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Sample records for preventing blood loss

  1. PREVENTION OF BLOOD LOSS IN THIRD STAGE OF LABOUR BY PLACENTAL BLOOD DRAINAGE- A CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    B. K. Dutta

    2017-12-01

    Full Text Available BACKGROUND Placental cord drainage is a simple, safe and non-invasive method which reduces the duration and blood loss in the third stage of labour thereby preventing PPH. This method is of great use in day to day obstetric practices not requiring any extra effort, cost or equipment, so this type of practice is more relevant in rural areas. The objectives of the study were1. To evaluate the effectiveness of placental blood drainage via umbilical cord in reducing duration and blood loss in third stage of labour. 2. Reducing the incidence of postpartum haemorrhage. 3. Decreasing the complications in third stage of labour and reduce maternal mortality. MATERIALS AND METHODS This study was carried out in 100 full term pregnant women admitted in the labour room in Gauhati medical college and hospital in the department of obstetrics and gynaecology since 1st August 2007 to 30th August 2008. Cases were divided into two. Study group and control group. RESULTS In control group the average duration of third stage was 7.41 minutes and in study group 5.57 minutes and p value was <0.001 which is very highly significant. The blood loss in third stage of labour was more in case of control group, the mean blood loss in control was 169.48 ml and study group was 110.38 ml after delivery of placenta. The post-partum haemorrhage was present in 2% of cases in control group while in study group it was present in 0% case. CONCLUSION Placental blood drainage is one of the additional components in active management of third stage of labour, which is safe, simple and non-invasive method. It reduces the duration of third stage of labour, amount of blood loss and decreases the duration of placental separation time.

  2. Preventing Excessive Blood Loss During Percutaneous Nephrolithotomy by Using Tranexamic Acid: A Double Blinded Prospective Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Adnan Siddiq

    2017-12-01

    Full Text Available Objective: Percutaneous nephrolithotomy (PCNL is most frequently performed procedure for renal stones 2 cm and larger. Perioperative hemorrhage being most common complication, warrants as important predicting factor of adverse outcomes. Prevention with inexpensive and safe drug like tranexamic acid (TA would ultimately turn out to be cornerstone for establishing future guidelines. Aim of this study is to evaluate whether TA is efficacious in preventing blood loss during PCNL. Materials and Methods: Ethical review board approval taken. Sample size calculation yielded 240 patients, comprising 120 in each group. Group A receiving TA and group B receiving placebo. Age, gender, body mass index (BMI, stone size, volume and location, preoperative blood count, creatinine, urine analysis, coagulation profile and necessary radiological investigations done. Randomization through lottery method. Both patient and investigator were blinded. Hemoglobin (Hb and hematocrit (Hct levels done at 24 hours postoperatively and fall in values recorded. Results: Both groups were equal in characteristics like age, gender, BMI, stone size, volume and location (p>0.05. Operative variables like calyx punctured, position of puncture and operative time were also found to be similar in both groups. Median change in Hb in placebo group was 1.6 interquartile range (IQR 4, while in TA group was 1.3 (IQR 7.8 (p=0.001. Similarly, median change in Hct level in placebo group was 3.6 (IQR 11.8 and in TA group was 2.4 (IQR 13 (p<0.001. Sixteen patients were transfused after surgery; 12 (75% belonged to placebo group while 4 (25% belonged to TA group (p=0.038. Hospital stay was not significantly different in both groups (p=0.177 with median of 4.0 and IQR of 0 in both groups. Conclusion: TA during PCNL reduces blood loss and minimizes blood transfusion rate.

  3. Quantification of surgical blood loss.

    Science.gov (United States)

    Lee, Marcel H; Ingvertsen, Britt T; Kirpensteijn, Jolle; Jensen, Asger L; Kristensen, Annemarie T

    2006-06-01

    To compare gravimetric and colorimetric methods of quantifying surgical blood loss, and to determine if there is a correlation between preoperative hemostatic tests (buccal mucosa bleeding time [BMBT] and intraoperative blood loss). Prospective clinical study. Dogs (n=15) admitted for cutaneous tumor excision, orthopedic procedure, or exploratory laparotomy. Intraoperative blood loss was quantified by measuring irrigation fluid and weighing surgical sponges used for blood and fluid collection during surgery. Results of gravimetric measurements were then correlated to blood loss quantified using spectrophotometric analysis of hemoglobin (Hb) content. Hemostatic variables including BMBT were measured before surgery and compared with the calculated amount of blood loss. Blood loss quantified by gravimetric measurement showed a significant correlation with colorimetric determination of Hb content in surgical sponges and collected irrigation fluid (r=0.93, P<.0001). BMBT correlated weakly but significantly with intraoperative blood loss (r=0.56, P<.05). Quantifying intraoperative blood loss using spectrophotometric Hb analysis accurately assessed the amount of blood loss; however, it is a time-consuming procedure, primarily applicable as a research tool. Gravimetric evaluation of intraoperative blood loss was found to be an accurate method, which can be recommended for use in a clinical setting. Estimation of blood loss using a gravimetric method is accurate and applicable in the clinical setting and provides surgeons with a simple and objective tool to evaluate intraoperative blood loss.

  4. Preventing High Blood Pressure

    Science.gov (United States)

    ... Heart Disease Cholesterol Salt Million Hearts® WISEWOMAN Preventing High Blood Pressure: Healthy Living Habits Recommend on Facebook Tweet Share ... meal and snack options can help you avoid high blood pressure and its complications. Be sure to eat plenty ...

  5. Blood lead levels and chronic blood loss

    Energy Technology Data Exchange (ETDEWEB)

    Manci, E.A.; Cabaniss, M.L.; Boerth, R.C.; Blackburn, W.R.

    1986-03-01

    Over 90% of lead in blood is bound to the erythrocytes. This high affinity of lead for red cells may mean that chronic blood loss is a significant means for excretion of lead. This study sought correlations between blood lead levels and clinical conditions involving chronic blood loss. During May, June and July, 146 patients with normal hematocrits and red cell indices were identified from the hospital and clinic populations. For each patient, age, race, sex and medical history were noted, and a whole blood sample was analyzed by flameless atomic absorption spectrophotometry. Age-and race-matched pairs showed a significant correlation of chronic blood loss with lead levels. Patients with the longest history of blood loss (menstruating women) had the lowest level (mean 6.13 ..mu..g/dl, range 3.6-10.3 ..mu..g/dl). Post-menopausal women had levels (7.29 ..mu..g/dl, 1.2-14 ..mu..g/dl) comparable to men with peptic ulcer disease, or colon carcinoma (7.31 ..mu..g/dl, 5.3-8.6 ..mu..g/dl). The highest levels were among men who had no history of bleeding problems (12.39 ..mu..g/dl, 2.08-39.35 ..mu..g/dl). Chronic blood loss may be a major factor responsible for sexual differences in blood lead levels. Since tissue deposition of environmental pollutants is implicated in diseases, menstruation may represent a survival advantage for women.

  6. Noise and Hearing Loss Prevention

    Science.gov (United States)

    ... message, please visit this page: About CDC.gov . NOISE AND HEARING LOSS PREVENTION Language: English (US) Español ( ... when hazardous noise levels cannot be adequately reduced. Noise and Hearing Loss on the NIOSH Science Blog ...

  7. Use of Tranexamic acid is a cost effective method in preventing blood loss during and after total knee replacement

    Directory of Open Access Journals (Sweden)

    Umer Chaudhry Muhammad

    2011-05-01

    Full Text Available Abstract Background & Purpose Allogenic blood transfusion in elective orthopaedic surgery is best avoided owing to its associated risks. Total knee replacement often requires blood transfusion, more so when bilateral surgery is performed. Many strategies are currently being employed to reduce the amount of peri-operative allogenic transfusions. Anti-fibrinolytic compounds such as aminocaproic acid and tranexamic acid have been used systemically in perioperative settings with promising results. This study aimed to evaluate the effectiveness of tranexamic acid in reducing allogenic blood transfusion in total knee replacement surgery. Methodology This was a retrospective cohort study conducted on patients undergoing total knee replacement during the time period November 2005 to November 2008. Study population was 99 patients, of which 70 underwent unilateral and 29 bilateral knee replacement. Forty-seven patients with 62 (49.5% knees (group-I had received tranexamic acid (by surgeon preference while the remaining fifty-two patients with 66 (51.5% knees (group-II had did not received any tranexamic acid either pre- or post-operatively. Results The mean drop in the post-operative haemoglobin concentration in Group-II for unilateral and bilateral cases was 1.79 gm/dl and 2.21 gm/dl, with a mean post-operative drainage of 1828 ml (unilateral and 2695 ml (bilateral. In comparison, the mean drop in the post-op haemoglobin in Group-I was 1.49 gm/dl (unilateral and 1.94 gm/dl (bilateral, with a mean drainage of 826 ml (unilateral and 1288 ml (bilateral (p-value Interpretation Tranexamic acid is effective in reducing post-operative drainage and requirement of blood transfusion after knee replacement.

  8. Remifentanil Reduces Blood Loss During Orthognathic Surgery.

    Science.gov (United States)

    Matsuura, Nobuyuki; Okamura, Taiki; Ide, Satoko; Ichinohe, Tatsuya

    2017-01-01

    Remifentanil is reported to reduce oral tissue blood flow. We performed a retrospective investigation using logistic regression analysis of anesthesia records to investigate whether the use of remifentanil infusion in a balanced anesthesia technique was useful as a primary technique to reduce blood loss during orthognathic surgery. Subjects were 80 patients who underwent Le Fort I osteotomy and sagittal split ramus osteotomy of the mandible. The variables included gender, age, weight, type of maintenance anesthetic, type and dose or infusion rate of opioid, mean systolic blood pressure (SBP-mean), coefficient of variation of systolic blood pressure (CVSBP) during surgery, mean heart rate (HR-mean), duration of surgery, total blood loss, volume of infusion used, amount of local anesthetic used, body temperature, and urine output. Gender, type of maintenance anesthetic, type of opioid, SBP-mean, CVSBP, HR-mean, and duration of surgery were used as candidates for independent variables. Logistic regression analysis was performed for the selected independent variables with the total blood loss as the dependent variable. The factors associated with the reduction of blood loss were the use of remifentanil (odds ratio, 3.112; 95% CI, 1.166-8.307; P = .023) and smaller CVSBP (odds ratio, 2.747; 95% CI, 1.07-7.053; P = .036). Use of remifentanil and smaller CVSBP were associated with a reduction of blood loss during orthognathic surgery.

  9. Blood-loss Management in Spine Surgery.

    Science.gov (United States)

    Bible, Jesse E; Mirza, Muhammad; Knaub, Mark A

    2018-01-15

    Substantial blood loss during spine surgery can result in increased patient morbidity and mortality. Proper preoperative planning and communication with the patient, anesthesia team, and operating room staff can lessen perioperative blood loss. Advances in intraoperative antifibrinolytic agents and modified anesthesia techniques have shown promising results in safely reducing blood loss. The surgeon's attention to intraoperative hemostasis and the concurrent use of local hemostatic agents also can lessen intraoperative bleeding. Conversely, the use of intraoperative blood salvage has come into question, both for its potential inability to reduce the need for allogeneic transfusions as well as its cost-effectiveness. Allogeneic blood transfusion is associated with elevated risks, including surgical site infection. Thus, desirable transfusion thresholds should remain restrictive.

  10. [Quantitative analysis of blood loss in liposuction].

    Science.gov (United States)

    Schor, N; Zatz, R M; Mendonça, A R; Takatu, P M; Patto, G S

    1989-01-01

    This study was performed in 15 female patients submitted to suction lipectomy as an isolated procedure, to establish blood loss in the procedure. A wide variation of blood-to-fat ratios was observed (17 to 59%) with a mean blood loss in lipoaspirates of 34 +/- 3%. Internal blood losses occurring in the first 72 post-operative hours were as important as or more important than external losses, and responsible for a mean 7% fall in the level of hemoglobin. Internal blood losses occurred between 72 hours and the 7th to the 10th post-operative days and were responsible for a mean 3% fall in the level of hemoglobin. Blood losses occurring in this study were demonstrated to be greater than usually assumed. Some prophylactic measures are recommended to provide for a safer treatment of these patients: an iron supplementation during the pre-operative period; careful clinical and laboratorial screening for bleeding disorders and for the intake of drugs that can interfere with coagulation; use of smaller-diameter cannulas for aspiration, auto-transfusion when aspirating in excess of 1,000 ml, and limiting the aspiration to 1,500 ml.

  11. Information Security - Data Loss Prevention Procedure

    Science.gov (United States)

    The purpose of this procedure is to extend and provide specificity to the Environmental Protection Agency (EPA) Information Security Policy regarding data loss prevention and digital rights management.

  12. Management of major blood loss: an update

    DEFF Research Database (Denmark)

    Johansson, P I; Ostrowski, S R; Secher, N H

    2010-01-01

    the early control of the cause of bleeding by non-definitive means, while haemostatic control resuscitation seeks early control of coagulopathy. Haemostatic resuscitation provides transfusions with plasma and platelets in addition to red blood cells (RBCs) in an immediate and sustained manner as part...... of the transfusion protocol for massively bleeding patients. Transfusion of RBCs, plasma and platelets in a similar proportion as in whole blood prevents both hypovolaemia and coagulopathy. Although an early and effective reversal of coagulopathy is documented, the most effective means of preventing coagulopathy....... Furthermore, viscoelastic whole blood assays, such as thrombelastography (TEG)/rotation thromboelastometry (ROTEM), appear advantageous for identifying coagulopathy in patients with severe haemorrhage, as opposed to conventional coagulation assays. In our view, patients with uncontrolled bleeding, regardless...

  13. Preventing Vision Loss in Diabetes - Summary

    Centers for Disease Control (CDC) Podcasts

    2008-04-24

    This podcast is for a professional audience and briefly discusses how to prevent vision loss in people with diabetes.  Created: 4/24/2008 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Diabetes Translation (DDT), National Diabetes Education Program (NDEP).   Date Released: 6/4/2008.

  14. Uncovering effective strategies for hearing loss prevention

    Science.gov (United States)

    Morata, Thais C.; Meinke, Deanna

    2016-01-01

    Occupational health agencies, researchers and policy makers have recognized the need for evidence on the effectiveness of interventions designed to reduce or prevent workplace injuries and illnesses. While many workplaces comply with legal or obligatory requirements and implement recommended interventions, few publications exist documenting the effectiveness of these actions. Additionally, some workplaces have discovered through their own processes, novel ways to reduce the risk of injury. Peer-reviewed information on the effectiveness of the many strategies and approaches currently in use could help correct weaknesses, or further encourage their adoption and expansion. The evaluation of intervention effectiveness would certainly contribute to improved worker health and safety. This need is particularly relevant regarding noise exposure in the workplace and hearing loss prevention interventions. In a 2006 review of the U.S. National Institute for Occupational Safety and Health (NIOSH) Hearing Loss Research Program, the independent National Academies of Sciences recommended that NIOSH place greater emphasis on identifying the effectiveness of hearing loss prevention measures on the basis of outcomes that are as closely related as possible to reducing noise exposure and work related hearing loss (http://www.nap.edu/openbook.php?record_id=11721). NIOSH used two different approaches to address that recommendation: the first one was to conduct research, including broad systematic reviews on the effectiveness of interventions to prevent occupational noise-induced hearing loss. The second was to create an award program, the Safe-In-Sound Excellence in Hearing Loss Prevention Award™, to identify and honor excellent real-world examples of noise control and other hearing loss prevention practices and innovations. PMID:27397968

  15. Hidden blood loss after surgery for hip fracture

    DEFF Research Database (Denmark)

    Foss, N B; Kehlet, H

    2006-01-01

    Our aim was to determine the total blood loss associated with surgery for fracture of the hip and to identify risk factors for increased blood loss. We prospectively studied 546 patients with hip fracture. The total blood loss was calculated on the basis of the haemoglobin difference, the number...

  16. Obesity Prevention and Weight Maintenance After Loss.

    Science.gov (United States)

    German, Alexander James

    2016-09-01

    Obesity is one of the most prevalent medical diseases in pets. Outcomes are often disappointing; many animals either fail to reach target weight or regain weight. This article discusses managing obesity, focusing on prevention. It gives guidance on establishing monitoring programs that use regular body weight and condition assessments to identify animals at risk of inappropriate weight gain, enabling early intervention. Weight management in obese animals is a lifelong process. Regular weight and body condition monitoring are key to identifying animals that rebound early, while continuing to feed a therapeutic weight loss diet can help prevent it from happening. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Original Article Blood Loss and Influencing Factors in Primary Total ...

    African Journals Online (AJOL)

    KIGZ

    aid the surgeon in the African region estimate the expected blood loss after total hip replacement. We conducted a study to quantify the blood loss following total hip arthroplasty and to determine the factors .... Hemoglobin European Overview (OSTHEO) study: blood management in elective knee and hip arthroplasty in ...

  18. Accuracy of Blood Loss Measurement during Cesarean Delivery

    OpenAIRE

    Doctorvaladan, Sahar V.; Jelks, Andrea T.; Hsieh, Eric W.; Thurer, Robert L.; Zakowski, Mark I.; Lagrew, David C.

    2017-01-01

    Objective?This study aims to compare the accuracy of visual, quantitative gravimetric, and colorimetric methods used to determine blood loss during cesarean delivery procedures employing a hemoglobin extraction assay as the reference standard. Study Design?In 50 patients having cesarean deliveries blood loss determined by assays of hemoglobin content on surgical sponges and in suction canisters was compared with obstetricians' visual estimates, a quantitative gravimetric method, and the blood...

  19. Blood Pressure Control: Stroke and Stroke Prevention

    Directory of Open Access Journals (Sweden)

    Hans-Christoph Diener

    2005-03-01

    Full Text Available Hypertension is the most important modifiable risk factor for primary and secondary stroke prevention.All antihypertensive drugs are effective in primary prevention: the risk reduction for stroke is 30—42%. However, not all classes of drugs have the same effects: there is some indication that angiotensin receptor blockers may be superior to other classes of antihypertensive drugs in stroke prevention.Seventy-five percent of patients who present to hospital with acute stroke have elevated blood pressure within the first 24—48 hours. Extremes of systolic blood pressure (SBP increase the risk of death or dependency. The aim of treatment should be to achieve and maintain the SBP in the range 140—160 mmHg. However, fast and drastic blood pressure lowering can have adverse consequences.The PROGRESS trial of secondary prevention with perindopril + indapamide versus placebo + placebo showed a decrease in numbers of stroke recurrences in patients given both active antihypertensive agents, more impressive for cerebral haemorrhage.There were also indications that active treatment might decrease the development of post-stroke dementia.

  20. Total Blood Loss After Transfemoral Amputations Is Twice the Intraoperative Loss

    DEFF Research Database (Denmark)

    Wied, Christian; Tengberg, Peter T; Kristensen, Morten T

    2017-01-01

    INTRODUCTION: Underestimation of the actual blood loss in patients undergoing nontraumatic transfemoral amputation (TFA) can impact negatively on outcome in these often frail patients, with very limited physiological reserves. The primary aim of this study is to estimate the total blood loss (TBL...

  1. [New non-volumetric method for estimating peroperative blood loss].

    Science.gov (United States)

    Tachoires, D; Mourot, F; Gillardeau, G

    1979-01-01

    The authors have developed a new method for the estimation of peroperative blood loss by measurement of the haematocrit of a fluid obtained by diluting the blood from swabs in a known volume of isotonic saline solution. This value, referred to a monogram, may be used to assess the volume of blood impregnating the compresses, in relation to the pre-operative or present haematocrit of the patient, by direct reading. The precision of the method is discussed. The results obtained justified its routine application in surgery in children, patients with cardiac failure and in all cases requiring precise compensation of per-operative blood loss.

  2. Intrathoracic Pressure Regulator for Blood Loss

    Science.gov (United States)

    2016-05-24

    hepatitis A antibody, and human immunodeficiency virus antibody), urine tests (drug screen I-abuse, marijuana, and a pregnancy test), and a 12-lead... sodium chloride; 250 mL over 2.5 minutes) were administered if systolic BP < 85 mmHg. Blood pressure, other hemodynamics, UO, and total amount of

  3. Management of major blood loss: an update

    DEFF Research Database (Denmark)

    Johansson, P I; Ostrowski, S R; Secher, N H

    2010-01-01

    the early control of the cause of bleeding by non-definitive means, while haemostatic control resuscitation seeks early control of coagulopathy. Haemostatic resuscitation provides transfusions with plasma and platelets in addition to red blood cells (RBCs) in an immediate and sustained manner as part...

  4. Interventions to prevent occupational noise-induced hearing loss

    NARCIS (Netherlands)

    Verbeek, Jos H.; Kateman, Erik; Morata, Thais C.; Dreschler, Wouter A.; Mischke, Christina

    2012-01-01

    Background Millions of workers worldwide are exposed to noise levels that increase their risk of hearing impairment. Little is known about the effectiveness of hearing loss prevention interventions. Objectives To assess the effectiveness of non-pharmaceutical interventions for preventing

  5. Interventions to prevent occupational noise induced hearing loss

    NARCIS (Netherlands)

    Verbeek, Jos H.; Kateman, Erik; Morata, Thais C.; Dreschler, Wout; Sorgdrager, Bas

    2009-01-01

    BACKGROUND: Millions of workers worldwide are exposed to noise levels that increase their risk of hearing impairment. Little is known about the effectiveness of hearing loss prevention interventions. OBJECTIVES: To assess the effectiveness of non-pharmaceutical interventions for preventing

  6. Visual estimation versus gravimetric measurement of postpartum blood loss: a prospective cohort study.

    Science.gov (United States)

    Al Kadri, Hanan M F; Al Anazi, Bedayah K; Tamim, Hani M

    2011-06-01

    One of the major problems in international literature is how to measure postpartum blood loss with accuracy. We aimed in this research to assess the accuracy of visual estimation of postpartum blood loss (by each of two main health-care providers) compared with the gravimetric calculation method. We carried out a prospective cohort study at King Abdulaziz Medical City, Riyadh, Saudi Arabia between 1 November 2009 and 31 December 2009. All women who were admitted to labor and delivery suite and delivered vaginally were included in the study. Postpartum blood loss was visually estimated by the attending physician and obstetrics nurse and then objectively calculated by a gravimetric machine. Comparison between the three methods of blood loss calculation was carried out. A total of 150 patients were included in this study. There was a significant difference between the gravimetric calculated blood loss and both health-care providers' estimation with a tendency to underestimate the loss by about 30%. The background and seniority of the assessing health-care provider did not affect the accuracy of the estimation. The corrected incidence of postpartum hemorrhage in Saudi Arabia was found to be 1.47%. Health-care providers tend to underestimate the volume of postpartum blood loss by about 30%. Training and continuous auditing of the diagnosis of postpartum hemorrhage is needed to avoid missing cases and thus preventing associated morbidity and mortality.

  7. Microdebrider tonsillectomy associated with more intraoperative blood loss than electrocautery.

    Science.gov (United States)

    Stansifer, Kyle J; Szramowski, Molly G; Barazsu, Lindsay; Buchinsky, Farrel J

    2012-10-01

    To describe and compare the intraoperative blood loss in children who underwent tonsillectomy and/or adenoidectomy during a transition from using electrocautery to a microdebrider. Retrospective case series of a single pediatric otolaryngologist at an urban general hospital. Patients aged 2-20 years who had tonsillectomy, adenoidectomy, or adenotonsillectomy over a 12 month period were included. Tonsillectomy was performed by microdebrider or electrocautery and adenoidectomy was performed by microdebrider, curette, or suction electrocautery. Total intraoperative blood loss was measured and compared between surgical techniques. Of the 148 patients, 109 had tonsillectomy with or without adenoidectomy and 39 had adenoidectomy alone. The mean blood loss was 47 ml or 1.8 ± 1.6 ml/kg and the maximum blood loss was 11 ml/kg. Adenoid curette and adenoid microdebrider yielded similar blood loss but were associated with more bleeding than suction electrocautery (Pelectrocautery tonsillectomy (mean of 2.6 ± 2.2 ml/kg versus 1.2 ± 1.2 ml/kg, P=0.0002). Eighteen percent of adenotonsillectomy patients lost greater than 5% of calculated circulating blood volume (95% CI, 9.8-26). Linear regression models did not show an association between the amount of blood loss and patient age, clinical indication, or the surgeon's experience with the microdebrider (P>0.05). Microdebrider tonsillectomy is associated with more intraoperative bleeding than electrocautery tonsillectomy. Approximately twice as much blood was lost with the microdebrider, but the absolute increase was insignificant from a hemodynamic perspective. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  8. Organizing knowledge for tutoring fire loss prevention

    Science.gov (United States)

    Daniel L. Schmoldt

    1989-01-01

    The San Bernardino National Forest in southern California has recently developed a systematic approach to wildfire prevention planning. However, a comprehensive document or other mechanism for teaching this process to other prevention personnel does not exist. An intelligent tutorial expert system is being constructed to provide a means for learning the process and to...

  9. Vaccines for preventing malaria (blood-stage).

    Science.gov (United States)

    Graves, P; Gelband, H

    2006-10-18

    A malaria vaccine is needed because of the heavy burden of mortality and morbidity due to this disease. This review describes the results of trials of blood (asexual)-stage vaccines. Several are under development, but only one (MSP/RESA, also known as Combination B) has been tested in randomized controlled trials. To assess the effect of blood-stage malaria vaccines in preventing infection, disease, and death. In March 2006, we searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (The Cochrane Library 2006, Issue 1), MEDLINE, EMBASE, LILACS, and the Science Citation Index. We also searched conference proceedings and reference lists of articles, and contacted organizations and researchers in the field. Randomized controlled trials comparing blood-stage vaccines (other than SPf66) against P. falciparum, P. vivax, P. malariae, or P. ovale with placebo, control vaccine, or routine antimalarial control measures in people of any age receiving a challenge malaria infection. Both authors independently assessed trial quality and extracted data. Results for dichotomous data were expressed as relative risks (RR) with 95% confidence intervals (CI). Five trials of MSP/RESA vaccine with 217 participants were included; all five reported on safety, and two on efficacy. No severe or systemic adverse effects were reported at doses of 13 to 15 microg of each antigen (39 to 45 microg total). One small efficacy trial with 17 non-immune participants with blood-stage parasites showed no reduction or delay in parasite growth rates after artificial challenge. In the second efficacy trial in 120 children aged five to nine years in Papua New Guinea, episodes of clinical malaria were not reduced, but MSP/RESA significantly reduced parasite density only in children who had not been pretreated with an antimalarial drug (sulfadoxine-pyrimethamine). Infections with the 3D7 parasite subtype of MSP2 (the variant included in the vaccine) were reduced (RR 0.38, 95% CI 0.26 to

  10. The comparison of placental removal methods on operative blood loss

    International Nuclear Information System (INIS)

    Waqar, F.; Fawad, A.

    2008-01-01

    On an average 1 litre of blood is lost during Caesarean Section. Many variable techniques have been tried to reduce this blood loss. Many study trials have shown the spontaneous delivery of placenta method to be superior over manual method because of reduced intra operative blood loss and reduced incidence of post operative endometritis. The main objective of our study was to compare the risk of blood loss associated with spontaneous and manual removal of the placenta during caesarean section. This study was conducted at Department of Obstetrics and Gynaecology, Islamic International Medical Complex, Islamabad from September 2004 to September 2005. All Women undergoing elective or emergency caesarean section were included in the study. Exclusion criteria were pregnancy below 37 weeks, severe maternal anaemia, and prolonged rupture of the membranes with fever, placenta praevia, placenta accreta and clotting disorders. Patients were allocated to the two groups randomly. Group A comprised of women in whom the obstetrician waited a maximum of 5 minutes till the placenta delivered spontaneously. In group B the obstetrician manually cleaved out the placenta as soon as the infant was delivered. The primary outcome measures noted were difference in haemoglobin of >2 gm/dl (preoperatively and postoperatively), time interval between delivery of baby and placenta, significant blood loss (>1000 cc), additional use of oxytocics, total operating time and blood transfusions. Data was analysed by SPSS. Statistical tests used for specific comparison were chi square-test and Student's t-test. One hundred and forty-five patients were allocated to two groups randomly. Seventy-eight patients were allocated to group A and 67 patients allocated to group B. Mean maternal age, birth weight, and total operating time were the same in two groups, but blood loss as measured by a difference in haemoglobin of greater then 2 grams/dl was statistically significant. Significant blood loss (>1000 cc

  11. Weight loss in the prevention and treatment of diabetes.

    Science.gov (United States)

    Delahanty, Linda M

    2017-11-01

    The American Diabetes Association nutrition and lifestyle recommendations for prediabetes and type 2 diabetes focus on losing 7% of body weight and increasing physical activity to at least 150minperweek. This emphasis is largely based on results of the Diabetes Prevention Program (DPP) and Look AHEAD (Action for Health in Diabetes) clinical trials. DPP demonstrated that a lifestyle intervention aimed at 7% weight loss and 150min of activity per week reduced diabetes incidence by 58% after 2.8years of follow-up and resulted in sustained improvements in hemoglobinA1c, blood pressure and lipid levels. After 15years of follow-up, DPP's lifestyle intervention sustained a 27% risk reduction in progression to diabetes. Look AHEAD's lifestyle intervention significantly reduced hemoglobinA1c, blood pressure, triglycerides, and the amount and costs of medications needed to treat these conditions when compared with diabetes support and education. Other clinical and psychological benefits achieved with lifestyle intervention were greater reductions in c-reactive protein, less self-reported retinopathy, reduced risk of nephropathy, less sexual dysfunction, decreased incidence of urinary incontinence and fatty liver, remission of sleep apnea, better physical functioning, less knee pain, more remission of diabetes, reduced incidence of depression, less body image dissatisfaction and improved quality-of-life. A number of DPP translation studies have demonstrated weight losses of 4 to 7% at 6month and 1year follow-up which has led to Medicare coverage for CDC recognized DPP lifestyle programs starting in April 2018. Translation studies of Look AHEAD using a variety of delivery formats are underway. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. [Evaluation of hearing loss parameters in workers and its relationship with fasting blood glucose levels].

    Science.gov (United States)

    Vicente-Herrero, M Teofila; Lladosa Marco, Silvia; Ramírez-Iñiguez de La Torre, M Victoria; Terradillos-García, M Jesús; López-González, Ángel Arturo

    2014-05-01

    Hearing loss due to noise is considered within the prevention plans of the most common occupational diseases. In addition to evaluation of working conditions, other personal factors increasing the risk of hypoacusis, such as diabetes, should be taken into account. To explore hearing loss in the workplace and its relationship to impaired fasting baseline blood glucose levels. An observational, cross-sectional study enrolling 1636 workers from service companies was conducted. Full audiometric evaluation was performed at different frequencies: high frequency (HF), early loss index (ELI), speech average loss (SAL), and monaural and binaural loss. Results were categorized by baseline blood glucose levels: G1 (125mg/dl). Based on both HF and ELI, 11% of workers had clear indication of deafness. Women with G3 levels showed significant differences in the results of HF and ELI indexes as compared to the G1 group (P=.038 and .046, respectively). A positive association was found between hearing loss and G3 blood glucose levels in HF (OR: .338; p=.002), ELI (OR: .407; p=.007), and the monaural test in the left ear (OR: 4.77×10-5; p=.006). Despite the methodological limitations of this study, there is evidence for an increased risk of high frequency hearing loss in workers with high baseline blood glucose levels. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  13. Can Tranexamic Acid Reduce Blood Loss during Major Cardiac Surgery? A Pilot Study.

    Science.gov (United States)

    Compton, Frances; Wahed, Amer; Gregoric, Igor; Kar, Biswajit; Dasgupta, Amitava; Tint, Hlaing

    2017-09-01

    We examined the effectiveness of tranexamic acid in preventing intraoperative blood loss during major cardiac surgery. Out of initial 81 patients undergoing major cardiac surgery (both coronary artery bypass and valve repair procedures) at our teaching hospital, sixty-seven patients were selected for this study. We compared estimated blood loss, decrease in percent hemoglobin and hematocrit following surgery between two groups of patients (none of them received any blood product during surgery), one group receiving no tranexamic acid (n=17) and another group receiving tranexamic acid (n=25). In the second study, we combined these patients with patients receiving modest amounts of blood products (1-2 unit) and compared these parameters between two groups of patients (25 patients received no tranexamic acid, 42 patients received tranexamic acid). In patients who received no blood product during surgery, those who received no tranexamic acid showed statistically significant (independent t-test two tailed at p tranexamic acid (mean: 987.2 mL, SD: 459.9, n=25). We observed similar results when the patients receiving no blood products and patients receiving modest amount of blood products were combined based on the use of tranexamic acid or not. No statistically significant difference was observed in percent reduced hemoglobin or hematocrit following surgery in any group of patients. We conclude that intraoperative antifibrinolytic therapy with tranexamic acid does not reduce intraoperative blood loss during major cardiac surgery which contradicts popular belief. © 2017 by the Association of Clinical Scientists, Inc.

  14. [FEDERAL CLINICAL RECOMMENDATIONS IN DIAGNOSIS, TREATMENT AND PREVENTION OF HEARING LOSS DUE TO NOISE].

    Science.gov (United States)

    Adeninskaya, E E; Bukhtiarov, I V; Bushmanov, A Iu; Dayhes, N A; Denisov, E I; Izmerov, N F; Mazitova, N N; Pankova, V B; Preobrazhenskaya, E A; Prokopenko, L V; Simonova, N I; Tavartkiladze, G A; Fedina, I N

    2016-01-01

    Noise induced hearing loss is a slowly developing hearing impairment, caused by occupational exposure to excessive noise levels, constitutes a lesion of the auditory analyzer and clinically manifested as chronic bilateral sensorineural hearing loss. Currently, there is not a treatment that provide a cure of sensorineural hearing loss. Regular, individually tailored treatment should be directed to the pathogenic mechanisms and specific clinical symptoms of hearing loss, as well as the prevention of complications. We recommend using non-drug therapies that can improve blood flow in labyrinth, tissue and cellular metabolism.

  15. FACTORS AFFECTING BLOOD LOSS DURING OpEN REDUCTION ...

    African Journals Online (AJOL)

    The use of diathermy and positioning of the patient in a way that encourages free venous drainage at the operative site (1) is a practical and inexpensive way of minimising blood loss during surgery. The operative site should be a little above the level of the heart (1). Good anaesthetic technique reduces episodes of.

  16. Perioperative blood loss and diclofenac in major arthroplastic surgery

    Directory of Open Access Journals (Sweden)

    Ljiljana Gvozdenović

    2011-04-01

    Full Text Available Introduction: Contemporary literature indicates precaution over the perioperative use of non-steroidal anti-inflammatory drugs, since they can potentially increase perioperative blood loss related to their mechanism of action. The aim of this study was to assess the influence of non-steroidal anti-inflammatory drugs on perioperative blood loss undergoing hip arthroplasty and its correlation with general and regional anesthesia.Methods: This prospective study included 120 patients who had undergone elective unilateral total hip arthroplasty. Patients were allocated into four groups. Groups 1 and 2 were pretreated with diclofenac and operated in general and regional anesthesia. Group 3 and 4 weren’t pretreated with any non-steroidal anti-inflammatory drug and were, as well, operated in general and regional anesthesia. Diclofenac was administered orally two times a day 75 mg (total 150 mg and also as intramuscular injection (75 mg preoperatively and 12 hours later on a day of surgery.Results: The perioperative blood loss in the rst 24 hours showed an increase of 29.4% in the diclofenac group operated in general anesthesia and increase of 26.8% in patients operated in regional anesthesia (P < 0.05 compared to control group. Statistical data evaluation of patients operated in general anesthesia compared to regional anesthesia, the overall blood loss in the rst 24 h after surgery, showed an increase of 6.4% in the diclofenac group and increase of 3.6% in placebo group. This was not statistically significant.Conclusion: Pretreatment with non-steroidal anti-inflammatory drugs (diclofenac before elective unilateral total hip arthroplasty increases the perioperative blood loss signficantly. Early discontinuation of non-selective non-steroidal anti-inflammatory drugs is advised.

  17. The use of torniquet to reduce blood loss at myomectomy.

    Science.gov (United States)

    Ikechebelu, J I; Ezeama, C O; Obiechina, N J A

    2010-06-01

    Fibroids remain the commonest pelvic tumour seen in women with myomectomy being the major form of treatment in our environment. Techniques to minimize blood loss will reduce patient morbidity and the need for blood transfusions. One such technique is the use of a tourniquet during myomectomy operation. This study examines the effectiveness and safety this tourniquet technique. A comparative analysis of the blood loss, transfusion rate and the morbidities associated with the use and non-use of a tourniquet during myomectomy operation at Nnamdi Azikiwe University Teaching Hospital, Nnewi Nigeria was undertaken. The Foley's urethral catheter was adapted as a uterine tourniquet and applied as low as possible at the base of the uterus before enucleating the fibroid masses. The patients who had their myomectomy performed with application of a tourniquet [tourniquet group] and those without [no-tourniquet group] were evenly matched for age, parity and presenting symptoms. The overall mean age of patients was 35.7 +/- 6.1 years and parity was 0.40 +/- 1.25. The main presenting symptoms of the patients were lower abdominal mass 65.6%, menorrhagia 38.7%, infertility 33.3%, abdominal pain 19.4% and dysmenorrhoea 14.0%. There was a statistically significant difference [P < 0.001] in mean blood loss for the no-tourniquet group [756.4 +/- 285.7] and the tourniquet group [515.7 +/- 292.8] as well as the mean blood transfusion rate in no-tourniquet group [1.0 units +/- 1.14] and the tourniquet group [0.24 units +/- 0.51]. However there was no significant difference between the two groups with respect to complication profile. The Foley's catheter form of tourniquet is cheap, safe, effectively reduces blood loss during myomectomy and significantly reduces transfusion rate while not adding to the complications due to the operation.

  18. 76 FR 62093 - Preventing Occupational Hearing Loss: Stakeholder Meeting

    Science.gov (United States)

    2011-10-06

    ... Loss: Stakeholder Meeting AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION... stakeholder meeting on preventing occupational hearing loss. Every year, between 20,000 and 25,000 workers... controls. OSHA is holding this stakeholder meeting as part of its commitment to work with stakeholders on...

  19. Intraoperative blood loss and blood transfusion requirements in patients undergoing orthognathic surgery.

    Science.gov (United States)

    Faverani, Leonardo Perez; Ramalho-Ferreira, Gabriel; Fabris, André Luis Silva; Polo, Tárik Ocon Braga; Poli, Guilherme Henrique Souza; Pastori, Cláudio Maldonado; Marzola, Clóvis; Assunção, Wirley Gonçalves; Garcia-Júnior, Idelmo Rangel

    2014-09-01

    Procedures for the surgical correction of dentofacial deformities may produce important complications, whether due to the potential for vascular injury or to prolonged surgery, both of which may lead to severe blood loss. Fluid replacement with crystalloid, colloid, or even blood products may be required. The aim of this study was to assess blood loss and transfusion requirements in 45 patients (18 males and 27 females; mean age 29.29 years, range 16-52 years) undergoing orthognathic surgery, assigned to one of two groups according to procedure type-rapid maxillary expansion or double-jaw orthognathic surgery. Preoperative hemoglobin and hematocrit levels and intraoperative blood loss were measured. There was a substantial individual variation in pre- and postoperative hemoglobin values (10.3-17 and 8.8-15.4 g/dL, respectively; p surgery and follow meticulous protocols to minimize the risks.

  20. Operative time, blood loss, hemoglobin drop, blood transfusion, and hospital stay in orthognathic surgery.

    Science.gov (United States)

    Salma, Ra'ed Ghaleb; Al-Shammari, Fahad Mohammed; Al-Garni, Bishi Abdullah; Al-Qarzaee, Mohammed Abdullah

    2017-06-01

    This study was conducted to evaluate the operative time, blood loss, hemoglobin drop, blood transfusion, and length of hospital stay in orthognathic surgery. A 10-year retrospective analysis was performed on patients who underwent bilateral sagittal split osteotomy (with or without genioplasty), Le Fort I osteotomy (with or without genioplasty), or any combination of these procedures. A total of 271 patients were included. The age range was 17 to 49 years, with a mean age of 24.13 ± 4.51 years. Approximately 62% of patients underwent double-jaw surgery. The most common procedure was bilateral sagittal split with Le Fort I (37%). The average operative time was 3.96 ± 1.25 h. The mean estimated blood loss was 345.2 ± 149.74 mL. Approximately 9% of patients received intraoperative blood transfusion. The mean hemoglobin drop in the non-transfusion cases was 2.38 ± 0.89 g/dL. The mean postoperative hospital stay was 1.85 ± 0.83 days. Only one patient was admitted to the ICU for one night. In orthognathic surgery, blood loss is relatively minor, blood transfusion is frequent, and ICU admission is unlikely. Operative time, blood loss, blood transfusion, and the complexity of the surgical procedure can significantly increase the length of hospital stay. Males may bleed more than females in orthognathic surgery. Hemoglobin drop can be overestimated due to hemodilution in orthognathic surgery, which may influence the decision to use blood transfusion.

  1. Factors contributing to postpartum blood-loss in low-risk mothers through expectant management in Japanese birth centres.

    Science.gov (United States)

    Eto, Hiromi; Hasegawa, Ayako; Kataoka, Yaeko; Porter, Sarah E

    2017-08-01

    To describe aspects of expectant midwifery care for low-risk women conducted in midwifery-managed birth centres during the first two critical hours after delivery and to compare differences between midwifery care, client factors and postpartum blood loss volume. As a secondary analysis from a larger study, this descriptive retrospective study examined data from birth records of 4051 women who birthed from 2001 to 2006 at nine (21%) of the 43 midwifery centres in Tokyo. Nonparametric and parametric analyses identified factors related to increased blood loss. Interviews to establish sequence of midwifery care were conducted. The midwifery centres provided care based on expectant management principles from birth to after expulsion of the placenta. Approximately 63.3% of women were within the normal limits of blood loss volume under 500g. A minority of women (12.9%) experienced blood loss between 500 and 800g and 4% had blood loss exceeding 1000g. Blood loss volume tended to increase with infant birth weight and duration of delivery. The total blood loss volume was significantly higher for primiparas than for multiparas during the critical two hours after delivery and for immediately after delivery, yet blood loss volume was significantly higher for multiparas than for primiparas during the first hour after delivery. Preventive uterine massage and umbilical cord clamping after placenta expulsion resulted in statistically significant less blood loss. Identified were two patterns of midwifery care based on expectant management principles from birth to after expulsion of the placenta. The practice of expectant management was not a significant factor for increased postpartum blood loss. These results detail specific midwifery practices and highlight the clinical significance of expectant management with low risk pregnant women experiencing a normal delivery. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  2. Tracking changes and preventing loss in critical tiger habitat.

    Science.gov (United States)

    Joshi, Anup R; Dinerstein, Eric; Wikramanayake, Eric; Anderson, Michael L; Olson, David; Jones, Benjamin S; Seidensticker, John; Lumpkin, Susan; Hansen, Matthew C; Sizer, Nigel C; Davis, Crystal L; Palminteri, Suzanne; Hahn, Nathan R

    2016-04-01

    The global population of wild tigers remains dangerously low at fewer than 3500 individuals. Habitat loss, along with poaching, can undermine the international target recovery of doubling the number of wild tigers by 2022. Using a new satellite-based monitoring system, we analyzed 14 years of forest loss data within the 76 landscapes (ranging from 278 to 269,983 km(2)) that have been prioritized for conservation of wild tigers. Our analysis provides an update of the status of tiger habitat and describes new applications of technology to detect precisely where forest loss is occurring in order to curb future habitat loss. Across the 76 landscapes, forest loss was far less than anticipated (79,597 ± 22,629 km(2), 7.7% of remaining habitat) over the 14-year study period (2001-2014). Habitat loss was unevenly distributed within a subset of 29 landscapes deemed most critical for doubling wild tiger populations: 19 showed little change (1.5%), whereas 10 accounted for more than 98% (57,392 ± 16,316 km(2)) of habitat loss. Habitat loss in source population sites within 76 landscapes ranged from no loss to 435 ± 124 km(2) ([Formula: see text], SD = 89, total = 1676 ± 476 km(2)). Doubling the tiger population by 2022 requires moving beyond tracking annual changes in habitat. We highlight near-real-time forest monitoring technologies that provide alerts of forest loss at relevant spatial and temporal scales to prevent further erosion.

  3. Is intraarticular administration of tranexamic acid better than its intravenous administration in reducing blood loss after total knee arthroplasty?

    Directory of Open Access Journals (Sweden)

    Ameet Pispati

    2013-01-01

    Full Text Available Context: It has been well-established now that intravenous (IV tranexamic acid (TXA is a potent agent to control postoperative blood loss following total knee arthroplasty (TKA. Recently, intraarticular administration of this agent has also shown good efficacy for the same. Aims: Comparison of postoperative blood loss between IV and topical administration of TXA in TKAs. Materials and Design: Eighty-six TKAs on knees were included in this study. Randomization was done so that 40 TKA received 1 g of IV TXA, while 46 had intraarticular administration of 1 g TXA. Subjets and Methods: We compared the postoperative blood loss by calculating the difference in pre- and postop hemoglobin and need for blood transfusion. Functional assessment was done on basis of Western Ontario McMaster Osteo-Arthritis Index (WOMAC scores and complications like postoperative infection, oozing from the wound site and thromboembolic manifestations. Results: Blood loss was significantly less in the intraarticular administration group as compared to the IV injection group. Total blood loss, blood transfusion group, and drain output was also less but the difference was not significant. The functional assessment (WOMAC scores were equivocal and so were the complications including thromboembolic manifestations (two cases each of deep vein thrombosis (DVT and no cases of pulmonary embolism (PE. Conclusion: Intraarticular administration of TXA to prevent postoperative blood loss in TKA is a safe and effective alternative/adjunct to its IV administration.

  4. Calibrated delivery drape versus indirect gravimetric technique for the measurement of blood loss after delivery: a randomized trial.

    Science.gov (United States)

    Ambardekar, Shubha; Shochet, Tara; Bracken, Hillary; Coyaji, Kurus; Winikoff, Beverly

    2014-08-15

    Trials of interventions for PPH prevention and treatment rely on different measurement methods for the quantification of blood loss and identification of PPH. This study's objective was to compare measures of blood loss obtained from two different measurement protocols frequently used in studies. Nine hundred women presenting for vaginal delivery were randomized to a direct method (a calibrated delivery drape) or an indirect method (a shallow bedpan placed below the buttocks and weighing the collected blood and blood-soaked gauze/pads). Blood loss was measured from immediately after delivery for at least one hour or until active bleeding stopped. Significantly greater mean blood loss was recorded by the direct than by the indirect measurement technique (253.9 mL and 195.3 mL, respectively; difference = 58.6 mL (95% CI: 31-86); p 500 mL (8.7% vs. 4.7%, p = 0.02). The study suggests a real and significant difference in blood loss measurement between these methods. Research using blood loss measurement as an endpoint needs to be interpreted taking measurement technique into consideration. This study has been registered at clinicaltrials.gov as NCT01885845.

  5. Interventions to prevent occupational noise-induced hearing loss

    NARCIS (Netherlands)

    Tikka, Christina; Verbeek, Jos H.; Kateman, Erik; Morata, Thais C.; Dreschler, Wouter A.; Ferrite, Silvia

    2017-01-01

    This is the second update of a Cochrane Review originally published in 2009. Millions of workers worldwide are exposed to noise levels that increase their risk of hearing disorders. There is uncertainty about the effectiveness of hearing loss prevention interventions. To assess the effectiveness of

  6. Reduction of aspirin-induced fecal blood loss with low-dose misoprostol tablets in man

    International Nuclear Information System (INIS)

    Cohen, M.M.; Clark, L.; Armstrong, L.; D'Souza, J.

    1985-01-01

    Misoprostol (SC-29333), a synthetic prostaglandin E1 methyl ester analog, was given simultaneously with acetylsalicylic acid in a double-blind, placebo-controlled randomized prospective study of 32 healthy human male subjects. Fecal blood loss was measured for eight days using the 51 Cr-labeled red blood cell technique. Aspirin (650 mg qid) and misoprostol (25 micrograms qid) or placebo were given during days 3, 4, and 5. There was a significant (P less than 0.05) increase in median blood loss (modified Friedman test) from 0.81 to 6.05 ml/day in the aspirin with placebo group (N = 16). Median blood loss was increased (from 0.75 to 3.75 ml/day) in the aspirin with misoprostol group (N = 16), but this was significantly less (Mann-Whitney U test, P less than 0.01) than the placebo group. Mean serum salicylate concentrations in the placebo and misoprostol groups were similar (7.8 and 6.8 micrograms/ml, respectively). There were no significant changes in laboratory values in any of the subjects studied, nor were any major side-effects encountered. This study demonstrates that oral misoprostol reduces aspirin-induced gastrointestinal bleeding even when administered simultaneously and at a dose level below its threshold for significant acid inhibition. This indicates a potential role for misoprostol in the prevention of gastric mucosal damage in selected patients

  7. Tranexamic acid: optimal blood loss management in surface replacement arthroplasty.

    Science.gov (United States)

    Sassoon, A; Nam, D; Jackups, R; Johnson, S R; Nunley, R M; Barrack, R L

    2016-02-01

    This study investigated whether the use of tranexamic acid (TXA) decreased blood loss and transfusion related cost following surface replacement arthroplasty (SRA). A retrospective review of patients treated with TXA during a SRA, who did not receive autologous blood (TXA group) was performed. Two comparison groups were established; the first group comprised of patients who donated their own blood pre-operatively (auto group) and the second of patients who did not donate blood pre-operatively (control). Outcomes included transfusions, post-operative haemoglobin (Hgb), complications, and length of post-operative stay. Between 2009 and 2013, 150 patients undergoing SRA were identified for inclusion: 51 in the auto, 49 in the control, and 50 in the TXA group. There were no differences in the pre-operative Hgb concentrations between groups. The mean post-operative Hgb was 11.3 g/dL (9.1 to 13.6) in the auto and TXA groups, and 10.6 g/dL (8.1 to 12.1)in the control group (p = 0.001). Accounting for cost of transfusions, administration of TXA, and length of stay, the cost per patient was $1731, $339, and $185 for the auto, control and TXA groups, respectively. TXA use demonstrated higher post-operative Hgb concentrations when compared with controls and decreased peri-operative costs. Tranexamic acid safely limits allogeneic transfusion, maintains post-operative haemoglobin, and decreases direct and indirect transfusion related costs in surface replacement arthroplasty. ©2016 The British Editorial Society of Bone & Joint Surgery.

  8. Does platform switching really prevent crestal bone loss around implants?

    Directory of Open Access Journals (Sweden)

    Yoshiyuki Hagiwara

    2010-08-01

    Full Text Available To maintain long-term implant stability, it is important to minimize bone loss around the implant. Several clinical studies have shown a mean marginal bone loss around dental implants of 1.5–2 mm in the first year after prosthetic restoration. Currently, concepts to prevent bone loss around dental implants have been reported as the platform switching (PLS. This technique use of prosthetic abutments with reduced width in relation to the implant platform diameter seems to have the greatest potential to limit the crestal resorption. However, there are only a few reports on the mechanism of action or the extent of bone loss prevention, and as such, it is difficult to say that the effect of PLS has been thoroughly examined. Excluding case reports, articles on PLS can be broadly categorized into: (1 radiographic evaluation of crestal bone level in humans, (2 histological and histomorphometrical analysis in animals, or (3 finite element analysis. This review revealed a shortage of published data for above three categories related PLS. Researchers have attempted to explain the mechanism of action of PLS; however, it is necessary to conduct further studies, including histological studies using animals, to clarify the mechanism fully.

  9. Quantitative determination of blood losses by a whole-body counter

    International Nuclear Information System (INIS)

    Rochna Viola, E.M.; Garreta, A.C. de; Soria, N.; Blanco, E.

    1976-01-01

    A method to quantitate blood losses by determination of the 51 Cr whole body retention (WBR) was developed. Autologous red cells labelled with Na 2 O 4 51 Cr were given intravenously. Blood losses were simulated by withdrawing blood samples. Percent relative variation (PRV) between real blood losses (blood withdrawal) and blood losses calculated by determining the WBR, were found. Withdrawal of 60 ml blood gave a PRV lower than 10.0%. 51 Cr body loss due to elution and red cell death was found to be 0.017 day -1 . The method allows the accurate detection of total blood losses of 60 ml or more, and it can be used to quantitate gastrointestinal or gynecological hemorrhages, avoiding the inconveniences involved by the complete recolection of faeces or of towels and tampons. (author) [es

  10. Cancer prevention knowledge of people with profound hearing loss.

    Science.gov (United States)

    Zazove, Philip; Meador, Helen E; Reed, Barbara D; Sen, Ananda; Gorenflo, Daniel W

    2009-03-01

    Deaf persons, a documented minority population, have low reading levels and difficulty communicating with physicians. The effect of these on their knowledge of cancer prevention recommendations is unknown. A cross-sectional study of 222 d/Deaf persons in Michigan, age 18 and older, chose one of four ways (voice, video of a certified American Sign Language interpreter, captions, or printed English) to complete a self-administered computer video questionnaire about demographics, hearing loss, language history, health-care utilization, and health-care information sources, as well as family and social variables. Twelve questions tested their knowledge of cancer prevention recommendations. The outcome measures were the percentage of correct answers to the questions and the association of multiple variables with these responses. Participants averaged 22.9% correct answers with no gender difference. Univariate analysis revealed that smoking history, types of medical problems, last physician visit, and women having previous cancer preventive tests did not affect scores. Improved scores occurred with computer use (p = 0.05), higher education (p internet (p = 0.02), and believing that smoking is bad (p bad (p = 0.05) were associated with improved scores. Persons with profound hearing loss have poor knowledge of recommended cancer prevention interventions. English use in multiple settings was strongly associated with increased knowledge.

  11. Blood loss associated with Ring uncemented total knee replacement: comparison between continuous and intermittent suction drainage.

    Science.gov (United States)

    Wittmann, F W; Ring, P A

    1984-01-01

    In a retrospective comparison of blood loss following uncemented total knee replacement, in which either continuous or intermittent suction drainage was used, measured blood loss was significantly greater with continuous drainage. However, a method of calculating actual blood loss demonstrated no significant difference. With intermittent drainage, more blood remains undetected around the knee joint; this technique should therefore be abandoned in favour of continuous suction drainage. PMID:6747978

  12. Prevention of catheter-related blood stream infection.

    Science.gov (United States)

    Byrnes, Matthew C; Coopersmith, Craig M

    2007-08-01

    Catheter-related blood stream infections are a morbid complication of central venous catheters. This review will highlight a comprehensive approach demonstrated to prevent catheter-related blood stream infections. Elements of prevention important to inserting a central venous catheter include proper hand hygiene, use of full barrier precautions, appropriate skin preparation with 2% chlorhexidine, and using the subclavian vein as the preferred anatomic site. Rigorous attention needs to be given to dressing care, and there should be daily assessment of the need for central venous catheters, with prompt removal as soon as is practicable. Healthcare workers should be educated routinely on methods to prevent catheter-related blood stream infections. If rates remain higher than benchmark levels despite proper bedside practice, antiseptic or antibiotic-impregnated catheters can also prevent infections effectively. A recent program utilizing these practices in 103 ICUs in Michigan resulted in a 66% decrease in infection rates. There is increasing recognition that a comprehensive strategy to prevent catheter-related blood stream infections can prevent most infections, if not all. This suggests that thousands of infections can potentially be averted if the simple practices outlined herein are followed.

  13. Preventing blood transfusion failures: FMEA, an effective assessment method.

    Science.gov (United States)

    Najafpour, Zhila; Hasoumi, Mojtaba; Behzadi, Faranak; Mohamadi, Efat; Jafary, Mohamadreza; Saeedi, Morteza

    2017-06-30

    Failure Mode and Effect Analysis (FMEA) is a method used to assess the risk of failures and harms to patients during the medical process and to identify the associated clinical issues. The aim of this study was to conduct an assessment of blood transfusion process in a teaching general hospital, using FMEA as the method. A structured FMEA was recruited in our study performed in 2014, and corrective actions were implemented and re-evaluated after 6 months. Sixteen 2-h sessions were held to perform FMEA in the blood transfusion process, including five steps: establishing the context, selecting team members, analysis of the processes, hazard analysis, and developing a risk reduction protocol for blood transfusion. Failure modes with the highest risk priority numbers (RPNs) were identified. The overall RPN scores ranged from 5 to 100 among which, four failure modes were associated with RPNs over 75. The data analysis indicated that failures with the highest RPNs were: labelling (RPN: 100), transfusion of blood or the component (RPN: 100), patient identification (RPN: 80) and sampling (RPN: 75). The results demonstrated that mis-transfusion of blood or blood component is the most important error, which can lead to serious morbidity or mortality. Provision of training to the personnel on blood transfusion, knowledge raising on hazards and appropriate preventative measures, as well as developing standard safety guidelines are essential, and must be implemented during all steps of blood and blood component transfusion.

  14. Continuous Postoperative Pericardial Flushing: A Pilot Study on Safety, Feasibility, and Effect on Blood Loss

    NARCIS (Netherlands)

    Manshanden, Johan S. J.; Gielen, Chantal L. I.; de Borgie, Corianne A. J. M.; Klautz, Robert J. M.; de Mol, Bas A. J. M.; Koolbergen, David R.

    2015-01-01

    Background: Prolonged or excessive blood loss is a common complication after cardiac surgery. Blood remnants and clots, remaining in the pericardial space in spite of chest tube drainage, induce high fibrinolytic activity that may contribute to bleeding complications. Continuous postoperative

  15. Metformin therapy prevents early pregnancy loss in polycystic ovarian syndrome

    International Nuclear Information System (INIS)

    Hassan, J.A.; Anbareen, T.

    2011-01-01

    Background: The study was done to compare the early pregnancy loss rate in women with polycystic ovarian syndrome who received or did not receive metformin in pregnancy. Study type, settings and duration: A case control interventional study carried out at Civil Hospital Karachi, Hamdard University Hospital and Private Gynaecology clinics from January 2005 to July 2008. Subjects and Methods Eighty two non diabetic patients with polycystic ovarian syndrome who became pregnant were included in the study. A questionnaire was filled for all patients that included information on basic demography and mean age, parity, weight. Fasting blood sugar and serum insulin levels were done for all these women. Only patients with raised insulin levels (more than 10 mu/l) were included in the study and all were offered to use oral metformin throughout pregnancy as 500 mg three times a day with folic acid supplements 5 mg once daily. Those who agreed to take the drug throughout pregnancy and to comply with the therapy were taken as cases, while those who did not agree to take the medicine acted as controls. Patients with other causes of recurrent pregnancy loss were excluded from the study. All pregnancies were followed using serial ultrasound examination to see any pregnancy loss in the two groups. Eighty two cases of polycystic ovaries with pregnancy were seen during the study period. All cases had raised serum insulin levels. Fifty patients agreed to take metformin through out pregnancy while, 32 cases did not agree to take metformin during pregnancy and thus acted as controls. The two groups did not differ in mean age, parity, weight and mean fasting blood sugar levels. Fasting insulin levels were high in metformin group (18.40 mu/l ) than in controls (12.53 mu/l). Missed abortion rate was significantly lower (12%) in metformin group than in controls (28%) (p<0.028). No congenital anomalies were found in both the groups on ultrasound at 16-19 weeks. Metformin treatment during

  16. Metformin therapy prevents early pregnancy loss in polycystic ovarian syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Hassan, J A; Anbareen, T [Dow University of Health Sciences, Karachi (Pakistan). Dept. of Gynae; Anbareen, T [Hamdard University Hospital, Karachi (Pakistan)

    2011-01-15

    Background: The study was done to compare the early pregnancy loss rate in women with polycystic ovarian syndrome who received or did not receive metformin in pregnancy. Study type, settings and duration: A case control interventional study carried out at Civil Hospital Karachi, Hamdard University Hospital and Private Gynaecology clinics from January 2005 to July 2008. Subjects and Methods Eighty two non diabetic patients with polycystic ovarian syndrome who became pregnant were included in the study. A questionnaire was filled for all patients that included information on basic demography and mean age, parity, weight. Fasting blood sugar and serum insulin levels were done for all these women. Only patients with raised insulin levels (more than 10 mu/l) were included in the study and all were offered to use oral metformin throughout pregnancy as 500 mg three times a day with folic acid supplements 5 mg once daily. Those who agreed to take the drug throughout pregnancy and to comply with the therapy were taken as cases, while those who did not agree to take the medicine acted as controls. Patients with other causes of recurrent pregnancy loss were excluded from the study. All pregnancies were followed using serial ultrasound examination to see any pregnancy loss in the two groups. Eighty two cases of polycystic ovaries with pregnancy were seen during the study period. All cases had raised serum insulin levels. Fifty patients agreed to take metformin through out pregnancy while, 32 cases did not agree to take metformin during pregnancy and thus acted as controls. The two groups did not differ in mean age, parity, weight and mean fasting blood sugar levels. Fasting insulin levels were high in metformin group (18.40 mu/l ) than in controls (12.53 mu/l). Missed abortion rate was significantly lower (12%) in metformin group than in controls (28%) (p<0.028). No congenital anomalies were found in both the groups on ultrasound at 16-19 weeks. Metformin treatment during

  17. Interventions to prevent occupational noise-induced hearing loss.

    Science.gov (United States)

    Tikka, Christina; Verbeek, Jos H; Kateman, Erik; Morata, Thais C; Dreschler, Wouter A; Ferrite, Silvia

    2017-07-07

    This is the second update of a Cochrane Review originally published in 2009. Millions of workers worldwide are exposed to noise levels that increase their risk of hearing disorders. There is uncertainty about the effectiveness of hearing loss prevention interventions. To assess the effectiveness of non-pharmaceutical interventions for preventing occupational noise exposure or occupational hearing loss compared to no intervention or alternative interventions. We searched the CENTRAL; PubMed; Embase; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; and OSH UPDATE to 3 October 2016. We included randomised controlled trials (RCT), controlled before-after studies (CBA) and interrupted time-series (ITS) of non-clinical interventions under field conditions among workers to prevent or reduce noise exposure and hearing loss. We also collected uncontrolled case studies of engineering controls about the effect on noise exposure. Two authors independently assessed study eligibility and risk of bias and extracted data. We categorised interventions as engineering controls, administrative controls, personal hearing protection devices, and hearing surveillance. We included 29 studies. One study evaluated legislation to reduce noise exposure in a 12-year time-series analysis but there were no controlled studies on engineering controls for noise exposure. Eleven studies with 3725 participants evaluated effects of personal hearing protection devices and 17 studies with 84,028 participants evaluated effects of hearing loss prevention programmes (HLPPs). Effects on noise exposure Engineering interventions following legislationOne ITS study found that new legislation in the mining industry reduced the median personal noise exposure dose in underground coal mining by 27.7 percentage points (95% confidence interval (CI) -36.1 to -19.3 percentage points) immediately after the implementation of stricter legislation. This roughly translates to a 4.5 dB(A) decrease in

  18. Blood pressure control to prevent decline in cognition after stroke

    Directory of Open Access Journals (Sweden)

    Ihle-Hansen H

    2015-06-01

    Full Text Available Hege Ihle-Hansen,1 Bente Thommessen,2 Morten W Fagerland,3 Anne R Øksengård,4 Torgeir B Wyller,5 Knut Engedal,6 Brynjar Fure7 1Department of Internal Medicine, Vestre Viken Hospital Trust, Bærum Hospital, Bærum, Norway; 2Department of Neurology, Akershus University Hospital, Lørenskog, Norway; 3Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Norway; 4Department of Internal medicine, Vestre Viken Hospital Trust, Bærum Hospital, Bærum, Norway; 5Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway; 6Norwegian Centre for Dementia Research, Oslo University Hospital, Oslo, Norway; 7Norwegian Knowledge Centre for the Health Services, Oslo, Norway Background: Treatment of hypertension post-stroke preserves cognition through prevention of recurrent stroke, but it is not clear whether it prevents cognitive decline through other mechanisms. We aimed to describe changes in blood pressure from baseline to 1 year post-stroke and to evaluate the association between achieved blood pressure targets and cognitive function, mild cognitive impairment (MCI, and dementia.Methods: We included patients with first-ever stroke, and defined achieved blood pressure goals as systolic blood pressure (SBP in the categories ≤125 mmHg, ≤140 mmHg, and ≤160 mmHg, SBP reduction of ≥10 mmHg, and diastolic blood pressure (DBP reduction of ≥5 mmHg. The main outcome variables were cognitive assessments 1 year post stroke. Secondary outcomes were diagnoses of MCI or dementia.Results: Forty-one of 166 patients (25% reached SBP ≤125 mmHg after 1 year, 92/166 (55% reached SBP ≤140 mmHg, and 150/166 (90% reached SBP ≤160 mmHg. SBP was reduced by ≥10 mmHg in 44/150 (29% and DBP by ≥5 mmHg in 57/150 (38%. We did not find any statistically significant associations between cognitive test performances and different blood pressure goals (P=0.070–1.0. Nor was there any significant association

  19. Safe surgery: how accurate are we at predicting intra-operative blood loss?

    LENUS (Irish Health Repository)

    2012-02-01

    Introduction Preoperative estimation of intra-operative blood loss by both anaesthetist and operating surgeon is a criterion of the World Health Organization\\'s surgical safety checklist. The checklist requires specific preoperative planning when anticipated blood loss is greater than 500 mL. The aim of this study was to assess the accuracy of surgeons and anaesthetists at predicting intra-operative blood loss. Methods A 6-week prospective study of intermediate and major operations in an academic medical centre was performed. An independent observer interviewed surgical and anaesthetic consultants and registrars, preoperatively asking each to predict expected blood loss in millilitre. Intra-operative blood loss was measured and compared with these predictions. Parameters including the use of anticoagulation and anti-platelet therapy as well as intra-operative hypothermia and hypotension were recorded. Results One hundred sixty-eight operations were included in the study, including 142 elective and 26 emergency operations. Blood loss was predicted to within 500 mL of measured blood loss in 89% of cases. Consultant surgeons tended to underestimate blood loss, doing so in 43% of all cases, while consultant anaesthetists were more likely to overestimate (60% of all operations). Twelve patients (7%) had underestimation of blood loss of more than 500 mL by both surgeon and anaesthetist. Thirty per cent (n = 6\\/20) of patients requiring transfusion of a blood product within 24 hours of surgery had blood loss underestimated by more than 500 mL by both surgeon and anaesthetist. There was no significant difference in prediction between patients on anti-platelet or anticoagulation therapy preoperatively and those not on the said therapies. Conclusion Predicted intra-operative blood loss was within 500 mL of measured blood loss in 89% of operations. In 30% of patients who ultimately receive a blood transfusion, both the surgeon and anaesthetist significantly underestimate

  20. Ethamsylate and blood loss in total hip replacement.

    Science.gov (United States)

    Keith, I

    1979-01-01

    Nineteen consecutive patients undergoing total hip replacement under epidural anaesthesia were randomly divided into two groups. The treatment group received 1000 mg of ethamsylate intravenously before induction of anaesthesia. Blood lost during surgery was measured by a colorimetric technique. Closed suction drains were used and all blood lost after operation collected for measurement. Ethamsylate did not decrease the average volumes of blood lost during or after the operation. Neither did it reduce the requirements for blood transfusion. Although there were no side-effects attributable to ethamyslate, there seems to be no indication for its use in total hip replacement under epidural anaesthesia.

  1. Prothrombin complex concentrate in the reduction of blood loss during orthotopic liver transplantation: PROTON-trial

    NARCIS (Netherlands)

    F. Arshad (Freeha); B. Ickx (Brigitte); R.T. van Beem (Rachel); W.G. Polak (Wojciech); F. Grüne (Frank); F. Nevens (Frederik); M. Ilmakunnas (Minna); A.M. Koivusalo (Anna-Maria); H. Isoniemi (Helena); P.F.W. Strengers; H.J.M. Groen (Henk); H.G.D. Hendriks (Herman); T. Lisman (Ton); J. Pirenne (Jacques); R.J. Porte (Robert)

    2013-01-01

    textabstractBackground: In patients with cirrhosis, the synthesis of coagulation factors can fall short, reflected by a prolonged prothrombin time. Although anticoagulants factors are decreased as well, blood loss during orthotopic liver transplantation can still be excessive. Blood loss during

  2. Prothrombin complex concentrate in the reduction of blood loss during orthotopic liver transplantation : PROTON-trial

    NARCIS (Netherlands)

    Arshad, Freeha; Ickx, Brigitte; van Beem, Rachel T.; Polak, Wojciech; Grune, Frank; Nevens, Frederik; Ilmakunnas, Minna; Koivusalo, Anna-Maria; Isoniemi, Helena; Strengers, Paul F. W.; Groen, Henk; Hendriks, Herman G. D.; Lisman, Ton; Pirenne, Jacques; Porte, Robert J.

    2013-01-01

    Background: In patients with cirrhosis, the synthesis of coagulation factors can fall short, reflected by a prolonged prothrombin time. Although anticoagulants factors are decreased as well, blood loss during orthotopic liver transplantation can still be excessive. Blood loss during orthotopic liver

  3. Gastrointestinal blood loss induced by three different non-steroidal anti-inflammatory drugs.

    Science.gov (United States)

    Bidlingmaier, A; Hammermaier, A; Nagyiványi, P; Pabst, G; Waitzinger, J

    1995-04-01

    A clinical study was performed on 18 healthy volunteers to compare the gastrointestinal daily blood loss induced by oral intake of three different non-steroidal anti-inflammatory drugs, lysine clonixinate (CAS 55837-30-4), ibuprofen (CAS 15687-27-1) and acetylsalicylic acid (CAS 50-78-2 ASA). For quantitative determination of gastrointestinal blood loss, autologous erythrocytes were radiolabelled in vitro with 51Cr and reinfused at study start. The amount of radioactivity excreted in faeces was measured during a placebo baseline phase of three days, a treatment phase of five days with thrice daily dosing of ASA, ibuprofen or lysine clonixinate and a subsequent wash-out phase of five days. The highest increase of mean daily blood loss over baseline was observed after treatment with ASA (+ 1.66 ml/d versus baseline). Treatment with ibuprofen led to an increase of mean daily blood loss by + 0.52 ml/d. During treatment with lysine clonixinate the mean increase of daily blood loss was +0.32 ml/d versus baseline. In the ibuprofen and lysine clonixinate treatment groups the values of mean daily blood loss decreased during the wash-out phase with respect to the verum phase, whereas the mean daily blood loss during the wash-out phase after treatment with ASA even increased in comparison to the verum phase (mean daily blood loss: +2.07 ml/d versus baseline.

  4. Tranexamic acid reduces blood loss during and after cesarean section: A double blinded, randomized, controlled trial

    Directory of Open Access Journals (Sweden)

    Amr H. Yehia

    2014-03-01

    Conclusions: Tranexamic acid can be used safely to reduce blood loss during cesarean section. Reduced blood loss after tranexamic acid was associated with improvement of post-operative hemoglobin, hematocrit and with reduction of post-partum need for iron replacement.

  5. Tranexamic acid reduces blood loss in patients with extracapsular fractures of the hip

    DEFF Research Database (Denmark)

    Tengberg, P T; Foss, N B; Palm, H

    2016-01-01

    AIMS: We chose unstable extra-capsular hip fractures as our study group because these types of fractures suffer the largest blood loss. We hypothesised that tranexamic acid (TXA) would reduce total blood loss (TBL) in extra-capsular fractures of the hip. PATIENTS AND METHODS: A single...

  6. Electrolyte-carbohydrate beverage prevents water loss in the early stage of high altitude training.

    Science.gov (United States)

    Yanagisawa, Kae; Ito, Osamu; Nagai, Satsuki; Onishi, Shohei

    2012-01-01

    To prevent water loss in the early stage of high altitude training, we focused on the effect of electrolyte-carbohydrate beverage (EC). Subjects were 16 male university students who belonged to a ski club. They had ski training at an altitude of 1,800 m. The water (WT) group drank only water, and the EC group drank only an electrolyte-carbohydrate beverage. They arrived at the training site in the late afternoon. The study started at 7 pm on the day of arrival and continued until noon of the 4(th) day. In the first 12 hours, 1 L of beverages were given. On the second and third days, 2.5 L of beverages were given. All subjects ate the same meals. Each morning while in fasting condition, subjects were weighed and blood was withdrawn for various parameters (hemoglobin, hematocrit, sodium, potassium and aldosterone). Urine was collected at 12 hour intervals for a total 60 hours (5 times). The urine volume, gravity, sodium and potassium concentrations were measured. Peripheral oxygen saturation and heart rate were measured during sleep with a pulse oximeter. Liquid intakes in both groups were similar, hence the electrolytes intake was higher in the EC group than in the WT group. The total urine volume was lower in the EC group than in the WT group, respectively (paltitude training may be effective in decreasing urinary output and preventing loss of blood plasma volume.

  7. Predicting operative blood loss during spinal fusion for adolescent idiopathic scoliosis.

    Science.gov (United States)

    Ialenti, Marc N; Lonner, Baron S; Verma, Kushagra; Dean, Laura; Valdevit, Antonio; Errico, Thomas

    2013-06-01

    Patient and surgical factors are known to influence operative blood loss in spinal fusion for adolescent idiopathic scoliosis (AIS), but have only been loosely identified. To date, there are no established recommendations to guide decisions to predonate autologous blood, and the current practice is based primarily on surgeon preference. This study is designed to determine which patient and surgical factors are correlated with, and predictive of, blood loss during spinal fusion for AIS. Retrospective analysis of 340 (81 males, 259 females; mean age, 15.2 y) consecutive AIS patients treated by a single surgeon from 2000 to 2008. Demographic (sex, age, height, weight, and associated comorbidities), laboratory (hematocrit, platelet, PT/PTT/INR), standard radiographic, and perioperative data including complications were analyzed with a linear stepwise regression to develop a predictive model of blood loss. Estimated blood loss was 907±775 mL for posterior spinal fusion (PSF, n=188), 323±171 mL for anterior spinal fusion (ASF, n=124), and 1277±821 mL for combined procedures (n=28). For patients undergoing PSF, stepwise analysis identified sex, preoperative kyphosis, and operative time to be the most important predictors of increased blood loss (Ploss in PSF: blood loss (mL)=C+Op-time (min)×(6.4)-pre-op T2-T12 kyphosis (degrees)×(8.7), C=233 if male and -270 if female. We find sex, operative time, and preoperative kyphosis to be the most important predictors of increased blood loss in PSF for AIS. Mean arterial pressure and operative time were predictive of estimated blood loss in ASF. For posterior fusions, we also present a model that estimates blood loss preoperatively and can be used to guide decisions regarding predonation of blood and the use of antifibrinolytic agents. Retrospective study: Level II.

