastating effects of AKI and provide guidance on preventive strategies, as well as early recognition and management. Efforts should be focused on minimizing causes of AKI, increasing awareness of the importance of serial measurements of serum creatinine in high risk patients, and documenting urine volume in acutely ill people to achieve early diagnosis; there is as yet no definitive role for alternative biomarkers. Protocols need to be developed to systematically manage prerenal conditions and specific infections. More accurate data about the true incidence and clinical impact of AKI will help to raise the importance of the disease in the community, increase awareness of AKI by governments, the public, general and family physicians and other health care professionals to help prevent the disease. Prevention is the key to avoid the heavy burden of mortality and morbidity associated with AKI.

Help seeking behavior and onset-to-alarm time in patients with acute stroke: sub-study of the preventive antibiotics in stroke study.

Science.gov (United States)

Zock, E; Kerkhoff, H; Kleyweg, R P; van Bavel-Ta, T B V; Scott, S; Kruyt, N D; Nederkoorn, P J; van de Beek, D

2016-11-25

Patients with acute stroke often do not seek immediate medical help, which is assumed to be driven by lack of knowledge of stroke symptoms. We explored the process of help seeking behavior in patients with acute stroke, evaluating knowledge about stroke symptoms, socio-demographic and clinical characteristics, and onset-to-alarm time (OAT). In a sub-study of the Preventive Antibiotics in Stroke Study (PASS), 161 acute stroke patients were prospectively included in 3 Dutch hospitals. A semi-structured questionnaire was used to assess knowledge, recognition and interpretation of stroke symptoms. With in-depth interviews, response actions and reasons were explored. OAT was recorded and associations with socio-demographic, clinical parameters were assessed. Knowledge about stroke symptoms does not always result in correct recognition of own stroke symptoms, neither into correct interpretation of the situation and subsequent action. In our study population of 161 patients with acute stroke, median OAT was 30 min (interquartile range [IQR] 10-150 min). Recognition of one-sided weakness and/or sensory loss (p = 0.046) and adequate interpretation of the stroke situation (p = 0.003), stroke at daytime (p = 0.002), severe stroke (p = 0.003), calling the emergency telephone number (p = 0.004), and transport by ambulance (p = 0.040) were associated with shorter OAT. Help seeking behavior after acute stroke is a complex process. A shorter OAT after stroke is associated with correct recognition of one-sided weakness and/or sensory loss, adequate interpretation of the stroke situation by the patient and stroke characteristics and logistics of stroke care, but not by knowledge of stroke symptoms.

Stratigraphic and structural framework of Yucca Mountain, Nevada

International Nuclear Information System (INIS)

Spengler, R.W.; Fox, K.F. Jr.

1988-01-01

Yucca Mountain is located within the southwestern Nevada volcanic field, ∼140 km northwest of Las Vegas, Nevada, and 50 km northeast of Death Valley, California. The mountain consist of a series of long, linear, north-trending volcanic ridges that approach an 1800-m maximum elevation near The Prow. The broad intermontane alluviated valleys of Crater Flat, the Amargosa Desert, and Jackass Flats, averaging 800 to 1100 m in elevation, form the western, southern, and eastern margins of Yucca Mountain, respectively. North of The Prow, Yucca Mountain merges with other volcanic highlands that flank the southern rim of the Timber Mountain-Oasis Valley caldera complex. The stratigraphy and structure of the area are discussed. Future geologic studies will attempt to determine if faults extend beneath Yucca Mountain, and, if present, their potential effects on the hydrologic and tectonic regimes

[Enterobius vermicularis causing symptoms of acute appendicitis].

Science.gov (United States)

Antal, András; Kocsis, Béla

2008-08-01

The authors present a case of enterobiasis of the appendix. Enterobius infection is an uncommon cause of acute appendicitis. Preoperative diagnosis of pinworm infestation is almost impossible unless there is a strong clinical suspicion. Parasites may produce symptoms which resemble acute appendicitis. Careful observation of the appendix stump may lead to intraoperative diagnosis of enterobiasis. A quick diagnosis and appropriate treatment may prevent future complications.

Yucca Mountain project prototype testing

International Nuclear Information System (INIS)

Hughes, W.T.; Girdley, W.A.

1990-01-01

The U.S. DOE is responsible for characterizing the Yucca Mountain site in Nevada to determine its suitability for development as a geologic repository to isolate high-level nuclear waste for at least 10,000 years. This unprecedented task relies in part on measurements made with relatively new methods or applications, such as dry coring and overcoring for studies to be conducted from the land surface and in an underground facility. The Yucca Mountain Project has, since 1988, implemented a program of equipment development and methods development for a broad spectrum of hydrologic, geologic, rock mechanics, and thermomechanical tests planned for use in an Exploratory Shaft during site characterization at the Yucca Mountain site. A second major program was fielded beginning in April 1989 to develop and test methods and equipment for surface drilling to obtain core samples from depth using only air as a circulating medium. The third major area of prototype testing has been during the ongoing development of the Instrumentation/ Data Acquisition System (IDAS), designed to collect and monitor data from down-hole instrumentation in the unsaturated zone, and store and transmit the data to a central archiving computer. Future prototype work is planned for several programs including the application of vertical seismic profiling methods and flume design to characterizing the geology at Yucca Mountain. The major objectives of this prototype testing are to assure that planned Site Characterization testing can be carried out effectively at Yucca Mountain, both in the Exploratory Shaft Facility (ESF), and from the surface, and to avoid potential major failures or delays that could result from the need to re-design testing concepts or equipment. This paper will describe the scope of the Yucca Mountain Project prototype testing programs and summarize results to date. 3 figs

Acetazolamide improves cerebral oxygenation during exercise at high altitude

NARCIS (Netherlands)

Vuyk, J.; Bos, J. van den; Terhell, K.; Bos, R. de; Vletter, A.; Valk, P.; Beuzekom, M. van; Kleef, J. van; Dahan, A.

2006-01-01

Acute mountain sickness is thought to be triggered by cerebral hypoxemia and be prevented by acetazolamide (Actz). The effect of Actz on cerebral oxygenation at altitude remains unknown. In 16 members of the 2005 Dutch Cho Oyu (8201 m, Tibet) expedition, the influence of Actz and exercise (750 mg PO

An integrative review of infection prevention and control programs for multidrug-resistant organisms in acute care hospitals: a socio-ecological perspective.

Science.gov (United States)

Backman, Chantal; Taylor, Geoffrey; Sales, Anne; Marck, Patricia Beryl

2011-06-01

The infection rates of multidrug-resistant organisms (MDRO) are increasing in Canada and the United States. The prevention and control of MDRO infections remain an important issue in acute care hospitals. Although comprehensive infection prevention and control programs have been recommended, there is little evidence to date of their effectiveness or of what aspects are most important. Our objectives were to review and critique the literature on the relationship between an MDRO infection and control program and MDRO rates in acute care hospitals. Studies including original research published between January 1, 1998, and May 14, 2009, were identified through MEDLINE, CINAHL, EMBASE, PUBMED, The Cochrane Library, and expert consultation. A comprehensive search strategy was developed with a librarian to find studies that covered the main subject areas of this integrative review. Of the 1,382 papers retrieved, 47 were reviewed, and 32 studies met the inclusion criteria. The interventions in the included studies were assessed using the tier 1/tier 2 framework. A total of 18 (56.25%) studies had an administrative measure as an intervention; 20 (62.5%) studies had education and training of health care personnel; 8 (25.0%) studies had judicious use of antimicrobial agents; 17 (53.1%) studies used surveillance; 24 (75.0%) studies had infection control precautions to prevent transmission; 7 studies (21.9%) introduced environmental measures; and 9 (28.1%) studies used patient decolonization. Although all the 32 studies were quasiexperimental studies, only 2 (5.9%) studies provided sample size calculations, and only 5 studies reported confounding factors. Whereas 27 used an interrupted time series design and 2 were controlled pre- and post-intervention designs, 3 were pre- and post-intervention without control groups. This integrative review demonstrated that the evidence of the relationship between MDRO infection prevention and control programs and the rates of MDRO is weak

A Single Long-Term Acute Care Hospital Experience with a Pressure Ulcer Prevention Program.

Science.gov (United States)

Young, Daniel L; Borris-Hale, Cathy; Falconio-West, Margaret; Chakravarthy, Debashish

2015-01-01

The occurrence of pressure ulcers (PrUs) challenges care facilities. Few studies report PrU reduction efforts in long-term acute care (LTAC). This study described the PrU reduction efforts of a single, LTAC facility using the Medline Pressure Ulcer Prevention Program (mPUPP). This study was a quasi-experimental, quality improvement project, with pre- and postmeasurement design. Outcomes were tracked for 24 months. The mPUPP was implemented in month 11. Education for caregivers was provided through an interactive web-based suite. In addition, all Patient Care Technicians attended a 4-week 1-hour inservice. New skin care products were implemented. The facility also implemented an algorithm for treatment of wounds. There was a significant reduction in the mean monthly hospital-acquired PrU (nPrU) rate when preprogram is compared to postprogram. Sustainable nPrU reduction can be achieved with mPUPP. LTAC hospitals could expect to reduce nPrU with education and incentive of caregivers. © 2014 Association of Rehabilitation Nurses.

Anticoagulants for secondary prevention after acute myocardial infarction: lessons from the past decade.

Science.gov (United States)

Atar, Dan; Bode, Christoph; Stuerzenbecher, André; Verheugt, Freek W A

2014-08-01

The impact of an acute coronary syndrome (ACS) event, such as an acute myocardial infarction (MI), is not limited to the acute management phase; patients face an elevated risk of residual atherothrombotic events that commonly requires chronic management for months or even years. Significant advances have been made in both the acute and chronic management of patients with acute MI over the past decade, resulting in improved prognoses. One of the hallmarks of modern treatment strategies is more aggressive antiplatelet treatment regimens. However, the risks of further ACS events, stroke and premature death remain elevated in these patients, and addressing this residual risk is challenging owing to interpatient variability, differences in management strategies between centres and countries, incomplete understanding of the specific pathophysiology of post-ACS thrombosis and limitations of current therapeutic approaches. The recent approval in Europe of the direct oral anticoagulant rivaroxaban for use in this setting in combination with clopidogrel and acetylsalicylic acid offers another strategy to consider in the management of these patients, and clinical strategies in this area continue to evolve. In this review, we chart the progress made over the past decade in reducing the burden of secondary thromboembolic events after acute MI and discuss the current position of and future perspectives on the inclusion of oral anticoagulants into care pathways in this setting. © 2014 The Authors. Fundamental & Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of Société Française de Pharmacologie et de Thérapeutique.

SNL Yucca Mountain Project data report: Density and porosity data for tuffs from the unsaturated zone at Yucca Mountain, Nevada

International Nuclear Information System (INIS)

Schwartz, B.M.

1990-02-01

Yucca Mountain, located on and adjacent to the Nevada Test Site in southern Nevada, is being evaluated as a potential site for underground disposal of nuclear wastes. At present, the physical, thermal, and mechanical properties of tuffaceous rocks from Yucca Mountain are being determined as part of the Yucca Mountain Project. This report documents experiment data, which have been obtained by Sandia National Laboratories or its contractors, for the density and porosity of tuffaceous rocks that lie above the water table at Yucca Mountain. 7 refs., 2 figs., 3 tabs

HYDROLOGIC CHARACTERISTICS OF FAULTS AT YUCCA MOUNTAIN, NEVADA

International Nuclear Information System (INIS)

R.P. Dickerson

2000-01-01

Yucca Mountain comprises a series of north-trending ridges composed of tuffs within the southwest Nevada volcanic field, 120 km northwest of Las Vegas, Nevada. These ridges are formed of east-dipping blocks of interbedded welded and nonwelded tuff that are offset along steep, mostly west-dipping faults that have tens to hundreds of meters of vertical separation. Yucca Mountain is currently under study as a potential site for underground storage of high-level radioactive waste, with the principle goal being the safe isolation of the waste from the accessible environment. To this end, an understanding of the behavior of ground-water flow through the mountain in the unsaturated zone and beneath the mountain in the saturated zone is critical. The percolation of water through the mountain and into the ground-water flow system beneath the potential repository site is predicated on: (1) the amount of water available at the surface as a result of the climatic conditions, (2) the hydrogeologic characteristics of the volcanic strata that compose the mountain. and (3) the hydrogeologic characteristics of the structures, particularly fault zones and fracture networks, that disrupt these strata. This paper addresses the hydrogeologic characteristics of the fault zones at Yucca Mountain, focusing primarily on the central part of the mountain where the potential repository block is located

Symposium 9: Rocky Mountain futures: preserving, utilizing, and sustaining Rocky Mountain ecosystems

Science.gov (United States)

Baron, Jill S.; Seastedt, Timothy; Fagre, Daniel B.; Hicke, Jeffrey A.; Tomback, Diana; Garcia, Elizabeth; Bowen, Zachary H.; Logan, Jesse A.

2013-01-01

In 2002 we published Rocky Mountain Futures, an Ecological Perspective (Island Press) to examine the cumulative ecological effects of human activity in the Rocky Mountains. We concluded that multiple local activities concerning land use, hydrologic manipulation, and resource extraction have altered ecosystems, although there were examples where the “tyranny of small decisions” worked in a positive way toward more sustainable coupled human/environment interactions. Superimposed on local change was climate change, atmospheric deposition of nitrogen and other pollutants, regional population growth, and some national management policies such as fire suppression.

[Life cycles of ground beetles (Coleoptera, Carabidae) from the mountain taiga and mountain forest-steppe in the Eastern Sayan].

Science.gov (United States)

Khobrakova, L Ts; Sharova, I Kh

2005-01-01

Seasonal dynamics and demographic structure was studied in 15 dominant ground beetle species in the mountain taiga and mountain forest-steppe belts of the Eastern Sayan (Okinskoe Plateau). Life cycles of the dominant ground beetle species were classified by developmental time, seasonal dynamics, and intrapopulation groups with different reproduction timing. The strategies of carabid life cycles adapted to severe mountain conditions of the Eastern Sayan were revealed.

Severe street and mountain bicycling injuries in adults: a comparison of the incidence, risk factors and injury patterns over 14 years.

Science.gov (United States)

Roberts, Derek J; Ouellet, Jean-Francois; Sutherland, Francis R; Kirkpatrick, Andrew W; Lall, Rohan N; Ball, Chad G

2013-06-01

Street and mountain bicycling are popular recreational activities and prevalent modes of transportation with the potential for severe injury. The purpose of this investigation was to compare the incidence, risk factors and injury patterns among adults with severe street versus mountain bicycling injuries. We conducted a retrospective cohort study using the Southern Alberta Trauma Database of all adults who were severely injured (injury severity score [ISS] ≥ 12) while street or mountain bicycling between Apr. 1, 1995, and Mar. 31, 2009. Among 11 772 severely injured patients, 258 (2.2%) were injured (mean ISS 17, hospital stay 6 d, mortality 7%) while street (n = 209) or mountain bicycling (n = 49). Street cyclists were often injured after being struck by a motor vehicle, whereas mountain bikers were frequently injured after faulty jump attempts, bike tricks and falls (cliffs, roadsides, embankments). Mountain cyclists were admitted more often on weekends than weekdays (61.2% v. 45.0%, p = 0.040). Injury patterns were similar for both cohorts (all p > 0.05), with trauma to the head (67.4%), extremities (38.4%), chest (34.1%), face (26.0%) and abdomen (10.1%) being common. Spinal injuries, however, were more frequent among mountain cyclists (65.3% v. 41.1%, p = 0.003). Surgical intervention was required in 33.3% of patients (9.7% open reduction internal fixation, 7.8% spinal fixation, 7.0% craniotomy, 5.8% facial repair and 2.7% laparotomy). With the exception of spine injuries, severely injured cyclists display similar patterns of injury and comparable outcomes, regardless of style (street v. mountain). Helmets and thoracic protection should be advocated for injury prevention.

Floristic analysis of the wanda mountain in north eastern china

International Nuclear Information System (INIS)

Wang, H.; Xu, L.; Zhang, Z.

2016-01-01

The plants of the Wanda Mountain area were investigated between 2009 to 2013. The results show that Wanda Mountain has 95 families of seed plants distributed in 334 genera and 705 species. A geographical component analysis shows that in addition to a small number of cosmopolitan species, cold, temperate and tropical species account for 14.9%, 77.3% and 4.4% of the total species, respectively, indicating that the flora of the Wanda Mountains exhibits a significant temperate nature and includes a small number of tropical components and certain cold components. In addition, the Wanda Mountains show a remarkable level of endemism and are geographically related to other regions in East Asia, particularly Japan. Furthermore, the Wanda Mountains present a complicated species composition, with a total of 14 distribution patterns and 10 variants. The coefficient of similarity between the flora of the Wanda Mountain area and the flora of the Changbai Mountain area is 43.1%, and the coefficient of similarity between the flora of the Wanda Mountain area and the flora of the Lesser Xingan Mountain area is 49.2%, indicating that the plants of the Wanda Mountain area are more common to those of the Lesser Xingan Mountain area. (author)

An evaluation of seven methods for controlling mountain laurel thickets in the mixed-oak forests of the central Appalachian Mountains, USA

Science.gov (United States)

Patrick H. Brose

2017-01-01

In the Appalachian Mountains of eastern North America, mountain laurel (Kalmia latifolia) thickets in mixed-oak (Quercus spp.) stands can lead to hazardous fuel situations, forest regeneration problems, and possible forest health concerns. Therefore, land managers need techniques to control mountain laurel thickets and limit...

Rest/stress myocardial perfusion imaging: A means to prevent missed acute ischemic coronary syndrome diagnoses

International Nuclear Information System (INIS)

Fink-Bennett, D.; Pattekar, A.M.

2002-01-01

Aim: The sensitivity and specificity of rest/stress (R/S) myocardial perfusion imaging (MPI) in detecting an acute ischemic coronary syndrome (AICS) was determined in 100 consecutive patients (pts) admitted to the Chest Pain Clinic-Observation Unit (CPC-OU) with chest pain (CP) of suspected cardiac etiology and a negative (neg) or non diagnostic (dx) EKG. There were 57 females and 43 males, 30-83 years of age. 50 studies were performed from 1/15/98 to 4/2/98; 50 from 11/19/99 to 1/10/00. Material and Methods: An AICS was deemed present if a reversible perfusion defect was demonstrated scintigraphically; a ?50% luminal narrow angiographically. No AICS if the pt had a normal R/S MPI, a fixed defect with normal wall motion and thickening, a neg cardiac catheterization, or was free of cardiac symptoms and had no history of a vascular event for 2-3 years post CPC-OU admission. 13 pts with a positive MPI had a cardiac catheterization, none with a neg MPI. SPECT rest MPI's were performed 30-90 minutes (mins) post 10.0 mCi of technetium 99m Sestamibi. SPECT stress MPI's were performed following a 6-8 hour acute myocardial infarction enzyme (CP-MB/Troponin 1) rule out and 30-90 mins post 30.0 mCi of technetium 99m Sestamibi. Results: 29 pts were lost to follow-up. There were 12 true positive, 5 false positive, 54 true negative and 0 false negative studies. The sensitivity, specificity, positive and negative predictive value of a R/S MPI in detecting an AICS is 100%, 91%, 70% and 100%, respectively. An AICS was detected in 12% of pts admitted to the CPC-OU; a finding that correlates with its reported incidence of 2-12%. 6 were managed medically, 3 required emergent bypass surgery, 3 were stented. Conclusion: R/S MPI should be included in the CPC-OU dx work-up of pts with CP of suspected cardiac etiology to prevent missed AICS diagnoses. Patient care will be optimized and health care and medical malpractice awards for failure to diagnosis an acute myocardial infarction

Effect of Zinc supplementation on the Management of Acute ...

African Journals Online (AJOL)

Supplementing the treatment of acute watery diarrhea with Zinc in just 2 cases will prevent recurrence of diarrhea in one of the children in the following 12 weeks. Fourteen days supplementation of Zinc in the treatment of acute diarrhea in children significantly reduced the average number of watery stools and duration of ...

Mountain biking. Breezy ups and traumatic downs; Mountainbiking. Luftige Hoehen und traumatische Tiefen

Energy Technology Data Exchange (ETDEWEB)

Schueller, G. [Medizinische Universitaet Wien, Univ.-Klinik fuer Radiodiagnostik, Wien (Austria)

2010-05-15

For more than two decades the popularity of mountain biking as a national pastime as well as a competitive sport has been undiminished. However, its related risks are not monitored as closely as those, for example, of skiing. The injuries caused by mountain biking are specific and cannot be compared with those caused by other cycling sports. This is due not only to the characteristics of the terrain but also to the readiness to assume a higher risk compared to cycle racing. The particular value of radiology is in the acute trauma setting. Most often musculoskeletal lesions must be examined and digital radiography and MRI are the most useful techniques. Severe trauma of the cranium, face, spine, thorax and abdomen are primarily evaluated with CT, particularly in dedicated trauma centers. Therefore, radiology can play a role in the rapid diagnosis and optimal treatment of the trauma-related injuries of mountain biking. Thus, the unnecessarily high economical damage associated with mountain biking can be avoided. (orig.) [German] Mountainbiking erfreut sich seit mehr als 2 Jahrzehnten sowohl im Breiten- als auch Wettkampfsport einer ungebrochenen Popularitaet. Die assoziierten Risiken werden allerdings nicht mit derselben Aufmerksamkeit beobachtet wie etwa jene des Skisports. Die Verletzungen beim Mountainbiking sind spezifisch und nicht mit den Verletzungen vergleichbar, die bei anderen Radsportarten entstehen. Dies ist z. T. durch die Besonderheiten des Terrains und z. T. durch eine im Vergleich zum Rennradfahren hoehere Risikobereitschaft zu erklaeren. Die Radiologie hat ihren Stellenwert besonders in der Akutdiagnostik. Hier beschaeftigt sie sich v. a. mit muskuloskelettalen Verletzungen und setzt in erster Linie auf die digitale Projektionsradiographie und die MRT. Zur Evaluierung schwerer Verletzungen des Kopfs, der Wirbelsaeule, des Thorax und des Abdomens wird die CT bevorzugt, insbesondere in dezidierten Traumazentren. Damit kann die Radiologie ihren Teil

Myocardial involvement in rocky mountain spotted fever: a case report and review.

Science.gov (United States)

Doyle, Amy; Bhalla, Karan S; Jones, James M; Ennis, David M

2006-10-01

Rocky Mountain Spotted Fever (RMSF), caused by Rickettia rickettsii, is a serious tickborne illness that is endemic in the southeastern United States. Although it is most commonly known as a cause of fever and rash, it can have systemic manifestations. The myocardium may rarely be involved, with symptoms that can mimic those of acute coronary syndromes. This report describes a case of serologically proven RMSF causing symptomatic myocarditis, manifested by chest pain, elevated cardiac enzyme levels, and decrease myocardial function. After treatment with antibiotics, the myocarditis resolved. Thus, although unusual, the clinician should be aware of myocardial disease in patients with appropriate exposure histories or other clinical signs of RMSF. Close monitoring and an aggressive approach are essential to reduce mortality rates.

MOUNTAIN-SCALE COUPLED PROCESSES (TH/THC/THM) MODELS

International Nuclear Information System (INIS)

Y.S. Wu

2005-01-01

This report documents the development and validation of the mountain-scale thermal-hydrologic (TH), thermal-hydrologic-chemical (THC), and thermal-hydrologic-mechanical (THM) models. These models provide technical support for screening of features, events, and processes (FEPs) related to the effects of coupled TH/THC/THM processes on mountain-scale unsaturated zone (UZ) and saturated zone (SZ) flow at Yucca Mountain, Nevada (BSC 2005 [DIRS 174842], Section 2.1.1.1). The purpose and validation criteria for these models are specified in ''Technical Work Plan for: Near-Field Environment and Transport: Coupled Processes (Mountain-Scale TH/THC/THM, Drift-Scale THC Seepage, and Drift-Scale Abstraction) Model Report Integration'' (BSC 2005 [DIRS 174842]). Model results are used to support exclusion of certain FEPs from the total system performance assessment for the license application (TSPA-LA) model on the basis of low consequence, consistent with the requirements of 10 CFR 63.342 [DIRS 173273]. Outputs from this report are not direct feeds to the TSPA-LA. All the FEPs related to the effects of coupled TH/THC/THM processes on mountain-scale UZ and SZ flow are discussed in Sections 6 and 7 of this report. The mountain-scale coupled TH/THC/THM processes models numerically simulate the impact of nuclear waste heat release on the natural hydrogeological system, including a representation of heat-driven processes occurring in the far field. The mountain-scale TH simulations provide predictions for thermally affected liquid saturation, gas- and liquid-phase fluxes, and water and rock temperature (together called the flow fields). The main focus of the TH model is to predict the changes in water flux driven by evaporation/condensation processes, and drainage between drifts. The TH model captures mountain-scale three-dimensional flow effects, including lateral diversion and mountain-scale flow patterns. The mountain-scale THC model evaluates TH effects on water and gas

MOUNTAIN-SCALE COUPLED PROCESSES (TH/THC/THM)MODELS

Energy Technology Data Exchange (ETDEWEB)

Y.S. Wu

2005-08-24

This report documents the development and validation of the mountain-scale thermal-hydrologic (TH), thermal-hydrologic-chemical (THC), and thermal-hydrologic-mechanical (THM) models. These models provide technical support for screening of features, events, and processes (FEPs) related to the effects of coupled TH/THC/THM processes on mountain-scale unsaturated zone (UZ) and saturated zone (SZ) flow at Yucca Mountain, Nevada (BSC 2005 [DIRS 174842], Section 2.1.1.1). The purpose and validation criteria for these models are specified in ''Technical Work Plan for: Near-Field Environment and Transport: Coupled Processes (Mountain-Scale TH/THC/THM, Drift-Scale THC Seepage, and Drift-Scale Abstraction) Model Report Integration'' (BSC 2005 [DIRS 174842]). Model results are used to support exclusion of certain FEPs from the total system performance assessment for the license application (TSPA-LA) model on the basis of low consequence, consistent with the requirements of 10 CFR 63.342 [DIRS 173273]. Outputs from this report are not direct feeds to the TSPA-LA. All the FEPs related to the effects of coupled TH/THC/THM processes on mountain-scale UZ and SZ flow are discussed in Sections 6 and 7 of this report. The mountain-scale coupled TH/THC/THM processes models numerically simulate the impact of nuclear waste heat release on the natural hydrogeological system, including a representation of heat-driven processes occurring in the far field. The mountain-scale TH simulations provide predictions for thermally affected liquid saturation, gas- and liquid-phase fluxes, and water and rock temperature (together called the flow fields). The main focus of the TH model is to predict the changes in water flux driven by evaporation/condensation processes, and drainage between drifts. The TH model captures mountain-scale three-dimensional flow effects, including lateral diversion and mountain-scale flow patterns. The mountain-scale THC model evaluates TH effects on

ECSS Position Statement 2009: Prevention of acute sports injuries

NARCIS (Netherlands)

Steffen, K.; Andersen, T.E.; Krosshaug, T.; van Mechelen, W.; Myklebust, G.; Verhagen, E.A.L.M.; Bahr, R.

