WorldWideScience

Sample records for prevention definitive treatment

  1. Traditional preventive treatment options

    DEFF Research Database (Denmark)

    Longbottom, C; Ekstrand, K; Zero, D

    2009-01-01

    Preventive treatment options can be divided into primary, secondary and tertiary prevention techniques, which can involve patient- or professionally applied methods. These include: oral hygiene (instruction), pit and fissure sealants ('temporary' or 'permanent'), fluoride applications (patient...... options....

  2. Chickenpox Prevention and Treatment

    Science.gov (United States)

    ... Multimedia Related Links Medline Plus Healthfinder.gov Shingles Prevention & Treatment Language: English Español (Spanish) Recommend on Facebook ... Prescribed by Your Doctor Español: Prevención y tratamiento Prevention The best way to prevent chickenpox is to ...

  3. Traditional preventive treatment options

    DEFF Research Database (Denmark)

    Longbottom, C; Ekstrand, K; Zero, D

    2009-01-01

    conventional operative care, and since controlling the caries process prior to first restoration is the key to breaking the repair cycle and improving care for patients, future research should address the shortcomings in the current level of supporting evidence for the various traditional preventive treatment......Preventive treatment options can be divided into primary, secondary and tertiary prevention techniques, which can involve patient- or professionally applied methods. These include: oral hygiene (instruction), pit and fissure sealants ('temporary' or 'permanent'), fluoride applications (patient...

  4. Dyslexia: Definition or Treatment?

    Science.gov (United States)

    Brown, Virginia L.; Botel, Morton

    A review of research literature on the subject of dyslexia printed since 1955 is presented, concentrating on the interest in the subject during the late 1960's. The authors initially admit that precise definition of the term dyslexia is quite impossible (they use the term to mean the inability to read) and devote chapters to describing problems…

  5. Novel preventive treatment options

    DEFF Research Database (Denmark)

    Longbottom, C; Ekstrand, K; Zero, D

    2009-01-01

    A number of novel preventive treatment options which, as with traditional methods, can be differentiated into 3 categories of prevention (primary, secondary and tertiary), have been and are being currently investigated. Those reviewed are either commercially available or appear relatively close...... of these techniques show considerable promise and dentists should be aware of these developments and follow their progress, the evidence for each of these novel preventive treatment options is currently insufficient to make widespread recommendations. Changes in dental practice should be explored to see how oral...

  6. Preventive Migraine Treatment

    Science.gov (United States)

    Silberstein, Stephen D.

    2015-01-01

    Purpose of Review: This article reviews the evidence base for the preventive treatment of migraine. Recent Findings: Evidence-based guidelines for the preventive treatment of migraine have recently been published by the American Academy of Neurology (AAN) and the Canadian Headache Society (CHS), providing valuable guidance for clinicians. Strong evidence exists to support the use of metoprolol, timolol, propranolol, divalproex sodium, sodium valproate, and topiramate for migraine prevention, according to the AAN. Based on best available evidence, adverse event profile, and expert consensus, topiramate, propranolol, nadolol, metoprolol, amitriptyline, gabapentin, candesartan, Petasites (butterbur), riboflavin, coenzyme Q10, and magnesium citrate received a strong recommendation for use from the CHS. Summary: Migraine preventive drug treatments are underutilized in clinical practice. Principles of preventive treatment are important to improve compliance, minimize side effects, and improve patient outcomes. Choice of preventive treatment of migraine should be based on the presence of comorbid and coexistent illness, patient preference, reproductive potential and planning, and best available evidence. PMID:26252585

  7. [Cellulite - causes, prevention, treatment ].

    Science.gov (United States)

    Janda, Katarzyna; Tomikowska, Anna

    2014-01-01

    Cellulite is a multifactorial etiology ailment. It changes the skin topography by the formation of the skin surface's appearance, changes described as "orange peel". This prob- lem concerns 85-98% of women, and for them it is one of the most intolerable aesthetic imperfections. In the past few years the interest of scientists in this problem has clearly increased. Several theories on the pathophysiology of cel- lulite have been produced A number of different thera- peutic regimens have been developed using modern tech- nology. However, despite the many treatment options for cellulite, it is extremely important that patients should be aware that only multidirectional treatment can bring sat- isfactory results. The aim of this review was to describe the causes of cellulite, and its prevention and treatment.

  8. Novel preventive treatment options

    DEFF Research Database (Denmark)

    Longbottom, C; Ekstrand, K; Zero, D

    2009-01-01

    to that point. These include: approximal sealants; fluoride applications, including slow-release devices; measures to help remineralize demineralized tissue, including 3 different methods of delivering amorphous calcium phosphate; measures to help modify the biofilm to reduce the cariogenic challenge, including...... of these techniques show considerable promise and dentists should be aware of these developments and follow their progress, the evidence for each of these novel preventive treatment options is currently insufficient to make widespread recommendations. Changes in dental practice should be explored to see how oral...

  9. Vulvodynia. Definition, diagnosis and treatment

    DEFF Research Database (Denmark)

    Petersen, Christina Damsted; Lundvall, Lene; Kristensen, Ellids

    2008-01-01

    Vulvodynia is a chronic painful disorder with an estimated prevalence of 9-12%. A rising incidence of the condition constitutes a growing problem. This has lead to an increased focus on etiology and treatment, while the definition also requires attention. Previous assumptions stating that the pro......Vulvodynia is a chronic painful disorder with an estimated prevalence of 9-12%. A rising incidence of the condition constitutes a growing problem. This has lead to an increased focus on etiology and treatment, while the definition also requires attention. Previous assumptions stating...... that the problem is solely a psychological disorder have been abandoned, because inflammatory mechanisms and genetic factors have been found to be involved in the pathogenesis as well as psychosexual contributors. This article describes the terminology and definition of the condition, theories on patho......-physiological mechanisms underlying the disorder, methods of diagnosis and evidence and recommendations on clinical management. A critical examination of the literature regarding vulvodynia reveals numerous strategies and recommendations for treatment, many of which are not evidence-based, and a lack of effective...

  10. ACTOplus Met XR in Treating Patients With Stage I-IV Oral Cavity or Oropharynx Cancer Undergoing Definitive Treatment | Division of Cancer Prevention

    Science.gov (United States)

    This randomized phase IIb trial studies how well ACTOplus met XR works in treating in patients with stage I-IV oral cavity or oropharynx cancer that are undergoing definitive treatment. Chemoprevention is the use of drugs to keep oral cavity or oropharynx cancer from forming or coming back. The use of ACTOplus met XR may slow disease progression in patients with oral cavity or oropharynx cancer. |

  11. Sunburn: Treatment and Prevention

    Science.gov (United States)

    ... 12 mos.) Toddler 1-3yrs. Preschool 3-5yrs Grade School 5-12yrs. Teen 12-18yrs. Young Adult 18-21yrs. Healthy Living Healthy Living Healthy Living Nutrition Fitness Sports Oral Health Emotional Wellness Growing Healthy Sleep Safety & Prevention Safety & Prevention Safety and Prevention Immunizations ...

  12. Genetics, Disease Prevention and Treatment

    Science.gov (United States)

    Skip to main content FAQ About Genetics, Disease Prevention and Treatment Enter Search Term(s): Español Research Funding An Overview Bioinformatics Current Grants Education and Training Funding Extramural Research News ...

  13. Postpartum haemorrhage: prevention and treatment.

    Science.gov (United States)

    Sentilhes, Loïc; Merlot, Benjamin; Madar, Hugo; Sztark, François; Brun, Stéphanie; Deneux-Tharaux, Catherine

    2016-11-01

    Postpartum hemorrhage (PPH) is one of the leading causes of maternal death and severe maternal morbidity worldwide and strategies to prevent and treat PPH vary among international authorities. Areas covered: This review seeks to provide a global overview of PPH (incidence, causes, risk factors), prevention (active management of the third stage of labor and prohemostatic agents), treatment (first, second and third-line measures to control PPH), by also underlining recommendations elaborated by international authorities and using algorithms. Expert commentary: When available, oxytocin is considered the drug of first choice for both prevention and treatment of PPH, while peripartum hysterectomy remains the ultimate life-saving procedure if pharmacological and resuscitation measures fail. Nevertheless, the level of evidence for preventing and treating PPH is globally low. The emergency nature of PPH makes randomized controlled trials (RCT) logistically difficult. Population-based observational studies should be encouraged as they can usefully strengthen the evidence base, particularly for components of PPH treatment that are difficult or impossible to assess through RCT.

  14. The Technostress: definition, symptoms and risk prevention

    Directory of Open Access Journals (Sweden)

    Marta Chiappetta

    2017-04-01

    Full Text Available With the advent of Web 2.0 and Social media, a radical change in the world of communication and information flows has occurred, that have crossed space and time limits. The new technology, with its rapid evolution marked by the access to the digital world through the Smartphone invention, resulted in a sharp acceleration of the rhythms of life and work. On the other hand a massive pervasiveness of digital technology in the professional and personal rhythms has been recorded. Technostress, defined for the first time in 1984, is a syndrome that occurs when the person, subjected to information overload and continuous contact with most digital devices, develops a state of stress, or an abnormal response characterized by specific symptoms at the cardiocirculatory, mental and neurological levels. The repercussions of Technostress invest business and relational sphere causing absenteeism, loss of professional effectiveness, conflict and isolation. In 2007, the syndrome has been recognized as an occupational disease: this requires that in all workplace where a frequently use of digital technologies (ICT, publishing etc. does exist, there is the needto include Technostress in the document of work-related risk assessment. This application is essential to put in place adequate protection and prevention measures, such as increased training of employees on the harmful effect of Technostress and implementation of specific strategies for managing symptoms.

  15. Prevention and Treatment of Drowning.

    Science.gov (United States)

    Mott, Timothy F; Latimer, Kelly M

    2016-04-01

    Nearly 4,000 drowning deaths occur annually in the United States, with drowning representing the most common injury-related cause of death in children one to four years of age. Drowning is a process that runs the spectrum from brief entry of liquid into the airways with subsequent clearance and only minor temporary injury, to the prolonged presence of fluid in the lungs leading to lung dysfunction, hypoxia, neurologic and cardiac abnormalities, and death. The World Health Organization has defined drowning as "the process of experiencing respiratory impairment from submersion/immersion in liquid." Terms such as near, wet, dry, passive, active, secondary, and silent drowning should no longer be used because they are confusing and hinder proper categorization and management. The American Heart Association's Revised Utstein Drowning Form and treatment guidelines are important in guiding care, disposition, and prognosis. Prompt resuscitation at the scene after a shorter duration of submersion is associated with better outcomes. Because cardiac arrhythmias due to drowning are almost exclusively caused by hypoxia, the resuscitation order prioritizes airway and breathing before compressions. Prevention remains the best treatment. Education, swimming and water safety lessons, and proper pool fencing are the interventions with the highest level of current evidence, especially in children two to four years of age. Alcohol use during water activities dramatically increases the risk of drowning; therefore, abstinence is recommended for all participants and supervisors.

  16. Volume definition system for treatment planning

    International Nuclear Information System (INIS)

    Alakuijala, Jyrki; Pekkarinen, Ari; Puurunen, Harri

    1997-01-01

    Purpose: Volume definition is a difficult and time consuming task in 3D treatment planning. We have studied a systems approach for constructing an efficient and reliable set of tools for volume definition. Our intent is to automate body outline, air cavities and bone volume definition and accelerate definition of other anatomical structures. An additional focus is on assisting in definition of CTV and PTV. The primary goals of this work are to cut down the time used in contouring and to improve the accuracy of volume definition. Methods: We used the following tool categories: manual, semi-automatic, automatic, structure management, target volume definition, and visualization tools. The manual tools include mouse contouring tools with contour editing possibilities and painting tools with a scaleable circular brush and an intelligent brush. The intelligent brush adapts its shape to CT value boundaries. The semi-automatic tools consist of edge point chaining, classical 3D region growing of single segment and competitive volume growing of multiple segments. We tuned the volume growing function to take into account both local and global region image values, local volume homogeneity, and distance. Heuristic seeding followed with competitive volume growing finds the body outline, couch and air automatically. The structure management tool stores ICD-O coded structures in a database. The codes have predefined volume growing parameters and thus are able to accommodate the volume growing dissimilarity function for different volume types. The target definition tools include elliptical 3D automargin for CTV to PTV transformation and target volume interpolation and extrapolation by distance transform. Both the CTV and the PTV can overlap with anatomical structures. Visualization tools show the volumes as contours or color wash overlaid on an image and displays voxel rendering or translucent triangle mesh rendering in 3D. Results: The competitive volume growing speeds up the

  17. Stereotactic treatment. Definitions and literature overview

    International Nuclear Information System (INIS)

    Fontenla, D.P.

    2008-01-01

    The topics discussed include, among others, the following: Radiosurgery definitions; Stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT); Available uncertainties in SRS; Gamma knife; Linac-based SRS; Components of a radiosurgery system; Stereotactic hardware (brain lab); m3 linac attachment; Radiosurgery - clinical procedure; Cancer management; Rationale for SRT; Role of radiosurgery in the management of intracranial tumors; Indications for stereotactic SRS/SRT; Physical components required for SRS/SRT; Stereotactic patient set-up; Stereotactic CT scan for SRS; Physical components required for SRT: Relocatable head frame (GTC); Patient immobilization; Treatment planning system; Basic requirements for SRS dosimetry (Linac based); Stereotactic set-up QA (Linac); Stereotactic frames and QA; Beam dose measurements; Dose evaluation tools; Phantoms. (P.A.)

  18. [Pulmonary hypertension: definition, classification and treatments].

    Science.gov (United States)

    Jutant, Etienne-Marie; Humbert, Marc

    2016-01-01

    Pulmonary hypertension (PH) is a cardio-pulmonary disorder that may involve multiple clinical conditions and can complicate the majority of cardiovascular and respiratory diseases. Its definition is an increase in mean pulmonary artery pressure (mPAP) \\hbox{$\\geqslant $} ⩾ 25 mmHg at rest, leading to right heart failure and ultimately death. The clinical classification of pulmonary hypertension (PH) categorizes PH into groups which share similar pathophysiological and hemodynamic characteristics and treatments. Five groups of disorders that cause PH are identified: pulmonary arterial hypertension (Group 1) which is a pre-capillary PH, defined by a normal pulmonary artery wedge pressure (PAWP) \\hbox{$\\leqslant $} ⩽ 15 mmH, due to remodelling of the small pulmonary arteries (hypertension due to left heart disease (Group 2) which is a post-capillary PH, defined by an increased pulmonary artery wedge pressure (PAWP) >15 mmHg; pulmonary hypertension due to chronic lung disease and/or hypoxia (Group 3); chronic thrombo-embolic pulmonary hypertension (Group 4); and pulmonary hypertension due to unclear and/or multifactorial mechanisms (Group 5). PAH (PH group 1) can be treated with agents targeting three dysfunctional endothelial pathways of PAH: nitric oxide (NO) pathway, endothelin-1 pathway and prostacyclin pathway. Patients at low or intermediate risk can be treated with either initial monotherapy or initial oral combination therapy. In patients at high risk initial combination therapy including intravenous prostacyclin analogues should be considered. Patients with inadequate clinical response to maximum treatment (triple therapy with an intravenous prostacyclin) should be assessed for lung transplantation. Despite progresses, PAH remains a fatal disease with a 3-year survival rate of 58%. Treatment of group 2, group 3 and group 5 PH is the treatment of the causal disease and PAH therapeutics are not recommended. Treatment of group 4 PH is pulmonary

  19. Diabetes Prevention and Treatment Strategies

    OpenAIRE

    Backholer, Kathryn; Peeters, Anna; Herman, William H.; Shaw, Jonathan E.; Liew, Danny; Ademi, Zanfina; Magliano, Dianna J.

    2013-01-01

    OBJECTIVE Effective interventions to prevent, delay, or remit diabetes are currently available. However, their impact on the prevalence of diabetes at the population level is unknown. This study aimed to estimate the impact of a range of diabetes interventions on the population prevalence of diabetes for Australian adults between 2010 and 2025. RESEARCH DESIGN AND METHODS We used the Australian Diabetes Projection Model to estimate the impact of a population-wide strategy, high-risk preventio...

  20. Facial Pores: Definition, Causes, and Treatment Options.

    Science.gov (United States)

    Lee, Sang Ju; Seok, Joon; Jeong, Se Yeong; Park, Kui Young; Li, Kapsok; Seo, Seong Jun

    2016-03-01

    Enlarged skin pores refer to conditions that present with visible topographic changes of skin surfaces. Although not a medical concern, enlarged pores are a cosmetic concern for a large number of individuals. Moreover, clear definition and possible causes of enlarged pores have not been elucidated. To review the possible causes and treatment options for skin pores. This article is based on a review of the medical literature and the authors' clinical experience in investigating and treating skin pores. There are 3 major clinical causes of enlarged facial pores, namely high sebum excretion, decreased elasticity around pores, and increased hair follicle volume. In addition, chronic recurrent acne, sex hormones, and skin care regimen can affect pore size. Given the different possible causes for enlarged pores, therapeutic modalities must be individualized for each patient. Potential factors that contribute to enlarged skin pores include excessive sebum, decreased elasticity around pores, and increased hair follicle volume. Because various factors cause enlarged facial pores, it might be useful to identify the underlying causes to be able to select the appropriate treatment.

  1. HIV / AIDS: Symptoms, Diagnosis, Prevention and Treatment

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV / AIDS: Symptoms , Diagnosis, Prevention and Treatment Past Issues / ... Most people who have become recently infected with HIV will not have any symptoms. They may, however, ...

  2. Impetigo: Tips for Treatment and Prevention

    Science.gov (United States)

    ... DO Videos Contact Close ‹ Back to Healthy Living Impetigo: Tips for Treatment and Prevention The symptoms of ... to other parts of their bodies. Causes of Impetigo Impetigo usually affects preschool and school-aged children, ...

  3. Kawasaki Disease: Complications, Treatment and Prevention

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Kawasaki Disease: Complications, Treatment and Prevention Updated:May 8, ... possibility of heart and coronary artery involvement makes Kawasaki disease unpredictable, but these problems usually are not ...

  4. Selective Mutism: Definition, Issues, and Treatment.

    Science.gov (United States)

    Brigham, Frederick J.; Cole, Jane E.

    This paper reviews definitions and issues in selective mutism in children and summarizes results of interventions conducted and published since 1982. Definitions and diagnostic criteria of the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (1994)" and the World Health Organization's…

  5. Drug Treatment as HIV Prevention: Expanding Treatment Options

    OpenAIRE

    Metzger, David S.; Zhang, Yan

    2010-01-01

    Research conducted during the first 20 years of the AIDS epidemic provided a solid foundation of data supporting methadone treatment as HIV prevention. Drug users in methadone treatment were consistently found to reduce the frequency of drug use, risk behaviors, and infections. These data have been consistent over time and across cultural settings and have been used to promote the expansion of drug treatment as a prevention intervention. More recently, data has emerged suggesting the preventi...

  6. Treatment and Prevention of Neonatal Anemia

    OpenAIRE

    Widness, John A.

    2008-01-01

    Because red blood cell (RBC) transfusion therapy remains the primary treatment of anemia encountered in early life, the basis for RBC transfusion in the treatment of symptomatic anemia is discussed in this review along with several important aspects of neonatal blood banking practices. Nontransfusion approaches to the prevention and treatment of neonatal anemia also are described. Finally, this review covers the controversy surrounding whether neonatal RBC transfusion therapy should be restri...

  7. Attitudes to malaria, prevention, treatment and management ...

    African Journals Online (AJOL)

    SERVER

    2007-11-05

    Nov 5, 2007 ... to clean environment, and most of times have no means of acquiring better mosquito-bite preventive measures and no access to modern treatment. Some of these conditions may greatly influence their knowledge and attitudes towards handling of malaria episode. Hence, it is the cardinal objective of this ...

  8. Garlic for Cardiovascular Disease: Prevention or Treatment?

    Science.gov (United States)

    Alali, Feras Q; El-Elimat, Tamam; Khalid, Lila; Hudaib, Reema; Al-Shehabi, Tuqa Saleh; Eid, Ali H

    2017-01-01

    Cardiovascular disease (CVD) is the leading cause of global mortality with a substantial economic impact. The annual deaths are expected to increase in the next decade. An array of dietary supplements is being used by people worldwide to ameliorate cardiovascular risk factors. Garlic (Allium sativum L.), a top-selling herbal dietary supplement, is renowned for its wide range beneficial effects, particularly in the treatment and prevention of CVD. This review aims to present a thorough discussion of the available evidence-based data which support the use of garlic in the treatment or prevention of cardiovascular diseases, including atherosclerosis, hypertension, and hyperlipidemia. The molecular mechanisms underlying these effects are dissected as well. This review supports the notion that garlic has the potential to treat mild hypertension, to decrease hypercholesterolemia, and to prevent atherosclerosis. More clinical studies are essential to unequivocally understand the mechanisms underlying treatment or prevention of these cardiovascular conditions. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  9. Intermittent preventive treatment of malaria in pregnancy

    DEFF Research Database (Denmark)

    Mbonye, A.K.; Bygbjerg, Ib Christian; Magnussen, Pascal

    2008-01-01

    OBJECTIVE: To assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. METHODS: A non-randomized comm......OBJECTIVE: To assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. METHODS: A non......, still births, and maternal and child deaths were secondary endpoints. FINDINGS: 1404 (67.5%) of 2081 with the new delivery system received two doses of sulfadoxine-pyrimethamine versus 281 (39.9%) of 704 with health units (P

  10. Deep vein thrombosis: diagnosis, treatment, and prevention

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, W.P.; Youngswick, F.D.

    Deep vein thrombosis (DVT) is a dangerous complication that may present after elective foot surgery. Because of the frequency with which DVT occurs in the elderly patient, as well as in the podiatric surgical population, the podiatrist should be acquainted with this entity. A review of the diagnosis, treatment, prevention, and the role of podiatry in the management of DVT is discussed in this paper.

  11. The prevention, diagnosis, and treatment of dyslexia.

    Science.gov (United States)

    Schulte-Körne, Gerd

    2010-10-01

    Reading and spelling disorder (dyslexia) is one of the more common specific developmental disorders, with a prevalence of approximately 5%. It is characterized by severe impairment of learning to read and spell. We discuss major aspects of the diagnosis, treatment, and prevention of dyslexia on the basis of a selective literature review and the guidelines of the German Society of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy. 40% to 60% of dyslexic children have psychological manifestations, including anxiety, depression, and attention deficit. The diagnostic assessment of dyslexia consists of a battery of standardized reading and spelling tests and an evaluation of the child's psychological state, including additional information obtained from parents and teachers. The treatment of dyslexia is based on two main strategies: specific assistance with the impaired learning areas (reading and spelling) and psychotherapy for any coexisting psychological disturbance that may be present. Evaluated preventive strategies are available for use in kindergarten and at home. The diagnosis of dyslexia should be established with the aid of the multiaxial classification system. The benefit of specific treatment strategies for dyslexia has not yet been demonstrated empirically. Nonetheless, evaluated prevention programs are available in kindergarten that have been found to promote children's ability to acquire reading and spelling skills in school.

  12. Probiotics for prevention and treatment of diarrhea.

    Science.gov (United States)

    Guandalini, Stefano

    2011-11-01

    Probiotics have been extensively studied over the past several years in the prevention and, to a larger extent, in the treatment of diarrheal diseases, especially in pediatric populations. Diarrhea is a symptom, and not a disease. This review will not address chronic disorders associated with diarrhea, or Clostridium difficile-induced diarrhea. Rather it will focus on published clinical trials performed on acute-onset, likely infectious diarrhea occurring in the settings of day-care centers, in the community, acquired in the hospital, antibiotic-associated diarrhea, and treatment of acute infectious diarrhea. For prevention of diarrhea acquired in day-care centers, 9 randomized and placebo-controlled trials have been published, conducted in different parts of the world. Probiotics tested were Lactobacillus GG, Bifidobacterium lactis (alone or in combination with Streptococcus thermophilus, and Lactobacillus reuteri, Lactobacillus rhamnosus (not GG), and Lactobacillus acidophilus, in various trials either alone or in comparison with each other. The evidence of their efficacy in these settings is only modest for the prevention of diarrhea, although somewhat better for prevention of upper respiratory infections. In the community, new trails conducted in underprivileged areas of India, again with modest efficacy. Previous trials that examined the potential role of probiotics in preventing the spreading of diarrhea in hospitalized children had yielded conflicting results. More recently, a large trial in Poland showed, however, rather good evidence of efficacy for Lactobacillus GG. The prevention of antibiotic-associated diarrhea has been the subject of many investigations, both in children and in adults. Most commonly used probiotics were Lactobacillus GG, Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium ssp, Streptococcus ssp, and the yeast Saccharomyces boulardii. In general, most of these trials do show clear evidence of efficacy, with the 2 most

  13. Lumbar supports for prevention and treatment of low back pain

    NARCIS (Netherlands)

    van Duijvenbode, I. C. D.; Jellema, P.; van Poppel, M. N. M.; van Tulder, M. W.

    2008-01-01

    Lumbar supports are used in the treatment of low-back pain patients, to prevent the onset of low-back pain (primary prevention) or to prevent recurrences of a low-back pain episode (secondary prevention). To assess the effects of lumbar supports for prevention and treatment of non-specific low-back

  14. Definition of treatment geometry in radiation therapy

    International Nuclear Information System (INIS)

    Aaltonen, P.

    1996-01-01

    When accurate systems for quality assurance and treatment optimization are employed, a precise system for fixation and dosimetric and portal verification are as important as a continued and standardized code of practice for dosimetry and patient follow-up, including registration of tumour responses and acute and late normal tissue reactions. To improve the accuracy of existing dose response relations in order to improve future therapy the treatment geometry and dose delivery concepts have to be accurately defined and uniformly employed. A Nordic working group was set up in 1991 (by Nordic Association of Clinica Physics) to standardize the concepts and quantities used during the whole radiotherapy process in the Nordic countries. Now the group is finalizing its report ''Specification of Dose Delivery in Radiation Therapy''. The report emphasizes that the treatment geometry shall be consistent with the geometry used during the diagnostic work up. The patient fixation is of importance early in the diagnostic phase to ensure that the same reference points and patients position will be used both during the diagnostic work up, simulation and treatment execution. Reference Coordinate System of the patient is a concept based on defined anatomic reference points. This Patient Reference System is a local system which has validity for the tissues, organs and volumes defined during radiotherapy. The reference points of the Patient Reference System should in turn be used for beam set-up. The treatment geometry is then defined by using different concepts describing tissues which are mobile in the Patient Reference System, and finally, volumes which are fixed in this coordinate system. A Set-up Margin has to be considered for movements of the volumes defined in the Reference Coordinate System of the Patient in relation to the radiation beam. The Set-up Margin is dependent on the treatment technique and it is needed in the treatment planning procedure to ensure that the prescribed

  15. Sepsis in Obstetrics: Treatment, Prognosis, and Prevention.

    Science.gov (United States)

    Parfitt, Sheryl E; Bogat, Mary L; Roth, Cheryl

    Sepsis during pregnancy is one of the five leading causes of maternal mortality worldwide. Early recognition and prompt treatment of maternal sepsis is necessary to improve patient outcomes. Patient education on practices that reduce infections may be helpful in decreasing rates of sepsis. Education of nurses about early signs and symptoms of sepsis in pregnancy and use of obstetric-specific tools can assist in timely identification and better outcomes. Although the Surviving Sepsis Campaign (SSC) criteria for diagnosis of sepsis in the general population are not pertinent for obstetric patients, their treatment bundles (guidelines) are applicable and can be used to guide care of obstetric patients who develop sepsis.This article is the third in a series of three that discuss the importance of sepsis and septic shock in pregnancy. This article includes case studies, treatment, prognosis, education, and prevention of maternal sepsis.

  16. Ciguatera Fish Poisoning: Treatment, Prevention and Management

    Directory of Open Access Journals (Sweden)

    Andrew Reich

    2008-08-01

    Full Text Available Ciguatera Fish Poisoning (CFP is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol, the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients.

  17. Ciguatera Fish Poisoning: Treatment, Prevention and Management

    Science.gov (United States)

    Friedman, Melissa A.; Fleming, Lora E.; Fernandez, Mercedes; Bienfang, Paul; Schrank, Kathleen; Dickey, Robert; Bottein, Marie-Yasmine; Backer, Lorraine; Ayyar, Ram; Weisman, Richard; Watkins, Sharon; Granade, Ray; Reich, Andrew

    2008-01-01

    Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol), the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients. PMID:19005579

  18. Nonpharmacologic treatment and prevention strategies for dementia.

    Science.gov (United States)

    Yaffe, Kristine; Hoang, Tina

    2013-04-01

    Epidemiologic studies can provide critical evidence to inform the timing and duration of nonpharmacologic interventions. Although more studies are needed to further determine long-term efficacy, the evidence supporting modifiable risk factors for prevention is compelling, and prevention strategies that incorporate multidomain nonpharmacologic factors may have the most impact. Epidemiologic studies have identified a number of promising nonpharmacologic factors that have the potential to lower the risk of developing dementia. Potential modifiable strategies for dementia prevention include cardiovascular risk factors; lifestyle risk factors such as physical, cognitive, and social activity as well as nutrition, smoking, and alcohol use; and sleep quality. Results of randomized controlled trials for the treatment of cardiovascular risk factors have not been consistent, while interventions that increase physical, cognitive, and social activity have demonstrated protective effects for dementia risk. Trials of single-nutrient dietary supplementation have also been conflicting, but focus on multinutrient supplementation shows promise. Observational data also indicate that sleep quality may be a modifiable risk factor for dementia prevention.

  19. Prevention and treatment of congenital toxoplasmosis

    DEFF Research Database (Denmark)

    Petersen, Eskild

    2007-01-01

    Infection with Toxoplasma gondii is transmitted to man by infected meat or meat products and by contact with soil or surface water. In theory, prevention by hygienic measures is possible, but this has never been proved to work in practice. Therefore, pre- and postnatal screening has been implemen......Infection with Toxoplasma gondii is transmitted to man by infected meat or meat products and by contact with soil or surface water. In theory, prevention by hygienic measures is possible, but this has never been proved to work in practice. Therefore, pre- and postnatal screening has been...... implemented in several countries aiming at early diagnosis. However, data on the effect of treatment are limited and no randomized, controlled trials have been performed. The risk of T. gondii infection in Europe is declining and studies using historical controls from earlier decades cannot be used...

  20. GENITAL CONDYLOMAS. PREVALENCE, ETIOLOGY, TREATMENT AND PREVENTION

    Directory of Open Access Journals (Sweden)

    L.K. Aslamazyan

    2008-01-01

    Full Text Available The article is dedicated to the papilloma virus infection. As it became known in October 2008, the nobel prize in the field of medicine and physiology this year is awarded to the German doctor of Harald Zur Hausen who has proved the role of the human papilloma virus as causative factor of the cervical carcinoma. This is epoch making discovery because of human papilloma virus is most frequent of sexually transmitted infections. The authors demonstrated the high HPV prevalence. One of the most frequent manifestations of this infection is in more details presented pointed condy loma, clinical course of the disease and differential diagnostics of its various forms. Considering treatment inefficiency, the authors convincingly demonstrate that the only opportunity available to keep a human from the illness development is a specific immune prevention.Key words: papillomavirus infection, pointed condylomas, precancers, prevention.

  1. Treatment-refractory anxiety; definition, risk factors, and treatment challenges

    OpenAIRE

    Roy-Byrne, Peter

    2015-01-01

    A sizable proportion of psychiatric patients will seek clinical evaluation and treatment for anxiety symptoms reportedly refractory to treatment. This apparent lack of response is either due to ?pseudo-resistance? (a failure to have received and adhered to a recognized and effective treatment or treatments for their condition) or to true ?treatment resistance.? Pseudo-resistance can be due to clinician errors in selecting and delivering an appropriate treatment effectively, or to patient nona...

  2. Toxic Stress: Effects, Prevention and Treatment.

    Science.gov (United States)

    Franke, Hillary A

    2014-11-03

    Children who experience early life toxic stress are at risk of long-term adverse health effects that may not manifest until adulthood. This article briefly summarizes the findings in recent studies on toxic stress and childhood adversity following the publication of the American Academy of Pediatrics (AAP) Policy Report on the effects of toxic stress. A review of toxic stress and its effects is described, including factors of vulnerability, resilience, and the relaxation response. An integrative approach to the prevention and treatment of toxic stress necessitates individual, community and national focus.

  3. Prevention and Treatment of Breast Cancer

    Science.gov (United States)

    2016-08-01

    pregnant 1>2 (41) 1ɚ (42) Pregnant, Black Pregnant, White 1>2 (20) 1ɚ (43) Pregnant, lean Pregnant, obese 1>2 (20) 1ɚ (22) Pregnant, consuming no...pregnant rats with AFPep showed no disruption of the estrous cycle, no effect on fecundity or fertility , and no evidence of teratogencity. (87) While...Bennett JA, Andersen TT. AFPep, a novel drug for the prevention and treatment of breast cancer, does not disrupt the estrous cycle or fertility in

  4. Treatment-refractory anxiety; definition, risk factors, and treatment challenges

    Science.gov (United States)

    Roy-Byrne, Peter

    2015-01-01

    A sizable proportion of psychiatric patients will seek clinical evaluation and treatment for anxiety symptoms reportedly refractory to treatment. This apparent lack of response is either due to “pseudo-resistance” (a failure to have received and adhered to a recognized and effective treatment or treatments for their condition) or to true “treatment resistance.” Pseudo-resistance can be due to clinician errors in selecting and delivering an appropriate treatment effectively, or to patient nonadherence to a course of treatment. True treatment resistance can be due to unrecognized exogenous anxiogenic factors (eg, caffeine overuse, sleep deprivation, use of alcohol or marijuana) or an incorrect diagnosis (eg, atypical bipolar illness, occult substance abuse, attention deficit-hyperactivity disorder). Once the above factors are eliminated, treatment should focus on combining effective medications and cognitive behavioral therapy, combining several medications (augmentation), or employing novel medications or psychotherapies not typically indicated as first-line evidence-based anxiety treatments. PMID:26246793

  5. Treatment-refractory anxiety; definition, risk factors, and treatment challenges.

    Science.gov (United States)

    Roy-Byrne, Peter

    2015-06-01

    A sizable proportion of psychiatric patients will seek clinical evaluation and treatment for anxiety symptoms reportedly refractory to treatment. This apparent lack of response is either due to "pseudo-resistance" (a failure to have received and adhered to a recognized and effective treatment or treatments for their condition) or to true "treatment resistance." Pseudo-resistance can be due to clinician errors in selecting and delivering an appropriate treatment effectively, or to patient nonadherence to a course of treatment. True treatment resistance can be due to unrecognized exogenous anxiogenic factors (eg, caffeine overuse, sleep deprivation, use of alcohol or marijuana) or an incorrect diagnosis (eg, atypical bipolar illness, occult substance abuse, attention deficit-hyperactivity disorder). Once the above factors are eliminated, treatment should focus on combining effective medications and cognitive behavioral therapy, combining several medications (augmentation), or employing novel medications or psychotherapies not typically indicated as first-line evidence-based anxiety treatments.

  6. [Pain in herpes zoster: Prevention and treatment].

    Science.gov (United States)

    Calvo-Mosquera, G; González-Cal, A; Calvo-Rodríguez, D; Primucci, C Y; Plamenov-Dipchikov, P

    Shingles is a painful rash that results from reactivation of latent varicella-zoster virus in the dorsal root ganglia or cranial nerves. In this article an update is presented on the prevention and pharmacological treatment of the secondary pain from the virus infection. The most effective way to prevent post-herpetic neuralgia and its consequences is the prevention of herpes itself. A live attenuated vaccine (the Oka strain varicella zoster virus) has been available for several years, and is approved in adults aged 50 years old. Although this vaccine has shown to be effective against herpes zoster and post-herpetic neuralgia, its effectiveness decreases with age and is contraindicated in patients with some form of immunosuppression. Today the recombinant vaccines provide an alternative, and may be administered to immunocompromised persons. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Neonatal pressure ulcers: prevention and treatment

    Directory of Open Access Journals (Sweden)

    García-Molina P

    2017-09-01

    Full Text Available Pablo García-Molina,1,2 Alba Alfaro-López,1 Sara María García-Rodríguez,1 Celia Brotons-Payá,1 Mari Carmen Rodríguez-Dolz,1,2 Evelin Balaguer-López1,2 1Department of Nursing, University of Valencia, 2Research Group of Pediatric Nutrition, INCLIVA Foundation, Valencia, Spain Abstract: Health professionals should be prepared to respond to the needs of hospitalized neonates. The health team must consider multiple situations, where the neonate is at risk of having an adverse effect. One of the main interventions that health professionals must practice when interacting with hospitalized newborns is skin care. Neonates often suffer from diaper rash or intravenous drugs extravasation. Recently, hospitalized neonates and especially those in an unstable clinical situation are also at a risk of developing pressure ulcers. The presence of a pressure ulcer in a neonate can lead to serious problems to survival (eg, sepsis, clinical instability. This is the reason why, with this literature review, we attempt to answer questions from health professionals caring for neonates about the prevention and treatment of pressure ulcers. Keywords: infant, pressure ulcer, treatment, prevention, wound, assessment

  8. Intermittent preventive treatment of malaria in pregnancy

    DEFF Research Database (Denmark)

    Mbonye, A.K.; Bygbjerg, Ib Christian; Magnussen, Pascal

    2008-01-01

    OBJECTIVE: To assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. METHODS: A non-randomized comm......OBJECTIVE: To assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. METHODS: A non......-randomized community trial was implemented in 21 community clusters (intervention) and four clusters where health units provided routine IPTp (control). The primary outcome measures were access and adherence to IPTp, number of malaria episodes, prevalence of anaemia, and birth weight. Numbers of live births, abortions......, still births, and maternal and child deaths were secondary endpoints. FINDINGS: 1404 (67.5%) of 2081 with the new delivery system received two doses of sulfadoxine-pyrimethamine versus 281 (39.9%) of 704 with health units (P malaria episodes decreased from 906 (49...

  9. Athletic pubalgia: definition and surgical treatment.

    Science.gov (United States)

    Ahumada, Leonik A; Ashruf, Salman; Espinosa-de-los-Monteros, Antonio; Long, James N; de la Torre, Jorge I; Garth, William P; Vasconez, Luis O

    2005-10-01

    Athletic pubalgia, or "sports hernia," affects people actively engaged in sports. Previously described in high-performance athletes, it can occur in recreational athletes. It presents with inguinal pain exacerbated with physical activity. Examination reveals absence of a hernia with pubic point tenderness accentuated by resisted adduction of the hip. Diagnosis is by history and physical findings. Treatment with an internal oblique flap reinforced with mesh alleviates symptoms. A retrospective review from December 1998 to November 2004 for patients with athletic pubalgia who underwent operative repair was performed. Descriptive variables included age, gender, laterality, sport, time to presentation, outcome, anatomy, and length of follow-up. Twelve patients, 1 female, with median age 25 years were evaluated. Activities included running (33%), basketball (25%), soccer (17%), football (17%), and baseball (8%). The majority were recreational athletes (50%). Median time to presentation was 9 months, with a median 4 months of follow-up. The most common intraoperative findings were nonspecific attenuation of the inguinal floor and cord lipomas. All underwent open inguinal repair, with 9 being reinforced with mesh. Four had adductor tenotomy. Results were 83.3% excellent and 16.7% satisfactory. All returned to sports. Diagnosis of athletic pubalgia can be elusive, but is established by history and physical examination. It can be found in recreational athletes. An open approach using mesh relieves the pain and restores activity.

  10. Role of STD Detection and Treatment in HIV Prevention

    Science.gov (United States)

    ... Sheet Treatment and Care Other Resources Archive STD Treatment to Prevent HIV Infection STDs Home Page Bacterial Vaginosis (BV) Chlamydia ... and prevent spreading STDs to your sex partners. Treatment for an STD other than HIV does not prevent the spread of HIV. If ...

  11. Prevention vs. treatment: what's the right balance?

    National Research Council Canada - National Science Library

    Faust, Halley S; Menzel, Paul T

    2012-01-01

    .... This book explores this observation by examining the actual spending on prevention, the history of health policies and structural features that affect prevention's apparent relative lack of emphasis...

  12. Milk Fistula: Diagnosis, Prevention, and Treatment.

    Science.gov (United States)

    Larson, Kelsey E; Valente, Stephanie A

    2016-01-01

    Milk fistula is an uncommon condition which occurs when there is an abnormal connection that forms between the skin surface and the duct in the breast of a lactating woman, resulting in spontaneous and often constant drainage of milk from this path of least resistance. A milk fistula is usually a complication that results from a needle biopsy or surgical intervention in a lactating patient. Here, the authors present an unusual case of a spontaneous milk fistula which developed from an abscess in the breast of a lactating woman. The patient initially presented to the office with a large open wound on her breast, formed from skin breakdown, within which milk was pooling. She was treated with local wound care and cessation of breastfeeding, with appropriate healing of the wound and closure of the fistula with 6 weeks. Diagnosis, prevention, and treatment of milk fistula were reviewed. © 2015 Wiley Periodicals, Inc.

  13. Herpes Genitalis: Diagnosis, Treatment and Prevention

    Science.gov (United States)

    Sauerbrei, A.

    2016-01-01

    Herpes genitalis is caused by the herpes simplex virus type 1 or type 2 and can manifest as primary or recurrent infection. It is one of the most common sexually transmitted infections and due to associated physical and psychological morbidity it constitutes a considerable, often underestimated medical problem. In addition to providing the reader with basic knowledge of the pathogen and clinical presentation of herpes genitalis, this review article discusses important aspects of the laboratory diagnostics, antiviral therapy and prophylaxis. The article is aimed at all health-care workers managing patients with herpes genitalis and attempts to improve the often suboptimal counselling, targeted use of laboratory diagnostics, treatment and preventive measures provided to patients. PMID:28017972

  14. Prevention and treatment of postmenopausal osteoporosis.

    Science.gov (United States)

    Tella, Sri Harsha; Gallagher, J Christopher

    2014-07-01

    In the beginning, that is from the 1960's, when a link between menopause and osteoporosis was first identified; estrogen treatment was the standard for preventing bone loss, however there was no fracture data, even though it was thought to be effective. This continued until the Women's Health Initiative (WHI) study in 2001 that published data on 6 years of treatment with hormone therapy that showed an increase in heart attacks and breast cancer. Even though the risks were small, 1 per 1500 users annually, patients were worried and there was a large drop off in estrogen use. In later analyses the WHI study showed that estrogen reduced fractures and actually prevented heart attacks in the 50-60 year age group. Estrogen alone appeared to be safer to use than estrogen+the progestin medroxyprogesterone acetate and actually reduced breast cancer. At the same time other drugs were being developed for bone that belong to the bisphosphonate group and the first generation of compounds showed moderate potency on bone resorption. The second and third generation compounds were much more potent and in a series of large trials were shown to reduce fractures. For the last 15 years the treatment of osteoporosis belonged to the bisphosphonate compounds, most of which reduce fracture rates by 50 percent. With the exception of gastrointestinal irritation the drugs are well tolerated and highly effective. The sophistication of the delivery systems now allow treatment that can be given daily, weekly, monthly and annually either orally or intravenously. Bone remodeling is a dynamic process that repairs microfractures and replaces old bone with new bone. In the last 10 years there has been a remarkable understanding of bone biology so that new therapies can be specifically designed on a biological basis. The realization that RANKL was the final cytokine involved in the resorption process and that marrow cells produced a natural antagonist called Osteoprotegerin (OPG) quickly led to two

  15. PIXE studies of osteoporosis preventive treatments

    International Nuclear Information System (INIS)

    Ynsa, M.D.; Pinheiro, T.; Ager, F.J.; Alves, L.C.; Millan, J.C.; Gomez-Zubelbia, M.A.; Respaldiza, M.A.

    2002-01-01

    Particle induced X-ray emission (PIXE) and nuclear microprobe (NMP) have been used in an exploratory work to study elemental alterations in tissues of experimental animals submitted to osteoporosis preventive treatments. Osteopathologies have been associated with several factors, such as hormonal disturbances, metabolic aberrations, low dietary Ca and vitamin D intake, excess of iron, among other possible factors. Hormonal treatments seem to be beneficial to the incorporation of Ca in bone but breast and endometrial cancers constitute significant side effects that cannot be ignored. Wistar female rats were used to test the effect of estrogen therapy in osteoporosis progression. The variations of elemental concentrations in uterus and the Ca content of femoral bones of ovariectomised rats under estrogen therapy were investigated. PIXE, Rutherford backscattering spectrometry and secondary electron microscopy techniques were applied for the characterisation of biological materials, with respect to morphology and trace element distribution determination. The increase of Ca and Fe concentrations in uterus and the variations for Ca distribution patterns in bone of rats submitted to estrogen therapy were the major features observed

  16. PIXE studies of osteoporosis preventive treatments

    Energy Technology Data Exchange (ETDEWEB)

    Ynsa, M.D. E-mail: ynsa@us.es; Pinheiro, T.; Ager, F.J.; Alves, L.C.; Millan, J.C.; Gomez-Zubelbia, M.A.; Respaldiza, M.A

    2002-04-01

    Particle induced X-ray emission (PIXE) and nuclear microprobe (NMP) have been used in an exploratory work to study elemental alterations in tissues of experimental animals submitted to osteoporosis preventive treatments. Osteopathologies have been associated with several factors, such as hormonal disturbances, metabolic aberrations, low dietary Ca and vitamin D intake, excess of iron, among other possible factors. Hormonal treatments seem to be beneficial to the incorporation of Ca in bone but breast and endometrial cancers constitute significant side effects that cannot be ignored. Wistar female rats were used to test the effect of estrogen therapy in osteoporosis progression. The variations of elemental concentrations in uterus and the Ca content of femoral bones of ovariectomised rats under estrogen therapy were investigated. PIXE, Rutherford backscattering spectrometry and secondary electron microscopy techniques were applied for the characterisation of biological materials, with respect to morphology and trace element distribution determination. The increase of Ca and Fe concentrations in uterus and the variations for Ca distribution patterns in bone of rats submitted to estrogen therapy were the major features observed.

  17. [Preventive prophylactic treatment in posttraumatic epilepsy].

    Science.gov (United States)

    Oliveros-Juste, A; Bertol, V; Oliveros-Cid, A

    Posttraumatic epilepsy (PTE) represents about 2 3% of all the etiologies of epilepsy. The so called early seizures , which appear in the first week after the traumatic brain injury (TBI), are related to the severity of the injury; they do not have an strictly epileptic mechanism, but they become a risk factor to the development of PTE. PTE appears in 5% of all the patients suffering from all TBI, and in 15 20% of the patients suffering from a severe TBI. However, the endpoint uses to be to use antiepileptic drugs (AEDs) as prophylactic treatment in all well established PTE. The efficacy of classic antiepileptic drugs (Phenobarbital, Phenytoin, Carbamazepine, Valproate acid) to control the kindling effect has not been confirmed yet as a prophylactic treatment for PTE. Prophylactic efficacy of other drugs, like lipid peroxidation inhibitors, neuroprotectors (especially antioxidants), glutamic receptor blockers, NMDA receptor blockers, and drugs that modulate apoptosis via caspasas inhibition; however, they constitute new ways of therapeutic investigation with a strong experimental basis. Our recommended therapeutic strategy is not to administrate AEDs indiscriminately, but analyzing risk factors, designing a careful prevention for late seizures using AEDs with proven efficacy in partial seizures and with the best achievable tolerability; being also attentive to the possible use of new drugs in the future, like lipid peroxidation inhibitors, and drugs designed to inhibit other excitotoxic, ionic or oxidative processes.

  18. Colonic diverticular disease. Treatment and prevention.

    Science.gov (United States)

    Gargallo Puyuelo, Carla J; Sopeña, Federico; Lanas Arbeloa, Angel

    2015-12-01

    Diverticular disease represents the most common disease affecting the colon in the Western world. Most cases remain asymptomatic, but some others will have symptoms or develop complications. The aims of treatment in symptomatic uncomplicated diverticular disease are to prevent complications and reduce the frequency and intensity of symptoms. Fibre, probiotics, mesalazine, rifaximin and their combinations seem to be usually an effective therapy. In the uncomplicated diverticulitis, outpatient management is considered the optimal approach in the majority of patients, and oral antibiotics remain the mainstay of treatment. Admission to hospital and intravenous antibiotic are recommended only when the patient is unable to intake food orally, affected by severe comorbidity or does not improve. However, inpatient management and intravenous antibiotics are necessary in complicated diverticulitis. The role of surgery is also changing. Most diverticulitis-associated abscesses can be treated with antibiotics and/or percutaneous drainage and emergency surgery is considered only in patients with acute peritonitis. Finally, patient related factors, and not the number of recurrences, play the most important role in selecting recipients of elective surgery to avoid recurrences. Copyright © 2015 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  19. Toxoplasmosis in pregnancy: prevention, screening, and treatment.

    Science.gov (United States)

    Paquet, Caroline; Yudin, Mark H

    2013-01-01

    One of the major consequences of pregnant women becoming infected by Toxoplasma gondii is vertical transmission to the fetus. Although rare, congenital toxoplasmosis can cause severe neurological or ocular disease (leading to blindness), as well as cardiac and cerebral anomalies. Prenatal care must include education about prevention of toxoplasmosis. The low prevalence of the disease in the Canadian population and limitations in diagnosis and therapy limit the effectiveness of screening strategies. Therefore, routine screening is not currently recommended. To review the prevention, diagnosis, and management of toxoplasmosis in pregnancy. OUTCOMES evaluated include the effect of screening on diagnosis of congenital toxoplasmosis and the efficacy of prophylaxis and treatment. The Cochrane Library and Medline were searched for articles published in English from 1990 to the present related to toxoplasmosis and pregnancy. Additional articles were identified through references of these articles. The quality of evidence is rated and recommendations made according to guidelines developed by the Canadian Task Force on Preventive Health Care (Table). Guideline implementation should assist the practitioner in developing an approach to screening for and treatment of toxoplasmosis in pregnancy. Patients will benefit from appropriate management of this condition. The Society of Obstetricians and Gynaecologists of Canada. 1. Routine universal screening should not be performed for pregnant women at low risk. Serologic screening should be offered only to pregnant women considered to be at risk for primary Toxoplasma gondii infection. (II-3E) 2. Suspected recent infection in a pregnant woman should be confirmed before intervention by having samples tested at a toxoplasmosis reference laboratory, using tests that are as accurate as possible and correctly interpreted. (II-2B) 3. If acute infection is suspected, repeat testing should be performed within 2 to 3 weeks, and consideration

  20. Treatment and prevention of music performance anxiety.

    Science.gov (United States)

    Spahn, Claudia

    2015-01-01

    Music performance anxiety (MPA) regularly occurs when musicians present themselves before an audience in performance situations, and thus, it plays an important role in the careers of professional musicians. MPA is expressed on the emotional and physical level, as well as on the levels of thinking and behavior, and extends along a continuum of varying severity. Its performance-impairing, afflicting form is considered to be a specific type of social phobia, which requires therapy. There are different psychological theories, which contribute to the understanding of the phenomenon of MPA and provide basic principles for the various treatment approaches. Current "best practice," in our clinical experience, is a personal- and problem-oriented approach within a multimodal therapy model, including the range of psychoanalytic and cognitive behavioral therapies, body-oriented methods, and mental techniques. In order to avoid severe MPA, prevention in the field of music pedagogic is very important. Thus, the concepts of dealing positively with MPA should be implemented very early into the instrumental and vocal education of musicians. © 2015 Elsevier B.V. All rights reserved.

  1. Pediatric obesity: Causes, symptoms, prevention and treatment.

    Science.gov (United States)

    Xu, Shumei; Xue, Ying

    2016-01-01

    , and mitochondrial uncoupling proteins, are known to affect body weight. These molecules serve as potential targets for the pharmacological manipulation of obesity. Sibutramine and orlistat are primariliy used for the treatment of adult obesity, which produces modest weight loss, of 3-8% compared to placebo. For children and obese adolescents, metformin is used in the case of insulin resistance and hyperinsulinemia. Octreotide is used for hypothalamic obesity. Bariatric surgery is performed for the treatment of severe childhood obesity. The causes, symptoms, prevention and treatment of pediatric obesity are described in the present review.

  2. Aseptic and Bacterial Meningitis: Evaluation, Treatment, and Prevention.

    Science.gov (United States)

    Mount, Hillary R; Boyle, Sean D

    2017-09-01

    The etiologies of meningitis range in severity from benign and self-limited to life-threatening with potentially severe morbidity. Bacterial meningitis is a medical emergency that requires prompt recognition and treatment. Mortality remains high despite the introduction of vaccinations for common pathogens that have reduced the incidence of meningitis worldwide. Aseptic meningitis is the most common form of meningitis with an annual incidence of 7.6 per 100,000 adults. Most cases of aseptic meningitis are viral and require supportive care. Viral meningitis is generally self-limited with a good prognosis. Examination maneuvers such as Kernig sign or Brudzinski sign may not be useful to differentiate bacterial from aseptic meningitis because of variable sensitivity and specificity. Because clinical findings are also unreliable, the diagnosis relies on the examination of cerebrospinal fluid obtained from lumbar puncture. Delayed initiation of antibiotics can worsen mortality. Treatment should be started promptly in cases where transfer, imaging, or lumbar puncture may slow a definitive diagnosis. Empiric antibiotics should be directed toward the most likely pathogens and should be adjusted by patient age and risk factors. Dexamethasone should be administered to children and adults with suspected bacterial meningitis before or at the time of initiation of antibiotics. Vaccination against the most common pathogens that cause bacterial meningitis is recommended. Chemoprophylaxis of close contacts is helpful in preventing additional infections.

  3. Impact of health education on home treatment and prevention

    African Journals Online (AJOL)

    Emmanuel Ameh

    Impact of health education on home treatment and prevention of malaria. Chirdan O. O. et al. Page | 115 taken at home and dangers of self treatment. Part 3: Treatment of uncomplicated malaria and prevention of malaria. Posters and chloroquine drug charts were used as teaching aids. Post intervention impact assessment.

  4. Bringing Central Line–Associated Bloodstream Infection Prevention Home: CLABSI Definitions and Prevention Policies in Home Health Care Agencies

    Science.gov (United States)

    Rinke, Michael L.; Bundy, David G.; Milstone, Aaron M.; Deuber, Kristin; Chen, Allen R.; Colantuoni, Elizabeth; Miller, Marlene R.

    2015-01-01

    Background A study was conducted to investigate home health care agency central line–associated bloodstream infection (CLABSI) definitions and prevention policies and compare them to the Joint Commission National Patient Safety Goal (NPSG.07.04.01), the Centers for Disease Control and Prevention (CDC) CLABSI prevention recommendations, and a best-practice central line care bundle for inpatients. Methods A telephone-based survey was conducted in 2011 of a convenience sample of home health care agencies associated with children’s hematology/oncology centers. Results Of the 97 eligible home health care agencies, 57 (59%) completed the survey. No agency reported using all five aspects of the National Healthcare and Safety Network/Association for Professionals in Infection Control and Epidemiology CLABSI definition and adjudication process, and of the 50 agencies that reported tracking CLABSI rates, 20 (40%) reported using none. Only 10 agencies (18%) had policies consistent with all elements of the inpatient-focused NPSG.07.04.01, 10 agencies (18%) were consistent with all elements of the home care targeted CDC CLABSI prevention recommendations, and no agencies were consistent with all elements of the central line care bundle. Only 14 agencies (25%) knew their overall CLABSI rate: mean 0.40 CLABSIs per 1,000 central line days (95% confidence interval [CI], 0.18 to 0.61). Six agencies (11%) knew their agency’s pediatric CLABSI rate: mean 0.54 CLABSIs per 1,000 central line days (95% CI, 0.06 to 1.01). Conclusions The policies of a national sample of home health care agencies varied significantly from national inpatient and home health care agency targeted standards for CLABSI definitions and prevention. Future research should assess strategies for standardizing home health care practices consistent with evidence-based recommendations. PMID:23991509

  5. [Definitions and prevention of cardiorespiratory arrest in children].

    Science.gov (United States)

    Carrillo Alvarez, A; López-Herce Cid, J

    2006-08-01

    In cardiopulmonary resuscitation ages are divided in neonates (in the inmediate period after the birth), infant (from birth to 12 months) and child (from 12 months to puberty). Respiratory arrest is defined by the absence of spontaneous respiration (apnea) or a severe respiratory insufficiency (agonal gasping) that require respiratory assistance. Cardiac arrest is defined as the absence of central arterial pulse or signs of circulation (movement, cough or normal breathing) or the presence of a central pulse less than 60 lpm in a child who does not respond, not breath and with poor perfusion. After resuscitation the return of spontaneous circulation is defined as the recuperation of central arterial pulse or signs of circulation in a child with previous cardiorespiratory arrest. It is maintained when the duration is longer than 20 minutes. Injuries, sudden infant death syndrome, and respiratory diseases are the most frequent etiologies of cardiorrespiratory arrest in children. The prevention and the formation of citizens in basic cardiopulmonary resuscitation are the most effective measures to reduce the mortality of cardiorespiratory arrest in children.

  6. Prevention: The Best Treatment for Back Pain

    Science.gov (United States)

    ... of the top reasons for doctor visits. Back pain has many causes, including bad posture, excessive weight, poor workstation setup, lack of exercise and limited flexibility. Fortunately, many of them are preventable and ... can help prevent back pain. Depending on the cause, the pain can occur ...

  7. 33 CFR 151.3000 - Definition of marine debris for the purposes of the Marine Debris Research, Prevention, and...

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Definition of marine debris for the purposes of the Marine Debris Research, Prevention, and Reduction Act. 151.3000 Section 151.3000... Definition of Marine Debris for the Purposes of the Marine Debris Research, Prevention, and Reduction Act...

  8. TINEA CAPITIS– SIGNIFICANCE OF TIMELY TREATMENT TO PREVENT SCARRING ALOPECIA

    Directory of Open Access Journals (Sweden)

    Sandrina Carvalho

    2016-09-01

    Conclusion: The treatment of tinea capitis is simple and effective. Timely identification and treatment are essential to prevent the formation of a cicatricial alopecia, often disturbing for the patient.

  9. Mediterranean Diet and Diabetes: Prevention and Treatment

    OpenAIRE

    Georgoulis, Michael; Kontogianni, Meropi D.; Yiannakouris, Nikos

    2014-01-01

    The aim of the present review is to examine current scientific knowledge on the association between the Mediterranean diet and diabetes mellitus (mostly type 2 diabetes). A definition of the Mediterranean diet and the tools widely used to evaluate adherence to this traditional diet (Mediterranean diet indices) are briefly presented. The review focuses on epidemiological data linking adherence to the Mediterranean diet with the risk of diabetes development, as well as evidence from interventi...

  10. Combinatorial Therapies for Neurofibroma and MPNST Treatment and Prevention

    Science.gov (United States)

    2017-08-01

    AWARD NUMBER: W81XWH-15-1-0193 TITLE: Combinatorial Therapies for Neurofibroma and MPNST Treatment and Prevention PRINCIPAL INVESTIGATOR...2016 - 31 Jul 2017 4. TITLE AND SUBTITLE Combinatorial Therapies for Neurofibroma and MPNST Treatment and Prevention 5a. CONTRACT NUMBER 5b. GRANT...with these drugs will prevent neurofibroma and MPNST pathogenesis. To test these hypotheses, we will: 1) determine whether tamoxifen, trifluoperazine

  11. effectiveness of intermittent preventive treatment with sulphadoxine

    African Journals Online (AJOL)

    2011-08-08

    Aug 8, 2011 ... East Africa Medical Journal Vol. ... AND INSECTICIDE TREATED NETS ON THE PREVENTION OF MALARIA IN PREGNANCY IN NON-MALARIAL .... With a population of 18,000 pregnant women annually. Study Duration. The study was conducted between. February and August 2010. Study Area: The ...

  12. . ORIGINAL ARTICLES Prevention and treatment of cardiovascular ...

    African Journals Online (AJOL)

    Since the clinical neonatal outcome is not worse after the use of ephedrine, it currently remains the first-line agent in most units. Adrenaline is not routinely used as an agent to prevent or treat spinal hypotension. Following a bolus dose its effect is brief and it is associated with cardiac arrhythmias. Because its use may be ...

  13. Prevalence of intermittent preventive treatment with sulphadoxine ...

    African Journals Online (AJOL)

    Cite as: Orish VN, Onyeabor OS, Boampong JN , Afoakwah R, Nwaefuna E, Acquah S, et al. Prevalence of intermittent preventive treat- ment with sulphadoxine-pyrimethamine (IPTp-SP) use ..... by the increase of SP drug resistance in pregnant wom- en in Ghana since the adoption and implementation of. IPTp-SP policy35.

  14. Mini implants for definitive prosthodontic treatment: a systematic review.

    Science.gov (United States)

    Bidra, Avinash S; Almas, Khalid

    2013-03-01

    Mini implants are commonly used in orthodontics and for interim prosthodontic treatment, but evidence for their use in definitive prosthodontic treatment is not clear. This systematic review evaluated the mini-implant literature to analyze short-term (1 to 5 years), medium-term (5 to 10 years), and long-term (beyond 10 years) survival rates when used for definitive prosthodontic treatment. An electronic search of the English language literature for articles published between January 1974 and May 2012 was performed by using PubMed and Cochrane databases with predetermined inclusion criteria. Key terms included in the search were mini dental implants, narrow diameter implants, reduced diameter implants, small diameter implants, transitional implants, interim implants, and provisional implants. After a systematic filtering process, the selected articles were subjected to a detailed review, and the data collected were used to calculate the 1-year interval survival rate (ISR) and the cumulative survival rate (CSR). The electronic database search yielded 1807 titles. By scrutinizing the titles and abstracts with inclusion and exclusion criteria, the researchers identified 9 studies of mini implants for definitive prosthodontic treatment. Of the studies identified, 1 was a randomized controlled trial, 2 were prospective studies, and 6 were retrospective studies. The majority of mini implants were placed by using a flapless surgical technique in the mandibular anterior region to support an overdenture. The 1st year ISR was 94.7% and the CSR over a 9-year period, primarily attributed to data from 1 study, was 92.2%. Most implants were immediately loaded and almost all implant failures occurred during the first year after implant placement. For short-term survival, the first year ISR of 94.7% of mini dental implants appears encouraging, but the true 1-year survival rate is unknown, as the minimum follow-up period reported for several implants was less than a year

  15. Conceptual definitions of indicators for the nursing outcome "Knowledge: Fall Prevention".

    Science.gov (United States)

    Luzia, Melissa de Freitas; Argenta, Carla; Almeida, Miriam de Abreu; Lucena, Amália de Fátima

    2018-01-01

    to construct conceptual definitions for indicators of nursing outcome Knowledge: Fall Prevention, selected for evaluation of hospitalized patients with the nursing diagnosis Risk for falls. integrative literature review performed in the LILACS, MEDLINE and Web of Science databases, comprising articles published in English, Spanish and Portuguese languages from 2005 to 2015. the final sample of the study was composed of 17 articles. The conceptualizations were constructed for 14 indicators of nursing outcome Knowledge: Fall Prevention focused on hospitalized patients. the theoretical support of the Nursing Outcomes Classification (NOC), through the process of constructing the conceptual definitions of the indicators of its results, allows nurses to accurately implement this classification in clinical practice and to evaluate the effectiveness of their interventions through the change of the patients' status over time.