  8. Coagulation competence and fluid recruitment after moderate blood loss in young men

    DEFF Research Database (Denmark)

    Zaar, Morten; Mørkeberg, Jakob; Pott, Frank C

    2014-01-01

    The coagulation system is activated by a reduction of the central blood volume during orthostatic stress and lower body negative pressure suggesting that also a blood loss enhances coagulation. During bleeding, however, the central blood volume is supported by fluid recruitment to the circulation...

  9. Contemporary noise-induced hearing loss (NIHL) prevention.

    Science.gov (United States)

    Sułkowski, Wiesław; Owczarek, Kalina; Olszewski, Jurek

    2017-08-31

    Hearing impairment caused by noise, traditionally called - depending on the duration of exposure - acute or chronic acoustic trauma, includes, in addition to presbyacusis, the most common adult population of hearing impaired. In Poland - according to the report of the Central Statistical Office (GUS, 2011), the number of workers employed in NDN exceeded the noise level (85 dB) is about 200 thousand, the highest in the mining, metal and metal products production, textiles and wood production. According to the Regulation of the Council of Ministers of on June 30, 2009, on the list of occupational diseases (Journal of Laws No. 132, item 1115), it is defined as "bilateral permanent hearing loss of the cochlear or sensory-nerve type, expressed as an increase in hearing threshold of at least 45 dB in the ear better heard, calculated as an arithmetic mean for frequencies 1,2 and 3 kHz. Hearing impairments also occur in the military and police during field training and in combat where the source of acoustic injuries are firearms and pulse-inducing explosions (as in some industries) with high C peak levels (Lc peak) Time to rise to a maximum of <1 ms. The prevalence of loud music listening, particularly by personal stereo players, is also affecting children and adolescents with audiometric hearing loss, according to the World Health Organization (WHO) estimates of around 15-20%. The preventive action strategy is defined by the European Union legislation and the national implementing legislation that reduces or eliminates the risk and reduces (if not eliminated), taking into account available technical and organizational solutions to minimize the risk of hearing damage. If you can not reduce the noise levels with technical and organizational methods, you need individual hearing protectors. Ear protectors may be equipped with electronic systems with active noise reduction (which can improve low and medium frequency performance), adjustable attenuation (improves speech

  10. DOES INTRAVENOUS TRANEXAMIC ACID REDUCE BLOOD LOSS DURING SURGICALLY ASSISTED RAPID PALATAL EXPANSION?

    Directory of Open Access Journals (Sweden)

    Emine AKBAŞ

    2017-10-01

    Full Text Available Purpose: The purpose of this study was to evaluate the efficacy of tranexamic acid (TXA in reducing blood loss during surgically assisted rapid palatal expansion (SARPE procedure. Subjects and Methods: A total of 34 patients (12 male, 22 female who had been treated surgically under general anesthesia with SARPE including pterygoid disjunction for transverse maxillary deficiency (TMD were included in this study. The study group (n=17 received intravenous (IV TXA 10 mg/kg as a preoperative bolus; the control group (n=17 received normal saline solution. Preoperative and postoperative haemoglobin and haematocrit values, intraoperative blood loss, and any blood product transfusion were recorded. Results: Blood loss during SARPE was statistically significantly less in the study group than the control group (p=0.0001. Conclusion: Preoperative IV administration of TXA can effectively control blood loss during when SARPE with pterygoid disjunction is performed.

  11. Blood Density Is Nearly Equal to Water Density: A Validation Study of the Gravimetric Method of Measuring Intraoperative Blood Loss.

    Science.gov (United States)

    Vitello, Dominic J; Ripper, Richard M; Fettiplace, Michael R; Weinberg, Guy L; Vitello, Joseph M

    2015-01-01

    Purpose. The gravimetric method of weighing surgical sponges is used to quantify intraoperative blood loss. The dry mass minus the wet mass of the gauze equals the volume of blood lost. This method assumes that the density of blood is equivalent to water (1 gm/mL). This study's purpose was to validate the assumption that the density of blood is equivalent to water and to correlate density with hematocrit. Methods. 50 µL of whole blood was weighed from eighteen rats. A distilled water control was weighed for each blood sample. The averages of the blood and water were compared utilizing a Student's unpaired, one-tailed t-test. The masses of the blood samples and the hematocrits were compared using a linear regression. Results. The average mass of the eighteen blood samples was 0.0489 g and that of the distilled water controls was 0.0492 g. The t-test showed P = 0.2269 and R (2) = 0.03154. The hematocrit values ranged from 24% to 48%. The linear regression R (2) value was 0.1767. Conclusions. The R (2) value comparing the blood and distilled water masses suggests high correlation between the two populations. Linear regression showed the hematocrit was not proportional to the mass of the blood. The study confirmed that the measured density of blood is similar to water.

  12. Quantitative assessment of gastrointestinal blood loss with anti-inflammatory drugs

    International Nuclear Information System (INIS)

    Dahanukar, S.A.; Sheth, U.K.; Bhiwankar, N.T.; Ramnath, S.R.; Mehta, B.C.; Katoch, D.S.

    1980-01-01

    A comparative study of gastrointestinal blood loss caused by aspirin, flurbiprofen and RH-8 was carried out in 24 normal volunteers in whom erythrocytes were labelled with radioactive chromium i.e. Cr 51 . Blood loss was estimated by counting radio-activity in vitro taking total amount of faeces. The method used was independent of distribution of radio-activity in the faeces, which does not require homogenization. Significant increase in blood loss occurred with aspirin, flurbiprofen and RH-8; only the difference between RH-8 and flurbiprofen group is significant. (auth.)

  13. A systematic review of the relationship between blood loss and clinical signs.

    Directory of Open Access Journals (Sweden)

    Rodolfo Carvalho Pacagnella

    Full Text Available INTRODUCTION: This systematic review examines the relationship between blood loss and clinical signs and explores its use to trigger clinical interventions in the management of obstetric haemorrhage. METHODS: A systematic review of the literature was carried out using a comprehensive search strategy to identify studies presenting data on the relationship of clinical signs & symptoms and blood loss. Methodological quality was assessed using the STROBE checklist and the general guidelines of MOOSE. RESULTS: 30 studies were included and five were performed in women with pregnancy-related haemorrhage (other studies were carried in non-obstetric populations. Heart rate (HR, systolic blood pressure (SBP and shock index were the parameters most frequently studied. An association between blood loss and HR changes was observed in 22 out of 24 studies, and between blood loss and SBP was observed in 17 out of 23 studies. An association was found in all papers reporting on the relationship of shock index and blood loss. Seven studies have used Receiver Operating Characteristic Curves to determine the accuracy of clinical signs in predicting blood loss. In those studies the AUC ranged from 0.56 to 0.74 for HR, from 0.56 to 0.79 for SBP and from 0.77 to 0.84 for shock index. In some studies, HR, SBP and shock index were associated with increased mortality. CONCLUSION: We found a substantial variability in the relationship between blood loss and clinical signs, making it difficult to establish specific cut-off points for clinical signs that could be used as triggers for clinical interventions. However, the shock index can be an accurate indicator of compensatory changes in the cardiovascular system due to blood loss. Considering that most of the evidence included in this systematic review is derived from studies in non-obstetric populations, further research on the use of the shock index in obstetric populations is needed.

  14. Diagnosis System for Diabetic Retinopathy and Glaucoma Screening to Prevent Vision Loss

    Directory of Open Access Journals (Sweden)

    Siva Sundhara Raja DHANUSHKODI

    2014-03-01

    Full Text Available Aim: Diabetic retinopathy (DR and glaucoma are two most common retinal disorders that are major causes of blindness in diabetic patients. DR caused in retinal images due to the damage in retinal blood vessels, which leads to the formation of hemorrhages spread over the entire region of retina. Glaucoma is caused due to hypertension in diabetic patients. Both DR and glaucoma affects the vision loss in diabetic patients. Hence, a computer aided development of diagnosis system for Diabetic retinopathy and Glaucoma screening is proposed in this paper to prevent vision loss. Method: The diagnosis system of DR consists of two stages namely detection and segmentation of fovea and hemorrhages. The diagnosis system of glaucoma screening consists of three stages namely blood vessel segmentation, Extraction of optic disc (OD and optic cup (OC region and determination of rim area between OD and OC. Results: The specificity and accuracy for hemorrhages detection is found to be 98.47% and 98.09% respectively. The accuracy for OD detection is found to be 99.3%. This outperforms state-of-the-art methods. Conclusion: In this paper, the diagnosis system is developed to classify the DR and glaucoma screening in to mild, moderate and severe respectively.

  15. Continuous Postoperative Pericardial Flushing: A Pilot Study on Safety, Feasibility, and Effect on Blood Loss

    Directory of Open Access Journals (Sweden)

    Johan S.J. Manshanden

    2015-09-01

    Conclusions: CPPF after cardiac surgery was found to be safe and feasible in this experimental setting. The clinically relevant effect on blood loss needs to be confirmed in a randomized clinical trial.

  16. Comparision of blood loss between computer assisted and conventional total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Paras Kumar Mohanlal

    2013-01-01

    Conclusion: These results suggest that there is no significant difference in blood loss in CAS TKA and conventional TKA. This study also highlights the heterogeneity of methods used in studies related to CAS TKA. We believe that there is a need for a large multicenter prospective randomized controlled trial to be performed before a consensus can be reached on the influence of CAS techniques on blood loss during primary TKA.

  17. An Evaluation of Intra‑ and Post‑operative Blood Loss in Total Hip ...

    African Journals Online (AJOL)

    2017-05-18

    May 18, 2017 ... Results: The mean intra‑ and post‑operative blood losses were 1222.7 ... To evaluate blood loss after total hip replacement. 2. To evaluate the .... 12.3. 4.2. 0.1. Median. 400.0. 150.0. 20.0. 3.0. Mode. 400.0. 100.0. 0.0. 3.0. SD.

  18. Blood Loss in Surgery for Aggressive Vertebral Haemangioma with and without Embolisation

    OpenAIRE

    Robinson, Yohan; Sheta, Reda; Salci, Konstantin; Willander, Johan

    2015-01-01

    Despite their benign nature some symptomatic aggressive vertebral haemangiomas (AVH) require surgery to decompress spinal cord and/or stabilise pathological fractures. Preoperative embolisation may reduce the considerable blood loss during surgical decompression. This systematic review investigated whether preoperative embolisation reduced surgical blood loss during treatment of symptomatic AVH. PubMed Medline, Web of Science, and Ovid Medline were searched for case reports and clinical studi...

  19. Decay in blood loss estimation skills after web-based didactic training.

    Science.gov (United States)

    Toledo, Paloma; Eosakul, Stanley T; Goetz, Kristopher; Wong, Cynthia A; Grobman, William A

    2012-02-01

    Accuracy in blood loss estimation has been shown to improve immediately after didactic training. The objective of this study was to evaluate retention of blood loss estimation skills 9 months after a didactic web-based training. Forty-four participants were recruited from a cohort that had undergone web-based training and testing in blood loss estimation. The web-based posttraining test, consisting of pictures of simulated blood loss, was repeated 9 months after the initial training and testing. The primary outcome was the difference in accuracy of estimated blood loss (percent error) at 9 months compared with immediately posttraining. At the 9-month follow-up, the median error in estimation worsened to -34.6%. Although better than the pretraining error of -47.8% (P = 0.003), the 9-month error was significantly less accurate than the immediate posttraining error of -13.5% (P = 0.01). Decay in blood loss estimation skills occurs by 9 months after didactic training.

  20. Real Time Intraoperative Monitoring of Blood Loss with a Novel Tablet Application

    Science.gov (United States)

    Sharareh, Behnam; Woolwine, Spencer; Satish, Siddarth; Abraham, Peter; Schwarzkopf, Ran

    2015-01-01

    Introduction : Real-time monitoring of blood loss is critical in fluid management. Visual estimation remains the standard of care in estimating blood loss, yet is demonstrably inaccurate. Photometric analysis, which is the referenced “gold-standard” for measuring blood loss, is both time-consuming and costly. The purpose of this study was to evaluate the efficacy of a novel tablet-monitoring device for measurement of Hb loss during orthopaedic procedures. Methods : This is a prospective study of 50 patients in a consecutive series of joint arthroplasty cases. The novel System with Feature Extraction Technology was used to measure the amount of Hb contained within surgical sponges intra-operatively. The system’s measures were then compared with those obtained via gravimetric method and photometric analysis. Accuracy was evaluated using linear regression and Bland-Altman analysis. Results : Our results showed a significant positive correlation between Triton tablet system and photometric analysis with respect to intra-operative hemoglobin and blood loss at 0.92 and 0.91, respectively. Discussion : This novel system can accurately determine Hb loss contained within surgical sponges. We believe that this user-friendly software can be used for measurement of total intraoperative blood loss and thus aid in a more accurate fluid management protocols during orthopaedic surgical procedures. PMID:26401167

  1. Hydroxyethyl Starch Reduces Coagulation Competence and Increases Blood Loss During Major Surgery

    DEFF Research Database (Denmark)

    Rasmussen, Kirsten C; Johansson, Pär I; Højskov, Michael

    2014-01-01

    OBJECTIVE: This study evaluated whether administration of hydroxyethyl starch (HES) 130/0.4 affects coagulation competence and influences the perioperative blood loss. BACKGROUND: Artificial colloids substitute blood volume during surgery; with the administration of HES 130/0.4 (Voluven, Fresenius...

  2. An evaluation of intra-operative and post-operative blood loss in ...

    African Journals Online (AJOL)

    Background: Total knee replacement is a rewarding and reliable procedure, producing a lasting relief to severe knee pains. However, significant blood loss usually in the post-operative period may be a challenge, necessitating prompt restoration of circulating blood volume to minimize morbidity and mortality. The aim of this ...

  3. Minimizing blood loss in liver transplantation : Progress through research and evolution of techniques

    NARCIS (Netherlands)

    de Boer, MT; Molenaar, IQ; Hendriks, HGD; Slooff, MJH; Porte, RJ

    2005-01-01

    Blood loss during liver transplantation has long been recognized as an important cause of morbidity and, especially in the early days, also mortality. It is well known that blood transfusions are associated with an increased risk of postoperative complications, such as infections, pulmonary

  4. The efficiency of voluntary incentive policies for preventing biodiversity loss

    Science.gov (United States)

    David J. Lewis; Andrew J. Plantinga; Erik Nelson; Stephen Polasky

    2011-01-01

    Habitat loss is a primary cause of loss of biodiversity but conserving habitat for species presents challenges. Land parcels differ in their ability to produce returns for landowners and landowners may have private information about the value of the land to them. Land parcels also differ in the type and quality of habitat and the spatial pattern of land use across...

  5. Plasmalemma Vesicle-Associated Protein Has a Key Role in Blood-Retinal Barrier Loss

    NARCIS (Netherlands)

    Wisniewska-Kruk, Joanna; van der Wijk, Anne-Eva; van Veen, Henk A.; Gorgels, Theo G. M. F.; Vogels, Ilse M. C.; Versteeg, Danielle; van Noorden, Cornelis J. F.; Schlingemann, Reinier O.; Klaassen, Ingeborg

    2016-01-01

    Loss of blood-retinal barrier (BRB) properties induced by vascular endothelial growth factor (VEGF) and other factors is an important cause of diabetic macular edema. Previously, we found that the presence of plasmalemma vesicle-associated protein (PLVAP) in retinal capillaries associates with loss

  6. Reducing security risk using data loss prevention technology.

    Science.gov (United States)

    Beeskow, John

    2015-11-01

    Data loss/leakage protection (DLP) technology seeks to improve data security by answering three fundamental questions: > Where are confidential data stored? > Who is accessing the information? > How are data being handled?

  7. Future Integrated Systems Concept for Preventing Aircraft Loss-of-Control Accidents

    Science.gov (United States)

    Belcastro, Christine M.; Jacobson, Steven r.

    2010-01-01

    Loss of control remains one of the largest contributors to aircraft fatal accidents worldwide. Aircraft loss-of-control accidents are highly complex in that they can result from numerous causal and contributing factors acting alone or (more often) in combination. Hence, there is no single intervention strategy to prevent these accidents. This paper presents future system concepts and research directions for preventing aircraft loss-of-control accidents.

  8. Role of Tranexamic Acid in Reducing Blood Loss in Vaginal Delivery.

    Science.gov (United States)

    Roy, Priyankur; Sujatha, M S; Bhandiwad, Ambarisha; Biswas, Bivas

    2016-10-01

    Anti-fibrinolytic agents are used to reduce obstetric blood loss as the fibrinolytic system is known to get activated after placental delivery. To evaluate the efficacy of parenteral tranexamic acid in reducing blood loss during normal labour and to compare it with the amount of blood loss in patients who received placebo in the third stage of labour. Patients with spontaneous labour or planned for induction of labour and fulfilling the inclusion criteria were recruited for the study. In each patient, the pre-delivery pulse rate, blood pressure, Hb gm% and PCV% were noted. Labour was monitored carefully using a partogram. The study group received Inj. Oxytocin and Inj. Tranexamic acid. The control group received Inj. Oxytocin and Placebo injection. Immediately after delivery of the baby, when all the liquor was drained, the patient was placed over a blood drape-a disposable conical, graduated plastic collection bag. The amount of blood collected in the blood drape was measured. Then the patient was given pre-weighed pads, which were weighed 2 h post-partum. The blood loss was measured by measuring the blood collected in the drape and by weighing the swabs before and after delivery. The total number of patients studied was 100-equally distributed in both the groups. The age group of the patients and BMI were comparable. There was a significant increase in the pulse rate and decrease in blood pressure in the control group as compared with the study group. The post-delivery haemoglobin and haematocrit were significantly reduced in the control group as compared to the study group. The mean blood loss at the end of 2 h was 105 ml in the study group and 252 ml in the control group. There was a significant increase in the usage of uterotonics and also in the need for blood transfusion in the control group; 12 % of the patients in the control group had to stay for more than 3 days compared to 2 % in the study group. Tranexamic acid injection, an antifibrinolytic

  9. Contaminants in blood cultures: importance, implications, interpretation and prevention.

    Science.gov (United States)

    Dargère, S; Cormier, H; Verdon, R

    2018-04-03

    Despite the development of new microbiologic technologies, blood cultures (BCs) remain the first-line tool for the diagnosis of bloodstream infections. Their diagnostic value may be affected when a microorganism of questionable evidence is isolated-for example, coagulase-negative staphylococci, Bacillus spp., viridans group streptococci, Corynebacterium spp., Propionibacterium spp. and Micrococcus spp. Finally, making a correct diagnosis of pathogenicity (vs. contamination) is challenging. To review the current ways of dealing with the problem of BC contaminants (BCCs) and to provide practical suggestions to decrease BCC rates. PubMed electronic databases and existing reviews were searched up to December 2017 to retrieve relevant publications related to the topic. This review describes the burden of BCC and analyses the main current issues and controversies in interpreting the occurrence of potential BC contaminants. It focuses on the best-described approaches to decide whether BCC is present and discusses the different strategies of prevention in adults. Each institution should have an efficient policy to prevent BCC, emphasizing the importance of following guidelines for prescribing and collecting BCs. Training healthcare workers should focus on detrimental influence on patient care and highlight the work and costs due to contaminants. The accurate differentiation of a contaminant from a true pathogen relies on a multidisciplinary approach and the clinical judgement of experienced practitioners. Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  10. Use of Otoacoustic emissions in noise induced hearing loss prevention

    CSIR Research Space (South Africa)

    Edwards, A

    2010-10-01

    Full Text Available in laboratory- main clinical use on identification of hearing loss in newborn babies • Clinically sensitive tool for assessing NIHL and the outer hair cells (OHC) • repeatable results • identify cochlear damage before evidenced on an audiogram – normal... audiogram but evidence of OHC loss • Feasible method of evaluating HPD effectiveness using temporary emission shift (TES) • CSIR research developed a prediction model for Hearing Threshold Levels Copy of dancing hair cell.wm © CSIR 2010 Slide 6...

  11. Postpartum Vaginal Blood Loss following Two Different Methods of Cervical Ripening

    Directory of Open Access Journals (Sweden)

    Okon Asuquo Okon

    2017-01-01

    Full Text Available Eighty women undergoing induction of labor at the University of Calabar Teaching Hospital were recruited and randomly allocated into two treatment groups (40 each, to receive either serial 50 µg doses of misoprostol or intracervical Foley catheter. Vaginal blood loss was collected and measured using an under buttocks plastic collection bag and by perineal pad weighing up to 6 hours postpartum. There were no significant differences between the two groups with respect to sociodemographic and obstetric characteristics. Comparison of blood loss in vaginal deliveries between the two groups revealed that subjects in the misoprostol group had significantly higher blood loss than subjects in the Foley catheter group (488 ± 222 versus 326 ± 106, p<0.05. In both groups, there was strong and statistically significant positive correlation between postpartum blood loss and induction delivery interval (r=0.75, p<0.0001; r=0.77, p<0.0001. There were no significant differences in maternal outcomes. In view of this, further study is required to ascertain if lower doses of misoprostol for induction of labor may result in lesser blood loss. This trial is registered with ISRCTN14479515.

  12. A worksite-based weight loss intervention for obesity prevention

    Science.gov (United States)

    Worksites are increasingly being used as locations for implementing healthy diet and weight loss interventions. Hence, there is an urgent need to identify programs that are both successful and sustainable. We conducted a 6-month pilot randomized controlled trial in overweight and obese employees a...

  13. Noise-Induced Hearing Loss - A Preventable Disease?

    DEFF Research Database (Denmark)

    Frederiksen, Thomas W.; Ramlau-Hansen, Cecilia H.; Stokholm, Zara A.

    2017-01-01

    AIMS: To survey current, Danish industrial noise levels and the use of hearing protection devices (HPD) over a 10-year period and to characterise the association between occupational noise and hearing threshold shift in the same period. Furthermore, the risk of hearing loss among the baseline and...

  14. Leukocytic Response and Peripheral Venous Blood Lymphocyte Apoptosis as a Marker of Tissue Ischemia in Acute Massive Blood Loss

    Directory of Open Access Journals (Sweden)

    N. V. Borovkova

    2013-01-01

    Full Text Available Objective: to estimate the level of peripheral venous blood lymphocyte apoptosis and intraoperative hypoxia in victims with acute massive blood loss. Subjects and methods. Twenty-two patients with open and close chest and abdominal traumas complicated by acute massive blood loss were examined. All the patients were emergently operated on to stop bleeding. Tissue metabolism was evaluated from gases, acid-base parameters, and plasma lactate, glucose, potassium, and sodium levels. Apoptosis of mononuclear cells was studied and dead leukocytes were counted using flow cytometry. Results. Preoperatively, the victims were found to have venous hypoxemia, hyperlactatemia, hyperglycemia, moderate leukocytosis, and higher dead leukocyte counts. There were also raised counts of lymphocytes coming into the process of apoptosis. A significant relationship was found between monocyte counts and hypoxia values. At the end of surgery, oxygen balance values became stable and exerted an effect on the count of leukocytes, the relative level of granulocytes, the relative and absolute counts of dead and damaged leukocytes, and the concentration of lymphocytes in the victims’ venous blood during the early stages of apoptosis, as evidenced by nonlinear regression models. Conclusion. The indicators of immunocompetent cell apoptosis and the count of venous blood dead leukocytes along with lactate levels and venous hypoxemia parameters reflect the degree of tissue hypoxia and may be used as specific markers.

  15. Donation frequency, iron loss, and risk of cancer among blood donors

    DEFF Research Database (Denmark)

    Edgren, Gustaf; Reilly, Marie; Hjalgrim, Henrik

    2008-01-01

    BACKGROUND: Long-term deleterious effects of repeated blood donations may be masked by the donors' healthy lifestyle. To investigate possible effects of blood donation and iron loss through blood donation on cancer incidence while minimizing "healthy donor effects," we made dose......-response comparisons within a cohort of Swedish and Danish blood donors. METHODS: We used a nested case-control study design, in which case patients were defined as all donors who were diagnosed with a malignancy between their first recorded blood donation and study termination (n = 10866). Control subjects (n...... plasma donors (> 25 vs 0 donations, OR = 2.14, 95% CI = 1.22 to 3.74). CONCLUSIONS: Repeated blood donation was not associated with increased or decreased risk of cancer overall. The lack of consistency across latency periods casts doubt on an apparent association between reduced cancer risk and iron...

  16. Energy-Efficiency Options for Insurance Loss Prevention

    Energy Technology Data Exchange (ETDEWEB)

    Mills, E. [Ernest Orlando Lawrence Berkeley National Lab., CA (United States). Environmental Energy Technologies Div.; Knoepfel, I. [Swiss Reinsurance Co., Zurich (Switzerland)

    1997-06-09

    Energy-efficiency improvements offer the insurance industry two areas of opportunity: reducing ordinary claims and avoiding greenhouse gas emissions that could precipitate natural disaster losses resulting from global climate change. We present three vehicles for taking advantage of this opportunity, including research and development, in- house energy management, and provision of key information to insurance customers and risk managers. The complementary role for renewable energy systems is also introduced.

  17. Tetrahydroxystilbene Glucoside Effectively Prevents Apoptosis Induced Hair Loss

    Directory of Open Access Journals (Sweden)

    Lulu Chen

    2018-01-01

    Full Text Available The effect of Polygonum multiflorum against hair loss has been widely recognized. 2,3,5,4′-Tetrahydroxystilbene-2-O-β-D-glucoside (TSG is the main component of Polygonum multiflorum; however, its role in hair regeneration has not been established. To evaluate the hair growth-promoting activity of TSG, depilated C57BL/6J mice were topically treated with normal saline, TSG, Pifithrin-α, Minoxidil for 2 weeks. In this study, we identified that p53, Caspase-3, Active Caspase-3, and Caspase-9 were obviously upregulated in the skin of human and mice with hair loss by western blot analysis. Depilated mice treated with TSG showed markedly hair regrowth. TUNEL+ cells were also reduced in mice with TSG. These changes were accompanied with inhibition of Fas, p53, Bax, Active Caspase-3, and Procaspase-9 activities. These results demonstrated that TSG exerts great hair regrowth effect on hair loss, which was probably mediated by inhibition of p53, Fas, and Bax induced apoptosis.

  18. Experimental Research Into High Barometric Oxygen Prevention of Guinea Pig Hearing Loss,

    Science.gov (United States)

    1992-08-28

    PREVENTION OF GUINEA PIG HEARING LOSS by Yin Jiacai, Sun Fang ren, et al. DTIC MLECTE •<• EP 2 9 1992 Approved for public release, Distribution unlimited...PREVENTION OF GUINEA PIG HEARING LOSS By: Yin Jiacai, Sun Fang ren, et al. English pages: 9 Source: Chung-Hua I Shueh Tsa Chih, Vol. 65, Nr. 11, Nov.eember...Distributionf._DL~~~t .•b • / or __ Dlist szeccat .lef ’ ~1 EXPERIMENTAL RESEARCH INTO HIGH BAROMETRIC OXYGEN PREVENTION OF GUINEA PIG HEARING LOSS BY: Yin

  19. ROLE OF 400 MCG INTRAOPERATIVE SUBLINGUAL MISOPROSTOL FOR REDUCTION OF CAESAREAN BLOOD LOSS

    Directory of Open Access Journals (Sweden)

    Lalmohan Nayak

    2017-02-01

    Full Text Available BACKGROUND Lower segment caesarean section is a common surgical procedure. Postpartum haemorrhage incidence after LSCS is 4%. Misoprostol is a prostaglandin E1 analogue with good uterotonic properties, easy availability, low cost, thermostability, long shelf life, easy administration and few adverse effects at therapeutic dose. It is readily absorbed by oral, sublingual, buccal, vaginal or rectal route. Sublingual route attains quickest concentration. Dose of 400 mcg was chosen in this study to minimise adverse effects with optimal therapeutic benefit. The aim of the study is to determine the efficacy of sublingual misoprostol in reducing caesarean blood loss. MATERIALS AND METHODS It is a prospective experimental study done in VSSIMSAR, Burla. Women undergoing LSCS were randomly assigned to study and control groups of equal strength of 100 each. In all cases, preoperative Hb%, haematocrit, pulse, BP was noted. Study group were given 400 mcg misoprostol at the time of cord clamping. In control group, nothing was given. In all patients, active management of third stage of labour was done by using oxytocin 10 IU (IV along with uterine massage. Blood loss soaked by tetra was calculated using formula, blood loss = wet weight-dry weight/1.05 (1.05 is constant. Amount of blood loss, postoperative Hb%, haematocrit, pulse rate, BP was noted in both groups and compared. BP and pulse were noted after 1 hour and Hb%, haematocrit were noted after 24 hours. RESULTS Study group showed significant decrease in total blood loss (around 117.9 mL as compared to control group. There was significant decrease in the postoperative fall in Hb in the study group as compared to control, the mean difference being 0.631 gm%. Study group also showed decrease in postoperative fall in haematocrit as compared to control, the mean difference being 0.055. CONCLUSION Misoprostol significantly reduced caesarean blood loss and doesn’t affect foetal outcome without significant

  20. Epsilon Aminocaproic Acid to Reduce Blood Loss and Transfusion After Total Hip and Total Knee Arthroplasty.

    Science.gov (United States)

    Hobbs, Juliann C; Welsby, Ian J; Green, Cynthia L; Dhakal, Ishwori B; Wellman, Samuel S

    2018-01-01

    Total hip and knee arthroplasty (THA and TKA) are associated with significant blood loss and some patients require postoperative blood transfusion. While tranexamic acid has been studied extensively among this population, we tested the hypothesis that epsilon aminocaproic acid (EACA) can reduce blood loss and transfusion after joint arthroplasty. In April 2014, our Veterans Affairs Medical Center introduced a protocol to administer EACA during THA and TKA. No antifibrinolytics were used previously. We retrospectively compared blood loss and incidence of transfusion among patients who underwent primary arthroplasty in the year before standardized administration of EACA with patients having the same procedures the following year. Blood loss was measured as delta hemoglobin (preoperative hemoglobin - hemoglobin on postoperative day 1). All patients undergoing primary THA or TKA were included. Patients having revision surgery were excluded. We identified 185 primary arthroplasty patients from the year before and 184 from the year after introducing the EACA protocol. There were no changes in surgical technique or attending surgeons during this period. Delta hemoglobin was significantly lower in the EACA group (2.7 ± 0.8 mg/dL) compared to the control group (3.4 ± 1.1 mg/dL) (P blood transfusion was also significantly lower in the EACA group (2.7%) compared to the control group (25.4%) (P transfusion following introduction of the EACA protocol in patients undergoing primary arthroplasty. EACA offers a lower cost alternative to TXA for reducing blood loss and transfusion in this population. Published by Elsevier Inc.

  1. Radiochromium (chromium-51) evaluation of gastrointestinal blood loss associated with placebo, aspirin, and nabumetone

    International Nuclear Information System (INIS)

    Lussier, A.; LeBel, E.

    1987-01-01

    Gastrointestinal blood loss is one of the most serious clinical events induced by drugs. To date, almost no nonsteroidal anti-inflammatory drug has been shown to be devoid of that side effect in a strictly controlled study. The objective of this study was to assess quantitatively, by use of radioactive chromium (chromium-51)-labeled red blood cells, gastrointestinal blood loss associated with nabumetone (1000 mg daily), aspirin (3.6 g daily), and placebo. A total of 37 normal subjects, divided among the three treatment groups and a fourth group that received no treatment, were assessed clinically and quantitatively for gastrointestinal blood loss over a period of 28 days of active treatment. The results with chromium-51, analyzed on a logarithmic scale, revealed no statistically significant differences between the nabumetone, placebo, and control groups. Gastrointestinal blood loss in the aspirin group, however, was elevated when compared with all other groups at a high level of statistical significance (p less than 0.001). It is concluded that, under conditions in which aspirin causes substantial gastrointestinal microbleeding, nabumetone is not significantly different from placebo

  2. The effect of aspirin on blood loss and transfusion requirements in patients with femoral neck fractures.

    LENUS (Irish Health Repository)

    Manning, Brian J

    2012-02-03

    Although it is widely accepted that aspirin will increase the risk of intra- and post-operative bleeding, clinical studies have not consistently supported this assumption. We aimed to assess the effect of pre-operative aspirin on blood loss and transfusion requirements in patients undergoing emergency fixation of femoral neck fractures. A prospective case-control study was undertaken in patients presenting with femoral neck fractures. Parameters recorded included intra-operative blood loss, post-operative blood loss, transfusion requirements and peri-operative reduction in haemoglobin concentration. Of 89 patients presenting with femoral neck fractures 32 were on long-term aspirin therapy. Pre-operative aspirin ingestion did not significantly affect peri-operative blood loss, or change in haemoglobin concentration or haematocrit. However those patients taking aspirin pre-operatively had a significantly lower haemoglobin concentration and haematocrit and were more likely to be anaemic at presentation than those who were not receiving aspirin. Patients taking aspirin were also more likely to receive blood transfusion post-operatively.

  3. Investment in paediatric tuberculosis prevention in Pakistan: Loss or gain

    International Nuclear Information System (INIS)

    Siddiqui, E.U.; Ejaz, K.; Lone, S.; Raza, S.J.

    2010-01-01

    Objective: To assess the effectiveness of paediatric tuberculosis prevention, by reevaluation factors in children exposed to tuberculosis from less privileged strata of Pakistan. Methods: This cross sectional descriptive study was conducted at National Institute of Child Health, from January 2004 to December 2005. Paediatric patients under 15 years of either gender, diagnosed with active tuberculosis were enrolled. Interviews were conducted with parents regarding common preventive measures and factors advocating tuberculosis spread. Later factors leading to non-compliance to safety recommendations were also evaluated. Results: Fifty five (70%) children younger than 5 years, had index cases in direct contact within their own house. Fifteen (14%) patients contracted the infection from neighbours, with 11 being older than 5 years. There were 82 (51%) cases with Protein Calorie Malnutrition (PCM). Total of 66(41%) cases of PCM were <5 years age (p <0.005). Data showed 123(77%) children living in a family with 5 or more members. Sixty eight (55%) children of these large families had to live in a single room house. Conclusion: There is a high frequency of direct contact tuberculosis in children belonging to the lower socioeconomic class. This is attributed to poor housing condition and over crowding. The current paediatric tuberculosis prevention strategies as adapted from World Health Organizations' Millennium Development Goals are ineffectual to make changes in children exposed to tuberculosis from less privileged strata of Pakistan. Our societal and demographic factors remain static, continually exposing our children to higher risk of tuberculosis exposure. (author)

  4. Intraoperative blood loss in bimaxillary orthognathic surgery with multisegmental Le Fort I osteotomies and additional procedures.

    Science.gov (United States)

    Kretschmer, W B; Baciut, G; Bacuit, Mihaela; Zoder, W; Wangerin, K

    2010-06-01

    Autologous blood donation is not currently recommended by most authors for routine bimaxillary osteotomies. There are few data about bimaxillary procedures with multisegmental maxillary osteotomies. Our aim was to investigate the effect of additional osteotomies and iliac crest grafts on operative blood loss. A total of 225 consecutive patients having bimaxillary multisegmental osteotomies during a three-year period (January 2006-January 2009) were examined to see if their haemoglobin concentration and packed cell volume were reduced. The influence of iliac crest grafts, additional osteotomies (genioplasty, malar osteotomy, iliac crest graft, anterior mandibular segmental osteotomy), operating time, age, and sex were assessed. Neither age nor sex influenced blood loss, whereas operating time correlated significantly with reductions in haemoglobin concentration and packed cell volume. Blood loss was significantly higher in the group who had additional procedures (p 0.001 for haemoglobin concentration and packed cell volume) than in the group who had no additional procedures, whereas there were no significant differences among the three subgroups who had additional procedures (additional osteotomies, iliac crest grafts, or both procedures). Four patients who had additional procedures required transfusion, whereas no blood was given in the group who had no additional procedures. Because the transfusion rate was so low, we could make no general recommendation for preoperative blood donation in such cases. Copyright 2009 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Evaluation of the use of shock index in identifying acute blood loss in healthy blood donor dogs.

    Science.gov (United States)

    McGowan, Erin E; Marryott, Kimberly; Drobatz, Kenneth J; Reineke, Erica L

    2017-09-01

    To determine if shock index (SI) would increase following blood donation and if it would be a more sensitive assessment of acute blood loss as compared with heart rate (HR), blood pressure, and plasma lactate. Prospective study. University teaching hospital. Twenty client-owned clinically normal dogs. Peripheral venous blood measurements and blood donation. Data were collected at 3 time points: prior to donation (T pre ), immediately after donation (T 0 ), and 10 minutes following completion of donation (T 10 ). HR and systolic blood pressure (SBP) were recorded and used to calculate SI at time points T pre , T 0 , and T 10 . Packed cell volume (PCV), total plasma protein (TPP), and plasma lactate were evaluated from a peripheral venous blood sample at T pre and T 10. The mean SI was significantly increased at both time points following blood donation as compared to baseline (SI pre = 0.88 ± 0.19 vs SI 0 = 1.17 ± 0.21 vs SI 10 = 1.12 ± 0.25 (P = 0.0002 and 0.0003, respectively). Following blood donation, the mean SBP was significantly lower (SBP pre = 149 ± 24 mm Hg, SBP 0 = 118 ± 20 mm Hg; P = 0.0001, SBP 10 = 133 ± 21 mm Hg; P = 0.011). The mean HR was not significantly different at T 0 but was significantly increased at T 10 (HR pre = 128 ± 21/min, HR 0 = 136 ± 25/min, P = 0.193; HR 10 = 146 ± 29/min, P = 0.003). There was no significant difference in mean PCV (PCV pre = 50 ± 4%, PCV 10 = 48 ± 4%, P = 0.08). The mean TPP and plasma lactate were significantly different following donation but still within the reference interval (TPP pre = 6.8 ± 0.4 g/dL, TPP 10 = 6.4 ± 0.4 g/dL, P = 0.0014; Lac pre = 1.7 ± 0.7mmol/L, Lac 10 = 1.9 ± 0.8 mmol/L, P = 0.04). A receiver operating characteristic (ROC) analysis comparing area under the curve (AUC) for SI, HR, and SBP at T 0 and T 10 compared to T pre found that SI (AUC at T 0 : 0.858, CI: 0.730, 0.984 AUC at T 10 : 0.769 CI: 0.617, 0.921) was a better indicator of blood loss

  6. The reversible P2Y12 antagonist ACT-246475 causes significantly less blood loss than ticagrelor at equivalent antithrombotic efficacy in rat.

    Science.gov (United States)

    Rey, Markus; Kramberg, Markus; Hess, Patrick; Morrison, Keith; Ernst, Roland; Haag, Franck; Weber, Edgar; Clozel, Martine; Baumann, Martine; Caroff, Eva; Hubler, Francis; Riederer, Markus A; Steiner, Beat

    2017-10-01

    The P2Y 12 receptor is a validated target for prevention of major adverse cardiovascular events in patients with acute coronary syndrome. The aim of this study was to compare two direct-acting, reversible P2Y 12 antagonists, ACT-246475 and ticagrelor, in a rat thrombosis model by simultaneous quantification of their antithrombotic efficacy and surgery-induced blood loss. Blood flow velocity was assessed in the carotid artery after FeCl 3 -induced thrombus formation using a Doppler flow probe. At the same time, blood loss after surgical wounding of the spleen was quantified. Continuous infusions of ACT-246475 and ticagrelor prevented the injury-induced reduction of blood flow in a dose-dependent manner. High doses of both antagonists normalized blood flow and completely abolished thrombus formation as confirmed by histology. Intermediate doses restored baseline blood flow to ≥65%. However, ACT-246475 caused significantly less increase of blood loss than ticagrelor; the difference in blood loss was 2.6-fold (P ACT-246475 and ticagrelor on vascular tone. At concentrations needed to achieve maximal antithrombotic efficacy, ticagrelor compared with ACT-246475 significantly increased carotid blood flow velocity in vivo (P = 0.003), induced vasorelaxation of precontracted rat femoral arteries, and inhibited contraction of femoral artery induced by electrical field stimulation or by phenylephrine. Overall, ACT-246475 showed a significantly wider therapeutic window than ticagrelor. The absence of vasodilatory effects due to high selectivity of ACT-246475 for P2Y 12 provides potential arguments for the observed safety advantage of ACT-246475 over ticagrelor. © 2017 The Authors. Pharmacology Research & Perspectives published by John Wiley & Sons Ltd, British Pharmacological Society and American Society for Pharmacology and Experimental Therapeutics.

  7. [Persistent pulmonary hypertension in a neonate caused by blood aspiration following vaginal blood loss].

    Science.gov (United States)

    Krüse-Ruijter, M F; Zimmermann, L J I

    2007-07-14

    A preterm neonate, with a gestational age of 30 1/7 weeks, was born after a period of prolonged rupture of the membranes and a retroplacental haematoma causing vaginal bleeding. During admission to the neonatal intensive-care unit, mechanical ventilation was indicated because of acute respiratory failure following blood aspiration, which was causing oxygenation and ventilation problems. Endotracheal surfactant was administered and, because of persistent pulmonary hypertension of the newborn (PPHN), NO-inhalation therapy was started. A quick recovery was seen and two days post partum the patient could be extubated. Blood aspiration may cause acute respiratory problems and PPHN, with quick recovery after effective mechanical ventilation, surfactant and NO-inhalation therapy.

  8. Donepezil prevents RANK-induced bone loss via inhibition of osteoclast differentiation by downregulating acetylcholinesterase

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Sato

    2015-09-01

    Conclusions: AChE promotes osteoclast differentiation in vitro. Donepezil inhibits osteoclast function in vitro and prevents bone loss by suppressing bone resorption in vivo, suggesting the possibility that donepezil reduces fracture risk in patients with Alzheimer's disease.

  9. Intravenous dexmedetomidine infusion in adult patients undergoing open nephrolithotomy: Effects on intraoperative hemodynamics and blood loss; a random

    Directory of Open Access Journals (Sweden)

    Doaa A. Rashwan

    2015-10-01

    Conclusion: Dexmedetomidine infusion in patients undergoing open nephrolithotomy under general anesthesia was associated with intraoperative hemodynamic stability, which decreases intraoperative blood loss and the need for intraoperative blood transfusion.

  10. Estimation and comparison of intra operative blood loss in patients with and without venous thromboembolism prophylaxis

    International Nuclear Information System (INIS)

    Ahsin, S.; Bashir, A.; Faiz, S.A.; Tahir, J.; Ijaz, A.

    2014-01-01

    To estimate and compare intraoperative blood loss in surgical patients with and without deep vein thrombosis (DVT) prophylaxis using unfractionated heparin Study Design: Clinical Trial Place and Duration: Surgery Department of Fauji Foundation Hospital and Physiology Department Foundation University Medical College from October 2011 to August 2012 Patients and Methodology: Patients were selected by non probability purposive sampling. Patients fulfilling the inclusion criteria were divided into 2 groups 25 each on the basis of order of presentation at Fauji Foundation Hospital until cohort numbers were reached. Group I received no heparin whereas group II received heparin. Written informed consent was taken from the patient after explaining the procedure of the study. Coagulation profile was done for both groups before the planned surgery. Heparin in a dose of 5000 units was administered subcutaneously to group II on the morning of the planned surgery and it was stopped 24 hours post operatively. Blood loss was estimated in both groups by weighing cotton swabs pre and post operatively. Data was analyzed by SPSS version 17. Results: Demographic data and surgical procedure time between the two groups did not differ. Blood loss between the two groups did not show any statistically significant difference. Conclusion: DVT prophylaxis using unfractionated heparin did not lead to any significant overt blood loss when compared with those without it. (author)

  11. The beneficial effect of Batroxobin on blood loss reduction in spinal fusion surgery

    DEFF Research Database (Denmark)

    Hu, Hui-Min; Chen, Li; Frary, Charles Edward

    2015-01-01

    Objective Our objective was to evaluate the efficacy and safety of Batroxobin on blood loss during spinal operations. Methods After obtaining approval from the ethics committee at the hospital along with informed written consent, we performed a double-blind, randomized, placebo-controlled study w...

  12. Combined Intra-Articular and Intravenous Tranexamic Acid Reduces Blood Loss in Total Knee Arthroplasty

    DEFF Research Database (Denmark)

    Nielsen, Christian Skovgaard; Jans, Øivind; Ørsnes, Thue

    2016-01-01

    BACKGROUND: In total knee arthroplasty, both intravenous (IV) and intra-articular (IA) administration of tranexamic acid (TXA) have been shown to reduce blood loss in several randomized controlled trials, although routine use of systemic TXA is considerably more common. However, to our knowledge...

  13. Quantifying Blood Loss and Transfusion Risk After Primary vs Conversion Total Hip Arthroplasty.

    Science.gov (United States)

    Newman, Jared M; Webb, Matthew R; Klika, Alison K; Murray, Trevor G; Barsoum, Wael K; Higuera, Carlos A

    2017-06-01

    Primary total hip arthroplasty (THA) and conversion THA may result in substantial blood loss, sometimes necessitating transfusion. Despite the complexities of the latter, both are grouped in the same category for quality assessment and reimbursement. This study's purpose was to compare both blood loss and transfusion risk in primary and conversion THA and identify their associated predictors. A total of 1616 patients who underwent primary and conversion THA at a single hospital from 2009-2013 were reviewed (primary THA = 1575; conversion THA = 41). Demographics, comorbidities, and perioperative data were collected from electronic records. Blood loss was calculated using a validated method. Transfusion triggers were based on standardized criteria. Separate multivariable regression models for blood loss and transfusion were performed. Conversion THA patients were younger (P = .002), had lower age-adjusted Charlson scores (P = .006), longer surgeries (P quantified in the present study and showed consistent results between the 2 metrics. The differences between these procedures should be addressed during quality assurance because conversion THA is associated with higher resource utilization, which is important in the allocation of resources and tiered reimbursement strategies. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Significant reduction in blood loss in patients undergoing minimal extracorporeal circulation

    NARCIS (Netherlands)

    Gerritsen, W. B.; van Boven, W. J.; Smelt, M.; Morshuis, W. J.; van Dongen, H. P.; Haas, F. J.; Aarts, L. P.

    2006-01-01

    Several recent studies have shown differences in blood loss and allogeneic transfusion requirements between on-pump and off-pump coronary artery bypass grafting (CABG). Recently a new concept, the mini-extracorporeal circulation, was introduced to minimize the side effects of extracorporeal

  15. ATLS Hypovolemic Shock Classification by Prediction of Blood Loss in Rats Using Regression Models.

    Science.gov (United States)

    Choi, Soo Beom; Choi, Joon Yul; Park, Jee Soo; Kim, Deok Won

    2016-07-01

    In our previous study, our input data set consisted of 78 rats, the blood loss in percent as a dependent variable, and 11 independent variables (heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, pulse pressure, respiration rate, temperature, perfusion index, lactate concentration, shock index, and new index (lactate concentration/perfusion)). The machine learning methods for multicategory classification were applied to a rat model in acute hemorrhage to predict the four Advanced Trauma Life Support (ATLS) hypovolemic shock classes for triage in our previous study. However, multicategory classification is much more difficult and complicated than binary classification. We introduce a simple approach for classifying ATLS hypovolaemic shock class by predicting blood loss in percent using support vector regression and multivariate linear regression (MLR). We also compared the performance of the classification models using absolute and relative vital signs. The accuracies of support vector regression and MLR models with relative values by predicting blood loss in percent were 88.5% and 84.6%, respectively. These were better than the best accuracy of 80.8% of the direct multicategory classification using the support vector machine one-versus-one model in our previous study for the same validation data set. Moreover, the simple MLR models with both absolute and relative values could provide possibility of the future clinical decision support system for ATLS classification. The perfusion index and new index were more appropriate with relative changes than absolute values.

  16. Vaccination with recombinant aspartic hemoglobinase reduces parasite load and blood loss after hookworm infection in dogs.

    Directory of Open Access Journals (Sweden)

    Alex Loukas

    2005-10-01

    Full Text Available Hookworms infect 730 million people in developing countries where they are a leading cause of intestinal blood loss and iron-deficiency anemia. At the site of attachment to the host, adult hookworms ingest blood and lyse the erythrocytes to release hemoglobin. The parasites subsequently digest hemoglobin in their intestines using a cascade of proteolysis that begins with the Ancylostoma caninum aspartic protease 1, APR-1.We show that vaccination of dogs with recombinant Ac-APR-1 induced antibody and cellular responses and resulted in significantly reduced hookworm burdens (p = 0.056 and fecal egg counts (p = 0.018 in vaccinated dogs compared to control dogs after challenge with infective larvae of A. caninum. Most importantly, vaccinated dogs were protected against blood loss (p = 0.049 and most did not develop anemia, the major pathologic sequela of hookworm disease. IgG from vaccinated animals decreased the catalytic activity of the recombinant enzyme in vitro and the antibody bound in situ to the intestines of worms recovered from vaccinated dogs, implying that the vaccine interferes with the parasite's ability to digest blood.To the best of our knowledge, this is the first report of a recombinant vaccine from a hematophagous parasite that significantly reduces both parasite load and blood loss, and it supports the development of APR-1 as a human hookworm vaccine.

  17. Storage Losses in Feedstuffs and How to Prevent Them | Eze | Lwati ...

    African Journals Online (AJOL)

    Biological deterioration of feedstuffs entails losses both in quantity and quality, including deterioration in chemical composition, contamination by mycotoxins, rancidity, loss in nutritive value and change in colour and smell. In this paper, the conditions for the safe storage of feedstuffs and also the methods for the prevention ...

  18. Vitamin K supplementation does not prevent bone loss in ovariectomized Norway rats

    Science.gov (United States)

    Despite plausible biological mechanisms, the differential abilities of phylloquinone (PK) and menaquinones (MKn) to prevent bone loss remain controversial. The objective of the current study was to compare the effects of PK, menaquinone-4 (MK-4) and menaquinone-7(MK-7) on the rate of bone loss in o...

  19. Reducing blood loss during laparoscopic myomectomy by temporary uterine artery clamping using bulldog clamp

    Directory of Open Access Journals (Sweden)

    Kai-Jo Chiang

    2014-01-01

    Full Text Available Uterine myoma is the most common benign gynecologic tumor worldwide. Mini-invasive surgery has become popular for myomectomy, with advantages over laparotomy. However, reducing blood loss during laparoscopic myomectomy is a major concern for the surgeon because of the limitation in making a quick control bleeding during the operation. Several methods have proved to decrease blood flow, but are not always effective or available. We present a case of uterine myoma with the uterine arteries clamped by bulldog clamps during laparoscopic myomectomy. The myoma was removed successfully with minimal blood loss (<50 ml during the operation. This is an effective, safe, and reliable method for reducing bleeding during laparoscopic myomectomy that does not require ligation of the uterine artery.

  20. Prevention of reproductive losses in women with systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    Davydova Iu.

    2017-01-01

    Full Text Available Purpose — to explore the peculiarities of pregnancy and childbirth in women with systemic lupus erythematosus in view of pregravid preparation. Patients and methods. The study included three groups. I group — 24 pregnant women with systemic lupus erythematosus who received pregravid preparation, group II of 28 pregnant women with systemic lupus erythematosus, have spontaneously pregnancy, III — control group 28 pregnant women without autoimmune diseases. Groups comparable in age, education, eating habits and living in similar climatic conditions. In pregravid preparations include micronized progesterone (utrozhestan in a daily dose of 200 mg of 16 to 25 days of the cycle when detecting failure II cycle phase — Tivortin in therapeutic dosage, drug containing iodine and folic acid at daily dosages recommended by WHO for preconception period (respectively, 200 mg and 400 mg. Results. In all three groups there were no spontaneous termination of pregnancy up to 12 weeks. In the first group shows significantly better results when comparing the frequency of pregnancy complications, pregnancy outcomes, metabolic disorders. Conduct prevention of endothelial dysfunction drug Tivortin and continued therapy support L-arginine in the early stages of gestation, in groups of pregnant women with high titers of anti-Ro antibodies, antiphospholipid antibodies, along with prolonged intake of micronized progesterone (utrozhestan, helped to reduce the incidence of hypertensive complications of pregnancy (gestational hypertension, pre!eclampsia and the birth of children with IUGR or low birth weight for gestational age. Group II women were not able to modify the drug therapy. Pregnant women in this group were receiving corticosteroids due to activation of an autoimmune disease. In some women was the need to enhance the treatment of SLE with corticosteroids in pulse mode using a 2-line therapy in the postpartum period. Conclusions. Pregnancy in women with

  1. Effectiveness of tranexamic acid in reducing blood loss during cytoreductive surgery for advanced ovarian cancer.

    Science.gov (United States)

    Kietpeerakool, Chumnan; Supoken, Amornrat; Laopaiboon, Malinee; Lumbiganon, Pisake

    2016-01-23

    Ovarian cancer is the third most common gynaecological cancer worldwide, with an age-standardised incidence rate of 6.1 per 10,000 women. Standard therapy for advanced epithelial ovarian cancer (EOC) includes a combination of cytoreductive surgery and platinum-based chemotherapy. Cytoreductive surgery aims to remove as much of the visible tumour as possible. As extensive intraperitoneal metastases are typical of advanced EOC, cytoreductive surgery is usually an extensive procedure with the risk of excessive bleeding. Tranexamic acid given perioperatively is effective in reducing blood loss and allogeneic blood transfusion requirements in a variety of surgical settings. Therefore, tranexamic acid seems to be a promising agent for minimising blood loss and the need for blood transfusion among women with advanced EOC undergoing cytoreductive surgery. To assess the effects of tranexamic acid for reducing blood loss associated with cytoreductive surgery in women with advanced EOC (stage III to IV). We searched the Cochrane Gynaecological, Neuro-oncology and Orphan Cancers Trial Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 5, 2015), MEDLINE, EMBASE and conference proceedings to May 2015. We also checked registers of clinical trials, citation lists of included studies, key textbooks and previous systematic reviews for potentially relevant studies. We included randomised controlled trials (RCTs) comparing tranexamic acid given during surgery versus placebo or no treatment, in adult women diagnosed with advanced EOC. Two review authors (CK, AS) independently selected potentially relevant trials, extracted data, assessed risk of bias, compared results and resolved disagreements by discussion. We found only one study that met our inclusion criteria. This was a randomised double blind, placebo-controlled multicentre study conducted to evaluate the effectiveness of a single dose of intravenous tranexamic acid (15 mg/kg body weight) versus

  2. Tranexamic acid reduces blood loss and blood transfusions in primary total hip arthroplasty: a prospective randomized double-blind study in 40 patients

    DEFF Research Database (Denmark)

    Husted, Henrik; Blønd, Lars; Sonne-Holm, Stig

    2003-01-01

    INTRODUCTION: We performed a prospective, randomized, double-blind study on 40 patients scheduled for primary total hip arthroplasty due to arthrosis or osteonecrosis to determine the effect of tranexamic acid on per- and postoperative blood losses and on the number of blood transfusions needed....... PATIENTS AND METHODS: 40 patients were randomized to tranexamic acid (10 mg/kg given as a bolus intravenous injection, followed by a continuous infusion of 1 mg/kg/hour for 10 hours) or placebo (20 mL saline given intravenously) 15 minutes before the incision. We recorded the peroperative and postoperative...... blood losses at removal of the drain 24 hours after the operation and the number of blood transfusions. RESULTS: Patients receiving tranexamic acid had a mean peroperative blood loss of 480 mL versus 622 mL in patients receiving placebo (p = 0.3), a postoperative blood loss of 334 mL versus 609 mL (p...

  3. Comparative Aspects of the Regulation of Cutaneous and Cerebral Microcirculation During Acute Blood Loss

    Directory of Open Access Journals (Sweden)

    I. A. Ryzhkov

    2017-01-01

    Full Text Available Objective. Using laser Doppler flowmetry (LDF and wavelet-analysis of microvascular blood flow oscillations to determine the features of regulation of cutaneous and cerebral microhemocirculation at early stages of acute fixed volume blood loss.Materials and methods.Experiments were carried out on 31 male outbred rats weighing 300 g to 400 g. The animals were anesthetized by intraperitoneal injection of pentobarbital (45 mg/kg. The tail artery was catheterized for invasive measurement of mean blood pressure (BP and blood withdrawal. The LDF method (ЛАКК-02 device, LAZMA, Russia was used to record microvascular blood flow simultaneously in the right ear and the pial vessels of the left parietal region. An acute fixed-volume hemorrhage model was used. The target blood loss volume was 30% of the total blood volume (TBV. Within 10 minutes after the end of hemorrhage (posthemorrhagic period, the blood pressure and the LDF-gram were recorded. The following LDF-gram parameters were analyzed: the mean value of IP; the maximum amplitude of blood flow oscillations (Amax and the corresponding frequency (Fmax in the frequency band 0.01—0.4 Hz. Statistical processing of the data was performed using Statistica 7.0.Results. At baseline, the values of IP, Аmax and Fmax in the brain were higher than in the skin. At posthemorrhagic period, BP decreased, on average, from 105 to 41 mm Hg. Against this background, IP in the skin decreased by 65%, while in the brain it reduced only by 17%, as compared with the baseline values (P0,0001. In the same time these organs were characterized by a unidirectional dynamics of patterns of fluxmotion. In both investigated organs, Amax increased sharply, and Fmax decreased. In posthemorrhagic period, fluxmotion not only «slowed down», but was also synchronized in a relatively narrow frequency band: for the skin Fmax was about 0.04 Hz (at the border of the endothelial and neurogenic band, for the brain about 0.09 Hz

  4. Is blood pressure control for stroke prevention the correct goal? The lost opportunity of preventing hypertension.

    Science.gov (United States)

    Howard, George; Banach, Maciej; Cushman, Mary; Goff, David C; Howard, Virginia J; Lackland, Daniel T; McVay, Jim; Meschia, James F; Muntner, Paul; Oparil, Suzanne; Rightmyer, Melanie; Taylor, Herman A

    2015-06-01

    Although pharmacological treatment of hypertension has important health benefits, it does not capture the benefit of maintenance of ideal health through the prevention or delay of hypertension. A total of 26 875 black and white participants aged 45+ years were assessed and followed for incident stroke events. The association was assessed between incident stroke and: (1) systolic blood pressure (SBP)categorized as normal (pressure strata, the risk of stroke increased with each additional class of required antihypertensive medication, with hazard ratio [HR], 1.33; 95% confidence interval, 1.16 to 1.52 for normotensive, HR, 1.15; 95% confidence interval, 1.05 to 1.26 for prehypertension, and HR, 1.22; 95% confidence interval, 1.06 to 1.39 for stage 1 hypertension. A successfully treated (SBP<120 mm Hg) hypertensive person on 3+ antihypertensive medication classes was at marginally higher stroke risk than a person with untreated stage 1 hypertension (HR, 2.48 versus HR=2.19; relative to those with SBP <120 on no antihypertensive medications). Maintaining the normotensive status solely through pharmacological treatment has a profound impact, as nearly half of this general population cohort were treated to guideline (SBP<140 mm Hg) but failed to return to risk levels similar to normotensive individuals. Even with successful treatment, there is a substantial potential gain by prevention or delay of hypertension. © 2015 American Heart Association, Inc.

  5. Occupational Noise Exposure, Bilateral High-Frequency Hearing Loss, and Blood Pressure.

    Science.gov (United States)

    Gan, Wen Qi; Mannino, David M

    2017-11-13

    The aim of this study was to investigate the relationships between occupational noise exposure and blood pressure using self-reported occupational exposure and bilateral high-frequency hearing loss. This study included 4548 participants aged 20 to 69 years from the National Health and Nutrition Examination Survey 1999 to 2004. On the basis of self-reported exposure status, participants were divided into the current, former, or never exposed groups. Bilateral high-frequency hearing loss was defined as the average high-frequency hearing threshold at least 25 dB in both ears. The currently exposed participants had slightly increased diastolic blood pressure compared with those never exposed. Among previously exposed participants, those with bilateral high-frequency hearing loss had increased systolic blood pressure, heart rate, and the prevalence of hypertension compared with those with normal high-frequency hearing. Although there were some significant results, the evidence was not consistent to support the associations between occupational noise exposure and blood pressure.

  6. Polysaccharides from astragali radix restore chemical-induced blood vessel loss in zebrafish

    Science.gov (United States)

    2012-01-01

    Background Astragali Radix has been used widely for the treatment of cardiovascular and cerebrovascular diseases, and to enhance endurance and stamina in traditional Chinese medicine (TCM) for over 2000 years. The polysaccharide constituents of Astragali Radix (ARP) are considered as one of the major constituents contributing to the multiple pharmacological effects of this medicinal plant. The purpose of the study is to evaluate the vascular regenerative activities of ARPs in a chemically-induced blood vessel loss model in zebrafish. Methods Blood vessel loss was induced in both Tg(fli-1a:EGFP)y1 and Tg(fli-1a:nEGFP)y7 embryos by administration of 300 nM VEGFR tyrosine kinase inhibitor II (VRI) for 3 h at 24 hpf (hour post-fertilization). Then, the blood vessel damaged zebrafish were treated with ARPs for 21 h and 45 h after VRI withdrawal. Morphological changes in intersegmental vessels (ISVs) of zebrafish larvae were observed under the fluorescence microscope and measured quantitatively. The rescue effect of ARPs in the zebrafish models was validated by measuring the relative mRNA expressions of Kdrl, Kdr and Flt-1 using real-time PCR. Results Two polysaccharide fractions, P4 (50000 D 0.1 μm), isolated from Astragali Radix by ultrafiltration, produced a significant and dose-dependent recovery in VRI-induced blood vessel loss in zebrafish. Furthermore, the down-regulation of Flk-1 and Flt-1 mRNA expression induced by VRI was reversed by treatment with P4. Conclusion The present study demonstrates that P4 isolated from Astragali Radix reduces VRI-induced blood vessel loss in zebrafish. These findings support the hypothesis that polysaccharides are one of the active constituents in Astragali Radix, contributing to its beneficial effect on treatment of diseases associated with a deficiency in angiogenesis. PMID:22357377

  7. Tranexamic acid for control of blood loss in bilateral total knee replacement in a single stage

    Directory of Open Access Journals (Sweden)

    Mandeep S Dhillon

    2011-01-01

    Full Text Available Background: Tranexamic acid (TEA reduces blood loss and red cell transfusions in patients undergoing unilateral total knee arthroplasty (TKA. However, there is not much literature regarding the use of TEA in patients undergoing bilateral TKA in a single stage and the protocols for administration of TEA in such patients are ill-defined. Materials and Methods: We carried out a case control study evaluating the effect of TEA on postoperative hemoglobin (Hb, total drain output, and number of blood units transfused in 52 patients undergoing bilateral TKA in a single stage, and compared it with 56 matched controls who did not receive TEA. Two doses of TEA were administered in doses of 10 mg / kg each (slow intravenous (IV infusion, with the first dose given just before tourniquet release of the first knee and the second dose three hours after the first one. Results: A statistically significant reduction in the total drain output and requirement of allogenic blood transfusion in cases who received TEA, as compared to the controls was observed. The postoperative Hb and Hb at the time of discharge were found to be lower in the control group, and this result was found to be statistically significant. Conclusion: TEA administered in patients undergoing single stage bilateral TKA helped reduce total blood loss and decreased allogenic blood transfusion requirements. This might be particularly relevant, where facilities such as autologous reinfusion might not be available.

  8. Influence of curve magnitude and other variables on operative time, blood loss and transfusion requirements in adolescent idiopathic scoliosis.

    LENUS (Irish Health Repository)

    Nugent, M

    2015-05-03

    Posterior spinal instrumentation and fusion for correction of adolescent idiopathic scoliosis (AIS) typically requires lengthy operating time and may be associated with significant blood loss and subsequent transfusion. This study aimed to identify factors predictive of duration of surgery, intraoperative blood loss and transfusion requirements in an Irish AIS cohort.

  9. Evaluation of the carotid artery stenosis based on minimization of mechanical energy loss of the blood flow.

    Science.gov (United States)

    Sia, Sheau Fung; Zhao, Xihai; Li, Rui; Zhang, Yu; Chong, Winston; He, Le; Chen, Yu

    2016-11-01

    Internal carotid artery stenosis requires an accurate risk assessment for the prevention of stroke. Although the internal carotid artery area stenosis ratio at the common carotid artery bifurcation can be used as one of the diagnostic methods of internal carotid artery stenosis, the accuracy of results would still depend on the measurement techniques. The purpose of this study is to propose a novel method to estimate the effect of internal carotid artery stenosis on the blood flow based on the concept of minimization of energy loss. Eight internal carotid arteries from different medical centers were diagnosed as stenosed internal carotid arteries, as plaques were found at different locations on the vessel. A computational fluid dynamics solver was developed based on an open-source code (OpenFOAM) to test the flow ratio and energy loss of those stenosed internal carotid arteries. For comparison, a healthy internal carotid artery and an idealized internal carotid artery model have also been tested and compared with stenosed internal carotid artery in terms of flow ratio and energy loss. We found that at a given common carotid artery bifurcation, there must be a certain flow distribution in the internal carotid artery and external carotid artery, for which the total energy loss at the bifurcation is at a minimum; for a given common carotid artery flow rate, an irregular shaped plaque at the bifurcation constantly resulted in a large value of minimization of energy loss. Thus, minimization of energy loss can be used as an indicator for the estimation of internal carotid artery stenosis.

  10. "Hidden" Preoperative Blood Loss With Extracapsular Versus Intracapsular Hip Fractures: What Is the Difference?

    Science.gov (United States)

    Harper, Katharine D; Navo, Paul; Ramsey, Frederick; Jallow, Sainabou; Rehman, Saqib

    2017-12-01

    Excessive blood loss with hip fracture management has been shown to result in increased rates of complications. Our goal is to compare blood loss and transfusion rates between patients with intracapsular and extracapsular (both intertrochanteric (IT) and subtrochanteric (ST)) hip fractures. 472 patients were evaluated over a five-year period. Those who presented to the hospital with a proximal femur fracture (femoral neck, IT or ST) were considered for the study. Exclusion criteria included polytrauma, gunshot injuries, periprosthetic fractures, and non-operative management. Primary endpoint was hemoglobin (Hgb) drop from admission to day of surgery (DOS); secondary endpoint was need for pre-op transfusion and discharge location. 304 patients were analyzed who sustained a proximal femur fracture. Median IC Hgb drop was 0.6g/dL; median EC Hgb drop was 1.1g/dL from admission to DOS ( p = 0.0272). Rate of pre-operative transfusions was higher in EC (36/194 = 18.6%) than IC fractures (5/105 = 4.5%) ( p = 0.0006), and overall transfusion rates remained higher throughout hospital stay (55.7% EC vs. 32.7% IC; p = 0.0001). Breakdown of bleeding rate and tranfusion rates between IT and ST fractures were not significant ( p = 0.07; p = 0.4483). Extracapsular hip fractures were more likely to be discharged to a skilled nursing facility (SNF) (84.4% EC vs. 73.8% IC; p = 0.027). Intracapsular hip fractures have significantly less pre-operative blood loss and fewer pre-operative transfusions than their extracapsular counterparts. These findings can be used to establish appropriate pre-operative resuscitative efforts, ensuring that hip fracture protocols account for the increased likelihood of blood loss in extracapsular fractures.

  11. Detection of Low-volume Blood Loss: Compensatory Reserve Versus Traditional Vital Signs

    Science.gov (United States)

    2014-01-01

    follows: heart rate (HR), blood pressure (BP), respiratory rate, and oxygen saturation. These vital signs are, however, notoriously unreliable.2,3 As...additional tests using specific equipment.22 Base deficit (BD) is a rapidly and widely available serum laboratory marker of systemic acidosis that...and mortality.23,24 BD can increase, however, because of any derangement causing metabolic acidosis and is not limited to intravascular volume loss

  12. Role of tranexamic acid in reducing blood loss during and after caesarean section

    Directory of Open Access Journals (Sweden)

    Simran Kaur Bhatia

    2015-01-01

    Full Text Available Introduction: Association between caesarean section and intra operative and post operative bleeding is known. Post-partum hemorrhage is still a leading cause for maternal morbidity and mortality. This study will evaluate the efficacy and safety of tranexamic acid in reducing the blood loss after placental delivery following lower segment caesarean section (LSCS and note any adverse effects. Materials and Methods: A total of 100 women, who underwent elective or emergency primary caesarean section at term between 37 and 41 weeks have been studied prospectively. They were divided into two groups. In the study group of 50, tranexamic acid 1 gm IV was given 20 minutes before making incision for caesarean section and the control group of 50 did not receive tranexamic acid. Statistical Analysis: For quantitative outcomes, the t-test was used to test for difference in the two groups. For categorical outcomes, chi square and odds ratio with 95% confidence interval were used as applicable. Results: The patient characteristics, namely age, height, weight, gestational age and gravidity in two groups were similar which was statistically insignificant. Hemoglobin decreased slightly after birth in both groups but no statistical difference between two groups was noticed. There was no episode of thrombosis in the study. Tranexamic acid significantly reduced the quantity of the blood loss from time of placental delivery to 2 hours postpartum (P < 0.001 and from end of LSCS to 2 hours postpartum (P < 0.001. However, there was no statistical difference in quantity of blood loss from time of placental delivery to end of LSCS in both groups (P < 0.001. Conclusion: A safe dose of tranexamic acid has an effective role in reducing blood loss during LSCS without causing adverse reaction. Thus, drug can be used effectively in reducing maternal morbidity and mortality during LSCS.

  13. Varicose vein surgery using a pneumatic tourniquet: reduced blood loss and improved cosmesis.

    OpenAIRE

    Thompson, J. F.; Royle, G. T.; Farrands, P. A.; Najmaldin, A.; Clifford, P. C.; Webster, J. H.

    1990-01-01

    A prospective controlled randomised study has been performed of 100 consecutive patients undergoing varicose vein surgery. One group underwent saphenofemoral flush ligation and multiple lower leg avulsions with the leg exsanguinated with a Rhys-Davies cuff, and ischaemia maintained with a pneumatic tourniquet. The other group underwent identical surgery but with a 30 degree head down tilt only. Blood loss was significantly less (13.5 +/- 12 ml vs 133 +/- 78 ml; P less than 0.01) and postopera...

  14. Blood Loss and Transfusion After Topical Tranexamic Acid Administration in Primary Total Knee Arthroplasty.

    Science.gov (United States)

    Wang, Hao; Shen, Bin; Zeng, Yi

    2015-11-01

    There has been much debate and controversy about the safety and efficacy of the topical use of tranexamic acid in primary total knee arthroplasty (TKA). The purpose of this study was to perform a meta-analysis to evaluate whether there is less blood loss and lower rates of transfusion after topical tranexamic acid administration in primary TKA. A systematic review of the electronic databases PubMed, CENTRAL, Web of Science, and Embase was undertaken. All randomized, controlled trials and prospective cohort studies evaluating the effectiveness of topical tranexamic acid during primary TKA were included. The focus of the analysis was on the outcomes of blood loss results, transfusion rate, and thromboembolic complications. Subgroup analysis was performed when possible. Of 387 studies identified, 16 comprising 1421 patients (1481 knees) were eligible for data extraction and meta-analysis. This study indicated that when compared with the control group, topical application of tranexamic acid significantly reduced total drain output (mean difference, -227.20; 95% confidence interval, -347.11 to -107.30; Ptranexamic acid in primary TKA. Furthermore, the currently available evidence does not support an increased risk of deep venous thrombosis or pulmonary embolism due to tranexamic acid administration. Topical tranexamic acid was effective for reducing postoperative blood loss and transfusion requirements without increasing the prevalence of thromboembolic complications. Copyright 2015, SLACK Incorporated.

  15. Antioxidants Attenuate Oxidative Stress-Induced Hidden Blood Loss in Rats

    Directory of Open Access Journals (Sweden)

    Hong Qian

    2017-12-01

    Full Text Available Objective: Hidden blood loss (HBL, commonly seen after total knee or hip arthroplasty, causes postoperative anemia even after reinfusion or blood transfusion based on the visible blood loss volume. Recent studies demonstrated that oxidative stress might be involved in HBL. However, whether the antioxidants proanthocyanidin (PA or hydrogen water (HW can ameliorate HBL remains poorly understood. The aim of this study was to evaluate the effects of PA and HW on HBL. Materials and Methods: A rat HBL model was established through administration of linoleic acid with or without treatment with PA or HW. The levels of hemoglobin (Hb, red blood cell (RBC count, superoxide dismutase (SOD activity, glutathione peroxidase (GSH-PX activity, malondialdehyde (MDA, and ferryl Hb were measured. Results: RBC and Hb values as well as the activity of SOD and GSH-PX were reduced after administration of linoleic acid, which was ameliorated by treatment with PA or HW. In addition, the quantity of MDA was significantly decreased with the administration of PA or HW. Conclusion: PA and HW could ameliorate HBL in a rat model by reducing oxidative stress, suggesting that they might be used as a novel therapeutic approach in the prophylaxis or treatment of HBL in clinics.

  16. Treatments to Prevent Bone Loss in Functional Hypothalamic Amenorrhea: A Systematic Review and Meta-Analysis

    OpenAIRE

    Altayar, Osama; Al Nofal, Alaa; Carranza Leon, B. Gisella; Prokop, Larry J.; Wang, Zhen; Murad, M. Hassan

    2017-01-01

    Objective: We conducted a systematic review and meta-analysis of studies that evaluated the effect of hormonal therapy [estrogen therapy including oral contraceptive pills (OCP)] and bisphosphonates in preventing bone loss in patients with functional hypothalamic amenorrhea (FHA). Methods: We searched several electronic databases for controlled and noncontrolled studies that enrolled females of any age presenting with FHA (including athletic, weight loss, and stress-associated amenorrhea/olig...

  17. [Single intravenous tranexamic acid dose to reduce blood loss in primary total knee replacement].

    Science.gov (United States)

    Sanz-Reig, J; Parra Ruiz, B; Ferrández Martínez, J; Martínez López, J F

    2016-01-01

    To evaluate the effectiveness and safety of a single intravenous dose of tranexamic acid in order to reduce blood loss in total knee replacement. Prospective observational study of the administration of tranexamic acid in patients undergoing primary total knee arthroplasty from November 2013 to February 2015, in which an autologous blood recovery system was used. The study included 98 patients, distributed into two groups of 49 patients according to whether or not they received intravenous tranexamic acid. The primary endpoint was the number of patients requiring autologous transfusion from the recovery system autologous blood recovery system. No drop-outs were recorded during follow-up. There were no significant differences between groups as regards the preoperative and hospital variables. The mean preoperative haemoglobin and haematocrit at 24 and 48 hours postoperatively were similar in both groups. The average volume of bleeding in the autologous blood recovery system and estimated average blood loss was lower in patients who had been administered tranexamic acid, with significant differences. No patients in the group that was administered tranexamic acid required blood autotransfusion. The transfusion rate was zero in the two groups. No adverse events related to the administration of tranexamic acid were recorded. Intravenous administration of tranexamic acid, according to the described protocol, has presented a non-autotransfusion or allo-transfusion rate of 100%, with no increased incidence of thrombotic events. Thus, its use in this group of patients is recommended. The indication should be individualized, its use justified in the patient medical records, and informed consent is mandatory. Copyright © 2015 SECOT. Published by Elsevier Espana. All rights reserved.

