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Sample records for previous 12-month wheeze

  1. Periodic progress report, 12 months

    DEFF Research Database (Denmark)

    Juhl, Thomas Winther; Nielsen, Jakob Skov

    The work performed during the first 12 months of the project started with the establishment of the cutting theory for the cutting of heavy sections (phase 1). Phase 2 comprises the design of the first laboratory version cutting head with optics, nozzle systems and interfaces for the various...

  2. Severity of rhinitis and wheezing is strongly associated in preschoolers: A population-based study.

    Science.gov (United States)

    Pereira, Ana Margarida; Morais-Almeida, Mário; Santos, Natacha; Nunes, Carlos; Bousquet, Jean; Fonseca, João Almeida

    2015-11-01

    In preschool children, no study assessed the relation between wheezing and rhinitis severity. Our aims were to estimate the prevalence of current wheezing (CW) in preschoolers and to study the association between CW and current rhinitis (CR), considering its severity/persistency. This is a cross-sectional, nationwide, population-based study including a representative sample of 5003 Portuguese children aged 3-5 years. Data were collected by a face-to-face interview with caregivers using an adapted ISAAC questionnaire. CW was defined as presence of ≥1 wheezing episode in the previous 12 months. Rhinitis severity/persistency was classified according to Allergic Rhinitis and its Impact on Asthma. Current wheezing prevalence was 24.5% [95% CI 23.3-25.7]; 9.4% of the participants had ≥4 wheezing episodes in the previous year. Children with CR had an odds ratio (OR) of 4.0 [95% CI 3.4-4.5] for CW; it was highest for children with moderate-severe persistent rhinitis (11.5 [95% CI 8.1-16.3]), even after adjusting for possible confounders. Wheezers with CR reported more wheezing treatment use (p = 0.024) than those without CR. There was a trend for a higher number of wheezing episodes with more persistent and severe nasal disease - 48.4% of children with moderate-severe persistent rhinitis had >4 wheezing episodes vs. 28.9% in moderate-severe intermittent, 20.0% in mild persistent, 10.8% in mild intermittent, and 3.6% in those without CR; p rhinitis, especially moderate-severe persistent disease. Preschoolers with both CW and rhinitis seem to have a more severe phenotype, emphasizing the need for concurrent evaluation of nasal and bronchial symptoms even in small children. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. A deceiving wheeze.

    LENUS (Irish Health Repository)

    Chotirmall, S H

    2009-08-07

    \\'Wheeze\\' is a common symptom in both paediatric and adult populations. Unexplained wheeze is concerning and warrants investigation. We present a case of a young girl with childhood asthma suffering with \\'persistent wheeze\\'. This was explained by the presence of a dual aortic arch which only became apparent during her teenage years. This report serves as a reminder to all clinicians that "not all that wheezes is asthma".

  4. Associations of ultra-processed food and drink products with asthma and wheezing among Brazilian adolescents.

    Science.gov (United States)

    Melo, B; Rezende, L; Machado, P; Gouveia, N; Levy, R

    2018-04-21

    Although both consumption of ultra-processed products and asthma are common during adolescence, the epidemiological evidence in regarding their association is unclear. We investigated the associations of ultra-processed products consumption with asthma and wheezing in a representative sample of Brazilian adolescents. We used data from a representative sample of 109,104 Brazilian adolescents enrolled in the National Survey of School Health, 2012. The consumption of ultra-processed products was based on the weekly consumption (0-2, 3-4, ≥5 days/week) of sweet biscuits, salty biscuits, ultra-processed meats, sweets/candies, soft drinks, and packaged snacks over the previous seven days. We also calculated an ultra-processed consumption score by adding partial scores corresponding to weekly frequency intake of each ultra-processed product. The ultra-processed consumption score ranged from 0 to 42, the higher score, the higher the intake of these products. Presence of wheezing in the previous 12 months and asthma at any time in the past were self-reported. The adjusted odds ratios of asthma comparing the extreme categories ranged from 1.08 (95% CI 1.03-1.13) for sweets/candies to 1.30 (1.21-1.40) for ultra-processed meats. Similar magnitude of associations was found for wheezing outcome. The ultra-processed consumption score was positively associated with presence of asthma and wheezing in a dose-response manner. The adjusted OR of asthma and wheezing comparing highest to lowest quintile of ultra-processed consumption score were 1.27 (95% CI 1.15-1.41) and 1.42 (1.35-1.50), respectively. The consumption of ultra-processed products was positively associated with the presence of asthma and wheezing in adolescents. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  5. The transient value of classifying preschool wheeze into episodic viral wheeze and multiple trigger wheeze

    NARCIS (Netherlands)

    Schultz, A.; Devadason, S. G.; Savenije, O. E. M.; Sly, P. D.; Le Souef, P. N.; Brand, P. L. P.

    Background: A recently proposed method for classifying preschool wheeze is to describe it as either episodic (viral) wheeze or multiple trigger wheeze. In research studies, phenotype is generally determined by retrospective questionnaire. Aim: To determine whether recently proposed phenotypes of

  6. Influence of the Mediterranean diet during pregnancy in the development of wheezing and eczema in infants in Pamplona, Spain.

    Science.gov (United States)

    Alvarez Zallo, N; Aguinaga-Ontoso, I; Alvarez-Alvarez, I; Marin-Fernandez, B; Guillén-Grima, F; Azcona-San Julián, C

    This study examined the relationship between different food groups and the adherence to a Mediterranean diet during pregnancy and the risk of wheezing and eczema in children aged 12-15 months. The study involves 1087 Spanish infants from the International Study of Wheezing in Infants (Estudio Internacional de Sibilancias en Lactantes, EISL). The study of the association of the different food consumption and Mediterranean diet with wheezing, recurrent wheezing and eczema was performed using different models of unconditional logistic regression to obtain adjusted prevalence odds ratios (OR) and 95% confidence intervals (95% CI). No association was found between a good adherence to the Mediterranean diet during pregnancy and the development of wheezing (p=0.372), recurrent wheezing (p=0.118) and eczema (p=0.315). The consumption once or twice a week of white fish (OR: 1.95[1.01-3.75]), cooked potatoes (OR: 1.75[1.22-2.51]) and industrial pastry (OR: 1.59[1.13-2.24]), and the consumption more than three times a week of industrial pastry (OR: 1.47 [1.01-2.13]) during pregnancy increases the risk of "wheezing" at 12 months. Instead, high fruit consumption during the pregnancy has a protective effect against "wheezing" in 12-month-old infants (OR: 0.44 [0.20-0.99]). No statistically significant differences were observed between food intake during pregnancy and "recurrent wheezing". No statistically significant differences were observed between the consumption of any food during pregnancy and the presence of eczema at 12 months. The present study showed that the consumption of Mediterranean diet during pregnancy did not have a protective effect for wheezing, recurrent wheezing or eczema. Copyright © 2017 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  7. Prevalence and risk factors associated with wheezing in the first year of life

    Directory of Open Access Journals (Sweden)

    Olivia A. A. Costa Bessa

    2014-04-01

    Full Text Available OBJECTIVE: to investigate the prevalence and risk factors associated with wheezing in infants in the first year of life. METHODS: this was a cross-sectional study, in which a validated questionnaire (Estudio Internacional de Sibilancias en Lactantes - International Study of Wheezing in Infants - EISL was applied to parents of infants aged between 12 and 15 months treated in 26 of 85 primary health care units in the period between 2006 and 2007. The dependent variable, wheezing, was defined using the following standards: occasional (up to two episodes of wheezing and recurrent (three or more episodes of wheezing. The independent variables were shown using frequency distribution to compare the groups. Measures of association were based on odds ratio (OR with a confidence interval of 95% (95% CI, using bivariate analysis, followed by multivariate analysis (adjusted OR [aOR]. RESULTS: a total of 1,029 (37.7% infants had wheezing episodes in the first 12 months of life; of these, 16.2% had recurrent wheezing. Risk factors for wheezing were family history of asthma (OR = 2.12; 95% CI: 1.76-2.54 and six or more episodes of colds (OR = 2.38; 95% CI: 1.91-2.97 and pneumonia (OR = 3.02; 95% CI: 2.43-3.76. For recurrent wheezing, risk factors were: familial asthma (aOR = 1.73; 95% CI: 1.22-2.46; early onset wheezing (aOR = 1.83; 95% CI: 1.75-3.75; nocturnal symptoms (aOR = 2.56; 95% CI: 1.75-3.75, and more than six colds (aOR = 2.07; 95% CI 1.43- .00. CONCLUSION: the main risk factors associated with wheezing in Fortaleza were respiratory infections and family history of asthma. Knowing the risk factors for this disease should be a priority for public health, in order to develop control and treatment strategies.

  8. Emotional and Social Development: 8 to 12 Months

    Science.gov (United States)

    ... Sleep Teething & Tooth Care Toddler Preschool Gradeschool Teen Young Adult Healthy Children > Ages & Stages > Baby > Emotional and Social Development: 8 to 12 Months Ages & Stages Listen Español ...