  16. Mediterranean Diet and Diabetes: Prevention and Treatment

    Science.gov (United States)

    Georgoulis, Michael; Kontogianni, Meropi D.; Yiannakouris, Nikos

    2014-01-01

    The aim of the present review is to examine current scientific knowledge on the association between the Mediterranean diet and diabetes mellitus (mostly type 2 diabetes). A definition of the Mediterranean diet and the tools widely used to evaluate adherence to this traditional diet (Mediterranean diet indices) are briefly presented. The review focuses on epidemiological data linking adherence to the Mediterranean diet with the risk of diabetes development, as well as evidence from interventional studies assessing the effect of the Mediterranean diet on diabetes control and the management of diabetes-related complications. The above mentioned data are explored on the basis of evaluating the Mediterranean diet as a whole dietary pattern, rather than focusing on the effect of its individual components. Possible protective mechanisms of the Mediterranean diet against diabetes are also briefly discussed. PMID:24714352

  17. Compulsory outpatient treatment can prevent involuntary commitment

    DEFF Research Database (Denmark)

    Hansen, Lene Nørregård; Svensson, Eva Maria Birgitta; Brandt-Christensen, Anne Mette

    2014-01-01

    Compulsory outpatient treatment (co-pt) has been possible in Denmark since 2010. The aim is to secure necessary treatment, reduce involuntary commitment and improve quality of life for patients with a severe psychiatric illness. Co-pt has been brought into use in 33 cases. This case report...

  18. Screening, prevention, and treatment of congenital cytomegalovirus.

    Science.gov (United States)

    Johnson, Julie; Anderson, Brenna

    2014-12-01

    Congenital cytomegalovirus (CMV) is a leading cause of permanent disability in children. The main source of maternal infection is from contact with young children. Primary maternal infection is diagnosed with demonstration of seroconversion or a positive CMV IgM in combination with a low-avidity CMV IgG. Fetal infection may be diagnosed with amniotic fluid polymerase chain reaction and culture. CMV-specific hyperimmune globulin has shown promise as a possible means to prevent congenital infection; large randomized trials are ongoing. To date, the only effective means of prevention is through reducing exposure to the virus. Rates of maternal infection may be reduced through education regarding sources of infection and improved hygiene. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Childhood obesity treatment and prevention. Psychological perspectives of clinical approaches

    Directory of Open Access Journals (Sweden)

    Maria Catena Quattropani

    2013-05-01

    Full Text Available Objective: This work focuses on clinical psychologist’ presence within childhood obesity prevention programmes in several countries. Method: The Authors collected articles considering psychological, biological and social aspects linked to childhood obesity. Results: Studies reveal that childhood obesity prevention programmes are based on biological, medical and educational aspects; clinical psychologists up until now have been engaged almost exclusively in the treatment of obesity. Conclusions: There is a clear need to consider psychological aspects (emotional, cognitive and relational related to the childhood obesity’s causes and involve psychologists in its prevention projects. Keywords: childhood obesity, overweight, multidisciplinary approach, clinical psychology, prevention, treatment

  20. Leishmaniasis: prevention, parasite detection and treatment

    Czech Academy of Sciences Publication Activity Database

    Kobets, Tetyana; Grekov, Igor; Lipoldová, Marie

    2012-01-01

    Roč. 19, č. 10 (2012), s. 1443-1474 ISSN 0929-8673 R&D Projects: GA ČR GA310/08/1697; GA MŠk(CZ) LC06009 Institutional research plan: CEZ:AV0Z50520514 Keywords : tropical disease * kala-azar * preventive medicine * animal model Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 4.070, year: 2012

  1. Prevention and treatment of diabetic foot ulcers.

    Science.gov (United States)

    Lim, Jonathan Zhang Ming; Ng, Natasha Su Lynn; Thomas, Cecil

    2017-03-01

    The rising prevalence of diabetes estimated at 3.6 million people in the UK represents a major public health and socioeconomic burden to our National Health Service. Diabetes and its associated complications are of a growing concern. Diabetes-related foot complications have been identified as the single most common cause of morbidity among diabetic patients. The complicating factor of underlying peripheral vascular disease renders the majority of diabetic foot ulcers asymptomatic until latter evidence of non-healing ulcers become evident. Therefore, preventative strategies including annual diabetic foot screening and diabetic foot care interventions facilitated through a multidisciplinary team have been implemented to enable early identification of diabetic patients at high risk of diabetic foot complications. The National Diabetes Foot Care Audit reported significant variability and deficiencies of care throughout England and Wales, with emphasis on change in the structure of healthcare provision and commissioning, improvement of patient education and availability of healthcare access, and emphasis on preventative strategies to reduce morbidities and mortality of this debilitating disease. This review article aims to summarise major risk factors contributing to the development of diabetic foot ulcers. It also considers the key evidence-based strategies towards preventing diabetic foot ulcer. We discuss tools used in risk stratification and classifications of foot ulcer.

  2. MIGRAINE: BASIC PRINCIPLES OF TREATMENT AND PREVENTION

    Directory of Open Access Journals (Sweden)

    O. R. Esin

    2011-01-01

    Full Text Available Modern recommendations for the migraine attack treatment and it's prophylaxis are analyzed in this review. Established, that acetylsalicylic acid, diclofenac potassium, ibuprofen, naproxen, paracetamol, metamizol and their combination with caffeine are drugs of the first choice for migraine attack treatment. Metoclopramide and domperidone are used to reduce nausea and vomiting. Also triptans are high effective drugs for migraine attack treatment. Metoprolol, propranolol, flunarizine, valproic acid can be used for migraine prophylaxis. Drugs of the second choice are: amitriptyline, venlafaxine, naproxen and bisoprolol.

  3. Oligometastatic prostate cancer: definitions, clinical outcomes, and treatment considerations

    Science.gov (United States)

    Tosoian, Jeffrey J.; Gorin, Michael A.; Ross, Ashley E.; Pienta, Kenneth J.; Tran, Phuoc T.; Schaeffer, Edward M.

    2018-01-01

    The oligometastatic state has been proposed as an intermediate stage of cancer spread between localized disease and widespread metastases. With improvements in diagnostic modalities such as functional imaging, oligometastatic prostate cancer is being diagnosed with greater frequency than ever before. Furthermore, the paradigm for treatment of advanced prostate cancers is shifting toward a more aggressive approach. Many questions surround the understanding of the process and consequences of oligometastasis, meaning that the contemporary literature offers a wide variety of definitions of oligometastatic prostate cancer. Until genomic data exist to provide a biological component to the definition of oligometastatic disease, a clinical diagnosis made on the basis of up to five extrapelvic lesions is reasonable for use. Retrospective studies suggest that interventions such as radical prostatectomy and local or metastasis-directed radiotherapy can be performed in the metastatic setting with minimal risk of toxic effects. These therapies seem to decrease the need for subsequent palliative interventions, but insufficient data are available to draw reliable conclusions regarding their effect on survival. Thus, a protocol for clinicians to manage the patient presenting with oligometastatic prostate cancer would be a useful clinical tool. PMID:27725639

  4. Probiotic bacteria in prevention and treatment of diarrhea

    Directory of Open Access Journals (Sweden)

    Jasmina Havranek

    2009-03-01

    Full Text Available Probiotic bacteria have beneficial effects in prevention and treatment of different diseases. The results of preventive and therapeutic effect of probiotic bacteria on diarrhea during last ten years are shown in this paper. The greatest preventive and therapeutic effect of probiotic bacteria was identified for acute diarrhea in children caused by rotaviruses. Significant, but slightly lower effect of probiotic bacteria was proved for antibiotic associated diarrhea. Positive effect in prevention of traveller’s diarrhea and radiation-induced diarrhea is not significant. Preventive and therapeutic effect on diarrhea is not dependent on the way of probiotic bacteria consumption, by fermented milk, capsule or oral rehydration solution.

  5. Feature Hepatitis: Hepatitis Symptoms, Diagnosis, Treatment & Prevention

    Science.gov (United States)

    ... many NIDDK research projects related to hepatitis and liver disease: A recent study concluded that about half of patients with chronic hepatitis C recovered after receiving initial treatments from two drugs, ...

  6. [Prevention and treatment of Alzheimer disease].

    Science.gov (United States)

    Donoso S, Archibaldo; Delgado D, Carolina

    2009-02-01

    The pharmacological interventions for Alzheimer disease should be based in its pathogenic mechanisms such as amyloidogenesis, tau hyperphosphorilation, disturbances in neurotransmission and changes in neuronal trophism. Other therapies derive from epidemiological observations, such as antioxidants and anti-inflammatory drugs, estrogens, statins and anti hypertensive drugs. Some life style interventions, such as changes in diet, exercise and brain stimulation could also be beneficial for the prevention of Alzheimer disease. Ongoing research on pathogenic mechanisms promises the discovery of more effective therapies. Healthy life style should always be recommended due to its benefit and lack of untoward effects.

  7. Intermittent preventive treatment for the prevention of malaria during pregnancy in high transmission areas

    Directory of Open Access Journals (Sweden)

    Massougbodji Achille

    2007-12-01

    Full Text Available Abstract Malaria in pregnancy is one of the major causes of maternal morbidity and adverse birth outcomes. In high transmission areas, its prevention has recently changed, moving from a weekly or bimonthly chemoprophylaxis to intermittent preventive treatment (IPTp. IPTp consists in the administration of a single curative dose of an efficacious anti-malarial drug at least twice during pregnancy – regardless of whether the woman is infected or not. The drug is administered under supervision during antenatal care visits. Sulphadoxine-pyrimethamine (SP is the drug currently recommended by the WHO. While SP-IPTp seems an adequate strategy, there are many issues still to be explored to optimize it. This paper reviewed data on IPTp efficacy and discussed how to improve it. In particular, the determination of both the optimal number of doses and time of administration of the drug is essential, and this has not yet been done. As both foetal growth and deleterious effects of malaria are maximum in late pregnancy women should particularly be protected during this period. Monitoring of IPTp efficacy should be applied to all women, and not only to primi- and secondigravidae, as it has not been definitively established that multigravidae are not at risk for malaria morbidity and mortality. In HIV-positive women, there is an urgent need for specific information on drug administration patterns (need for higher doses, possible interference with sulpha-based prophylaxis of opportunistic infections. Because of the growing level of resistance of parasites to SP, alternative drugs for IPTp are urgently needed. Mefloquine is presently one of the most attractive options because of its long half life, high efficacy in sub-Saharan Africa and safety during pregnancy. Also, efforts should be made to increase IPTp coverage by improving the practices of health care workers, the motivation of women and their perception of malaria complications in pregnancy. Because IPTp

  8. Integrating HIV prevention and treatment: from slogans to impact.

    Directory of Open Access Journals (Sweden)

    Joshua A Salomon

    2005-01-01

    Full Text Available Through major efforts to reduce costs and expand access to antiretroviral therapy worldwide, widespread delivery of effective treatment to people living with HIV/AIDS is now conceivable even in severely resource-constrained settings. However, the potential epidemiologic impact of treatment in the context of a broader strategy for HIV/AIDS control has not yet been examined. In this paper, we quantify the opportunities and potential risks of large-scale treatment roll-out.We used an epidemiologic model of HIV/AIDS, calibrated to sub-Saharan Africa, to investigate a range of possible positive and negative health outcomes under alternative scenarios that reflect varying implementation of prevention and treatment. In baseline projections, reflecting "business as usual," the numbers of new infections and AIDS deaths are expected to continue rising. In two scenarios representing treatment-centered strategies, with different assumptions about the impact of treatment on transmissibility and behavior, the change in the total number of new infections through 2020 ranges from a 10% increase to a 6% reduction, while the number of AIDS deaths through 2020 declines by 9% to 13%. A prevention-centered strategy provides greater reductions in incidence (36% and mortality reductions similar to those of the treatment-centered scenarios by 2020, but more modest mortality benefits over the next 5 to 10 years. If treatment enhances prevention in a combined response, the expected benefits are substantial-29 million averted infections (55% and 10 million averted deaths (27% through the year 2020. However, if a narrow focus on treatment scale-up leads to reduced effectiveness of prevention efforts, the benefits of a combined response are considerably smaller-9 million averted infections (17% and 6 million averted deaths (16%. Combining treatment with effective prevention efforts could reduce the resource needs for treatment dramatically in the long term. In the various

  9. Prevention and treatment of intracranial hypertension.

    Science.gov (United States)

    Jantzen, Jan-Peter A H

    2007-12-01

    Intracranial pressure (ICP) is the pressure exerted by cranial contents on the dural envelope. It comprises the partial pressures of brain, blood and cerebrospinal fluid (CSF). Normal intracranial pressure is somewhere below 10 mmHg; it may increase as a result of traumatic brain injury, stroke, neoplasm, Reye's syndrome, hepatic coma, or other pathologies. When ICP increases above 20 mmHg it may damage neurons and jeopardize cerebral perfusion. If such a condition persists, treatment is indicated. Control of ICP requires measurement, which can only be performed invasively. Standard techniques include direct ventricular manometry or measurement in the parenchyma with electronic or fiberoptic devices. Displaying the time course of pressure (high-resolution ICP tonoscopy) allows assessment of the validity of the signal and identification of specific pathological findings, such as A-, B- and C-waves. When ICP is pathologically elevated--at or above 20-25 mmHg--it needs to be lowered. A range of treatment modalities is available and should be applied with consideration of the underlying cause. When intracranial hypertension is caused by hematoma, contusion, tumor, hygroma, hydrocephalus or pneumatocephalus, surgical treatment is indicated. In the absence of a surgically treatable condition, ICP may be controlled by correcting the patient's position, temperature, ventilation or hemodynamics. If intracranial hypertension persists, drainage of CSF via external drainage is most effective. Other first-tier options include induced hypocapnea (hyperventilation; paCO2 < 35 mmHg), hyperosmolar therapy (mannitol, hypertonic saline) and induced arterial hypertension (CPP concept). When autoregulation of cerebral blood flow is compromised, hyperoncotic treatment aimed at reducing vasogenic edema and intracranial blood volume may be applied. When intracranial hypertension persists, second-tier treatments may be indicated. These include 'forced hyperventilation' (paCO2 < 25 mm

  10. Methods employed in the prevention and treatment of malaria ...

    African Journals Online (AJOL)

    onasoga olayinka

    Therefore, there is need to concentrate on health education of these women on the hazards associated with the crude methods as well as importance of intermittent preventive treatment (IPT) during pregnancy so as to achieve effective control of malaria among pregnant women. Key words: Malaria prevention, Malaria ...

  11. Childhood obesity treatment and prevention. Psychological perspectives of clinical approaches

    OpenAIRE

    Maria Catena Quattropani; Teresa Buccheri

    2013-01-01

    Objective: This work focuses on clinical psychologist’ presence within childhood obesity prevention programmes in several countries. Method: The Authors collected articles considering psychological, biological and social aspects linked to childhood obesity. Results: Studies reveal that childhood obesity prevention programmes are based on biological, medical and educational aspects; clinical psychologists up until now have been engaged almost exclusively in the treatment of obesity. Conclusion...

  12. Current problems of prevention diagnosis and treatment of radiation sickness

    International Nuclear Information System (INIS)

    Gus'kova, A.K.

    1986-01-01

    Causes of increasing interest to the problems of prevention, diagnosis and treatment of radiation sickness are presented. On the basis of recent publications some new aspects as quantitative criteria in radiobiology, organization problems of medical aid at radiation incidents estimation of efficiency of preventive medicine and radiation sickness therapy, theoretical development of radiotherapy of different organs et al., are characterized

  13. Book Review The origins, prevention and treatment of infant crying ...

    African Journals Online (AJOL)

    Book Review The origins, prevention and treatment of infant crying and sleeping problems: An evidence based guide for healthcare professionals and the families they support By Ian St James-Roberts (2012)

  14. Future of obesity prevention and treatment.

    Science.gov (United States)

    Ness-Abramof, Rosane; Apovian, Caroline M

    2009-01-01

    The prevalence of obesity has risen sharply during the last 4 decades imposing a serious health burden to modern society. Obesity is known to cause and exacerbate many chronic diseases such as diabetes, hypertension, dyslipidemia, coronary heart disease, stroke, obstructive sleep apnea and certain cancers, among many others. The rise in obesity prevalence is mainly caused by overconsumption of energy, coupled to a sedentary life in susceptible individuals. Weight homeostasis is paramount for survival and its control is coordinated by neural and endocrine signals emanating from the fat tissue, digestive system and brain. During thousands of years humans were challenged by nutrient deprivation, developing an efficient mechanism to store energy. It explains the difficulty in losing weight, making obesity prevention the main effective health approach to halt the obesity epidemic.

  15. 15 CFR 909.1 - Definition of marine debris for the purposes of the Marine Debris Research, Prevention, and...

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Definition of marine debris for the purposes of the Marine Debris Research, Prevention, and Reduction Act. 909.1 Section 909.1 Commerce and... ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS MARINE DEBRIS § 909.1 Definition of...

  16. Pressure ulcer prevention and treatment knowledge of Jordanian nurses.

    Science.gov (United States)

    Saleh, Mohammad Y N; Al-Hussami, Mahmoud; Anthony, Denis

    2013-02-01

    The aims of the study were to determine: (1) Jordanian nurses' level of knowledge of pressure ulcer prevention and treatment of hospitalized patients based on guidelines for pressure ulcer prevention and treatment. (2) Frequency of utilization of pressure ulcer prevention and treatment interventions in clinical practice. (3) Variables that are associated with nurses' utilization of pressure ulcer prevention and treatment interventions. Pressure ulcers are common and previous studies have shown education, knowledge and attitude affect implementation of interventions. A cross-sectional survey design was used to collect data from 460 nurses between June 2010 and November 2010. We used a questionnaire, which was informed by earlier work and guidelines, to collect data about nurses' knowledge and practice of pressure ulcer prevention and treatment. Knowledge and education show an association with implementation of prevention, and demographic variables do not. Similarly knowledge and type of hospital showed an association with implementing treatment. Of concern the use of "donuts" and massage are reported in use. Although pressure ulcer care is well known by nurses, inappropriate pressure ulcer interventions were reported in use. Copyright © 2013 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

  17. Treatment and prevention of invasive pneumococcal disease.

    Science.gov (United States)

    Domínguez-Alegría, A R; Pintado, V; Barbolla, I

    2018-02-12

    Invasive pneumococcal disease is a severe infection that mainly affects patients with associated comorbidity. The paediatric conjugate vaccination has resulted in a change in the adult vaccination strategy. The antibiotic resistance of pneumococcus is not currently a severe problem. Nevertheless, the World Health Organisation has included pneumococcus among the bacteria whose treatment requires the introduction of new drugs, such as ceftaroline and ceftobiprole. Although the scientific evidence is still limited, the combination of beta-lactams and macrolides is recommended as empiric therapy for bacteraemic pneumococcal pneumonia. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  18. Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment.

    Science.gov (United States)

    Daniels, Stephen R; Arnett, Donna K; Eckel, Robert H; Gidding, Samuel S; Hayman, Laura L; Kumanyika, Shiriki; Robinson, Thomas N; Scott, Barbara J; St Jeor, Sachiko; Williams, Christine L

    2005-04-19

    The prevalence of overweight among children and adolescents has dramatically increased. There may be vulnerable periods for weight gain during childhood and adolescence that also offer opportunities for prevention of overweight. Overweight in children and adolescents can result in a variety of adverse health outcomes, including type 2 diabetes, obstructive sleep apnea, hypertension, dyslipidemia, and the metabolic syndrome. The best approach to this problem is prevention of abnormal weight gain. Several strategies for prevention are presented. In addition, treatment approaches are presented, including behavioral, pharmacological, and surgical treatment. Childhood and adolescent overweight is one of the most important current public health concerns.

  19. [Treatment and prevention of venous thromboembolic disease: what's new?].

    Science.gov (United States)

    Rey, Marie-Antoinette; Bron, Cédric; Haesler, Erik; Mazzolai, Lucia

    2009-02-04

    Venous thromboembolic (VTE) disease is frequent and questions regarding its treatment or prevention are numerous. This review is aimed at summarizing and pointing out the novelties on VTE treatment and prevention recently published in the Chest journal earlier this year (8th edition of ACCP guidelines). Generally, the aim of guidelines and of this review as well, is to offer guidance to practictioners in making the most appropriate choice for treating or preventing VTE. They are not intended for strict application and doctors will always have to decide individually case by case taking into account patients preference and the risk-benefit balance.

  20. Prevention and treatment of neonatal nosocomial infections.

    Science.gov (United States)

    Ramasethu, Jayashree

    2017-01-01

    Nosocomial or hospital acquired infections threaten the survival and neurodevelopmental outcomes of infants admitted to the neonatal intensive care unit, and increase cost of care. Premature infants are particularly vulnerable since they often undergo invasive procedures and are dependent on central catheters to deliver nutrition and on ventilators for respiratory support. Prevention of nosocomial infection is a critical patient safety imperative, and invariably requires a multidisciplinary approach. There are no short cuts. Hand hygiene before and after patient contact is the most important measure, and yet, compliance with this simple measure can be unsatisfactory. Alcohol based hand sanitizer is effective against many microorganisms and is efficient, compared to plain or antiseptic containing soaps. The use of maternal breast milk is another inexpensive and simple measure to reduce infection rates. Efforts to replicate the anti-infectious properties of maternal breast milk by the use of probiotics, prebiotics, and synbiotics have met with variable success, and there are ongoing trials of lactoferrin, an iron binding whey protein present in large quantities in colostrum. Attempts to boost the immunoglobulin levels of preterm infants with exogenous immunoglobulins have not been shown to reduce nosocomial infections significantly. Over the last decade, improvements in the incidence of catheter-related infections have been achieved, with meticulous attention to every detail from insertion to maintenance, with some centers reporting zero rates for such infections. Other nosocomial infections like ventilator acquired pneumonia and staphylococcus aureus infection remain problematic, and outbreaks with multidrug resistant organisms continue to have disastrous consequences. Management of infections is based on the profile of microorganisms in the neonatal unit and community and targeted therapy is required to control the disease without leading to the development of more

  1. Prevention: Exercise

    Medline Plus

    Full Text Available ... Information Feature Articles Patient Q&A Success Stories Definitions Anatomy of the Spine Definitions A-Z Spine Specialists Videos 9 for Spine Epidural Steroid Injections Exercise: The Backbone of Spine Treatment Spondylolisthesis BLOG FIND A SPECIALIST Prevention ...

  2. An empirically generated responder definition for rosacea treatment

    Directory of Open Access Journals (Sweden)

    Staedtler G

    2017-09-01

    Full Text Available Gerald Staedtler,1 Kaweh Shakery,2 Jan Endrikat,3,4 Richard Nkulikiyinka,2 Christoph Gerlinger1,4 1Bayer AG, Pharmaceutical Statistics, 2Bayer AG, Dermatology & Anti-infectives 2, 3Bayer AG, Radiology, Berlin, 4Department of Gynecology, Obstetrics and Reproductive Medicine, University Medical School of Saarland, Homburg/Saar, Germany Objective: The aim of this study was to empirically generate a responder definition for the treatment of papulopustular rosacea.Methods: A total of 8 multicenter clinical studies on patients with papulopustular facial rosacea were analyzed. All patients were treated with azelaic acid and/or comparator treatments. The severity of rosacea was described by the Investigator Global Assessment (IGA and the number of lesions. Patients with the IGA score of “clear/minimal” were considered as responders, and those staying in the range of IGA “mild to severe” as nonresponders. The respective number of lesions was determined.Results: A total of 2,748 patients providing 12,410 measurements were included. After treatment, responders showed 2.23±2.48 lesions (median 2 lesions [0–3], and nonresponders showed 13.74±10.40 lesions (median 12 lesions [6–18]. The optimal cutoff point between both groups was 5.69 lesions.Conclusion: The calculated cutoff point of 5.69 lesions allows discrimination of responders (5 or less remaining lesions and nonresponders (6 or more remaining lesions of therapeutic interventions in rosacea. Keywords: rosacea, Investigator Global Assessment, facial lesions, responder

  3. Treatment of Memory Disorders in Gulf War Illness with High-Definition Transcranial Direct Cortical Stimulation

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-16-1-0521 TITLE: Treatment of Memory Disorders in Gulf War Illness with High- Definition Transcranial Direct Cortical...Sep 2017 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Treatment of Memory Disorders in Gulf War Illness with High-Definition Transcranial Direct...0521 15. SUBJECT TERMS Gulf War Illness; High Definition Transcranial Direct Current Stimulation; word finding; semantic memory 16. SECURITY

  4. Nanotechnology for the Prevention and Treatment of Cataract.

    Science.gov (United States)

    Cetinel, Sibel; Montemagno, Carlo

    2015-01-01

    The purpose of this article was to review recent advances in the applications of nanotechnology in cataract treatment and prevention strategies. A literature review on the use of nanotechnology for the prevention and treatment of cataract was done. Research articles about nanotechnology-based treatments and prevention technologies for cataract were searched on Web of Science, and the most recent advances were reported. Nonsteroid anti-inflammatory drugs, natural antioxidants, biologic and chemical chaperones, and chaperones such as molecules have found great application in preventing and treating cataracts. Current scientific research on new treatment strategies, which focuses on the biochemical basis of the disease, will likely result in new anticataract agents. However, none of the drug formulations will be approved for use unless efficient delivery is promised. Nanoparticle engineering together with biomimetic strategies enable the development of next-generation, more efficient, less complex, and personalized treatments. The only currently available treatment for cataracts, surgical replacement of the opacified lens, is not an easily accessible option in developing countries. New treatment strategies based on topical drugs would enable treatment to reach massive populations facing the threat of blindness and more effectively deal with the postsurgical complications. Nanotechnology plays a key role in improving drug delivery systems with enhanced controlled release, targeted delivery, and bioavailability to overcome diffusion limitations in the eye.

  5. Impact Of Health Education On Home Treatment And Prevention Of ...

    African Journals Online (AJOL)

    Background: Malaria accounts for 1 million deaths among children under five annually. It has been shown that improving home treatment and preventing delays in seeking treatment, by teaching women to respond promptly when their children have fever, can decrease malaria related complications and mortality. This study ...

  6. Prevention and treatment ofvenous thromboembolism. Case report

    Directory of Open Access Journals (Sweden)

    Andrzej Kolbuszewski

    2015-06-01

    Full Text Available The problem of thromboembolic complications concerns nearly all orthopaedic and trauma patients. However, risk factors are different and prophylaxis slightly varies depending on the complication. The presence of thrombosis of complex and insidious clinical picture, which is presented in this case report, is alarming. The article reports a case of a 64-year-old male patient with risk factors of thromboembolism. The patient underwent high tibial osteotomy for varus deformity correction due to gonarthrosis. Venus thrombosis and pulmonary embolism developed in the postoperative period. Additionally, symptoms of infection appeared during the treatment in the form of inappropriate wound healing, which was an indication for surgical revision of the wound. The authors present the manner of safe perioperative management of a patient, which is consistent with the standards, taking into account the risk of recurrence of thromboembolism.

  7. Pertussis: Microbiology, Disease, Treatment, and Prevention

    Science.gov (United States)

    Salim, Abdulbaset M.; Zervos, Marcus J.; Schmitt, Heinz-Josef

    2016-01-01

    SUMMARY Pertussis is a severe respiratory infection caused by Bordetella pertussis, and in 2008, pertussis was associated with an estimated 16 million cases and 195,000 deaths globally. Sizeable outbreaks of pertussis have been reported over the past 5 years, and disease reemergence has been the focus of international attention to develop a deeper understanding of pathogen virulence and genetic evolution of B. pertussis strains. During the past 20 years, the scientific community has recognized pertussis among adults as well as infants and children. Increased recognition that older children and adolescents are at risk for disease and may transmit B. pertussis to younger siblings has underscored the need to better understand the role of innate, humoral, and cell-mediated immunity, including the role of waning immunity. Although recognition of adult pertussis has increased in tandem with a better understanding of B. pertussis pathogenesis, pertussis in neonates and adults can manifest with atypical clinical presentations. Such disease patterns make pertussis recognition difficult and lead to delays in treatment. Ongoing research using newer tools for molecular analysis holds promise for improved understanding of pertussis epidemiology, bacterial pathogenesis, bioinformatics, and immunology. Together, these advances provide a foundation for the development of new-generation diagnostics, therapeutics, and vaccines. PMID:27029594

  8. Emerging nanotechnology approaches for HIV/AIDS treatment and prevention

    Science.gov (United States)

    Mamo, Tewodros; Moseman, E Ashley; Kolishetti, Nagesh; Salvador-Morales, Carolina; Shi, Jinjun; Kuritzkes, Daniel R; Langer, Robert; von Andrian, Ulrich

    2010-01-01

    Currently, there is no cure and no preventive vaccine for HIV/AIDS. Combination antiretroviral therapy has dramatically improved treatment, but it has to be taken for a lifetime, has major side effects and is ineffective in patients in whom the virus develops resistance. Nanotechnology is an emerging multidisciplinary field that is revolutionizing medicine in the 21st century. It has a vast potential to radically advance the treatment and prevention of HIV/AIDS. In this review, we discuss the challenges with the current treatment of the disease and shed light on the remarkable potential of nanotechnology to provide more effective treatment and prevention for HIV/AIDS by advancing antiretroviral therapy, gene therapy, immunotherapy, vaccinology and microbicides. PMID:20148638

  9. The acute and preventative treatment of episodic migraine

    Directory of Open Access Journals (Sweden)

    Sarah Miller

    2012-01-01

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

  10. Prepsychotic treatment for schizophrenia: preventive medicine, social control, or drug marketing strategy?

    Science.gov (United States)

    Gosden, R

    1999-01-01

    The definition of schizophrenia is currently being extended to include a "prepsychotic" phase. Prepsychosis detection and intervention programs have already been established in Australia. These are intended to identify people "at-risk" for schizophrenia and treat them to prevent their transition into psychosis. However, analysis of leading research in this field shows high levels of arbitrariness in the selection of diagnostic indicators and a lack of convincing evidence about the efficacy of treatments. The favored prophylactic treatment is atypical neuroleptic medication, and sponsorship of research is providing manufacturers of these drugs with a ubiquitous presence in the field. Many risks are associated with atypical neuroleptics and adverse reactions include psychosis. Taken together these factors suggest that prepsychotic intervention may be more concerned with expanding the market for atypical neuroleptics than with preventing schizophrenia.

  11. Prevention and Treatment of Noise-Induced Tinnitus

    Science.gov (United States)

    2014-09-01

    Tinnitus PRINCIPAL INVESTIGATOR: Dr. Richard A. Altschuler CONTRACTING ORGANIZATION: University of Michigan REPORT DATE: 2014...3 Ju 2014 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Prevention and Treatment of Noise-Induced Tinnitus 5b. GRANT NUMBER 5c. PROGRAM...prevent or treat noise induced tinnitus . Our studies showed a military relevant small arms fire-like noise will induce tinnitus in approximately 33

  12. Attitudes to publicly funded obesity treatment and prevention

    DEFF Research Database (Denmark)

    Lund, Thomas Bøker; Sandøe, Peter; Lassen, Jesper

    2011-01-01

    The aim of this study was to investigate the Danish public’s support for publicly funded obesity treatment and prevention. It was also examined whether levels of support could be explained by dislike of obese people and / or the belief that those who are obese are personally responsible......, the perceived controllability of obesity, self-reported BMI, and additional attitudinal and sociodemographic characteristics. Public funding of some obesity treatments, such as weight-loss surgery, attracted only limited public support. A majority of the Danish public did support ‘softer’ treatment...... interventions and preventive initiatives. Attitudes to the treatment of obesity were clearly best predicted by the belief that individuals are personally responsible for their own obesity. Dislike of obese persons had no direct effect on the preference for collective treatment initiatives and only a small...

  13. Persistent pain after breast cancer treatment: a critical review of risk factors and strategies for prevention

    DEFF Research Database (Denmark)

    Andersen, Kenneth Geving; Kehlet, Henrik

    2011-01-01

    . This review is a systematic analysis on methodology and evidence in research into persistent pain after breast cancer treatment during the period 1995 to 2010, in order to clarify the significance and relative role of potential risk factors. Literature was identified by a search in PubMed and OVID, as well...... principles of surgical and adjuvant therapy. In summary, the data show inconsistencies in definition of chronic pain and treatment groups, as well as in the collection of pre- intra- and post-operative data, precluding conclusions with regard to pathophysiologic mechanisms as well as rational strategies...... for prevention and treatment. However, nerve damage and radiotherapy appear to be significant risk factors for chronic pain. A proposal for the design of future prospective studies is presented. PERSPECTIVE: A comprehensive and systematic approach to research in chronic pain after breast cancer treatment...

  14. Complications of an implantable venous access port: Prevention and treatment

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Tae Seok; Song, Myung Gyu [Dept. of Radiology, Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Cha, In Ho [Dept. Radiology, Chungang University Hospital, Chungang University College of Medicine, Seoul (Korea, Republic of)

    2016-11-15

    Placement of an implantable venous access port (IVAP) is a popular procedure for repeated and intermittent chemotherapy in patients with malignancy. In this article, we present various IVAP related complications. In addition, we review the technical tips to prevent and manage the complications. It is important that the operator should keep the mechanism of the complications in mind, perform a careful procedure for prevention, and manage the complication properly and immediately in case of its development for safety and satisfaction of the patients Complications of an implantable venous access port: Prevention and treatment.

  15. Lifestyle and Sarcopenia—Etiology, Prevention, and Treatment

    Directory of Open Access Journals (Sweden)

    Oren Rom

    2012-10-01

    Full Text Available The term sarcopenia describes the loss of skeletal muscle mass, strength, and function in old age. As the world population continues to grow older, more attention is given to the phenomena of sarcopenia and the search for strategies of prevention and treatment. The progression of sarcopenia is affected by age-related physiological and systemic changes in the body, including alterations in skeletal muscle tissue, hormonal changes, increased inflammatory activities, and oxidative stress. Sarcopenia progression is also affected by lifestyle factors which are far more controllable. These factors include various aspects of nutrition, physical activity, exercise, alcohol intake, and tobacco use. Raising the public awareness regarding the impact of these factors, as causes of sarcopenia and potential strategies of prevention and treatment, is of great importance. In this review we aim to describe various lifestyle factors that affect the etiology, prevention, and treatment of sarcopenia.

  16. Definitions and methods of measuring and reporting on injurious falls in randomised controlled fall prevention trials: a systematic review

    Directory of Open Access Journals (Sweden)

    Schwenk Michael

    2012-04-01

    Full Text Available Abstract Background The standardisation of the assessment methodology and case definition represents a major precondition for the comparison of study results and the conduction of meta-analyses. International guidelines provide recommendations for the standardisation of falls methodology; however, injurious falls have not been targeted. The aim of the present article was to review systematically the range of case definitions and methods used to measure and report on injurious falls in randomised controlled trials (RCTs on fall prevention. Methods An electronic literature search of selected comprehensive databases was performed to identify injurious falls definitions in published trials. Inclusion criteria were: RCTs on falls prevention published in English, study population ≥ 65 years, definition of injurious falls as a study endpoint by using the terms "injuries" and "falls". Results The search yielded 2089 articles, 2048 were excluded according to defined inclusion criteria. Forty-one articles were included. The systematic analysis of the methodology applied in RCTs disclosed substantial variations in the definition and methods used to measure and document injurious falls. The limited standardisation hampered comparability of study results. Our results also highlight that studies which used a similar, standardised definition of injurious falls showed comparable outcomes. Conclusions No standard for defining, measuring, and documenting injurious falls could be identified among published RCTs. A standardised injurious falls definition enhances the comparability of study results as demonstrated by a subgroup of RCTs used a similar definition. Recommendations for standardising the methodology are given in the present review.

  17. The post-discectomy syndrome. Aetiology, diagnosis, treatment, prevention.

    Science.gov (United States)

    Ivanic, G M; Pink, T P; Homann, N C; Scheitza, W; Goyal, S

    2001-10-01

    The post-discectomy syndrome (PDS) is a common diagnosis in patients with problems following a disc operation. The different causes of PDS make the establishment of the correct diagnosis and its corresponding efficient treatment difficult. A general overview published in the bibliographical data covering the entity of PDS is rare. The following paper aims to specify PDS according to its aetiology, diagnosis, treatment and prevention. The diagnosis should be made efficiently, so that the patient can receive prompt adequate therapy.

  18. [Prevention and treatment of materno-fetal toxoplasmosis].

    Science.gov (United States)

    Fortier, B; Ajana, F; Pinto de Sousa, M I; Aissi, E; Camus, D

    1991-09-21

    Preventing congenital toxoplasmosis is fundamental, and in France screening tests for primary infection are obligatory for pregnant women. All nonimmunized women should be encouraged to follow good dietary and general health rules until delivery. Nevertheless, the risk of seroconversion does exist but can be detected early through monthly serum tests. Spiramycin as initial treatment of maternal primary infection is an essential step in preventing parasite transmission to the fetus. Fetal antitoxoplasmosis antibodies and indirect signs of congenital abnormalities should be detected early by amniotic fluid and fetal blood tests before echographic evidence confirms the diagnosis. Pyrimethamine-sulfonamide therapy should be undertaken and modulated according to laboratory results in order to prevent or treat any possible fetopathy. Congenital toxoplasmosis can be prevented in utero through biological diagnosis and specific therapy.

  19. Methods employed in the prevention and treatment of malaria ...

    African Journals Online (AJOL)

    Background: Malaria remains a major public health problem in Nigeria and is the most common cause of hospital attendance in all age groups, of which children and pregnant women are the major risk groups; therefore this study was designed to explore various methods of prevention and treatment of malaria among ...

  20. missed opportunities for intermittent preventive treatment for malaria ...

    African Journals Online (AJOL)

    Background: Malaria is of global health concern particularly among pregnant women. Nigeria contributes largely to global burden but coverage of. Intermittent Preventive Treatment of malaria in pregnancy using. Sulphadoxine pyrimethamine ..... awareness campaigns at sensitizing the community about the dangers of ...

  1. Extent of use of orthodox and traditional treatments and preventive ...

    African Journals Online (AJOL)

    The study assessed the extent of use of the orthodox and traditional treatment preventive measures against malaria among rural dwellers in Abia State. Primary data were collected using structured questionnaire from 180 respondents via multi- stage procedure. Data were subjected to descriptive statistics analysis.

  2. [The nurse in an addiction treatment, support and prevention centre].

    Science.gov (United States)

    Panhaleux, Nathalie; Mantelet, Corinne

    2017-06-01

    The nurse in an addiction treatment, support and prevention centre works within a multidisciplinary team. She is available to listen to the addicts and support them. Thanks to her specific skills and training, she plays a key role in the follow-up. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. Intermittent Preventive Therapy and Treatment of Malaria during ...

    African Journals Online (AJOL)

    Intermittent Preventive Therapy and Treatment of Malaria during Pregnancy: A Study of Knowledge among Pregnant Women in Rufiji District, Southern Tanzania. ... Most women (76.6 %) did not know the use of SP for IPT in relationship with gestation age. Overall, the results show that most women had very low knowledge ...

  4. Prevention and Treatment of Bone Metastases in Breast Cancer

    Directory of Open Access Journals (Sweden)

    Ripamonti Carla

    2013-09-01

    Full Text Available In breast cancer patients, bone is the most common site of metastases. Medical therapies are the basic therapy to prevent distant metastases and recurrence and to cure them. Radiotherapy has a primary role in pain relief, recalcification and stabilization of the bone, as well as the reduction of the risk of complications (e.g., bone fractures, spinal cord compression. Bisphosphonates, as potent inhibitors of osteoclastic-mediated bone resorption are a well-established, standard-of-care treatment option to reduce the frequency, severity and time of onset of the skeletal related events in breast cancer patients with bone metastases. Moreover bisphosphonates prevent cancer treatment-induced bone loss. Recent data shows the anti-tumor activity of bisphosphonates, in particular, in postmenopausal women and in older premenopausal women with hormone-sensitive disease treated with ovarian suppression. Pain is the most frequent symptom reported in patients with bone metastases, and its prevention and treatment must be considered at any stage of the disease. The prevention and treatment of bone metastases in breast cancer must consider an integrated multidisciplinary approach.

  5. Patients' Awareness Of The Prevention And Treatment Of Colorectal Cancer.

    Science.gov (United States)

    Dziki, Łukasz; Puła, Anna; Stawiski, Konrad; Mudza, Barbara; Włodarczyk, Marcin; Dziki, Adam

    2015-09-01

    The aim of the study was to assess patients' awareness of the prevention and treatment of colorectal cancer. Patients diagnosed with colorectal cancer, hospitalised at the Department of General and Colorectal Surgery of the Medical University in Łódź during the period from January 2015 to April 2015, were asked to complete a questionnaire concerning their families' medical case record, factors predisposing them to the development of colorectal cancer, the tests applied in diagnostics, and the treatment process. The questionnaire comprised 42 closed-ended questions with one correct answer. A statistical analysis of all answers was carried out. The study group consisted of 30 men and 20 women aged 27-94 years old. A strong, statistically significant negative correlation between a patient's age and his/her awareness of the prevention and treatment of colorectal cancer was noted (pcolorectal cancer (p=0.008), and the awareness of the prevention programme. The women's group was characterised by statistically significantly greater awareness of colonoscopy as a screening examination (p=0.004). Patients need more information on colorectal cancer, its risk factors, prevention, the treatment process, and postoperative care. Lack of awareness of the colorectal cancer issue can be one of the major factors contributing to the high incidence of this disease.

  6. Perception and practice of malaria prevention and treatment among ...

    African Journals Online (AJOL)

    Conclusion: Mothers of children under five in Kuje had poor knowledge of the cause of malaria and its prevention method, and were not using the recommended drug by the Federal Government of Nigeria (ACTs) for the treatment of uncomplicated malaria. However adequate health education to women especially in the ...

  7. [Complications of cervicofacial radiotherapy. Prevention, diagnosis and multidisciplinary treatment].

    Science.gov (United States)

    Mano Azul, A; Rebelo, H

    1991-05-01

    This paper presents a review on the state of art about scientific knowledge on oral complications of head and neck radiotherapy, in an attempt to contribute for a better prevention, diagnosis and treatment. The authors also describe the protocols used on Instituto Português de Oncologia of Lisboa.

  8. Studies on asymptomatic malaria, prevention and treatment seeking ...

    African Journals Online (AJOL)

    Studies on asymptomatic malaria, prevention and treatment seeking behaviours in Abeokuta, south-west Nigeria. ... Self-diagnosis for the disease was more common (60.8%) among the participants, compared to other measures; seeking laboratory test (26.5%) and clinical diagnosis (9.1%). A good proportion of the ...

  9. Access for all: contextualising HIV treatment as prevention in Swaziland

    NARCIS (Netherlands)

    Vernooij, E.; Mehlo, M.; Hardon, A.; Reis, R.

    2016-01-01

    This article explores how notions of the individual and population are evoked in two ongoing HIV treatment as prevention (TasP) implementation studies in Swaziland. By contrasting policy discourses with lived kinship experiences of people living with HIV, we seek to understand how TasP unfolds in

  10. Prevention and treatment of incontinence-associated dermatitis: literature review.

    NARCIS (Netherlands)

    Beeckman, D.; Schoonhoven, L.; Verhaeghe, S.; Heyneman, A.; Defloor, T.

    2009-01-01

    AIM: This paper is a report of a review conducted to describe the current evidence about the prevention and treatment of incontinence-associated dermatitis and to formulate recommendations for clinical practice and research. BACKGROUND: Incontinence-associated dermatitis is a common problem in

  11. [Medical prevention and treatment of radiation-induced pulmonary complications].

    Science.gov (United States)

    Vallard, A; Rancoule, C; Le Floch, H; Guy, J-B; Espenel, S; Le Péchoux, C; Deutsch, É; Magné, N; Chargari, C

    2017-08-01

    Radiation-induced lung injuries mainly include the (acute or sub-acute) radiation pneumonitis, the lung fibrosis and the bronchiolitis obliterans organizing pneumonia (BOOP). The present review aims at describing the diagnostic process, the current physiopathological knowledge, and the available (non dosimetric) preventive and curative treatments. Radiation-induced lung injury is a diagnosis of exclusion, since clinical, radiological, or biological pathognomonic evidences do not exist. Investigations should necessarily include a thoracic high resolution CT-scan and lung function tests with a diffusing capacity of the lung for carbon monoxide. No treatment ever really showed efficacy to prevent acute radiation-induced lung injury, or to treat radiation-induced lung fibrosis. The most promising drugs in order to prevent radiation-induced lung injury are amifostine, angiotensin-converting-enzyme inhibitors and pentoxifylline. Inhibitors of collagen synthesis are currently tested at a pre-clinical stage to limit the radiation-induced lung fibrosis. Regarding available treatments of radiation-induced pneumonitis, corticoids can be considered the cornerstone. However, no standardized program or guidelines concerning the initial dose and the gradual tapering have been scientifically established. Alternative treatments can be prescribed, based on clinical cases reporting on the efficacy of immunosuppressive drugs. Such data highlight the major role of the lung dosimetric protection in order to efficiently prevent radiation-induced lung injury. Copyright © 2017 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  12. Prevention and treatment of complications following percutaneous nephrolithotomy

    NARCIS (Netherlands)

    Skolarikos, Andreas; de la Rosette, Jean

    2008-01-01

    PURPOSE OF REVIEW: The aim of this article is to identify classification and grading systems of percutaneous nephrolithotomy-related complications and evidence for the prevention and treatment of these complications. RECENT FINDINGS: A total complication rate of up to 83% following percutaneous

  13. Prevention and treatment of complications for thyroid-arterial embolization

    International Nuclear Information System (INIS)

    Yang Jijin; Yuan Min; Tian Jianming; Chen Wei; Yang Chaoai; Hao Qiang; Zou Dajing; Wang Yongchun

    2003-01-01

    Objective: To investigate the complications of thyroid-arterial embolization and their prevention and treatment. Methods: 61 cases of thyroid disorders received the therapy of thyroid-arterial embolization were retrospectively studied. The complications of arterial embolization during or after the procedure were analyzed. How to prevent and deal with these complications were discussed. Results: Sensitivity to contrast media occurred in 1 case and surgical arterial injury in 2. After embolization thyroid storm occurred in 1 patient and all other complications including headache (23 cases), toothache (11 cases), neckache (13 cases), hoarseness (37 cases) were caused by non-target arterial embolization with the most serious one of cerebral infarction (1 case) and another eyelid ptosis (1 case). The cerebral infarct one was treated with some vasodilating drugs and anti-coagulant, all others were given anti-symptomatics or no special treatment. Conclusions: Proper treatment should be ready during thyroid arterial embolization and given in time with occurrence of complications

  14. Cognitive Impairment in Bipolar Disorder: Treatment and Prevention Strategies

    Science.gov (United States)

    Solé, Brisa; Jiménez, Esther; Torrent, Carla; Reinares, Maria; Bonnin, Caterina del Mar; Torres, Imma; Varo, Cristina; Grande, Iria; Valls, Elia; Salagre, Estela; Sanchez-Moreno, Jose; Martinez-Aran, Anabel; Carvalho, André F

    2017-01-01

    Abstract Over the last decade, there has been a growing appreciation of the importance of identifying and treating cognitive impairment associated with bipolar disorder, since it persists in remission periods. Evidence indicates that neurocognitive dysfunction may significantly influence patients’ psychosocial outcomes. An ever-increasing body of research seeks to achieve a better understanding of potential moderators contributing to cognitive impairment in bipolar disorder in order to develop prevention strategies and effective treatments. This review provides an overview of the available data from studies examining treatments for cognitive dysfunction in bipolar disorder as well as potential novel treatments, from both pharmacological and psychological perspectives. All these data encourage the development of further studies to find effective strategies to prevent and treat cognitive impairment associated with bipolar disorder. These efforts may ultimately lead to an improvement of psychosocial functioning in these patients. PMID:28498954

  15. Pancreatic Fistula after Pancreatectomy: Definitions, Risk Factors, Preventive Measures, and Management—Review

    Directory of Open Access Journals (Sweden)

    Norman Oneil Machado

    2012-01-01

    Full Text Available Resection of pancreas, in particular pancreaticoduodenectomy, is a complex procedure, commonly performed in appropriately selected patients with benign and malignant disease of the pancreas and periampullary region. Despite significant improvements in the safety and efficacy of pancreatic surgery, pancreaticoenteric anastomosis continues to be the “Achilles heel” of pancreaticoduodenectomy, due to its association with a measurable risk of leakage or failure of healing, leading to pancreatic fistula. The morbidity rate after pancreaticoduodenectomy remains high in the range of 30% to 65%, although the mortality has significantly dropped to below 5%. Most of these complications are related to pancreatic fistula, with serious complications of intra-abdominal abscess, postoperative bleeding, and multiorgan failure. Several pharmacological and technical interventions have been suggested to decrease the pancreatic fistula rate, but the results have been controversial. This paper considers definition and classification of pancreatic fistula, risk factors, and preventive approach and offers management strategy when they do occur.

  16. The Mediterranean Diet: its definition and evaluation of a priori dietary indexes in primary cardiovascular prevention.

    Science.gov (United States)

    D'Alessandro, Annunziata; De Pergola, Giovanni

    2018-01-18

    We have analysed the definition of Mediterranean Diet in 28 studies included in six meta-analyses evaluating the relation between the Mediterranean Diet and primary prevention of cardiovascular disease. Some typical food of this dietary pattern like whole cereals, olive oil and red wine were taken into account only in a few a priori indexes, and the dietary pattern defined as Mediterranean showed many differences among the studies and compared to traditional Mediterranean Diet of the early 1960s. Altogether, the analysed studies show a protective effect of the Mediterranean Diet against cardiovascular disease but present different effects against specific conditions as cerebrovascular disease and coronary heart disease. These different effects might depend on the definition of Mediterranean Diet and the indexes of the adhesion to the same one used. To compare the effects of the Mediterranean Diet against cardiovascular disease, coronary heart disease and stroke a univocal model of Mediterranean Diet should be established as a reference, and it might be represented by the Modern Mediterranean Diet Pyramid. The a priori index to evaluate the adhesion to Mediterranean Diet might be the Mediterranean-Style Dietary Pattern Score that has some advantages in comparison to the others a priori indexes.

  17. Improving disease prevention and treatment in controlled fish culture

    Directory of Open Access Journals (Sweden)

    Terech-Majewska Elżbieta

    2016-09-01

    Full Text Available The aim of the work was to evaluate long-term results of studies focusing on improving methods for preventing and treating fish diseases using selected natural and syntetic immunomodulators and vaccines in fish culture. Simultaneously, attention is drawn to infectious or environmental threats against which appropriately composed immunoprophylaxis can be used in production cycles. Fish culture is intensifying in Poland and globally, which means that the role of prevention and well-designed prophylaxis is of increasing significance to the prevention and treatment of fish diseases. Currently, 33 fish species are cultured in Poland as stocking material or for production. The primary methods for preventing diseases in controlled fish culture are ensuring the welfare of fish and other prophylactic methods, including immunoprophylaxis. Many infectious and non-infectious threats that can cause direct losses and limit fish culture are present in the aquatic environment. Fish diseases generally stem from the simultaneous action of many factors that coincide and are difficult to distinguish. Pesticides (organochlorine insecticides, organophosphorus herbicides, aromatic hydrocarbons, pentachlorophenol, heavy metals, and chemotherapeutics are particularly toxic to fish. Biodegradation, which is continual in aquatic environments, is a process by which toxic and other substances that negatively affect fish become bioavailable and impact the immune system, the functioning of which is a specific bioindicator of environmental quality. Innate immunity plays a key role in the defense against disadvantageous factors, which also include pathogens. Immunomodulation methods can protect resistance mechanisms, thereby increasing disease prevention and treatment in controlled fish culture.

  18. An update in prevention and treatment of pediatric obesity.

    Science.gov (United States)

    Moya, Manuel

    2008-08-01

    Obesity prevalence is growing as well as its severity with increasing morbidity and mortality. This "globesity" also affects developing countries where under nutrition and stunting frequently coexist with overweight and obesity. One third of obese adults began to be so in the pediatric ages. There are two main types of prevention: general one representing greater actions from health authorities and the individual one carried out by the pediatrician and the patient at risk. Once the state of obesity is reached (relative body mass index, rBMI >121%) the longer lasting care becomes more complex and frequently unsuccessful. The treatment of obesity is aimed to care for the present and silent disorders and for preventing its further tracking to adulthood. Identification of pediatric population at risk which is the one with an rBMI of 111%-120% plus other risk factors. Specific individual actions include reduction of food intake, increase of energy expenditure, involvement of parents, and the child-adolescent himself in the prevention. Therapy is based on some principles plus the important medical and emotional approach. A Cochrane study based on only 10 appropriate studies showed a predominant poor efficacy of the undergone preventive action. Treatment guides are presented after our own experience with a group of 400 kids with an average follow-up of 7 years and other individual prevention studies. Involving motivated pediatricians with a minimum of time for visits and better follow-up in the frame of a general national preventive programme could be a rational outcome. Treatment of obesity should never be postponed whatever the clinical care is.

  19. Improving access to tuberculosis preventive therapy and treatment for children.

    Science.gov (United States)

    Marais, Ben J

    2017-03-01

    Children suffer a huge burden of disease in tuberculosis (TB) endemic countries. This disease burden was largely invisible when TB control programmes focused exclusively on adults with sputum smear-positive disease. High-level advocacy and better data have improved visibility, but the establishment of functional paediatric TB programmes remains challenging. The key issues that limit children's access to TB preventive therapy and treatment in endemic areas are briefly discussed. Barriers to preventive therapy include (1) the perceived inability to rule out active disease, (2) fear of creating drug resistance, (3) non-implementation of existing guidelines in the absence of adequate monitoring, and (4) poor adherence with long preventive therapy courses. Barriers to TB treatment include (1) perceived diagnostic difficulties, (2) non-availability of chest radiography, (3) young children presenting to unprepared maternal and child health (MCH) services, and (4) the absence of child-friendly formulations. With drug-resistant disease there is currently no guidance on the use of preventive therapy and treatment is usually restricted to cases with bacteriologically confirmed disease, which excludes most young children from care, even if their likely source case has documented drug-resistant TB. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  20. Challenges in HIV vaccine research for treatment and prevention

    Directory of Open Access Journals (Sweden)

    Barbara eEnsoli

    2014-09-01

    Full Text Available Many attempts have been made or are ongoing for HIV prevention and HIV cure. Many successes are in the list, particularly for HIV drugs, recently proposed also for prevention. However, no eradication of infection has been achieved so far with any drug.Further, a residual immune dysregulation associated to chronic immune activation and incomplete restoration of B and T cell subsets, together with HIV DNA persistence in reservoirs, are still unmet needs of the highly active antiretroviral therapy (HAART, causing novel non-AIDS related diseases that account for a higher risk of death even in virologically suppressed patients. These ART unmet needs represent a problem, which is expected to increase by ART roll out. Further, in countries such as South Africa, where 6 millions of individuals are infected, ART appears unable to contain the epidemics. Regretfully, all the attempts at developing a preventative vaccine have been largely disappointing. However, recent therapeutic immunization strategies have opened new avenues for HIV treatment, which might be exploitable also for preventative vaccine approaches. For example, immunization strategies aimed at targeting key viral products responsible of virus transmission, activation and maintenance of virus reservoirs may intensify drug efficacy and lead to a functional cure providing new perspectives also for prevention and future virus eradication strategies. However, this approach imposes new challenges to the scientific community, vaccine developers and regulatory bodies, such as the identification of novel immunological and virological biomarkers to assess efficacy endpoints, taking advantage from the natural history of infection and exploiting lessons from former trials.This review will focus first on recent advancement of therapeutic strategies, then on the progresses made in preventative approaches, discussing concepts and problems for the way ahead for the development of vaccines for HIV treatment

  1. Prevention and treatment of biofilms by hybrid- and nanotechnologies.

    Science.gov (United States)

    Kasimanickam, Ramanathan K; Ranjan, Ashish; Asokan, G V; Kasimanickam, Vanmathy R; Kastelic, John P

    2013-01-01

    Bacteria growing as adherent biofilms are difficult to treat and frequently develop resistance to antimicrobial agents. To counter biofilms, various approaches, including prevention of bacterial surface adherence, application of device applicators, and assimilation of antimicrobials in targeted drug delivery machinery, have been utilized. These methods are also combined to achieve synergistic bacterial killing. This review discusses various multimodal technologies, presents general concepts, and describes therapies relying on the principles of electrical energy, ultrasound, photodynamics, and targeted drug delivery for prevention and treatment of biofilms.

  2. Definition, assessment and treatment of wheezing disorders in preschool children

    DEFF Research Database (Denmark)

    Brand, P L P; Baraldi, E; Bisgaard, H

    2008-01-01

    There is poor agreement on definitions of different phenotypes of preschool wheezing disorders. The present Task Force proposes to use the terms episodic (viral) wheeze to describe children who wheeze intermittently and are well between episodes, and multiple-trigger wheeze for children who wheeze...

  3. Targeting burn prevention in Ukraine: evaluation of base knowledge in burn prevention and first aid treatment.

    Science.gov (United States)

    Gamelli, Liza; Mykychack, Iryna; Kushnir, Antin; Driscoll, Daniel N; Fuzaylov, Gennadiy

    2015-01-01

    Burn prevention has been identified by the World Health Organization (WHO) as a topic in need of further investigation and education throughout the world, with an increased need in low-income countries. It has been noted that implementing educational programs for prevention in high income countries has aided in lowering the rate of burn injuries. The purpose of this study is to evaluate the current education level of knowledge of prevention and first aid treatment of scald burns. A prevention campaign will target these educational needs as a part of an outreach program to improve burn care in Ukraine. The research team evaluated the current health structure in Ukraine and how it could benefit from the increased knowledge of burn prevention and first aid. A test was designed to assess the baseline level of knowledge with regard to first aid and scald prevention in parents, pregnant woman, and healthcare and daycare providers. A total of 14,456 tests were sent to pediatric clinics, obstetrician clinics, and daycare facilities to test respondents. A total of 6,120 completed tests were returned. Doctors presented with the highest level of knowledge averaging 77.0% on prevention and 67.5% on first aid while daycare workers presented the largest gap in knowledge at 65.0% in prevention and 54.3% in first aid. Interest in further educational materials was reported by 92% of respondents. The results of this study clearly show a lack of knowledge in first aid and prevention of scald burn injury in all the populations tested.

  4. Early definitive treatment rate as a quality indicator of care in acute gallstone pancreatitis.

    Science.gov (United States)

    Green, R; Charman, S C; Palser, T

    2017-11-01

    Early definitive treatment (cholecystectomy or endoscopic sphincterotomy in the same admission or within 2 weeks after discharge) of gallstone disease after a biliary attack of acute pancreatitis is standard of care. This study investigated whether compliance with early definitive treatment for acute gallstone pancreatitis can be used as a care quality indicator for the condition. A retrospective cohort study was conducted using the Hospital Episode Statistics database. All emergency admissions to National Health Service hospitals in England with a first time diagnosis of acute gallstone pancreatitis in the financial years 2008, 2009 and 2010 were examined. Trends in early definitive treatment between hospital trusts were examined and patient morbidity outcomes were determined. During the study interval there were 19 510 patients with an overall rate of early definitive treatment at 34·7 (range 9·4-84·7) per cent. In the 1-year follow-up period, 4661 patients (23·9 per cent) had one or more emergency readmissions for complications related to gallstone pancreatitis. Of these, 2692 (57·8 per cent) were readmissions for acute pancreatitis; 911 (33·8 per cent) were within the first 2 weeks of discharge, with the remaining 1781 (66·2 per cent) occurring after the point at which definitive treatment should have been received. Early definitive treatment resulted in a 39 per cent reduction in readmission risk (adjusted risk ratio (RR) 0·61, 95 per cent c.i. 0·58 to 0·65). The risk was further reduced for acute pancreatitis readmissions to 54 per cent in the early definitive treatment group (adjusted RR 0·46, 0·42 to 0·51). In acute gallstone pancreatitis, compliance with recommended early definitive treatment varied considerably, with associated variation in outcomes. Compliance should be used as a quality indicator to improve care. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  5. [Psychological and behavioural symptoms of dementia: prevention, diagnosis and treatment].

    Science.gov (United States)

    Olazaran-Rodriguez, J; Aguera-Ortiz, L F; Muniz-Schwochert, R

    2012-11-16

    The psychological and behavioural symptoms of dementia (BPSD) [corrected] give rise to personal suffering, are the cause of added deterioration and worsen the economic and social cost of dementias. To offer a systematic approach to the prevention, diagnosis and treatment of BPSD. [corrected]. The study adopts a global perspective that takes into account biological, psychological and social factors in an attempt to avoid both excessive medicalisation and a purely psychology-based attitude. Satisfying basic needs, treating medical and psychiatric comorbidity, the adaptation of the setting, and the specific pharmacological treatment of dementia, as well as offering patients and their caregivers the counselling and support they need, all contribute to prevent the onset of BPSD. [corrected]. The diagnosis of BPSD [corrected] is based on the patient's medical history and on observation. It is useful to identify a primary or destabilising BPSD [corrected] on which to deploy hypotheses and specific treatments based on modifying the environment, drugs, non-pharmacological therapies and continuous assessment. Any action taken must be integrated within a person-focused care plan aimed at accomplishing the patients' and their caregivers' welfare and quality of life. BPSD [corrected] are the result of biological, psychological and social factors. In the present scenario, in which there are no curative treatments in most cases of dementia, a systematic and multidisciplinary approach aimed at preventing and treating BPSD [corrected] is a highly cost-effective therapeutic opportunity in both personal and social terms.

  6. Pomegranate for Prevention and Treatment of Cancer: An Update.

    Science.gov (United States)

    Sharma, Pooja; McClees, Sarah F; Afaq, Farrukh

    2017-01-24

    Cancer is the second leading cause of death in the United States, and those who survive cancer may experience lasting difficulties, including treatment side effects, as well as physical, cognitive, and psychosocial struggles. Naturally-occurring agents from dietary fruits and vegetables have received considerable attention for the prevention and treatment of cancers. These natural agents are safe and cost efficient in contrast to expensive chemotherapeutic agents, which may induce significant side effects. The pomegranate ( Punica granatum L.) fruit has been used for the prevention and treatment of a multitude of diseases and ailments for centuries in ancient cultures. Pomegranate exhibits strong antioxidant activity and is a rich source of anthocyanins, ellagitannins, and hydrolysable tannins. Studies have shown that the pomegranate fruit as well as its juice, extract, and oil exert anti-inflammatory, anti-proliferative, and anti-tumorigenic properties by modulating multiple signaling pathways, which suggest its use as a promising chemopreventive/chemotherapeutic agent. This review summarizes preclinical and clinical studies highlighting the role of pomegranate in prevention and treatment of skin, breast, prostate, lung, and colon cancers.

  7. Pomegranate for Prevention and Treatment of Cancer: An Update

    Directory of Open Access Journals (Sweden)

    Pooja Sharma

    2017-01-01

    Full Text Available Cancer is the second leading cause of death in the United States, and those who survive cancer may experience lasting difficulties, including treatment side effects, as well as physical, cognitive, and psychosocial struggles. Naturally-occurring agents from dietary fruits and vegetables have received considerable attention for the prevention and treatment of cancers. These natural agents are safe and cost efficient in contrast to expensive chemotherapeutic agents, which may induce significant side effects. The pomegranate (Punica granatum L. fruit has been used for the prevention and treatment of a multitude of diseases and ailments for centuries in ancient cultures. Pomegranate exhibits strong antioxidant activity and is a rich source of anthocyanins, ellagitannins, and hydrolysable tannins. Studies have shown that the pomegranate fruit as well as its juice, extract, and oil exert anti-inflammatory, anti-proliferative, and anti-tumorigenic properties by modulating multiple signaling pathways, which suggest its use as a promising chemopreventive/chemotherapeutic agent. This review summarizes preclinical and clinical studies highlighting the role of pomegranate in prevention and treatment of skin, breast, prostate, lung, and colon cancers.