  18. Interventions to prevent occupational noise-induced hearing loss: A Cochrane systematic review

    Science.gov (United States)

    Verbeek, Jos H.; Kateman, Erik; Morata, Thais C.; Dreschler, Wouter A.; Mischke, Christina

    2015-01-01

    Objective To assess the effectiveness of interventions for preventing occupational noise exposure or hearing loss compared to no intervention or alternative interventions. Design We searched biomedical databases up to 25 January 2012 for randomized controlled trials (RCT), controlled before-after studies and interrupted time-series of hearing loss prevention among workers exposed to noise. Study sample We included 19 studies with 82 794 participants evaluating effects of hearing loss prevention programs (HLPP). The overall quality of studies was low to very low, as rated using the GRADE approach. Results One study of stricter legislation showed a favorable effect on noise levels. Three studies, of which two RCTs, did not find an effect of a HLPP. Four studies showed that better use of hearing protection devices in HLPPs decreased the risk of hearing loss. In four other studies, workers in a HLPP still had a 0.5 dB greater hearing loss at 4 kHz (95% CI – 0.5 to 1.7) than non-exposed workers. In two similar studies there was a substantial risk of hearing loss in spite of a HLPP. Conclusions Stricter enforcement of legislation and better implementation of HLPPs can reduce noise levels in workplaces. Better evaluations of technical interventions and long-term effects are needed. PMID:24564697

  19. Interventions to prevent occupational noise-induced hearing loss: a Cochrane systematic review.

    Science.gov (United States)

    Verbeek, Jos H; Kateman, Erik; Morata, Thais C; Dreschler, Wouter A; Mischke, Christina

    2014-03-01

    To assess the effectiveness of interventions for preventing occupational noise exposure or hearing loss compared to no intervention or alternative interventions. We searched biomedical databases up to 25 January 2012 for randomized controlled trials (RCT), controlled before-after studies and interrupted time-series of hearing loss prevention among workers exposed to noise. We included 19 studies with 82 794 participants evaluating effects of hearing loss prevention programs (HLPP). The overall quality of studies was low to very low, as rated using the GRADE approach. One study of stricter legislation showed a favorable effect on noise levels. Three studies, of which two RCTs, did not find an effect of a HLPP. Four studies showed that better use of hearing protection devices in HLPPs decreased the risk of hearing loss. In four other studies, workers in a HLPP still had a 0.5 dB greater hearing loss at 4 kHz (95% CI - 0.5 to 1.7) than non-exposed workers. In two similar studies there was a substantial risk of hearing loss in spite of a HLPP. Stricter enforcement of legislation and better implementation of HLPPs can reduce noise levels in workplaces. Better evaluations of technical interventions and long-term effects are needed.

  20. Tranexamic acid reduces blood loss and blood transfusions in primary total hip arthroplasty: a prospective randomized double-blind study in 40 patients

    DEFF Research Database (Denmark)

    Husted, Henrik; Blønd, Lars; Sonne-Holm, Stig

    2003-01-01

    INTRODUCTION: We performed a prospective, randomized, double-blind study on 40 patients scheduled for primary total hip arthroplasty due to arthrosis or osteonecrosis to determine the effect of tranexamic acid on per- and postoperative blood losses and on the number of blood transfusions needed...... blood losses at removal of the drain 24 hours after the operation and the number of blood transfusions. RESULTS: Patients receiving tranexamic acid had a mean peroperative blood loss of 480 mL versus 622 mL in patients receiving placebo (p = 0.3), a postoperative blood loss of 334 mL versus 609 mL (p...... = 0.001), a total blood loss of 814 mL versus 1231 mL (p = 0.001) and a total need for 4 blood transfusions versus 25 (p = 0.04). No patient in either group had symptoms of deep venous thrombosis, pulmonary embolism or prolonged wound drainage. INTERPRETATION: Transemic acid is effective in reducing...

  1. On preventive blood pressure self-monitoring at home

    DEFF Research Database (Denmark)

    Verdezoto, Nervo; Grönvall, Erik

    2015-01-01

    for self-measuring, the importance of interpretation, understanding and health awareness, sharing self-monitoring information for prevention, various motivational factors, the role of the doctor in prevention, and the home as a distributed information space. An awareness of these aspects can help designers......, to understand existing challenges, and uncover opportunities for self-monitoring technologies to support preventive healthcare activities among older adults. From our study, several important aspects emerged to consider when designing preventive self-monitoring technology, such as the complexity of guidelines...... how these aspects can both inform people engaged in Quantified Self activities and designers alike, and the tools and approaches that have sprung from the so-called Quantified Self movement...

  2. Effectiveness of protocols for preventing occupational exposure to blood and body fluids in Dutch hospitals

    NARCIS (Netherlands)

    van Gemert-Pijnen, Julia E.W.C.; Hendrix, M.G.R.; van der Palen, Jacobus Adrianus Maria; Schellens, P.J.

    2006-01-01

    Compliance of different healthcare workers (HCWs) (nurses, physicians, laboratory technicians and cleaners) with protocols to prevent exposure to blood and body fluids (BBF) was studied. Questionnaires were used to assess perception of risks, familiarity with protocols, motivation and actual

  3. Experimental studies on the blood loss and intake of /sup 51/Cr labelled red cells by Clonorchis sinensis in rabbits

    Energy Technology Data Exchange (ETDEWEB)

    Lee, M.J.; Kim, J.R.; Rim, H.J. (Korea Univ, Seoul (Republic of Korea). Coll. of Medicine)

    1982-03-01

    Experimental study was carried out to observe the blood loss due to the ingestion of host blood by Colonorchis sinensis in the rabbits by using chromium radioisotope /sup 51/Cr. On the other hand, in order to confirm the blood intake activity by the worms, the radioactivity was measured on blood, bile juice and flukes removed from the bile ducts of the rabbits experimentally infected with C. sinensis.

  4. Experimental studies on the blood loss and intake of 51Cr labelled red cells by Clonorchis sinensis in rabbits

    International Nuclear Information System (INIS)

    Lee, M.J.; Kim, J.R.; Rim, H.J.

    1982-01-01

    Experimental study was carried out to observe the blood loss due to the ingestion of host blood by Colonorchis sinensis in the rabbits by using chromium radioisotope 51 Cr. On the other hand, in order to confirm the blood intake activity by the worms, the radioactivity was measured on blood, bile juice and flukes removed from the bile ducts of the rabbits experimentally infected with C. sinensis. (Author)

  5. Comparative study of topical vs. intravenous tranexamic acid regarding blood loss in total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Ari Zekcer

    Full Text Available ABSTRACT Objective: To compare topical vs. intravenous tranexamic acid (TA in total knee arthroplasty regarding blood loss and transfusion., Methods: Ninety patients were randomized to receive TA intravenously (20 mg/kg in 100 mL of saline; group IV, topically (1.5 g in 50 mL of saline, sprayed over the operated site, before release of the tourniquet; topical group, or intravenous saline (100 mL with anesthesia; control group. The volume of drained blood in 48, h, the amount of transfused blood, and the serum levels of hemoglobin and hematocrit before and after surgery were evaluated., Results: The groups were similar for gender, age, weight, laterality, and preoperative hemoglobin and hematocrit levels (p> 0.2. The hemoglobin level dropped in all groups when comparing the preoperative and the 48-h evaluations: the control group decreased 3.8 mg/dL on average, while the IV, group had a decrease of 3.0, and the topical group, of 3.2 (p= 0.019. The difference between the control and IV, groups was confirmed by Bonferroni test (p= 0.020. The difference between the control group and the topical group was not significant (p= 0.130, although there was less reduction in hemoglobin in the topical group; the comparison between the IV, group and the topical group was also not significant (p= 1.000. Conclusion: Using topic and IV, tranexamic acid decreased blood loss and the need for transfusion in total knee arthroplasty. Topical application showed results similar to IV use regarding the need for blood transfusion, but without the possible side effects of IV, administration.

  6. Use of tranexamic acid in primary total knee replacement: effects on perioperative blood loss.

    Science.gov (United States)

    Volquind, Daniel; Zardo, Remi Antônio; Winkler, Bruno Costamilan; Londero, Bruno Bertagnolli; Zanelatto, Natália; Leichtweis, Gisele Perondi

    2016-01-01

    The use of tranexamic acid in primary total knee replacement surgeries has been the subject of constant study. The strategies to reduce bleeding are aimed at reducing the need for blood transfusion due to the risks involved. In this study we evaluated the use of tranexamic acid in reducing bleeding, need for blood transfusion, and prevalence of postoperative deep vein thrombosis in primary total knee replacement. 62 patients undergoing primary total knee replacement were enrolled in the study, from June 2012 to May 2013, and randomized to receive a single dose of 2.5g of intravenous tranexamic acid (Group TA) or saline (Group GP), 5min before opening the pneumatic tourniquet, respectively. Hemoglobin, hematocrit, and blood loss were recorded 24h after surgery. Deep vein thrombosis was investigated during patient's hospitalization and 15 and 30 days after surgery in review visits. There was no demographic difference between groups. Group TA had 13.89% decreased hematocrit (p=0.925) compared to placebo. Group TA had a decrease of 12.28% (p=0.898) in hemoglobin compared to Group GP. Group TA had a mean decrease of 187.35mL in blood loss (25.32%) compared to group GP (p=0.027). The number of blood transfusions was higher in Group GP (p=0.078). Thromboembolic events were not seen in this study. Tranexamic acid reduced postoperative bleeding without promoting thromboembolic events. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  7. Events at blood collection area due to nonconforming blood bags and plateletpheresis kits: need for timely corrective and preventive actions.

    Science.gov (United States)

    Verma, Anupam; Sachan, Deepti; Elhence, Priti; Pandey, Hem; Dubey, Anju

    2012-07-01

    Good blood banking practice requires that every effort should be made to detect any deviation or defect in blood bank products and to identify any potential risk to blood donor or recipient(s). We report the findings of an exercise that provide an insight into why feedback from the user side is crucial. Various events involving blood bags and plateletpheresis kits and the corresponding appropriate actions instituted for remedial measures were recorded. These scattered events were recorded for 6 months following the use of a new batch of improved blood bags with add-on features. Several events related to plateletpheresis kits from three different manufacturers were also recorded for 1 year. The affected blood bags were utilized with no untoward incident. The complaint was closed following satisfactory response from the blood bag manufacturing company that acted in a timely manner in addressing the root causes of the problems. However, corrective and preventive actions (CAPA) could not be implemented for plateletpheresis kits. The rate of undesirable events was higher with plateletpheresis kits as compared with whole blood bags (1.75% vs. 0.06%). As defects or deviations that trigger the need for CAPA can stem from numerous sources, it is important to clearly identify and document the problems and level of risk so that appropriate investigations can be instituted and remedial actions can be taken in a timely manner. This study demonstrates the usefulness of a quality initiative to collate and analyze blood product faults in conjunction with blood product manufacturers. © 2012 American Association of Blood Banks.

  8. The physiology of blood loss and shock: New insights from a human laboratory model of hemorrhage.

    Science.gov (United States)

    Schiller, Alicia M; Howard, Jeffrey T; Convertino, Victor A

    2017-04-01

    The ability to quickly diagnose hemorrhagic shock is critical for favorable patient outcomes. Therefore, it is important to understand the time course and involvement of the various physiological mechanisms that are active during volume loss and that have the ability to stave off hemodynamic collapse. This review provides new insights about the physiology that underlies blood loss and shock in humans through the development of a simulated model of hemorrhage using lower body negative pressure. In this review, we present controlled experimental results through utilization of the lower body negative pressure human hemorrhage model that provide novel insights on the integration of physiological mechanisms critical to the compensation for volume loss. We provide data obtained from more than 250 human experiments to classify human subjects into two distinct groups: those who have a high tolerance and can compensate well for reduced central blood volume (e.g. hemorrhage) and those with low tolerance with poor capacity to compensate.We include the conceptual introduction of arterial pressure and cerebral blood flow oscillations, reflex-mediated autonomic and neuroendocrine responses, and respiration that function to protect adequate tissue oxygenation through adjustments in cardiac output and peripheral vascular resistance. Finally, unique time course data are presented that describe mechanistic events associated with the rapid onset of hemodynamic failure (i.e. decompensatory shock). Impact Statement Hemorrhage is the leading cause of death in both civilian and military trauma. The work submitted in this review is important because it advances the understanding of mechanisms that contribute to the total integrated physiological compensations for inadequate tissue oxygenation (i.e. shock) that arise from hemorrhage. Unlike an animal model, we introduce the utilization of lower body negative pressure as a noninvasive model that allows for the study of progressive

  9. Interventions to prevent occupational noise-induced hearing loss: a Cochrane systematic review

    NARCIS (Netherlands)

    Verbeek, Jos H.; Kateman, Erik; Morata, Thais C.; Dreschler, Wouter A.; Mischke, Christina

    2014-01-01

    To assess the effectiveness of interventions for preventing occupational noise exposure or hearing loss compared to no intervention or alternative interventions. We searched biomedical databases up to 25 January 2012 for randomized controlled trials (RCT), controlled before-after studies and

  10. Non-pharmacological interventions for preventing job loss in workers with inflammatory arthritis

    NARCIS (Netherlands)

    Hoving, Jan L.; Lacaille, Diane; Urquhart, Donna M.; Hannu, Timo J.; Sluiter, Judith K.; Frings-Dresen, Monique H. W.

    2014-01-01

    Work participation of patients with inflammatory arthritis (IA) is important not only economically but also for physical and psychological health. There is no Cochrane Review to date on studies of non-pharmacological interventions specifically aimed at preventing job loss in people with IA. To

  11. The effect of aprotinin, tranexamic acid, and aminocaproic acid on blood loss and use of blood products in major pediatric surgery : A meta-analysis

    NARCIS (Netherlands)

    Schouten, Esther S.; van de Pol, Alma C.; Schouten, Anton N. J.; Turner, Nigel M.; Jansen, Nicolaas J. G.; Bollen, Casper W.

    Objective: Aprotinin reduces the blood loss and transfusion of blood products in children undergoing major surgery. Aprotinin has been associated with severe side effects in adults, and tranexamic acid and aminocaproic acid have been found to be safer alternatives in adults. This systematic review

  12. Weight loss efficacy of a novel mobile Diabetes Prevention Program delivery platform with human coaching

    Science.gov (United States)

    Michaelides, Andreas; Raby, Christine; Wood, Meghan; Farr, Kit

    2016-01-01

    Objective To evaluate the weight loss efficacy of a novel mobile platform delivering the Diabetes Prevention Program. Research Design and Methods 43 overweight or obese adult participants with a diagnosis of prediabetes signed-up to receive a 24-week virtual Diabetes Prevention Program with human coaching, through a mobile platform. Weight loss and engagement were the main outcomes, evaluated by repeated measures analysis of variance, backward regression, and mediation regression. Results Weight loss at 16 and 24 weeks was significant, with 56% of starters and 64% of completers losing over 5% body weight. Mean weight loss at 24 weeks was 6.58% in starters and 7.5% in completers. Participants were highly engaged, with 84% of the sample completing 9 lessons or more. In-app actions related to self-monitoring significantly predicted weight loss. Conclusions Our findings support the effectiveness of a uniquely mobile prediabetes intervention, producing weight loss comparable to studies with high engagement, with potential for scalable population health management. PMID:27651911

  13. Charts for weight loss to detect hypernatremic dehydration and prevent formula supplementing.

    Science.gov (United States)

    van Dommelen, Paula; Boer, Suzanne; Unal, Sevim; van Wouwe, Jacobus P

    2014-06-01

    Most breast-fed newborns get the milk they need. However, very rarely milk intake is insufficient mostly as a result of poor breastfeeding techniques. Dramatic weight loss and hypernatremic dehydration may occur. Our aim was to construct charts for weight loss. A case-control study was performed. Charts with standard deviation score (SDS) lines for weight loss in the first month were constructed for 2,359 healthy breast-fed term newborns and 271 cases with breastfeeding-associated hypernatremic dehydration with serum sodium level > 149 mEq/L. Day 0 was defined as the day of birth. Many cases with (or who will develop) hypernatremic dehydration (84%; +1 SDS line) fell below the -1 SDS line at day 3, the -2 SDS line at day 4, and the -2.5 SDS line at day 5 in the chart of the healthy breast-fed newborns. Weight loss of cases with permanent residual symptoms was far below the -2.5 SDS. Already at an early age, weight loss differs between healthy breast-fed newborns and those with hypernatremic dehydration. Charts for weight loss are, therefore, useful tools to detect early, or prevent newborns from developing, breastfeeding-associated hypernatremic dehydration, and also to prevent unnecessary formula supplementing. © 2014 Wiley Periodicals, Inc.

  14. Progressive sensorineural hearing loss, subjective tinnitus and vertigo caused by elevated blood lipids.

    Science.gov (United States)

    Pulec, J L; Pulec, M B; Mendoza, I

    1997-10-01

    The otologist frequently sees patients with progressive sensorineural hearing loss, subjective aural tinnitus and vertigo with no apparent cause. Elevated blood lipids may be a cause of inner ear malfunction on a biochemical basis. To establish the true incidence of this condition, all new patients (4,251) seen during an eight-year period were evaluated; of these, 2,332 patients had complaints of inner ear disease. All had a complete neurotologic examination, appropriate audiometric and vestibular studies and imaging, and blood tests including lipid phenotype studies. Hyperlipoproteinemia was found in 120 patients (5.1%). Most patients were found to be overweight and had additional coexisting conditions such as diabetes mellitus. Treatment with vasodilators and a 500-calorie, high-protein, low-carbohydrate diet yielded improvement of symptoms in 83% of patients within five months of initiation of treatment.

  15. Cerebral blood flow studied by 133Xe inhalation technique in parkinsonism: loss of hyperfrontal pattern

    International Nuclear Information System (INIS)

    Bes, A.; Gueell, A.; Fabre, N.; Dupui, P.; Victor, G.; Geraud, G.

    1983-01-01

    Cerebral blood flow (grey matter flow) in parkinsonism requires further investigation. The noninvasive method of 133 Xe inhalation permits study of larger numbers of subjects than previously used invasive techniques such as the intracarotid 133 Xe injection method. Measurements were made in this laboratory in 30 subjects having Parkinson's disease. Mean hemispheric blood flow (F1) values were 70.4 +/- 9.3 ml/100 g/min, compared to 76.3 for a group of age-matched normal subjects, which is a decrease of -7.8%. The most striking difference was the loss of the hyperfrontal distribution in parkinsonism. The prefrontal F1 values were only 1.8% greater than the hemisphere grey matter flow, compared with 8.5% in controls of a similar age group

  16. Tourniquets do not increase the total blood loss or re-amputation risk in transtibial amputations

    DEFF Research Database (Denmark)

    Wied, Christian; Tengberg, Peter T; Holm, Gitte

    2017-01-01

    AIM: To investigate the total blood loss (TBL) and the safety with respect to the re-amputation rate after transtibial amputation (TTA) conducted with and without a tourniquet. METHODS: The study was a single-centre retrospective cohort study of patients with a primary TTA admitted between January...... 2013 and April 2015. All patients with a primary TTA were assessed for inclusion if the amputation was performed because of arteriosclerosis or diabetic complications. All patients underwent a standardized TTA procedure that was performed approximately 10 cm below the knee joint and performed...... portion, which equals 55 g/L of haemoglobin. The TBL during the first four postoperative days was calculated based on the haemoglobin level and the estimated blood volume. The re-amputation rate was evaluated within 30 d. RESULTS: Seventy-four out of 86 consecutive patients who underwent TTA within...

  17. The efficacy of bipolar sealer on blood loss in spine surgery: a meta-analysis.

    Science.gov (United States)

    Lan, Tao; Hu, Shi-Yu; Yang, Xin-Jian; Chen, Yang; Qiu, Yi-Yan; Guo, Wei-Zhuang; Lin, Jian-Ze; Ren, Kai

    2017-07-01

    The purpose of this meta-analysis of randomized controlled trials (RCTs) and non-RCTs was to gather data to evaluate the efficacy and safety of bipolar sealer versus standard electrocautery in the management of spinal disease. The electronic databases including Embase, PubMed and Cochrane library were searched to identify relevant studies published from the time of the establishment of these databases up to January 2017. The primary outcomes were total blood loss, requirement of transfusion (rate and amount), and operation time. The secondary outcomes were length of hospital stay and postoperative wound infection. Data analysis was conducted with RevMan 5.3 software. A total of five studies involving 500 patients (261 patients in the BS group and 239 in the control group) were included in the meta-analysis. The pooled results revealed that application of bipolar sealer could decrease the total blood loss in spine surgery [WMD = -467.49, 95% CI (685.47 to -249.51); p SMD = -0.36, 95% CI (-0.60 to -0.13), p infection [OR = 0.88, 95% CI (0.31-2.48), p = 0.81; I 2  = 0.0%] between both groups. The available evidence suggests that bipolar sealer is superior to standard electrocautery with less blood loss, shorter operation time and less transfusion requirement. There is no significant difference between both groups regarding length of hospitalization and wound infection. Hence, bipolar sealer is recommended in spine surgery. Because of the limitation of our study, more well-designed RCTs with large sample are required to provide further evidence of safety and efficacy between bipolar sealer and standard electrocautery in the treatment of spinal disease.

  18. Strategies for the prevention of MP3-induced hearing loss among adolescents : Expert opinions from a Delphi study

    NARCIS (Netherlands)

    Vogel, I.; Brug, J.; Ploeg, C.P.B. van der; Raat, H.

    2009-01-01

    OBJECTIVE. To identify parties involved in the prevention of MP3-induced hearing loss among adolescents and potentially effective prevention strategies and interventions. METHODS. Thirty experts in fields such as scientific research, medical practice, community health professions, education, youth

  19. Effect of a Modest Weight Loss in Normalizing Blood Pressure in Obese Subjects on Antihypertensive Drugs

    Directory of Open Access Journals (Sweden)

    Luisa Gilardini

    2016-07-01

    Full Text Available Objective: To assess the effect of a lifestyle intervention in lowering/normalizing blood pressure (BP levels in hypertensive (controlled or not obese patients. Methods: In this prospective observational study, 490 obese hypertensive patients, 389 controlled (BP Results: 18.9% of CH and 20.0% of UH were on ≥ 3 antihypertensive drugs. Weight change (average -4.9 ± 2.7% was independent of the antihypertensive drugs employed. Systolic BP (SBP decreased by 23 mm Hg and diastolic BP (DBP by 9 mm Hg, in patients with UH most of whom (89% normalized BP levels (in 49% after a weight loss Conclusion: Lifestyle interventions are useful for all obese hypertensive patients in most of whom a modest weight loss is sufficient to normalize BP levels avoiding the aggressive use of multiple antihypertensive drugs.

  20. Intratympanic steroid prevents long-term spiral ganglion neuron loss in experimental meningitis

    DEFF Research Database (Denmark)

    Worsøe, Lise Lotte; Brandt, C.T.; Lund, S.P.

    2010-01-01

    Hypothesis: Intratympanic steroid treatment prevents hearing loss and cochlear damage in a rat model of pneumococcal meningitis. Background: Sensorineural hearing loss is a long-term complication of meningitis affecting up to a third of survivors. Streptococcus pneumoniae is the bacterial species...... for 3 days. Hearing loss and cochlear damage were assessed by distortion product otoacoustic emissions, auditory brainstem response at 16 kHz, and spiral ganglion neuron density. Results: Fifty-six days after infection, auditory brainstem response showed no significant differences between groups...... in the spiral ganglion compared with both intratympanic and systemic saline (p = 0.0082 and p = 0.0089; Mann-Whitney test). Histology revealed fibrosis of the tympanic membrane and cavity in steroid-treated animals, which plausibly caused the low-frequency hearing loss. Conclusion: Intratympanic betamethasone...

  1. Neural, Endocrine and Local Mechanisms in the Effects of Environmental Stressors on the Cardiovascular Response to Blood Loss

    National Research Council Canada - National Science Library

    Schadt, James C

    2006-01-01

    Our studies have provided important, new information about the role of neurohumoral systems as well as the interaction of these systems with local mechanisms in cardiovascular control during blood loss...

  2. Preference for gain- or loss-framed electronic cigarette prevention messages.

    Science.gov (United States)

    Kong, Grace; Cavallo, Dana A; Camenga, Deepa R; Morean, Meghan E; Krishnan-Sarin, Suchitra

    2016-11-01

    Effective electronic cigarette (e-cigarette) prevention messages are needed to combat the rising popularity/uptake of e-cigarettes among youth. We examined preferences for e-cigarette prevention messages that either emphasized gains (e.g., You save money by not using e-cigarettes) or losses (e.g., You spend money by using e-cigarettes) among adolescents and young adults. Using surveys in two middle schools, four high schools, and one college in CT (N=5405), we assessed students' preferences for gain- or loss-framed e-cigarette prevention messages related to four themes: financial cost, health risks, addiction potential, and social labeling as a smoker. We also assessed whether preferences for each message framing theme differed by sex, school level, cigarette-use status, and e-cigarette use-status. We also examined whether preference for message framing differed by cigarette and e-cigarette susceptibility status among never e-cigarette users. Overall, loss-framing was preferred for message themes related to health risks, addiction potential, and social labeling as a smoker, whereas gain-framing was preferred for message themes related to financial cost. Logistic regression analyses showed that 1) females preferred loss-framed messages for all themes relative to males, 2) lifetime e-cigarette users preferred loss-framed health risks and social labeling messages relative to never users, and 3) high school students preferred gain-framed social labeling messages relative to college students. The preference for message framing did not differ by cigarette or e-cigarette susceptibility. Preference for message framing differed by themes and individual characteristics. This formative research could inform the construction of persuasive e-cigarette prevention messages. Copyright © 2016. Published by Elsevier Ltd.

  3. Comparison of blood loss between using non central part cutting knee prosthesis and distal central part cutting.

    Science.gov (United States)

    Malairungsakul, Anan

    2014-12-01

    Patients who undergo knee replacement surgery may need to receive a blood transfusion due to blood loss during the operation. Therefore it was important to improve the design of knee implant operative procedures in an attempt to reduce the rate of blood loss. The present study aimed to compare the blood loss between two types of knee replacement surgery. This is a retrospective study in which 78 patients received cemented knee replacements in Phayao Hospital between October 2010 and March 2012. There were two types of surgical procedure: 1) using an implant position covering the end of the femoral bone without cutting into the central part of the distal femoral, 2) using an implant position covering the end of the femoral bone cutting the central part of the distal femoral. Blood loss, blood transfusion, hemoglobin and hematocrit were recorded preoperatively, immediately postsurgery and 48 hours after surgery. Findings revealed that the knee replacement surgery using the implant position covering the end of the femoral bone without cutting the central part of the distal femoral significantly lowered the rate of blood loss when compared to using the implant position covering the end of the femoral bone with central cutting of the distal femor. The average blood loss during the operation without cutting at the central part of distal femoral was 49.50 ± 11.11 mL; whereas the operation cutting the central part of the distal femoral was 58.50 ± 11.69 mL. As regards blood loss, the knee replacement surgery using the implant position covering the end ofthefemoral bone without cutting the central part of distal femor was better than using the implant position covering the end of the femoral bone cutting at the central part of the distal femor.

  4. Operative blood loss and the frequency of haemorrhage associated with adenotonsillectomy in children: a double-blind trial of ethamsylate.

    Science.gov (United States)

    Arora, Y R; Manford, M L

    1979-06-01

    One hundred children were allocated randomly to receive either ethamsylate (Dicynene) or a placebo before undergoing adenotonsillectomy. Blood loss at operation was estimated from the haemoglobin content of swabs and aspirated fluid. Mean blood loss in the ethamsylate-treated group was not significantly less than in the controls. The frequency of secondary haemorrhage was significantly less in children treated with ethamsylate (P less than 0.01). No side-effects were reported in either group.

  5. Effects of preoperative aspirin and clopidogrel therapy on perioperative blood loss and blood transfusion requirements in patients undergoing off-pump coronary artery bypass graft surgery.

    Science.gov (United States)

    Shim, Jae Kwang; Choi, Yong Seon; Oh, Young Jun; Bang, Sou Ouk; Yoo, Kyung Jong; Kwak, Young Lan

    2007-07-01

    Preoperative exposure to clopidogrel and aspirin significantly increases postoperative bleeding in patients undergoing on-pump coronary artery bypass graft surgery. Off-pump coronary bypass grafting has been proposed as an alternative technique to attenuate postoperative bleeding associated with clopidogrel. This study aimed to determine the effects of aspirin and clopidogrel therapy on perioperative blood loss and blood transfusion requirements in off-pump coronary artery bypass grafting. One hundred six patients scheduled for off-pump coronary artery bypass grafting were divided into three groups: aspirin and clopidogrel discontinued more than 6 days before surgery (group 1, n = 35), aspirin and clopidogrel continued until 3 to 5 days before surgery (group 2, n = 51), and both medications continued within 2 days of surgery (group 3, n = 20). Thromboelastographic tracings were analyzed before induction of anesthesia. Routine coagulation profiles were measured before and after surgery. A cell salvage device was used during surgery and salvaged blood was reinfused. Chest tube drainage and blood transfusion requirement were recorded postoperatively. Patient characteristics, operative data, and thromboelastographic tracings were similar among the groups. There were significant decreases in hematocrit level and platelet count and prolongation in prothrombin time postoperatively in all groups without any intergroup differences. The amounts of perioperative blood loss and blood transfusion required were all similar among the groups. Preoperative clopidogrel and aspirin exposure even within 2 days of surgery does not increase perioperative blood loss and blood transfusion requirements in patients undergoing elective off-pump coronary artery bypass grafting.

  6. Relative blood loss and operative time can predict length of stay following orthognathic surgery.

    Science.gov (United States)

    Andersen, K; Thastum, M; Nørholt, S E; Blomlöf, J

    2016-10-01

    The aim of this study was to investigate the length of stay (LOS) following orthognathic surgery and thereby to establish a benchmark. The secondary aim was to identify predictors of postoperative LOS following orthognathic surgery. Patients were treated consecutively during the period 2010 to 2012. Inclusion criteria were (1) patient age ≥18 years, and (2) surgery involving a three-piece Le Fort I osteotomy, or a bilateral sagittal split osteotomy (BSSO), or bimaxillary surgery. A total of 335 patients were included. The following data were recorded: height, weight, body mass index (BMI), age, sex, operative time, intraoperative blood loss, and type of surgery. LOS was defined as the duration of time from date of surgery to date of discharge. The average LOS was 1.3 days following Le Fort I osteotomy, 1.3 days following BSSO, and 1.8 days following bimaxillary surgery. In the multivariate regression model (R(2)=0.11), predictors of a prolonged LOS were operative time (P<0.001) and relative blood loss (P=0.002). No significant effect of age, BMI, sex, or treatment on LOS was observed. The short duration of LOS found in this study supports the possibility of increasing outpatient pathways for selected patients. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Rectal red blood loss in a healthy toddler is not always a juvenile polyp.

    Science.gov (United States)

    Rousseff, T; Matthyssens, L; Van Renterghem, K; Van de Putte, D; De Wulf, D; Van Winckel, M; Van de Velde, S; De Bruyne, R; Van Biervliet, S

    2017-01-01

    Aim Heterotopic gastric mucosa is a well-known congenital anomaly in Meckel's diverticula and duplication cysts. Solitary heterotopic gastric mucosa in the rectum is a rare and frequently overlooked abnormality. Starting from a patient history, the literature is searched and all cases reported over the past 20 years are reviewed and compared to a summary of the older cases. Differences between adult and childhood presentation are outlined and our patient is compared with prior reported cases. Case A 3-year-old girl presented with recurrent rectal blood loss caused by heterotopic gastric mucosa without duplication cyst. She was endoscopically treated with two-stage endoscopic surgical dissection (ESD). Up to now, rectal heterotopic gastric mucosa has been reported in 34 adults and 24 children, including this patient. There is an overall male dominance (69%). Presenting complaints in children were recurrent fresh blood loss per anum (96%), pain (46%), perineal ulcers (25%), diarrhoea (8%) and one patient had an ano-cutaneous fistula. Endoscopy revealed a mucosal elevation with a slightly different aspect (33%), a polyp (42%) and a solitary ulcer (25%). Endoscopy in adults reveals more frequently polyps compared to children. Treatment in childhood is mainly surgical where adults are more frequently treated with endoscopic techniques. Conclusion In a child with recurrent rectal bleeding in good general health, it is important to withhold heterotopic gastric mucosa in the differential diagnosis and take sufficient biopsies during endoscopy. © Acta Gastro-Enterologica Belgica.

  8. DOES TRANEXAMIC ACID REDUCE BLOOD LOSS IN OFF-PUMP CORONARY ARTERY BYPASS?

    Directory of Open Access Journals (Sweden)

    A. Mehr-Aein

    2006-09-01

    Full Text Available Tranexamic acid is now used on a routine basis for on-pump coronary artery bypass grafting (CABG. We assessed the hemostatic effects of tranexamic acid to decrease bleeding tendency and transfusion requirements in patients undergoing off-pump coronary artery bypass surgery (OPCAB. A total of 66 patients were enrolled to elective OPCAB in a double-blind, prospective randomized study. Of these, 33 patients received tranexamic acid (15 mg/kg before the infusion of heparin and 15 mg/kg after protamin infusion, and 33 patients received only saline. Preoperative hematologic variables, postoperative bleeding and allogeneic transfusions were considered. D-dimer plasma levels were also evaluated to monitor the activation of fibrinolysis. Postoperative bleeding was significantly lower in the tranexamic acid group compared with the control group (320 ± 38 mL vs. 480 ± 75 mL at 12 hour, P < 0.001. The tranexamic acid group had significantly lesser need for allogeneic blood products (0.46 units/patients vs. 0.94 units/patients, P < 0.001. They had also lower post-operative D-dimer plasma levels. No postoperative thrombotic complications were observed in either group. The defective hemostasis occurs even in the OPCABG. Tranexamic acid effectively reduces postoperative blood loss and the need for allogeneic blood products after OPCAB is decreased.

  9. Tranexamic acid reduces blood loss and need of blood transfusion in total knee arthroplasty: A prospective, randomized, double-blind study in Indian population

    Directory of Open Access Journals (Sweden)

    Abhishek Shinde

    2015-01-01

    Full Text Available Introduction: For quite a few years, tranexamic acid (TEA has been used during total knee arthroplasty (TKA to reduce blood loss. However, no consensus exits regarding its timing and doses. Materials and Methods: We conducted a prospective, randomized double-blinded study of 56 patients in the Indian population undergoing TKA from 2011 to 2012. A dose of 10 mg/kg body weight of TEA (three doses was given in one group and normal saline was administered in the other. Results: The mean blood loss in the TEA unilateral group was 295 mL ± 218 mL and in the placebo group was 482 mL ± 186 mL (P < 0.005. In the bilateral TEA group, the mean blood loss was 596 mL ± 235 mL and in the placebo group was 1349 mL ± 41 mL (P < 0.005. Conclusion: The number of patients requiring blood transfusion reduced substantially. There was no increase in the risk of deep vein thrombosis (DVT and pulmonary embolism. TEA reduces intraoperative and postoperative blood loss and thus reduces the need of allogenic blood transfusion.

  10. No Effect of a Bipolar Sealer on Total Blood Loss or Blood Transfusion in Nonseptic Revision Knee Arthroplasty-A Prospective Study With Matched Retrospective Controls.

    Science.gov (United States)

    Nielsen, Christian Skovgaard; Gromov, Kirill; Jans, Øivind; Troelsen, Anders; Husted, Henrik

    2017-01-01

    Postoperative anemia is frequent after revision of total knee arthroplasty (TKA) with reported transfusion rates up to 83%. Despite increased efforts of reducing blood loss and enhancing fast recovery within the fast-track setup, a considerable transfusion rate is still evident. The aim of this study was therefore to evaluate the effect of a bipolar sealer on blood loss and transfusion in revision TKA. In this single-center prospective cohort study with retrospective controls, 51 patients were enrolled in a fast-track setup for revision TKA without the use of a tourniquet. Twenty-five prospectively enrolled patients received treatment with both a bipolar sealer and electrocautery, whereas 26 patients had received treatment with a conventional electrocautery only in the retrospective group. No significant differences were found neither for calculated blood loss, with 1397 (standard deviation, ± 452) mL in the bipolar sealer group vs 1452 (SD, ± 530) mL in the control group (P = .66), nor for blood transfusion rates of 53% and 46% (P = .89), respectively. Four controls were readmitted within 90 days follow-up. The use of a bipolar sealer in a TKA revision setting without the use of a tourniquet did not reduce blood loss or blood transfusion rates. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Preventing land loss in coastal Louisiana: estimates of WTP and WTA.

    Science.gov (United States)

    Petrolia, Daniel R; Kim, Tae-Goun

    2011-03-01

    A dichotomous-choice contingent-valuation survey was conducted in the State of Louisiana (USA) to estimate compensating surplus (CS) and equivalent surplus (ES) welfare measures for the prevention of future coastal wetland losses in Louisiana. Valuations were elicited using both willingness to pay (WTP) and willingness to accept compensation (WTA) payment vehicles. Mean CS (WTP) estimates based on a probit model using a Box-Cox specification on income was $825 per household annually, and mean ES (WTA) was estimated at $4444 per household annually. Regression results indicate that the major factors influencing support for land-loss prevention were income (positive, WTP model only), perceived hurricane protection benefits (positive), environmental and recreation protection (positive), distrust of government (negative), age (positive, WTA model only), and race (positive for whites). Copyright © 2010 Elsevier Ltd. All rights reserved.

  12. Total glucosides of paeony prevents juxta-articular bone loss in experimental arthritis

    OpenAIRE

    Wei, Chen Chao; You, Fan Tian; Mei, Li Yu; Jian, Sun; Qiang, Chen Yong

    2013-01-01

    Background Total glucosides of paeony (TGP) is a biologically active compound extracted from Paeony root. TGP has been used in rheumatoid arthritis therapy for many years. However, the mechanism by which TGP prevents bone loss has been less explored. Methods TGP was orally administered for 3?months to New Zealand rabbits with antigen-induced arthritis (AIA). Digital x-ray knee images and bone mineral density (BMD) measurements of the subchondral knee bone were performed before sacrifice. Chon...

  13. Mosaic Loss of Chromosome Y in Blood Is Associated with Alzheimer Disease.

    Science.gov (United States)

    Dumanski, Jan P; Lambert, Jean-Charles; Rasi, Chiara; Giedraitis, Vilmantas; Davies, Hanna; Grenier-Boley, Benjamin; Lindgren, Cecilia M; Campion, Dominique; Dufouil, Carole; Pasquier, Florence; Amouyel, Philippe; Lannfelt, Lars; Ingelsson, Martin; Kilander, Lena; Lind, Lars; Forsberg, Lars A

    2016-06-02

    Men have a shorter life expectancy compared with women but the underlying factor(s) are not clear. Late-onset, sporadic Alzheimer disease (AD) is a common and lethal neurodegenerative disorder and many germline inherited variants have been found to influence the risk of developing AD. Our previous results show that a fundamentally different genetic variant, i.e., lifetime-acquired loss of chromosome Y (LOY) in blood cells, is associated with all-cause mortality and an increased risk of non-hematological tumors and that LOY could be induced by tobacco smoking. We tested here a hypothesis that men with LOY are more susceptible to AD and show that LOY is associated with AD in three independent studies of different types. In a case-control study, males with AD diagnosis had higher degree of LOY mosaicism (adjusted odds ratio = 2.80, p = 0.0184, AD events = 606). Furthermore, in two prospective studies, men with LOY at blood sampling had greater risk for incident AD diagnosis during follow-up time (hazard ratio [HR] = 6.80, 95% confidence interval [95% CI] = 2.16-21.43, AD events = 140, p = 0.0011). Thus, LOY in blood is associated with risks of both AD and cancer, suggesting a role of LOY in blood cells on disease processes in other tissues, possibly via defective immunosurveillance. As a male-specific risk factor, LOY might explain why males on average live shorter lives than females. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

  14. [Clinical signification of a modified dilution method (MDM) for blood loss assessment in the cases of nonvariceal upper gastrointestinal bleeding].

    Science.gov (United States)

    Geogiev, G; Shishenkov, M; Ninov, B; Dosheva, I

    2006-01-01

    The aim of this study was to compare the modified dilution method (MDM) for in vivo bloodless assessment with the accepted in the clinical practice methods. We measured 148 blood samples from 134 patients with nonvariceal upper gastrointestinal bleeding (NUGB) and 21 blood samples from healthy persons as a negative control. In the randomized group of 53 patients with NUGB we compared accuracy of the blood loss determination by means of erythrocyte mass loss (estimated with MDM), Allgower-Burri index and American College of Surgeon Index (ACSI). The obtained results give us a reason to recommend a combination between American College of Surgeon classification for blood loss in patients with NUGB and a parallel measurement of the MDM values.

  15. Validation of Safety-Critical Systems for Aircraft Loss-of-Control Prevention and Recovery

    Science.gov (United States)

    Belcastro, Christine M.

    2012-01-01

    Validation of technologies developed for loss of control (LOC) prevention and recovery poses significant challenges. Aircraft LOC can result from a wide spectrum of hazards, often occurring in combination, which cannot be fully replicated during evaluation. Technologies developed for LOC prevention and recovery must therefore be effective under a wide variety of hazardous and uncertain conditions, and the validation framework must provide some measure of assurance that the new vehicle safety technologies do no harm (i.e., that they themselves do not introduce new safety risks). This paper summarizes a proposed validation framework for safety-critical systems, provides an overview of validation methods and tools developed by NASA to date within the Vehicle Systems Safety Project, and develops a preliminary set of test scenarios for the validation of technologies for LOC prevention and recovery

  16. Noise exposure and hearing loss prevention programmes after 20 years of regulations in the United States.

    Science.gov (United States)

    Daniell, W E; Swan, S S; McDaniel, M M; Camp, J E; Cohen, M A; Stebbins, J G

    2006-05-01

    To evaluate noise exposures and hearing loss prevention efforts in industries with relatively high rates of workers' compensation claims for hearing loss. Washington State workers' compensation records were used to identify up to 10 companies in each of eight industries. Each company (n = 76) was evaluated by a management interview, employee personal noise dosimetry (n = 983), and employee interviews (n = 1557). Full-shift average exposures were > or =85 dBA for 50% of monitored employees, using Occupational Safety and Health Administration (OSHA) parameters with a 5 dB exchange rate (L(ave)), but 74% were > or =85 dBA using a 3 dB exchange rate (L(eq)). Only 14% had L(ave) > or =90 dBA, but 42% had L(eq) > or =90 dBA. Most companies conducted noise measurements, but most kept no records, and consideration of noise controls was low in all industries. Hearing loss prevention programmes were commonly incomplete. Management interview scores (higher score = more complete programme) showed significant associations with percentage of employees having L(ave) > or =85 dBA and presence of a union (multiple linear regression; R2 = 0.24). Overall, 62% of interviewed employees reported always using hearing protection when exposed. Protector use showed significant associations with percentage of employees specifically required to use protection, management score, and average employee time spent > or =95 dBA (R2 = 0.65). The findings raise serious concerns about the adequacy of prevention, regulation, and enforcement strategies in the United States. The percentage of workers with excessive exposure was 1.5-3 times higher using a 3 dB exchange rate instead of the OSHA specified 5 dB exchange rate. Most companies gave limited or no attention to noise controls and relied primarily on hearing protection to prevent hearing loss; yet 38% of employees did not use protectors routinely. Protector use was highest when hearing loss prevention programmes were most complete, indicating that

  17. Improving patient access to prevent sight loss: ophthalmic electronic referrals and communication (Scotland).

    Science.gov (United States)

    Khan, A A; Mustafa, M Z; Sanders, R

    2015-02-01

    With the number of people with sight loss predicted to double to four million people in the UK by the year 2050, preventable visual loss is a significant public health issue. Sight loss is associated with an increased risk of falls, accidents and depression and evidence suggests that 50% of sight loss can be avoided. Timely diagnosis is central to the prevention of sight loss. Access to care can be a limiting factor in preventable cases. By improving referrals and access to hospital eye services it is possible to treat and minimise the number of patients with preventable sight loss and the impact this has on wider society. In 2005, NHS Fife took part in a flagship pilot funded by the Scottish government e-health department to evaluate the feasibility, safety, clinical effectiveness, and cost of electronic referral with images of patients directly from community optometrists to Hospital Eye Service (HES). The pilot study showed that electronic referral was feasible, fast, safe, and obviated the need for outpatient appointments in 128 (37%) patients with a high patient satisfaction. The results of the pilot study were presented and in May 2007, the electronic referral system was rolled out regionally in southeast Scotland. Referrals were accepted at a single site with vetting by a trained team and appointments were allocated within 48 hours. Following the implementation of electronic referral, waiting times were reduced from a median of 14 to 4 weeks. Significantly fewer new patients were seen (7462 vs 8714 [p electronic communication between community optometry practices and hospital eye departments. Five electronic forms were specifically designed for cataract, glaucoma, macula, paediatric and general ophthalmic disease. A Virtual Private Network was created which enabled optometrists to connect to the Scottish clinical information gateway system and send referrals to hospital and receive referral status feedback. Numerous hurdles have been encountered and overcome

  18. Low-Dose Epinephrine Plus Tranexamic Acid Reduces Early Postoperative Blood Loss and Inflammatory Response: A Randomized Controlled Trial.

    Science.gov (United States)

    Zeng, Wei-Nan; Liu, Jun-Li; Wang, Fu-You; Chen, Cheng; Zhou, Qiang; Yang, Liu

    2018-02-21

    The reductions of perioperative blood loss and inflammatory response are important in total knee arthroplasty. Tranexamic acid reduced blood loss and the inflammatory response in several studies. However, the effect of epinephrine administration plus tranexamic acid has not been intensively investigated, to our knowledge. In this study, we evaluated whether the combined administration of low-dose epinephrine plus tranexamic acid reduced perioperative blood loss or inflammatory response further compared with tranexamic acid alone. This randomized placebo-controlled trial consisted of 179 consecutive patients who underwent primary total knee arthroplasty. Patients were randomized into 3 interventions: Group IV received intravenous low-dose epinephrine plus tranexamic acid, Group TP received topical diluted epinephrine plus tranexamic acid, and Group CT received tranexamic acid alone. The primary outcome was perioperative blood loss on postoperative day 1. Secondary outcomes included perioperative blood loss on postoperative day 3, coagulation and fibrinolysis parameters (measured by thromboelastography), inflammatory cytokine levels, transfusion values (rate and volume), thromboembolic complications, length of hospital stay, wound score, range of motion, and Hospital for Special Surgery (HSS) score. The mean calculated total blood loss (and standard deviation) in Group IV was 348.1 ± 158.2 mL on postoperative day 1 and 458.0 ± 183.4 mL on postoperative day 3, which were significantly reduced (p 0.05). The combined administration of low-dose epinephrine and tranexamic acid demonstrated an increased effect in reducing perioperative blood loss and the inflammatory response compared with tranexamic acid alone, with no apparent increased incidence of thromboembolic and other complications. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

  19. Testing the effects of a message framing intervention on intentions towards hearing loss prevention in adolescents.

    Science.gov (United States)

    de Bruijn, Gert-Jan; Spaans, Pieter; Jansen, Bastiaan; van't Riet, Jonathan

    2016-04-01

    Adolescent hearing loss is a public health problem that has eluded effective intervention. A persuasive message strategy was tested for its effectiveness on adolescents' intention to listen to music at a reduced volume. The messages manipulated both type of message frame [positive consequences of listening to music at a reduced volume (gain-framed) versus negative consequences of not listening to music at a reduced volume (loss-framed)] and type of temporal context (short-term versus long-term consequences). Participants were recruited from four vocational and secondary education schools in the Netherlands and message exposure took place online during class hours. Two weeks prior to message exposure, adolescents provided data on intention and risk perception towards hearing loss and use of (digital) music players. After message exposure, 194 adolescents (mean age = 14.71 years, SD = 1.00, 37.8% males) provided immediate follow-up data on intention. Results revealed that intention to listen to music at a reduced volume increased in those exposed to a loss-framed message with short-term consequences. No changes were found in the other conditions. Messages that emphasize negative short-term consequences of not listening to music at a moderate volume have the ability to influence adolescents' intention towards hearing loss prevention. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  20. Planning a multilevel intervention to prevent hearing loss among farmworkers and managers: a systematic approach.

    Science.gov (United States)

    Fernandez, M E; Bartholomew, L K; Alterman, T

    2009-01-01

    Noise-induced hearing loss (NIHL) is the second most prevalent self-reported occupational illness or injury in the U.S., and agricultural workers experience high rates of hearing loss. This article uses Intervention Mapping (IM), a systematic approach to intervention development, to make recommendations for a program to improve hearing loss protection among farmworkers and managers. Final recommendations, based on previous work in the literature on hearing loss prevention, qualitative formative research, and theoretical considerations, include a specification of a multilevel theory- and evidence-based hearing protection program for farmworkers and farm managers. Twelve performance objectives (e.g., "monitor hearing and hearing loss with regular hearing testing") are specified and crossed with six relevant determinants (knowledge and behavioral capability; perceived exposure and susceptibility and noise annoyance; outcome expectations; barriers; social influence; skills and self-efficacy) to create a highly detailed matrix of change objectives for farmworkers and for their managers. These change objectives are then grouped into five categories: two for both farmworkers and their managers (noticing exposures, taking action) and three only for the latter (surveying and planning, implementation and evaluation, and communication). Theoretical methods and practical strategies, including program materials and activities, are then delineated.

  1. The optimal protocol to reduce blood loss and blood transfusion after unilateral total knee replacement: Low-dose IA-TXA plus 30-min drain clamping versus drainage clamping for the first 3 h without IA-TXA.

    Science.gov (United States)

    Park, Joo Hyun; Choi, Sung Wook; Shin, Eun Ho; Park, Myung Hoon; Kim, Myung Ku

    2017-01-01

    Although intraarticular tranexamic acid (IA-TXA) administration or drainage clamping are popular methods used to reduce blood loss after total knee replacement (TKR), the protocol remains controversial. We aimed (1) to establish new protocols through investigating whether two methods, that is, low-dose (500 mg) IA-TXA plus 30-min drain clamping and drainage clamping for the first 3 h without IA-TXA, can reduce blood loss and blood transfusion after unilateral TKR and (2) to make recommendations related to clinical application. This study, conducted from September 2014 to June 2016 related to enrolled 95 patients with primary osteoarthritis who were to have a unilateral cemented TKR, was nonrandomized and retrospective. In group A, the drain was released following tourniquet deflation. In group B, 500-mg TXA was injected into the knee joint via a drain tube after fascia closure and the drain was clamped for the first 30 min to prevent leakage. In group C, the drain was clamped for the first 3-h postoperation. Demographic characteristics and clinical data were collected, including the levels of hematocrit (Hct), the total blood loss (TBL), drained blood volume (BV), the amount of blood transfused, and any complications that developed. We found a significantly lower postoperative TBL, drained BV, decreasing Hct level, and less transfused BV in the IA-TXA injection group (group B) and the 3-h drainage clamping group (group C) compared to the conventional negative drainage group (group A; p optimal than drainage clamping in patients with high bleeding tendency or lateral retinacular release during TKR, who would be concerned about postoperative wound complication.

  2. Age-related hearing loss: prevention of threshold declines, cell loss and apoptosis in spiral ganglion neurons

    Science.gov (United States)

    Zhu, Xiaoxia; Walton, Joseph P.

    2016-01-01

    Age-related hearing loss (ARHL) -presbycusis - is the most prevalent neurodegenerative disease and number one communication disorder of our aged population; and affects hundreds of millions of people worldwide. Its prevalence is close to that of cardiovascular disease and arthritis, and can be a precursor to dementia. The auditory perceptual dysfunction is well understood, but knowledge of the biological bases of ARHL is still somewhat lacking. Surprisingly, there are no FDA-approved drugs for treatment. Based on our previous studies of human subjects, where we discovered relations between serum aldosterone levels and the severity of ARHL, we treated middle age mice with aldosterone, which normally declines with age in all mammals. We found that hearing thresholds and suprathreshold responses significantly improved in the aldosterone-treated mice compared to the non-treatment group. In terms of cellular and molecular mechanisms underlying this therapeutic effect, additional experiments revealed that spiral ganglion cell survival was significantly improved, mineralocorticoid receptors were upregulated via post-translational protein modifications, and age-related intrinsic and extrinsic apoptotic pathways were blocked by the aldosterone therapy. Taken together, these novel findings pave the way for translational drug development towards the first medication to prevent the progression of ARHL. PMID:27667674

  3. Effect of heat-killed Lactobacillus brevis SBC8803 on cutaneous arterial sympathetic nerve activity, cutaneous blood flow and transepidermal water loss in rats.

    Science.gov (United States)

    Horii, Y; Kaneda, H; Fujisaki, Y; Fuyuki, R; Nakakita, Y; Shigyo, T; Nagai, K

    2014-05-01

    To evaluate the efficacy of the effects of heat-killed Lactobacillus brevis SBC8803 (HK-SBC8803) on the standard physiological markers of skin health of cutaneous arterial sympathetic nerve activity (CASNA), cutaneous blood flow and transepidermal water loss (TEWL) and to determine whether SBC8803 targets serotonin 5-HT3 receptors in rats. A set of three experiments were conducted to examine the effects of SBC8803 on CASNA, cutaneous blood flow and TEWL using Wistar and hairless rats. Two additional experiments further attempted to determine whether HK-SBC8803 was targeting the serotonin 5-HT3 receptors by pretreatment with the 5-HT3 antagonist granisetron. Administration of HK-SBC8803 in the first three experiments caused marked inhibition of CASNA and significant elevation of cutaneous blood flow under urethane anaesthesia as well as significant decrease in TEWL on the dorsal skin of conscious hairless rats. Pretreatment with granisetron decreased the effects of HK-SBC8803 on CASNA and cutaneous blood flow. These findings suggest that HK-SBC8803 reduces CASNA, increases cutaneous blood flow and decreases TEWL and that 5-HT3 receptors may be involved in CASNA and cutaneous blood flow responses. HK-SBC8803 could be a useful substance in the treatment/prevention of skin problems, specifically chapped or dry skin. © 2014 The Society for Applied Microbiology.

  4. Wireless Capsule Endoscopy Detects Meckel’s Diverticulum in a Child with Unexplained Intestinal Blood Loss

    Directory of Open Access Journals (Sweden)

    I. Xinias

    2012-10-01

    Full Text Available Meckel’s diverticulum (MD is the most common congenital anomaly of the gastrointestinal (GI tract, affecting about 2% of the population. Most cases of Meckel’s diverticula are asymptomatic. The diagnosis of symptomatic MD is often difficult to make. We report the case of an 8-year-old boy who presented with GI bleeding due to MD. The diagnostic difficulties after an initial negative endoscopic evaluation and the diagnostic value of the various endoscopic procedures are discussed. The patient had suffered from bright red stools for 20 h before hospital admission. GI scintigraphy with 99mTc-Na-pertechnetate was negative for heterotopic gastric tissue in the small bowel area. Colonoscopy performed in order to exclude Crohn’s disease was also negative. He was placed on ranitidine at a dose of 6 mg/kg body weight twice daily. The patient remained asymptomatic over a period of 6 months before he was readmitted due to macroscopic rectal bleeding. Upper endoscopy and colonoscopy used to investigate the source of bleeding showed normal macroscopic findings. Radiolabeling of blood constituents with 99mTc on delayed imaging showed radionucleotide concentration in the ascending and transverse colon suggestive of a lesion in the ileocecal area. Further investigation with the use of wireless capsule endoscopy revealed a MD. Wireless capsule endoscopy may thus be indicated for patients with GI blood loss when other diagnostic methods, such as upper and lower endoscopy and colonoscopy, have failed to identify the source of bleeding.

  5. Two Different Isomers of Vitamin E Prevent Bone Loss in Postmenopausal Osteoporosis Rat Model

    Directory of Open Access Journals (Sweden)

    Norliza Muhammad

    2012-01-01

    Full Text Available Postmenopausal osteoporotic bone loss occurs mainly due to cessation of ovarian function, a condition associated with increased free radicals. Vitamin E, a lipid-soluble vitamin, is a potent antioxidant which can scavenge free radicals in the body. In this study, we investigated the effects of alpha-tocopherol and pure tocotrienol on bone microarchitecture and cellular parameters in ovariectomized rats. Three-month-old female Wistar rats were randomly divided into ovariectomized control, sham-operated, and ovariectomized rats treated with either alpha-tocopherol or tocotrienol. Their femurs were taken at the end of the four-week study period for bone histomorphometric analysis. Ovariectomy causes bone loss in the control group as shown by reduction in both trabecular volume (BV/TV and trabecular number (Tb.N and an increase in trabecular separation (Tb.S. The increase in osteoclast surface (Oc.S and osteoblast surface (Ob.S in ovariectomy indicates an increase in bone turnover rate. Treatment with either alpha-tocopherol or tocotrienol prevents the reduction in BV/TV and Tb.N as well as the increase in Tb.S, while reducing the Oc.S and increasing the Ob.S. In conclusion, the two forms of vitamin E were able to prevent bone loss due to ovariectomy. Both tocotrienol and alpha-tocopherol exert similar effects in preserving bone microarchitecture in estrogen-deficient rat model.

  6. Prevention of post-transfusion hepatitis c transmission through donor blood and its components

    Directory of Open Access Journals (Sweden)

    A. V. Chechetkin

    2015-01-01

    Full Text Available The aim of organizational aspects of preventing the transmission of hepatitis C virus with donor blood and its components.Materials and methods. An activity of the blood service establishments in Russia for the prevention of HCV infection through transfusion of blood and its components on the basis of the analysis of sectoral statistical surveys was studied.Results. The frequency of detection of antibodies to hepatitis C virus in blood donors and its components during 2009–2013 decreased by more than 1,5 times. The percentage of donors who have identified markers of hepatitis C virus was significantly different in different regions: from 0,51% to 1,36%. The activity of the blood service implemented method of plasma quarantine resulting annually rejected from 0,32% to 0,23% as a result of the identified markers of HCV. Pathogen inactivated plasma volume increased in 3 times, the platelet concentrate in 3,2 times.Conclusion. To ensure the safety of donated blood and its components in the blood service effectively the modern technology use for to prevention transmission of the HCV: quarantine of plasma, donor selection and development, inactivation of pathogens. The degree of implementation in practice of nonpaid voluntary blood transfusions significantly increased and is characterized by regional features in recent years .

  7. Effect of tranexamic acid on intraoperative blood loss and transfusion requirements in patients undergoing excision of intracranial meningioma.

    Science.gov (United States)

    Hooda, Bhavna; Chouhan, Rajendra Singh; Rath, Girija Prasad; Bithal, Parmod Kumar; Suri, Ashish; Lamsal, Ritesh

    2017-07-01

    Surgical excision of meningioma is often complicated by significant blood loss requiring blood transfusion with its attendant risks. Although tranexamic acid is used to reduce perioperative blood loss, its blood conservation effect is uncertain in neurosurgery. Sixty adults undergoing elective craniotomy for meningioma excision were randomized to receive either tranexamic acid or placebo, initiated prior to skin incision. Patients in the tranexamic acid group received intravenous bolus of 20mg/kg over 20min followed by an infusion of 1mg/kg/h till the conclusion of surgery. Intraoperative blood loss, transfusion requirements and estimation of surgical hemostasis using a 5-grade scale were noted. Postoperatively, the extent of tumor excision on CT scan and complications were observed. Demographics, tumor characteristics, amount of fluid infusion, and duration of surgery and anesthesia were comparable between the two groups. The amount of blood loss was significantly less in tranexamic acid group compared to placebo (830mlvs 1124ml; p=0.03). The transfusion requirement was less in tranexamic acid group (p>0.05). The patients in tranexamic acid group fared better on a 5-grade surgical hemostasis scale with more patients showing good hemostasis (p=0.007). There were no significant differences between the groups with regards to extent of tumor removal, perioperative complications, hospital stay or neurologic outcome. To conclude, administration of tranexamic acid significantly reduced blood loss in patients undergoing excision of meningioma. Fewer patients in the tranexamic acid group received blood transfusions. Surgical field hemostasis was better achieved in patients who received tranexamic acid. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Preventive effects of bee pollen Cistus ladaniferus extract on bone loss in ovariectomized rats in vivo

    International Nuclear Information System (INIS)

    Yamaguchi, Masayoshi; Uchiyama, Satoshi; Nakagawa, Taeko

    2007-01-01

    The effect of bee pollen Cistus ladaniferus extract on ovariectomy (OVX)-induced bone loss in vivo was investigated. The water-solubilized extracts were obtained from the bee pollen of Cistus ladaniferus. Cistus extract (5.0 or 10.0 mg/100 g body weight) was orally administered once daily for 30 days to OVX rats. The analysis using a peripheral quantitative computed tomography (pQCT) showed that OVX-induced a significant decrease in mineral content, mineral density, and polar strength strain index in the femoral-metaphyseal tissues. These decreases were significantly prevented after the administration of Cistus extract (10.0 mg/100 g). Moreover, OVX-induced a significant decrease in calcium content in the femoral-diaphyseal and -metaphyseal tissues. This decrease was significantly prevented after the administration of cistus extract (5.0 or 10.0 mg/100 g). This study demonstrates that cistus extract has a preventive effect on OVX-induced bone loss in vivo. (author)

  9. [Intra-Articular Application of Tranexamic Acid Significantly Reduces Blood Loss and Transfusion Requirement in Primary Total Knee Arthroplasty].

    Science.gov (United States)

    Lošťák, J; Gallo, J; Špička, J; Langová, K

    2016-01-01

    PURPOSE OF THE STUDY The aim of this prospective study was to investigate the effect of topical application of tranexamic acid (TXA, Exacyl) on the amount of post-operative blood loss, and blood transfusion requirement in patients undergoing primary total knee arthroplasty (TKA). Attention was paid to early complications potentially associated with TXA administration, such as haematoma, wound exudate, or knee swelling. In addition, the economic benefit of TXA treatment was also taken into account. MATERIAL AND METHODS The study included 238 patients (85 men and 153 women) who underwent primary total knee arthroplasty (TKA) at our department between January 2013 and November 2015. A group of 119 patients (41 men and 78 women) received intraarticular TXA injections according to the treatment protocol (TXA group). A control group matched in basic characteristics to the TXA group also consisted of 119 patients. The average age in the TXA group was 69.8 years, and the most frequent indication for TKA surgery was primary knee osteoarthritis (81.5%). In each patient, post-operative volume of blood lost from drains and total blood loss including hidden blood loss were recorded, as well as post-operative haemoglobin and haematocrit levels. On discharge of each patient from hospital, the size and site of a haematoma; wound exudate, if present after post-operative day 4; joint swelling; range of motion and early revision surgery, if performed, were evaluated. Requirements of analgesic drugs after surgery were also recorded. RESULTS In the TXA group, blood losses from drains were significantly lower than in the control group (456.7 ± 270.8 vs 640.5 ±448.2; p = 0.004). The median value for blood losses from drains was lower by 22% and the average value for total blood loss, including hidden losses, was also lower than in the control group (762.4 ± 345.2 ml vs 995.5 ± 457.3 ml). The difference in the total amount of blood loss between the two groups was significant (p = 0

  10. Brazilian status in blood irradiation in Graft-Versus-Host Disease (GVHD) prevention

    International Nuclear Information System (INIS)

    Goes, E.G. de; Borges, J.C.; Ghilardi Netto, T.

    1996-01-01

    A short overview of the Brazilian reality concerning Graft-Versus-Host Disease (GVHD) is presented. Suggestions of policies and procedures to optimise GVHD prevention are reported. A national irradiator device using cobalt teletherapy unit is proposed for irradiation of blood and cellular components

  11. Productivity loss due to premature mortality caused by blood cancer: a study based on patients undergoing stem cell transplantation.

    Science.gov (United States)

    Ortega-Ortega, Marta; Oliva-Moreno, Juan; Jiménez-Aguilera, Juan de Dios; Romero-Aguilar, Antonio; Espigado-Tocino, Ildefonso

    2015-01-01

    Stem cell transplantation has been used for many years to treat haematological malignancies that could not be cured by other treatments. Despite this medical breakthrough, mortality rates remain high. Our purpose was to evaluate labour productivity losses associated with premature mortality due to blood cancer in recipients of stem cell transplantations. We collected primary data from the clinical histories of blood cancer patients who had undergone stem cell transplantation between 2006 and 2011 in two Spanish hospitals. We carried out a descriptive analysis and calculated the years of potential life lost and years of potential productive life lost. Labour productivity losses due to premature mortality were estimated using the Human Capital method. An alternative approach, the Friction Cost method, was used as part of the sensitivity analysis. Our findings suggest that, in a population of 179 transplanted and deceased patients, males and people who die between the ages of 30 and 49 years generate higher labour productivity losses. The estimated loss amounts to over €31.4 million using the Human Capital method (€480,152 using the Friction Cost method), which means an average of €185,855 per death. The highest labour productivity losses are produced by leukaemia. However, lymphoma generates the highest loss per death. Further efforts are needed to reduce premature mortality in blood cancer patients undergoing transplantations and reduce economic losses. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  12. Safflower bud inhibits RANKL-induced osteoclast differentiation and prevents bone loss in ovariectomized mice.

    Science.gov (United States)

    Choi, Joo-Hee; Lim, Seul-Ki; Kim, Dong-Il; Park, Min-Jung; Kim, Young-Kuk; Lee, An-Chul; Kim, Young-Min; Yang, Soo-Jin; Park, Jong-Hwan

    2017-10-15

    The powder and extract of safflower seeds are known to be effective in the prevention of bone loss in ovariectomized animals. However, the inhibitory effect and molecular mechanisms of safflower bud (SB), the germinated safflower, on bone destruction is unclear. The present study was designed to investigate the inhibitory effect and molecular mechanism of SB on osteoclastic differentiation and on bone loss in ovarietomized (OVX) mice. Osteoclastogenesis was determined by TRAP staining, F-actin ring formation, and bone resorption assay. NF-κB and MAPKs activation was analyzed by transfection assay and Western blot, respectively. Real-time PCR was performed to examine the expression of osteoclastogenesis-related genes. Histological changes, increases in TRAP-positive cells, and cathepsin K expression were examined in the metaphysis of OVX mice. Density of bone marrow was evaluated by µCT. SB inhibited the RANKL-induced differentiation of BMDMs into osteoclasts in a dose-dependent manner. F-actin ring formation and bone resorption were also reduced by SB in RANKL-treated BMDMs. In addition, SB decreased the activation of NF-κB and MAPKs and the expression of osteoclastogenesis-related genes in BMDMs treated with RANKL. Feeding of SB-included diet prevented bone loss in OVX mice. The number of TRAP-positive cells and level of protein expression of cathepsin K was reduced and bone mineral density was increased in the metaphysis of mice fed SB compared with OVX mice. These findings suggest that SB can be a preventive and therapeutic candidate for destructive bone diseases. Copyright © 2017. Published by Elsevier GmbH.

  13. Mercury antagonists: loss of photoactive response in the brine shrimp Artemia and its prevention by thiamine

    Energy Technology Data Exchange (ETDEWEB)

    Yaeger, E.; Siegel, B.Z.; Siegel, S.M.; Lasconia, M.; Correal, T.

    1986-01-01

    The positive photoatactic behavior of Artemia was disturbed when larvae cultured in 0.25 M NaCl were introduced into 10/sup -7/ to 10/sup -5/ M HgCl/sub 2/. At 10/sup -8/ M, and in controls, Hg had no effect either on orientation or mortality, and 65% of the larvae were collected at the light source in 30 min or less. In contrast, at 10/sup -6/ M, only 29% were able to do so. The presence of 10/sup -4/ M thiamine hydrochloride in the excystment medium prevented fully the loss of light-sensitivity.

  14. The Lampedusa Disaster: How to Prevent Further Loss of Life at Sea?

    Directory of Open Access Journals (Sweden)

    Jasmine Coppens

    2013-12-01

    Full Text Available Lampedusa – an Italian island barely 70 miles from northern Africa and 100 miles from Malta – has become a gateway to Europe for migrants. In some seasons, boats filled with asylum seekers arrive almost daily. However, yearly, hundreds of people die trying to cross the Mediterranean Sea. This paper will deal with the obligations of States towards seaborne migrants, the question of why so many people die near Lampedusa and the possible solutions in order to prevent further loss of life at sea.

  15. No Effect of a Bipolar Sealer on Total Blood Loss or Blood Transfusion in Nonseptic Revision Knee Arthroplasty-A Prospective Study With Matched Retrospective Controls

    DEFF Research Database (Denmark)

    Nielsen, Christian Skovgaard; Gromov, Kirill; Jans, Øivind

    2017-01-01

    deviation, ± 452) mL in the bipolar sealer group vs 1452 (SD, ± 530) mL in the control group (P = .66), nor for blood transfusion rates of 53% and 46% (P = .89), respectively. Four controls were readmitted within 90 days follow-up. CONCLUSION: The use of a bipolar sealer in a TKA revision setting without......BACKGROUND: Postoperative anemia is frequent after revision of total knee arthroplasty (TKA) with reported transfusion rates up to 83%. Despite increased efforts of reducing blood loss and enhancing fast recovery within the fast-track setup, a considerable transfusion rate is still evident. The aim......-five prospectively enrolled patients received treatment with both a bipolar sealer and electrocautery, whereas 26 patients had received treatment with a conventional electrocautery only in the retrospective group. RESULTS: No significant differences were found neither for calculated blood loss, with 1397 (standard...

  16. Role of Local Infiltration of Tranexamic Acid in Reducing Blood Loss in Peritrochanteric Fracture Surgery in the Elderly Population

    Directory of Open Access Journals (Sweden)

    Virani SR

    2016-11-01

    Full Text Available Introduction: Peritrochanteric fractures are common injuries occurring in elderly patients. Surgeries for these fractures are associated with significant blood loss. Intravenous tranexamic acid has a proven track record in many orthopaedic surgeries including trauma, arthroplasty and spine surgeries. Objective: To study the effect of local subfascial and intramuscular infiltration of tranexamic acid in reducing blood loss and the requirement for blood transfusion in intertrochanteric fracture surgery. Study Design: Single centre prospective analytical study. Materials and Methods: One hundred and thirty seven patients above 65 years of age were included in the study, divided into two groups: the intervention group received subfascial and intramuscular infiltration of 2g tranexamic acid before wound closure and the control group of alternate patients did not receive any tranexamic acid infiltration. The postoperative drain output was recorded, as well as the haemoglobin level and the patients needing blood transfusion. Results and Conclusions: The preoperative and postoperative haemoglobin values were recorded. The mean preoperative haemoglobin was 10.9% and 10.8% (p=0.79 in the trial and control groups respectively. The mean postoperative haemoglobin was 9.5gm% and 9.2gm% (p=0.36 in the two groups. The total postoperative blood loss in the tranexamic acid group and the control group was 190.3ml and 204.3ml respectively (p=0.25. Ten patients (14.9% in the intervention group and 12 patients (17.1% in the control group required blood transfusion. We conclude that tranexamic acid does not play a significant role in reducing postoperative blood loss and blood transfusion when used locally in peritochanteric fracture surgery. However a larger double blinded study comparing various modalities of use of tranexamic acid is needed to conclusively establish its role.

  17. Overview of revised measures to prevent malaria transmission by blood transfusion in France.

    Science.gov (United States)

    Garraud, O; Assal, A; Pelletier, B; Danic, B; Kerleguer, A; David, B; Joussemet, M; de Micco, P

    2008-10-01

    Plasmodial transmission by blood donation is rare in non-endemic countries, but a very serious complication of blood transfusion. The French national blood service (Etablissement Français du Sang and Centre de Transfusion sanguine des Armees) intended to revise the measures to strengthen blood safety with regard to Plasmodiae as transmissible pathogens. To limit the risk of transmission during infusion, serious additive measures have been taken for more than a decade in France, which is the European country with the highest rate of exposure to imported plasmodial infections or malaria. These measures were revised and strengthened after the occurrence of a lethal transfusion-transmitted infection in 2002, but did not prevent another occurrence in 2006. This report examines the weaknesses of the systems and aims at emphasizing the safety measures already taken and addresses issues to best respond to that risk.

  18. Which Route of Tranexamic Acid Administration is More Effective to Reduce Blood Loss Following Total Knee Arthroplasty?

    Science.gov (United States)

    Keyhani, Sohrab; Esmailiejah, Ali Akbar; Abbasian, Mohammad Reza; Safdari, Farshad

    2016-01-01

    The most appropriate route of tranexamic acid administration is controversial. In the current study, we compared the efficacy of intravenous (IV) and topical intra-articular tranexamic acid in reducing blood loss and transfusion rate in patients who underwent primary total knee arthroplasty. One hundred twenty 120 patients were scheduled to undergo primary total knee arthroplasty. Patients were randomly allocated to three equal groups: IV tranexamic acid (500 mg), topical tranexamic acid (3 g in 100 mL normal saline) and the control. In the topical group, half of the volume was used to irrigate the joint and the other half was injected intra-articularly. The volume of blood loss, hemoglobin (Hb) level at 24 hours postoperative, and rate of transfusion was compared between groups. The blood loss and Hb level were significantly greater and lower in the control group, respectively (P=0.031). Also, the rate of transfusion was significantly greater in the control group (P=0.013). However, IV and topical groups did not differ significantly in terms of measured variables. No patient experienced a thromboembolic event in our study. Tranexamic acid is a useful antifibrinolytic drug to reduce postoperative blood loss, Hb drop, and rate of blood transfusion in patients undergoing total knee arthroplasty. The route of tranexamic acid administration did not affect the efficacy and safety.