  9. Perceptual Learning: 12-Month-Olds' Discrimination of Monkey Faces

    Science.gov (United States)

    Fair, Joseph; Flom, Ross; Jones, Jacob; Martin, Justin

    2012-01-01

    Six-month-olds reliably discriminate different monkey and human faces whereas 9-month-olds only discriminate different human faces. It is often falsely assumed that perceptual narrowing reflects a permanent change in perceptual abilities. In 3 experiments, ninety-six 12-month-olds' discrimination of unfamiliar monkey faces was examined. Following…

  10. Surgical crown lengthening: a 12-month study - radiographic results

    Directory of Open Access Journals (Sweden)

    Daniela Eleutério Diniz

    2007-08-01

    Full Text Available OBJECTIVE: The purpose of this study was to perform a radiographic follow-up evaluation after a 12-month healing period, following crown lengthening surgery. MATERIAL AND METHODS: Twenty-three periodontally healthy subjects (mean age 32.5 years that required crown lengthening surgery in premolars were recruited. In a total of 30 premolars, full thickness flaps, osseous resection, and flap suturing were performed. The restorative margin was defined in the pre-surgical phase and maintained unaltered during the healing period, serving as a reference point. Standardized bitewing radiographs were taken before and after osseous reduction, and at 2, 3, 6, and 12-month healing periods. RESULTS: Intact lamina dura was observed at both mesial and distal alveolar crests only from the 3rd month. At 12-months, all alveolar crests presented lamina dura. The overall mean distance from the restorative margin to the alveolar crest achieved after osseous resection was 3.28±0.87 mm at mesial and 2.81±0.51 mm at distal sites. No significant radiographic changes in the bone crest were observed during a 12-month healing period. CONCLUSION: The findings of this study suggest that the radiographic proximal bone level observed on bitewing radiographs following crown lengthening surgery can be used as a reference to predict the future level of the healed alveolar crest.

  11. Farming environments and childhood atopy, wheeze, lung function, and exhaled nitric oxide

    NARCIS (Netherlands)

    Fuchs, O.; Genuneit, J.; Latzin, P.; Büchele, G.; Horak, E.; Loss, G.; Sozanska, B.; Heederik, D.|info:eu-repo/dai/nl/072910542; Braun-Fahrländer, C.; Frey, U.; von Mutius, E.

    2012-01-01

    BACKGROUND: Previous studies have demonstrated that children raised on farms are protected from asthma and allergies. It is unknown whether the farming effect is solely mediated by atopy or also affects nonatopic wheeze phenotypes. OBJECTIVE: We sought to study the farm effect on wheeze phenotypes

  12. Episodic Viral Wheeze and Multiple Trigger Wheeze in preschool children : A useful distinction for clinicians?

    NARCIS (Netherlands)

    Schultz, Andre; Brand, Paul L. P.

    Accumulating evidence suggest that splitting preschool recurrent wheezing disorders into Episodic (Viral) Wheeze (EVW) and Multiple Trigger Wheeze (MTW) is an oversimplification. There is little evidence that the EVW and MTW phenotypes are related to the longitudinal patterns of wheeze, or to

  13. Stability of cocaine impurity profiles during 12 months of storage

    DEFF Research Database (Denmark)

    Nielsen, Louise Stride; Villesen, Palle; Lindholst, Christian

    2016-01-01

    During the lifetime of a cocaine batch from production end to consumption, several alterations may occur, leading to possible changes in the original impurity profile. Such profile changes may eventually result in erroneous forensic evaluations. In the present study, the stability of both...... the alkaloid and the residual solvent impurity profiles of cocaine were evaluated over a period of 12 months under different storage conditions (temperature, purity and weight) using GC-MS and HS-GC-MS, respectively. The sample purity (p ... profile. The most significant change was observed in low purity samples stored at 37 °C. In contrast, no changes were observed in the residual solvent profile at all storage conditions for the entire 12-month study period. This finding indicates...

  14. Early child care and obesity at 12 months of age in the Danish National Birth Cohort.

    Science.gov (United States)

    Benjamin Neelon, S E; Schou Andersen, C; Schmidt Morgen, C; Kamper-Jørgensen, M; Oken, E; Gillman, M W; Sørensen, T I A

    2015-01-01

    Evidence suggests that the child care environment may be more obesogenic than the family home, and previous studies have found that child care use may be associated with obesity in children. Few studies, however, have focused on child care during infancy, which may be an especially vulnerable period. This study examined child care use in infancy and weight status at 12 months of age in a country where paid maternity leave is common and early child care is not as prevalent as in other developed countries. We studied 27,821 children born to mothers participating in the Danish National Birth Cohort, a longitudinal study of pregnant women enrolled between 1997 and 2002, who were also included in the Childcare Database, a national record of child care use in Denmark. The exposure was days in child care from birth to 12 months. The outcomes were sex-specific body mass index (BMI) z-score and overweight/obesity (BMI ⩾ 85th percentile based on the World Health Organization classification) at 12 months. We conducted multivariable linear and logistic regression analyses examining child care use and weight outcomes. A total of 17,721 (63.7%) children attended child care during their first year of life. After adjustment for potential confounders, a 30-day increment of child care was associated with a modestly higher BMI z-score at 12 months (0.03 units; 95% confidence interval (CI) = 0.01, 0.05; P=0.003). Similarly, child care use was associated with increased odds of being overweight/obese at 12 months of age (odds ratio = 1.05; 95% CI = 1.01, 1.10; P=0.047). Child care in the first year of life was associated with slightly higher weight at 12 months, suggesting that child care settings may be important targets for obesity prevention in infancy.

  15. Early child care and obesity at 12 months of age in the Danish National Birth Cohort

    Science.gov (United States)

    Neelon, Sara E Benjamin; Andersen, Camilla Schou; Morgen, Camilla Schmidt; Kamper-Jørgensen, Mads; Oken, Emily; Gillman, Matthew W; Sørensen, Thorkild IA

    2014-01-01

    Background/Objectives Evidence suggests that the child care environment may be more obesogenic than the family home, and previous studies have found that child care use may be associated with obesity in children. Few studies, however, have focused on child care during infancy, which may be an especially vulnerable period. This study examined child care use in infancy and weight status at 12 months of age in a country where paid maternity leave is common and early child care is not as prevalent as in other developed countries. Subjects/Methods We studied 27821 children born to mothers participating in the Danish National Birth Cohort (DNBC), a longitudinal study of pregnant women enrolled between 1997 and 2002, who were also included in the Childcare Database, a national record of child care use in Denmark. The exposure was days in child care from birth to 12 months. The outcomes were sex-specific body mass index (BMI) z-score and overweight/obesity (BMI ≥85th percentile based on the World Health Organization classification) at 12 months. We conducted multivariable linear and logistic regression analyses examining child care use and weight outcomes. Results A total of 17721 (63.7%) children attended child care during their first year of life. After adjustment for potential confounders, a 30-day increment of child care was associated with a modestly higher BMI z-score at 12 months (0.03 units; 95% CI: 0.01, 0.05; p=0.003). Similarly, child care use was associated with increased odds of being overweight/obese at 12 months of age (OR 1.05; 95% CI: 1.01, 1.10; p=0.047). Conclusions Child care in the first year of life was associated with slightly higher weight at 12 months, suggesting that child care settings may be important targets for obesity prevention in infancy. PMID:25233894

  16. Twelve-month safety and efficacy of inhaled fluticasone propionate in children aged 1 to 3 years with recurrent wheezing

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Allen, David; Milanowski, Janusz

    2004-01-01

    OBJECTIVE: Our aim was to compare the 12-month safety and efficacy of fluticasone propionate (FP) and sodium cromoglycate (SCG) in children aged 1 to 3 years with mild to moderate recurrent wheeze. METHODS: The study was a randomized, parallel-group, open-label multicenter study of 625 children...... clinically important side effects but is more efficacious than SCG....

  17. Clinical Evaluation of Resin-Based Composites in Posterior Restorations: 12-Month Results

    Science.gov (United States)

    Celik, Cigdem; Arhun, Neslihan; Yamanel, Kivanc

    2010-01-01

    Objectives: The purpose of this study was to evaluate and compare the 12 month clinical performances of two different posterior composites in Class I and Class II restorations. Methods: Thirty-one patients (10 male, 21 female) were recruited into the study. A total of 82 Class I and Class II cavities were restored with either a nanohybrid composite (Grandio) or a low-shrinkage composite (Quixfil), using their self etch adhesives (Futura Bond and Xeno III) according to manufacturers’ instructions. The restorations were clinically evaluated 1 week after placement as baseline, and after 6 and 12 months post-operatively using modified USPHS criteria by two previously calibrated operators. Statistical analysis were performed using Pearson Chi-square and Fisher’s Exact Test (P.05). None of the restorations had marginal discoloration and anatomic form loss on the 12 month follow-up. Restorations did not exhibit post-operative sensitivity at any evaluation period. Conclusions: Clinical assessment of nanohybrid (Grandio) and low-shrinkage posterior composite (Quixfil) exhibited good clinical results with predominating alpha scores after 12 months. However; further evaluations are necessary for the long-term clinical performance of these materials. PMID:20046481

  18. Determinants of developmental delay in infants aged 12 months.

    Science.gov (United States)

    Slykerman, Rebecca F; Thompson, John M D; Clark, Phillipa M; Becroft, David M O; Robinson, Elizabeth; Pryor, Jan E; Wild, Chris J; Mitchell, Edwin A

    2007-03-01

    The aim of this study was to determine which demographic, maternal, obstetric and postnatal variables were associated with achievement of developmental milestones at the age of 12 months in term infants. Mothers and babies were enrolled in the Auckland Birthweight Collaborative Study shortly after birth. All infants were full term (gestation >or= 37 weeks). Approximately half of the sample were small for gestational age (SGA = birthweight 10th percentile). A maternal interview was conducted soon after birth. Phase 2 of the study occurred 12 months later when mothers were sent a postal questionnaire requesting information about the child's health and development during the first year of life using the Denver Prescreening Developmental Questionnaire. Seven hundred and forty-four (85.4%) European mothers returned the postal questionnaire. SGA children were not at increased risk of developmental delay at 12 months of age. In a sample representative of New Zealand European children, after adjustment for the effects of potential confounders, maternal smoking during pregnancy (OR = 2.1 [95% CI 1.1, 4.0]), maternal smoking during the first year of life (OR = 1.9 [95% CI 1.0, 3.8]) and low levels of satisfaction with parenting (OR = 2.4 [95% CI 1.1, 5.2]) were associated with significantly increased risk of developmental delay. In the subgroup of SGA children, maternal smoking during pregnancy (OR = 2.9 [95% CI 1.4, 6.2]), high levels of stress associated with parenting (OR = 2.2 [95% CI 1.2, 4.0]), and low levels of satisfaction with parenting (OR = 4.3 [95% CI 1.3, 13.5]) were significantly associated with developmental delay after adjustment for the effects of potential confounders. In conclusion, maternal and postnatal factors were better predictors of developmental delay than demographic variables.