2010-01-01

To maximize the health benefits of sports and exercise and to minimize the direct and indirect costs associated with injuries, developing and adopting injury prevention strategies is an important goal. The aim of this ECSS consensus paper on injury prevention is to review current evidence on injury

THE TEAM BUILDING IN COLLECTIVES AS PREVENTIVE AND THERAPEUTIC ACTIVITY IN ACUTE AND CHRONIC STRESS

Directory of Open Access Journals (Sweden)

Tsvetelina Mihaylova

2018-04-01

Full Text Available The stress contributes to almost all medical illnesses while the acute and chronic stress - related to work - is a primary cause of such life-threatening conditions as myocardial infarction, brain stroke, etc. The aim of the current study is an investigation of the methods for team building related to prevention and therapy in connection with acute or chronic stress. The accomplishment of the aim set is achieved by means of assessment of the applicability of laughter therapy, as a method for team building suitable in practice. It was found that the laughter therapy may help reduction of stress and tension, improvement of the quality of work, strengthening of the social relations and interrelations, etc. Increasingly more studies maintain the theory that the laughter may have therapeutic value and brings about physical benefits to the particular individual, as a member of the personnel. The laughter is a part of human behavior, and it helps people to clarify their intentions in the social interaction. The laughter is used as a signal for accepting the positive interactions with other people and is a precondition for friendly attitude in the working environment as well. Conclusions may be drawn that the laughter therapy is a suitable method for team building; the laughter therapy is appropriate for everyone as a means for the alleviation of stress, and it has a positive impact on the working process. In terms of business, a positive assessment of the methods for pulling together of members of the collective (team building may be given by a way which has subsequent positive consequences on their work.

Yucca Mountain Milestone

International Nuclear Information System (INIS)

Hunt, Rod

1997-01-01

The Department of Energy project to determine if the Yucca Mountain site in Nevada is suitable for geologic disposal of high-level nuclear waste reached a major milestone in late April when a 25-foot-diameter tunnel boring machine ''holed through'' completing a five-mile-long, horseshoe-shaped excavation through the mountain. When the cutting-head of the giant machine broke through to daylight at the tunnel's south portal, it ended a 2 1/2-year excavation through the mountain that was completed ahead of schedule and with an outstanding safety record. Video of the event was transmitted live by satellite to Washington, DC, where it was watched by Secretary of Energy Frederico Pena and other high-level DOE officials, signifying the importance of the project's mission to find a repository for high-level nuclear waste and spent nuclear fuel produced by nuclear power plants. This critical undertaking is being performed by DOE's Office of Civilian Radioactive Waste Management (OCRWM). The tunnel is the major feature of the Exploratory Studies Facility (ESF), which serves as an underground laboratory for engineers and scientists to help determine if Yucca Mountain is suitable to serve as a repository for the safe disposal of high-level nuclear waste. Morrison Knudsen's Environmental/Government Group is providing design and construction-management services on the project. The MK team is performing final design for the ESF and viability assessment design for the underground waste repository that will be built only if the site is found suitable for such a mission. In fact, if at anytime during the ESF phase, the site is found unsuitable, the studies will be stopped and the site restored to its natural state

Challenges in secondary prevention after acute myocardial infarction

DEFF Research Database (Denmark)

Piepoli, Massimo F; Corrà, Ugo; Dendale, Paul

2017-01-01

in the first year and approximately 50% of major coronary events occur in those with a previous hospital discharge diagnosis of ischaemic heart disease. The people behind these numbers spur this call for action. Prevention after myocardial infarction is crucial to reduce risk and suffering. Evidence...... document in which the existing gaps for secondary prevention strategies are reviewed. Effective interventions in relation to the patients, healthcare providers and healthcare systems are proposed and discussed. Finally, innovative strategies in hospital as well as in outpatient and long-term settings...

Mountain laurel toxicosis in a dog.

Science.gov (United States)

Manhart, Ingrid O; DeClementi, Camille; Guenther, Christine L

2013-01-01

To describe a case of mountain laurel (Kalmia latifolia) toxicosis in a dog, including case management and successful outcome. A dog presented for vomiting, hematochezia, bradycardia, weakness, and ataxia, which did not improve with supportive treatment. Mountain laurel ingestion was identified as cause of clinical signs after gastrotomy was performed to remove stomach contents. Supportive treatment was continued and the dog made a full recovery. This report details a case of mountain laurel toxicosis in a dog, including management strategies and outcome, which has not been previously published in the veterinary literature. © Veterinary Emergency and Critical Care Society 2013.

Mountain Warfare: The Need for Specialist Training

National Research Council Canada - National Science Library

Malik, Muhammad

2003-01-01

This study focuses on the need for specialist training for mountain warfare. It analyzes the special characteristics of mountain and high altitude terrain which affect conduct of military operations...

Yucca Mountain Project public interactions

International Nuclear Information System (INIS)

Reilly, B.E.

1990-01-01

The US Department of Energy (DOE) is committed to keeping the citizens of Nevada informed about activities that relate to the high-level nuclear waste repository program. This paper presents an overview of the Yucca Mountain Project's public interaction philosophy, objectives, activities and experiences during the two years since Congress directed the DOE to conduct site characterization activities only for the Yucca Mountain site

Bilateral acute retinal necrosis after herpetic meningitis

Directory of Open Access Journals (Sweden)

Katsura T

2012-04-01

Full Text Available Keisho Hirota1,2, Masayuki Akimoto1,3, Toshiaki Katsura21Department of Ophthalmology, Kyoto Medical Center, National Hospital Organization, 2Internal Medicine, Kyoto Medical Center, 3Clinical Research Center, Kyoto Medical Center, Kyoto, JapanPurpose: The report of a case of bilateral acute retinal necrosis after herpetic meningitis.Case report: A 47-year-old man was admitted with the chief complaint of persistent high fever and transient loss of consciousness. Although his general condition improved after intravenous acyclovir administration, the patient presented with visual loss in both eyes 4 days after admission. Visual acuity in his right eye was 20/200 and his left eye had light perception alone. Both eyes showed panretinal arteritis diagnosed as acute retinal necrosis. Panretinal photocoagulation was performed for both eyes. Progression of retinal detachment was prevented in both eyes; however, visual acuity of the left eye was totally lost because of neovascular glaucoma. Visual acuity of the right eye recovered to 20/20.Conclusion: Although cases of bilateral acute retinal necrosis have been reported after herpetic encephalitis, this condition is rare after herpetic meningitis. Prophylactic acyclovir therapy and early panretinal photocoagulation may prevent retinal detachment and improve the prognosis. Neurologists and ophthalmologists should be aware that not only herpetic encephalitis but also herpetic meningitis can lead to acute retinal necrosis within a very short interval.Keywords: acute retinal necrosis, herpetic meningitis, herpes simplex, varicella zoster virus

Transference of 3D accelerations during cross country mountain biking.

Science.gov (United States)

Macdermid, Paul W; Fink, Philip W; Stannard, Stephen R

2014-06-03

Investigations into the work demands of Olympic format cross country mountain biking suggest an incongruent relationship between work done and physiological strain experienced by participants. A likely but unsubstantiated cause is the extra work demand of muscle damping of terrain/surface induced vibrations. The purpose of this study was to describe the relationship between vibration mechanics and their interaction with terrain, bicycle and rider during a race pace effort on a cross country mountain bike track, on both 26″ and 29″ wheels. Participants completed one lap of a cross country track using 26″ and 29″ wheels, at race pace. Power, cadence, speed, heart rate and geographical position were sampled and logged every second for control purposes. Tri-axial accelerometers located on the bicycle and rider, recorded accelerations (128Hz) and were used to quantify vibrations experienced during the whole lap and over terrain sections (uphill and downhill). While there were no differences in power output (p=0.3062) and heart rate (p=0.8423), time to complete the lap was significantly (p=0.0061) faster on the 29″ wheels despite increased vibrations in the larger wheels (p=0.0020). Overall accelerometer data (RMS) showed location differences (pbike-body compared to those experienced at the lower back and head. The reduction in accelerations at both the lower back and head are imperative for injury prevention and demonstrates an additional non-propulsive, muscular, challenge to riding. Stress was greatest during downhill sections as acceleration differences between locations were greater when compared to uphill sections, and thus possibly prevent the recovery processes that may occur during non-propulsive load. Copyright © 2014 Elsevier Ltd. All rights reserved.

ARCOS Network: A Sustainable Mountain Development Hub for Africa

Directory of Open Access Journals (Sweden)

Gilbert Muvunankiko

2017-05-01

Full Text Available The African continent is endowed with mountains of high productivity, biodiversity, endemism, and cultural diversity. African mountain ecosystems play an important role in economic development, poverty alleviation, and environmental protection. However, climate change and extreme events, as well as human activities, alter the capacity of mountains to provide such services to millions of Africans who depend on them. Since the creation in 1995 of the Albertine Rift Conservation Society (ARCOS, mountains have been at the core of its programs, and collaboration among stakeholders is a key aspect of its search for sustainable solutions to threats affecting African mountains.

Effect of a prostaglandin - given rectally for prevention of radiation-induced acute proctitis - on late rectal toxicity. Results of phase III randomized, placebo-controlled, double-blind study

International Nuclear Information System (INIS)

Kertesz, Tereza; Herrmann, Markus K.A.; Christiansen, Hans; Hermann, Robert M.; Hess, Clemens F.; Hille, Andrea; Zapf, Antonia; Pradier, Olivier; Schmidberger, Heinz

2009-01-01

Background and purpose: to assess the late effect of a prostaglandin, given rectally during irradiation, on late rectal toxicity. In the acute treatment setting no significant differences in reducing the incidence of acute proctitis symptoms in patients receiving misoprostol, however, significantly more rectal bleeding had been reported. Patients and methods: a total of 100 patients who had undergone radiotherapy for prostate cancer had been entered into this phase III randomized, placebo-controlled, double-blind study with misoprostol or placebo suppositories. The toxicity was evaluated yearly after cessation of irradiation by the RTOG/LENT-SOMA scale. Results: the median follow-up was 50 months. 20 patients suffered from grade 1, four patients from grade 2 as well, and three patients only from grade 2 toxicity. Frequency, bleeding and urgency were the most commonly reported symptoms. In keeping with other studies and clinical experience, the symptoms peaked within the first 2 years with a median for grade 1 of 13 months and for grade 2 of 15 months. The presence of acute toxicity grade 2 showed a correlation with the development of any late toxicity (p = 0.03). Any acute rectal bleeding was significant correlated with any late rectal bleeding (p = 0.017). Conclusion: misoprostol given as once-daily suppository for prevention of acute radiation-induced proctitis does neither influence the incidence and severity of radiation-induced acute nor late rectal toxicity. Misoprostol has no negative impact on the incidence and severity of late rectal bleeding, in contrast to acute rectal bleeding. The routine clinical use of misoprostol suppositories cannot be recommended. (orig.)

Effect of a prostaglandin - given rectally for prevention of radiation-induced acute proctitis - on late rectal toxicity. Results of phase III randomized, placebo-controlled, double-blind study

Energy Technology Data Exchange (ETDEWEB)

Kertesz, Tereza; Herrmann, Markus K.A.; Christiansen, Hans; Hermann, Robert M.; Hess, Clemens F.; Hille, Andrea [Dept. of Radiotherapy and Radiooncology, Univ. of Goettingen (Germany); Zapf, Antonia [Dept. of Medical Statistics, Univ. of Goettingen (Germany); Pradier, Olivier [Dept. of Radiotherapy and Radiooncology, Univ. of Brest (France); Schmidberger, Heinz [Dept. of Radiotherapy and Radiooncology, Univ. of Mainz (Germany)

2009-09-15

Background and purpose: to assess the late effect of a prostaglandin, given rectally during irradiation, on late rectal toxicity. In the acute treatment setting no significant differences in reducing the incidence of acute proctitis symptoms in patients receiving misoprostol, however, significantly more rectal bleeding had been reported. Patients and methods: a total of 100 patients who had undergone radiotherapy for prostate cancer had been entered into this phase III randomized, placebo-controlled, double-blind study with misoprostol or placebo suppositories. The toxicity was evaluated yearly after cessation of irradiation by the RTOG/LENT-SOMA scale. Results: the median follow-up was 50 months. 20 patients suffered from grade 1, four patients from grade 2 as well, and three patients only from grade 2 toxicity. Frequency, bleeding and urgency were the most commonly reported symptoms. In keeping with other studies and clinical experience, the symptoms peaked within the first 2 years with a median for grade 1 of 13 months and for grade 2 of 15 months. The presence of acute toxicity grade 2 showed a correlation with the development of any late toxicity (p = 0.03). Any acute rectal bleeding was significant correlated with any late rectal bleeding (p = 0.017). Conclusion: misoprostol given as once-daily suppository for prevention of acute radiation-induced proctitis does neither influence the incidence and severity of radiation-induced acute nor late rectal toxicity. Misoprostol has no negative impact on the incidence and severity of late rectal bleeding, in contrast to acute rectal bleeding. The routine clinical use of misoprostol suppositories cannot be recommended. (orig.)

Field test of foliar-spray herbicides to control mountain laurel in mature mixed-oak forests in western Maryland

Science.gov (United States)

Gary W. Miller; Patrick H. Brose; Jeffrey D. Kochenderfer; James N. Kochenderfer; Kurt W. Gottschalk; John R. Denning

2016-01-01

Successful oak (Quercus spp.) regeneration requires the presence of competitive sources of oak reproduction before parent oaks are harvested. Mountain laurel (Kalmia latifolia) in the understory of many Appalachian forests prevents new oak seedlings from receiving adequate sunlight to survive and grow into competitive size classes. This study examined the efficacy of...

Probiotics, calcium and acute diarrhea : a randomized trial in Indonesian children

NARCIS (Netherlands)

Agustina, R.

2012-01-01

Background
Acute diarrhea and acute respiratory tract infections (ARTIs) continue to lead the infectious cause of morbidity and mortality among children <5 years of age in developing countries, including Indonesia. Efforts to prevent diarrheal disease by probiotics and milk calcium

Potential Harmful Effects of PM2.5 on Occurrence and Progression of Acute Coronary Syndrome: Epidemiology, Mechanisms, and Prevention Measures

Directory of Open Access Journals (Sweden)

Xu Meng

2016-07-01

Full Text Available The harmful effects of particulate matter with an aerodynamic diameter of <2.5 µm (PM2.5 and its association with acute coronary syndrome (ACS has gained increased attention in recent years. Significant associations between PM2.5 and ACS have been found in most studies, although sometimes only observed in specific subgroups. PM2.5-induced detrimental effects and ACS arise through multiple mechanisms, including endothelial injury, an enhanced inflammatory response, oxidative stress, autonomic dysfunction, and mitochondria damage as well as genotoxic effects. These effects can lead to a series of physiopathological changes including coronary artery atherosclerosis, hypertension, an imbalance between energy supply and demand to heart tissue, and a systemic hypercoagulable state. Effective strategies to prevent the harmful effects of PM2.5 include reducing pollution sources of PM2.5 and population exposure to PM2.5, and governments and organizations publicizing the harmful effects of PM2.5 and establishing air quality standards for PM2.5. PM2.5 exposure is a significant risk factor for ACS, and effective strategies with which to prevent both susceptible and healthy populations from an increased risk for ACS have important clinical significance in the prevention and treatment of ACS.

Extreme ground motions and Yucca Mountain

Science.gov (United States)

Hanks, Thomas C.; Abrahamson, Norman A.; Baker, Jack W.; Boore, David M.; Board, Mark; Brune, James N.; Cornell, C. Allin; Whitney, John W.

2013-01-01

Yucca Mountain is the designated site of the underground repository for the United States' high-level radioactive waste (HLW), consisting of commercial and military spent nuclear fuel, HLW derived from reprocessing of uranium and plutonium, surplus plutonium, and other nuclear-weapons materials. Yucca Mountain straddles the western boundary of the Nevada Test Site, where the United States has tested nuclear devices since the 1950s, and is situated in an arid, remote, and thinly populated region of Nevada, ~100 miles northwest of Las Vegas. Yucca Mountain was originally considered as a potential underground repository of HLW because of its thick units of unsaturated rocks, with the repository horizon being not only ~300 m above the water table but also ~300 m below the Yucca Mountain crest. The fundamental rationale for a geologic (underground) repository for HLW is to securely isolate these materials from the environment and its inhabitants to the greatest extent possible and for very long periods of time. Given the present climate conditions and what is known about the current hydrologic system and conditions around and in the mountain itself, one would anticipate that the rates of infiltration, corrosion, and transport would be very low—except for the possibility that repository integrity might be compromised by low-probability disruptive events, which include earthquakes, strong ground motion, and (or) a repository-piercing volcanic intrusion/eruption. Extreme ground motions (ExGM), as we use the phrase in this report, refer to the extremely large amplitudes of earthquake ground motion that arise at extremely low probabilities of exceedance (hazard). They first came to our attention when the 1998 probabilistic seismic hazard analysis for Yucca Mountain was extended to a hazard level of 10-8/yr (a 10-4/yr probability for a 104-year repository “lifetime”). The primary purpose of this report is to summarize the principal results of the ExGM research program

Improving Prevention, Early Recognition and Management of Acute Kidney Injury after Major Surgery: Results of a Planning Meeting with Multidisciplinary Stakeholders

Directory of Open Access Journals (Sweden)

Matthew T James

2014-08-01

Full Text Available Purpose of review: Acute kidney injury (AKI is common after major surgery, and is associated with morbidity, mortality, increased length of hospital stay, and high health care costs. Although recent guidelines for AKI provide recommendations for identification of patients at risk, monitoring, diagnosis, and management of AKI, there is lack of understanding to guide successful implementation of these recommendations into clinical practice. Sources of information: We held a planning meeting with multidisciplinary stakeholders to identify barriers, facilitators, and strategies to implement recommendations for prevention, early identification, and management of AKI after major surgery. Barriers and facilitators to knowledge use for peri-operative AKI prevention and care were discussed. Findings: Stakeholders identified barriers in knowledge (how to identify high-risk patients, what criteria to use for diagnosis of AKI, attitudes (self-efficacy in preventive care and management of AKI, and behaviors (common use of diuretics, non-steroidal anti-inflammatory drugs, withholding of intravenous fluids, and competing time demands in peri-operative care. Educational, informatics, and organizational interventions were identified by stakeholders as potentially useful elements for future interventions for peri-operative AKI. Limitation: Meeting participants were from a single centre. Implications: The information and recommendations obtained from this stakeholder's meeting will be useful to design interventions to improve prevention and early care for AKI after major surgery.

Preventive Ceftriaxone in Patients with Stroke Treated with Intravenous Thrombolysis: Post Hoc Analysis of the Preventive Antibiotics in Stroke Study

NARCIS (Netherlands)

Vermeij, Jan-Dirk; Westendorp, Willeke F.; Roos, Yvo B.; Brouwer, Matthijs C.; van de Beek, Diederik; Nederkoorn, Paul J.

2016-01-01

The Preventive Antibiotics in Stroke Study (PASS), a randomized open-label masked endpoint trial, showed that preventive ceftriaxone did not improve functional outcome at 3 months in patients with acute stroke (adjusted common OR 0.95; 95% CI 0.82-1.09). Post-hoc analyses showed that among patients

Ondansetron versus granisetron in the prevention of chemotherapy induced nausea and vomiting in children with acute lymphoblastic leukemia.

Science.gov (United States)

Siddique, R; Hafiz, M G; Rokeya, B; Jamal, C Y; Islam, A

2011-10-01

Effect of ondansetron and granisetron were evaluated in sixty (60) children (age 4-11 years) irrespective of sex, diagnosed case of acute lymphoblastic leukemia (ALL) who received high dose methotrexate and did not receive any antiemetic 24 hours prior to HDMTX. This was a prospective, randomized, double-blind, single center study. Of 60 children, 30 received oral ondansetron (4mg) and rest 30 granisetron (1mg) half an hour before therapy. Drugs were randomly allocated with appropriate code. The patients were followed up from day 1 to day 5 of therapy. Episodes of nausea and vomiting were recorded and scorings was done every 24 hours following chemotherapy. No significant difference was found between two groups according to acute emesis (Day-1) (p=0.053). In day two and day three it was significant (pgranisetron and 70% in children who received ondansetron. Delayed (Day 2-4) CINV were controlled in 80% of children who received granisetron and 43.4% who received ondansetron (pGranisetron group required additional doses only 3.3% cases and ondanseton group 30% cases on the second day (pgranisetron group due to adverse effects of antiemetic drug itself (p=0.001). Maximum episodes of vomiting were found on the second day in ondansetron group 33.3% and in granisetron group 3.3% (p=0.003). Though adverse effects like headache, constipation, abdominal pain and loose motion were common in both group of children but their number was much less in children who received granisetron. On second day of therapy score of nausea and vomiting was maximum in ondansetron and minimum in granisetron treated on day 4 and the result was significant. So, to prevent acute and delayed CINV in children with ALL, oral graniseteron can be considered as more effective and well tolerated with minimum adverse effects compared with ondansetrons.

Bacteriotherapy with Streptococcus salivarius 24SMB and Streptococcus oralis 89a nasal spray for preventing recurrent acute otitis media in children: a real-life clinical experience

Directory of Open Access Journals (Sweden)

La Mantia I

2017-06-01

Full Text Available Ignazio La Mantia, Attilio Varricchio, Giorgio Ciprandi Associazione Italiana Vie Aeree Superiori, Naples, Italy Abstract: Recurrence of acute otitis media (RAOM is a relevant issue in the clinical practice. “Bacteriotherapy” has been proposed as an option in children with RAOM. Streptococcus salivarius 24SMB nasal spray has been previously demonstrated to reduce the risk of acute otitis media (AOM in otitis-prone children. The current retrospective and observational study aimed to confirm this outcome in a real-life setting, such as the common pediatric practice. Group A (108 children served as control; group B (159 children was treated with S. salivarius 24SMB and Streptococcus oralis 89a nasal spray after the first AOM episode. Active treatment consisted of 3 monthly courses: 2 puffs per nostril twice/day for a week. Group B showed a significant reduction of AOM episodes in comparison with group A (p<0.0001. Notably, all actively treated children with the highest AOM recurrence had a reduction of recurrence, whereas only 50% of the control group children had reduced RAOM (p<0.0001. Also, severity grade of AOM significantly diminished after the preventive bacteriotherapy (p<0.0001. In conclusion, the current retrospective and observational study demonstrated that S. salivarius 24SMB and S. oralis 89a nasal spray could be effective in the prevention of RAOM in a real-life setting. Keywords: recurrent acute otitis media, bacteriotherapy, Streptococcus salivarius 24SMB, Streptococcus oralis 89a, nasal spray, children

Solar-wind system powers mountain clean-up

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-03-01

By using a hybrid solar-wind system, the Japanese have tackled the problem of human excrement left by tourists in mountain lodges and in natural parks by installing flush toilets and wastewater treatment plants. The solar array (4.9 kW{sub p}) consists of 76 panels of single-crystal photovoltaic cells each with an output of 64 Wp. The wind turbines (total capacity 2.1 kW) operate whatever the wind strength or direction. Storage batteries prevent any dip in power which would result from low ambient temperatures. The system can still function at temperatures as low as minus 25{sup o}C. Between November and April when the lodge is closed, the waste is decomposed biologically. A block diagram shows the elements of the system, and details of cost are given. The system won the 1999 New Energy Award.

Vital Signs: Preventing Antibiotic-Resistant Infections in Hospitals - United States, 2014.

Science.gov (United States)

Weiner, Lindsey M; Fridkin, Scott K; Aponte-Torres, Zuleika; Avery, Lacey; Coffin, Nicole; Dudeck, Margaret A; Edwards, Jonathan R; Jernigan, John A; Konnor, Rebecca; Soe, Minn M; Peterson, Kelly; McDonald, L Clifford

2016-03-11

Health care-associated antibiotic-resistant (AR) infections increase patient morbidity and mortality and might be impossible to successfully treat with any antibiotic. CDC assessed health care-associated infections (HAI), including Clostridium difficile infections (CDI), and the role of six AR bacteria of highest concern nationwide in several types of health care facilities. During 2014, approximately 4,000 short-term acute care hospitals, 501 long-term acute care hospitals, and 1,135 inpatient rehabilitation facilities in all 50 states reported data on specific infections to the National Healthcare Safety Network. National standardized infection ratios and their percentage reduction from a baseline year for each HAI type, by facility type, were calculated. The proportions of AR pathogens and HAIs caused by any of six resistant bacteria highlighted by CDC in 2013 as urgent or serious threats were determined. In 2014, the reductions in incidence in short-term acute care hospitals and long-term acute care hospitals were 50% and 9%, respectively, for central line-associated bloodstream infection; 0% (short-term acute care hospitals), 11% (long-term acute care hospitals), and 14% (inpatient rehabilitation facilities) for catheter-associated urinary tract infection; 17% (short-term acute care hospitals) for surgical site infection, and 8% (short-term acute care hospitals) for CDI. Combining HAIs other than CDI across all settings, 47.9% of Staphylococcus aureus isolates were methicillin resistant, 29.5% of enterococci were vancomycin-resistant, 17.8% of Enterobacteriaceae were extended-spectrum beta-lactamase phenotype, 3.6% of Enterobacteriaceae were carbapenem resistant, 15.9% of Pseudomonas aeruginosa isolates were multidrug resistant, and 52.6% of Acinetobacter species were multidrug resistant. The likelihood of HAIs caused by any of the six resistant bacteria ranged from 12% in inpatient rehabilitation facilities to 29% in long-term acute care hospitals. Although

Religio-cultural factors contributing to perinatal mortality and morbidity in mountain villages of Nepal: Implications for future healthcare provision

Science.gov (United States)

Javanparast, Sara; Dasvarma, Gouranga; Newman, Lareen

2018-01-01

Objective and the context This paper examines the beliefs and experiences of women and their families in remote mountain villages of Nepal about perinatal sickness and death and considers the implications of these beliefs for future healthcare provision. Methods Two mountain villages were chosen for this qualitative study to provide diversity of context within a highly disadvantaged region. Individual in-depth interviews were conducted with 42 women of childbearing age and their family members, 15 health service providers, and 5 stakeholders. The data were analysed using a thematic analysis technique with a comprehensive coding process. Findings Three key themes emerged from the study: (1) ‘Everyone has gone through it’: perinatal death as a natural occurrence; (2) Dewata (God) as a factor in health and sickness: a cause and means to overcome sickness in mother and baby; and (3) Karma (Past deeds), Bhagya (Fate) or Lekhanta (Destiny): ways of rationalising perinatal deaths. Conclusion Religio-cultural interpretations underlie a fatalistic view among villagers in Nepal’s mountain communities about any possibility of preventing perinatal deaths. This perpetuates a silence around the issue, and results in severe under-reporting of ongoing high perinatal death rates and almost no reporting of stillbirths. The study identified a strong belief in religio-cultural determinants of perinatal death, which demonstrates that medical interventions alone are not sufficient to prevent these deaths and that broader social determinants which are highly significant in local life must be considered in policy making and programming. PMID:29544226

Religio-cultural factors contributing to perinatal mortality and morbidity in mountain villages of Nepal: Implications for future healthcare provision.