  19. Riboflavin, MTHFR genotype and blood pressure: A personalized approach to prevention and treatment of hypertension.

    Science.gov (United States)

    McNulty, Helene; Strain, J J; Hughes, Catherine F; Ward, Mary

    2017-02-01

    Hypertension is the leading risk factor contributing to mortality worldwide, primarily from cardiovascular disease (CVD), while effective treatment of hypertension is proven to reduce CVD events. Along with the well recognized nutrition and lifestyle determinants, genetic factors are implicated in the development and progression of hypertension. In recent years genome-wide association studies have identified a region near the gene encoding the folate-metabolizing enzyme methylenetetrahydrofolate reductase (MTHFR) among eight loci associated with blood pressure. Epidemiological studies, which provide a separate line of evidence to link this gene with blood pressure, show that the 677C→T polymorphism in MTHFR increases the risk of hypertension by 24-87% and CVD by up to 40%, albeit with a large geographical variation in the extent of excess disease risk suggestive of a gene-environment interaction. Emerging evidence indicates that the relevant environmental factor may be riboflavin, the MTHFR co-factor, via a novel and genotype-specific effect on blood pressure. Randomized trials conducted in hypertensive patients (with and without overt CVD) pre-screened for this polymorphism show that targeted riboflavin supplementation in homozygous individuals (MTHFR 677TT genotype) lowers systolic blood pressure by 6 to 13 mmHg, independently of the effect of antihypertensive drugs. The latest evidence, that the blood pressure phenotype associated with this polymorphism is modifiable by riboflavin, has important clinical and public health implications. For hypertensive patients, riboflavin supplementation can offer a non-drug treatment to effectively lower blood pressure in those identified with the MTHFR 677TT genotype. For sub-populations worldwide with this genotype, better riboflavin status may prevent or delay the development of high blood pressure. Thus riboflavin, targeted at those homozygous for a common polymorphism in MTHFR, may offer a personalized treatment or

  20. Influence of sibutramine in addition to diet and exercise on the relationship between weight loss and blood glucose changes

    DEFF Research Database (Denmark)

    Kamil, S; Finer, N; James, W P T

    2017-01-01

    on glycemic control. METHODS AND RESULTS: 8192 obese patients with diabetes were randomized to sibutramine or placebo plus diet and exercise after a preliminary 6 weeks in which all patients received sibutramine. Patients were classified into four groups of weight change. A total of 1582 patients had a weight...... loss induced by sibutramine, diet, and exercise attenuates falls in blood glucose levels and HbA1c compared with similar weight loss with placebo, diet and exercise....

  1. Prevention of the Evolution of Workers' Hearing Loss from Noise-Induced Hearing Loss in Noisy Environments through a Hearing Conservation Program

    OpenAIRE

    Fonseca, Vinicius Ribas; Marques, Jair; Panegalli, Flavio; Gonçalves, Claudia Giglio de Oliveira; Souza, Wesley

    2016-01-01

    Introduction Noise-induced hearing loss (NIHL) is a serious problem for workers and therefore for businesses. The hearing conservation program (HCP) is a set of coordinated measures to prevent the development or evolution of occupational hearing loss, which involves a continuous and dynamic process of implementation of hearing conservation routines through anticipation, recognition, evaluation, and subsequent control of the occurrence of existing environmental risks or of those thatmay exist...

  2. Achieved Blood Pressure and Outcomes in the Secondary Prevention of Small Subcortical Strokes Trial.

    Science.gov (United States)

    Odden, Michelle C; McClure, Leslie A; Sawaya, B Peter; White, Carole L; Peralta, Carmen A; Field, Thalia S; Hart, Robert G; Benavente, Oscar R; Pergola, Pablo E

    2016-01-01

    Studies suggest a J-shaped association between blood pressure and cardiovascular events in the setting of intensive systolic blood pressure control; whether there is a similar association with stroke remains less well established. The Secondary Prevention of Small Subcortical Strokes was a randomized trial to evaluate higher (130-149 mm Hg) versus lower (blood pressure targets in participants with recent lacunar infarcts. We evaluated the association of mean achieved blood pressure, 6 months after randomization, and recurrent stroke, major vascular events, and all-cause mortality. After a mean follow up of 3.7 years, there was a J-shaped association between achieved blood pressure and outcomes; the lowest risk was at ≈124 and 67 mm Hg systolic and diastolic blood pressure, respectively. For example, above a systolic blood pressure of 124 mm Hg, 1 standard deviation higher (11.1 mm Hg) was associated with increased mortality (adjusted hazard ratio: 1.9; 95% confidence interval: 1.4, 2.7), whereas below this level, this relationship was inverted (0.29; 0.10, 0.79), Pblood pressure of 67 mm Hg, a 1 standard deviation higher (8.2 mm Hg) was associated with an increased risk of stroke (2.2; 1.4, 3.6), whereas below this level, the association was in the opposite direction (0.34; 0.13, 0.89), P=0.02 for interaction. The lowest risk of all events occurred at a nadir of ≈120 to 128 mm Hg systolic blood pressure and 65 to 70 mm Hg diastolic blood pressure. Future studies should evaluate the impact of excessive blood pressure reduction, especially in older populations with preexisting vascular disease. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00059306. © 2015 American Heart Association, Inc.

  3. X-ray irradiation on blood products for the purpose of prevention of PT-GVHD

    International Nuclear Information System (INIS)

    Tayama, Tatsuya; Naohara, Tooru; Haneda, Kenji; Juji, Takeo.

    1990-01-01

    X-ray irradiation on blood products is a common method to prevent the risk of inducing PT-GVHD, and has recently become to be used in Japan. We have tried X-ray irradiation on WB, CRC and PC using HITACHI X-ray Irradiation Apparatus MBR1520R, and studied its practical usefulness. In case of irradiation on blood bags as the minimum dose of 1,500 rads, these conditions are thought to be practical: 1) the use of 1.0 mm Al filter, 2) the distance of 550 nm from X-ray source, and 3) irradiation on 4 bags at the same time. But, it has also been noticed that total doses and qualities of X-ray absorbed into blood were different between upper and lower side of the bag. Bloods on upper side absorbed much doses and a wide range of X-ray, on the other hand, bloods on lower side absorbed less doses and hard X-ray. In these conditions, irradiated lymphocytes showed a complete inhibition of thymidine uptake in MLC test, still had 15% of activity in PHA stimulation. The qualities of other blood components have not changed before and after irradiation. X-ray irradiation is useful in a routine work of blood center, but problems of proper doses and a uniformity of irradiation are remained to be solved. (author)

  4. Effect of a Modest Weight Loss in Normalizing Blood Pressure in Obese Subjects on Antihypertensive Drugs.

    Science.gov (United States)

    Gilardini, Luisa; Redaelli, Gabriella; Croci, Marina; Conti, Antonio; Pasqualinotto, Lucia; Invitti, Cecilia

    2016-01-01

    To assess the effect of a lifestyle intervention in lowering/normalizing blood pressure (BP) levels in hypertensive (controlled or not) obese patients. In this prospective observational study, 490 obese hypertensive patients, 389 controlled (BP < 140/90 mm Hg; CH) and 101 uncontrolled (BP ≥ 140/90 mm Hg; UH) attended a 3-month lifestyle intervention. Before and after the intervention we assessed weight, waist circumference, fat mass, BP, metabolic and renal variables, and physical activity. A multivariate regression model was used to determine the predictors of BP changes. 18.9% of CH and 20.0% of UH were on ≥ 3 antihypertensive drugs. Weight change (average -4.9 ± 2.7%) was independent of the antihypertensive drugs employed. Systolic BP (SBP) decreased by 23 mm Hg and diastolic BP (DBP) by 9 mm Hg, in patients with UH most of whom (89%) normalized BP levels (in 49% after a weight loss < 5%). Age, gender, whole and central obesity, concomitance of type 2 diabetes, chronic renal disease, physical activity intensification, and pharmacological therapy did not affect BP lowering. In the regression analysis with SBP change as dependent variable, weight reduction (β = 0.523, p = 0.005) and group (UH vs. CH, β = -19.40, p = 0.0005) remained associated with SBP reduction. When DBP change was entered as dependent variable, baseline uric acid remained associated with DBP reduction (β = 0.824, p < 0.05). Lifestyle interventions are useful for all obese hypertensive patients in most of whom a modest weight loss is sufficient to normalize BP levels avoiding the aggressive use of multiple antihypertensive drugs. © 2016 The Author(s) Published by S. Karger GmbH, Freiburg.

  5. 'Rakter dosh'--corrupting blood: The challenges of preventing thalassemia in Bengal, India.

    Science.gov (United States)

    Chattopadhyay, Sreeparna

    2006-11-01

    Thalassemia is an inherited blood disorder that has been receiving increasing attention in India. However, prevention of thalassemia in India continues to be difficult despite efforts of public health professionals and the government. Using West Bengal as a case study, this paper attempts to unravel some of the barriers to the prevention campaign and the consequent under utilization of the program. Lack of access, low awareness, low-risk perception and poverty are all important proximate constraints; however, one of the greatest barriers to the program is rooted in cultural notions of blood, marriage, identity, personhood and kinship in Bengali society. Blood is so deeply valued in the Bengali kinship system that this genetic mutation is perceived to be corrupting the blood (rakter dosh). Being a thalassemia carrier (i.e., having thalassemia minor) renders an individual unfit as a suitable marriage partner because of beliefs related to purity of blood, its association with the continuity of the lineage, and subsequent transmission of desirable traits to future generations. The risk of non-marriage affects women disproportionately, and parents are not inclined to test their daughters because of the possibility of not being able to marry them off to eligible suitors. The stigma associated with having thalassemia minor (TMI) is a deterrent to the disclosure of thalassemia status as well as to testing. Using anthropological theories and ethnographic methods, this paper focuses on the gendered process by which the diagnosis of a thalassemia carrier 'spoils' identities, thereby creating a disjuncture between the goals of the prevention program and people's need for social conformity, and ultimately between medical desirability and social desirability. The paper also suggests policies for enhancing the utilization of the program. Finally the conclusions from this study have potential applications for public health prevention programs that confront problems of stigma in

  6. Non-pharmacological interventions for preventing job loss in workers with inflammatory arthritis.

    Science.gov (United States)

    Hoving, Jan L; Lacaille, Diane; Urquhart, Donna M; Hannu, Timo J; Sluiter, Judith K; Frings-Dresen, Monique H W

    2014-11-06

    Work participation of patients with inflammatory arthritis (IA) is important not only economically but also for physical and psychological health. There is no Cochrane Review to date on studies of non-pharmacological interventions specifically aimed at preventing job loss in people with IA. To assess the effects of non-pharmacological interventions that aim to prevent job loss, work absenteeism or improve work functioning for employees with IA (rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), other spondylarthritis (SpA) or IA associated with connective tissue diseases, such as Systemic Lupus Erythematosus (SLE)). We searched the following databases from inception up to 30 April 2014; The Cochrane Library (including Cochrane Central Register of Controlled Trials, i.e. CENTRAL and DARE), MEDLINE (PubMed), EMBASE (Embase.com), CINAHL (EbSCOhost), ClinicalTrials.gov and PsycINFO (ProQuest). We did not impose language restrictions in the search. We included randomised controlled trials (RCTs) that evaluated interventions aimed at preventing job loss in adults of working age (18 to 65 years) diagnosed with IA, including RA, AS, PsA, SpA or other types of IA. Primary outcomes were job loss and sickness absenteeism and the secondary outcome was work functioning. Two review authors independently selected trials for inclusion, extracted data and assessed risk of bias in the included RCTs. We included three RCTs with a total of 414 participants at risk of job loss. The majority of participants had IA, most with RA and to a lesser degree AS. The interventions aimed to prevent job loss and improve work functioning in several ways: firstly by evaluating work changes or adaptations and secondly by providing any person-directed interventions including vocational counselling, advice or education. Interventions directly targeted at the work environment were minimal and included workplace visits (one trial) or any actions by an occupational

  7. Bipolar sealer device reduces blood loss and transfusion requirements in posterior spinal fusion for adolescent idiopathic scoliosis.

    Science.gov (United States)

    Gordon, Zachary L; Son-Hing, Jochen P; Poe-Kochert, Connie; Thompson, George H

    2013-01-01

    Reducing perioperative blood loss and transfusion requirements is important in the operative treatment of idiopathic scoliosis. This can be achieved with special frames, cell saver systems, pharmacologic aspects, and other techniques. Recently there has been interest in bipolar sealer devices as an adjunct to traditional monopolar electrocautery. However, there is limited information on this device in pediatric spinal deformity surgery. We reviewed our experience with this device in a setting of a standard institutional operative carepath. Perioperative blood loss and transfusion requirements of 50 consecutive patients with adolescent idiopathic scoliosis undergoing a posterior spinal fusion and segmental spinal instrumentation and who had a bipolar sealer device used during their surgery was compared with a control group of the 50 preceding consecutive patients who did not. Anesthesia, surgical technique, use of intraoperative epsilon aminocaproic acid (Amicar), postoperative protocol, and indications for transfusions (hemoglobin≤7.0 g/dL) were identical in both groups. The preoperative demographics for the patients in both groups were statistically the same. The bipolar sealer group demonstrated a significant reduction in intraoperative estimated blood loss, total perioperative blood loss, volume of blood products transfused, and overall transfusion rate when compared with the control group. When subgroups consisting of only hybrid or all-pedicle screw constructs were considered individually, these findings remained consistent. There were no complications associated with the use of this device. Using the bipolar sealer device is a significant adjunct in decreasing perioperative blood loss and transfusion requirements in patients undergoing surgery for adolescent idiopathic scoliosis. Level III-retrospective comparative study.

  8. Epothilone D prevents binge methamphetamine-mediated loss of striatal dopaminergic markers.

    Science.gov (United States)

    Killinger, Bryan A; Moszczynska, Anna

    2016-02-01

    Exposure to binge methamphetamine (METH) can result in a permanent or transient loss of dopaminergic (DAergic) markers such as dopamine (DA), dopamine transporter, and tyrosine hydroxylase (TH) in the striatum. We hypothesized that the METH-induced loss of striatal DAergic markers was, in part, due to a destabilization of microtubules (MTs) in the nigrostriatal DA pathway that ultimately impedes anterograde axonal transport of these markers. To test this hypothesis, adult male Sprague-Dawley rats were treated with binge METH or saline in the presence or absence of epothilone D (EpoD), a MT-stabilizing compound, and assessed 3 days after the treatments for the levels of several DAergic markers as well as for the levels of tubulins and their post-translational modifications (PMTs). Binge METH induced a loss of stable long-lived MTs within the striatum but not within the substantia nigra pars compacta (SNpc). Treatment with a low dose of EpoD increased the levels of markers of stable MTs and prevented METH-mediated deficits in several DAergic markers in the striatum. In contrast, administration of a high dose of EpoD appeared to destabilize MTs and potentiated the METH-induced deficits in several DAergic markers. The low-dose EpoD also prevented the METH-induced increase in striatal DA turnover and increased behavioral stereotypy during METH treatment. Together, these results demonstrate that MT dynamics plays a role in the development of METH-induced losses of several DAergic markers in the striatum and may mediate METH-induced degeneration of terminals in the nigrostriatal DA pathway. Our study also demonstrates that MT-stabilizing drugs such as EpoD have a potential to serve as useful therapeutic agents to restore function of DAergic nerve terminals following METH exposure when administered at low doses. Administration of binge methamphetamine (METH) negatively impacts neurotransmission in the nigrostriatal dopamine (DA) system. The effects of METH include

  9. Implications of Postharvest Food Loss/Waste Prevention to Energy and Resources Conservation

    Science.gov (United States)

    Cai, X.; Shafiee-Jood, M.

    2015-12-01

    World's growing demand for food is driven by population and income growth, dietary changes, and the ever-increasing competition between food, feed and bioenergy challenges food security; meanwhile agricultural expansion and intensification threats the environment by the various detrimental impacts. Researchers have attempted to explore strategies to overcome this grand challenge. One of the promising solutions that have attracted considerable attention recently is to increase the efficiency of food supply chain by reducing food loss and waste (FLW). According to recent studies conducted by Food and Agriculture Organization (FAO), United Nation, almost one third of the food produced for human consumption globally is lost or wasted along the food supply chain. This amount of food discarded manifests a missing, yet potential, opportunity to sustainably enhance both food security and environmental sustainability. However, implementing the strategies and technologies for tackling FLW does not come up as an easy solution since it requires economic incentives, benefit and cost analysis, infrastructure development, and appropriate market mechanism. In this presentation I will provide a synthesis of knowledge on the implications of postharvest food loss/waste prevention to energy and resource conservation, environmental protection, as well as food security. I will also discuss how traditional civil and environmental engineering can contribute to the reduction of postharvest food loss, an important issue of sustainable agriculture.

  10. Self-determination theory and weight loss in a Diabetes Prevention Program translation trial.

    Science.gov (United States)

    Trief, Paula M; Cibula, Donald; Delahanty, Linda M; Weinstock, Ruth S

    2017-06-01

    We examined self-determination theory (SDT) and weight loss, and hypothesized that the Diabetes Prevention Program's (DPP) intervention would result in an increase in autonomous regulation of motivation (AR) in participants. Further, that those with higher AR, and those who perceived educators as supporting SDT-defined needs, would lose more weight. Support, Health Information, Nutrition and Exercise (SHINE) Study data (N = 257) were analyzed. SHINE was a randomized, controlled DPP translation trial (2-years, telephonic, primary care staff). Autonomous motivation in males increased significantly, while females showed no change. Males with high AR, but not females, lost more weight. However, the significance of these relationships varied over time. Participants who perceived educators as more supportive of psychological needs lost more weight (especially males). However, effect of support on weight loss was not mediated by AR change. Autonomous motivation and educator support are relevant to male weight loss. Future research might develop interventions to enhance autonomous motivation and educator support, and understand change pathways.

  11. Effects of total flavonoids from Drynariae Rhizoma prevent bone loss in vivo and in vitro

    Directory of Open Access Journals (Sweden)

    Shuang-hong Song

    2016-12-01

    Full Text Available Estrogen deficiency is one of the major causes of osteoporosis in postmenopausal women. Drynariae Rhizoma is a widely used traditional Chinese medicine for the treatment of bone diseases. In this study, we investigated the therapeutic effects of the total Drynariae Rhizoma flavonoids (DRTF on estrogen deficiency-induced bone loss using an ovariectomized rat model and osteoblast-like MC3T3-E1 cells. Our results indicated that DRTF produced osteo-protective effects on the ovariectomized rats in terms of bone loss reduction, including decreased levels of bone turnover markers, enhanced biomechanical femur strength and trabecular bone microarchitecture deterioration prevention. In vitro experiments revealed that the actions of DRTF on regulating osteoblastic activities were mediated by the estrogen receptor (ER dependent pathway. Our data also demonstrated that DRTF inhibited osteoclastogenesis via up-regulating osteoprotegrin (OPG, as well as down-regulating receptor activator of NF–κB ligand (RANKL expression. In conclusion, this study indicated that DRTF treatment effectively suppressed bone mass loss in an ovariectomized rat model, and in vitro evidence suggested that the effects were exerted through actions on both osteoblasts and osteoclasts. Keywords: Osteoporosis, Osteoblast, Osteoclast, Ovariectomy, Drynariae Rhizoma

  12. A Preliminary Study of a Spanish Graphic Novella Targeting Hearing Loss Prevention.

    Science.gov (United States)

    Guiberson, Mark; Wakefield, Emily

    2017-09-18

    This preliminary study developed a digital graphic novella targeting hearing protection beliefs of Spanish-speaking agricultural workers. Researchers used pretest-posttest interview surveys to establish if the novella had an immediate influence on the participants' beliefs about noise-induced hearing loss and usage of hearing protection devices. Researchers developed a digital graphic novella directed to increase knowledge about noise-induced hearing loss and increase the proper use of hearing protection devices. The novella was tailored to meet the specific linguistic and literacy needs of Spanish-speaking agricultural workers. Thirty-one Spanish-speaking farmworkers of Mexican nationality participated. This study included an interview survey with specific questions on noise-induced hearing loss, myths, and hearing protection device usage. A pretest-posttest design was applied to measure the graphic novella's immediate influence on workers. The posttest scores on Hearing Protection Beliefs statements were significantly better than pretest scores, with a large effect size observed. Digital media may be an effective way to overcome language and literacy barriers with Spanish-speaking workers when providing health education and prevention efforts.

  13. Acute Blood Loss During Burn and Soft Tissue Excisions: An Observational Study of Blood Product Resuscitation Practices and Focused Review

    Science.gov (United States)

    2015-06-24

    prospective observational study. Number, component type , volume, and age of the blood products transfused were recorded during burn excision/grafting or soft...tissue debridement . Component bags (packed red blood cells, fresh frozen plasma, platelets, and cryoprecipitate) were collected, and the remaining...collection of information if it does not display a currently valid OMB control number. 1. REPORT DATE 24 JUN 2015 2. REPORT TYPE N/A 3. DATES

  14. Intraoperative blood loss independently predicts survival and recurrence after resection of colorectal cancer liver metastasis.

    Directory of Open Access Journals (Sweden)

    Wu Jiang

    Full Text Available BACKGROUND: Although numerous prognostic factors have been reported for colorectal cancer liver metastasis (CRLM, few studies have reported intraoperative blood loss (IBL effects on clinical outcome after CRLM resection. METHODS: We retrospectively evaluated the clinical and histopathological characteristics of 139 patients who underwent liver resection for CRLM. The IBL cutoff volume was calculated using receiver operating characteristic curves. Overall survival (OS and recurrence free survival (RFS were assessed using the Kaplan-Meier and Cox regression methods. RESULTS: All patients underwent curative resection. The median follow up period was 25.0 months (range, 2.1-88.8. Body mass index (BMI and CRLM number and tumor size were associated with increased IBL. BMI (P=0.01; 95% CI = 1.3-8.5 and IBL (P500mL were 71%, 33%, and 0%, respectively (P<0.01. RFS of patients within three IBL volumes at the end of the first year were 67%, 38%, and 18%, respectively (P<0.01. CONCLUSIONS: IBL during CRLM resection is an independent predictor of long term survival and tumor recurrence, and its prognostic value was confirmed by a dose-response relationship.

  15. Reduced Operating Time but Not Blood Loss With Cruciate Retaining Total Knee Arthroplasty

    Science.gov (United States)

    Vermesan, Dinu; Trocan, Ilie; Prejbeanu, Radu; Poenaru, Dan V; Haragus, Horia; Gratian, Damian; Marrelli, Massimo; Inchingolo, Francesco; Caprio, Monica; Cagiano, Raffaele; Tatullo, Marco

    2015-01-01

    Background There is no consensus regarding the use of retaining or replacing cruciate implants for patients with limited deformity who undergo a total knee replacement. Scope of this paper is to evaluate whether a cruciate sparing total knee replacement could have a reduced operating time compared to a posterior stabilized implant. Methods For this purpose, we performed a randomized study on 50 subjects. All procedures were performed by a single surgeon in the same conditions to minimize bias and only knees with a less than 20 varus deviation and/or maximum 15° fixed flexion contracture were included. Results Surgery time was significantly shorter with the cruciate retaining implant (P = 0.0037). The mean duration for the Vanguard implant was 68.9 (14.7) and for the NexGen II Legacy was 80.2 (11.3). A higher range of motion, but no significant Knee Society Scores at 6 months follow-up, was used as controls. Conclusions In conclusion, both implants had the potential to assure great outcomes. However, if a decision has to be made, choosing a cruciate retaining procedure could significantly reduce the surgical time. When performed under tourniquet, this gain does not lead to reduced blood loss. PMID:25584102

  16. Workers' compensation loss prevention representative contact and risk of lost-time injury in construction policyholders.

    Science.gov (United States)

    Schofield, Katherine E; Alexander, Bruce H; Gerberich, Susan G; MacLehose, Richard F

    2017-09-01

    Insurance loss prevention (LP) representatives have access and contact with businesses and employees to provide targeted safety and health resources. Construction firms, especially those smaller in size, are a high-risk population. This research evaluated the association between LP rep contact and risk for lost-time injuries in construction policyholders. Workers' compensation data were utilized to track LP rep contact with policyholders and incidence of lost-time injury over time. Survival analysis with repeated events modeling calculated hazard ratios (HR) and 95% confidence intervals (CI). Compared no LP contact, one contact was associated with a 27% reduction of risk (HR=0.73, CI=0.65-0.82), two with a 41% (HR=0.59, CI=0.51-0.68), and three or more contacts with a 28% reduction of risk (HR=0.72, CI=0.65-0.81). LP reps appear to be a valuable partner in efforts to reduce injury burden. Their presence or contact with policyholders is consistent with reduction in overall incidence of lost-time injuries. Reduction in lost-time injuries, resulting in reduced workers' compensation costs for policyholders and insurance companies, builds a business-case for safety and injury prevention. LP reps are often a low or no-cost benefit for insurance policyholders and may be an important injury prevention resource for small firms and/or those with lack of safety resources and staff. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Prevention of the Evolution of Workers' Hearing Loss from Noise-Induced Hearing Loss in Noisy Environments through a Hearing Conservation Program.

    Science.gov (United States)

    Fonseca, Vinicius Ribas; Marques, Jair; Panegalli, Flavio; Gonçalves, Claudia Giglio de Oliveira; Souza, Wesley

    2016-01-01

    Introduction Noise-induced hearing loss (NIHL) is a serious problem for workers and therefore for businesses. The hearing conservation program (HCP) is a set of coordinated measures to prevent the development or evolution of occupational hearing loss, which involves a continuous and dynamic process of implementation of hearing conservation routines through anticipation, recognition, evaluation, and subsequent control of the occurrence of existing environmental risks or of those that may exist in the workplace and lead to workers' hearing damage. Objective The aim of this study was to evaluate the effectiveness of the HCP in preventing further hearing loss in workers with audiograms suggestive of NIHL. The audiometric tests and medical records of 28 furniture company workers exposed to noise were reviewed and monitored for 2 years. Methods This retrospective, cross-sectional study examined five audiometric tests in the medical records (on admission and every semester) of 28 workers in a furniture company (totaling 140 audiometric exams) following the introduction of the HCP. Results Data analysis showed no differences between the audiometric tests conducted on admission and those performed every semester. Conclusions The HCP implemented was effective in preventing the worsening of hearing loss in workers already with NIHL when exposed to occupational noise. Therefore, such a measure could be useful for the employment of workers with hearing loss in job sectors that have noise exposure.

  18. Prevention of the Evolution of Workers' Hearing Loss from Noise-Induced Hearing Loss in Noisy Environments through a Hearing Conservation Program

    Science.gov (United States)

    Fonseca, Vinicius Ribas; Marques, Jair; Panegalli, Flavio; Gonçalves, Claudia Giglio de Oliveira; Souza, Wesley

    2015-01-01

    Introduction Noise-induced hearing loss (NIHL) is a serious problem for workers and therefore for businesses. The hearing conservation program (HCP) is a set of coordinated measures to prevent the development or evolution of occupational hearing loss, which involves a continuous and dynamic process of implementation of hearing conservation routines through anticipation, recognition, evaluation, and subsequent control of the occurrence of existing environmental risks or of those that may exist in the workplace and lead to workers' hearing damage. Objective The aim of this study was to evaluate the effectiveness of the HCP in preventing further hearing loss in workers with audiograms suggestive of NIHL. The audiometric tests and medical records of 28 furniture company workers exposed to noise were reviewed and monitored for 2 years. Methods This retrospective, cross-sectional study examined five audiometric tests in the medical records (on admission and every semester) of 28 workers in a furniture company (totaling 140 audiometric exams) following the introduction of the HCP. Results Data analysis showed no differences between the audiometric tests conducted on admission and those performed every semester. Conclusions The HCP implemented was effective in preventing the worsening of hearing loss in workers already with NIHL when exposed to occupational noise. Therefore, such a measure could be useful for the employment of workers with hearing loss in job sectors that have noise exposure. PMID:26722345

  19. Uptake and Loss Kinetics of 57Co, 85Sr and 134Cs on Blood Cockle Anadara granosa

    International Nuclear Information System (INIS)

    Srisuksawad, K; Prasertchiewchan, N.; Tungkitjanukij, S.; Pakkong, P.

    2005-02-01

    Adult blood cockle (A. granosa) were exposed in the laboratory to 57 Co, 85 Sr, and 134 Cs in seawater at average +- s.e. stable activities of 0.725+-0.010 Bq/ml, 0.917+-0.066 Bq/ml and 1.37+-0.105 Bq/ml, respectively. The study aims to determine key contaminant bioaccumulation, retention and loss parameters for bio-indicator organisms used in assessment of the impact of the effluent discharge from nuclear and non-nuclear facilities on coastal area. Natural coastal water conditions in dry season with a salinity of 30 ppt, at 30οC and p H 8.1+-0.1 of the study area (Bang Pa Kong river basin) were simulated as far as practicable. 19 d uptake of radiotracers showed that blood cockle did not accumulate 134 Cs and 85 Sr but considerably accumulated 57 Co. Non-linear regression model fitting of a 1-compartment exponential uptake model derived overall weight concentration factors for the whole cockle at saturation of 687.6+-6.23 ml/g for 57 Co. 22 d loss experiment showed that 57 Co is tightly bounded in blood cockle and 63.2+-15.2% retained in the whole body. Loss of 57 Co displayed 2-compartment loss kinetic. The calculated half time for the short and long components of loss model was estimated 1.4 dand 41 d, respectively

  20. Effect of antifibrinolytic drugs on transfusion requirement and blood loss during orthotopic liver transplantation: Results from a single center

    Directory of Open Access Journals (Sweden)

    Devi A

    2008-01-01

    Full Text Available Background: During orthotopic liver transplantation (OLT, activation of the fibrinolytic system can contribute significantly to perioperative bleeding. Prophylactic administration of antifibrinolytic agents has been shown to reduce blood loss and the need for allogenic transfusion. Objective: To study the effect of antifibrinolytics on requirement of blood components, blood loss and operative time during OLT in patients with end stage liver disease, reporting to a single centre. Materials and Methods: Consecutive patients who underwent OLT at this centre during the period February 2003-October 2007 were the subjects of this study. Based on the individual anesthesiologist′s preference, patients were assigned to receive either two million units of aprotinin (AP as a bolus followed by 5,00,000 units/hour or 10 mg/kg tranexamic acid (TAas a bolus followed by 10 mg/kg every six to eight hours, administered from the induction till the end of the surgery. Transfusion policy was standardized in all patients. Intraoperative red cell salvage was done wherever possible. The effect of these two antifibrinolytic drugs on transfusion requirement was evaluated as a whole and in a sub group of patients from each treatment group and compared with a concurrent control group that did not receive antifibrinolytic drugs. Results: Fifty patients (40 M / 10 F, 44 adults, 6 pediatric patients underwent OLT in the study period. Fourteen patients were given AP, 25 patients were given TA and 11 patients did not receive any of the agents(control group. The median volume of total blood components transfused in antifibrinolytic group (n=39 was 4540 ml(0-19,200ml, blood loss 5 l(0.7-35l and operative time 9h (4.5-17h and that of control group(n=11 was 5700 ml(0-15,500ml, 10 l(0.6-25 l and 9h (6.4-15.8h respectively. The median volume of blood transfusions, blood loss and operative time was lesser in AP group(n=14 than that of TA group(n=25. Conclusion: There is definite

  1. Kit W-sh Mutation Prevents Cancellous Bone Loss during Calcium Deprivation.

    Science.gov (United States)

    Lotinun, Sutada; Suwanwela, Jaijam; Poolthong, Suchit; Baron, Roland

    2018-01-01

    Calcium is essential for normal bone growth and development. Inadequate calcium intake increases the risk of osteoporosis and fractures. Kit ligand/c-Kit signaling plays an important role in regulating bone homeostasis. Mice with c-Kit mutations are osteopenic. The present study aimed to investigate whether impairment of or reduction in c-Kit signaling affects bone turnover during calcium deprivation. Three-week-old male WBB6F1/J-Kit W /Kit W-v /J (W/W v ) mice with c-Kit point mutation, Kit W-sh /HNihrJaeBsmJ (W sh /W sh ) mice with an inversion mutation in the regulatory elements upstream of the c-Kit promoter region, and their wild-type controls (WT) were fed either a normal (0.6% calcium) or a low calcium diet (0.02% calcium) for 3 weeks. μCT analysis indicated that both mutants fed normal calcium diet had significantly decreased cortical thickness and cancellous bone volume compared to WT. The low calcium diet resulted in a comparable reduction in cortical bone volume and cortical thickness in the W/W v and W sh /W sh mice, and their corresponding controls. As expected, the low calcium diet induced cancellous bone loss in the W/W v mice. In contrast, W sh /W sh cancellous bone did not respond to this diet. This c-Kit mutation prevented cancellous bone loss by antagonizing the low calcium diet-induced increase in osteoblast and osteoclast numbers in the W sh /W sh mice. Gene expression profiling showed that calcium deficiency increased Osx, Ocn, Alp, type I collagen, c-Fms, M-CSF, and RANKL/OPG mRNA expression in controls; however, the W sh mutation suppressed these effects. Our findings indicate that although calcium restriction increased bone turnover, leading to osteopenia, the decreased c-Kit expression levels in the W sh /W sh mice prevented the low calcium diet-induced increase in cancellous bone turnover and bone loss but not the cortical bone loss.

  2. Surface Acting and Job-Related Affective Wellbeing: Preventing Resource Loss Spiral and Resource Loss Cycle for Sustainable Workplaces

    Directory of Open Access Journals (Sweden)

    Seongwook Ha

    2018-04-01

    Full Text Available This study empirically examines the synergistic negative effect of two kinds of job demand on job-related affective wellbeing (JAW and the accelerating effects of cynicism in the negative relationships between job demands and JAW using a sample of 299 employees in the Chinese banking industry. Job demands include quantitative role overload and surface acting to represent the quantitative and qualitative aspects of job demands. Cynicism is introduced as a state where one’s energy resource is lost. The results of this study show that surface acting has a negative relationship with JAW, but quantitative role overload has no relationship with JAW. High levels of quantitative role overload exacerbate the negative relationship between surface acting and JAW. Cynicism also exacerbates the negative relationship between surface acting and JAW but does not have any moderating effect in the relationship between quantitative role overload and JAW. These results are consistent with the relationships predicted by resource loss spiral and resource loss cycle. The resource loss spiral means that resource loss, caused by handling with a quantitative role overload, lessens the employee’s ability to cope with surface acting. The resource loss cycle represents a vicious circle that amplifies the resource loss caused by surface acting. Surface acting reduces the level of one’s resources. Furthermore, surface acting reduces JAW and resources more strongly when an individual has low levels of previous energy resources than it reduces JAW and resources when he or she has high levels of previous energy resources.

  3. High-sodium intake prevents pregnancy-induced decrease of blood pressure in the rat.

    Science.gov (United States)

    Beauséjour, Annie; Auger, Karine; St-Louis, Jean; Brochu, Michéle

    2003-07-01

    Despite an increase of circulatory volume and of renin-angiotensin-aldosterone system (RAAS) activity, pregnancy is paradoxically accompanied by a decrease in blood pressure. We have reported that the decrease in blood pressure was maintained in pregnant rats despite overactivation of RAAS following reduction in sodium intake. The purpose of this study was to evaluate the impact of the opposite condition, e.g., decreased activation of RAAS during pregnancy in the rat. To do so, 0.9% or 1.8% NaCl in drinking water was given to nonpregnant and pregnant Sprague-Dawley rats for 7 days (last week of gestation). Increased sodium intakes (between 10- and 20-fold) produced reduction of plasma renin activity and aldosterone in both nonpregnant and pregnant rats. Systolic blood pressure was not affected in nonpregnant rats. However, in pregnant rats, 0.9% sodium supplement prevented the decreased blood pressure. Moreover, an increase of systolic blood pressure was obtained in pregnant rats receiving 1.8% NaCl. The 0.9% sodium supplement did not affect plasma and fetal parameters. However, 1.8% NaCl supplement has larger effects during gestation as shown by increased plasma sodium concentration, hematocrit level, negative water balance, proteinuria, and intrauterine growth restriction. With both sodium supplements, decreased AT1 mRNA levels in the kidney and in the placenta were observed. Our results showed that a high-sodium intake prevents the pregnancy-induced decrease of blood pressure in rats. Nonpregnant rats were able to maintain homeostasis but not the pregnant ones in response to sodium load. Furthermore, pregnant rats on a high-sodium intake (1.8% NaCl) showed some physiological responses that resemble manifestations observed in preeclampsia.

  4. Total glucosides of paeony prevents juxta-articular bone loss in experimental arthritis.

    Science.gov (United States)

    Wei, Chen Chao; You, Fan Tian; Mei, Li Yu; Jian, Sun; Qiang, Chen Yong

    2013-07-21

    Total glucosides of paeony (TGP) is a biologically active compound extracted from Paeony root. TGP has been used in rheumatoid arthritis therapy for many years. However, the mechanism by which TGP prevents bone loss has been less explored. TGP was orally administered for 3 months to New Zealand rabbits with antigen-induced arthritis (AIA). Digital x-ray knee images and bone mineral density (BMD) measurements of the subchondral knee bone were performed before sacrifice. Chondrocytes were observed using transmission electron microscopy (TEM). Histological analysis and mRNA expression of receptor activator of nuclear factor-B ligand (RANKL) and osteoprotegerin (OPG) were evaluated in joint tissues. The BMD value in TGP rabbits was significantly higher compared with that seen in the AIA model rabbits. In addition, the subchondral bone plate was almost completely preserved by TGP treatment, while there was a decrease in bone plate integrity in AIA rabbits. There was less damage to the chondrocytes of the TGP treated group. Immunohistochemical examination of the TGP group showed that a higher percentage of TGP treated chondrocytes expressed OPG as compared to the chondrocytes isolated from AIA treated animals. In contrast, RANKL expression was significantly decreased in the TGP treated group compared to the AIA group. In support of the immunohistochemistry data, the expression of RANKL mRNA was decreased and OPG mRNA expression was enhanced in the TGP group when compared to that of the AIA model group. These results reveal that TGP suppresses juxta-articular osteoporosis and prevents subchondral bone loss. The decreased RANKL and increased OPG expression seen in TGP treated animals could explain how administration of TGP maintains higher BMD.

  5. Predicting Factors for Allogeneic Blood Transfusion and Excessive Postoperative Blood Loss after Single Low-Dosage Intra-Articular Tranexamic Acid Application in Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    Paphon Sa-ngasoongsong

    2017-01-01

    Full Text Available Background. Recently, intra-articular tranexamic acid (IA-TXA application has become a popular method for perioperative blood loss (PBL reduction in total knee replacement (TKR. Nevertheless, through our knowledge, no previous studies had shown the correlation perioperative factors and the risk of excessive PBL or need of blood transfusion (BT after IA-TXA. Materials and Methods. A retrospective study was conducted in patients underwent 299 primary TKRs, using IA-TXA, during 2-year period (2013-2014. Patient’s characteristic and perioperative data were reviewed and collected. PBL was measured as total hemoglobin loss (THL, estimated total blood loss (ETBL, and drainage volume per kg (DV/kg. Excessive PBL was defined as PBL that exceeded 90th percentile. Results. From multivariate analysis, low preoperative hemoglobin (Hb level and body mass index (BMI were the significant predictors of postoperative BT (p<0.0001 and 0.003, resp.. Excessive THL significant associated with preoperative Hb (p<0.0001. Excessive ETBL significantly associated with preoperative Hb, height, preoperative range-of-motion, and creatinine clearance (p<0.05 all. Low BMI and large prosthesis size were the significant predictors of excessive DV/kg (p=0.0001 and 0.002, resp.. Conclusions. Low preoperative Hb and BMI were the significant risks of postoperative transfusion after TKR with IA-TXA. Moreover, multiple perioperative factors could result in higher PBL.

  6. Factors Contributing to Massive Blood Loss on Peripartum Hysterectomy for Abnormally Invasive Placenta: Who Bleeds More?

    Directory of Open Access Journals (Sweden)

    Hironori Takahashi

    2016-01-01

    Full Text Available Introduction. To identify factors that determine blood loss during peripartum hysterectomy for abnormally invasive placenta (AIP-hysterectomy. Methods. We reviewed all of the medical charts of 11,919 deliveries in a single tertiary perinatal center. We examined characteristics of AIP-hysterectomy patients, with a single experienced obstetrician attending all AIP-hysterectomies and using the same technique. Results. AIP-hysterectomy was performed in 18 patients (0.15%: 18/11,919. Of the 18, 14 (78% had a prior cesarean section (CS history and the other 4 (22% were primiparous women. Planned AIP-hysterectomy was performed in 12/18 (67%, with the remaining 6 (33% undergoing emergent AIP-hysterectomy. Of the 6, 4 (4/6: 67% patients were primiparous women. An intra-arterial balloon was inserted in 9/18 (50%. Women with the following three factors significantly bled less in AIP-hysterectomy than its counterpart: the employment of an intra-arterial balloon (4,448±1,948 versus 8,861±3,988 mL, planned hysterectomy (5,003±2,057 versus 9,957±4,485 mL, and prior CS (5,706±2,727 versus 9,975±5,532 mL. Patients with prior CS (− bled more: this may be because these patients tended to undergo emergent surgery or attempted placental separation. Conclusion. Patients with intra-arterial balloon catheter insertion bled less on AIP-hysterectomy. Massive bleeding occurred in emergent AIP-hysterectomy without prior CS.

  7. Hearing loss prevention for carpenters: Part 2 - Demonstration projects using individualized and group training

    Directory of Open Access Journals (Sweden)

    Mark R Stephenson

    2011-01-01

    Full Text Available Two demonstration projects were conducted to evaluate the effectiveness of a comprehensive training program for carpenters. This training was paired with audiometry and counseling and a survey of attitudes and beliefs in hearing loss prevention. All participants received hearing tests, multimedia instruction on occupational noise exposure/hearing loss, and instruction and practice in using a diverse selection of hearing protection devices (HPDs. A total of 103 apprentice carpenters participated in the Year 1 training, were given a large supply of these HPDs, and instructions on how to get additional free supplies if they ran out during the 1-year interval between initial and follow-up training. Forty-two participants responded to the survey a second time a year later and completed the Year 2 training. Significant test-retest differences were found between the pre-training and the post-training survey scores. Both forms of instruction (individual versus group produced equivalent outcomes. The results indicated that training was able to bring all apprentice participants up to the same desired level with regard to attitudes, beliefs, and behavioral intentions to use hearing protection properly. It was concluded that the health communication models used to develop the educational and training materials for this effort were extremely effective.

  8. Cepharanthine Prevents Estrogen Deficiency-Induced Bone Loss by Inhibiting Bone Resorption

    Directory of Open Access Journals (Sweden)

    Chen-he Zhou

    2018-03-01

    Full Text Available Osteoporosis is a common health problem worldwide caused by an imbalance of bone formation vs. bone resorption. However, current therapeutic approaches aimed at enhancing bone formation or suppressing bone resorption still have some limitations. In this study, we demonstrated for the first time that cepharanthine (CEP, derived from Stephania cepharantha Hayata exerted a protective effect on estrogen deficiency-induced bone loss. This protective effect was confirmed to be achieved through inhibition of bone resorption in vivo, rather than through enhancement of bone formation in vivo. Furthermore, the in vitro study revealed that CEP attenuated receptor activator of nuclear factor κB ligand (RANKL-induced osteoclast formation, and suppressed bone resorption by impairing the c-Jun N-terminal kinase (JNK and phosphatidylinositol 3-kinase (PI3K-AKT signaling pathways. The inhibitory effect of CEP could be partly reversed by treatment with anisomycin (a JNK and p38 agonist and/or SC79 (an AKT agonist in vitro. Our results thus indicated that CEP could prevent estrogen deficiency-induced bone loss by inhibiting osteoclastogenesis. Hence, CEP might be a novel therapeutic agent for anti-osteoporosis therapy.

  9. Prevention of aromatase inhibitor-induced bone loss with alendronate in postmenopausal women: The BATMAN Trial.

    Science.gov (United States)

    Lomax, Anna J; Yee Yap, Saw; White, Karen; Beith, Jane; Abdi, Ehtesham; Broad, Adam; Sewak, Sanjeev; Lee, Chooi; Sambrook, Philip; Pocock, Nicholas; Henry, Margaret J; Yeow, Elaine G; Bell, Richard

    2013-12-01

    Postmenopausal women on aromatase inhibitors (AI) are at risk of aromatase inhibitor-associated bone loss (AIBL) and fractures. In 2005 Osteoporosis Australia proposed an algorithm for bisphosphonate intervention. Three hundred and three postmenopausal women with early breast cancer (EBC) were enrolled (osteoporotic, n=25; osteopaenic, n=146; normal bone mineral density (BMD), n=126). Weekly alendronate (70 mg) treatment efficacy as triggered by the algorithm in preventing bone loss was evaluated. All patients received anastrozole (1 mg daily), calcium and vitamin D. All osteoporotic patients received alendronate at baseline. Eleven out of the 146 (7.5%) osteopaenic patients commenced alendronate within 18 months of participation and eleven commenced after. One hundred and twenty four out of the 146 (84.9%) osteopaenic patients and all 126 with normal baseline BMD did not trigger the algorithm. At three years, lumbar spine mean BMD increased (15.6%, p<0.01) in the osteoporotic group. BMD in the osteopaenic group with early intervention significantly increased at three years (6.3%, p=0.02). No significant change was seen in the late intervention group. No change was observed in those with osteopaenia without alendronate. There was a significant drop in lumbar spine (-5.4%) and hip (-4.5%) mean BMD, in the normal BMD group, none of whom received alendronate. Fracture data will be presented. In postmenopausal women with endocrine-responsive EBC, BMD improved over time when a bisphosphonate is administered with anastrozole in osteoporotic patients using an osteoporosis schedule. Subjects with normal baseline BMD experienced the greatest BMD loss, although none became osteoporotic.

  10. Understanding and Preventing Loss to Follow-up: Experiences From the Spinal Cord Injury Model Systems.

    Science.gov (United States)

    Kim, Hwasoon; Cutter, Gary R; George, Brandon; Chen, Yuying

    2018-01-01

    Background: One of the most critical threats to the validity of any longitudinal research is the bias caused by study attrition. Prevention efforts should be focused on those individuals at high risk of non-participation to improve the generalizability of study findings. Objective: To identify demographic and clinical factors associated with loss to follow-up (FU) at post-injury years 1 to 35 among 25,871 people with spinal cord injury (SCI) enrolled in the National Spinal Cord Injury Database. Methods: Loss to FU was defined as no research information obtained from participants who were eligible for the planned data collection. Generalized linear mixed models were used for analysis of factors at each post-injury year. Results: The loss to FU rates were 23.1% and 32.9% for post-injury years 1 and 5, respectively, and remained >40% between post-injury years 20 and 35. The FU rate varied by study sites and was improved in recent injury cohorts. People who were more seriously injured and those who attained higher levels of education were more likely to return for FU than their counterparts. People who were at risk of being marginalized in society (non-whites, those with less education, the unemployed, victims of violence, and those with no health insurance) had the highest odds of being lost to FU across all post-injury years. Conclusion: These findings can be used to identify individuals who are less likely to participate in follow-up, which may allow targeted attention to improve their response rate.

  11. Tranexamic Acid versus Placebo to Prevent Blood Transfusion during Radical Cystectomy for Bladder Cancer (TACT): Study Protocol for a Randomized Controlled Trial.

    Science.gov (United States)

    Breau, Rodney H; Lavallée, Luke T; Cnossen, Sonya; Witiuk, Kelsey; Cagiannos, Ilias; Momoli, Franco; Bryson, Gregory; Kanji, Salmaan; Morash, Christopher; Turgeon, Alexis; Zarychanski, Ryan; Mallick, Ranjeeta; Knoll, Greg; Fergusson, Dean A

    2018-05-02

    Radical cystectomy for bladder cancer is associated with a high risk of needing red blood cell transfusion. Tranexamic acid reduces blood loss during cardiac and orthopedic surgery, but no study has yet evaluated tranexamic acid use during cystectomy. A randomized, double-blind (surgeon-, anesthesiologist-, patient-, data-monitor-blinded), placebo-controlled trial of tranexamic acid during cystectomy was initiated in June 2013. Prior to incision, the intervention arm participants receive a 10 mg/kg loading dose of intravenously administered tranexamic acid, followed by a 5 mg/kg/h maintenance infusion. In the control arm, the patient receives an identical volume of normal saline that is indistinguishable from the intervention. The primary outcome is any blood transfusion from the start of surgery up to 30 days post operative. There are no strict criteria to mandate the transfusion of blood products. The decision to transfuse is entirely at the discretion of the treating physicians who are blinded to patient allocation. Physicians are allowed to utilize all resources to make transfusion decisions, including serum hemoglobin concentration and vital signs. To date, 147 patients of a planned 354 have been randomized to the study. This protocol reviews pertinent data relating to blood transfusion during radical cystectomy, highlighting the need to identify methods for reducing blood loss and preventing transfusion in patients receiving radical cystectomy. It explains the clinical rationale for using tranexamic acid to reduce blood loss during cystectomy, and outlines the study methods of our ongoing randomized controlled trial. Canadian Institute for Health Research (CIHR) Protocol: MOP-342559; ClinicalTrials.gov, ID: NCT01869413. Registered on 5 June 2013.

  12. Bcl-2 prevents loss of mitochondria in CCCP-induced apoptosis

    International Nuclear Information System (INIS)

    Graaf, Aniek O. de; Heuvel, Lambert P. van den; Dijkman, Henry B.P.M.; Abreu, Ronney A. de; Birkenkamp, Kim U.; Witte, Theo de; Reijden, Bert A. van der; Smeitink, Jan A.M.; Jansen, Joop H.

    2004-01-01

    Bcl-2 family proteins regulate apoptosis at the level of mitochondria. To examine the mechanism of Bcl-2 function, we investigated the effects of the protonophore carbonyl cyanide m-chlorophenyl hydrazone (CCCP) on two hematopoietic cell lines and Bcl-2 overexpressing transfectants. CCCP directly interferes with mitochondrial function and induces apoptosis. We show that Bcl-2 inhibits apoptosis and that the antiapoptotic effect of Bcl-2 takes place upstream of caspase activation and nuclear changes associated with apoptosis, since these were markedly inhibited in cells overexpressing Bcl-2. Bcl-2 does not prevent the decrease in mitochondrial membrane potential nor the alterations in cellular ATP content induced by CCCP in FL5.12 and Jurkat cells. A higher number of mitochondria was observed in untreated Bcl-2 transfected cells compared to parental cells, as shown by electron microscopy. Exposure to CCCP induced a dramatic decrease in the number of mitochondria and severely disrupted mitochondrial ultrastructure, with apparent swelling and loss of cristae in parental cells. Bcl-2 clearly diminished the disruption of mitochondrial structure and preserved a higher number of mitochondria. These data suggest that CCCP induces apoptosis by structural disruption of mitochondria and that Bcl-2 prevents apoptosis and mitochondrial degeneration by preserving mitochondrial integrity

  13. Bcl-2 prevents loss of mitochondria in CCCP-induced apoptosis.

    Science.gov (United States)

    de Graaf, Aniek O; van den Heuvel, Lambert P; Dijkman, Henry B P M; de Abreu, Ronney A; Birkenkamp, Kim U; de Witte, Theo; van der Reijden, Bert A; Smeitink, Jan A M; Jansen, Joop H

    2004-10-01

    Bcl-2 family proteins regulate apoptosis at the level of mitochondria. To examine the mechanism of Bcl-2 function, we investigated the effects of the protonophore carbonyl cyanide m-chlorophenyl hydrazone (CCCP) on two hematopoietic cell lines and Bcl-2 overexpressing transfectants. CCCP directly interferes with mitochondrial function and induces apoptosis. We show that Bcl-2 inhibits apoptosis and that the antiapoptotic effect of Bcl-2 takes place upstream of caspase activation and nuclear changes associated with apoptosis, since these were markedly inhibited in cells overexpressing Bcl-2. Bcl-2 does not prevent the decrease in mitochondrial membrane potential nor the alterations in cellular ATP content induced by CCCP in FL5.12 and Jurkat cells. A higher number of mitochondria was observed in untreated Bcl-2 transfected cells compared to parental cells, as shown by electron microscopy. Exposure to CCCP induced a dramatic decrease in the number of mitochondria and severely disrupted mitochondrial ultrastructure, with apparent swelling and loss of cristae in parental cells. Bcl-2 clearly diminished the disruption of mitochondrial structure and preserved a higher number of mitochondria. These data suggest that CCCP induces apoptosis by structural disruption of mitochondria and that Bcl-2 prevents apoptosis and mitochondrial degeneration by preserving mitochondrial integrity.

  14. A new topical hemostatic agent TT-173 reduces blood loss in a sheep model of total knee arthroplasty.

    Science.gov (United States)

    Centeno, Alberto; Rojas, Santiago; Arias, Belén; Miquel, Ignasi; Sánchez, Pilar; Ureta, Claudia; Rincón, Esther; López, Ramón; Murat, Jesús

    2017-12-01

    Total knee arthroplasty is associated with blood loss during the intervention and may require allogenic blood transfusion. Treatments such as tranexamic acid and fibrin sealants improved the bleeding control in several clinical trials, but the hemorrhage associated with the intervention is still significant. Thus far, very few studies have evaluated hemostatic treatments in animal models of total knee arthroplasty. This work describes a sheep model of bleeding associated with total knee arthroplasty and investigates a new class of hemostatic treatment based on recombinant tissue factor. Sheep were treated with the anticoagulant heparin, and the joint was accessed by a paramedial incision. Ligaments and menisci were eliminated and femoral condyles and tibia plateau were sectioned exposing the trabecular bone. An intra-articular drain was used to recover and quantify the blood loss during the 90-min period after treatment. The efficacy of one milligram and three milligrams of TT-173 was evaluated and compared with tranexamic acid. The occurrence of analytical alterations and systemic absorption was also investigated. Treatment with TT-173 reduced the blood loss in comparison with control or tranexamic acid. No significant differences were observed between the two doses evaluated. Moreover, a dose of six milligrams of TT-173 did not induce any clinical or analytical alteration, and significant systemic absorption was not observed. Data obtained strongly suggest that TT-173 could be useful in reducing the blood loss associated with total knee arthroplasty and without safety concerns derived from the systemic absorption of the product. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. The association between low levels of lead in blood and occupational noise-induced hearing loss in steel workers

    International Nuclear Information System (INIS)

    Hwang, Yaw-Huei; Chiang, Han-Yueh; Yen-Jean, Mei-Chu; Wang, Jung-Der

    2009-01-01

    As the use of leaded gasoline has ceased in the last decade, background lead exposure has generally been reduced. The aim of this study was to examine the effect of low-level lead exposure on human hearing loss. This study was conducted in a steel plant and 412 workers were recruited from all over the plant. Personal information such as demographics and work history was obtained through a questionnaire. All subjects took part in an audiometric examination of hearing thresholds, for both ears, with air-conducted pure tones at frequencies of 500, 1000, 2000, 3000, 4000, 6000 and 8000 Hz. Subjects' blood samples were collected and analyzed for levels of manganese, copper, zinc, arsenic, cadmium and lead with inductive couple plasma-mass spectrometry. Meanwhile, noise levels in different working zones were determined using a sound level meter with A-weighting network. Only subjects with hearing loss difference of no more than 15 dB between both ears and had no congenital abnormalities were included in further data analysis. Lead was the only metal in blood found significantly correlated with hearing loss for most tested sound frequencies (p < 0.05 to p < 0.0001). After adjustment for age and noise level, the logistic regression model analysis indicated that elevated blood lead over 7 μg/dL was significantly associated with hearing loss at the sound frequencies of 3000 through 8000 Hz with odds ratios raging from 3.06 to 6.26 (p < 0.05 ∼ p < 0.005). We concluded that elevated blood lead at level below 10 μg/dL might enhance the noise-induced hearing loss. Future research needs to further explore the detailed mechanism.

  16. The association between low levels of lead in blood and occupational noise-induced hearing loss in steel workers

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Yaw-Huei [Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC Rm. 735, 17, Xu-Zhou Rd., Taipei, Taiwan, ROC (China); Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC Rm. 735, 17, Xu-Zhou Rd., Taipei, Taiwan, ROC (China); Chiang, Han-Yueh [Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC Rm. 735, 17, Xu-Zhou Rd., Taipei, Taiwan, ROC (China); Yen-Jean, Mei-Chu [Division of Family Medicine, E-Da Hospital, Taiwan, ROC 1, E-Da Rd., Jiau-Shu Tsuen, Yan-Chau Shiang, Kaohsiung County, Taiwan, ROC (China); I-Shou University, Kaohsiung County, Taiwan, ROC 1, Sec. 1, Syuecheng Rd., Da-Shu Shiang, Kaohsiung County, Taiwan, ROC (China); Wang, Jung-Der, E-mail: jdwang@ntu.edu.tw [Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC Rm. 735, 17, Xu-Zhou Rd., Taipei, Taiwan, ROC (China); Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC Rm. 735, 17, Xu-Zhou Rd., Taipei, Taiwan, ROC (China); Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, ROC No. 1, Chang-Teh St., Taipei, Taiwan, ROC (China)

    2009-12-15

    As the use of leaded gasoline has ceased in the last decade, background lead exposure has generally been reduced. The aim of this study was to examine the effect of low-level lead exposure on human hearing loss. This study was conducted in a steel plant and 412 workers were recruited from all over the plant. Personal information such as demographics and work history was obtained through a questionnaire. All subjects took part in an audiometric examination of hearing thresholds, for both ears, with air-conducted pure tones at frequencies of 500, 1000, 2000, 3000, 4000, 6000 and 8000 Hz. Subjects' blood samples were collected and analyzed for levels of manganese, copper, zinc, arsenic, cadmium and lead with inductive couple plasma-mass spectrometry. Meanwhile, noise levels in different working zones were determined using a sound level meter with A-weighting network. Only subjects with hearing loss difference of no more than 15 dB between both ears and had no congenital abnormalities were included in further data analysis. Lead was the only metal in blood found significantly correlated with hearing loss for most tested sound frequencies (p < 0.05 to p < 0.0001). After adjustment for age and noise level, the logistic regression model analysis indicated that elevated blood lead over 7 {mu}g/dL was significantly associated with hearing loss at the sound frequencies of 3000 through 8000 Hz with odds ratios raging from 3.06 to 6.26 (p < 0.05 {approx} p < 0.005). We concluded that elevated blood lead at level below 10 {mu}g/dL might enhance the noise-induced hearing loss. Future research needs to further explore the detailed mechanism.

  17. Evaluation of the impact of density gradient centrifugation on fetal cell loss during enrichment from maternal peripheral blood.

    Science.gov (United States)

    Emad, Ahmed; Drouin, Régen

    2014-09-01

    Physical separation by density gradient centrifugation (DGC) is usually used as an initial step of multistep enrichment protocols for purification of fetal cells (FCs) from maternal blood. Many protocols were designed but no single approach was efficient enough to provide noninvasive prenatal diagnosis. Procedures and methods were difficult to compare because of the nonuniformity of protocols among different groups. Recovery of FCs is jeopardized by their loss during the process of enrichment. Any loss of FCs must be minimized because of the multiplicative effect of each step of the enrichment process. The main objective of this study was to evaluate FC loss caused by DGC. Fetal cells were quantified in peripheral blood samples obtained from both euploid and aneuploid pregnancies before and after enrichment by buoyant DGC using Histopaque 1.119 g/mL. Density gradient centrifugation results in major loss of 60% to 80% of rare FCs, which may further complicate subsequent enrichment procedures. Eliminating aggressive manipulations can significantly minimize FC loss. Data obtained raise questions about the appropriateness of the DGC step for the enrichment of rare FCs and argues for the use of the alternative nonaggressive version of the procedure presented here or prioritizing other methods of enrichments. © 2014 John Wiley & Sons, Ltd.

  18. A randomized trial of the effect of low dose epinephrine infusion in addition to tranexamic acid on blood loss during total hip arthroplasty

    DEFF Research Database (Denmark)

    Jans, Ø.; Grevstad, U.; Mandoe, H.

    2016-01-01

    procedure. Intraoperative tranexamic acid (TXA) was administered to all subjects. The primary outcome was intraoperative blood loss directly measured by drains and weighing swabs. Secondary outcome was total blood loss at 24 h postoperatively calculated using the Gross formula. Results: Of 106 subjects...

  19. The relationship between blood lead levels and periodontal bone loss in the United States, 1988-1994.

    OpenAIRE

    Dye, Bruce A; Hirsch, Rosemarie; Brody, Debra J

    2002-01-01

    An association between bone disease and bone lead has been reported. Studies have suggested that lead stored in bone may adversely affect bone mineral metabolism and blood lead (PbB) levels. However, the relationship between PbB levels and bone loss attributed to periodontal disease has never been reported. In this study we examined the relationship between clinical parameters that characterize bone loss due to periodontal disease and PbB levels in the U.S. population. We used data from the T...

  20. The first Iranian recommendations on prevention, evaluation and management of high blood pressure

    Directory of Open Access Journals (Sweden)

    Feridoun Noohi

    2012-10-01

    Full Text Available This paper presents the complete report of the first Iranian Recommendations on Prevention, Evaluation and Management of High Blood Pressure. The purpose is to provide an evidence-based approach to the prevention, management and control of hypertension (HTN by adapting the most internationally known and used guidelines to the local health care status with consideration of the currently available data and based on the locally conducted researches on HTN as well as social and health care requirements. A working group of national and international experts participated in discussions and collaborated in decision-making, writing and reviewing the whole report. Multiple subcommittees worked together to review the recent national and international literature on HTN in different areas. We used the evaluation tool that is called “AGREE” and considered a score of > 60% as a high score. We adapted the Canadian Hypertension Education Program (CHEP, the United Kingdom’s National Institute for Health and Clinical Excellence (NICE and the US-based joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7. The key topics that are highlighted in this report include: The importance of ambulatory and self-measurement of blood pressure, evaluation of cardiovascular risk in HTN patients, the role of lifestyle modification in the prevention of HTN and its control with more emphasis on salt intake reduction and weight control, introducing pharmacotherapy suitable for uncomplicated HTN or specific situations and the available drugs in Iran, highlighting the importance of angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers and calcium channel blockers as the first line therapy in many situations, the non-use of beta blockers as the first time treatment except in specific conditions, treating HTN in women, children, obese and elderly patients, the patient compliance to improve HTN control, practical

  1. Prevention of blood transfusion with intravenous iron in gynecologic cancer patients receiving platinum-based chemotherapy.

    Science.gov (United States)

    Athibovonsuk, Punnada; Manchana, Tarinee; Sirisabya, Nakarin

    2013-12-01

    To compare the efficacy of intravenous iron and oral iron for prevention of blood transfusions in gynecologic cancer patients receiving platinum-based chemotherapy. Sixty-four non anemic gynecologic cancer patients receiving adjuvant platinum-based chemotherapy were stratified and randomized according to baseline hemoglobin levels and chemotherapy regimen. The study group received 200mg of intravenous iron sucrose immediately after each chemotherapy infusion. The control group received oral ferrous fumarate at a dose of 200mg three times a day. Complete blood count was monitored before each chemotherapy infusion. Blood transfusions were given if hemoglobin level was below 10mg/dl. There were 32 patients in each group. No significant differences in baseline hemoglobin levels and baseline characteristics were demonstrated between both groups. Nine patients (28.1%) in the study group and 18 patients (56.3%) in the control group required blood transfusion through 6 cycles of chemotherapy (p=0.02). Fewer median number of total packed red cell units were required in the study group compared to the control group (0 and 0.5 unit, respectively, p=0.04). Serious adverse events and hypersensitivity reactions were not reported. However, constipation was significantly higher in the control group (3.1% and 40.6%, p=gynecologic cancer patients receiving platinum-based chemotherapy, associated with less constipation than the oral formulation. © 2013 Elsevier Inc. All rights reserved.

  2. Establishing and prioritizing research questions for the prevention, diagnosis and treatment of hair loss (excluding alopecia areata): the Hair Loss Priority Setting Partnership.

    Science.gov (United States)

    Macbeth, A; Tomlinson, J; Messenger, A; Moore-Millar, K; Michaelides, C; Shipman, A; Kassim, J; Brockley, J; Szczecinska, W; Farrant, P; Robinson, R; Rodgers, J; Chambers, J; Upadhyaya, S; Harries, M

    2018-02-01

    Hair and scalp problems are common. Unfortunately, many uncertainties exist around the most effective management and treatment strategies for these disorders. To identify uncertainties in hair-loss management, prevention, diagnosis and treatment that are important to both people with hair loss and healthcare professionals. A Hair Loss Priority Setting Partnership was established between patients, their carers and relatives, and healthcare professionals to identify the most important uncertainties in hair loss. The methodology of the James Lind Alliance was followed to ensure a balanced, inclusive and transparent process. In total, 2747 treatment uncertainties were submitted by 912 participants; following exclusions 884 uncertainties relating to hair loss (excluding alopecia areata) were analysed. Questions were combined into 'indicative uncertainties' following a structured format. A series of ranking exercises further reduced this list to a top 25 that was taken to a final prioritization workshop where the top 10 priorities were agreed. We present the top 10 research priorities for hair loss (excluding alopecia areata) to guide researchers and funding bodies to support studies important to both patients and clinicians. © 2017 British Association of Dermatologists.

  3. Niclosamide suppresses RANKL-induced osteoclastogenesis and prevents LPS-induced bone loss

    Energy Technology Data Exchange (ETDEWEB)

    Cheon, Yoon-Hee [Center for Metabolic Function Regulation, Wonkwang University School of Medicine, Iksan, Jeonbuk 570-749 (Korea, Republic of); Kim, Ju-Young [Imaging Science-based Lung and Bone Diseases Research Center, Wonkwang University School of Medicine, Iksan, Jeonbuk 570-749 (Korea, Republic of); Baek, Jong Min; Ahn, Sung-Jun [Department of Anatomy, School of Medicine, Wonkwang University School of Medicine, Iksan, Jeonbuk 570-749 (Korea, Republic of); So, Hong-Seob, E-mail: jeanso@wku.ac.kr [Center for Metabolic Function Regulation, Wonkwang University School of Medicine, Iksan, Jeonbuk 570-749 (Korea, Republic of); Oh, Jaemin, E-mail: jmoh@wku.ac.kr [Imaging Science-based Lung and Bone Diseases Research Center, Wonkwang University School of Medicine, Iksan, Jeonbuk 570-749 (Korea, Republic of); Department of Anatomy, School of Medicine, Wonkwang University School of Medicine, Iksan, Jeonbuk 570-749 (Korea, Republic of); Institute for Skeletal Disease, Wonkwang University School of Medicine, Iksan, Jeonbuk 570-749 (Korea, Republic of)

    2016-02-05

    Niclosamide (5-chloro-salicyl-(2-chloro-4-nitro) anilide) is an oral anthelmintic drug used for treating intestinal infection of most tapeworms. Recently, niclosamide was shown to have considerable efficacy against some tumor cell lines, including colorectal, prostate, and breast cancers, and acute myelogenous leukemia. Specifically, the drug was identified as a potent inhibitor of signal transducer and activator of transcription 3 (STAT3), which is associated with osteoclast differentiation and function. In this study, we assessed the effect of niclosamide on osteoclastogenesis in vitro and in vivo. Our in vitro study showed that receptor activator of nuclear factor-kappaB ligand (RANKL)-induced osteoclast differentiation was inhibited by niclosamide, due to inhibition of serine–threonine protein kinase (Akt) phosphorylation, inhibitor of nuclear factor-kappaB (IκB), and STAT3 serine{sup 727}. Niclosamide decreased the expression of the major transcription factors c-Fos and NFATc1, and thereafter abrogated the mRNA expression of osteoclast-specific genes, including TRAP, OSCAR, αv/β3 integrin (integrin αv, integrin β3), and cathepsin K (CtsK). In an in vivo model, niclosamide prevented lipopolysaccharide-induced bone loss by diminishing osteoclast activity. Taken together, our results show that niclosamide is effective in suppressing osteoclastogenesis and may be considered as a new and safe therapeutic candidate for the clinical treatment of osteoclast-related diseases such as osteoporosis. - Highlights: • We first investigated the anti-osteoclastogenic effects of niclosamide in vitro and in vivo. • Niclosamide impairs the activation of the Akt-IκB-STAT3 ser{sup 727} signaling axis. • Niclosamide acts a negative regulator of actin ring formation during osteoclast differentiation. • Niclosamide suppresses LPS-induced bone loss in vivo. • Niclosamide deserves new evaluation as a potential treatment target in various bone diseases.

  4. Berberine prevents nigrostriatal dopaminergic neuronal loss and suppresses hippocampal apoptosis in mice with Parkinson's disease.

    Science.gov (United States)

    Kim, Mia; Cho, Ki-Ho; Shin, Mal-Soon; Lee, Jae-Min; Cho, Han-Sam; Kim, Chang-Ju; Shin, Dong-Hoon; Yang, Hyeon Jeong

    2014-04-01

    Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by the selective loss of nigral dopaminergic neurons and a reduction in striatal dopaminergic fibers, which result in tremors, rigidity, bradykinesia and gait disturbance. In addition to motor dysfunction, dementia is a widely recognized symptom of patients with PD. Berberine, an isoquinoline alkaloid isolated from Berberis vulgaris L., is known to exert anxiolytic, analgesic, anti-inflammatory, antipsychotic, antidepressant and anti-amnesic effects. In the present study, we investigated the effects of berberine on short-term memory in relation to dopamine depletion and hippocampal neurogenesis using a mouse model of PD, induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine/probenecid (MPTP/P) treatment. Mice in the berberine-treated groups were orally administered berberine once a day for a total of 5 weeks. Our results revealed that the injection of MPTP/P induced dopaminergic neuronal death in the substantia nigra and fiber loss in the striatum. This resulted in impaired motor balance and coordination, as assessed by the beam walking test. We further demonstrated that MPTP/P-induced apoptosis in the hippocampus deteriorated short-term memory, as shown by the step-down avoidance task. By contrast, neurogenesis in the hippocampal dentate gyrus, which is a compensatory adaptive response to excessive apoptosis, was increased upon PD induction. However, treatment with berberine enhanced motor balance and coordination by preventing dopaminergic neuronal damage. Treatment with berberine also improved short-term memory by inhibiting apoptosis in the hippocampus. Berberine demonstrated maximal potency at 50 mg/kg. Based on these data, treatment with berberine may serve as a potential therapeutic strategy for the alleviation of memory impairment and motor dysfunction in patients with PD.

  5. Vitamin D Supplementation in Elderly Black Women Does Not Prevent Bone Loss, a Randomized Controlled Trial.

    Science.gov (United States)

    Aloia, John F; Fazzari, Melissa; Islam, Shahidul; Mikhail, Mageda; Katumuluwa, Subhashini; Dhaliwal, Ruban; Stolberg, Alexandra; Usera, Gianina; Ragolia, Louis

    2018-06-15

    Black Americans have lower levels of serum 25(OH)D but superior bone health compared to white Americans. There is controversy over whether they should be screened for vitamin D deficiency and have higher vitamin D requirements than recommended by the Institute of Medicine (IOM). The purpose of this trial was to determine whether Vitamin D supplementation in elderly black women prevents bone loss. 260 healthy black American women, 60 years of age and older were recruited to take part in a two arm, double-dummy 3 year RCT of vitamin D 3 vs. placebo. The study was conducted in an ambulatory clinical research center. Vitamin D 3 dose was adjusted to maintain serum 25(OH)D above 75 nmol/L. Bone mineral density (BMD) and serum were measured for [parathyroid hormone (PTH), C-terminal crosslink telopeptide (CTX) and bone specific alkaline phosphatase (BSAP) every 6 months. Baseline serum 25(OH)D 3 was 54.8 ± 16.8 nmol/L. There was no group xtime interaction effect for any BMD measurement. For all BMD measurements, except for total body and spine, there was a statistically significant negative effect of time (P D above 75 nmol/L is comparable to the rate of loss with serum 25(OH)D at the RDA of 50 nmol/L. Black Americans should have the same exposure to vitamin D as white Americans. The trial was registered at clinical trials.gov: NCT01153568. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  6. Treatments to Prevent Bone Loss in Functional Hypothalamic Amenorrhea: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Altayar, Osama; Al Nofal, Alaa; Carranza Leon, B Gisella; Prokop, Larry J; Wang, Zhen; Murad, M Hassan

    2017-05-01

    We conducted a systematic review and meta-analysis of studies that evaluated the effect of hormonal therapy [estrogen therapy including oral contraceptive pills (OCP)] and bisphosphonates in preventing bone loss in patients with functional hypothalamic amenorrhea (FHA). We searched several electronic databases for controlled and noncontrolled studies that enrolled females of any age presenting with FHA (including athletic, weight loss, and stress-associated amenorrhea/oligomenorrhea) through 9 January 2017. The outcomes of interest were fractures and bone mineral density (BMD). Random effects meta-analysis was used to pool outcomes across studies expressed as weighted mean difference and 95% confidence interval (CI). Nine studies reporting on 280 patients that received different hormonal therapies were included. We did not identify studies that evaluated bisphosphonates. Meta-analysis demonstrated a statistically significant increase in BMD of the lumbar spine in patients receiving hormonal therapy after a median follow-up of 12 months (weighted mean difference, 0.032 g/cm 2 ; 95% CI, 0.017 to 0.047; percentage change in BMD, 3.30%; 95% CI, 1.74 to 4.86). There was no substantial effect of receiving hormonal therapy on BMD of the femoral neck, trochanteric region, Ward triangle, or total body BMD. The quality of evidence was low because of the high risk of bias, imprecision (small sample size), and indirectness (as BMD is a surrogate outcome). None of the studies reported the incidence of fractures. The current evidence does not support using hormonal therapy for the sole purpose of improving bone health in patients with FHA. There are no data about bisphosphonates in this population.

  7. Can local application of Tranexamic acid reduce post-coronary bypass surgery blood loss? A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Latter David

    2009-06-01

    Full Text Available Abstract Background Diffuse microvascular bleeding remains a common problem after cardiac procedures. Systemic use of antifibrinolytic reduces the postoperative blood loss. The purpose of this study was to examine the effectiveness of local application of tranexamic acid to reduce blood loss after coronary artery bypass grafting (CABG. Methods Thirty eight patients scheduled for primary isolated coronary artery bypass grafting were included in this double blind, prospective, randomized, placebo controlled study. Tranexamic acid (TA group (19 patients received 1 gram of TA diluted in 100 ml normal saline. Placebo group (19 patients received 100 ml of normal saline only. The solution was purred in the pericardial and mediastinal cavities. Results Both groups were comparable in their baseline demographic and surgical characteristics. During the first 24 hours post-operatively, cumulative blood loss was significantly less in TA group (median of 626 ml compared to Placebo group (median of 1040 ml (P = 0.04. There was no significant difference in the post-op Packed RBCs transfusion between both groups (median of one unit in each (P = 0.82. Significant less platelets transfusion required in TA group (median zero unit than in placebo group (median 2 units (P = 0.03. Apart from re-exploration for excessive surgical bleeding in one patient in TA group, no difference was found in morbidity or mortality between both groups. Conclusion Topical application of tranexamic acid in patients undergoing primary coronary artery bypass grafting led to a significant reduction in postoperative blood loss without adding extra risk to the patient.