  19. Exposure to cats and dogs as risk factors for wheezing in preschool children: are their effects modified by removal?

    Directory of Open Access Journals (Sweden)

    Patricia García Marcos

    2013-06-01

    Full Text Available Objective: To define the relationship between current wheezing in preschoolers and exposure to dogs and cats at home, and to find out to what extent their removal modifies the associations.Methods: Previously validated questionnaires were completed by parents of 1784 preschoolers (mean age 4.08±0.8 years. Children were stratified according to the presence (20.0 % or absence of wheezing in the previous year. Information regarding cat or dog exposure currently and during the first year of life was collected, as well as information about the removal of the pets.Results: A higher proportion of families owning a cat in the first year of the child’s life, as well as in the previous year, was found in the wheezing group. The proportion of families owning a dog was marginally higher in this group. Cat exposure was shown to be a significant risk factor when present in the first year of the child’s life (Adjusted Odds Ratio [aOR] 1.73, 95 % CI 1.04-2.88, and an even higher association was found with current exposure (aOR 2.00, 95 % CI 1.22-3.26. The association was highest (aOR 2.68, 95 % CI 1.32-5.44 among the wheezing group for the subset of families that had removed a cat from the home. Dog exposure did not appear to be a significant risk factor, neither during the first year of life (aOR 1.24, 95 % CI 0.88-1.76 nor with current ownership (aOR 1.04, 95 % CI 0.73-1.50. However, a significant association was found in the group that had removed a dog from the home (aOR 5.88, 95 % CI 2.62-13.17.Conclusions: Exposure to cat allergens is a risk factor for asthma, when exposure occurs during the first 12 months of life. However, this factor is of limited influence beyond the first year. It is likely that children who are prone to developing an allergy would benefit from control of environmental allergen exposure, including cat avoidance. 

  20. Design of Wearable Breathing Sound Monitoring System for Real-Time Wheeze Detection

    Directory of Open Access Journals (Sweden)

    Shih-Hong Li

    2017-01-01

    Full Text Available In the clinic, the wheezing sound is usually considered as an indicator symptom to reflect the degree of airway obstruction. The auscultation approach is the most common way to diagnose wheezing sounds, but it subjectively depends on the experience of the physician. Several previous studies attempted to extract the features of breathing sounds to detect wheezing sounds automatically. However, there is still a lack of suitable monitoring systems for real-time wheeze detection in daily life. In this study, a wearable and wireless breathing sound monitoring system for real-time wheeze detection was proposed. Moreover, a breathing sounds analysis algorithm was designed to continuously extract and analyze the features of breathing sounds to provide the objectively quantitative information of breathing sounds to professional physicians. Here, normalized spectral integration (NSI was also designed and applied in wheeze detection. The proposed algorithm required only short-term data of breathing sounds and lower computational complexity to perform real-time wheeze detection, and is suitable to be implemented in a commercial portable device, which contains relatively low computing power and memory. From the experimental results, the proposed system could provide good performance on wheeze detection exactly and might be a useful assisting tool for analysis of breathing sounds in clinical diagnosis.

  1. Obesity, Diet, and Activity in relation to Asthma and Wheeze among Rural Dwelling Children and Adolescents

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    Joshua A. Lawson

    2013-01-01

    Full Text Available Aims and Objectives. We investigated associations between weight status, activity level, and diet with asthma or wheeze as well as the interrelationship between these factors. Methods. We conducted a case-control study of 6–18-year olds from 2005 to 2007. Cases ( were subjects reporting episodes or breathing medication use along with doctor-diagnosed asthma or wheeze in the past 12 months. Controls were randomly selected ( and without asthma or wheeze. Data regarding health outcomes, diet, and activity were obtained from questionnaire. Objectively measured height and weight were collected. Results. In the adjusted analysis, there was a trend ( towards an increased risk of asthma or wheeze associated with high fast food and/or pop consumption. Among cases, a significantly lower proportion (66% classified as overweight participated in hard exercise in ≥9 of the past 14 days compared to those who were not overweight (86%. This pattern was not seen among controls (76% participating in hard exercise versus 78%, resp.. However, based on perceived weight status by the parent, the patterns were similar regardless of case-control status. Conclusions. Overweight status may negatively impact activity level among those with asthma or wheeze. Efforts should be made to encourage healthy food choices, and activity programming must consider the needs of overweight children with asthma.

  2. Hepatitis A seroprevalence among infants aged 12 months in Ankara.

    Science.gov (United States)

    Ince, Osman Tolga; Yalçin, S Songül; Yurdakök, Kadriye; Ozmert, Elif N

    2011-01-01

    Seroprevalence studies in various age groups contribute to a better understanding of hepatitis A infection and response to hepatitis A immunization. Hepatitis A seroprevalence in 12-month-old infants from Ankara was studied. Among 601 healthy infants, overall hepatitis A seropositivity was found to be 23.5%. There were no gender differences in seropositivity (22.6% for male and 24.5% for female infants). Although vaccination of infants would be an ideal prevention strategy, presence of maternal anti-hepatitis A virus (HAV) antibody interferes with the immune response to hepatitis A vaccine in infants and young children. Therefore, further knowledge about decay of maternal antibody in infants is important in determining the optimal age for vaccination against hepatitis A. There is no recommendation for routine hepatitis A vaccination in Turkey. However, we need more seroprevalence studies in different age groups to decide the appropriate timing/age of vaccination.

  3. 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...

  4. Early child care and obesity at 12 months of age in the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Benjamin Neelon, S E; Schou Andersen, C; Schmidt Morgen, C

    2014-01-01

    BACKGROUND/OBJECTIVES: Evidence suggests that the child care environment may be more obesogenic than the family home, and previous studies have found that child care use may be associated with obesity in children. Few studies, however, have focused on child care during infancy, which may...... be an especially vulnerable period. This study examined child care use in infancy and weight status at 12 months of age in a country where paid maternity leave is common and early child care is not as prevalent as in other developed countries. SUBJECTS/METHODS: We studied 27,821 children born to mothers...... participating in the Danish National Birth Cohort, a longitudinal study of pregnant women enrolled between 1997 and 2002, who were also included in the Childcare Database, a national record of child care use in Denmark. The exposure was days in child care from birth to 12 months. The outcomes were sex...

  5. Wheezing in Children with Sickle Cell Disease

    Science.gov (United States)

    Glassberg, Jeffrey A.; Strunk, Robert

    2014-01-01

    Purpose of review The purpose of this article is to provide a comprehensive review of wheezing in sickle cell disease (SCD) including epidemiology, pathophysiology, associations between wheezing and SCD morbidity and finally the clinical approach to evaluation and management of individuals with SCD who wheeze. Recent findings Wheezing is common in SCD and in some individuals represents an intrinsic component of SCD related lung disease rather than asthma. Emerging data suggest that regardless of the etiology, individuals with SCD and with recurrent wheezing are at increased risk for subsequent morbidity and premature mortality. We believe Individuals that acutely wheeze and have respiratory symptoms should be managed with a beta agonist and short term treatment of oral steroids, typically less than 3 days to attenuate rebound vaso-occlusive disease. For those that wheeze and have a history or examination associated with atopy, we consider asthma treatment and monitoring per NHLBI asthma guidelines. Summary Wheezing in SCD should be treated aggressively in both the acute setting and with controller medications. Prospective SCD-specific clinical trials will be necessary to address whether anti-inflammatory asthma therapies (leukotriene antagonists, inhaled corticosteroids) can safely mitigate the sequelae of wheezing in SCD. PMID:24370489

  6. Poverty-associated risk factors for wheezing in the first year of life in Honduras and El Salvador.

    Science.gov (United States)

    Bueso, A; Figueroa, M; Cousin, L; Hoyos, W; Martínez-Torres, A E; Mallol, J; Garcia-Marcos, L