Science.gov (United States)

Paudel, Mohan; Javanparast, Sara; Dasvarma, Gouranga; Newman, Lareen

2018-01-01

This paper examines the beliefs and experiences of women and their families in remote mountain villages of Nepal about perinatal sickness and death and considers the implications of these beliefs for future healthcare provision. Two mountain villages were chosen for this qualitative study to provide diversity of context within a highly disadvantaged region. Individual in-depth interviews were conducted with 42 women of childbearing age and their family members, 15 health service providers, and 5 stakeholders. The data were analysed using a thematic analysis technique with a comprehensive coding process. Three key themes emerged from the study: (1) 'Everyone has gone through it': perinatal death as a natural occurrence; (2) Dewata (God) as a factor in health and sickness: a cause and means to overcome sickness in mother and baby; and (3) Karma (Past deeds), Bhagya (Fate) or Lekhanta (Destiny): ways of rationalising perinatal deaths. Religio-cultural interpretations underlie a fatalistic view among villagers in Nepal's mountain communities about any possibility of preventing perinatal deaths. This perpetuates a silence around the issue, and results in severe under-reporting of ongoing high perinatal death rates and almost no reporting of stillbirths. The study identified a strong belief in religio-cultural determinants of perinatal death, which demonstrates that medical interventions alone are not sufficient to prevent these deaths and that broader social determinants which are highly significant in local life must be considered in policy making and programming.

Hydrologeologic characteristics of faults at Yucca Mountain, Nevada

International Nuclear Information System (INIS)

Dickerson, Robert P.

2001-01-01

Yucca Mountain is under study as a potential site for underground storage of high-level radioactive waste, with the principle goal being the safe isolation of the waste from the accessible environment. This paper addresses the hydrogeologic characteristics of the fault zones at Yucca Mountain, focusing primarily on the central part of the mountain where the potential repository block is located

Severe hypertriglyceridemia-related acute pancreatitis.

Science.gov (United States)

Stefanutti, Claudia; Labbadia, Giancarlo; Morozzi, Claudia

2013-04-01

Acute pancreatitis is a potentially life-threatening complication of severe hypertriglyceridemia. In some cases, inborn errors of metabolism such as lipoprotein lipase deficiency, apoprotein C-II deficiency, and familial hypertriglyceridemia have been reported as causes of severe hypertriglyceridemia. More often, severe hypertriglyceridemia describes various clinical conditions characterized by high plasma levels of triglycerides (>1000 mg/dL), chylomicron remnants, or intermediate density lipoprotein like particles, and/or chylomicrons. International guidelines on the management of acute pancreatitis are currently available. Standard therapeutic measures are based on the use of lipid-lowering agents (fenofibrate, gemfibrozil, niacin, Ω-3 fatty acids), low molecular weight heparin, and insulin in diabetic patients. However, when standard medical therapies have failed, non-pharmacological approaches based upon the removal of triglycerides with therapeutic plasma exchange can also provide benefit to patients with severe hypertriglyceridemia and acute pancreatitis. Plasma exchange could be very helpful in reducing triglycerides levels during the acute phase of hyperlipidemic pancreatitis, and in the prevention of recurrence. The current evidence on management of acute pancreatitis and severe hypertriglyceridemia, focusing on symptoms, treatment and potential complications is reviewed herein. © 2013 The Authors. Therapeutic Apheresis and Dialysis © 2013 International Society for Apheresis.

Hyper-alkalinization without hyper-hydration for the prevention of high-dose methotrexate acute nephrotoxicity in patients with osteosarcoma.

Science.gov (United States)

Mir, Olivier; Ropert, Stanislas; Babinet, Antoine; Alexandre, Jérôme; Larousserie, Frédérique; Durand, Jean-Philippe; Enkaoua, Eric; Anract, Philippe; Goldwasser, François

2010-11-01

To evaluate the reliability and renal safety of an original schedule of high-dose methotrexate (HDMTX) administration with hyper-alkalinization, and without hyper-hydration. Patients with osteosarcoma received HDMTX (8-12 g/m(2)) as a 4-h infusion. Hypertonic 8.4% sodium bicarbonate was infused prior to HDMTX, then once daily for 3 days. Methotrexate serum concentrations were measured at hour 4 (Cmax), hour 24, hour 48, and hour 72. Urinary pH was measured on each miction. Serum creatinine was assessed on days 1, 3, and 8. Twenty-six patients (median age: 18 years, range: 15-25) received a total of 344 cycles of HDMTX, including 16 patients treated in an outpatient basis. Urinary pH remained constantly higher than 7.5 in all patients. Grade 1 creatininemia toxicity was observed in 31 cycles (9%), and grade 2 creatinine toxicity was observed in one patient. No episode of acute severe nephrotoxicity was observed. No significant worsening was observed in serum creatinine and calculated creatinine clearance from baseline to the end of therapy (P = 0.74). The main extra-renal toxicity was alkalinization-related hypokalemia from H48. No re-hospitalization was required. Hyper-alkalinization appears an efficient and reliable method to prevent the acute renal toxicity of HDMTX and allows its safe administration in the outpatient setting.

Transport of neptunium through Yucca Mountain tuffs

International Nuclear Information System (INIS)

Triay, I.R.; Robinson, B.A.; Mitchell, A.J.; Overly, C.M.; Lopez, R.M.

1993-01-01

Neptunium has a high solubility in groundwaters from Yucca Mountain [1]. Uranium in nuclear reactors produces 237 Np which has a half-life of 2.1 4 x 10 6 years. Consequently, the transport of 237 Np through tuffs is of major importance in assessing the performance of a high-level nuclear waste repository at Yucca Mountain. The objective of this work is to determine the amount of Np retardation that is provided by the minerals in Yucca Mountain tuffs as a function of groundwater chemistry

Acute organophosphorus poisoning complicated by acute coronary syndrome.

Science.gov (United States)

Pankaj, Madhu; Krishna, Kavita

2014-07-01

We report a case of 30 year old alcoholic male admitted with vomiting, drowsiness, limb weakness and fasciculations after alleged history of consumption of 30 ml of chlorpyriphos insecticide. He had low serum cholinesterase levels. With standard treatment for organophosphorus poisoning (OPP), he improved gradually until day 5, when he developed neck and limb weakness and respiratory distress. This intermediate syndrome was treated with oximes, atropine and artificial ventilation. During treatment, his ECG showed fresh changes of ST elevation. High CPK & CPK-MB levels, septal hypokinesia on 2D echo suggested acute coronary syndrome. Coronary angiography was postponed due to his bedridden and obtunded status. The patient finally recovered fully by day 15 and was discharged. Acute coronary syndrome is a rare occurrence in OP poisoning. The present case thus emphasises the need for careful electrocardiographic and enzymatic monitoring of all patients of organophosphorus poisoning to prevent potential cardiac complication which can prove fatal.

The Correlation of Geo-Ecological Environment and Mountain Urban planning

Science.gov (United States)

Yang, Chun; Zeng, Wei

2018-01-01

As a special area with the complex geological structure, mountain city is more prone to geological disasters. Due to air pollution, ground subsidence, serious water pollution, earthquakes and floods geo-ecological environment problems have become increasingly serious, mountain urban planning is facing more severe challenges. Therefore, this article bases on the correlation research of geo-ecological environment and mountain urban planning, and re-examins mountain urban planning from the perspective of geo-ecological, coordinates the relationship between the human and nature by geo-ecological thinking, raises the questions which urban planning need to pay attention. And advocates creating an integrated system of geo-ecological and mountain urban planning, analysis the status and dynamics of present mountain urban planning.

Mountain tourism development in Serbia and neighboring countries

Directory of Open Access Journals (Sweden)

Krunić Nikola

2010-01-01

Full Text Available Mountain areas with their surroundings are important parts of tourism regions with potentials for all-season tourism development and complementary activities. Development possibilities are based on size of high mountain territory, nature protection regimes, infrastructural equipment, provided conditions for leisure and recreation as well as involvement of local population in processes of development and protection. This paper analyses the key aspects of tourism development, winter tourism in high-mountain areas of Serbia and some neighboring countries (Slovakia, Romania, Bulgaria, and Greece. Common determinants of cohesion between nature protection and mountain tourism development, national development policies, applied models and concepts and importance of trans-border cooperation are indicated.

The Effects of Inhaled Steroids on Recurrent Wheeze After Acute Bronchiolitis

Directory of Open Access Journals (Sweden)

Patricia Green MD

2015-07-01

Full Text Available Background. Acute bronchiolitis infection during infancy is associated with an increased risk of asthma later in life. The objective of this study was to determine if inhaled steroids are effective in preventing the development of recurrent wheeze or asthma following acute bronchiolitis. Methods. Multiple databases and bibliographies of selected references were searched. Inclusion required (a a randomized controlled trial of inhaled steroids and control group, (b at least 2 weeks duration of therapy started during the acute phase of disease, and (c identification of the rate of recurrent wheeze or asthma at least 6 months after therapy. Results. Of 1410 studies reviewed, 8 reports were included in this meta-analysis (748 patients. The overall odds ratio for developing recurrent wheeze or asthma with treatment versus without treatment was 1.02 (95% confidence interval = 0.58-1.81. Conclusions. A course of inhaled steroids after acute bronchiolitis is not effective in preventing recurrent wheeze or asthma.

Numerical studies of rock-gas flow in Yucca Mountain; Yucca Mountain Site Characterization Project

Energy Technology Data Exchange (ETDEWEB)

Ross, B.; Amter, S.; Lu, Ning [Disposal Safety, Inc., Washington, DC (United States)

1992-02-01

A computer model (TGIF -- Thermal Gradient Induced Flow) of two-dimensional, steady-state rock-gas flow driven by temperature and humidity differences is described. The model solves for the ``fresh-water head,`` a concept that has been used in models of variable-density water flow but has not previously been applied to gas flow. With this approach, the model can accurately simulate the flows driven by small differences in temperature. The unsaturated tuffs of Yucca Mountain, Nevada, are being studied as a potential site for a repository for high-level nuclear waste. Using the TGIF model, preliminary calculations of rock-gas flow in Yucca Mountain are made for four east-west cross-sections through the mountain. Calculations are made for three repository temperatures and for several assumptions about a possible semi-confining layer above the repository. The gas-flow simulations are then used to calculate travel-time distributions for air and for radioactive carbon-14 dioxide from the repository to the ground surface.

Mountaineering and photography. Contacts between 1880 and 1940

Directory of Open Access Journals (Sweden)

Maria Andorno

2014-12-01

Full Text Available Since the second half of the nineteenth century, the photograph produced in high altitude mountain (mountaineering photography gives rise to peculiar images that do not belong to the tradition of landscape painting. Mountaineering is similar to the art of performance, if we talk about physical and mental commitment. Therefore, photos taken during the ascent of a peak shows both conceptual and formal values.

Pyritic ash-flow tuff, Yucca Mountain, Nevada

International Nuclear Information System (INIS)

Castor, S.B.; Tingley, J.V.; Bonham, H.F. Jr.

1994-01-01

The Yucca Mountain site is underlain by a 1,500-m-thick Miocene volcanic sequence that comprises part of the southwestern Nevada volcanic field. Rocks of this sequence, which consists mainly of ash-flow tuff sheets with minor flows and bedded tuff, host precious metal mineralization in several areas as near as 10 km from the site. In two such areas, the Bullfrog and Bare Mountain mining districts, production and reserves total over 60 t gold and 150 t silver. Evidence of similar precious metal mineralization at the Yucca Mountain site may lead to mining or exploratory drilling in the future, compromising the security of the repository. The authors believe that most of the pyrite encountered by drilling at Yucca Mountain was introduced as pyroclastic ejecta, rather than by in situ hydrothermal activity. Pyritic ejecta in ash-flow tuff are not reported in the literature, but there is no reason to believe that the Yucca Mountain occurrence is unique. The pyritic ejecta are considered by us to be part of a preexisting hydrothermal system that was partially or wholly destroyed during eruption of the tuff units. Because it was introduced as ejecta in tuff units that occur at depths of about 1,000 m, such pyrite does not constitute evidence of shallow mineralization at the proposed repository site; however, the pyrite may be evidence for mineralization deep beneath Yucca Mountain or as much as tens of kilometers from it

Approach to identification and development of mountain tourism regions and destinations in Serbia with special reference to the Stara Planina mountain

Directory of Open Access Journals (Sweden)

Milijić Saša

2010-01-01

Full Text Available This paper deals with theoretical-methodological issues of tourism offer planning and regulation of settlements in mountain destinations. The basic determinants of the development of mountain tourist regions destinations in EU countries, in which respectable development results have been achieved, first of all in terms of income, together with appropriately adjusted development and environmental management system, have been emphasized. The ongoing transition and structural processes in Serbia will have an impact on application of these experiences. At the same time, a basis for competitiveness of mountain regions will not be determined only by spatial capacity and geological location, but also by creative-innovative developing environment. Taking into account the spatial-functional criteria and criteria for the development and protection, the possible spatial definition of mountain tourist regions/destinations in Serbia are presented. The justifiability and positioning of tourism development projects are analyzed aiming at uniform regional development, where two segments of demand are of particularly importance, i.e. demand for mountain tourism services and for real estates in mountain centers. Furthermore, holders of tourism offer will be analyzed through a contemporary approach which may be defined as the development and noncommercial and market and commercial one. International criteria which are evaluated while selecting city/mountain destination for Winter Olympic Games are particularly analyzed. Considering experience of countries with higher level of development of mountain regions, the main starting point for positioning projects for sustainable development of tourist destinations are defined by specifying them according to specific local and regional conditions. A rational model for spatial organization of tourism offer is shown on the example of the Stara Planina tourist region.

Spiders in mountain habitats of the Giant Mountains

Czech Academy of Sciences Publication Activity Database

Růžička, Vlastimil; Vaněk, J.; Šmilauer, P.

2012-01-01

Roč. 43, č. 4 (2012), s. 341-347 ISSN 1067-4136 Institutional research plan: CEZ:AV0Z50070508 Keywords : Giant Mountains (Krkonoše, Karkonosze) * spider s * anemo-orographic systems Subject RIV: EH - Ecology, Behaviour Impact factor: 0.236, year: 2012 http://www.springerlink.com/content/0k5g721q1155r146/fulltext.pdf

How to approach the acute respiratory distress syndrome: Prevention, plan, and prudence.

Science.gov (United States)

Koh, Younsuck

2017-05-01

The acute respiratory distress syndrome (ARDS) is typically manifested by refractory hypoxemia with high mortality. A correct diagnosis is the first step to achieve better outcomes. An early intervention to manage modifiable risk factors of ARDS development and the avoidance of aggravating factors that increase disease severity and progression should be carefully addressed. A management plan is necessary at an early stage of ARDS to determine the level of intensive care. It should be carefully decided which therapeutic measures should be performed depending on the patient׳s underlying clinical condition. The clinician׳s considerate prudence is required in decisions of when to apply intensive measures for an ARDS treatment. Mechanical ventilator support should be carefully used depending on the patient׳s severity and pathological phase. Decreasing inappropriate alveolar strain through a low tidal volume under optimal positive end-expiratory pressure is key for ventilator support in ARDS. The extracorporeal membrane oxygenation applied in the experienced centers seems to improve the survival of patients with severe ARDS. A constellation of physical and psychological problems can develop or persist for up to 5 years in patients with ARDS. Therefore, an early mobilization with rehabilitation, even during an intensive care unit stay, should be seriously considered whenever feasible. Lastly, prevention of aspiration, stress ulcers, deep vein thrombosis, catheter-related infection, overhydration, and heavy sedation is essential to achieve better outcomes in ARDS. Copyright © 2017 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

Eastern Arc Mountains and their national and global importance ...

African Journals Online (AJOL)

The Eastern Arc Mountains comprise a chain of separate mountain blocks running from southern Kenya through Tanzania in a crescent or arc shape. In Tanzania, the Eastern Arc consists of North and South Pare, East and West Usambaras, Nguru, Ukaguru, Rubeho, Uluguru, Udzungwa and Mahenge Mountains.

The preventive effects of lifestyle intervention on the occurrence of diabetes mellitus and acute myocardial infarction in metabolic syndrome.

Science.gov (United States)

Kim, D; Yoon, S-J; Lim, D-S; Gong, Y-H; Ko, S; Lee, Y-H; Lee, H S; Park, M-S; Kim, K-H; Kim, Y A

2016-10-01

Metabolic syndrome (MS), as a precursor of diabetes mellitus (DM) and cardiovascular disease, is increasing steadily worldwide. We examined the preventive effects of lifestyle intervention on the occurrence of DM and acute myocardial infarction (AMI) in MS. Observational study on disease occurrence after lifestyle intervention. The lifestyle intervention was administered to subjects with MS participating in a metropolitan lifestyle intervention program for 1 year. The same numbers of non-participating age- and sex-matched subjects with MS were randomly extracted from national health examination data. After intervention or examination, new occurrences of hypertension, DM, and AMI were identified through the national health insurance claims data during 1 year. For DM and AMI, multivariate logistic regression analysis for the factors affecting each disease was performed. In the intervention group and the control group (14,918 in each group), the occurrence of hypertension was 555 (6.07%) and 751 (8.33%), the occurrence of DM was 324 (2.55%) and 488 (3.89%), the occurrence of dyslipidemia was 321 (2.59%) and 373 (2.72%), and the occurrence of AMI was 13 (0.09%) and 26 (0.17%), respectively. In multivariate logistic regression analysis, adjusted odds ratios for intervention were 0.752 (95% confidence interval [CI]: 0.644-0.879) and 0.499 (95% CI: 0.251-0.992) for DM and AMI, respectively, indicating that lifestyle intervention has a preventive effect. Lifestyle intervention in MS has preventive effects on the occurrence of DM and AMI, and long-term follow-up is needed to evaluate these preventive effects in more detail. Copyright © 2016. Published by Elsevier Ltd.

Winter Tourism and mountain wetland management and restoration

Science.gov (United States)

Gaucherand, S.; Mauz, I.

2012-04-01

The degradation and loss of wetlands is more rapid than that of other ecosystems (MEA 2005). In mountains area, wetlands are small and scattered and particularly sensitive to global change. The development of ski resorts can lead to the destruction or the deterioration of mountain wetlands because of hydrologic interferences, fill in, soil compression and erosion, etc. Since 2008, we have studied a high altitude wetland complex in the ski resort of Val Thorens. The aim of our study was to identify the impacts of mountain tourism development (winter and summer tourism) on wetland functioning and to produce an action plan designed to protect, rehabilitate and value the wetlands. We chose an approach based on multi-stakeholder participatory process at every stage, from information gathering to technical choices and monitoring. In this presentation, we show how such an approach can efficiently improve the consideration of wetlands in the development of a ski resort, but also the bottlenecks that need to be overcome. We will also discuss some of the ecological engineering techniques used to rehabilitate or restore high altitude degraded wetlands. Finally, this work has contributed to the creation in 2012 of a mountain wetland observatory coordinated by the conservatory of Haute-Savoie. The objective of this observatory is to estimate ecosystem services furnished by mountain wetlands and to find restoration strategies adapted to the local socio-economical context (mountain agriculture and mountain tourism).

Lithospheric Strength Beneath the Zagros Mountains of Southwestern Iran

Science.gov (United States)

Adams, A. N.; Nyblade, A.; Brazier, R.; Rodgers, A.; Al-Amri, A.

2006-05-01

The Zagros Mountain Belt of southwestern Iran is among the most seismically active mountain belts in the world. Early seismic studies of this area found that the lithosphere underlying the Zagros Mountains follows the "jelly sandwich" model, having a strong upper crust and a strong lithospheric mantle, separated by a weak lower crust. More recent studies, which analyzed earthquakes originating within the Zagros Mountains that were recorded at teleseismic distances, however, found that these earthquakes occurred only within the upper crust, thus indicating that the strength of the Zagros Mountains' lithosphere lies only within the upper crust, in accordance with the "creme brulee" lithospheric model. Preliminary analysis of regionally recorded earthquakes that originated within the Zagros Mountains is presented here. Using earthquakes recorded at regional distances will allow the analysis of a larger dataset than has been used in previous studies. Preliminary results show earthquakes occurring throughout the crust and possibly extending into the upper mantle.

Rocky Mountain spotted fever in children.

Science.gov (United States)

Woods, Charles R

2013-04-01

Rocky Mountain spotted fever is typically undifferentiated from many other infections in the first few days of illness. Treatment should not be delayed pending confirmation of infection when Rocky Mountain spotted fever is suspected. Doxycycline is the drug of choice even for infants and children less than 8 years old. Copyright © 2013 Elsevier Inc. All rights reserved.

MOUNTAIN NATURAL BIODIVERSITY CONSERVATION IN RUSSIA

Directory of Open Access Journals (Sweden)

Arkady Tishkov

2012-01-01

Full Text Available High biodiversity and degree of endemism of mountain biota strengthen the mountain regions’ status for the territorial nature conservation. Analysis of the protected areas’ representativeness in various mountain regions of Russia shows some discrepancy between their quantity, square and regional biodiversity originality. The biggest divergences are marked for the Northern Caucasus. The main problems: small area of the protected territories and also cluster character of their spatial distribution, mostly in the high mountains are not supposed to conform with the highest values of the regional flora’s and fauna’s uniqueness, to compensate representativeness of the protected biota and, in anyway, to correspond with the purpose of nature protection frame—the protected territories ecologic network’s forming. The situation in the Urals, Siberia and the Far East seems to be better. The large areas of the protected territories are in general agreement with the high originality of the nature ecosystems. Nevertheless each concrete case needs analysis of the regional biota’s and ecosystems’ biodiversity distribution within the protected areas, including character and (or unique elements of the regional biodiversity to be held. The development of the effectual territorial conservation of mountain regions needs differential approach. The creation of the large representative parcels of nature landscapes in the key-areas has the considerable meaning in the low-developed regions, difficult to access. And well-developed regions have the necessity of nature protected territories’ network development and the planning of the ecological frame’s forming. The territorial biodiversity conservation, including the system of federal, regional and local levels with protective conservation of the rare species has to be combined with ecosystem’s restoration, especially in the zones disturbed by erosion, recreation and military actions. Also it is

Association between triglyceride levels and cardiovascular disease in patients with acute pancreatitis.

Science.gov (United States)

Copeland, Laurel A; Swendsen, C Scott; Sears, Dawn M; MacCarthy, Andrea A; McNeal, Catherine J

2018-01-01

Conventional wisdom supports prescribing "fibrates before statins", that is, prioritizing treatment of hypertriglyceridemia (hTG) to prevent pancreatitis ahead of low-density lipoprotein cholesterol to prevent coronary heart disease. The relationship between hTG and acute pancreatitis, however, may not support this approach to clinical management. This study analyzed administrative data from the Veterans Health Administration for evidence of (1) temporal association between assessed triglycerides level and days to acute pancreatitis admission; (2) association between hTG and outcomes in the year after hospitalization for acute pancreatitis; (3) relative rates of prescription of fibrates vs statins in patients with acute pancreatitis; (4) association of prescription of fibrates alone versus fibrates with statins or statins alone with rates of adverse outcomes after hospitalization for acute pancreatitis. Only modest association was found between above-normal or extremely high triglycerides and time until acute pancreatitis. CHD/MI/stroke occurred in 23% in the year following AP, supporting cardiovascular risk management. Fibrates were prescribed less often than statins, defying conventional wisdom, but the high rates of cardiovascular events in the year following AP support a clinical focus on reducing cardiovascular risk factors.

The Olympic Mountains Experiment (OLYMPEX)

Energy Technology Data Exchange (ETDEWEB)

Houze, Robert A. [University of Washington, Seattle, Washington; Pacific Northwest National Laboratory, Richland, Washington; McMurdie, Lynn A. [University of Washington, Seattle, Washington; Petersen, Walter A. [NASA Marshall Space Flight Center, Huntsville, Alabama; Schwaller, Mathew R. [NASA Goddard Space Flight Center, Greenbelt, Maryland; Baccus, William [Olympic National Park, Port Angeles, Washington; Lundquist, Jessica D. [University of Washington, Seattle, Washington; Mass, Clifford F. [University of Washington, Seattle, Washington; Nijssen, Bart [University of Washington, Seattle, Washington; Rutledge, Steven A. [Colorado State University, Fort Collins, Colorado; Hudak, David R. [Environment and Climate Change Canada, King City, Ontario, Canada; Tanelli, Simone [Jet Propulsion Laboratory, California Institute of Technology, Pasadena, California; Mace, Gerald G. [University of Utah, Salt Lake City, Utah; Poellot, Michael R. [University of North Dakota, Grand Forks, North Dakota; Lettenmaier, Dennis P. [University of California, Los Angeles, Los Angeles, California; Zagrodnik, Joseph P. [University of Washington, Seattle, Washington; Rowe, Angela K. [University of Washington, Seattle, Washington; DeHart, Jennifer C. [University of Washington, Seattle, Washington; Madaus, Luke E. [National Center for Atmospheric Research, Boulder, Colorado; Barnes, Hannah C. [Pacific Northwest National Laboratory, Richland, Washington

2017-10-01

the Olympic Mountains Experiment (OLYMPEX) took place during the 2015-2016 fall-winter season in the vicinity of the mountainous Olympic Peninsula of Washington State. The goals of OLYMPEX were to provide physical and hydrologic ground validation for the U.S./Japan Global Precipitation Measurement (GPM) satellite mission and, more specifically, to study how precipitation in Pacific frontal systems is modified by passage over coastal mountains. Four transportable scanning dual-polarization Doppler radars of various wavelengths were installed. Surface stations were placed at various altitudes to measure precipitation rates, particle size distributions, and fall velocities. Autonomous recording cameras monitored and recorded snow accumulation. Four research aircraft supplied by NASA investigated precipitation processes and snow cover, and supplemental rawinsondes and dropsondes were deployed during precipitation events. Numerous Pacific frontal systems were sampled, including several reaching "atmospheric river" status, warm and cold frontal systems, and postfrontal convection

Rocky Mountain Spotted Fever: Statistics and Epidemiology

Science.gov (United States)

... Search Form Controls Cancel Submit Search the CDC Rocky Mountain Spotted Fever (RMSF) Note: Javascript is disabled or is not ... message, please visit this page: About CDC.gov . Rocky Mountain Spotted Fever (RMSF) Transmission Signs and Symptoms Diagnosis and Testing ...

Evolution of endemism on a young tropical mountain.