  8. Preventive and conservative prosthodontic treatment using overdenture and Richmond crown

    Directory of Open Access Journals (Sweden)

    Jevin Stivie Cialy

    2016-12-01

    Full Text Available Prosthodontic treatment aims to restore the chewing function (rehabilitation and to prevent tooth decay and bone resorption (preventive and conservative. As an example, treatment by overdenture and Richmond crown. Overdenture is a partial or complete removable denture covered and supported by one or more teeth, the tooth roots and/or dental implants. Richmond crown is fixed denture by post and crown system, in which the post part goes into the root canal and its crown covers the entire of original tooth crown surface. By retaining the original teeth and/or roots, it could improve the stability and retention of the denture, and defend proprioseptic of teeth and vertical dimensions. To provide information about preventive prosthodontic treatment and prevention by using overdenture and Richmond crown. Case Report: A 50 year old woman only has 44 teeth on the mandible which is indicated for the overdenture construction and loss teeth 13, 14, 17 and 27 on the maxilla with deep caries in teeth 22 which is indicated for a removable partial denture (RPDs construction by Richmond crown gear 22. On an early stage study, printing models is done. Then treatment of the root canal on teeth 22 and 44, followed by root canal preparation, core construction (cast post and Richmond crown on tooth 22 and bareroot preparation on tooth 44 for overdenture construction. The procedure followed by printing, recording bite to insertion. Choosing treatment either overdenture or Richmond crown is very important because it could mantain remain original teeth, thus it can help to improve the retention and stabilization.

  9. Implementing intermittent preventive treatment for malaria in pregnancy

    DEFF Research Database (Denmark)

    Mubyazi, Godfrey Martin; Magnussen, Pascal; Goodman, Catherine

    2011-01-01

    Introduction Implementing Intermittent Preventive Treatment for malaria in Pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) through antenatal care (ANC) clinics is recommended for malaria endemic countries. The vast biomedical literature on malaria prevention focuses more on the epidemiological....... Results The importance of IPTp in preventing unnecessary anaemia, morbidity and mortality in pregnancy and improving childbirth outcomes is highly acknowledged, although the following factors appear to be the main constraints to IPTp service delivery and uptake: cost of accessing ANC; myths and other...... discriminatory socio-cultural values on and attitudes towards SP, malaria, and quality of ANC; supply and cost of SP at health facilities; understaffing and demoralised staff; ambiguity and impracticability of user-fee exemption policy guidelines on essential ANC services; implementing IPTp, bednets, HIV...

  10. Treatment and Prevention of Pandemic H1N1 Influenza.

    Science.gov (United States)

    Rewar, Suresh; Mirdha, Dashrath; Rewar, Prahlad

    2015-01-01

    Swine influenza is a respiratory infection common to pigs worldwide caused by type A influenza viruses, principally subtypes H1N1, H1N2, H2N1, H3N1, H3N2, and H2N3. Swine influenza viruses also can cause moderate to severe illness in humans and affect persons of all age groups. People in close contact with swine are at especially high risk. Until recently, epidemiological study of influenza was limited to resource-rich countries. The World Health Organization declared an H1N1 pandemic on June 11, 2009, after more than 70 countries reported 30,000 cases of H1N1 infection. In 2015, incidence of swine influenza increased substantially to reach a 5-year high. In India in 2015, 10,000 cases of swine influenza were reported with 774 deaths. The Centers for Disease Control and Prevention recommend real-time polymerase chain reaction as the method of choice for diagnosing H1N1. Antiviral drugs are the mainstay of clinical treatment of swine influenza and can make the illness milder and enable the patient to feel better faster. Antiviral drugs are most effective when they are started within the first 48 hours after the clinical signs begin, although they also may be used in severe or high-risk cases first seen after this time. The Centers for Disease Control and Prevention recommends use of oseltamivir (Tamiflu, Genentech) or zanamivir (Relenza, GlaxoSmithKline). Prevention of swine influenza has 3 components: prevention in swine, prevention of transmission to humans, and prevention of its spread among humans. Because of limited treatment options, high risk for secondary infection, and frequent need for intensive care of individuals with H1N1 pneumonia, environmental control, including vaccination of high-risk populations and public education are critical to control of swine influenza out breaks. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  11. Dietary Natural Products for Prevention and Treatment of Liver Cancer

    Directory of Open Access Journals (Sweden)

    Yue Zhou

    2016-03-01

    Full Text Available Liver cancer is the most common malignancy of the digestive system with high death rate. Accumulating evidences suggests that many dietary natural products are potential sources for prevention and treatment of liver cancer, such as grapes, black currant, plum, pomegranate, cruciferous vegetables, French beans, tomatoes, asparagus, garlic, turmeric, ginger, soy, rice bran, and some edible macro-fungi. These dietary natural products and their active components could affect the development and progression of liver cancer in various ways, such as inhibiting tumor cell growth and metastasis, protecting against liver carcinogens, immunomodulating and enhancing effects of chemotherapeutic drugs. This review summarizes the potential prevention and treatment activities of dietary natural products and their major bioactive constituents on liver cancer, and discusses possible mechanisms of action.

  12. Osteoradionecrosis of the mandible: Etiology, prevention, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Rayatt Sukh

    2007-12-01

    Full Text Available The treatment of head and neck cancer remains a challenge. Despite advances in surgical reconstructive techniques, most patients will require adjuvant therapy in the form of radiotherapy or chemo-radiotherapy to improve locoregional control. The short- and long term side effects of radiotherapy can be difficult to treat. In this review the causative effects and pathogenesis of osteoradionecrosis of the mandible will be highlighted. In addition, preventive measures and clinical features of radiotherapy induced damage will be presented. Finally, medical and surgical management of osteoradionecrosis, as well as, reconstructive surgery of the mandible will be discussed. At the end of this paper the reader should have up to date knowledge concerning the etiology, prevention, diagnosis and treatment of patients with osteoradionecrosis of the mandible.

  13. Complications of Proximal Interphalangeal Joint Injuries: Prevention and Treatment.

    Science.gov (United States)

    Kamnerdnakta, Sirichai; Huetteman, Helen E; Chung, Kevin C

    2018-05-01

    Proximal interphalangeal joint injuries are one of the most common injuries of the hand. The severity of injury can vary from a minor sprain to a complex intra-articular fracture. Because of the complex anatomy of the joint, complications may occur even after an appropriate treatment. This article provides a comprehensive review on existing techniques to manage complications and imparts practical points to help prevent further complications after proximal interphalangeal joint injury. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. [New trends in the treatment and prevention of addictive disorders].

    Science.gov (United States)

    Nespor, K

    2004-01-01

    Some trends in the treatment and prevention of diseases related to alcohol, drugs and gambling are reviewed. Brief intervention is crucially important, considering high prevalence of addictive diseases. Motivation enhancement according to the stage of motivation is used in brief intervention and also during more comprehensive therapy. Psychological and pharmacological management of craving is used more than before. Close and systematic co-operation between professional services and Alcoholics Anonymous and/or other self-helping groups is common and useful. Prevention of addictive diseases includes measures such as taxation, restriction of availability, age limits, restrictions of advertisements, and prevention of drinking under the influence of alcohol and other drugs. Effective school based prevention utilises interactive programmes and training of relevant skills (e.g. refusal skills, relaxation and decision making). Prevention on family level includes appropriate family monitoring and rules, moderate and consistent family discipline and family conflict resolution. Special attention should be paid to the children whose parents are alcohol or drug dependent. These children should, even as adults, abstain from alcohol and other addictive substances.

  15. Prevention and treatment of complications after transjugular intrahepatic portosystemic shunt

    Directory of Open Access Journals (Sweden)

    XUE Hui

    2016-02-01

    Full Text Available The application of transjugular intrahepatic portosystemic shunt (TIPS in the treatment of cirrhotic portal hypertension has been widely accepted both at home and abroad. This article focuses on the fatal complications of TIPS (including intraperitoneal bleeding and acute pulmonary embolism, shunt failure, and recurrent portosystemic hepatic encephalopathy, and elaborates on the reasons for such conditions and related preventive measures, in order to improve the accuracy and safety of intraoperative puncture, reduce common complications such as shunt failure and hepatic encephalopathy, and improve the clinical effect of TIPS in the treatment of cirrhotic portal hypertension.

  16. Candidiasis: predisposing factors, prevention, diagnosis and alternative treatment.

    Science.gov (United States)

    Martins, Natália; Ferreira, Isabel C F R; Barros, Lillian; Silva, Sónia; Henriques, Mariana

    2014-06-01

    Candidiasis is the most common opportunistic yeast infection. Candida species and other microorganisms are involved in this complicated fungal infection, but Candida albicans continues to be the most prevalent. In the past two decades, it has been observed an abnormal overgrowth in the gastrointestinal, urinary and respiratory tracts, not only in immunocompromised patients, but also related to nosocomial infections and even in healthy individuals. There is a widely variety of causal factors that contribute to yeast infection which means that candidiasis is a good example of a multifactorial syndrome. Due to rapid increase in the incidence in these infections, this is the subject of numerous studies. Recently, the focus of attention is the treatment and, above all, the prevention of those complications. The diagnosis of candidiasis could become quite complicated. Prevention is the most effective "treatment," much more than eradication of the yeast with antifungal agents. There are several aspects to consider in the daily routine that can provide a strength protection. However, a therapeutic approach is necessary when the infection is established, and therefore, other alternatives should be explored. This review provides an overview on predisposition factors, prevention and diagnosis of candidiasis, highlighting alternative approaches for candidiasis treatment.

  17. [Preventive treatment of retinal detachment in aphakic eyes].

    Science.gov (United States)

    Regnault, F; Bregeat, P

    1977-01-01

    We have examined 243 cases with retinal detachment occurring within 6 months following cataract surgery. In 92 of them retinal tear was due to lattice degeneration, in 66 to snail track degeneration and in 17 to equatorial degeneration. 290 other patients had preventive treatments. In this group, there were only 10 cases of retinal detachment. 9 out of 22 patients who had no preventive treatment suffered retinal detachments. There are two reasons for the occurrence of this retinal detachment in the 6 months following cataract surgery in eyes where retinal degenerations are found: (1) surgical trauma even with cryoextraction is responsible for traction of the vitreous base, (2) rapid disappearance of the hyaluronic acid in the aphakic vitreous is responsible for the degradation of the vitreous with formation of large zones of liquid vitreous. When adhesion between the vitreous and the retinal degeneration area remains, the traction is responsible for retinal tear or retinal detachment. The importance of the preventive treatment of retinal lesions prior to cataract surgery should be stressed.

  18. Exercise-associated muscle cramps: causes, treatment, and prevention.

    Science.gov (United States)

    Miller, Kevin C; Stone, Marcus S; Huxel, Kellie C; Edwards, Jeffrey E

    2010-07-01

    Exercise-associated muscle cramps (EAMC) are a common condition experienced by recreational and competitive athletes. Despite their commonality and prevalence, their cause remains unknown. Theories for the cause of EAMC are primarily based on anecdotal and observational studies rather than sound experimental evidence. Without a clear cause, treatments and prevention strategies for EAMC are often unsuccessful. A search of Medline (EBSCO), SPORTDiscus, and Silverplatter (CINHAL) was undertaken for journal articles written in English between the years 1955 and 2008. Additional references were collected by a careful analysis of the citations of others' research and textbooks. Dehydration/electrolyte and neuromuscular causes are the most widely discussed theories for the cause of EAMC; however, strong experimental evidence for either theory is lacking. EAMC are likely due to several factors coalescing to cause EAMC. The variety of treatments and prevention strategies for EAMC are evidence of the uncertainty in their cause. Acute EAMC treatment should focus on moderate static stretching of the affected muscle followed by a proper medical history to determine any predisposing conditions that may have triggered the onset of EAMC. Based on physical findings, prevention programs should be implemented to include fluid and electrolyte balance strategies and/or neuromuscular training.

  19. Food Allergies: Symptoms, Diagnosis, Prevention and Treatment | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Food Allergies Food Allergies: Symptoms, Diagnosis, Prevention and Treatment Past Issues / Spring ... available treatments only ease the symptoms. Preventing a food allergy reaction There are no drugs or treatments available ...

  20. Developing a Mobile App for Prevention and Treatment of Pressure Injuries.

    Science.gov (United States)

    Salomé, Geraldo Magela; Ferreira, Lydia Masako

    2018-02-01

    This descriptive study describes the planning and development of a mobile application (app) for prevention and treatment of pressure injuries for use by providers in a university research center. The app delineates risk factors for pressure injury development, provides an evaluation of the wound, recommends wound cleansing procedures, performs pressure injury staging, and recommends treatment interventions. A mobile app was developed using a contextualized instructional design, which involves a constructivist proposal and planning, developing, and applying specific didactic situations, thus incorporating mechanisms that favor contextualization. A literature search was conducted to identify relevant studies for the construction of the mobile app. The development process involved the selection of app tools, definition of the navigation structure, and planning of the environment configuration. The environment for downloading the app software on the Internet and installing it on the mobile device was created. The literature search yielded 18 articles, 2 books, and 1 master's degree thesis. A mobile app was created with an easy-to-use graphic interface. The app stores the patient's demographic characteristics and provides an evaluation of his/her wound, a list of risk factors for pressure injury development, wound cleansing procedures, and treatment interventions. The developed app may be useful in clinical practice, helping to prevent pressure injuries and promote select nursing interventions for the treatment of patients with pressure injury.

  1. Drug treatments in the secondary prevention of ischaemic stroke.

    Science.gov (United States)

    Schulz, Ursula G

    2013-11-01

    Stroke is an important cause of death and disability. However, about two thirds of cerebrovascular events are initially minor. They carry a high risk of potentially severe recurrent events, but they also offer an opportunity for secondary prevention to avoid such recurrences. As most recurrent events occur within a short time after the initial presentation, secondary prevention has to be started as soon as possible. Dramatic risk reduction can be achieved with well-established drugs if used in a timely manner. A standard secondary preventive regimen will address multiple vascular risk factors and will usually consist of an antiplatelet agent, a lipid lowering drug, and an antihypertensive agent. Depending on the risk factor profile of each patient, this will have to be adjusted individually, for example, taking into account the presence of cardioembolism or of stenotic disease of the brain-supplying arteries. In recent years, the approach to treating these risk factors has evolved. In addition to absolute blood pressure, blood pressure variability has emerged as an important contributing factor to stroke risk, which is affected differently by different antihypertensive agents. New oral anticoagulants reduce the risk of cerebral haemorrhage and the need for regular blood checks. The best antiplatelet regimen for stroke prevention is still uncertain, and treatment of dyslipidaemia may change if trials with cholesteryl ester transfer protein (CETP) inhibitors, which increase levels of HDL-cholesterol, are successful. This article reviews the current evidence for drug treatments in the secondary prevention of ischaemic stroke. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Prenatal treatment prevents learning deficit in Down syndrome model.

    Directory of Open Access Journals (Sweden)

    Maddalena Incerti

    Full Text Available Down syndrome is the most common genetic cause of mental retardation. Active fragments of neurotrophic factors release by astrocyte under the stimulation of vasoactive intestinal peptide, NAPVSIPQ (NAP and SALLRSIPA (SAL respectively, have shown therapeutic potential for developmental delay and learning deficits. Previous work demonstrated that NAP+SAL prevent developmental delay and glial deficit in Ts65Dn that is a well-characterized mouse model for Down syndrome. The objective of this study is to evaluate if prenatal treatment with these peptides prevents the learning deficit in the Ts65Dn mice. Pregnant Ts65Dn female and control pregnant females were randomly treated (intraperitoneal injection on pregnancy days 8 through 12 with saline (placebo or peptides (NAP 20 µg +SAL 20 µg daily. Learning was assessed in the offspring (8-10 months using the Morris Watermaze, which measures the latency to find the hidden platform (decrease in latency denotes learning. The investigators were blinded to the prenatal treatment and genotype. Pups were genotyped as trisomic (Down syndrome or euploid (control after completion of all tests.two-way ANOVA followed by Neuman-Keuls test for multiple comparisons, P<0.05 was used to denote statistical significance. Trisomic mice who prenatally received placebo (Down syndrome-placebo; n = 11 did not demonstrate learning over the five day period. DS mice that were prenatally exposed to peptides (Down syndrome-peptides; n = 10 learned significantly better than Down syndrome-placebo (p<0.01, and similar to control-placebo (n = 33 and control-peptide (n = 30. In conclusion prenatal treatment with the neuroprotective peptides (NAP+SAL prevented learning deficits in a Down syndrome model. These findings highlight a possibility for the prevention of sequelae in Down syndrome and suggest a potential pregnancy intervention that may improve outcome.

  3. Treatment outcomes of definitive chemoradiotherapy for patients with hypopharyngeal cancer

    International Nuclear Information System (INIS)

    Nakahara, Rie; Kodaira, Takeshi; Furutani, Kazuhisa

    2012-01-01

    We analyzed the efficacy of definitive chemoradiotherapy (CRT) for patients with hypopharyngeal cancer (HPC). Subjects comprised 97 patients who were treated with definitive CRT from 1990 to 2006. Sixty-one patients (62.9%) with resectable disease who aimed to preserve the larynx received induction chemotherapy (ICT), whereas 36 patients (37.1%) with resectable disease who refused an operation or who had unresectable disease received primary alternating CRT or concurrent CRT (non-ICT). The median dose to the primary lesion was 66 Gy. The median follow-up time was 77 months. The 5-year rates of overall survival (OS), progression-free survival (PFS), local control (LC), and laryngeal preservation were 68.7%, 57.5%, 79.1%, and 70.3%, respectively. The T-stage was a significant prognostic factor in terms of OS, PFS and LC in both univariate and multivariate analyses. The 5-year rates of PFS were 45.4% for the ICT group and 81.9% for the non-ICT group. The difference between these groups was significant with univariate analysis (P=0.006). Acute toxicity of Grade 3 to 4 was observed in 34 patients (35.1%). Grade 3 dysphagia occurred in 20 patients (20.6%). Twenty-nine (29.8%) of 44 patients with second primary cancer had esophageal cancer. Seventeen of 29 patients had manageable superficial esophageal cancer. The clinical efficacy of definitive CRT for HPC is thought to be promising in terms of not only organ preservation but also disease control. Second primary cancer may have a clinical impact on the outcome for HPC patients, and special care should be taken when screening at follow-up. (author)

  4. Therapies for Prevention and Treatment of Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    J. Mendiola-Precoma

    2016-01-01

    Full Text Available Alzheimer’s disease (AD is the most common cause of dementia associated with a progressive neurodegenerative disorder, with a prevalence of 44 million people throughout the world in 2015, and this figure is estimated to double by 2050. This disease is characterized by blood-brain barrier disruption, oxidative stress, mitochondrial impairment, neuroinflammation, and hypometabolism; it is related to amyloid-β peptide accumulation and tau hyperphosphorylation as well as a decrease in acetylcholine levels and a reduction of cerebral blood flow. Obesity is a major risk factor for AD, because it induces adipokine dysregulation, which consists of the release of the proinflammatory adipokines and decreased anti-inflammatory adipokines, among other processes. The pharmacological treatments for AD can be divided into two categories: symptomatic treatments such as acetylcholinesterase inhibitors and N-methyl-D-aspartate (NMDA receptor antagonists and etiology-based treatments such as secretase inhibitors, amyloid binders, and tau therapies. Strategies for prevention of AD through nonpharmacological treatments are associated with lifestyle interventions such as exercise, mental challenges, and socialization as well as caloric restriction and a healthy diet. AD is an important health issue on which all people should be informed so that prevention strategies that minimize the risk of its development may be implemented.

  5. Alzheimer’s disease: oral manifestations, treatment and preventive measures.

    Directory of Open Access Journals (Sweden)

    Jordi Ortega-Martínez

    2014-08-01

    Full Text Available In the treatment of patients with dementia types such as Alzheimer’s, non-current and tough situations are faced. Treatment should be tailored to each stage of the disease and for each patient. In this type of disease, it is very important to involve families and caregivers to improve the patients´ quality of life. The main goal with these patients is prevention. All oral manifestations caused by the lack of inadequate oral hygiene, xerostomia and manifestations derived from taking drugs should be controlled. The aim of this review is to describe the main oral manifestations which can result from this disease and the best treatment options taking into account the patients’ clinical stages.

  6. MODERN ASPECTS OF DIAGNOSTICS, TREATMENT AND PREVENTION OF CONGENITAL TOXOPLASMOSIS

    Directory of Open Access Journals (Sweden)

    M. S. Savenkova

    2017-01-01

    Full Text Available Diagnostics of intrauterine infection associated with T. gondii, today is a task with an ambiguous solution for different specialists — gynecologists, obstetricians, neonatologists, infectious disease specialists, resuscitators. This problem is interdisciplinary, and its coordinated decision, diagnosis and treatment of this disease at an early stage will reduce the risk of stillbirths, deaths and severe consequences. The article reflects the current literature data on the clinical features of toxoplasmosis in relation to the genotype of Toxoplasmа, circulating in the world. Particular importance is given to the selection of methods for prenatal and postnatal diagnosis of toxoplasmosis. The data of the latest review (2017 of theAmericanAcademy of Pediatrics on the diagnosis, treatment and prevention of congenital toxoplasmosis are presented. The main clinical manifestations of toxoplasmosis were revealed. Basic preparations for treatment of toxoplasmosis is Trimethoprim + sulfamethoxazole (Biseptol and spiramycin (Rovamycin.

  7. Guidelines for the diagnosis, prevention and treatment of osteoporosis

    Directory of Open Access Journals (Sweden)

    M. Rossini

    2011-06-01

    Full Text Available The guidelines for the osteoporosis management were first drafted by a working group and then critically evaluated by the board of SIOMMMS. The most relevant points are: Definition: Osteoporosis is defined as a quantitative and qualitative deterioration of bone tissue leading to increased risk of fracture. Postmenopausal and senile osteoporosis are defined as primitive. Diagnosis: The cornerstone for the diagnosis of osteoporosis is the measurement of bone mineral density (BMD by DXA (dual-energy X-ray absortiometry at the femoral neck with T-score values -2.5 is usually not justified. Pharmacological intervention: The use of drugs registered for the treatment of osteoporosis are recommended when the benefits overcome the risk. This is the case only when the risk of fracture is rather high. FRAX™ is recognized as a useful tool for easily estimate the long-term fracture risk. SIOMMMS with these guidelines is committed to validate and further develop this diagnostic tool.

  8. NH4Cl Treatment Prevents Tissue Calcification in Klotho Deficiency

    Science.gov (United States)

    Leibrock, Christina B.; Alesutan, Ioana; Voelkl, Jakob; Pakladok, Tatsiana; Michael, Diana; Schleicher, Erwin; Kamyabi-Moghaddam, Zahra; Quintanilla-Martinez, Leticia; Kuro-o, Makoto

    2015-01-01

    Klotho, a cofactor in suppressing 1,25(OH)2D3 formation, is a powerful regulator of mineral metabolism. Klotho-hypomorphic mice (kl/kl) exhibit excessive plasma 1,25(OH)2D3, Ca2+, and phosphate concentrations, severe tissue calcification, volume depletion with hyperaldosteronism, and early death. Calcification is paralleled by overexpression of osteoinductive transcription factor Runx2/Cbfa1, Alpl, and senescence-associated molecules Tgfb1, Pai-1, p21, and Glb1. Here, we show that NH4Cl treatment in drinking water (0.28 M) prevented soft tissue and vascular calcification and increased the life span of kl/kl mice >12-fold in males and >4-fold in females without significantly affecting extracellular pH or plasma concentrations of 1,25(OH)2D3, Ca2+, and phosphate. NH4Cl treatment significantly decreased plasma aldosterone and antidiuretic hormone concentrations and reversed the increase of Runx2/Cbfa1, Alpl, Tgfb1, Pai-1, p21, and Glb1 expression in aorta of kl/kl mice. Similarly, in primary human aortic smooth muscle cells (HAoSMCs), NH4Cl treatment reduced phosphate-induced mRNA expression of RUNX2/CBFA1, ALPL, and senescence-associated molecules. In both kl/kl mice and phosphate-treated HAoSMCs, levels of osmosensitive transcription factor NFAT5 and NFAT5-downstream mediator SOX9 were higher than in controls and decreased after NH4Cl treatment. Overexpression of NFAT5 in HAoSMCs mimicked the effect of phosphate and abrogated the effect of NH4Cl on SOX9, RUNX2/CBFA1, and ALPL mRNA expression. TGFB1 treatment of HAoSMCs upregulated NFAT5 expression and prevented the decrease of phosphate-induced NFAT5 expression after NH4Cl treatment. In conclusion, NH4Cl treatment prevents tissue calcification, reduces vascular senescence, and extends survival of klotho-hypomorphic mice. The effects of NH4Cl on vascular osteoinduction involve decrease of TGFB1 and inhibition of NFAT5-dependent osteochondrogenic signaling. PMID:25644113

  9. [Delirium prevention and treatment in elderly hip fracture].

    Science.gov (United States)

    Robles, María José; Formiga, Francesc; Vidán, M Teresa

    2014-04-22

    The fracture of the proximal femur or hip fracture in the elderly usually happens after a fall and carries a high morbidity and mortality. One of the most common complications during hospitalization for hip fracture is the onset of delirium or acute confusional state that in elderly patients has a negative impact on the hospital stay, and prognosis, worsening functional ability, cognitive status and mortality. Also the development of delirium during hospitalization increases health care costs. Strategies to prevent and treat delirium during hospitalization for hip fracture have been less studied. In this context, this paper aims to conduct a review of the literature on strategies that exist in the prevention and treatment of delirium in elderly patients with hip fracture. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  10. Implementing intermittent preventive treatment for malaria in pregnancy

    DEFF Research Database (Denmark)

    Mubyazi, Godfrey Martin; Magnussen, Pascal; Goodman, Catherine

    2008-01-01

    INTRODUCTION: Implementing Intermittent Preventive Treatment for malaria in Pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) through antenatal care (ANC) clinics is recommended for malaria endemic countries. Vast biomedical literature on malaria prevention focuses more on the epidemiological...... of the recommended interventions. OBJECTIVE: To review literature on policy advances, achievements, constraints and challenges to malaria IPTp implementation, emphasising on its operational feasibility in the context of health-care financing, provision and uptake, resource constraints and psychosocial factors...... and other discriminatory socio-cultural values on pregnancy; target users, perceptions and attitudes towards SP, malaria, and quality of ANC; supply and cost of SP at health facilities; understaffing and demoralised staff; ambiguity and impracticability of user-fee exemption policy guidelines on essential...

  11. Implementing intermittent preventive treatment for malaria in pregnancy

    DEFF Research Database (Denmark)

    Mubyazi, Godfrey Martin; Magnussen, Pascal; Goodman, Catherine

    2011-01-01

    Introduction Implementing Intermittent Preventive Treatment for malaria in Pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) through antenatal care (ANC) clinics is recommended for malaria endemic countries. The vast biomedical literature on malaria prevention focuses more on the epidemiological...... of the recommended interventions. Objective To review literature on policy advances, achievements, constraints and challenges to malaria IPTp implementation, emphasising its operational feasibility in the context of health-care financing, provision and uptake, resource constraints and psychosocial factors in Africa...... discriminatory socio-cultural values on and attitudes towards SP, malaria, and quality of ANC; supply and cost of SP at health facilities; understaffing and demoralised staff; ambiguity and impracticability of user-fee exemption policy guidelines on essential ANC services; implementing IPTp, bednets, HIV...

  12. [Technical guidelines for the prevention and treatment of chikungunya fever].

    Science.gov (United States)

    Barrera-Cruz, Antonio; Díaz-Ramos, Rita Delia; Viniegra-Osorio, Arturo; Grajales-Muñiz, Concepción; Dávila-Torres, Javier

    2015-01-01

    Chikungunya fever is an emerging disease caused by an alphavirus belonging to the Togaviridae family, transmitted by the bite of Aedes genus species: Aedesaegypti and Aedesalbopictus. In 2013, PAHO/WHO received confirmation of the first cases of indigenous transmission of chikungunya in the Americas. This disease may be acute, subacute and chronic, affecting all age groups. Following an incubation period from three to seven days, the patient usually begins with a high fever (greater than 39 °C), arthralgia, back pain, headache, nausea, vomiting, arthritis, rash, and conjunctivitis (acute phase: 3-10 days). Most patients recover fully, but in some cases, joint involvement may persist chronically and cause discapacity and affect life quality. Serious complications are rare, however, attention must be focused on vulnerable populations (the elderly, children and pregnant women). So far, there is no specific antiviral treatment or effective vaccine, so it is giving priority symptomatic and supportive treatment for the acute phase and make an early diagnosis of atypical and severe forms, and to implement effective prevention and control measures. Given the eco-epidemiological conditions and distribution of vectors in the region of the Americas, the spread of the virus to other countries is likely, so that health professionals should be aware of and identify risk factors and major clinical manifestations, allow timely prevention and safe and effective treatment of this disease.

  13. [Paraphilia, sexual preference disorders. Diagnosis, etiology, epidemiology, treatment and prevention].

    Science.gov (United States)

    Berner, Wolfgang; Briken, P

    2007-01-01

    Hostility towards relationships is one prominent characteristic symptom for disorders of sexual preference (ICD-10) and paraphilias (DSM-IV). Paraphilic symptoms sometimes progress to obsessive or addictive- like forms leading to a loss of self-control but can occur also as single incidents or as episodic events. Besides constitutional aspects, problems in the development of close relationships to primary caregivers (attachment) play an important role in the development of these disorders. Actual relationship- and self-confidence problems often trigger the severity of disturbance, especially in the episodic forms of paraphilia. For patients who are in conflict with the law, cognitive-behavioral therapeutic approaches with the aim to minimize self-deception regarding the effects of the paraphilic behavior have become more and more relevant. Regarding the medical treatment, anti-hormonal therapy plays an important role, but also treatment with serotonergic agents and naltrexone are used. Only little can be advised in terms of prevention; general psycho-hygiene (regarding the parent-child relationship) is recommended. Beside these general measures, institutions which offer special treatment for people in danger to become delinquents may be able to prevent serious harm for possible victims of abuse.

  14. Prescription drug therapies for prevention and treatment of postmenopausal osteoporosis.

    Science.gov (United States)

    O'Connell, Mary Beth

    2006-07-01

    To characterize the changes in bone mass with age in women and men, explain the physiology and pathophysiology of the bone remodeling process, identify the targets for prescription osteoporosis drugs in this process, and provide details about the uses, efficacy, safety, and economics of prescription drug therapies for osteoporosis prevention and treatment. Preventing accelerated bone loss and decreasing age-related decreases in bone density are the primary goals of prescription drug therapy for osteoporosis. Bisphosphonates are the drugs of choice for preventing and treating postmenopausal osteoporosis. Alternatives for patients who cannot take bisphosphonates include raloxifene and calcitonin salmon. Menopause is accompanied by a rapid loss in bone mass that is followed by annual losses due to aging in women, which are similar to age-related bone mass decreases in men. Most prescription drug therapies for osteoporosis prevention or treatment reduce bone resorption by inhibiting osteoclast activation and activity, with only one medication class able to increase bone formation by stimulating osteoblasts. Denosumab, an investigational monoclonal antibody that inhibits nuclear factor kB ligand, would be a new class of anti-resorptive medications. Bisphosphonates currently are the drugs of choice for preventing and treating osteoporosis, with 7- and 10-year safety data available for risedronate and alendronate, respectively. Weekly and monthly regimens of bisphosphonates improve patient acceptance. Recently, an injectable form of ibandronate received U.S. Food and Drug Administration approval for once every 3 months administration. Raloxifene and calcitonin salmon are alternatives for patients who cannot take bisphosphonates because of contraindications or adverse effects. Teriparatide, a recombinant parathyroid hormone fragment, not only increases bone mineral density but also increases bone connectivity. Osteoporosis medications are usually safe, especially if used

  15. [Progress of researches on prevention and treatment of sports fatigue with moxibustion therapy].

    Science.gov (United States)

    Xu, Hui-Qian; Zhang, Hong-Ru; Gu, Yi-Huang

    2014-04-01

    Sports fatigue belongs to the category of functional deficiency-syndrome according to the theory of traditional Chinese medicine. The moxibustion therapy has a long history and possesses a definite therapeutic effect in the prevention and treatment of sports fatigue. In the present paper, the authors reviewed development of researches on the effects of moxibustion intervention in the prevention and treatment of sports fatigue in recent 5 years. Results of researches showed that moxibustion intervention can 1) eliminate free radicals and reduce oxidative damage; 2) increase energy (glycogen) supply to delay the production of fatigue; 3) raise serum testosterone level (relieve exercise-induced neuroendocrine disorder) and reduce post-sports fatigue; 4) raise the anaerobic exercise ability, reduce the accumulation of metabolic products in the body and strengthen the endurance capacity of the skeletal muscle; and 5) improve ischemic cardiac function, and suppress cardiomyocyte apopotosis, etc. However, we should further strengthen our investigations on the moxibustion therapy in the ancient classical literature and sum up academic thoughts of different academic schools in the successive dynasties, put emphasis on the large sample randomized controlled clinical trails, establish united treatment standards, etc., and provide much evidence for effectively treating sports fatigue in the future.

  16. Prevention and treatment of sleep deprivation among emergency physicians.

    Science.gov (United States)

    Nelson, Douglas

    2007-07-01

    Emergency physicians commonly experience sleep deprivation because of the need to work shifts during evening and late night hours. The negative effects of this problem are compounded by job stress and traditional methods of scheduling work shifts. Sleep deprivation may be reduced by schedules designed to lessen interference with normal sleep patterns and circadian rhythms. Pharmacological treatments for sleep deprivation exist in the form of alertness-enhancing agents, caffeine and modafinil. Sleep-promoting agents may also help treat the problem by helping physicians to sleep during daytime hours. Minimizing sleep deprivation may help prevent job burnout and prolong the length of an emergency physician's career.

  17. Natural Polyphenols for Prevention and Treatment of Cancer

    Directory of Open Access Journals (Sweden)

    Yue Zhou

    2016-08-01

    Full Text Available There is much epidemiological evidence that a diet rich in fruits and vegetables could lower the risk of certain cancers. The effect has been attributed, in part, to natural polyphenols. Besides, numerous studies have demonstrated that natural polyphenols could be used for the prevention and treatment of cancer. Potential mechanisms included antioxidant, anti-inflammation as well as the modulation of multiple molecular events involved in carcinogenesis. The current review summarized the anticancer efficacy of major polyphenol classes (flavonoids, phenolic acids, lignans and stilbenes and discussed the potential mechanisms of action, which were based on epidemiological, in vitro, in vivo and clinical studies within the past five years.

  18. Application of nanotechnology in cancers prevention, early detection and treatment.

    Science.gov (United States)

    Patel, Shraddha P; Patel, Parshottambhai B; Parekh, Bhavesh B

    2014-01-01

    Use of nanotechnology in medical science is a rapidly developing area. New opportunities of diagnosis, imaging and therapy have developed due to recent rapid advancement by nanotechnology. The most common areas to be affected are diagnostic, imaging and targeted drug delivery in gastroenterology, oncology, cardiovascular medicine, obstetrics and gynecology. Mass screening with inexpensive imaging might be possible in the near future with the help of nanotechnology. This review paper provides an overview of causes of cancer and the application of nanotechnology in cancer prevention, detection and treatment.

  19. Atraumatic restorative treatment for prevention and treatment of caries in an underserved community.

    Science.gov (United States)

    Lopez, Naty; Simpser-Rafalin, Sara; Berthold, Peter

    2005-08-01

    We evaluated the acceptability and effectiveness of atraumatic restorative treatment to prevent and treat caries in an underserved community in Mexico. We placed 370 restorations and 193 sealants in 118 children aged 5 to 18; 85% reported no pain, and 93% were comfortable with their restorations. We then evaluated the children 1 and 2 years later. At 2-year evaluation, 66% of restorations and 35% of sealants were retained. Atraumatic restorative treatment is acceptable and effective to control and prevent decay in a socioeconomically deprived community.

  20. Nanomedicine for the prevention, treatment and imaging of atherosclerosis.

    Science.gov (United States)

    Psarros, Costas; Lee, Regent; Margaritis, Marios; Antoniades, Charalambos

    2012-09-01

    Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in developed countries, with an increasing prevalence due to an aging population. The pathology underpinning CVD is atherosclerosis, a chronic inflammatory state involving the arterial wall. Accumulation of low density lipoprotein (LDL) laden macrophages in the arterial wall and their subsequent transformation into foam cells lead to atherosclerotic plaque formation. Progression of atherosclerotic lesions may gradually lead to plaque related complications and clinically manifest as acute vascular syndromes including acute myocardial or cerebral ischemia. Nanotechnology offers emerging therapeutic strategies, which may have advantage overclassical treatments for atherosclerosis. In this review, we present the potential applications of nanotechnology toward prevention, identification and treatment of atherosclerosis. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Treatment and Prevention of Common Complications of Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Sheikh Salahuddin Ahmed

    2014-01-01

    Full Text Available Chronic kidney disease (CKD is a worldwide public health problem with an increasing incidence and prevalence. Outcomes of CKD include not only complications of decreased kidney function and cardiovascular disease but also kidney failure causing increased morbidity and mortality. Unfortunately, CKD is often undetected and undertreated because of its insidious onset, variable progression, and length of time to overt kidney failure. Diabetes is now the leading cause of CKD requiring renal replacement therapy in many parts of the world, and its prevalence is increasing disproportionately in the developing countries. This review article outlines the current recommendations from various clinical guidelines and research studies for treatment, prevention and delaying the progression of both CKD and its common complications such as hypertension, anemia, renal osteodystrophy, electrolyte and acid-base imbalance, and hyperlipidemia. Recommendations for nutrition in CKD and measures adopted for early diabetic kidney disease to prevent further progression have also been reviewed. There is strong evidence that early detection and management of CKD can prevent or reduce disease progression, decrease complications and improve outcomes. Evidence supports that achieving optimal glucose control, blood pressure, reduction in albuminuria with a multifactorial intervention slows the progression of CKD. Angiotensin-converting enzyme inhibitors and angiotensin-II receptor antagonists are most effective because of their unique ability to decrease proteinuria, a factor important for the progression of CKD.

  2. Metformin Treatment Prevents Sedentariness Related Damages in Mice

    Directory of Open Access Journals (Sweden)

    Pamela Senesi

    2016-01-01

    Full Text Available Metformin (METF, historical antihyperglycemic drug, is a likely candidate for lifespan extension, treatment and prevention of sedentariness damages, insulin resistance, and obesity. Skeletal muscle is a highly adaptable tissue, capable of hypertrophy response to resistance training and of regeneration after damage. Aims of this work were to investigate METF ability to prevent sedentariness damage and to enhance skeletal muscle function. Sedentary 12-week-old C57BL/6 mice were treated with METF (250 mg/kg per day, in drinking water for 60 days. METF role on skeletal muscle differentiation was studied in vitro using murine C2C12 myoblasts. Muscular performance evaluation revealed that METF enhanced mice physical performance (Estimated VO2max. Biochemical analyses of hepatic and muscular tissues indicated that in liver METF increased AMPK and CAMKII signaling. In contrast, METF inactivated ERKs, the principal kinases involved in hepatic stress. In skeletal muscle, METF activated AKT, key kinase in skeletal muscle mass maintenance. In in vitro studies, METF did not modify the C2C12 proliferation capacity, while it positively influenced the differentiation process and myotube maturation. In conclusion, our novel results suggest that METF has a positive action not only on the promotion of healthy aging but also on the prevention of sedentariness damages.

  3. Otitis media with effusion: benefits and harms of strategies in use for treatment and prevention.

    Science.gov (United States)

    Principi, Nicola; Marchisio, Paola; Esposito, Susanna

    2016-01-01

    Otitis media with effusion (OME) is a common clinical condition that is associated with hearing loss. It can be diagnosed at least once in approximately 80% of preschool children: 30-40% of them have recurrent episodes, and 5-10% have chronic disease. OME, in recurrent and persistent cases, might significantly delay or impair communication skills, resulting in behavioral and educational difficulties. Several therapeutic approaches have been used to avoid these problems. Most, however, have not been adequately studied, and no definitive conclusions can be drawn. Official guidelines do not recommend the use of decongestants, antihistamines, steroids, or antibiotics. The data are too scanty to assess other interventions, although autoinflation, because it incurs neither cost nor adverse events, deserves attention. Surgical procedures (i.e., tympanostomy tube insertion and adenoidectomy as an adjuvant) can be useful in some cases. This review evaluates all the current OME treatments and preventive measures, including their possible adverse events.

  4. Smoldering multiple myeloma requiring treatment: time for a new definition?

    Science.gov (United States)

    Dispenzieri, Angela; Stewart, A Keith; Chanan-Khan, Asher; Rajkumar, S Vincent; Kyle, Robert A; Fonseca, Rafael; Kapoor, Prashant; Bergsagel, P Leif; McCurdy, Arleigh; Gertz, Morie A; Lacy, Martha Q; Lust, John A; Russell, Stephen J; Zeldenrust, Steven R; Reeder, Craig; Roy, Vivek; Buadi, Francis; Dingli, David; Hayman, Suzanne R; Leung, Nelson; Lin, Yi; Mikhael, Joseph; Kumar, Shaji K

    2013-12-19

    Smoldering multiple myeloma (SMM) bridges the gap between monoclonal gammopathy of undetermined significance (a mostly premalignant disorder) and active multiple myeloma (MM). Until recently, no interventional study in patients with SMM showed improved overall survival (OS) with therapy as compared with observation. A report from the PETHEMA-GEM (Programa Español de Tratamientos en Hematologica) group described both fewer myeloma-related events and better OS among patients with high-risk SMM who were treated with lenalidomide and dexamethasone. This unique study prompted us to review current knowledge about SMM and address the following questions: (1) Are there patients currently defined as SMM who should be treated routinely? (2) Should the definitions of SMM and MM be reconsidered? (3) Has the time come when not treating is more dangerous than treating? (4) Could unintended medical harm result from overzealous intervention? Our conclusion is that those patients with the highest-risk SMM (extreme bone marrow plasmacytosis, extremely abnormal serum immunoglobulin free light chain ratio, and multiple bone lesions detected only by modern imaging) should be reclassified as active MM so that they can receive MM-appropriate therapy and the paradigm of careful observation for patients with SMM can be preserved.

  5. Inhaled therapeutics for prevention and treatment of pneumonia.

    Science.gov (United States)

    Safdar, Amar; Shelburne, Samuel A; Evans, Scott E; Dickey, Burton F

    2009-07-01

    The lungs are the most common site of serious infection owing to their large surface area exposed to the external environment and minimum barrier defense. However, this architecture makes the lungs readily available for topical therapy. Therapeutic aerosols include those directed towards improving mucociliary clearance of pathogens, stimulation of innate resistance to microbial infection, cytokine stimulation of immune function and delivery of antibiotics. In our opinion inhaled antimicrobials are underused, especially in patients with difficult-to-treat lung infections. The use of inhaled antimicrobial therapy has become an important part of the treatment of airway infection with Pseudomonas aeruginosa in cystic fibrosis and the prevention of invasive fungal infection in patients undergoing heart and lung transplantation. Cytokine inhaled therapy has also been explored in the treatment of neoplastic and infectious disease. The choice of pulmonary drug delivery systems remains critical as air-jet and ultrasonic nebulizer may deliver sub-optimum drug concentration if not used properly. In future development of this field, we recommend an emphasis on the study of the use of aerosolized hypertonic saline solution to reduce pathogen burden in the airways of subjects infected with microbes of low virulence, stimulation of innate resistance to prevent pneumonia in immunocompromised subjects using cytokines or synthetic pathogen-associated molecular pattern analogues and more opportunities for the use of inhaled antimicrobials. These therapeutics are still in their infancy but show great promise.

  6. Antioxidant Phytochemicals for the Prevention and Treatment of Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Yu-Jie Zhang

    2015-11-01

    Full Text Available Overproduction of oxidants (reactive oxygen species and reactive nitrogen species in the human body is responsible for the pathogenesis of some diseases. The scavenging of these oxidants is thought to be an effective measure to depress the level of oxidative stress of organisms. It has been reported that intake of vegetables and fruits is inversely associated with the risk of many chronic diseases, and antioxidant phytochemicals in vegetables and fruits are considered to be responsible for these health benefits. Antioxidant phytochemicals can be found in many foods and medicinal plants, and play an important role in the prevention and treatment of chronic diseases caused by oxidative stress. They often possess strong antioxidant and free radical scavenging abilities, as well as anti-inflammatory action, which are also the basis of other bioactivities and health benefits, such as anticancer, anti-aging, and protective action for cardiovascular diseases, diabetes mellitus, obesity and neurodegenerative diseases. This review summarizes recent progress on the health benefits of antioxidant phytochemicals, and discusses their potential mechanisms in the prevention and treatment of chronic diseases.

  7. Antioxidant Phytochemicals for the Prevention and Treatment of Chronic Diseases.

    Science.gov (United States)

    Zhang, Yu-Jie; Gan, Ren-You; Li, Sha; Zhou, Yue; Li, An-Na; Xu, Dong-Ping; Li, Hua-Bin

    2015-11-27

    Overproduction of oxidants (reactive oxygen species and reactive nitrogen species) in the human body is responsible for the pathogenesis of some diseases. The scavenging of these oxidants is thought to be an effective measure to depress the level of oxidative stress of organisms. It has been reported that intake of vegetables and fruits is inversely associated with the risk of many chronic diseases, and antioxidant phytochemicals in vegetables and fruits are considered to be responsible for these health benefits. Antioxidant phytochemicals can be found in many foods and medicinal plants, and play an important role in the prevention and treatment of chronic diseases caused by oxidative stress. They often possess strong antioxidant and free radical scavenging abilities, as well as anti-inflammatory action, which are also the basis of other bioactivities and health benefits, such as anticancer, anti-aging, and protective action for cardiovascular diseases, diabetes mellitus, obesity and neurodegenerative diseases. This review summarizes recent progress on the health benefits of antioxidant phytochemicals, and discusses their potential mechanisms in the prevention and treatment of chronic diseases.

  8. Assesment, treatment and prevention of atypical hemolytic uremic syndrome

    Directory of Open Access Journals (Sweden)

    Azar Nickavar

    2013-01-01

    Full Text Available Hemolytic uremic syndrome (HUS is a heterogeneous group of hemolytic disorders. Different terminologies have been described in HUS, which are as follows: (1 D+ HUS: Presentation with a preceding diarrhea; (2 typical HUS: D+ HUS with a single and self-limited episode; (3 atypical HUS (aHUS: Indicated those with complement dysregulation; (4 recurrent HUS: Recurrent episodes of thrombocytopenia and/or microangiopathic hemolytic anemia (MAHA after improvement of hematologic abnormalities; and (5 familial HUS: Necessary to distinct synchronous outbreaks of D+ HUS in family members and asynchronous disease with an inherited risk factor. aHUS is one of the potential causes of end-stage renal disease (ESRD in children. It has a high recurrence after renal transplantation in some genetic forms. Therefore, recognition of the responsible mechanism and proper prophylactic treatment are recommended to prevent or delay the occurrence of ESRD and prolong the length of survival of the transplanted kidney. A computerized search of MEDLINE and other databases was carried out to find the latest results in pathogenesis, treatment, and prevention of aHUS.

  9. Assesment, treatment and prevention of atypical hemolytic uremic syndrome.

    Science.gov (United States)

    Nickavar, Azar; Sotoudeh, Kambiz

    2013-01-01

    Hemolytic uremic syndrome (HUS) is a heterogeneous group of hemolytic disorders. Different terminologies have been described in HUS, which are as follows: (1) D+ HUS: Presentation with a preceding diarrhea; (2) typical HUS: D+ HUS with a single and self-limited episode; (3) atypical HUS (aHUS): Indicated those with complement dysregulation; (4) recurrent HUS: Recurrent episodes of thrombocytopenia and/or microangiopathic hemolytic anemia (MAHA) after improvement of hematologic abnormalities; and (5) familial HUS: Necessary to distinct synchronous outbreaks of D+ HUS in family members and asynchronous disease with an inherited risk factor. aHUS is one of the potential causes of end-stage renal disease (ESRD) in children. It has a high recurrence after renal transplantation in some genetic forms. Therefore, recognition of the responsible mechanism and proper prophylactic treatment are recommended to prevent or delay the occurrence of ESRD and prolong the length of survival of the transplanted kidney. A computerized search of MEDLINE and other databases was carried out to find the latest results in pathogenesis, treatment, and prevention of aHUS.

  10. Social Media and Mobile Technology for Cancer Prevention and Treatment

    Science.gov (United States)

    Prochaska, Judith J.; Coughlin, Steven S.; Lyons, Elizabeth J.

    2018-01-01

    OVERVIEW Given the number of lives affected by cancer and the great potential for optimizing well-being via lifestyle changes, patients, providers, health care systems, advocacy groups, and entrepreneurs are looking to digital solutions to enhance patient care and broaden prevention efforts. Thousands of health-oriented mobile websites and apps have been developed, with a majority focused upon lifestyle behaviors (e.g., exercise, diet, smoking). In this review, we consider the use and potential of social media and mHealth technologies for cancer prevention, cancer treatment, and survivorship. We identify key principles in research and practice, summarize prior reviews, and highlight notable case studies and patient resources. Further, with the potential for scaled delivery and broad reach, we consider application of social media and mHealth technologies in low-resource settings. With clear advantages for reach, social media and mHealth technologies offer the ability to scale and engage entire populations at low cost, develop supportive social networks, connect patients and providers, encourage adherence with cancer care, and collect vast quantities of data for advancing cancer research. Development efforts have been rapid and numerous, yet evaluation of intervention effects on behavior change and health outcomes are sorely needed, and regulation around data security issues is notably lacking. Attention to broader audiences is also needed, with targeted development for culturally diverse groups and non-English speakers. Further investment in research to build the evidence base and identify best practices will help delineate and actualize the potential of social media and mHealth technologies for cancer prevention and treatment. PMID:28561647

  11. Social Media and Mobile Technology for Cancer Prevention and Treatment.

    Science.gov (United States)

    Prochaska, Judith J; Coughlin, Steven S; Lyons, Elizabeth J

    2017-01-01

    Given the number of lives affected by cancer and the great potential for optimizing well-being via lifestyle changes, patients, providers, health care systems, advocacy groups, and entrepreneurs are looking to digital solutions to enhance patient care and broaden prevention efforts. Thousands of health-oriented mobile websites and apps have been developed, with a majority focused upon lifestyle behaviors (e.g., exercise, diet, smoking). In this review, we consider the use and potential of social media and mHealth technologies for cancer prevention, cancer treatment, and survivorship. We identify key principles in research and practice, summarize prior reviews, and highlight notable case studies and patient resources. Further, with the potential for scaled delivery and broad reach, we consider application of social media and mHealth technologies in low-resource settings. With clear advantages for reach, social media and mHealth technologies offer the ability to scale and engage entire populations at low cost, develop supportive social networks, connect patients and providers, encourage adherence with cancer care, and collect vast quantities of data for advancing cancer research. Development efforts have been rapid and numerous, yet evaluation of intervention effects on behavior change and health outcomes are sorely needed, and regulation around data security issues is notably lacking. Attention to broader audiences is also needed, with targeted development for culturally diverse groups and non-English speakers. Further investment in research to build the evidence base and identify best practices will help delineate and actualize the potential of social media and mHealth technologies for cancer prevention and treatment.

  12. HIV treatment as prevention: debate and commentary--will early infection compromise treatment-as-prevention strategies?

    Directory of Open Access Journals (Sweden)

    Myron S Cohen

    Full Text Available Universal HIV testing and immediate antiretroviral therapy for infected individuals has been proposed as a way of reducing the transmission of HIV and thereby bringing the HIV epidemic under control. It is unclear whether transmission during early HIV infection--before individuals are likely to have been diagnosed with HIV and started on antiretroviral therapy--will compromise the effectiveness of treatment as prevention. This article presents two opposing viewpoints by Powers, Miller, and Cohen, and Williams and Dye, followed by a commentary by Fraser.

  13. TAPWAT: Definition structure and applications for modelling drinking water treatment

    NARCIS (Netherlands)

    Versteegh JFM; Gaalen FW van; Rietveld LC; Evers EG; Aldenberg TA; Cleij P; Technische Universiteit Delft; LWD

    2001-01-01

    The 'Tool for the Analysis of the Production of drinking WATer' (TAPWAT) model has been developed for describing drinking-water quality in integral studies in the context of the Environmental Policy Assessment of the RIVM. The model consists of modules that represent individual steps in a treatment

  14. Effectiveness of combined intermittent preventive treatment for children and timely home treatment for malaria control

    Directory of Open Access Journals (Sweden)

    Seakey Atsu K

    2009-12-01

    Full Text Available Abstract Background Whiles awaiting for the arrival of an effective and affordable malaria vaccine, there is a need to make use of the available control tools to reduce malaria risk, especially in children under five years and pregnant women. Intermittent preventive treatment (IPT has recently been accepted as an important component of the malaria control strategy. This study explored the potential of a strategy of intermittent preventive treatment for children (IPTC and timely treatment of malaria-related febrile illness in the home in reducing the parasite prevalence and malaria morbidity in young children in a coastal village in Ghana. Methods The study combined home-based delivery of IPTC among six to 60 months old and home treatment of suspected febrile malaria illness within 24 hours. All children between six and 60 months of age received intermittent preventive treatment using amodiaquine and artesunate, delivered by community assistants every four months (three times in 12 months. Malaria parasite prevalence surveys were conducted before the first and after the third dose of IPTC. Results Parasite prevalence was reduced from 25% to 3% (p Conclusion The evaluation result indicates that IPTC given three times in a year combined with timely treatment of febrile malaria illness, impacts significantly on the parasite prevalence. The marked reduction in the parasite prevalence with this strategy points to the potential for reducing malaria-related childhood morbidity and mortality, and this should be explored by control programme managers.

  15. Neonatal Respiratory Distress Syndrome: Early Diagnosis, Prevention, and Treatment

    Directory of Open Access Journals (Sweden)

    S. A. Perepelitsa

    2012-01-01

    Full Text Available to improve treatment results in premature infants with neonatal respiratory distress syndrome (NRDS, by establishing developmental mechanisms and elaborating methods for its early diagnosis, treatment, and prevention. Material and methods. The paper analyzes the results of a clinical observation and laboratory, instrumental, immunological, morphological, and radiological studies of 320 premature neonates at 26—35 weeks gestational age. The following groups of neonates were identified: 1 40 premature neonatal infants without NRDS and with the physiological course of an early neonatal period (a comparison group; 2 190 premature neonates with severe NRDS in whom the efficiency of therapy with exogenous surfactants, such as surfactant BL versus curosurf, was evaluated; 3 90 premature newborn infants who had died from NRDS at its different stages. Results. The poor maternal somatic, obstetric, and gynecological histories in the early periods of the current pregnancy create prerequisites for its termination, favor the development of severe acute gestosis, and cause abnormal placental changes. Each gestational age is marked by certain placental changes that promote impaired uterineplacentalfetal blood flow and premature birth. Alveolar and bronchial epithelial damages, including those ante and intranatally, microcircula tory disorders play a leading role in the tanatogenesis of NRDS. Intranatal hypoxia and amniotic fluid aspiration are one of the important factors contributing to alveolar epithelial damage and NRDS in premature neonates. Exogenous surfactants prevent the development of hyaline membranes and are useful in the normalization of ventilation-perfusion relationships and lung biomechanical properties. Conclusion. This study could improve the diagnosis and treatment of NRDS, which assisted in reducing the duration of mechanical ventilation from 130±7.6 to 65±11.6 hours, the number of complications (the incidence of intragastric

  16. 45 CFR 96.46 - Substance abuse prevention and treatment services.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Substance abuse prevention and treatment services... organizations under the substance abuse prevention and treatment Block Grant. (b) For the purpose of determining... substance abuse prevention and treatment Block Grant, an Indian tribe or tribal organization is not required...

  17. 21 CFR 516.13 - Definitions.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Definitions. 516.13 Section 516.13 Food and Drugs... Minor Species New Animal Drug § 516.13 Definitions. The following definitions of terms apply only in the... treatment, control or prevention of a disease or condition, or the intention to affect the structure or...

  18. Development of a foundation for a case definition of post-treatment Lyme disease syndrome.

    Science.gov (United States)

    Aucott, John N; Crowder, Lauren A; Kortte, Kathleen B

    2013-06-01

    The study objective is to demonstrate the clinical and research utility of an operationalized definition of post-treatment Lyme disease syndrome (PTLDS), as proposed by the Infectious Diseases Society of America. Seventy-four patients with confirmed erythema migrans and 14 controls were enrolled. Patient-reported symptoms and health function (SF-36) were collected pre-treatment and at follow-up visits over 6 months post-treatment. Eight (11%) patients met our operationalized definition of PTLDS, which included self-reported symptoms of fatigue, widespread musculoskeletal pain or cognitive complaints, and functional impact as measured by a T score of definition of PTLDS allows for identification of those patients who are treated for early Lyme disease and have significant post-treatment illness, as they have both residual symptoms and impact on daily life functioning. With further refinement and improvement of this operationalized definition, the true incidence of PTLDS can be determined and future studies can be designed to examine its pathophysiology and treatment. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  19. Cardiorenal Syndrome Type 1: Definition, Etiopathogenesis, Diagnostics and Treatment

    Directory of Open Access Journals (Sweden)

    Nikolic Tomislav

    2018-03-01

    Full Text Available Cardiorenal Syndrome Type 1 (CRS-1 is defined as an acute worsening of heart function leading to acute kidney injury and/or dysfunction. It is an important cause of hospitalization which affects the diagnosis as well as the prognosis and treatment of patients. The purpose of this paper is to analyze causes that lead to the development of cardiorenal syndrome type 1 and its clinical consequences, as well as to emphasize the clinical importance of its early detection. The clinical studies and professional papers dealing with etiopathogenesis, diagnosis and treatment of cardiorenal syndrome type 1, have been analyzed. The most important role in the occurrence of cardio renal syndrome type 1 is played by hemodynamic mechanisms, activation of neurohumoral systems, inflammation and imbalance between the production of reactive oxygen species (ROS and nitric oxide (NO. Diagnosis of cardiorenal syndrome type 1 involves biomarkers of acute renal injury among which the most important are: neutrophil gelatinaseassociated lipocalin (NGAL, cystatin C, kidney injury molecule 1 (KIM-1, liver-type fatty acid binding protein (L-FABP, IL-18 and the values of nitrogen compounds in serum. In addition to a pharmacological therapy, various modalities of extracorporeal ultrafiltration are applied in treatment of CRS-1, particularly if there is resistance to the use of diuretic therapy. As opposed to the experimental models, in clinical practice acute renal injury is often diagnosed late so that the measures taken do not give the expected results and the protective role shown in experimental conditions do not give the same results. For all these reasons, it is necessary to analyze the pathophysiology of renal impairment in cardiorenal syndrome as well as detect early indicators of kidney injury that could have clinical benefit and positive impact on reducing the cost of treatment.

  20. [Antibiotic treatment for prevention of infectious complications in joint replacement].

    Science.gov (United States)

    Jahoda, D; Nyc, O; Pokorný, D; Landor, I; Sosna, A

    2006-04-01

    Prophylactic antibiotic treatment is mandatory in every operation involving an orthopedic implant. Carefully selected and correctly administered antibiotics can provide effective protection of the implant from bacterial colonization. The prevention of deep wound infection in joint replacement includes several procedures and measures which constitute three basic groups: 1) Promotion of patient's ability to resist infection (careful pre-operative preparation, elimination of potential infectious loci, good nutritional status, etc). 2) Optimal conditions for the operative wound (surgical technique, prophylactic antibiotics). 3) Reduction of the number of bacteria brought in the wound (control measures, super-sterile operating theatres). Clear rules for the system of prophylactic antibiotic treatment should be adopted. A program in which responsibility for antibiotic administration was shifted from the nursing staff to the anesthesiologist in the operating theatre showed improved outcomes and reduced costs. Poor timing of prophylactic antibiotic administration is one of the basic mistakes. If the wound happened to be contaminated during surgery, the first three post-operative hours would be most decisive for the development of infection. An effective bactericidal concentration of antibiotic should be present in tissues and serum immediately after surgery has begun. Therefore the appropriate time for antibiotic application is before a skin incision is made, and not after the operation has started; the highest serum and bone tissue levels appear 20 to 30 min. after intravenous antibiotic injection. To allow antibiotics to reach target tissues, they should be introduced at least 10 min. before tourniquet application. For long surgical procedures or when blood loss is high, an additional dose of antibiotics is recommended during the operation. If a sample for bacterial cultivation is required, antibiotic administration is postponed until during surgery. However, this is

  1. [Prevention and treatment of tardive dyskinesia caused by antipsychotic drugs].

    Science.gov (United States)

    Seigneurie, A-S; Sauvanaud, F; Limosin, F

    2016-06-01

    Tardive dyskinesia (TD) is a movement disorder of tongue, jawbone, trunk and/or limbs that may appear after a prolonged use of dopamine receptor blocking agents (after 3 months of treatment or after 1 month for patients over 60), and that are present during at least four consecutive weeks. TD is a frequent side effect of both classical neuroleptics and new generation antipsychotic drugs. The prevalence of iatrogenic TD is between 24 and 32 % after treatment with classical neuroleptics and about 13 % after treatment with a new generation antipsychotic. This paper presents an updated literature review of data on diagnosis, prevention and treatment of TD. We conducted a review of literature using the Medline Browser tool, screening studies from 1950 to 2013 in English or French with keywords « tardive dyskinesia », « tardive dystonia », and « abnormal movements caused by antipsychotic drugs ». We first describe and define semeiological features of TD: dystonia, tremor, myoclonus, acathisie, chorea, ballism and athetosia. Secondarily, we resume the main differential diagnoses to exclude when confronted with this kind of movement disorders. Differential diagnoses for dyskinesia can be classified between primary (Parkinson and Huntington diseases) and secondary (Wilson disease, intoxication, metabolic abnormality, cerebrovascular accident) abnormal movements. Psychogenic TD can be evocated if previous pathologies are excluded in case of atypical clinical presentation. We detail the risk factors for TD. Endogenous risk factors are related to the patient's age, underlying psychiatric disease (bipolar disorder or Alzheimer dementia), addiction to alcohol or cocaine, female gender, or neurodevelopmental vulnerability. Iatrogenic risk factors are high doses of antipsychotics, long or intermittent administration, and particular pharmaceutical classes or associations of antipsychotics. As a comprehensive tool, we review the main physiopathological hypotheses to

  2. Patient factors influencing dermal filler complications: prevention, assessment, and treatment

    Directory of Open Access Journals (Sweden)

    De Boulle K

    2015-04-01

    Full Text Available Koenraad De Boulle,1 Izolda Heydenrych2 On behalf of the Consensus Group 1Aalst Dermatology Group, Aalst, Belgium; 2Cape Town Cosmetic Dermatology Centre, Century City, South Africa Abstract: While rare, complications do occur with the esthetic use of dermal fillers. Careful attention to patient factors and technique can do much to avoid these complications, and a well-informed practitioner can mitigate problems when they do occur. Since cosmetic surgery is usually an elective process, requested by the patient, clinical trials are complex to organize and run. For this reason, an international group of practicing physicians in the field of esthetics came together to share knowledge and to try and produce some informed guidance for their colleagues, considering the literature and also pooling their own extensive clinical experience. This manuscript aims to summarize the crucial aspects of patient selection, including absolute contraindications as well as situations that warrant caution, and also covers important considerations for the pre- and posttreatment periods as well as during the procedure itself. Guidance is given on both immediate and long-term management of adverse reactions. The majority of complications are related to accepting patients inappropriate for treatment or issues of sterility, placement, volume, and injection technique. It is clear that esthetic practitioners need an in-depth knowledge of all aspects of treatment with dermal fillers to achieve optimal outcomes for their patients. Keywords: dermal fillers, complications, prevention, assessment, treatment, patient factors

  3. Prevention and treatment of white spot lesions in orthodontic patients

    Directory of Open Access Journals (Sweden)

    Maryam Khoroushi

    2017-01-01

    Full Text Available Decalcification of enamel, appearing as white spot lesions (WSLs, around fixed orthodontic appliances is a major challenge during and after fixed orthodontic treatment by considering the fact that the goal of orthodontic treatment is to enhance facial and dental esthetic appearance. Banded or bonded teeth exhibit a significantly higher rate of WSLs compared to the controls with no braces as fixed appliances and the bonding materials promote retention of biofilms. These lesions are managed in the first step by establishing good oral hygiene habits and prophylaxis with topical fluorides, including high-fluoride toothpastes, fluoride mouthwashes, gels, varnishes, fluoride-containing bonding materials, and elastic ligatures. Recently, other materials and methods have been recommended, including the application of casein phosphopeptides-amorphous calcium phosphate, antiseptics, probiotics, polyols, sealants, laser, tooth bleaching agents, resin infiltration, and microabrasion. This article reviews the currently used methods to manage enamel demineralization during and after orthodontic treatment and the risk factors and preventive measures based on the latest evidence.