    2010-01-01

    Risk factors for wheezing specifically during the first year of life have been studied in well-developed countries, but the information from developing countries is very scarce. There are no such studies focusing on factors derived from poverty. The aim of the present study was to determine if risk factors related to poverty are associated to wheezing during the first year of life in infants from Honduras and El Salvador. A survey, using a validated questionnaire, was carried out in the metropolitan area of San Pedro Sula (Honduras) and in La Libertad (El Salvador) in centres where infants attended for a scheduled vaccination shot or a healthy child visit at 12 months of age. Fieldworkers offered questionnaires to parents and helped the illiterate when necessary. The main outcome variable was wheezing during the first year of life, as reported by parents. A total of 1047 infants in El Salvador and 780 in Honduras were included in the analysis. The prevalence of wheeze in the first year was higher in El Salvador (41.2%) than in Honduras (27.7%), as was recurrent wheezing defined as three or more episodes (18.4% vs. 11.7%). Wheezing and recurrent wheezing was associated to unpaved floor in the household (summary odds ratios for both countries 1.55, p=0.036 and 1.72, p=0.054 for any wheeze and recurrent wheezing, respectively); dust entering from streets (1.30, p=0.052 and 1.67, p=0.008); living in a heavily polluted area (1.33, p=0.037 and 1.52, p=0.033); and having mould stains on the household walls (1.36, p=0.072 and 1.76, p=0.007). Furthermore, marginal associations were found for additional person at home and use of kerosene as cooking fuel. University studies in the mother (0.34, p=0.046 and 0.32, p=0.022) and a professional occupation in the father (0.34, p=0.046 and 0.26, p=0.047) were associated to a lower risk. The prevalence of wheezing and recurrent wheezing is notoriously high in El Salvador and Honduras. In those populations factors related to poverty

  7. Tuberculosis is frequently diagnosed within 12 months of diabetes mellitus.

    Science.gov (United States)

    Heo, E Y; Choi, N-K; Yang, B R; Koo, B K; Hwang, S-S; Lee, C-H; Kang, Y A

    2015-09-01

    Evidence regarding the effects of tuberculosis (TB) screening among patients with diabetes mellitus (DM) in intermediate TB burden countries is insufficient, and the most appropriate time point for TB screening is unclear. To investigate trends in TB incidence among newly diagnosed DM patients. A retrospective cohort study of the claims database of the Health Insurance Review and Assessment Service in Korea was performed. Participants were newly diagnosed with type 2 DM in 2009. The study outcome was TB incidence between 2009 and 2011 among participants according to duration of type 2 DM. A cohort of 331,601 patients with newly diagnosed type 2 DM in 2009 was identified. During the 3-year follow-up period, 1533 patients were diagnosed with TB. The estimated incidence of TB among newly diagnosed type 2 DM patients was 18/10,000 patient-years (py) (95%CI 17.5-19.4). TB incidence was 33/10,000 py (95%CI 30.0-35.6) in the first 6 months, and 19/10,000 py (95%CI 16.5-20.6) in the following 6-month period. The risk of developing TB was increased among DM patients, particularly during the first 12 months after DM diagnosis.

  8. Population-Attributable Risk of Risk Factors for Recurrent Wheezing in Moderate Preterm Infants During the First Year of Life

    NARCIS (Netherlands)

    Blanken, M.O.; Korsten, K.; Achten, N.B.; Tamminga, S.; Nibbelke, E.E.; Sanders, E.A.; Smit, H.A.; Groenwold, R.H.; Bont, L.; Liem, D.; et al.,

    2016-01-01

    BACKGROUND: Recurrent wheezing in young infants has a high prevalence, influences quality of life, and generates substantial health care costs. We previously showed that respiratory syncytial virus infection is an important mechanism of recurrent wheezing in moderate preterm infants. We aimed to

  9. Pneumonia and Wheezing in the First Year : An International Perspective

    NARCIS (Netherlands)

    Garcia-Marcos, Luis; Mallol, Javier; Sole, Dirceu; Brand, Paul L. P.; Martinez-Torres, Antonela; Sanchez-Solis, Manuel

    2015-01-01

    Background: The relationship between pneumonia and recurrent wheezing (RW) and the factors associated to pneumonia in wheezing and non-wheezing infants have not been compared between affluent and non-affluent populations. Methods: The International Study of Wheezing in Infants (EISL) is a large

  10. Communication development in children who receive a cochlear implant by 12 months of age.

    Science.gov (United States)

    Leigh, Jaime; Dettman, Shani; Dowell, Richard; Briggs, Robert

    2013-04-01

    Describe the long-term benefits of early cochlear implantation. Provide a comprehensive description of outcomes, including: language, speech production, and speech perception. Compare the communication outcomes for the early implanted children to those of normally hearing children and children who received a cochlear implant at a comparatively older age. Retrospective review of the communication development of 35 children implanted between 6 and 12 months of age and 85 children implanted between 13 and 24 months of age. Audiologic assessments included unaided and aided audiograms, auditory brainstem response (ABR), auditory steady state response (ASSR), and otoacoustic emissons (OAEs). Formal language, speech production, and speech perception measures were administered, preimplant and at 1, 2, 3, and 5 years postimplant. The children who received their cochlear implant by 12 months of age demonstrated language growth rates equivalent to their normally hearing peers and achieved age appropriate receptive language scores 3 years postimplant. The children who received their cochlear implant between 13 and 24 months demonstrated a significant language delay at 3 years postimplant. Speech production development followed a similar pattern to that of normal-hearing children, although was delayed, for both groups of children. Mean open-set speech perception scores were comparable with previous reports for children and adults who use cochlear implants. Children implanted by 12 months of age demonstrate better language development compared with children who receive their cochlear implant between 13 and 24 months. This supports the provision of a cochlear implant within the first year of life to enhance the likelihood that a child with severe-to-profound hearing impairment will commence elementary school with age-appropriate language skills.

  11. Paliperidone Palmitate and Metabolic Syndrome in Patients With Schizophrenia: A 12-Month Observational Prospective Cohort Study.

    Science.gov (United States)

    Rosso, Gianluca; Pessina, Enrico; Martini, Azzurra; Di Salvo, Gabriele; Maina, Giuseppe

    2016-06-01

    Oral and long-acting injectable second-generation antipsychotics are known to be associated with a high risk of metabolic adverse effects. Together with other drug treatments, poor lifestyle choices, and genetic liability, they contribute to development of metabolic syndrome (MetS), which occurs in nearly one third of patients with schizophrenia.The primary objective of this multicenter prospective observational study was to explore the prevalence of MetS in a sample of 60 real-world patients treated with paliperidone palmitate (PP) over a period of 12 months. The secondary objectives were to assess other tolerability aspects and the efficacy of PP on schizophrenic symptoms.The proportion of patients with MetS at baseline (33%) did not significantly change neither at 6 (39.0%) nor at 12 months (29.5%) of PP treatment. The same applies to each individual component of MetS. We found a slight but statistically significant increase in body mass index (26.3 ± 6.0 vs 27.1 ± 4.6, P = 0.031) and of waist circumference (98.2 ± 17.9 vs 100.3 ± 15.9, P = 0.021) from baseline to end point. Weight gain was detected in approximately 15% of patients.At least 1 mild or moderate adverse event was found in 71.3%, 88.0%, and 52.1% of patients, respectively, at baseline, 6 months, and 12 months. A significant improvement in schizophrenic symptoms emerged by means of Positive and Negative Syndrome Scale total and subscale scores.Together with previous literature findings, our results seem to indicate that PP could be a valid therapeutic option for patients with a severe disorder and with a high metabolic risk profile.

  12. Divalproex sodium in children with partial seizures: 12-month safety study.

    Science.gov (United States)

    Lenz, Robert A; Elterman, Roy D; Robieson, Weining Z; Vigna, Namita V; Saltarelli, Mario D

    2009-08-01

    This phase III, open-label, multicenter, outpatient study evaluated the 12-month safety of valproate using divalproex sodium sprinkle capsules for partial seizures, with or without secondary generalization, in children aged 3-10 years (n = 169). Laboratory parameters and vital signs were assessed, and the Wechsler Scales of Intelligence, the Developmental Profile-II, movement-related items from the Udvalg for Kliniske Undersøgelser, and the Behavior Assessment System for Children were administered. Efficacy was measured by the 4-week seizure rate. The most common treatment-emergent adverse events in the 169 study patients were typical childhood illnesses: pyrexia (18%), cough (17%), and nasopharyngitis (14%). The most common adverse events not considered typical childhood illnesses were vomiting (14%), tremor (9%), somnolence (8%), and diarrhea (8%). Of the 169 patients, 11 (6.5%) were hospitalized with serious treatment-emergent adverse events. Although elevated ammonia levels were observed in 31 treated patients, and mean increases in uric acid concentrations and decreases in platelets were observed, the majority of patients were asymptomatic. Except for tremor, no increases in movement-related adverse effects were observed. Small numeric improvements were reported in the Wechsler Scales and the Behavior Assessment System for Children. The safety findings in this 12-month study are generally consistent with previous reports of valproate in adult and pediatric epilepsy patients.

  13. Is it traffic type, volume, or distance? Wheezing in infants living near truck and bus traffic.

    Science.gov (United States)

    Ryan, Patrick H; LeMasters, Grace; Biagini, Jocelyn; Bernstein, David; Grinshpun, Sergey A; Shukla, Rakesh; Wilson, Kimberly; Villareal, Manuel; Burkle, Jeff; Lockey, James

    2005-08-01

    Previous studies of air pollution have not examined the association between exposure to varying types, distance, and amounts of traffic and wheezing in very young infants. We sought to determine the relationship between types of traffic, traffic volume, and distance and wheezing among infants less than 1 year of age. A geographic information system and a classification scheme were developed to categorize infants enrolled in the study as living near moving truck and bus traffic (highway >50 miles per hour, >1000 trucks daily, bus traffic (bus and truck traffic had a significantly increased prevalence of wheezing (adjusted odds ratio, 2.50; 95% CI, 1.15-5.42) when compared with unexposed infants. The prevalence of wheezing among nonwhite infants was at least twice that of white infants, regardless of exposure. Infants living less than 400 m from a high volume of moving traffic, however, did not have an increased prevalence of wheezing. These results suggest that the distance from and type of traffic exposures are more significant risk factors than traffic volume for wheezing in early infancy.