Science.gov (United States)

Merckx, Vincent S F T; Hendriks, Kasper P; Beentjes, Kevin K; Mennes, Constantijn B; Becking, Leontine E; Peijnenburg, Katja T C A; Afendy, Aqilah; Arumugam, Nivaarani; de Boer, Hugo; Biun, Alim; Buang, Matsain M; Chen, Ping-Ping; Chung, Arthur Y C; Dow, Rory; Feijen, Frida A A; Feijen, Hans; Feijen-van Soest, Cobi; Geml, József; Geurts, René; Gravendeel, Barbara; Hovenkamp, Peter; Imbun, Paul; Ipor, Isa; Janssens, Steven B; Jocqué, Merlijn; Kappes, Heike; Khoo, Eyen; Koomen, Peter; Lens, Frederic; Majapun, Richard J; Morgado, Luis N; Neupane, Suman; Nieser, Nico; Pereira, Joan T; Rahman, Homathevi; Sabran, Suzana; Sawang, Anati; Schwallier, Rachel M; Shim, Phyau-Soon; Smit, Harry; Sol, Nicolien; Spait, Maipul; Stech, Michael; Stokvis, Frank; Sugau, John B; Suleiman, Monica; Sumail, Sukaibin; Thomas, Daniel C; van Tol, Jan; Tuh, Fred Y Y; Yahya, Bakhtiar E; Nais, Jamili; Repin, Rimi; Lakim, Maklarin; Schilthuizen, Menno

2015-08-20

Tropical mountains are hot spots of biodiversity and endemism, but the evolutionary origins of their unique biotas are poorly understood. In varying degrees, local and regional extinction, long-distance colonization, and local recruitment may all contribute to the exceptional character of these communities. Also, it is debated whether mountain endemics mostly originate from local lowland taxa, or from lineages that reach the mountain by long-range dispersal from cool localities elsewhere. Here we investigate the evolutionary routes to endemism by sampling an entire tropical mountain biota on the 4,095-metre-high Mount Kinabalu in Sabah, East Malaysia. We discover that most of its unique biodiversity is younger than the mountain itself (6 million years), and comprises a mix of immigrant pre-adapted lineages and descendants from local lowland ancestors, although substantial shifts from lower to higher vegetation zones in this latter group were rare. These insights could improve forecasts of the likelihood of extinction and 'evolutionary rescue' in montane biodiversity hot spots under climate change scenarios.

The effect of vitamin E on acute skin reaction caused by radiotherapy.

Science.gov (United States)

Dirier, A; Akmansu, M; Bora, H; Gurer, M

2007-09-01

Ionizing radiation affects healthy organs and tissues as well as diseased tissues during radiation therapy. Skin reactions varying from acute erythema to necrosis can be seen. It has been found that vitamin E can prevent mutagenic and/or carcinogenic effects of ionizing radiation in both animals and cell cultures. This study investigated the preventative effect of antioxidant vitamin E on irradiation-induced acute skin reactions. No protective effect of vitamin E was demonstrated. It is possible that the vehicle induced free radical exposure in the irradiated skin.

Copper Mountain, Wyoming, a uranium district--rediscovered

International Nuclear Information System (INIS)

Cramer, R.T.; Yellich, J.A.; Kendall, R.G.

1979-01-01

The Copper Mountain area is physiographically located along the Owl Creek Mountains. Economic uranium mineralization was delineated in the late 1950's with production of approximately 500,000 pounds from 1961-1970. Continued exploration and research has discovered additional resources. 20 refs

The Acute Risks of Exercise in Apparently Healthy Adults and Relevance for Prevention of Cardiovascular Events.

Science.gov (United States)

Goodman, Jack M; Burr, Jamie F; Banks, Laura; Thomas, Scott G

2016-04-01

Increased physical activity (PA) is associated with improved quality of life and reductions in cardiovascular (CV) morbidity and all-cause mortality in the general population in a dose-response manner. However, PA acutely increases the risk of adverse CV event or sudden cardiac death (SCD) above levels expected at rest. We review the likelihood of adverse CV events related to exercise in apparently healthy adults and strategies for prevention, and contextualize our understanding of the long-term risk reduction conferred from PA. A systematic review of the literature was performed using electronic databases; additional hand-picked relevant articles from reference lists and additional sources were included after the search. The incidence of adverse CV events in adults is extremely low during and immediately after PA of varying types and intensities and is significantly lower in those with long-standing PA experience. The risk of SCD and nonfatal events during and immediately after PA remains extremely low (well below 0.01 per 10,000 participant hours); increasing age and PA intensity are associated with greater risk. In most cases of exercise-related SCD, occult CV disease is present and SCD is typically the first clinical event. Exercise acutely increases the risk of adverse CV events, with greater risk associated with vigorous intensity. The risks of an adverse CV event during and immediately after exercise are outweighed by the health benefits of vigorous exercise performed regularly. A key challenge remains the identification of occult structural heart disease and inheritable conditions that increase the chances of lethal arrhythmias during exercise. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

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

Energy Technology Data Exchange (ETDEWEB)

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

2009-04-15

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

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

International Nuclear Information System (INIS)

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

2009-01-01

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

Yucca Mountain Biological resources monitoring program

International Nuclear Information System (INIS)

1991-01-01

The US Department of Energy (US DOE) is required by the Nuclear Waste Policy Act of 1982 (as amended in 1987) to study and characterize Yucca Mountain as a possible site for a geological repository for high-level radioactive waste. To ensure site characterization activities do not adversely affect the Yucca Mountain area, an environmental program, the Yucca Mountain Biological Resources Monitoring Program, has been implemented monitor and mitigate environmental impacts and to ensure activities comply with applicable environmental laws. Potential impacts to vegetation, small mammals, and the desert tortoise (an indigenous threatened species) are addressed, as are habitat reclamation, radiological monitoring, and compilation of baseline data. This report describes the program in Fiscal Years 1989 and 1990. 12 refs., 4 figs., 17 tabs

Xylitol for preventing acute otitis media in children up to 12 years of age.

Science.gov (United States)

Azarpazhooh, Amir; Lawrence, Herenia P; Shah, Prakeshkumar S

2016-08-03

Acute otitis media (AOM) is the most common bacterial infection among young children in the United States. There are limitations and concerns over its treatment with antibiotics and surgery and so effective preventative measures are attractive. A potential preventative measure is xylitol, a natural sugar substitute that reduces the risk of dental decay. Xylitol can reduce the adherence of Streptococcus pneumoniae (S pneumoniae) and Haemophilus influenzae (H influenzae) to nasopharyngeal cells in vitro. This is an update of a review first published in 2011. To assess the efficacy and safety of xylitol to prevent AOM in children aged up to 12 years. We searched CENTRAL (to Issue 12, 2015), MEDLINE (1950 to January 2016), Embase (1974 to January 2016), CINAHL (1981 to January 2016), LILACS (1982 to January 2016), Web of Science (2011 to January 2016) and International Pharmaceutical Abstracts (2000 to January 2016). Randomised controlled trials (RCTs) or quasi-RCTs of children aged 12 years or younger where xylitol supplementation was compared with placebo or no treatment to prevent AOM. Two review authors independently selected trials from search results, assessed and rated study quality and extracted relevant data for inclusion in the review. We contacted trial authors to request missing data. We noted data on any adverse events of xylitol. We extracted data on relevant outcomes and estimated the effect size by calculating risk ratio (RR), risk difference (RD) and associated 95% confidence intervals (CI). We identified five clinical trials that involved 3405 children for inclusion. For this 2016 update, we identified one new trial for inclusion. This trial was systematically reviewed but due to several sources of heterogeneity, was not included in the meta-analysis. The remaining four trials were of adequate methodological quality. In three RCTs that involved a total of 1826 healthy Finnish children attending daycare, there is moderate quality evidence that

Fatigue following Acute Q-Fever: A Systematic Literature Review

Science.gov (United States)

Delsing, Corine E.; Bleijenberg, Gijs; Langendam, Miranda; Timen, Aura; Bleeker-Rovers, Chantal P.

2016-01-01

Background Long-term fatigue with detrimental effects on daily functioning often occurs following acute Q-fever. Following the 2007–2010 Q-fever outbreak in the Netherlands with over 4000 notified cases, the emphasis on long-term consequences of Q-fever increased. The aim of this study was to provide an overview of all relevant available literature, and to identify knowledge gaps regarding the definition, diagnosis, background, description, aetiology, prevention, therapy, and prognosis, of fatigue following acute Q-fever. Design A systematic review was conducted through searching Pubmed, Embase, and PsycInfo for relevant literature up to 26th May 2015. References of included articles were hand searched for additional documents, and included articles were quality assessed. Results Fifty-seven articles were included and four documents classified as grey literature. The quality of most studies was low. The studies suggest that although most patients recover from fatigue within 6–12 months after acute Q-fever, approximately 20% remain chronically fatigued. Several names are used indicating fatigue following acute Q-fever, of which Q-fever fatigue syndrome (QFS) is most customary. Although QFS is described to occur frequently in many countries, a uniform definition is lacking. The studies report major health and work-related consequences, and is frequently accompanied by nonspecific complaints. There is no consensus with regard to aetiology, prevention, treatment, and prognosis. Conclusions Long-term fatigue following acute Q-fever, generally referred to as QFS, has major health-related consequences. However, information on aetiology, prevention, treatment, and prognosis of QFS is underrepresented in the international literature. In order to facilitate comparison of findings, and as platform for future studies, a uniform definition and diagnostic work-up and uniform measurement tools for QFS are proposed. PMID:27223465

Impact of Hypoxia on Man on Mountaineering

Directory of Open Access Journals (Sweden)

A. N. Kislitsyn

2006-01-01

Full Text Available External respiratory function was studied in those engaged in mountaineering. A negative correlation was found between the intensity of exercise and the changes in vital capacity under mountainous conditions. Changes occurring in the levels of glucose and cholesterol were considered in tourists.

Prevention of reflex natriuresis after acute unilateral nephrectomy by neonatal administration of MSG

International Nuclear Information System (INIS)

Lin, S.Y.; Wiedemann, E.; Deschepper, C.F.; Alper, R.H.; Humphreys, M.H.

1987-01-01

Acute unilateral nephrectomy (AUN) results in natriuresis from the remaining kidney through reflex pathways involving the central nervous system and requiring an intact pituitary gland. The natriuresis is accompanied by an increase in the plasma concentration of a peptide or peptides derived from the N-terminal fragment (NTF) of proopiomelanocortin. The authors measured plasma immunoreactive NTF-like material (IR-NTF) by radioimmunoassay, before and after AUN in control rats and rats treated neonatally with monosodium glutamate (MSG), a procedure that produces neuroendocrine dysfunction by destroying cell bodies in the hypothalamic arcuate nucleus, median eminence, and other brain regions. In control rats, IR-NTF increased from 85.8 +/- 54.9 (SD) to 207 +/- 98.1 fmol/ml after AUN as sodium excretion (U/sub Na/V) doubled. In MSG-treated rats, AUN produced no change in plasma IR-NTF concentration, nor did U/sub Na/V increase. Tissue content of IR-NTF was reduced in the arcuate nucleus and anterior lobe of pituitaries from MSG-treated rats compared with controls, but was no different in the neurointermediate lobe. These results indicate that the hypothalamic lesion produced by neonatal administration of MSG prevents both the increase in plasma IR-NTF concentration and the natruiuresis after AUN, and therefore lend further support to the concept of a casual relationship between these two consequences of AUN

Prophylaxis and treatment of acute and chronic postherpetic neuralgia

Directory of Open Access Journals (Sweden)

Anna Michalska-Bańkowska

2014-06-01

Full Text Available Herpes zoster (HZ is a disease caused by varicella zoster virus (VZV, where the initial contact leads to varicella. The low immunity of the patient might reactivate the virus and provoke symptoms of HZ, which is characterized by vesicles and blisters localized unilaterally and accompanied by pain. The greatest diagnostic problems occur in Zoster sine herpete and painless HZ. A significant complication of acute HZ infection is chronic postherpetic neuralgia (PHN, which manifests as dull and burning pain persisting for more than 3 months after the beginning of the rash. Senility, female gender, presence of prodromal pain, more severe skin lesions, dysaesthesia, and more intense acute PHN predispose to chronic PHN. Early diagnosis and treatment of HZ infection with antiviral medications prevent PHN. Use of local anesthetics is a very good choice in acute PHN treatment. Tricyclic antidepressants (amitriptyline, nortriptyline are conventional drugs which alleviate subacute PHN. Immunomodulatory drugs such as gabapentin help prevent or reduce the severity of PHN. The other therapeutic options are RFA (radiofrequency ablation, TENS (transcutaneous electrical nerve stimulation, physical methods such as magnetotherapy and laser therapy. The attenuated vaccine, used in patients over 60 years old, is expected to prevent the occurrence of PHN.

DANGERS AND SAFETY MEASURES IN A MOUNTAIN

Directory of Open Access Journals (Sweden)

Jovica Petković

2013-07-01

Full Text Available Mountaineering and everything that is connected with it is a sport with con¬tro¬lled risk. Mountaineers, alpinists, climbers, cavers and all the others who visit and sojourn in mountains are faced with many risks and dangers, which are caused by na¬ture and also by their own mistakes. The dangers in the mountains, like dangers in any other environment, are mainly predictable, so it is best to deal with them with good esti¬mation, knowledge and skill. One has to be aware of his surroundings – the moun¬tain, to respect it and to know what is dangerous and how much it is dangerous at any moment. The organization of the mountaineering expeditions and leadership per¬haps re¬present the highest level of security control. To develop skills for organizing and lead¬ing a group means to ensure the safety of the entire group – to work pre¬ven¬ti¬ve¬ly at the level of the entire group, not only at the level of an individual. The success of the enti¬re group as well as safety depends on the organization and leadership.

Fatal Rocky Mountain spotted fever in the United States, 1999-2007.

Science.gov (United States)

Dahlgren, F Scott; Holman, Robert C; Paddock, Christopher D; Callinan, Laura S; McQuiston, Jennifer H

2012-04-01

Death from Rocky Mountain spotted fever (RMSF) is preventable with prompt, appropriate treatment. Data from two independent sources were analyzed to estimate the burden of fatal RMSF and identify risk factors for fatal RMSF in the United States during 1999-2007. Despite increased reporting of RMSF cases to the Centers for Disease Control and Prevention, no significant changes in the estimated number of annual fatal RMSF cases were found. American Indians were at higher risk of fatal RMSF relative to whites (relative risk [RR] = 3.9), and children less than 10 years of age (RR=5.1) [corrected] and adults ≥ 70 years of age (RR = 3.0) were also at increased risk relative to other ages. Persons with cases of RMSF with an immunosuppressive condition were at increased risk of death (RR = 4.4). Delaying treatment of RMSF was also associated with increased deaths. These results may indicate a gap between recommendations and practice.

75 FR 29656 - Amendment of Class E Airspace; Mountain View, AR

Science.gov (United States)

2010-05-27

...-1181; Airspace Docket No. 09-ASW-36] Amendment of Class E Airspace; Mountain View, AR AGENCY: Federal... Mountain View, AR. Decommissioning of the Wilcox non-directional beacon (NDB) at Mountain View Wilcox Memorial Field Airport, Mountain View, AR, has made this action necessary to enhance the safety and...

Acute Management and Secondary Prophylaxis of Esophageal Variceal Bleeding: A Western Canadian Survey

Directory of Open Access Journals (Sweden)

Justin Cheung

2006-01-01

Full Text Available BACKGROUND: Acute esophageal variceal bleeding (EVB is a major cause of morbidity and mortality in patients with liver cirrhosis. Guidelines have been published in 1997; however, variability in the acute management and prevention of EVB rebleeding may occur.

Mountain pastures of Qilian Shan: plant communities, grazing impact and degradation status (Gansu province, NW China)

Science.gov (United States)

Baranova, Alina; Schickhoff, Udo; Shunli, Wang; Ming, Jin

2015-04-01

Qilian Mountains are the water source region for the low arid reaches of HeiHe river basin (Gansu province, NW China). Due to overstocking and overgrazing during the last decades adverse ecological ef¬fects, in particular on soil properties and hydrological cycle, are to be expected in growing land areas. Vegetation cover is very important to prevent erosion process and to sustain stable subsurface runoff and ground water flow. The aim of this research is to identify plant communities, detecting grazing-induced and spatially differentiated changes in vegetation patterns, and to evaluate status of pasture land degradation.The study area is located in the spring/autumn pasture area of South Qilian Mountains between 2600-3600 m a.s.l., covering five main vegetation types: spruce forest, alpine shrubland, shrubby grassland, mountain grassland, degraded mountain grassland. In order to analyze gradual changes in vegetation patterns along altitudinal and grazing gradients and to classify related plant communities, quantitative and qualitative relevé data were collected (coverage, species composition, abundance of unpalatable plants, plant functional types, etc.). Vegetation was classified using hierarchical cluster analyses. Indirect Detrended Correspondence Analysis (DCA) was used to analyze variation in relationships between vegetation, environmental factors, and grazing impact. According to DCA results, distribution of the plant communities was strongly affected by altitude and exposition. Grassland floristic gradients showed greater dependence on grazing impact, which correlated contrarily with soil organic content, soil moisture and pH. Highest numbers of species richness and alpha diversity were detected in alpine shrubland vegetation type. Comparing the monitoring data for the recent nine years, a trend of deterioration, species successions and shift in dominant species becomes obvious. Species indicating degrading site environmental conditions were identified

78 FR 29366 - Green Mountain Power Corporation

Science.gov (United States)

2013-05-20

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. TS04-277-002] Green Mountain Power Corporation Notice of Filing Take notice that on May 2, 2013, Green Mountain Power Corporation filed additional information in support of its request for continued waiver of Standards of Conduct. Any...

Mountain Plover [ds109

Data.gov (United States)

California Natural Resource Agency — Point locations representing observations of mountain plover (Charadrius montanus) feeding and roosting flocks (and occasional individuals) documented during an...

CT findings of acute appendicitis in children

International Nuclear Information System (INIS)

Lee, Hae Seung; Kim, Young Tong; Kim, Hyun Cheol; Bae, Won Kyung; Kim, Il Young

2005-01-01

Acute appendicitis is the most common cause of surgical abdomen in children. Because of the various locations where you can find the appendix and the different presentation for the symptoms of appendicitis, the clinical diagnosis of appendicitis is often difficult in children, and radiologic diagnosis is becoming increasingly important. Being familiar with the findings of acute appendicitis on the MDCT axial image and the multiplanar reformation images may aid the physician in reaching an early diagnosis and so prevent complications and reduce negative appendectomy rates

Origin, development, and impact of mountain laurel thickets on the mixed-oak forests of the central Appalachian Mountains, USA

Science.gov (United States)

Patrick H. Brose

2016-01-01

Throughout forests of the northern hemisphere, some species of ericaceous shrubs can form persistent understories that interfere with forest regeneration processes. In the Appalachian Mountains of eastern North America, mountain laurel (Kalmia latifolia) may interfere in the regeneration of mixed-oak (Quercus spp.) forests. To...

Review article: The mountain motif in the plot of Matthew

Directory of Open Access Journals (Sweden)

Gert J. Volschenk

2010-09-01

Full Text Available This article reviewed T.L. Donaldson’s book, Jesus on the mountain: A study in Matthean theology, published in 1985 by JSOT Press, Sheffield, and focused on the mountain motif in the structure and plot of the Gospel of Matthew, in addition to the work of Donaldson on the mountain motif as a literary motif and as theological symbol. The mountain is a primary theological setting for Jesus’ ministry and thus is an important setting, serving as one of the literary devices by which Matthew structured and progressed his narrative. The Zion theological and eschatological significance and Second Temple Judaism serve as the historical and theological background for the mountain motif. The last mountain setting (Mt 28:16–20 is the culmination of the three theological themes in the plot of Matthew, namely Christology, ecclesiology and salvation history.

Rickettsia parkeri rickettsiosis and its clinical distinction from Rocky Mountain spotted fever.

Science.gov (United States)

Paddock, Christopher D; Finley, Richard W; Wright, Cynthia S; Robinson, Howard N; Schrodt, Barbara J; Lane, Carole C; Ekenna, Okechukwu; Blass, Mitchell A; Tamminga, Cynthia L; Ohl, Christopher A; McLellan, Susan L F; Goddard, Jerome; Holman, Robert C; Openshaw, John J; Sumner, John W; Zaki, Sherif R; Eremeeva, Marina E

2008-11-01

Rickettsia parkeri rickettsiosis, a recently identified spotted fever transmitted by the Gulf Coast tick (Amblyomma maculatum), was first described in 2004. We summarize the clinical and epidemiological features of 12 patients in the United States with confirmed or probable disease attributable to R. parkeri and comment on distinctions between R. parkeri rickettsiosis and other United States rickettsioses. Clinical specimens from patients in the United States who reside within the range of A. maculatum for whom an eschar or vesicular rash was described were evaluated by > or =1 laboratory assays at the Centers for Disease Control and Prevention (Atlanta, GA) to identify probable or confirmed infection with R. parkeri. During 1998-2007, clinical samples from 12 patients with illnesses epidemiologically and clinically compatible with R. parkeri rickettsiosis were submitted for diagnostic evaluation. Using indirect immunofluorescence antibody assays, immunohistochemistry, polymerase chain reaction assays, and cell culture isolation, we identified 6 confirmed and 6 probable cases of infection with R. parkeri. The aggregate clinical characteristics of these patients revealed a disease similar to but less severe than classically described Rocky Mountain spotted fever. Closer attention to the distinct clinical features of the various spotted fever syndromes that exist in the United States and other countries of the Western hemisphere, coupled with more frequent use of specific confirmatory assays, may unveil several unique diseases that have been identified collectively as Rocky Mountain spotted fever during the past century. Accurate assessments of these distinct infections will ultimately provide a more valid description of the currently recognized distribution, incidence, and case-fatality rate of Rocky Mountain spotted fever.

[Prevention of virus hepatitis A to E].

Science.gov (United States)

Cornberg, M; Manns, M P

2011-03-01

Infection with hepatitis viruses can lead to acute hepatitis with the risk of developing liver failure. Chronic viral hepatitis may evolve into liver cirrhosis and hepatocellular carcinoma. Thus, prevention of viral hepatitis and its sequels is essential. Vaccination against hepatitis A is successful in almost all individuals. Protective antibodies maintain for at least 20 years. Booster vaccinations are not necessary. Since the introduction of hepatitis A vaccines, the incidence of new HAV-infections has declined significantly. Hepatitis B vaccines are safe and highly effective. Special populations such as dialysis patients or immunocompromised patients require special vaccine schedules. New vaccines with improved adjuvants are currently being tested in clinical trials. So far there is no hepatitis C vaccine on the horizon. Prophylaxis of HCV-infections relies primarily on hygiene measures. Early therapy of acute hepatitis C can prevent chronic hepatitis C. HDV-infection can only be established if HBsAg is present. Thus, prevention of hepatitis B or elimination of HBsAg means prevention of hepatitis delta. Hepatitis E vaccines have been evaluated in phase III studies. The development of HEV vaccines becomes more relevant since chronic HEV infections have been reported in immunosuppressed individuals.

Turonian Radiolarians in the Section of Ak Mountain, Crimea

Science.gov (United States)

Bragina, L. G.

2018-01-01

In the sections from the western and eastern peaks of Ak Mountain, the Patellula selbukhraensis Zone (upper part of the lower Turonian), which is established for the first time in the southwestern Mountainous Crimea, is traced. The first data on the radiolarian distribution in the section of the eastern peak of Ak Mountain, which is stratotypical of the Phaseliforma turovi (middle Turonian, without the upper part) and Actinomma (?) belbekense (upper part of the middle Turonian-upper Turonian) zones, are presented. These zones are also traced in the parallel section of the western peak of Ak Mountain.

The role of probiotics in the prevention and treatment of childhood infectious diarrhea

Directory of Open Access Journals (Sweden)

Maria Maragkoudaki

2013-10-01

Full Text Available Probiotics are beneficial bacteria that colonize and replicate in the human intestinal tract providing a positive benefit to the host. Several clinical trials support the efficacy of certain probiotics in the prevention and treatment of various diarrheal illnesses. This paper reviews published clinical trials assessing the efficacy of various probiotic species and strains in preventing and treating acute diarrhea in children. The available evidence shows that few probiotic species (mostly Lactobacillus GG and Saccharomyces boulardii are efficacious in decreasing the duration and the severity of acute gastroenteritis, with the most prominent of the reported benefits, the reduction of the duration of diarrhea by approximately 1 day. With regard to the prevention of acute diarrhea in the community and the hospital, there is modest evidence that some probiotic species may be efficacious in preventing community acquired diarrhea (Bifidobacterium lactis, Lactobacillus reuteri, Lactobacillus GG, nosocomial acquired diarrhea (Lactobacillus GG and Clostridium difficile diarrhea (Lactobacillus GG and Saccharomyces boulardii. In conclusion, the available evidence suggests that probiotics are safe when used in healthy children and effective in reducing the duration of acute infectious diarrhea. Further studies are required to assess the efficacy of selected probiotic species and strains at different dosages for different clinical indications and patient groups.

Can nuclear waste be stored safely at Yucca mountain?

International Nuclear Information System (INIS)

Whipple, C.G.

1996-01-01

In 1987 the federal government narrowed to one its long-term options for disposing of nuclear waste: storing it permanently in a series of caverns excavated out of the rock deep below Yucca mountain in southern Nevada. Whether it makes sense at this time to dispose permanently of spent fuel and radioactive waste in a deep geologic repository is hotly disputed. But the Nuclear Waste Policy Act amendements of 1987 decree that waste be consolidated in Yucca Mountain if the mountain is found suitable. Meanwhile the spent fuel continues to pile up across the country, and 1998 looms, adding urgency to the question: What can science tell us about the ability of the mountain to store nuclear waste safely? This paper discusses this issue and describes how studies of the mountain's history and geology can contribute useful insights but not unequivocal conclusions

The mountains influence on Turkey Climate

International Nuclear Information System (INIS)

Sensoy, Serhat

2004-01-01

Since the Black sea mountains at the north of the country and the Taurus mountains in the south lay parallel to the seashore and rise very sharply rain clouds can not penetrate to the internal part of the country. Rain clouds drops most of their water on the slopes opposite the sea. As rain clouds pass over the mountains and reach Central Anatolia they have no significant capability of rain. For this reason, the Central Anatolia does not have very much precipitation. The difference between the rates of precipitation on the inner and outer slopes seems to be effective on the expansion of plants. For example, there is a subtropical climate prevailing on the Black sea shore between Sinop and Batum where precipitation is more than 1000-2000 mm yearly. Going from Sinop to the mouth of the Sakarya River the rate of precipitation goes down to 800-1250 mm in a year. Running from the Sakarya River to the western area covering Thrace the climate seems to be continental, and in the area dominant plant cover is of the Mediterranean type. Since the succession of the mountains in Western Anatolia lay perpendicular to the seashore, rain clouds penetrate towards the inner regions for about 400 km. The continental climate with long, dry and summer affects this area. In the Eastern region of Anatolia, since the elevation of the mountains exceeds 2500-3000 m, valleys are disorderly scattered and located at high elevations, and the northern Black sea mountains and Caucasian mountains hold the rain clouds, the area is effected by the continental climate with long and very cold winters. Consequently precipitation at the lgdir River goes down to 300 mm while it is 500-800 mm in most of areas and 1000-1500 mm in some regions towards northern Mu and Bingol provinces. As mentioned above, high mountains, which hold rain clouds, surround the Central Anatolia, which has caused drought in this region. In the central Anatolia covering Afyon, Eski hir, Ankara, Qankiri, Qorum, Amasya, Kayseri

Celiac artery trunk thrombosis presenting as acute liver failure

International Nuclear Information System (INIS)

Akbarian, M.A.; Kahrom, M.; Kahrom, H.