  8. A Mobile Phone-Based Health Coaching Intervention for Weight Loss and Blood Pressure Reduction in a National Payer Population: A Retrospective Study.

    Science.gov (United States)

    Mao, Alice Yuqing; Chen, Connie; Magana, Candy; Caballero Barajas, Karla; Olayiwola, J Nwando

    2017-06-08

    The prevalence of obesity and associated metabolic conditions continue to be challenging and costly to address for health care systems; 71% of American adults were overweight, with 35% of men and 40% of women diagnosed with obesity in 2014. Digital health coaching is an innovative approach to decreasing the barriers of cost and accessibility of receiving health coaching for the prevention and management of chronic disease in overweight or obese individuals. To evaluate the early impact of a mobile phone-based health coaching service on weight loss and blood pressure management in a commercially insured population. This was a retrospective study using existing registry data from a pilot commercial collaboration between Vida Health and a large national insurance provider, which enrolled adult members who were overweight (body mass index >25 kg/m2) and able to engage in a mobile phone-based coaching intervention. Participants received 4 months of intensive health coaching via live video, phone, and text message through the Vida Health app. Participants were also provided with a wireless scale, pedometer, and blood pressure cuff. Of the 1012 enrolled, 763 (75.40%) participants had an initial weight upon enrollment and final weight between 3 and 5 months from enrollment; they served as our intervention group. There were 73 participants out of the 1012 (7.21%) who had weight data 4 months prior to and after Vida coaching, who served as the matched-pair control group. Participants in the intervention group lost an average of 3.23% total body weight (TBW) at 4 months of coaching and 28.6% (218/763) intervention participants achieved a clinically significant weight loss of 5% or more of TBW, with an average of 9.46% weight loss in this cohort. In the matched-pair control group, participants gained on average 1.81% TBW in 4 months without Vida coaching and lost, on average, 2.47% TBW after 4 months of Vida coaching, demonstrating a statistically significant difference of 4

  9. Comparison of topical and intravenous administration of tranexamic acid for blood loss control during total joint replacement: Review of literature

    Directory of Open Access Journals (Sweden)

    Georgi P. Georgiev

    2018-04-01

    Full Text Available Purpose: Many randomised controlled trials and meta-analysis studies have presented the efficacy of tranexamic acid (TXA without an increase of complications. However, questions still remain about the type of administration, optimal dose and secondary outcomes of TXA in total hip arthroplasty and total knee arthroplasty. The aim of this review is to summarise the existing information in literature concerning the pharmacological characteristics of TXA, forms, doses, types of application and contraindications for its use. Methods: A literature review containing 63 articles from the PubMed data starting from the first description of tranexamic acid until now was made in trying to present the existing information in a simple and effective way. Results: TXA leads to statistically significant reduction of peri and postoperative bleeding and in that way decreases blood transfusion rates and the infection risk. Topical and intravenous (IV use of TXA revealed similar results, with no increase of deep venous thrombosis. Therefore, topical TXA could be a reasonable alternative in patients with contraindications for IV application of TXA. Conclusions: Blood loss control with TXA, a synthetic analogue of the amino acid lysine, may be an excellent and safe alternative to allogeneic blood transfusion after total hip arthroplasty and total knee arthroplasty. Further studies are needed to establish the efficacy of combined IV and topical administration of TXA with regard to diminishing blood loss and reducing hospital stay. The Translational Potential of this Article: This review briefly presents the pharmacological characteristics of TXA, forms, doses, types of application and contraindications for its use with regard to diminishing blood loss and reducing hospital stay for better therapeutic strategies in orthopaedics. Keywords: Arthroplasty, Review, Tranexamic acid

  10. Forensic Luminol Blood Test for Preventing Cross-contamination in Dentistry: An Evaluation of a Dental School Clinic

    Directory of Open Access Journals (Sweden)

    Marcelo Carlos Bortoluzzi

    2014-01-01

    Conclusions: We suggest that the luminol method is suitable for identifying contamination with invisible blood traces and this method may be a useful tool to prevent cross-contamination in the dental care setting.

  11. Effect of Childhood Obesity Prevention Programs on Blood Pressure: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Cai, Li; Wu, Yang; Wilson, Renee F.; Segal, Jodi B.; Kim, Miyong T.; Wang, Youfa

    2015-01-01

    Background Childhood overweight and obesity are associated with elevated blood pressure (BP). However, little is known about how childhood obesity lifestyle prevention programs affect BP. We assessed the effects of childhood obesity prevention programs on BP in children in developed countries. Methods and Results We searched databases up to April 22, 2013 for relevant randomized controlled trials, quasi-experimental studies, and natural experiments. Studies were included if they applied a diet and/or physical activity intervention(s) and were followed for ≥1 year (or ≥ 6 months for school-based intervention studies); they were excluded if they targeted only overweight/obese subjects or those with a medical condition. In our meta-analysis, intervention effects were calculated for systolic blood pressure (SBP) and diastolic blood pressure (DBP) using weighted random effects models. Of the 23 included intervention studies (involving 18,925 participants), 21 involved a school setting. Our meta-analysis included 19 studies reporting on SBP and 18 on DBP. The pooled intervention effect was −1.64 mmHg (95% CI: -2.56, −0.71; P=0.001) for SBP and -1.44 mmHg (95% CI: −2.28, −0.60; P=0.001) for DBP. The combined diet and physical activity interventions led to a significantly greater reduction in both SBP and DBP than the diet-only or physical activity-only intervention. Thirteen interventions (46%) had a similar effect on both adiposity-related outcomes and BP; while 11 interventions (39%) showed a significant desirable effect on BP, but not on adiposity-related outcomes. Conclusions Obesity prevention programs have a moderate effect on reducing BP and those targeting at both diet and physical activity seem to be more effective. PMID:24552832

  12. Effects of Clonidine Premedication on Intraoperative Blood Loss in Patients With and Without Opium Addiction During Elective Femoral Fracture Surgeries.

    Science.gov (United States)

    Ommi, Davood; Teymourian, Houman; Zali, Alireza; Ashrafi, Farzad; Jabbary Moghaddam, Morteza; Mirkheshti, Alireza

    2015-08-01

    Opium is an addictive agent and one of the most common narcotics With great challenges of intraoperative hemodynamic instabilities. The current study aimed to assess the effects of clonidine on intraoperative blood loss in patients with and without opium addiction in femoral fracture surgeries. In a randomized clinical trial, 160 candidates for elective femoral fracture operations under general anesthesia were divided into four groups of 40 subjects: group 1 (placebo 1), subjects without addiction received placebo 90 minutes before the operation; group 2 (placebo 2), patients with opium addiction received placebo as group 1; group 3 (Clonidine 1), patients without addiction received clonidine 90 minutes before the operation and group 4 (Clonidine 2), patients with opium addiction received clonidine as premedication. Intraoperative blood loss in clonidine recipient groups, patients with and without addiction, was less than that of the placebos (both P values opium addiction. Premedication with clonidine to decrease intraoperative blood loss can be more effective in patients with opium addiction than the ones without addiction.

  13. Effect of dietary patterns differing in carbohydrate and fat content on blood lipid and glucose profiles based on weight-loss success of breast-cancer survivors.

    Science.gov (United States)

    Thompson, Henry J; Sedlacek, Scot M; Paul, Devchand; Wolfe, Pamela; McGinley, John N; Playdon, Mary C; Daeninck, Elizabeth A; Bartels, Sara N; Wisthoff, Mark R

    2012-01-06

    Healthy body weight is an important factor for prevention of breast cancer recurrence. Yet, weight loss and weight gain are not currently included in clinical-practice guidelines for posttreatment of breast cancer. The work reported addresses one of the questions that must be considered in recommending weight loss to patients: does it matter what diet plan is used, a question of particular importance because breast cancer treatment can increase risk for cardiovascular disease. Women who completed treatment for breast cancer were enrolled in a nonrandomized, controlled study investigating effects of weight loss achieved by using two dietary patterns at the extremes of macronutrient composition, although both diet arms were equivalent in protein: high fat, low carbohydrate versus low fat, high carbohydrate. A nonintervention group served as the control arm; women were assigned to intervention arms based on dietary preferences. During the 6-month weight-loss program, which was menu and recipe defined, participants had monthly clinical visits at which anthropometric data were collected and fasting blood was obtained for safety monitoring for plasma lipid profiles and fasting glucose. Results from 142 participants are reported. Adverse effects on fasting blood lipids or glucose were not observed in either dietary arm. A decrease in fasting glucose was observed with progressive weight loss and was greater in participants who lost more weight, but the effect was not statistically significant, even though it was observed across both diet groups (P = 0.21). Beneficial effects of weight loss on cholesterol (4.7%; P = 0.001), triglycerides (21.8%; P = 0.01), and low-density lipoprotein (LDL) cholesterol (5.8%; P = 0.06) were observed in both groups. For cholesterol (P = 0.07) and LDL cholesterol (P = 0.13), greater reduction trends were seen on the low-fat diet pattern; whereas, for triglycerides (P = 0.01) and high-density lipoprotein (HDL) cholesterol (P = 0.08), a decrease

  14. Detection of gastrointestinal blood loss with 99mTc-labeled, heat-treated red blood cells

    International Nuclear Information System (INIS)

    Som, P.; Oster, Z.H.; Atkins, H.L.; Goldman, A.G.; Sacker, D.F.; Harold, W.H.; Fairchild, R.G.; Richards, P.; Brill, A.B.

    1981-01-01

    Studies in dogs showed that heat-treated 99mTc-labeled red blood cells (HT/RBC) afford a highly sensitive means of detecting gastrointetinal bleeding as low as 0.12 ml/min., which could not be seen with unheated 99mTc-RBC, 99mTc-sulfur colloid, or 99mTc-DTPA. In addition, as the right upper quadrant and epigastrium remained free of activity, only one fifth to one tenth of the dose of 99mTc was needed. The safety of HT/RBC in humans has been documented, and the experiments in dogs suggest that it may have advantages over other agents in detecting gastrointestinal bleeding

  15. Detection of gastrointestinal blood loss with /sup 99m/Tc-labeled, heat-treated red blood cells

    International Nuclear Information System (INIS)

    Som, P.; Oster, Z.H.; Atkins, H.L.; Goldman, A.G.; Sacker, D.F.; Harold, W.H.; Fairchild, R.G.; Richards, P.; Brill, A.B.

    1981-01-01

    Studies in dogs showed that heat-treated /sup 99m/Tc-labeled red blood cells (HT/RBC) afford a highly sensitive means of detecting gastrointestinal bleeding as low as 0.12 ml/min, which could not be seen with unheated /sup 99m/Tc-RBC, /sup 99m/Tc-sulfur colloid, or /sup 99m/Tc-DTPA. In addition, as the right upper quadrant and epigastrium remained free of activity, only one fifth to one tenth of the dose of /sup 99m/Tc was needed. The safety of HT/RBC in humans has been documented, and the experiments in dogs suggest that it may have advantages over other agents in detecting gastrointestinal bleeding

  16. The role of the health system in the prevention of hearing loss among children in Sub-Saharan Africa

    OpenAIRE

    Abdalla, Fayrouz Mohammed; Omar, Mayeh Abu

    2011-01-01

    Around 1.2 million children living in Sub-Saharan Africa have a hearing impairment (HI) or hearing loss (HL). Limited attention and scarce resources dedicated to this condition means that such children often receive no management for their problem. This has substantial negative effects on their development, and ultimately results in poverty. Half of the number of cases of HI in such countries results from preventable causes. Formulation of effective prevention strategies to address the causes...

  17. Hearing Health in College Instrumental Musicians and Prevention of Hearing Loss.

    Science.gov (United States)

    Olson, Anna D; Gooding, Lori F; Shikoh, Fara; Graf, Julie

    2016-03-01

    College musicians exhibit greater declines in hearing than the general population and are at particular risk because they rehearse and perform daily in loud environments. Also, they engage in use of personal listening devices which increases the amount of "exposure" time. Despite increased risk, many do not use hearing protection devices (HPD). The purpose of this study was to (1) to identify the present level of education about hearing health, (2) identify the perceived advantages and disadvantages of using HPD, and (3) evaluate results among different musical instrument groups. A mixed-methods group design was used including both quantitative and qualitative instruments. SPSS was used to generate descriptive statistics, and non-parametric statistical analysis was performed on quantitative data. NVivo software was used to evaluate qualitative responses. Of the 90 college instrumental music students who participated, 12% reported a history of hearing loss, and over one-third reported tinnitus. Seventy-seven percent of participants had never received any training about hearing health and only a small percentage of students used HPD. The most cited reason for lack of protection use was its negative impact on sound quality. However, group differences were noted between brass, woodwind, and percussion musicians in terms of HPD uptake. Improving the type of information disseminated to college musicians may reduce the risk of ear-related deficits. Noise dosage information, HPD information, and prevention education grounded in theories like the Health Belief Model may increase awareness and promote greater use of HPDs in this population.

  18. High-impact exercise in rats prior to and during suspension can prevent bone loss

    International Nuclear Information System (INIS)

    Yanagihara, G.R.; Paiva, A.G.; Gasparini, G.A.; Macedo, A.P.; Frighetto, P.D.; Volpon, J.B.; Shimano, A.C.

    2016-01-01

    High-impact exercise has been considered an important method for treating bone loss in osteopenic experimental models. In this study, we investigated the effects of osteopenia caused by inactivity in femora and tibiae of rats subjected to jump training using the rat tail suspension model. Eight-week-old female Wistar rats were divided into five groups (n=10 each group): jump training for 2 weeks before suspension and training during 3 weeks of suspension; jump training for 2 weeks before suspension; jump training only during suspension; suspension without any training; and a control group. The exercise protocol consisted of 20 jumps/day, 5 days/week, with a jump height of 40 cm. The bone mineral density of the femora and tibiae was measured by double energy X-ray absorptiometry and the same bones were evaluated by mechanical tests. Bone microarchitecture was evaluated by scanning electron microscopy. One-way ANOVA was used to compare groups. Significance was determined as P<0.05. Regarding bone mineral density, mechanical properties and bone microarchitecture, the beneficial effects were greater in the bones of animals subjected to pre-suspension training and subsequently to training during suspension, compared with the bones of animals subjected to pre-suspension training or to training during suspension. Our results indicate that a period of high impact exercise prior to tail suspension in rats can prevent the installation of osteopenia if there is also training during the tail suspension

  19. High-impact exercise in rats prior to and during suspension can prevent bone loss

    Energy Technology Data Exchange (ETDEWEB)

    Yanagihara, G.R.; Paiva, A.G.; Gasparini, G.A.; Macedo, A.P. [Laboratório de Bioengenharia, Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Frighetto, P.D. [Instituto Federal de Educação, Ciência e Tecnologia de São Paulo, São Paulo, SP (Brazil); Volpon, J.B.; Shimano, A.C. [Laboratório de Bioengenharia, Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil)

    2016-02-02

    High-impact exercise has been considered an important method for treating bone loss in osteopenic experimental models. In this study, we investigated the effects of osteopenia caused by inactivity in femora and tibiae of rats subjected to jump training using the rat tail suspension model. Eight-week-old female Wistar rats were divided into five groups (n=10 each group): jump training for 2 weeks before suspension and training during 3 weeks of suspension; jump training for 2 weeks before suspension; jump training only during suspension; suspension without any training; and a control group. The exercise protocol consisted of 20 jumps/day, 5 days/week, with a jump height of 40 cm. The bone mineral density of the femora and tibiae was measured by double energy X-ray absorptiometry and the same bones were evaluated by mechanical tests. Bone microarchitecture was evaluated by scanning electron microscopy. One-way ANOVA was used to compare groups. Significance was determined as P<0.05. Regarding bone mineral density, mechanical properties and bone microarchitecture, the beneficial effects were greater in the bones of animals subjected to pre-suspension training and subsequently to training during suspension, compared with the bones of animals subjected to pre-suspension training or to training during suspension. Our results indicate that a period of high impact exercise prior to tail suspension in rats can prevent the installation of osteopenia if there is also training during the tail suspension.

  20. Brazilian situation of blood component irradiation practice for the prevention of transfusion associated Graft-versus-Host disease

    International Nuclear Information System (INIS)

    Goes, E.G.; Borges, J.C.; Covas, D.T.; Motta, I.

    1998-01-01

    Transfusion-associated graft-versus-host disease (TA-GVHD) is a usually complication of transfusion of blood component containing T lymphocytes what recently has also involved immunocompetent patient. Gamma irradiation of cellular blood components has been the mainstay against TA-GVHD, nevertheless there is little information in the literature about current transfusion medicine practices regarding gamma irradiation of blood products. This work presents an overview of the Brazilian reality and suggests policies to optimize TA-GVHD prevention. (Author)

  1. Brazilian situation of blood component irradiation practice for the prevention of transfusion associated Graft-versus-Host disease

    Energy Technology Data Exchange (ETDEWEB)

    Goes, E.G.; Borges, J.C. [EE/COPPE-UFRJ (Brazil); Covas, D.T. [Faculdade deMedicina-USP-RP (Brazil); Motta, I. [Instituto Nacional do Cancer- Rio deJaneiro (Brazil)

    1998-12-31

    Transfusion-associated graft-versus-host disease (TA-GVHD) is a usually complication of transfusion of blood component containing T lymphocytes what recently has also involved immunocompetent patient. Gamma irradiation of cellular blood components has been the mainstay against TA-GVHD, nevertheless there is little information in the literature about current transfusion medicine practices regarding gamma irradiation of blood products. This work presents an overview of the Brazilian reality and suggests policies to optimize TA-GVHD prevention. (Author)

  2. Avoidance of cellular blood product transfusions in LVAD recipients does not prevent HLA allosensitization.

    Science.gov (United States)

    Stringham, J C; Bull, D A; Fuller, T C; Kfoury, A G; Taylor, D O; Renlund, D G; Karwande, S V

    1999-02-01

    Transfusion of cellular blood products during left ventricular assist device (LVAD) implantation has been associated with HLA allosensitization, resulting in the need for a negative prospective cross-match and prolonged transplant waiting times. In order to prevent this risk, we developed a protocol to avoid transfusion of cellular blood products. The protocol included preoperative patient stabilization, perioperative recombinant erythropoietin and blood conservation strategies, and postoperative monitoring of mixed venous oxygen saturation (SVO2) to assure adequate peripheral oxygen delivery. Panel reactive antibody (PRA) was measured in all patients pre and post LVAD placement to assess HLA sensitization. Seven consecutive patients underwent LVAD implantation without transfusion of blood or platelets, one of whom expired perioperatively. Mean hematocrit was 35.2% preoperatively, and 21.8% postoperatively, reaching a nadir of 20.2%. Postoperative SVO2 was >60% in all patients. In the six survivors, mean hematocrit reach 24.3%, 27.3%, and 33.0% by postoperative day seven, fourteen, and thirty, respectively. PRA in three patients was 0% preoperatively and remained 0% until transplantation after 33, 34, and 50 days of support. In two patients, preoperative PRA was 7% and 17%, dropped to 3% and 0% after thirty days, then progressively rose to 96% and 100% after 60 and 90 days, respectively. In one other patient, preoperative PRA was 0%, remained at 0% after thirty days, then rose to 96% by 60 days. Avoiding transfusion of cellular blood products in LVAD recipients is safe and well tolerated, but does not universally protect from HLA allosensitization. Other factors may also produce sensitization, such as immunogenic components of the LVAD, soluble antigen in fresh frozen plasma, or latent sensitization which is not initially evident in critically ill and possibly anergic patients.

  3. Effect of Tranexamic Acid on Blood Loss, D-Dimer, and Fibrinogen Kinetics in Adult Spinal Deformity Surgery.

    Science.gov (United States)

    Pong, Ryan P; Leveque, Jean-Christophe A; Edwards, Alicia; Yanamadala, Vijay; Wright, Anna K; Herodes, Megan; Sethi, Rajiv K

    2018-05-02

    Antifibrinolytics such as tranexamic acid reduce operative blood loss and blood product transfusion requirements in patients undergoing surgical correction of scoliosis. The factors involved in the unrelenting coagulopathy seen in scoliosis surgery are not well understood. One potential contributor is activation of the fibrinolytic system during a surgical procedure, likely related to clot dissolution and consumption of fibrinogen. The addition of tranexamic acid during a surgical procedure may mitigate the coagulopathy by impeding the derangement in D-dimer and fibrinogen kinetics. We retrospectively studied consecutive patients who had undergone surgical correction of adult spinal deformity between January 2010 and July 2016 at our institution. Intraoperative hemostatic data, surgical time, estimated blood loss, and transfusion records were analyzed for patients before and after the addition of tranexamic acid to our protocol. Each patient who received tranexamic acid and met inclusion criteria was cohort-matched with a patient who underwent a surgical procedure without tranexamic acid administration. There were 17 patients in the tranexamic acid cohort, with a mean age of 60.7 years, and 17 patients in the control cohort, with a mean age of 60.9 years. Estimated blood loss (932 ± 539 mL compared with 1,800 ± 1,029 mL; p = 0.005) and packed red blood-cell transfusions (1.5 ± 1.6 units compared with 4.0 ± 2.1 units; p = 0.001) were significantly lower in the tranexamic acid cohort. In all single-stage surgical procedures that met inclusion criteria, the rise of D-dimer was attenuated from 8.3 ± 5.0 μg/mL in the control cohort to 3.3 ± 3.2 μg/mL for the tranexamic acid cohort (p tranexamic acid cohort to 60.6 ± 35.1 mg/dL (p = 0.004). In patients undergoing spinal surgery, intravenous administration of tranexamic acid is effective at reducing intraoperative blood loss. Monitoring of D-dimer and fibrinogen during spinal surgery suggests that tranexamic acid

  4. Comparison of Two Methods of Bolus and Infusion of Tranexamic Acid in Reduction of Blood Loss in Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Mohammadreza Moshari

    2018-01-01

    Full Text Available AbstractBackground: So far, many studies have been performed to determine the optimal dose and regimen of tranexamic acid to reduce preoperative and postoperative blood loss in primary total knee arthroplasty. In the present study, two different methods of administration (bolus and infusion, were compared.Materials and Methods: Forty patients were randomized in the two groups (A and B of 20 patients each. All patients received 500 mg tranexamic acid before inflation of tourniquet. Group A (mean age, 64± 6.1 years received 500 mg tranexamic acid 10 minutes before loosening of tourniquet and group B (mean age, 63.5 ± 7.7 years received 500 mg tranexamic acid through IV infusion during 6 hours from the time of tourniquet loosening (total dose of TA, 1 g in both groups. Intraoperative blood loss,postoperative drainage (in 6 and 12 hours, blood transfusion (in 48 hours, and decrease in hematocrit and hemoglobin (6 and 12 hours later, were compared between the two groups.Results: The patients in group B had lower intra- and postoperative blood loss in 6 and 12 hours and also had lower decrease in hemoglobin, and their packed cell transfusion rate was significantly lower compared to the group A.Conclusion: The findings of this study indicated that infusion administration of tranexamic acid in primary total knee arthroplasty, was more effective in the reduction of perioperative blood loss as well as need for blood transfusion in 48 hours.

  5. Effects of Weight Loss, Weight Cycling, and Weight Loss Maintenance on Diabetes Incidence and Change in Cardiometabolic Traits in the Diabetes Prevention Program

    Science.gov (United States)

    Pan, Qing; Jablonski, Kathleen A.; Aroda, Vanita R.; Watson, Karol E.; Bray, George A.; Kahn, Steven E.; Florez, Jose C.; Perreault, Leigh; Franks, Paul W.

    2014-01-01

    OBJECTIVE This study examined specific measures of weight loss in relation to incident diabetes and improvement in cardiometabolic risk factors. RESEARCH DESIGN AND METHODS This prospective, observational study analyzed nine weight measures, characterizing baseline weight, short- versus long-term weight loss, short- versus long-term weight regain, and weight cycling, within the Diabetes Prevention Program (DPP) lifestyle intervention arm (n = 1,000) for predictors of incident diabetes and improvement in cardiometabolic risk factors over 2 years. RESULTS Although weight loss in the first 6 months was protective of diabetes (hazard ratio [HR] 0.94 per kg, 95% CI 0.90, 0.98; P weight loss from 0 to 2 years was the strongest predictor of reduced diabetes incidence (HR 0.90 per kg, 95% CI 0.87, 0.93; P Weight cycling (defined as number of 5-lb [2.25-kg] weight cycles) ranged 0–6 times per participant and was positively associated with incident diabetes (HR 1.33, 95% CI 1.12, 1.58; P weight, the effect of weight cycling remained statistically significant for diabetes risk (HR 1.22, 95% CI 1.02, 1.47; P = 0.03) but not for cardiometabolic traits. CONCLUSIONS Two-year weight loss was the strongest predictor of reduced diabetes risk and improvements in cardiometabolic traits. PMID:25024396

  6. First Trimester Pregnancy Loss and the Expression of alternatively spliced NKp30 isoforms in Maternal Blood and Placental Tissue

    Directory of Open Access Journals (Sweden)

    Avishai eShemesh

    2015-06-01

    Full Text Available In this study, we aimed to investigate whether first trimester pregnancy loss is associated with differences in expression of NKp30 splice variants (isoforms in maternal peripheral blood or placental tissue. We conducted a prospective case-control study; a total of 33 women undergoing dilation and curettage due to first trimester pregnancy loss were further subdivided into groups with sporadic or recurrent pregnancy loss. The control group was comprised of women undergoing elective termination of pregnancy. The qPCR approach was employed to assess the relative expression of NKp30 isoforms as well as the total expression of NKp30 and NKp46 receptors between the selected groups. Results show that in both PBMC and placental tissue, NKp46 and NKp30 expression was mildly elevated in the pregnancy loss groups compared with the elective group. In particular, NKp46 elevation was significant. Moreover, expression analysis of NKp30 isoforms manifested a different profile between PBMC and the placenta. NKp30-a and NKp30-b isoforms in the placental tissue, but not in PBMC, showed a significant increase in the pregnancy loss groups compared with the elective group. Placental expression of NKp30 activating isoforms -a and -b in the pregnancy loss groups was negatively correlated with PLGF expression. In contrast, placental expression of these isoforms in the elective group was positively correlated with TNFα, IL-10 and VEGF-A expression. The altered expression of NKp30 activating isoforms in placental tissue from patients with pregnancy loss compared to the elective group and the different correlations with cytokine expression point to the involvement of NKp30-mediated function in pregnancy loss.

  7. Menstrual blood loss measurement: validation of the alkaline hematin technique for feminine hygiene products containing superabsorbent polymers.

    Science.gov (United States)

    Magnay, Julia L; Nevatte, Tracy M; Dhingra, Vandana; O'Brien, Shaughn

    2010-12-01

    To validate the alkaline hematin technique for measurement of menstrual blood loss using ultra-thin sanitary towels that contain superabsorbent polymer granules as the absorptive agent. Laboratory study using simulated menstrual fluid (SMF) and Always Ultra Normal, Long, and Night "with wings" sanitary towels. Keele Menstrual Disorders Laboratory. None. None. Recovery of blood, linearity, and interassay variation over a range of SMF volumes applied to towels. Because of the variable percentage of blood in menstrual fluid, blood recovery was assessed from SMF constituted as 10%, 25%, 50%, and 100% blood. The lower limit of reliable detection and the effect of storing soiled towels for up to 4 weeks at 15°C-20°C, 4°C, and -20°C before analysis were determined. Ninety percent recovery was reproducibly achieved up to 30 mL applied volume at all tested SMF compositions, except at low volume or high dilution equivalent to sanitary towels that contain superabsorbent polymers. Copyright © 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  8. Schema reliance for developmental goals increases from early to late adulthood: improvement for the young, loss prevention for the old.

    Science.gov (United States)

    Ebner, Natalie C; Riediger, Michaela; Lindenberger, Ulman

    2009-06-01

    People tend to encode and retrieve information in terms of schemata, especially when processing resources are low. This study argues that the life-span schema about developmental goals constitutes a generalized expectation about the life course that associates young adults with growth and older adults with loss prevention. Predictions were that young and older adults possess this schema; that both age groups rely on it when remembering age-associated information about goals; and that this schema reliance is particularly pronounced among older adults, due to age-related difficulties in overcoming schemata. In Experiment 1, participants assigned growth or loss-prevention orientations to young and older faces and adhered to the life-span schema. In Experiment 2, participants were presented young and older faces paired with growth or loss prevention. When later asked to recognize faces and remember goal orientations, participants were more likely to remember young faces with growth and older faces with loss prevention than vice versa. This effect was more pronounced among older adults. Conclusions are that reliance on life-span schemata when remembering developmentally relevant information increases with age. (c) 2009 APA, all rights reserved.

  9. Strategies for the prevention of MP3-induced hearing loss among adolescents: expert opinions from a Delphi study.

    Science.gov (United States)

    Vogel, Ineke; Brug, Johannes; van der Ploeg, Catharina P B; Raat, Hein

    2009-05-01

    To identify parties involved in the prevention of MP3-induced hearing loss among adolescents and potentially effective prevention strategies and interventions. Thirty experts in fields such as scientific research, medical practice, community health professions, education, youth work, music entertainment, and enforcement authorities participated in a qualitative, electronic, 3-round, Web-based Delphi study. Multiple parties involved in the prevention of MP3-induced hearing loss among adolescents were identified; the most relevant are the adolescents themselves, their parents, manufacturers of MP3 players and earphones, and the authorities. The experts did not expect that adolescents in general would perform the necessary protective behaviors to prevent MP3-induced hearing loss. Two environmental health protection measures were identified as both relevant and feasible to be implemented (ie, authorities encourage manufacturers to produce safer products, and public health campaigns will be held to improve knowledge of the risks of high-volume music, possible protective measures, and consequences of hearing loss). Authorities, the music industry in general, and especially manufacturers of MP3 players and earphones should recognize their responsibility and create a safer MP3-listening environment by taking measures to protect today's youth from the dangers of listening to high-volume music on MP3 players.

  10. The effect of prophylactic intravenous tranexamic acid on blood loss after vaginal delivery in women at low risk of postpartum haemorrhage: a double-blind randomised controlled trial.

    Science.gov (United States)

    Mirghafourvand, Mojgan; Mohammad-Alizadeh, Sakineh; Abbasalizadeh, Fatemeh; Shirdel, Mina

    2015-02-01

    To determine the effect of prophylactic tranexamic acid (TA) on calculated and measured blood loss after vaginal delivery in women at low risk of postpartum haemorrhage. In this double-blind randomised controlled trial, 120 women with a singleton pregnancy were randomly allocated to receive either one gram intravenous TA or placebo in addition to 10 IU oxytocin after delivery of the fetus. Calculated blood loss was determined based on haematocrit before delivery and 12-24 h postdelivery. The quantity of blood loss was measured during two time periods: from delivery of the fetus to placental expulsion and from placental expulsion to the end of the second hour after childbirth. The mean (SD) calculated total blood loss (519 (320) vs 659 (402) mL, P = 0.036) and measured blood loss from placental delivery to 2 h postpartum (69 (39) vs 108 (53) mL, P  1000 mL was lower in the TA group (7% vs 18%, P = 0.048). Prophylactic TA reduces blood loss after vaginal delivery in women with a low risk of postpartum haemorrhage. The prophylactic use of TA may reduce blood loss complications and enhance maternal health. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  11. Propitious Therapeutic Modulators to Prevent Blood-Spinal Cord Barrier Disruption in Spinal Cord Injury.

    Science.gov (United States)

    Kumar, Hemant; Ropper, Alexander E; Lee, Soo-Hong; Han, Inbo

    2017-07-01

    The blood-spinal cord barrier (BSCB) is a specialized protective barrier that regulates the movement of molecules between blood vessels and the spinal cord parenchyma. Analogous to the blood-brain barrier (BBB), the BSCB plays a crucial role in maintaining the homeostasis and internal environmental stability of the central nervous system (CNS). After spinal cord injury (SCI), BSCB disruption leads to inflammatory cell invasion such as neutrophils and macrophages, contributing to permanent neurological disability. In this review, we focus on the major proteins mediating the BSCB disruption or BSCB repair after SCI. This review is composed of three parts. Section 1. SCI and the BSCB of the review describes critical events involved in the pathophysiology of SCI and their correlation with BSCB integrity/disruption. Section 2. Major proteins involved in BSCB disruption in SCI focuses on the actions of matrix metalloproteinases (MMPs), tumor necrosis factor alpha (TNF-α), heme oxygenase-1 (HO-1), angiopoietins (Angs), bradykinin, nitric oxide (NO), and endothelins (ETs) in BSCB disruption and repair. Section 3. Therapeutic approaches discusses the major therapeutic compounds utilized to date for the prevention of BSCB disruption in animal model of SCI through modulation of several proteins.

  12. The first Iranian recommendations on prevention, evaluation and management of high blood pressure.

    Science.gov (United States)

    Noohi, Feridoun; Sarrafzadegan, Nizal; Khosravi, Alireza; Andalib, Elham

    2012-01-01

    This paper presents the complete report of the first Iranian Recommendations on Prevention, Evaluation and Management of High Blood Pressure. The purpose is to provide an evidence-based approach to the prevention, management and control of hypertension (HTN) by adapting the most internationally known and used guidelines to the local health care status with consideration of the currently available data and based on the locally conducted researches on HTN as well as social and health care requirements. A working group of national and international experts participated in discussions and collaborated in decision-making, writing and reviewing the whole report. Multiple subcommittees worked together to review the recent national and international literature on HTN in different areas. We used the evaluation tool that is called "AGREE" and considered a score of > 60% as a high score. We adapted the Canadian Hypertension Education Program (CHEP), the United Kingdom's National Institute for Health and Clinical Excellence (NICE) and the US-based joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7). The key topics that are highlighted in this report include: The importance of ambulatory and self-measurement of blood pressure, evaluation of cardiovascular risk in HTN patients, the role of lifestyle modification in the prevention of HTN and its control with more emphasis on salt intake reduction and weight control, introducing pharmacotherapy suitable for uncomplicated HTN or specific situations and the available drugs in Iran, highlighting the importance of angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers and calcium channel blockers as the first line therapy in many situations, the non-use of beta blockers as the first time treatment except in specific conditions, treating HTN in women, children, obese and elderly patients, the patient compliance to improve HTN control, practical guidelines to improve

  13. Piloted Simulation Evaluation of a Model-Predictive Automatic Recovery System to Prevent Vehicle Loss of Control on Approach

    Science.gov (United States)

    Litt, Jonathan S.; Liu, Yuan; Sowers, Thomas S.; Owen, A. Karl; Guo, Ten-Huei

    2014-01-01

    This paper describes a model-predictive automatic recovery system for aircraft on the verge of a loss-of-control situation. The system determines when it must intervene to prevent an imminent accident, resulting from a poor approach. It estimates the altitude loss that would result from a go-around maneuver at the current flight condition. If the loss is projected to violate a minimum altitude threshold, the maneuver is automatically triggered. The system deactivates to allow landing once several criteria are met. Piloted flight simulator evaluation showed the system to provide effective envelope protection during extremely unsafe landing attempts. The results demonstrate how flight and propulsion control can be integrated to recover control of the vehicle automatically and prevent a potential catastrophe.

  14. Serial transmission of human T-cell leukemia virus type I by blood transfusion in rabbits and its prevention by use of X-irradiated stored blood

    Energy Technology Data Exchange (ETDEWEB)

    Kotani, S.; Yoshimoto, S.; Yamato, K.; Fujishita, M.; Yamashita, M.; Ohtsuki, Y.; Taguchi, H.; Miyoshi, I.

    1986-06-15

    Human T-cell leukemia virus type I (HTLV-I) was serially transmitted for 5 passages from rabbit to rabbit by blood transfusion. The virus could be transmitted with 20 ml of whole blood or washed blood cell suspension (fresh or stored for 1-2 weeks at 4 degrees C) but not with cell-free plasma from seroconverted rabbits. Seroconversion occurred 2-4 weeks after blood transfusion and serum anti-HTLV-I titers ranged from 1:20 to 1:640 with the immunofluorescence assay. From transfusion recipients of the 1st to 4th passages, virus-producing cell lines were established by culturing lymphocytes in the presence of T-cell growth factor (TCGF). Three of the 4 cell lines became TCGF-independent after 2-12 months of continuous culture. Blood was transfused between rabbits of opposite sexes and the recipient origin of each cell line was determined by chromosome analysis. We also investigated the effect of X-irradiation (6,000 rad) on blood from seropositive rabbits. Seroconversion likewise occurred in rabbits transfused with blood that had been irradiated immediately before transfusion but not in rabbits transfused with blood that had been irradiated and stored for 1-2 weeks at 4 degrees C. Thus, our rabbit model shows that HTLV-I is serially transmissible by blood transfusion and that this can be prevented by irradiation of blood. The same procedure, therefore, may be useful for the prevention of transfusion-related transmission of HTLV-I in humans.

  15. High-throughput sequencing of microRNAs in peripheral blood mononuclear cells: identification of potential weight loss biomarkers.

    Directory of Open Access Journals (Sweden)

    Fermín I Milagro

    Full Text Available INTRODUCTION: MicroRNAs (miRNAs are being increasingly studied in relation to energy metabolism and body composition homeostasis. Indeed, the quantitative analysis of miRNAs expression in different adiposity conditions may contribute to understand the intimate mechanisms participating in body weight control and to find new biomarkers with diagnostic or prognostic value in obesity management. OBJECTIVE: The aim of this study was the search for miRNAs in blood cells whose expression could be used as prognostic biomarkers of weight loss. METHODS: Ten Caucasian obese women were selected among the participants in a weight-loss trial that consisted in following an energy-restricted treatment. Weight loss was considered unsuccessful when 5% (responders. At baseline, total miRNA isolated from peripheral blood mononuclear cells (PBMC was sequenced with SOLiD v4. The miRNA sequencing data were validated by RT-PCR. RESULTS: Differential baseline expression of several miRNAs was found between responders and non-responders. Two miRNAs were up-regulated in the non-responder group (mir-935 and mir-4772 and three others were down-regulated (mir-223, mir-224 and mir-376b. Both mir-935 and mir-4772 showed relevant associations with the magnitude of weight loss, although the expression of other transcripts (mir-874, mir-199b, mir-766, mir-589 and mir-148b also correlated with weight loss. CONCLUSIONS: This research addresses the use of high-throughput sequencing technologies in the search for miRNA expression biomarkers in obesity, by determining the miRNA transcriptome of PBMC. Basal expression of different miRNAs, particularly mir-935 and mir-4772, could be prognostic biomarkers and may forecast the response to a hypocaloric diet.

  16. The role of the health system in the prevention of hearing loss among children in Sub-Saharan Africa.

    Science.gov (United States)

    Abdalla, Fayrouz Mohammed; Omar, Mayeh Abu

    2011-01-01

    Around 1.2 million children living in Sub-Saharan Africa have a hearing impairment (HI) or hearing loss (HL). Limited attention and scarce resources dedicated to this condition means that such children often receive no management for their problem. This has substantial negative effects on their development, and ultimately results in poverty. Half of the number of cases of HI in such countries results from preventable causes. Formulation of effective prevention strategies to address the causes requires an understanding of the factors that lead to the causes of HI in Sub-Saharan Africa. A number of preventable causes were shown to significantly contribute to the prevalence of HI. The most significant causes include perinatal problems, middle ear problems, infective diseases, and ototoxic drugs. These causes persist because there are few effective prevention strategies in place, and those which exist are poorly implemented. There is little public and health care worker awareness about HL and its prevention. Few resources are allocated to the prevention of HL, meaning that these issues are not addressed. Evidence have shown that current failings in the prevention of HI from such causes include widespread limited resources, inadequate staff training, and absent or ineffectual prevention guidelines. The burden of HL has been shown to be significantly reduced through effective prevention strategies, both in the developed and developing world, justifying the need for increased attention and more resources in Sub-Saharan Africa.

  17. How to Prevent High Blood Pressure: MedlinePlus Health Topic

    Science.gov (United States)

    ... Spanish Understanding Blood Pressure Readings (American Heart Association) Weightlifting: Bad for Your Blood Pressure? (Mayo Foundation for ... High Blood Pressure High Blood Pressure in Pregnancy Nutrition Quitting Smoking Stress National Institutes of Health The ...

  18. Key-note speaker: Predictors of weight loss after preventive Health consultations

    DEFF Research Database (Denmark)

    Lous, Jørgen; Freund, Kirsten S

    2018-01-01

    Invited key-note speaker ved conferencen: Preventive Medicine and Public Health Conference 2018, July 16-17, London.......Invited key-note speaker ved conferencen: Preventive Medicine and Public Health Conference 2018, July 16-17, London....

  19. [Evaluation of the efficacy of medical screening of blood donors on preventing blood transfusion-transmitted infectious agents].

    Science.gov (United States)

    Seck, M; Dièye, B; Guèye, Y B; Faye, B F; Senghor, A B; Toure, S A; Dieng, N; Sall, A; Toure, A O; Dièye, T N; Diop, S

    2016-05-01

    The aim of this study was to evaluate the efficacy of medical screening to retain blood donors in window period by comparing the seroprevalence of infectious agents (HIV, hepatitis B and C, syphilis) in deferred versus accepted blood donors. This prospective and transversal study was performed during 4 months in the National Blood Transfusion Center in Dakar (Senegal). We conducted a convenience sampling comparing the seroprevalence of infectious agents (HIV, HBsAg, HCV and syphilis) in deferred versus accepted blood donors after medical selection. In total, 8219 blood donors were included. Medical selection had authorized 8048 donors (97.92%) and deferred donors were 171 (2.08%). The prevalence of HIV was higher in the deferred than in accepted blood donors (1.75% vs. 0.05%) (P=0.0003; OR=35.91), as well as for HBsAg (12.87% vs. 7.35%) (P=0.006; OR=1.86). HCV antibodies were present in 0.71% of accepted blood donors and 0.58% in deferred blood donors (P=0.65; OR=0.82). Only accepted donors had brought the infection of syphilis (0.34%) (P=0.56; OR=0). Medical selection is efficient to exclude blood donors at high risk of HIV transmission and to a lesser extent of HBV. However, current medical screening procedures do not allow us to exclude donors asymptomatic carriers of HCV and syphilis. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  20. Hearing loss prevention for carpenters: Part 1 - Using health communication and health promotion models to develop training that works

    Directory of Open Access Journals (Sweden)

    Carol Merry Stephenson

    2011-01-01

    Full Text Available In phase 1 of a large multiyear effort, health communication and health promotion models were used to develop a comprehensive hearing loss prevention training program for carpenters. Additionally, a survey was designed to be used as an evaluation instrument. The models informed an iterative research process in which the authors used key informant interviews, focus groups, and early versions of the survey tool to identify critical issues expected to be relevant to the success of the hearing loss prevention training. Commonly held attitudes and beliefs associated with occupational noise exposure and hearing losses, as well as issues associated with the use or non-use of hearing protectors, were identified. The training program was then specifically constructed to positively shape attitudes, beliefs, and behavioral intentions associated with healthy hearing behaviors - especially those associated with appropriate hearing protector use. The goal was to directly address the key issues and overcome the barriers identified during the formative research phase. The survey was finalized using factor analysis methods and repeated pilot testing. It was designed to be used with the training as an evaluation tool and thus could indicate changes over time in attitudes, beliefs, and behavioral intentions regarding hearing loss prevention. Finally, the training program was fine tuned with industry participation so that its delivery would integrate seamlessly into the existing health and safety training provided to apprentice carpenters. In phase 2, reported elsewhere in this volume, the training program and the survey were tested through a demonstration project at two sites.

  1. Grizzly bears (Ursus arctos horribilis) and black bears (Ursus americanus) prevent trabecular bone loss during disuse (hibernation).

    Science.gov (United States)

    McGee-Lawrence, Meghan E; Wojda, Samantha J; Barlow, Lindsay N; Drummer, Thomas D; Castillo, Alesha B; Kennedy, Oran; Condon, Keith W; Auger, Janene; Black, Hal L; Nelson, O Lynne; Robbins, Charles T; Donahue, Seth W

    2009-12-01

    Disuse typically causes an imbalance in bone formation and bone resorption, leading to losses of cortical and trabecular bone. In contrast, bears maintain balanced intracortical remodeling and prevent cortical bone loss during disuse (hibernation). Trabecular bone, however, is more detrimentally affected than cortical bone in other animal models of disuse. Here we investigated the effects of hibernation on bone remodeling, architectural properties, and mineral density of grizzly bear (Ursus arctos horribilis) and black bear (Ursus americanus) trabecular bone in several skeletal locations. There were no differences in bone volume fraction or tissue mineral density between hibernating and active bears or between pre- and post-hibernation bears in the ilium, distal femur, or calcaneus. Though indices of cellular activity level (mineral apposition rate, osteoid thickness) decreased, trabecular bone resorption and formation indices remained balanced in hibernating grizzly bears. These data suggest that bears prevent bone loss during disuse by maintaining a balance between bone formation and bone resorption, which consequently preserves bone structure and strength. Further investigation of bone metabolism in hibernating bears may lead to the translation of mechanisms preventing disuse-induced bone loss in bears into novel treatments for osteoporosis.

  2. Treatment of Radix Dipsaci extract prevents long bone loss induced by modeled microgravity in hindlimb unloading rats.

    Science.gov (United States)

    Niu, Yinbo; Li, Chenrui; Pan, Yalei; Li, Yuhua; Kong, Xianghe; Wang, Shuo; Zhai, YuanKun; Wu, Xianglong; Fan, Wutu; Mei, Qibing

    2015-01-01

    Radix Dipsaci is a kidney tonifying herbal medicine with a long history of safe use for treatment of bone fractures and joint diseases in China. Previous studies have shown that Radix Dipsaci extract (RDE) could prevent bone loss in ovariectomized rats. This study investigates the effect of RDE against bone loss induced by simulated microgravity. A hindlimb unloading rat model was established to determine the effect of RDE on bone mineral density and bone microarchitecture. Twenty-four male Sprague-Dawley rats were divided into four groups (n = 6 per group): control (CON), hindlimb unloading with vehicle (HLU), hindlimb unloading treated with alendronate (HLU-ALN, 2.0 mg/kg/d), and hindlimb unloading treated with RDE (HLU-RDE, 500 mg/kg/d). RDE or ALN was administrated orally for 4 weeks. Treatment with RDE had a positive effect on mechanical strength, BMD, BMC, bone turnover markers, and the changes in urinary calcium and phosphorus excretion. MicroCT analysis showed that RDE significantly prevented the reduction of the bone volume fraction, connectivity density, trabecular number, thickness, tissue mineral density, and tissue mineral content as well as improved the trabecular separation and structure model index. RDE was demonstrated to prevent the loss of bone mass induced by HLU treatment, which suggests the potential application of RDE in the treatment of microgravity-induced bone loss.

  3. Feeding blueberry diets in early life prevent senescence of osteoblasts and bone loss in ovariectomized adult female rats.

    Directory of Open Access Journals (Sweden)

    Jian Zhang

    Full Text Available Appropriate nutrition during early development is essential for maximal bone mass accretion; however, linkage between early nutrition, childhood bone mass, peak bone mass in adulthood, and prevention of bone loss later in life has not been studied.In this report, we show that feeding a high quality diet supplemented with blueberries (BB to pre-pubertal rats throughout development or only between postnatal day 20 (PND20 and PND34 prevented ovariectomy (OVX-induced bone loss in adult life. This protective effect of BB is due to suppression of osteoblastic cell senescence associated with acute loss of myosin expression after OVX. Early exposure of pre-osteoblasts to serum from BB-fed rats was found to consistently increase myosin expression. This led to maintenance osteoblastic cell development and differentiation and delay of cellular entrance into senescence through regulation of the Runx2 gene. High bone turnover after OVX results in insufficient collagenous matrix support for new osteoblasts and their precursors to express myosin and other cytoskeletal elements required for osteoblast activity and differentiation.These results indicate: 1 a significant prevention of OVX-induced bone loss from adult rats can occur with only 14 days consumption of a BB-containing diet immediately prior to puberty; and 2 the molecular mechanisms underlying these effects involves increased myosin production which stimulates osteoblast differentiation and reduces mesenchymal stromal cell senescence.

  4. Effect of a high-protein diet on maintenance of blood pressure levels achieved after initial weight loss

    DEFF Research Database (Denmark)

    Engberink, M F; Geleijnse, J M; Bakker, S J L

    2015-01-01

    Randomized trials have shown significant blood pressure (BP) reductions after increased protein compared with carbohydrate intake, but the effect on BP maintenance after initial weight loss is unclear. We examined the effect of a high-protein diet on the maintenance of reduced BP after weight loss......(-2), BP was 118/73 mm Hg and 28 subjects (6.5%) used antihypertensive agents. Systolic BP during 26 weeks of weight maintenance dietary intervention increased in both treatment groups, but it was 2.2 mm Hg less (95% CI: -4.6 to 0.2 mm Hg, P=0.08) in the high-protein group than in the lower...

  5. Comparison of Two Methods of Bolus and Infusion of Tranexamic Acid in Reduction of Blood Loss in Total Knee Arthroplasty

    OpenAIRE

    Mohammadreza Moshari; Bahman Malek; Mohammadreza Minator-Sajjadi; Maryam Vosoghian; Mastaneh Dahi; Mahshid Ghasemi; Razieh Shekari

    2018-01-01

    AbstractBackground: So far, many studies have been performed to determine the optimal dose and regimen of tranexamic acid to reduce preoperative and postoperative blood loss in primary total knee arthroplasty. In the present study, two different methods of administration (bolus and infusion), were compared.Materials and Methods: Forty patients were randomized in the two groups (A and B) of 20 patients each. All patients received 500 mg tranexamic acid before inflation of tourniquet. Group A (...

  6. The knowledge and skills related to sexual abuse prevention among Chinese children with hearing loss in Beijing.

    Science.gov (United States)

    Yu, Buyi; Chen, Jingqi; Jin, Yichen; Zhang, Wenjing; Feng, Yanan; Zhao, Xiaoxia

    2017-04-01

    The prevalence of any child sexual abuse (CSA) experience before the age of 16 years ranges from 10.2 to 35.2% in China, 1-5 but there has been no research so far exploring the level of awareness of CSA prevention and self-protection skills among Chinese children with hearing loss. The school based survey examines the CSA prevention knowledge and self-protection skills in Chinese children with hearing loss. Fifty-one students (30 boys, 21 girls) from 10 to 16 years old participated in the study. Children's CSA prevention knowledge and self-protection skills were tested by using anonymous self-administered questionnaire which was mainly designed based on previous Chinese CSA research questionnaires, the Personal Safety Questionnaire, and the 'What If' Situations Test (WIST). There were ten questions assessing the knowledge of CSA but none of the children could correctly answer all and seventy percent of the students could not answer more than five questions correctly. Only three students got the maximum skills score. If sexual abuse occurs, about fifty two percent of the children would report it to trusted adults and most of them would report it to their relatives. Girls received significantly higher scores than boys. Chinese children with hearing loss lack knowledge regarding child sexual abuse and the way to protect themselves. There is an urgent need to develop CSA prevention programs in the school for children with hearing loss in China. Parental training and parent-child interaction on CSA prevention should be developed and promoted as well. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Forensic Luminol Blood Test for Preventing Cross-contamination in Dentistry: An Evaluation of a Dental School Clinic.

    Science.gov (United States)

    Bortoluzzi, Marcelo Carlos; Cadore, Peterson; Gallon, Andrea; Imanishi, Soraia Almeida Watanabe

    2014-10-01

    More than 200 different diseases may be transmitted from exposure to blood in the dental setting. The aim of this study is to identify possible faults in the crosscontamination chain control in a dental school clinic searching for traces of blood in the clinical contact surfaces (CCS) through forensic luminol blood test. Traces of invisible blood where randomly searched in CCS of one dental school clinic. Forty eight surfaces areas in the CCS were tested and the presence of invisible and remnant blood was identified in 28 (58.3%) items. We suggest that the luminol method is suitable for identifying contamination with invisible blood traces and this method may be a useful tool to prevent cross-contamination in the dental care setting.

  8. Effect of a Modest Weight Loss in Normalizing Blood Pressure in Obese Subjects on Antihypertensive Drugs

    OpenAIRE

    Gilardini, Luisa; Redaelli, Gabriella; Croci, Marina; Conti, Antonio; Pasqualinotto, Lucia; Invitti, Cecilia

    2016-01-01

    Objective To assess the effect of a lifestyle intervention in lowering/normalizing blood pressure (BP) levels in hypertensive (controlled or not) obese patients. Methods In this prospective observational study, 490 obese hypertensive patients, 389 controlled (BP < 140/90 mm Hg; CH) and 101 uncontrolled (BP ≥ 140/90 mm Hg; UH) attended a 3-month lifestyle intervention. Before and after the intervention we assessed weight, waist circumference, fat mass, BP, metabolic and renal variables, and ph...

  9. Syringe access for the prevention of blood borne infections among injection drug users

    Directory of Open Access Journals (Sweden)

    Rich Josiah D

    2003-11-01

    Full Text Available Abstract Background Approximately one-third of acquired immunodeficiency syndrome cases in the United States are associated with the practice of sharing of injection equipment and are preventable through the once-only use of syringes, needles and other injection equipment. Discussion Sterile syringes may be obtained legally by 4 methods depending on the state. They may be purchased over the counter, prescribed, obtained at syringe exchange programs or furnished by authorized agencies. Each of these avenues has advantages and disadvantages; therefore, legal access through all means is the most likely way to promote the use of sterile syringes. Summary By assisting illicit drug injectors to obtain sterile syringes the primary care provider is able to reduce the incidence of blood borne infections, and educate patients about safe syringe disposal. The provider is also able to initiate discussion about drug use in a nonjudgmental manner and to offer care to patients who are not yet ready to consider drug treatment.

  10. Psychosocial Predictors of Weight Loss among American Indian and Alaska Native Participants in a Diabetes Prevention Translational Project

    Directory of Open Access Journals (Sweden)

    Edward J. Dill

    2016-01-01

    Full Text Available The association of psychosocial factors (psychological distress, coping skills, family support, trauma exposure, and spirituality with initial weight and weight loss among American Indians and Alaska Natives (AI/ANs in a diabetes prevention translational project was investigated. Participants (n=3,135 were confirmed as prediabetic and subsequently enrolled in the Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP demonstration project implemented at 36 Indian health care programs. Measures were obtained at baseline and after completing a 16-session educational curriculum focusing on weight loss through behavioral changes. At baseline, psychological distress and negative family support were linked to greater weight, whereas cultural spirituality was correlated with lower weight. Furthermore, psychological distress and negative family support predicted less weight loss, and positive family support predicted greater weight loss, over the course of the intervention. These bivariate relationships between psychosocial factors and weight remained statistically significant within a multivariate model, after controlling for sociodemographic characteristics. Conversely, coping skills and trauma exposure were not significantly associated with baseline weight or change in weight. These findings demonstrate the influence of psychosocial factors on weight loss in AI/AN communities and have substantial implications for incorporating adjunctive intervention components.

  11. Ferulic acid promotes survival and differentiation of neural stem cells to prevent gentamicin-induced neuronal hearing loss.

    Science.gov (United States)

    Gu, Lintao; Cui, Xinhua; Wei, Wei; Yang, Jia; Li, Xuezhong

    2017-11-15

    Neural stem cells (NSCs) have exhibited promising potential in therapies against neuronal hearing loss. Ferulic acid (FA) has been widely reported to enhance neurogenic differentiation of different stem cells. We investigated the role of FA in promoting NSC transplant therapy to prevent gentamicin-induced neuronal hearing loss. NSCs were isolated from mouse cochlear tissues to establish in vitro culture, which were then treated with FA. The survival and differentiation of NSCs were evaluated. Subsequently, neurite outgrowth and excitability of the in vitro neuronal network were assessed. Gentamicin was used to induce neuronal hearing loss in mice, in the presence and absence of FA, followed by assessments of auditory brainstem response (ABR) and distortion product optoacoustic emissions (DPOAE) amplitude. FA promoted survival, neurosphere formation and differentiation of NSCs, as well as neurite outgrowth and excitability of in vitro neuronal network. Furthermore, FA restored ABR threshold shifts and DPOAE in gentamicin-induced neuronal hearing loss mouse model in vivo. Our data, for the first time, support potential therapeutic efficacy of FA in promoting survival and differentiation of NSCs to prevent gentamicin-induced neuronal hearing loss. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Effect of self-efficacy on weight loss: a psychosocial analysis of a community-based adaptation of the diabetes prevention program lifestyle intervention.

    Science.gov (United States)

    Hays, Laura M; Finch, Emily A; Saha, Chandan; Marrero, David G; Ackermann, Ronald T

    2014-11-01

    Objective. Weight loss is the most effective approach to reducing diabetes risk. It is a research priority to identify factors that may enhance weight loss success, particularly among those at risk for diabetes. This analysis explored the relationships between self-efficacy, weight loss, and dietary fat intake among adults at risk for developing type 2 diabetes. Methods. This pilot, site-randomized trial was designed to compare group-based Diabetes Prevention Program lifestyle intervention delivery by YMCA staff to brief counseling alone (control) in 92 adults at risk for diabetes (BMI ≥ 24 kg/m(2), ≥ 2 diabetes risk factors, and a random capillary blood glucose of 110-199 mg/dl). Self-efficacy was measured using the Weight Efficacy Lifestyle questionnaire. Data were collected at baseline, 6 months, and 12 months. A paired t test was used to determine within-group changes in self-efficacy and weight at 6 and 12 months. Using a fitted model, we estimated how much of an increase in self-efficacy was related to a 5% weight reduction at 6 and 12 months. Results. Self-efficacy was associated with a 5% reduction in baseline weight at 6 and 12 months but was not related to fat intake. Conclusion. These findings suggest that it is important to assess the level of self-efficacy when counseling adults at high risk for diabetes about weight loss. Certain aspects of self-efficacy seem to play a greater role, depending on the stage of weight loss.

  13. Effect of Self-Efficacy on Weight Loss: A Psychosocial Analysis of a Community-Based Adaptation of the Diabetes Prevention Program Lifestyle Intervention

    Science.gov (United States)

    Finch, Emily A.; Saha, Chandan; Marrero, David G.; Ackermann, Ronald T.

    2014-01-01

    Abstract Objective. Weight loss is the most effective approach to reducing diabetes risk. It is a research priority to identify factors that may enhance weight loss success, particularly among those at risk for diabetes. This analysis explored the relationships between self-efficacy, weight loss, and dietary fat intake among adults at risk for developing type 2 diabetes. Methods. This pilot, site-randomized trial was designed to compare group-based Diabetes Prevention Program lifestyle intervention delivery by YMCA staff to brief counseling alone (control) in 92 adults at risk for diabetes (BMI ≥ 24 kg/m2, ≥ 2 diabetes risk factors, and a random capillary blood glucose of 110–199 mg/dl). Self-efficacy was measured using the Weight Efficacy Lifestyle questionnaire. Data were collected at baseline, 6 months, and 12 months. A paired t test was used to determine within-group changes in self-efficacy and weight at 6 and 12 months. Using a fitted model, we estimated how much of an increase in self-efficacy was related to a 5% weight reduction at 6 and 12 months. Results. Self-efficacy was associated with a 5% reduction in baseline weight at 6 and 12 months but was not related to fat intake. Conclusion. These findings suggest that it is important to assess the level of self-efficacy when counseling adults at high risk for diabetes about weight loss. Certain aspects of self-efficacy seem to play a greater role, depending on the stage of weight loss. PMID:25647049

  14. Iron supplement prevents lead-induced disruption of the blood-brain barrier during rat development

    International Nuclear Information System (INIS)

    Wang Qiang; Luo Wenjing; Zheng Wei; Liu Yiping; Xu Hui; Zheng Gang; Dai Zhongming; Zhang Wenbin; Chen Yaoming; Chen Jingyuan

    2007-01-01

    Children are known to be venerable to lead (Pb) toxicity. The blood-brain barrier (BBB) in immature brain is particularly vulnerable to Pb insults. This study was designed to test the hypothesis that Pb exposure damaged the integrity of the BBB in young animals and iron (Fe) supplement may prevent against Pb-induced BBB disruption. Male weanling Sprague-Dawley rats were divided into four groups. Three groups of rats were exposed to Pb in drinking water containing 342 μg Pb/mL as Pb acetate, among which two groups were concurrently administered by oral gavage once every other day with 7 mg Fe/kg and 14 mg Fe/kg as FeSO 4 solution as the low and high Fe treatment group, respectively, for 6 weeks. The control group received sodium acetate in drinking water. Pb exposure significantly increased Pb concentrations in blood by 6.6-folds (p < 0.05) and brain tissues by 1.5-2.0-folds (p < 0.05) as compared to controls. Under the electron microscope, Pb exposure in young animals caused an extensive extravascular staining of lanthanum nitrate in brain parenchyma, suggesting a leakage of cerebral vasculature. Western blot showed that Pb treatment led to 29-68% reduction (p < 0.05) in the expression of occludin as compared to the controls. Fe supplement among Pb-exposed rats maintained the normal ultra-structure of the BBB and restored the expression of occludin to normal levels. Moreover, the low dose Fe supplement significantly reduced Pb levels in blood and brain tissues. These data suggest that Pb exposure disrupts the structure of the BBB in young animals. The increased BBB permeability may facilitate the accumulation of Pb. Fe supplement appears to protect the integrity of the BBB against Pb insults, a beneficial effect that may have significant clinical implications

  15. Tranexamic acid reduces intraoperative occult blood loss and tourniquet time in obese knee osteoarthritis patients undergoing total knee arthroplasty: a prospective cohort study.

    Science.gov (United States)

    Meng, Yutong; Li, Zhirui; Gong, Ke; An, Xiao; Dong, Jiyuan; Tang, Peifu

    2018-01-01

    Obesity can result in increased blood loss, which is correlated with poor prognosis in total knee arthroplasty (TKA). Clinical application of tranexamic acid is effective in reducing blood loss in TKA. However, most previous studies focused on the effect of tranexamic acid in the whole population, neglecting patients with specific health conditions, such as obesity. We hypothesized that tranexamic acid would reduce blood loss to a greater extent in obese patients than in those of normal weight. A total of 304 patients with knee osteoarthritis treated with TKA from October 2013 to March 2015 were separated into tranexamic, non-tranexamic, obese, and non-obese groups. The demographic characteristics, surgical indices, and hematological indices were all recorded. We first investigated the ability of intravenous tranexamic acid to reduce intraoperative blood loss in knee osteoarthritis patients undergoing unilateral TKA. Second, we performed subgroup analysis to compare the effects of tranexamic acid between obese and non-obese patients separately. Of the 304 patients, 146 (52.0%) received tranexamic acid and 130 (42.8%) were obese. In the analysis of the whole group, both the actual and occult blood loss volume were lower in the tranexamic acid group (both P tranexamic acid group ( P tranexamic acid was shown to reduce theoretical and actual blood loss in both the obese and non-obese groups ( P Tranexamic acid reduced occult blood loss and tourniquet time in the obese group ( P 0.05). Tranexamic acid can reduce occult blood loss and tourniquet time in obese patients to a greater extent than in patients of normal weight. Therefore, obese knee osteoarthritis patients undergoing TKA can benefit more from tranexamic acid.

  16. Food loss rates at the food retail, influencing factors and reasons as a basis for waste prevention measures.

    Science.gov (United States)

    Lebersorger, S; Schneider, F

    2014-11-01

    This paper quantifies food loss rates for fruit & vegetables, dairy products and bread & pastry as well as donations to social services. In addition potential influencing factors and reasons for food losses are investigated in order to provide a basis for the development of waste prevention measures. Detailed data from 612 retail outlets all over Austria, which covered the period of one year, were analysed and sorting analyses of discarded food were carried out in a small sample of retail outlets. Food loss amounts to 1.3% of the sales of dairy products, 2.8% for bread & pastry and 4.2% for fruit & vegetables. Returned bread amounts to additional 9.7% of the sales of bread & pastry. The food loss rates are similar to the results of previous publications. At present, 7% of the food loss is donated to social services, 38% of retail outlets do not donate any articles at all. Food loss rates are declining with increasing sales areas, increasing numbers of purchases per year and increasing sales of the retail outlet, but explain only 33% or less of the variation of food loss rates. Large differences between retail outlets of comparable structure indicate potential for reduction. More than a quarter of discarded food articles did not show any flaws besides the expiration of the best before or sell-by date. Waste prevention approaches should focus on avoiding returns, transfer of best practices, information and education of employees and customers as well as strengthening the donation to social services. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Gcg-XTEN: an improved glucagon capable of preventing hypoglycemia without increasing baseline blood glucose.

    Directory of Open Access Journals (Sweden)

    Nathan C Geething

    2010-04-01

    Full Text Available While the majority of current diabetes treatments focus on reducing blood glucose levels, hypoglycemia represents a significant risk associated with insulin treatment. Glucagon plays a major regulatory role in controlling hypoglycemia in vivo, but its short half-life and hyperglycemic effects prevent its therapeutic use for non-acute applications. The goal of this study was to identify a modified form of glucagon suitable for prophylactic treatment of hypoglycemia without increasing baseline blood glucose levels.Through application of the XTEN technology, we report the construction of a glucagon fusion protein with an extended exposure profile (Gcg-XTEN. The in vivo half-life of the construct was tuned to support nightly dosing through design and testing in cynomolgus monkeys. Efficacy of the construct was assessed in beagle dogs using an insulin challenge to induce hypoglycemia. Dose ranging of Gcg-XTEN in fasted beagle dogs demonstrated that the compound was biologically active with a pharmacodynamic profile consistent with the designed half-life. Prophylactic administration of 0.6 nmol/kg Gcg-XTEN to dogs conferred resistance to a hypoglycemic challenge at 6 hours post-dose without affecting baseline blood glucose levels. Consistent with the designed pharmacokinetic profile, hypoglycemia resistance was not observed at 12 hours post-dose. Importantly, the solubility and stability of the glucagon peptide were also significantly improved by fusion to XTEN.The data show that Gcg-XTEN is effective in preventing hypoglycemia without the associated hyperglycemia expected for unmodified glucagon. While the plasma clearance of this Gcg-XTEN has been optimized for overnight dosing, specifically for the treatment of nocturnal hypoglycemia, constructs with significantly longer exposure profiles are feasible. Such constructs may have multiple applications such as allowing for more aggressive insulin treatment regimens, treating hypoglycemia due to insulin

  18. Effect of tranexamic acid irrigation on perioperative blood loss during orthognathic surgery: a double-blind, randomized controlled clinical trial.

    Science.gov (United States)

    Eftekharian, Hamidreza; Vahedi, Ruhollah; Karagah, Tuba; Tabrizi, Reza

    2015-01-01

    Perioperative hemorrhage is an important concern during orthognathic surgery. The purpose of this study was to assess the effect of tranexamic acid (TXA) irrigation on perioperative hemorrhage during orthognathic surgery. In this double-blind, randomized controlled clinical trial, 56 participants who underwent orthognathic surgery were divided into 2 groups. The patients in the first group received TXA irrigation with normal saline (1 mg/mL), and the patients in the second group had normal saline for irrigation during orthognathic surgery. Age, gender, operation duration, the amount of irrigation solution used, and preoperative hemoglobin, hematocrit, and weight were the variables that were studied. The use of TXA solution for irrigation was the predictive factor of the study. Each group consisted of 28 patients. Group 1 consisted of 15 male patients (53.6%) and 13 female patients (46.4%) and group 2 consisted of 14 male patients (50%) and 14 female patients (50%). There was no difference in the distributions of the variables between the 2 groups, except for the duration of the operation. The mean duration of the operation was 3.94 ± 0.61 hours in group 1 and 4.17 ± 0.98 hours in group 2, and the difference in this respect between the 2 groups was statistically significant (P .05). TXA is effective in reducing intraoperative blood loss in patients for whom substantial blood loss is anticipated. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  19. The effect of blood volume loss on cardiovascular response to lower body negative pressure using a mathematical model

    Science.gov (United States)

    Karam, E. H.; Srinivasan, R. S.; Charles, J. B.; Fortney, S. M.

    1994-01-01

    Different mathematical models of varying complexity have been proposed in recent years to study the cardiovascular (CV) system. However, only a few of them specifically address the response to lower body negative pressure (LBNP), a stress that can be applied in weightlessness to predict changes in orthostatic tolerance. Also, the simulated results produced by these models agree only partially with experimental observations. In contrast, the model proposed by Melchior et al., and modified by Karam et al. is a simple representation of the CV system capable of accurately reproducing observed LBNP responses up to presyncopal levels. There are significant changes in LBNP response due to a loss of blood volume and other alterations that occur in weightlessness and related one-g conditions such as bedrest. A few days of bedrest can cause up to 15% blood volume loss (BVL), with consequent decreases in both stroke volume and cardiac output, and increases in heart rate, mean arterial pressure, and total peripheral resistance. These changes are more pronounced at higher levels of LBNP. This paper presents the results of a simulation study using our CV model to examine the effect of BVL on LBNP response.

  20. Tranexamic acid administration to older patients undergoing primary total hip arthroplasty conserves hemoglobin and reduces blood loss.

    Science.gov (United States)

    El Beheiry, Hossam; Lubberdink, Ashley; Clements, Nigel; Dihllon, Kiran; Sharma, Vicky

    2018-06-01

    Tranexamic acid effects in older people are difficult to predict. This study investigated the following research questions: 1) Is tranexamic acid effective in older patients undergoing primary total hip arthroplasty (THA)? and 2) Is there a difference in the effect of tranexamic acid between younger and older patients? This was a 2-phase retrospective matched-pair study of patients who underwent THA in 2007-2013. All procedures were performed by surgeons with at least 10 years' experience as senior consultant. In the first phase, 58 patients aged 65 years or more who received tranexamic acid were matched 1:1 with patients who did not receive tranexamic acid for age, sex, American Society of Anesthesiologists (ASA) classification and body mass index. In the second phase, 58 patients aged 65 years or more who received tranexamic acid were matched 1:1 with patients less than 65 years of age who received tranexamic acid for sex, ASA classification and body mass index. The primary outcome measures were percent maximum decrease in hemoglobin level and estimated blood loss after surgery. In the first phase, patients who received tranexamic acid conserved postoperative hemoglobin by a mean of 10.26 g/L (standard deviation [SD] 9.89 g/L) compared to the control group ( p Tranexamic acid reduced the postoperative decrease in hemoglobin level and blood loss in older patients. Moreover, the significant hemoglobin-sparing effect of tranexamic acid in older patients was similar to that observed in younger patients.

  1. Effect of childhood obesity prevention programs on blood pressure: a systematic review and meta-analysis.

    Science.gov (United States)

    Cai, Li; Wu, Yang; Wilson, Renee F; Segal, Jodi B; Kim, Miyong T; Wang, Youfa

    2014-05-06

    Childhood overweight and obesity are associated with elevated blood pressure (BP). However, little is known about how childhood obesity lifestyle prevention programs affect BP. We assessed the effects of childhood obesity prevention programs on BP in children in developed countries. We searched databases up to April 22, 2013, for relevant randomized, controlled trials, quasi-experimental studies, and natural experiments. Studies were included if they applied a diet or physical activity intervention(s) and were followed for ≥ 1 year (or ≥ 6 months for school-based intervention studies); they were excluded if they targeted only overweight/obese subjects or those with a medical condition. In our meta-analysis, intervention effects were calculated for systolic BP and diastolic BP with the use of weighted random-effects models. Of the 23 included intervention studies (involving 18 925 participants), 21 involved a school setting. Our meta-analysis included 19 studies reporting on systolic BP and 18 on diastolic BP. The pooled intervention effect was -1.64 mm Hg (95% confidence interval, -2.56 to -0.71; P=0.001) for systolic BP and -1.44 mm Hg (95% confidence interval, -2.28 to -0.60; P=0.001) for diastolic BP. The combined diet and physical activity interventions led to a significantly greater reduction in both systolic BP and diastolic BP than the diet-only or physical activity-only intervention. Thirteen interventions (46%) had a similar effect on both adiposity-related outcomes and BP, whereas 11 interventions (39%) showed a significant desirable effect on BP but not on adiposity-related outcomes. Obesity prevention programs have a moderate effect on reducing BP, and those targeting both diet and physical activity seem to be more effective.

  2. Influence of sibutramine in addition to diet and exercise on the relationship between weight loss and blood glucose changes.

    Science.gov (United States)

    Kamil, Sadaf; Finer, Nicholas; James, William Philip T; Caterson, Ian D; Andersson, Charlotte; Torp-Pedersen, Christian

    2017-07-01

    Weight loss is expected to improve glycaemic control in patients with diabetes or at high risk hereof. Sibutramine causes weight loss and is associated with an increased risk of myocardial infarction and stroke in high-risk patients. We examined the impact of sibutramine-induced weight loss on glycaemic control. In total, 8192 obese patients with diabetes were randomized to sibutramine or placebo plus diet and exercise after a preliminary 6 weeks in which all patients received sibutramine. Patients were classified into four groups of weight change. A total of 1582 patients had a weight loss >5.7 kg; 2047 patients lost 3.7-5.7 kg; 2432 patients lost sibutramine lost slightly more weight than those on placebo (-0.2 kg on average, P sibutramine-treated patients were -0.4 mmol/L (±3.2, P = 0.0002), +0.1 mmol/L (±3.0, P = 0.04), +0.4 mmol/L (±2.8, P = 0.01), and +0.2 mmol/L (±3.4, P = 0.003). Mean values of HbA1c followed the same pattern though the HbA1c changes were smaller with weight loss and greater with weight gain in the sibutramine group. All results were statistically significant (P sibutramine, diet, and exercise attenuates falls in blood glucose levels and HbA1c compared with similar weight loss with placebo, diet, and exercise. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For Permissions, please email: journals.permissions@oup.com.

  3. Effect of a high-protein diet on maintenance of blood pressure levels achieved after initial weight loss : the DiOGenes randomized study

    NARCIS (Netherlands)

    Engberink, M. F.; Geleijnse, J. M.; Bakker, S. J. L.; Larsen, T. M.; Handjieva-Darlesnka, T.; Kafatos, A.; Martinez, J. A.; Pfeiffer, A. F. H.; Kunesova, M.; Jebb, S. A.; Holst, C.; Astrup, A.; Saris, W. H. M.; Brink, E. J.; van Baak, M. A.