  14. A Traditional Diet Is Associated with a Reduced Risk of Eczema and Wheeze in Colombian Children

    Directory of Open Access Journals (Sweden)

    Alfonso M. Cepeda

    2015-06-01

    Full Text Available Background: Diet might influence the risk of allergic diseases. Evidence from developing countries with high prevalence of childhood asthma is scant. Methods: Information on wheeze, rhinitis, and eczema was collected from 3209 children aged 6–7 years in 2005, who were taking part in the International Study on Asthma and Allergy in Children (ISAAC in Colombia. Intake frequency of twelve food groups was assessed. Associations between each food group and current wheeze, rhino-conjunctivitis, and eczema were investigated with multiple logistic regressions, adjusting for potential confounders. Simes’ procedure was used to test for multiple comparisons. Results: 14.9% of children reported wheeze in the last 12 months, 16% rhino-conjunctivitis, and 22% eczema. Eczema was negatively associated with consumption of fresh fruits and pulses three or more times per week (adjusted Odds ratio (aOR: 0.64; 95% Confidence Interval (CI: 0.49 to 0.83; p value = 0.004; and aOR: 0.62, 95% CI: 0.47 to 0.80; p value < 0.001, respectively. Current wheeze was negatively associated with intake of potatoes (aOR: 0.44, 95% CI: 0.31 to 0.62, p value = 0.005, whilst this outcome was positively associated with consumption of fast food (aOR: 1.76, 95% CI: 1.32 to 2.35, p value = 0.001. These associations remained statistically significant after controlling for multiple comparisons. Conclusions: A traditional diet might have a protective effect against eczema and wheeze in Colombian children, whilst intake of fast foods increases this risk.

  15. Obese individuals experience wheezing without asthma but not asthma without wheezing

    DEFF Research Database (Denmark)

    Çolak, Yunus; Shoaib, Afzal; Lange, Peter

    2016-01-01

    individuals experienced wheezing and 5406 had asthma. Wheezing was self-reported, and asthma was ascertained through self-report, hospital contacts with asthma, and/or receiving medication for asthma. BMI was calculated as measured weight divided by measured height squared (kg/m(2)). RESULTS: In observational......BACKGROUND: Observational studies suggest that obesity is associated with increased risk of asthma. However, it is unknown whether this could be explained by wheezing. We tested the hypothesis that high body mass index (BMI) observationally and genetically is associated with high risk of wheezing...... and asthma, and that the association between high BMI and asthma is explained by wheezing. METHODS: We genotyped 85 437 individuals aged 20-100 years from the Copenhagen General Population Study for FTO (rs9939609), MC4R (rs17782313), TMEM18 (rs6548238) GNPDA2 (rs10938397) and BDNF (rs10767664); 14 500...

  16. Outcomes of a Multi-Component Family Enrichment Project: 12-Month Follow-up

    Directory of Open Access Journals (Sweden)

    Sara Anne Tompkins

    2014-02-01

    Full Text Available Previous research has established that family enrichment programs work with a variety of populations (e.g., Hawkins, Stanley, Blanchard, & Albright, 2012. It is unclear if a multi-component program focusing on a variety of family outcomes can lead to lasting change. This study used growth modeling to examine effects of relationship (i.e., Within My Reach, parenting (i.e., Making Parenting a Pleasure, and financial enrichment (i.e., Spend Some, Save Some, Share Some classes over 12 months. Results revealed improvement in family functioning at one year post for all three programs. Program specific improvements included relationship functioning and parenting alliance. Program participants reported overall satisfaction and gaining of valuable skills. Findings suggest these family enrichment programs can have long-lasting effects; potential reasons for sample success and implications are discussed.

  17. Management of anaphylaxis in child care centers: evaluation 6 and 12 months after an intervention program.

    Science.gov (United States)

    Patel, Bina M; Bansal, Priya J; Tobin, Mary C

    2006-12-01

    Many young children with a history of allergic reactions or anaphylaxis spend considerable time in child care centers. We previously reported that a significant knowledge deficit exists in anaphylaxis recognition, evaluation, and treatment and that greater anaphylaxis education is needed among child care providers. To determine whether child care centers can recognize, evaluate, and treat anaphylactic episodes in children aged 1 to 6 years 6 months and 1 year after attending an allergy seminar. All 39 child care centers participating in the original study were selected to complete 6-month and 1-year follow-up surveys using a similar questionnaire. Those who did not attend the seminar or complete all the previous surveys were excluded. At 6 months and 1 year, 37 and 29 centers, respectively, completed surveys. There was a significant improvement regarding when to administer intramuscular epinephrine compared with before the allergy seminar. However, only 48% of the centers at 6 months (P = .02) and 31% at 1 year (P = .002) knew how to correctly administer intramuscular epinephrine compared with 77% four weeks after the seminar. With time, there was a significant decline in correctly recognizing typical anaphylaxis symptoms, including abdominal cramping, chest tightness, shortness of breath, low blood pressure, and diarrhea, whereas symptoms such as hives, swelling, and wheezing continued to be identified correctly. There is a need for renewed anaphylaxis education among child care providers. Initially, this intervention significantly increased the ability of child care center staff to recognize, evaluate, and treat anaphylaxis, but knowledge diminished gradually at 6-month and 1-year follow-up.

  18. Patients' experiences after bariatric surgery: a qualitative study at 12-month follow-up.

    Science.gov (United States)

    da Silva, Susana Sofia Pereira; Maia, Ângela da Costa

    2013-12-01

    This study used a qualitative approach to understand patients' experiences in post-surgery adaptation related to bariatric surgery, 12 months after this procedure. The study population included 30 obese adults, with a mean age of 40.17 years, who were interviewed 12 months after bariatric surgery. Individual interviews, using open-ended questions, were audiotaped, transcribed and coded according to the grounded theory methodology. The data showed that the subjects described themselves as belonging to one of two opposite and separate groups: success or failure. In both groups, two core categories emerged from the data: outcomes and treatment. Previous expectations were reached by the patients who described themselves as successful, with some remaining concerns related to future weight maintenance and aesthetics issues. The failure group emphasized their unmet expectations and the expectancy that surgery would change their lives remained. Treatment in the successful cases integrated lifestyle changes and bariatric surgery, highlighting the personal commitment required to achieve the objectives. The failure group emphasized bariatric surgery without personal commitment, and healthy eating behaviour was understood as a sacrifice. The post-surgical adaptation experiences were diverse: the cases that were described as a success highlighted lifestyle changes, personal efforts and commitment with the global treatment process. External understanding and the desire for a miracle surgery characterized the cases described as a failure. According to these results, it is necessary to promote adequate information about the whole process and skills required to ensure commitment in all treatment dimensions. © 2013 The Authors. Clinical Obesity © 2013 International Association for the Study of Obesity.

  19. Protective effect of an oral natural phytonutrient in recurrent vulvovaginal candidiasis: a 12-month study.

    Science.gov (United States)

    Kumari, A; Bishier, M P; Naito, Y; Sharma, A; Solimene, U; Jain, S; Yadava, H; Minelli, E; Tomella, C; Marotta, F

    2011-01-01

    The aim of the present study is to assess the clinical efficacy of a phytocompound with antimicotic properties (K-712, with the following 100 mg composition: 10 mg of oleoresin from Pseudowintera colorata at 30 percent concentration in Polygodial together with trace amounts of Olea europea) in recurrent vulvo-vaginal candidiasis (RVVC) as compared to an azole drug during a 12-month period: 6 months of treatment followed by 6 months of observation. This prospective randomized study involved 82 women (19-61 years) with complaints of abnormal vaginal discharge and with a history of at least four proven episodes of RVVC in the previous 12 months. Patients were divided into two groups of treatment of 41 patients each and were given: A) Itraconazole 200 mg orally daily for 4 days, then 200 mg once weekly for 6 months or B) 1 tablet twice a day of a K-712 for 4 weeks and then for the first 2 weeks of each month for a total of 6 months. Both groups were then followed-up for further 6 months. Each treatment schedule was well tolerated with only 4 patients in the azole group complaining of transient mild symptoms (nausea, abdominal discomfort, unpleasant taste). Itraconazole reached an earlier symptomatic relief during the first two weeks of observation as compared with K-712 (psymptom/sign score (itraconazole vs K-712: 9 vs 11). At 6-month observation, mycological cure was reached by 83 percent in the itraconazole group and in 78 percent of the K-712-treated patients. During the further 6-month observation period without treatment, the itraconazole group showed significantly more relapses (65.7 vs 34.2 in K-712, papproach seems to maintain a higher mycological success rate afterwards by reducing the number of relapses and probably of the growth of azole-resistant species.

  20. Immunogenicity and safety of an inactivated trivalent split influenza virus vaccine in young children with recurrent wheezing.