  4. Prevention of relapse in generalized anxiety disorder by escitalopram treatment.

    Science.gov (United States)

    Allgulander, Christer; Florea, Ioana; Huusom, Anna K Trap

    2006-10-01

    Escitalopram has demonstrated a robust and dose-dependent efficacy in the treatment of generalized anxiety disorder (GAD) for up to 3 months. In the present study, the efficacy and tolerability of escitalopram in the prevention of relapse in GAD was investigated. A total of 491 patients with a primary diagnosis of GAD and a Hamilton Anxiety (HAMA) total score>or=20 received 12 wk of open-label treatment with a fixed dose of escitalopram (20 mg/d). Of these, 375 patients responded (HAMA total scoretreatment with 20 mg/d escitalopram (n=187) or placebo (n=188). Treatment was continued for 24-76 wk unless the patient relapsed or was withdrawn for other reasons. Relapse was defined as either an increase in HAMA total score to >or=15, or lack of efficacy, as judged by the investigator. The results of the primary analysis showed a clear beneficial effect of escitalopram relative to placebo on the time to relapse of GAD (log-rank test, pinsomnia (2-6%). Escitalopram 20 mg/d significantly reduced the risk of relapse and was well tolerated in patients with GAD.

  5. Lasofoxifene for the prevention and treatment of postmenopausal osteoporosis

    Directory of Open Access Journals (Sweden)

    E Michael Lewiecki

    2009-10-01

    Full Text Available E Michael LewieckiNew Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USAAbstract: Lasofoxifene is a selective estrogen receptor modulator (estrogen agonist/antagonist that has completed phase III trials to evaluate safety and efficacy for the prevention and treatment of osteoporosis and for the treatment of vaginal atrophy in postmenopausal women. In postmenopausal women with low or normal bone mineral density (BMD, lasofoxifene increased BMD at the lumbar spine and hip and reduced bone turnover markers compared with placebo. In women with postmenopausal osteoporosis, lasofoxifene increased BMD, reduced bone turnover markers, reduced the risk of vertebral and nonvertebral fractures, and decreased the risk of estrogen receptor-positive breast cancer. In postmenopausal women with low bone mass, lasofoxifene improved the signs and symptoms of vulvovaginal atrophy. Clinical trials show that lasofoxifene is generally well tolerated with mild to moderate adverse events that commonly resolve even with drug continuation. Lasofoxifene has been associated with an increase in the incidence of venous thromboembolic events, hot flushes, muscle spasm, and vaginal bleeding. It is approved for the treatment of postmenopausal women at increased risk for fracture in some countries and is in the regulatory review process in others.Keywords: osteoporosis, SERM, fracture, efficacy, safety, BMD, CP-336,156

  6. Aloe vera for prevention and treatment of infusion phlebitis.

    Science.gov (United States)

    Zheng, Guo Hua; Yang, Liu; Chen, Hai Ying; Chu, Jian Feng; Mei, Lijuan

    2014-06-04

    Up to 80% of hospitalised patients receive intravenous therapy at some point during their admission. About 20% to 70% of patients receiving intravenous therapy develop phlebitis. Infusion phlebitis has become one of the most common complications in patients with intravenous therapy. However, the effects of routine treatments such as external application of 75% alcohol or 50% to 75% magnesium sulphate (MgSO4) are unsatisfactory. Therefore, there is an urgent need to develop new methods to prevent and alleviate infusion phlebitis. To systematically assess the effects of external application of Aloe vera for the prevention and treatment of infusion phlebitis associated with the presence of an intravenous access device. The Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator (TSC) searched the Specialised Register (last searched February 2014) and CENTRAL (2014, Issue 1). In addition the TSC searched MEDLINE to week 5 January 2014, EMBASE to Week 6 2014 and AMED to February 2014. The authors searched the following Chinese databases until 28 February 2014: Chinese BioMedical Database; Traditional Chinese Medical Database System; China National Knowledge Infrastructure; Chinese VIP information; Chinese Medical Current Contents; Chinese Academic Conference Papers Database and Chinese Dissertation Database; and China Medical Academic Conference. Bibliographies of retrieved and relevant publications were searched. There were no restrictions on the basis of date or language of publication. Randomised controlled trials (RCTs) and quasi-randomised controlled trials (qRCTs) were included if they involved participants receiving topical Aloe vera or Aloe vera-derived products at the site of punctured skin, with or without routine treatment at the same site. Two review authors independently extracted the data on the study characteristics, description of methodology and outcomes of the eligible trials, and assessed study quality. Data were analysed using RevMan 5

  7. Modern concepts of treatment and prevention of lightning injuries.

    Science.gov (United States)

    Edlich, Richard F; Farinholt, Heidi-Marie A; Winters, Kathryne L; Britt, L D; Long, William B

    2005-01-01

    Lightning is the second most common cause of weather-related death in the United States. Lightning is a natural atmospheric discharge that occurs between regions of net positive and net negative electric charges. There are several types of lightning, including streak lightning, sheet lightning, ribbon lightning, bead lightning, and ball lightning. Lightning causes injury through five basic mechanisms: direct strike, flash discharge (splash), contact, ground current (step voltage), and blunt trauma. While persons struck by lightning show evidence of multisystem derangement, the most dramatic effects involve the cardiovascular and central nervous systems. Cardiopulmonary arrest is the most common cause of death in lightning victims. Immediate resuscitation of people struck by lightning greatly affects the prognosis. Electrocardiographic changes observed following lightning accidents are probably from primary electric injury or burns of the myocardium without coronary artery occlusion. Lightning induces vasomotor spasm from direct sympathetic stimulation resulting in severe loss of pulses in the extremities. This vasoconstriction may be associated with transient paralysis. Damage to the central nervous system accounts for the second most debilitating group of injuries. Central nervous system injuries from lightning include amnesia and confusion, immediate loss of consciousness, weakness, intracranial injuries, and even brief aphasia. Other organ systems injured by lightning include the eye, ear, gastrointestinal system, skin, and musculoskeletal system. The best treatment of lightning injuries is prevention. The Lightning Safety Guidelines devised by the Lightning Safety Group should be instituted in the United States and other nations to prevent these devastating injuries.

  8. Atrio-Esophageal Fistula After AF Ablation: Pathophysiology, Prevention &Treatment.

    Science.gov (United States)

    Pappone, Carlo; Vicedomini, Gabriele; Santinelli, Vincenzo

    2013-01-01

    Atrioesophageal fistula is an extremely rare but often fatal late complication of atrial fibrillation ablation procedures resulting from massive thermal injury to the esophagus and surrounding structures. Causes of death include cerebral air embolism, massive gastrointestinal bleeding, and septic shock. Because of its exceptionally low rate of occurrence, no predictors of lesion development have been found and there has not been an uniform approach to either early diagnosis or corrective therapy. Currently, preventive strategies include empirically reducing power titration during PVI and/or while ablating the posterior left atrial wall, limiting energy delivery time and number, avoiding overlapping ablation lines as well as monitoring intraluminal esophageal temperature. In addition, it has been suggested to use conscious sedation rather than general anesthesia for better pain perception, monitoring intraprocedural esophageal position in relation to the posterior left atrium and extensive patient education regarding signs and symptoms of esophageal injury. Early diagnosis is essential to enable an aggressive treatment including stenting and/or surgical intervention to minimize the excessive morbidity and mortality associated with this condition. Unfortunately, despite application of such preventive measures, cases of complete atrial-esophageal fistula have still been reported.

  9. UK clinical guideline for the prevention and treatment of osteoporosis.

    Science.gov (United States)

    Compston, J; Cooper, A; Cooper, C; Gittoes, N; Gregson, C; Harvey, N; Hope, S; Kanis, J A; McCloskey, E V; Poole, K E S; Reid, D M; Selby, P; Thompson, F; Thurston, A; Vine, N

    2017-12-01

    In 2008, the UK National Osteoporosis Guideline Group (NOGG) produced a guideline on the prevention and treatment of osteoporosis, with an update in 2013. This paper presents a major update of the guideline, the scope of which is to review the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women and men age 50 years or over. Where available, systematic reviews, meta-analyses and randomised controlled trials were used to provide the evidence base. Conclusions and recommendations were systematically graded according to the strength of the available evidence. Review of the evidence and recommendations are provided for the diagnosis of osteoporosis, fracture-risk assessment, lifestyle measures and pharmacological interventions, duration and monitoring of bisphosphonate therapy, glucocorticoid-induced osteoporosis, osteoporosis in men, postfracture care and intervention thresholds. The guideline, which has received accreditation from the National Institute of Health and Care Excellence (NICE), provides a comprehensive overview of the assessment and management of osteoporosis for all healthcare professionals who are involved in its management.

  10. Dietary Polyphenols in Prevention and Treatment of Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Rahul K. Lall

    2015-02-01

    Full Text Available Prostate cancer is the most prevalent disease affecting males in many Western countries, with an estimated 29,480 deaths in 2014 in the US alone. Incidence rates for prostate cancer deaths have been decreasing since the early 1990s in men of all races/ethnicities, though they remain about 60% higher in African Americans than in any other group. The relationship between dietary polyphenols and the prevention of prostate cancer has been examined previously. Although results are sometimes inconsistent and variable, there is a general agreement that polyphenols hold great promise for the future management of prostate cancer. Various dietary components, including polyphenols, have been shown to possess anti-cancer properties. Generally considered as non-toxic, dietary polyphenols act as key modulators of signaling pathways and are therefore considered ideal chemopreventive agents. Besides possessing various anti-tumor properties, dietary polyphenols also contribute to epigenetic changes associated with the fate of cancer cells and have emerged as potential drugs for therapeutic intervention. Polyphenols have also been shown to affect post-translational modifications and microRNA expressions. This article provides a systematic review of the health benefits of selected dietary polyphenols in prostate cancer, especially focusing on the subclasses of polyphenols, which have a great effect on disease prevention and treatment.

  11. [Community acquired pneumonia in children: Outpatient treatment and prevention].

    Science.gov (United States)

    Moreno-Pérez, D; Andrés Martín, A; Tagarro García, A; Escribano Montaner, A; Figuerola Mulet, J; García García, J J; Moreno-Galdó, A; Rodrigo Gonzalo de Lliria, C; Ruiz Contreras, J; Saavedra Lozano, J

    2015-12-01

    There have been significant changes in community acquired pneumonia (CAP) in children in the last decade. These changes relate to epidemiology and clinical presentation. Resistance to antibiotics is also a changing issue. These all have to be considered when treating CAP. In this document, two of the main Spanish pediatric societies involved in the treatment of CAP in children, propose a consensus concerning therapeutic approach. These societies are the Spanish Society of Paediatric Infectious Diseases and the Spanish Society of Paediatric Chest Diseases. The Advisory Committee on Vaccines of the Spanish Association of Paediatrics (CAV-AEP) has also been involved in the prevention of CAP. An attempt is made to provide up-to-date guidelines to all paediatricians. The first part of the statement presents the approach to ambulatory, previously healthy children. We also review the prevention with currently available vaccines. In a next second part, special situations and complicated forms will be addressed. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  12. Canine angiostrongylosis: recent advances in diagnosis, prevention, and treatment

    Directory of Open Access Journals (Sweden)

    Di Cesare A

    2014-12-01

    Full Text Available Angela Di Cesare, Donato Traversa Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy Abstract: Angiostrongylus vasorum is a parasitic nematode affecting the heart and pulmonary arteries of wild (eg, foxes and domestic canids. The parasite has an indirect life cycle in which slugs and snails act as intermediate hosts. In the last few years the parasite has spread outside the traditional endemic foci, and there is a rise of documented cases of canine angiostrongylosis across Europe. Angiostrongylus vasorum causes cardiopulmonary disorders and coagulopathies, along with different nonspecific clinical signs. Fatal infections are frequently reported. Given the severity of the infection and the recent geographic spreading of the parasite, this article reviews and discusses the current knowledge of A. vasorum, with a special focus on recent insights on diagnosis, prevention, and treatment of dog angiostrongylosis. Keywords: Angiostrongylus vasorum, dog, epidemiology, diagnostic approaches, control, therapy

  13. Chronic low back pain: possibilities for prevention and treatment

    Directory of Open Access Journals (Sweden)

    P. R. Kamchatnov

    2013-01-01

    Full Text Available Low back pain (LBP is a very common syndrome that is associated with the extremely high rate of temporary disability and the development of chronic pain syndrome. In addition to structural changes in the locomotor system, psychological and social factors contribute to the development and maintenance of chronic pain. Drug therapy for chronic LBP frequently gives rise to complications. A physician’s important task in this situation is to prevent pain chronization and to reduce the risk of side effects of treatment. One of the ways to solve this task is to use the vitamin B complex (milgamma along with analgesics and myorelaxants. The review considers the possible effects of combination therapy in patients with LBP and discusses whether it should be used.

  14. Scale prevention with special reference to threshold treatment

    Energy Technology Data Exchange (ETDEWEB)

    van Rosmalen, G.M.

    1983-01-01

    Various chemical, physical, and mechanical methods to prevent unwanted deposition of mineral scale are described. The suitability of the different methods, which largely depends on the specific features and requirements of the system involved, is discussed. Special emphasis is placed upon the threshold treatment, where the growth process is retarded by the addition of trace amounts of growth inhibitors. Growth experiments have been performed on barium sulfate and calcium sulfate dihydrate seed crystals, suspended in a supersaturated solution with and without organic bisphosphonates as inhibitors. Two methods are selected for the analysis of the growth data. A degree of inhibition is defined to obtain a quantitative description of the influence of a growth inhibitor on the growth rate of the crystals. In addition the influence of the molecular structure of various bisphosphonates with different substituents is shown. The effect of a bisphosphonate on the geometry of calcium sulfate dihydrate crystals is illustrated. 28 references.

  15. Exosomes: A Novel Strategy for Treatment and Prevention of Diseases

    Directory of Open Access Journals (Sweden)

    Jiaqi Wang

    2017-06-01

    Full Text Available An “exosome” is a nanoscale membrane vesicle derived from cell endocytosis that functions as an important intercellular communication mediator regulating the exchange of proteins and genetic materials between donor and surrounding cells. Exosomes secreted by normal and cancer cells participate in tumor initiation, progression, invasion, and metastasis. Furthermore, immune cells and cancer cells exert a two-way bidirectional regulatory effect on tumor immunity by exchanging exosomes. Current studies on exosomes have further expanded their known functions in physiological and pathological processes. The purpose of this review is to describe their discovery and biological functions in the context of their enormous potential in the clinical diagnosis, prevention, and treatment of cancer as well as bacterial and viral infectious diseases.

  16. USAID program for the prevention and treatment of vaginal fistula.

    Science.gov (United States)

    MacDonald, P; Stanton, M E

    2007-11-01

    The cornerstone of the US Agency for International Development (USAID) fistula program is to support and strengthen local capacity for fistula repair. The USAID program includes support to upgrade facilities, enhance local surgical repair capability, allocate equipment and supplies to operating rooms, implement quality improvement systems, and cover the women's transportation costs to and from the treatment facilities. The program also offers training in clinical and counseling skills; transferring skills South-to-South; and monitoring and evaluating the program's effectiveness. As new fistula cases continually increase the backlog of untreated cases, its efforts are also directed toward the prevention of fistula and the reintegration of treated women into their communities. Furthermore, the program challenges the culture of sexual violence against women that leads to traumatic gynecologic fistulas.

  17. Preventive Treatment with Methylprednisolone Paradoxically Exacerbates Experimental Autoimmune Encephalomyelitis

    Directory of Open Access Journals (Sweden)

    Simone Wüst

    2012-01-01

    Full Text Available Glucocorticoids (GCs represent the standard treatment for acute disease bouts in multiple sclerosis (MS patients, for which methylprednisolone (MP pulse therapy is the most frequently used protocol. Here, we compared the efficacy of therapeutic and preventive MP application in MOG35-55-induced experimental autoimmune encephalomyelitis (EAE in C57Bl/6 mice. When administered briefly after the onset of the disease, MP efficiently ameliorated EAE in a dose-dependent manner. Surprisingly, MP administration around the time of immunization was contraindicated as it even increased leukocyte infiltration into the CNS and worsened the disease symptoms. Our analyses suggest that in the latter case an incomplete depletion of peripheral T cells by MP triggers homeostatic proliferation, which presumably results in an enhanced priming of autoreactive T cells and causes an aggravated disease course. Thus, the timing and selection of a particular GC derivative require careful consideration in MS therapy.

  18. Teaching of pressure injury prevention and treatment using simulation

    Directory of Open Access Journals (Sweden)

    Alessandra Mazzo

    2017-12-01

    Full Text Available Abstract Objective: To describe the construction of a high-fidelity clinical scenario simulation of "Pressure injury patient nursing care". Method: Report the experience of constructing a high-fidelity clinical scenario simulation based on the literature and on Bloom's taxonomy. Learning objectives, prior study material, fidelity, clinical case, necessary resources, problem solving, face and content validity, debriefing and evaluation were considered. Results: The scenario included cognitive, psychomotor and affective aspects; role-playing and the moulage technique were used, and it was positively evaluated by the students. Conclusion: The construction of planned, structured and validated simulated clinical scenarios brings learners closer to the clinical practice, allowing the development of the skills required for the prevention and treatment of pressure injuries. Implications for practice: Well-designed simulated clinical settings simulate nursing care training with fidelity to patients with pressure injury.

  19. Genetic predisposition to colorectal cancer: Implications for treatment and prevention.

    Science.gov (United States)

    Stoffel, Elena M; Yurgelun, Matthew B

    2016-10-01

    Colorectal cancer (CRC) is the third most common cancer diagnosed in men and women and approximately 5% of cases are associated with identifiable germline mutations associated with hereditary cancer syndromes. Lifetime risks for CRC can approach 50%-80% for mutation carriers in the absence of endoscopic and/or surgical intervention, and early identification of at-risk individuals can guide clinical interventions for cancer prevention and treatment. Personal and family history and molecular phenotype of CRC tumors are used in determining which patients should be referred for clinical genetic evaluation. Outcomes of genetic testing performed using next-generation sequencing (NGS) multigene panels suggest there can be significant overlap in clinical features among the various hereditary cancer syndromes. This review summarizes new developments in diagnosis and management of patients with genetic predisposition to CRC. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. 42 CFR 2.34 - Disclosures to prevent multiple enrollments in detoxification and maintenance treatment programs.

    Science.gov (United States)

    2010-10-01

    ... detoxification and maintenance treatment programs. 2.34 Section 2.34 Public Health PUBLIC HEALTH SERVICE... detoxification and maintenance treatment programs. (a) Definitions. For purposes of this section: Central... information about individuals applying for maintenance treatment or detoxification treatment for the purpose...

  1. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma

    NARCIS (Netherlands)

    Chung, Kian Fan; Wenzel, Sally E.; Brozek, Jan L.; Bush, Andrew; Castro, Mario; Sterk, Peter J.; Adcock, Ian M.; Bateman, Eric D.; Bel, Elisabeth H.; Bleecker, Eugene R.; Boulet, Louis-Philippe; Brightling, Christopher; Chanez, Pascal; Dahlen, Sven-Erik; Djukanovic, Ratko; Frey, Urs; Gaga, Mina; Gibson, Peter; Hamid, Qutayba; Jajour, Nizar N.; Mauad, Thais; Sorkness, Ronald L.; Teague, W. Gerald

    2014-01-01

    Severe or therapy-resistant asthma is increasingly recognised as a major unmet need. A Task Force, supported by the European Respiratory Society and American Thoracic Society, reviewed the definition and provided recommendations and guidelines on the evaluation and treatment of severe asthma in

  2. Epidemiology, treatment and prevention of herpes zoster: A comprehensive review.

    Science.gov (United States)

    Koshy, Elsam; Mengting, Lu; Kumar, Hanasha; Jianbo, Wu

    2018-01-01

    Herpes zoster is a major health burden that can affect individuals of any age. It is seen more commonly among individuals aged ≥50 years, those with immunocompromised status, and those on immunosuppressant drugs. It is caused by a reactivation of varicella zoster virus infection. Cell-mediated immunity plays a role in this reactivation. Fever, pain, and itch are common symptoms before the onset of rash. Post-herpetic neuralgia is the most common complication associated with herpes zoster. Risk factors and complications associated with herpes zoster depend on the age, immune status, and the time of initializing treatment. Routine vaccination for individuals over 60 years has shown considerable effect in terms of reducing the incidence of herpes zoster and post-herpetic neuralgia. Treatment with antiviral drugs and analgesics within 72 hours of rash onset has been shown to reduce severity and complications associated with herpes zoster and post-herpetic neuralgia. This study mainly focuses on herpes zoster using articles and reviews from PubMed, Embase, Cochrane library, and a manual search from Google Scholar. We cover the incidence of herpes zoster, gender distribution, seasonal and regional distribution of herpes zoster, incidence of herpes zoster among immunocompromised individuals, incidence of post-herpetic neuralgia following a zoster infection, complications, management, and prevention of herpes zoster and post-herpetic neuralgia.

  3. Groin injuries in athletes--development of clinical entities, treatment, and prevention.

    Science.gov (United States)

    Hölmich, Per

    2015-12-01

    The doctoral thesis is based on eight papers published in peer-reviewed journals and a review of the literature. The papers are published between 1997 and 2013 in cooperation with Sankt Elisabeth Hospital, Herlev Hospital, Glostrup Hospital, Rigshospitalet, Hvidovre Hospital, Amager Hospital, Copenhagen Trial Unit, and Institute of Preventive Medicine, Copenhagen. Groin injuries in sport are very common and in football they are among the most common and most time-consuming injuries. These injuries are treated very differently around the world. There is no consensus in the literature regarding definitions, examination methods, diagnosis or treatment and in general the level of evidence is very low. There is a need for identification of the painful anatomical structures, how to examine them and how to define clinical entities to develop effective treatment and prevention. The aim of these studies were: - To review the literature to create an overview of the ideas and the knowledge in order to plan future studies in this field. - Develop and test clinical examination techniques of the relevant tendons and muscles in the region. - Since no evidence-based diagnosis exist; to develop a set of clinical entities to identify the different groups of patients. - To test the effect of a dedicated exercise program developed for treatment of long-standing adductor-related groin pain in athletes in a randomised clinical trial comparing it to the treatment modalities used at that time. - To examine the long-term effect of the above mentioned training program for treatment of long-standing adductor-related groin pain. - To develop a training program for prevention of groin injuries in soccer and test it in a randomised clinical trial. - To describe the occurrence and presentation in clinical entities of groin injuries in male football and to examine the characteristics of these injuries. - Evaluate if radiological signs of femuro-acetabular impingement (FAI) or dysplasia affect the

  4. Definition and Treatment of Dyslexia: A Report by the Committee on Dyslexia of the Health Council of the Netherlands.

    Science.gov (United States)

    Gersons-Wolfensberger, D. C. M.; Ruijssenaars, Wied A. J. J. M.

    1997-01-01

    This report by a Dutch national committee addresses the definition of dyslexia; characteristic symptoms; consequences of the proposed definition for identification and treatment; appropriate methods of treatment; involvement of various professionals (e.g., neuropsychologist, remedial teacher, speech and language therapist, and neurologist); and…

  5. What works for obesity prevention and treatment in black Americans? Research directions.

    Science.gov (United States)

    Kumanyika, S K; Whitt-Glover, M C; Haire-Joshu, D

    2014-10-01

    Obesity prevalence in black/African American children and adults of both sexes is high overall and compared with US whites. What we know, and do not know, about how to enhance the effectiveness of obesity prevention and treatment interventions in African Americans is the focus of the 10 articles in this special issue of Obesity Reviews. The evidence base is limited in quantity and quality and insufficient to provide clear guidance. With respect to children, there is relatively consistent, but not definitive support for prioritizing the systematic implementation and evaluation of child-focused interventions in pre-school and school settings and outside of school time. For adults or all ages, developing and refining e-health approaches and faith-based or other culturally and contextually relevant approaches, including translation of the Diabetes Prevention Program intervention to community settings is indicated. Major evidence gaps were identified with respect to interventions with black men and boys, ways to increase participation and retention of black adults in lifestyle behaviour change programmes, and studies of the impact of environmental and policy changes on eating and physical activity in black communities. Bold steps related to research funding priorities, research infrastructure and methodological guidelines are recommended to improve the quantity and quality of research in this domain. © 2014 World Obesity.

  6. Pericyte: Potential Target for Hemorrhagic Stroke Prevention and Treatment.

    Science.gov (United States)

    Li, Qiang; Liu, Xin; Ruan, Huaizhen; Chen, Yujie; Feng, Hua

    2017-09-06

    Despite long-standing and worldwide efforts, hemorrhagic stroke remains a critical clinical syndrome that exerts a heavy toll on affected individuals and their families due to the lack of preventive and therapeutic targets. To clarify the pathogenesis of hemorrhagic stroke and to identify novel therapeutic targets. Targeting pericytes, the typical mural cells of microvessels, could serve as a way to modulate microvascular permeability, development, and maturation by regulating endothelial cell functions and modulating tissue fibrosis and inflammatory responses. Pericytes in hemorrhagic stroke may exert the following functions: before bleeding, the morphological aberration and dysfunction of pericytes may lead to aneurysm formation, angiopsathyrosis, and hemodynamic disturbances, ultimately causing vasculature rupture. In the acute phase after hemorrhage, pericytes are faced with a complicated bleeding environment, which results in the death of pericytes, blood-brain barrier damage, pericyte-mediated inflammatory cascades, white matter impairment, and ultimately aggravated neural injury. In the recovery period post-hemorrhage, in situ pericytes are activated and differentiate into neurons, glia and endothelial cells to repair the neural vascular network. Moreover, many pericytes are recruited to the lesion and contribute to blood-brain barrier remodeling, thus facilitating neurovascular functional recovery after stroke. Due to the multiple functions of pericytes in the development of vascular rupture and hemorrhagic stroke pathophysiology, additional drugs and trials targeting pericytes and evaluations of their effectiveness are required in future investigations to develop new strategies for the prevention and treatment of hemorrhagic stroke. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  7. Dietetic approaches in prevention and treatment of cardiovascular diseases

    Directory of Open Access Journals (Sweden)

    Ines Banjari

    2014-03-01

    Full Text Available Cardiovascular diseases (CVDs are responsible for 30% of all death causes worldwide, and according to the World Health Organization predictions this negative trend will be continued further on. CVDs include diseases related to macro and microvascular system. There are numerous underlying risk factors, but the biggest emphasis is on those that can be modified and therefore lower the incidence of CVD, its complications, and causative morbidity and mortality due to CVDs. This is especially related to hypertension, hyperlipidemias, smoking, increased body mass, diagnosis of type 2 diabetes, and inadequate level of physical activity and unfavourable dietary habits. The last two are the mostly highlighted and all preventive measures and actions go in that direction. From the aspect of diet, high intake of fats in total, and especially saturated and trans fats, high intake of salt, and high intake of simple carbohydrates, i.e. refined carbohydrates present the backbone of unfavourable dietary habits responsible for rising global problem of CVDs. World’s, European’s as well as the national’s guidelines for prevention and treatment of CVDs contain specific guidelines aiming at the abovementioned aspects. Several dietary approaches arise from these guidelines, but the Mediterranean diet positioned itself as the most optimal for its centuries-old reputation. The other thing is that the Mediterranean diet contains all of the principles set by guidelines, and has another important aspects - the aspects of cultural, sociological, and quality-of-life aspect. Mediterranean diet was and has remained the most frequently researched dietary principle, not only across the Mediterranean, but in countries with non-Mediterranean populations. All of these researches have proven its beneficial impact that goes well beyond the impact on CVDs.

  8. HIV prevention fatigue and HIV treatment optimism among young men who have sex with men

    Science.gov (United States)

    Macapagal, Kathryn; Birkett, Michelle; Janulis, Patrick; Garofalo, Robert; Mustanski, Brian

    2017-01-01

    HIV prevention fatigue (the sense that prevention messages are tiresome) and being overly optimistic about HIV treatments are hypothesized to increase HIV risk behavior. Little research has examined these constructs and their correlates among young men who have sex with men (YMSM), who are at high risk for HIV. YMSM (N = 352; M age = 20; 50% Black) completed measures of prevention fatigue, treatment optimism, HIV risk behaviors, and HIV-related knowledge and attitudes during a longitudinal study. Overall, YMSM reported low levels of HIV prevention fatigue and treatment optimism. Path analysis (n = 307) indicated that greater prevention fatigue and treatment optimism predicted higher rates of condomless sex, but condomless sex did not predict later increases in prevention fatigue or treatment optimism. Results are inconsistent with the hypothesis of high prevention fatigue and treatment optimism among YMSM and point to potential causal relationships among these variables and condomless sex. PMID:28825861

  9. HIV Prevention Fatigue and HIV Treatment Optimism Among Young Men Who Have Sex With Men.

    Science.gov (United States)

    Macapagal, Kathryn; Birkett, Michelle; Janulis, Patrick; Garofalo, Robert; Mustanski, Brian

    2017-08-01

    HIV prevention fatigue (the sense that prevention messages are tiresome) and being overly optimistic about HIV treatments are hypothesized to increase HIV risk behavior. Little research has examined these constructs and their correlates among young men who have sex with men (YMSM), who are at high risk for HIV. YMSM (N = 352; M age = 20; 50% Black) completed measures of prevention fatigue, treatment optimism, HIV risk behaviors, and HIV-related knowledge and attitudes during a longitudinal study. Overall, YMSM reported low levels of HIV prevention fatigue and treatment optimism. Path analysis (n = 307) indicated that greater prevention fatigue and treatment optimism predicted higher rates of condomless sex, but condomless sex did not predict later increases in prevention fatigue or treatment optimism. Results are inconsistent with the hypothesis of high prevention fatigue and treatment optimism among YMSM and point to potential causal relationships among these variables and condomless sex.

  10. Digital design of a surgical guide for placement of definitive implants before orthodontic treatment.

    Science.gov (United States)

    Bayraktaroglu, Hanife Canan; Kim, Jae Seon; Londono, Jimmy; Baker, Philip S

    2015-08-01

    Interdisciplinary treatment planning is an essential part of orthodontic therapy for patients with partial edentulism, especially when dental implants are to serve initially as anchorage and ultimately as prosthetic abutments for the definitive fixed restoration. A technique is presented for designing and fabricating a computed tomography-based surgical guide to place definitive implants before orthodontic therapy. First, the diagnostic cast and the orthodontic tooth arrangement and diagnostic waxing cast are scanned with a 3-dimensional optical scanner. Three-dimensional renderings of these scans are then merged and superimposed onto the cone beam computed tomography (CBCT) image with implant planning software to develop definitive implant positions. A custom surgical guide is fabricated from these data. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  11. Passive movements for the treatment and prevention of contractures.

    Science.gov (United States)

    Prabhu, Rama K R; Swaminathan, Narasimman; Harvey, Lisa A

    2013-12-28

    Contractures, a common complication following immobility, lead to restricted joint range of motion. Passive movements (PMs) are widely used for the treatment and prevention of contractures; however, it is not clear whether they are effective. The aim of this review was to determine the effects of PMs on persons with contractures or at risk of developing contractures. Specifically, the aim was to determine whether PMs increase joint mobility. We searched the Cochrane Injuries Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid SP), EMBASE (Ovid SP), ISI Web of Science (SCI-EXPANDED; SSCI; CPCI-S; CPCI-SSH), PEDro and PsycINFO (Ovid SP). The search was run on 21 November 2013. Randomised controlled trials of PMs administered for the treatment or prevention of contractures were included. Studies were included if they compared the effectiveness of PMs versus no intervention, sham intervention or placebo in people with or at risk of contracture. Studies that involved other co-interventions were included, provided the co-interventions were administered in the same way to all groups. Interventions administered through mechanical devices and interventions that involved sustained stretch were excluded. Three independent review authors screened studies for inclusion. Two review authors then extracted data and assessed risk of bias. Primary outcomes were joint mobility and occurrence of adverse events such as joint subluxations or dislocations, heterotopic ossification, autonomic dysreflexia and fractures or muscle tears. Secondary outcomes were quality of life, pain, spasticity, activity limitations and participation restrictions. We used standard methodological procedures as advocated by the Cochrane Handbook for Systematic Reviews of Interventions. Two identified studies randomly assigned a total of 122 participants with neurological conditions comparing PMs versus no PMs. Data from 121 participants were available for

  12. Clinical Virtual Reality tools to advance the prevention, assessment, and treatment of PTSD.

    Science.gov (United States)

    Rizzo, Albert 'Skip'; Shilling, Russell

    2017-01-01

    Numerous reports indicate that the incidence of posttraumatic stress disorder (PTSD) in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) military personnel has created a significant behavioural healthcare challenge. These findings have served to motivate research on how to better develop and disseminate evidence-based treatments for PTSD. The current article presents the use of Virtual Reality (VR) as a clinical tool to address the assessment, prevention, and treatment of PTSD, based on the VR projects that were evolved at the University of Southern California Institute for Creative Technologies since 2004. A brief discussion of the definition and rationale for the clinical use of VR is followed by a description of a VR application designed for the delivery of prolonged exposure (PE) for treating Service Members (SMs) and Veterans with combat- and sexual assault-related PTSD. The expansion of the virtual treatment simulations of Iraq and Afghanistan for PTSD assessment and prevention is then presented. This is followed by a forward-looking discussion that details early efforts to develop virtual human agent systems that serve the role of virtual patients for training the next generation of clinical providers, as healthcare guides that can be used to support anonymous access to trauma-relevant behavioural healthcare information, and as clinical interviewers capable of automated behaviour analysis of users to infer psychological state. The paper will conclude with a discussion of VR as a tool for breaking down barriers to care in addition to its direct application in assessment and intervention.

  13. Plant phenolics in the prevention and treatment of cancer.

    Science.gov (United States)

    Wahle, Klaus W J; Brown, Iain; Rotondo, Dino; Heys, Steven D

    2010-01-01

    Epidemiological studies indicate that populations consuming high levels of plant derived foods have low incidence rates of various cancers. Recent findings implicate a variety of phytochemicals, including phenolics, in these anticancer properties. Both monophenolic and polyphenolic compounds from a large variety of plant foods, spices and beverages have been shown to inhibit or attenuate the initiation, progression and spread of cancers in cells in vitro and in animals in vivo. The cellular mechanisms that phenolics modulate to elicit these anticancer effects are multi-faceted and include regulation of growth factor-receptor interactions and cell signaling cascades, including kinases and transcription factors, that determine the expression of genes involved in cell cycle arrest, cell survival and apoptosis or programmed cell death. A major focus has been the inhibitory effects of phenolics on the stress-activated NF-KB and AP-1 signal cascades in cancer cells which are regarded as major therapeutic targets. Phenolics can enhance the body's immune system to recognize and destroy cancer cells as well as inhibiting the development of new blood vessels (angiogenesis) that is necessary for tumour growth. They also attenuate adhesiveness and invasiveness of cancer cells thereby reducing their metastatic potential. Augmentation of the efficacy ofstandard chemo- and radiotherapeutic treatment regimes and the prevention of resistance to these agents is another important effect of plant phenolics that warrants further research. Plant phenolics appear to have both preventative and treatment potential in combating cancer and warrant further, in-depth research. It is interesting that these effects of plant phenolics on cancer inhibition resemble effects reported for specific fatty acids (omega-3 PUFA, conjugated linoleic acids). Although phenolic effects in cells in vitro and in animal models are generally positive, observations from the less numerous human interventions are

  14. Foot ulcers in the diabetic patient, prevention and treatment

    Directory of Open Access Journals (Sweden)

    Stephanie C Wu

    2007-03-01

    Full Text Available Stephanie C Wu1, Vickie R Driver1, James S Wrobel2, David G Armstrong21Center for Lower Extremity Ambulatory Research,William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, and National Center of Limb Salvage, Advocate Lutheran General Hospital, Chicago, IL, USA; 2Center for Lower Extremity Ambulatory Research, Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine, Chicago, IL, USAAbstract: Lower extremity complications in persons with diabetes have become an increasingly significant public health concern in both the developed and developing world. These complications, beginning with neuropathy and subsequent diabetic foot wounds frequently lead to infection and lower extremity amputation even in the absence of critical limb ischemia. In order to diminish the detrimental consequences associated with diabetic foot ulcers, a common-sense-based treatment approach must be implemented. Many of the etiological factors contributing to the formation of diabetic foot ulceration may be identified using simple, inexpensive equipment in a clinical setting. Prevention of diabetic foot ulcers can be accomplished in a primary care setting with a brief history and screening for loss of protective sensation via the Semmes-Weinstein monofilament. Specialist clinics may quantify neuropathy, plantar foot pressure, and assess vascular status with Doppler ultrasound and ankle-brachial blood pressure indices. These measurements, in conjunction with other findings from the history and physical examination, may enable clinicians to stratify patients based on risk and help determine the type of intervention. Other effective clinical interventions may include patient education, optimizing glycemic control, smoking cessation, and diligent foot care. Recent technological advanced combined with better understanding of the wound healing process have resulted in a myriad of advanced

  15. Impact of a change in surveillance definition on performance assessment of a catheter-associated urinary tract infection prevention program at a tertiary care medical center.

    Science.gov (United States)

    Sopirala, Madhuri M; Syed, Asma; Jandarov, Roman; Lewis, Margaret

    2018-03-16

    In January 2015, the Centers for Disease Control and Prevention (CDC)/National Health Safety Network (NHSN) changed the definition of catheter-associated urinary tract infection (CAUTI). We evaluated the outcomes of a robust CAUTI prevention program when we performed surveillance using the old definition (before 2015) versus the new definition (after 2015). This is the first study to evaluate how the change in CDC/NHSN definitions affected the outcomes of a CAUTI reduction program. Baseline was from January 2012 to September 2014; the intervention period was from October 2014 to February 2016. Staff nurses were trained to be liaisons of infection prevention (Link Nurses) with clearly defined CAUTI prevention goals and with ongoing monthly activities. CAUTI incidence per 1000 catheter days was compared between the baseline and intervention periods, using the 2 definitions. With the new definition, CAUTIs decreased by 33%, from 2.69 to 1.81 cases per 1000 catheter days (incidence rate ratio [IRR] = 0.67; 95% confidence interval [CI]: 0.48-0.93; P definition, CAUTIs increased by 12%, from 3.38 to 3.80 cases per 1000 catheter days (IRR = 1.12; 95% CI: 0.88-1.43; P = .348). We aggressively targeted CAUTI prevention, but a reduction was observed only with the new definition. Our findings stress the importance of having a reasonably accurate surveillance definition to monitor infection prevention initiatives. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  16. Analysis of consumer information brochures on osteoporosis prevention and treatment

    Directory of Open Access Journals (Sweden)

    Mühlhauser, Ingrid

    2007-01-01

    Full Text Available Purpose: Evidence-based consumer information is a prerequisite for informed decision making. So far, there are no reports on the quality of consumer information brochures on osteoporosis. In the present study we analysed brochures on osteoporosis available in Germany. Method: All printed brochures from patient and consumer advocacy groups, physician and governmental organisations, health insurances, and pharmaceutical companies were initially collected in 2001, and updated in December 2004. Brochures were analysed by two independent researchers using 37 internationally proposed criteria addressing evidence-based content, risk communication, transparency of the development process, and layout and design. Results: A total of 165 brochures were identified; 59 were included as they specifically targeted osteoporosis prevention and treatment. Most brochures were provided by pharmaceutical companies (n=25, followed by health insurances (n=11 and patient and consumer advocacy groups (n=11. Quality of brochures did not differ between providers. Only 1 brochure presented lifetime risk estimate; 4 mentioned natural course of osteoporosis. A balanced report on benefit versus lack of benefit was presented in 2 brochures and on benefit versus adverse effects in 8 brochures. Four brochures mentioned relative risk reduction, 1 reported absolute risk reduction through hormone replacement therapy (HRT. Out of 28 brochures accessed in 2004 10 still recommended HRT without discussing adverse effects. Transparency of the development process was limited: 25 brochures reported publication date, 26 cited author and only 1 references. In contrast, readability and design was generally good. Conclusion: The quality of consumer brochures on osteoporosis in Germany is utterly inadequate. They fail to give evidence-based data on diagnosis and treatment options. Therefore, the material is not useful to enhance informed consumer choice.

  17. HYDROTHERMAL TREATMENT IN PREVENTION BROWNING OF LYCHEE PERICARP

    Directory of Open Access Journals (Sweden)

    Rosana Gonçalves Pires Matias1

    2012-07-01

    Full Text Available The browning of litchi pericarp (Litchi chinensis Sonn. occurs rapidly after harvest, limiting the marketing period of the fruits. The objective of this study was to evaluate the effect of hot water treatments in preventing browning of the pericarp and the maintenance of postharvest quality of litchi fruit. Fruits of litchi cv. Bengal uniformly red pericarp were submitted to immersion in water at tree temperature (45, 50 and 55°C x five soaking times (0, 4, 8, 12 and 16 minutes in a completely randomized design with tree replications and five fruit per replicate. After drying, the fruits were packed in polystyrene trays, covered with plastic wrap with 12 mm thick and stored in the lab benches at room temperature (19.0 ± 2.4°C and 75 ± 5% RH to simulate the exposure conditions at supermarket counters. Every two days, during eight days, were evaluated the weight loss, color of the pericarp, soluble solids, titratable acidity of the pulp and ascorbic acid content of the pericarp and pulp. It was observed that the weight loss was higher in fruits that were not subjected to hydrothermal treatment. Fruits subjected to 50°C during 16 minutes and 55°C in all immersion times were evaluated only until the 4th day, thereafter, these fruits are not suitable for commercialization. Immersion at 45°C during four minutes was the most effective in maintaining the red color of the pericarp and did not affect the quality measured during the experimental period.

  18. Schizophrenia and the immune system: pathophysiology, prevention, and treatment.

    Science.gov (United States)

    Richard, Michelle D; Brahm, Nancy C

    2012-05-01

    Published evidence on established and theoretical connections between immune system dysfunction and schizophrenia is reviewed, with a discussion of developments in the search for immunologically-targeted treatments. A growing body of evidence indicates that immunologic influences may play an important role in the etiology and course of schizophrenia. A literature search identified more than 100 articles pertaining to suspected immunologic influences on schizophrenia published over the past 15 years. Schizophrenia researchers have explored a wide range of potential immune system-related causal or contributory factors, including neurobiological and neuroanatomical disorders, genetic abnormalities, and environmental influences such as maternal perinatal infection. Efforts to establish an immunologic basis for schizophrenia and identify reliable immune markers continue to be hindered by sampling challenges and methodological problems. In aggregate, the available evidence indicates that at least some cases of schizophrenia have an immunologic component, suggesting that immune-focused prevention strategies (e.g., counseling of pregnant women to avoid immune stressors) and close monitoring of at-risk children are appropriate. While antipsychotics remain the standard treatments for schizophrenia, a variety of drugs with immunologic effects have been investigated as adjunctive therapies, with variable and sometimes conflicting results; these include the cyclooxygenase-2 inhibitor celecoxib, immune-modulating agents (e.g., azathioprine and various anticytokine agents such as atlizumab, anakinra, and tumor necrosis factor-α blockers), and an investigational anti-interferon-γ agent. The published evidence indicates that immune system dysfunction related to genetic, environmental, and neurobiological influences may play a role in the etiology of schizophrenia in a subset of patients.

  19. Historical and current perspectives on bone marrow transplantation for prevention and treatment of immunodeficiencies and autoimmunities.

    Science.gov (United States)

    Good, R A; Verjee, T

    2001-01-01

    Primary immunodeficiency diseases often fully meet the definition of "experiments of nature." Much of the expanding understanding of the lymphoid systems and immunologic functions generated in recent years has been derived from studying patients with primary, generally genetically determined immunodeficiency diseases, as well as other relatively rare secondary immunodeficiency diseases. Increasing knowledge of immunologic defenses, their interacting cellular and molecular components, the evolving details of sequential stages of cellular differentiation, and the nature and control of the cellular and molecular interactions in immunity have now made it possible to define precisely many primary immunodeficiency diseases in full molecular genetic terms. With this wealth of scientific information based on experimental and clinical research, incredible advances have also been made in using bone marrow transplantation (BMT) often as a curative treatment for immunodeficiency, some 60 to 70 other diseases, leukemias, lymphomas, other cancers, and a rapidly expanding constellation of metabolic diseases or enzyme deficiencies. Also, progress in applying allogeneic BMT to prevent, treat, and cure complex autoimmune diseases, primary immunodeficiency diseases and certain forms of cancers, is considered. Further, mixed BMT (syngeneic plus allogeneic) that establishes a form of stable mixed chimerism has also been employed in animal experiments, which revealed that BMT can be used to treat not only immunodeficiency diseases, but also systemic and organ-specific autoimmune diseases, eg, diabetes and erythematous lupus-like diseases. Moreover, performing BMT in conjunction with organ allografts, eg, thymus or pancreatic transplants, has successfully prevented rejection of these allografts, sometimes without recourse to long-term irradiation or toxic chemical immunosuppressive agents. A crucial role for stromal cells in cellular engineering has now also been realized in animal

  20. Protocol of prevention and treatment of pressure ulcers

    Directory of Open Access Journals (Sweden)

    Francisco José García Sánchez

    2008-09-01

    Full Text Available The care of wounds, specially the ones produced by the pressure, has been and it keeps on being a challenge for all the health professionals, especially for nurses, which still today cannot be considered as totally solved.Nobody may deny the magnitude of the problem that chronic wounds nowadays supposes in this country. There are thousands of people who demand nursing assistance everyday to take care of the problems derived from chronic wounds.Starting off of these premises it has been considered to approach a standardized and protocolized performance of the professionals regarding the care of wounds, to unify criteria that favour the continuity of cares between the different levels and that all the nursing actions were suppported by a common norm, being possible to register, evaluate and research them.The unification of criteria and performance guidelines in the prevention and treatment of the wounds is one of the main objectives that we marked ourselves due to the increasing number of prophylactic and therapeutic options available, that makes it necessary to prepare nurses for making them being able to choose the most suitable tool to reach the objectives marked in the care of wounds.

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

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    Andrew T. Taylor

    2011-01-01

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

  2. Phytochemicals in Skin Cancer Prevention and Treatment: An Updated Review

    Directory of Open Access Journals (Sweden)

    Chau Yee Ng

    2018-03-01

    Full Text Available Skin is the largest human organ, our protection against various environmental assaults and noxious agents. Accumulation of these stress events may lead to the formation of skin cancers, including both melanoma and non-melanoma skin cancers. Although modern targeted therapies have ameliorated the management of cutaneous malignancies, a safer, more affordable, and more effective strategy for chemoprevention and treatment is clearly needed for the improvement of skin cancer care. Phytochemicals are biologically active compounds derived from plants and herbal products. These agents appear to be beneficial in the battle against cancer as they exert anti-carcinogenic effects and are widely available, highly tolerated, and cost-effective. Evidence has indicated that the anti-carcinogenic properties of phytochemicals are due to their anti-oxidative, anti-inflammatory, anti-proliferative, and anti-angiogenic effects. In this review, we discuss the preventive potential, therapeutic effects, bioavailability, and structure–activity relationship of these selected phytochemicals for the management of skin cancers. The knowledge compiled here will provide clues for future investigations on novel oncostatic phytochemicals and additional anti-skin cancer mechanisms.

  3. Glans Necrosis Following Penile Prosthesis Implantation: Prevention and Treatment Suggestions.

    Science.gov (United States)

    Wilson, Steven K; Mora-Estaves, Cesar; Egydio, Paulo; Ralph, David; Habous, Mohamad; Love, Christopher; Shamsodini, Ahmad; Valenzuela, Robert; Yafi, Faysal A

    2017-09-01

    To examine possible etiology and treatment outcomes in 21 patients with glans necrosis following penile prosthesis implantation. Glans necrosis typically presented with a dusky glans on the first postoperative day following prosthesis implantation. The blood supply to the glans penis consists of the dorsal arteries and the terminal branches of the spongiosal arteries. Using the cohort in our study, we compiled preoperative comorbidities and adjunctive surgical maneuvers that might compromise glans vascularity, leading to glans necrosis. Preoperative risk factors were arteriosclerotic cardiovascular disease (90%), diabetes mellitus (81%), smoking (81%), previous prosthesis explantation (57%), and previous radiation therapy (48%). The most prevalent intraoperative and postoperative factor was subcoronal incision for reasons as simple as coincident circumcision or as complex as for penile degloving (86%). Other factors detected were penile wrapping with an occlusive elastic bandage (62%), use of a sliding technique for penile lengthening (33%), and coincident distal urethral injury repair (29%). Seventeen patients (81%) managed expectantly with preservation of implanted prosthesis sustained significant glandular loss. Four patients managed with immediate prosthesis removal healed without sequelae. Patients with preoperative risk factors undergoing penile prosthesis implantation should avoid high-risk adjunctive surgical maneuvers. Upon development of signs of glans necrosis postoperatively, in the setting of these high-risk factors, immediate implant removal may prevent subsequent glans necrosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. [Dietary prevention and treatment of diverticular disease of the colon].

    Science.gov (United States)

    Milewska, Magdalena; Sińska, Beata; Kluciński, Andrzej

    2015-04-01

    Diverticular disease is more often categorized as a civilization disease that affects both women and men, especially at an old age. The pathophysiology remains complex and arises from the interaction between dietary fiber intake, bowel motility and mucosal changes in the colon. Obesity, smoking, low physical activity, low-fiber diet (poor in vegetables, fruit, whole grain products, seeds and nuts) are among factors that increase the risk for developing diverticular disease. Additionally, the colonic outpouchings may be influenced by involutional changes of the gastrointestinal tract. Therefore, the fiber rich diet (25-40 g/day) plays an important role in prevention, as well as nonpharmacological treatment of uncomplicated diverticular disease. The successful goal of the therapy can be achieved by well-balanced diet or fiber supplements intake. Research indicate the effectiveness of probiotics in dietary management during the remission process. Moreover, drinking of appropriate water amount and excluding from the diet products decreasing colonic transit time - should be also applied. © 2015 MEDPRESS.

  5. Treatment planning: A key milestone to prevent treatment dropout in adolescents with borderline personality disorder.

    Science.gov (United States)

    Desrosiers, Lyne; Saint-Jean, Micheline; Breton, Jean-Jacques

    2015-06-01

    The aim of this study was to gain a broader appreciation of processes involved in treatment dropout in adolescents with borderline personality disorder (BPD). A constructivist grounded theory was chosen using a multiple-case research design with three embedded levels of analysis (adolescent, parent, and care setting). Theoretical sampling and the different stages of analysis specific to grounded theory were performed according to the iterative process of constant comparative analysis. Twelve cases were examined (nine dropouts among adolescents with BPD and for the purpose of falsification, one dropout of suicidal adolescent without BPD and two completed treatments among adolescents with BPD). To document the cases, three groups of informants were recruited (adolescents, parents, and therapists involved in the treatment) and 34 interviews were conducted. Psychological characteristics, perception of mental illness and mental health care, and help-seeking context were the specific treatment dropout vulnerabilities identified in adolescents with BPD and in their parents. However, their disengagement became an issue only when care-setting response--including mitigation of accessibility problems, adaptation of services to needs of adolescents with BPD, preparation for treatment, and concern for clinicians' disposition to treat--was ill-suited to these treatment dropout vulnerabilities. Treatment planning proves to be a key milestone to properly engage adolescents with BPD and their parent. Systematic assessment of treatment dropout vulnerabilities before the intervention plan is laid out could foster better-suited responses of the care setting thus decreasing the incidence of treatment discontinuation in adolescents with BPD. Treatment dropout vulnerabilities specific to adolescents with BPD and their parents can be detected before the beginning of treatment. Premature treatment termination may be prevented if the care setting considers these vulnerabilities at treatment

  6. Interventions for prevention and treatment of vulvovaginal candidiasis in women with HIV infection.

    Science.gov (United States)

    Ray, Amita; Ray, Sujoy; George, Aneesh Thomas; Swaminathan, Narasimman

    2011-08-10

    trial with three arms of comparison;Clotrimazole,Lactobacillus and Placebo gave no definitive results in preventing an episode of VVC. Clotrimazole against placebo (RR 0.49; 95% CI 0.22 to 1.09), Clotrimazole against lactobacillus (RR 1.11; 95% CI 0.45 to 2.76) and lactobacillus against placebo (RR 0.54 ;95% CI 0.26 to 1.13). Implications for practiceNo trials were found addressing treatment of VVC in HIV positive women.In comparison to placebo,Fluconazole was found to be an effective preventative intervention. However, the potential for resistant Candida organisms to develop might impact the feasibility of implementation.Direction of findings suggests that Clotrimazole and Lactobacillus improved the prophylactic outcomes when compared to placebo.Implications for research There is a need to evaluate drugs and drug regimens for VVC treatment and prophylaxis in HIV positive women through randomised clinical trials. Development of resistance to azoles remains under-studied and more work must be done in this area, so as to determine whether routine prophylaxis for VVC is at all needed or whether adequate ART would be sufficient to prevent recurrent VVC. The viral load in vaginal secretions with or without treatment or prophylaxis has not been studied, this is very relevant to the spread of HIV.

  7. [On "2015 Guidelines for Prevention and Treatment of Osteoporosis". Medical treatment for osteoporosis].

    Science.gov (United States)

    Yamauchi, Mika; Sugimoto, Toshitsugu

    2015-09-01

    The main revisions to the item of medical treatment in the 2015 edition of the Guidelines for Prevention and Treatment of Osteoporosis are the additions of the drugs such as ibandronate, teriparatide acetate (once-weekly preparation), and denosumab, which were approved after the release of the 2011 edition, and of information on new dosage forms for existing drugs. Furthermore, the heading "Evaluation and Recommendations" for each drug was changed to "Evaluation of Efficacy" . The choice of drug is determined based on evidence for the effectiveness of each drug and in accordance with the age, fracture risk, and pathophysiology of each patient. As for the selection and combined use of the various drugs, accumulation of evidence is anticipated, but sequential therapy using antiresorptive agents following treatment with teriparatide preparations is recommended.

  8. Impact of the Definition of Peak Standardized Uptake Value on Quantification of Treatment Response

    Science.gov (United States)

    Vanderhoek, Matt; Perlman, Scott B.; Jeraj, Robert

    2012-01-01

    PET-based treatment response assessment typically measures the change in maximum standardized uptake value (SUVmax), which is adversely affected by noise. Peak SUV (SUVpeak) has been recommended as a more robust alternative, but its associated region of interest (ROIpeak) is not uniquely defined. We investigated the impact of different ROIpeak definitions on quantification of SUVpeak and tumor response. Methods Seventeen patients with solid malignancies were treated with a multitargeted receptor tyrosine kinase inhibitor resulting in a variety of responses. Using the cellular proliferation marker 3′-deoxy-3′-18F-fluorothymidine (18F-FLT), whole-body PET/CT scans were acquired at baseline and during treatment. 18F-FLT–avid lesions (~2/patient) were segmented on PET images, and tumor response was assessed via the relative change in SUVpeak. For each tumor, 24 different SUVpeaks were determined by changing ROIpeak shape (circles vs. spheres), size (7.5–20 mm), and location (centered on SUVmax vs. placed in highest-uptake region), encompassing different definitions from the literature. Within each tumor, variations in the 24 SUVpeaks and tumor responses were measured using coefficient of variation (CV), standardized deviation (SD), and range. For each ROIpeak definition, a population average SUVpeak and tumor response were determined over all tumors. Results A substantial variation in both SUVpeak and tumor response resulted from changing the ROIpeak definition. The variable ROIpeak definition led to an intratumor SUVpeak variation ranging from 49% above to 46% below the mean (CV, 17%) and an intratumor SUVpeak response variation ranging from 49% above to 35% below the mean (SD, 9%). The variable ROIpeak definition led to a population average SUVpeak variation ranging from 24% above to 28% below the mean (CV, 14%) and a population average SUVpeak response variation ranging from only 3% above to 3% below the mean (SD, 2%). The size of ROIpeak caused more

  9. Effectiveness of Mindfulness-Based Relapse Prevention in opioid Dependence Treatment &Mental Health

    Directory of Open Access Journals (Sweden)

    2008-11-01

    Findings: therapy compliance, retention in treatment, decrease in somatic symptoms, anxiety, social dysfunction and increase in health was significantly in both combination of psychological intervention method than the Naltroxan group. Mindfulness-based on relapse prevention was more effective than CBT relapse prevention in decreasing of, social dysfunction, relapse prevention, increase of therapy compliance, and health. Results: Mindfulness based relapse prevention was superior to CBT and Naltroxan and considerably increased effectiveness of opioid relapse prevention therapy.

  10. Remission Time after Rituximab Treatment for Autoimmune Bullous Disease: A Proposed Update Definition.

    Science.gov (United States)

    Iranzo, Pilar; Pigem, Ramon; Giavedoni, Priscila; Alsina-Gibert, Mercè

    2015-01-01

    A therapeutic endpoint is a very important tool to evaluate response in clinical trials. In 2005, a consensus statement identified two late endpoints of disease activity in pemphigus: complete remission off therapy and complete remission on therapy, both definitions applying to patients without lesions for at least 2 months. The same period of time was considered for partial remission off/on therapy. These definitions were later applied to bullous pemphigoid and are considered in most studies on autoimmune bullous disease. These endpoints were established for different adjuvant agents, but at that moment, rituximab was not considered. Rituximab is known for the long duration of its effect, and in most studies relapses have been reported later than 6 months after treatment. In our opinion, time to remission after rituximab treatment should be redefined. © 2015 S. Karger AG, Basel.

  11. Preventing treatment errors in radiotherapy by identifying and evaluating near misses and actual incidents

    LENUS (Irish Health Repository)

    Holmberg, Ola

    2002-06-01

    When preparing radiation treatment, the prescribed dose and irradiation geometry must be translated into physical machine parameters. An error in the calculations or machine settings can negatively affect the intended treatment outcome. Analysing incidents originating in the treatment preparation chain makes it possible to find weak links and prevent treatment errors. The aim of this work is to study the effectiveness of a multilayered error prevention system by analysing both near misses and actual treatment errors.

  12. An Expanded Behavioral Paradigm for Prevention and Treatment of HIV-1 Infection

    OpenAIRE

    Coates, Thomas J.

    2013-01-01

    This paper addresses behavioral and social research priorities for prevention and treatment of HIV-1 infection. The approach used to define these priorities is based on three premises: (1) Behavioral interventions for prevention and treatment are necessary but not sufficient for producing reductions in transmission or advances in treatment; the same is true of biomedical interventions; by themselves they cannot maximally impact the health of communities. (2) Combination prevention and treatme...

  13. Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments

    DEFF Research Database (Denmark)

    Tesfaye, Solomon; Boulton, Andrew J M; Dyck, Peter J

    2010-01-01

    Preceding the joint meeting of the 19th annual Diabetic Neuropathy Study Group of the European Association for the Study of Diabetes (NEURODIAB) and the 8th International Symposium on Diabetic Neuropathy in Toronto, Canada, 13-18 October 2009, expert panels were convened to provide updates on cla...... on classification, definitions, diagnostic criteria, and treatments of diabetic peripheral neuropathies (DPNs), autonomic neuropathy, painful DPNs, and structural alterations in DPNs....

  14. Preventive treatment in migraine and the new US guidelines

    Directory of Open Access Journals (Sweden)

    Estemalik E

    2013-05-01

    Full Text Available E Estemalik, S TepperCleveland Clinic, Neurological Center for Pain, Cleveland, Ohio, USAAbstract: Migraine headaches are among the most common headache disorders seen in various practices. The prevalence of migraine headaches is 18% in women and 6% in men. While millions of Americans suffer from migraine headaches, roughly 3%–13% of identified migraine patients are on preventive therapy, while an estimated 38% actually need a preventive agent. The challenge among physicians is not only when to start a daily preventive agent but which preventive agent to choose. Circumstances warranting prevention have been described in the past, and in 2012, a new set of guidelines with an evidence review on preventive medications was published. A second set of guidelines provided evidence on nonsteroidal anti-inflammatory drugs, herbs, minerals, and vitamins for prevention of episodic migraine. This article describes the updated US guidelines for the prevention of migraines and also outlines the major studies from which these guidelines were derived.Keywords: US guidelines, Canadian guidelines, classification, preventive medication

  15. Trichotillomania and trichophagia - diagnosis, treatment, prevention. The attempt to establish guidelines of treatment in Poland.

    Science.gov (United States)

    Gawłowska-Sawosz, Marta; Wolski, Marek; Kamiński, Andrzej; Albrecht, Piotr; Wolańczyk, Tomasz

    2016-01-01

    Trichotillomania is a disorder characterised by inability to control over pulling own hair from various parts of a body resulting in noticeable hair loss. Due to its long-term, progressive course, untreated trichotillomania can lead to disturbances in the functioning of patients and complications which are dangerous to life and health. Due to the ambiguous nature of the symptoms, they often remain unrecognised by clinicians. Most patients are afraid of revealing symptoms and reluctantly seek for professional help. In our opinion, it is necessary to increase the awareness of the disorder of physicians of different specialties to improve the detection, treatment efficacy and to prevent dangerous complications of trichotillomania. This paper summarises the current state of knowledge on the epidemiology, aetiology, clinical presentation, and treatment of trichotillomania. It is also an attempt to create guidelines in all cases of suspected trichotillomania - adapted to Polish conditions. It also highlights the importance of a multidisciplinary treatment as a condition of effectiveness of the therapy and prevention of relapse.

  16. The role of disease management in the treatment and prevention of obesity with associated comorbidities.

    Science.gov (United States)

    May, Jeanette; Buckman, Ellen

    2007-06-01

    Nearly two thirds of the US population is overweight or obese and those numbers are climbing. Many organizations are beginning to recognize overweight and obesity as severe health threats and to acknowledge that treatment can serve as an important first step in addressing this epidemic. Through its Obesity with Co-morbidities Initiative, the Disease Management Association of America (DMAA) seeks to raise awareness and improve understanding of the role disease management (DM) can play in the treatment and management of obesity with comorbidities. Among the objectives of the Obesity with Co-morbidities Initiative was to develop standard definitions of obesity and obesity with comorbidities and to conduct qualitative research among key DM stakeholders. The first project undertaken and completed by the Obesity with Associated Co-morbidities Steering Committee and work group was to define the term "obesity" for consistent usage within the DM community for the purposes of population-based interventions. As part of this initiative, DMAA partnered with Synovate, a global market research firm, to conduct focus groups and in-depth interviews in order to collect qualitative data on attitudes and practices related to obesity treatment and coverage among key industry stakeholders, including health plans, disease management organizations, employers, and the business community. The findings indicated that obesity was widely recognized as a serious issue, but there remained varying opinions regarding responsibility, health and productivity costs, coverage, and best treatment methods among the participants. DMAA will continue this initiative through 2007 and will continue to develop a knowledge base of obesity guidelines and management practices, create valuable tools and resources including an online resource center, and facilitate partnerships with other organizations involved in the management and prevention of obesity.