2011-01-01

Acute mesenteric ischemia is a life-threatening vascular emergency that requires early diagnosis and intervention to adequately restore mesenteric blood flow and to prevent bowel necrosis and patient death. While, almost always superior and inferior mesenteric arteries are involved, we report a 57-year-old male with an unusual celiac artery trunk thrombosis leading to gastero-duodenal and hepato-splenic infarction, and presenting an acute liver failure. (author)

Geology of the Saddle Mountains between Sentinel Gap and 119030' longitude

International Nuclear Information System (INIS)

Reidel, S.P.

1978-09-01

Members and flows of the Grande Ronde, Wanapum, and Saddle Mountains basalts of the Columbia River Basalt Group were mapped in the Saddle Mountains between Sentinel Gap and the eastern edge of Smyrna Bench. The Grande Ronde Basalt consists of the Schwana (low-MgO) and Sentinel Bluffs (high-MgO) members (informal names). The Wanapum Basalt consists of the aphyric and phyric units of the Frenchman Springs Member, the Roza-Like Member, and the Priest Rapids Member. The Saddle Mountains Basalt consists of the Wahluke, Huntzinger, Pomona, Mattawa, and Elephant Mountain basalts. The Wanapum and Saddle Mountains basalts are unevenly distributed across the Saddle Mountains. The Wanapum Basalt thins from south to north and across a northwest-southeast-trending axis at the west end of Smyrna Bench. The Priest Rapids, Roza-Like, and aphyric Frenchman Springs units are locally missing across this zone. The Saddle Mountains basalt has a more irregular distribution and, within an area between Sentinel Gap and Smyrna Bench, is devoid of the basalt. The Wahluke, Huntzinger, and Mattawa flows are locally present, but the Pomona is restricted to the southern flank west of Smyrna Bench, and the Elephant Mountain Basalt only occurs on the flanks and in three structurally controlled basins on the northwest side. The structure of the Saddle Mountains is dominated by an east-west trend and, to a lesser degree, controlled by a northwest-southeast and northeast-southwest trend. The geomorphological expression of the Saddle Mountains results from the east-west fold set and the Saddle Mountains fault along the north side. The oldest structures follow the northwest-southeast trend. The distribution of the flows, combined with the structural features, indicates a complex geologic history for the Saddel Mountains

Neonatal Pressure Ulcer Prevention.

Science.gov (United States)

Scheans, Patricia

2015-01-01

The incidence of pressure ulcers in acutely ill infants and children ranges up to 27 percent in intensive care units, with a range of 16-19 percent in NICUs. Anatomic, physiologic, and developmental factors place ill and preterm newborns at risk for skin breakdown. Two case studies illustrate these factors, and best practices for pressure ulcer prevention are described.

Dance floors as injury risk: analysis and evaluation of acute injuries caused by dance floors in professional dance with regard to preventative aspects.

Science.gov (United States)

Wanke, Eileen M; Mill, Helmgard; Wanke, Alice; Davenport, Jaqueline; Koch, Franziska; Groneberg, David A

2012-09-01

A dance floor is often the only support of movements in dance. A dance floor surface that shows deficiencies, can result in acute injuries and chronic problems. Although the significance of an adequate dance floor is well known, there is still a lack of differentiated analyses of dance floor-related acute injuries. This study presents data on acute injuries exclusively caused by the dance floor. The data were obtained from standardized work accident reports from consultants (F 1000), documentary accident records from all Berlin theatres, a state ballet school (n=2,281), and case records from the Berlin State Accident Insurance (UKB) covering a period of 17 years. All analyses and descriptive statistics were conducted with Excel 2007 and SPSS 18. Dance floor surfaces were the causative factor in 12.8% of all accidents (n=291, female 183, male 108). Almost two thirds (62.6%) of all accidents in professional dancers happened on stage, and almost half (49.5%) occurred during performances. As for causative factors, 53.1% of the professional dancers (P) and 42.5% of the dance students (S) claimed that the floor had been "too slippery," with "getting stuck" or (tripping) as the second most common problem (P 18.4%, S 11.3%). Of the injured dancers, 41.8% were older than 30 years and can therefore be categorized as experienced. Dance floors play a significant role in the occurrence of acute injuries, even in experienced dancers. Performances on stage seem to be a particular risk. However, injury prevention measures should include all work locations (P) as well as non-dance-specific locations (S).

Mountains and energy transition. Status of use of renewable energies and challenges for their development in mountain areas - Renewable energies Volume 1

International Nuclear Information System (INIS)

Peguin, Marion; Moncorps, Sebastien; Fourcade, Michel; Denis, Helene

2013-10-01

After an overview of challenges related to the development of renewable energies in mountain areas (conservation of biodiversity and landscapes, main legal measures regarding biodiversity and landscapes), this report proposes an overview of the status and potentials of the different renewable energies (solar, wind, hydroelectricity, bio-energies, geothermal) in mountain areas. It proposes an assessment (strengths and weaknesses) and recommendations for solar, wind, hydroelectricity and bio energies in mountain areas

Thermally driven gas flow beneath Yucca Mountain, Nevada

International Nuclear Information System (INIS)

Amter, S.; Lu, Ning; Ross, B.

1991-01-01

A coupled thermopneumatic model is developed for simulating heat transfer, rock-gas flow and carbon-14 travel time beneath Yucca Mountain, NV. The aim of this work is to understand the coupling of heat transfer and gas flow. Heat transfer in and near the potential repository region depends on several factors, including the geothermal gradient, climate, and local sources of heat such as radioactive wastes. Our numerical study shows that small temperature changes at the surface can change both the temperature field and the gas flow pattern beneath Yucca Mountain. A lateral temperature difference of 1 K is sufficient to create convection cells hundreds of meters in size. Differences in relative humidities between gas inside the mountain and air outside the mountain also significantly affect the gas flow field. 6 refs., 7 figs

Importance of viruses in acute otitis media.

Science.gov (United States)

Nokso-Koivisto, Johanna; Marom, Tal; Chonmaitree, Tasnee

2015-02-01

Acute otitis media occurs as a complication of viral upper respiratory tract infection. Bacterial otopathogens and respiratory viruses interact and play important roles in acute otitis media development. A better understanding of viral and bacterial interactions may lead to innovative ways to lessen the burden of this common childhood disease. There has been increasing evidence that acute otitis media occurs during upper respiratory infection, even in the absence of nasopharyngeal bacterial colonization. Among the types of viruses associated with acute otitis media, respiratory syncytial virus continues to be the most commonly detected. It is still unclear whether viral load plays an important role in acute otitis media development, but symptomatic upper respiratory tract infection (as opposed to asymptomatic viral infection) is crucial. Widespread use of bacterial and viral vaccines in young children, including pneumococcal conjugate and influenza vaccines, has led to the reduction in otitis media-related healthcare use between 2001 and 2011. There has been no new vaccine against respiratory viruses other than influenza. Progress has been made toward the reduction of the burden of acute otitis media in the last decade. Success in reducing acute otitis media incidence will rely mainly on prevention of nasopharyngeal otopathogen colonization, as well as reduction in the incidence of viral upper respiratory tract infection.

Sport and Recreation Influence upon Mountain Area and Sustainable Tourism Development

Directory of Open Access Journals (Sweden)

Jelica J. MARKOVIĆ

2013-10-01

Full Text Available In contemporary tourism, sport and recreation are increasingly becoming the dominant motives for undertaking the journey, and as a result of modern living, active holidays are more frequent. Mountain areas have always been attractive to deal with the various sports activities. Winter sports were the initiators of the development of mountain resorts. Mountain resorts invest in construction of hotels, ski lifts, snowmaking equipment, for the sake of attracting a growing number of tourist clientele. On the other hand, sport and recreation also serve to promote summer mountain tourism. Tennis, golf, swimming, horseback riding are key tools to attract visitors in the summer months toward the resorts facilities. The main problems regarding the development of mountain tourism centers come in the form of the growing concern for the preservation of the environment, of the human and traffic congestion in the mountains and the intensive use of natural resources by tourists. This paper aims to highlight the positive and negative impacts of sport and recreation in the development of mountain tourism and to present possible solutions to reduce negative impacts. Methodology is based on document review of many bibliographic resources, which are related with skiing and mountain biking as examples of winter and summer sport activities on mountains.

CURRENT MICROBIOLOGICAL ASPECTS IN HIGH MOUNTAIN

OpenAIRE

KURT HANSELMANN; MUNTI YUHANA

2006-01-01

Remote and normally unpolluted high mountain lakes provide habitats with no or very limited anthropogenic influences and, therefore, their hydrodynamics are mostly regulated by the natural c onditions. Researches in high mountain lakes deal with measuring and modeling the response of the habitats to environmental changes especially correlated to acid deposition, pollutants influx and climatic variability. The microbial world has also become a focus in many studies of these extreme ecosystem...

Preventing falls and fractures.

Science.gov (United States)

Ulfarsson, J; Robinson, B E

1994-11-01

One of four persons over age 65 in the community falls; those over age 75 in institutions fall more frequently. Falls, a complex phenomena suggesting present disease and predicting future disability, are caused by interactions between the environment and dynamic balance which is determined by the quality of sensory input, central processing, and motor responses. Clinical factors which predispose to falling often produce observable disturbances in gait and balance, making observation critical in assessment. Acute illness and drug therapy produce particularly preventable falls. Therapeutic exercise and environmental modification for safety are the clinical interventions most likely to successfully prevent fall-related injury.

Preemptive mechanical ventilation can block progressive acute lung injury.

Science.gov (United States)

Sadowitz, Benjamin; Jain, Sumeet; Kollisch-Singule, Michaela; Satalin, Joshua; Andrews, Penny; Habashi, Nader; Gatto, Louis A; Nieman, Gary

2016-02-04

Mortality from acute respiratory distress syndrome (ARDS) remains unacceptable, approaching 45% in certain high-risk patient populations. Treating fulminant ARDS is currently relegated to supportive care measures only. Thus, the best treatment for ARDS may lie with preventing this syndrome from ever occurring. Clinical studies were examined to determine why ARDS has remained resistant to treatment over the past several decades. In addition, both basic science and clinical studies were examined to determine the impact that early, protective mechanical ventilation may have on preventing the development of ARDS in at-risk patients. Fulminant ARDS is highly resistant to both pharmacologic treatment and methods of mechanical ventilation. However, ARDS is a progressive disease with an early treatment window that can be exploited. In particular, protective mechanical ventilation initiated before the onset of lung injury can prevent the progression to ARDS. Airway pressure release ventilation (APRV) is a novel mechanical ventilation strategy for delivering a protective breath that has been shown to block progressive acute lung injury (ALI) and prevent ALI from progressing to ARDS. ARDS mortality currently remains as high as 45% in some studies. As ARDS is a progressive disease, the key to treatment lies with preventing the disease from ever occurring while it remains subclinical. Early protective mechanical ventilation with APRV appears to offer substantial benefit in this regard and may be the prophylactic treatment of choice for preventing ARDS.

Prevention and management of gastroesophageal varices.

Science.gov (United States)

Seo, Yeon Seok

2018-03-01

Bleeding from gastroesophageal varices is a serious complication in patients with liver cirrhosis and portal hypertension. Although there has been significance improvement in the prognosis of variceal bleeding with advancement in diagnostic and therapeutic modalities for its management, mortality rate still remains high. Therefore, appropriate prevention and rapid, effective management of bleeding from gastroesophageal varices is very important. Recently, various studies about management of gastoesophageal varices, including prevention of development and aggravation of varices, prevention of first variceal bleeding, management of acute variceal bleeding, and prevention of variceal rebleeding, have been published. The present article reviews published articles and practice guidelines to present the most optimal management of patients with gastroesophageal varices.

Room at the Mountain: Estimated Maximum Amounts of Commercial Spent Nuclear Fuel Capable of Disposal in a Yucca Mountain Repository

International Nuclear Information System (INIS)

Kessler, John H.; Kemeny, John; King, Fraser; Ross, Alan M.; Ross, Benjamen

2006-01-01

The purpose of this paper is to present an initial analysis of the maximum amount of commercial spent nuclear fuel (CSNF) that could be emplaced into a geological repository at Yucca Mountain. This analysis identifies and uses programmatic, material, and geological constraints and factors that affect this estimation of maximum amount of CSNF for disposal. The conclusion of this initial analysis is that the current legislative limit on Yucca Mountain disposal capacity, 63,000 MTHM of CSNF, is a small fraction of the available physical capacity of the Yucca Mountain system assuming the current high-temperature operating mode (HTOM) design. EPRI is confident that at least four times the legislative limit for CSNF (∼260,000 MTHM) can be emplaced in the Yucca Mountain system. It is possible that with additional site characterization, upwards of nine times the legislative limit (∼570,000 MTHM) could be emplaced. (authors)

Relief and Recurrence of Congestion During and After Hospitalization for Acute Heart Failure: Insights From Diuretic Optimization Strategy Evaluation in Acute Decompensated Heart Failure (DOSE-AHF) and Cardiorenal Rescue Study in Acute Decompensated Heart Failure (CARESS-HF).

Science.gov (United States)

Lala, Anuradha; McNulty, Steven E; Mentz, Robert J; Dunlay, Shannon M; Vader, Justin M; AbouEzzeddine, Omar F; DeVore, Adam D; Khazanie, Prateeti; Redfield, Margaret M; Goldsmith, Steven R; Bart, Bradley A; Anstrom, Kevin J; Felker, G Michael; Hernandez, Adrian F; Stevenson, Lynne W

2015-07-01

Congestion is the most frequent cause for hospitalization in acute decompensated heart failure. Although decongestion is a major goal of acute therapy, it is unclear how the clinical components of congestion (eg, peripheral edema, orthopnea) contribute to outcomes after discharge or how well decongestion is maintained. A post hoc analysis was performed of 496 patients enrolled in the Diuretic Optimization Strategy Evaluation in Acute Decompensated Heart Failure (DOSE-AHF) and Cardiorenal Rescue Study in Acute Decompensated Heart Failure (CARRESS-HF) trials during hospitalization with acute decompensated heart failure and clinical congestion. A simple orthodema congestion score was generated based on symptoms of orthopnea (≥2 pillows=2 points, fails to relieve orthodema during hospitalization or to prevent recurrence after discharge. URL: http://www.clinicaltrials.gov. Unique identifiers: NCT00608491, NCT00577135. © 2015 American Heart Association, Inc.

A point-to-point simple telehealth application for cardiovascular prevention: the ESINO LARIO experience. Cardiovascular prevention at point of care.

Science.gov (United States)

Malacarne, Mara; Gobbi, Giorgio; Pizzinelli, Paolo; Lesma, Alessandro; Castelli, Alberto; Lucini, Daniela; Pagani, Massimo

2009-01-01

Recent epidemiological evidence indicates that chronic degenerative diseases, notably cardiovascular, represent the major toll in terms of death and of impaired quality of life. Recent estimates indicate that a small increase in financial resources in a number of clinical cases may be sufficient to minimize the consequences of elevated cardiovascular risk per individual. The observation that lifestyle choices, and in particular increased physical exercise, might strongly impact cardiovascular risk, suggests a redesign of preventive strategies, based on the combination of pharmacological and behavioral interventions. Following our recent experience with the INteractive teleConsultation network for worldwide healthcAre Services (INCAS) system, we designed a simpler point-to-point telehealth infrastructure, to be employed in cardiovascular risk reduction programs, predicting a high level of acceptance from the population, at the cost of very limited investment. This model was tested on 181 subjects (ages 18-80 years) in the Italian mountain village of Esino Lario. These subjects underwent a screening test to evaluate arrhythmia and cardiometabolic risks (arrhythmias were found in 14% of subjects, systolic arterial pressure was observed in 43% of subjects above 140 mm Hg, diastolic arterial pressure in 31% above 90 mm Hg). This study demonstrates the feasibility of a scaled-down telehealth application particularly suited to cardiovascular prevention in remote areas, such as in mountain villages.

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

Science.gov (United States)

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

2009-04-01

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

A retrospective population-based cohort study identifying target areas for prevention of acute lower respiratory infections in children

Directory of Open Access Journals (Sweden)

Richmond Peter

2010-12-01

Full Text Available Abstract Background Acute lower respiratory infections (ALRI are a major cause of hospitalisation in young children. Many factors can lead to increased risk of ALRI in children and predispose a child to hospitalisation, but population attributable fractions for different risk factors and how these fractions differ between Indigenous and non-Indigenous children is unknown. This study investigates population attributable fractions of known infant and maternal risk factors for ALRI to inform prevention strategies that target high-risk groups or particular risk factors. Methods A retrospective population-based data linkage study of 245,249 singleton births in Western Australia. Population attributable fractions of known maternal and infant risk factors for hospitalisation with ALRI between 1996 and 2005 were calculated using multiple logistic regression. Results The overall ALRI hospitalisation rate was 16.1/1,000 person-years for non-Aboriginal children and 93.0/1,000 for Aboriginal children. Male gender, being born in autumn, gestational age Conclusions The population attributable fractions estimated in this study should help in guiding public health interventions to prevent ALRI. A key risk factor for all children is maternal smoking during pregnancy, and multiple previous pregnancies and autumnal births are important high-risk groups. Specific key target areas are reducing elective caesareans in non-Aboriginal women and reducing teenage pregnancies and improving access to services and living conditions for the Aboriginal population.

Acute treatment of migraine headaches.

Science.gov (United States)

Taylor, Frederick R

2010-04-01

Optimum acute treatment of migraine requires prevention of headache as a top priority. Recognition of the multitude of migraine presentations, the frequency of total headache attacks, and number of days of headache disability are critical. Successful treatment requires excellent patient-clinician communication enhancing confidence and mutual trust based on patient needs and preferences. Optimum management of acute migraine nearly always requires pharmacologic treatment for rapid resolution. Migraine-specific triptans, dihydroergotamine, and several antiinflammatories have substantial empirical clinical efficacy. Older nonspecific drugs, particularly butalbital and opioids, contribute to medication overuse headache and are to be avoided. Clinicians should utilize evidence-based acute migraine-specific therapy stressing the imperative acute treatment goal of early intervention, but not too often with the correct drug, formulation, and dose. This therapy needs to provide cost-effective fast results, meaningful to the patient while minimizing the need for additional drugs. Migraine-ACT evaluates 2-hour pain freedom with return to normal function, comfort with treatment, and consistency of response. Employ a thoroughly educated patient, formulary, testimonials, stratification, and rational cotherapy against the race to central sensitization for optimum outcomes. Thieme Medical Publishers.

The White Mountain Recreational Enterprise: Bio-Political Foundations for White Mountain Apache Natural Resource Control, 1945–1960

Directory of Open Access Journals (Sweden)

David C. Tomblin

2016-07-01

Full Text Available Among American Indian nations, the White Mountain Apache Tribe has been at the forefront of a struggle to control natural resource management within reservation boundaries. In 1952, they developed the first comprehensive tribal natural resource management program, the White Mountain Recreational Enterprise (WMRE, which became a cornerstone for fighting legal battles over the tribe’s right to manage cultural and natural resources on the reservation for the benefit of the tribal community rather than outside interests. This article examines how White Mountain Apaches used the WMRE, while embracing both Euro-American and Apache traditions, as an institutional foundation for resistance and exchange with Euro-American society so as to reassert control over tribal eco-cultural resources in east-central Arizona.

Ischemic preconditioning provides both acute and delayed protection against renal ischemia and reperfusion injury in mice.

Science.gov (United States)

Joo, Jin Deok; Kim, Mihwa; D'Agati, Vivette D; Lee, H Thomas

2006-11-01

Acute as well as delayed ischemic preconditioning (IPC) provides protection against cardiac and neuronal ischemia reperfusion (IR) injury. This study determined whether delayed preconditioning occurs in the kidney and further elucidated the mechanisms of renal IPC in mice. Mice were subjected to IPC (four cycles of 5 min of ischemia and reperfusion) and then to 30 min of renal ischemia either 15 min (acute IPC) or 24 h (delayed IPC) later. Both acute and delayed renal IPC provided powerful protection against renal IR injury. Inhibition of Akt but not extracellular signal-regulated kinase phosphorylation prevented the protection that was afforded by acute IPC. Neither extracellular signal-regulated kinase nor Akt inhibition prevented protection that was afforded by delayed renal IPC. Pretreatment with an antioxidant, N-(2-mercaptopropionyl)-glycine, to scavenge free radicals prevented the protection that was provided by acute but not delayed renal IPC. Inhibition of protein kinase C or pertussis toxin-sensitive G-proteins attenuated protection from both acute and delayed renal IPC. Delayed renal IPC increased inducible nitric oxide synthase (iNOS) as well as heat-shock protein 27 synthesis, and the renal protective effects of delayed preconditioning were attenuated by a selective inhibitor of iNOS (l-N(6)[1-iminoethyl]lysine). Moreover, delayed IPC was not observed in iNOS knockout mice. Both acute and delayed IPC were independent of A(1) adenosine receptors (AR) as a selective A(1)AR antagonist failed to block preconditioning and acute and delayed preconditioning occurred in mice that lacked A(1)AR. Therefore, this study demonstrated that acute or delayed IPC provides renal protection against IR injury in mice but involves distinct signaling pathways.

Rapid differentiation of rocky mountain spotted fever from chickenpox, measles, and enterovirus infections and bacterial meningitis by frequency-pulsed electron capture gas-liquid chromatographic analysis of sera.

Science.gov (United States)

Brooks, J B; McDade, J E; Alley, C C

1981-01-01

Normal sera and sera from patients with Rocky Mountain spotted fever, chickenpox, enterovirus infections, measles, and Neisseria meningitidis infections were extracted with organic solvents under acidic and basic conditions and then derivatized with trichloroethanol or heptafluorobutyric anhydride-ethanol to form electron-capturing derivatives of organic acids, alcohols, and amines. The derivatives were analyzed by frequency-pulsed electron capture gas-liquid chromatography (FPEC-GLC). There were unique differences in the FPEC-GLC profiles of sera obtained from patients with these respective diseases. With Rocky Mountain spotted fever patients, typical profiles were detected as early as 1 day after onset of disease and before antibody could be detected in the serum. Rapid diagnosis of Rocky Mountain spotted fever by FPEC-GLC could permit early and effective therapy, thus preventing many deaths from this disease. PMID:7276147

Mountain-Plains Curriculum.

Science.gov (United States)

Mountain-Plains Education and Economic Development Program, Inc., Glasgow AFB, MT.

The document lists the Mountain-Plains curriculum by job title (where applicable), including support courses. The curriculum areas covered are mathematics skills, communication skills, office education, lodging services, food services, marketing and distribution, welding support, automotive, small engines, career guidance, World of Work, health…

Inhibitors of ORAI1 Prevent Cytosolic Calcium-Associated Injury of Human Pancreatic Acinar Cells and Acute Pancreatitis in 3 Mouse Models

Science.gov (United States)

Wen, Li; Voronina, Svetlana; Javed, Muhammad A.; Awais, Muhammad; Szatmary, Peter; Latawiec, Diane; Chvanov, Michael; Collier, David; Huang, Wei; Barrett, John; Begg, Malcolm; Stauderman, Ken; Roos, Jack; Grigoryev, Sergey; Ramos, Stephanie; Rogers, Evan; Whitten, Jeff; Velicelebi, Gonul; Dunn, Michael; Tepikin, Alexei V.; Criddle, David N.; Sutton, Robert

2015-01-01

Background & Aims Sustained activation of the cytosolic calcium concentration induces injury to pancreatic acinar cells and necrosis. The calcium release–activated calcium modulator ORAI1 is the most abundant Ca2+ entry channel in pancreatic acinar cells; it sustains calcium overload in mice exposed to toxins that induce pancreatitis. We investigated the roles of ORAI1 in pancreatic acinar cell injury and the development of acute pancreatitis in mice. Methods Mouse and human acinar cells, as well as HEK 293 cells transfected to express human ORAI1 with human stromal interaction molecule 1, were hyperstimulated or incubated with human bile acid, thapsigargin, or cyclopiazonic acid to induce calcium entry. GSK-7975A or CM_128 were added to some cells, which were analyzed by confocal and video microscopy and patch clamp recordings. Acute pancreatitis was induced in C57BL/6J mice by ductal injection of taurolithocholic acid 3-sulfate or intravenous' administration of cerulein or ethanol and palmitoleic acid. Some mice then were given GSK-7975A or CM_128, which inhibit ORAI1, at different time points to assess local and systemic effects. Results GSK-7975A and CM_128 each separately inhibited toxin-induced activation of ORAI1 and/or activation of Ca2+ currents after Ca2+ release, in a concentration-dependent manner, in mouse and human pancreatic acinar cells (inhibition >90% of the levels observed in control cells). The ORAI1 inhibitors also prevented activation of the necrotic cell death pathway in mouse and human pancreatic acinar cells. GSK-7975A and CM_128 each inhibited all local and systemic features of acute pancreatitis in all 3 models, in dose- and time-dependent manners. The agents were significantly more effective, in a range of parameters, when given at 1 vs 6 hours after induction of pancreatitis. Conclusions Cytosolic calcium overload, mediated via ORAI1, contributes to the pathogenesis of acute pancreatitis. ORAI1 inhibitors might be developed

Interactions between Shrubs and Permafrost in the Torngat Mountains, Northern Labrador, Canada

Science.gov (United States)

Lewkowicz, A.; Way, R. G.; Hermanutz, L.; Trant, A.; Siegwart Collier, L.; Whitaker, D.

2017-12-01

Discontinuous permafrost is acutely sensitive to climate warming and vegetation dynamics. Shrub height is positively correlated with accumulation of snow in the tundra resulting in warming of the ground in winter, and greater shading and lower surface temperatures in summer. Rapid greening due to climate warming has been observed throughout northeastern Canada and particularly in the coastal mountainous terrain of the Torngat Mountains National Park. Our research examines how this shrubification in the Torngat Mountains is modifying permafrost characteristics using observations which extend over a 100 km south-north transect from the sporadic zone (Saglek, Torr Bay) to where permafrost is widespread (Nakvak Brook, Kangalaksiorvik Lake) and potentially continuous (Komaktorvik River). We use air and ground temperature monitoring, vegetation surveys, dendrochronology, frost probing and electrical resistivity tomography (ERT) to describe the complex interactions between shrub growth, geomorphology, climate and permafrost in a region where climate warming is rapidly altering the landscape. Preliminary analysis of field data shows low resistivity anomalies in the ERT profiles at some sites with thin permafrost, interpreted as unfrozen zones correlated with areas of tall shrubs (Alnus spp., Salix spp. and Betula glandulosa; ranging from prostrate to 2 m). Elsewhere, high resistivities extend to the base of the ERT profiles, indicating thicker permafrost, and no obvious impact of medium to low-prostrate shrubs (Salix spp., Betula glandulosa, Rhododendron spp., and Vaccinium spp.; up to 50 cm). Permafrost is interpreted to be present at most sites with low or prostrate shrubs, except where hydrological conditions favour warmer ground temperatures. We infer that the net impact of increasing shrub heights on the active layer and permafrost depends on antecedent ground temperatures and surficial geology. Increasing shrub heights may cause permafrost degradation at sites where

Conservation of biodiversity in mountain ecosystems -- At a glance

OpenAIRE

MacKinnon, K.