    Science.gov (United States)

    Bae, E Young; Choi, Ui Yoon; Kwon, Hyo Jin; Jeong, Dae Chul; Rhim, Jung Woo; Ma, Sang Hyuk; Lee, Kyung Il; Kang, Jin Han

    2013-06-01

    Influenza virus vaccination is recommended for children, but so far, active vaccination has not been achieved because most parents lack knowledge of vaccine safety and many doctors are reluctant to administer vaccine due to concerns that steroids might alter immunogenicity. The aim of this study was to compare the immunogenicity and safety of inactivated trivalent split influenza virus vaccine between children with recurrent wheezing and healthy children of the same age group. Sixty-eight healthy children and 62 children with recurrent wheezing took part in this study. Seroconversion rates, seroprotection rates, geometric mean titers (GMTs), and geometric mean titer ratios (GMTRs) were measured by a hemagglutination inhibition assay for the assessment of immunogenicity. Solicited and unsolicited local and systemic adverse events were measured for the assessment of safety. Regarding immunogenicity, the seroconversion and seroprotection rates showed no difference overall between healthy children and children with recurrent wheezing. Also, no difference was observed between steroid-treated and nontreated groups with recurrent wheezing. Generally, the GMTs after vaccination were higher in the one-dose vaccination groups for healthy children and children with recurrent wheezing, but the GMTRs revealed different results according to strain in the two groups. Regarding safety, solicited local and systemic adverse events showed no differences between healthy children and children with recurrent wheezing. This study demonstrates that inactivated split influenza virus vaccine is able to induce protective immune responses in healthy children, as observed in previous studies, as well as in children with recurrent wheezing who require frequent steroid treatment.

  1. Consumption of vegetables, fruit, and antioxidants during pregnancy and wheeze and eczema in infants.

    Science.gov (United States)

    Miyake, Y; Sasaki, S; Tanaka, K; Hirota, Y

    2010-06-01

    Two previous cohort studies showed inverse relationships between maternal vitamin E and zinc intake during pregnancy and the risk of wheeze and/or asthma in the offspring. We investigated the association between maternal intake of vegetables, fruit, and selected antioxidants during pregnancy and the risk of wheeze and eczema in the offspring aged 16-24 months. Subjects were 763 Japanese mother-child pairs. Data on maternal intake during pregnancy were assessed with a diet history questionnaire. Data on symptoms of wheeze and eczema were based on criteria of the International Study of Asthma and Allergies in Childhood. Higher maternal intake of green and yellow vegetables, citrus fruit, and beta-carotene during pregnancy was significantly associated with a reduced risk of eczema, but not wheeze, in the offspring {adjusted odds ratios (ORs) between extreme quartiles [95% confidence intervals (CIs)] = 0.41 (0.24-0.71), 0.53 (0.30-0.93), and 0.52 (0.30-0.89), respectively}. Maternal vitamin E consumption during pregnancy was significantly inversely related to the risk of infantile wheeze, but not eczema [adjusted OR (95% CI) = 0.54 (0.32-0.90)]. No statistically significant exposure-response associations were observed between maternal intake of total vegetables, vegetables other than green and yellow vegetables, total fruit, apples, alpha-carotene, vitamin C, or zinc and the risk of wheeze or eczema in the children. Higher maternal consumption of green and yellow vegetables, citrus fruit, and beta-carotene during pregnancy may be protective against the development of eczema in the offspring. Higher maternal vitamin E intake during pregnancy may reduce the risk of infantile wheeze.

  2. Wheeze after Hospitalization for Respiratory Syncytial Virus Infection in Children

    DEFF Research Database (Denmark)

    Stensballe, Lone Graff; Simonsen, Jacob; Breindahl, Morten

    2018-01-01

    Introduction Prior studies found associations between respiratory syncytial virus (RSV) infection, wheezing, and asthma. The present study aimed to examine the risk of wheezing after RSV, by the history of wheezing. Methods We included 39 children hospitalized for RSV infection (cases) and 23...... children hospitalized for nonrespiratory tract infection reasons (controls) and followed the children prospectively with regular standardized telephone interviews until 18 months, and again 5 years after inclusion. The risk of wheeze was estimated by odds ratios (OR), comparing children hospitalized...

  3. Incidence of new-onset wheeze: a prospective study in a large middle-aged general population.

    Science.gov (United States)

    Holm, Mathias; Torén, Kjell; Andersson, Eva

    2015-12-16

    Wheeze is a very common respiratory symptom, which is associated with several factors and diseases. Studies on incidence of new-onset wheeze in general adult populations are rare. The present prospective study aimed to investigate the incidence rate of new-onset wheeze, and predictors for wheeze, in a general, middle-aged population. Individuals, born 1943-1973, who had participated in a previous Swedish study in 1993 (n = 15,813), were mailed a new respiratory questionnaire in 2003. The questionnaire, which included items about respiratory symptoms, atopy, and smoking was answered by 11,463 (72%). Incidence rates of new-onset wheeze were calculated. Cox regression analyses were performed with incident wheeze as an event and person-years under observation as dependent variable. Among those free of wheeze at baseline (n = 8885), there were 378 new cases of wheeze during the study period (1993-2003). The incidence rate was 4.3/1000 person-years. The adjusted risk was increased in relation to smoking (HR 2.1;95% CI 1.7-2.7), ex-smoking (HR 1.4;95% CI 1.1-1.9), young age (HR 1.7;95% CI 1.3-2.2), chronic bronchitis (HR 2.3;95% CI 0.96-5.7), and rhinitis (HR 1.8;95% CI 1.4-2.2) at baseline, and body mass index ≥30 (HR 1.9;95% CI 1.5-2.6) at follow-up. This is a unique study that presents an incidence rate for new-onset wheeze in a middle-aged, general population sample previously free of adult wheeze. The results indicate that new-onset wheeze is quite common in this age group. Health care staff should bear this in mind since new-onset wheeze could be one of the earliest symptoms of severe respiratory disease. Special attention should be paid to patients with a smoking history, chronic bronchitis, rhinitis or obesity.

  4. A 12-month exercise intervention decreased stress symptoms and increased mental resources among working adults - Results perceived after a 12-month follow-up.

    Science.gov (United States)

    Kettunen, Oili; Vuorimaa, Timo; Vasankari, Tommi

    2015-01-01

    This study evaluated the effect of a 12-month physical exercise intervention accompanied by a 12-month followup evaluating stress symptoms (SS), mental resources (MR) and cardiorespiratory fitness (CRF) in healthy, working adults. We hypothesized that the stress symptoms would decrease and mental resources would increase during the intervention and that these results are associated with changes in CRF. The study group included healthy adults (N = 371). Three hundred thirty eight participants (212 women, 126 men) were allocated in the exercise group and 33 in the control group (17 women and 16 men). For the analysis, the exercise group was divided into subgroups according to the baseline SS and MR. Stress symptoms and MR were measured using the Occupational Stress Questionnaire. During the 12-month exercise intervention, SS decreased by 16% (p exercise group, while no changes occurred in the control group (ANCOVA, p exercise group, the results (SS, MR, and CRF) remained improved during the follow-up. There was a positive correlation between the change in SS and the change in CRF (r = 0.19, p exercise intervention improved mental well-being among working adults and this was associated with an improvement in cardiorespiratory fitness. The positive changes remained after the 12-month follow-up. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  5. Perievent panic attacks and panic disorder after mass trauma: a 12-month longitudinal study.

    Science.gov (United States)

    Wood, Cristina M; Salguero, José M; Cano-Vindel, Antonio; Galea, Sandro

    2013-06-01

    Panic attacks frequently lead to psychopathological disorders, including panic disorder. Even though panic disorder is a highly comorbid and disabling mental health problem associated with stressful life or traumatic events, perievent panic attacks and their association with panic disorder have hardly been investigated as a central topic after mass trauma. Using data from a longitudinal population-based assessment of Madrid residents after the March 11, 2004 train bombings (N = 1,589), with assessments conducted 1, 6, and 12 months after the attacks, the rate of perievent panic attacks was 10.9%. Level of exposure, previous life stressors, and negative emotionality were associated with perievent panic attacks (β = .12, .15, and .10, respectively), which in turn mediated the relationship between exposure to the terrorist event and panic disorder in the following year. Previous life stressors (β = .15) and low social support (β = -.14) were directly associated with panic disorder during the subsequent year. The most vulnerable individuals who experienced perievent panic attacks were 3.7 times, 95% confidence interval [CI] = [2.1, 6.4], more likely to suffer from panic disorder in the following year. Results suggest that early identification of perievent panic attacks following mass trauma may be helpful for reducing panic disorder. Copyright © 2013 International Society for Traumatic Stress Studies.

  6. Plasticity after perceptual narrowing for voice perception: reinstating the ability to discriminate monkeys by their voices at 12 months of age.

    Science.gov (United States)

    Friendly, Rayna H; Rendall, Drew; Trainor, Laurel J

    2013-01-01

    Differentiating individuals by their voice is an important social skill for infants to acquire. In a previous study, we demonstrated that the ability to discriminate individuals by voice follows a pattern of perceptual narrowing (Friendly et al., 2013). Specifically, we found that the ability to discriminate between two foreign-species (rhesus monkey) voices decreased significantly between 6 and 12 months of age. Also during this period, there was a trend for the ability to discriminate human voices to increase. Here we investigate the extent to which plasticity remains at 12 months, after perceptual narrowing has occurred. We found that 12-month-olds who received 2 weeks of monkey-voice training were significantly better at discriminating between rhesus monkey voices than untrained 12-month-olds. Furthermore, discrimination was reinstated to a level slightly better than that of untrained 6-month-olds, suggesting that voice-processing abilities remain considerably plastic at the end of the first year.