  17. Corneal allograft rejection: Risk factors, diagnosis, prevention, and treatment

    Directory of Open Access Journals (Sweden)

    Dua Harminder

    1999-01-01

    Full Text Available Recent advances in corneal graft technology, including donor tissue retrieval, storage and surgical techniques, have greatly improved the clinical outcome of corneal grafts. Despite these advances, immune mediated corneal graft rejection remains the single most important cause of corneal graft failure. Several host factors have been identified as conferring a "high risk" status to the host. These include: more than two quadrant vascularisation, with associated lymphatics, which augment the afferent and efferent arc of the immune response; herpes simplex keratitis; uveitis; silicone oil keratopathy; previous failed (rejected grafts; "hot eyes"; young recipient age; and multiple surgical procedures at the time of grafting. Large grafts, by virtue of being closer to the host limbus, with its complement of vessels and antigen-presenting Langerhans cells, also are more susceptible to rejection. The diagnosis of graft rejection is entirely clinical and in its early stages the clinical signs could be subtle. Graft rejection is largely mediated by the major histocompatibility antigens, minor antigens and perhaps blood group ABO antigens and some cornea-specific antigens. Just as rejection is mediated by active immune mediated events, the lack of rejection (tolerance is also sustained by active immune regulatory mechanisms. The anterior chamber associated immune deviation (ACAID and probably, conjunctiva associated lymphoid tissue (CALT induced mucosal tolerance, besides others, play an important role. Although graft rejection can lead to graft failure, most rejections can be readily controlled if appropriate management is commenced at the proper time. Topical steroids are the mainstay of graft rejection management. In the high-risk situations however, systemic steroids, and other immunosuppressive drugs such as cyclosporin and tacrolimus (FK506 are of proven benefit, both for treatment and prevention of rejection.

  18. Osteoporosis – a current view of pharmacological prevention and treatment

    Directory of Open Access Journals (Sweden)

    Das S

    2013-05-01

    Full Text Available Subhajit Das, Julie C Crockett Musculoskeletal Research Programme, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK Abstract: Postmenopausal osteoporosis is the most common bone disease, associated with low bone mineral density (BMD and pathological fractures which lead to significant morbidity. It is defined clinically by a BMD of 2.5 standard deviations or more below the young female adult mean (T-score = −2.5. Osteoporosis was a huge global problem both socially and economically – in the UK alone, in 2011 £6 million per day was spent on treatment and social care of the 230,000 osteoporotic fracture patients – and therefore viable preventative and therapeutic approaches are key to managing this problem within the aging population of today. One of the main issues surrounding the potential of osteoporosis management is diagnosing patients at risk before they develop a fracture. We discuss the current and future possibilities for identifying susceptible patients, from fracture risk assessment to shape modeling and in relation to the high heritability of osteoporosis now that a plethora of genes have been associated with low BMD and osteoporotic fracture. This review highlights the current therapeutics in clinical use (including bisphosphonates, anti-RANKL [receptor activator of NF-κB ligand], intermittent low dose parathyroid hormone, and strontium ranelate and some of those in development (anti-sclerostin antibodies and cathepsin K inhibitors. By highlighting the intimate relationship between the activities of bone forming (osteoblasts and bone-resorbing (osteoclasts cells, we include an overview and comparison of the molecular mechanisms exploited in each therapy. Keywords: BMD, fracture, bisphosphonate, strontium, denosumab, teriparatide, raloxifene

  19. PROGNOSIS, PREVENTION, AND TREATMENT OF DIABETIC CATARACT SURGERY POSTOPERATIVE COMPLICATIONS

    Directory of Open Access Journals (Sweden)

    M. A. Kovalevskaya

    2015-01-01

    Full Text Available Aim. To study immune and antioxidant status of diabetic cataract patients and to assess the efficacy of preoperative preparation for diabetic cataract surgery to prevent intra- and postoperative complications and the efficacy of cataract treatment in metabolic syndrome patients. Patients and methods. 136 cataract patients (272 eyes were examined (mean age 62±3.2 years. Among these patients, women predominated (n = 74. Control group included 25 healthy volunteers (10 men and 15 women aged 32‑56 (mean age 44.3±2.4 years without ocular diseases (50 eyes. Two patient groups were examined. Group 1 included 78 patients (mean age 54±1.5 younger than 60 (52.5 % with similar lens morphological changes and metabolic disorders who were diagnosed with complicated (diabetic cataract. Group 2 included 58 patients with age-related cataract. Tear, anterior chamber (AC humor, and blood tests were performed. Immune status, lipid peroxidation parameters in tear fluid and blood, active peroxiredoxin 6 (PRDX6 and / or its breakdown fragments in tear fluid and AC humor were studied. In group 1 (age-related cataracts, somatic disorders were diagnosed in 4.5 % of cases, in group 2 (complicated cataracts, somatic disorders were diagnosed in 100 % of cases. Expression of protective enzymes against oxidative stress in tear fluid was studied. Activity of tear antioxidant enzymes under oxidative stress conditions in therapy and after cataract surgery was evaluated. Results. Postoperatively, increase in PRDX6 level was revealed in age-related cataract patients. The absence of phaco complications confirms these findings. In complicated (diabetic cataracts, PRDX6 level was 6‑times less than in age-related cataracts. Conclusions. Prophylaxis of inflammatory complications in age-related cataract patients can be performed using the following schedule: 0.5 % levofloxacin 4 times daily, bromfenac once daily. 

  20. Nuts in the prevention and treatment of metabolic syndrome.

    Science.gov (United States)

    Salas-Salvadó, Jordi; Guasch-Ferré, Marta; Bulló, Mònica; Sabaté, Joan

    2014-07-01

    Nuts are rich in many bioactive compounds that can exert beneficial effects on cardiovascular health. We reviewed the evidence relating nut consumption and the metabolic syndrome (MetS) and its components. Nuts reduce the postprandial glycemic response; however, long-term trials of nuts on insulin resistance and glycemic control in diabetic individuals are inconsistent. Epidemiologic studies have shown that nuts may lower the risk of diabetes incidence in women. Few studies have assessed the association between nuts and abdominal obesity, although an inverse association with body mass index and general obesity has been observed. Limited evidence suggests that nuts have a protective effect on blood pressure and endothelial function. Nuts have a cholesterol-lowering effect, but the relation between nuts and hypertriglyceridemia and high-density lipoprotein cholesterol is not well established. A recent pooled analysis of clinical trials showed that nuts are inversely related to triglyceride concentrations only in subjects with hypertriglyceridemia. An inverse association was found between the frequency of nut consumption and the prevalence and the incidence of MetS. Several trials evaluated the effect of nuts on subjects with MetS and found that they may have benefits in some components. Compared with a low-fat diet, a Mediterranean diet enriched with nuts could be beneficial for MetS management. The protective effects on metabolism could be explained by the modulation of inflammation and oxidation. Further trials are needed to clarify the role of nuts in MetS prevention and treatment. © 2014 American Society for Nutrition.

  1. A critical evaluation of the clinical evidence for pomegranate preparations in the prevention and treatment of cardiovascular diseases.

    Science.gov (United States)

    Vlachojannis, Christian; Erne, Paul; Schoenenberger, Andreas W; Chrubasik-Hausmann, Sigrun

    2015-04-01

    This study attempts a critical evaluation of the clinical evidence behind the use of dietary pomegranate preparations in the prevention and treatment of cardiovascular diseases. A search of PubMed on August 10, 2014 identified 228 references, which yielded extractable data from 24 clinical studies of pomegranate preparations. Hand searching identified two further studies. The quality of the studies and evidence of effectiveness of pomegranate were assessed by an established set of conventional criteria. Overall, the study quality was poor. Even in the best studies, indications of benefit did not reach the conventional levels of statistical significance. The only study with a definitive design had a biochemical rather than a clinical endpoint: it showed the expected difference in blood concentrations of myeloperoxidase after a single dose of either pomegranate or placebo. Only 10 of the 26 studies provided HPLC data on the amounts of co-active ingredients in the preparations that were consumed by the subjects. If pomegranate has a role in the prevention and treatment of cardiovascular diseases, there is a pressing need for dose-finding and long-term confirmatory studies. The ultimate endpoint for definitive studies would be mortality, but reductions in blood pressure or demonstrable decreases in atherosclerotic plaques would be useful surrogates. Sample sizes for various assumptions are provided. Future studies need to prove the clinical benefit. Copyright © 2015 John Wiley & Sons, Ltd.

  2. Nonbeneficial treatment Canada: definitions, causes, and potential solutions from the perspective of healthcare practitioners*.

    Science.gov (United States)

    Downar, James; You, John J; Bagshaw, Sean M; Golan, Eyal; Lamontagne, Francois; Burns, Karen; Sridhar, S Kavita; Seely, Andrew; Meade, Maureen O; Fox-Robichaud, Alison; Cook, Deborah; Turgeon, Alexis F; Dodek, Peter; Xiong, Wei; Fowler, Rob

    2015-02-01

    Many healthcare workers are concerned about the provision of nonbeneficial treatment in the acute care setting. We sought to explore the perceptions of acute care practitioners to determine whether they perceived nonbeneficial treatment to be a problem, to generate an acceptable definition of nonbeneficial treatment, to learn about their perceptions of the impact and causes of nonbeneficial treatment, and the ways that they feel could reduce or resolve nonbeneficial treatment. National, bilingual, cross-sectional survey of a convenience sample of nursing and medical staff who provide direct patient care in acute medical wards or ICUs in Canada. We received 688 responses (response rate 61%) from 11 sites. Seventy-four percent of respondents were nurses. Eighty-two percent of respondents believe that our current means of resolving nonbeneficial treatment are inadequate. The most acceptable definitions of nonbeneficial treatment were "advanced curative/life-prolonging treatments that would almost certainly result in a quality of life that the patient has previously stated that he/she would not want" (88% agreement) and "advanced curative/life-prolonging treatments that are not consistent with the goals of care (as indicated by the patient)" (83% agreement). Respondents most commonly believed that nonbeneficial treatment was caused by substitute decision makers who do not understand the limitations of treatment, or who cannot accept a poor prognosis (90% agreement for each cause), and 52% believed that nonbeneficial treatment was "often" or "always" continued until the patient died or was discharged from hospital. Respondents believed that nonbeneficial treatment was a common problem with a negative impact on all stakeholders (> 80%) and perceived that improved advance care planning and communication training would be the most effective (92% and 88%, respectively) and morally acceptable (95% and 92%, respectively) means to resolve the problem of nonbeneficial treatment

  3. The prevention and treatment of cognitive decline and dementia: An overview of recent research on experimental treatments

    OpenAIRE

    Andrade, Chittaranjan; Radhakrishnan, Rajiv

    2009-01-01

    The prevention and treatment of cognitive impairment in the elderly has assumed increasing importance in an aging population. This article presents a qualitative review of recent research on experimental interventions for the prevention and treatment of mild cognitive impairment and Alzheimer's disease in elderly subjects. Interventions addressed range from lifestyle measures to pharmacological treatments. Epidemiological studies suggest that dietary measures, physical exercise, and mental ac...

  4. Nasal CPAP and surfactant for treatment of respiratory distress syndrome and prevention of bronchopulmonary dysplasia

    DEFF Research Database (Denmark)

    Verder, Henrik; Bohlin, Kajsa; Kamper, Jens

    2009-01-01

    The Scandinavian approach is an effective combined treatment for respiratory distress syndrome (RDS) and prevention of bronchopulmonary dysplasia (BPD). It is composed of many individual parts. Of significant importance is the early treatment with nasal continuous positive airway pressure (n...

  5. Preventing treatment errors in radiotherapy by identifying and evaluating near misses and actual incidents

    International Nuclear Information System (INIS)

    Holmberg, Ola; McClean, Brendan

    2002-01-01

    The aim of this work is to study the effectiveness of a multilayered error prevention system by analysing both the near misses found at calculation-check stations and the actual treatment errors originating in the treatment preparation chain

  6. Prevention and treatment of periodontal diseases in primary care.

    Science.gov (United States)

    Matthews, Debora C

    2014-09-01

    The aim of this guidance is to support the dental team to; manage patients with periodontal diseases in primary care appropriately; improve the quality of decision making for referral to secondary care; improve the overall oral health of the population. It focuses on the prevention and non-surgical treatment of periodontal diseases and implant diseases in primary care. The surgical treatment of periodontal and implant diseases and the management of patients by periodontal specialists or in a secondary care setting are outwith the scope of this guidance and are not discussed in detail. The guidance is based on existing guidelines, including those from the British Society of Periodontology, relevant systematic reviews, research evidence and the opinion of experts and experienced practitioners. The methodological approach is based on the international standards set out by the Appraisal of Guidelines Research and Evaluation (AGREE) Collaboration (www.agreetrust.org). The guiding principle for developing guidance within SDCEP is to first source existing guidelines, policy documents, legislation or other recommendations. Similarly, relevant systematic reviews are also initially identified. These documents are appraised for their quality of development, evidence base and applicability to the remit of the guidance under development. In the absence of these documents or when supplementary information is required, other published literature and unpublished work may be sought.Review and updating. The guidance will be reviewed in three years and updated accordingly. Recommendations are provided for assessment and diagnosis; changing patient behaviour; treatment of gingival conditions; periodontal conditions; long term maintenance; management of patients with dental implants; referral and record keeping. The key recommendations highlighted are: Assess and explain risk factors for periodontal diseases to patients. Screen all patients for periodontal diseases at every routine

  7. 1 Knowledge, treatment seeking and preventive practices in respect ...

    African Journals Online (AJOL)

    2011-10-04

    Oct 4, 2011 ... patient, date and demographic characteristics including age, sex, educational qualification ... was at P 8. 3. 0.6. The various preventive measures used by these patients against malaria were insecticide.

  8. Nutrition in the prevention and treatment of disease

    National Research Council Canada - National Science Library

    Coulston, Ann M; Boushey, Carol; Ferruzzi, Mario G

    2013-01-01

    .... Given its unique focus and extensive coverage of clinical applications and disease prevention, this edition is organized for easy integration into advanced upper-division or graduate nutrition curriculums...

  9. Prevention and treatment of emergencies in thyroid patients

    Directory of Open Access Journals (Sweden)

    Anatoliy Filippovich Romanchishen

    2015-03-01

    Full Text Available AimTo evaluate the surgical treatment outcomes for patients with acute complications of thyroid disease (compression syndrome, early postoperative complications - like bilateral recurrent laryngeal nerve injure, bleeding (PB in thyroid bed and others performed in the single medical center.Material and methodsAnaplastic Thyroid Cancer (243 patients, multiglandular retrosternal goiter (25 cases, and purulent acute thyroiditis (9 observations made heavy compression of neck and mediastinal aerodigestive organs and were the reason for emergent thyroid surgery. Were estimated intraoperative recurrent nerve (RLN injures consequences and postoperative bleeding, made necessary for reoperations after 25663 thyroid surgeries during 36 years of the Center practice.ResultsSurgical intervention for Anaplastic Thyroid Cancer in all of patients has got palliative character only. Postop. lethality rate made 21,0% after emergency interventions, and 2,5% - after routine procedure. Combinations of it with radiochemotherapy has prolonged survival rate up to 13 month in 25% of cases.Follow up results of thyroid surgery in 23777 patients has found unexpected and relevant unilateral RLN injures in 251 (1.0% and bilateral – in 91 (0.38% cases. Recurrent laryngeal nerves and larynges reconstruction surgery allow us to decanulate more that 75% those patients.Postoperative bleeding (PB and thyroid bad hematomas were found in 138 больных (0.58% patients. The most often PB happened in initial and recurrent DTG (1.07%, 0.94%, TC (0.82% patients. In most (65.5% of cases PB began during the first 6 hours. In case of PB we parted wound edges anywhere, intubated repeatedly trachea, inspected wound; performed hemostasis and drained wound. Main sources of PB were inferior (40.38% or superior (17.30% thyroid artery. Source was not found in 13.35%. PB prevention included: careful hemostasis with control lavage of the wound; fascia covering of the thyroid bed and high

  10. Treatment and prevention of kidney stones: an update.

    Science.gov (United States)

    Frassetto, Lynda; Kohlstadt, Ingrid

    2011-12-01

    The incidence of nephrolithiasis (kidney stones) is rising worldwide, especially in women and with increasing age. Kidney stones are associated with chronic kidney disease. Preventing recurrence is largely specific to the type of stone (e.g., calcium oxalate, calcium phosphate, cystine, struvite [magnesium ammonium phosphate]), and uric acid stones); however, even when the stone cannot be retrieved, urine pH and 24-hour urine assessment provide information about stone-forming factors that can guide prevention. Medications, such as protease inhibitors, antibiotics, and some diuretics, increase the risk of some types of kidney stones, and patients should be counseled about the risks of using these medications. Managing diet, medication use, and nutrient intake can help prevent the formation of kidney stones. Obesity increases the risk of kidney stones. However, weight loss could undermine prevention of kidney stones if associated with a high animal protein intake, laxative abuse, rapid loss of lean tissue, or poor hydration. For prevention of calcium oxalate, cystine, and uric acid stones, urine should be alkalinized by eating a diet high in fruits and vegetables, taking supplemental or prescription citrate, or drinking alkaline mineral waters. For prevention of calcium phosphate and struvite stones, urine should be acidified; cranberry juice or betaine can lower urine pH. Antispasmodic medications, ureteroscopy, and metabolic testing are increasingly being used to augment fluid and pain medications in the acute management of kidney stones.

  11. Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: provider knowledge and acceptability.

    Directory of Open Access Journals (Sweden)

    Lucy Smith Paintain

    Full Text Available Malaria in pregnancy (MiP is associated with increased risks of maternal and foetal complications. The WHO recommends a package of interventions including intermittent preventive treatment (IPT with sulphadoxine-pyrimethamine (SP, insecticide-treated nets and effective case management. However, with increasing SP resistance, the effectiveness of SP-IPT has been questioned. Intermittent screening and treatment (IST has recently been shown in Ghana to be as efficacious as SP-IPT. This study investigates two important requirements for effective delivery of IST and SP-IPT: antenatal care (ANC provider knowledge, and acceptance of the different strategies. Structured interviews with 134 ANC providers at 67 public health facilities in Ashanti Region, Ghana collected information on knowledge of the risks and preventative and curative interventions against MiP. Composite indicators of knowledge of SP-IPT, and case management of MiP were developed. Log binomial regression of predictors of provider knowledge was explored. Qualitative data were collected through in-depth interviews with fourteen ANC providers with some knowledge of IST to gain an indication of the factors influencing acceptance of the IST approach. 88.1% of providers knew all elements of the SP-IPT policy, compared to 20.1% and 41.8% who knew the treatment policy for malaria in the first or second/third trimesters, respectively. Workshop attendance was a univariate predictor of each knowledge indicator. Qualitative findings suggest preference for prevention over cure, and increased workload may be barriers to IST implementation. However, a change in strategy in the face of SP resistance is likely to be supported; health of pregnant women is a strong motivation for ANC provider practice. If IST was to be introduced as part of routine ANC activities, attention would need to be given to improving the knowledge and practices of ANC staff in relation to appropriate treatment of MiP. Health

  12. Folliculitis keloidalis nuchae and pseudofolliculitis barbae: are prevention and effective treatment within reach?

    Science.gov (United States)

    Alexis, Andrew; Heath, Candrice R; Halder, Rebat M

    2014-04-01

    Pseudofolliculitis barbae and folliculitis keloidalis nuchae are chronic follicular disorders disproportionately affecting men of African ancestry. This article explores the etiology, pathogenesis, treatment, and prevention strategies of these conditions. Effective treatment and prevention of these disorders involves pharmacologic and procedural interventions as well as behavioral modifications. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Definitive radiotherapy for early glottic carcinoma: prognostic factors and implications for treatment

    International Nuclear Information System (INIS)

    Burke, Lisa S.; Greven, Kathryn M.; McGuirt, Wyman T.; Case, Douglas; Hoen, Helena M.; Raben, Milton

    1997-01-01

    Purpose: Treatment and disease-related factors were analyzed for their influence on the outcome of patients treated definitively with irradiation (RT) for early glottic carcinoma. Methods and Materials: One hundred two patients with stage T1 or T2 glottic carcinomas were treated definitively with RT from December 1983 through September 1993. Median follow-up time was 63 months. Factors analyzed for each patient included age, sex, stage, anterior commissure involvement, surgical alternative, histologic differentiation, field size, total dose, fraction size, and total treatment time. Survival analysis methods were employed to assess the effects of these factors on local control and complication rates. Results: The 5-year local control rates by stage were as follows: T1a, 92%; T1b, 80%; T2a, 94%; and T2b, 23%. By univariate analysis, factors found to have a significant impact on local control were stage, surgical alternative, fraction size, anterior commissure involvement, and overall treatment time. By multivariate analysis, stage, field size, and fraction size were the only significant factors that independently influenced local control. Conclusion: The inferior control rate for stage T2b lesions has implications for treatment. Our study supports the conclusion of reports in the literature showing that low fraction size negatively influences outcome in patients with early glottic cancer

  14. Definitive radiotherapy for early glottic carcinoma: prognostic factors and implications for treatment

    International Nuclear Information System (INIS)

    Burke, Lisa S.; Greven, Kathryn M.; McGuirt, Wyman T.; Case, Douglas; Hoen, Helena M.; Raben, Milton

    1997-01-01

    Purpose: Treatment and disease-related factors were analyzed for their influence on the outcome of patients treated definitively with irradiation (RT) for early glottic carcinoma. Methods and Materials: One hundred two patients with stage T1 or T2 glottic carcinomas were treated definitively with RT from December 1983 through September 1993. Median follow-up time was 63 months. Factors analyzed for each patient included age, sex, stage, anterior commissure involvement, surgical alternative, histologic differentiation, field size, total dose, fraction size, and total treatment time. Survival analysis methods were employed to assess the effects of these factors on local control and complication rates. Results: The 5-year local control rates by stage were as follows: T1a, 92%; T1b, 80%; T2a, 94%; and T2b, 23%. By univariate analysis, factors found to have a significant impact on local control were stage, surgical alternative, fraction size, anterior commissure involvement, and overall treatment time. By multivariate analysis, stage, field size, and fraction size were the only significant factors that independently influenced local control. Conclusions: The inferior control rate for stage T2b lesions has implications for treatment. Our study supports the conclusions of reports in the literature showing that low fraction size negatively influences outcome in patients with early glottic cancer

  15. Furanyl Fatty Acid Inhibition of FABP5 as a Mechanism for Treatment and Prevention of Cancer

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-16-1-0699 TITLE: Furanyl Fatty Acid Inhibition of FABP5 as a Mechanism for Treatment and Prevention of Cancer PRINCIPAL...pharmacologic inhibition will prevent the oncogenic effects of FABP5 overexpression in highly relevant breast cancer models that display a high ratio of...Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std. Z39.18 Furanyl Fatty Acid Inhibition of FABP5 as a Mechanism for Treatment and Prevention of

  16. Pressure ulcer prevention and treatment: use of prophylactic dressings

    Directory of Open Access Journals (Sweden)

    Reid K

    2016-10-01

    Full Text Available Kathleen Reid,1 Elizabeth A Ayello,2 Afsaneh Alavi,3 1Department of Nursing Practice and Education, Bridgepoint Active Healthcare, Toronto, Canada; 2School of Nursing, Excelsior College, Albany, NY, USA; 3Department of Medicine, University of Toronto, Toronto, Canada Abstract: The management of pressure ulcers is challenging for health care providers across disciplines. Pressure ulcers have significant impact on emotional and physical wellbeing, quality of life, and health care costs. The use of wound dressings could be an important and cost-effective strategy in preventing pressure ulcers. The main types of dressings that are examined for this purpose in the literature are foam, hydrocolloid, and films. Some small studies have shown a preventative role for sacral dressings with low-shear backings, though they raise concerns about over-hydration of the skin. Further research demonstrates the application of barrier films over bony prominences to have a prophylactic effect; however, adhesive dressings can also contribute to shearing forces on the skin. There is a vast body of research that examines the use of dressings to prevent pressure ulcers; however, there is limited high-level evidence, such as randomized control trials. A 2013 Cochrane review indicated that there is a paucity of high-level evidence to support the prophylactic use of dressings to prevent pressure ulcers; this paper will examine the emerging literature and consider its relevance to pressure ulcer prevention protocols. Keywords: quality of life, hydrocolloid dressing, topical agent

  17. Treatment of LF slag to prevent powdering during cooling

    Directory of Open Access Journals (Sweden)

    Ghorai S.

    2017-01-01

    Full Text Available The polymorphic transformation of the monoclinic β-polymorph to the orthorhombic γ-polymorph of di-calcium silicate at around 500°C during cooling results in disintegration of slag. The slag generated, during the production of thermo mechanically treated steel in ladle furnace at M/s Tata Steel Limited, Jamshedpur, India, behaves in similar manner. An attempt has been made to prevent the crumbling of ladle furnace slag. The experiments were conducted in 10 kg air induction furnace. Various types of silica source were used to prevent the disintegration of ladle furnace slag by reducing the basicity and optimizing the additives amount. Apart from silica sources, other additives like borax and barium carbonate were also used to stabilize the β phase. Present investigation reveals that disintegration of ladle furnace slag can be prevented either by addition of 0.2% boarx or 2% barium carbonate. Dust formation can also be prevented by decreasing the ladle furnace slag basicity to about 1.7. Toxicity Characteristic Leaching Procedure test, of the borax and barium carbonate treated slag samples, indicates that barium carbonate treated slag cannot be used for the dusting prevention as it contains high level of barium.

  18. Obesity Revised. Chapter at "Periodontal Disease: Symptoms, Treatment and Prevention"

    DEFF Research Database (Denmark)

    Cinar, Ayse Basak

    2011-01-01

    Abstract: Obesity, diabetes and oral diseases (dental cariesand periodontal diseases), largely preventable chronic diseases, are described as global pandemic due their distribution and severe consequences. WHO has called for a global action for prevention and promotion of these diseases as a vital...... the likelihood of periodontitis which is one of the most common chronic diseases worldwide, described as pandemic, and closely related to DM2. Promoting good oral health is significantly essential for prevention and reducing the negative consequences of periodontal diseases, DM2 and obesity, and to maintain good...... investment in urgent need. Diabetes and obesity, showing an increasing trend, lead to disabilities and negatively impacts on the quality of life through life course along with oral diseases. WHO projects that the prevalence of diabetes and deaths/year attrituble to diabetes complications will double...

  19. Definition and Outcome of a Curriculum to Prevent Disordered Eating and Body-Shaping Drug Use

    Science.gov (United States)

    Elliot, Diane L.; Moe, Esther L.; Goldberg, Linn; DeFrancesco, Carol A.; Durham, Melissa B.; Hix-Small, Hollie

    2006-01-01

    Almost one half of male and female students participate in high school-sponsored athletics, and high school also is a time when classroom health promotion curricula are less effective. The Athletes Training and Learning to Avoid Steroids is a sport team-centered drug-use prevention program for male high school athletes, which has been shown to…

  20. Greenhouse Gases Emissions from Wastewater Treatment Plants: Minimization, Treatment, and Prevention

    Directory of Open Access Journals (Sweden)

    J. L. Campos

    2016-01-01

    Full Text Available The operation of wastewater treatment plants results in direct emissions, from the biological processes, of greenhouse gases (GHG such as carbon dioxide (CO2, methane (CH4, and nitrous oxide (N2O, as well as indirect emissions resulting from energy generation. In this study, three possible ways to reduce these emissions are discussed and analyzed: (1 minimization through the change of operational conditions, (2 treatment of the gaseous streams, and (3 prevention by applying new configurations and processes to remove both organic matter and pollutants. In current WWTPs, to modify the operational conditions of existing units reveals itself as possibly the most economical way to decrease N2O and CO2 emissions without deterioration of effluent quality. Nowadays the treatment of the gaseous streams containing the GHG seems to be a not suitable option due to the high capital costs of systems involved to capture and clean them. The change of WWTP configuration by using microalgae or partial nitritation-Anammox processes to remove ammonia from wastewater, instead of conventional nitrification-denitrification processes, can significantly reduce the GHG emissions and the energy consumed. However, the area required in the case of microalgae systems and the current lack of information about stability of partial nitritation-Anammox processes operating in the main stream of the WWTP are factors to be considered.

  1. [Prevention of retinal detachment and treatment of retinoschisis].

    Science.gov (United States)

    Messmer, E P

    1990-01-01

    The necessity for prophylactic treatment for degenerative disease in the peripheral retina cannot be evaluated merely on the basis of the ophthalmoscopic findings. Factors such as the patient's history, refraction, the status of the vitreous, and prospective future cataract extraction all have a major impact on the risk of developing retinal detachment. The latter condition can be classified in to three groups: (1) low risk (patients with no history of retinal detachment, intraocular surgery or posterior vitreous detachment, myopia less than three diopters): treatment of atrophic holes and lattice degeneration is not justified, treatment of flap tears according to the circumstances; (2) medium risk (patients with no history of retinal or posterior vitreous detachment; however, myopia of more than three diopters and/or aphakia): the treatment of lattice degeneration is not justified; treatment of breaks according to the circumstances; (3) high risk: (patients with symptoms of posterior vitreous detachment): the treatment of lattice degeneration and atrophic holes is not justified: treatment of tears is necessary; fellow eyes: the treatment of retinal breaks is necessary; treatment of lattice degeneration seems advisable in cases with bilateral symmetric findings or prior to cataract extraction. Treatment of senile retinoschisis is only justified in cases with large and centrally located holes in the outer wall or in the presence of symptomatic schisis detachment.

  2. Validation of treatment escalation as a definition of atopic eczema flares.

    Directory of Open Access Journals (Sweden)

    Kim S Thomas

    Full Text Available Atopic eczema (AE is a chronic disease with flares and remissions. Long-term control of AE flares has been identified as a core outcome domain for AE trials. However, it is unclear how flares should be defined and measured.To validate two concepts of AE flares based on daily reports of topical medication use: (i escalation of treatment and (ii days of topical anti-inflammatory medication use (topical corticosteroids and/or calcineurin inhibitors.Data from two published AE studies (studies A (n=336 and B (n=60 were analysed separately. Validity and feasibility of flare definitions were assessed using daily global bother (scale 0 to 10 as the reference standard. Intra-class correlations were reported for continuous variables, and odds ratios and area under the receiver operator characteristic (ROC curve for binary outcome measures.Good agreement was found between both AE flare definitions and change in global bother: area under the ROC curve for treatment escalation of 0.70 and 0.73 in studies A and B respectively, and area under the ROC curve of 0.69 for topical anti-inflammatory medication use (Study A only. Significant positive relationships were found between validated severity scales (POEM, SASSAD, TIS and the duration of AE flares occurring in the previous week - POEM and SASSAD rose by half a point for each unit increase in number of days in flare. Smaller increases were observed on the TIS scale. Completeness of daily diaries was 95% for Study A and 60% for Study B over 16 weeks.Both definitions were good proxy indicators of AE flares. We found no evidence that 'escalation of treatment' was a better measure of AE flares than 'use of topical anti-inflammatory medications'. Capturing disease flares in AE trials through daily recording of medication use is feasible and appears to be a good indicator of long-term control.Current Controlled Trials ISRCTN71423189 (Study A.

  3. CAN WINTER DEPRESSION BE PREVENTED BY LIGHT TREATMENT

    NARCIS (Netherlands)

    MEESTERS, Y; LAMBERS, PA; JANSEN, JHC; BOUHUYS, AL; BEERSMA, DGM; VANDENHOOFDAKKER, RH

    1991-01-01

    The administration of light at the development of the first signs of a winter depression appears to prevent it from developing into a full-blown depression. No patient from a group of 10 treated in this way developed any signs of depression during the rest of the winter season, while five of seven

  4. Can winter depression be prevented by light treatment?

    NARCIS (Netherlands)

    Meesters, Ybe; Lambers, Petrus A.; Jansen, Jacob; Bouhuys, Antoinette L.; Beersma, Domien G.M.; Hoofdakker, Rutger H. van den

    1991-01-01

    The administration of light at the development of the first signs of a winter depression appears to prevent it from developing into a full-blown depression. No patient from a group of 10 treated in this way developed any signs of depression during the rest of the winter season, while five of seven

  5. Eating Disorders in Childhood: Prevention and Treatment Supports

    Science.gov (United States)

    Cook-Cottone, Catherine

    2009-01-01

    Eating disorders (EDs) are chronic clinical mental disorders that are disruptive to the psychological and social development of children and adolescents. They can be difficult to prevent and treat and are considered among the most chronic and medically lethal of mental disorders. Research suggests that the incidence and prevalence of eating…

  6. Eating Disorder Intervention, Prevention, and Treatment: Recommendations for School Counselors

    Science.gov (United States)

    Bardick, Angela D.; Bernes, Kerry B.; McCulloch, Ariana R. M.; Witko, Kim D.; Spriddle, Jennifer W.; Roest, Allison R.

    2004-01-01

    School counselors are in daily contact with the highest risk group for developing eating disorders--children and adolescents. School counselors are in a position to identify at-risk individuals, implement effective school-based prevention programs, make appropriate referrals, and provide support for recovering individuals. An overview of a theory…

  7. Prevention and treatment of childhood malnutrition in rural Malawi ...

    African Journals Online (AJOL)

    The review highlighted the fact that determinants of malnutrition may not have the same importance in all settings and thus preventive strategies that work in one place may not work in all settings. This meant that determination of local causes and effective interventions was one way of alleviating the problem. It had been ...

  8. Orthopedic Health: Joint Health and Care: Prevention, Symptoms, Diagnosis & Treatment

    Science.gov (United States)

    ... version of this page please turn Javascript on. Prevention Regular exercise, a balanced diet, and a healthful weight can help you reduce your risk of developing osteoarthritis, especially in the hips and knees, or suffering sports injuries. Exercise helps bone density, improves muscle strength and ...

  9. Knowledge of physiotherapy in the prevention and treatment of ...

    African Journals Online (AJOL)

    This study was designed to evaluate the knowledge of physiotherapy among managers of amateur soccer teams in preventing and treating soccer injuries. A total of 32 amateur soccer team managers from Kano State, Nigeria were purposively recruited to participate in this study. Thereafter, a questionnaire seeking ...

  10. Tick-Associated Diseases: Symptoms, Treatment and Prevention

    Science.gov (United States)

    Anderson, Alice; Chaney, Elizabeth

    2009-01-01

    According to the Centers for Disease Control and Prevention (CDC), there are eleven tick-associated diseases prevalent in the United States. Most commonly diagnosed are Lyme disease, anaplasmosis (ehrlichiosis) and babeisois, with Lyme disease being the most common vector-borne disease in the country. In southeastern states, studies have shown the…

  11. Parasite clearance following treatment with sulphadoxine-pyrimethamine for intermittent preventive treatment in Burkina-Faso and Mali

    DEFF Research Database (Denmark)

    Coulibaly, Sheick O; Kayentao, Kassoum; Taylor, Steve

    2014-01-01

    Intermittent Preventive Treatment in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) is widely used for the control of malaria in pregnancy in Africa. The emergence of resistance to SP is a concern requiring monitoring the effectiveness of SP for IPTp....

  12. Austrian consensus on the definition and treatment of portal hypertension and its complications (Billroth II).

    Science.gov (United States)

    Peck-Radosavljevic, Markus; Angermayr, Bernhard; Datz, Christian; Ferlitsch, Arnulf; Ferlitsch, Monika; Fuhrmann, Valentin; Häfner, Michael; Kramer, Ludwig; Maieron, Andreas; Payer, Berit; Reiberger, Thomas; Stauber, Rudolf; Steininger, Rudolf; Trauner, Michael; Thurnher, Siegfried; Ulbrich, Gregor; Vogel, Wolfgang; Zoller, Heinz; Graziadei, Ivo

    2013-04-01

    In November 2004, the Austrian Society of Gastroenterology and Hepatology (ÖGGH) held for the first time a consensus meeting on the definitions and treatment of portal hypertension and its complications in the Billroth-Haus in Vienna, Austria (Billroth I-Meeting). This meeting was preceded by a meeting of international experts on portal hypertension with some of the proponents of the Baveno consensus conferences (http://www.oeggh.at/videos.asp). The consensus itself is based on the Baveno III consensus with regard to portal hypertensive bleeding and the suggestions of the International Ascites Club regarding the treatment of ascites. Those statements were modified by new knowledge derived from the recent literature and also by the current practice of medicine as agreed upon by the participants of the consensus meeting. In October 2011, the ÖGGH organized the second consensus meeting on portal hypertension and its complications in Vienna (Billroth II-Meeting). The Billroth II-Guidelines on the definitions and treatment of portal hypertension and its complications take into account the developments of the last 7 years, including the Baveno-V update and several key publications.

  13. Treatment for cancer in the cervical esophagus. Surgery versus definitive chemoradiotherapy

    International Nuclear Information System (INIS)

    Umeno, Hirohito; Fujita, Hiromasa; Inoue, Youjirou

    2012-01-01

    Eighty-two patients with cervical esophageal cancer were treated by definitive chemoradiotherapy (10 patients) or surgery (72 patients) between 1989 and 2009 at the Kurume University Hospital. The 3-year overall survival rate after surgery was 51% and that after definitive chemoradiotherapy was 44%, showing no significant difference between the two groups. The 3-year local control rate after surgery was significantly better than that after definitive chemoradiotherapy. The overall 5-year survival rate of patients requiring a mediastinal tracheostomy was 11%, while that of those without a mediastinal tracheostomy was 39%. There was no significant difference between the two groups. The commencement of oral intake took a long time after treatment in patients with a T4 tumor who underwent chemoradiotherapy and who had vocal fold paralysis. Almost all patients who underwent esophageal reconstruction using the alimentary tract after pharyngolaryngoesophagectomy could take food within two weeks after surgery. On the other hand, in patients with vocal cord paralysis after cervical esophagectomy without laryngectomy, several months were needed after surgery to take food orally. (author)

  14. Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach

    DEFF Research Database (Denmark)

    Brand, P.L.; Baraldi, E.; Bisgaard, H.

    2008-01-01

    There is poor agreement on definitions of different phenotypes of preschool wheezing disorders. The present Task Force proposes to use the terms episodic (viral) wheeze to describe children who wheeze intermittently and are well between episodes, and multiple-trigger wheeze for children who wheeze...... preschool child with recurrent wheeze, but should be discontinued if there is no clear clinical benefit. Large well-designed randomised controlled trials with clear descriptions of patients are needed to improve the present recommendations on the treatment of these common syndromes Udgivelsesdato: 2008/10...

  15. Prevention of reinforcement corrosion by hydrophobic treatment of concrete

    NARCIS (Netherlands)

    Polder, R.B.; Borsje, H.; Vries, H. de

    2001-01-01

    Corrosion of reinforcement in concrete bridge decks may occur due to penetration of de-icing salts, even in the presence of an asphalt overlay. This paper reports a laboratory study into additional protection of concrete by hydrophobic treatment. It was found that hydrophobic treatment strongly

  16. Obesity Revised. Chapter at "Periodontal Disease: Symptoms, Treatment and Prevention"

    DEFF Research Database (Denmark)

    Cinar, Ayse Basak

    2011-01-01

    investment in urgent need. Diabetes and obesity, showing an increasing trend, lead to disabilities and negatively impacts on the quality of life through life course along with oral diseases. WHO projects that the prevalence of diabetes and deaths/year attrituble to diabetes complications will double......Abstract: Obesity, diabetes and oral diseases (dental cariesand periodontal diseases), largely preventable chronic diseases, are described as global pandemic due their distribution and severe consequences. WHO has called for a global action for prevention and promotion of these diseases as a vital...... worldwide by 2030. Globally, more than 1 billion adults are overweight; almost 300 million of them are clinically obese. Being obese/overweight raises steeply the likelihood of developing DM2. Approximately 85% of people with diabetes are DM2, and of these 90% are obese or overweight. Obesity increases...

  17. Treatment and Prevention of Oral Candidiasis in Elderly Patients.

    Science.gov (United States)

    Sakaguchi, Hideo

    2017-01-01

    The incidence of oral candidiasis has increased in the elderly in recent years. Although the increase of the elderly population plays a big role in this rise of oral candidiasis, the broader recognition that elderly people have higher infection rates for oral candidiasis is considered to be also an important factor. Oral candidiasis can be categorized into three types. Pseudomembranous oral candidiasis is characterized by the appearance of white moss, erythematous oral candidiasis by the eruption of erythema, and hyperplastic oral candidiasis by mucosal hyperplasia. Miconazole has been commonly used when treating oral candidiasis. Elderly patients, however, have a tendency to develop oral candidiasis repeatedly. It is therefore critical to take measures to prevent recurrence. We recommend the use an oral moisturizer containing hinokitiol, an antifungal substance, on a regular basis, to help prevent recurrence of oral candidiasis.

  18. Opportunities for AIDS prevention in a rural state in criminal justice and drug treatment settings.

    Science.gov (United States)

    Farabee, D; Leukefeld, C G

    1999-01-01

    This study examined the likelihood that drug users would receive HIV/ AIDS prevention information and supplies (e.g., condoms and bleach) in the rural state of Kentucky. Despite evidence of high HIV risk among criminal justice and substance-using populations, incarceration and substance-user treatment were only minimally associated with prior HIV prevention exposure or HIV testing. These data strongly support the use of criminal justice and treatment settings to provide AIDS prevention interventions for the high-risk drug-using populations they serve, and to target HIV prevention services in rural as well as urban areas.

  19. Engineered Osteoclasts for the Treatment and Prevention of Heterotopic Ossification

    Science.gov (United States)

    2015-10-01

    animals were euthanized and the right calf muscle and tibiae were harvested and processed for histology. As shown in Figure 1, delivery of...tibia bone morphology. At the end of the 4- week prevention study, the mice were euthanized and the HO nodules, right calf muscle , and tibiae were...performed and the mice were euthanized and the HO nodules, right calf muscle , and tibiae were harvested and processed for histology. As shown in

  20. IntermIttent PreventIve treatment and Bed nets uPtake among ...

    African Journals Online (AJOL)

    prenatal exposure to malaria parasites lowers development of protective immunity in infants, shortening the time to a first incidence of malaria and increased frequency of malaria in the first two years of life(4,5). Because of these increased risks, prevention of malaria during pregnancy is crucial for both the mother and infant.

  1. Evidence of effectiveness of preventive dental care in reducing dental treatment use and related expenditures.

    Science.gov (United States)

    Pourat, Nadereh; Choi, Moonkyung Kate; Chen, Xiao

    2018-02-06

    Preventive dental health services are intended to reduce the likelihood of development of tooth decay and the need for more intensive treatment overtime. The evidence on the effectiveness of preventive dental care in reducing treatment services and expenditures is lagging for adults, particularly those with lower incomes and chronic conditions. We assessed the impact of preventive dental services on dental treatment service use and expenditures overall and by category of service. We calculated the annual numbers of preventive (periodic diagnostic and prophylactic procedures) and treatment (restorative, surgery, prosthodontic, endodontic, and periodontic) services per beneficiary using Medicaid enrollment and claims data for beneficiaries with three categories of conditions (diabetes, heart disease, and respiratory disease) from 10 largest California counties. We used Cragg hurdle exponential regression models controlling for past service use, demographics, length of enrollment, and county. We found that using preventive services in 2005-2007 was associated with higher likelihood and number of treatment dental services used, but associated with lower treatment expenditures in 2008. The reduction in expenditures was noted only in restorative, prosthodontics, and periodontic services. The findings provide much needed evidence of the contribution of preventive dental care in maintaining oral health of low-income adults with chronic conditions and potential for savings to the Medicaid program. Providing lower cost preventive dental care to the individuals with chronic conditions would achieve better oral health and lower treatment expenditures. © 2018 American Association of Public Health Dentistry.

  2. Importance of local skin treatments during radiotherapy for prevention and treatment of radio-induced epithelitis

    International Nuclear Information System (INIS)

    Chargari, C.; Fromantin, I.; Kirova, Y.M.; Chargari, C.

    2009-01-01

    Radio-epithelitis represents a common problem, for which treatments are characterized by a great heterogeneity. The present review of literature focuses on data referenced in Pub med/Medline and published in French/English. Despite a real preclinical rationale, aloe vera and trolamine failed to demonstrate any benefit in the prophylactic settings. In a prospective assessment phase III assessment, Calendula officinalis was shown to be superior to trolamine for the prevention of radio-epithelitis. In the curative settings, sucrafalte failed to demonstrate any benefit. The benefit of dermo-corticoids was suggested in terms of erythema and itching. Promising clinical results are available with hyaluronic acid (M.A. S065D and Ialugen) and silver leaf may reduce the intensity of cutaneous radio-induced side effects. Data from the literature are conflicting, making real the difficulty to adopt from clinical trials any proof-of-principle strategy. Considering these uncertainties, several strategies are allowed. New topics are under investigation. Present data from the literature highlight the need for further trials, in order to propose evidence-based treatments and to harmonize clinical practice. (authors)

  3. Testosterone Therapy on Active Surveillance and Following Definitive Treatment for Prostate Cancer.

    Science.gov (United States)

    Golla, Vishnukamal; Kaplan, Alan L

    2017-07-01

    Previously considered an absolute contraindication, the use of testosterone therapy in men with prostate cancer has undergone an important paradigm shift. Recent data has changed the way we approach the treatment of testosterone deficiency in men with prostate cancer. In the current review, we summarize and analyze the literature surrounding effects of testosterone therapy on patients being treated in an active surveillance protocol as well as following definitive treatment for prostate cancer. The conventional notion that defined the relationship between increasing testosterone and prostate cancer growth was based on limited studies and anecdotal case reports. Contemporary evidence suggests testosterone therapy in men with testosterone deficiency does not increase prostate cancer risk or the chances of more aggressive disease at prostate cancer diagnosis. Although the studies are limited, men who received testosterone therapy for localized disease did not have higher rates of recurrences or worse clinical outcomes. Current review of the literature has not identified adverse progression events for patients receiving testosterone therapy while on active surveillance/watchful waiting or definitive therapies. The importance of negative effects of testosterone deficiency on health and health-related quality of life measures has pushed urologists to re-evaluate the role testosterone plays in prostate cancer. This led to a paradigm shift that testosterone therapy might in fact be a viable option for a select group of men with testosterone deficiency and a concurrent diagnosis of prostate cancer.

  4. Definition and Means of Maintaining the Criticality Prevention Design Features Portion of the PFP Safety Envelope

    International Nuclear Information System (INIS)

    RAMBLE, A.L.

    2000-01-01

    The purpose of this document is to record the technical evaluation of the Operational Safety Requirements described in the Plutonium Finishing Plant Final (PFP) Operational Safety Requirements, WHC-SD-CP-OSR-010. Rev. 0-N , Section 3.1.1, ''Criticality Prevention System.'' This document, with its appendices, provides the following: (1) The results of a review of Criticality Safety Analysis Reports (CSAR), later called Criticality Safety Evaluation Reports (CSER), and Criticality Prevention Specifications (CPS) to determine which equipment or components analyzed in the CSER or CPS are considered as one of the two unlikely, independent, and concurrent changes before a criticality accident is possible. (2) Evaluations of equipment or components to determine the safety boundary for the system (Section 4). (3) A list of essential drawings that show the safety system or component (Appendix A). (4) A list of the safety envelope (SE) equipment (Appendix B). (5) Functional requirements for the individual safety envelope equipment (Sections 3 and 4). (6) A list of the operational and surveillance procedures necessary to maintain the system equipment within the safety envelope (Section 5)

  5. [The evaluation of aphasic deficits for the definition of a targetted logotherapeutic treatment].

    Science.gov (United States)

    Bazzini, A; Pezzoni, F; Zonca, G; Guarnaschelli, C; Zelaschi, F; Luzzatti, C

    1997-01-01

    The Aachener Aphasie Test (AAT) is the major German test for the diagnosis of aphasic disorders. The test is easy to use and is valid and reliable for the diagnosis of aphasia and its severity and to evaluate the recovery of the aphasic disorder after language rehabilitation. The AAT is, however, not sufficient to define cognitively sound logotherapeutic treatment. The use of tasks which are based on cognitive functional models allows the identification of specific processing levels that have been damaged by a cerebral lesion, and the definition of a focussed rehabilitation plan. In this paper, we will discuss the results of a cognitive neurolinguistic treatment in a patient who suffered of Broca's aphasia with agrammatism and phonological dyslexia.

  6. Preventive treatment of calcium oxalate crystal deposition with immortal flowers.

    Science.gov (United States)

    Orhan, Nilüfer; Onaran, Metin; Şen, İlker; Işık Gönül, İpek; Aslan, Mustafa

    2015-04-02

    A number of medicinal plants are used for their diuretic, urolithiatic and anti-inflammatory effects on urinary system problems in Turkey and the most common traditional remedy for kidney stones is the tea of immortal flowers. The aim of this study is to evaluate the preventive effect of infusions prepared from capitulums of Helichrysum graveolens (M.Bieb.) Sweet (HG) and Helichrysum stoechas ssp. barellieri (Ten.) Nyman (HS) on formation of kidney stones. Sodium oxalate (Ox-70mg/kg intraperitoneally) was used to induce kidney stones on Wistar albino rats. At the same time, two different doses of the plant extracts (HG: 62.5 and 125mg/kg; HS: 78 and 156mg/kg) were dissolved in the drinking water and administered to animals for 5 days. Potassium citrate was used as positive control in the experiments. During the experiment, water intake, urine volume and body weights of the animals were recorded. At the end of the experiments, liver, kidney and body weights of the animals were determined; biochemical analysis were conducted on urine, blood and plasma samples. Histopathological changes in kidney tissues were examined and statistical analysis were evaluated. HS extract showed the highest preventive effect at 156mg/kg dose (stone formation score: 1.16), whereas a number of kidney stones were maximum in sodium oxalate group (stone formation score: 2.66). Helichrysum extracts decreased urine oxalate and uric acid levels and increased citrate levels significantly. In addition, Helichrysum extracts regulated the negative changes in biochemical and hematological parameters occurred after Ox injection. We conclude that Helichrysum extracts could reduce the formation and growth of kidney stones in Ox-induced urolithiasis and can be beneficial for patients with recurrent stones. In addition, this is the first study on the preventive effect of immortal flowers. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. ENERGY PRODUCTION AND POLLUTION PREVENTION AT SEWAGE TREATMENT PLANTS USING FUEL CELL POWER PLANTS

    Science.gov (United States)

    The paper discusses energy production and pollution prevention at sewage treatment plants using fuel cell power plants. Anaerobic digester gas (ADG) is produced at waste water treatment plants during the anaerobic treatment of sewage to reduce solids. The major constituents are...

  8. Enzymatic treatment for preventing biofilm formation in the paper industry.

    Science.gov (United States)

    Torres, Claudia Esperanza; Lenon, Giles; Craperi, Delphine; Wilting, Reinhard; Blanco, Angeles

    2011-10-01

    Microbiological control programmes at industrial level should aim at reducing both the detrimental effects of microorganisms on the process and the environmental impact associated to the use of biocides as microbiological control products. To achieve this target, new efficient and environmentally friendly products are required. In this paper, 17 non-specific, commercial enzymatic mixtures were tested to assess their efficacy for biofilm prevention and control at laboratory and pilot plant scale. Pectin methylesterase, an enzyme found in the formulation of two of the mixtures tested, was identified as an active compound able to reduce biofilm formation by 71% compared to control tests.

  9. Update on otitis media – prevention and treatment

    Directory of Open Access Journals (Sweden)

    Qureishi A

    2014-01-01

    Full Text Available Ali Qureishi,1 Yan Lee,2 Katherine Belfield,3 John P Birchall,4 Matija Daniel,21Otolaryngology Head and Neck Surgery, Northampton General Hospital, Northampton, UK; 2NIHR Nottingham Hearing Biomedical Research Unit, Nottingham, UK; 3Biomaterials Related Infection Group, 4Otorhinolaryngology Head and Neck Surgery, The University of Nottingham, Nottingham, UKAbstract: Acute otitis media and otitis media with effusion are common childhood disorders, a source of significant morbidity, and a leading cause of antibiotic prescription in primary health care. Although effective treatments are available, some shortcomings remain, and thus better treatments would be welcome. Recent discoveries within the field of otitis media research relating to its etiology and pathogenesis have led to further investigation aimed at developing novel treatments. This article provides a review of the latest evidence relating to the understanding of acute otitis media and otitis media with effusion, current treatment strategies, their limitations, new areas of research, and novel strategies for treatment.Keywords: otitis media, ear, hearing, infection, biofilm, antibiotics

  10. Gastrin: from pathophysiology to cancer prevention and treatment.

    Science.gov (United States)

    Maddalo, Gemma; Spolverato, Ylenia; Rugge, Massimo; Farinati, Fabio

    2014-07-01

    Gastrin has been identified as the principal effector of gastric secretion, but several studies have demonstrated its role as a biomarker of cancer risk and as a growth factor for colorectal, stomach, liver, and pancreatic cancer. Hypergastrinemia characterizes autoimmune gastritis, with body and fundic gland atrophy and increased risk for both gastric adenocarcinoma and neuroendocrine tumors. Gastric type I carcinoids develop in the context of autoimmune gastritis because of the stimulus exerted by gastrin on enterochromaffin-like cells and remain gastrin-sensitive for long durations because the removal of hypergastrinemia leads to tumor regression. The treatment of gastric carcinoid is still open to debate, but when the disease frequently relapses, or is multicentric or infiltrating, surgery is advocated or, in the alternative, a costly and long-lasting treatment with long-acting somatostatin analogues is prescribed. A technology allowing the preparation of an immunogen eliciting an immune system response with generation of antibodies against G17 has been developed. This vaccine has been tested in patients with colorectal, pancreatic or advanced gastric cancer. The vaccine has also been used in the treatment of gastric type I carcinoids, and the administration of G17DT in patients harboring these lesions leads to carcinoid regression. Antigastrin vaccination in the treatment of gastrointestinal cancer obviously needs validation, but this immunotherapy may well represent a simple, inexpensive, and active 'adjuvant' treatment.

  11. Marine natural products in prevention and treatment of osteoporosis

    Directory of Open Access Journals (Sweden)

    Zahra Ghanbari

    2015-05-01

    Full Text Available Undoubtedly, pharmaceutical and nutritional factors play an important role in the prevention of age-related bone loss. According to the several studies so far, the effects of nutrients and bioactive components which are extracted from marine resources are very promising in osteoporosis. Most of these investigations have been done on various marine algae extracts. Since, algae are rich source of essential minerals, primary and secondary unique natural products, several amino acids and growth factors their extracts show favorable effects on bone metabolism. Moreover, it has been shown that marine nutrients such as marine fishes, shrimp and crabs increase the absorption of calcium and bone collagen synthesis or reduce the production of prostaglandins and decrease the deoxypyridinoline disposal. On the other hand, secondary products which are extracted and characterized from marine organisms such as mollusks, fungi, bacteria, sponges and coral reefs show anti-osteoporosis activities via the inhibition of osteoclast differentiation and the induction of apoptosis in osteoclasts like cells or stimulation of osteoblast differentiation. Although, several investigations have been done in this area, many of studies have been carried out on animal models, like ovariectomy-induced bone loss in mice. Hence, clinical investigations are warranted to develop marine natural products against bone loss and to prevent osteoporosis.

  12. Unproven (questionable) dietary and nutritional methods in cancer prevention and treatment.

    Science.gov (United States)

    Herbert, V

    1986-10-15

    "Unproven" is a euphemism for questionable. The definition of a questionable method is that it has not successfully answered the two basic consumer protection questions of efficacy and safety, to wit: Has it been responsibly, objectively, reproducibly, and reliably demonstrated in humans in the responsible (peer-reviewed) literature accepted for the shelves of the National Library of Medicine in Bethesda, Maryland, to be: More effective than suggestion or doing nothing? and in addition, either As safe as doing nothing? or, in the alternative, If there is any question with respect to safety, to have a reasonably and objectively clear potential for benefit which exceeds its potential for harm? Any proposed cancer prevention or treatment modality which has not successfully answered the above efficacy question plus one of the two safety questions is by definition questionable. It is experimental if it is new, and very probably quackery if it is old. Experimental therapy may be either ethical and responsible or unethical and irresponsible. It is unethical and irresponsible to not tell the patient experiments are being conducted on him, to charge the patient to perform research on him, or to ask the patient to sign an informed consent aimed at exculpating the doctor rather than protecting the patient. Ethical and responsible informed consents clearly delineate that what is being done is experimental, and that efficacy and safety have not been determined. Products promoted for profit to the public without passing peer process are almost without exception ineffective, often harmful, and sometimes lethal. This includes Laetrile, immunoaugmentative therapy, chelation therapy, macrobiotic diets, and other alternative therapies. Anecdotal and testimonial claims of cure, on investigation, almost invariably prove due to coincidence, suggestibility, and/or the natural history of the disorder, and fall into one of the five categories of "cures that are not": The patient never had

  13. [Guideline-adherent inpatient psychiatric psychotherapeutic treatment of borderline personality disorder : Normative definition of personnel requirements].

    Science.gov (United States)

    Bohus, M; Schmahl, C; Herpertz, S C; Lieb, K; Berger, M; Roepke, S; Heinz, A; Gallinat, J; Lyssenko, L

    2016-07-01

    Borderline personality disorders (BPD) are severe mental diseases which place high pressure on the psychiatric healthcare system. Nowadays, well-tested, disorder-specific treatment concepts are available also for inpatient treatment in Germany. These show very good and long-term improvements in the psychopathology as well as posttreatment social participation; however, prerequisites for the implementation of these evidence-based inpatient psychotherapy programs are well-trained treatment teams and appropriate financing of resource expenditure. The aim was to formulate a definition of normative needs for treatment duration and intensity for a guideline-conform, empirically proven and effective inpatient treatment of borderline personality disorder as well as the derived personnel requirements in comparison to the currently available resources within the framework of the Psychiatry Personnel Act (Psych-PV). The resource requirements were established based on evaluated hospital ward models, the recommendations of the S2 guidelines and the criteria of specialist societies and compared with the personnel stipulations according to the Psych-PV. The results for a normatively established treatment program showed a pronounced deficit in the financing of the evaluated resource requirements, even when the stipulations laid down in the Psych-PV were implemented to 100 %. Disorder-specific inpatient treatment programs for borderline personality disorder have been scientifically proven to be highly effective; however, resource analyses show that the personnel requirements necessary for effective implementation of these programs are much higher than those allocated by the funding according to the Pysch-PV. The current underfunding leads to inadequate treatment outcomes with high readmission rates and as a result high direct and indirect costs of illness.

  14. Organic seed treatment of vegetables to prevent seedborne diseases

    NARCIS (Netherlands)

    Spadaro, D.; Herforth-Rahmé, J.; Wolf, van der J.M.

    2017-01-01

    Seedborne pathogens of vegetables are responsible for the re-emergence of diseases of the past, as well as the introduction of diseases into new geographical areas. Seed treatment can be used to eradicate seedborne pathogens or to protect from soilborne pathogens. The European Commission Regulation

  15. Guidelines for diagnosis, prevention and treatment of hand eczema

    DEFF Research Database (Denmark)

    Diepgen, Thomas L; Andersen, Klaus E; Chosidow, Oliver

    2015-01-01

    ) for patients with severe chronic HE. Randomized control trials (RCT) are missing for other used systemic treatments and comparison of systemic drugs in “head-to-head” RCTs are needed.The guidelines development group is a working group of the European Society of Contact Dermatitis (ESCD) and has carefully tried...

  16. Acute lateral ankle sprains: from functional treatment to prevention

    NARCIS (Netherlands)

    Kemler, H.J.

    2015-01-01

    Ankle sprains are common in daily life and often considered to be minor injuries. The objective in this thesis was to provide more evidence on the burden and optimal management of ankle sprains in terms of the magnitude of the problem, the prognostic consequences and ways to improve treatment and

  17. Nurturing the continuum of HIV testing, treatment and prevention ...

    African Journals Online (AJOL)

    Background: Despite the shift in antiretroviral therapy (ARVs) eligibility cascade from CD4 ≤ 200 to CD4 ≤ 350 to CD4 ≤ 500 mm3, HIV related morbidity and mortality continue to escalate annually, as do HIV infections. The new paradigm of treatment for all HIV positives individual irrespective of CD4 count may ...

  18. Animal models for arthritis: innovative tools for prevention and treatment

    NARCIS (Netherlands)

    Kollias, G.; Papadaki, P.; Apparailly, F.; Vervoordeldonk, M.J.; Holmdahl, R.; Baumans, V.; Desaintes, C.; Di Santo, J.; Distler, J.; Garside, P.; Hegen, M.; Huizinga, T.W.J.; Jüngel, A.; Klareskog, L.; McInnes, I.; Ragoussis, I.; Schett, G.; Hart, B.t.; Tak, P.P.; Toes, R.; van den Berg, W.; Wurst, W.; Gay, S.

    2011-01-01

    The development of novel treatments for rheumatoid arthritis (RA) requires the interplay between clinical observations and studies in animal models. Given the complex molecular pathogenesis and highly heterogeneous clinical picture of RA, there is an urgent need to dissect its multifactorial nature

  19. A National Model for Diabetes Prevention and Treatment Program in Civilian and Military Healthcare Beneficiary Populations

    Science.gov (United States)

    2010-03-01

    of renal function)  Dipstick urinalysis (Routine screening for proteinuria and urinary glucose)  AST, ALT (Screening for non - alcoholic fatty liver ...method of pediatric obesity treatment and chronic disease prevention. Pediatrics Diabetes Prevention and Weight Management Programs...developing type 2 diabetes (T2D) as well as cardiovascular disease (CVD) [1]. Moreover, approximately 65% of US adults are overweight or obese . [2

  20. Malaria Prevention and Treatment Using Educational Animations: A Case Study in Kakamega County, Kenya

    Science.gov (United States)

    Bello-Bravo, Julia; Namatsi Lutomia, Anne; Madela, Lawrence Mbhekiseni; Pittendrigh, Barry Robert

    2017-01-01

    Despite worldwide efforts to prevent malaria, the disease continues to take its strongest toll in sub-Saharan Africa. Kenya is no exception, with millions of cases and thousands of deaths reported annually. This pilot study looks at knowledge on malaria prevention and treatment among peri-urban communities in Western Kenya. Through a study on the…

  1. 76 FR 66721 - CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment

    Science.gov (United States)

    2011-10-27

    ... Advisory Committee on HIV and STD Prevention and Treatment In accordance with section l0(a)(2) of the... the Administrator, HRSA, regarding activities related to prevention and control of HIV/AIDS and other STDs, the support of health care services to persons living with HIV/AIDS, and education of health...

  2. Osteoporosis: Symptoms, Diagnosis, Treatment and Prevention | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Osteoporosis Osteoporosis: Symptoms, Diagnosis, Treatment and Prevention Past Issues / Winter 2011 Table of Contents Osteoporosis can strike at any age, although the risk ...

  3. Overdose prevention in injecting opioid users: The role of substance abuse treatment and training programs

    Directory of Open Access Journals (Sweden)

    Ana Sarasa-Renedo

    2014-03-01

    Conclusions: These findings suggest that preventive programs would benefit from accounting for linguistic and educational limitations and from participation in every treatment episode. Comprehensiveness and broad coverage of such programs could help to maximize their impact.

  4. Multiplicity of Plasmodium falciparum infection following intermittent preventive treatment in infants

    NARCIS (Netherlands)

    Buchholz, Ulrike; Kobbe, Robin; Danquah, Ina; Zanger, Philipp; Reither, Klaus; Abruquah, Harry H.; Grobusch, Martin P.; Ziniel, Peter; May, Jürgen; Mockenhaupt, Frank P.

    2010-01-01

    Intermittent preventive treatment in infants with sulphadoxine-pyrimethamine (IPTi-SP) reduces malaria morbidity by 20% to 33%. Potentially, however, this intervention may compromise the acquisition of immunity, including the tolerance towards multiple infections with Plasmodium falciparum.

  5. Multiplicity of Plasmodium falciparum infection following intermittent preventive treatment in infants

    NARCIS (Netherlands)

    Buchholz, U.; Kobbe, R.; Danquah, I.; Zanger, P.; Reither, K.; Abruquah, H.H.; Grobusch, M.P.; Ziniel, P.; May, J.; Mockenhaupt, F.P.

    2010-01-01

    Background: Intermittent preventive treatment in infants with sulphadoxine-pyrimethamine (IPTi-SP) reduces malaria morbidity by 20% to 33%. Potentially, however, this intervention may compromise the acquisition of immunity, including the tolerance towards multiple infections with Plasmodium

  6. [Prevention, diagnosis and treatment of blood group immunization during pregnancy].