2002-01-01

Metadata only record Mountains are especially important for biodiversity conservation since many harbor unique assemblages of plants and animals, including high levels of endemic species. Mountain biodiversity and natural habitats bestow multiple ecosystem, soil conservation, and watershed benefits. Mountains are often centers of endemism, where species are prevalent in or peculiar to a particular region, and Pleistocene refuges, which are hypothesized to have high levels of diversity wher...

Paleogene Sediment Character of Mountain Front Central Sumatra Basin

Directory of Open Access Journals (Sweden)

P. A. Suandhi

2014-07-01

Full Text Available DOI: 10.17014/ijog.v8i3.164The SE-NW trending Mountain Front of Central Sumatra Basin is located in the southern part of the basin. The Mountain Front is elongated parallel to the Bukit Barisan Mountain, extending from the Regencies of North Padang Lawas (Gunung Tua in the northwest, Rokan Hulu, Kampar, Kuantan Singingi, and Inderagiri Hulu Regency in the southeast. The Palaeogene sediments also represent potential exploration objectives in Central Sumatra Basin, especially in the mountain front area. Limited detailed Palaeogene sedimentology information cause difficulties in hydrocarbon exploration in this area. Latest age information and attractive sediment characters based on recent geological fieldwork (by chaining method infer Palaeogene sediment potential of the area. The Palaeogene sedimentary rock of the mountain front is elongated from northwest to southeast. Thickness of the sedimentary unit varies between 240 - 900 m. Palynology samples collected recently indicate that the oldest sedimentary unit is Middle Eocene and the youngest one is Late Oligocene. This latest age information will certainly cause significant changes to the existing surface geological map of the mountain front area. Generally, the Palaeogene sediments of the mountain front area are syn-rift sediments. The lower part of the Palaeogene deposit consists of fluvial facies of alluvial fan and braided river facies sediments. The middle part consists of fluvial meandering facies, lacustrine delta facies, and turbidity lacustrine facies sediments. The upper part consists of fluvial braided facies and transitional marine facies sediments. Volcanism in the area is detected from the occurrence of volcanic material as lithic material and spotted bentonite layers in the middle part of the mountain front area. Late rifting phase is indicated by the presence of transitional marine facies in the upper part of the Palaeogene sediments.

Small fishes crossed a large mountain range: Quaternary stream capture events and freshwater fishes on both sides of the Taebaek Mountains.

Science.gov (United States)

Kim, Daemin; Hirt, M Vincent; Won, Yong-Jin; Simons, Andrew M

2017-07-01

The Taebaek Mountains in Korea serve as the most apparent biogeographic barrier for Korean freshwater fishes, resulting in 2 distinct ichthyofaunal assemblages on the eastern (East/Japan Sea slope) and western (Yellow Sea and Korea Strait slopes) sides of the mountain range. Of nearly 100 species of native primary freshwater fishes in Korea, only 18 species occur naturally on both sides of the mountain range. Interestingly, there are 5 rheophilic species (Phoxinus phoxinus, Coreoleuciscus splendidus, Ladislavia taczanowskii, Iksookimia koreensis and Koreocobitis rotundicaudata) found on both sides of the Taebaek Mountains that are geographically restricted to the Osip River (and several neighboring rivers, for L. taczanowskii and I. koreensis) on the eastern side of the mountain range. The Osip River and its neighboring rivers also shared a rheophilic freshwater fish, Liobagrus mediadiposalis, with the Nakdong River on the western side of the mountain range. We assessed historical biogeographic hypotheses on the presence of these rheophilic fishes, utilizing DNA sequence data from the mitochondrial cytochrome b gene. Results of our divergence time estimation indicate that ichthyofaunal transfers into the Osip River (and several neighboring rivers in East Sea slope) have occurred from the Han (Yellow Sea slope) and Nakdong (Korea Strait slope) Rivers since the Late Pleistocene. The inferred divergence times for the ichthyofaunal transfer across the Taebaek Mountains were consistent with the timing of hypothesized multiple reactivations of the Osip River Fault (Late Pleistocene), suggesting that the Osip River Fault reactivations may have caused stream capture events, followed by ichthyofaunal transfer, not only between the Osip and Nakdong Rivers, but also between the Osip and Han Rivers. © 2016 International Society of Zoological Sciences, Institute of Zoology/Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

A measure for the promotion of mountain ecological villages in South Korea: focus on the national mountain ecological village investigation of 2014

OpenAIRE

Choi, Soo Im; Kang, Hag Mo; Kim, Hyun; Lee, Chang Heon; Lee, Chong Kyu

2016-01-01

Background Although South Korean mountain villages occupy 44 and 55?% of land and forest areas, respectively, these villages account for only 3?% of the national population and they suffer from a declining workforce owing to aging, wage inflation, and low forestry productivity. As a result, the South Korean government implemented a mountain ecological village development project from 1995 to 2013 in 312 of the 4972 mountain villages and investigated project performance in 2014. The present st...

The Mountains of Io: Global and Geological Perspectives from Voyager and Galileo

Science.gov (United States)

Schenk, Paul; Hargitai, Henrik; Wilson, Ronda; McEwen, Alfred; Thomas, Peter; Bredekamp, Joe (Technical Monitor)

2001-01-01

To search for local and global scale geologic associations that may be related to the internal dynamics of Io, we have completed a global catalog of all mountains and volcanic centers. We have identified 115 mountain structures (covering approx. 3% of the surface) and 541 volcanic centers, including paterae (calderas and dark spots) and shield volcanoes. The average length of an Ionian mountain is 157 km, with the longest being 570 km. The mean height of Ionian mountains is 6.3 km, and the highest known mountain is Boosaule Montes (17.5 +/- 3 km). Five basic morphologic types of mountains have been identified; mesa, plateau peak, ridge, and massif. Very few mountains bear any physical similarity. to classic volcanic landforms, but many resemble flatiron mountains on Earth and are interpreted as tilted crustal blocks. This would be consistent with the hypothesis that most mountains are thrust blocks formed as a result of compressive stresses built up in the lower crust due to the global subsidence of volcanic layers as they are buried over time. More than one mechanism may be responsible for all Ionian mountains, however. The proximity of some mountains to paterae may indicate a direct link between some mountains and volcanism, although it is not always clear which came first. In contrast to earlier studies, a pronounced bimodal pattern is observed in the global distribution of both mountains and volcanic centers. The regions of highest areal densities of volcanic centers are near the sub- and anti-Jovian regions, but are offset roughly 90deg in longitude from the two, regions of greatest concentration of mountains. This anticorrelation may indicate the overprinting of a second stress field on the global compressive stresses due to subsidence. The bimodal distribution of volcanic centers and mountains is consistent with models of asthenospheric tidal heating and internal convection developed by Tackley et al.Over regions of mantle upwelling, compressive stresses in

Rocky Mountain Research Station: 2011 Annual Accomplishments

Science.gov (United States)

Rick Fletcher

2011-01-01

The Rocky Mountain Research Station is one of seven regional units that make up the USDA Forest Service Research and Development organization ­ the most extensive natural resources research organization in the world. We maintain 12 field laboratories throughout a 12-state territory encompassing the Great Basin, Southwest, Rocky Mountains, and parts of the Great Plains...

Rocky Mountain Research Station: 2010 Research Accomplishments

Science.gov (United States)

Rick Fletcher

2010-01-01

The Rocky Mountain Research Station is one of seven regional units that make up the USDA Forest Service Research and Development organization ­ the most extensive natural resources research organization in the world. We maintain 12 field laboratories throughout a 12-state territory encompassing the Great Basin, Southwest, Rocky Mountains, and parts of the Great Plains...

Physiotherapy and occupational therapy: a geriatric experience in the acute care hospital.

Science.gov (United States)

Landi, F; Zuccalà, G; Bernabei, R; Cocchi, A; Manigrasso, L; Tafani, A; De Angelis, G; Carbonin, P U

1997-01-01

The continuously growing segment of the geriatric population with the high incidence and prevalence of comorbidity and disability suggests that enhanced preventive and rehabilitative programs will be mandatory. The early arrangement of comprehensive assessment and rehabilitation services is extremely important not only in preventing the decline of patients in the acute care settings and successive prolonged care before discharge, but also in improving functional status at discharge. We have considered the effectiveness of a rehabilitation program in acute medical care of the elderly. This article discusses a pilot project being carried out at Catholic University Hospital "A. Gemelli" of Rome.

Acute intestinal injury induced by acetic acid and casein: prevention by intraluminal misoprostol

International Nuclear Information System (INIS)

Miller, M.J.; Zhang, x.J.; Gu, x.A.; Clark, D.A.

1991-01-01

Acute injury was established in anesthetized rabbits by intraluminal administration of acetic acid with and without bovine casein, into loops of distal small intestine. Damage was quantified after 45 minutes by the blood-to-lumen movement of 51 Cr-labeled ethylenediaminetetraacetic acid (EDTA) and fluorescein isothiocyanate-tagged bovine serum albumin as well as luminal fluid histamine levels. The amount of titratable acetic acid used to lower the pH of the treatment solutions to pH 4.0 was increased by the addition of calcium gluconate. Luminal acetic acid caused a 19-fold increase in 51 Cr-EDTA accumulation over saline controls; casein did not modify this effect. In saline controls, loop fluid histamine levels bordered on the limits of detection (1 ng/g) but were elevated 19-fold by acetic acid exposure and markedly increased (118-fold) by the combination of acid and casein. Intraluminal misoprostol (3 or 30 micrograms/mL), administered 30 minutes before acetic acid, significantly attenuated the increase in epithelial permeability (luminal 51 Cr-EDTA, fluorescein isothiocyanate-bovine serum albumin accumulation) and histamine release (P less than 0.05). Diphenhydramine, alone or in combination with cimetidine, and indomethacin (5 mg/kg IV) were not protective. It is concluded that exposure of the epithelium to acetic acid promotes the transepithelial movement of casein leading to enhanced mast cell activation and mucosal injury. Damage to the epithelial barrier can be prevented by misoprostol

Acute intestinal injury induced by acetic acid and casein: prevention by intraluminal misoprostol

Energy Technology Data Exchange (ETDEWEB)

Miller, M.J.; Zhang, x.J.; Gu, x.A.; Clark, D.A. (Department of Pediatrics, Louisiana State University School of Medicine, New Orleans (USA))

1991-07-01

Acute injury was established in anesthetized rabbits by intraluminal administration of acetic acid with and without bovine casein, into loops of distal small intestine. Damage was quantified after 45 minutes by the blood-to-lumen movement of {sup 51}Cr-labeled ethylenediaminetetraacetic acid (EDTA) and fluorescein isothiocyanate-tagged bovine serum albumin as well as luminal fluid histamine levels. The amount of titratable acetic acid used to lower the pH of the treatment solutions to pH 4.0 was increased by the addition of calcium gluconate. Luminal acetic acid caused a 19-fold increase in {sup 51}Cr-EDTA accumulation over saline controls; casein did not modify this effect. In saline controls, loop fluid histamine levels bordered on the limits of detection (1 ng/g) but were elevated 19-fold by acetic acid exposure and markedly increased (118-fold) by the combination of acid and casein. Intraluminal misoprostol (3 or 30 micrograms/mL), administered 30 minutes before acetic acid, significantly attenuated the increase in epithelial permeability (luminal {sup 51}Cr-EDTA, fluorescein isothiocyanate-bovine serum albumin accumulation) and histamine release (P less than 0.05). Diphenhydramine, alone or in combination with cimetidine, and indomethacin (5 mg/kg IV) were not protective. It is concluded that exposure of the epithelium to acetic acid promotes the transepithelial movement of casein leading to enhanced mast cell activation and mucosal injury. Damage to the epithelial barrier can be prevented by misoprostol.

Fatal Rocky Mountain Spotted Fever in the United States, 1999–2007

Science.gov (United States)

Dahlgren, F. Scott; Holman, Robert C.; Paddock, Christopher D.; Callinan, Laura S.; McQuiston, Jennifer H.

2012-01-01

Death from Rocky Mountain spotted fever (RMSF) is preventable with prompt, appropriate treatment. Data from two independent sources were analyzed to estimate the burden of fatal RMSF and identify risk factors for fatal RMSF in the United States during 1999–2007. Despite increased reporting of RMSF cases to the Centers for Disease Control and Prevention, no significant changes in the estimated number of annual fatal RMSF cases were found. American Indians were at higher risk of fatal RMSF relative to whites (relative risk [RR] = 3.9), and children 5–9 years of age (RR = 6.0) and adults ≥ 70 years of age (RR = 3.0) were also at increased risk relative to other ages. Persons with cases of RMSF with an immunosuppressive condition were at increased risk of death (RR = 4.4). Delaying treatment of RMSF was also associated with increased deaths. These results may indicate a gap between recommendations and practice. PMID:22492159

75 FR 29686 - Proposed Establishment of the Pine Mountain-Mayacmas Viticultural Area

Science.gov (United States)

2010-05-27

... states that local growers report that Pine Mountain vineyards are naturally free of mildew, a vineyard... often stall over Pine Mountain and the Mayacmas range, dropping more rain than in other areas. Pine..., these mountain soils include large amounts of sand and gravel. Pine Mountain soils are generally less...

Does acute tobacco smoking prevent cue-induced craving?

Science.gov (United States)

Schlagintweit, Hera E; Barrett, Sean P

2016-05-01

Smoking cessation aids appear to be limited in their ability to prevent craving triggered by exposure to smoking-associated stimuli; however, the extent to which cue-induced cravings persist following denicotinized or nicotine-containing tobacco smoking is not known. Thirty (17 male) ⩾12-hour abstinent dependent smokers completed two sessions during which they smoked a nicotine-containing or denicotinized cigarette. Instructions regarding the nicotine content of the cigarette varied across sessions, and all participants were exposed to a neutral cue followed by a smoking cue after cigarette consumption. Craving was assessed before and after cigarette consumption and cue exposure. Reduced intentions to smoke were associated with both nicotine expectancy (pSmoking-associated stimuli increased craving regardless of nicotine expectancy or administration (p-valuessmoking, neither smoking-related nicotine administration nor expectation prevents increases in craving following exposure to smoking-associated stimuli. These findings suggest that cue-induced craving may be resistant to various pharmacological and psychological interventions. © The Author(s) 2016.

Gastric cancer incidence and mortality is associated with altitude in the mountainous regions of Pacific Latin America.

Science.gov (United States)

Torres, Javier; Correa, Pelayo; Ferreccio, Catterina; Hernandez-Suarez, Gustavo; Herrero, Rolando; Cavazza-Porro, Maria; Dominguez, Ricardo; Morgan, Douglas

2013-02-01

In Latin America, gastric cancer is a leading cancer, and countries in the region have some of the highest mortality rates worldwide, including Chile, Costa Rica, and Colombia. Geographic variation in mortality rates is observed both between neighboring countries and within nations. We discuss epidemiological observations suggesting an association between altitude and gastric cancer risk in Latin America. In the Americas, the burden of gastric cancer mortality is concentrated in the mountainous areas along the Pacific rim, following the geography of the Andes sierra, from Venezuela to Chile, and the Sierra Madre and Cordillera de Centroamérica, from southern Mexico to Costa Rica. Altitude is probably a surrogate for host genetic, bacterial, dietary, and environmental factors that may cluster in the mountainous regions. For example, H. pylori strains from patients of the Andean Nariño region of Colombia display European ancestral haplotypes, whereas strains from the Pacific coast are predominantly of African origin. The observation of higher gastric cancer rates in the mountainous areas is not universal: the association is absent in Chile, where risk is more strongly associated with the age of H. pylori acquisition and socio-economic determinants. The dramatic global and regional variations in gastric cancer incidence and mortality rates offer the opportunity for scientific discovery and focused prevention programs.

Estimating abundance of mountain lions from unstructured spatial sampling

Science.gov (United States)

Russell, Robin E.; Royle, J. Andrew; Desimone, Richard; Schwartz, Michael K.; Edwards, Victoria L.; Pilgrim, Kristy P.; Mckelvey, Kevin S.

2012-01-01

Mountain lions (Puma concolor) are often difficult to monitor because of their low capture probabilities, extensive movements, and large territories. Methods for estimating the abundance of this species are needed to assess population status, determine harvest levels, evaluate the impacts of management actions on populations, and derive conservation and management strategies. Traditional mark–recapture methods do not explicitly account for differences in individual capture probabilities due to the spatial distribution of individuals in relation to survey effort (or trap locations). However, recent advances in the analysis of capture–recapture data have produced methods estimating abundance and density of animals from spatially explicit capture–recapture data that account for heterogeneity in capture probabilities due to the spatial organization of individuals and traps. We adapt recently developed spatial capture–recapture models to estimate density and abundance of mountain lions in western Montana. Volunteers and state agency personnel collected mountain lion DNA samples in portions of the Blackfoot drainage (7,908 km2) in west-central Montana using 2 methods: snow back-tracking mountain lion tracks to collect hair samples and biopsy darting treed mountain lions to obtain tissue samples. Overall, we recorded 72 individual capture events, including captures both with and without tissue sample collection and hair samples resulting in the identification of 50 individual mountain lions (30 females, 19 males, and 1 unknown sex individual). We estimated lion densities from 8 models containing effects of distance, sex, and survey effort on detection probability. Our population density estimates ranged from a minimum of 3.7 mountain lions/100 km2 (95% Cl 2.3–5.7) under the distance only model (including only an effect of distance on detection probability) to 6.7 (95% Cl 3.1–11.0) under the full model (including effects of distance, sex, survey effort, and

Winter severity and snowiness and their multiannual variability in the Karkonosze Mountains and Jizera Mountains

Science.gov (United States)

Urban, Grzegorz; Richterová, Dáša; Kliegrová, Stanislava; Zusková, Ilona; Pawliczek, Piotr

2017-09-01

This paper analyses winter severity and snow conditions in the Karkonosze Mountains and Jizera Mountains and examines their long-term trends. The analysis used modified comprehensive winter snowiness (WSW) and winter severity (WOW) indices as defined by Paczos (1982). An attempt was also made to determine the relationship between the WSW and WOW indices. Measurement data were obtained from eight stations operated by the Institute of Meteorology and Water Management - National Research Institute (IMGW-PIB), from eight stations operated by the Czech Hydrological and Meteorological Institute (CHMI) and also from the Meteorological Observatory of the University of Wrocław (UWr) on Mount Szrenica. Essentially, the study covered the period from 1961 to 2015. In some cases, however, the period analysed was shorter due to the limited availability of data, which was conditioned, inter alia, by the period of operation of the station in question, and its type. Viewed on a macroscale, snow conditions in the Karkonosze Mountains and Jizera Mountains (in similar altitude zones) are clearly more favourable on southern slopes than on northern ones. In the study area, negative trends have been observed with respect to both the WSW and WOW indices—winters have become less snowy and warmer. The correlation between the WOW and WSW indices is positive. At stations with northern macroexposure, WOW and WSW show greater correlation than at ones with southern macroexposure. This relationship is the weakest for stations that are situated in the upper ranges (Mount Śnieżka and Mount Szrenica).

Yucca Mountain Biological Resources Monitoring Program

International Nuclear Information System (INIS)

1992-01-01

The US Department of Energy (DOE) is required by the Nuclear Waste Policy Act of 1982 (as amended in 1987) to study and characterize Yucca Mountain as a possible site for a geologic repository for high-level nuclear waste. During site characterization, the DOE will conduct a variety of geotechnical, geochemical, geological, and hydrological studies to determine the suitability of Yucca Mountain as a repository. To ensure that site characterization activities (SCA) do not adversely affect the Yucca Mountain area, an environmental program has been implemented to monitor and mitigate potential impacts and to ensure that activities comply with applicable environmental regulations. This report describes the activities and accomplishments during fiscal year 1991 (FY91) for six program areas within the Terrestrial Ecosystem component of the YMP environmental program. The six program areas are Site Characterization Activities Effects, Desert Tortoises, Habitat Reclamation, Monitoring and Mitigation, Radiological Monitoring, and Biological Support

Computation of spatial significance of mountain objects extracted from multiscale digital elevation models

International Nuclear Information System (INIS)

Sathyamoorthy, Dinesh

2014-01-01

The derivation of spatial significance is an important aspect of geospatial analysis and hence, various methods have been proposed to compute the spatial significance of entities based on spatial distances with other entities within the cluster. This paper is aimed at studying the spatial significance of mountain objects extracted from multiscale digital elevation models (DEMs). At each scale, the value of spatial significance index SSI of a mountain object is the minimum number of morphological dilation iterations required to occupy all the other mountain objects in the terrain. The mountain object with the lowest value of SSI is the spatially most significant mountain object, indicating that it has the shortest distance to the other mountain objects. It is observed that as the area of the mountain objects reduce with increasing scale, the distances between the mountain objects increase, resulting in increasing values of SSI. The results obtained indicate that the strategic location of a mountain object at the centre of the terrain is more important than its size in determining its reach to other mountain objects and thus, its spatial significance

Vorinostat plus tacrolimus/methotrexate to prevent GVHD after myeloablative conditioning, unrelated donor HCT

NARCIS (Netherlands)

Choi, S.W.; Braun, T.; Henig, I.; Gatza, E.; Magenau, J.; Parkin, B.; Pawarode, A.; Riwes, M.; Yanik, G.; Dinarello, C.A.; Reddy, P.

2017-01-01

The oral histone deacetylase (HDAC) inhibitor (vorinostat) is safe and results in low incidence of acute graft-versus-host disease (GVHD) after reduced-intensity conditioning, related donor hematopoietic cell transplantation (HCT). However, its safety and efficacy in preventing acute GVHD in

Modeling fluid-rock interaction at Yucca Mountain, Nevada

International Nuclear Information System (INIS)

Viani, B.E.; Bruton, C.J.

1992-08-01

Volcanic rocks at Yucca Mountain, Nevada aie being assessed for their suitability as a potential repository for high-level nuclear waste. Recent progress in modeling fluid-rock interactions, in particular the mineralogical and chemical changes that may accompany waste disposal at Yucca Mountain, will be reviewed in this publication. In Part 1 of this publication, ''Geochemical Modeling of Clinoptilolite-Water Interactions,'' solid-solution and cation-exchange models for the zeolite clinoptilolite are developed and compared to experimental and field observations. At Yucca Mountain, clinoptilolite which is found lining fractures and as a major component of zeolitized tuffs, is expected to play an important role in sequestering radionuclides that may escape from a potential nuclear waste repository. The solid-solution and ion-exchange models were evaluated by comparing predicted stabilities and exchangeable cation distributions of clinoptilolites with: (1) published binary exchange data; (2) compositions of coexisting clinoptilolites and formation waters at Yucca Mountain; (3) experimental sorption isotherms of Cs and Sr on zeolitized tuff, and (4) high temperature experimental data. Good agreement was found between predictions and expertmental data, especially for binary exchange and Cs and Sr sorption on clinoptilolite. Part 2 of this publication, ''Geochemical Simulation of Fluid-Rock Interactions at Yucca Mountain,'' describes preliminary numerical simulations of fluid-rock interactions at Yucca Mountain. The solid-solution model developed in the first part of the paper is used to evaluate the stability and composition of clinciptilolite and other minerals in the host rock under ambient conditions and after waste emplacement

Acute respiratory distress syndrome

OpenAIRE

Confalonieri, Marco; Salton, Francesco; Fabiano, Francesco

2017-01-01

Since its first description, the acute respiratory distress syndrome (ARDS) has been acknowledged to be a major clinical problem in respiratory medicine. From July 2015 to July 2016 almost 300 indexed articles were published on ARDS. This review summarises only eight of them as an arbitrary overview of clinical relevance: definition and epidemiology, risk factors, prevention and treatment. A strict application of definition criteria is crucial, but the diverse resource-setting scenarios foste...

Environmental scan of infection prevention and control practices for containment of hospital-acquired infectious disease outbreaks in acute care hospital settings across Canada.

Science.gov (United States)

Ocampo, Wrechelle; Geransar, Rose; Clayden, Nancy; Jones, Jessica; de Grood, Jill; Joffe, Mark; Taylor, Geoffrey; Missaghi, Bayan; Pearce, Craig; Ghali, William; Conly, John

2017-10-01

Ward closure is a method of controlling hospital-acquired infectious diseases outbreaks and is often coupled with other practices. However, the value and efficacy of ward closures remains uncertain. To understand the current practices and perceptions with respect to ward closure for hospital-acquired infectious disease outbreaks in acute care hospital settings across Canada. A Web-based environmental scan survey was developed by a team of infection prevention and control (IPC) experts and distributed to 235 IPC professionals at acute care sites across Canada. Data were analyzed using a mixed-methods approach of descriptive statistics and thematic analysis. A total of 110 completed responses showed that 70% of sites reported at least 1 outbreak during 2013, 44% of these sites reported the use of ward closure. Ward closure was considered an "appropriate," "sometimes appropriate," or "not appropriate" strategy to control outbreaks by 50%, 45%, and 5% of participants, respectively. System capacity issues and overall risk assessment were main factors influencing the decision to close hospital wards following an outbreak. Results suggest the use of ward closure for containment of hospital-acquired infectious disease outbreaks in Canadian acute care health settings is mixed, with outbreak control methods varying. The successful implementation of ward closure was dependent on overall support for the IPC team within hospital administration. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

National Veterans Health Administration inpatient risk stratification models for hospital-acquired acute kidney injury

OpenAIRE

Cronin, Robert M; VanHouten, Jacob P; Siew, Edward D; Eden, Svetlana K; Fihn, Stephan D; Nielson, Christopher D; Peterson, Josh F; Baker, Clifton R; Ikizler, T Alp; Speroff, Theodore; Matheny, Michael E

2015-01-01

Objective Hospital-acquired acute kidney injury (HA-AKI) is a potentially preventable cause of morbidity and mortality. Identifying high-risk patients prior to the onset of kidney injury is a key step towards AKI prevention.

A 12-month follow-up study on the preventive effect of oral lansoprazole on acute exacerbation of chronic obstructive pulmonary disease.