  7. Diesel Exhaust Exposure, Wheezing and Sneezing

    Science.gov (United States)

    2012-01-01

    The rising incidence of allergic disorders in developed countries is unexplained. Exposure to traffic related air pollutants may be an important cause of wheezing and asthma in childhood. Experimental evidence from human studies suggests that diesel exhaust particles, constituents of fine particulate matter less than 2.5 microns (PM2.5), may act to enhance IgE mediated aeroallergen sensitization and Th2 directed cytokine responses. To date, epidemiologic investigations indicate that children living in close proximity to heavily travelled roads are more likely to be atopic and wheeze. The Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS) birth cohort study was initiated to test the hypothesis that early high exposure to traffic related air pollutants is associated with early aeroallergen sensitization and allergic respiratory phenotypes. Using an exposure cohort design, more than 700 infants born to atopic parents were recruited at age 1 living either less than 400 meters (high traffic pollutant exposure) or greater than 1,500 meters (low exposure) from a major road. Children were medically evaluated and underwent skin prick testing with aeroallergen at screening, and re-evaluated sequentially at ages 1, 2, 3, 4, and 7. In this study, both proximity and land use regression (LUR) models of traffic air pollutant exposure have been assessed. Proximity to stop and go traffic with large concentrations of bus and truck traffic predicted persistent wheezing during infancy. The LUR model estimated elemental carbon attributable to traffic (ECAT) as a proxy for diesel exhaust particulate exposure. High ECAT was significantly associated with wheezing at age 1 as well as persistent wheezing at age 3. High mold exposure predicted a well defined asthma phenotype at age 7. PMID:22754710

  8. The South African Stress and Health (SASH) study: 12- month and ...

    African Journals Online (AJOL)

    scale population-based study of common mental disorders in the country. This paper provides data on the 12-month and lifetime prevalence of these conditions. Methods. Data from a nationally representative sample of 4 351 adults were ...

  9. Cochlear implantation at 12 months: Limitations and benefits for vocabulary production.

    Science.gov (United States)

    Fagan, Mary K

    2015-01-01

    The purpose of this investigation was to learn the degree to which cochlear implantation at 12 months of age could reduce gaps in performance between hearing age and chronological age - that is, whether infants with access to cochlear implants at 12 months of age would be 12 months delayed, or less, in vocabulary production one year later. Baseline vocabulary production was measured by parent interview and direct observation approximately 4 months post cochlear implant (CI) activation, and again 12 months after CI activation using the MacArthur-Bates Communicative Development Inventory: Words and Sentences. Infants produced few if any words shortly after CI activation. Word production increased significantly during the 12 months following CI activation but scores were still significantly below age-level expectations based on chronological age. Vocabulary scores were, however, significantly better than expected based on hearing age, or duration of implant use. Word production was delayed at both time points; however, access to cochlear implants at 12 months of age decreased the size of anticipated delays one year later, narrowing the expected gap between hearing age and chronological age.

  10. Accuracy of Fall Prediction in Parkinson Disease: Six-Month and 12-Month Prospective Analyses

    Directory of Open Access Journals (Sweden)

    Ryan P. Duncan

    2012-01-01

    Full Text Available Introduction. We analyzed the ability of four balance assessments to predict falls in people with Parkinson Disease (PD prospectively over six and 12 months. Materials and Methods. The BESTest, Mini-BESTest, Functional Gait Assessment (FGA, and Berg Balance Scale (BBS were administered to 80 participants with idiopathic PD at baseline. Falls were then tracked for 12 months. Ability of each test to predict falls at six and 12 months was assessed using ROC curves and likelihood ratios (LR. Results. Twenty-seven percent of the sample had fallen at six months, and 32% of the sample had fallen at 12 months. At six months, areas under the ROC curve (AUC for the tests ranged from 0.8 (FGA to 0.89 (BESTest with LR+ of 3.4 (FGA to 5.8 (BESTest. At 12 months, AUCs ranged from 0.68 (BESTest, BBS to 0.77 (Mini-BESTest with LR+ of 1.8 (BESTest to 2.4 (BBS, FGA. Discussion. The various balance tests were effective in predicting falls at six months. All tests were relatively ineffective at 12 months. Conclusion. This pilot study suggests that people with PD should be assessed biannually for fall risk.

  11. From early stress to 12-month development in very preterm infants: Preliminary findings on epigenetic mechanisms and brain growth.

    Science.gov (United States)

    Fumagalli, Monica; Provenzi, Livio; De Carli, Pietro; Dessimone, Francesca; Sirgiovanni, Ida; Giorda, Roberto; Cinnante, Claudia; Squarcina, Letizia; Pozzoli, Uberto; Triulzi, Fabio; Brambilla, Paolo; Borgatti, Renato; Mosca, Fabio; Montirosso, Rosario

    2018-01-01

    Very preterm (VPT) infants admitted to Neonatal Intensive Care Unit (NICU) are at risk for altered brain growth and less-than-optimal socio-emotional development. Recent research suggests that early NICU-related stress contributes to socio-emotional impairments in VPT infants at 3 months through epigenetic regulation (i.e., DNA methylation) of the serotonin transporter gene (SLC6A4). In the present longitudinal study we assessed: (a) the effects of NICU-related stress and SLC6A4 methylation variations from birth to discharge on brain development at term equivalent age (TEA); (b) the association between brain volume at TEA and socio-emotional development (i.e., Personal-Social scale of Griffith Mental Development Scales, GMDS) at 12 months corrected age (CA). Twenty-four infants had complete data at 12-month-age. SLC6A4 methylation was measured at a specific CpG previously associated with NICU-related stress and socio-emotional stress. Findings confirmed that higher NICU-related stress associated with greater increase of SLC6A4 methylation at NICU discharge. Moreover, higher SLC6A4 discharge methylation was associated with reduced anterior temporal lobe (ATL) volume at TEA, which in turn was significantly associated with less-than-optimal GMDS Personal-Social scale score at 12 months CA. The reduced ATL volume at TEA mediated the pathway linking stress-related increase in SLC6A4 methylation at NICU discharge and socio-emotional development at 12 months CA. These findings suggest that early adversity-related epigenetic changes might contribute to the long-lasting programming of socio-emotional development in VPT infants through epigenetic regulation and structural modifications of the developing brain.

  12. Peripartum nevirapine exposure and subsequent clinical outcomes among HIV-infected women receiving antiretroviral therapy for at least 12 months.

    Science.gov (United States)

    Chintu, Namwinga; Giganti, Mark J; Putta, Nande B; Sinkala, Moses; Sadoki, Ebedy; Stringer, Elizabeth M; Stringer, Jeffrey S A; Chi, Benjamin H

    2010-07-01

    Prior exposure to intrapartum/neonatal nevirapine (NVP) is associated with compromised virologic treatment outcomes once non-nucleoside reverse transcriptase inhibitor (NNRTI)-based antiretroviral therapy (ART) is initiated. We examined the longer-term clinical outcomes in a programmatic setting. We compared post-12 month mortality and clinical treatment failure (defined by WHO clinical and immunologic criteria) among women with and without prior NVP exposure in Lusaka, Zambia. Between April 2004 and July 2006, 6740 women initiated an NNRTI-containing regimen. At 12 months, 5172 (78%) remained active and were included in this analysis. Of these, 596 (12%) reported prior NVP exposure, whose time from exposure to ART initiation was: 12 months for 37%, unknown for 39%. Overall, women with prior NVP exposure trended towards increased survival (adjusted hazard ratio [AHR]: 0.53; 95% confidence interval [CI]: 0.27-1.06, P = 0.07) and towards increased hazard of clinical treatment failure (AHR: 1.18; 95% CI: 0.95-1.47, P = 0.14), particularly those with exposure for <6 months (AHR: 1.52; 95% CI: 0.94-2.45, P = 0.09). Prior NVP exposure appeared to increase risk for clinical treatment failure after 12 months of follow-up, but this finding did not reach statistical significance. With growing evidence linking recent NVP exposure to virologic failure, optimized monitoring algorithms should be considered for women with starting NNRTI-based ART. The association between prior NVP exposure and improved survival has not been previously shown and may be a result of residual confounding around health-seeking behaviours.

  13. An unusual case of refractory wheeze

    Science.gov (United States)

    Ramesh, Venkat; Acharya, Vishak; Pai, Narasimha; Krishnan, Ananda

    2015-01-01

    A 37-year-old man presented with a history of episodic wheeze and breathlessness of 3 years’ duration refractory to treatment. Physical examination revealed diffuse expiratory polyphonic rhonchi while the remainder of the examination including the cardiac examination was reported as normal. Pulmonary function testing revealed mild obstruction with bronchodilator reversibility. The patient was discharged on a 6-month course of antitubercular treatment (ATT) as bronchial brush cytology (obtained via bronchoscopy) was positive for acid-fast bacilli. The patient presented after completing 6 months of ATT with persistent symptoms, a loud S1 and a mid-diastolic murmur at the apex. High-resolution CT of the chest showed bilateral dependent ground glass opacities. An echocardiogram revealed a left atrial myxoma, and normal RV size and pressures. The patient underwent successful surgical removal of the same, and made a complete recovery. Refractory wheeze is a very unusual presentation of a left atrial myxoma. PMID:25733086

  14. Maternal obesity and childhood wheezing and asthma.

    Science.gov (United States)

    Rusconi, Franca; Popovic, Maja

    2017-03-01

    Obesity represents one of the major public health problems worldwide, with an increased prevalence also among women of reproductive age. Maternal pre-pregnancy overweight and obesity are important risk factors for a number of maternal and foetal/neonatal complications. The objective of this review is to provide an overview of the most recent evidence regarding the associations between pre-pregnancy overweight/obesity and wheezing and asthma in childhood. Potential mechanisms, mediators and confounding factors involved in these associations are also discussed. Despite the relatively large body of studies examining these associations and taking into account main confounders and potential mediators, the causal relationship between maternal obesity and wheezing and asthma in childhood is still uncertain. This uncertainty is not trivial, as any prevention strategy aimed at reducing the burden of these conditions would necessarily imply better understanding of the factors that are in the causal chain. Copyright © 2016. Published by Elsevier Ltd.