    Science.gov (United States)

    van Aken, W G; Christiaens, G C

    1999-12-11

    In the Netherlands last year two important policy changes were introduced to prevent haemolytic disease of the newborn: antenatal administration of anti RhD immunoglobulin and screening for antibodies against irregular erythrocyte antigens in all pregnant women. As the predictive value of such antibodies for the detection of hemolytic disease of the newborn is limited, it is uncertain if this measure is really cost-effective. Because blood transfusion is the most important probable cause of the immunization, and because of the clinical severity of anti-K antibodies, it is advised to give exclusively K negative blood to girls and women under the age of 45 years. In addition there is a need for a uniform protocol to deal with women who have been exposed to immunization.

  7. [Refeeding syndrome : Pathophysiology, risk factors, prevention, and treatment].

    Science.gov (United States)

    Wirth, R; Diekmann, R; Janssen, G; Fleiter, O; Fricke, L; Kreilkamp, A; Modreker, M K; Marburger, C; Nels, S; Pourhassan, M; Schaefer, R; Willschrei, H-P; Volkert, D

    2018-04-01

    Refeeding syndrome is a life-threatening complication that may occur after initiation of nutritional therapy in malnourished patients, as well as after periods of fasting and hunger. Refeeding syndrome can be effectively prevented and treated if its risk factors and pathophysiology are known. The initial measurement of thiamine level and serum electrolytes, including phosphate and magnesium, their supplementation if necessary, and a slow increase in nutritional intake along with close monitoring of serum electrolytes play an important role. Since refeeding syndrome is not well known and the symptoms can be extremely heterogeneous, this complication is poorly recognized, especially against the background of severe disease and multimorbidity. This overview aims to summarize the current knowledge and increase awareness about refeeding syndrome.

  8. Pollybeak Deformity in Middle Eastern Rhinoplasty: Prevention and Treatment.

    Science.gov (United States)

    Hussein, Wael K A; Foda, Hossam M T

    2016-08-01

    The pollybeak deformity is one of the commonest causes of revision rhinoplasty. The Middle Eastern nose has certain criteria that predispose to the development of pollybeak deformity. The aim of this study is to detect the factors contributing to the development of pollybeak deformity in the Middle Eastern nose and methods used to prevent as well as to treat such deformity. Out of the 1,160 revision patients included in this study, 720 (62%) patients had a pollybeak deformity. The commonest contributing factors included underprojected tip with poor support in 490 (68%) patients, excessive supratip scarring in 259 (36%) patients, overresected bony dorsum in 202 (28%) patients, and high anterior septal angle in 173 (24%) patients. The methods used by the authors to treat the pollybeak deformity are described, along with the local steroid injection protocol used to guard against the recurrence of pollybeak deformity. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

    Directory of Open Access Journals (Sweden)

    R.M. Torshkhoeva

    2006-01-01

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

  10. [Experiences of prevention and treatment of infectious diseases in Chinese Soviet Republic].

    Science.gov (United States)

    Tang, Guo-Ping

    2004-07-01

    Many kinds of infectious diseases had been prevalent during the Chinese Soviet Republic period. Experiences were accumulated during the fighting against these diseases, and high attention paid by the government including the party, the military and the administration, and strengthening of legislation for prevention and treatment works, with the Red Army as the main task force for the work, and the great mass actively involved in this work, with active propaganda for its prevention and treatment.

  11. Molecular Mechanisms Linking Exercise to Cancer Prevention and Treatment

    DEFF Research Database (Denmark)

    Hojman, Pernille; Gehl, Julie; Christensen, Jesper F.

    2018-01-01

    The benefits of exercise training for cancer patients are becoming increasingly evident. Physical exercise has been shown to reduce cancer incidence and inhibit tumor growth. Here we provide the status of the current molecular understanding of the effect of exercise on cancer. We propose...... that exercise has a role in controlling cancer progression through a direct effect on tumor-intrinsic factors, interplay with whole-body exercise effects, alleviation of cancer-related adverse events, and improvement of anti-cancer treatment efficacy. These findings have wide-ranging societal implications......, as this understanding may lead to changes in cancer treatment strategies. Hojman et al. discuss the role of exercise in controlling cancer progression through direct effects on tumor-intrinsic factors, interplay with whole-body exercise effects, alleviation of cancer-related adverse events, and improvement of cancer...

  12. Prevention and treatment of complicated urinary tract infection

    Directory of Open Access Journals (Sweden)

    Shingo Yamamoto

    2016-12-01

    Full Text Available A complicated urinary tract infection (UTI has relapsing and refractory characteristics, and is sometimes life-threatening because of patient predisposing factors as well as the recent worldwide spread of multi-drug resistant bacteria. Patients with complicated UTI should be treated with effective antimicrobial therapy along with appropriate urological intervention to remove predisposing factors when the symptoms are associated. By contrast, routine use of antimicrobial prophylaxis for asymptomatic bacteriuria (ASB is not recommended, as that would contribute to an increase in even more resistant pathogens. Here, four classifications of complicated UTI, which are considered to be clinically important for general urologists, are reviewed, including UTI in patients with diabetes mellitus (DM and those with a neurogenic bladder, as well as catheter-associated UTI (CAUTI and obstructive pyelonephritis secondary to urolithiasis. Appropriate treatment approaches can only be chosen by proper understanding of the etiologies of complicated UTI, as well as correct diagnostic strategies and treatment options.

  13. Prevention and treatment of vascular vagovagal reflexes in patients with cardiovascular disease during intervention

    International Nuclear Information System (INIS)

    Shao Mingfeng; Su Jingrong

    2002-01-01

    Objective: To study the prevention and treatment of vascular vagovagal reflexes (VVRs) in patients with cardiovascular disease during intervention. Methods: The causes and results in 61 patients with VVRs during intervention of 2100 patients were analysed. Results: In 61 patients with VVRs, there were 12 cases having vascular restriction, 7 cases with heart restriction, 42 cases with mixed type. All patients were recovered after treatment, no adverse reaction happened. Conclusions: The major causes of VVRs during interventional treatment were mental tension, pain, low blood volume and expansive stimulation of hollow organs. Preventive measure and prompt treatment are necessary

  14. Novel methods of hepatitis C treatment and prevention

    Directory of Open Access Journals (Sweden)

    Alicja M. Chmielewska

    2015-08-01

    Full Text Available Despite available treatment, Hepatitis C remains one of most serious burdens to public health. Current therapy based on pegylated interferon-alpha and ribavirin has significant side effects and its effectiveness varies for different genotypes of the virus. Four novel drugs – viral protease inhibitors (telaprevir, boceprevir, simeprevir and polymerase inhibitor – sofosbuvir have been introduced in last years for use in combination with standard-of-care treatment. For the first time interferon free therapies were approved with the use of combination of sofosbuvir+ribavirin. New therapies improve virological response rates but also increase the cost, side effects and raise the issue of drug resistance. Numerous novel anti-HCV compounds have been evaluated in advanced clinical trials including inhibitors of viral proteins (protease, polymerase and NS5A and inhibitors of host factors involved in HCV replication (cyclophilin A, microRNA – miR-122. New interferon-free therapies reducing severe side effects are expected to enter the market within few months. At the same time efforts are undertaken to determine the host and viral factors with predictive value for HCV treatment response, enabling personalized therapy approach. The main success in this field was the discovery of interleukin IL28B polymorphism, which correlates with positive standard-of-care treatment response. An effective vaccination may be an alternative for antiviral drugs, but no anti-HCV vaccine is available currently. It is well proved that successful vaccination should induce antibody and T-cell responses specific against a range of HCV genotypes. With this aim, new subunit and genetic candidate vaccines have been evaluated in I and II phase clinical trials. This review summarizes the recent developments in the field of new drug development and vaccine studies against hepatitis C virus.

  15. Prevention of biofilm formation in dialysis water treatment systems.

    Science.gov (United States)

    Smeets, Ed; Kooman, Jeroen; van der Sande, Frank; Stobberingh, Ellen; Frederik, Peter; Claessens, Piet; Grave, Willem; Schot, Arend; Leunissen, Karel

    2003-04-01

    Biofilm formations in dialysis systems may be relevant because they continuously release bacterial compounds and are resistant against disinfection. The aim of the study was to compare the development of biofilm between a water treatment system based on a single reverse osmosis unit producing purified dialysate water [bacterial count, 350 colony-forming unit (CFU)/L] (center A) and a water treatment system based on double reverse osmosis and electric deionization, which is continuously disinfected with ultraviolet light and treated with ozone once a week (bacterial count, 1 CFU/L) (center B). During a period of 12 weeks, biofilm formation was studied in the tubing segment between the water piping and the dialysis module, using four dialysis monitors in each center. On a weekly basis, tubing samples of 5 cm length (N = 96) were taken under aseptic conditions and investigated for microbiologic contamination [cystine lactose electrolyte-deficient (CLED) Agar], endotoxin levels [limulus amoeben lysate (LAL) gel test, cutoff value, 0.0125 EU/mL], and biofilm formation [electron scanning microscopy (SEM)]. In center A, tube cultures were positive (>100 CFU/mL) in 16% of samples at 22 degrees C and 37 degrees C, compared to 3% of samples of center B (P tubing samples of center A and negative in all of the samples of center B (P < 0.05). Biofilm was present in 91.7% of the samples of center A (Fig. 1), and only present in one sample (taken after 9 weeks) of center B (P < 0.05) (Fig. 2). In center A, biofilm formation was already observed after 1 week. In contrast to a standard water treatment system producing purified water, the use of a system producing highly purified water, which is also treated with regular disinfection procedures, leads to a significant reduction in biofilm formation, bacterial growth, and endotoxin levels in a highly vulnerable part of a water treatment system.

  16. Targeting Mitochondrial Bioenergetics for Alzheimer’s Prevention and Treatment

    OpenAIRE

    Yao, Jia; Brinton, Roberta Diaz

    2011-01-01

    Alzheimer’s is a neurodegenerative disease with a complex and progressive pathological phenotype characterized first by hypometabolism and impaired mitochondrial bioenergetics followed by pathological burden. The progressive and multifaceted degenerative phenotype of Alzheimer’s suggests that successful treatment strategies necessarily will be equally multi-faceted and disease stage specific. Traditional therapeutic strategies based on the pathological aspect of the disease have achieved succ...

  17. Synthetic prevention and treatment for hypothyroidism after radioiodine therapy hyperthyroidism

    International Nuclear Information System (INIS)

    Li Shiyun

    2004-01-01

    Hypothyroidism is main complication after 131 I therapy for hyperthyroidism in Graves' disease. The hypothyroidism restricts its popular application that 131 I treatment for Graves' disease. In clinic practice, different factors of every patient, involved case selection, sensitivity estimation, unite using medicine before 131 I therapy are analysed, and synthetic measures for posttreatment examination, transient hypothyroidism and permanent hypothyroidism after 131 I therapy are discussed

  18. [Prevention and treatment strategy for burn wound sepsis in children].

    Science.gov (United States)

    Niu, Xihua; Li, Xiaoling

    2016-02-01

    Wound sepsis is one of the main causes of death in patients with severe burn and trauma. The high incidence of burn wound sepsis in children is attributed to their imperfect immune system function, poor resistance against infection, and the weakened skin barrier function after burn. The key to reduce the mortality of pediatric patients with burn wound sepsis is to enhance the understanding of its etiology, epidemiology, pathogenesis, and diagnostic criteria, in order to improve its early diagnosis and treatment.

  19. Prevention

    Science.gov (United States)

    ... Error processing SSI file About Heart Disease & Stroke Prevention Heart disease and stroke are an epidemic in ... secondhand smoke. Barriers to Effective Heart Disease & Stroke Prevention Many people with key risk factors for heart ...

  20. Treatment of Oral Cavity Squamous Cell Carcinoma With Adjuvant or Definitive Intensity-Modulated Radiation Therapy

    International Nuclear Information System (INIS)

    Sher, David J.; Thotakura, Vijaya; Balboni, Tracy A.; Norris, Charles M.; Haddad, Robert I.; Posner, Marshall R.; Lorch, Jochen; Goguen, Laura A.; Annino, Donald J.; Tishler, Roy B.

    2011-01-01

    Purpose: The optimal management of oral cavity squamous cell carcinoma (OCSCC) typically involves surgical resection followed by adjuvant radiotherapy or chemoradiotherapy (CRT) in the setting of adverse pathologic features. Intensity-modulated radiation therapy (IMRT) is frequently used to treat oral cavity cancers, but published IMRT outcomes specific to this disease site are sparse. We report the Dana-Farber Cancer Institute experience with IMRT-based treatment for OCSCC. Methods and Materials: Retrospective study of all patients treated at Dana-Farber Cancer Institute for OCSCC with adjuvant or definitive IMRT between August 2004 and December 2009. The American Joint Committee on Cancer disease stage criteria distribution of this cohort included 5 patients (12%) with stage I; 10 patients (24%) with stage II (n = 10, 24%),; 14 patients (33%) with stage III (n = 14, 33%),; and 13 patients (31%) with stage IV. The primary endpoint was overall survival (OS); secondary endpoints were locoregional control (LRC) and acute and chronic toxicity. Results: Forty-two patients with OCSCC were included, 30 of whom were initially treated with surgical resection. Twenty-three (77%) of 30 surgical patients treated with adjuvant IMRT also received concurrent chemotherapy, and 9 of 12 (75%) patients treated definitively without surgery were treated with CRT or induction chemotherapy and CRT. With a median follow-up of 2.1 years (interquartile range, 1.1–3.1 years) for all patients, the 2-year actuarial rates of OS and LRC following adjuvant IMRT were 85% and 91%, respectively, and the comparable results for definitive IMRT were 63% and 64% for OS and LRC, respectively. Only 1 patient developed symptomatic osteoradionecrosis, and among patients without evidence of disease, 35% experienced grade 2 to 3 late dysphagia, with only 1 patient who was continuously gastrostomy-dependent. Conclusions: In this single-institution series, postoperative IMRT was associated with promising LRC

  1. Treatment of Oral Cavity Squamous Cell Carcinoma With Adjuvant or Definitive Intensity-Modulated Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Sher, David J., E-mail: dsher@lroc.harvard.edu [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Thotakura, Vijaya [Department of Medical Oncology, Dana-Farber Cancer Institute and Department of Medicine, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Balboni, Tracy A. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Norris, Charles M.; Haddad, Robert I.; Posner, Marshall R.; Lorch, Jochen [Department of Medical Oncology, Dana-Farber Cancer Institute and Department of Medicine, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Goguen, Laura A.; Annino, Donald J. [Department of Surgery, Division of Otolaryngology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Tishler, Roy B. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States)

    2011-11-15

    Purpose: The optimal management of oral cavity squamous cell carcinoma (OCSCC) typically involves surgical resection followed by adjuvant radiotherapy or chemoradiotherapy (CRT) in the setting of adverse pathologic features. Intensity-modulated radiation therapy (IMRT) is frequently used to treat oral cavity cancers, but published IMRT outcomes specific to this disease site are sparse. We report the Dana-Farber Cancer Institute experience with IMRT-based treatment for OCSCC. Methods and Materials: Retrospective study of all patients treated at Dana-Farber Cancer Institute for OCSCC with adjuvant or definitive IMRT between August 2004 and December 2009. The American Joint Committee on Cancer disease stage criteria distribution of this cohort included 5 patients (12%) with stage I; 10 patients (24%) with stage II (n = 10, 24%),; 14 patients (33%) with stage III (n = 14, 33%),; and 13 patients (31%) with stage IV. The primary endpoint was overall survival (OS); secondary endpoints were locoregional control (LRC) and acute and chronic toxicity. Results: Forty-two patients with OCSCC were included, 30 of whom were initially treated with surgical resection. Twenty-three (77%) of 30 surgical patients treated with adjuvant IMRT also received concurrent chemotherapy, and 9 of 12 (75%) patients treated definitively without surgery were treated with CRT or induction chemotherapy and CRT. With a median follow-up of 2.1 years (interquartile range, 1.1-3.1 years) for all patients, the 2-year actuarial rates of OS and LRC following adjuvant IMRT were 85% and 91%, respectively, and the comparable results for definitive IMRT were 63% and 64% for OS and LRC, respectively. Only 1 patient developed symptomatic osteoradionecrosis, and among patients without evidence of disease, 35% experienced grade 2 to 3 late dysphagia, with only 1 patient who was continuously gastrostomy-dependent. Conclusions: In this single-institution series, postoperative IMRT was associated with promising LRC

  2. Definition and outcome of a curriculum to prevent disordered eating and body-shaping drug use.

    Science.gov (United States)

    Elliot, Diane L; Moe, Esther L; Goldberg, Linn; DeFrancesco, Carol A; Durham, Melissa B; Hix-Small, Hollie

    2006-02-01

    Almost one half of male and female students participate in high school-sponsored athletics, and high school also is a time when classroom health promotion curricula are less effective. The Athletes Training and Learning to Avoid Steroids is a sport team-centered drug-use prevention program for male high school athletes, which has been shown to reduce alcohol and illicit drug use. Just as anabolic steroid use is associated with male athletes, female sport participants may be at a greater risk for disordered eating and body-shaping drug use. Extending sport team-centered programs to young women athletes required defining and ranking factors related to developing those harmful behaviors. Survey results from a cross-sectional cohort of female middle and high school student athletes were used to identify and prioritize potential curriculum components, including mood and self-esteem, norms of behavior, perceptions of healthy body weight, effects of media depictions of women, and societal pressures to be thin. The derived sport team-centered program was prospectively assessed among a second group of female student athletes from 18 high schools, randomized to receive the intervention or the usual care control condition. The Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) intervention is a scripted, coach-facilitated, peer-led 8-session program, which was incorporated into a team's usual training activities. The ATHENA program significantly altered the targeted risk factors and reduced ongoing and new use of diet pills and body-shaping substances (amphetamines, anabolic steroids, and sport supplements). These findings illustrate the utility of a structured process to define curriculum content, and the program's positive results also confirm the sport team's potential as a vehicle to effectively deter health-harming behaviors.

  3. The prevention and treatment of radiotherapy induced nausea and vomiting

    International Nuclear Information System (INIS)

    Van Zyl, A.J.

    1992-11-01

    Nausea and vomiting are side-effects that are associated with chemo- and radiotherapy. A single-blind study to compare the efficacy and safety of intravenous granisetron (G) with metoclopramide (M) plus dexamethasone (D) in the prophylaxis and control of nausea and emesis in patients undergoing hemi-body irradiation (HBI) was performed. G (3 mg) or M (20 mg) plus D (12 mg) were given intravenously, thirty minutes prior to the start of radiotherapy. Patients were monitored for nausea, vomiting and side-effects. Thirty-five patients were treated, 28 men and 7 women. A total of 21 (60%) patients did not vomit during the first 24 hours after the start of radiotherapy. Both G and M plus D offer safe and effective anti-emetic regimes for the prophylaxis and control of radiotherapy induced nausea and vomiting. However, granisetron was found to be more effective than metoclopramide plus dexamethasone in preventing nausea and vomiting. 101 refs., 40 tabs., 8 figs

  4. [Nutritional deficiencies in bariatric surgery patients: prevention, diagnosis and treatment].

    Science.gov (United States)

    Schweiger, Chaya; Keidar, Andrei

    2010-11-01

    The number of people suffering from surgery and obesity in the western world is constantly growing. In 1997 the World Health Organization (WHO) defined obesity as a plague and one of greatest public health hazards of our time. The National Institution of Health (NIH) declared that surgery is the only long-term solution for obesity. Today there are four different types of bariatric surgery. Each variation has different implications on the nutritional status of bariatric surgery patients. Bariatric surgery candidates are at risk of developing vitamin and mineral nutritional deficiencies in the post-operative stage, due to vomiting, decrease in food intake, food intolerance, diminution of gastric secretions and bypass of absorption area. It is easier and more efficient to treat nutritional deficiencies in the preoperative stage. Therefore, preoperative detection and correction are crucial. Blood tests before surgery to detect and treat nutritional deficiencies are crucial. In the postoperative period, blood tests should be conducted every 3 months in the first year after operation, every six months in the second year and annually thereafter. Multivitamin is recommended to prevent nutritional deficiencies in all bariatric surgery patients. Furthermore, iron, calcium, Vitamin D and B12 are additionally recommended for Roux-en-Y Gastric Bypass patients. Patients with Biliopancreatic diversion and Duodenal Switch should also take fat soluble vitamins.

  5. PHARMACEUTICAL AEROSOLS FOR THE TREATMENT AND PREVENTION OF TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    Shumaila N Muhammad Hanif

    2012-09-01

    Full Text Available Historically, pharmaceutical aerosols have been employed for the treatment of obstructive airway diseases, such as asthma and chronic obstructive pulmonary disease, but in the past decades their use has been expanded to treat lung infections associated with cystic fibrosis and other respiratory diseases. Tuberculosis (TB is acquired after inhalation of aerosol droplets containing the bacilli from the cough of infected individuals. Even though TB affects other organs, the lungs are the primary site of infection, which makes the pulmonary route an ideal alternative route to administer vaccines or drug treatments. Optimization of formulations and delivery systems for anti-TB vaccines and drugs, as well as the proper selection of the animal model to evaluate those is of paramount importance if novel vaccines or drug treatments are to be successful. Pharmaceutical aerosols for patient use are generated from metered dose inhalers, nebulizers and dry powder inhalers. In addition to the advantages of providing more efficient delivery of the drug, low cost and portability, pharmaceutical dry powder aerosols are more stable than inhalable liquid dosage forms and do not require refrigeration. Methods to manufacture dry powders in respirable sizes include micronization, spray drying and other proprietary technologies. Inhalable dry powders are characterized in terms of their drug content, particle size and dispersibility to ensure deposition in the appropriate lung region and effective aerosolization from the device. These methods will be illustrated as they were applied for the manufacture and characterization of powders containing anti-tubercular agents and vaccines for pulmonary administration. The influence of formulation, selection of animal model, method of aerosol generation and administration on the efficacy demonstrated in a given study will be illustrated by the evaluation of pharmaceutical aerosols of anti-TB drugs and vaccines in guinea pigs by

  6. Strategies for prevention and treatment of staphylococcal biofilms

    DEFF Research Database (Denmark)

    Meyer, Rikke Louise

    Biofilm formation by bacteria that colonize biomedical implants cause infections that cannot be eradicated by antibiotic therapy. Bacteria in biofilms are tolerant to every antibiotic known today, and this tolerance is partly due to their low metabolic activity, the occurrence of persister cells...... in biofilms. Innovative biomaterials may at best delay biofilm formation and an important question in this context is to understand how the material can contribute to more successful antibiotic treatment by not providing the cues that trigger the onset of antibiotic tolerance in the attached bacteria...

  7. [Spontaneous bacterial peritonitis in liver cirrhosis: optimization issues of prevention and treatment].

    Science.gov (United States)

    Vinnitskaia, E V; Drozdov, V N; Petyrakov, A V; Sil'vestrova, S Iu; Brezgin, A G

    2012-01-01

    Research of features of a current of a spontaneous bacterial peritonitis (SBP) allows to allocate close interrelation between SBP, system inflammatory reaction and a sepsis to consider SBP, as one of stages in evolution of the difficult infectious process caused, as a rule, by resident flora, developing at patients with decompensated liver cirrhosis (LC), which demands timely preventive maintenance and adequate antibacterial therapy. In the present work therapy and preventive maintenance SBP questions are considered. In article the extensive review of the data of the literature and own supervision by efficiency of treatment SBP also is presented. For the purpose of optimization of pharmacotherapy of the sick LC, the complicated ascites, had been conducted pharmacokinetics research ciprofloxacin (CPF) according to dynamics of its maintenance in blood serum (BS) and ascitic fluid (AF) depending on presence and ascites size. Materials and methods. Researches are spent 18 sick decompensated liver cirrhosis (a class B and C on Ch-P), without signs SBP after unitary reception of 500 mg CPF per os on an empty stomach. All patients have been divided on two groups: I gr. (n = 10) with the expressed, intense ascites (> 10 1) and II gr. (n = 8) with the moderate, small ascites. Definition CPF in BS also was already carried out by a method of a highly effective liquid chromatography. On the basis of the received data for each patient counted the semidelucing period (T1/2), the area under pharmacokinetic curve (curve concentration - time) - (AUC), volume of distribution of a preparation (Avd), factor AUC(AF)\\MIC (size of the relation of the area under pharmacokinetic curve to its minimum inhibitive concentration). Results of research have shown that concentration levels (C) (CPF in BS and AF for the given concrete patient are at one level, showing thus distinctions in dynamic behavior. Average value AUC(AF)\\MIC (MIC - minimum inhibitive concentration) at patients II gr. has

  8. Prevention of atrial fibrillation in patients with aortic valve stenosis with candesartan treatment after aortic valve replacement

    DEFF Research Database (Denmark)

    Dahl, J. S.; Videbaek, L.; Poulsen, M. K.

    2013-01-01

    Background: Accumulating data has suggested that treatment with Angiotensin-II receptor antagonists can prevent the new onset of atrial fibrillation (AF). The aim of this study was to evaluate whether treatment with candesartan on top of conventional treatment could prevent new onset AF in patien...... with candesartan may prevent the new onset of atrial fibrillation. (C) 2011 Elsevier Ireland Ltd. All rights reserved....

  9. Antibody-Mediated Rejection: Pathogenesis, Prevention, Treatment, and Outcomes

    Directory of Open Access Journals (Sweden)

    Olivia R. Blume

    2012-01-01

    Full Text Available Antibody-mediated rejection (AMR is a major cause of late kidney transplant failure. It is important to have an understanding of human-leukocyte antigen (HLA typing including well-designed studies to determine anti-MHC-class-I-related chain A (MICA and antibody rejection pathogenesis. This can allow for more specific diagnosis and treatment which may improve long-term graft function. HLA-specific antibody detection prior to transplantation allows one to help determine the risk for AMR while detection of DSA along with a biopsy confirms it. It is now appreciated that biopsy for AMR does not have to include diffuse C4d, but does require a closer look at peritubular capillary microvasculature. Although plasmapheresis (PP is effective in removing alloantibodies (DSAs from the circulation, rebound synthesis of alloantibodies can occur. Splenectomy is used in desensitization protocols for ABO incompatible transplants as well as being found to treat AMR refractory to conventional treatment. Also used are agents targeted for plasma cells, B cells, and the complement cascade which are bortezomib rituximab and eculizumab, respectively.

  10. [Pay attention to the prevention and treatment of retinopathy of prematurity in China].

    Science.gov (United States)

    Wang, Yu-sheng; Li, Rong

    2011-06-01

    Retinopathy of prematurity (ROP) remains the major cause of childhood blindness in developing countries. Visual prognosis in ROP can be improved if the patients can receive early treatment. Therefore, establishing a perfect prevention and treatment system is the key to reduce blindness rate caused by ROP. The situation of ROP in China is serious and the prevention of ROP remains inadequate. Therefore, the government and medical personnel should pay more attention to its prevention. It is necessary to set-up more prevention centers to screen, diagnose and treat ROP, as well as to afford disease propaganda and follow-up care. These centers can build collaborative relationship by means of professional networks to improve the prevention efficiency of ROP in China.

  11. Novel Nanotechnology Strategies for the Treatment and Prevention of HIV Infection

    Science.gov (United States)

    Tan, Jian Jun; Sun, Xiao Hui; Ma, Xue Ting; Guan, Jian Qing; Wang, Cun Xin

    2013-09-01

    It is a hard work to develop an hightly effective cure and prevention of HIV/AIDS. The widespread used of some therapy approaches such as highly active anti retroviral therapy (HAART) has improved life quality and span of infected individuals. However, some limitations of these approaches prevent them achieving further advancement. Recent research on drug delivery approaches indicates that engineered nanosystems may bring positive effect on the improvement of current antiretroviral therapy. Furthermore, the basic researches of nanotechnology- based systems which prevent HIV transmission have been started. Therefore, nanotechnology may become a potential approach in the field of HIV/AIDS treatment and prevention. This chapter reviews the latest advancement in the field of nanotechnology-based systems which improve the fields of HIV/AIDS treatment and prevention.

  12. Age-related macular degeneration: prevention and treatment. A review

    Directory of Open Access Journals (Sweden)

    K. A. Mirzabekova

    2014-07-01

    Full Text Available Age-related macular degeneration (AMD is a multifactorial disease. Age, light exposure, smoking, melanin levels and low-antioxidant diet are contributed to AMD development and progression. Cardiovascular disorders are of considerable importance as well. In macula, photoreceptor outer segments that are rich in polyunsaturated fatty acids (FA, particularly, docosahexaenoic acid (DHA, are susceptible to free radicals damage. High blood flow velocity and oxygen partial pressure as well as direct sunlight exposure induce oxidative processes. The source of free radicals in photoreceptor cells and retinal pigment epithelium (RPE is an extensive mitochondrial metabolism, photoreceptor outer segments phagocytosis, lipofuscin phototoxic activity and hemoglobin or protoporphyrin precursors photosensitization. Oxidative stress is considered as an universal component of cell depth in necrosis, apoptosis and toxic damage. Antioxidant protective system consists of enzymes (superoxide dismutase, glutathione peroxidase and catalase and non-enzymatic factors (ascorbic acid, alpha tocopherol, retinol, carotenoids. Specific antioxidant food supplement containing ascorbic acid (500 mg, vitamin E (400 IU and beta carotene (15 mg coupled with zinc (80 mg of zinc oxide and copper (2 mg of copper oxide results in 25 % decrease in late-stage AMD development rate. Amongst the agents that can protect retina from oxidative stress and AMD development, carotenoids are of special importance. Lutein and zeaxanthin containing in retina and lens screen blue light from central area of the retina. They also absorb blue light and inhibit free radicals generation thus preventing polyunsaturated FA light destruction. Association between lutein and zeaxanthin intake and late-stage AMD risk was revealed. Amongst the most important factors which deficiency favors macular degeneration are omega-3 FAs, i.e., DHA. DHA is the key component of visual pigment rhodopsin transformation. It

  13. Age-related macular degeneration: prevention and treatment. A review

    Directory of Open Access Journals (Sweden)

    K. A. Mirzabekova

    2014-01-01

    Full Text Available Age-related macular degeneration (AMD is a multifactorial disease. Age, light exposure, smoking, melanin levels and low-antioxidant diet are contributed to AMD development and progression. Cardiovascular disorders are of considerable importance as well. In macula, photoreceptor outer segments that are rich in polyunsaturated fatty acids (FA, particularly, docosahexaenoic acid (DHA, are susceptible to free radicals damage. High blood flow velocity and oxygen partial pressure as well as direct sunlight exposure induce oxidative processes. The source of free radicals in photoreceptor cells and retinal pigment epithelium (RPE is an extensive mitochondrial metabolism, photoreceptor outer segments phagocytosis, lipofuscin phototoxic activity and hemoglobin or protoporphyrin precursors photosensitization. Oxidative stress is considered as an universal component of cell depth in necrosis, apoptosis and toxic damage. Antioxidant protective system consists of enzymes (superoxide dismutase, glutathione peroxidase and catalase and non-enzymatic factors (ascorbic acid, alpha tocopherol, retinol, carotenoids. Specific antioxidant food supplement containing ascorbic acid (500 mg, vitamin E (400 IU and beta carotene (15 mg coupled with zinc (80 mg of zinc oxide and copper (2 mg of copper oxide results in 25 % decrease in late-stage AMD development rate. Amongst the agents that can protect retina from oxidative stress and AMD development, carotenoids are of special importance. Lutein and zeaxanthin containing in retina and lens screen blue light from central area of the retina. They also absorb blue light and inhibit free radicals generation thus preventing polyunsaturated FA light destruction. Association between lutein and zeaxanthin intake and late-stage AMD risk was revealed. Amongst the most important factors which deficiency favors macular degeneration are omega-3 FAs, i.e., DHA. DHA is the key component of visual pigment rhodopsin transformation. It

  14. Prevention and treatment of venous thromboembolism in the elderly patient

    Directory of Open Access Journals (Sweden)

    Enrico Tincani

    2007-07-01

    Full Text Available Enrico Tincani1, Mark A Crowther2, Fabrizio Turrini1, Domenico Prisco31Unità Operativa di Medicina Interna Cardiovascolare, Nuovo Ospedale Civile di Modena S.Agostino-Estense, Modena, Italy; 2McMaster University, St. Joseph’s Hospital and McMaster University, Hamilton, Canada; 3Dipartimento di Area Critica Medico Chirurgica, Universita’ di Firenze, Florence, ItalyAbstract: Venous thromboembolism (VTE is a common complication among hospitalized patients. Pharmacological thromboprophylaxis has emerged as the cornerstone for VTE prevention. As trials on thromboprophylaxis in medical patients have proven the efficacy of both lowmolecular-weight heparins (LMWHs and unfractionated heparin (UFH, all acutely medical ill patients should be considered for pharmacological thromboprophylaxis. Unlike in the surgical setting where the risk of associated VTE attributable to surgery is well recognized, and where widespread use of pharmacological thromboprophylaxis and early mobilization has resulted in significant reductions in the risk of VTE, appropriate VTE prophylaxis is under-used in medical patients. Many reasons for this under-use have been identified, including low perceived risk of VTE in medical patients, absence of optimal tools for risk assessment, heterogeneity of patients and their diseases, and fear of bleeding complications. A consistent group among hospitalized medical patients is composed of elderly patients with impaired renal function, a condition potentially associated with bleeding. How these patients should be managed is discussed in this review. Particular attention is devoted to LMWHs and fondaparinux and to measures to improve the safety and the efficacy of their use.Keywords: venous thromboembolism, elderly patient, fondaparinux

  15. 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.

  16. Steroid-associated osteonecrosis: Epidemiology, pathophysiology, animal model, prevention, and potential treatments (an overview

    Directory of Open Access Journals (Sweden)

    Xin-Hui Xie

    2015-04-01

    Full Text Available Steroid-associated osteonecrosis (SAON is a common orthopaedic problem caused by administration of corticosteroids prescribed for many nonorthopaedic medical conditions. We summarised different pathophysiologies of SAON which have adverse effects on multiple systems such as bone marrow stem cells (BMSCs pool, bone matrix, cell apoptosis, lipid metabolism, and angiogenesis. Different animal models were introduced to mimic the pathophysiology of SAON and for testing the efficacy of both prevention and treatment effects of various chemical drugs, biological, and physical therapies. According to the classification of SAON, several prevention and treatment methods are applied at the different stages of SAON. For the current period, Chinese herbs may also have the potential to prevent the occurrence of SAON. In the future, genetic analysis might also be helpful to effectively predict the development of ON and provide information for personalised prevention and treatment of patients with SAON.

  17. Dyslipidemias and Cardiovascular Prevention: Tailoring Treatment According to Lipid Phenotype.

    Science.gov (United States)

    Sanin, Veronika; Pfetsch, Vanessa; Koenig, Wolfgang

    2017-07-01

    This study aimed to present the current information on the genetic background of dyslipidemias and provide insights into the complex pathophysiological role of several plasma lipids/lipoproteins in the pathogenesis of atherosclerotic cardiovascular disease. Furthermore, we aim to summarize established therapies and describe the scientific rationale for the development of novel therapeutic strategies. Evidence from genetic studies suggests that besides lowering low-density lipoprotein cholesterol, pharmacological reduction of triglyceride-rich lipoproteins, or lipoprotein(a) will reduce risk for coronary heart disease. Dyslipidemia, in particular hypercholesterolemia, is a common clinical condition and represents an important determinant of atherosclerotic vascular disease. Treatment decisions are currently guided by the causative lipid phenotype and the presence of other risk factors suggesting a very high cardiovascular risk. Therefore, the identification of lipid disorders and the optimal combination of therapeutic strategies provide an outstanding opportunity for reducing the onset and burden of cardiovascular disease.

  18. Highly active antiretroviral treatment as prevention of HIV transmission: review of scientific evidence and update.

    Science.gov (United States)

    Granich, Reuben; Crowley, Siobhan; Vitoria, Marco; Smyth, Caoimhe; Kahn, James G; Bennett, Rod; Lo, Ying-Ru; Souteyrand, Yves; Williams, Brian

    2010-07-01

    An estimated 33 million people are living with HIV and universal access remains a dream for millions of people. By the end of year 2008, four million people were on treatment; however, over five million needed treatment, and in 2007, there were 2.7 million new infections. Without significant improvement in prevention, we are unlikely to meet universal access targets including the growing demand for highly active antiretroviral treatment (HAART). This review examines HAART as a potential tool for preventing HIV transmission. We discuss recent scientific evidence regarding the treatment and prevention gap, importance viral load and HIV transmission, HAART and HIV transmission, when to start, HIV counseling and testing, modeling results and next steps. HAART has considerable treatment and prevention benefits and it needs to be considered as a key element of combination prevention. To explore HAART as an effective prevention strategy, we recommend further evaluation of human rights and ethical considerations, clarification of research priorities and exploration of feasibility and acceptability issues.

  19. Intraoperative radiotherapy in the definitive treatment of localized carcinoma of the prostate

    International Nuclear Information System (INIS)

    Takahashi, M.; Okada, K.; Shibamoto, Y.; Abe, M.; Yoshida, O.

    1985-01-01

    A preliminary analysis of the effectiveness of intraoperative radiotherapy with an electron beam for the treatment of prostatic cancer in 14 patients is presented. The perineal approach was employed as an operative procedure for placing a treatment cone onto the tumor. The electron energy used for irradiation ranged from 10 to 14 MeV. Of five patients treated by intraoperative radiotherapy alone, four who received single doses of 3000 to 3500 cGy achieved local control. A single dose of 2000 or 2500 cGy was delivered intraoperatively to nine patients as a boost dose in conjunction with external irradiation of 5000 cGy for the treatment of pelvic lymph nodes. All nine patients achieved local control. None of the 14 patients developed any serious complication of the bladder, urethra or rectum, which has been associated with intraoperative electron irradiation. Although no definite conclusion can be drawn at present because of the small number of patients and insufficient follow-up, the results suggest that single doses of 3300 cGy by intraoperative radiotherapy alone or 2500 cGy as a boost in conjunction with external radiotherapy can be curative for prostatic cancer with minimal moribidity

  20. A Randomized Controlled Trial of an Online Relapse Prevention Program for Adolescents in Substance Abuse Treatment

    Science.gov (United States)

    Trudeau, Kimberlee J.; Black, Ryan A.; Kamon, Jody L.; Sussman, Steve

    2017-01-01

    Background: An Internet-based relapse prevention supplement to adolescent substance abuse treatment programming is a promising modality to reinforce treatment gains and enhance recovery; however, an evidence base is lacking. Objective: To assess the efficacy of the online Navigating my Journey (NmJ) program. Methods: 129 adolescent-aged…

  1. Role of Phytosterols in Cancer Prevention and Treatment.

    Science.gov (United States)

    Ramprasath, Vanu Ramkumar; Awad, Atif B

    2015-01-01

    Plant sterols or phytosterols have been shown to be effective in improving blood lipid profile and thereby protective against cardiovascular disease. In addition to their cardioprotective effects, phytosterols have gained more insight for their protective effect against various forms of cancer. Phytosterols have been reported to alleviate cancers of breast, prostate, lung, liver, stomach and ovary. Reductions in growth of various cancer cells including liver, prostate and breast by phytosterols treatment have been demonstrated. Although exact mechanisms of phytosterols for their anticancer effects are not very well delineated, there have been several mechanisms proposed such as inhibition of carcinogen production, cancer cell growth and multiplication, invasion and metastasis and induction of cell cycle arrest and apoptosis. Other mechanisms including reduction of angiogenesis, invasion and adhesion of cancer cells and production of reactive oxygen species have also been suggested. However, cancer therapy using phytosterol formulations have yet to be designed, largely due to the gap in the literature with regards to mode of action. Furthermore, most of the studies on anticancer effects of phytosterols were conducted in vitro and animal studies and need to be confirmed in humans.

  2. Sex differences in drug abuse: Etiology, prevention, and treatment.

    Science.gov (United States)

    Evans, Suzette M; Reynolds, Brady

    2015-08-01

    This special issue exemplifies one of the major goals of the current editor of Experimental and Clinical Psychopharmacology (Dr. Suzette Evans): to increase the number of manuscripts that emphasize females and address sex differences. Taken together, these articles represent a broad range of drug classes and approaches spanning preclinical research to treatment to better understand the role of sex differences in drug abuse. While not all studies found sex differences, we want to emphasize that finding no sex difference is just as important as confirming one, and should be reported in peer-reviewed journals. It is our intention and hope that this special issue will further advance scientific awareness about the importance of accounting for sex differences in the study of substance abuse. Participant sex is an essential variable to consider in developing a more comprehensive understanding of substance abuse. Rather than viewing investigating sex differences as burdensome, investigators should seize this opportune area ripe for innovative research that is long overdue. (c) 2015 APA, all rights reserved).

  3. Hemodialysis Catheter Heat Transfer for Biofilm Prevention and Treatment.

    Science.gov (United States)

    Richardson, Ian P; Sturtevant, Rachael; Heung, Michael; Solomon, Michael J; Younger, John G; VanEpps, J Scott

    2016-01-01

    Central line-associated bloodstream infections (CLABSIs) are not easily treated, and many catheters (e.g., hemodialysis catheters) are not easily replaced. Biofilms (the source of infection) on catheter surfaces are notoriously difficult to eradicate. We have recently demonstrated that modest elevations of temperature lead to increased staphylococcal susceptibility to vancomycin and significantly soften the biofilm matrix. In this study, using a combination of microbiological, computational, and experimental studies, we demonstrate the efficacy, feasibility, and safety of using heat as an adjuvant treatment for infected hemodialysis catheters. Specifically, we show that treating with heat in the presence of antibiotics led to additive killing of Staphylococcus epidermidis with similar trends seen for Staphylococcus aureus and Klebsiella pneumoniae. The magnitude of temperature elevation required is relatively modest (45-50°C) and similar to that used as an adjuvant to traditional cancer therapy. Using a custom-designed benchtop model of a hemodialysis catheter, positioned with tip in the human vena cava as well as computational fluid dynamic simulations, we demonstrate that these temperature elevations are likely achievable in situ with minimal increased in overall blood temperature.

  4. SIALOLITHIASIS IN PATIENTS WITH THYROID CANCER: TREATMENT, REHABILITATION AND PREVENTION

    Directory of Open Access Journals (Sweden)

    Doklaeva Malika Nurdynovna

    2013-04-01

    Full Text Available Diseases of the salivary glands is one of the most frequent pathologies among dental patients. Salivolithiasis is most common among the diseases of the salivary glands. Half of the patients after the surgery relapse stone formation. One of the etiological causes salivolithiasis is a violation of mineral metabolism. Known effects of thyroid hormones on the balance of bone remodeling. The aim of our study was to improve treatment of patients with salivolithiasis in thyroid pathology. Materials and methods. To determine thyroid function in patients were studied: thyroid-stimulating hormone (TSH, free thyroxine (free T4.. State of mineral metabolism was assessed by content in the blood calcium-regulating hormones parathyrin (PTH (pg / ml and calcitonin (CAT (pg / ml, a marker of bone resorption-Cross laps (ng / ml and bone formation - osteocalcin (ng / ml. Postoperatively, the patients were divided into two groups: the first consisted of patients with preoperative correction of thyroid status at the doctor, endocrinologist, the second (control - without preoperative correction of thyroid status doctor endocrinologist. Results. In the control group of patients compared with the group that received the necessary correction, much heavier passed the postoperative period. Output. Reasonable pharmacological correction in violation of mineral metabolism in patients with calculous sialadenitis is the best procedure that can reduce the number of complications such as acute exacerbations of chronic sialadenitis.

  5. Lymph Node Failure Pattern and Treatment Results of Esophageal Cancer Patients Treated with Definitive Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sun Young; Kwon, Hyoung Cheol; Kim, Jung Soo [Chonbuk National University Hospital, Jeonju (Korea, Republic of); Lee, Heui Kwan [The Catholic University of Korea, Seoul (Korea, Republic of); Kim, Soo Geon [Jesushospital, Jeonju (Korea, Republic of)

    2008-06-15

    We evaluated the failure pattern of the celiac axis, gastric lymph node, and treatment outcome in the upper and mid-esophageal region of cancer patients treated by definitive radiotherapy, except when treating the celiac axis and gastric lymph node for treatment volume, retrospectively. Materials and Methods: The study constituted the evaluation 108 patients with locally advanced esophageal cancer receiving radiotherapy or a combination of radiotherapy and chemotherapy at Chonbuk National University Hospital from January 1986 to December 2006. In total, 82 patients treated by planned radiotherapy, except when treating the celiac axis and gastric lymph node for treatment volume, were analysed retrospectively. The study population consisted of 78 men and 2 women (mean age of 63.2 years). In addition, 51 patients received radiotherapy alone, whereas 31 patients received a combination of radiation therapy and chemotherapy. The primary cancer sites were located in the upper portion (17 patients), and mid portion (65 patients), respectively. Further, the patients were in various clinical stages including T1N0-1M0 (7 patients), T2N0-1M0 (18 patients), T3N0-1M0 (44 patients) and T4N0-1M0 (13 patients). The mean follow up period was 15 months. Results: The various treatment outcomes included complete response (48 patients), partial response (31 patients) and no response (3 patients). The failure patterns of the lymph node were comprised of the regional lymph node (23 patients) and the distance lymph node which included celiac axis and gastric lymph node (13 patients). However, metastasis was not observed in the regional and distant lymph node in 10 patients, whereas 36 patients were not evaluated. Furthermore, of the 13 patients who developed celiac axis and gastric lymph node metastases, 3 were in stage T1N0-1M0 and 10 were in stage T2-4N0-1M0. A complete response appeared in 12 patients, whereas a partial response appeared in 1 patient. The mean survival time of the

  6. Delivery Unit Costs for Antiretroviral Treatment and Prevention of Mother-to-Child-Transmission of HIV

    Science.gov (United States)

    Galárraga, Omar; Wirtz, Veronika J.; Figueroa-Lara, Alejandro; Santa-Ana-Tellez, Yared; Coulibaly, Ibrahima; Viisainen, Kirsi; Medina-Lara, Antonieta; Korenromp, Eline L.

    2013-01-01

    Background As antiretroviral treatment (ART) for HIV/AIDS is scaled-up globally, information on per-person costs is critical to improve efficiency in service delivery and maximize coverage and health impact. Objective To review studies on delivery unit costs for adult and pediatric ART provision per-patient-year, and prevention of mother-to-child transmission (PMTCT) interventions per mother-infant pair screened or treated, in low- and middle-income countries. Methods Systematic review of English, French and Spanish publications from 2001 to 2009, reporting empirical costing that accounted for at least antiretroviral (ARV) medicines, laboratory testing and personnel. Expenditures were analyzed by country income level and cost component. All costs were standardized to 2009 US dollars. Results Analyses covered 29 eligible, comprehensive costing studies. In the base case, in low-income countries (LIC), median, ART cost per patient-year was $792 (mean: $839, range: $682-$1089); for lower-middle-income countries (LMIC), the median was $932 (mean: $1246, range: $156-$3904); and for upper-middle-income countries (UMIC) the median was $1454 (mean: $2783, range: $1230-$5667). ARV drugs were largest component of overall ART cost in all settings (62%, 50% and 47% in LIC, LMIC and UMIC respectively). Out of 26 ART studies, 14 report which drug regimes were used, and only one study explicitly reported second line treatment costs. The second cost driver was laboratory cost in LIC and LMIC (14% and 19.5%) whereas it was personnel costs in UMIC (26%). Two studies specified the types of laboratory tests costed, and three studies specifically included above-facility-level personnel costs. Three studies reported detailed PMTCT costs, and two studies reported on pediatric ART. Conclusions There is a paucity of data on the full ART and PMTCT delivery unit costs, in particular for low-and middle-income countries. Heterogeneity in activities costed and insufficient detail regarding

  7. Prevention and treatment of peripheral neuropathy after bariatric surgery.

    Science.gov (United States)

    Rudnicki, Stacy A

    2010-01-01

    Given the ever-increasing problem of obesity, it is not surprising that the number of patients who undergo bariatric surgery continues to rise. For patients who have gastric banding, the amount of food they can consume is limited, and nausea and vomiting may further limit nutritional intake early on. More extensive procedures, such as the Roux-en-Y or biliopancreatic diversion with or without a duodenal switch, not only restrict intake but also limit absorption in the small intestine. As a result, deficiencies in vitamins, minerals, and trace elements may develop, leading to a variety of neurologic complications. The peripheral neuropathies best described with a clear-cut cause are an acute, frequently painful neuropathy or polyradiculoneuropathy associated with thiamine deficiency, and an isolated neuropathy or myeloneuropathy associated with deficiencies of either vitamin B12 or copper. Thiamine deficiency tends to occur in the first weeks or months after surgery, vitamin B12 deficiency may develop at any time from a few years to many years after surgery, and copper deficiency tends to be a fairly late complication, developing several years to many years following surgery. Patients who have undergone bariatric surgery may also have an increased risk of developing focal neuropathies, though these are less clearly related to specific nutritional deficiencies.Ideally, one would like to prevent these neuropathies, but there is no consensus of opinion as to what vitamins and micronutrients need to be taken following bariatric surgery. In addition, many patients who take supplements early on fail to maintain the regimen even though some of the neuropathies can occur fairly late. Supplements frequently recommended include a multivitamin, iron, vitamin D, folic acid, calcium citrate, and vitamin B12. Although thiamine is typically included in a multivitamin, the amount is fairly small, so I recommend adding 100 mg daily for at least the first year. Some have suggested

  8. Error prevention in radiotherapy treatments using a record and verify system

    International Nuclear Information System (INIS)

    Navarrete Campos, S.; Hernandez Vitoria, A.; Canellas Anoz, M.; Millan Cebrian, E.; Garcia Romero, A.

    2001-01-01

    Computerized record-and-verify systems (RVS) are being used increasingly to improve the precision of radiotherapy treatments. With the introduction of new treatment devices, such as multileaf or asymmetric collimators and virtual wedges, the responsibility to ensure correct treatment has increased. The purpose of this paper is to present the method that we are following to prevent some potential radiotherapy errors and to point out some errors that can be easily detected using a RVS, through a check of the daily recorded treatment information. We conclude that a RVS prevents the occurrence of many errors, when the settings of the treatment machine do not match the intended parameters within some maximal authorized deviation, and allows to detect easily other potential errors related with a incorrect selection of the treatment patient data. A quality assurance program, including a check of all beam data and a weekly control of the manual and electronic chart, has helped reduce errors. (author)

  9. Preventive physical therapy and care humanization in the treatment of a bedridden, home care, neurologic patient

    Directory of Open Access Journals (Sweden)

    Lina Faria

    Full Text Available Abstract Introduction: This case study investigated the impact of preventive physical therapy on shoulder problems and the prevention of pressure ulcers (PU in a bedridden, home care, post-neurological surgery patient. Objective: To highlight the importance of physical therapy in the prevention of comorbidities, chronic neurological sequelae, and PU. Materials and Methods: In the immediate post-surgical phase, the patient was treated with preventive measures against PU, according to the Pressure Ulcer Prevention Protocol of the University of São Paulo, the National Pressure Ulcer Advisory Panel, and the Braden Scale. In addition, we used the modified Ashworth scale to assess spasticity. A kinesiotherapy program based on the Bobath's concept was used to prevent subluxation of the plegic arm and help in the recovery of functional movements. Results: The use of preventive measures and delivery of humanized care during a six-month period helped prevent the development of stage 3 and 4 PU and physical, functional, and respiratory complications. By the end of six months, the patient was found to be at low risk of developing PU. Conclusion: Notwithstanding the difficulties experienced during treatment, especially for the positioning of the arm and performance of transferring and positioning techniques, the results of this study are in agreement with aspects considered important for treatment outcomes.

  10. Mitochondrial-Based Treatments that Prevent Post-Traumatic Osteoarthritis in a Translational Large Animal Intraarticular Fracture Survival Model

    Science.gov (United States)

    2016-09-01

    treatments that prevent ROS overproduction, scavenge ROS , or dissolve the cytoskeleton in mitochondria on preventing PTOA in a large animal IAF...Aim 1. Specific Aim 3: Determine the efficacy of treatments that prevent ROS overproduction, scavenge ROS , or dissolve the cytoskeleton in...AWARD NUMBER: W81XWH-11-1-0583 TITLE: Mitochondrial-Based Treatments that Prevent Post-Traumatic Osteoarthritis in a Translational Large

  11. Stomach cancer involving esophagus. Diagnosis, treatment and prevention by specific methods.

    OpenAIRE

    Filippov, Yu. О.; Tyutyunnik, V. M.

    2014-01-01

    Stomach cancer is a leader in the structure of cancer pathology in Ukraine and in the world. This paper summarizes own results and literature data on diagnosis, treatment and prevention of stomach cancer. Authors analyzed the experience and specific features of long-term treatment and diagnostic approach to patients with stomach cancer involving esophagus. Conducting pre-and postoperative cytostatic herbal therapy and cryosurgical operations during surgical treatment in patients with spread o...

  12. Stress-induced structural remodeling in hippocampus: Prevention by lithium treatment

    Science.gov (United States)

    Wood, Gwendolyn E.; Young, L. Trevor; Reagan, Lawrence P.; Chen, Biao; McEwen, Bruce S.

    2004-03-01

    Chronic restraint stress, psychosocial stress, as well as systemic or oral administration of the stress-hormone corticosterone induces a morphological reorganization in the rat hippocampus, in which adrenal steroids and excitatory amino acids mediate a reversible remodeling of apical dendrites on CA3 pyramidal cell neurons of the hippocampus. This stress-induced neuronal remodeling is accompanied also by behavioral changes, some of which can be prevented with selective antidepressant and anticonvulsive drug treatments. Lithium is an effective treatment for mood disorders and has neuroprotective effects, which may contribute to its therapeutic properties. Thus, we wanted to determine whether lithium treatment could prevent the effects of chronic stress on CA3 pyramidal cell neuroarchitecture and the associated molecular and behavioral measures. Chronic lithium treatment prevented the stress-induced decrease in dendritic length, as well as the stress-induced increase in glial glutamate transporter 1 (GLT-1) mRNA expression and the phosphorylation of cAMP-response element binding in the hippocampus. Lithium treatment, however, did not prevent stress effects on behavior in the open field or the plus-maze. These data demonstrate that chronic treatment with lithium can protect the hippocampus from potentially deleterious effects of chronic stress on glutamatergic activation, which may be relevant to its therapeutic efficacy in the treatment of major depressive disorder and bipolar disorder.

  13. The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention.

    Science.gov (United States)

    Holick, Michael F

    2017-06-01

    Vitamin D deficiency and insufficiency is a global health issue that afflicts more than one billion children and adults worldwide. The consequences of vitamin D deficiency cannot be under estimated. There has been an association of vitamin D deficiency with a myriad of acute and chronic illnesses including preeclampsia, childhood dental caries, periodontitis, autoimmune disorders, infectious diseases, cardiovascular disease, deadly cancers, type 2 diabetes and neurological disorders. This review is to put into perspective the controversy surrounding the definition for vitamin D deficiency and insufficiency as well as providing guidance for how to treat and prevent vitamin D deficiency.

  14. Practitioner Review: Definition, recognition, and treatment challenges of irritability in young people.

    Science.gov (United States)

    Stringaris, Argyris; Vidal-Ribas, Pablo; Brotman, Melissa A; Leibenluft, Ellen

    2017-10-30

    Irritability is one of the most common reasons for referral to child and adolescent mental health services and is the main characteristic of the new diagnosis of disruptive mood dysregulation disorder (DMDD). However, the recognition and management of irritability presents a major challenge in clinical practice and may be partly responsible for the dramatic increase in antipsychotic prescribing in recent years. In this review, we provide up-to-date information on the definition and mechanisms underlying irritability, and its assessment in clinical practice. We aim to discuss the latest research on DMDD, and the presence of severe irritability in the context of other disorders, as well as to recommend a treatment algorithm. Severe irritability is associated with aberrant reward processing and bias toward threatening stimuli. Several measures are available to easily assess irritability. The recent diagnosis of DMDD captures children whose main problem is severe irritability and differ from those with bipolar disorder in longitudinal outcomes, family history, and behavioral and neural correlates. Treatment of irritability might depend on the context it appears. Indirect evidence suggests that parent management training (PMT) and cognitive behavioral therapy (CBT) are the most supported psychological treatments for irritability. Irritability, recognized as a mood problem rather than a purely behavioral manifestation, is a common condition for young people. Practitioners should not ignore irritability as it is associated with substantial morbidity and impairment. Although there are no trials with irritability as main outcome, clinicians can apply several existing pharmacological and psychological interventions for its treatment. Also, new promising approaches relying on pathophysiological findings, such as exposure-based cognitive behavioral therapy techniques and interpretation bias training (IBT), are being currently investigated. © 2017 Association for Child and

  15. Insights from a national survey into why substance abuse treatment units add prevention and outreach services

    Directory of Open Access Journals (Sweden)

    Lemak Christy

    2006-08-01

    Full Text Available Abstract Background Previous studies have found that even limited prevention-related interventions can affect health behaviors such as substance use and risky sex. Substance abuse treatment providers are ideal candidates to provide these services, but typically have little or no financial incentive to do so. The purpose of this study was therefore to explore why some substance abuse treatment units have added new prevention and outreach services. Based on an ecological framework of organizational strategy, three categories of predictors were tested: (1 environmental, (2 unit-level, and (3 unit leadership. Results A lagged cross-sectional logistic model of 450 outpatient substance abuse treatment units revealed that local per capita income, mental health center affiliation, and clinical supervisors' graduate degrees were positively associated with likelihood of adding prevention-related education and outreach services. Managed care contracts and methadone treatment were negatively associated with addition of these services. No hospital-affiliated agencies added prevention and outreach services during the study period. Conclusion Findings supported the study's ecological perspective on organizational strategy, with factors at environmental, unit, and unit leadership levels associated with additions of prevention and outreach services. Among the significant predictors, ties to managed care payers and unit leadership graduate education emerge as potential leverage points for public policy. In the current sample, units with managed care contracts were less likely to add prevention and outreach services. This is not surprising, given managed care's emphasis on cost control. However, the association with this payment source suggests that public managed care programs might affects prevention and outreach differently through revised incentives. Specifically, government payers could explicitly compensate substance abuse treatment units in managed care

  16. Mammographic findings after breast cancer treatment with local excision and definitive irradiation

    International Nuclear Information System (INIS)

    Dershaw, D.D.; Shank, B.; Reisinger, S.

    1987-01-01

    Following local excision and definitive irradiation of 163 breast cancers in 160 women, alterations in mammographic patterns were observed for up to 7 years. Skin thickening was observed in 96% of mammograms obtained within 1 year of completing therapy and was most pronounced in women treated with iridium implant, chemotherapy, or axillary dissection. In 76% of mammograms, alterations in the parenchymal pattern, including coarsening of stroma and increased breast density, were seen at 1 year. Neither skin nor parenchymal changes progressed after 1 year. Within 3 years of treatment the parenchymal density, which usually regressed, did not change in all patients. At 3 years skin thickness and the parenchymal pattern had returned to normal in less than 50% of the breasts of these women. Scars developed in approximately one-quarter of women. They were present on the initial post-treatment mammogram and remained unchanged on serial studies. Coarse, benign calcifications also developed in the breasts of about one-quarter of women. Microcalcifications developed in 11 breasts; biopsy specimens of six were benign. Benign microcalcifications may be related to therapy

  17. Clinical consequences of the revised DSM-5 definition of agoraphobia in treatment-seeking anxious youth

    Science.gov (United States)

    Cornacchio, Danielle; Chou, Tommy; Sacks, Hayley; Pincus, Donna; Comer, Jonathan

    2015-01-01

    Background In DSM-5, the agoraphobia core symptom criterion has been revised to require fear about multiple situations from across at least two distinct domains in which escape might be difficult or panic-like symptoms might develop. The present study examined patterns and correlates of the recent change in a sample of anxious youth with symptom presentations consistent with the DSM-IV agoraphobia definition and/or specific phobia (SP) to consider how the recent diagnostic change impacts the prevalence and composition of agoraphobia in children and adolescents. Method Analyses (N=151) evaluated impairment and correlates of agoraphobic youth who no longer meet the DSM-5 agoraphobia criteria relative to agoraphobic youth who do meet the new DSM-5 criteria. Secondary analyses compared agoraphobic youth not meeting DSM-5 criteria to SP youth. Results One-quarter of youth with symptom presentations consistent with the DSM-IV agoraphobia definition no longer met criteria for DSM-5 agoraphobia, but showed comparable severity and impairment across most domains to youth who do meet criteria for DSM-5 agoraphobia. Further, these youth showed higher levels of anxiety sensitivity and internalizing psychopathology relative to youth with SP. Conclusions A substantial proportion of impaired youth with considerable agoraphobic symptom presentations have been left without a specified anxiety diagnosis by the DSM-5, which may affect their ability to receive and/or get coverage for services and their representation in treatment evaluations. Future DSM iterations may do well to include a “circumscribed” agoraphobia specifier that would characterize presentations of fear or anxiety about multiple situations, but that do not span across at least two distinct situational domains. PMID:25845579

  18. Cost effectiveness of intermittent screening followed by treatment versus intermittent preventive treatment during pregnancy in West Africa

    DEFF Research Database (Denmark)

    Fernandes, Silke; Sicuri, Elisa; Halimatou, Diawara

    2016-01-01

    Background: Emergence of high-grade sulfadoxine-pyrimethamine (SP) resistance in parts of Africa has led to growing concerns about the efficacy of intermittent preventive treatment of malaria during pregnancy (IPTp) with SP. The incremental cost-effectiveness of intermittent screening and treatme...

  19. Silicone pressure-reducing pads for the prevention and treatment of pressure ulcers.

    Science.gov (United States)

    Hughes, Maria A

    2014-06-01

    Pressure ulcers, a key quality of care indicator, cause emotional distress to the patient, affecting quality of life. They also have significant financial implications for the NHS. Pressure ulcer prevention and management are fundamental aspects of nursing. This article reports on the Wirral Community Trust's policy and guidelines for the maintenance of skin integrity. Tissue viability nurses have a duty to review and assess new prevention devices and dressings as they become available to ensure a high standard of care is provided. A report of an evaluation of the use of KerraPro in combination with current best practice guidelines for the prevention or treatment of pressure ulcers is provided. The author concludes that silicone pressure-reducing pads are a valuable tool in the prevention and treatment of pressure ulcers when used in combination with recommendations from the latest guidelines.

  20. Prevalence of metabolic syndrome in urban and suburban Rivers State, Nigeria: International Diabetes Federation and Adult Treatment Panel III definitions.

    Science.gov (United States)

    Siminialayi, I M; Emem-Chioma, P C; Odia, O J

    2010-06-01

    It was not clear for a while, which of the definitions of metabolic syndrome best predicted those at risk of cardiovascular disease and diabetes but recent studies have confirmed the predictive ability of various definitions of metabolic syndrome and have reported that the International Diabetes Federation definition, although more sensitive is associated with a higher false positive predictive rate. To determine the prevalence of metabolic syndrome, using the International Diabetes Federation and Adult Treatment Panel III definitions among adult Nigerians attending Family Medicine Clinics at two hospitals in Rivers State Nigeria. Adult subjects attending family medicine clinics at an urban and a sub-urban hospital in Rivers State, Nigeria were bled after an overnight fast, and venous blood obtained for lipid studies and fasting plasma glucose estimations. Measurements were made to determine height, weight, waist circumference and blood pressure. The data obtained was analysed using SPSS for Windows software version 12 and Epi info version 6.04D RESULTS: The prevalence of metabolic syndrome was 19.81% (ATP III) and 23.19% (IDF) at one centre and 34.17% (ATP III) and 35.42% (IDF) at the other centre. The prevalence of metabolic syndrome by the two definitions was significantly higher at the second centre. The difference in the prevalence rates by the two definitions was also much smaller in the second centre perhaps because the second centre had more women and the mean age of the subjects was significantly higher.