Science.gov (United States)

Xiong, Wei; Zhang, Quan-San; Zhao, Wei; Ding, Wei; Liu, Jin-Ming; Zhao, Yun-Feng

2016-04-01

The objective of this study was to evaluate the preventive effects of oral administration of lansoprazole on acute exacerbation of chronic obstructive pulmonary disease (COPD). Patients with COPD in groups C and D in the stable phase were stratified into a group with neither gastroesophageal reflux nor lansoprazole therapy (group A) and a group subjected to oral lansoprazole therapy (group B1 ) and a group not subjected to oral lansoprazole therapy (group B2 ). The frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) questionnaire, COPD assessment test (CAT) questionnaire, pulmonary function test and the 6-minute walk test were applied; in addition, arterial blood gas, white blood cell (WBC), hs-CRP, liver function and the levels of IL-1β, IL-6, IL-8, TNF-α and GM-CSF in sputum were monitored during follow-up. In the 12-month follow-up period, the frequency of exacerbation in group B2 was statistically higher than that in groups A and B1 (P lansoprazole therapy decreased the frequency of acute exacerbation of COPD by alleviating gastroesophageal reflux and lowering the levels of IL-1β, IL-6, IL-8, TNF-α and GM-CSF in the sputum. © 2016 The Authors. International Journal of Experimental Pathology © 2016 International Journal of Experimental Pathology.

Aspen biology, community classification, and management in the Blue Mountains

Science.gov (United States)

David K. Swanson; Craig L. Schmitt; Diane M. Shirley; Vicky Erickson; Kenneth J. Schuetz; Michael L. Tatum; David C. Powell

2010-01-01

Quaking aspen (Populus tremuloides Michx.) is a valuable species that is declining in the Blue Mountains of northeastern Oregon. This publication is a compilation of over 20 years of aspen management experience by USDA Forest Service workers in the Blue Mountains. It includes a summary of aspen biology and occurrence in the Blue Mountains, and a...

Breaking the Rhythm of Depression: Cognitive Behavior Therapy and Relapse Prevention for Depression

Directory of Open Access Journals (Sweden)

Claudi L.H. Bockting

2010-12-01

Full Text Available A crucial part of the treatment of depression is the prevention of relapse and recurrence. Psychological interventions, especially cognitive behavior therapy (CBT are helpful in preventing relapse and recurrence in depression. The effectivity of four types of relapse prevention cognitive behavior therapy strategies will be addressed, i.e. acute prophylactic cognitive behavior therapy, continuation cognitive behavior therapy, sequential cognitive behavior therapy and cognitive behavior therapy in partial remission.Specific ingredients of three sequential cognitive behavior therapy programs (well-being cognitive therapy, preventive cognitive therapy, and mindfulness-based cognitive therapy will be discussed as applied after remission in patients that experienced previous depressive episodes. Sequential preventive cognitive behavior therapy after acute treatment may be an attractive alternative treatment for many patients who currently use antidepressants for years and years to prevent relapse and recurrence. This is an extremely challenging issue to research thoroughly. Future studies must rule out what intervention for whom is the best protection against relapse and recurrence in depression.

Prevention and treatment of diarrhoea with Saccharomyces boulardii in children with acute lower respiratory tract infections.

Science.gov (United States)

Shan, L-S; Hou, P; Wang, Z-J; Liu, F-R; Chen, N; Shu, L-H; Zhang, H; Han, X-H; Han, X-X; Cai, X-X; Shang, Y-X; Vandenplas, Y

2013-12-01

The aim of this study was to determine whether Saccharomyces boulardii prevents and treats diarrhoea and antibiotic-associated diarrhoea (AAD) in children. A total of 333 hospitalised children with acute lower respiratory tract infection were enrolled in a 2-phase open randomised controlled trial. During the 1st phase, all children received intravenous antibiotics (AB). They were randomly allocated to group A (S. boulardii 500 mg/day + AB, n=167) or group B (AB alone, n=166) and followed for 2 weeks. Diarrhoea was defined as ≥3 loose/watery stools/day during at least 2 days, occurring during treatment and/or up to 2 weeks after AB therapy had stopped. AAD was considered when diarrhoea was caused by Clostridium difficile or when stool cultures remained negative. In the 2nd phase of the study, group B patients who developed diarrhoea were randomly allocated to two sub-groups: group B1 (S. boulardii + oral rehydration solution (ORS)) and group B2 (ORS alone). Data from 283 patients were available for analysis. Diarrhoea prevalence was lower in group A than in group B (11/139 (7.9%) vs. 42/144 (29.2%); relative risk (RR): 0.27, 95% confidence interval (CI): 0.1-0.5). S. boulardii reduced the risk of AAD (6/139 (4.3%) vs. 28/144 (19.4%); RR: 0.22; 95% CI: 0.1-0.5). When group B patients developed diarrhoea (n=42), S. boulardii treatment during 5 days (group B1) resulted in lower stool frequency (Pboulardii were observed. S. boulardii appeared to be effective in the prevention and treatment of diarrhoea and AAD in children treated with intravenous antibiotics.

Mechanical excavator performance in Yucca Mountain tuffs

International Nuclear Information System (INIS)

Ozdemir, L.; Hansen, F.D.

1991-01-01

A research effort of four phases is in progress at the Colorado School of Mines. The overall program will evaluate the cutability of welded tuff and other lithologies likely to be excavated at Yucca Mountain in the site characterization process. Several mechanical systems are considered with emphasis given to the tunnel boring machine. The research comprises laboratory testing, linear drag bit and disc cutter tests and potentially large-scale laboratory demonstrations to support potential use of a tunnel boring machine in welded tuff. Preliminary estimates of mechanical excavator performance in Yucca Mountain tuff are presented here. As phases of the research project are completed, well quantified estimates will be made of performance of mechanical excavators in the Yucca Mountain tuffs. 3 refs., 2 tabs

Mechanical excavator performance in Yucca Mountain tuffs

International Nuclear Information System (INIS)

Ozdemir, L.; Hansen, F.D.

1991-01-01

A research effort of four phases is in progress at the Colorado School of Mines. The overall program will evaluate the cutability of welded tuff and other lithologies likely to be excavated at Yucca Mountain in the site characterization process. Several mechanical systems are considered with emphasis given to the tunnel boring machine. The research comprises laboratory testing, linear drag bit and disc cutter tests, and potentially large-scale lab. demonstrations to support potential use of a tunnel boring machine in welded tuff. Preliminary estimates of mechanical excavator performance in Yucca Mountain tuff are presented here. As phases of the research project are completed, well-quantified estimates will be made of performance of mechanical excavators in the Yucca Mountain tuffs

A SPECIAL FOEHN CASE IN NORTH-EASTERN APUSENI MOUNTAINS

Directory of Open Access Journals (Sweden)

T. TUDOSE

2016-03-01

Full Text Available The paper presents a case study for the 9-10 January 2015 period, when foehn processes were occurred on the eastern slope of the Apuseni Mountains. With a view to establishing the synoptic context in which the phenomenon was manifested, an analysis of the atmospheric fields was used, while for determining the intensity of the process several meteorological parameters (temperature, wind and relative humidity were analyzed along three west-east profiles across the Apuseni Mountains. The analysis points out the presence of foehn processes on the eastern part of the Apuseni Mountains, the highest thermal and hygric differences being recorded on the north-eastern part of the mountains. The most important effect of this synoptic situation was the reduction of the snow cover depth.

Respiratory disease, behavior, and survival of mountain goat kids

Science.gov (United States)

Blanchong, Julie A.; Anderson, Christopher A.; Clark, Nicholas J.; Klaver, Robert W.; Plummer, Paul J.; Cox, Mike; Mcadoo, Caleb; Wolff, Peregrine L.

2018-01-01

Bacterial pneumonia is a threat to bighorn sheep (Ovis canadensis) populations. Bighorn sheep in the East Humboldt Mountain Range (EHR), Nevada, USA, experienced a pneumonia epizootic in 2009–2010. Testing of mountain goats (Oreamnos americanus) that were captured or found dead on this range during and after the epizootic detected bacteria commonly associated with bighorn sheep pneumonia die‐offs. Additionally, in years subsequent to the bighorn sheep epizootic, the mountain goat population had low kid:adult ratios, a common outcome for bighorn sheep populations that have experienced a pneumonia epizootic. We hypothesized that pneumonia was present and negatively affecting mountain goat kids in the EHR. From June–August 2013–2015, we attempted to observe mountain goat kids with marked adult females in the EHR at least once per week to document signs of respiratory disease; identify associations between respiratory disease, activity levels, and subsequent disappearance (i.e., death); and estimate weekly survival. Each time we observed a kid with a marked adult female, we recorded any signs of respiratory disease and collected behavior data that we fit to a 3‐state discrete hidden Markov model (HMM) to predict a kid's state (active vs. sedentary) and its probability of disappearing. We first observed clinical signs of respiratory disease in kids in late July–early August each summer. We observed 8 of 31 kids with marked adult females with signs of respiratory disease on 13 occasions. On 11 of these occasions, the HMM predicted that kids were in the sedentary state, which was associated with increased probability of subsequent death. We estimated overall probability of kid survival from June–August to be 0.19 (95% CI = 0.08–0.38), which was lower than has been reported in other mountain goat populations. We concluded that respiratory disease was present in the mountain goat kids in the EHR and negatively affected their activity levels and survival

The Geologic Story of the Uinta Mountains

Science.gov (United States)

Hansen, Wallace R.

1969-01-01

The opening of the West after the Civil War greatly stimulated early geologic exploration west of the 100th Meridian. One of the areas first studied, the Uinta Mountains region, gained wide attention as a result of the explorations of three Territorial Surveys, one headed by John Wesley Powell, one by Clarence King, and one by Ferdinand V. Hayden. Completion of the Union Pacific Railroad across southern Wyoming 100 years ago, in 1869, materially assisted geologic exploration, and the railheads at Green River and Rock Springs greatly simplified the outfitting of expeditions into the mountains. The overlap of the Powell, King, and Hayden surveys in the Uinta Mountains led to efforts that were less concerted than competitive and not without acrimony. Many parts of the area were seen by all three parties at almost the same time. Duplication was inevitable, of course, but all three surveys contributed vast quantities of new knowledge to the storehouse of geology, and many now-basic concepts arose from their observations. Powell's area of interest extended mainly southward from the Uinta Mountains to the Grand Canyon, including the boundless plateaus and canyons of southern Utah and northern Arizona. King's survey extended eastward from the High Sierra in California to Cheyenne, Wyoming, and encompassed a swath of country more than 100 miles wide. Hayden's explorations covered an immense region of mountains and basins from Yellowstone Park in Wyoming southeast throughout most of Colorado. Powell first entered the Uinta Mountains in the fall of 1868, having traveled north around the east end of the range from the White River country to Green River, Wyoming, then south over a circuitous route to Flaming Gorge and Browns Park, and finally back to the White River, where he spent the winter. In 1869, after reexamining much of the area visited the previous season, Powell embarked on his famous 'first boat trip' down the Green and Colorado Rivers. This trip was more exploratory

Hypothermia-Related Acute Pancreatitis

Directory of Open Access Journals (Sweden)

Kyawzaw Lin

2018-05-01

Full Text Available Acute pancreatitis (AP is an inflammatory disease presenting from mild localized inflammation to severe infected necrotic pancreatic tissue. In the literature, there are a few cases of hypothermia-induced AP. However, the association between hypothermia and AP is still a myth. Generally, mortality from acute pancreatitis is nearly 3–6%. Here, we present a 40-year-old chronic alcoholic female who presented with acute pancreatitis induced by transient hypothermia. A 40-year-old chronic alcoholic female was hypothermic at 81°F on arrival which was improved to 91.7°F with warming blanket and then around 97°F in 8 h. Laboratory tests including complete blood count, lipid panel, and comprehensive metabolic panels were within the normal limit. Serum alcohol level was 0.01, amylase 498, lipase 1,200, ammonia 26, serum carboxyhemoglobin level 2.4, and β-HCG was negative. The entire sepsis workup was negative. During rewarming period, she had one episode of witnessed generalized tonic-clonic seizure. It was followed by transient hypotension. Fluid challenge was successful with 2 L of normal saline. Sonogram (abdomen showed fatty liver and trace ascites. CAT scan (abdomen and pelvis showed evidence of acute pancreatitis without necrosis, peripancreatic abscess, pancreatic mass, or radiopaque gallstones. The patient was managed medically and later discharged from the hospital on the 4th day as she tolerated a normal low-fat diet. In our patient, transient hypothermia from chronic alcohol abuse and her social circumstances might predispose to microcirculatory disturbance resulting in acute pancreatitis. Early and aggressive fluid resuscitation prevents complications.

Peculiarities of high-altitude landscapes formation in the Small Caucasus mountains

Science.gov (United States)

Trifonova, Tatiana

2014-05-01

Various mountain systems differ in character of landscapes and soil. Basic problem of present research: conditions and parameters determining the development of various landscapes and soils in mountain areas. Our research object is the area of Armenia where Small Caucasus, a part of Armenian upland is located. The specific character of the area is defined by the whole variety of all mountain structures like fold, block folding mountain ridges, volcanic upland, individual volcanoes, and intermountain depressions. As for the climate, the area belongs to dry subtropics. We have studied the peculiarities of high-altitude landscapes formation and mountain river basins development. We have used remote sensing data and statistic database of climatic parameters in this research. Field observations and landscape pictures analysis of space images allow distinguishing three types of mountain geosystems clearly: volcanic massifs, fold mountainous structures and closed high mountain basins - area of the lakes. The distribution of precipitation according to altitude shows some peculiarities. It has been found that due to this factor the investigated mountain area may be divided into three regions: storage (fold) mountainous area; Ararat volcanic area (southern macro exposure); closed high mountainous basin-area of the lake Sevan. The mountainous nature-climatic vertical landscapes appear to be horizontally oriented and they are more or less equilibrium (stable) geosystems, where the stable functional relationship between the landscape components is formed. Within their limits, definite bioclimatic structure of soil is developed. Along the slopes of fold mountains specific landscape shapes like litho-drainage basins are formed. They are intensively developing like relatively independent vertical geosystems. Mechanism of basin formation is versatile resulting in formation of the polychronous soil mantle structure. Landscapes and soils within the basin are of a different age, since

Persistent Bovine Viral Diarrhea Virus infection in domestic and wild small ruminants and camelids including the mountain goat (Oreamnos americanus

Directory of Open Access Journals (Sweden)

Danielle Darracq Nelson

2016-01-01

Full Text Available Bovine viral diarrhea virus (BVDV is a Pestivirus best known for causing a variety of disease syndromes in cattle, including gastrointestinal disease, reproductive insufficiency, immunosuppression, mucosal disease, and hemorrhagic syndrome. The virus can be spread by transiently infected individuals and by persistently infected animals that may be asymptomatic while shedding large amounts of virus throughout their lifetime. BVDV has been reported in over 40 domestic and free-ranging species, and persistent infection has been described in eight of those species: white-tailed deer, mule deer, eland, mousedeer, mountain goats, alpacas, sheep, and domestic swine. This paper reviews the various aspects of BVDV transmission, disease syndromes, diagnosis, control, and prevention, as well as examines BVDV infection in domestic and wild small ruminants and camelids including mountain goats (Oreamnos americanus.

Climate Change Adaptation in the Carpathian Mountain Region

NARCIS (Netherlands)

Werners, Saskia Elisabeth; Szalai, Sándor; Zingstra, Henk; Kőpataki, Éva; Beckmann, Andreas; Bos, Ernst; Civic, Kristijan; Hlásny, Tomas; Hulea, Orieta; Jurek, Matthias; Koch, Hagen; Kondor, Attila Csaba; Kovbasko, Aleksandra; Lakatos, M.; Lambert, Stijn; Peters, Richard; Trombik, Jiří; De Velde, Van Ilse; Zsuffa, István

2016-01-01

The Carpathian mountain region is one of the most significant natural refuges on the European continent. It is home to Europe’s most extensive tracts of montane forest, the largest remaining virgin forest and natural mountain beech-fir forest ecosystems. Adding to the biodiversity are semi-natural

Understanding the implementation of 'sick day guidance' to prevent acute kidney injury across a primary care setting in England: a qualitative evaluation.

Science.gov (United States)

Martindale, Anne-Marie; Elvey, Rebecca; Howard, Susan J; McCorkindale, Sheila; Sinha, Smeeta; Blakeman, Tom

2017-11-08

The study sought to examine the implementation of sick day guidance cards designed to prevent acute kidney injury (AKI), in primary care settings. Qualitative semistructured interviews were conducted and comparative analysis informed by normalisation process theory was undertaken to understand sense-making, implementation and appraisal of the cards and associated guidance. A single primary care health setting in the North of England. 29 participants took part in the qualitative evaluation: seven general practitioners, five practice nurses, five community pharmacists, four practice pharmacists, two administrators, one healthcare assistant and five patients. The sick day guidance intervention was rolled out (2015-2016) in general practices (n=48) and community pharmacies (n=60). The materials consisted of a 'medicine sick day guidance' card, provided to patients who were taking the listed drugs. The card provided advice about medicines management during episodes of acute illness. An information leaflet was provided to healthcare practitioners and administrators suggesting how to use and give the cards. Implementation of sick day guidance cards to prevent AKI entailed a new set of working practises across primary care. A tension existed between ensuring reach in administration of the cards to at risk populations while being confident to ensure patient understanding of their purpose and use. Communicating the concept of temporary cessation of medicines was a particular challenge and limited their administration to patient populations at higher risk of AKI, particularly those with less capacity to self-manage. Sick day guidance cards that focus solely on medicines management may be of limited patient benefit without adequate resourcing or if delivered as a standalone intervention. Development and evaluation of primary care interventions is urgently warranted to tackle the harm associated with AKI. © Article author(s) (or their employer(s) unless otherwise stated in the

The physiology of mountain biking.

Science.gov (United States)

Impellizzeri, Franco M; Marcora, Samuele M

2007-01-01

Mountain biking is a popular outdoor recreational activity and an Olympic sport. Cross-country circuit races have a winning time of approximately equal 120 minutes and are performed at an average heart rate close to 90% of the maximum, corresponding to 84% of maximum oxygen uptake (VO2max). More than 80% of race time is spent above the lactate threshold. This very high exercise intensity is related to the fast starting phase of the race; the several climbs, forcing off-road cyclists to expend most of their effort going against gravity; greater rolling resistance; and the isometric contractions of arm and leg muscles necessary for bike handling and stabilisation. Because of the high power output (up to 500W) required during steep climbing and at the start of the race, anaerobic energy metabolism is also likely to be a factor of off-road cycling and deserves further investigation. Mountain bikers' physiological characteristics indicate that aerobic power (VO2max >70 mL/kg/min) and the ability to sustain high work rates for prolonged periods of time are prerequisites for competing at a high level in off-road cycling events. The anthropometric characteristics of mountain bikers are similar to climbers and all-terrain road cyclists. Various parameters of aerobic fitness are correlated to cross-country performance, suggesting that these tests are valid for the physiological assessment of competitive mountain bikers, especially when normalised to body mass. Factors other than aerobic power and capacity might influence off-road cycling performance and require further investigation. These include off-road cycling economy, anaerobic power and capacity, technical ability and pre-exercise nutritional strategies.

Risk management among mountain bikers in selected clubs in ...

African Journals Online (AJOL)

Risk management among mountain bikers in selected clubs in Malaysia. ... Journal of Fundamental and Applied Sciences. Journal Home · ABOUT ... is more risky. Keywords: mountain biking, risk management, event management, Malaysia ...

Characterize Eruptive Processes at Yucca Mountain, Nevada

International Nuclear Information System (INIS)

D. Krier

2004-01-01

The purpose of this scientific analysis report, ''Characterize Eruptive Processes at Yucca Mountain, Nevada'', is to present information about natural volcanic systems and the parameters that can be used to model their behavior. This information is used to develop parameter-value distributions appropriate for analysis of the consequences of volcanic eruptions through a repository at Yucca Mountain. This scientific analysis report provides information to four other reports: ''Number of Waste Packages Hit by Igneous Intrusion'', (BSC 2004 [DIRS 170001]); ''Atmospheric Dispersal and Deposition of Tephra from Potential Volcanic Eruption at Yucca Mountain, Nevada'' (BSC 2004 [DIRS 170026]); ''Dike/Drift Interactions'' (BSC 2004 [DIRS 170028]); ''Development of Earthquake Ground Motion Input for Preclosure Seismic Design and Postclosure Performance Assessment of a Geologic Repository at Yucca Mountain, NV'' (BSC 2004 [DIRS 170027], Section 6.5). This report is organized into seven major sections. This section addresses the purpose of this document. Section 2 addresses quality assurance, Section 3 the use of software, Section 4 identifies the requirements that constrain this work, and Section 5 lists assumptions and their rationale. Section 6 presents the details of the scientific analysis and Section 7 summarizes the conclusions reached

The mountain Cer: Potentials for tourism development

Directory of Open Access Journals (Sweden)

Grčić Mirko D.

2003-01-01

Full Text Available In northwest of Serbia in the meridians directions an elongated mountain range of Cer with Iverak and Vlašić stretches itself. On the north it goes down to Mačva and Posavina, on the west to Podrinje, on the east to the valley of Kolubara, on the south to the basins and valleys of Jadar and upper Kolubara, which separate it from the mountains of Valjevo and Podrinje area. Cer mountain offers extremely good condition for development of eco-tourism. The variety of relief with gorgeous see-sites, natural rarities, convenient bio-climatic conditions, significant water resources, forest complexes, medieval fortresses, cultural-historic monuments, richness of flora and fauna, preserved rural environment, traditions and customs of local population, were all neglected as strategic factors in the development of tourism. This mountain’s potentials are quite satisfactory for the needs of eco-tourism, similar to the National Park of Fruška Gora, but it has lacked an adequate ecotourist strategy so far. This study aims to pointing to the potential and possibilities of ecotourist valorization of this mountain.

Raising the veil: mountains from a masculine and a feminine angle

OpenAIRE

2012-01-01

Context The present call for papers seeks to offer a feminine/masculine reading of mountains. Many works have already analysed the roles of human activity in mountain spaces, in agricultural production, the travel trade, the economy and the arts. But such investigation has often focused on the masculine side, revealing the practices, customs and narratives of men in the mountains. However the relations between humans and mountains do not all take a masculine form, their feminine side being eq...

The status of Yucca Mountain site characterization activities

International Nuclear Information System (INIS)

Gertz, Carl P.; Larkin, Erin L.; Hamner, Melissa

1992-01-01

The U.S. Department of Energy (DOE) Office of Civilian Radioactive Waste Management (OCRWM) is continuing its studies to determine if Yucca Mountain, Nevada, can safely isolate high-level nuclear waste for the next ten thousand years. As mandated by Congress in 1987, DOE is studying the rocks, the climate, and the water table at Yucca Mountain to ensure that the site is suitable before building a repository adopt 305 meters below the surface. Yucca Mountain, located 160.9 kilometers northwest of Las Vegas, lies on the western edge of the Nevada Test Site. Nevada and DOE have been in litigation over environmental permits needed to conduct studies, but recent court decisions have allowed limited new work to begin. This paper will examine progress made on the Yucca Mountain Site Characterization Project (YMP) during 1991 and continuing into 1992, discuss the complex legal issues and describe new site drilling work. Design work on the underground exploratory studies facility (ESF) will also be discussed. (author)

Economic impact of enoxaparin after acute ischemic stroke based on PREVAIL.

Science.gov (United States)

Pineo, Graham; Lin, Jay; Stern, Lee; Subrahmanian, Tarun; Annemans, Lieven

2011-04-01

The efficacy and safety of low-molecular-weight heparins (LMWHs) versus unfractionated heparin (UFH) has been demonstrated for the prevention of venous thromboembolism (VTE) after acute ischemic stroke. Few data exist regarding the economic impact of LMWHs versus UFH in this population. A decision-analytic model was constructed using clinical information from the Prevention of VTE after Acute Ischemic stroke with LMWH Enoxaparin (PREVAIL) study, and drug costs and mean Centers for Medicare & Medicaid Services event costs. When considering the total cost of events and drugs, enoxaparin was associated with cost-savings of $895 per patient compared with UFH ($2018 vs $2913). Findings were retained within the univariate and multivariate analyses. From a payer perspective, enoxaparin was cost-effective compared with UFH in patients with acute ischemic stroke. The difference was driven by the lower clinical event rates with enoxaparin. Use of enoxaparin may help to reduce the clinical and economic burden of VTE.

Yucca Mountain biological resources monitoring program

International Nuclear Information System (INIS)

1993-02-01

The US Department of Energy (DOE) is required by the Nuclear Waste Policy Act of 1982 (as amended in 1987) to study and characterize Yucca Mountain as a potential site for a geologic repository for high-level nuclear waste. During site characterization, the DOE will conduct a variety of geotechnical, geochemical, geological, and hydrological studies to determine the suitability of Yucca Mountain as a potential repository. To ensure that site characterization activities (SCA) do not adversely affect the environment at Yucca Mountain, an environmental program has been implemented to monitor and mitigate potential impacts and ensure activities comply with applicable environmental regulations. This report describes the activities and accomplishments of EG ampersand G Energy Measurements, Inc. (EG ampersand G/EM) during fiscal year 1992 (FY92) for six program areas within the Terrestrial Ecosystem component of the YMP environmental program. The six program areas are Site Characterization Effects, Desert Tortoises, Habitat Reclamation, Monitoring and Mitigation, Radiological Monitoring, and Biological Support

Rocky Mountain High.

Science.gov (United States)

Hill, David

2001-01-01

Describes Colorado's Eagle Rock School, which offers troubled teens a fresh start by transporting them to a tuition- free campus high in the mountains. The program encourages spiritual development as well as academic growth. The atmosphere is warm, loving, structured, and nonthreatening. The article profiles several students' experiences at the…

[Acute asthma attacks introduced by anesthesia before nasal endoscopic surgery].

Science.gov (United States)

Lü, Xiaofei; Han, Demin; Zhou, Bing; Ding, Bin

2004-05-01

In order to pay our attention to the perioperative treatment before nasal endoscopic surgery. Three patients with asthma accompanied chronic sinusitis were analyzed systemically, who had undergone acute attacks of asthma introduced by anesthesia. Anesthetic drugs and instruments can lead to acute attacks of asthma, because sinusitis with asthma means allergic airway inflammation, broncho-hyperreactivity and lower compensatory pulmonary function. Then all of the 3 cases had missed the preoperative treatment. Anesthetic drugs and instruments can lead to acute attacks of asthma. The perioperative treatment before nasal endoscopic surgery is very important for the prevention of the occurrences of this severe complication. Except emergency, the operation should be can celled for avoiding the acute attack of asthma introduced by anesthesia.

Does the Intestinal Parasite Enterobius vermicularis Cause Acute Appendicitis?