    Randomized trials have shown significant blood pressure (BP) reductions after increased protein compared with carbohydrate intake, but the effect on BP maintenance after initial weight loss is unclear. We examined the effect of a high-protein diet on the maintenance of reduced BP after weight loss

  4. Effect of a high-protein diet on maintenance of blood pressure levels achieved after initial weight loss: the DiOGenes randomized study

    NARCIS (Netherlands)

    Engberink, M.F.; Geleijnse, J.M.; Bakker, S.J.L.; Larsen, T.

    2015-01-01

    Randomized trials have shown significant blood pressure (BP) reductions after increased protein compared with carbohydrate intake, but the effect on BP maintenance after initial weight loss is unclear. We examined the effect of a high-protein diet on the maintenance of reduced BP after weight loss

  5. Alpha-1 antitrypsin gene therapy prevented bone loss in ovariectomy induced osteoporosis mouse model

    Science.gov (United States)

    Osteoporosis is a major healthcare burden affecting mostly postmenopausal women characterized by compromised bone strength and increased risk of fragility fracture. Although pathogenesis of this disease is complex, elevated proinflammatory cytokine production is clearly involved in bone loss at meno...

  6. Measuring Post-Partum Haemorrhage in Low-Resource Settings: The Diagnostic Validity of Weighed Blood Loss versus Quantitative Changes in Hemoglobin.

    Directory of Open Access Journals (Sweden)

    Esther Cathyln Atukunda

    Full Text Available Accurate estimation of blood loss is central to prompt diagnosis and management of post-partum hemorrhage (PPH, which remains a leading cause of maternal mortality in low-resource countries. In such settings, blood loss is often estimated visually and subjectively by attending health workers, due to inconsistent availability of laboratory infrastructure. We evaluated the diagnostic accuracy of weighed blood loss (WBL versus changes in peri-partum hemoglobin to detect PPH.Data from this analysis were collected as part of a randomized controlled trial comparing oxytocin with misoprostol for PPH (NCT01866241. Blood samples for complete blood count were drawn on admission and again prior to hospital discharge or before blood transfusion. During delivery, women were placed on drapes and had pre-weighed sanitary towels placed around their perineum. Blood was then drained into a calibrated container and the sanitary towels were added to estimate WBL, where each gram of blood was estimated as a milliliter. Sensitivity, specificity, negative and positive predictive values (PPVs were calculated at various blood volume loss and time combinations, and we fit receiver-operator curves using blood loss at 1, 2, and 24 hours compared to a reference standard of haemoglobin decrease of >10%.A total of 1,140 women were enrolled in the study, of whom 258 (22.6% developed PPH, defined as a haemoglobin drop >10%, and 262 (23.0% had WBL ≥500mL. WBL generally had a poor sensitivity for detection of PPH (85% in high prevalence settings when WBL exceeds 750mL.WBL has poor sensitivity but high specificity compared to laboratory-based methods of PPH diagnosis. These characteristics correspond to a high PPV in areas with high PPH prevalence. Although WBL is not useful for excluding PPH, this low-cost, simple and reproducible method is promising as a reasonable method to identify significant PPH in such settings where quantifiable red cell indices are unavailable.

  7. Intra-articular injection of tranexamic acid via a drain plus drain-clamping to reduce blood loss in cementless total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Mutsuzaki Hirotaka

    2012-09-01

    Full Text Available Abstract Background Patients undergoing cementless total knee arthroplasty (TKA sometimes suffer large blood loss. In a retrospective study, we explored whether postoperative intra-articular retrograde injection of tranexamic acid (TA and leaving a drain clamp in place for 1 h reduced blood loss. Patients and methods Patients (n = 140 treated with unilateral primary cementless TKA (posterior cruciate ligament retained were divided into two groups: those who had an intra-articular injection of TA (1000 mg and drain clamping for 1 h postoperatively (study group, n = 70 and those who were not given TA and did not undergo clamping of their drains (control group, n = 70. Postoperative total blood loss, volume of drainage, hemoglobin level, transfusion amounts and rates, D-dimer level at postoperative day (POD 7, and complications were recorded. Results Total blood loss, total drainage, mean transfusion volume, and transfusion rates were lower in the study group than in controls (P P P  Conclusions Immediately postoperative intra-articular retrograde injection of TA and 1 h of drain-clamping effectively reduced blood loss and blood transfusion after cementless TKA. We believe that this method is simple, easy, and suitable for these patients.

  8. Probiotic Lactobacillus rhamnosus GG prevents alveolar bone loss in a mouse model of experimental periodontitis.

    Science.gov (United States)

    Gatej, Simona M; Marino, Victor; Bright, Richard; Fitzsimmons, Tracy R; Gully, Neville; Zilm, Peter; Gibson, Rachel J; Edwards, Suzanne; Bartold, Peter M

    2018-02-01

    This study investigated the role of Lactobacillus rhamnosus GG (LGG) on bone loss and local and systemic inflammation in an in vivo mouse model of experimental periodontitis (PD). Experimental PD was induced in mice by oral inoculation with Porphyromonas gingivalis and Fusobacterium nucleatum over a period of 44 days. The probiotic LGG was administered via oral inoculation or oral gavage prior to, and during disease induction. The antimicrobial activity of LGG on the inoculum was also tested. Alveolar bone levels and gingival tissue changes were assessed using in vivo microcomputed tomography and histological analysis. Serum levels of mouse homologues for IL-8 were measured using multiplex assays. Pre-treatment with probiotics either via oral gavage or via oral inoculation significantly reduced bone loss (p loss in a mouse model of induced PD irrespective of the mode of administration. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Intratympanic steroid prevents long-term spiral ganglion neuron loss in experimental meningitis

    DEFF Research Database (Denmark)

    Worsøe, Lise Lotte; Brandt, C.T.; Lund, S.P.

    2010-01-01

    most often associated with a hearing loss. Methods: Rats were randomly assigned to 3 treatment groups: a group treated with intratympanic betamethasone and 2 control groups treated with either intratympanic or systemic saline. Treatment was initiated 21 hours after infection and repeated once a day......, and distortion product otoacoustic emissions showed significant hearing loss at the low frequencies in animals treated with intratympanic steroid compared with animals treated with systemic saline (p ... in the spiral ganglion compared with both intratympanic and systemic saline (p = 0.0082 and p = 0.0089; Mann-Whitney test). Histology revealed fibrosis of the tympanic membrane and cavity in steroid-treated animals, which plausibly caused the low-frequency hearing loss. Conclusion: Intratympanic betamethasone...

  10. Prevention and control of blood stream infection using the balanced scorecard approach.

    Science.gov (United States)

    Rohsiswatmo, Rinawati; Rafika, Sarah; Marsubrin, Putri M T

    2014-07-01

    to obtain formulation of an effective and efficient strategy to overcome blood stream infection (BSI). operational research design with qualitative and quantitative approach. The study was divided into two stages. Stage I was an operational research with problem solving approach using qualitative and quantitative method. Stage II was performed using quantitative method, a form of an interventional study on strategy implementation, which was previously established in stage I. The effective and efficient strategy for the prevention and control of infection in neonatal unit Cipto Mangunkusumo (CM) Hospital was established using Balanced Scorecard (BSC) approach, which involved several related processes. the BSC strategy was proven to be effective and efficient in substantially reducing BSI from 52.31°/oo to 1.36°/oo in neonates with birth weight (BW) 1000-1499 g (p=0.025), and from 29.96°/oo to 1.66°/oo in BW 1500-1999 g (p=0.05). Gram-negative bacteria still predominated as the main cause of BSI in CMH Neonatal Unit. So far, the sources of the microorganisms were thought to be from the environment of treatment unit (tap water filter and humidifying water in the incubator). Significant reduction was also found in neonatal mortality rate weighing 1000-1499 g at birth, length of stay, hospitalization costs, and improved customer satisfaction. effective and efficient infection prevention and control using BSC approach could significantly reduce the rate of BSI. This approach may be applied for adult patients in intensive care unit with a wide range of adjustment.

  11. Fingolimod prevents blood-brain barrier disruption induced by the sera from patients with multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Hideaki Nishihara

    Full Text Available OBJECTIVE: Effect of fingolimod in multiple sclerosis (MS is thought to involve the prevention of lymphocyte egress from lymphoid tissues, thereby reducing autoaggressive lymphocyte infiltration into the central nervous system across blood-brain barrier (BBB. However, brain microvascular endothelial cells (BMECs represent a possible additional target for fingolimod in MS patients by directly repairing the function of BBB, as S1P receptors are also expressed by BMECs. In this study, we evaluated the effects of fingolimod on BMECs and clarified whether fingolimod-phosphate restores the BBB function after exposure to MS sera. METHODS: Changes in tight junction proteins, adhesion molecules and transendothelial electrical resistance (TEER in BMECs were evaluated following incubation in conditioned medium with or without fingolimod/fingolimod-phosphate. In addition, the effects of sera derived from MS patients, including those in the relapse phase of relapse-remitting (RR MS, stable phase of RRMS and secondary progressive MS (SPMS, on the function of BBB in the presence of fingolimod-phosphate were assessed. RESULTS: Incubation with fingolimod-phosphate increased the claudin-5 protein levels and TEER values in BMECs, although it did not change the amount of occludin, ICAM-1 or MelCAM proteins. Pretreatment with fingolimod-phosphate restored the changes in the claudin-5 and VCAM-1 protein/mRNA levels and TEER values in BMECs after exposure to MS sera. CONCLUSIONS: Pretreatment with fingolimod-phosphate prevents BBB disruption caused by both RRMS and SPMS sera via the upregulation of claudin-5 and downregulation of VCAM-1 in BMECs, suggesting that fingolimod-phosphate is capable of directly modifying the BBB. BMECs represent a possible therapeutic target for fingolimod in MS patients.

  12. The value of blood serotonin for effective weight loss in obese women

    Directory of Open Access Journals (Sweden)

    Natal'ya Vadimovna Anikina

    2015-07-01

    Full Text Available Introduction. Obesity is a disorder of energy balance, which leads to excessive accumulation of fat. In recent years, many important discoveries were made in this field, including the discovery of hormones produced by adipose tissue and the identification of many of the central and peripheral pathways of energy balance. Objective. To study the levels of hormones that affect appetite and metabolism in women with obesity baseline and after weight loss while taking sibutramine. Materials and methods. The study included 56 women aged 42,9±9,5 years, with a BMI of 34,6±6,1 kg/m2. All patients underwent clinical, laboratory and instrumental examination. Hormonal study included determination of serotonin, leptin, ghrelin, endothelin-1, adiponectin. Results: In women with obesity we identified hyperleptinemia and increased serotonin levels. The decrease in body weight in patients receiving sibutramine was accompanied by lower levels of serotonin, leptin, ghrelin, endothelin-1, and increase of adiponectin. Conclusions: Obese patients have significantly elevated levels of leptin, serotonin, ghrelin compared to women of normal weight. Sibutramine treatment leads to a decrease in serotonin, leptin, ghrelin and is more effective in women with a BMI less than 36,5 kg/m2.

  13. Mental stress as consequence and cause of vision loss: the dawn of psychosomatic ophthalmology for preventive and personalized medicine.

    Science.gov (United States)

    Sabel, Bernhard A; Wang, Jiaqi; Cárdenas-Morales, Lizbeth; Faiq, Muneeb; Heim, Christine

    2018-06-01

    The loss of vision after damage to the retina, optic nerve, or brain has often grave consequences in everyday life such as problems with recognizing faces, reading, or mobility. Because vision loss is considered to be irreversible and often progressive, patients experience continuous mental stress due to worries, anxiety, or fear with secondary consequences such as depression and social isolation. While prolonged mental stress is clearly a consequence of vision loss, it may also aggravate the situation. In fact, continuous stress and elevated cortisol levels negatively impact the eye and brain due to autonomous nervous system (sympathetic) imbalance and vascular dysregulation; hence stress may also be one of the major causes of visual system diseases such as glaucoma and optic neuropathy. Although stress is a known risk factor, its causal role in the development or progression of certain visual system disorders is not widely appreciated. This review of the literature discusses the relationship of stress and ophthalmological diseases. We conclude that stress is both consequence and cause of vision loss. This creates a vicious cycle of a downward spiral, in which initial vision loss creates stress which further accelerates vision loss, creating even more stress and so forth. This new psychosomatic perspective has several implications for clinical practice. Firstly, stress reduction and relaxation techniques (e.g., meditation, autogenic training, stress management training, and psychotherapy to learn to cope) should be recommended not only as complementary to traditional treatments of vision loss but possibly as preventive means to reduce progression of vision loss. Secondly, doctors should try their best to inculcate positivity and optimism in their patients while giving them the information the patients are entitled to, especially regarding the important value of stress reduction. In this way, the vicious cycle could be interrupted. More clinical studies are now

  14. Winter-catastrophies in the reindeer husbandry of Finland: Losses and their prevention

    Directory of Open Access Journals (Sweden)

    Timo Helle

    1982-05-01

    Full Text Available The paper deals with the occurreance of disastrous winters to the reindeer industry in Finland with special attention on the winter catastrophies and tje condition of the pastures, the influence of the disasters upon the population dynamic of the reindeer and the methods used to prevent catastrophies. A reindeer catastrophy has been defined as a situation where the number of reindeer stays 20% below the mean of the reindeer numbers during the two preceeding years. During the winter-catastrophies from 1970/71 to 1980/81 4.5% of the total reindeer number was lost. The highest losses were found in the northwesternmost part of Lappland, where there is no alternative to the reindeer lichen as it is in the middle and southern part of the reindeer industry area (arboreal lichens and supplemental feeding. In Kaldoaivi reindeer association (district, which has been studied in detail, the calf percentage is depending upon how the reindeer is able to manage the winter (r=0.62, n=ll, p«0.05. There is also a positive correlation between the slaughterweight of the calves in the early winter and the calf rate (r=0.79, n=7, p«0.05.During severe winters the mortality rate of males exceeds that of the females. Winter-catastrophies may be prevented by deminishing the numer of reindeer and by guiding the harvest to the most risky cohorts of the population. It has been proved that supplementary and emergency feeding are the most effective methods. In a normal year during the 1970s the total use of dry hay was 0.5—1.5 mill, kg., being up to 5.9—12.5 kg. per reindeer/year. In normal winters 10—16% of the total reindeer stock was intensively fed in enclosures. Supplementary feeding in enclosures is most common in the middle and southern parts of the reindeer industry area, where the essential feed is grown on own land.Katotalvet suomen poronhoidossa: menetykset ja Niiden Torjunta.Abstract in Finnish / Yhteenveto: Artikkeli käsittelee katastrofitalvien

  15. Prevention of Incident Knee Osteoarthritis by Moderate Weight Loss in Overweight and Obese Females

    NARCIS (Netherlands)

    J. Runhaar (Jos); B.C. de Vos (Bastiaan); M. van Middelkoop (Marienke); D. Vroegindeweij (Dammis); E.H.G. Oei (Edwin); S.M. Bierma-Zeinstra (Sita)

    2016-01-01

    markdownabstract__Objective:__ This study evaluated the effect of moderate weight loss on the incidence of knee osteoarthritis (OA) in middle-aged overweight and obese women, without clinical and radiologic knee OA at baseline. __Methods:__ A total of 353 women (87%) with followup data available

  16. Prevention of adolescents' music-induced hearing loss due to discotheque attendance: a Delphi study

    NARCIS (Netherlands)

    Vogel, I.; Brug, J.; Ploeg, van der C.P.B.; Raat, H.

    2009-01-01

    Noise-induced hearing loss is a significant social and public health problem, which is found in increasing numbers of adolescents. Young people are particularly likely to expose themselves to potentially damaging loud sounds during leisure activities. Visiting discotheques is one of the most popular

  17. High-fat, carbohydrate-free diet markedly aggravates obesity but prevents beta-cell loss and diabetes in the obese, diabetes-susceptible db/db strain.

    Science.gov (United States)

    Mirhashemi, Farshad; Kluth, Oliver; Scherneck, Stephan; Vogel, Heike; Kluge, Reinhart; Schurmann, Annette; Joost, Hans-Georg; Neschen, Susanne

    2008-01-01

    We have previously reported that a high-fat, carbohydrate-free diet prevents diabetes and beta-cell destruction in the New Zealand Obese (NZO) mouse strain. Here we investigated the effect of diets with and without carbohydrates on obesity and development of beta-cell failure in a second mouse model of type 2 diabetes, the db/db mouse. When kept on a carbohydrate-containing standard (SD; with (w/w) 5.1, 58.3, and 17.6% fat, carbohydrates and protein, respectively) or high-fat diet (HFD; 14.6, 46.7 and 17.1%), db/db mice developed severe diabetes (blood glucose >20 mmol/l, weight loss, polydipsia and polyurea) associated with a selective loss of pancreatic beta-cells, reduced GLUT2 expression in the remaining beta-cells, and reduced plasma insulin levels. In contrast, db/db mice kept on a high-fat, carbohydrate-free diet (CFD; with 30.2 and 26.4% (w/w) fat or protein) did not develop diabetes and exhibited near-normal, hyperplastic islets in spite of a morbid obesity (fat content >60%) associated with hyperinsulinaemia. These data indicate that in genetically different mouse models of obesity-associated diabetes, obesity and dietary fat are not sufficient, and dietary carbohydrates are required, for beta-cell destruction.

  18. Constitutively Elevated Blood Serotonin Is Associated with Bone Loss and Type 2 Diabetes in Rats.

    Directory of Open Access Journals (Sweden)

    Igor Erjavec

    Full Text Available Reduced peripheral serotonin (5HT in mice lacking tryptophan hydroxylase (TPH1, the rate limiting enzyme for 5HT synthesis, was reported to be anabolic to the skeleton. However, in other studies TPH1 deletion either had no bone effect or an age dependent inhibition of osteoclastic bone resorption. The role of 5HT in bone therefore remains poorly understood. To address this issue, we used selective breeding to create rat sublines with constitutively high (high-5HT and low (low-5HT platelet 5HT level (PSL and platelet 5HT uptake (PSU. High-5HT rats had decreased bone volume due to increased bone turnover characterized by increased bone formation and mineral apposition rate, increased osteoclast number and serum C-telopeptide level. Daily oral administration of the TPH1 inhibitor (LX1032 for 6 weeks reduced PSL and increased the trabecular bone volume and trabecular number of the spine and femur in high-5HT rats. High-5HT animals also developed a type 2 diabetes (T2D phenotype with increased: plasma insulin, glucose, hemoglobin A1c, body weight, visceral fat, β-cell pancreatic islets size, serum cholesterol, and decreased muscle strength. Serum calcium accretion mediated by parathyroid hormone slightly increased, whereas treatment with 1,25(OH2D3 decreased PSL. Insulin reduction was paralleled by a drop in PSL in high-5HT rats. In vitro, insulin and 5HT synergistically up-regulated osteoblast differentiation isolated from high-5HT rats, whereas TPH1 inhibition decreased the number of bone marrow-derived osteoclasts. These results suggest that constitutively elevated PSL is associated with bone loss and T2D via a homeostatic interplay between the peripheral 5HT, bone and insulin.

  19. Efficacy of tranexamic acid in reducing blood loss in posterior lumbar spine surgery for degenerative spinal stenosis with instability: a retrospective case control study

    Directory of Open Access Journals (Sweden)

    Endres Stefan

    2011-11-01

    Full Text Available Abstract Background Degenerative spinal stenosis and instability requiring multilevel spine surgery has been associated with large blood losses. Factors that affect perioperative blood loss include time of surgery, surgical procedure, patient height, combined anterior/posterior approaches, number of levels fused, blood salvage techniques, and the use of anti-fibrinolytic medications. This study was done to evaluate the efficacy of tranexamic acid in reducing blood loss in spine surgery. Methods This retrospective case control study includes 97 patients who had to undergo surgery because of degenerative lumbar spinal stenosis and instability. All operations included spinal decompression, interbody fusion and posterior instrumentation (4-5 segments. Forty-six patients received 1 g tranexamic acid intravenous, preoperative and six hours and twelve hours postoperative; 51 patients without tranexamic acid administration were evaluated as a control group. Based on the records, the intra- and postoperative blood losses were measured by evaluating the drainage and cell saver systems 6, 12 and 24 hours post operation. Additionally, hemoglobin concentration and platelet concentration were reviewed. Furthermore, the number of red cell transfusions given and complications associated with tranexamic acid were assessed. Results The postoperative hemoglobin concentration demonstrated a statistically significant difference with a p value of 0.0130 showing superiority for tranexamic acid use (tranexamic acid group: 11.08 g/dl, SD: 1.68; control group: 10.29 g/dl, SD: 1.39. The intraoperative cell saver volume and drainage volume after 24 h demonstrated a significant difference as well, which indicates a less blood loss in the tranexamic acid group than the control group. The postoperative drainage volume at12 hours showed no significant differences; nor did the platelet concentration Allogenic blood transfusion (two red cell units was needed for eight patients

  20. Development and validation of a predictive model for excessive postpartum blood loss: A retrospective, cohort study.

    Science.gov (United States)

    Rubio-Álvarez, Ana; Molina-Alarcón, Milagros; Arias-Arias, Ángel; Hernández-Martínez, Antonio

    2018-03-01

    postpartum haemorrhage is one of the leading causes of maternal morbidity and mortality worldwide. Despite the use of uterotonics agents as preventive measure, it remains a challenge to identify those women who are at increased risk of postpartum bleeding. to develop and to validate a predictive model to assess the risk of excessive bleeding in women with vaginal birth. retrospective cohorts study. "Mancha-Centro Hospital" (Spain). the elaboration of the predictive model was based on a derivation cohort consisting of 2336 women between 2009 and 2011. For validation purposes, a prospective cohort of 953 women between 2013 and 2014 were employed. Women with antenatal fetal demise, multiple pregnancies and gestations under 35 weeks were excluded METHODS: we used a multivariate analysis with binary logistic regression, Ridge Regression and areas under the Receiver Operating Characteristic curves to determine the predictive ability of the proposed model. there was 197 (8.43%) women with excessive bleeding in the derivation cohort and 63 (6.61%) women in the validation cohort. Predictive factors in the final model were: maternal age, primiparity, duration of the first and second stages of labour, neonatal birth weight and antepartum haemoglobin levels. Accordingly, the predictive ability of this model in the derivation cohort was 0.90 (95% CI: 0.85-0.93), while it remained 0.83 (95% CI: 0.74-0.92) in the validation cohort. this predictive model is proved to have an excellent predictive ability in the derivation cohort, and its validation in a latter population equally shows a good ability for prediction. This model can be employed to identify women with a higher risk of postpartum haemorrhage. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Systemic Mesenchymal Stromal Cell Transplantation Prevents Functional Bone Loss in a Mouse Model of Age-Related Osteoporosis.

    Science.gov (United States)

    Kiernan, Jeffrey; Hu, Sally; Grynpas, Marc D; Davies, John E; Stanford, William L

    2016-05-01

    Age-related osteoporosis is driven by defects in the tissue-resident mesenchymal stromal cells (MSCs), a heterogeneous population of musculoskeletal progenitors that includes skeletal stem cells. MSC decline leads to reduced bone formation, causing loss of bone volume and the breakdown of bony microarchitecture crucial to trabecular strength. Furthermore, the low-turnover state precipitated by MSC loss leads to low-quality bone that is unable to perform remodeling-mediated maintenance--replacing old damaged bone with new healthy tissue. Using minimally expanded exogenous MSCs injected systemically into a mouse model of human age-related osteoporosis, we show long-term engraftment and markedly increased bone formation. This led to improved bone quality and turnover and, importantly, sustained microarchitectural competence. These data establish proof of concept that MSC transplantation may be used to prevent or treat human age-related osteoporosis. This study shows that a single dose of minimally expanded mesenchymal stromal cells (MSCs) injected systemically into a mouse model of human age-related osteoporosis display long-term engraftment and prevent the decline in bone formation, bone quality, and microarchitectural competence. This work adds to a growing body of evidence suggesting that the decline of MSCs associated with age-related osteoporosis is a major transformative event in the progression of the disease. Furthermore, it establishes proof of concept that MSC transplantation may be a viable therapeutic strategy to treat or prevent human age-related osteoporosis. ©AlphaMed Press.

  2. Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease

    Science.gov (United States)

    Estcourt, Lise J; Fortin, Patricia M; Hopewell, Sally; Trivella, Marialena; Wang, Winfred C

    2017-01-01

    Background Sickle cell disease is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. Sickle cell disease can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Stroke affects around 10% of children with sickle cell anaemia (HbSS). Chronic blood transfusions may reduce the risk of vaso-occlusion and stroke by diluting the proportion of sickled cells in the circulation. This is an update of a Cochrane Review first published in 2002, and last updated in 2013. Objectives To assess risks and benefits of chronic blood transfusion regimens in people with sickle cell disease for primary and secondary stroke prevention (excluding silent cerebral infarcts). Search methods We searched for relevant trials in the Cochrane Library, MEDLINE (from 1946), Embase (from 1974), the Transfusion Evidence Library (from 1980), and ongoing trial databases; all searches current to 04 April 2016. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register: 25 April 2016. Selection criteria Randomised controlled trials comparing red blood cell transfusions as prophylaxis for stroke in people with sickle cell disease to alternative or standard treatment. There were no restrictions by outcomes examined, language or publication status. Data collection and analysis Two authors independently assessed trial eligibility and the risk of bias and extracted data. Main results We included five trials (660 participants) published between 1998 and 2016. Four of these trials were terminated early. The vast majority of participants had the haemoglobin (Hb)SS form of sickle cell disease. Three trials compared regular red cell transfusions to standard care in primary prevention of stroke: two in children with no previous long-term transfusions; and one in children and adolescents on long-term transfusion. Two trials compared the drug

  3. Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease.

    Science.gov (United States)

    Estcourt, Lise J; Fortin, Patricia M; Hopewell, Sally; Trivella, Marialena; Wang, Winfred C

    2017-01-17

    Sickle cell disease is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. Sickle cell disease can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Stroke affects around 10% of children with sickle cell anaemia (HbSS). Chronic blood transfusions may reduce the risk of vaso-occlusion and stroke by diluting the proportion of sickled cells in the circulation.This is an update of a Cochrane Review first published in 2002, and last updated in 2013. To assess risks and benefits of chronic blood transfusion regimens in people with sickle cell disease for primary and secondary stroke prevention (excluding silent cerebral infarcts). We searched for relevant trials in the Cochrane Library, MEDLINE (from 1946), Embase (from 1974), the Transfusion Evidence Library (from 1980), and ongoing trial databases; all searches current to 04 April 2016.We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register: 25 April 2016. Randomised controlled trials comparing red blood cell transfusions as prophylaxis for stroke in people with sickle cell disease to alternative or standard treatment. There were no restrictions by outcomes examined, language or publication status. Two authors independently assessed trial eligibility and the risk of bias and extracted data. We included five trials (660 participants) published between 1998 and 2016. Four of these trials were terminated early. The vast majority of participants had the haemoglobin (Hb)SS form of sickle cell disease.Three trials compared regular red cell transfusions to standard care in primary prevention of stroke: two in children with no previous long-term transfusions; and one in children and adolescents on long-term transfusion.Two trials compared the drug hydroxyurea (hydroxycarbamide) and phlebotomy to long-term transfusions and iron chelation therapy: one in

  4. Mutation of p107 exacerbates the consequences of Rb loss in embryonic tissues and causes cardiac and blood vessel defects.

    Science.gov (United States)

    Berman, Seth D; West, Julie C; Danielian, Paul S; Caron, Alicia M; Stone, James R; Lees, Jacqueline A

    2009-09-01

    The retinoblastoma tumor-suppressor protein, pRb, is a member of the pocket protein family that includes p107 and p130. These proteins have well-defined roles in regulating entry into and exit from the cell cycle and also have cell cycle-independent roles in facilitating differentiation. Here we investigate the overlap between pocket protein's function during embryonic development by using conditional mutant alleles to generate Rb;p107 double-mutant embryos (DKOs) that develop in the absence of placental defects. These DKOs die between e13.5 and e14.5, much earlier than either the conditional Rb or the germline p107 single mutants, which survive to birth or are largely viable, respectively. Analyses of the e13.5 DKOs shows that p107 mutation exacerbates the phenotypes resulting from pRb loss in the central nervous system and lens, but not in the peripheral nervous system. In addition, these embryos exhibit novel phenotypes, including increased proliferation of blood vessel endothelial cells, and heart defects, including double-outlet right ventricle (DORV). The DORV is caused, at least in part, by a defect in blood vessel endothelial cells and/or heart mesenchymal cells. These findings demonstrate novel, overlapping functions for pRb and p107 in numerous murine tissues.

  5. RANKL/RANK: from bone loss to the prevention of breast cancer.

    Science.gov (United States)

    Sigl, Verena; Jones, Laundette P; Penninger, Josef M

    2016-11-01

    RANK and RANKL, a receptor ligand pair belonging to the tumour necrosis factor family, are the critical regulators of osteoclast development and bone metabolism. Besides their essential function in bone, RANK and RANKL have also been identified as the key factors for the formation of a lactating mammary gland in pregnancy. Mechanistically, RANK and RANKL link the sex hormone progesterone with stem cell expansion and proliferation of mammary epithelial cells. Based on their normal physiology, RANKL/RANK control the onset of hormone-induced breast cancer through the expansion of mammary progenitor cells. Recently, we and others were able to show that RANK and RANKL are also critical regulators of BRCA1-mutation-driven breast cancer. Currently, the preventive strategy for BRCA1-mutation carriers includes preventive mastectomy, associated with wide-ranging risks and psychosocial effects. The search for an alternative non-invasive prevention strategy is therefore of paramount importance. As our work strongly implicates RANK and RANKL as key molecules involved in the initiation of BRCA1-associated breast cancer, we propose that anti-RANKL therapy could be a feasible preventive strategy for women carrying BRCA1 mutations, and by extension to other women with high risk of breast cancer. © 2016 The Authors.

  6. Fecal blood loss in patients with colonic polyps: a comparison of measurements with 51chromium-labeled erythrocytes and with the Haemoccult test

    International Nuclear Information System (INIS)

    Herzog, P.; Holtermueller, K.H.; Preiss, J.; Fischer, J.; Ewe, K.; Schreiber, H.J.; Berres, M.

    1982-01-01

    The quantitative determinations of fecal daily blood loss after intravenous administration of 51 Cr-labeled erythrocytes in 44 patients with colonic polyps and in 11 controls were compared with the results of the daily performed Haemoccult test without dietary restrictions. A total of 642 stool specimens was analyzed for 51 Cr loss and the Haemoccult test. The mean fecal daily blood loss in the 34 patients with adenomatous polyps of the descending colon and rectosigmoid was 1.36 +/- 0.14 ml/day (mean +/- SEM), in the 10 patients with polyps of the ascending and transverse colon it was 1.28 +/- 0.31 ml/day, and in the 11 controls 0.62 +/- 0.07 ml/day. There was no positive Haemoccult test in the controls. In fecal specimens from patients with polyps in the descending colon and rectosigmoid containing 2.0-3.99 ml blood/day, the Haemoccult-test was positive in 86%. Fecal specimens from patients with polyps in the ascending colon and transverse colon containing equal blood loss yielded a positive Haemoccult test result in 26%. Thus, the positivity of the Haemoccult test is determined by the fecal daily blood loss and the anatomic location of colonic bleeding sites

  7. Continuing versus discontinuing antiplatelet drugs, vasodilators, and/or cerebral ameliorators on perioperative total blood loss in total knee arthroplasty without pneumatic tourniquet

    Directory of Open Access Journals (Sweden)

    Sachiyuki Tsukada, MD

    2018-03-01

    Full Text Available Background: Although studies have supported the utility of perioperative continuation of antiplatelet drugs, vasodilators, and cerebral ameliorators in most procedures, no study compared total volume of blood loss after total knee arthroplasty (TKA in patients continuing and discontinuing these drugs. Methods: We retrospectively reviewed 266 consecutive patients undergoing TKA, and included 67 patients (25.2% taking antiplatelet drugs, vasodilators, or cerebral ameliorators in this study. All TKAs were performed without a pneumatic tourniquet. The primary outcome was perioperative total blood loss calculated from blood volume and change in hemoglobin. As subgroup analysis, we compared perioperative total blood loss in patients taking antiplatelet drugs. Results: There was no significant difference between the continuing group (n = 38 and discontinuing group (n = 29 in terms of the perioperative total blood loss (1025 ± 364 vs 1151 ± 327 mL, respectively; mean difference 126 mL; 95% confidence interval −45 to 298 mL; P = .15. No major bleeding or thrombotic events occurred in either group until postoperative 3-month follow-up. In patients taking antiplatelet drugs (n = 51, no significant difference was observed in the total blood loss between the continuing group (n = 30 and discontinuing group (n = 21 (1056 ± 287 vs 1151 ± 305 mL, respectively; mean difference 95 mL; 95% confidence interval −75 to 264 mL; P = .27. Conclusions: No significant differences in terms of perioperative total blood loss were observed between patients continuing and discontinuing study drugs. Continuing these drugs may be preferable in the perioperative period of TKA. Keywords: Knee, Primary arthroplasty, Bleeding events, Thrombotic events, Noncardiac surgery

  8. The effect of three different doses of tranexamic acid on blood loss after cardiac surgery with mild systemic hypothermia (32 degrees C).

    Science.gov (United States)

    Karski, J M; Dowd, N P; Joiner, R; Carroll, J; Peniston, C; Bailey, K; Glynn, M F; Teasdale, S J; Cheng, D C

    1998-12-01

    Prophylactic administration of tranexamic acid (TA), an antifibrinolytic agent, decreases bleeding after cardiac surgery with systemic hypothermia (25 degrees C to 29 degrees C). Warmer systemic temperatures during cardiopulmonary bypass (CPB) may reduce bleeding and thus alter the requirement for TA. The effect of three different doses of TA on bleeding after cardiac surgery with mild systemic hypothermia (32 degrees C) is evaluated. Double-blind, prospective, randomized study. University hospital. One hundred fifty adult patients undergoing aortocoronary bypass or valvular cardiac surgery. Patients received TA, 50 (n = 50), 100 (n = 50), or 150 (n = 50) mg/kg intravenously before CPB with mild systemic hypothermia. Blood loss through chest drains over 6, 12, and 24 hours after surgery and total hemoglobin loss were measured. Autotransfused blood, transfused banked blood and blood products, and coagulation profiles were measured. Analysis of variance on log-transformed data for blood loss and confidence intervals (CIs) of 0.95 were calculated and transformed to milliliters of blood. No patient was re-explored for bleeding. Blood loss at 6 hours was statistically greater in the 50-mg/kg group compared with the other two groups (p = 0.03; p = 0.02). Total hemoglobin loss was statistically greater in the 50-mg/kg group compared with the 150-mg/kg group (p = 0.04). There was no statistical difference in blood tranfusion rate or coagulation profiles among the three groups. However, preoperative hemoglobin level was statistically lower in the 150-mg/kg group compared with the other two groups (p = 0.01). Of the three doses of TA studied, the most efficacious and cost-effective dose to reduce bleeding after cardiac surgery with mild hypothermic systemic perfusion is 100 mg/kg.

  9. Prevention of noise-induced hearing loss in the Canadian military.

    Science.gov (United States)

    Pelausa, E O; Abel, S M; Simard, J; Dempsey, I

    1995-10-01

    A prospective study was undertaken to investigate the development of noise-induced hearing loss in Canadian military recruits, and to assess the effectiveness of the hearing conservation program currently in place. The participants were 134 men and women, 20 to 30 years of age, employed in four trades, three of these (infantry, artillery, and armour) associated with high noise levels. The data comprised audiometric measurements made at the time of entry and after 3 years of employment, and responses to a questionnaire mainly relating to noise exposure in the workplace and during leisure activities, and the utilization of personal hearing protective devices. The findings showed that group audiograms at entry and at the 3-year recall were characterized by a 6-kHz notch that was indicative of noise-induced hearing loss, although mean threshold values were within normal limits. By the 3-year recall, 11% of the infantry had sustained a mild-to-moderate hearing loss in the left ear, greater than 25-dB HL, that was consistent with the use of small-calibre weapons. Responses to the questionnaire indicated that, while subjects appreciated the potential benefit of wearing hearing protectors, instructions in their proper use and education on the hazards of noise exposure were poor. The results suggested methods to strengthen the existing scheme for hearing conservation to further minimize risk.

  10. Fiscal loss and program fidelity: impact of the economic downturn on HIV/STI prevention program fidelity.

    Science.gov (United States)

    Catania, Joseph A; Dolcini, M Margaret; Gandelman, Alice A; Narayanan, Vasudha; McKay, Virginia R

    2014-03-01

    The economic downturn of 2007 created significant fiscal losses for public and private agencies conducting behavioral prevention. Such macro-economic changes may influence program implementation and sustainability. We examined how public and private agencies conducting RESPECT, a brief HIV/STI (sexually transmitted infection) counseling and testing intervention, adapted to fiscal loss and how these adaptations impacted program fidelity. We collected qualitative and quantitative data in a national sample of 15 agencies experiencing fiscal loss. Using qualitative analyses, we examined how program fidelity varied with different types of adaptations. Agencies reported three levels of adaptation: agency-level, program-level, and direct fiscal remedies. Private agencies tended to use direct fiscal remedies, which were associated with higher fidelity. Some agency-level adaptations contributed to reductions in procedural fit, leading to negative staff morale and decreased confidence in program effectiveness, which in turn, contributed to poor fidelity. Findings describe a "work stress pathway" that links program fiscal losses to poor staff morale and low program fidelity.

  11. Resistance Training Prevents Muscle Loss Induced by Caloric Restriction in Obese Elderly Individuals: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Amanda V. Sardeli

    2018-03-01

    Full Text Available It remains unclear as to what extent resistance training (RT can attenuate muscle loss during caloric restriction (CR interventions in humans. The objective here is to address if RT could attenuate muscle loss induced by CR in obese elderly individuals, through summarized effects of previous studies. Databases MEDLINE, Embase and Web of Science were used to perform a systematic search between July and August 2017. Were included in the review randomized clinical trials (RCT comparing the effects of CR with (CRRT or without RT on lean body mass (LBM, fat body mass (FBM, and total body mass (BM, measured by dual-energy X-ray absorptiometry, on obese elderly individuals. The six RCTs included in the review applied RT three times per week, for 12 to 24 weeks, and most CR interventions followed diets of 55% carbohydrate, 15% protein, and 30% fat. RT reduced 93.5% of CR-induced LBM loss (0.819 kg [0.364 to 1.273], with similar reduction in FBM and BM, compared with CR. Furthermore, to address muscle quality, the change in strength/LBM ratio tended to be different (p = 0.07 following CRRT (20.9 ± 23.1% and CR interventions (−7.5 ± 9.9%. Our conclusion is that CRRT is able to prevent almost 100% of CR-induced muscle loss, while resulting in FBM and BM reductions that do not significantly differ from CR.

  12. Prevention of Yersinia enterocolitica growth in red-blood-cell concentrates

    NARCIS (Netherlands)

    Pietersz, R. N.; Reesink, H. W.; Pauw, W.; Dekker, W. J.; Buisman, L.

    1992-01-01

    In response to concern about Yersinia enterocolitica contamination of blood products, we have studied the effects on Y enterocolitica growth of holding whole blood at 22 degrees C for 20 h and then removing leucocytes. Thirty pools of three bags of blood were inoculated with Y enterocolitica (2 x

  13. Comparison of Four Antiseptic Preparations for Skin in the Prevention of Contamination of Percutaneously Drawn Blood Cultures: a Randomized Trial

    Science.gov (United States)

    Calfee, David P.; Farr, Barry M.

    2002-01-01

    A number of skin antiseptics have been used to prevent the contamination of blood cultures, but the comparative efficacies of these agents have not been extensively evaluated. We therefore sought to compare the efficacy of four skin antiseptics in preventing blood culture contamination in a randomized, crossover, investigator-blinded study conducted in an emergency department and the inpatient wards of a university hospital. The patient group included all patients from whom blood samples were obtained percutaneously for culture. Skin antisepsis was performed with 10% povidone-iodine, 70% isopropyl alcohol, tincture of iodine, or povidone-iodine with 70% ethyl alcohol (i.e., Persist). The blood culture contamination rate associated with each antiseptic was then determined. A total of 333 (2.62%) of 12,692 blood cultures were contaminated during the study period compared to 413 (3.21%) of 12,859 blood cultures obtained during the previous 12-month period (relative risk = 0.82; 95% confidence interval, 0.71 to 0.94; P = 0.006). During the study, the contamination rates were determined to be 2.93% with povidone-iodine, 2.58% with tincture of iodine, 2.50% with isopropyl alcohol, and 2.46% with Persist (P = 0.62). We detected no significant differences in the blood culture contamination rates among these four antiseptics, although there was some evidence suggesting greater efficacy among the alcohol-containing antiseptics. Among the evaluated antiseptics, isopropyl alcohol may be the optimal antiseptic for use prior to obtaining blood for culture, given its convenience, low cost, and tolerability. PMID:11980938

  14. Skin preparation with alcohol versus alcohol followed by any antiseptic for preventing bacteraemia or contamination of blood for transfusion.

    Science.gov (United States)

    Webster, Joan; Bell-Syer, Sally E M; Foxlee, Ruth

    2015-02-12

    Blood for transfusion may become contaminated at any point between collection and transfusion and may result in bacteraemia (the presence of bacteria in the blood), severe illness or even death for the blood recipient. Donor arm skin is one potential source of blood contamination, so it is usual to cleanse the skin with an antiseptic before blood donation. One-step and two-step alcohol based antiseptic regimens are both commonly advocated but there is uncertainty as to which is most effective. To assess the effects of cleansing the skin of blood donors with alcohol in a one-step compared with alcohol in a two-step procedure to prevent contamination of collected blood or bacteraemia in the recipient. In December 2014, for this third update, we searched the Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Library; Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. All randomised trials (RCTs) comparing alcohol based donor skin cleansing in a one-step versus a two-step process that includes alcohol and any other antiseptic for pre-venepuncture skin cleansing were considered. Quasi randomised trials were to have been considered in the absence of RCTs. Two review authors independently assessed studies for inclusion. No studies (RCTs or quasi RCTs) met the inclusion criteria. We did not identify any eligible studies for inclusion in this review. It is therefore unclear whether a two-step, alcohol followed by antiseptic skin cleansing process prior to blood donation confers any reduction in the risk of blood contamination or bacteraemia in blood recipients, or conversely whether a one-step process increases risk above that associated with a two-step process.

  15. Combat, prevention and optimization of commercial losses of power energy; Combate, prevencao e otimizacao das perdas comerciais da energia eletrica

    Energy Technology Data Exchange (ETDEWEB)

    Penin, Carlos Alexandre de Sousa

    2008-07-01

    The objective of this work is to study the problem of NTL using a wide approach, analyze the experience of dealerships in Brazil and abroad, discuss the best practices for mitigation of those losses and propose improvements in the combat and prevention processes, and the legal procedures for recovery of incomes, leaning on a careful regulatory context. This study draws attention to Brazil's socioeconomic diversity, comparing it to various international examples, and intends to identify the most relevant aspects that must be considered on the theme, discussing procedures and methodologies for the equation of the amount of resources to be applied by distributing companies to achieve the appropriate reduction of NTL. (author)

  16. Prevention of adsorption losses during radioimmunoassay of polypeptide hormones: effectiveness of albumins, gelatin, caseins, Tween 20 and plasma

    International Nuclear Information System (INIS)

    Livesey, J.H.; Donald, R.A.

    1982-01-01

    It is well known that polypeptide hormones adsorb to glass and plastic surfaces and that this adsorption may be reduced by adding a relatively large quantity of another protein. Consequently proteins (or sometimes detergents) are added almost universally to peptide hormone radioimmunassays to minimise loss of analyte by adsorption. This study was undertaken because there are few reports of the relative effectiveness of the proteins so used. The results suggest that moderate concentrations of the widely used albumins of Tween 20 do not always adequately prevent the adsorption of hormonal polypeptides to surfaces. Casein and alkali-treated casein appear to be more effective than the adsorption inhibitors in general use in radioimmunoassay for the range of hormones and adsorptive surfaces tested. They were also found to be very effective for preventing the adsorption of radio-labelled human luteinizing hormone, human growth hormone and Tyr-somatostatin. (Auth.)

  17. Niceritrol prevents the decrease in red blood cell 2,3-diphosphoglycerate and neuropathy in streptozotocin-induced diabetic rats.

    Science.gov (United States)

    Hotta, N; Nakamura, J; Kakuta, H; Fukasawa, H; Koh, N; Sakakibara, F; Mori, K; Sakamoto, N

    1995-01-01

    Nerve ischemia/hypoxia has been linked to the pathogenesis of diabetic complications. Red blood cell 2,3-diphosphoglycerate is an important regulator of peripheral tissue oxygenation; however, the relationship between 2,3-diphosphoglycerate concentration and diabetic complications has not been studied in detail. This investigation focused on the relationship between red blood cell 2,3-diphosphoglycerate and diabetic neuropathy, by measuring motor nerve conduction velocity and sciatic nerve blood flow in streptozotocin-induced diabetic rats. The effect of treatment with niceritrol, a nicotinic acid derivative that acts as a vasodilator and reduces serum lipid concentrations, on 2,3-diphosphoglycerate concentration and diabetic neuropathy was also examined. Untreated diabetic rats had significantly lower concentrations of red blood cell 2,3-diphosphoglycerate, higher concentrations of serum total cholesterol and triglyceride, as well as reduced motor nerve conduction velocity and sciatic nerve blood flow, compared to untreated normal rats. Niceritrol prevented these abnormalities without correcting hyperglycemia in diabetic rats, but had no effect on these parameters in normal rats. Red blood cell 2,3-diphosphoglycerate concentration and motor nerve conduction velocity showed a positive correlation with sciatic nerve blood flow and 2,3-diphosphoglycerate, respectively. These observations suggest that ischemia/hypoxia plays an important role in the development of diabetic neuropathy, and that niceritrol has a therapeutic effect on this condition by improving endoneurial ischemia/hypoxia.

  18. 85 dBA: is it protective enough to prevent hearing loss in South African miners?

    CSIR Research Space (South Africa)

    Edwards, A

    2009-09-01

    Full Text Available .(2007) was found to be exacerbated by workload and heat stress. In addition, the development of TTS and potentially NIHL is accelerated by smoking, and hearing loss is accelerated by drugs for the treatment of tuberculosis (TB) and by HIV/AIDS (Khoza... Pulmonary Disease in Workers of Southern Italy. Journal of Occupational & Environmental Medicine, 50(3):366-370. Campbell, K.C., Meech, R.P., Klemens, J.J., Gerberi, M.T., Dysstad, S.S., Larsen, D.L., Mitchell, D.L., El-Azizi, M., Verhulst, S...

  19. Predictive Value of Intraoperative Thromboelastometry for the Risk of Perioperative Excessive Blood Loss in Infants and Children Undergoing Congenital Cardiac Surgery: A Retrospective Analysis.

    Science.gov (United States)

    Kim, Eunhee; Shim, Haeng Seon; Kim, Won Ho; Lee, Sue-Young; Park, Sun-Kyung; Yang, Ji-Hyuk; Jun, Tae-Gook; Kim, Chung Su

    2016-10-01

    Laboratory hemostatic variables and parameters of rotational thromboelastometry (ROTEM) were evaluated for their ability to predict perioperative excessive blood loss (PEBL) after congenital cardiac surgery. Retrospective and observational. Single, large university hospital. The study comprised 119 children younger than 10 years old undergoing congenital cardiac surgery with cardiopulmonary bypass (CPB). Intraoperative excessive blood loss was defined as estimated blood loss≥50% of estimated blood volume (EBV). Postoperative excessive blood loss was defined as measured postoperative chest tube and Jackson-Pratt drainage≥30% of EBV over 12 hours or≥50% of EBV over 24 hours in the intensive care unit. PEBL was defined as either intraoperative or postoperative excessive blood loss. External temogram (EXTEM) and fibrinogen temogram (FIBTEM) were analyzed before and after CPB with ROTEM and laboratory hemostatic variables. Multivariate logistic regression was performed. Incidence of PEBL was 19.3% (n = 23). Independent risk factors for PEBL were CPB time>120 minutes, post-CPB FIBTEM alpha-angle, clot firmness after 10 minutes20%. Laboratory hemostatic variables were not significant in multivariate analysis. The risk prediction model was developed from the results of multivariate analysis. The area under the receiver operating characteristic curve was 0.94 (95% confidence interval: 0.90-0.99). Post-CPB ROTEM may be useful for predicting both intraoperative and postoperative excessive blood loss in congenital cardiac surgery. This study provided an accurate prediction model for PEBL and supported intraoperative transfusion guidance using post-CPB FIBTEM-A10 and EXTEM-A10. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Applications of Solar Technology for Catastrophe Response, Claims Management, and Loss Prevention

    Energy Technology Data Exchange (ETDEWEB)

    Deering, A.; Thornton, J.P.

    1999-02-17

    Today's insurance industry strongly emphasizes developing cost-effective hazard mitigation programs, increasing and retaining commercial and residential customers through better service, educating customers on their exposure and vulnerabilities to natural disasters, collaborating with government agencies and emergency management organizations, and exploring the use of new technologies to reduce the financial impact of disasters. In June of 1998, the National Renewable Energy Laboratory (NREL) and the National Association of Independent Insurers (NAII) sponsored a seminar titled, ''Solar Technology and the Insurance Industry.'' Presentations were made by insurance company representatives, insurance trade groups, government and state emergency management organizations, and technology specialists. The meeting was attended by insurers, brokers, emergency managers, and consultants from more than 25 US companies. Leading insurers from the personal line and commercial carriers were shown how solar technology can be used in underwriting, claims, catastrophe response, loss control, and risk management. Attendees requested a follow-up report on solar technology, cost, and applications in disasters, including suggestions on how to collaborate with the utility industry and how to develop educational programs for business and consumers. This report will address these issues, with an emphasis on pre-disaster planning and mitigation alternatives. It will also discuss how energy efficiency and renewable technologies can contribute to reducing insurance losses.

  1. Blood profile of proteins and steroid hormones predicts weight change after weight loss with interactions of dietary protein level and glycemic index.

    Directory of Open Access Journals (Sweden)

    Ping Wang

    2011-02-01

    Full Text Available Weight regain after weight loss is common. In the Diogenes dietary intervention study, high protein and low glycemic index (GI diet improved weight maintenance.To identify blood predictors for weight change after weight loss following the dietary intervention within the Diogenes study.Blood samples were collected at baseline and after 8-week low caloric diet-induced weight loss from 48 women who continued to lose weight and 48 women who regained weight during subsequent 6-month dietary intervention period with 4 diets varying in protein and GI levels. Thirty-one proteins and 3 steroid hormones were measured.Angiotensin I converting enzyme (ACE was the most important predictor. Its greater reduction during the 8-week weight loss was related to continued weight loss during the subsequent 6 months, identified by both Logistic Regression and Random Forests analyses. The prediction power of ACE was influenced by immunoproteins, particularly fibrinogen. Leptin, luteinizing hormone and some immunoproteins showed interactions with dietary protein level, while interleukin 8 showed interaction with GI level on the prediction of weight maintenance. A predictor panel of 15 variables enabled an optimal classification by Random Forests with an error rate of 24±1%. A logistic regression model with independent variables from 9 blood analytes had a prediction accuracy of 92%.A selected panel of blood proteins/steroids can predict the weight change after weight loss. ACE may play an important role in weight maintenance. The interactions of blood factors with dietary components are important for personalized dietary advice after weight loss.ClinicalTrials.gov NCT00390637.

  2. Non-pharmacological treatment and prevention of bone loss after spinal cord injury: a systematic review

    DEFF Research Database (Denmark)

    Biering-Sørensen, F; Hansen, B; Lee, B S B

    2009-01-01

    OBJECTIVE: Review the literature on non-pharmacological prevention and treatment of osteoporosis after spinal cord injury (SCI). METHODS: PubMed, EMBASE and the Cochrane Controlled Trials Register were searched. All identified papers were read by title, abstract and full-length article when...... bone mineral, and the longer the period of athletic career, the higher the (leg) bone mineral. Early after SCI, there may be some effects of electrical stimulation (ES) (five studies). Chronic-phase ES studies vary (14 studies, including mixed periods after injury), but improvement is seen with longer...

  3. Pomegranate Peel Extract Prevents Bone Loss in a Preclinical Model of Osteoporosis and Stimulates Osteoblastic Differentiation in Vitro

    Directory of Open Access Journals (Sweden)

    Mélanie Spilmont

    2015-11-01

    Full Text Available The nutritional benefits of pomegranate have attracted great scientific interest. The pomegranate, including the pomegranate peel, has been used worldwide for many years as a fruit with medicinal activity, mostly antioxidant properties. Among chronic diseases, osteoporosis, which is associated with bone remodelling impairment leading to progressive bone loss, could eventually benefit from antioxidant compounds because of the involvement of oxidative stress in the pathogenesis of osteopenia. In this study, with in vivo and ex vivo experiments, we investigated whether the consumption of pomegranate peel extract (PGPE could limit the process of osteopenia. We demonstrated that in ovariectomized (OVX C57BL/6J mice, PGPE consumption was able to significantly prevent the decrease in bone mineral density (−31.9%; p < 0.001 vs. OVX mice and bone microarchitecture impairment. Moreover, the exposure of RAW264.7 cells to serum harvested from mice that had been given a PGPE-enriched diet elicited reduced osteoclast differentiation and bone resorption, as shown by the inhibition of the major osteoclast markers. In addition, PGPE appeared to substantially stimulate osteoblastic MC3T3-E1 alkaline phosphatase (ALP activity at day 7, mineralization at day 21 and the transcription level of osteogenic markers. PGPE may be effective in preventing the bone loss associated with ovariectomy in mice, and offers a promising alternative for the nutritional management of this disease.

  4. Pomegranate Peel Extract Prevents Bone Loss in a Preclinical Model of Osteoporosis and Stimulates Osteoblastic Differentiation in Vitro.

    Science.gov (United States)

    Spilmont, Mélanie; Léotoing, Laurent; Davicco, Marie-Jeanne; Lebecque, Patrice; Miot-Noirault, Elisabeth; Pilet, Paul; Rios, Laurent; Wittrant, Yohann; Coxam, Véronique

    2015-11-11

    The nutritional benefits of pomegranate have attracted great scientific interest. The pomegranate, including the pomegranate peel, has been used worldwide for many years as a fruit with medicinal activity, mostly antioxidant properties. Among chronic diseases, osteoporosis, which is associated with bone remodelling impairment leading to progressive bone loss, could eventually benefit from antioxidant compounds because of the involvement of oxidative stress in the pathogenesis of osteopenia. In this study, with in vivo and ex vivo experiments, we investigated whether the consumption of pomegranate peel extract (PGPE) could limit the process of osteopenia. We demonstrated that in ovariectomized (OVX) C57BL/6J mice, PGPE consumption was able to significantly prevent the decrease in bone mineral density (-31.9%; p < 0.001 vs. OVX mice) and bone microarchitecture impairment. Moreover, the exposure of RAW264.7 cells to serum harvested from mice that had been given a PGPE-enriched diet elicited reduced osteoclast differentiation and bone resorption, as shown by the inhibition of the major osteoclast markers. In addition, PGPE appeared to substantially stimulate osteoblastic MC3T3-E1 alkaline phosphatase (ALP) activity at day 7, mineralization at day 21 and the transcription level of osteogenic markers. PGPE may be effective in preventing the bone loss associated with ovariectomy in mice, and offers a promising alternative for the nutritional management of this disease.

  5. Isokinetic eccentric resistance training prevents loss in mechanical muscle function after running

    DEFF Research Database (Denmark)

    Oliveira, Anderson S. C.; Caputo, Fabrizio; Aagaard, Per

    2013-01-01

    session, subjects performed treadmill running (~35 min) and the previously mentioned measurements were repeated immediately after running. Subsequently, subjects were randomized to training (n = 12) consisting of 24 sessions of maximal IERT knee extensors actions at 180° s(-1), or served as controls (n...... damages. However, IERT may not avoid reductions in explosive muscle actions. In turn, this may allow more intense training sessions to be performed, facilitating the adaptive response to running training.......The aim of the study was to verify whether 8 weeks of resistance training employing maximal isokinetic eccentric (IERT) knee extensor actions would reduce the acute force loss observed after high-intensity treadmill running exercise. It was hypothesized that specific IERT would induce protective...

  6. Blood

    Science.gov (United States)

    ... a reduced production of red blood cells, including: Iron deficiency anemia. Iron deficiency anemia is the most common type of anemia and ... inflammatory bowel disease are especially likely to have iron deficiency anemia. Anemia due to chronic disease. People with chronic ...

  7. Applying Magneto-rheology to Reduce Blood Viscosity and Suppress Turbulence to Prevent Heart Attacks

    Science.gov (United States)

    Tao, R.

    Heart attacks are the leading causes of death in USA. Research indicates one common thread, high blood viscosity, linking all cardiovascular diseases. Turbulence in blood circulation makes different regions of the vasculature vulnerable to development of atherosclerotic plaque. Turbulence is also responsible for systolic ejection murmurs and places heavier workload on heart, a possible trigger of heart attacks. Presently, neither medicine nor method is available to suppress turbulence. The only method to reduce the blood viscosity is to take medicine, such as aspirin. However, using medicine to reduce the blood viscosity does not help suppressing turbulence. In fact, the turbulence gets worse as the Reynolds number goes up with the viscosity reduction by the medicine. Here we report our new discovery: application of a strong magnetic field to blood along its flow direction, red blood cells are polarized in the magnetic field and aggregated into short chains along the flow direction. The blood viscosity becomes anisotropic: Along the flow direction the viscosity is significantly reduced, but in the directions perpendicular to the flow the viscosity is considerably increased. In this way, the blood flow becomes laminar, turbulence is suppressed, the blood circulation is greatly improved, and the risk for heart attacks is reduced. While these effects are not permanent, they last for about 24 hours after one magnetic therapy treatment.

  8. Mobilizing Transit-Amplifying Cell-Derived Ectopic Progenitors Prevents Hair Loss from Chemotherapy or Radiation Therapy.

    Science.gov (United States)

    Huang, Wen-Yen; Lai, Shih-Fan; Chiu, Hsien-Yi; Chang, Michael; Plikus, Maksim V; Chan, Chih-Chieh; Chen, You-Tzung; Tsao, Po-Nien; Yang, Tsung-Lin; Lee, Hsuan-Shu; Chi, Peter; Lin, Sung-Jan

    2017-11-15

    Genotoxicity-induced hair loss from chemotherapy and radiotherapy is often encountered in cancer treatment, and there is a lack of effective treatment. In growing hair follicles (HF), quiescent stem cells (SC) are maintained in the bulge region, and hair bulbs at the base contain rapidly dividing, yet genotoxicity-sensitive transit-amplifying cells (TAC) that maintain hair growth. How genotoxicity-induced HF injury is repaired remains unclear. We report here that HFs mobilize ectopic progenitors from distinct TAC compartments for regeneration in adaptation to the severity of dystrophy induced by ionizing radiation (IR). Specifically, after low-dose IR, keratin 5 + basal hair bulb progenitors, rather than bulge SCs, were quickly activated to replenish matrix cells and regenerated all concentric layers of HFs, demonstrating their plasticity. After high-dose IR, when both matrix and hair bulb cells were depleted, the surviving outer root sheath cells rapidly acquired an SC-like state and fueled HF regeneration. Their progeny then homed back to SC niche and supported new cycles of HF growth. We also revealed that IR induced HF dystrophy and hair loss and suppressed WNT signaling in a p53- and dose-dependent manner. Augmenting WNT signaling attenuated the suppressive effect of p53 and enhanced ectopic progenitor proliferation after genotoxic injury, thereby preventing both IR- and cyclophosphamide-induced alopecia. Hence, targeted activation of TAC-derived progenitor cells, rather than quiescent bulge SCs, for anagen HF repair can be a potential approach to prevent hair loss from chemotherapy and radiotherapy. Cancer Res; 77(22); 6083-96. ©2017 AACR . ©2017 American Association for Cancer Research.

  9. A selective androgen receptor modulator that reduces prostate tumor size and prevents orchidectomy-induced bone loss in rats.

    Science.gov (United States)

    Allan, George; Lai, Muh-Tsann; Sbriscia, Tifanie; Linton, Olivia; Haynes-Johnson, Donna; Bhattacharjee, Sheela; Dodds, Robert; Fiordeliso, James; Lanter, James; Sui, Zhihua; Lundeen, Scott

    2007-01-01

    The pharmacological activity of JNJ-26146900 is described. JNJ-26146900 is a nonsteroidal androgen receptor (AR) ligand with tissue-selective activity in rats. The compound was evaluated in in vitro and in vivo models of AR activity. It binds to the rat AR with a K(i) of 400nM and acts as a pure androgen antagonist in an in vitro cell-based assay. Its in vitro profile is similar to the androgen antagonist bicalutamide (Casodex). In intact rats, JNJ-26146900 reduces ventral prostate weight with an oral potency (ED(50)) of 20-30mg/kg, again comparable to that of bicalutamide. JNJ-26146900 prevented prostate tumor growth in the Dunning rat model, maximally inhibiting growth at a dose of 10mg/kg. It slowed tumor growth significantly in a CWR22-LD1 mouse xenograft model of human prostate cancer. It was tested in aged male rats for its ability to prevent bone loss and loss of lean body mass following orchidectomy. After 6 weeks of dosing, bone volume decreased by 33% in orchidectomized versus intact vehicle-treated rats with a probability (P) of less than 0.05, as measured by micro-computerized tomography analysis. At a dose of 30mg/kg, JNJ-26146900 significantly reduced castration-induced tibial bone loss as indicated by the following parameters: bone volume, trabecular connectivity, trabecular number and spacing between trabeculae. Bone mineral density decreased from 229+/-34mg/cm(3) of hydroxyapatite to 166+/-26mg/cm(3) following orchidectomy, and was maintained at 194+/-20mg/cm(3) with JNJ-26146900 treatment (Pselective androgen receptor modulators (SARMs) have the potential for anabolic effects on bone and muscle while maintaining therapeutic efficacy in prostate cancer.

  10. Immunization with FSHβ fusion protein antigen prevents bone loss in a rat ovariectomy-induced osteoporosis model

    Energy Technology Data Exchange (ETDEWEB)

    Geng, Wenxin; Yan, Xingrong; Du, Huicong; Cui, Jihong; Li, Liwen, E-mail: liven@nwu.edu.cn; Chen, Fulin, E-mail: chenfl@nwu.edu.cn

    2013-05-03

    Highlights: •A GST-FSH fusion protein was successfully expressed in E. coli. •Immunization with GST-FSH antigen can raise high-titer anti-FSH polyclonal sera. •Anti-FSH polyclonal sera can neutralize osteoclastogenic effect of FSH in vitro. •FSH immunization can prevent bone loss in a rat osteoporosis model. -- Abstract: Osteoporosis, a metabolic bone disease, threatens postmenopausal women globally. Hormone replacement therapy (HTR), especially estrogen replacement therapy (ERT), is used widely in the clinic because it has been generally accepted that postmenopausal osteoporosis is caused by estrogen deficiency. However, hypogonadal α and β estrogen receptor null mice were only mildly osteopenic, and mice with either receptor deleted had normal bone mass, indicating that estrogen may not be the only mediator that induces osteoporosis. Recently, follicle-stimulating hormone (FSH), the serum concentration of which increases from the very beginning of menopause, has been found to play a key role in postmenopausal osteoporosis by promoting osteoclastogenesis. In this article, we confirmed that exogenous FSH can enhance osteoclast differentiation in vitro and that this effect can be neutralized by either an anti-FSH monoclonal antibody or anti-FSH polyclonal sera raised by immunizing animals with a recombinant GST-FSHβ fusion protein antigen. Moreover, immunizing ovariectomized rats with the GST-FSHβ antigen does significantly prevent trabecular bone loss and thereby enhance the bone strength, indicating that a FSH-based vaccine may be a promising therapeutic strategy to slow down bone loss in postmenopausal women.

  11. Gefitinib, an EGFR Tyrosine Kinase inhibitor, Prevents Smoke-Mediated Ciliated Airway Epithelial Cell Loss and Promotes Their Recovery.

    Directory of Open Access Journals (Sweden)

    Monica Valencia-Gattas

    Full Text Available Cigarette smoke exposure is a major health hazard. Ciliated cells in the epithelium of the airway play a critical role in protection against the noxious effects of inhaled cigarette smoke. Ciliated cell numbers are reduced in smokers which weakens host defense and leads to disease. The mechanisms for the loss of ciliated cells are not well understood. The effects of whole cigarette smoke exposure on human airway ciliated ciliated cells were examined using in vitro cultures of normal human bronchial epithelial cells and a Vitrocell® VC 10® Smoking Robot. These experiments showed that whole cigarette smoke causes the loss of differentiated ciliated cells and inhibits differentiation of ciliated cells from undifferentiated basal cells. Furthermore, treatment with the epidermal growth factor receptor (EGFR tyrosine kinase inhibitor, Gefitinib, during smoke exposure prevents ciliated cell loss and promotes ciliated cell differentiation from basal cells. Finally, restoration of ciliated cells was inhibited after smoke exposure was ceased but was enhanced by Gefitinib treatment. These data suggest that inhibition of EGFR activity may provide therapeutic benefit for treating smoke related diseases.

  12. Newborn Dried Blood Spot Polymerase Chain Reaction to Identify Infants with Congenital Cytomegalovirus-Associated Sensorineural Hearing Loss.

    Science.gov (United States)

    Ross, Shannon A; Ahmed, Amina; Palmer, April L; Michaels, Marian G; Sánchez, Pablo J; Stewart, Audra; Bernstein, David I; Feja, Kristina; Fowler, Karen B; Boppana, Suresh B

    2017-05-01

    To determine the utility of dried blood spot (DBS) polymerase chain reaction (PCR) in identifying infants with cytomegalovirus (CMV) infection-associated sensorineural hearing loss (SNHL). Newborns at 7 US hospitals between March 2007 and March 2012 were screened for CMV by saliva rapid culture and/or PCR. Infected infants were monitored for SNHL during the first 4 years of life to determine sensitivity, specificity, and positive and negative likelihood ratios of DBS PCR for identifying CMV-associated SNHL. DBS at birth was positive in 11 of 26 children (42%) with SNHL at age 4 years and in 72 of 270 children (27%) with normal hearing (P = .11). The sensitivity (42.3%; 95% CI, 23.4%-63.1%) and specificity (73.3%; 95% CI, 67.6%-78.5%) was low for DBS PCR in identifying children with SNHL at age 4 years. The positive and negative likelihood ratios of DBS PCR positivity to detect CMV-associated SNHL at age 4 years were 1.6 (95% CI, 0.97-2.6) and 0.8 (95% CI, 0.6-1.1), respectively. There was no difference in DBS viral loads between children with SNHL and those without SNHL. DBS PCR for CMV has low sensitivity and specificity for identifying infants with CMV-associated hearing loss. These findings, together with previous reports, demonstrate that DBS PCR does not identify either the majority of CMV-infected newborns or those with CMV-associated SNHL early in life. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Combined effects of resistance training and carbohydrate-restrictive or conventional diets on weight loss, blood variables and endothelium function

    Directory of Open Access Journals (Sweden)

    Claudia Mello MEIRELLES

    Full Text Available ABSTRACT Objective: To compare the effects of either a carbohydrate-restrictive diets or a conventional hypoenergetic diet combined with resistance training. Methods: Twenty-one overweight and obese adults participated in an eight-week program consisting of progressive resistance training combined with carbohydrate-restrictive diets (initially set at <30 g carbohydrate; n=12 or conventional hypoenergetic diet (30% energetic restriction; carbohydrate/protein/lipid: 51/18/31% of total energy consumption; n=9. It was hypothesized that the carbohydrate-restrictive diets would induce greater weight loss but that both diets would elicit similar effects on selected health markers. Body mass, and body composition, blood variables and flow-mediated brachial artery dilation (flow-mediated brachial artery dilation; by ultrasound were used to assess changes due to the interventions. Results: Significant within-group reductions in body mass (-5.4±3.5%; p=0.001 versus -3.7±3.0%; p=0.015 and body fat (body fat; -10.2±7.0%; p=0.005 versus -9.6±8.8%; p=0.017 were identified for carbohydrate-restrictive diets and conventional hypoenergetic diet, respectively, but there were no significant differences between groups as the result of the interventions. Fat free mass, blood variables and flow-mediated brachial artery dilation did not significantly change, except for the total cholesterol/high-density lipoprotein ratio, which was reduced 10.4±16.9% in carbohydrate-restrictive diets (p=0.037 and 0.5±11.3% in conventional hypoenergetic diet (p=0.398. Conclusion: Carbohydrate-restrictive diets associated with resistance training was as effective as conventional hypoenergetic diet in decreasing body mass and body fat, as well as maintaining fat free mass, blood variables and flow-mediated brachial artery dilation, however it was more effective at lowering the total cholesterol/low density lipoprotein ratio.

  14. Simulation Modeling Requirements for Loss-of-Control Accident Prevention of Turboprop Transport Aircraft

    Science.gov (United States)

    Crider, Dennis; Foster, John V.

    2012-01-01

    In-flight loss of control remains the leading contributor to aviation accident fatalities, with stall upsets being the leading causal factor. The February 12, 2009. Colgan Air, Inc., Continental Express flight 3407 accident outside Buffalo, New York, brought this issue to the forefront of public consciousness and resulted in recommendations from the National Transportation Safety Board to conduct training that incorporates stalls that are fully developed and develop simulator standards to support such training. In 2010, Congress responded to this accident with Public Law 11-216 (Section 208), which mandates full stall training for Part 121 flight operations. Efforts are currently in progress to develop recommendations on implementation of stall training for airline pilots. The International Committee on Aviation Training in Extended Envelopes (ICATEE) is currently defining simulator fidelity standards that will be necessary for effective stall training. These recommendations will apply to all civil transport aircraft including straight-wing turboprop aircraft. Government-funded research over the previous decade provides a strong foundation for stall/post-stall simulation for swept-wing, conventional tail jets to respond to this mandate, but turboprops present additional and unique modeling challenges. First among these challenges is the effect of power, which can provide enhanced flow attachment behind the propellers. Furthermore, turboprops tend to operate for longer periods in an environment more susceptible to ice. As a result, there have been a significant number of turboprop accidents as a result of the early (lower angle of attack) stalls in icing. The vulnerability of turboprop configurations to icing has led to studies on ice accumulation and the resulting effects on flight behavior. Piloted simulations of these effects have highlighted the important training needs for recognition and mitigation of icing effects, including the reduction of stall margins

  15. Maximizing Home Equity or Preventing Home Loss: Reverse Mortgage Decision Making and Racial Inequality.

    Science.gov (United States)

    Keene, Danya E; Sarnak, Ann; Coyle, Caitlin

    2018-03-07

    Reverse mortgages are loans that allow older homeowners to borrow from their home equity with no repayment due until the borrower dies or moves out of the home. We currently know very little about how homeowners evaluate and experience reverse mortgages as solutions to their financial and housing needs in later life. Furthermore, despite an increasingly diverse population of reverse mortgage borrowers, we know little about how social inequalities may contribute to reverse mortgage decisions and their outcomes. In this paper, we examine reverse mortgage decision-making and experiences in a racially and economically diverse sample of older US homeowners. We conducted 44 in-depth interviews with older homeowners who were considering or who had obtained a reverse mortgage loan. We inductively and iteratively developed a thematic coding scheme that was applied to all interview transcripts. Our analysis produced a dichotomous schema of reverse mortgage decision making that was shaped by social and economic opportunities and constraints. For some participants, reverse mortgages represented strategic tools used to maximize home equity and its benefits. For others, it was an option of last resort to which participants turned when faced with the imminent loss of their home. Focusing on reverse mortgages, our analysis suggests way that social inequalities may be reproduced through financial decisions and the unequal landscapes of opportunity in which they are made.

  16. Management of knowledge across generations: preventing knowledge loss, enabling knowledge readiness

    International Nuclear Information System (INIS)

    Day, John A.

    2012-01-01

    J. Day argued that the preservation of records is a necessary, but not a sufficient condition to enable intelligent future decision making and management of nuclear waste. He distinguishes knowledge management from information management. Information without the potential to act on it is information for its own sake. He believes that knowledge will be a key factor for the generations that follow us. Records need knowledge, and knowledge needs records. A single representation of knowledge can be dangerous. Knowledge is multifaceted and complex, which necessitates a holistic approach. Throughout the presentation the concepts of 'knowledge readiness' and 'knowledge mothballing' (the process of knowing, forgetting and relearning) were proposed. Based on experiences at Sellafield the actions of knowledge audit mapping (including technical, societal and historical knowledge), knowledge loss risk assessing (although we would like to we cannot hold on to everything, and should thus take a risk approach, asking ourselves what is at stake if we delete certain parts of information), and knowledge retention for the long term management of a nuclear facility were presented. During the discussion, the link between knowledge and behaviour was raised. It was argued that the better informed people are, the less likely they are to make mistakes

  17. Preventive measures to prevent loss to follow-up in highly active antiretroviral therapy (HAART): implementing a strategy in Ziguinchor (Casamance, Senegal) in 2014.

    Science.gov (United States)

    Randé, H; Rouffy, D

    2016-05-01

    Since 2010, the Pharmacie et Aide Humanitaire (PAH) in Casamance (Senegal) has been maintaining a software package (Tacojo) that allows monthly monitoring of the distribution of treatment to every patient with HIV infection receiving highly active antiretroviral therapy (HAART). We used this program to set up measures to prevent the loss to follow-up of patients receiving HAART. Our involvement focused on two main areas. First, each patient is routinely contacted after inclusion, to help us to understand the patient's experience of the disease and the treatment. This process aims to improve adherence to the treatment. Then, all patients who miss an appointment are routinely contacted by telephone within seven days of that appointment. The goal is to understand the reasons for the absence and to encourage patients to continue their treatment. Despite the lack of distance due to the relative newness of this program, these preventive measures have shown hopeful results (80% of the patients came back after a call). It would be interesting to apply it in a sustainable manner and in more medical facilities.

  18. Designing Skin Cancer Prevention Messages: Should We Emphasize Gains or Losses? Message Framing, Risk Type, and Prior Experience.