  1. Definition and recommendations for the convention on the prevention of marine pollution by dumping of wastes and other matter, 1972. 1986 ed.

    International Nuclear Information System (INIS)

    1986-01-01

    Under the terms of the Convention on the Prevention of Marine Pollution by Dumping of Wastes and Other Matter, the IAEA is the organization with the responsibility for defining high level radioactive wastes or other high level radioactive matter which is unsuitable for dumping at sea, and for making recommendations to Contracting Parties about the issue of permits for dumping radioactive waste or other radioactive matter. The IAEA established a provisional Definition and Recommendations in 1974 and a revised version in 1978. This Safety Series document contains the second revised Definition and Recommendations, which were established in 1985. The Annexes to the document contain a description of the calculations which form the basis of the quantitative Definition, a comparison between the new and the previous version and a list of all the meetings held during the process of establishing the new document

  2. Radiotherapy induced xerostomia: mechanisms, diagnostics, prevention and treatment--evidence based up to 2013.

    Science.gov (United States)

    Kałużny, Jarosław; Wierzbicka, Małgorzata; Nogala, Hanna; Milecki, Piotr; Kopeć, Tomasz

    2014-01-01

    Definition and prevalence of xerostomia were shortly presented. Radiosensitivity of the salivary glands, mechanism, diagnostics, and possible prediction methods of the intensity of xerostomia in the pre-radiotherapy period are widely discussed. Prevention of xerostomia: salivary gland sparing radiotherapy, cytoprotective agents, preservation by stimulation with cholinergic muscarinic agonists, surgical transfer of submandibular glands according to ASCO Management Guidelines and Quality of Life Recommendations were cited. Oral Care Study Group (2010) therapeutic approaches for relieving xerostomia are referred. Current therapies, restricted to symptom relief such as oral hygiene with fluoride agents, antimicrobials to prevent dental caries, saliva substitutes to relieve symptoms, and sialogenic agents to stimulate saliva were also discussed. Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

  3. [Advances in the research of prevention and treatment of postburn contractures of hand].

    Science.gov (United States)

    Wang, K A; Wu, G S; Sun, Y; Xia, Z F

    2017-01-20

    Scar contracture deformity, which can lead to dysfunction of hand and low quality of life, is one of the common complication after hand burns. The prevention measures of scar contracture after hand burns include large skin grafting, prevention of infection, insistence on wearing pressure gloves, use of silicone sheets, wearing orthosis, accepting proper physical therapy, and early functional exercise. The primary treatments of postburn contractures of the hand are surgery, drugs, laser treatment, and rehabilitation therapy. Excision of scars, release of muscle, joints or bones, and soft tissue transplantation are the core of surgery. Laser treatment has a bright future but still needs to be further studied. Additionally, some novel treatments such as molecular targeted therapy, cell therapy, fat injection, and botulinum toxin injection will play important roles in prevention and treatment of postburn contractures in the future. The purpose of this article is to review the literature concerning postburn contractures of the hand, and summarize the present situation of prevention and treatment of such disease comprehensively.

  4. Evidence Map of Prevention and Treatment Interventions for Depression in Young People

    Directory of Open Access Journals (Sweden)

    Patrick Callahan

    2012-01-01

    Full Text Available Introduction. Depression in adolescents and young people is associated with reduced social, occupational, and interpersonal functioning, increases in suicide and self-harm behaviours, and problematic substance use. Age-appropriate, evidence-based treatments are required to provide optimal care. Methods. “Evidence mapping” methodology was used to quantify the nature and distribution of the extant high-quality research into the prevention and treatment of depression in young people across psychological, medical, and other treatment domains. Results. Prevention research is dominated by cognitive-behavioral- (CBT- based interventions. Treatment studies predominantly consist of CBT and SSRI medication trials, with few trials of other psychological interventions or complementary/alternative treatments. Quality studies on relapse prevention and treatment for persistent depression are distinctly lacking. Conclusions. This map demonstrates opportunities for future research to address the numerous evidence gaps for interventions to prevent or treat depression in young people, which are of interest to clinical researchers, policy makers, and funding bodies.

  5. Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Systematic Review for a National Institutes of Health Pathways to Prevention Workshop.

    Science.gov (United States)

    Smith, M E Beth; Haney, Elizabeth; McDonagh, Marian; Pappas, Miranda; Daeges, Monica; Wasson, Ngoc; Fu, Rongwei; Nelson, Heidi D

    2015-06-16

    Myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS) is a debilitating multisystem condition affecting more than 1 million adults in the United States. To determine benefits and harms of treatments for adults with ME/CFS and identify future research needs. MEDLINE, PsycINFO, and Cochrane databases (January 1988 to September 2014); clinical trial registries; reference lists; and manufacturer information. English-language randomized trials of the effectiveness and adverse effects of ME/CFS treatments. Data on participants, study design, analysis, follow-up, and results were extracted and confirmed. Study quality was dual-rated by using prespecified criteria; discrepancies were resolved through consensus. Among 35 treatment trials enrolling participants primarily meeting the 1994 Centers for Disease Control and Prevention and Oxford case definitions of CFS, the immune modulator rintatolimod improved some measures of exercise performance compared with placebo in 2 trials (low strength of evidence). Trials of galantamine, hydrocortisone, IgG, valganciclovir, isoprinosine, fluoxetine, and various complementary medicines were inconclusive (insufficient evidence). Counseling therapies and graded exercise therapy compared with no treatment, relaxation, or support improved fatigue, function, global improvement, and work impairment in some trials; counseling therapies also improved quality of life (low to moderate strength of evidence). Harms were rarely reported across studies (insufficient evidence). Trials were heterogeneous and were limited by size, number, duration, applicability, and methodological quality. Trials of rintatolimod, counseling therapies, and graded exercise therapy suggest benefit for some patients meeting case definitions for CFS, whereas evidence for other treatments and harms is insufficient. More definitive studies comparing participants meeting different case definitions, including ME, and providing subgroup analysis are needed to fill

  6. Clinical Trial Design for Testing the Stem Cell Model for the Prevention and Treatment of Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Reddy, Rishindra M., E-mail: reddyrm@med.umich.edu [Medical Center, University of Michigan, 1500 E. Medical Center Drive, 2120 Taubman Center, Ann Arbor, MI 48109 (United States); Kakarala, Madhuri; Wicha, Max S. [Comprehensive Cancer Center, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109 (United States)

    2011-06-20

    The cancer stem cell model introduces new strategies for the prevention and treatment of cancers. In cancers that appear to follow the stem cell model, pathways such as Wnt, Notch and Hedgehog may be targeted with natural compounds such as curcumin or drugs to reduce the risk of initiation of new tumors. Disease progression of established tumors could also potentially be inhibited by targeting the tumorigenic stem cells alone, rather than aiming to reduce overall tumor size. These new approaches mandate a change in the design of clinical trials and biomarkers chosen for efficacy assessment for preventative, neoadjuvant, adjuvant, and palliative treatments. Cancer treatments could be evaluated by assessing stem cell markers before and after treatment. Targeted stem cell specific treatment of cancers may not result in “complete” or “partial” responses radiologically, as stem cell targeting may not reduce the tumor bulk, but eliminate further tumorigenic potential. These changes are discussed using breast, pancreatic, and lung cancer as examples.

  7. [Dementia prevention: potential treatments and how to target high risk patients].

    Science.gov (United States)

    Samaras, Nikolaos; Samaras, Dimitrios; Frangos, Emilia; Forster, Alexandre

    2013-05-22

    The burden related to the ever-increasing dementia prevalence in older individuals, imposes the implementation of prevention strategies. It is now known that brain lesions related to Alzheimer's disease precede the onset of the first symptoms. Consequently, prevention strategies should be implemented early, before clinically overt dementia. Blood and spine fluid tests, electroencephalogram, brain magnetic resonance and brain nuclear imaging should help physicians to better target "high-risk" patients prone to benefit from such strategies, already in a preclinical disease stage. Since no efficient pharmacological treatments exist for the time being, lifestyle factors such as nutritionand physical exercise are the cornerstones for dementia prevention.

  8. Wilderness Medical Society practice guidelines for the prevention and treatment of lightning injuries: 2014 update.

    Science.gov (United States)

    Davis, Chris; Engeln, Anna; Johnson, Eric L; McIntosh, Scott E; Zafren, Ken; Islas, Arthur A; McStay, Christopher; Smith, William R; Cushing, Tracy

    2014-12-01

    To provide guidance to clinicians about best practices, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for the treatment and prevention of lightning injuries. These guidelines include a review of the epidemiology of lightning and recommendations for the prevention of lightning strikes, along with treatment recommendations organized by organ system. Recommendations are graded on the basis of the quality of supporting evidence according to criteria put forth by the American College of Chest Physicians. This is an updated version of the original WMS Practice Guidelines for Prevention and Treatment of Lightning Injuries published in Wilderness & Environmental Medicine 2012;23(3):260-269. Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  9. Primary care in the prevention, treatment and control of cardiovascular disease in sub-Saharan Africa

    Science.gov (United States)

    Ojji, Dike B; Ojji, Dike B Ojji; Lamont, Kim; Sliwa, Karen; Ojji, Olubunmi I; Egenti, Bibiana Nonye; Sliwa, Karen

    2017-01-01

    Summary Cardiovascular disease (CVD) is the frontrunner in the disease spectrum of sub-Saharan Africa, with stroke and ischaemic heart disease ranked seventh and 14th as leading causes of death, respectively, on this sub-continent. Unfortunately, this region is also grappling with many communicable, maternal, neonatal and nutritional disorders. Limited resources and the high cost of CVD treatment necessitate that primary prevention should have a high priority for CVD control in sub- Saharan Africa. One major challenge of such an approach is how to equip primary care to respond promptly and effectively to this burden. We present a practical approach on how primary care in sub-Saharan Africa could effectively address the prevention, treatment and control of CVD on the subcontinent. For effective prevention, control and treatment of CVD in sub-Saharan Africa, there should be strategic plans to equip primary care clinics with well-trained allied healthcare workers who are supervised by physicians. PMID:28752890

  10. Primary care in the prevention, treatment and control of cardiovascular disease in sub-Saharan Africa.

    Science.gov (United States)

    Ojji, Dike B; Lamont, Kim; Ojji, Olubunmi I; Egenti, Bibiana Nonye; Sliwa, Karen

    Cardiovascular disease (CVD) is the frontrunner in the disease spectrum of sub-Saharan Africa, with stroke and ischaemic heart disease ranked seventh and 14th as leading causes of death, respectively, on this sub-continent. Unfortunately, this region is also grappling with many communicable, maternal, neonatal and nutritional disorders. Limited resources and the high cost of CVD treatment necessitate that primary prevention should have a high priority for CVD control in sub-Saharan Africa. One major challenge of such an approach is how to equip primary care to respond promptly and effectively to this burden. We present a practical approach on how primary care in sub-Saharan Africa could effectively address the prevention, treatment and control of CVD on the subcontinent. For effective prevention, control and treatment of CVD in sub-Saharan Africa, there should be strategic plans to equip primary care clinics with well-trained allied healthcare workers who are supervised by physicians.

  11. Prevention and Treatment of White Spot Lesions During and After Treatment with Fixed Orthodontic Appliances: a Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Kristina Lopatiene

    2016-06-01

    Full Text Available Objectives: The aim of the systematic literature review is to update the evidence for the prevention of white spot lesions, using materials containing fluoride and/or casein phosphopeptide-amorphous calcium phosphate during and after treatment with fixed orthodontic appliances. Material and Methods: Information search for controlled studies on humans published between January 2008 and February 2016 was performed in PubMed, ScienceDirect, Embase, The Cochrane Library. Inclusion criteria were: the English language, study on humans, patients undergoing orthodontic treatment with fixed appliances, randomized or quasi-randomized controlled clinical studies fluoride-containing product or casein derivates used throughout the appliance therapy or straightaway after debonding. Results: 326 articles were reviewed (Embase 141, PubMed 129, ScienceDirect 41, Cochrane 15. Twelve clinical studies fulfilled all inclusion criteria. Use of fluoridated toothpaste had a remineralizing effect on white spot lesions (WSLs (P < 0.05; fluoride varnish and casein supplements were effective in prevention and early treatment of WSLs (P < 0.05. Conclusions: Early detection of white spot lesions during orthodontic treatment would allow implementing preventive measures to control the demineralization process before lesions progress. The systemic review has showed that the usage of fluoride and casein supplements in ameliorating white spot lesions during and after fixed orthodontic treatment is significantly effective. However the use of casein phosphopeptide-amorphous calcium phosphate can be more beneficial than fluoride rinse in the reduction of demineralization spots.

  12. Laparoscopic peritoneal lavage for perforated colonic diverticulitis: a definitive treatment? Retrospective analysis of 63 cases.

    Science.gov (United States)

    Sorrentino, M; Brizzolari, M; Scarpa, E; Malisan, D; Bruschi, F; Bertozzi, S; Bernardi, S; Petri, R

    2015-02-01

    The ideal treatment of perforated diverticulitis and the indications for elective colon resection remain controversial. Considering the significant morbidity and mortality rates related to traditional resection, efforts have been made to reduce the invasiveness of surgery in recent decades. Laparoscopic peritoneal lavage has emerged as an effective alternative option. We retrospectively investigated the effectiveness of laparoscopic peritoneal lavage for perforated diverticulitis and the possibility that it could be a definitive treatment. We included patients treated with laparoscopic peritoneal lavage for perforated diverticulitis. The inclusion criteria were all emergency patients with generalized peritonitis due to Hinchey III perforated diverticulitis and some cases of Hinchey II and IV. Sixty-three patients were treated with laparoscopic peritoneal lavage. Six patients (9.5 %) had Hinchey II diverticulitis; 54 patients (85.7 %) had Hinchey III; and three patients (4.8 %) had Hinchey IV. The mean operative time was 87.3 min (±25.4 min), and the overall morbidity rate was 14.3 %. One patient died because of pulmonary embolism, and there were six early reinterventions because of treatment failure. Delayed colon resection was performed in four of the remaining 57 patients (7 %) because of recurrent diverticulitis. In the other 53 patients (93 %), we saw no recurrence of diverticulitis and no intervention was performed after a median follow-up period of 54 months (interquartile range 27-98 months). Laparoscopic peritoneal lavage for perforated diverticulitis can be considered a safe and effective alternative to traditional surgical resection, and using this approach, most elective colon resection might be avoided.

  13. 77 FR 66469 - CDC/HRSA Advisory Committee on HIV, Viral Hepatitis and STD Prevention and Treatment

    Science.gov (United States)

    2012-11-05

    ... Advisory Committee on HIV, Viral Hepatitis and STD Prevention and Treatment In accordance with section 10(a...--Treatment as Prevention; (2) Ryan White HIV/AIDS Program Client Level Data Update; (3) Viral Hepatitis... prevention and control of HIV/AIDS and other STDs, the support of health care services to persons living with...

  14. Prevention

    Science.gov (United States)

    ... Contact Aging & Health A to Z Find a Geriatrics Healthcare Professional Medications & Older Adults Making Your Wishes ... Prevention Hearing Loss Heart Attack High Blood Pressure Nutrition Osteoporosis Shingles Skin Cancer Related News Quitting Smoking, ...

  15. Prevention and treatment of radiotherapy-induced oral mucositis: a literature review

    International Nuclear Information System (INIS)

    Albuquerque, Ieda Lessa de Souza; Camargo, Teresa Caldas

    2007-01-01

    The prevention and treatment of radiotherapy-induced oral mucositis have still not been fully defined. The current study thus involved a literature search aimed at identifying preventive and therapeutic measures in relation to oral mucositis in patients submitted to radiotherapy, analyzing the level of evidence in the selected studies, identifying which indications for prevention and treatment in the literature pertain to the field of nursing, and critically analyzing the results and their implications for nursing care. This was a systematic literature survey without a meta analysis, consulting the following databases: BIREME, Medline, CancerLit, Scirus, CAPES, Free medical journal, High wire press, SCIELO, and Medscape, from 2000 to 2005. According to observations, nursing care was capable of improving patient's quality of life, promoting education of patients, implementing and supervising oral care programs, and providing guidance on hygiene, prevention, and treatment of oral mucositis, including pain management. However, no Brazilian nursing publications were found on the subject. Research and publications focusing on nursing experience in the prevention and treatment of radiotherapy-related oral mucositis and the implications for patients and nurses are important to provide evidence-based nursing guidelines. (author)

  16. Misconceptions about Ebola seriously affect the prevention efforts: KAP related to Ebola prevention and treatment in Kouroussa Prefecture, Guinea.

    Science.gov (United States)

    Buli, Benti Geleta; Mayigane, Landry Ndriko; Oketta, Julius Facki; Soumouk, Aguide; Sandouno, Tamba Emile; Camara, Bole; Toure, Mory Saidou; Conde, Aissata

    2015-01-01

    Guinea is the third hardest hit country in the region with 2,806 cases and 1,814 deaths as of January 11, 2015 after Sierra Leone and Liberia respectively. This KAP study was conducted in three sub-prefectures of Kouroussa in the Kankan region of Guinea from 15 December 2014 to 15 January 2015. It was conducted with the general objective of examining the knowledge, attitude and practice related to Ebola prevention and care among the public of Kouroussa Prefecture. A cross-sectional study design was employed to collect quantitative data to examine knowledge, attitude and practice related to Ebola. Structured questionnaire was administered by trained data collectors who were supervised by doctors and epidemiologists from WHO and Africa Union. Data were collected from 358 individuals (93% response rate) and analyzed in STATA 13 while tables and graphs are used to display results. Over 96% of the respondents have ever heard about Ebola while only 76.2% believed the disease existed in Kouroussa. Avoiding physical contacts including hand shaking and contacts with body fluids, and early treatment of persons sick from Ebola were the two important prevention methods frequently mentioned (96.8% and 93.9%). Only 35.7% of respondents were found to have comprehensive knowledge about Ebola (composite of correctly accepting three methods of prevention (85%) and rejecting misconceptions (55.7%)). The high level of knowledge about modes of transmission and prevention methods has not positively affected the level of comprehensive knowledge about Ebola. In contrast, the prevailing high level of misconceptions surrounding Ebola was found to be responsible for a low comprehensive knowledge.

  17. [Physical exercise and yoga in prevention and treatment of addictive diseases].

    Science.gov (United States)

    Nespor, K

    2005-01-01

    Prevention of addictive diseases should be complex and systematic and it should include training of social skills, decision-making skills, family intervention, etc. Similarly, effective treatment is usually long-term, systematic and complex. Physical exercise and yoga can be useful components of comprehensive prevention and treatment programmes. On the other hand, competitive professional sport rather increases the number of risk factors for substance-related problems. Practical experience with the use of yoga in substance dependent patients and pathological gambles are mentioned. One of the advantages of yoga is the integration of physical exercise and relaxation.

  18. Confronting a rising tide of eating disorders and obesity: treatment vs. prevention and policy.

    Science.gov (United States)

    Battle, E K; Brownell, K D

    1996-01-01

    Eating disorders and obesity are rising in prevalence and are problems of considerable public health significance. Prevailing treatments have a limited impact on public health because the disorders do not yield easily to intervention and because the treatments are costly and available to few. Shifting from a medical to a public health model argues for increased focus on both prevention and public policy. Research on prevention is in its early stages but must be aggressively pursued. Even less is known about policy, but recommendations are made to alter policy so that consumption of healthful foods increases, consumption of unhealthful foods decreases, and levels of physical activity are enhanced.

  19. PREVENTION AND TREATMENT OF ERECTILE DYSFUNCTION IN PATIENTS AFTER RADICAL NERVESPARING PROSTATECTOMY

    Directory of Open Access Journals (Sweden)

    P. A. Karnaukh

    2015-01-01

    Full Text Available The purpose of our research is to improve the quality of life of patients undergoing radical prostatectomy. With the increasing frequency of prostate cancer and determining the effectiveness of surgical treatment significantly increased the number of radical prostatectomy. Surgical treatment is definitely in much greater extent when compared to radiation treatments related to the development of impotence, erectile dysfunction and urinary incontinence.The incidence of erectile dysfunction after prostatectomy ranges from 10 to 50%. Therefore, the development of new programmes for the rehabilitation of patients can improve their quality of life, due to the greater likelihood of recovery of erectile function after the operation. In our study we observed 84 patient. The incidence of erectile dysfunction was 76%. After applying one of the existing methods of stimulation: FDÈ5 inhibitors, intracavernose injections of prostaglandin, physical therapy, we were able to increase the effectiveness of treatment up to 54.8%, 40% and 70% respectively.

  20. Prevention and treatment of respiratory consequences induced by sulfur mustard in Iranian casualties.

    Science.gov (United States)

    Razavi, Seyed M; Salamati, Payman; Harandi, Ali Amini; Ghanei, Mostafa

    2013-04-01

    About 100,000 Iranian have been exposed to chemical weapons during Iraq-Iran conflict (1980-88). After being spent of more than two decades, still about 30,000 of them are under follow-up treatment. The main aim of this study was to review various preventive and therapeutic methods for injured patients with sulfur mustard in different phases. For gathering information, we have used the electronic databases including Scopus, Medline, ISI, IranMedex, Irandoc sites. According to this search strategy, 104 published articles associated to respiratory problems and among them 50 articles related to prevention and treatment of respiratory problems were found and reviewed. There is not any curative treatment for sulfur mustard induced lung injuries, but some valuable experienced measures for prevention and palliative treatments are available. Some useful measures in acute phase include: Symptomatic management, oxygen supplementation, tracheostomy in laryngospasm, use of moist air, respiratory physical therapy, mucolytic agents and bronchodilators. In the chronic phases, these measures include: Periodic clinical examinations, administration of inhaled corticosteroids alone or with long-acting beta 2 agonists, use of antioxidants, magnesium ions, long term oxygen supplement, therapeutic bronchoscopy, laser therapy, and use of respiratory tract stents. Most treatments are symptomatic but using preventive points immediately after exposure could improve following outcomes.

  1. Prevention and treatment of respiratory consequences induced by sulfur mustard in Iranian casualties

    Directory of Open Access Journals (Sweden)

    Seyed M Razavi

    2013-01-01

    Full Text Available Background: About 100,000 Iranian have been exposed to chemical weapons during Iraq-Iran conflict (1980-88. After being spent of more than two decades, still about 30,000 of them are under follow-up treatment. The main aim of this study was to review various preventive and therapeutic methods for injured patients with sulfur mustard in different phases. Methods: For gathering information, we have used the electronic databases including Scopus, Medline, ISI, IranMedex, Irandoc sites. According to this search strategy, 104 published articles associated to respiratory problems and among them 50 articles related to prevention and treatment of respiratory problems were found and reviewed. Results: There is not any curative treatment for sulfur mustard induced lung injuries, but some valuable experienced measures for prevention and palliative treatments are available. Some useful measures in acute phase include: Symptomatic management, oxygen supplementation, tracheostomy in laryngospasm, use of moist air, respiratory physical therapy, mucolytic agents and bronchodilators. In the chronic phases, these measures include: Periodic clinical examinations, administration of inhaled corticosteroids alone or with long-acting beta 2 agonists, use of antioxidants, magnesium ions, long term oxygen supplement, therapeutic bronchoscopy, laser therapy, and use of respiratory tract stents. Conclusions: Most treatments are symptomatic but using preventive points immediately after exposure could improve following outcomes.

  2. Modern aspects of diagnosis, treatment and prevention of obesity in children

    Directory of Open Access Journals (Sweden)

    S.D. Saltanova

    2017-09-01

    Full Text Available Obesity is a topical medical and social problem. Prevalence of obesity is increasing among children. The number of children under 5 years of age with overweight and obesity in the world is 44 millions. Obesity in childhood is a risk factor for the development of severe concomitant pathologies. Childhood obesity is an important prognostic factor for obesity in adults. Measures to prevent and treat childhood obesity should be directed not only to the child, but also to the whole family. To prevent obesity, excessive calorie intake should be limited. To increase the effectiveness of preventing obesity among children, we should combine reduction of energy intake with an increased physical activity. Lifestyle modification (correction of nutrition, exercise and behavioral therapy is the main method of treating children’s obesity. Introduction of school programs that increase physical activity and optimize the nutrition improve the effectiveness of treatment for childhood obesity. In case of ineffectiveness of lifestyle modification, pharmacotherapy may be prescribed. Orlistat is a medication for the treatment of obesity in children. The effectiveness of pharmacotherapy is enhanced when it is combined with integrated programs of lifestyle modification. Bariatric surgery should be used in cases of morbid obesity or failure of non-surgical treatment. Surgical treatment leads to body mass index decrease, improvement of concomitant diseases and quality of life. Bariatric surgery also has a risk of side effects, which requires continuous monitoring of complications. For the treatment and prevention of obesity, children need a multidisciplinary approach involving different specialists.

  3. Predictive factors of isolated distant metastasis after primary definitive surgery without systemic treatment for head and neck squamous cell carcinoma.

    Science.gov (United States)

    Lim, Jae-Yol; Lim, Young Chang; Kim, Se-Heon; Kim, Jae Wook; Jeong, Ha Min; Choi, Eun Chang

    2010-07-01

    Incidence of isolated distant metastasis (IDM) was relatively low in patients who achieved locoregional control after primary definitive surgery. However, the prognosis of patients with IDM was dismal. The aim of this study was to evaluate the clinical outcome of patients with IDM and identify independent predictive factors of IDM after primary definitive surgery for head and neck squamous cell carcinoma (HNSCC). A retrospective data review was conducted for 795 patients who underwent primary definitive surgery without any systemic treatment for squamous cell carcinoma (SCC) of the oral cavity, oropharynx, larynx, and hypopharynx. Distant metastasis-free survival was calculated and independent predictive factors for IDM were determined by Cox proportional-hazards model. For the entire study cohort, IDM developed in 75 patients (9.4%). Among 631 patients who achieved locoregional control, IDM occurred in 44 patients (7%). The median time to IDM after primary surgery was 13months, ranging from 2 to 70months. The overall salvage rate was 9% (4 of 44) after salvage treatment for IDM. In the Cox proportional-hazards model, clinical N status, and histological grade were independent predictive factors of IDM. Patients who had clinically palpable neck disease and a histologically poor grade were more likely to develop IDM after primary definitive surgery. Patients with these factors should be considered candidates for proper adjuvant systemic treatment and evaluated more thoroughly for early detection of IDM during follow-up.

  4. Are Graduating Pediatric Residents Prepared to Engage in Obesity Prevention and Treatment?

    Science.gov (United States)

    Frintner, Mary Pat; Liebhart, Janice L; Lindros, Jeanne; Baker, Alison; Hassink, Sandra G

    2016-01-01

    Little information is available to gauge residents' perceived receipt of comprehensive training and preparedness to manage children with obesity in practice. A national, random sample of 1000 graduating pediatric residents were surveyed in 2013 on childhood overweight/obesity and preparedness to prevent and treat obesity. A composite training measure was created by summing the number of areas (10 possible) where training on overweight/obesity was received. Multivariable logistic regression explored relationships of resident and training characteristics to residents' belief that their own counseling on prevention and treatment of overweight/obesity is very effective (vs somewhat/slightly/not effective). Of 625 survey respondents (63% response), most (68-92%) reported receipt of training in each of 10 assessed areas on overweight/obesity prevention, assessment, and treatment. Most residents did not desire more training in the assessed areas; however, 54% wanted more training in motivational interviewing. About one-fourth believed that their own counseling on the prevention of overweight/obesity (26%) and treatment of obesity (22%) was very effective. Residents who rated their ability to use motivational interviewing as very good/excellent were more likely to rate their counseling on both the prevention and treatment of overweight/obesity as very effective (adjusted odds ratio [aOR] 4.33, 95% confidence interval [CI] 2.63-7.13; and aOR 4.69, 95% CI 2.72-8.07, respectively). Residents who received training in all 10 assessed areas were also more likely to rate their counseling on both prevention and treatment as very effective (aOR 2.58, 95% CI 1.61-4.14; aOR 2.41, 95% CI 1.46-3.97, respectively). Comprehensive training on overweight/obesity and inclusion of training in motivational interviewing may help residents feel better prepared to care for children with overweight/obesity. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights

  5. Stenting of the Cystic Duct in Benign Disease: A Definitive Treatment for the Elderly and Unwell

    Energy Technology Data Exchange (ETDEWEB)

    Hersey, N., E-mail: naomi.hersey@sth.nhs.uk [Sheffield Teaching Hospitals NHS Trust, Department of Radiology, Northern General Hospital (United Kingdom); Goode, S. D., E-mail: s.goode@sheffield.sc.uk [Sheffield Teaching Hospitals NHS Trust, Sheffield Vascular Institute (United Kingdom); Peck, R. J., E-mail: robert.peck@sth.nhs.uk; Lee, F., E-mail: fred.lee@sth.nhs.uk [Sheffield Teaching Hospitals NHS Trust, Department of Radiology, Northern General Hospital (United Kingdom)

    2015-08-15

    PurposeThere have been few case reports describing cystic duct stent insertion in the management of acute cholecystitis secondary to benign disease with no case series published to date. We present our series demonstrating the role of cystic duct stents in managing benign gallbladder disease in those patients unfit for surgery.Materials and MethodsThirty three patients unfit for surgery in our institution underwent cystic duct stent insertion for the management of acute cholecystitis in the period June 2008 to June 2013. Patients underwent a mixture of transperitoneal and transhepatic gallbladder puncture. The cystic duct was cannulated with a hydrophilic guidewire which was subsequently passed through the common bile duct and into the duodenum. An 8Fr 12-cm double-pigtail stent was placed with the distal end lying within the duodenum and the proximal end within the gallbladder.ResultsTen patients presented with gallbladder perforation, 21 patients with acute cholecystitis, 1 with acute cholangitis and 1 with necrotising pancreatitis. The technical success rate was 91 %. We experienced a 13 % complication rate with 3 % mortality rate at 30 days.ConclusionCystic duct stent insertion can be successfully used to manage acute cholecystitis, gallbladder empyema or gallbladder perforations in those unfit for surgery and should be considered alongside external gallbladder drainage as a definitive mid-term treatment option.

  6. [Definition and classification of basal joint osteoarthritis. A critical analysis and proposals. Treatment options].

    Science.gov (United States)

    Comtet, J J; Gazarian, A; Fockens, W

    2001-02-01

    Several definitions and classifications of basal joint osteoarthritis exist. Each of them can be criticized. The authors propose to define basal thumb osteoarthritis as osteoarthritis of the trapezometacarpal joint associated or not with lesions of scapho-trapezio-trapezoid and/or metacarpophalangeal joints. The proposed classification is derived from the Eaton-Littler classification. Stage O is identical to stage I of the Eaton-Littler classification: trapeziometacarpal instability without cartilage lesions. Stage I is osteoarthritis of the trapeziometacarpal joint only, without metacarpophalangeal deformity. Stage II is trapeziometacarpal osteoarthrites combined with reductible hyperextension deformity of the metacarpophalangeal joint. Stage III is trapeziometacarpal osteoarthrites combined with irreductible metacarpophalangeal deformity. Stage IV is identical to stage IV of the Eaton-Littler classification: combined trapeziometacarpal and scapho-trapezio-trapezoid osteoarthritis. The advantage of the proposed classification is that basal joint osteoarthritis is not only defined as real or potential (stage O) osteoarthritis of the trapeziometacarpal joint, but also includes precise evaluation of two other joints at the base of the thumb. This classification can be a guide for treatment options.

  7. Stenting of the Cystic Duct in Benign Disease: A Definitive Treatment for the Elderly and Unwell

    International Nuclear Information System (INIS)

    Hersey, N.; Goode, S. D.; Peck, R. J.; Lee, F.

    2015-01-01

    PurposeThere have been few case reports describing cystic duct stent insertion in the management of acute cholecystitis secondary to benign disease with no case series published to date. We present our series demonstrating the role of cystic duct stents in managing benign gallbladder disease in those patients unfit for surgery.Materials and MethodsThirty three patients unfit for surgery in our institution underwent cystic duct stent insertion for the management of acute cholecystitis in the period June 2008 to June 2013. Patients underwent a mixture of transperitoneal and transhepatic gallbladder puncture. The cystic duct was cannulated with a hydrophilic guidewire which was subsequently passed through the common bile duct and into the duodenum. An 8Fr 12-cm double-pigtail stent was placed with the distal end lying within the duodenum and the proximal end within the gallbladder.ResultsTen patients presented with gallbladder perforation, 21 patients with acute cholecystitis, 1 with acute cholangitis and 1 with necrotising pancreatitis. The technical success rate was 91 %. We experienced a 13 % complication rate with 3 % mortality rate at 30 days.ConclusionCystic duct stent insertion can be successfully used to manage acute cholecystitis, gallbladder empyema or gallbladder perforations in those unfit for surgery and should be considered alongside external gallbladder drainage as a definitive mid-term treatment option

  8. Mindfulness-based treatment to prevent addictive behavior relapse: theoretical models and hypothesized mechanisms of change.

    Science.gov (United States)

    Witkiewitz, Katie; Bowen, Sarah; Harrop, Erin N; Douglas, Haley; Enkema, Matthew; Sedgwick, Carly

    2014-04-01

    Mindfulness-based treatments are growing in popularity among addiction treatment providers, and several studies suggest the efficacy of incorporating mindfulness practices into the treatment of addiction, including the treatment of substance use disorders and behavioral addictions (i.e., gambling). The current paper provides a review of theoretical models of mindfulness in the treatment of addiction and several hypothesized mechanisms of change. We provide an overview of mindfulness-based relapse prevention (MBRP), including session content, treatment targets, and client feedback from participants who have received MBRP in the context of empirical studies. Future research directions regarding operationalization and measurement, identifying factors that moderate treatment effects, and protocol adaptations for specific populations are discussed.

  9. HIV treatment as prevention in Jamaica and Barbados: magic bullet or sustainable response?

    Science.gov (United States)

    Barrow, Geoffrey; Barrow, Christine

    2015-01-01

    This discursive article introduces HIV treatment as prevention (TasP) and identifies various models for its extrapolation to wider population levels. Drawing on HIV surveillance data for Jamaica and Barbados, the article identifies significant gaps in HIV response programming in relation to testing, antiretroviral treatment coverage, and treatment adherence, thereby highlighting the disparity between assumptions and prerequisites for TasP success. These gaps are attributable, in large part, to sociocultural impediments and structural barriers, severe resource constraints, declining political will, and the redefinition of HIV as a manageable, chronic health issue. Antiretroviral treatment and TasP can realize success only within a combination prevention frame that addresses structural factors, including stigma and discrimination, gender inequality and gender-based violence, social inequality, and poverty. The remedicalization of the response compromises outcomes and undermines the continued potential of HIV programming as an entry point for the promotion of sexual, health, and human rights. © The Author(s) 2013.

  10. Impact of treatment on hepatitis C virus transmission and incidence in Egypt: A case for treatment as prevention.

    Science.gov (United States)

    Ayoub, H H; Abu-Raddad, L J

    2017-06-01

    Egypt has launched a hepatitis C virus (HCV) treatment programme using direct-acting antivirals (DAAs). Our aim was to assess the impact of five plausible programme scale-up and sustainability scenarios for HCV treatment as prevention in Egypt. We developed and analysed a mathematical model to assess programme impact using epidemiologic, programming and health economics measures. The model was parametrized with current and representative natural history, HCV prevalence and programme data. HCV incidence in Egypt is declining, but will persist at a considerable level for decades unless controlled by interventions. Across the five programme scenarios, 1.75-5.60 million treatments were administered by 2030. Reduction in incidence (annual number of new infections) by 2030 ranged between 29% and 99%, programme-attributed reduction in incidence rate (new infections per susceptible person per year) ranged between 18% and 99%, number of infections averted ranged between 42 393 and 469 599, and chronic infection prevalence reached as low as 2.8%-0.1%. Reduction in incidence rate year by year hovered around 7%-15% in the first decade of the programme in most scenarios. Treatment coverage in 2030 ranged between 24.9% and 98.8%, and number of treatments required to avert one new infection ranged between 9.5 and 12.1. Stipulated targets for HCV by 2030 could not be achieved without scaling-up treatment to 365 000 per year and sustaining it for a decade. In conclusion, DAA scale-up will have an immense and immediate impact on HCV incidence in Egypt. Elimination by 2030 is feasible if sufficient resources are committed to programme scale-up and sustainability. HCV treatment as prevention is a potent and effective prevention approach. © 2017 The Authors. Journal of Viral Hepatitis Published by John Wiley & Sons Ltd.

  11. Factors influencing the treatment outcome for patients with T2N0 glottic carcinoma treated by definitive radiotherapy

    International Nuclear Information System (INIS)

    Fukuda, Ichiro; Kanehira, Chihiro; Kobayashi, Masao; Aoki, Manabu; Takagi, Sayako; Shirahama, Jun; Honda, Chikara

    2007-01-01

    The purpose of this study was to determine the prognostic factors affecting local outcomes for patients with T2N0 glottic carcinoma treated by definitive radiotherapy. A total of 48 patients with T2N0 squamous cell carcinoma treated by definitive radiotherapy between 1992 and 2005 were studied. Cumulative probability of overall survival, cause-specific survival, local control and larynx-preserving were calculated according the Kaplan-Meier method, and the prognostic significance of patient's age, number of subsites involved, impaired cord mobility, anterior commisure involved, total dose and overall treatment time were analyzed using the log-rank test in univariate analysis and Cox regression in multivariate analysis. Follow-up ranged from 13 to 141 months (median, 62 months). Five-year survivals were: overall, 95.3%; cause-specific, 97.9% and five years rates were local control, 61.4%; larynx-preserving, 76.4%. Multivariate analyses of the six parameters showed that overall treatment time significantly influenced the probability of local control, and impaired mobility and overall treatment time affected the probability of larynx-preserving. Our study showed that longer overall treatment time significantly worsened the percentage of local control and larynx-preserving for patients with T2N0 glottic carcinoma treated with definitive radiotherapy. Therefore, we suggest treating, the patients in a shorter treatment course. (author)

  12. Biologically effective dose and definitive radiation treatment for localized prostate cancer. Treatment gaps do affect the risk of biochemical failure

    Energy Technology Data Exchange (ETDEWEB)

    Sanpaolo, P.; Barbieri, V. [CROB, Rionero in Vulture (Italy). Radiation Oncology Dept.; Genovesi, D. [' ' G. D' Annunzio Univ., Chieti (Italy). Radiation Oncology Dept.

    2014-08-15

    It is not clear if prolongation of definitive external radiation therapy for prostate cancer has an effect on biochemical failure. The aim of this work was to evaluate whether the biologically effective dose (BED), and in particular the duration of radiotherapy, intended as overall treatment time, has an effect on biochemical failure rates and to develop a nomogram useful to predict the 6-year probability of biochemical failure. A total of 670 patients with T1-3 N0 prostate cancer were treated with external beam definitive radiotherapy, to a total dose of 72-79.2 Gy in 40-44 fractions. The computed BED values were treated with restricted cubic splines. Variables were checked for colinearity using Spearman's test. The Kaplan-Meier method was used to calculate freedom from biochemical relapse (FFBR) rates. The Cox regression analysis was used to identify prognostic factors of biochemical relapse in the final most performing model and to create a nomogram. Concordance probability estimate and calibration methods were used to validate the nomogram. Neoadjuvant and concomitant androgen deprivation was administered to 475 patients (70 %). The median follow-up was 80 months (range 20-129 months). Overall, the 6-year FFBR rate was 88.3 %. BED values were associated with higher biochemical failure risk. Age, iPSA, risk category, and days of radiotherapy treatment were independent variables of biochemical failure. A prolongation of RT (lower BED values) is associated with an increased risk of biochemical failure. The nomogram may be helpful in decision making for the individual patient. (orig.) [German] Es ist nicht geklaert, ob die Verlaengerung einer definitiven Strahlentherapie bei der Behandlung von Prostatakarzinompatienten einen Effekt auf das biochemische Versagen hat. Die vorliegende Studie hat das Ziel zu evaluieren, ob biologisch die effektive Dosis und insbesondere die Gesamtdauer der Behandlung eine Wirkung auf das biochemisches Rezidiv haben koennte. Ferner

  13. On the definition of chronic cough and current treatment pathways: an international qualitative study

    Science.gov (United States)

    2014-01-01

    Background The pathogenesis of chronic cough is not well understood and treatment options are limited. In this study we sought to explore the current understanding and management of chronic cough across an international group of specialists. Methods This was an international study of cross sectional qualitative design. In depth interviews were carried out with “Respiratory Specialists” experienced in treating treating Chronic Obstructive Pulmonary Disease (COPD), idiopathic pulmonary fibrosis (IPF), idiopathic chronic cough (ICC) and/or lung cancer patients and with “Disease Experts” in the field of Chronic Cough. Participants in the study were recruited from the USA, UK, Germany, Ireland, Australia and Japan. Interviews with specialists were held at research facilities and with DEs over the telephone. These were preceded by the specialists completing case records of patients recently seen. All interviews were conducted by native speaking trained moderators using a semi-structured interview guide script. This was designed to elicit the definition of chronic cough, explore the unmet needs for each disease state, define therapy goals, identify patient phenotypes and give an overview of the treatment pathway. Results 76 specialists and 10 experts took part in the study. Over two thirds (70%) of respondents defined chronic cough as “cough lasting more than 8/12 weeks” (range 2 weeks to 2 years). Physicians emphasised three interdependent aspects of clinical assessment: impact on quality of life, type of cough (productive versus non-productive) and the underlying pathology. Specialists emphasised treating the underlying cause rather than the cough, this being most prominent in Japan. Experts as a group focussed on chronic cough independently. Evaluation of the respiratory system, GI tract and upper airway (ENT) for establishing an underlying cause was recommended. Type of cough (productive vs non-productive) and impact on quality of life influenced

  14. Interventions for healthcare providers to improve treatment and prevention of female genital mutilation: a systematic review.

    Science.gov (United States)

    Balfour, Julie; Abdulcadir, Jasmine; Say, Lale; Hindin, Michelle J

    2016-08-19

    Studies on healthcare providers' awareness, knowledge and attitudes regarding female genital mutilation (FGM) have shown a lack of awareness of the prevalence, diagnosis, and management of FGM. Our objective was to systematically review the literature on interventions improving healthcare providers' capacities of prevention and treatment of FGM. Systematic review of the published and grey literature on interventions aimed at improving healthcare providers' capacities of prevention and treatment of FGM (1995-2015). Outcomes observed were knowledge and attitudes about FGM, medicalization, and prevention. Only two studies met our inclusion criteria. They reported on educational interventions aimed at increasing caregivers' knowledge on FGM. One was conducted with 59 providers, in Mali; the other one with 11 certified nurse-midwives in the United States. The studies report basic statistics regarding the improvement of healthcare professionals' knowledge, attitude on FGM and medicalization of the practice. Neither conducted multivariable analysis nor evaluated the training effects on the quality of the care offered, the clinical outcomes and the satisfaction of women attended, and prevention. As health care providers are essential in prevention and treatment of FGM, developing effective interventions is crucial.

  15. Situation of radioactive wastes and their prevention and treatment measures in China's uranium mining and metallurgy

    International Nuclear Information System (INIS)

    Li Renjie.

    1988-01-01

    The sorts of radioactive wastes produced in uranium mining and metallurgy and their hazards are discribed in this paper. The characteristics of the radioactive wastes are discussed. The measurements and results are introduced for treatment and disposal of the radioactive wastes. The way to deal with prevention and treatment of radioactive wastes is presented in the stages of engineering design, construction, production and decommission of uranium mines and plants

  16. 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....

  17. Prevention, screening and treatment of colorectal cancer: a global and regional generalized cost effectiveness analysis

    Directory of Open Access Journals (Sweden)

    Johns Benjamin P

    2010-03-01

    Full Text Available Abstract Background Regional generalized cost-effectiveness estimates of prevention, screening and treatment interventions for colorectal cancer are presented. Methods Standardised WHO-CHOICE methodology was used. A colorectal cancer model was employed to provide estimates of screening and treatment effectiveness. Intervention effectiveness was determined via a population state-transition model (PopMod that simulates the evolution of a sub-regional population accounting for births, deaths and disease epidemiology. Economic costs of procedures and treatment were estimated, including programme overhead and training costs. Results In regions characterised by high income, low mortality and high existing treatment coverage, the addition of screening to the current high treatment levels is very cost-effective, although no particular intervention stands out in cost-effectiveness terms relative to the others. In regions characterised by low income, low mortality with existing treatment coverage around 50%, expanding treatment with or without screening is cost-effective or very cost-effective. Abandoning treatment in favour of screening (no treatment scenario would not be cost effective. In regions characterised by low income, high mortality and low treatment levels, the most cost-effective intervention is expanding treatment. Conclusions From a cost-effectiveness standpoint, screening programmes should be expanded in developed regions and treatment programmes should be established for colorectal cancer in regions with low treatment coverage.

  18. Prevalence of the metabolic syndrome among North Indian adolescents using Adult Treatment Panel III and pediatric International Diabetic Federation definitions

    Directory of Open Access Journals (Sweden)

    Riyaz Ahmad Bhat

    2015-01-01

    Full Text Available Background and Objective: Childhood obesity is an important risk factor for the development of metabolic syndrome (MS in children and adolescent. Because of high prevalence of insulin resistance and MS in Indian adult population, studies are needed to identify the prevalence of these metabolic abnormalities in the adolescent population. The objective of this study was to estimate the prevalence of MS using pediatric International Diabetic Federation (IDF definition and compare it with estimates of Adult Treatment Panel III (ATP III definition among adolescents in Northern India. Materials and Methods: At a total of 899 adolescents attending school (aged 10-18 years participated in this population-based prospective study. All the clinical and biochemical assessment were done after proper consent. The MS was determined by the National Cholesterol Education Program ATP III definition modified for age and pediatric IDF definition. Results: The prevalence of MS was 3.5% according to ATP III criteria and 1.5% based on IDF criteria. No significant gender difference was observed in the distribution of MS. Hypertriglyceridemia was the most common and abdominal obesity the least common constituent of MS. Conclusion: This study provides the first estimates of MS using pediatric IDF definition in the adolescent population from Northern India.

  19. The cost of prevention and treatment of pressure ulcers: A systematic review.

    Science.gov (United States)

    Demarré, Liesbet; Van Lancker, Aurélie; Van Hecke, Ann; Verhaeghe, Sofie; Grypdonck, Maria; Lemey, Juul; Annemans, Lieven; Beeckman, Dimitri

    2015-11-01

    Pressure ulcers impose a substantial financial burden. The need for high-quality health care while expenditures are constrained entails the interest to calculate the cost of preventing and treating pressure ulcers and their impact on patients, healthcare, and society. The aim of this paper is to provide insight into the cost of pressure ulcer prevention and treatment in an adult population. A systematic literature review was performed to conform the Cochrane Collaboration guidelines for systematic reviews. The search strategy contained index terms and key words related to pressure ulcers and cost. The search was performed in Medline, CINAHL, Web of Science, The Cochrane Library, Embase, and EconLit covering articles up to September 2013. Reference lists and conference abstracts were screened. Articles were eligible if they reported on direct medical cost of pressure ulcer prevention or treatment, and provided national cost estimates, cost per patient, or cost per patient per day. The Consensus on Health Economic Criteria checklist was used to assess methodological quality of the included studies. In total, 2542 records were retrieved. After assessing eligibility, 17 articles were included. Five articles reported on both the cost of prevention and treatment, three articles reported on cost of prevention, and nine articles reported on the cost of pressure ulcer treatment. All articles were published between 2001 and 2013. Cost of pressure ulcer prevention per patient per day varied between 2.65 € to 87.57 € across all settings. Cost of pressure ulcer treatment per patient per day ranged from 1.71 € to 470.49 € across different settings. The methodological heterogeneity among studies was considerable, and encompassed differences regarding type of health economic design, perspective, cost components, and health outcomes. Cost of pressure ulcer prevention and treatment differed considerable between studies. Although the cost to provide pressure ulcer prevention

  20. Candidiasis: a fungal infection--current challenges and progress in prevention and treatment.

    Science.gov (United States)

    Hani, Umme; Shivakumar, Hosakote G; Vaghela, Rudra; Osmani, Riyaz Ali M; Shrivastava, Atul

    2015-01-01

    Despite therapeutic advances candidiasis remains a common fungal infection most frequently caused by C. albicans and may occur as vulvovaginal candidiasis or thrush, a mucocutaneous candidiasis. Candidiasis frequently occurs in newborns, in immune-deficient people like AIDS patients, and in people being treated with broad spectrum antibiotics. It is mainly due to C. albicans while other species such as C. tropicalis, C. glabrata, C. parapsilosis and C. krusei are increasingly isolated. OTC antifungal dosage forms such as creams and gels can be used for effective treatment of local candidiasis. Whereas, for preventing spread of the disease to deeper vital organs, candidiasis antifungal chemotherapy is preferred. Use of probiotics and development of novel vaccines is an advanced approach for the prevention of candidiasis. Present review summarizes the diagnosis, current status and challenges in the treatment and prevention of candidiasis with prime focus on host defense against candidiasis, advancements in diagnosis, probiotics role and recent progress in the development of vaccines against candidiasis.

  1. Bioactive Peptide of Marine Origin for the Prevention and Treatment of Non-Communicable Diseases.

    Science.gov (United States)

    Pangestuti, Ratih; Kim, Se-Kwon

    2017-03-09

    Non-communicable diseases (NCD) are the leading cause of death and disability worldwide. The four main leading causes of NCD are cardiovascular diseases, cancers, respiratory diseases and diabetes. Recognizing the devastating impact of NCD, novel prevention and treatment strategies are extensively sought. Marine organisms are considered as an important source of bioactive peptides that can exert biological functions to prevent and treatment of NCD. Recent pharmacological investigations reported cardio protective, anticancer, antioxidative, anti-diabetic, and anti-obesity effects of marine-derived bioactive peptides. Moreover, there is available evidence supporting the utilization of marine organisms and its bioactive peptides to alleviate NCD. Marine-derived bioactive peptides are alternative sources for synthetic ingredients that can contribute to a consumer's well-being, as a part of nutraceuticals and functional foods. This contribution focus on the bioactive peptides derived from marine organisms and elaborates its possible prevention and therapeutic roles in NCD.

  2. Delinquency and Crime Prevention: Overview of Research Comparing Treatment Foster Care and Group Care

    Science.gov (United States)

    Osei, Gershon K.; Gorey, Kevin M.; Jozefowicz, Debra M. Hernandez

    2016-01-01

    Background: Evidence of treatment foster care (TFC) and group care's (GC) potential to prevent delinquency and crime has been developing. Objectives: We clarified the state of comparative knowledge with a historical overview. Then we explored the hypothesis that smaller, probably better resourced group homes with smaller staff/resident ratios have…

  3. A summary of the symposium "Current strategies in the prevention and treatment of obesity".

    Science.gov (United States)

    Katzmarzyk, Peter T

    2006-12-01

    This symposium addressed important issues related to the prevention and treatment of obesity and provided practical advice for health professionals. The importance of the maintenance of long-term lifestyle changes were emphasized throughout the symposium as being an integral component to the maintenance of healthy body masses.

  4. Recommendations for the diagnosis, treatment and prevention of the pneumonia acquired in the community in adults

    International Nuclear Information System (INIS)

    2003-01-01

    The pneumonia acquired in the community in adults, is the acute infection of the pulmonary parenchyma that is developed away from the hospital environment, it is manifested in the first 48 hours from the entrance to the hospital or after seven days of having left. The supplement includes clinical square, epidemiology, etiology classification, diagnostic, treatment and prevention among others

  5. Lactobacillus GG prevents recurrence of colitis in HLA-B27 transgenic rats after antibiotic treatment

    NARCIS (Netherlands)

    Dieleman, L. A.; Goerres, M. S.; Arends, A.; Sprengers, D.; Torrice, C.; Hoentjen, F.; Grenther, W. B.; Sartor, R. B.

    2003-01-01

    Bacteroides vulgatus induces colitis in gnotobiotic HLA-B27 transgenic (TG) rats while broad spectrum antibiotics prevent and treat colitis in specific pathogen free (SPF) TG rats although disease recurs after treatment ends. Lactobacilli treat human pouchitis and experimental colitis. We

  6. Considerations for a Human Rights Impact Assessment of a Population Wide Treatment for HIV Prevention Intervention.

    Science.gov (United States)

    Hanefeld, Johanna; Bond, Virginia; Seeley, Janet; Lees, Shelley; Desmond, Nicola

    2015-12-01

    Increasing attention is being paid to the potential of anti-retroviral treatment (ART) for HIV prevention. The possibility of eliminating HIV from a population through a universal test and treat intervention, where all people within a population are tested for HIV and all positive people immediately initiated on ART, as part of a wider prevention intervention, was first proposed in 2009. Several clinical trials testing this idea are now in inception phase. An intervention which relies on universally testing the entire population for HIV will pose challenges to human rights, including obtaining genuine consent to testing and treatment. It also requires a context in which people can live free from fear of stigma, discrimination and violence, and can access services they require. These challenges are distinct from the field of medical ethics which has traditionally governed clinical trials and focuses primarily on patient researcher relationship. This paper sets out the potential impact of a population wide treatment as prevention intervention on human rights. It identifies five human right principles of particular relevance: participation, accountability, the right to health, non-discrimination and equality, and consent and confidentiality. The paper proposes that explicit attention to human rights can strengthen a treatment as prevention intervention, contribute to mediating likely health systems challenges and offer insights on how to reach all sections of the population. © 2013 John Wiley & Sons Ltd.

  7. Family Factors in the Development, Treatment, and Prevention of Childhood Anxiety Disorders

    Science.gov (United States)

    Drake, Kelly L.; Ginsburg, Golda S.

    2012-01-01

    It is now widely accepted that anxiety disorders run in families, and current etiological models have proposed both genetic and environmental pathways to anxiety development. In this paper, the familial role in the development, treatment, and prevention of anxiety disorders in children is reviewed. We focus on three anxiety disorders in youth,…

  8. Fluoride in the prevention and treatment of glucocorticoid-induced osteoporosis

    NARCIS (Netherlands)

    Lems, W. F.; Jacobs, J. W. G.; Bijlsma, J. W. J.

    2000-01-01

    Since the use of fluoride has been shown to stimulate bone formation and since decreased bone formation is a key feature in the pathogenesis of corticosteroid-induced osteoporosis (CIOP), fluoride is, at least theoretically, attractive for the prevention and treatment of CIOP. In postmenopausal

  9. State Part C Agency Practices and the Child Abuse Prevention and Treatment Act (CAPTA)

    Science.gov (United States)

    Stahmer, Aubyn C.; Sutton, Danielle Thorp; Fox, Lise; Leslie, Laurel K.

    2008-01-01

    Each year nearly 900,000 cases of child abuse and neglect are substantiated in the United States, with the highest rates of maltreatment occurring among infants and toddlers. Children exposed to maltreatment are at increased risk of developmental delay. The Child Abuse Prevention and Treatment Act specifies that children under age 3 with…

  10. Future Directions in Etiologic, Prevention, and Treatment Research for Eating Disorders

    Science.gov (United States)

    Stice, Eric; South, Kelsey; Shaw, Heather

    2012-01-01

    Significant advances have occurred regarding the understanding of etiologic processes that give rise to eating disorders and the design and evaluation of efficacious prevention programs and treatment interventions. Herein we offer suggestions regarding potentially fruitful directions for future research in these areas. We suggest it would be…

  11. [Recognizing prevention and treatment of burn sepsis with the concept of holistic integrative medicine].

    Science.gov (United States)

    Huan, J N

    2017-04-20

    Sepsis remains a major cause of death in severe burns. The effect of sepsis management is influenced by its complicated pathophysiologic changes. In order to improve the outcome of burn sepsis, the predisposing factor of sepsis after burn analyzed by advanced technology, the early prevention, antibiotics therapy, and combined treatment in severe burns with sepsis are discussed using the concept of holistic integrative medicine.

  12. Prevention and Treatment of Venous Thromboembolism in Patients with Cancer: Focus on Drug Therapy

    NARCIS (Netherlands)

    van Es, Nick; Bleker, Suzanne M.; Wilts, Ineke T.; Porreca, Ettore; Di Nisio, Marcello

    2016-01-01

    Venous thromboembolism (VTE) is a frequent complication in patients with cancer and is associated with significant morbidity and mortality. The use of anticoagulants for the prevention and treatment of VTE in this population is challenging given the high risk of both recurrent VTE and bleeding

  13. Cost-effectiveness of prevention and treatment of the diabetic foot: a Markov analysis

    NARCIS (Netherlands)

    M.M. Ortegon (Monica); W.K. Redekop (Ken); L.W. Niessen (Louis Wilhelmus)

    2004-01-01

    textabstractOBJECTIVE: To estimate the lifetime health and economic effects of optimal prevention and treatment of the diabetic foot according to international standards and to determine the cost-effectiveness of these interventions in the Netherlands. RESEARCH DESIGN AND METHODS:

  14. Methods used for prevention of white spot lesion development during orthodontic treatment with fixed appliances

    NARCIS (Netherlands)

    Kerbusch, A.E.; Kuijpers-Jagtman, A.M.; Mulder, J.; Sanden, W.J.M. van der

    2012-01-01

    OBJECTIVES: The aim of this study was to survey methods that Dutch orthodontists use to prevent development or progression of enamel decalcifications during orthodontic treatment. MATERIALS AND METHODS: A pre-tested questionnaire was sent by post to all orthodontists in the Netherlands with a

  15. A systematic review on zinc for the prevention and treatment of age-related macular degeneration

    Science.gov (United States)

    Zinc is a potential candidate for the prevention and treatment of age-related macular degeneration (AMD) due to its high concentration in the retina and role as a cofactor for antioxidant enzymes. The objective of this work was to conduct a systematic review of studies that investigated dietary inta...

  16. The Adolescent Drug Abuse Prevention and Treatment (ADAPT) Program: A Mental Health-Law Enforcement Collaboration

    Science.gov (United States)

    Van Hasselt, Vincent B.; Schlessinger, Kari M.; DiCicco, Tina M.; Anzalone, William F.; Leslie, Tricia L.; George, John A.; Werder, Edward J.; Massey, Larry L.

    2006-01-01

    The present study provides preliminary data concerning the efficacy of the Adolescent Drug Abuse Prevention and Treatment (ADAPT) Program, a collaborative effort involving mental health and law enforcement. ADAPT is a multi-component, cognitive-behavioral outpatient intervention serving children and youth referred directly from local police…

  17. Treatment of superficial vein thrombosis to prevent deep vein thrombosis and pulmonary embolism: a systematic review

    NARCIS (Netherlands)

    Wichers, Iris M.; Di Nisio, Marcello; Büller, Harry R.; Middeldorp, Saskia

    2005-01-01

    The aim of this systematic review was to summarize the evidence from randomized controlled trials (RCT) concerning the efficacy and safety of medical or surgical treatments of superficial vein thrombosis (SVT) for the prevention of deep venous thrombosis (DVT) and pulmonary embolism (PE). A

  18. Prevention and Treatment of Venous Thromboembolism in Patients with Cancer : Focus on Drug Therapy

    NARCIS (Netherlands)

    van Es, Nick; Bleker, Suzanne M.; Wilts, Ineke T.; Porreca, Ettore; Di Nisio, Marcello

    Venous thromboembolism (VTE) is a frequent complication in patients with cancer and is associated with significant morbidity and mortality. The use of anticoagulants for the prevention and treatment of VTE in this population is challenging given the high risk of both recurrent VTE and bleeding

  19. Eating Disorders in Female College Athletes: Risk Factors, Prevention, and Treatment

    Science.gov (United States)

    Pearson, Frances C.; Rivers, Tara C.

    2006-01-01

    Female athletes are at risk for developing eating disorders because of the pressures that are placed on them by society, their peers, their coaches, and the sports culture itself. This paper reviews the literature on the risk factors involved and various methods of prevention and treatment. The authors conclude that individual and group approaches…

  20. Diagnosis, treatment and prevention of ankle sprains : an evidence-based clinical guideline

    NARCIS (Netherlands)

    Kerkhoffs, Gino M.; van den Bekerom, Michel; Elders, Leon A. M.; van Beek, Peter A.; Hullegie, Wim A. M.; Bloemers, Guus M. F. M.; de Heus, Elly M.; Loogman, Masja C. M.; Rosenbrand, Kitty C. J. G. M.; Kuipers, Ton; Hoogstraten, J. W. A. P.; Dekker, Rienk; ten Duis, Henk-Jan; van Dijk, C. Niek; van Tulder, Maurits W.; van der Wees, Philip J.; de Bie, Rob A.

    Ankle injuries are a huge medical and socioeconomic problem. Many people have a traumatic injury of the ankle, most of which are a result of sports. Total costs of treatment and work absenteeism due to ankle injuries are high. The prevention of recurrences can result in large savings on medical

  1. Reflections on involuntary treatment in the prevention of fatal anorexia nervosa: A review of five cases

    DEFF Research Database (Denmark)

    Holm, Janni Schmidt; Brixen, Kim; Andries, Alin

    2011-01-01

    OBJECTIVE: Involuntary treatment in the prevention of fatal anorexia nervosa (AN) is still controversial. METHOD: Five fatal cases of AN were identified out of 1,160 patients who attended a specialized eating disorder unit between 1994 and 2006. Information on inpatient, ambulatory, and emergency...

  2. 77 FR 23733 - CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment

    Science.gov (United States)

    2012-04-20

    ... Resources and Services Administration CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment In... and control of HIV/AIDS and other STDs, the support of health care services to persons living with HIV/AIDS, and education of health professionals and the public about HIV/AIDS and other STDs. Matters To Be...

  3. 75 FR 39264 - CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment

    Science.gov (United States)

    2010-07-08

    ... Resources and Services Administration CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment In... and control of HIV/AIDS and other STDs, the support of health care services to persons living with HIV/AIDS, and education of health professionals and the public about HIV/AIDS and other STDs. Matters To Be...

  4. Examining trends in the treatment of ureterocele yields no definitive solution.

    Science.gov (United States)

    Cohen, S A; Juwono, T; Palazzi, K L; Kaplan, G W; Chiang, G

    2015-02-01

    difference in unplanned revision surgery was noted in the UTA group versus each of the other groups with VUR as the predominant indication (88.9%). The likelihood of requiring revision surgery in comparison to the SLTR group was significantly increased in the UTA group (OR 9.67, CI 2.15-43.56), but not in the LTR (OR 2.61, CI 0.66-10.37) or the ULTA group (OR 2.04, CI 0.41-10.13). Obstruction, recurring UTIs and VUR were the main indications for revision surgery overall. There is a large body of literature examining the surgical management of ureteroceles. It most recently primarily focuses on an endoscopic approach to the lower tract. The present retrospective review examined the need for re-operative intervention by comparing four different surgical approaches, and found that there is no panacea. Although heminephrectomy (UTA) was a definitive procedure in some patients without reflux at presentation, many who underwent heminephrectomy, went on to require later bladder surgery for either recurrent UTI or persistent reflux. The present study has multiple limitations. Although VUR was an indication for revision surgery in the early part of the series, the current treatment of VUR is not necessarily as stringent. In addition, no distinction was made between an orthotopic or ectopic ureterocele, although some authors have reported differing outcomes in these two groups. However, it is felt that given the large data set of a relatively uncommon condition, the lack of superiority of one approach is apparent. There is no definitive surgical repair for the ureterocele complex. All groups except UTA had statistically similar rates of revision surgery. The widespread variability in current management echoes the lack of one superior approach found in this comprehensive series. Copyright © 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  5. Safety climate and workplace violence prevention in state-run residential addiction treatment centers.