Science.gov (United States)

Pirhan, Yavuz; Özen, Fatma Zeynep; Kılınç, Çetin; Güçkan, Rıdvan

2017-06-01

Although intestinal parasitic infections rarely cause acute appendicitis, they are common public health problems in undeveloped and developing countries. Parasitic infections should be kept in mind in patients clinically suspected of having acute appendicitis, and treatment procedures should be adopted according to the etiology. Herein we presented the cases of four patients with clinical findings of acute appendicitis. Patients were clinically suspected of having acute appendicitis, and Enterobius vermicularis was detected in the pathological examinations of specimens. Pinworm infections are common parasitic infections that may mimic appendicitis. The pathology of the four cases was noted when the file of 186 patients aged between 4 and 72 years who underwent surgery for acute appendicitis in my hospital was retrospectively reviewed. When the appendectomy specimen was examined histopathologically it was understood that acute appendicitis was caused by Enterobius vermicularis parasite. In Enterobius infections, performing systemic therapy for patients and their family members is sufficient. To prevent unnecessary appendectomy, this type of infection should be made to ask in the history and clinical findings of patients.

Selective Toll-Like Receptor 4 Antagonists Prevent Acute Blood-Brain Barrier Disruption After Subarachnoid Hemorrhage in Mice.

Science.gov (United States)

Okada, Takeshi; Kawakita, Fumihiro; Nishikawa, Hirofumi; Nakano, Fumi; Liu, Lei; Suzuki, Hidenori

2018-05-31

There are no direct evidences showing the linkage between Toll-like receptor 4 (TLR4) and blood-brain barrier (BBB) disruption after subarachnoid hemorrhage (SAH). The purpose of this study was to examine if selective blockage of TLR4 prevents BBB disruption after SAH in mice and if the TLR4 signaling involves mitogen-activated protein kinases (MAPKs). One hundred and fifty-one C57BL/6 male mice underwent sham or endovascular perforation SAH operation, randomly followed by an intracerebroventricular infusion of vehicle or two dosages (117 or 585 ng) of a selective TLR4 antagonist IAXO-102 at 30 min post-operation. The effects were evaluated by survival rates, neurological scores, and brain water content at 24-72 h and immunoglobulin G immunostaining and Western blotting at 24 h post-SAH. IAXO-102 significantly prevented post-SAH neurological impairments, brain edema, and BBB disruption, resulting in improved survival rates. IAXO-102 also significantly suppressed post-SAH activation of a major isoform of MAPK p46 c-Jun N-terminal kinase (JNK) and matrix metalloproteinase-9 as well as periostin induction and preserved tight junction protein zona occludens-1. Another selective TLR4 antagonist TAK-242, which has a different binding site from IAXO-102, also showed similar effects to IAXO-102. This study first provided the evidence that TLR4 signaling is involved in post-SAH acute BBB disruption and that the signaling is mediated at least partly by JNK activation. TLR4-targeted therapy may be promising to reduce post-SAH morbidities and mortalities.

Modeling the Biophysical Impacts of Global Change in Mountain Biosphere Reserves

NARCIS (Netherlands)

Bugmann, H.; Björnsen Gurung, A.; Ewert, F.; Haeberli, W.; Guisan, A.; Fagre, D.; Kääb, A.

2007-01-01

Mountains and mountain societies provide a wide range of goods and services to humanity, but they are particularly sensitive to the effects of global environmental change. Thus, the definition of appropriate management regimes that maintain the multiple functions of mountain regions in a time of

Yucca Mountain Site characterization project bibliography, January--June 1991

International Nuclear Information System (INIS)

1992-06-01

Following a reorganization of the Office of Civilian Radioactive Waste Management in 1990, the Yucca Mountain Project was renamed Yucca Mountain Site Characterization Project. The title of this bibliography was also changed to Yucca Mountain Site Characterization Project Bibliography. Prior to August 5, 1988, this project was called the Nevada Nuclear Waste Storage Investigations. This bibliography contains information on this ongoing project that was added to the Department of Energy's Science and Technology Database from January 1, 1990, through December 31, 1991

Periodic Burning In Table Mountain-Pitch Pine Stands

Science.gov (United States)

Russell B. Randles; David H. van Lear; Thomas A. Waldrop; Dean M. Simon

2002-01-01

Abstract - The effects of multiple, low intensity burns on vegetation and wildlife habitat in Table Mountain (Pinus pungens Lamb.)-pitch (Pinus rigida Mill.) pine communities were studied in the Blue Ridge Mountains of North Carolina. Treatments consisted of areas burned from one to four times at 3-4 year...

Sediment budgets of mountain catchments: Scale dependence and the influence of land-use

Science.gov (United States)

Förster, Helga; Dotterweich, Markus; Wunderlich, Jürgen

2010-05-01

Long-term sediment budgets of forested mountain catchments are scarcely investigated today. This is because they are traditionally expected to show few erosion features and low sediment delivery. This opinion originates from process-based hydrological studies proving the runoff preventing properties of trees and forest soils. In addition mountain areas have been colonized later and only sporadically compared to the fruitful loess-covered lowlands. On the other hand steep hillslopes, narrow valleys and the availability of regolith cause a high erosion potential. And there is evidence that historical floods and yearly occurring storms initiate intensive but local and sporadic erosion events. Sediment budgets from zero-order catchments of the Palatinate Forest in the south-western sandstone escarpment in Rhineland-Palatinate show spatially varying intensities of land use impact and relief conditions. The budgets are based on field data and a soilscape model of an upper periglacial cover bed with a homogenous thickness. OSL- and 14C-dates of colluvial deposits allow relating erosion events to land-use changes derived from historical maps and written archives. The presented case studies from the Palatinate Forest are of special interest as the high proximity to the loess-covered and intensively cultivated Rhine Graben effected settlement and land-use intensity in the mountain catchments. Clear cuts for settlements were joined by deforestation for agriculture and stretched mainly along the Haardtrand and high order valleys. Off these areas the strength of interference in the forest ecosystem depended on transport possibilities and distance to the Rhine Graben. In the vicinity strong devastation and clear cutting occurred. With increasing distance the felling intensity decreased and some parts seem to be nearly undisturbed until the 18th century. The needs for wood were controlled by the economical development as well as political decisions on local to European scale. The

Acute Respiratory Distress Syndrome: Insights Gained from Clinical and Translational Research

Directory of Open Access Journals (Sweden)

Marija Kojicic

2009-10-01

Full Text Available Acute lung injury and its more severe form acute respiratory distress syndrome (ARDS are characterized by diffuse impairment of alveolocapillary membrane in the settings of different predisposing conditions such as sepsis, trauma and shock. Many intrahospital exposures, including aspiration, delayed resuscitation, high tidal volume mechanical ventilation and non critical use of transfusions may contribute or worsen ARDS. Therapy is targeted to treatment of predisposing condition, life supportive measures and prevention of nosocomial complications. Rigorous adherence to lung-protective mechanical ventilation is critical to prevent ventilator induced lung injury and decrease mortality. Although survival of ARDS patients has improved in the last decades ARDS mortality rates are still high and survivors encounter significant physical and psychological impairments

Landforms of High Mountains

Directory of Open Access Journals (Sweden)

Derek A. McDougall

2016-05-01

Full Text Available Reviewed: Landforms of High Mountains. By Alexander Stahr and Ewald Langenscheidt. Heidelberg, Germany: Springer, 2015. viii + 158 pp. US$ 129.99. Also available as an e-book. ISBN 978-3-642-53714-1.

Preparing to Submit a License Application for Yucca Mountain

International Nuclear Information System (INIS)

W.J. Arthur; M.D. Voegele

2005-01-01

In 1982, the U.S. Congress passed the Nuclear Waste Policy Act, a Federal law that established U.S. policy for the permanent disposal of spent nuclear fuel and high-level radioactive waste. Congress amended the Act in 1987, directing the Department of Energy to study only Yucca Mountain, Nevada as the site for a permanent geologic repository. As the law mandated, the Department evaluated Yucca Mountain to determine its suitability as the site for a permanent geologic repository. Decades of scientific studies demonstrated that Yucca Mountain would protect workers, the public, and the environment during the time that a repository would be operating and for tens of thousands of years after closure of the repository. A repository at this remote site would also: preserve the quality of the environment; allow the environmental cleanup of Cold War weapons facilities; provide the nation with additional protection from acts of terrorism; and support a sound energy policy. Throughout the scientific evaluation of Yucca Mountain, there has been no evidence to disqualify Yucca Mountain as a suitable site for the permanent disposal of spent nuclear fuel and high-level radioactive waste. Upon completion of site characterization, the Secretary of Energy considered the results and concluded that a repository at Yucca Mountain would perform in a manner that protects public health and safety. The Secretary recommended the site to the President in February 2002; the President agreed and recommended to Congress that the site be approved. The Governor of Nevada submitted a notice of disapproval, and both houses of Congress acted to override the disapproval. In July 2002, the President's approval allowed the Department to begin the process of submittal of a license application for Yucca Mountain as the site for the nation's first repository for spent nuclear fuel and high-level radioactive waste. Yucca Mountain is located on federal land in Nye County in southern Nevada, an arid region

Yucca Mountain Project bibliography, January--June 1989

International Nuclear Information System (INIS)

1990-01-01

Following a reorganization of the Office of Civilian Radioactive Waste Management, the Yucca Mountain Project was renamed Yucca Mountain Site Characterization Project. The title of this bibliography was also changed to Yucca Mountain Site Characterization Project Bibliography. Prior to August 5, 1988, this project was called the Nevada Nuclear Waste Storage Investigations. This bibliography contains information on this ongoing project that was added to the Department of Energy's Energy Science and Technology Database from January 1990 through June 1990. The bibliography is categorized by principal project participating organization. Participant-sponsored subcontractor reports, papers, and articles are included in the sponsoring organization's list. Another section contains information about publications on the Energy Science and Technology Database that were not sponsored by the project but have some relevance to it

Socio-cultural and economic valuation of ecosystem services provided by Mediterranean mountain agroecosystems.

Science.gov (United States)

Bernués, Alberto; Rodríguez-Ortega, Tamara; Ripoll-Bosch, Raimon; Alfnes, Frode

2014-01-01

The aim of this work was to elucidate the socio-cultural and economic value of a number of ecosystem services delivered by mountain agroecosystems (mostly grazing systems) in Euro-Mediterranean regions. We combined deliberative (focus groups) and survey-based stated-preference methods (choice modelling) to, first, identify the perceptions of farmers and other citizens on the most important ecosystem services and, second, to value these in economic terms according to the willingness to pay of the local (residents of the study area) and general (region where the study area is located) populations. Cultural services (particularly the aesthetic and recreational values of the landscape), supporting services (biodiversity maintenance) and some regulating services (particularly fire risk prevention) were clearly recognized by both farmers and citizens, with different degrees of importance according to their particular interests and objectives. The prevention of forest fires (≈50% of total willingness to pay) was valued by the general population as a key ecosystem service delivered by these agroecosystems, followed by the production of specific quality products linked to the territory (≈20%), biodiversity (≈20%) and cultural landscapes (≈10%). The value given by local residents to the last two ecosystem services differed considerably (≈10 and 25% for biodiversity and cultural landscape, respectively). The Total Economic Value of mountain agroecosystems was ≈120 € person(-1) year(-1), three times the current level of support of agro-environmental policies. By targeting and quantifying the environmental objectives of the European agri-environmental policy and compensating farmers for the public goods they deliver, the so-called "green" subsidies may become true Payments for Ecosystems Services.

Socio-cultural and economic valuation of ecosystem services provided by Mediterranean mountain agroecosystems.

Directory of Open Access Journals (Sweden)

Alberto Bernués

Full Text Available The aim of this work was to elucidate the socio-cultural and economic value of a number of ecosystem services delivered by mountain agroecosystems (mostly grazing systems in Euro-Mediterranean regions. We combined deliberative (focus groups and survey-based stated-preference methods (choice modelling to, first, identify the perceptions of farmers and other citizens on the most important ecosystem services and, second, to value these in economic terms according to the willingness to pay of the local (residents of the study area and general (region where the study area is located populations. Cultural services (particularly the aesthetic and recreational values of the landscape, supporting services (biodiversity maintenance and some regulating services (particularly fire risk prevention were clearly recognized by both farmers and citizens, with different degrees of importance according to their particular interests and objectives. The prevention of forest fires (≈50% of total willingness to pay was valued by the general population as a key ecosystem service delivered by these agroecosystems, followed by the production of specific quality products linked to the territory (≈20%, biodiversity (≈20% and cultural landscapes (≈10%. The value given by local residents to the last two ecosystem services differed considerably (≈10 and 25% for biodiversity and cultural landscape, respectively. The Total Economic Value of mountain agroecosystems was ≈120 € person(-1 year(-1, three times the current level of support of agro-environmental policies. By targeting and quantifying the environmental objectives of the European agri-environmental policy and compensating farmers for the public goods they deliver, the so-called "green" subsidies may become true Payments for Ecosystems Services.

Education and Yucca Mountain

International Nuclear Information System (INIS)

Lamont, M.A.

1995-01-01

This paper outlines a middle school social studies curriculum taught in Nevada. The curriculum was designed to educate students about issues related to the Yucca Mountain project. The paper focuses on the activities used in the curriculum

Diaphragm Muscle Weakness Following Acute Sustained Hypoxic Stress in the Mouse Is Prevented by Pretreatment with N-Acetyl Cysteine

Directory of Open Access Journals (Sweden)

Andrew J. O’Leary

2018-01-01

Full Text Available Oxygen deficit (hypoxia is a major feature of cardiorespiratory diseases characterized by diaphragm dysfunction, yet the putative role of hypoxic stress as a driver of diaphragm dysfunction is understudied. We explored the cellular and functional consequences of sustained hypoxic stress in a mouse model. Adult male mice were exposed to 8 hours of normoxia, or hypoxia (FiO2 = 0.10 with or without antioxidant pretreatment (N-acetyl cysteine, 200 mg/kg i.p.. Ventilation and metabolism were measured. Diaphragm muscle contractile function, myofibre size and distribution, gene expression, protein signalling cascades, and oxidative stress (TBARS were determined. Hypoxia caused pronounced diaphragm muscle weakness, unrelated to increased respiratory muscle work. Hypoxia increased diaphragm HIF-1α protein content and activated MAPK, mTOR, Akt, and FoxO3a signalling pathways, largely favouring protein synthesis. Hypoxia increased diaphragm lipid peroxidation, indicative of oxidative stress. FoxO3 and MuRF-1 gene expression were increased. Diaphragm 20S proteasome activity and muscle fibre size and distribution were unaffected by acute hypoxia. Pretreatment with N-acetyl cysteine substantially enhanced cell survival signalling, prevented hypoxia-induced diaphragm oxidative stress, and prevented hypoxia-induced diaphragm dysfunction. Hypoxia is a potent driver of diaphragm weakness, causing myofibre dysfunction without attendant atrophy. N-acetyl cysteine protects the hypoxic diaphragm and may have application as a potential adjunctive therapy.

A randomized, double-blind trial on the use of 1% hydrocortisone cream for the prevention of acute radiation dermatitis.

Science.gov (United States)

Meghrajani, Chandra F; Co, Henri S; Arcillas, Jon G; Maaño, Clarita C; Cupino, Nonette A

2016-01-01

To determine whether the application of 1% hydrocortisone cream during radiation therapy can prevent the occurrence of moist desquamation. Fifty adult female breast carcinoma patients were randomized after modified radical mastectomy and chemotherapy to receive prophylactic placebo cream (n = 27) or 1% hydrocortisone cream (n = 23) during radiation therapy. The patients, caregiver and assessor were all blinded to the treatment received. Occurrence of moist desquamation, severity of acute radiation dermatitis (ARD) and hyperpigmentation were evaluated weekly until the end of radiotherapy. Five patients in each group developed moist desquamation; however, its extent and severity were milder in the steroid group. Mean ARD scores were also lower in the steroid group (0.713 vs. 0.874, p = 0.024). A lower incidence of Grades 1 and 2 radiation dermatitis was also noted in the steroid group at weeks 2 and 4, respectively, indicating prophylactic use of steroids delayed the onset of radiodermatitis.

Efficacy of chloramphenicol, enrofloxacin, and tetracycline for treatment of experimental Rocky Mountain spotted fever in dogs.

Science.gov (United States)

Breitschwerdt, E B; Davidson, M G; Aucoin, D P; Levy, M G; Szabados, N S; Hegarty, B C; Kuehne, A L; James, R L

1991-01-01

Dogs were experimentally inoculated with Rickettsia rickettsii to characterize the comparative efficacies of chloramphenicol, enrofloxacin, and tetracycline for the treatment of Rocky Mountain spotted fever (RMSF). All three antibiotics were equally effective in abrogating the clinical, hematologic, and vascular indicators of rickettsial infection. Antibiotic treatment for 24 h was sufficient to decrease the rickettsemia to levels below detection by Vero cell culture. Early treatment with all three antibiotics resulted in a similar decrease in antibody titer, but acute and convalescent serum samples taken at appropriate times would have still facilitated an accurate diagnosis of RMSF in all but one dog, which did not seroconvert. We conclude that chloramphenicol, enrofloxacin, and tetracycline are equally efficacious for treating experimental canine RMSF. PMID:1666498

Acute pulmonary embolism. Part 1: Epidemiology and diagnosis

NARCIS (Netherlands)

Douma, Renée A.; Kamphuisen, Pieter W.; Büller, Harry R.

2010-01-01

Pulmonary embolism (PE) is a frequently occurring, acute, and potentially fatal condition. Numerous risk factors for PE, both inherited and acquired, have been identified. Adequate diagnosis is mandatory to prevent PE-related morbidity and mortality on the one hand, and unnecessary treatment on the

Organ protection possibilities in acute heart failure.

Science.gov (United States)

Montero-Pérez-Barquero, M; Morales-Rull, J L

2016-04-01

Unlike chronic heart failure (HF), the treatment for acute HF has not changed over the last decade. The drugs employed have shown their ability to control symptoms but have not achieved organ protection or managed to reduce medium to long-term morbidity and mortality. Advances in our understanding of the pathophysiology of acute HF suggest that treatment should be directed not only towards correcting the haemodynamic disorders and achieving symptomatic relief but also towards preventing organ damage, thereby counteracting myocardial remodelling and cardiac and extracardiac disorders. Compounds that exert vasodilatory and anti-inflammatory action in the acute phase of HF and can stop cell death, thereby boosting repair mechanisms, could have an essential role in organ protection. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Rocky Mountain spotted fever in the United States, 1997-2002.

Science.gov (United States)

Chapman, Alice S; Murphy, Staci M; Demma, Linda J; Holman, Robert C; Curns, Aaron T; McQuiston, Jennifer H; Krebs, John W; Swerdlow, David L

2006-01-01

Rocky Mountain spotted fever (RMSF) is the most commonly reported fatal tick-borne disease in the United States. During 1997-2002, 3,649 cases of RMSF were reported to the Centers for Disease Control and Prevention via the National Electronic Telecommunications System for Surveillance; 2,589 case report forms, providing supplemental information, were also submitted. The average annual RMSF incidence during 1997-2002 was 2.2 cases/million persons. The annual incidence increased during 1997-2002 to a rate of 3.8 cases/million persons in 2002. The incidence was lowest among persons aged<5 and 10-29 years, and highest among adults aged 60-69 years. The overall case-fatality rate was 1.4%; the rate peaked in 1998 at 2.9% and declined to 0.7% in 2001 and 2002. Children<5 years of age had a case-fatality rate (5%) that was significantly greater than the rates for age groups<60 years of age, except for that for 40-49 years of age. Continued national surveillance is needed to assess the effectiveness of prevention efforts and early treatment in decreasing severe morbidity and mortality associated with RMSF.

Geology of the Yucca Mountain Region, Chapter in Stuckless, J.S., ED., Yucca Mountain, Nevada - A Proposed Geologic Repository for High-Level Radioactive Waste

International Nuclear Information System (INIS)

J.S. Stuckless; D. O'Leary

2006-01-01

Yucca Mountain has been proposed as the site for the Nation's first geologic repository for high-level radioactive waste. This chapter provides the geologic framework for the Yucca Mountain region. The regional geologic units range in age from late Precambrian through Holocene, and these are described briefly. Yucca Mountain is composed dominantly of pyroclastic units that range in age from 11.4 to 15.2 Ma. The proposed repository would be constructed within the Topopah Spring Tuff, which is the lower of two major zoned and welded ash-flow tuffs within the Paintbrush Group. The two welded tuffs are separated by the partly to nonwelded Pah Canyon Tuff and Yucca Mountain Tuff, which together figure prominently in the hydrology of the unsaturated zone. The Quaternary deposits are primarily alluvial sediments with minor basaltic cinder cones and flows. Both have been studied extensively because of their importance in predicting the long-term performance of the proposed repository. Basaltic volcanism began about 10 Ma and continued as recently as about 80 ka with the eruption of cones and flows at Lathrop Wells, approximately 10 km south-southwest of Yucca Mountain. Geologic structure in the Yucca Mountain region is complex. During the latest Paleozoic and Mesozoic, strong compressional forces caused tight folding and thrust faulting. The present regional setting is one of extension, and normal faulting has been active from the Miocene through to the present. There are three major local tectonic domains: (1) Basin and Range, (2) Walker Lane, and (3) Inyo-Mono. Each domain has an effect on the stability of Yucca Mountain

European mountain biodiversity

Directory of Open Access Journals (Sweden)

Nagy, Jennifer

1998-12-01

Full Text Available This paper, originally prepared as a discussion document for the ESF Exploratory Workshop «Trends in European Mountain Biodiversity - Research Planning Workshop», provides an overview of current mountain biodiversity research in Europe. It discusses (a biogeographical trends, (b the general properties of biodiversity, (c environmental factors and the regulation of biodiversity with respect to ecosystem function, (d the results of research on mountain freshwater ecosystems, and (e climate change and air pollution dominated environmental interactions.- The section on biogeographical trends highlights the importance of altitude and latitude on biodiversity. The implications of the existence of different scales over the different levels of biodiversity and across organism groups are emphasised as an inherent complex property of biodiversity. The discussion on ecosystem function and the regulation of biodiversity covers the role of environmental factors, productivity, perturbation, species migration and dispersal, and species interactions in the maintenance of biodiversity. Regional and long-term temporal patterns are also discussed. A section on the relatively overlooked topic of mountain freshwater ecosystems is presented before the final topic on the implications of recent climate change and air pollution for mountain biodiversity.

[fr] Ce document a été préparé à l'origine comme une base de discussion pour «ESF Exploratory Workshop» intitulé «Trends in European Mountain Biodiversity - Research Planning Workshop»; il apporte une vue d'ensemble sur les recherches actuelles portant sur la biodiversité des montagnes en Europe. On y discute les (a traits biogéographiques, (b les caractéristiques générales- de la biodiversité, (c les facteurs environnementaux et la régulation de la biodiversité par rapport à la fonction des écosystèmes, (d les résultats des études sur les écosystèmes aquatiques des montagnes et (e les

Crisis prevention and management during SARS outbreak, Singapore.

Science.gov (United States)

Quah, Stella R; Hin-Peng, Lee

2004-02-01

We discuss crisis prevention and management during the first 3 months of the severe acute respiratory syndrome (SARS) outbreak in Singapore. Four public health issues were considered: prevention measures, self-health evaluation, SARS knowledge, and appraisal of crisis management. We conducted telephone interviews with a representative sample of 1,201 adults, > or = 21 years of age. We found that sex, age, and attitude (anxiety and perception of open communication with authorities) were associated with practicing preventive measures. Analysis of Singapore's outbreak improves our understanding of the social dimensions of infectious disease outbreaks.

THE STRATEGY OF ANTIMICROBIAL THERAPY OF ACUTE UNCOMPLICATED PYELONEPHRITIS FROM THE POSITION OF ETIOLOGICAL DATA

Directory of Open Access Journals (Sweden)

A. D. Kaprin

2015-01-01

Full Text Available Abstract:Acute pyelonephritis is one of the common diseases both in outpatient and in the hospital practice. The leading causative agent of this disease is E. coli. Obstructive uropathy, foreign body, vesicoureteral reflux, sexual activity, use of local contraceptives contribute to the upward development of urinary infection. The goals of antimicrobial therapy for acute uncomplicated pyelonephritis are: relief of symptoms, restoration of social activity, prevention of complications and relapse prevention. The choice of an antimicrobial agent in most cases is carried out empirically based on the data on the dominant pathogens and their regional resistance. In acute uncomplicated pyelonephritis duration of antimicrobial therapy should be 7–14 days. The drugs of choice for treatment of acute uncomplicated pyelonephritis non-severe in adults are ciprofloxacin and levofloxacin, ceftibuten and cefixime. Patients with acute uncomplicated pyelonephritis severe emergency hospitalization is shown in urological outpatient and parenteral antimicrobial therapy (carbapenems or protected aminopenicillins combined with or without amikacin with subsequent conversion to oral drugs and infusion therapy.

Representing and Retrieving Patients' Falls Risk Factors and Risk for Falls among Adults in Acute Care through the Electronic Health Record

Science.gov (United States)

Pfaff, Jann

2013-01-01

Defining fall risk factors and predicting fall risk status among patients in acute care has been a topic of research for decades. With increasing pressure on hospitals to provide quality care and prevent hospital-acquired conditions, the search for effective fall prevention interventions continues. Hundreds of risk factors for falls in acute care…

Diabetes and Stroke Prevention: A Review

Directory of Open Access Journals (Sweden)

Jonathan Hewitt

2012-01-01

Full Text Available Stroke and diabetes mellitus are two separate conditions which share multiple common threads. Both are increasing in prevalence, both are diseases which affect blood vessels, and both are associated with other vascular risk factors, such as hypertension and dyslipidemia. Abnormal glucose regulation, of which diabetes is one manifestation, is seen in up to two-thirds of people suffering from an acute stroke. Surprisingly, aggressive management of glucose after an acute stroke has not been shown to improve outcome or reduce the incidence of further strokes. More encouragingly, active management of other cardiovascular risk factors has been demonstrated to prevent stroke disease and improve outcome following a stroke in the diabetic person. Hypertension should be treated with a target of 140/80 mmHg, as a maximum. The drug of choice would be an ACE inhibitor, although the priority is blood pressure reduction regardless of the medication chosen. Lipids should be treated with a statin whatever the starting cholesterol. Antiplatelet treatment is also essential but there are no specific recommendations for the diabetic person. As these conditions become more prevalent it is imperative that the right treatment is offered for both primary and secondary prevention in diabetic people, in order to prevent disease and minimize disability.

Rocky Mountain Research Station: 2012-2013 Annual Report

Science.gov (United States)

Cass Cairns

2013-01-01

The Rocky Mountain Research Station is one of seven regional units that make up the USDA Forest Service Research and Development organization - the most extensive natural resources research organization in the world. We maintain 12 field laboratories throughout a 12-state territory encompassing the Great Basin, Southwest, Rocky Mountains, and parts of the...

Refresher Course on Mountain Hydrology and Climate Change

Indian Academy of Sciences (India)

IAS Admin

2016-01-29

Jan 29, 2016 ... The programme focuses on hydrology of mountains, which provide water around 40 % of the world population. Changes in temperature and precipitation have in recent years led to the retreat of glaciers in mountains. Climatic changes do not only affect glaciers or the nival zone; a change in climatic ...

Estimating Acute Viral Hepatitis Infections From Nationally Reported Cases