    Science.gov (United States)

    Lee, Moon J; Kang, Hannah

    2018-05-01

    To test whether message framing (ie, gain vs. loss) and risk type (ie, health vs appearance risk) in skin cancer prevention messages interact with one's prior experience. Two experiments with a 2 (message framing: gain vs loss) × 2 (risk type: health vs appearance risk) factorial design were conducted. The participants were given a URL to the experiment website via e-mail. On the first page of the website, the participants were told that they would be asked to evaluate a skin cancer print public service announcement (PSA): Online experiments. A total of 397 individuals participated (236 for experiment 1 and 161 for experiment 2). Apparatus: Four versions of the skin cancer print PSAs were developed. Four PSAs were identical except for the 2 manipulated components: message framing and risk type. Measures were adopted from Cho and Boster (message framing), Jones and Leary and Kiene et al. (risk type), De Vries, Mesters, van't Riet, Willems, and Reubsaet and Knight, Kirincich, Farmer, and Hood (prior experience), and Hammond, Fong, Zanna, Thrasher, and Borland and Hoffner and Ye (behavioral intent). General linear models were used to test hypotheses. Three-way interactions among message framing, risk type, and prior experience were found: When the intent of the message was to encourage sunscreen use, the effects of message framing and risk type were shown to be the exact opposite directions from when the intent was to discourage indoor/outdoor tanning. To discourage tanning among those with prior experience, messages emphasizing losses in terms of one's health will work better. For those with no prior experience, messages emphasizing potential appearance losses will work better for discouraging tanning while messages emphasizing gains like improving appearance will do a better job in encouraging sunscreen use.

  19. Does blood pressure lowering treatment prevents dementia or cognitive decline in patients with cardiovascular and cerebrovascular disease?

    Science.gov (United States)

    Feigin, Valery; Ratnasabapathy, Yogini; Anderson, Craig

    2005-03-15

    There is increasing evidence that both hypertension and stroke play important roles in the development of cognitive decline and dementia. Despite five high-quality randomised controlled trials (RCTs) in this area to date, there remains uncertainty about the role of blood pressure lowering therapy in the prevention of cognitive decline and dementia. It appears that lack of definitive results from these trials can be explained on the basis of (a) insufficient power to detect modest treatment effects; (b) measurement error in the diagnosis of dementia; (c) variations in the treatment effects between different types of antihypertensive agents; and (d) bias due to missing data, variation in baseline factors such as levels of blood pressure, and the inclusion of patients with cognitive impairment at entry. Preliminary meta-analysis of RCTs supports the hypothesis that blood pressure lowering may prevent dementia in high-risk patients, that is those with vascular disease. However, a meta-analysis of individual patient data (IPD) from these, and other relevant trials in patients with vascular disease, would provide much more reliable data. If the hypothesis were confirmed, it would certainly be of considerable importance not only in terms of our understanding of the aetiology of dementia, but also in promoting blood pressure lowering strategies for broader public health good.

  20. Selecting K compatible blood components for transfusion can prevent anti-K immunization in women of childbearing age.

    Directory of Open Access Journals (Sweden)

    Andreja Hrašovec-Lampret

    2016-07-01

    Full Text Available With selecting K compatible blood for transfusion, we prevent K immunization and many unnecessary prenatal testing and gynecological examinations for at least 78% of pregnant women with K negative partners, whose fetus is not at risk of hemolytic disease of fetus and newborn. Abstract  Background Kell antibodies are beside RhD and c antibodies one of most clinically important antibodies that can cause severe hemolytic disease of the fetus and newborn (HDFN in pregnancy,which is still remaining one of the major causes of perinatal morbidity and mortality. Therefore, pregnant women with eryhrocyte alloantibodies anti-K need many prenatal testing and gynecological examinations. The major cause for anti-K immunisation is transfusion of incompatible blood in the past.    Methods We analysed retrospectively the data of 71 pregnant woman with alloantibodies anti-K, which were followed in Blood Transfusion Centre of Slovenia from 2004 -2014. We collected data of partner´s phenotype and woman´s transfusion history. Data were statistically analyzed with basic statistical methods.   Results 61 out of 71 partners were tested (86% and 48 were K negative (78%.The transfusion history was available for only 23 women (32%. The transfusion history was available for 23 out of 48 women with K negative partner (48%. All of them were transfused. 78% received incompatible-K positive blood, for the rest 22% women donations they received were not K typed.    Conclusions From the obtained data, we found that in 78% of cases cause for K alloimunnization is transfusion of K incompatible blood in past. With selecting K compatible blood for transfusion, we can prevent K immunization and many unnecessary prenatal testing and gynecological examinations for 78% pregnant women with K negative partners . 

  1. Longitudinal and postural changes of blood pressure predict dementia: the Malmö Preventive Project.

    Science.gov (United States)

    Holm, Hannes; Nägga, Katarina; Nilsson, Erik D; Melander, Olle; Minthon, Lennart; Bachus, Erasmus; Fedorowski, Artur; Magnusson, Martin

    2017-04-01

    The role of blood pressure (BP) changes in dementia is debatable. We aimed to analyse how resting and postural BP changes relate to incident dementia over a long-term follow-up. In the prospective population-based Malmö Preventive Project, 18,240 study participants (mean age: 45 ± 7 years, 63% male) were examined between 1974 and 1992 with resting and standing BP measurement, and re-examined between 2002 and 2006 at mean age of 68 ± 6 years with resting BP. A total of 428 participants (2.3%) were diagnosed with dementia through Dec 31, 2009. The association of resting and postural BP changes with risk of dementia was studied using multivariable-adjusted Cox regression models controlling for traditional risk factors. Diastolic BP (DBP) decrease on standing indicated higher risk of dementia [Hazard ratio (HR) per 10 mmHg: 1.22; 95% confidence interval (CI) 1.01-1.44, p = 0.036], which was mainly driven by increased risk in normotensive individuals. Higher systolic (SBP) and diastolic BP at re-examination was associated with lower risk of dementia (HR per 10 mmHg: 0.94; 95% CI 0.89-0.99, p = 0.011; and 0.87; 0.78-0.96, p = 0.006, respectively). Extreme decrease in SBP/DBP between baseline and re-examination (4th quartile; -7 ± 12/-15 ± 7 mmHg, respectively) indicated higher risk of dementia (HR 1.46; 95% CI 1.11-1.93, p = 0.008, and 1.54; 95% CI 1.14-2.08, p = 0.005; respectively) compared with reference group characterised by pronounced BP increase over the same period (1st quartile; +44 ± 13/+15 ± 7 mmHg). Diastolic BP decrease on standing in the middle age, decline in BP between middle-and advanced age, and lower BP in advanced age are independent risk factors of developing dementia.

  2. Olive oil and vitamin D synergistically prevent bone loss in mice.

    Directory of Open Access Journals (Sweden)

    Camille Tagliaferri

    Full Text Available As the Mediterranean diet (and particularly olive oil has been associated with bone health, we investigated the impact of extra virgin oil as a source of polyphenols on bone metabolism. In that purpose sham-operated (SH or ovariectomized (OVX mice were subjected to refined or virgin olive oil. Two supplementary OVX groups were given either refined or virgin olive oil fortified with vitamin D3, to assess the possible synergistic effects with another liposoluble nutrient. After 30 days of exposure, bone mineral density and gene expression were evaluated. Consistent with previous data, ovariectomy was associated with increased bone turnover and led to impaired bone mass and micro-architecture. The expression of oxidative stress markers were enhanced as well. Virgin olive oil fortified with vitamin D3 prevented such changes in terms of both bone remodeling and bone mineral density. The expression of inflammation and oxidative stress mRNA was also lower in this group. Overall, our data suggest a protective impact of virgin olive oil as a source of polyphenols in addition to vitamin D3 on bone metabolism through improvement of oxidative stress and inflammation.

  3. Resveratrol prevents alveolar bone loss in an experimental rat model of periodontitis.

    Science.gov (United States)

    Bhattarai, Govinda; Poudel, Sher Bahadur; Kook, Sung-Ho; Lee, Jeong-Chae

    2016-01-01

    Resveratrol is an antioxidant and anti-inflammatory polyphenol. Periodontitis is induced by oral pathogens, where a systemic inflammatory response accompanied by oxidative stress is the major event initiating disease. We investigated how resveratrol modulates cellular responses and the mechanisms related to this modulation in lipopolysaccharide (LPS)-stimulated human gingival fibroblasts (hGFs). We also explored whether resveratrol protects rats against alveolar bone loss in an experimental periodontitis model. Periodontitis was induced around the first upper molar of the rats by applying ligature infused with LPS. Stimulating hGFs with 5μg/ml LPS augmented the expression of cyclooxygenase-2, matrix metalloproteinase (MMP)-2, MMP-9, and Toll-like receptor-4. LPS treatment also stimulated the production of reactive oxygen species (ROS) and the phosphorylation of several protein kinases in the cells. However, the expression of heme oxygenase-1 (HO-1) and nuclear factor-E2 related factor 2 (Nrf2) was inhibited by the addition of LPS. Resveratrol treatment almost completely inhibited all of these changes in LPS-stimulated cells. Specifically, resveratrol alone augmented HO-1 induction via Nrf2-mediated signaling. Histological and micro-CT analyses revealed that administration of resveratrol (5mg/kg body weight) improved ligature/LPS-mediated alveolar bone loss in rats. Resveratrol also attenuated the production of inflammation-related proteins, the formation of osteoclasts, and the production of circulating ROS in periodontitis rats. Furthermore, resveratrol suppressed LPS-mediated decreases in HO-1 and Nrf2 levels in the inflamed periodontal tissues. Collectively, our findings suggest that resveratrol protects rats from periodontitic tissue damage by inhibiting inflammatory responses and by stimulating antioxidant defense systems. The aims of this study were to investigate how resveratrol modulates cellular responses and the mechanisms related to this modulation in

  4. EFFICACY OF TRANEXAMIC ACID IN DECREASING BLOOD LOSS DURING AND AFTER CAESAREAN SECTION IN MULTIGRAVIDA PARTURIENTS: A CASE CONTROLLED PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Gunavathi Kandappan

    2016-06-01

    Full Text Available OBJECTIVES To study the efficacy of Tranexamic acid in reducing blood loss during and after the lower segment caesarean section in Multigravida parturients. METHODOLOGY A case controlled prospective study was conducted in 50 multigravida parturient women undergoing elective lower segment caesarean section in our hospital after getting Institutional Ethical Committee approval, over a period of two months. 25 of them were given Tranexamic acid 15 mg/kg immediately before caesarean section. Blood loss was collected and measured during two periods. The first period was from placental delivery to end of LSCS and the second from the end LSCS to 2 hours postpartum. RESULTS Tranexamic acid significantly reduces the quantity of blood loss from the end of LSCS to 2 hours post-partum in multigravida parturients. No complications or side effects are noted in both the groups. CONCLUSION Tranexamic acid significantly reduces the amount of blood loss during and after the lower segment caesarean section in multigravida parturients and its use was not associated with any side effects or complications.

  5. Understanding Challenges and Opportunities of Preventive Blood Pressure Self-Monitoring at Home

    DEFF Research Database (Denmark)

    Grönvall, Erik; Verdezoto, Nervo

    2013-01-01

    methods to understand existing challenges and uncover opportunities of self-monitoring technologies to support preventive healthcare activities among older adults. Emerging challenges from our study were: rule complexity for self-measuring, reliability of measurements, interpretation, understanding...... to support people’s preventive self-monitoring needs compared with existing solutions. Furthermore, supporting the active and informed citizen can improve older adult’s care abilities, awareness and activation towards preventive care....

  6. Aircraft Loss-of-Control Accident Prevention: Switching Control of the GTM Aircraft with Elevator Jam Failures

    Science.gov (United States)

    Chang, Bor-Chin; Kwatny, Harry G.; Belcastro, Christine; Belcastro, Celeste

    2008-01-01

    Switching control, servomechanism, and H2 control theory are used to provide a practical and easy-to-implement solution for the actuator jam problem. A jammed actuator not only causes a reduction of control authority, but also creates a persistent disturbance with uncertain amplitude. The longitudinal dynamics model of the NASA GTM UAV is employed to demonstrate that a single fixed reconfigured controller design based on the proposed approach is capable of accommodating an elevator jam failure with arbitrary jam position as long as the thrust control has enough control authority. This paper is a first step towards solving a more comprehensive in-flight loss-of-control accident prevention problem that involves multiple actuator failures, structure damages, unanticipated faults, and nonlinear upset regime recovery, etc.

  7. Combat, prevention and optimization of commercial losses of power energy; Combate, prevencao e otimizacao das perdas comerciais da energia eletrica

    Energy Technology Data Exchange (ETDEWEB)

    Penin, Carlos Alexandre de Sousa

    2008-07-01

    The objective of this work is to study the problem of NTL using a wide approach, analyze the experience of dealerships in Brazil and abroad, discuss the best practices for mitigation of those losses and propose improvements in the combat and prevention processes, and the legal procedures for recovery of incomes, leaning on a careful regulatory context. This study draws attention to Brazil's socioeconomic diversity, comparing it to various international examples, and intends to identify the most relevant aspects that must be considered on the theme, discussing procedures and methodologies for the equation of the amount of resources to be applied by distributing companies to achieve the appropriate reduction of NTL. (author)

  8. Sealed Radioactive Sources. Information, Resources, and Advice for Key Groups about Preventing the Loss of Control over Sealed Radioactive Sources

    International Nuclear Information System (INIS)

    2013-10-01

    Among its many activities to improve the safety and security of sealed sources, the IAEA has been investigating the root causes of major accidents and incidents since the 1980's and publishes findings so that others can learn from them. There are growing concerns today about the possibility that an improperly stored source could be stolen and used for malicious purposes. To improve both safety and security, information needs to be in the hands of those whose actions and decisions can prevent a source from being lost or stolen in the first place. The IAEA developed this booklet to help improve communication with key groups about hazards that may result from the loss of control over sealed radioactive sources and measures that should be implemented to prevent such loss of control. Many people may benefit from the information contained in this booklet, particularly those working with sources and those likely to be involved if control over a source is lost; especially: officials in government agencies, first responders, medical users, industrial users and the metal recycling industry. The general public may also benefit from an understanding of the fundamentals of radiation safety. This booklet is comprised of several stand-alone chapters intended to communicate with these key groups. Various accidents that are described and information that is provided are relevant to more than one key group and therefore, some information is repeated throughout the booklet. This booklet seeks to raise awareness of the importance of the safety and security of sealed radioactive sources. However, it is not intended to be a comprehensive 'how to' guide for implementing safety and security measures for sealed radioactive sources. For more information on these measures, readers are encouraged to consult the key IAEA safety and security-related publications identified in this booklet

  9. Noise-induced hearing loss in agriculture: Creating partnerships to overcome barriers and educate the community on prevention

    Directory of Open Access Journals (Sweden)

    Janet J Ehlers

    2011-01-01

    Full Text Available Noise-induced hearing loss (NIHL is a common and preventable injury for farmers. Farmers are frequently exposed to excessive noise, ranking among the top three occupations and industries with the highest risk for hearing loss. Use of hearing protection among farmers is not common. Although the age when NIHL begins among farmers is unknown, its prevalence is higher among male adolescents who live and work on farms. The purpose of this paper is to describe how NIOSH created partnerships to promote hearing conservation for this hard-to-reach population. Partnerships included organizations and individuals who were trusted sources of information for the target population, young farmers 14-35 years of age and their families, and those who had linkages in rural communities. NIOSH engaged partners through exhibits and train-the-trainer workshops at state or national conventions. NIOSH workshops included basic information on NIHL as well as information on free or low-lost resources that participants could use in training others at schools and community events. People with hearing conservation expertise have an important role and many opportunities to improve the knowledge and implementation of hearing conservation among those in agriculture.

  10. Improving access to optometry services for people at risk of preventable sight loss: a qualitative study in five UK locations.

    Science.gov (United States)

    Leamon, S; Hayden, C; Lee, H; Trudinger, D; Appelbee, E; Hurrell, D-L; Richardson, I

    2014-12-01

    Reducing preventable sight loss is an increasing priority for public health and health care providers. We examined the factors affecting people's use of optometry services in population groups at increased risk of sight loss. This is a qualitative study in five UK locations. In England, participants were from the Pakistani and Black Caribbean communities; in Scotland from the Pakistani community; and in Northern Ireland and Wales from white socio-economically deprived communities. Thirty-four focus groups were conducted (n = 289). The study included people who attend optometry services and people not engaged with services. Barriers to access included limited awareness of eye health and eye disease, concern about the cost of spectacles and the appropriateness of optometry in a commercial setting. Attendance at the optometrist was primarily symptom led. A positive previous experience or continuing relationship with the optometrist helped to alleviate the barriers and promote attendance. Addressing the disparity between the broader messages about eye health and the current perception of the function of optometry could help improve access to services. Uptake may be improved through the co-production of interventions that better resonate with local communities. Non-retail service delivery options should be explored. © The Author 2014, Published by Oxford University Press on behalf of Faculty of Public Health.

  11. Chronic Microdose Lithium Treatment Prevented Memory Loss and Neurohistopathological Changes in a Transgenic Mouse Model of Alzheimer's Disease.

    Science.gov (United States)

    Nunes, Marielza Andrade; Schöwe, Natalia Mendes; Monteiro-Silva, Karla Cristina; Baraldi-Tornisielo, Ticiana; Souza, Suzzanna Ingryd Gonçalves; Balthazar, Janaina; Albuquerque, Marilia Silva; Caetano, Ariadiny Lima; Viel, Tania Araujo; Buck, Hudson Sousa

    2015-01-01

    The use of lithium is well established in bipolar disorders and the benefits are being demonstrated in neurodegenerative disorders. Recently, our group showed that treatment with microdose lithium stabilized the cognitive deficits observed in Alzheimer's disease (AD) patients. In order to verify the lithium microdose potential in preventing the disease development, the aim of this work was to verify the effects of chronic treatment with microdose lithium given before and after the appearance of symptoms in a mouse model of a disease similar to AD. Transgenic mice (Cg-Tg(PDGFB-APPSwInd)20Lms/2J) and their non-transgenic litter mate genetic controls were treated with lithium carbonate (0.25mg/Kg/day in drinking water) for 16 or 8 months starting at two and ten months of age, respectively [corrected]. Similar groups were treated with water. At the end of treatments, both lithium treated transgenic groups and non-transgenic mice showed no memory disruption, different from what was observed in the water treated transgenic group. Transgenic mice treated with lithium since two months of age showed decreased number of senile plaques, no neuronal loss in cortex and hippocampus and increased BDNF density in cortex, when compared to non-treated transgenic mice. It is suitable to conclude that these data support the use of microdose lithium in the prevention and treatment of Alzheimer's disease, once the neurohistopathological characteristics of the disease were modified and the memory of transgenic animals was maintained.

  12. Chronic Microdose Lithium Treatment Prevented Memory Loss and Neurohistopathological Changes in a Transgenic Mouse Model of Alzheimer's Disease.

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    Marielza Andrade Nunes

    Full Text Available The use of lithium is well established in bipolar disorders and the benefits are being demonstrated in neurodegenerative disorders. Recently, our group showed that treatment with microdose lithium stabilized the cognitive deficits observed in Alzheimer's disease (AD patients. In order to verify the lithium microdose potential in preventing the disease development, the aim of this work was to verify the effects of chronic treatment with microdose lithium given before and after the appearance of symptoms in a mouse model of a disease similar to AD. Transgenic mice (Cg-Tg(PDGFB-APPSwInd20Lms/2J and their non-transgenic litter mate genetic controls were treated with lithium carbonate (0.25mg/Kg/day in drinking water for 16 or 8 months starting at two and ten months of age, respectively [corrected]. Similar groups were treated with water. At the end of treatments, both lithium treated transgenic groups and non-transgenic mice showed no memory disruption, different from what was observed in the water treated transgenic group. Transgenic mice treated with lithium since two months of age showed decreased number of senile plaques, no neuronal loss in cortex and hippocampus and increased BDNF density in cortex, when compared to non-treated transgenic mice. It is suitable to conclude that these data support the use of microdose lithium in the prevention and treatment of Alzheimer's disease, once the neurohistopathological characteristics of the disease were modified and the memory of transgenic animals was maintained.

  13. 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)

  14. Prevention of vision loss protects against age-related impairment in learning and memory performance in DBA/2J mice.

    Science.gov (United States)

    Wong, Aimée A; Brown, Richard E

    2013-01-01

    The DBA/2J mouse is a model of pigmentary glaucoma in humans as it shows age-related increases in intraocular pressure (IOP), retinal ganglion cell death and visual impairment. Previously, we showed that visual ability declines from 9 to 12 months of age and visual impairment is correlated with poor learning and memory performance in visuo-spatial tasks but not in tasks that do not depend on visual cues. To test the "sensory impairment" hypothesis of aging, which postulates that sensory impaired individuals are disadvantaged in their performance on psychometric tests as a direct result of difficulties in sensory perception, we treated DBA/2J mice with a conventional glaucoma medication used in humans (Timoptic-XE, 0.00, 0.25, or 0.50%) daily from 9 weeks to 12 months of age to determine whether prevention of vision loss prevented the decline in visuo-spatial learning and memory performance. At all ages tested (3, 6, 9, and 12 months of age), mice treated with Timoptic-XE (0.25 and 0.50%) maintained a high level of performance, while 12 month old control mice (0.00%) exhibited impaired performance in visually-dependent, but not non-visual tasks. These results demonstrate that when sensory function is preserved, cognitive performance is normalized. Thus, as in many aging humans, DBA/2J mice show age-related decrements in performance on visually presented cognitive tests, not because of cognitive impairment but as a direct consequence of poor visual ability. Our results demonstrate that age-related impairment in performance in visuo-spatial tasks in DBA/2J mice can be prevented by the preservation of visual ability.

  15. Prevention of vision loss protects against age-related impairment in learning and memory performance in DBA/2J mice

    Directory of Open Access Journals (Sweden)

    Aimee eWong

    2013-09-01

    Full Text Available The DBA/2J mouse is a model of pigmentary glaucoma in humans as it shows age‐related increases in intraocular pressure, retinal ganglion cell death and visual impairment. Previously, we showed that visual ability declines from 9 ‐12 months of age and visual impairment is correlated with poor learning and memory performance in visuo‐spatial tasks but not in tasks that do not depend on visual cues. To test the sensory impairment hypothesis of aging, which postulates that sensory impaired individuals are disadvantaged in their performance on psychometric tests as a direct result of difficulties in sensory perception, we treated DBA/2J mice with a conventional glaucoma medication used in humans (Timoptic‐XE, 0.00, 0.25 or 0.50% daily from 9 weeks to 12 months of age to determine whether prevention of vision loss prevented the decline in visuo-spatial learning and memory performance. At all ages tested (3, 6, 9 and 12 months of age, mice treated with Timoptic-XE (0.25 and 0.50% maintained a high level of performance, while 12 month old control mice (0.00% exhibited impaired performance in visually‐dependent, but not non‐visual tasks. These results demonstrate that when sensory function is preserved, cognitive performance is normalized. Thus, as in many aging humans, DBA/2J mice show age-related decrements in performance on visually presented cognitive tests, not because of cognitive impairment but as a direct consequence of poor visual ability. Our results demonstrate that age-related impairment in performance in visuo-spatial tasks in DBA/2J mice can be prevented by the preservation of visual ability.

  16. Potassium citrate prevents increased osteoclastogenesis resulting from acidic conditions: Implication for the treatment of postmenopausal bone loss.

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    Donatella Granchi

    Full Text Available The extracellular acidic milieu in bones results in activation of osteoclasts (OC and inhibition of osteoblasts (OB causing a net loss of calcium from the skeleton and the deterioration of bone microarchitecture. Alkalinization through supplementation with potassium citrate (K citrate has been proposed to limit the osteopenia progression, even though its pharmacological activity in bone microenvironment is not well defined. We evaluated if K citrate was able to prevent the adverse effects that acidic milieu induces on bone cells. OC and OB were maintained in neutral (pH 7.4 versus acidic (pH 6.9 culture medium, and treated with different K citrate concentrations. We evaluated the OC differentiation at seven days, by counting of multinucleated cells expressing tartrate-resistant acid phosphatase, and the activity of mature OC at 14 days, by quantifying of collagen degradation. To evaluate the effects on OB, we analyzed proliferation, mineralization, and expression of bone-related genes. We found that the low pH increased OC differentiation and activity and decreased OB function. The osteoclastogenesis was also promoted by RANKL concentrations ineffective at pH 7.4. Non-cytotoxic K citrate concentrations were not sufficient to steadily neutralize the acidic medium, but a inhibited the osteoclastogenesis, the collagen degradation, and the expression of genes involved in RANKL-mediated OC differentiation, b enhanced OB proliferation and alkaline phosphatase expression, whereas it did not affect the in vitro mineralization, and c were effective also in OC cultures resistant to alendronate, i.e. the positive control of osteoclastogenesis inhibition. In conclusion, K citrate prevents the increase in OC activity induced by the acidic microenvironment, and the effect does not depend exclusively on its alkalizing capacity. These data provide the biological basis for the use of K citrate in preventing the osteopenia progression resulting from low

  17. A Computational Framework to Optimize Subject-Specific Hemodialysis Blood Flow Rate to Prevent Intimal Hyperplasia

    Science.gov (United States)

    Mahmoudzadeh, Javid; Wlodarczyk, Marta; Cassel, Kevin

    2017-11-01

    Development of excessive intimal hyperplasia (IH) in the cephalic vein of renal failure patients who receive chronic hemodialysis treatment results in vascular access failure and multiple treatment complications. Specifically, cephalic arch stenosis (CAS) is known to exacerbate hypertensive blood pressure, thrombosis, and subsequent cardiovascular incidents that would necessitate costly interventional procedures with low success rates. It has been hypothesized that excessive blood flow rate post access maturation which strongly violates the venous homeostasis is the main hemodynamic factor that orchestrates the onset and development of CAS. In this article, a computational framework based on a strong coupling of computational fluid dynamics (CFD) and shape optimization is proposed that aims to identify the effective blood flow rate on a patient-specific basis that avoids the onset of CAS while providing the adequate blood flow rate required to facilitate hemodialysis. This effective flow rate can be achieved through implementation of Miller's surgical banding method after the maturation of the arteriovenous fistula and is rooted in the relaxation of wall stresses back to a homeostatic target value. The results are indicative that this optimized hemodialysis blood flow rate is, in fact, a subject-specific value that can be assessed post vascular access maturation and prior to the initiation of chronic hemodialysis treatment as a mitigative action against CAS-related access failure. This computational technology can be employed for individualized dialysis treatment.

  18. Preventive effect of curcumin and its highly bioavailable preparation on hearing loss induced by single or repeated exposure to noise: A comparative and mechanistic study

    Directory of Open Access Journals (Sweden)

    Taro Yamaguchi

    2017-08-01

    Full Text Available We sought to determine the preventive effects of curcumin and its highly bioavailable preparation on noise-induced hearing loss in a novel murine model of permanent hearing loss developed by repeated exposure to noise. Upon exposure to noise (8-kHz octave band noise, 90 dB sound pressure level, 1 h, hearing ability was impaired in a temporary and reversible manner. During repeated noise exposure (1-h exposure per day, 5 days, there was a progressive increase in the auditory threshold shift at 12 and 20 kHz. The threshold shift persisted for at least 6 days after noise exposure. Oral administration of curcumin for 3 days before and each day during noise exposure significantly alleviated the hearing loss induced by repeated noise exposure. Curcumin abolished intranuclear translocation of nuclear factor-κB-p65 and generation of 4-hydroxynonenal-adducted proteins found in the cochlea after noise exposure. Theracurmin®, a highly absorbable and bioavailable preparation of curcumin, had strong preventive effects on hearing loss induced by repeated noise exposure. Together, these data suggest that curcumin exerts a preventive effect on noise-induced hearing loss and is therefore a good therapeutic candidate for preventing sensorineural hearing loss.

  19. Preventive effect of curcumin and its highly bioavailable preparation on hearing loss induced by single or repeated exposure to noise: A comparative and mechanistic study.

    Science.gov (United States)

    Yamaguchi, Taro; Yoneyama, Masanori; Onaka, Yusuke; Imaizumi, Atsushi; Ogita, Kiyokazu

    2017-08-01

    We sought to determine the preventive effects of curcumin and its highly bioavailable preparation on noise-induced hearing loss in a novel murine model of permanent hearing loss developed by repeated exposure to noise. Upon exposure to noise (8-kHz octave band noise, 90 dB sound pressure level, 1 h), hearing ability was impaired in a temporary and reversible manner. During repeated noise exposure (1-h exposure per day, 5 days), there was a progressive increase in the auditory threshold shift at 12 and 20 kHz. The threshold shift persisted for at least 6 days after noise exposure. Oral administration of curcumin for 3 days before and each day during noise exposure significantly alleviated the hearing loss induced by repeated noise exposure. Curcumin abolished intranuclear translocation of nuclear factor-κB-p65 and generation of 4-hydroxynonenal-adducted proteins found in the cochlea after noise exposure. Theracurmin ® , a highly absorbable and bioavailable preparation of curcumin, had strong preventive effects on hearing loss induced by repeated noise exposure. Together, these data suggest that curcumin exerts a preventive effect on noise-induced hearing loss and is therefore a good therapeutic candidate for preventing sensorineural hearing loss. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  20. Normative evaluation of blood banks in the Brazilian Amazon region in respect to the prevention of transfusion-transmitted malaria

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    Daniel Roberto Coradi Freitas

    2014-12-01

    Full Text Available Objective:To evaluate blood banks in the Brazilian Amazon region with regard to structure and procedures directed toward the prevention of transfusion-transmitted malaria (TTM.Methods:This was a normative evaluation based on the Brazilian National Health Surveillance Agency (ANVISA Resolution RDC No. 153/2004. Ten blood banks were included in the study and classified as 'adequate' (≥80 points, 'partially adequate' (from 50 to 80 points, or 'inadequate' (<50 points. The following components were evaluated: 'donor education' (5 points, 'clinical screening' (40 points, 'laboratory screening' (40 points and 'hemovigilance' (15 points.Results:The overall median score was 49.8 (minimum = 16; maximum = 78. Five blood banks were classified as 'inadequate' and five as 'partially adequate'. The median clinical screening score was 26 (minimum = 16; maximum = 32. The median laboratory screening score was 20 (minimum = 0; maximum = 32. Eight blood banks performed laboratory tests for malaria; six tested all donations. Seven used thick smears, but only one performed this procedure in accordance with Ministry of Health requirements. One service had a Program of External Quality Evaluation for malaria testing. With regard to hemovigilance, two institutions reported having procedures to detect cases of transfusion-transmitted malaria.Conclusion:Malaria is neglected as a blood–borne disease in the blood banks of the Brazilian Amazon region. None of the institutions were classified as 'adequate' in the overall classification or with regard to clinical screening and laboratory screening. Blood bank professionals, the Ministry of Health and Health Surveillance service managers need to pay more attention to this matter so that the safety procedures required by law are complied with.

  1. The effect of blood injection for the prevention of Ethanol reflux after intrahepatic Ethanol injection in the rat

    International Nuclear Information System (INIS)

    Ahn, Kook Jin; Kim, Choon Yul; Kim, Bum Soo; Hahn, Seong Tai; Lee, Jae Mun; Shinn, Kyung Sub

    1998-01-01

    To reduce ethanol reflux from the needle channel by injecting rat blood immediately after the injection of ethanol into rat liver. The first experiment involved 33 rat livers which were divided into four groups (three livers in group 1;ten in groups 2, 3, and 4). Group 1 animals were used as controls, and 0.1ml saline was injected into the liver; in group 2, ethanol-Tc-99m-O 4 - mixed solution (0.1ml, 0.2mCi) was injected into the liver;in groups 3 and 4, the needle channel was blocked with 0.02ml of fresh blood and old blood, respectively, after the injection of ethanol. After removing the needle, a 3cm round filter paper was laid on each injection site to absorb refluxed ethanol-T c -99m-O 4 - mixed solution from the liver, and each paper was then counted by a gamma camera unit. In the second experiment, 33rats were divided into four groups (three rats in group 1;ten in groups 2, 3, and 4). Group 1 animals were used as controls, and after exposing the left lateral lobe of the liver, 0.05 ml of saline was injected;in group 2, 0.05 ml of ethanol was injected into the livder;in groups 3 and 4 the needle channel was blocked with 0.02 ml of fresh blood and old blood, respectively, after the injection of ethanol. After ten days, peritoneal adhesions were scored macroscopically and microscopically. In the first experiment using ethanol- T c -99m-O 4 - mixed solution, groups blocked with blood after the injection of mixed solution showed lower gamma counts than the group injected with mixed solution only (p-value=3D0.0002). The group blocked with old blood showed the lowest count. Macroscopical and microscopical examination of peritoneal adhesions indicated that the grade of adhesion was lower in groups blocked with blood than in the group injected with ethanol onluy (p-value=3D0.0261 and 0.0163, respectively). The above results suggest that an injection of blood after an injection of ethanol is a very effective way of preventing reflux from the liver.=20

  2. Bcl-2 over-expression fails to prevent age-related loss of calretinin positive neurons in the mouse dentate gyrus

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    Han Mingbo

    2006-08-01

    Full Text Available Abstract Background Cognitive performance declines with increasing age. Possible cellular mechanisms underlying this age-related functional decline remain incompletely understood. Early studies attributed this functional decline to age-related neuronal loss. Subsequent studies using unbiased stereological techniques found little or no neuronal loss during aging. However, studies using specific cellular markers found age-related loss of specific neuronal types. To test whether there is age-related loss of specific neuronal populations in the hippocampus, and subsequently, whether over-expression of the B-cell lymphoma protein-2 (Bcl-2 in these neurons could delay possible age-related neuronal loss, we examined calretinin (CR positive neurons in the mouse dentate gyrus during aging. Result In normal mice, there was an age-related loss of CR positive cells in the dentate gyrus. At the same region, there was no significant decrease of total numbers of neurons, which suggested that age-related loss of CR positive cells was due to the decrease of CR expression in these cells instead of cell death. In the transgenic mouse line over-expressing Bcl-2 in neurons, there was an age-related loss of CR positive cells. Interestingly, there was also an age-related neuronal loss in this transgenic mouse line. Conclusion These data suggest an age-related loss of CR positive neurons but not total neuronal loss in normal mice and this age-related neuronal change is not prevented by Bcl-2 over-expression.

  3. Virgin Coconut Oil Prevents Blood Pressure Elevation and Improves Endothelial Functions in Rats Fed with Repeatedly Heated Palm Oil

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    Badlishah Sham Nurul-Iman

    2013-01-01

    Full Text Available This study was performed to explore the effects of virgin coconut oil (VCO in male rats that were fed with repeatedly heated palm oil on blood pressure, plasma nitric oxide level, and vascular reactivity. Thirty-two male Sprague-Dawley rats were divided into four groups: (i control (basal diet, (ii VCO (1.42 mL/kg, oral, (iii five-times-heated palm oil (15% (5HPO, and (iv five-times-heated palm oil (15% and VCO (1.42 mL/kg, oral (5HPO + VCO. Blood pressure was significantly increased in the group that was given the 5HPO diet compared to the control group. Blood pressure in the 5HPO + VCO group was significantly lower than the 5HPO group. Plasma nitric oxide (NO level in the 5HPO group was significantly lower compared to the control group, whereas in the 5HPO + VCO group, the plasma NO level was significantly higher compared to the 5HPO group. Aortic rings from the 5HPO group exhibited attenuated relaxation in response to acetylcholine and sodium nitroprusside as well as increased vasoconstriction to phenylephrine compared to the control group. Aortic rings from the 5HPO + VCO group showed only attenuated vasoconstriction to phenylephrine compared to the 5HPO group. In conclusion, VCO prevents blood pressure elevation and improves endothelial functions in rats fed with repeatedly heated palm oil.

  4. Topical fibrin sealant versus intravenous tranexamic acid for reducing blood loss following total knee arthroplasty: A systematic review and meta-analysis.

    Science.gov (United States)

    Gao, Fuqiang; Ma, Jinhui; Sun, Wei; Guo, Wanshou; Li, Zirong; Wang, Weiguo

    2016-08-01

    Efficacy and safety of topical application of a fibrin sealant (FS) compared with intravenous administration of tranexamic acid (TXA) for reducing blood loss after total knee arthroplasty (TKA) is controversial. We undertook a meta-analysis to compare the effects of topical application of FS or intravenous administration of TXA on blood loss after TKA. PubMed, Medline, Embase, Web of Science and the Cochrane Library were searched to identify studies comparing FS with TXA for TKA patients. The mean difference (MD) of blood loss, hemoglobin value, and odds ratios (ORs) of transfusion requirements and adverse events in FS and TXA groups were pooled throughout the study. Relevant data were analyzed using RevMan v5.3. Five studies involving 359 patients were included (181 FS vs. 178 TXA). TXA use had a significantly lower prevalence of blood transfusion (OR = 3.14; 95% confidence interval (CI), 1.67 to 5.90, P = 0.0004) and higher hemoglobin level (MD = -1.23; 95% CI, -2.19 to -0.27, P = 0.01) than FS in the early postoperative period. No significant difference was seen in total blood loss between the two groups (MD = 198.06; 95% CI, -267.45 to 663.57; P = 0.40). There were no significant differences in adverse events, superficial infections, or deep-vein thrombosis among study groups. Our meta-analysis suggests that intravenous administration of TXA for patients undergoing TKA may reduce blood-transfusion requirements and maintain higher hemoglobin levels compared with topical application of FS in the early postoperative period. There were no significant differences in total calculated blood loss and prevalence of complications between the two groups. However, owing to the variation of included studies, no firm conclusions can be drawn. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  5. Changes in glucose-elicited blood metabolite responses following weight loss and long term weight maintenance in obese individuals with impaired glucose tolerance.

    Science.gov (United States)

    Geidenstam, Nina; Danielsson, Anders P H; Spégel, Peter; Ridderstråle, Martin

    2016-03-01

    Weight loss improves insulin sensitivity and glucose tolerance in obese subjects with impaired glucose tolerance (IGT), but the long term dynamic effects on blood metabolites other than glucose during an oral glucose tolerance test (OGTT), are largely unknown. Here, we studied changes in OGTT-elicited metabolite patterns in obese subjects during a diet-induced weight loss study. Blood samples from 14 obese individuals with IGT were collected at 0, 30 and 120 min during a standard 75 g OGTT at baseline (BMI 44 ± 2 kg/m(2)), after weight loss (BMI 36 ± 2 kg/m(2)) and after weight maintenance (BMI 35 ± 2 kg/m(2)). Serum metabolite levels were analyzed by gas chromatography/mass spectrometry and compared to a lean glucose tolerant group. Changes in the OGTT-elicited metabolite patterns occurred differentially during weight loss and weight maintenance. Enhanced suppression of aromatic amino acids were associated with decreased insulinogenic index observed after weight loss (tyrosine: r=0.72, p=0.013; phenylalanine: r=0.63, p=0.039). The OGTT-elicited suppression and/or lack of increase in levels of glutamate, glutamine, isoleucine, leucine, and the fatty acids laurate, oleate and palmitate, improved towards the lean profile after weight maintenance, paralleling an improvement in glucose tolerance. The greater heterogeneity in the response before and after weight loss in the obese, compared to lean subjects, was markedly reduced after weight maintenance. Diet-induced weight loss followed by weight maintenance results in changes in metabolite profiles associated with either hepatic insulin sensitivity or peripheral glucose tolerance. Our results highlight the importance of evaluating the effects of weight loss and weight maintenance separately. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. A study of the blood flow restriction pressure of a tourniquet system to facilitate development of a system that can prevent musculoskeletal complications.

    Science.gov (United States)

    Maeda, Hiroyuki; Iwase, Hideaki; Kanda, Akio; Morohashi, Itaru; Kaneko, Kazuo; Maeda, Mutsuhiro; Kakinuma, Yuki; Takei, Yusuke; Amemiya, Shota; Mitsui, Kazuyuki

    2017-01-01

    After an emergency or disaster, subsequent trauma can cause severe bleeding and this can often prove fatal, so promptly stopping that bleeding is crucial to preventing avoidable trauma deaths. A tourniquet is often used to restrict blood flow to an extremity. In operation and hospital, the tourniquet systems currently in use are pneumatically actuated by an air compressor, so they must have a steady power supply. These devices have several drawbacks: they vibrate and are noisy since they are pneumatically actuated and they are far from portable since they are large and heavy. Presumably, the drawbacks of pneumatic tourniquets could be overcome by developing a small, lightweight, vibration-free, quiet, and battery-powered tourniquet system. The current study built a small, vibration-free electrohydrodynamic (EHD) pump and then used that pump to restrict blood flow to the leg of rats in an experiment. This study explored the optimal conditions for effective restriction of blood flow by assessing biochemical and musculoskeletal complications following the restriction of blood flow, and this study also examined whether or not an EHD pump could be used to actuate a tourniquet system. A tourniquet cuff (width 12 mm × length 150 mm, material: polyolefin) was placed on the thigh of Wistar rats and pressure was applied for 2 hours by a device that uses EHD phenomena to generate pressure (an EHD pump). Animals were divided into four groups based on how much compressive pressure was applied with a tourniquet: 40 kPa (300 mm Hg, n = 13), 30 kPa (225 mm Hg, n = 12), 20 kPa (150 mm Hg, n = 15), or 0 kPa (controls, n = 25). Tissue oxygen saturation (regional oxygen saturation, denoted here as rSO 2 ) was measured to assess the restriction of blood flow. To assess behavior once blood flow resumed, animal activity was monitored for third day and the amount of movement was counted with digital counters. Body weight was measured before and after the behavioral experiment, and

  7. Evidence for the prevention of bone loss in elderly and old early non-metastatic breast cancer patients treated with aromatase inhibitors

    DEFF Research Database (Denmark)

    Gunmalm, V.; Jørgensen, N. R.; Abrahamsen, B.

    2017-01-01

    Breast cancer (BC) is the most common cancer amongst women worldwide. Bone health is emerging as an important issue for BC survivors. In this literature study, we focus on agents for preventing bone loss in early non-metastatic estrogen receptor positive BC in treatment with aromatase inhibitors...... (AI) and to assess the evidence for antiresorptive treatment of bone loss in early non-metastatic breast cancer. We included randomized controlled trials (RCT's) comparing: (a) bisphosphonates and control; (b) different bisphosphonates; (c) denosumab and control and (d) bisphosphonates vs. denosumab...... in early non-metastatic BC women in AI treatment. Among antiresorptives, zoledronic acid currently has the highest evidence for prevention of AI associated bone loss in early non-metastatic BC. Data on fracture prevention among all patients, elderly and old is sparse. More randomized controlled studies...

  8. Human albumin prevents 6-hydroxydopamine-induced loss of tyrosine hydroxylase in in vitro and in vivo.

    Directory of Open Access Journals (Sweden)

    Li-Juan Zhang

    Full Text Available Human albumin has recently been demonstrated to protect brain neurons from injury in rat ischemic brain. However, there is no information available about whether human albumin can prevent loss of tyrosine hydroxylase (TH expression of dopaminergic (DA neurons induced by 6-hydroxydopamine (6-OHDA toxicity that is most commonly used to create a rat model of Parkinson's disease (PD. In the present study, two microliters of 1.25% human albumin were stereotaxically injected into the right striatum of rats one day before or 7 days after the 6-OHDA lesion in the same side. D-Amphetamine-induced rotational asymmetry was measured 7 days, 3 and 10 weeks after 6-OHDA lesion. We observed that intrastriatal administration of human albumin significantly reduced the degree of rotational asymmetry. The number of TH-immunoreactive neurons present in the substantia nigra was greater in 6-OHDA lesioned rats following human albumin-treatment than non-human albumin treatment. TH-immunoreactivity in the 6-OHDA-lesioned striatum was also significantly increased in the human albumin-treated rats. To examine the mechanisms underlying the effects of human albumin, we challenged PC12 cells with 6-OHDA as an in vitro model of PD. Incubation with human albumin prevented 6-OHDA-induced reduction of cell viability in PC12 cell cultures, as measured by MTT assay. Furthermore, human albumin reduced 6-OHDA-induced formation of reactive oxygen species (ROS and apoptosis in cultured PC12 cells, as assessed by flow cytometry. Western blot analysis showed that human albumin inhibited 6-OHDA-induced activation of JNK, c-Jun, ERK, and p38 mitogen-activated protein kinases (MAPK signaling in PC12 cultures challenged with 6-OHDA. Human albumin may protect against 6-OHDA toxicity by influencing MAPK pathway followed by anti-ROS formation and anti-apoptosis.

  9. Perioperative warming with a thermal gown prevents maternal temperature loss during elective cesarean section. A randomized clinical trial.

    Science.gov (United States)

    de Bernardis, Ricardo Caio Gracco; Siaulys, Monica Maria; Vieira, Joaquim Edson; Mathias, Lígia Andrade Silva Telles

    2016-01-01

    Decrease in body temperature is common during general and regional anesthesia. Forced-air warming intraoperative during cesarean section under spinal anesthesia seems not able to prevent it. The hypothesis considers that active warming before the intraoperative period avoids temperature loss during cesarean. Forty healthy pregnant patients undergoing elective cesarean section with spinal anesthesia received active warming from a thermal gown in the preoperative care unit 30min before spinal anesthesia and during surgery (Go, n=20), or no active warming at any time (Ct, n=20). After induction of spinal anesthesia, the thermal gown was replaced over the chest and upper limbs and maintained throughout study. Room temperature, hemoglobin saturation, heart rate, arterial pressure, and tympanic body temperature were registered 30min before (baseline) spinal anesthesia, right after it (time zero) and every 15min thereafter. There was no difference for temperature at baseline, but they were significant throughout the study (p<0.0001; repeated measure ANCOVA). Tympanic temperature baseline was 36.6±0.3°C, measured 36.5±0.3°C at time zero and reached 36.1±0.2°C for gown group, while control group had baseline temperature of 36.4±0.4°C, measured 36.3±0.3°C at time zero and reached 35.4±0.4°C (F=32.53; 95% CI 0.45-0.86; p<0.001). Hemodynamics did not differ throughout the study for both groups of patients. Active warming 30min before spinal anesthesia and during surgery prevented a fall in body temperature in full-term pregnant women during elective cesarean delivery. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  10. [Perioperative warming with a thermal gown prevents maternal temperature loss during elective cesarean section. A randomized clinical trial].

    Science.gov (United States)

    Bernardis, Ricardo Caio Gracco de; Siaulys, Monica Maria; Vieira, Joaquim Edson; Mathias, Lígia Andrade Silva Telles

    2016-01-01

    Decrease in body temperature is common during general and regional anesthesia. Forced-air warming intraoperative during cesarean section under spinal anesthesia seems not able to prevent it. The hypothesis considers that active warming before the intraoperative period avoids temperature loss during cesarean. Forty healthy pregnant patients undergoing elective cesarean section with spinal anesthesia received active warming from a thermal gown in the preoperative care unit 30min before spinal anesthesia and during surgery (Go, n=20), or no active warming at any time (Ct, n=20). After induction of spinal anesthesia, the thermal gown was replaced over the chest and upper limbs and maintained throughout study. Room temperature, hemoglobin saturation, heart rate, arterial pressure, and tympanic body temperature were registered 30min before (baseline) spinal anesthesia, right after it (time zero) and every 15min thereafter. There was no difference for temperature at baseline, but they were significant throughout the study (p<0.0001; repeated measure ANCOVA). Tympanic temperature baseline was 36.6±0.3°C, measured 36.5±0.3°C at time zero and reached 36.1±0.2°C for gown group, while control group had baseline temperature of 36.4±0.4°C, measured 36.3±0.3°C at time zero and reached 35.4±0.4°C (F=32.53; 95% CI 0.45-0.86; p<0.001). Hemodynamics did not differ throughout the study for both groups of patients. Active warming 30min before spinal anesthesia and during surgery prevented a fall in body temperature in full-term pregnant women during elective cesarean delivery. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  11. Human Albumin Prevents 6-Hydroxydopamine-Induced Loss of Tyrosine Hydroxylase in In Vitro and In Vivo

    Science.gov (United States)

    Zhang, Li-Juan; Xue, Yue-Qiang; Yang, Chun; Yang, Wei-Hua; Chen, Long; Zhang, Qian-Jin; Qu, Ting-Yu; Huang, Shile; Zhao, Li-Ru; Wang, Xiao-Min; Duan, Wei-Ming

    2012-01-01

    Human albumin has recently been demonstrated to protect brain neurons from injury in rat ischemic brain. However, there is no information available about whether human albumin can prevent loss of tyrosine hydroxylase (TH) expression of dopaminergic (DA) neurons induced by 6-hydroxydopamine (6-OHDA) toxicity that is most commonly used to create a rat model of Parkinson's disease (PD). In the present study, two microliters of 1.25% human albumin were stereotaxically injected into the right striatum of rats one day before or 7 days after the 6-OHDA lesion in the same side. D-Amphetamine-induced rotational asymmetry was measured 7 days, 3 and 10 weeks after 6-OHDA lesion. We observed that intrastriatal administration of human albumin significantly reduced the degree of rotational asymmetry. The number of TH-immunoreactive neurons present in the substantia nigra was greater in 6-OHDA lesioned rats following human albumin-treatment than non-human albumin treatment. TH-immunoreactivity in the 6-OHDA-lesioned striatum was also significantly increased in the human albumin-treated rats. To examine the mechanisms underlying the effects of human albumin, we challenged PC12 cells with 6-OHDA as an in vitro model of PD. Incubation with human albumin prevented 6-OHDA-induced reduction of cell viability in PC12 cell cultures, as measured by MTT assay. Furthermore, human albumin reduced 6-OHDA-induced formation of reactive oxygen species (ROS) and apoptosis in cultured PC12 cells, as assessed by flow cytometry. Western blot analysis showed that human albumin inhibited 6-OHDA-induced activation of JNK, c-Jun, ERK, and p38 mitogen-activated protein kinases (MAPK) signaling in PC12 cultures challenged with 6-OHDA. Human albumin may protect against 6-OHDA toxicity by influencing MAPK pathway followed by anti-ROS formation and anti-apoptosis. PMID:22815976

  12. Lipoxin A4 suppresses osteoclastogenesis in RAW264.7 cells and prevents ovariectomy-induced bone loss

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Changyu; Guan, Hanfeng; Cai, Cong; Li, Feng, E-mail: lifengmd@hust.edu.cn; Xiao, Jun, E-mail: jun_xiao@hust.edu.cn

    2017-03-15

    Lipoxin A4 (LXA4; 5S, 6R, 15Strihydroxy- 7,9,13-trans-11-eicosatetraenoic acid) is a metabolic product of arachidonic acid under the action of lipoxidase. This lipid molecule plays important roles in several biological functions, especially inflammatory processes. In vivo, LXA4 regulates the inflammatory response through several signaling pathways. Its mechanism suggests that it might have an effect on osteoclastogenesis and bone loss. Using both in vitro and in vivo studies, it was here observed that LXA4 could significantly inhibit the formation and function of osteoclasts and these effects could be blocked by Boc-2, the specific inhibitor of FPR2/ALX (the receptor of LXA4). Meanwhile, LXA4 reduce the amount of ovariectomy-induced bone loss. These protective effects was found to be associated with inhibition of nuclear factor-κB (NF-κB), activator protein-1 (AP-1), PI3K-AKT, and p-38, ERK, and JNK in MAPKs. The expression of the receptor activator of the NF-κB ligand RANKL:osteoprotegerin ratio and serum levels of TNF-α, IL-1β, and IL-6 were decreased by LXA4. Moreover, LXA4 prevented the production of reactive oxygen species (ROS), the expression of osteoclast-specific genes, including tartrate-resistant acid phosphatase (TRAP), cathepsin K (CK), matrix metalloproteinase (MMP)-9, RANK, and osteoclastic related transcription factors of c-Fos, NFATc1 could also be significantly inhibited by LXA4 in a dose-dependent manner. Studies have demonstrated that LXA4 can inhibit the formation and function of osteoclasts through modulation of several pathways both upstream and downstream of RANKL signaling and FPR2/ALX was involved in the procedures. This shows that LXA4 may be used as a new strategy for the treatment of osteoclast-related diseases. - Highlights: • Lipoxin A4 can significantly inhibit the formation and function of osteoclasts. • Several pathways both upstream and downstream of RANKL signaling can be inhibit by Lipoxin A4. • Lipoxin A4 can

  13. T cell-mediated increased osteoclast formation from peripheral blood as a mechanism for crohn's disease-associated bone loss

    NARCIS (Netherlands)

    Oostlander, A.E.; Everts, V.; Schoenmaker, T.; Bravenboer, N.; van Vliet, S.J.; van Bodegraven, A.A.; Lips, P.; de Vries, T.J.

    2012-01-01

    The pathophysiology of osteoporosis in patients with Crohn's disease (CD) is still not completely elucidated. In this study, we evaluated osteoclastogenesis from peripheral blood cells of CD patients and studied the role of lymphocytes and inflammatory cytokines in this process. Peripheral blood

  14. Ultraviolet blood irradiation in acute exogeneus poisoming for the prevention and treatment of pneumonia

    International Nuclear Information System (INIS)

    Gol'dfarb, Yu.S.; Glukhovskaya, N.Ya.; Shirinova, M.N.; Burykina, I.A.; Potskhveliya, M.M.

    1987-01-01

    Possibility of therapeutic application of UV irradiation (UVI) of blood and the mechanism of its medical effect has been studied in 111 patients with intoxication by psychotropic drugs and organic phosphorus insecticides with poisonings by cautering substances and by alcohol in patients with pneumonia. UVI has been carried out by means of MD-73M ''Izol'da'' device with the DRB-8 mercury lamp. The procedure permits to reduce lethality and cases of pneumonia development more than two times as well as to decrease periods of treatment. To achieve the best effect, the radiation energy should be not less than 100 J and not more than 15 J. Early application (in 1-2 days before poisoning or pneumonia development) of UVI in 100-150 J dose per a period of treatment is most effective. It is established that the mechanism of medical UVI effect in blood is mainly related to stimulation of a cell unit of immunity as well as to improvement of rheologic properties of blood and a qualitative composition of erythrocytes, that favours the strengthening of redox and desintoxication processes in an organism

  15. The efficiency and safety of fibrin sealant for reducing blood loss in primary total hip arthroplasty: A systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Zhiyuan; Xiao, Lin; Guo, Hao; Zhao, Guanghui; Ma, Jianbing

    2017-01-01

    Total hip arthroplasty (THA) is associated with substantial blood loss. The objective of present systematic review and meta-analysis is to provide evidence from randomized controlled trials (RCTs) on the efficiency and safety of administration of fibrin sealant (FS) for reducing blood loss in patients undergoing primary THA. Potential relevant studies were identified from electronic databases including Medline, PubMed, Embase, ScienceDirect, web of science and Cochrane Library. Gray academic studies were also identified from the reference list of included studies. There was no language restriction. Pooling of data was carried out by using RevMan 5.1. Six randomized controlled trials (RCTs) met the inclusion criteria. Current meta-analysis indicated that there were significant differences in terms of total blood loss (MD = -153.77, 95% CI: -287.21 to -20.34, P = 0.02), postoperative hemoglobin level (MD = -0.25, 95% CI: -0.46 to -0.05, P = 0.02) and transfusion rate (RD = -0.12, 95% CI: -0.22 to -0.03, P = 0.01) between groups. No significant differences were found regarding the incidence of deep venous thrombosis (DVT) (RD = 0.00, 95% CI: -0.01to 0.01, P = 0.51) or other side effects. Administration of fibrin sealant in total hip arthroplasty may reduce total blood loss, postoperative hemoglobin decline and transfusion requirements. Moreover, no adverse effect was related to FS. Due to the limited quality of the evidence currently available, higher quality RCTs are required. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  16. Tranexamic Acid Safely Reduced Blood Loss in Hemi- and Total Hip Arthroplasty for Acute Femoral Neck Fracture: A Randomized Clinical Trial.

    Science.gov (United States)

    Watts, Chad D; Houdek, Matthew T; Sems, S Andrew; Cross, William W; Pagnano, Mark W

    2017-07-01

    We aimed to determine whether (1) tranexamic acid (TXA) reduces the incidence of transfusion (2) TXA reduces the calculated blood loss, and (3) there are any observable differences in 30- and 90-day complications with TXA administration during arthroplasty for femoral neck fracture (FNF). Prospective, double-blinded, randomized controlled trial. Level 1 Academic Trauma Center. One hundred thirty-eight patients who presented with a low-energy, isolated, FNF (AO 31B) treated with either hemi- or total hip arthroplasty within 72 hours of injury were randomized to either the TXA group (69 patients) or placebo group (69 patients). In the TXA group, patients received 2 doses of 15 mg/kg intravenous TXA dissolved in 100 mL of saline, each administered over 10 minutes; 1 dose just before incision, and the second at wound closure. In the placebo group, 100 mL of saline solution was administered in a similar fashion. Perioperative care was otherwise standardized including conservative transfusion criteria. Our primary outcome was to determine the proportion of patients who underwent blood transfusion during hospitalization. Secondary outcomes were calculated blood loss, number of units transfused during hospitalization, and incidence of adverse events at 30 and 90 days including thromboembolic event, wound complications, reoperation, hospital readmission, and all-cause mortality. TXA reduced mean incidence of transfusion by 305 mL (P = 0.0005). There was a trend toward decreased transfusion rate in the TXA group (17% vs. 26%, P = 0.22). TXA was safe with no differences in adverse events at 30 and 90 days. This randomized clinical trial found that TXA administration safely reduced blood loss with a tendency for decreased transfusion rate and total blood product consumption for patients undergoing hip arthroplasty for acute FNF. More studies are needed to further ascertain the role of TXA in the management of patients with FNF. Therapeutic Level I. See Instructions for Authors

  17. The effect of different dosage regimens of tranexamic acid on blood loss in bimaxillary osteotomy: a randomized, double-blind, placebo-controlled study.

    Science.gov (United States)

    Apipan, B; Rummasak, D; Narainthonsaenee, T

    2018-05-01

    The purpose of this study was to compare the effects of three dosage regimens of intravenous tranexamic acid and normal saline placebo on blood loss and the requirement for transfusion during bimaxillary osteotomy. A prospective, randomized, double-blind, placebo-controlled study was performed. Eighty patients scheduled for elective bimaxillary osteotomy were divided into four groups: a placebo group and three groups receiving a single dose of tranexamic acid 10, 15, or 20mg/kg body weight after the induction of anaesthesia. Demographic data, the anaesthetic time, the operative time, and the experience of the surgical team were similar in the four groups. Patients receiving placebo had increased blood loss compared to those receiving tranexamic acid. No significant difference in blood loss was found among those who received 10, 15, or 20mg/kg body weight of tranexamic acid. There was no significant difference in transfusion requirement, amount of 24-h postoperative vacuum drainage, length of hospital stay, or complications among the four groups. Prophylactic tranexamic acid decreased bleeding during bimaxillary osteotomy. Of the three dosages of tranexamic acid studied, the most efficacious and cost-effective dose to reduce bleeding was 10mg/kg body weight. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Effects of a new mild shampoo for preventing hair loss in Asian by a simple hand-held phototrichogram technique.

    Science.gov (United States)

    Baek, J H; Lee, S Y; Yoo, M; Park, W-S; Lee, S J; Boo, Y C; Koh, J-S

    2011-12-01

    This study was conducted to evaluate the effects of a commercially available shampoo in Korean subjects with alopecia using a simple hand-held phototrichogram technique. Forty-four subjects with alopecia were enrolled and forty subjects continued for 16 weeks. In the test group, total hair counts increased significantly at weeks 8 and 16, and the number of shedding hair significantly decreased at week 16. Terminal hair counts significantly increased at week 8. In the control group, hair thickness and the number of vellus hairs significantly decreased at week 16. The number of total hairs significantly increased in the test group than in the control group at weeks 8 and 16. The number of shedding hairs significantly decreased in the test group than in the control group at week 16. Visual assessment using clinical digital images showed that the number of total hairs appeared to increase although there was no statistical significance. In this study, it was found that the test shampoo could prevent hair loss. © 2011 DERMAPRO Co Ltd. ICS © 2011 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

  19. Prevention of postmenopausal bone loss - effects of alternative administration forms of estrogens, alternative gestagens and calcium addition

    Energy Technology Data Exchange (ETDEWEB)

    Riis, B.J.; Christiansen, C.

    1987-02-01

    Calcium metabolism was examined in 133 healthy postmenopausal women every three months during two years of treatment with oral or percutaneous 17..beta..-estradiol combined with different doses of calcium supplementation and/or different gestagens. Bone mineral content measured in the forearm (single photon absorptiometry), in the spine and in the total skeleton (dual photon absorptiometry) was unchanged in all estrogen-treated groups during the two years of treatment, and the responses in the groups with and without calcium supplementation and with different gestagens were not significantly different. Furthermore, the responses were independent of route of administration of the estrogen. Biochemical indices of bone turnover (serum alkaline phosphatase and fasting urinary hydroxyproline/creatinine) decreased highly significantly during estrogen treatment (p<0.001) independent of route of administration of the estrogen, of calcium supplementation, and of gestagen agent. We conclude that estrogen treatment independently of route of administration, prevents postmenopausal bone loss. The gestagen agents used here do not affect calcium metabolism, and calcium supplementation has no additive effect to estrogen therapy.

  20. The bisphosphonate zoledronate prevents vertebral bone loss in mature estrogen-deficient rats as assessed by micro-computed tomography

    Directory of Open Access Journals (Sweden)

    Glatt M.

    2001-01-01

    Full Text Available The effect of long-term treatment with the bisphosphonate zoledronate on vertebral bone architecture was investigated in estrogen-deficient mature rats. 4-month-old rats were ovariectomized and development of cancellous osteopenia was assessed after 1 year. The change of bone architectural parameters was determined with a microtomographic instrument of high resolution. After 1 year of estrogen-deficiency, animals lost 55% of vertebral trabecular bone in comparison to sham operated control animals. Trabecular number (Tb.N and trabecular thickness (Tb.Th were significantly reduced in ovariectomized animals, whereas trabecular separation (Tb.Sp, bone surface to volume fraction (BS/BV and trabecular bone pattern factor (TBPf were significantly increased, indicating a loss of architectural integrity throughout the vertebral body. 3 groups of animals were treated subcutaneously with zoledronate for 1 year with 0.3, 1.5 and 7.5 microgram/kg/week to inhibit osteoclastic bone degradation. Administration started immediately after ovariectomy and treatment dose-dependently prevented the architectural bone deterioration and completely suppressed the effects of estrogen deficiency at the higher doses. The results show that microtomographic determination of static morphometric parameters can be used to quantitate the effects of drugs on vertebral bone architecture in small laboratory animals and that zoledronate is highly effective in this rat model.

  1. Grape juice concentrate prevents oxidative DNA damage in peripheral blood cells of rats subjected to a high-cholesterol diet.

    Science.gov (United States)

    Aguiar, Odair; Gollücke, Andréa Pittelli Boiago; de Moraes, Bárbara Bueno; Pasquini, Gabriela; Catharino, Rodrigo Ramos; Riccio, Maria Francesca; Ihara, Silvia Saiuli Miki; Ribeiro, Daniel Araki

    2011-03-01

    The goal of the present study was to investigate whether subchronic treatment with grape juice concentrate is able to protect liver and peripheral blood cells against cholesterol-induced injury in rats. The effects of the grape juice concentrate treatment on histopathological changes, immunohistochemistry for cyclo-oxygenase-2 (COX-2), and basal and oxidative DNA damage induced by H2O2 using a single-cell gel (comet) assay were evaluated. Male Wistar rats (n 18) were divided into three groups: group 1--negative control; group 2--cholesterol at 1 % (w/w) in their diet, treated for 5 weeks; group 3--cholesterol at 1 % in their chow, treated for 5 weeks, and grape juice concentrate at 222 mg/d in their drinking-water in the final week only. The results indicated that the treatment with grape juice concentrate did not show remarkable differences regarding liver tissue in group 3 compared with group 2. However, grape juice concentrate was able to decrease oxidative DNA damage induced by H2O2 in peripheral blood cells, as depicted by the tail moment results. COX-2 expression in the liver did not show statistically significant differences (P>0·05) between groups. Taken together, the present results suggest that the administration of subchronic grape juice concentrate prevents oxidative DNA damage in peripheral blood cells.

  2. Blood loss predictive factors and transfusion practice during percutaneous nephrolithotomy of kidney stones: a prospective study [version 1; referees: 1 approved, 2 approved with reservations

    Directory of Open Access Journals (Sweden)

    Firtantyo Adi Syahputra

    2016-06-01

    Full Text Available Objectives Bleeding is the most common complication of percutaneous nephrolithotomy (PCNL. Injudicious transfusion is frequently performed in current practice, even though it is not always needed. This study aimed to identify the predictive factors of blood loss in the PCNL procedure and evaluate the perioperative transfusion practice.   Methods A prospective study of PCNL was randomly performed by two consultants of endo-urology at our institution. The inclusion criteria were adults with kidney pelvic stones >20 mm or stone in inferior calyx >10 mm or staghorn stone. Those with coagulopathy, under anti-coagulant treatment or open conversion were excluded. A full blood count was taken at baseline and during 12, 24, 36, 72-hours post-operatively. Factors such as stone burden, sex, body surface area, shifting of hematocrit level and amount of blood transfused were analyzed statistically using line regression to identify the predictive factors of total blood loss (TBL.   Results Eighty-five patients were enrolled in this study. Mean TBL was 560.92 ± 428.43 mL for both endo-urology surgeons. Stone burden was the most influential factor for TBL (p=0.037. Our results revealed that TBL (mL = -153.379 + 0.229 × stone burden (mm2 + 0.203 x baseline serum hematocrit (%; thus considerably predicted the need for blood transfusion. A total of 87.1% patients did not receive perioperative transfusion, 3.5% received intra-operative transfusion, 7.1% received post-operative transfusion, 23% had both intra and post-operative transfusion, resulting in a cross-matched transfusion ratio of 7.72. Mean perioperative blood transfused was 356.00 ± 145.88 mL.

  3. Blood Stem Cell Activity Is Arrested by Th1-Mediated Injury Preventing Engraftment following Nonmyeloablative Conditioning

    Science.gov (United States)

    Florek, Mareike; Kohrt, Holbrook E. K.; Küpper, Natascha J.; Filatenkov, Alexander; Linderman, Jessica A.; Hadeiba, Husein; Negrin, Robert S.

    2016-01-01

    T cells are widely used to promote engraftment of hematopoietic stem cells (HSCs) during an allogeneic hematopoietic cell transplantation. Their role in overcoming barriers to HSC engraftment is thought to be particularly critical when patients receive reduced doses of preparative chemotherapy and/or radiation compared with standard transplantations. In this study, we sought to delineate the effects CD4+ cells on engraftment and blood formation in a model that simulates clinical hematopoietic cell transplantation by transplanting MHC-matched, minor histocompatibility–mismatched grafts composed of purified HSCs, HSCs plus bulk T cells, or HSCs plus T cell subsets into mice conditioned with low-dose irradiation. Grafts containing conventional CD4+ T cells caused marrow inflammation and inhibited HSC engraftment and blood formation. Posttransplantation, the marrows of HSCs plus CD4+ cell recipients contained IL-12–secreting CD11c+ cells and IFN-γ–expressing donor Th1 cells. In this setting, host HSCs arrested at the short-term stem cell stage and remained in the marrow in a quiescent cell cycling state (G0). As a consequence, donor HSCs failed to engraft and hematopoiesis was suppressed. Our data show that Th1 cells included in a hematopoietic allograft can negatively impact HSC activity, blood reconstitution, and engraftment of donor HSCs. This potential negative effect of donor T cells is not considered in clinical transplantation in which bulk T cells are transplanted. Our findings shed new light on the effects of CD4+ T cells on HSC biology and are applicable to other pathogenic states in which immune activation in the bone marrow occurs such as aplastic anemia and certain infectious conditions. PMID:27815446

  4. Cytokine-Mediated Loss of Blood Dendritic Cells During Epstein-Barr Virus-Associated Acute Infectious Mononucleosis: Implication for Immune Dysregulation.

    Science.gov (United States)

    Panikkar, Archana; Smith, Corey; Hislop, Andrew; Tellam, Nick; Dasari, Vijayendra; Hogquist, Kristin A; Wykes, Michelle; Moss, Denis J; Rickinson, Alan; Balfour, Henry H; Khanna, Rajiv

    2015-12-15

    Acute infectious mononucleosis (IM) is associated with altered expression of inflammatory cytokines and disturbed T-cell homeostasis, however, the precise mechanism of this immune dysregulation remains unresolved. In the current study we demonstrated a significant loss of circulating myeloid and plasmacytoid dendritic cells (DCs) during acute IM, a loss correlated with the severity of clinical symptoms. In vitro exposure of blood DCs to acute IM plasma resulted in loss of plasmacytoid DCs, and further studies with individual cytokines showed that exposure to interleukin 10 could replicate this effect. Our data provide important mechanistic insight into dysregulated immune homeostasis during acute IM. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  5. Hypotensive anesthesia: Comparing the effects of different drug combinations on mean arterial pressure, estimated blood loss, and surgery time in orthognathic surgery.

    Science.gov (United States)

    Jeong, James; Portnof, Jason E; Kalayeh, Mona; Hardigan, Patrick

    2016-07-01

    Sevoflurane, an inhalational hypotensive anesthetic agent with a vasodilatory property, has been commonly used as a single agent to induce hypotension and effectively decrease blood loss in orthognathic surgery. However, it is common for patients to receive other hypotensive anesthetic agents in combination with sevoflurane. The purpose of our retrospective cohort study is to investigate whether administering an additional hypotensive agent has greater effect at reducing mean arterial pressure (MAP), estimated blood loss (EBL) and surgery time during orthognathic surgery. 57 subjects, aged 0-89 of both genders, who underwent orthognathic surgery were investigated in this study. Each patient's anesthesia records were reviewed to record the following variables of interest: EBL, duration of surgery, and MAP reduction in %. 41 subjects were placed in Group I and they received sevoflurane alone. 16 subjects were placed in Group II and they received sevoflurane plus a "supportive" agent. These "supportive" agents were esmolol, labetalol, metoprolol, nicardipine, and dexmedetomidine. The significant differences between two groups were assessed by using ANCOVA and p surgery time. Subjects in Group II experienced a greater reduction in MAP during surgery than subjects in Group I, 27.30% and 20.44%, respectively (p = 0.027). There was no significant difference for sex (p = 0.417) or age group (p = 0.113) in estimated blood loss, however. The mean surgery time in Group I was 1.93, 2.77, and 4.54 h with respect to LeFort, BSSO/IVRO, and double jaw surgery. Patients in Group II had a mean surgery time of 1.73, 2.07, and 5.64 h with respect to LeFort, BSSO/IVRO, and double jaw surgery. No statistically significant difference was demonstrated in surgery time between Group I vs. Group II (p > 0.05). Subjects in Group II experienced, on average, more blood loss than subjects in Group I, 355.50 ml and 238.90 ml, respectively. The use of multi-drug combination may offer

  6. Defining clinically important perioperative blood loss and transfusion for the Standardised Endpoints for Perioperative Medicine (StEP) collaborative: a protocol for a scoping review.

    Science.gov (United States)

    Bartoszko, Justyna; Vorobeichik, Leon; Jayarajah, Mohandas; Karkouti, Keyvan; Klein, Andrew A; Lamy, Andre; Mazer, C David; Murphy, Mike; Richards, Toby; Englesakis, Marina; Myles, Paul S; Wijeysundera, Duminda N

    2017-06-30

    'Standardised Endpoints for Perioperative Medicine' (StEP) is an international collaboration undertaking development of consensus-based consistent definitions for endpoints in perioperative clinical trials. Inconsistency in endpoint definitions can make interpretation of trial results more difficult, especially if conflicting evidence is present. Furthermore, this inconsistency impedes evidence synthesis and meta-analyses. The goals of StEP are to harmonise definitions for clinically meaningful endpoints and specify standards for endpoint reporting in clinical trials. To help inform this endeavour, we aim to conduct a scoping review to systematically characterise the definitions of clinically important endpoints in the existing published literature on perioperative blood loss and transfusion. The scoping review will be conducted using the widely adopted framework developed by Arksey and O'Malley, with modifications from Levac. We refined our methods with guidance from research librarians as well as researchers and clinicians with content expertise. The electronic literature search will involve several databases including Medline, PubMed-not-Medline and Embase. Our review has three objectives, namely to (1) identify definitions of significant blood loss and transfusion used in previously published large perioperative randomised trials; (2) identify previously developed consensus-based definitions for significant blood loss and transfusion in perioperative medicine and related fields; and (3) describe the association between different magnitudes of blood loss and transfusion with postoperative outcomes. The multistage review process for each question will involve two reviewers screening abstracts, reading full-text articles and performing data extraction. The abstracted data will be organised and subsequently analysed in an iterative process. This scoping review of the previously published literature does not require research ethics approval. The results will be used

  7. Impact of donor arm cleaning with different aseptic solutions for prevention of contamination in blood bags.

    Science.gov (United States)

    Patel, Tanvi G; Shukla, Rinku V; Gupte, Snehalata C

    2013-03-01

    Transfusion associated sepsis cases are encountered occasionally and bacterial transmission remains the major cause. The goal of our study was to compare the efficacy of disinfectants in phlebotomy site preparation. After selection of donor the antecubital fossa area of the arm was disinfected with different types of disinfectants namely sprit (70% isopropyl alcohol), povidone iodine (0.5% w/v available iodine in distilled water), savlon (1.5% v/v chlorhexidine gluconate solution and 3.0% cetrimide solution) and combination of sprit and povidone iodine. Swabs were collected from 20 donors using a sterile forceps, after cleaning with different antiseptic solutions. Swab was streaked on blood agar plate aseptically and the plate was incubated at 37°C for 24 h. Colonies were counted and a single colony was re-cultured by growing on nutrient and Mac-Conkey agar. The biochemical characteristics were determined by performing Gram staining, Motility, Catalase and Oxidase tests. The mean values of colonies were significantly higher with savlon compared to other three solutions. The difference was statistically significant by "t" test (t values 1.7-3.0; P bag were aseptically inoculated in aerobic and anaerobic culture bottles to be tested on BacT/Alert system. The bag containing donor's blood did not show any contamination when three cleanings were carried out using sprit, povidone iodine and spirit respectively.

  8. Intracameral air injection during Ahmed glaucoma valve implantation in neovascular glaucoma for the prevention of tube obstruction with blood clot: Case Report.