    Science.gov (United States)

    Lipscomb, Jane A; London, M; Chen, Y M; Flannery, K; Watt, M; Geiger-Brown, J; Johnson, J V; McPhaul, K

    2012-01-01

    To examine the association between violence prevention safety climate measures and self reported violence toward staff in state-run residential addiction treatment centers. In mid-2006, 409 staff from an Eastern United States state agency that oversees a system of thirteen residential addiction treatment centers (ATCs) completed a self-administered survey as part of a comprehensive risk assessment. The survey was undertaken to identify and measure facility-level risk factors for violence, including staff perceptions of the quality of existing US Occupational Safety and Health Administration (OSHA) program elements, and ultimately to guide violence prevention programming. Key informant interviews and staff focus groups provided researchers with qualitative data with which to understand safety climate and violence prevention efforts within these work settings. The frequency with which staff reported experiencing violent behavior ranged from 37% for "clients raised their voices in a threatening way to you" to 1% for "clients pushed, hit, kicked, or struck you". Findings from the staff survey included the following significant predictors of violence: "client actively resisting program" (OR=2.34, 95% CI=1.35, 4.05), "working with clients for whom the history of violence is unknown" (OR=1.91, 95% CI=1.18, 3.09) and "management commitment to violence prevention" reported as "never/hardly ever" and "seldom or sometimes" (OR=4.30 and OR=2.31 respectively), while controlling for other covariates. We utilized a combination of qualitative and quantitative research methods to begin to describe the risk and potential for violence prevention in this setting. The prevalence of staff physical violence within the agency's treatment facilities was lower than would be predicted. Possible explanations include the voluntary nature of treatment programs; strong policies and consequences for resident behavior and ongoing quality improvement efforts. Quantitative data identified low

  6. Mapping the evidence for the prevention and treatment of eating disorders in young people

    Science.gov (United States)

    2014-01-01

    Abstract Eating disorders often develop during adolescence and young adulthood, and are associated with significant psychological and physical burden. Identifying evidence-based interventions is critical and there is need to take stock of the extant literature, to inform clinical practice regarding well-researched interventions and to direct future research agendas by identifying gaps in the evidence base. Aim To investigate and quantify the nature and distribution of existing high-quality research on the prevention and treatment of eating disorders in young people using evidence mapping methodology. Method A systematic search for prevention and treatment intervention studies in adolescents and young adults (12–25 years) was conducted using EMBASE, PSYCINFO and MEDLINE. Studies were screened and mapped according to disorder, intervention modality, stage of eating disorder and study design. Included studies were restricted to controlled trials and systematic reviews published since 1980. Results The eating disorders evidence map included 197 trials and 22 systematic reviews. Prevention research was dominated by trials of psychoeducation (PE). Bulimia nervosa (BN) received the most attention in the treatment literature, with cognitive behavioural therapy (CBT) and antidepressants the most common interventions. For anorexia nervosa (AN), family based therapy (FBT) was the most studied. Lacking were trials exploring treatments for binge eating disorder (BED) and eating disorder not otherwise specified (EDNOS). Relapse prevention strategies were notably absent across the eating disorders. Conclusions Despite substantial literature devoted to the prevention and treatment of eating disorders in young people, the evidence base is not well established and significant gaps remain. For those identified as being at-risk, there is need for prevention research exploring strategies other than passive PE. Treatment interventions targeting BED and EDNOS are required, as are

  7. Mapping the evidence for the prevention and treatment of eating disorders in young people.

    Science.gov (United States)

    Bailey, Alan P; Parker, Alexandra G; Colautti, Lauren A; Hart, Laura M; Liu, Ping; Hetrick, Sarah E

    2014-01-01

    Eating disorders often develop during adolescence and young adulthood, and are associated with significant psychological and physical burden. Identifying evidence-based interventions is critical and there is need to take stock of the extant literature, to inform clinical practice regarding well-researched interventions and to direct future research agendas by identifying gaps in the evidence base. To investigate and quantify the nature and distribution of existing high-quality research on the prevention and treatment of eating disorders in young people using evidence mapping methodology. A systematic search for prevention and treatment intervention studies in adolescents and young adults (12-25 years) was conducted using EMBASE, PSYCINFO and MEDLINE. Studies were screened and mapped according to disorder, intervention modality, stage of eating disorder and study design. Included studies were restricted to controlled trials and systematic reviews published since 1980. The eating disorders evidence map included 197 trials and 22 systematic reviews. Prevention research was dominated by trials of psychoeducation (PE). Bulimia nervosa (BN) received the most attention in the treatment literature, with cognitive behavioural therapy (CBT) and antidepressants the most common interventions. For anorexia nervosa (AN), family based therapy (FBT) was the most studied. Lacking were trials exploring treatments for binge eating disorder (BED) and eating disorder not otherwise specified (EDNOS). Relapse prevention strategies were notably absent across the eating disorders. Despite substantial literature devoted to the prevention and treatment of eating disorders in young people, the evidence base is not well established and significant gaps remain. For those identified as being at-risk, there is need for prevention research exploring strategies other than passive PE. Treatment interventions targeting BED and EDNOS are required, as are systematic reviews synthesising BN treatment

  8. Determinants for acceptance of preventive treatment against heart disease - a web-based population survey.

    Science.gov (United States)

    Bo, Nielsen Jesper; Ejg, Jarbøl Dorte; Dorte, Gyrd-Hansen; Lind, Barfoed Benedicte Marie; Veldt, Larsen Pia

    2014-08-02

    Patients' perception of risk and their lifestyle choices are of major importance in the treatment of common chronic diseases. This study reveals determinants for and knowledge about why people accept or reject preventive medical interventions against heart disease. A representative sample of 40-60-year-old Danish inhabitants was invited to participate in a web-based survey. The respondents were presented with a hypothetical scenario and asked to imagine that they were at an increased risk of heart disease, and subsequently presented with an offer of a preventive medical intervention. The aim was to elicit preference structures when potential patients are presented with different treatment conditions. About one third of the respondents were willing to accept preventive medical treatment. Respondents with personal experience with heart disease were more likely to accept treatment than respondents with family members with heart disease or no prior experience with heart disease. The willingness to accept treatment was similar for both genders, and when adjusting for experience with heart disease, age was not associated with willingness to accept treatment. Socioeconomic status in terms of lower education was positively associated with acceptance. The price of treatment reduced willingness to accept for the lower income groups, whereas it had no effect in the highest income group. Some 57% of respondents who were willing to accept treatment changed their decision following information on potential side effects. In accordance with our pre-study hypothesis, individuals with low income were more sensitive to price than individuals with high income. Thus, if the price of preventive medication increases above certain limits, a substantial proportion of the population may refrain from treatment. More than half of the respondents who were initially willing to accept treatment changed their decision when informed about the presence of potential side effects. This is an

  9. Oral diagnosis and treatment planning: part 6. Preventive and treatment planning for periodontal disease.

    Science.gov (United States)

    Corbet, E; Smales, R

    2012-09-01

    A high level of sustained personal plaque control is fundamental for successful treatment outcomes in patients with active periodontal disease and, hence, oral hygiene instructions are the cornerstone of periodontal treatment planning. Other risk factors for periodontal disease also should be identified and modified where possible. Many restorative dental treatments in particular require the establishment of healthy periodontal tissues for their clinical success. Failure by patients to control dental plaque because of inappropriate designs and materials for restorations and prostheses will result in the long-term failure of the restorations and the loss of supporting tissues. Periodontal treatment planning considerations are also very relevant to endodontic, orthodontic and osseointegrated dental implant conditions and proposed therapies.

  10. Limitations of the bowel bag contouring technique in the definitive treatment of cervical cancer.

    Science.gov (United States)

    Dominello, Michael M; Nalichowski, Adrian; Paximadis, Peter; Kaufman, Isaac; McSpadden, Erin; Joiner, Michael; Miller, Steven; Konski, Andre

    2014-01-01

    Incidence of acute grade 3 and 4 small bowel toxicity in the definitive treatment of cervical cancer is approximately 15%. Given uncertainties in position of the bowel at time of treatment, techniques including the contouring of a bowel bag have been suggested. The purpose of this study is to describe interfraction variability in bowel location for the female pelvis with intact reproductive organs and to characterize the ability of the bowel bag technique, as described in the Radiation Therapy Oncology Group pelvic normal tissue contouring guidelines, to account for organ motion in this specific clinical setting. Bowel position was assessed for 45 computed tomographic scans used in treatment planning for 9 consecutive cervical cancer patients. After a single operator contoured bowel loops, most superior, anterior, posterior, and inferior positions of bowel were recorded. Mixed effects models were used to assess significance of interfraction variability. Frequency of bowel loop migration outside of the bowel bag was then considered for each patient given all potential bowel bag volumes. Standardized scoring was used to determine additional margins that would be required to account for 95%, 90%, and 85% of significant bowel motion. Interfraction variability in the inferior-most bowel position was significant (P = .002). Median maximum variation in the inferior bowel position was 2.1 cm (range, 0.9 cm-4.8 cm). When applying the bowel bag technique, 100% of bowel motion was accounted for as the bowel translated laterally, anteriorly, posteriorly, and superiorly, though accounted for just 70.3% of motion in the inferior direction. A 4-cm inferior margin was required to account for 90% of motion in the inferior direction. In the intact female pelvis, the bowel bag technique is successful in accounting for most interfraction variability in bowel position but underestimates inferior motion. Until an improved approach to predicting small bowel motion can be routinely

  11. Investigation of knowledge, attitudes and perceptions of nursing staff in oncology hospital regarding the prevention and treatment of pressure ulcers

    Directory of Open Access Journals (Sweden)

    Aikaterini Vangelatou

    2017-10-01

    Full Text Available Introduction: Approximately 300 million people, 3% of the world population, need palliative care or terminal care each year, including prevention and care of pressure ulcers. Aim: The aim of this study was to evaluate the knowledge, practices and attitudes of nurses of an oncology hospital in Greece on the prevention and treatment of pressure ulcers. Methodology: This is a cross-sectional study in an Oncology Hospital of Athens. The study population was nurses and their assistants working in the particular hospital. Data collection was conducted by using a specially designed research tool. In total, 150 questionnaires were distributed and 115 were collected (response rate 76.7%. The study lasted 6 months (from July 2016 to December 2016. The statistical analysis was performed with the statistical program SPSS for Windows (version 21 statistical software. Results: The study sample consisted of 115 nurses and their assistants, age 41.6 (±6.8 years old. The average length of employment of the participants was 17.1(±7.5 years. Of the total sample, 16 (13.9% participants reported that the hospital they work organize training seminars/courses for the prevention and treatment of pressure ulcers. Almost all participants (99.1% answered correctly to the definition of pressure ulcers. Only 42.6% of the respondents answered correctly for the best position to prevent pressure sores, while most answered correctly to the questions concerning the risk factors for the development of pressure ulcers. About half of participants (48 reported that the clinic they work use an assessment scale for pressure ulcers and 35 (72.9% participants completed it once a day. On the total of 27 questions, the correct answers given by respondents were 20.9 (±2.8 or 77.7% with a minimum of 8 (29.6% and maximum 27 (100% correct answers. Conclusions: Although oncology patients often experience problems with depression, however, the hospital did not seem to systematically

  12. Treatment and prevention of tumor lysis syndrome in children. Experience of Associazione Italiana Ematologia Oncologia Pediatrica.

    Science.gov (United States)

    Pession, Andrea; Barbieri, Eveline

    2005-01-01

    Hyperuricemia and tumor lysis syndrome (TLS) are complications that can arise from treatment of rapidly proliferating and drug-sensitive neoplasms. Clinical trials have shown rasburicase, a recombinant urate oxidase to be more effective than allopurinol for the prevention and treatment of malignancy-associated hyperuricemia. We investigated the safety and efficacy of rasburicase in the AIEOP centers' experience. We reviewed the data of 26 children with malignancy at risk for TLS, submitted to treatment (group 1) or prophylaxis (group 2) of acute hyperuricemia with rasburicase (0.20 mg/kg intravenously daily) for a median period of 4 days. Rasburicase produced a significant decrease in uric acid concentrations in all the patients. The control of uric acid levels was obtained in both the groups within 24 h of the first dose with a response rate of 100% (group 1) and 93% (group 2). Normalization of creatinine and phosphorus levels was obtained in 5 and 4 days respectively. Tolerance was excellent without toxicity. These data confirm that rasburicase is a safe, highly and rapidly effective agent in the treatment and prevention of malignancy-associated acute hyperuricemia and could be considered the treatment of choice to prevent tumor lysis syndrome in children at high risk for this metabolic complication.

  13. Considering treatment of male genital schistosomiasis as a tool for future HIV prevention

    DEFF Research Database (Denmark)

    Stecher, Chalotte Willemann; Kallestrup, Per; Kjetland, Eyrun Floerecke

    2015-01-01

    and acquisition, and treatment could be a neglected chance of HIV prevention. This review summarizes current knowledge on epidemiology, clinical manifestations, diagnosis and treatment of MGS as a hypothesized risk factor for HIV transmission. Future research areas of global interest are suggested. METHODS: Pub...... association between MGS and HIV are urgently needed. Furthermore, field diagnostic tools should be developed and future mass treatment programs should include adults to reduce morbidity and prevent HIV acquisition. SYSTEMATIC REVIEW REGISTRATION NUMBER: CRD42015016252.......OBJECTIVES: Male genital schistosomiasis (MGS) is a neglected manifestation of Schistosoma haematobium infection with ignored implications on reproductive health and a differential diagnosis to sexually transmitted infections in endemic regions. MGS may have associations with HIV transmission...

  14. Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population

    Science.gov (United States)

    There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demo...

  15. Interventions for pressure ulcers: a summary of evidence for prevention and treatment.

    Science.gov (United States)

    Atkinson, Ross A; Cullum, Nicky A

    2018-03-01

    Narrative review. Pressure ulcers are a common complication in people with reduced sensation and limited mobility, occurring frequently in those who have sustained spinal cord injury. This narrative review summarises the evidence relating to interventions for the prevention and treatment of pressure ulcers, in particular from Cochrane systematic reviews. It also aims to highlight the degree to which people with spinal cord injury have been included as participants in randomised controlled trials included in Cochrane reviews of such interventions. Global. The Cochrane library (up to July 2017) was searched for systematic reviews of any type of intervention for the prevention or treatment of pressure ulcers. A search of PubMed (up to July 2017) was undertaken to identify other systematic reviews and additional published trial reports of interventions for pressure ulcer prevention and treatment. The searches revealed 38 published systematic reviews (27 Cochrane and 11 others) and 6 additional published trial reports. An array of interventions is available for clinical use, but few have been evaluated adequately in people with SCI. The effects of most interventions for preventing and treating pressure ulcers in people with spinal cord injury are highly uncertain. Existing evaluations of pressure ulcer interventions include very few participants with spinal cord injury. Subsequently, there is still a need for high-quality randomised trials of such interventions in this patient population.

  16. Involvement of Fathers in Pediatric Obesity Treatment and Prevention Trials: A Systematic Review.

    Science.gov (United States)

    Morgan, Philip J; Young, Myles D; Lloyd, Adam B; Wang, Monica L; Eather, Narelle; Miller, Andrew; Murtagh, Elaine M; Barnes, Alyce T; Pagoto, Sherry L

    2017-02-01

    Despite their important influence on child health, it is assumed that fathers are less likely than mothers to participate in pediatric obesity treatment and prevention research. This review investigated the involvement of fathers in obesity treatment and prevention programs targeting children and adolescents (0-18 years). A systematic review of English, peer-reviewed articles across 7 databases. Retrieved records included at least 1 search term from 2 groups: "participants" (eg, child*, parent*) and "outcomes": (eg, obes*, diet*). Randomized controlled trials (RCTs) assessing behavioral interventions to prevent or treat obesity in pediatric samples were eligible. Parents must have "actively participated" in the study. Two authors independently extracted data using a predefined template. The search retrieved 213 eligible RCTs. Of the RCTs that limited participation to 1 parent only (n = 80), fathers represented only 6% of parents. In RCTs in which participation was open to both parents (n = 133), 92% did not report objective data on father involvement. No study characteristics moderated the level of father involvement, with fathers underrepresented across all study types. Only 4 studies (2%) suggested that a lack of fathers was a possible limitation. Two studies (1%) reported explicit attempts to increase father involvement. The review was limited to RCTs published in English peer-reviewed journals over a 10-year period. Existing pediatric obesity treatment or prevention programs with parent involvement have not engaged fathers. Innovative strategies are needed to make participation more accessible and engaging for fathers. Copyright © 2017 by the American Academy of Pediatrics.

  17. The Definition and Treatment of Bulimarexia in College Women--A Pilot Study.

    Science.gov (United States)

    Boskind-Ledahl, Marlene; White, William C., Jr.

    1978-01-01

    A study of college women suffering from bulimarexia, a cyclical eating disorder characterized by bingeing/purging behaviors and abnormally low self-esteem, indicates the importance of sociocultural factors in female role definition. (JMF)

  18. [Raloxifene - an unexploited possibility of prevention and treatment of postmenopausal osteoporosis].

    Science.gov (United States)

    Štěpán, Jan; Rosa, Jan; Pavelka, Karel

    Long-term estrogen deficiency after menopause is responsible for different disorders, which not only make the quality of life in the older age worse but also are the major causes of womens mortality. It is especially the case for cardiovascular disease and osteoporosis. Aim of this review is to point at efficacy of raloxifene (a selective estrogen receptor modulator) in the long-term care of the women in their non-reproductive period of life, and namely in prevention and treatment of postmenopausal osteoporosis.Key words: bone turnover - breast cancer - postmenopausal osteoporosis - prevention - raloxifene.

  19. [Problem of motivation of the population to prevention and treatment dental diseases].

    Science.gov (United States)

    Kochlashvili, L Sh; Gogilashvili, K T; Gerzmava, O Kh

    2012-10-01

    Dental health is an integral part of a normal state of a human body and, first of all, depends on knowledge of the population of bases of individual hygiene of an oral cavity and ability to use them in practical life. Numerous researches indicate low level of knowledge of the population in questions of prevention of dental diseases and individual hygiene of an oral cavity that testifies to existence of problems in the organization of sanitary education. Existing practice of hygienic training and education, in a certain measure, lags behind modern requirements, and some questions demand specification and optimization. For efficiency of sanitary and preventive actions it is necessary to study character and motivation structure to prevention and treatment of dental diseases and to develop an effective method of its increase. Therefore actual search of new forms of psycho hygiene and psycho prevention with use of modern information technologies which should provide high level of dental health of the military personnel is represented. The purpose of the real research was establishment of the factors forming motivation to prevention and treatment of the main dental diseases, and development of a psycho physiological method of its increase. The carried-out research allows to expand and systematize ideas necessary for the practical doctor of the major factors forming motivation to prevention and treatment of the main dental diseases. Development of an objective technique of a complex assessment of level of motivation of patients to prevention and treatment of dental pathology will allow to prove the new perspective direction of the sanitary educational work, allowing to reduce fobiya level, effectively to increase motivation of the patient to receiving the timely dental help. It especially is important if to consider that numerous programs of hygienic training and the education, applied in our country, didn't lead to change of hygienic skills of the population in expected

  20. Health worker and policy-maker perspectives on use of intramuscular artesunate for pre-referral and definitive treatment of severe malaria at health posts in Ethiopia

    OpenAIRE

    Kefyalew, Takele; Kebede, Zelalem; Getachew, Dawit; Mukanga, David; Awano, Tessema; Tekalegne, Agonafer; Batisso, Esey; Edossa, Wasihun; Mekonnen, Emebet; Tibenderana, James; Baba, Ebenezer Sheshi; Shumba, Constance; Nankabirwa, Joaniter I.; Hamade, Prudence

    2016-01-01

    Abstract Background The World Health Organization (WHO) recommends injectable artesunate given either intravenously or by the intramuscular route for definitive treatment for severe malaria and recommends a single intramuscular dose of intramuscular artesunate or intramuscular artemether or intramuscular quinine, in that order of preference as pre-referral treatment when definitive treatment is not possible. Where intramuscular injections are not available, children under 6 years may be admin...

  1. NCI's Dr. Barry Kramer on C-SPAN Over-Diagnosis and Treatment of Cancer | Division of Cancer Prevention

    Science.gov (United States)

    Dr. Barnett Kramer on Over-Diagnosis and Treatment of Cancer. Dr. Barnett Kramer talked about a study published in the Journal of American Medical Association on the changing the definition of cancer that could reduce unnecessary treatments for benign cancers. He also responded to telephone calls and electronic communications. |

  2. Determinants for acceptance of preventive treatment against heart disease - a web-based population survey

    DEFF Research Database (Denmark)

    Nielsen, Jesper Bo; Jarbøl, Dorte Ejg; Gyrd-Hansen, Dorte

    2014-01-01

    Background: Patients' perception of risk and their lifestyle choices are of major importance in the treatment of common chronic diseases. This study reveals determinants for and knowledge about why people accept or reject preventive medical interventions against heart disease. Methods: A represen......Background: Patients' perception of risk and their lifestyle choices are of major importance in the treatment of common chronic diseases. This study reveals determinants for and knowledge about why people accept or reject preventive medical interventions against heart disease. Methods....... Socioeconomic status in terms of lower education was positively associated with acceptance. The price of treatment reduced willingness to accept for the lower income groups, whereas it had no effect in the highest income group. Some 57% of respondents who were willing to accept treatment changed their decision...... following information on potential side effects. Conclusions: In accordance with our pre-study hypothesis, individuals with low income were more sensitive to price than individuals with high income. Thus, if the price of preventive medication increases above certain limits, a substantial proportion...

  3. Effectiveness of probiotics in the prevention of carious lesions during treatment with fixed orthodontic appliances.

    Directory of Open Access Journals (Sweden)

    Paula Contreras

    2017-07-01

    Full Text Available The difficulty experienced by patients with fixed orthodontic appliances in maintaining adequate oral hygiene poses a risk for dental caries. The use of probiotics has been proposed as a means of prevention. The following systematic review aims to determine the effectiveness of probiotics in the prevention of dental caries during treatment with fixed orthodontic appliances. This review was carried out according to the PRISMA guidelines. A comprehensive electronic search was conducted in the Cochrane Library, EMBASE, PubMed and Google Scholar Beta databases. The inclusion criteria included randomized controlled clinical trials involving the use of probiotics, caries and patients under fixed orthodontic treatment. The methodological quality of the articles was evaluated according to risk of bias. Of the five included studies, three reported significant differences compared to the control group. Of the others, one article reported significant decrease in the final count of microorganisms compared to the beginning of treatment. Only one study reported no differences of any kind. It was estimated that the eligible studies were of moderate methodological quality and had an unclear risk of bias, without affecting key domains for the research. It is concluded that the daily consumption of probiotics can be effective in the prevention of carious lesions in patients under fixed orthodontic treatment. However, this should be interpreted with caution and corroborated by clinical trials of better methodological quality.

  4. Chronic caffeine treatment prevents sleep deprivation-induced impairment of cognitive function and synaptic plasticity.

    Science.gov (United States)

    Alhaider, Ibrahim A; Aleisa, Abdulaziz M; Tran, Trinh T; Alzoubi, Karem H; Alkadhi, Karim A

    2010-04-01

    This study was undertaken to provide a detailed account of the effect of chronic treatment with a small dose of caffeine on the deleterious effects of sleep loss on brain function in rats. We investigated the effects of chronic (4 weeks) caffeine treatment (0.3 g/L in drinking water) on memory impairment in acutely (24 h) sleep-deprived adult male Wistar rats. Sleep deprivation was induced using the modified multiple platform model. The effects of caffeine on sleep deprivation-induced hippocampus-dependent learning and memory deficits were studied by 3 approaches: learning and memory performance in the radial arm water maze task, electrophysiological recording of early long-term potentiation (E-LTP) in area CA1 of the hippocampus, and levels of memory- and synaptic plasticity-related signaling molecules after E-LTP induction. The results showed that chronic caffeine treatment prevented impairment of hippocampus-dependent learning, shortterm memory and E-LTP of area CA1 in the sleep-deprived rats. In correlation, chronic caffeine treatment prevented sleep deprivation-associated decrease in the levels of phosphorylated calcium/calmodulin-dependent protein kinase II (P-CaMKII) during expression of E-LTP. The results suggest that long-term use of a low dose of caffeine prevents impairment of short-term memory and E-LTP in acutely sleep-deprived rats.

  5. Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults

    Science.gov (United States)

    Günthard, Huldrych F.; Saag, Michael S.; Benson, Constance A.; del Rio, Carlos; Eron, Joseph J.; Gallant, Joel E.; Hoy, Jennifer F.; Mugavero, Michael J.; Sax, Paul E.; Thompson, Melanie A.; Gandhi, Rajesh T.; Landovitz, Raphael J.; Smith, Davey M.; Jacobsen, Donna M.; Volberding, Paul A.

    2016-01-01

    IMPORTANCE New data and therapeutic options warrant updated recommendations for the use of antiretroviral drugs (ARVs) to treat or to prevent HIV infection in adults. OBJECTIVE To provide updated recommendations for the use of antiretroviral therapy in adults (aged ≥18 years) with established HIV infection, including when to start treatment, initial regimens, and changing regimens, along with recommendations for using ARVs for preventing HIV among those at risk, including preexposure and postexposure prophylaxis. EVIDENCE REVIEW A panel of experts in HIV research and patient care convened by the International Antiviral Society-USA reviewed data published in peer-reviewed journals, presented by regulatory agencies, or presented as conference abstracts at peer-reviewed scientific conferences since the 2014 report, for new data or evidence that would change previous recommendations or their ratings. Comprehensive literature searches were conducted in the PubMed and EMBASE databases through April 2016. Recommendations were by consensus, and each recommendation was rated by strength and quality of the evidence. FINDINGS Newer data support the widely accepted recommendation that antiretroviral therapy should be started in all individuals with HIV infection with detectable viremia regardless of CD4 cell count. Recommended optimal initial regimens for most patients are 2 nucleoside reverse transcriptase inhibitors (NRTIs) plus an integrase strand transfer inhibitor (InSTI). Other effective regimens include nonnucleoside reverse transcriptase inhibitors or boosted protease inhibitors with 2 NRTIs. Recommendations for special populations and in the settings of opportunistic infections and concomitant conditions are provided. Reasons for switching therapy include convenience, tolerability, simplification, anticipation of potential new drug interactions, pregnancy or plans for pregnancy, elimination of food restrictions, virologic failure, or drug toxicities. Laboratory

  6. Therapeutic eyelids hygiene in the algorithms of prevention and treatment of ocular surface diseases

    Directory of Open Access Journals (Sweden)

    V. N. Trubilin

    2016-01-01

    Full Text Available When acute inflammation in anterior eye segment of a forward piece of an eye was stopped, ophthalmologists face a problem of absence of acute inflammation signs and at the same time complaints to the remain discomfort feelings. It causes dissatisfaction from the treatment. The complaints are typically caused by disturbance of tears productions. No accidental that the new group of diseases was allocated — the diseases of the ocular surface. Ocular surface is a difficult biologic system, including epithelium of the conjunctiva, cornea and limb, as well as the area costal margin eyelid and meibomian gland ducts. Pathological processes in conjunctiva, cornea and eyelids are linked with tears production. Ophthalmologists prescribes tears substitutions, providing short-term relief to patients. However, in respect that the lipid component of the tear film plays the key role in the preservation of its stability, eyelids hygiene is the basis for the treatment of dry eye associated with ocular surface diseases. Eyelids hygiene provides normal functioning of glands, restores the metabolic processes in skin and ensures the formation of a complete tear film. Protection of eyelids, especially the marginal edge from aggressive environmental agents, infections and parasites and is the basis for the prevention and treatment of blepharitis and dry eye syndrome. The most common clinical situations and algorithms of their treatment and prevention of dysfunction of the meibomian glands; demodectic blepharitis; seborrheic blepharitis; staphylococcal blepharitis; allergic blepharitis; barley and chalazion are discussed in the article. The prevention keratoconjunctival xerosis (before and postoperative period, caused by contact lenses, computer vision syndrome, remission after acute conjunctiva and cornea inflammation is also presented. The first part of the article presents the treatment and prevention algorithms for dysfunction of the meibomian glands, as well as

  7. In a Randomized Controlled Trial of Iron Fortification, Anthelmintic Treatment, and Intermittent Preventive Treatment of Malaria for Anemia Control in Ivorian Children, only Anthelmintic Treatment Shows Modest Benefit

    NARCIS (Netherlands)

    Rohner, F.; Zimmermann, M.B.; Amon, R.J.; Vounatsou, P.; Tschannen, A.B.; N'goran, E.K.; Nindjin, C.; Cacou, M.C.; Té-Bonlé, D.; Aka, H.; Sess, D.E.; Utzinger, J.; Hurrell, R.F.

    2010-01-01

    Anemia is common among children in sub-Saharan Africa and its etiology is multifactorial. Likely causes of anemia are low bioavailability of dietary iron, malaria, and helminth infection. In this study, we aimed to assess the effect of iron fortification, intermittent preventive treatment (IPT) of

  8. [Results of a comprehensive workplace program for the prevention and treatment of smoking addiction].

    Science.gov (United States)

    Nerín, I; Crucelaegui, A; Más, A; Villalba, J A; Guillén, D; Gracia, A

    2005-04-01

    To assess a comprehensive smoking prevention and treatment program in an electrical appliances company with 1600 employees. The program included smoking restrictions with the designation of smoking areas and the offer of smoking cessation treatment for the smokers affected. Study variables were age, sex, nicotine dependence (Fagerström Test), carbon monoxide in expired air, adherence to therapy, and smoking abstinence at 1 week, 1 month, 3 months (end of treatment), and 6 months. Successful smoking abstinence was defined as continuous abstinence from the beginning of treatment. Smoking prevalence was 34.8% and 19.5% of smokers requested treatment (77.4% men and 22.6% women). Mean (SD) age was 41.3 (10.3) years. Mean score of nicotine dependence was 5.3 (2.6) and the mean quantity of carbon monoxide in expired air was 35.6 (23.7) ppm. Adherence to therapy was good in 80% of patients. Rate of abstinence was 57.5% at 6 months, signifying a 4% reduction in prevalence. Workplace smoking cessation programs reduce prevalence and facilitate the establishment of smoking restrictions at the worksite. Companies are convenient settings for the implementation of programs aimed at smoking prevention and treatment.

  9. Reason analysis and preventive treatment countermeasure of impaired vision after LASIK

    Directory of Open Access Journals (Sweden)

    Zhang-Bing Mu

    2015-02-01

    Full Text Available AIM: To analyze the reasons of impaired vision after LASIK and explore its preventive treatment measures preliminarily. METHODS: In this retrospective study, 175 eyes of 134 patients whose vision was decreased after LASIK were included. The constituent ratio of every reason was counted and uncorrected visual acuity(UCVAbetween pre-treatment and post-treatment were compared by paired t-test respectively. RESULTS: The overall incidence of impaired vision after LASIK was 1.86%. The constituent ratio of regression was 51.43% and UCVA increased from 0.61±0.22 to 0.90±0.38(t=8.00, Pt=20.00, Pt=8.14, Pt=6.33, Pt=2.53, P0.05after treatment. The constituent ratio of fundus lesions and diffuse lamellar keratitis(DLKwas 2.86% and UCVA all increased by different degrees after treatment. CONCLUSION: The reasons of impaired vision after LASIK are many and varied. These cases could recover their vision by discovery and treatment in time, and the appropriate preventive measures were essential.

  10. Pulmonary Bacteriophage Therapy on Pseudomonas aeruginosa Cystic Fibrosis Strains: First Steps Towards Treatment and Prevention

    Science.gov (United States)

    Morello, Eric; Saussereau, Emilie; Maura, Damien; Huerre, Michel; Touqui, Lhousseine; Debarbieux, Laurent

    2011-01-01

    Multidrug-resistant bacteria are the cause of an increasing number of deadly pulmonary infections. Because there is currently a paucity of novel antibiotics, phage therapy—the use of specific viruses that infect bacteria—is now more frequently being considered as a potential treatment for bacterial infections. Using a mouse lung-infection model caused by a multidrug resistant Pseudomonas aeruginosa mucoid strain isolated from a cystic fibrosis patient, we evaluated bacteriophage treatments. New bacteriophages were isolated from environmental samples and characterized. Bacteria and bacteriophages were applied intranasally to the immunocompetent mice. Survival was monitored and bronchoalveolar fluids were analysed. Quantification of bacteria, bacteriophages, pro-inflammatory and cytotoxicity markers, as well as histology and immunohistochemistry analyses were performed. A curative treatment (one single dose) administrated 2 h after the onset of the infection allowed over 95% survival. A four-day preventive treatment (one single dose) resulted in a 100% survival. All of the parameters measured correlated with the efficacy of both curative and preventive bacteriophage treatments. We also showed that in vitro optimization of a bacteriophage towards a clinical strain improved both its efficacy on in vivo treatments and its host range on a panel of 20 P. aeruginosa cystic fibrosis strains. This work provides an incentive to develop clinical studies on pulmonary bacteriophage therapy to combat multidrug-resistant lung infections. PMID:21347240

  11. Pulmonary bacteriophage therapy on Pseudomonas aeruginosa cystic fibrosis strains: first steps towards treatment and prevention.

    Directory of Open Access Journals (Sweden)

    Eric Morello

    Full Text Available Multidrug-resistant bacteria are the cause of an increasing number of deadly pulmonary infections. Because there is currently a paucity of novel antibiotics, phage therapy--the use of specific viruses that infect bacteria--is now more frequently being considered as a potential treatment for bacterial infections. Using a mouse lung-infection model caused by a multidrug resistant Pseudomonas aeruginosa mucoid strain isolated from a cystic fibrosis patient, we evaluated bacteriophage treatments. New bacteriophages were isolated from environmental samples and characterized. Bacteria and bacteriophages were applied intranasally to the immunocompetent mice. Survival was monitored and bronchoalveolar fluids were analysed. Quantification of bacteria, bacteriophages, pro-inflammatory and cytotoxicity markers, as well as histology and immunohistochemistry analyses were performed. A curative treatment (one single dose administrated 2 h after the onset of the infection allowed over 95% survival. A four-day preventive treatment (one single dose resulted in a 100% survival. All of the parameters measured correlated with the efficacy of both curative and preventive bacteriophage treatments. We also showed that in vitro optimization of a bacteriophage towards a clinical strain improved both its efficacy on in vivo treatments and its host range on a panel of 20 P. aeruginosa cystic fibrosis strains. This work provides an incentive to develop clinical studies on pulmonary bacteriophage therapy to combat multidrug-resistant lung infections.

  12. Outcome of Congenitally Hypothyroid Screening Program in Isfahan: Iran From Prevention to Treatment

    Directory of Open Access Journals (Sweden)

    Mahin Hashemipour

    2010-01-01

    Full Text Available Objectives: Early and proper treatment is crucial to prevent neuropsychologic deficits in congenital hypothyroidism (CH. Considering the high prevalence of CH in Isfahan, the aim of this study was to evaluate the outcome of treatment in CH patients.Methods: In this study CH neonates diagnosed during screening program in Isfahan from May 2002 to September 2009 were studied. Frequent visits were performed to CH patients to monitor and follow their treatments. Quality of treatment was assessed by evaluating mean age of treatment initiation and mean TSH and T4 levels before and after treatment and during the first and second years according to their normal reference ranges.Results: Of 225,224 screened neonates, 536 were diagnosed as CH patients. The prevalence of CH was 1/420 live births. Mean age at starting treatment was 22.9  13.2 days. In 93.7% of patients, treatment was begun before the 45th day of life. In the first measurement after initiating the treatment, T4 and TSH were not in their acceptable range in 3.9% and 9.8% of CH patients, respec-tively. Mean T4 and TSH reached to normal range during the treatment period. T4 reached the normal range earlier than TSH.Conclusions: The mean age of treatment initiation was in acceptable range but the findings suggest that both early and high-dose treatments are crucial for optimal treatment, especially in patients with severe CH. Further studies are needed to determine the outcome of treatment specially regarding to different etiologies of CH.

  13. PREVENTION AND TREATMENT OF VITAMIN D DEFICIENCY: CURRENT LOOK AT THE ISSUE

    Directory of Open Access Journals (Sweden)

    Yu. S. Lashkova

    2015-01-01

    Full Text Available The article presents the current data on the metabolism of vitamin D and its role in the development of bone tissue in children and the further condition thereof. Natural vitamin D sources, as well as the current routine practice of preventing deficiency of this organic substance are unable to fully satisfy a child's demand for this vitamin, which is why recommendations on vitamin D intake ought to be revised. The article details schedules for prescription of vitamin D for preventing and treating the body deficiency thereof based on results of the studies completed in the recent years. The role of the main marker enabling assessing vitamin D concentration in the body — 25(OHD — the reference values whereof are yet to be commonly established has been analyzed. The article lists recommendations on rickets prevention and treatment in children. The article presents data on the possible mechanisms of development of toxic effects in the setting of vitamin D intake.

  14. Paleolithic diets as a model for prevention and treatment of Western disease.

    Science.gov (United States)

    Lindeberg, Staffan

    2012-01-01

    To explore the possibility that a paleolithic-like diet can be used in the prevention of age-related degenerative Western disease. Literature review of African Paleolithic foods in relation to recent evidence of healthy nutrition. Available evidence lends weak support in favor and little against the notion that lean meat, fish, vegetables, tubers, and fruit can be effective in the prevention and treatment of common Western diseases. There are no obvious risks with avoiding dairy products, margarine, oils, refined sugar, and cereal grains, which provide 70% or more of the dietary intake in northern European populations. If stroke, coronary heart disease, type 2 diabetes, and cancer are preventable by dietary changes, an ancestral-like diet may provide an appropriate template. Copyright © 2012 Wiley Periodicals, Inc.

  15. Use of statins in cardiorenal syndrome : possibilities for its treatment and prevention

    Directory of Open Access Journals (Sweden)

    A. M. Minasyan

    2014-07-01

    Full Text Available Cardiovascular diseases are the major cause of disease and death not only in the general population, but also in patients with chronic kidney disease. The growing morbidity and mortality from chronic kidney disease and chronic heart failure conduce to an increase in cases of cardiorenal syndrome. Along with angiotensin-converting enzyme inhibitors, β-adrenoblockers, antianemic drugs, and diuretics, statins are appropriate and recommended by a number of trials for the prevention and treatment of the cardiorenal syndrome. Statins are effective in preventing the cardiorenal syndrome in patients at its high risk, improve quality of life and survival; in predialysis patients with chronic kidney disease, they may be secondary prevention of cardiovascular death.

  16. Influence of intermittent preventive treatment on antibodies to VAR2CSA in pregnant Cameroonian women

    DEFF Research Database (Denmark)

    Babakhanyan, Anna; Tutterrow, Yeung L; Bobbili, Naveen

    2016-01-01

    Intermittent preventive treatment (IPT) and insecticide-treated bed nets are the standard of care for preventing malaria in pregnant women. Since these preventive measures reduce exposure to malaria, their influence on the antibody (Ab) response to the parasite antigen VAR2CSA was evaluated...... in pregnant Cameroonian women exposed to holoendemic malaria. Ab levels to full-length VAR2CSA (FV2), variants of the six Duffy binding like (DBL) domains, and proportion of high avidity Ab to FV2 were measured longitudinally in 92 women before and 147 women after IPT. As predicted, reduced exposure...... interfered with acquisition of Ab in primigravidae, with 71% primigravidae being seronegative to FV2 at delivery. Use of IPT for > 13 weeks by multigravidae resulted in 26% of women being seronegative at delivery and a significant reduction in Ab levels to FV2, DBL5, DBL6, proportion of high avidity Ab to FV...

  17. Integration of three-dimensional magnetic resonance spectrometry to the irradiation treatment plan for glioblastomas: definition of new target volumes

    International Nuclear Information System (INIS)

    Ken, S.; Vieillevigne, L.; Cohen-Jonathan, E.M.; Laprie, A.; Ken, S.; Franceries, X.; Lotterie, J.A.; Lubrano, V.; Catalaa, I.; Celsis, P.; Berry, I.; Laprie, A.; Lotterie, J.A.; Lubrano, V.; Berry, I.; Catalaa, I.

    2010-01-01

    Based on a clinic trial, the authors report the definition of a new reliable and reproducible method to delimit and integrate targets to the treatment plan which are specific to magnetic resonance spectrometry imagery for the radiotherapy of glioblastomas, in order to perform a treatment by intensity-modulated conformational radiotherapy (IMRT). A weighted conventional MRI has been performed before radiotherapy. The importation of anatomic-metabolic images into the dose planning system comprises two steps: normalization on the whole volume of magnetic resonance spectrometry imagery, and segmentation of target volumes specific to spectrometry anomalies. This integration of target volumes is thus facilitated. Short communication

  18. Treatment of cardiovascular risk factors to prevent cognitive decline and dementia: a systematic review

    Directory of Open Access Journals (Sweden)

    Suzanne A Ligthart

    2010-08-01

    Full Text Available Suzanne A Ligthart1, Eric P Moll van Charante1, Willem A Van Gool2, Edo Richard21Department of General Practice, 2Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam, The NetherlandsBackground: Over the last decade, evidence has accumulated that vascular risk factors increase the risk of Alzheimer disease (AD. So far, few randomized controlled trials have focused on lowering the vascular risk profile to prevent or postpone cognitive decline or dementia.Objective: To systematically perform a review of randomized controlled trials (RCTs evaluating drug treatment effects for cardiovascular risk factors on the incidence of dementia or cognitive decline.Selection criteria: RCTs studying the effect of treating hypertension, dyslipidemia, ­hyperhomocysteinemia, obesity, or diabetes mellitus (DM on cognitive decline or dementia, with a minimum follow-up of 1 year in elderly populations.Outcome measure: Cognitive decline or incident dementia.Main results: In the identified studies, dementia was never the primary outcome. Statins (2 studies and intensified control of type II DM (1 study appear to have no effect on prevention of cognitive decline. Studies on treatment of obesity are lacking, and the results of lowering homocysteine (6 studies are inconclusive. There is some evidence of a preventive effect of antihypertensive medication (6 studies, but results are inconsistent.Conclusion: The evidence of a preventive treatment effect aimed at vascular risk factors on cognitive decline and dementia in later life is scarce and mostly based on secondary outcome parameters. Several important sources of bias such as differential dropout may importantly affect interpretation of trial results.Keywords: cardiovascular risk factors, cognitive decline, dementia, prevention

  19. Nurturing the Continuum of HIV Testing, Treatment and Prevention Matrix Cascade in Reducing HIV Transmission.

    Science.gov (United States)

    Yah, Clarence S

    2017-11-01

    Despite the shift in antiretroviral therapy (ARVs) eligibility cascade from CD4 ≤ 200 to CD4 ≤ 350 to CD4 ≤ 500 mm 3 , HIV related morbidity and mortality continue to escalate annually, as do HIV infections. The new paradigm of treatment for all HIV positives individual irrespective of CD4 count may significantly reduce HIV and related illnesses. The author assumes that all HIV infected partners should be eligible for HIV treatment and care, irrespective of CD4 count. A second assumption is that high risk HIV negative partners have free access to continuum of HIV pre-exposure prophylaxis (PrEP), post exposure prophylaxis (PEP) and other prevention packages. A literature review search was used to extract evidence-based ARVs-HIV treatment and prevention interventions among HIV positives and high risk partners respectively. Only articles published in English and indexed in journal nuclei were used for the study. The information was used to nurture understanding of HIV treatment and prevention approaches as well as HIV incidence multiplier effect among HIV serodiscordant partners. The imputed HIV incident reference was assumed at 1.2 per 100 person-years (2). This was based on the imputation that retention in care, adherence and other predetermined factors are functions of an effective health care delivery system. The model showed a reduced HIV transmission from 1.2 per 100 person-years to 1.032 per 100 person-years in 6 months. The average threshold period of HIV suppressed partners on ARVs to an undetectable level. The combined multiplier protective-effect probability of transmitting HIV from HIV positive partners on ARVs-suppressed viremic load to HIV negative partners on PrEP/PEP-prevention was detected at 86. The model showed a significant reduction in HIV incidence. Placing serodiscordant sexual partners in HIV treatment and prevention plays a significant role in reducing and controlling HIV infection. Therefore, the policy of enrolling all HIV positives

  20. Probiotics in the Prevention and Treatment of Postmenopausal Vaginal Infections: Review Article.

    Science.gov (United States)

    Kim, Jun-Mo; Park, Yoo Jin

    2017-12-01

    Bacterial vaginosis (BV) and complicated vulvovaginal candidiasis (VVC) are frequently occurring vaginal infections in postmenopausal women, caused by an imbalance in vaginal microflora. Postmenopausal women suffer from decreased ovarian hormones estrogen and progesterone. A normal, healthy vaginal microflora mainly comprises Lactobacillus species (spp.), which act beneficially as a bacterial barrier in the vagina, interfering with uropathogens. During premenopausal period, estrogen promotes vaginal colonization by lactobacilli that metabolizing glycogen and producing lactic acid, and maintains intravaginal health by lowering the intravaginal pH level. A lower vaginal pH inhibits uropathogen growth, preventing vaginal infections. Decreased estrogen secretion in postmenopausal women depletes lactobacilli and increases intravaginal pH, resulting in increased vaginal colonization by harmful microorganisms (e.g., Enterobacter , Escherichia coli , Candida , and Gardnerella ). Probiotics positively effects on vaginal microflora composition by promoting the proliferation of beneficial microorganisms, alters the intravaginal microbiota composition, prevents vaginal infections in postmenopausal. Probiotics also reduce the symptoms of vaginal infections (e.g., vaginal discharge, odor, etc.), and are thus helpful for the treatment and prevention of BV and VVC. In this review article, we provide information on the intravaginal mechanism of postmenopausal vaginal infections, and describes the effectiveness of probiotics in the treatment and prevention of BV and VVC.

  1. A review on prevention and treatment of post-orthodontic white spot lesions - evidence-based methods and emerging technologies

    DEFF Research Database (Denmark)

    Bergstrand, Fredrik; Twetman, Svante

    2011-01-01

    The aim of this paper was to update the evidence for primary and secondary prevention (treatment) of white spot lesions (WSL) adjacent to fixed orthodontic appliances.......The aim of this paper was to update the evidence for primary and secondary prevention (treatment) of white spot lesions (WSL) adjacent to fixed orthodontic appliances....

  2. 78 FR 64221 - CDC/HRSA Advisory Committee on HIV, Viral Hepatitis and STD Prevention and Treatment; Notice of...

    Science.gov (United States)

    2013-10-28

    ... Advisory Committee on HIV, Viral Hepatitis and STD Prevention and Treatment; Notice of Meeting In... given of the following virtual committee meeting. Name: CDC/HRSA Advisory Committee on HIV, Viral Hepatitis and STD Prevention and Treatment Dates and Times: November 13, 2013, 10:00 a.m.-4:30 p.m. November...

  3. Prevention and treatment of pressure ulcers in the daily lives of intensivist nurses

    Directory of Open Access Journals (Sweden)

    Jaiany Alencar Rolim

    2013-05-01

    Full Text Available Exploratory study aimed to identify activities of prevention and treatment of pressure ulcers planned and implemented by nurses in the Intensive Care Unit; the importance ascribed to the interventions; and the difficulties to carry out those interventions. The study took place in the Intensive Care Unit of a University Hospital, with participation of nine nurses. The data, collected by means of interviews, were analyzed in the light of the discourse of the collective subject technique. Data revealed that changes in position stand out as a prevention measure and dressings are the main care in the treatment of pressure ulcer. The difficulties reported by nurses indicate limitations in human resources regarding number, training, and lack of involvement of the team; and in material resources to promote comfort and safety to the patient.

  4. Treatment and prevention of malaria in pregnancy in the private health sector in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Buregyeya, Esther; Rutebemberwa, Elizeus

    2016-01-01

    BACKGROUND: Malaria in pregnancy is a major public health problem in Uganda; and it is the leading cause of anaemia among pregnant women and low birth weight in infants. Previous studies have noted poor quality of care in the private sector. Thus there is need to explore ways of improving quality...... and prevention practices for malaria among pregnant women. The main study outcome was the proportion of private health facilities who prescribe treatment of fever among pregnant women as recommended in the guidelines. RESULTS: A total of 241 private health facilities were surveyed; 70.5 % were registered drug......-pyrimethamine and quinine were commonly prescribed, often without consideration of gestational age. The majority of providers (>75 %) at all private facilities prescribed SP for intermittent preventive treatment but artemisinin-based combination therapy was prescribed: 8.3, 6.9 and 8.3 % respectively at drug shops, private...

  5. Epidemiological overview, advances in diagnosis, prevention, treatment and management of epithelial ovarian cancer in Mexico.

    Science.gov (United States)

    Gallardo-Rincón, Dolores; Espinosa-Romero, Raquel; Muñoz, Wendy Rosemary; Mendoza-Martínez, Roberto; Villar-Álvarez, Susana Del; Oñate-Ocaña, Luis; Isla-Ortiz, David; Márquez-Manríquez, Juan Pablo; Apodaca-Cruz, Ángel; Meneses-García, Abelardo

    2016-04-01

    The epithelial ovarian cancer (EOC) has been underdiagnosed because it does not have a specific clinical presentation, and the signs and symptoms are similar to the irritable bowel syndrome and pelvic inflammatory disease. EOC is less common than breast and cervical cancer, but it is more lethal. On the whole, EOC has an early dissemination to peritoneal cavity, which delays a timely diagnosis and increases the rate of advanced diagnosed disease. The diagnosis usually surprises the women and the primary care physician. Therefore, it is necessary to count on prevention and early diagnosis programs. EOC has 80% response to surgical treatment, but nearly 70% of the patients may relapse in five years. The objectives of this document are presenting a summary of the EOC epidemiology and comment about advancements in prevention, diagnosis, and treatment of this cancer. That will raise awareness about the importance of this disease.

  6. Systematic Review of Interventions Supported by ICT for the Prevention Treatment of Occupational Stress.

    Science.gov (United States)

    Narváez, Santiago; Tobar, Angela M; López, Diego M

    2014-01-01

    Stress-related disorders have become one of the main problems of public health in many countries and of worldwide organizations, and they are expected to become more common in the forthcoming decades. This article aims at providing a systematic review and a descriptive evaluation of the interventions supported by ICT for the prevention and treatment of occupational stress. A systematic review of five databases (EBSCO, The Cochrane Library, PubMed, ScienceDirect and IEEEXplorer) was carried out. This article provides a quantitative and qualitative description of 21 studies about occupational stress interventions supported by ICT. The following factors were considered for the analysis: impact of the intervention, design of the study, type of intervention, purpose of the intervention, type of instrument for the measurement of occupational stress, and type of ICT used. The systematic review demonstrated that interventions supported by ICT for the prevention and treatment of occupational stress are scarce but effective.

  7. Towards the prevention of potential aluminum toxic effects and an effective treatment for Alzheimer's disease.

    Science.gov (United States)

    Percy, Maire E; Kruck, Theo P A; Pogue, Aileen I; Lukiw, Walter J

    2011-11-01

    In 1991, treatment with low dose intramuscular desferrioxamine (DFO), a trivalent chelator that can remove excessive iron and/or aluminum from the body, was reported to slow the progression of Alzheimer's disease (AD) by a factor of two. Twenty years later this promising trial has not been followed up and why this treatment worked still is not clear. In this critical interdisciplinary review, we provide an overview of the complexities of AD and involvement of metal ions, and revisit the neglected DFO trial. We discuss research done by us and others that is helping to explain involvement of metal ion catalyzed production of reactive oxygen species in the pathogenesis of AD, and emerging strategies for inhibition of metal-ion toxicity. Highlighted are insights to be considered in the quests to prevent potentially toxic effects of aluminum toxicity and prevention and intervention in AD. Copyright © 2011 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Elisei, Walter; Tursi, Antonio

    2016-01-01

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

  9. Natural Products for the Prevention and Treatment of Hangover and Alcohol Use Disorder

    Directory of Open Access Journals (Sweden)

    Fang Wang

    2016-01-01

    Full Text Available Alcoholic beverages such as beer, wine and spirits are widely consumed around the world. However, alcohol and its metabolite acetaldehyde are toxic and harmful to human beings. Chronic alcohol use disorder or occasional binge drinking can cause a wide range of health problems, such as hangover, liver damage and cancer. Some natural products such as traditional herbs, fruits, and vegetables might be potential dietary supplements or medicinal products for the prevention and treatment of the problems caused by excessive alcohol consumption. The aim of this review is to provide an overview of effective natural products for the prevention and treatment of hangover and alcohol use disorder, and special emphasis is paid to the possible functional component(s and related mechanism(s of action.

  10. Cryptococcal antigen screening and early antifungal treatment to prevent cryptococcal meningitis: a review of the literature.

    Science.gov (United States)

    Kaplan, Jonathan E; Vallabhaneni, Snigdha; Smith, Rachel M; Chideya-Chihota, Sekai; Chehab, Joel; Park, Benjamin

    2015-04-15

    Screening individuals with AIDS for serum cryptococcal antigen (CrAg), followed by treatment of CrAg positives with antifungals, may prevent cryptococcal meningitis. This review examined data on CrAg screening and treatment in resource-limited settings. We searched articles published during 2007-2014 on the effectiveness and cost-effectiveness of CrAg screening and treatment on the outcomes of mortality, morbidity, retention in care, quality of life, and/or prevention of ongoing HIV transmission. We rated overall quality of individual articles, summarized the body of evidence, the expected impact, and cost-effectiveness for each outcome. We identified 2613 articles. Eight met all inclusion criteria. Five studies addressed mortality and/or morbidity outcomes; all were observational and had small sample sizes; 3 lacked a comparison group. Ratings of study quality ranged from "medium" to "weak," and the quality of the overall body of evidence for mortality and morbidity outcomes was rated as "fair." The intervention's expected impact on mortality and morbidity was rated as "moderate." The 4 cost-effectiveness studies included in the analysis showed that CrAg screening and treatment interventions are highly cost-effective. No studies addressed retention in care, quality of life, or HIV transmission. Although limited, the body of evidence regarding CrAg screening and treatment suggests that the intervention may have an impact on preventing cryptococcal meningitis and death in persons with AIDS. Additional research is needed to quantify the intervention's effectiveness and identify optimal treatment dosing and implementation best practices.

  11. Treatment and Prevention of Vitamin D Insufficiency and Deficiency in Children and Adolescents

    Directory of Open Access Journals (Sweden)

    A.Ye. Abaturov

    2015-04-01

    Full Text Available The article describes the data on vitamin D metabolism. The causes and clinical picture of its deficiency, the role of the latter in the development of rickets, osteoporosis, some diseases of childhood are discussed. The guidelines on the treatment and prevention of vitamin D deficiency in the population of Central Europe countries relative to the recommended doses of vitamin D preparations are presented.

  12. Applied Interventions in the Prevention and Treatment of Obesity Through the Research of Professor Jane Wardle

    OpenAIRE

    Croker, Helen; Beeken, Rebecca J.

    2017-01-01

    Purpose of Review Obesity presents a challenge for practitioners, policy makers, researchers and for those with obesity themselves. This review focuses on psychological approaches to its management and prevention in children and adults. Recent Findings Through exploring the work of the late Professor Jane Wardle, we look at the earliest behavioural treatment approaches and how psychological theory has been used to develop more contemporary approaches, for example incorporating genetic feedbac...

  13. Primary care in the prevention, treatment and control of cardiovascular disease in sub-Saharan Africa

    OpenAIRE

    Ojji, Dike B; Ojji, Dike B Ojji; Lamont, Kim; Sliwa, Karen; Ojji, Olubunmi I; Egenti, Bibiana Nonye; Sliwa, Karen

    2017-01-01

    Summary Cardiovascular disease (CVD) is the frontrunner in the disease spectrum of sub-Saharan Africa, with stroke and ischaemic heart disease ranked seventh and 14th as leading causes of death, respectively, on this sub-continent. Unfortunately, this region is also grappling with many communicable, maternal, neonatal and nutritional disorders. Limited resources and the high cost of CVD treatment necessitate that primary prevention should have a high priority for CVD control in sub- Saharan A...

  14. Modeling social transmission dynamics of unhealthy behaviors for evaluating prevention and treatment interventions on childhood obesity.

    Science.gov (United States)

    Frerichs, Leah M; Araz, Ozgur M; Huang, Terry T-K

    2013-01-01

    Research evidence indicates that obesity has spread through social networks, but lever points for interventions based on overlapping networks are not well studied. The objective of our research was to construct and parameterize a system dynamics model of the social transmission of behaviors through adult and youth influence in order to explore hypotheses and identify plausible lever points for future childhood obesity intervention research. Our objectives were: (1) to assess the sensitivity of childhood overweight and obesity prevalence to peer and adult social transmission rates, and (2) to test the effect of combinations of prevention and treatment interventions on the prevalence of childhood overweight and obesity. To address the first objective, we conducted two-way sensitivity analyses of adult-to-child and child-to-child social transmission in relation to childhood overweight and obesity prevalence. For the second objective, alternative combinations of prevention and treatment interventions were tested by varying model parameters of social transmission and weight loss behavior rates. Our results indicated child overweight and obesity prevalence might be slightly more sensitive to the same relative change in the adult-to-child compared to the child-to-child social transmission rate. In our simulations, alternatives with treatment alone, compared to prevention alone, reduced the prevalence of childhood overweight and obesity more after 10 years (1.2-1.8% and 0.2-1.0% greater reduction when targeted at children and adults respectively). Also, as the impact of adult interventions on children was increased, the rank of six alternatives that included adults became better (i.e., resulting in lower 10 year childhood overweight and obesity prevalence) than alternatives that only involved children. The findings imply that social transmission dynamics should be considered when designing both prevention and treatment intervention approaches. Finally, targeting adults may

  15. Program for suicidal prevention, mental disorder treatment, and mental health development for resident doctors

    OpenAIRE

    José Luis Jiménez López; Jesús Arenas Osuna

    2017-01-01

    High demand of care and the academic burden of courses of specialization in medicine affect the mental health of medical residents with events ranging from simple emotional discomfort to development of affective disorders in susceptible individuals. The suicide of physicians has produced programs for their attention in some countries. We present the first mental health clinic for residents of a high specialty hospital in Mexico, focused on the prevention of suicide and depression, treatment o...

  16. Pathophysiology, prevention, and treatment of acute graft-versus-host disease

    Directory of Open Access Journals (Sweden)

    Abhinav Deol

    2011-03-01

    Full Text Available Abhinav Deol, Voravit Ratanatharathorn, Joseph P UbertiDepartment of Oncology, Blood and Marrow Stem Cell Transplant Program, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USAAbstract: Acute graft-versus-host disease (aGVHD is an immunologically mediated inflammatory reaction, which continues to be a major cause of morbidity and mortality in patients undergoing allogeneic hematopoietic stem cell transplant. Although the occurrence and severity of this disease may be devastating, there is a proven immunologically mediated antitumor activity that accompanies the disease process, which has a beneficial effect on outcome. Animal models of graft-versus-host disease (GVHD have given us a conceptual model that has allowed a better understanding of the pathophysiology and offers a framework for understanding the complex interactions between antigen-presenting cells, donor T-cells, and cytokines in the development of aGVHD. It has also given us a model that allows testing of various strategies for prevention and treatment. New, innovative approaches for treatment and prevention of aGVHD including better donor selection with the use of sophisticated human leukocyte antigen typing, use of T-cell depletion, reduced-intensity transplant regimens, and improved pharmacologic immunosuppression have improved outcomes by decreasing the incidence and severity of aGVHD. However, the limitation of these strategies is that effective treatment and prevention of aGVHD is often accompanied by a concomitant rise in relapses, graft failure and infections, and ultimately no improvement in overall survival. Investigators are working on understanding the difference between GVHD and graft versus tumor effect, as this would be the key in improving outcomes for our patients. In this review, we will discuss the pathophysiology of aGVHD along with the preventative and treatment strategies.Keywords: acute GVHD, GVHD, acute graft

  17. Bisphosphonate-associated osteonecrosis of the jaw in breast cancer patients: recommendations for prevention and treatment.

    Science.gov (United States)

    Fehm, T; Felsenberg, D; Krimmel, M; Solomayer, E; Wallwiener, D; Hadjii, P

    2009-08-01

    Osteonecrosis of the jaw (ONJ) is a rare but severe disease which has been diagnosed in women with breast cancer on a bisphosphonate (BP) therapy. Thus, the German society of senology appointed a multidisciplinary task force to establish a consensus on the use of bisphosphonates in breast cancer patients with bone metastases, considering in particular the possible risk of ONJ. This report summarizes the results and recommendations for the prevention and treatment of ONJ in breast cancer patients receiving BP.

  18. Cost-effectiveness of prevention and treatment of the diabetic foot: a Markov analysis

    OpenAIRE

    Ortegon, Monica; Redekop, Ken; Niessen, Louis Wilhelmus

    2004-01-01

    textabstractOBJECTIVE: To estimate the lifetime health and economic effects of optimal prevention and treatment of the diabetic foot according to international standards and to determine the cost-effectiveness of these interventions in the Netherlands. RESEARCH DESIGN AND METHODS: A risk-based Markov model was developed to simulate the onset and progression of diabetic foot disease in patients with newly diagnosed type 2 diabetes managed with care according to guidelines for their lifetime. M...

  19. HIV Treatment and Prevention: A Simple Model to Determine Optimal Investment.

    Science.gov (United States)

    Juusola, Jessie L; Brandeau, Margaret L

    2016-04-01

    To create a simple model to help public health decision makers determine how to best invest limited resources in HIV treatment scale-up and prevention. A linear model was developed for determining the optimal mix of investment in HIV treatment and prevention, given a fixed budget. The model incorporates estimates of secondary health benefits accruing from HIV treatment and prevention and allows for diseconomies of scale in program costs and subadditive benefits from concurrent program implementation. Data sources were published literature. The target population was individuals infected with HIV or at risk of acquiring it. Illustrative examples of interventions include preexposure prophylaxis (PrEP), community-based education (CBE), and antiretroviral therapy (ART) for men who have sex with men (MSM) in the US. Outcome measures were incremental cost, quality-adjusted life-years gained, and HIV infections averted. Base case analysis indicated that it is optimal to invest in ART before PrEP and to invest in CBE before scaling up ART. Diseconomies of scale reduced the optimal investment level. Subadditivity of benefits did not affect the optimal allocation for relatively low implementation levels. The sensitivity analysis indicated that investment in ART before PrEP was optimal in all scenarios tested. Investment in ART before CBE became optimal when CBE reduced risky behavior by 4% or less. Limitations of the study are that dynamic effects are approximated with a static model. Our model provides a simple yet accurate means of determining optimal investment in HIV prevention and treatment. For MSM in the US, HIV control funds should be prioritized on inexpensive, effective programs like CBE, then on ART scale-up, with only minimal investment in PrEP. © The Author(s) 2015.

  20. Modeling social transmission dynamics of unhealthy behaviors for evaluating prevention and treatment interventions on childhood obesity.

    Directory of Open Access Journals (Sweden)

    Leah M Frerichs

    Full Text Available Research evidence indicates that obesity has spread through social networks, but lever points for interventions based on overlapping networks are not well studied. The objective of our research was to construct and parameterize a system dynamics model of the social transmission of behaviors through adult and youth influence in order to explore hypotheses and identify plausible lever points for future childhood obesity intervention research. Our objectives were: (1 to assess the sensitivity of childhood overweight and obesity prevalence to peer and adult social transmission rates, and (2 to test the effect of combinations of prevention and treatment interventions on the prevalence of childhood overweight and obesity. To address the first objective, we conducted two-way sensitivity analyses of adult-to-child and child-to-child social transmission in relation to childhood overweight and obesity prevalence. For the second objective, alternative combinations of prevention and treatment interventions were tested by varying model parameters of social transmission and weight loss behavior rates. Our results indicated child overweight and obesity prevalence might be slightly more sensitive to the same relative change in the adult-to-child compared to the child-to-child social transmission rate. In our simulations, alternatives with treatment alone, compared to prevention alone, reduced the prevalence of childhood overweight and obesity more after 10 years (1.2-1.8% and 0.2-1.0% greater reduction when targeted at children and adults respectively. Also, as the impact of adult interventions on children was increased, the rank of six alternatives that included adults became better (i.e., resulting in lower 10 year childhood overweight and obesity prevalence than alternatives that only involved children. The findings imply that social transmission dynamics should be considered when designing both prevention and treatment intervention approaches. Finally