    Science.gov (United States)

    Hwang, Sung Ha; Yoo, Chungkwon; Kim, Yong Yeon; Lee, Dae Young; Nam, Dong Heun; Lee, Jong Yeon

    2017-12-01

    Glaucoma drainage implant surgery is a treatment option for the management of neovascular glaucoma. However, tube obstruction by blood clot after Ahmed glaucoma valve (AGV) implantation is an unpredictable clinically challenging situation. We report 4 cases using intracameral air injection for the prevention of the tube obstruction of AGV by blood clot. The first case was a 57-year-old female suffering from ocular pain because of a tube obstruction with blood clot after AGV implantation in neovascular glaucoma. Surgical blood clot removal was performed. However, intractable bleeding was noted during the removal of the blood clot, and so intracameral air injection was performed to prevent a recurrent tube obstruction. After the procedure, although blood clots formed around the tube, the tube opening where air could touch remained patent. In 3 cases of neovascular glaucoma with preoperative severe intraocular hemorrhages, intracameral air injection and AGV implantation were performed simultaneously. In all 3 cases, tube openings were patent. It appears that air impeded the blood clots formation in front of the tube opening. Intracameral air injection could be a feasible option to prevent tube obstruction of AGV implant with a blood clot in neovascular glaucoma with high risk of tube obstruction. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  9. Cost-effectiveness of milk powder fortified with potassium to decrease blood pressure and prevent cardiovascular events among the adult population in China: a Markov model.

    Science.gov (United States)

    Dainelli, Livia; Xu, Tingting; Li, Min; Zimmermann, Diane; Fang, Hai; Wu, Yangfeng; Detzel, Patrick

    2017-09-25

    To model the long-term cost-effectiveness of consuming milk powder fortified with potassium to decrease systolic blood pressure (SBP) and prevent cardiovascular events. A best case scenario analysis using a Markov model was conducted. 8.67% of 50-79 year olds who regularly consume milk in China, including individuals with and without a prior diagnosis of hypertension. The model simulated the potential impact of a daily intake of two servings of milk powder fortified with potassium (+700 mg/day) vs the consumption of a milk powder without potassium fortification, assuming a market price equal to 0.99 international dollars (intl$; the consumption of a milk powder without potassium fortification, assuming a market price equal to intl$0.99 for the latter and to intl$1.12 for the first (+13.13%). Both deterministic and probabilistic sensitivity analyses were conducted to test the robustness of the results. Estimates of the incidence of cardiovascular events and subsequent mortality in China were derived from the literature as well as the effect of increasing potassium intake on blood pressure. The incremental cost-effectiveness ratio (ICER) was used to determine the cost-effectiveness of a milk powder fortified with potassium taking into consideration the direct medical costs associated with the cardiovascular events, loss of working days and health utilities impact. With an ICER equal to int$4711.56 per QALY (quality-adjusted life year) in the best case scenario and assuming 100% compliance, the daily consumption of a milk powder fortified with potassium shown to be a cost-effective approach to decrease SBP and reduce cardiovascular events in China. Healthcare savings due to prevention would amount to intl$8.41 billion. Sensitivity analyses showed the robustness of the results. Together with other preventive interventions, the consumption of a milk powder fortified with potassium could represent a cost-effective strategy to attenuate the rapid rise in

  10. N-acetylcysteine prevents nitrosative stress-associated depression of blood pressure and heart rate in streptozotocin diabetic rats.

    Science.gov (United States)

    Nagareddy, Prabhakara Reddy; Xia, Zhengyuan; MacLeod, Kathleen M; McNeill, John H

    2006-04-01

    Previous studies have indicated that cardiovascular abnormalities such as depressed blood pressure and heart rate occur in streptozotocin (STZ) diabetic rats. Chronic diabetes, which is associated with increased expression of inducible nitric oxide synthase (iNOS) and oxidative stress, may produce peroxynitrite/nitrotyrosine and cause nitrosative stress. We hypothesized that nitrosative stress causes cardiovascular depression in STZ diabetic rats and therefore can be corrected by reducing its formation. Control and STZ diabetic rats were treated orally for 9 weeks with N-acetylcysteine (NAC), an antioxidant and inhibitor of iNOS. At termination, the mean arterial blood pressure (MABP) and heart rate (HR) were measured in conscious rats. Nitrotyrosine and endothelial nitric oxide synthase (eNOS) and iNOS expression were assessed in the heart and mesenteric arteries by immunohistochemistry and Western blot experiments. Untreated diabetic rats showed depressed MABP and HR that was prevented by treatment with NAC. In untreated diabetic rats, levels of 15-F(2t)-isoprostane, an indicator of lipid peroxidation increased, whereas plasma nitric oxide and antioxidant concentrations decreased. Furthermore, decreased eNOS and increased iNOS expression were associated with elevated nitrosative stress in blood vessel and heart tissue of untreated diabetic rats. N-acetylcysteine treatment of diabetic rats not only restored the antioxidant capacity but also reduced the expression of iNOS and nitrotyrosine and normalized the expression of eNOS to that of control rats in heart and superior mesenteric arteries. The results suggest that nitrosative stress depress MABP and HR following diabetes. Further studies are required to elucidate the mechanisms involved in nitrosative stress mediated depression of blood pressure and heart rate.

  11. Blood Pressure Reduction and Secondary Stroke Prevention: A Systematic Review and Metaregression Analysis of Randomized Clinical Trials.

    Science.gov (United States)

    Katsanos, Aristeidis H; Filippatou, Angeliki; Manios, Efstathios; Deftereos, Spyridon; Parissis, John; Frogoudaki, Alexandra; Vrettou, Agathi-Rosa; Ikonomidis, Ignatios; Pikilidou, Maria; Kargiotis, Odysseas; Voumvourakis, Konstantinos; Alexandrov, Anne W; Alexandrov, Andrei V; Tsivgoulis, Georgios

    2017-01-01

    Current recommendations do not specifically address the optimal blood pressure (BP) reduction for secondary stroke prevention in patients with previous cerebrovascular events. We conducted a systematic review and metaregression analysis on the association of BP reduction with recurrent stroke and cardiovascular events using data from randomized controlled clinical trials of secondary stroke prevention. For all reported events during each eligible study period, we calculated the corresponding risk ratios to express the comparison of event occurrence risk between patients randomized to antihypertensive treatment and those randomized to placebo. On the basis of the reported BP values, we performed univariate metaregression analyses according to the achieved BP values under the random-effects model (Method of Moments) for those adverse events reported in ≥10 total subgroups of included randomized controlled clinical trials. In pairwise meta-analyses, antihypertensive treatment lowered the risk for recurrent stroke (risk ratio, 0.73; 95% confidence interval, 0.62-0.87; Psecondary stroke prevention. © 2016 American Heart Association, Inc.

  12. The effect of tranexamic acid on blood loss and maternal outcome in the treatment of persistent postpartum hemorrhage: A nationwide retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Ada Gillissen

    Full Text Available Recent results show a protective effect of tranexamic acid on death due to bleeding in patients with postpartum hemorrhage in low- and middle-resource countries. We quantify the association between early administration of tranexamic acid compared to late or no administration and severe acute maternal morbidity and blood loss among women suffering from persistent severe postpartum hemorrhage in a high-income country.We performed a nationwide retrospective cohort study in 61 hospitals in the Netherlands. The study population consisted of 1260 women with persistent postpartum hemorrhage who had received at least four units of red cells, or fresh frozen plasma or platelets in addition to red cells. A review of medical records was performed and cross-referenced with blood bank data. The composite endpoint comprised maternal morbidity (hysterectomy, ligation of the uterine arteries, emergency B-Lynch suture, arterial embolization or admission into an intensive care unit and mortality.247 women received early tranexamic acid treatment. After adjustment for confounding, odds ratio for the composite endpoint for early tranexamic acid (n = 247 versus no/late tranexamic acid (n = 984 was 0.92 (95% confidence interval (CI 0.66 to 1.27. Propensity matched analysis confirmed the absence of a difference between women with and without tranexamic acid. Blood loss after administration of first line therapy did not differ significantly between the two groups (adjusted difference -177 mL, CI -509.4 to +155.0.Our findings suggest that in a high-resource country the effect of tranexamic acid on both blood loss and the combined endpoint of maternal mortality and morbidity may be disappointing.

  13. The effect of tranexamic acid on blood loss and maternal outcome in the treatment of persistent postpartum hemorrhage: A nationwide retrospective cohort study

    Science.gov (United States)

    Henriquez, Dacia D. C. A.; van den Akker, Thomas; Wind, Merlijn; Zwart, Joost J.; van Roosmalen, Jos; Eikenboom, Jeroen; Bloemenkamp, Kitty W. M.; van der Bom, Johanna G.

    2017-01-01

    Background Recent results show a protective effect of tranexamic acid on death due to bleeding in patients with postpartum hemorrhage in low- and middle-resource countries. We quantify the association between early administration of tranexamic acid compared to late or no administration and severe acute maternal morbidity and blood loss among women suffering from persistent severe postpartum hemorrhage in a high-income country. Methods and findings We performed a nationwide retrospective cohort study in 61 hospitals in the Netherlands. The study population consisted of 1260 women with persistent postpartum hemorrhage who had received at least four units of red cells, or fresh frozen plasma or platelets in addition to red cells. A review of medical records was performed and cross-referenced with blood bank data. The composite endpoint comprised maternal morbidity (hysterectomy, ligation of the uterine arteries, emergency B-Lynch suture, arterial embolization or admission into an intensive care unit) and mortality. Results 247 women received early tranexamic acid treatment. After adjustment for confounding, odds ratio for the composite endpoint for early tranexamic acid (n = 247) versus no/late tranexamic acid (n = 984) was 0.92 (95% confidence interval (CI) 0.66 to 1.27). Propensity matched analysis confirmed the absence of a difference between women with and without tranexamic acid. Blood loss after administration of first line therapy did not differ significantly between the two groups (adjusted difference -177 mL, CI -509.4 to +155.0). Conclusions Our findings suggest that in a high-resource country the effect of tranexamic acid on both blood loss and the combined endpoint of maternal mortality and morbidity may be disappointing. PMID:29107951

  14. Blood pressure 1 year after stroke: the need to optimize secondary prevention

    DEFF Research Database (Denmark)

    Hornnes, Nete; Larsen, Klaus; Boysen, Gudrun

    2011-01-01

    Lowering blood pressure (BP) in stroke survivors reduces the risk of recurrent stroke. We tested the hypothesis that a nurse-led nonpharmacologic intervention would lower the BP of participants in an intervention group compared with a control group. A total of 349 patients who had sustained acute...... with antihypertensive therapy, and 92% of the hypertensive patients in the intervention group followed the advice to see a general practitioner (GP) for BP checkups. At follow-up, 187 patients (62%) were hypertensive, with no difference in the rate of hypertension seen between the groups. Our data indicate that home...... visits by nurses did not result in a lowering of BP. Patients complied with antihypertensive therapy and GP visits in the case of hypertension. Nonetheless, the majority of patients were hypertensive at the 1-year follow up....

  15. Comparative effectiveness of a portion-controlled meal replacement program for weight loss in adults with and without diabetes/high blood sugar.

    Science.gov (United States)

    Coleman, C D; Kiel, J R; Mitola, A H; Arterburn, L M

    2017-07-10

    Individuals with type 2 diabetes (DM2) may be less successful at achieving therapeutic weight loss than their counterparts without diabetes. This study compares weight loss in a cohort of adults with DM2 or high blood sugar (D/HBS) to a cohort of adults without D/HBS. All were overweight/obese and following a reduced or low-calorie commercial weight-loss program incorporating meal replacements (MRs) and one-on-one behavioral support. Demographic, weight, body composition, anthropometric, pulse and blood pressure data were collected as part of systematic retrospective chart review studies. Differences between cohorts by D/HBS status were analyzed using Mann-Whitney U-tests and mixed model regression. A total of 816 charts were included (125 with self-reported D/HBS). The cohort with D/HBS had more males (40.8 vs 25.6%), higher BMI (39.0 vs 36.3 kg m - 2 ) and was older (56 vs 48 years). Among clients continuing on program, the cohorts with and without D/HBS lost, on average, 5.6 vs 5.8 kg (NS) (5.0 vs 5.6%; P=0.005) of baseline weight at 4 weeks, 11.0 vs 11.6 kg (NS) (9.9 vs 11.1%; P=0.027) at 12 weeks and 16.3 vs 17.1 kg (13.9 vs 15.7%; NS) at 24 weeks, respectively. In a mixed model regression controlling for baseline weight, gender and meal plan, and an intention-to-treat analysis, there was no significant difference in weight loss between the cohorts at any time point. Over 70% in both cohorts lost ⩾5% of their baseline weight by the final visit on their originally assigned meal plan. Both cohorts had significant reductions from baseline in body fat, blood pressure, pulse and abdominal circumference. Adults who were overweight/obese and with D/HBS following a commercial weight-loss program incorporating MRs and one-on-one behavioral support achieved therapeutic weight loss. The program was equally effective for weight loss and reductions in cardiometabolic risk factors among adults with and without D/HBS.

  16. Prenatal programming of adult mineral metabolism: relevance to blood pressure, dietary prevention strategies, and cardiovascular disease.

    Science.gov (United States)

    Schulter, Günter; Goessler, Walter; Papousek, Ilona

    2012-01-01

    Mounting evidence indicates that adult health outcomes such as the development of cardiovascular disease or diabetes can trace some of their roots back to prenatal development. This study investigated the epigenetic impact of a particular prenatal hormonal condition on specific health-related consequences, i.e., on concentrations of minerals and mineral metabolism in adults. In 70 university students, the second-to-fourth digit length (2D:4D) was measured as a proxy of prenatal sex steroid action, and the concentrations of sodium (Na), potassium (K), magnesium (Mg), and calcium (Ca) were determined in hair samples by inductively coupled plasma-mass spectrometry. Mineral concentrations and the mineral ratios Na/K, Na/Mg, and Na/Ca were analyzed in multivariate analyses of variance, with digit ratios and sex of participants as grouping variables. The results were validated in a replication cohort from the general population, and with a wider age-range. In addition, the correlation of mineral concentrations and mineral ratios with blood pressure was examined. Men with relatively lower (i.e., more masculine) and women with relatively higher (i.e., more feminine) digit ratios had higher Na/K, Na/Mg, and Na/Ca ratios than their counterparts. Virtually identical results were obtained in the replication study. Moreover, Na concentrations and Na/K ratios were significantly correlated with systolic blood pressure. The findings suggest that the individual variation in mineral metabolism can be predicted by 2D:4D, indicating that prenatal sex steroid action may be involved in the epigenetic programming of specific metabolic conditions which are highly relevant to adult health and disease. 2011 Wiley Periodicals, Inc.

  17. Preventing Loss of Independence through Exercise (PLIÉ): qualitative analysis of a clinical trial in older adults with dementia.

    Science.gov (United States)

    Wu, Eveline; Barnes, Deborah E; Ackerman, Sara L; Lee, Jennifer; Chesney, Margaret; Mehling, Wolf E

    2015-01-01

    Preventing Loss of Independence through Exercise (PLIÉ) is a novel, integrative exercise program for individuals with dementia that combines elements of different conventional and complementary exercise modalities (e.g. tai-chi, yoga, Feldenkrais, and dance movement therapy) and focuses on training procedural memory for basic functional movements (e.g., sit-to-stand) while increasing mindful body awareness and facilitating social connection. This study presents analyses of qualitative data collected during a 36-week cross-over pilot clinical trial in 11 individuals. Qualitative data included exercise instructors' written notes, which were prepared after each class and also following biweekly telephone calls with caregivers and monthly home visits; three video-recorded classes; and written summaries prepared by research assistants following pre- and post-intervention quantitative assessments. Data were extracted for each study participant and placed onto a timeline for month of observation. Data were coded and analyzed to identify themes that were confirmed and refined through an iterative, collaborative process by the entire team including a qualitative researcher (SA) and the exercise instructors. Three overarching themes emerged: (1) Functional changes included increasing body awareness, movement memory and functional skill. (2) Emotional changes included greater acceptance of resting, sharing of personal stories and feelings, and positive attitude toward exercise. (3) Social changes included more coherent social interactions and making friends. These qualitative results suggest that the PLIÉ program may be associated with beneficial functional, emotional, and social changes for individuals with mild to moderate dementia. Further study of the PLIÉ program in individuals with dementia is warranted.

  18. Treatment of whole blood with riboflavin plus ultraviolet light, an alternative to gamma irradiation in the prevention of transfusion-associated graft-versus-host disease?

    Science.gov (United States)

    Fast, Loren D; Nevola, Martha; Tavares, Jennifer; Reddy, Heather L; Goodrich, Ray P; Marschner, Susanne

    2013-02-01

    Exposure of blood products to gamma irradiation is currently the standard of care in the prevention of transfusion-associated graft-versus-host disease (TA-GVHD). Regulatory, technical, and clinical challenges associated with the use of gamma irradiators are driving efforts to develop alternatives. Pathogen reduction methods were initially developed to reduce the risk of microbial transmission by blood components. Through modifications of nucleic acids, these technologies interfere with the replication of both pathogens and white blood cells (WBCs). To date, systems for pathogen and WBC inactivation of products containing red blood cells are less well established than those for platelets and plasma. In this study, the in vitro and in vivo function of WBCs present in whole blood after exposure to riboflavin plus ultraviolet light (Rb-UV) was examined and compared to responses of WBCs obtained from untreated or gamma-irradiated blood by measuring proliferation, cytokine production, activation, and antigen presentation and xenogeneic (X-)GVHD responses in an in vivo mouse model. In vitro studies demonstrated that treatment of whole blood with Rb-UV was as effective as gamma irradiation in preventing WBC proliferation, but was more effective in preventing antigen presentation, cytokine production, and T-cell activation. Consistent with in vitro findings, treatment with Rb-UV was as effective as gamma irradiation in preventing X-GVHD, a mouse model for TA-GVHD. The ability to effectively inactivate WBCs in fresh whole blood using Rb-UV, prior to separation into components, provides the transfusion medicine community with a potential alternative to gamma irradiation. © 2012 American Association of Blood Banks.

  19. Differing associations between Aβ accumulation, hypoperfusion, blood-brain barrier dysfunction and loss of PDGFRB pericyte marker in the precuneus and parietal white matter in Alzheimer's disease.

    Science.gov (United States)

    Miners, J Scott; Schulz, Isabel; Love, Seth

    2018-01-01

    Recent studies implicate loss of pericytes in hypoperfusion and blood-brain barrier (BBB) leakage in Alzheimer's disease (AD). In this study, we have measured levels of the pericyte marker, platelet-derived growth factor receptor-β (PDGFRB), and fibrinogen (to assess blood-brain barrier leakage), and analyzed their relationship to indicators of microvessel density (von Willebrand factor level), ante-mortem oxygenation (myelin-associated glycoprotein:proteolipid protein-1 ratio and vascular endothelial growth factor level), Aβ level and plaque load, in precuneus and underlying white matter from 49 AD to 37 control brains. There was reduction in PDGFRB and increased fibrinogen in the precuneus in AD. These changes correlated with reduction in oxygenation and with plaque load. In the underlying white matter, increased fibrinogen correlated with reduced oxygenation, but PDGFRB level was unchanged. The level of platelet-derived growth factor-ββ (PDGF-BB), important for pericyte maintenance, was increased in AD but mainly in the insoluble tissue fraction, correlating with insoluble Aβ level. Loss of the PDGFRB within the precuneus in AD is associated with fibrinogen leakage and reduced oxygenation, and related to fibrillar Aβ accumulation. In contrast, fibrinogen leakage and reduced oxygenation of underlying white matter occur independently of loss of PDGFRB, perhaps secondary to reduced transcortical perfusion.

  20. MODIFICATION OF THE NUSS PROCEDURE-PREVENTION OF INJURIES OF THE HEART AND MAJOR BLOOD VESSELS

    Directory of Open Access Journals (Sweden)

    Mirko Žganjer

    2012-09-01

    Full Text Available Objective: The Nuss procedure is a widely accepted technique for correcting pectus excavatum. Unfortunately, fatal complications such as cardiac perforation and injury of the great blood vessels have been noticed in a few patients.We modified original Nuss technique to be simpler and lessdangerous.Methods: We modified Nuss procedure with the sternal elevation to improve sternal depression. Modified Nuss procedure was carried out by applying metal lifter raise sterum until the patient starts to raise from the operating table. The space behind sternum is now wider, and surgeryhas become safer with less probability of injuries intrathoracic organs. We compared 46 patients operated by the original Nuss method (taking into account the data from the literature on complications of the original method on a large series of patients with 54 patients operated by a modified Nuss method.Results: Before lifting the sternum depth of the deformity was between 2.9 and 6.2 cm (mean 5.4 cm, and the increase were between 1.5 and 4.0 cm (mean 2.8 cm. The difference of 2.6 cm is large enough, and the width of introducer and bars are about 3 mm for securely passed along the chest.Conclusions: A modified method of treating pectus excavatum is safer, better and with fewer complications than the original method of Nuss.

  1. Hearing loss prevention education using adopt-a-band: changes in self-reported earplug use in two high school marching bands.

    Science.gov (United States)

    Auchter, Melissa; Le Prell, Colleen G

    2014-06-01

    Hearing loss prevention has always been an important issue for audiologists. The importance of hearing loss prevention education for young musicians is now recognized by the National Association for Music Education as well as the National Association of Schools of Music. Adopt-a-Band is a commercial program designed to foster hearing loss prevention behavior in young musicians. This study assessed changes in earplug use, measured using self-report surveys, after Adopt-a-Band training. Participants were members of 2 high school marching bands who viewed an informational DVD and reviewed fact sheets. Flat-attenuation earplugs were distributed, and training was provided. In addition, study participants engaged in discussion of hearing loss with a doctor of audiology student. Before training, 23% of participants reported they had previously used hearing protection. Immediately after training, 94% of participants reported they planned to use hearing protection at least occasionally. In a final end-of-season survey, earplug use had reliably increased; 62% of participants reported they used earplugs at least occasionally. Earplug use increased, but self-reported behavioral change was not as robust as predicted from self-reported participant intentions. Participant comments regarding factors that influenced their earplug use decisions suggest opportunities to improve training.

  2. Prevention

    DEFF Research Database (Denmark)

    Halken, S; Høst, A

    2001-01-01

    , breastfeeding should be encouraged for 4-6 months. In high-risk infants a documented extensively hydrolysed formula is recommended if exclusive breastfeeding is not possible for the first 4 months of life. There is no evidence for preventive dietary intervention neither during pregnancy nor lactation...... populations. These theories remain to be documented in proper, controlled and prospective studies. Breastfeeding and the late introduction of solid foods (>4 months) is associated with a reduced risk of food allergy, atopic dermatitis, and recurrent wheezing and asthma in early childhood. In all infants....... Preventive dietary restrictions after the age of 4-6 months are not scientifically documented....

  3. Case study: Atlantis Systems International - Using KM principles to drive productivity and performance, prevent critical knowledge loss and encourage innovation

    International Nuclear Information System (INIS)

    Melnick, B.

    2007-01-01

    necessarily produce innovation in the form of new products and services or in the continual improvement of work flows. Innovation at this level requires the creation of a knowledge building culture where the explicit goal for everyone in the organization is to continuously build and contribute new knowledge to the benefit of both the individual and the organization. By 2007, Atlantis revenues had grown by over 200%; the workforce increased from 102 employees to approx 210 employees; retention rates have remained consistent at 3% over a three year period, and the business has expanded its operations into the United States. In addition the company successfully leveraged its knowledge and expertise in training from the aerospace sector to enter the nuclear energy sector. The paper will present a conceptual framework for understanding Knowledge Management as it relates to organizational development, change management and innovation. Using concrete examples over a 3 three period, it will describe how knowledge management strategies applied by Atlantis to increase performance and profitability, encourage growth, accelerate innovation, attract and retain key talent, prevent knowledge loss, can be applied to the address the looming 'Grey Out' of the nuclear energy sector. (author)

  4. Blood Clotting and Pregnancy

    Medline Plus

    Full Text Available ... blood clots are treated with an anticoagulant, a medicine that prevents the blood from clotting. Certain anticoagulants are safe to use during pregnancy. back to top Are Blood Clots Preventable? There ...

  5. The Effect of Radioactive Lantern Mantle Powder and Bentonite-Zeoloite Minerals on the Volume of Blood Loss, Bleeding and Clotting Time

    Directory of Open Access Journals (Sweden)

    M Atefi

    2009-04-01

    Full Text Available ABSTRACT Introduction & Objective: Over the past decade the US army has widely studied new technologies for stopping sever hemorrhages and has introduced an effective Zeolite based hemostatic agent. On the other hand, Mortazavi and his colleagues previously reported the bio-stimulatory effects of the topical application of radioactive lantern mantle powder on wound healing. Their subsequent studies showed significant changes in some histological parameters concerning healing. In this light, here the bio-stimulatory effect of burned radioactive lantern mantles powder as well as two minerals bentonite and zeolite are presented. Materials & Methods: This experimental study was conducted in the center for radiological studies, Shiraz University of Medical Sciences in 2008. Fifty male Wistar rats were divided randomly into 5 groups of 10 animals each. Following anesthesia, animals’ tails were cut at a thickness of 5 mm by using a surgical scissor. No intervention was made on the animals of the 1st group. The 2nd to 4th group received topical non-radioactive lantern mantle powder, radioactive lantern mantle powder, Bentonite mineral or a mixture of Bentonite-Zeoliteat minerals respectively. After treatment with above mentioned agents, the volume of blood loss was measured using a scaled test-tube. The bleeding time and clotting time were also measured using a chronometer. SPSS software was used for statistical analysis. ANOVA was used for comparing the means of each parameter in the 5 groups. Results: The the volume of blood loss, bleeding and clotting times in control animals were 4.39±1.92 cc, 112.10±39.60 sec and 94.9±54.26 sec, respectively. In the 5th group in which the animals were treated with a mixture of Bentonite-Zeoliteat minerals, the volume of blood loss, bleeding and clotting times were 1.31±0.60 cc, 34.50±4.65 sec and 24.2±4.61 sec, respectively. Conclusion: This is the 1st investigation that studied the alterations of bleeding

  6. Association of various blood pressure variables and vascular phenotypes with coronary, stroke and renal deaths: Potential implications for prevention.

    Science.gov (United States)

    Harbaoui, Brahim; Courand, Pierre-Yves; Milon, Hughes; Fauvel, Jean-Pierre; Khettab, Fouad; Mechtouff, Laura; Cassar, Emmanuel; Girerd, Nicolas; Lantelme, Pierre

    2015-11-01

    The relationship between blood pressure (BP) and cardiovascular diseases has been extensively documented. However, the benefit of anti-hypertensive drugs differs according to the type of cardiovascular event. Aortic stiffness is tightly intertwined with BP and aorta cross-talk with small arteries. We endeavored to elucidate which BP component and type of vessel remodeling was predictive of the following outcomes: fatal myocardial infarction (MI), fatal stroke, renal -, coronary- or cerebrovascular-related deaths. Large vessel remodeling was estimated by an aortography-based aortic atherosclerosis score (ATS) while small vessel disease was documented by the presence of a hypertensive retinopathy. We included 1031 subjects referred for hypertension workup and assessed outcomes 30 years later. After adjustment for major risk factors, ATS and pulse pressure (PP) were predictive of coronary events while mean BP (MBP) and retinopathy were not. On the contrary, MBP was predictive of cerebrovascular and renal related deaths while ATS and PP were not. Retinopathy was only predictive of cerebrovascular related deaths. Lastly, the aortic atherosclerosis phenotype and increased PP identified patients prone to develop fatal MI whereas the retinopathy phenotype and increased MBP identified patients at higher risk of fatal stroke. These results illustrate the particular feature of the resistive coronary circulation comparatively to the brain and kidneys' low-resistance circulation. Our results advocate for a rational preventive strategy based on the identification of distinct clinical phenotypes. Accordingly, decreasing MBP levels could help preventing stroke in retinopathy phenotypes whereas targeting PP is possibly more efficient in preventing MI in atherosclerotic phenotypes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Iatrogenic hyperthyroidism does not promote weight loss or prevent ageing-related increases in body mass in thyroid cancer survivors.

    Science.gov (United States)

    Polotsky, Hanah N; Brokhin, Matvey; Omry, Gal; Polotsky, Alex J; Tuttle, R Michael

    2012-04-01

    otherwise, healthy patients with differentiated thyroid cancer, significant weight gain occurred during the 3-5 years of follow-up despite ongoing thyrotropin suppression. The data suggest that mild iatrogenic hyperthyroidism does not promote weight loss or prevent ageing-related weight gain. Greater weight gain was seen in patients prepared for radioactive remnant ablation with THW than with rhTSH. © 2012 Blackwell Publishing Ltd.

  8. PRC2 inhibition counteracts the culture-associated loss of engraftment potential of human cord blood-derived hematopoietic stem and progenitor cells.

    Science.gov (United States)

    Varagnolo, Linda; Lin, Qiong; Obier, Nadine; Plass, Christoph; Dietl, Johannes; Zenke, Martin; Claus, Rainer; Müller, Albrecht M

    2015-07-22

    Cord blood hematopoietic stem cells (CB-HSCs) are an outstanding source for transplantation approaches. However, the amount of cells per donor is limited and culture expansion of CB-HSCs is accompanied by a loss of engraftment potential. In order to analyze the molecular mechanisms leading to this impaired potential we profiled global and local epigenotypes during the expansion of human CB hematopoietic stem and progenitor cells (HPSCs). Human CB-derived CD34+ cells were cultured in serum-free medium together with SCF, TPO, FGF, with or without Igfbp2 and Angptl5 (STF/STFIA cocktails). As compared to the STF cocktail, the STFIA cocktail maintains in vivo repopulation capacity of cultured CD34+ cells. Upon expansion, CD34+ cells genome-wide remodel their epigenotype and depending on the cytokine cocktail, cells show different H3K4me3 and H3K27me3 levels. Expanding cells without Igfbp2 and Angptl5 leads to higher global H3K27me3 levels. ChIPseq analyses reveal a cytokine cocktail-dependent redistribution of H3K27me3 profiles. Inhibition of the PRC2 component EZH2 counteracts the culture-associated loss of NOD scid gamma (NSG) engraftment potential. Collectively, our data reveal chromatin dynamics that underlie the culture-associated loss of engraftment potential. We identify PRC2 component EZH2 as being involved in the loss of engraftment potential during the in vitro expansion of HPSCs.

  9. Effects of Hypotensive Anesthesia on Reducing Intraoperative Blood Loss, Duration of Operation, and Quality of Surgical Field During Orthognathic Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Lin, Susie; McKenna, Samuel J; Yao, Chuan-Fong; Chen, Yu-Ray; Chen, Chit

    2017-01-01

    The objective of this study was to evaluate the efficacy of hypotensive anesthesia in reducing intraoperative blood loss, decreasing operation time, and improving the quality of the surgical field during orthognathic surgery. A systematic review and meta-analysis of randomized controlled trials addressing these issues were carried out. An electronic database search was performed. The risk of bias was evaluated with the Jadad Scale and Delphi List. The inverse variance statistical method and a random-effects model were used. Ten randomized controlled trials were included for analysis. Our meta-analysis indicated that hypotensive anesthesia reduced intraoperative blood loss by a mean of about 169 mL. Hypotensive anesthesia was not shown to reduce the operation time for orthognathic surgery, but it did improve the quality of the surgical field. Subgroup analysis indicated that for blood loss in double-jaw surgery, the weighted mean difference favored the hypotensive group, with a reduction in blood loss of 175 mL, but no statistically significant reduction in blood loss was found for anterior maxillary osteotomy. If local anesthesia with epinephrine was used in conjunction with hypotensive anesthesia, the reduction in intraoperative blood loss was increased to 254.93 mL. Hypotensive anesthesia was effective in reducing blood loss and improving the quality of the surgical field, but it did not reduce the operation time for orthognathic surgery. The use of local anesthesia in conjunction with hypotensive general anesthesia further reduced the amount of intraoperative blood loss for orthognathic surgery. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Blood Clotting and Pregnancy

    Medline Plus

    Full Text Available ... known as venous thromboembolism, are highly preventable (see prevention tips below). The U.S. Surgeon General has issued ... blood conditions and increase research on the causes, prevention, and treatment. Blood clots are also potentially dangerous ...

  11. Family support is associated with success in achieving weight loss in a group lifestyle intervention for diabetes prevention in Arab Americans.

    Science.gov (United States)

    Pinelli, Nicole R; Brown, Morton B; Herman, William H; Jaber, Linda A

    2011-01-01

    We have recently shown the feasibility of a community-based, culturally-specific, Diabetes Prevention Program-adapted, goal-oriented group lifestyle intervention targeting weight loss in Arab Americans. The objective of this study was to examine factors associated with weight-loss goal attainment at 24-weeks of the lifestyle intervention. We assessed the relationship among demographic, psychosocial, and behavioral measures and the attainment of > or =7% decrease of initial body weight among 71 lifestyle intervention participants. Weight loss goal of > or = 7% of body weight was achieved by 44% of study participants. Demographic and psychosocial factors were not associated with weight loss. Individuals attaining the weight loss goal were more likely to have family support during the core curriculum sessions (70% vs 30%; P=.0023). Decrease in body weight was positively correlated with attendance at sessions (r=.46; P=.0016) and physical activity minutes (r=.66; Pwomen; these trends were similar but not significant in men. Family support was an important predictor of attainment of the weight loss goal. Family-centered lifestyle interventions are likely to succeed in curtailing the rising epidemic of diabetes in the Arab-American Community.

  12. Decreased bone turnover with balanced resorption and formation prevent cortical bone loss during disuse (hibernation) in grizzly bears (Ursus arctos horribilis)

    OpenAIRE

    McGee, Meghan E.; Maki, Aaron J.; Johnson, Steven E.; Lynne Nelson, O.; Robbins, Charles T.; Donahue, Seth W.

    2007-01-01

    Disuse uncouples bone formation from resorption, leading to increased porosity, decreased bone geometrical properties, and decreased bone mineral content which compromises bone mechanical properties and increases fracture risk. However, black bear bone properties are not adversely affected by aging despite annual periods of disuse (i.e., hibernation), which suggests that bears either prevent bone loss during disuse or lose bone and subsequently recover it at a faster rate than other animals. ...

  13. A Lifestyle Program of Exercise and Weight Loss is Effective in Preventing and Treating Type 2 Diabetes Mellitus: Why Are Programs Not More Available?

    OpenAIRE

    Ades, Philip A.

    2015-01-01

    There is substantial evidence that type 2 diabetes mellitus (T2DM) can be prevented in high-risk individuals by a lifestyle program of regular exercise and weight reduction. Additionally, there is emerging evidence that new onset T2DM (< 1 year) can go into remission after weight loss and exercise in a majority of motivated individuals, obviating a need for glucose lowering medications. Yet, lifestyle programs to support such behavior change are not widely available. Moreover, health care ins...

  14. Short-term, daily exposure to cold temperature may be an efficient way to prevent muscle atrophy and bone loss in a microgravity environment

    Science.gov (United States)

    Deng, Claudia; Wang, Ping; Zhang, Xiangming; Wang, Ya

    2015-04-01

    Microgravity induces less pressure on muscle/bone, which is a major reason for muscle atrophy as well as bone loss. Currently, physical exercise is the only countermeasure used consistently in the U.S. human space program to counteract the microgravity-induced skeletal muscle atrophy and bone loss. However, the routinely almost daily time commitment is significant and represents a potential risk to the accomplishment of other mission operational tasks. Therefore, development of more efficient exercise programs (with less time) to prevent astronauts from muscle atrophy and bone loss are needed. Consider the two types of muscle contraction: exercising forces muscle contraction and prevents microgravity-induced muscle atrophy/bone loss, which is a voluntary response through the motor nervous system; and cold temperature exposure-induced muscle contraction is an involuntary response through the vegetative nervous system, we formed a new hypothesis. The main purpose of this pilot study was to test our hypothesis that exercise at 4 °C is more efficient than at room temperature to prevent microgravity-induced muscle atrophy/bone loss and, consequently reduces physical exercise time. Twenty mice were divided into two groups with or without daily short-term (10 min × 2, at 12 h interval) cold temperature (4 °C) exposure for 30 days. The whole bodyweight, muscle strength and bone density were measured after terminating the experiments. The results from the one-month pilot study support our hypothesis and suggest that it would be reasonable to use more mice, in a microgravity environment and observe for a longer period to obtain a conclusion. We believe that the results from such a study will help to develop efficient exercise, which will finally benefit astronauts' heath and NASA's missions.

  15. miRNA-431 Prevents Amyloid-β-Induced Synapse Loss in Neuronal Cell Culture Model of Alzheimer's Disease by Silencing Kremen1.

    Science.gov (United States)

    Ross, Sean P; Baker, Kelly E; Fisher, Amanda; Hoff, Lee; Pak, Elena S; Murashov, Alexander K

    2018-01-01

    Synapse loss is well regarded as the underlying cause for the progressive decline of memory function over the course of Alzheimer's disease (AD) development. Recent observations suggest that the accumulation of the Wnt antagonist Dickkopf-1 (Dkk1) in the AD brain plays a critical role in triggering synaptic degeneration. Mechanistically, Dkk1 cooperates with Kremen1 (Krm1), its transmembrane receptor, to block the Wnt/β-catenin signaling pathway. Here, we show that silencing Krm1 with miR-431 prevents amyloid-β-mediated synapse loss in cortico-hippocampal cultures isolated from triple transgenic 3xTg-AD mice. Exposure to AβDDL (an amyloid-β derived diffusive ligand) or Dkk1 reduced the number of pre- and post-synaptic puncta in primary neuronal cultures, while treatment with miR-431 prevented synapse loss. In addition, treatment with miR-431 also prevented neurite degeneration. Our findings demonstrate that miR-431 protects synapses and neurites from Aβ-toxicity in an AD cell culture model and may be a promising therapeutic target.

  16. GLP-1 receptor agonist treatment increases bone formation and prevents bone loss in weight-reduced obese women

    DEFF Research Database (Denmark)

    Iepsen, Eva Pers Winning; Lundgren, Julie Rehné; Hartmann, Bolette

    2015-01-01

    with or without administration of the GLP-1 RA liraglutide (1.2mg/day) for 52 weeks. In case of weight gain, up to two meals per day could be substituted with a low-calorie diet product in order to maintain the weight loss. MAIN OUTCOME MEASURES: Total, pelvic and arm-leg bone mineral content (BMC) and bone...... markers (CTX-1 and P1NP) were investigated before, after weight loss and after 52 weeks weight maintenance. Primary end points: Change in BMC and bone markers after 52 weeks weight maintenance with or without GLP-1 RA treatment. RESULTS: Total, pelvic and arm-leg BMC decreased during weight maintenance...... in the control group (ptotal and arm-leg BMC loss was 4 times greater in the control group compared to the liraglutide group (estimated difference 27g (95% CI 5-48), p=0.01), although the 12% weight loss was maintained in both groups...

  17. Defilade, Stationary Target and Moving Target Embankment, Low Water Crossing, and Course Road Designs for Soil Loss Prevention

    National Research Council Canada - National Science Library

    Svendsen, Niels G; Kalita, Prasanta K; Gebhart, Dick L; Denight, Michael L

    2006-01-01

    ... for military training requirements. This report proposes several new range structure designs to begin the iterative process of developing new range edifices that reduce soil loss, control erosion, promote sustainability, and enhance training...

  18. Tensor tenopexy: a clinical study to assess its effectiveness in improving Eustachian tube function and preventing hearing loss in patients with cleft palate.

    Science.gov (United States)

    Tiwari, Raja; Sharma, Ramesh K; Panda, Naresh K; Munjal, Sanjay; Makkar, Surinder

    2013-09-01

    There is a consensus about the occurrence of otitis media in children with cleft palate before repair. However, controversy continues regarding the recovery of Eustachian tube function and level of hearing loss in the patients after cleft palate repair. Levator sling palatoplasty is an important component of the cleft repair. Most surgeons would routinely transect the tensor tendon (tensor tenotomy) during the course of palatoplasty. However, this procedure may pose a risk to Eustachian tube function. Some authorities feel that addition of tensor tenopexy during palatoplasty would maintain the Eustachian tube in an open conformation, thereby improving middle ear ventilation. The present study assesses the effectiveness of tensor tenopexy in improving Eustachian tube function and preventing hearing loss in cleft palate patients treated with palatoplasty. A prospective randomised controlled trial was conducted in the Department of Plastic Surgery at a tertiary care institute in India. A total of 17 children in the age group of 9-24 months were assigned to one of two groups: palatoplasty with either tensor tenotomy (n = 8) or tensor tenotomy with tensor tenopexy (n = 9). All patients were subjected to tympanometry, otoscopy and brainstem evoked response audiometry before surgery and at 3, 6, 9 and 12 months after surgery. Of these, 52.9% of patients already had hearing loss at the time of presentation. Hearing loss and middle ear effusion persisted even after palatoplasty. There was no significant difference in hearing loss and middle ear effusion between the two groups of patients. Thus, tensor tenopexy was not found to be helpful in maintaining Eustachian tube function or preventing hearing loss in cleft palate patients. However, further long-term studies are needed to confirm this study. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. Duration of works, flight hours, and blood pressure related to noise-induced hearing loss among Indonesian Air Force helicopter pilots

    Directory of Open Access Journals (Sweden)

    Kholidah Hanum

    2006-09-01

    Full Text Available Helicopter pilots exposed to high intensity noise and other risk factors had increased risk to be noise-induced hearing loss (NIHL. Therefore, it is beneficial to study several risk factors related to NIHL. This study was a nested case-control. Data was extracted from available medical records among helicopter pilots who performed routine aerophysiology training indoctrination (ILA during 1980 through March 2004 at Saryanto Institute for Aviation and Aerospace Medicine (Lakespra, Jakarta. Case was those who had audiogram with a notch of 40 dB or more and of 4000 Hertz on one site or bilateral ears. A case was matched by two controls who free from NIHL up to 2004. All risk factors for cases and controls were counted as of reference date of cases diagnosed. There were 187 medical records available for this study. A number of 32 cases and 64 controls were identified. The final model reveals that NIHL was related to total duration of works, flight hours, and blood pressure. Those who had 500 hours or more than less 500 hours had a moderate increased risk for 2.5 to be NIHL [Adjusted odds ratio (ORa= 2.50; 95% confidence intervals (CI = 0.66-9.29; p = 0.180]. Those who had total duration works 11-24 years had a moderate increased to be NIHL for 2.7 times (ORa = 2.71; 95% CI=0.90-8.10; p = 0.075. Furthermore, prehypertension and hypertension stage 1 subjects than normal blood pressure had moderate trend increased risk to be NIHL. In conclusion total flight hours for 500 hours or more, total duration works 11-24 years, or prehypertension and hypertension stage 1 increased risk NIHL. (Med J Indones 2006; 15:185-90 Keywords: noise induced hearing loss, flight hours, working duration, blood pressure

  20. Blood ketones are directly related to fatigue and perceived effort during exercise in overweight adults adhering to low-carbohydrate diets for weight loss: a pilot study.

    Science.gov (United States)

    White, Andrea M; Johnston, Carol S; Swan, Pamela D; Tjonn, Sherrie L; Sears, Barry

    2007-10-01

    Ketogenic diets have been associated with reductions in free-living physical activity, a response that can be counterproductive in individuals trying to lose weight. To explore whether popular low-carbohydrate diets might impact the desire to exercise by raising blood ketone concentrations, fatigue and perceived effort during exercise were compared in untrained, overweight adults adhering to a ketogenic low-carbohydrate diet or to a control diet low in carbohydrate, but not ketogenic (5%, 65%, and 30% or 40%, 30%, and 30% of energy from carbohydrate, fat, and protein, respectively). In this prospective, randomized, 2-week pilot study, all meals and snacks were provided to subjects, and energy intake was strictly controlled to provide approximately 70% of that needed for weight maintenance. At baseline and at the end of week 2, exercise testing was conducted in fasting participants. Weight loss and the reductions in fat mass did not differ by group during the trial. At week 2, blood beta-hydroxybutyrate concentrations were 3.6-fold greater for the ketogenic vs nonketogenic group (P=0.018) and correlated significantly with perceived exercise effort (r2=0.22, P=0.049). Blood beta-hydroxybutyrate was also significantly correlated to feelings of "fatigue" (r=0.458, P=0.049) and to "total mood disturbance" (r=0.551, P=0.015) while exercising. These pilot data indicate that ketogenic, low-carbohydrate diets enhance fatigability and can reduce the desire to exercise in free-living individuals.

  1. Temporary Intraoperative Porto-Caval Shunts in Piggy-Back Liver Transplantation Reduce Intraoperative Blood Loss and Improve Postoperative Transaminases and Renal Function: A Meta-Analysis.

    Science.gov (United States)

    Pratschke, Sebastian; Rauch, Alexandra; Albertsmeier, Markus; Rentsch, Markus; Kirschneck, Michaela; Andrassy, Joachim; Thomas, Michael; Hartwig, Werner; Figueras, Joan; Del Rio Martin, Juan; De Ruvo, Nicola; Werner, Jens; Guba, Markus; Weniger, Maximilian; Angele, Martin K

    2016-12-01

    The value of temporary intraoperative porto-caval shunts (TPCS) in cava-sparing liver transplantation is discussed controversially. Aim of this meta-analysis was to analyze the impact of temporary intraoperative porto-caval shunts on liver injury, primary non-function, time of surgery, transfusion of blood products and length of hospital stay in cava-sparing liver transplantation. A systematic search of MEDLINE/PubMed, EMBASE and PsycINFO retrieved a total of 909 articles, of which six articles were included. The combined effect size and 95 % confidence interval were calculated for each outcome by applying the inverse variance weighting method. Tests for heterogeneity (I 2 ) were also utilized. Usage of a TPCS was associated with significantly decreased AST values, significantly fewer transfusions of packed red blood cells and improved postoperative renal function. There were no statistically significant differences in primary graft non-function, length of hospital stay or duration of surgery. This meta-analysis found that temporary intraoperative porto-caval shunts in cava-sparing liver transplantation reduce blood loss as well as hepatic injury and enhance postoperative renal function without prolonging operative time. Randomized controlled trials investigating the use of temporary intraoperative porto-caval shunts are needed to confirm these findings.

  2. Assessment of preventive measures for accidental blood exposure in operating theaters: a survey of 20 hospitals in Northern France.

    Science.gov (United States)

    Tarantola, Arnaud; Golliot, Franck; L'Heriteau, François; Lebascle, Karin; Ha, Catherine; Farret, Danièle; Bignon, Sylvie; Smaïl, Amar; Doutrellot-Philippon, Catherine; Astagneau, Pascal; Bouvet, Elisabeth

    2006-08-01

    Accidental exposures to blood of body fluids (ABE) expose health care workers (HCW) to the risk of occupational infection. Our aim was to assess the prevention equipment available in the operating theater (OT) with reference to guidelines or recommendations and its use by the staff in that OT on that day and past history of ABE. Correspondents of the Centre de Coordination de la Lutte contre les Infections Nosocomiales (CCLIN) Paris-Nord ABE Surveillance Taskforce carried out an observational multicenter survey in 20 volunteer French hospitals. In total, 260 operating staff (including 151 surgeons) were investigated. Forty-nine of the 260 (18.8%) staff said they double-gloved for all patients and procedures, changing gloves hourly. Blunt-tipped suture needles were available in 49.1% of OT; 42 of 76 (55.3%) of the surgeons in these OT said they never used them. Overall, 60% and 64% of surgeons had never self-tested for HIV and hepatitis C virus (HCV), respectively. Fifty-five surgeons said they had sustained a total of 96 needlestick injuries during the month preceding the survey. Ten of these surgeons had notified of 1 needlestick injury each to the occupational health department of their hospital (notification rate, 10.4%). The occurrence of needlestick injury remained high in operating personnel in France in 2000. Although hospitals may improve access to protective devices, operating staff mindful of safety in the OT should increase their use of available devices, their knowledge of their own serostatus, and their ABE notification rate to guide well-targeted prevention efforts.

  3. 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.

  4. Importance of weight loss maintenance and risk prediction in the prevention of type 2 Diabetes: analysis of European Diabetes Prevention Study RCT

    NARCIS (Netherlands)

    Penn, L.; White, M.; Lindström, J.; Boer, den A.Th.; Blaak, E.E.; Eriksson, J.G.; Feskens, E.J.M.; Ilanne-Parikka, P.; Keinanen-Kiukaanniemi, S.M.; Walker, M.; Mathers, J.C.; Uusitupa, M.; Tuomilehto, J.

    2013-01-01

    Background Prevalence of type 2 diabetes (T2D) is increasing worldwide. T2D prevention by lifestyle intervention is effective. Pragmatic scalable interventions are needed, with evidence to efficiently target and monitor such interventions. We report pooled analyses of data from three European trial

  5. Different systolic blood pressure targets for people with history of stroke or transient ischaemic attack: PAST-BP (Prevention After Stroke—Blood Pressure) randomised controlled trial

    Science.gov (United States)

    McManus, Richard J; Roalfe, Andrea; Fletcher, Kate; Taylor, Clare J; Martin, Una; Virdee, Satnam; Greenfield, Sheila; Hobbs, F D Richard

    2016-01-01

    Objective To assess whether using intensive blood pressure targets leads to lower blood pressure in a community population of people with prevalent cerebrovascular disease. Design Open label randomised controlled trial. Setting 99 general practices in England, with participants recruited in 2009-11. Participants People with a history of stroke or transient ischaemic attack whose systolic blood pressure was 125 mm Hg or above. Interventions Intensive systolic blood pressure target (different target, patients in both arms were actively managed in the same way with regular reviews by the primary care team. Main outcome measure Change in systolic blood pressure between baseline and 12 months. Results 529 patients (mean age 72) were enrolled, 266 to the intensive target arm and 263 to the standard target arm, of whom 379 were included in the primary analysis (182 (68%) intensive arm; 197 (75%) standard arm). 84 patients withdrew from the study during the follow-up period (52 intensive arm; 32 standard arm). Mean systolic blood pressure dropped by 16.1 mm Hg to 127.4 mm Hg in the intensive target arm and by 12.8 mm Hg to 129.4 mm Hg in the standard arm (difference between groups 2.9 (95% confidence interval 0.2 to 5.7) mm Hg; P=0.03). Conclusions Aiming for target below 130 mm Hg rather than 140 mm Hg for systolic blood pressure in people with cerebrovascular disease in primary care led to a small additional reduction in blood pressure. Active management of systolic blood pressure in this population using a blood pressure. Trial registration Current Controlled Trials ISRCTN29062286. PMID:26919870

  6. [Measures to prevent patient identification errors in blood collection/physiological function testing utilizing a laboratory information system].

    Science.gov (United States)

    Shimazu, Chisato; Hoshino, Satoshi; Furukawa, Taiji

    2013-08-01

    We constructed an integrated personal identification workflow chart using both bar code reading and an all in-one laboratory information system. The information system not only handles test data but also the information needed for patient guidance in the laboratory department. The reception terminals at the entrance, displays for patient guidance and patient identification tools at blood-sampling booths are all controlled by the information system. The number of patient identification errors was greatly reduced by the system. However, identification errors have not been abolished in the ultrasound department. After re-evaluation of the patient identification process in this department, we recognized that the major reason for the errors came from excessive identification workflow. Ordinarily, an ultrasound test requires patient identification 3 times, because 3 different systems are required during the entire test process, i.e. ultrasound modality system, laboratory information system and a system for producing reports. We are trying to connect the 3 different systems to develop a one-time identification workflow, but it is not a simple task and has not been completed yet. Utilization of the laboratory information system is effective, but is not yet perfect for patient identification. The most fundamental procedure for patient identification is to ask a person's name even today. Everyday checks in the ordinary workflow and everyone's participation in safety-management activity are important for the prevention of patient identification errors.

  7. Gamma ray induced oxidative damage to human red blood cells proteins under hypotonic conditions and its prevention by natural phenolic malabaricone compounds

    International Nuclear Information System (INIS)

    Meenakshi, K.; Chattopadhyay, Subrata

    2015-01-01

    As an oxygen shuttle, Human RBCs must continue to perform the task while being exposed to a wide range of environments for each vascular circuit and to a variety of xenobiotics across its life time. The inability to synthesise new protein makes them uniquely vulnerable to oxidative stress. Antioxidants can help in protecting the RBCs from oxidative insults. Currently herbal antioxidants gained worldwide popularity as drugs and food/drug supplements for the treatment of various diseases. The present effort was aimed at formulating some natural phenolic compounds isolated from M.malabarica (mal B and mal C) to prevent the biochemical parameters which are considered as biomarkers of redox balance primarily contribute to alterations in red blood cells proteins during gamma radiation induced oxidative stress. Compared to control gamma ray treatment with hypotonic stress resulted in significant haemolysis, associated with increased MDA (3.3 fold, p<0.001) and met-haemoglobin (7.0 fold, p<0.001). The structural deformation due to membrane damage was confirmed from SEM images and Heinz body formation, while the cell permeability was evident from the K + efflux (30.4%, p<0.05) and increased intracellular Na + concentration (5.2%, p<0.05). The membrane damage, due to the reduction of the cholesterol/phospholipids ratio and depletion (p<0.001) of ATP, 2,3-DPG by 54.7% and Na + -K + ATPase activity (48.%) indicated loss of RBC functionally. Pre-treatment of the RBCs with mal B (5μM), mal C (2.5 μM) or vitamin E (50 μM) for 1 h reversed these adverse effects of gamma radiation under hypotonic conditions on all these parameters and provided significant protection against oxidative haemolysis. (author)

  8. Blood Group Substances as Potential Therapeutic Agents for the Prevention and Treatment of Infection with Noroviruses Proving Novel Binding Patterns in Human Tissues

    Science.gov (United States)

    Yazawa, Shin; Yokobori, Takehiko; Ueta, Gen; Ide, Munenori; Altan, Bolag; Thongprachum, Aksara; Nishimura, Toyo; Nakajima, Tamiko; Kominato, Yoshihiko; Asao, Takayuki; Saniabadi, Abby R.; Furukawa, Kiyoshi; Kuwano, Hiroyuki; Le Pendu, Jacques; Ushijima, Hiroshi

    2014-01-01

    Blood group-related glycans determining ABO and Lewis blood groups are known to function as attachment factors for most of the norovirus (NoV) strains. To identify binding specificity of each NoV, recombinant norovirus-like particles (VLPs) and human saliva samples with different ABO, Lewis phenotypes and secretor status have been commonly applied. When binding specificities of VLPs prepared from 16 different genotypes of NoVs in GI and GII genogroups were characterized in samples of human gastric mucosa compared to human saliva based on blood group phenotypes, considerable differences were observed for several strains. Novel binding specificities determined by an ELISA using preparations from human gastric mucosa were also ascertained by immunohistochemical analyses using human jejunal mucosa, widely believed to be susceptible to NoV infection. Further, A, B and O(H) blood group substances prepared from porcine and squid tissues were found to be effective for preventing ABO blood group-specific binding of VLPs to both saliva and mucosa samples. Therefore, these blood group substances might have potential for the prevention and treatment of NoV infection. PMID:24558470

  9. Study on the Measurement of 51Cr-tagged Red Cell Survival: Reevaluation of its method and the effect of Blood loss on red cell survival with 51Cr

    International Nuclear Information System (INIS)

    Choi, Hak Yong; Koh, Chang Soon; Lee, Moon Ho

    1970-01-01

    Reappraisal measurement of apparent half survival time of red cell by 51 Cr method was made and effects of blood-letting over red cell survival were observed. The study was performed on 53 normal male subjects under three different experimental conditions. 1) Group 1: Mean 51 Cr red cell half survival by ACD wash method was 29.7 days. T 1 /2 of Ascorbic acid method was 29.0 days in group with 100 mg dose and 29.1 days in group with 50 mg dose respectively. There was no difference between these two methods in regards to red cell half survival. No difference were noted in amount of ascorbic acid administered. 2) Group 2: As daily amount of blood loss in increased the shortening of red cell half survival was noted. Rapid phase was seen when blood loss ranged 10 to 25 ml per day, while slow phase noted when more loss amounted 25 ml more daily. Thus, it was clear that there was more than an exponential relation between T 1 /2 and the amount of blood loss. 3) Group 3: T 1 /2 measured cpm per whole blood was within normal range and T 1 /2 measured by cpm per red mass showed shortening tendency when compared with the former in the group measured after blood loss (from 25 ml daily up to 100 ml daily in 10 days). In the group with rather constant blood loss of 100 ml daily for 10 consecutive days revealed the significant difference in two measurement (P 1 /2 in non-steady state. When red cell production is increased compared with red cell destruction, T 1 /2 measured by cpm per red cell mass shorter than that by cpm per whole blood. Shortening of T 1 /2 measured by cpm per whole blood is more prominent, if red destruction is enhanced and exceeds production. 5) It is clear that when expressing red cell destruction rate, T 1 /2 measured by cpm per whole blood is more adequate and production more consistent with cpm red cell mass. 6) T 1 /2 measured during blood-letting, when corrected by amount of blood loss, it remains normal. It is erroneous to use conventional equational

  10. Genetic Predisposition to Weight Loss and Regain With Lifestyle Intervention: Analyses From the Diabetes Prevention Program and the Look AHEAD Randomized Controlled Trials.

    Science.gov (United States)

    Papandonatos, George D; Pan, Qing; Pajewski, Nicholas M; Delahanty, Linda M; Peter, Inga; Erar, Bahar; Ahmad, Shafqat; Harden, Maegan; Chen, Ling; Fontanillas, Pierre; Wagenknecht, Lynne E; Kahn, Steven E; Wing, Rena R; Jablonski, Kathleen A; Huggins, Gordon S; Knowler, William C; Florez, Jose C; McCaffery, Jeanne M; Franks, Paul W

    2015-12-01

    Clinically relevant weight loss is achievable through lifestyle modification, but unintentional weight regain is common. We investigated whether recently discovered genetic variants affect weight loss and/or weight regain during behavioral intervention. Participants at high-risk of type 2 diabetes (Diabetes Prevention Program [DPP]; N = 917/907 intervention/comparison) or with type 2 diabetes (Look AHEAD [Action for Health in Diabetes]; N = 2,014/1,892 intervention/comparison) were from two parallel arm (lifestyle vs. comparison) randomized controlled trials. The associations of 91 established obesity-predisposing loci with weight loss across 4 years and with weight regain across years 2-4 after a minimum of 3% weight loss were tested. Each copy of the minor G allele of MTIF3 rs1885988 was consistently associated with greater weight loss following lifestyle intervention over 4 years across the DPP and Look AHEAD. No such effect was observed across comparison arms, leading to a nominally significant single nucleotide polymorphism×treatment interaction (P = 4.3 × 10(-3)). However, this effect was not significant at a study-wise significance level (Bonferroni threshold P lifestyle. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  11. Using the extended parallel process model to prevent noise-induced hearing loss among coal miners in Appalachia

    Energy Technology Data Exchange (ETDEWEB)

    Murray-Johnson, L.; Witte, K.; Patel, D.; Orrego, V.; Zuckerman, C.; Maxfield, A.M.; Thimons, E.D. [Ohio State University, Columbus, OH (US)

    2004-12-15

    Occupational noise-induced hearing loss is the second most self-reported occupational illness or injury in the United States. Among coal miners, more than 90% of the population reports a hearing deficit by age 55. In this formative evaluation, focus groups were conducted with coal miners in Appalachia to ascertain whether miners perceive hearing loss as a major health risk and if so, what would motivate the consistent wearing of hearing protection devices (HPDs). The theoretical framework of the Extended Parallel Process Model was used to identify the miners' knowledge, attitudes, beliefs, and current behaviors regarding hearing protection. Focus group participants had strong perceived severity and varying levels of perceived susceptibility to hearing loss. Various barriers significantly reduced the self-efficacy and the response efficacy of using hearing protection.

  12. The unsuitability of implantable Doppler probes for the early detection of renal vascular complications - a porcine model for prevention of renal transplant loss

    DEFF Research Database (Denmark)

    Amdisen, Chris; Jespersen, Bente; Møldrup, Ulla

    2017-01-01

    Abstract Background: Vascular occlusion is a rare, but serious complication after kidney transplantation often resulting in graft loss. We therefore aimed to develop an experimental porcine model for stepwise reduction of the renal venous blood flow and to compare an implantable Doppler probe...... and microdialysis for fast detection of vascular occlusion. Methods: In 20 pigs, implantable Doppler probes were placed on the renal artery and vein and a microdialysis catheter was placed in the renal cortex. An arterial flowprobe served as gold standard. Following two-hour baseline measurements, the pigs were....../3 (66%) reduction in renal blood flow. The implantable Doppler probe was not able to detect flow changes until there was total venous occlusion. Microdialysis detected changes in local metabolism after both arterial and venous occlusion; the implantable Doppler probe could only detect vascular...

  13. Prevention of bone loss by vitamin D supplementation in elderly women : A randomized double-blind trial

    NARCIS (Netherlands)

    Ooms, Marcel E.; Roos, Jan C.; Bezemer, P. Dick; van der Vijgh, Wim J F; Bouter, Lex M.; Lips, Paul

    1995-01-01

    The purpose of the study was to determine the effect of vitamin D supplementation on bone turnover and bone loss in elderly women. Three hundred forty-eight women, ages 70 yr and older, were randomized to receive 400 IU vitamin D3 per day (n = 177) or placebo (n = 171), double-blind, for a period of

  14. Sustained Dorzolamide Release Prevents Axonal and Retinal Ganglion Cell Loss in a Rat Model of IOP-Glaucoma.

    Science.gov (United States)

    Pitha, Ian; Kimball, Elizabeth C; Oglesby, Ericka N; Pease, Mary Ellen; Fu, Jie; Schaub, Julie; Kim, Yoo-Chun; Hu, Qi; Hanes, Justin; Quigley, Harry A

    2018-04-01

    To determine if one injection of a sustained release formulation of dorzolamide in biodegradable microparticles (DPP) reduces retinal ganglion cell (RGC) loss in a rat model of glaucoma. We injected either DPP or control microparticles intravitreally in rats. Two days later, unilateral ocular hypertension was induced by translimbal, diode laser treatment by a surgeon masked to treatment group. IOP and clinical exams were performed until sacrifice 6 weeks after laser treatment. RGC loss was measured by masked observers in both optic nerve cross-sections and RGC layer counts from retinal whole mounts. Cumulative IOP exposure was significantly reduced by DPP injection (49 ± 48 mm Hg × days in treated versus 227 ± 191 mm Hg × days in control microparticle eyes; P = 0.012, t -test). While control-injected eyes increased in axial length by 2.4 ± 1.7%, DPP eyes did not significantly enlarge (0.3 ± 2.2%, difference from control, P = 0.03, t -test). RGC loss was significantly less in DPP eyes compared with control microparticle injection alone (RGC axon count reduction: 21% vs. 52%; RGC body reduction: 25% vs. 50% [beta tubulin labeling]; P = 0.02, t -test). A single injection of sustained release DPP protected against RGC loss and axial elongation in a rat model of IOP glaucoma. Sustained release IOP-lowering medications have the potential to stop glaucoma progression.

  15. Implant-supported overdentures, a prevention of bone loss in edentulous mandibles? A 5-year follow-up study

    DEFF Research Database (Denmark)

    von Wowern, N; Gotfredsen, K

    2001-01-01

    The purpose of this study were to analyse 1) the changes in the bone mineral content (BMC) in mandibles with implant-supported overdentures when compared with the physiologic age-related mandibular BMC loss, 2) whether the BMC changes were different in groups without or with a bar connecting...

  16. Dosage Effects of a Preventive Social-Emotional Learning Intervention on Achievement Loss Associated with Middle School Transition

    Science.gov (United States)

    Rosenblatt, Jennifer L.; Elias, Maurice J.

    2008-01-01

    A number of studies have documented a normative decline in academic achievement across the transition from elementary school to middle or junior high school. The current study examined the effectiveness of varying levels of a social-emotional learning intervention, "Talking with TJ," in limiting achievement loss across transition. Data were…

  17. Forensic Luminol Blood Test for Preventing Cross-contamination in Dentistry: An Evaluation of a Dental School Clinic

    OpenAIRE

    Marcelo Carlos Bortoluzzi; Peterson Cadore; Andrea Gallon; Soraia Almeida Watanabe Imanishi

    2014-01-01

    Background: More than 200 different diseases may be transmitted from exposure to blood in the dental setting. The aim of this study is to identify possible faults in the cross-contamination chain control in a dental school clinic searching for traces of blood in the clinical contact surfaces (CCS) through forensic luminol blood test. Methods: Traces of invisible blood where randomly searched in CCS of one dental school clinic. Results: Forty eight surfaces areas in the CCS were tes...

  18. BRCA1 loss pre-existing in small subpopulations of prostate cancer is associated with advanced disease and metastatic spread to lymph nodes and peripheral blood

    Energy Technology Data Exchange (ETDEWEB)

    Bednarz, Natalia; Eltze, Elke; Semjonow, Axel; Rink, Michael; Andreas, Antje; Mulder, Lennart; Hannemann, Juliane; Fisch, Margit; Pantel, Klaus; Weier, Heinz-Ulrich G.; Bielawski, Krzysztof P.; Brandt, Burkhard

    2010-03-19

    A recent study concluded that serum prostate specific antigen (PSA)-based screening is beneficial for reducing the lethality of PCa, but was also associated with a high risk of 'overdiagnosis'. Nevertheless, also PCa patients who suffered from organ confined tumors and had negative bone scans succumb to distant metastases after complete tumor resection. It is reasonable to assume that those tumors spread to other organs long before the overt manifestation of metastases. Our current results confirm that prostate tumors are highly heterogeneous. Even a small subpopulation of cells bearing BRCA1 losses can initiate PCa cell regional and distant dissemination indicating those patients which might be at high risk of metastasis. A preliminary study performed on a small cohort of multifocal prostate cancer (PCa) detected BRCA1 allelic imbalances (AI) among circulating tumor cells (CTCs). The present analysis was aimed to elucidate the biological and clinical role of BRCA1 losses on metastatic spread and tumor progression in prostate cancer patients. Experimental Design: To map molecular progression in PCa outgrowth we used FISH analysis of tissue microarrays (TMA), lymph node sections and CTC from peripheral blood. We found that 14% of 133 tested patients carried monoallelic BRCA1 loss in at least one tumor focus. Extended molecular analysis of chr17q revealed that this aberration was often a part of larger cytogenetic rearrangement involving chr17q21 accompanied by AI of the tumor suppressor gene PTEN and lack of the BRCA1 promoter methylation. The BRCA1 losses correlated with advanced T stage (p < 0.05), invasion to pelvic lymph nodes (LN, p < 0.05) as well as BR (p < 0.01). Their prevalence was twice as high within 62 LN metastases (LNMs) as in primary tumors (27%, p < 0.01). The analysis of 11 matched primary PCa-LNM pairs confirmed the suspected transmission of genetic abnormalities between those two sites. In 4 of 7 patients with metastatic disease, BRCA1

  19. Pregnancy Loss in Dairy Cattle: Relationship of Ultrasound, Blood Pregnancy-Specific Protein B, Progesterone and Production Variables.

    Science.gov (United States)

    Gábor, G; Kastelic, J P; Abonyi-Tóth, Z; Gábor, P; Endrődi, T; Balogh, O G

    2016-08-01

    Objectives were to determine associations between percentage pregnancy loss (PPL) in dairy cattle and: (i) pregnancy diagnosis by ultrasonography; (ii) pregnancy diagnosis by serum pregnancy-specific protein B (PSPB) concentrations, with or without serum progesterone concentrations; and (iii) production and environmental factors. This study included 149 822 pregnancy diagnoses conducted over 13 years in Holstein-Friesian cows in Hungarian dairy herds. The following were determined: PPL in cows diagnosed pregnant by transrectal ultrasonography 29-42 days after artificial insemination (AI; n = 11 457); PPL in cows diagnosed pregnant by serum PSPB 29-35 days after AI (n = 138 365); and PPL and its association with serum progesterone concentrations, PSPB and production/environmental variables. The definition of PPL was percentage of cows initially diagnosed pregnant based on ultrasonography or PSPB, but not pregnant when examined by transrectal palpation 60 -70 days after AI. The PPL was lower (p 1.1 ng/ml) was lowest (15.0%), whereas cows with low concentrations of both PSPB and progesterone (0.6-1.1 and production, when ambient temperatures were high, although body condition score (BCS) had no effect on PPL. Finally, there were no significant associations between serum PSPB and environmental temperatures or number of post-partum uterine treatments. © 2016 Blackwell Verlag GmbH.

  20. Prevention of Paclitaxel-induced allodynia by Minocycline: Effect on loss of peripheral nerve fibers and infiltration of macrophages in rats

    Directory of Open Access Journals (Sweden)

    Xin Wen-Jun

    2010-11-01

    Full Text Available Abstract Background Although paclitaxel is a frontline antineoplastic agent for treatment of solid tumors, the paclitaxel-evoked pain syndrome is a serious problem for patients. There is currently no valid drug to prevent or treat the paclitaxel-induced allodynia, partly due to lack of understanding regarding the cellular mechanism. Studies have shown that minocycline, an inhibitor of microglia/macrophage, prevented neuropathic pain and promoted neuronal survival in animal models of neurodegenerative disease. Recently, Cata et al also reported that minocycline inhibited allodynia induced by low-dose paclitaxel (2 mg/kg in rats, but the mechanism is still unclear. Results Here, we investigate by immunohistochemistry the change of intraepidermal nerve fiber (IENF in the hind paw glabrous skin, expression of macrophage and activating transcription factor 3 (ATF3 in DRG at different time points after moderate-dose paclitaxel treatment (cumulative dose 24 mg/kg; 3 × 8 mg/kg in rats. Moreover, we observe the effect of minocycline on the IENF, macrophages and ATF3. The results showed that moderate-dose paclitaxel induced a persisted, gradual mechanical allodynia, which was accompanied by the loss of IENF in the hind paw glabrous skin and up-regulation of macrophages and ATF3 in DRG in rats. The expressions of ATF3 mainly focus on the NF200-positive cells. More importantly, we observed that pretreatment of minocycline at dose of 30 mg/kg or 50 mg/kg, but not 5 mg/kg, prevented paclitaxel-evoked allodynia. The evidence from immunohistochemistry showed that 30 mg/kg minocycline rescued the degeneration of IENF, attenuated infiltration of macrophages and up-regulation of ATF3 induced by paclitaxel treatment in rats. Conclusions Minocycline prevents paclitaxel-evoked allodynia, likely due to its inhibition on loss of IENF, infiltration of macrophages and up-regulation of ATF3 in rats. The finding might provide potential target for preventing paclitaxel

  1. Decreased bone turnover with balanced resorption and formation prevent cortical bone loss during disuse (hibernation) in grizzly bears (Ursus arctos horribilis).

    Science.gov (United States)

    McGee, Meghan E; Maki, Aaron J; Johnson, Steven E; Nelson, O Lynne; Robbins, Charles T; Donahue, Seth W

    2008-02-01

    Disuse uncouples bone formation from resorption, leading to increased porosity, decreased bone geometrical properties, and decreased bone mineral content which compromises bone mechanical properties and increases fracture risk. However, black bear bone properties are not adversely affected by aging despite annual periods of disuse (i.e., hibernation), which suggests that bears either prevent bone loss during disuse or lose bone and subsequently recover it at a faster rate than other animals. Here we show decreased cortical bone turnover during hibernation with balanced formation and resorption in grizzly bear femurs. Hibernating grizzly bear femurs were less porous and more mineralized, and did not demonstrate any changes in cortical bone geometry or whole bone mechanical properties compared to active grizzly bear femurs. The activation frequency of intracortical remodeling was 75% lower during hibernation than during periods of physical activity, but the normalized mineral apposition rate was unchanged. These data indicate that bone turnover decreases during hibernation, but osteons continue to refill at normal rates. There were no changes in regional variation of porosity, geometry, or remodeling indices in femurs from hibernating bears, indicating that hibernation did not preferentially affect one region of the cortex. Thus, grizzly bears prevent bone loss during disuse by decreasing bone turnover and maintaining balanced formation and resorption, which preserves bone structure and strength. These results support the idea that bears possess a biological mechanism to prevent disuse osteoporosis.

  2. Antiviral therapy during primary simian immunodeficiency virus infection fails to prevent acute loss of CD4+ T cells in gut mucosa but enhances their rapid restoration through central memory T cells.

    Science.gov (United States)

    Verhoeven, David; Sankaran, Sumathi; Silvey, Melanie; Dandekar, Satya

    2008-04-01

    Gut-associated lymphoid tissue (GALT) is an early target of human immunodeficiency virus (HIV) and simian immunodeficiency virus (SIV) and a site for severe CD4+ T-cell depletion. Although antiretroviral therapy (ART) is effective in suppressing HIV replication and restoring CD4+ T cells in peripheral blood, restoration in GALT is delayed. The role of restored CD4+ T-cell help in GALT during ART and its impact on antiviral CD8+ T-cell responses have not been investigated. Using the SIV model, we investigated gut CD4+ T-cell restoration in infected macaques, initiating ART during either the primary stage (1 week postinfection), prior to acute CD4+ cell loss (PSI), or during the chronic stage at 10 weeks postinfection (CSI). ART led to viral suppression in GALT and peripheral blood mononuclear cells of PSI and CSI animals at comparable levels. CSI animals had incomplete CD4+ T-cell restoration in GALT. In PSI animals, ART did not prevent acute CD4+ T-cell loss by 2 weeks postinfection in GALT but supported rapid and complete CD4+ T-cell restoration thereafter. This correlated with an accumulation of central memory CD4+ T cells and better suppression of inflammation. Restoration of CD4+ T cells in GALT correlated with qualitative changes in SIV gag-specific CD8+ T-cell responses, with a dominance of interleukin-2-producing responses in PSI animals, while both CSI macaques and untreated SIV-infected controls were dominated by gamma interferon responses. Thus, central memory CD4+ T-cell levels and qualitative antiviral CD8+ T-cell responses, independent of viral suppression, were the immune correlates of gut mucosal immune restoration during ART.

  3. Short-term blueberry-enriched antioxidant diet prevents and reverses object recognition memory loss in aged rats

    Science.gov (United States)

    Objective Previously, four months of a blueberry-enriched (BB) antioxidant diet prevented impaired object recognition memory in aged rats. Experiment 1 determined whether one and two-month BB diets would have a similar effect and whether the benefits would disappear promptly after terminating the d...

  4. The Nordic Obstetric Surveillance Study: a study of complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery.

    Science.gov (United States)

    Colmorn, Lotte B; Petersen, Kathrine B; Jakobsson, Maija; Lindqvist, Pelle G; Klungsoyr, Kari; Källen, Karin; Bjarnadottir, Ragnheidur I; Tapper, Anna-Maija; Børdahl, Per E; Gottvall, Karin; Thurn, Lars; Gissler, Mika; Krebs, Lone; Langhoff-Roos, Jens

    2015-07-01

    To assess the rates and characteristics of women with complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery in the Nordic countries. Prospective, Nordic collaboration. The Nordic Obstetric Surveillance Study (NOSS) collec