  15. An unusual case of refractory wheeze

    OpenAIRE

    Ramesh, Venkat; Acharya, Vishak; Pai, Narasimha; Krishnan, Ananda

    2015-01-01

    A 37-year-old man presented with a history of episodic wheeze and breathlessness of 3?years? duration refractory to treatment. Physical examination revealed diffuse expiratory polyphonic rhonchi while the remainder of the examination including the cardiac examination was reported as normal. Pulmonary function testing revealed mild obstruction with bronchodilator reversibility. The patient was discharged on a 6-month course of antitubercular treatment (ATT) as bronchial brush cytology (obtaine...

  16. Predictors of physical activity at 12 month follow-up after a supervised exercise intervention in postmenopausal women.

    Science.gov (United States)

    Aparicio-Ting, Fabiola E; Farris, Megan; Courneya, Kerry S; Schiller, Ashley; Friedenreich, Christine M

    2015-05-05

    Few studies have examined recreational physical activity (RPA) after participating in a structured exercise intervention. More specifically, little is known about the long-term effects of exercise interventions in post-menopausal women. This study had two objectives: 1) To compare RPA in postmenopausal women in the exercise group and the control group 12 months after the end of the Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial; and 2) To apply the Theory of Planned Behaviour (TPB) to identify predictors of RPA 12 months post-intervention among women in the exercise group. Self-reported RPA 12-months post-intervention from a validated questionnaire was used to estimate RPA levels for control group (118/160, 74% response) and exercise group participants (126/160, 79% response). Bivariate analysis was used to compare RPA between exercise and control group participants and to identify TPB variables for multivariate analysis. Logistic regression was applied to TPB data collected from self- administered questionnaires at end of trial by exercise group participants (126/160, 79% response) to identify predictors of long-term RPA. At 12 months post-intervention, 62% of women in the exercise group were active compared to 58% of controls (p = 0.52). Of the TPB constructs examined, self-efficacy (OR =2.98 (1.08-8.20)) and behavioural beliefs (OR = 1.46 (1.03-2.06)) were identified as predictors of RPA for exercise group participants. Levels of RPA in the exercise and control groups were comparable 12 months post intervention, indicating that participation in the ALPHA trial was associated with increased physical activity in previously inactive women, regardless of randomization into either the exercise group or in the control group. Exercise interventions that promote self-efficacy and positive behavioural beliefs have the potential to have long-term impacts on physical activity behaviour, although further research is needed to examine additional

  17. Immediate Implant Placement and Provisionalization Using the Patient's Extracted Crown: 12-Month Follow-Up.

    Science.gov (United States)

    Deliberador, Tatiana Miranda; Begnini, Gilmar José; Tomazinho, Flávia; Rezende, Carlos Eduardo Edwards; Florez, Fernando Luis Esteban; Leonardi, Denise Piotto

    2018-03-01

    Immediate placement and provisionalization of implants in fresh sockets has been previously demonstrated to be a predictable treatment in the restoration of non-recoverable teeth in the anterior regions of the maxilla. This article reports a clinical case in which an immediate implant placement protocol was used in combination with two distinct and sequential grafts (bovine bone and connective tissue, respectively) followed by immediate implant provisionalization using the patient's crown of an extracted tooth. Physical, clinical, and image examinations of the patient (female, 23 years old) revealed a maxillary central incisor (tooth No. 8) with slight mobility due the presence of extensive cervical resorption. The treatment proposed was the atraumatic extraction of the tooth followed by immediate implant placement and provisionalization. Two grafts (bovine bone and connective tissue) were used due to the presence of a very thin maxillary bone plate associated with a thin gingival biotype. The use of the extracted crown as a temporary crown after immediate implant placement resulted in immediate attainment of an esthetically pleasing outcome and long-term favorable results. The treatment protocol proposed can be efficiently used to immediately restore the patient's esthetics and function while maintaining the health, volume, and contours of gingival tissues over a 12-month follow-up period. Anterior teeth extractions typically require the execution of single-unit prostheses using dental materials of synthetic origin (such as polymers), which often are incapable of achieving the esthetic and physiological results patients expect. The use of the patient's own crown was demonstrated, which allowed good clinical results to be achieved and the natural shape and function of tissues to be maintained.

  18. Evaluation of a 12-Month Pilot of Long-Term and Temporary Assisted Peritoneal Dialysis.

    Science.gov (United States)

    Bevilacqua, Micheli U; Turnbull, Linda; Saunders, Sushila; Er, Lee; Chiu, Helen; Hill, Penny; Singh, Rajinder S; Levin, Adeera; Copland, Michael A; Jamal, Abeed; Brumby, Catherine; Dunne, Orla; Taylor, Paul A

    2017-01-01

    ♦ BACKGROUND: Peritoneal dialysis (PD) is challenging for patients with functional limitations, and assisted PD can support these patients, but previous reports of assisted PD have not examined the role of temporary assisted PD and had difficulty identifying adequate comparator cohorts. ♦ METHODS: Peritoneal Dialysis Assist (PDA), a 12-month pilot of long-term and temporary assisted PD was completed in multiple PD centers in British Columbia, Canada. Continuous cycler PD (CCPD) patients were identified for PDA by standardized criteria, and service could be long-term or temporary/respite. The PDA program provided daily assistance with cycler dismantle and setup, but patients remained responsible for cycler connections and treatment decisions. Outcomes were compared against both the general CCPD population and patients who met PDA criteria but were not enrolled (PDA-eligible). ♦ RESULTS: Fifty-three PDA patients had an 88% 1-year death- and transplant-censored technique survival that was similar to the general CCPD cohort (84%) and PDA-eligible cohort (86%). The PDA cohort had lower peritonitis rates (0.18 episodes/patient-year vs 0.22 and 0.36, respectively), but higher hospitalization (55% vs 34% and 35%, respectively). Long-term PDA cost approximately CDN$15,000/year in addition to existing dialysis costs. A total of 8/11 respite PDA patients (73%) returned to self-care PD after a median PDA use of 29 days, which costs $1,250/patient. ♦ CONCLUSIONS: Peritoneal Dialysis Assist provides effective support to functionally-limited CCPD patients and yields acceptable clinical outcomes. The program costs less than transfer to HD or long-term care, which represents cost minimization for failing self-care PD patients. Respite PDA provides effective temporary support; most patients returned to self-care PD and service was cost-effective compared with alternatives of hospitalization or transfer to HD. Copyright © 2017 International Society for Peritoneal Dialysis.

  19. Embolization for the treatment of intractable epistaxis: 12 month outcomes in a two centre case series.

    Science.gov (United States)

    Robinson, Anthony E; McAuliffe, William; Phillips, Timothy J; Phatouros, Constantine C; Singh, Tejinder P

    2017-12-01

    Embolization is a treatment option for intractable epistaxis; however, concerns regarding tissue necrosis, stroke and blindness persist in the literature. A retrospective review of patients from September 2010 to January 2016 treated with embolization for epistaxis was performed. No patient was excluded. Follow-up was 12 months and no patient was lost. 62 embolizations on 59 patients occurred. 21 cases were taking anticoagulants, P2Y12 inhibiting agents or had a systemic coagulopathy. Embolized territories typically involved bilateral distal internal maxillary arteries with unilateral or bilateral facial arteries with polyvinyl alcohol particles. 60 cases had procedural general anaesthesia. There were no major complications. Six died of unrelated causes. Of the surviving 53 patients, excluding the 3 patients with hereditary haemorrhagic telangiectasia, 5 had recurrent epistaxis post-embolization. Four were taking P2Y12 inhibiting and/or anticoagulants, none of which required surgery, prolonged packing or repeat embolization. This group had a propensity to recur compared with cases taking aspirin only or no antiplatelet/anticoagulant (77.8 vs 97.1%, p = 0.04). The fifth underwent repeat embolization after previously only having ipsilateral distal internal maxillary and facial arteries treated. Embolization for epistaxis is safe and effective. Of those who had recurrent epistaxis post embolization, most were taking P2Y12 inhibition and/or anticoagulation. We prefer bilateral distal internal maxillary artery and unilateral facial artery embolization under general anaesthesia for optimal safety and efficacy. Advances in knowledge: Embolization with this technique seems to facilitate superior outcomes without complications despite the large proportion of patients taking anticoagulating or P2Y12 inhibiting agents.

  20. Unfulfilled rehabilitation needs and dissatisfaction with care 12 months after a stroke

    DEFF Research Database (Denmark)

    Tistad, Malin; Tham, Kerstin; von Koch, Lena

    2012-01-01

    a questionnaire. Stroke severity, domains of the Stroke Impact Scale (SIS), the Sense of Coherence scale (SOC) and socio demographic factors were used as independent variables in four logistic regression analyses. RESULTS: Unfulfilled needs for rehabilitation at 12 months were predicted by strength (SIS) (odds......BACKGROUND: People who have suffered a stroke commonly report unfulfilled need for rehabilitation. Using a model of patient satisfaction, we examined characteristics in individuals that at 3 months after stroke predicted, or at 12 months were associated with unmet need for rehabilitation...... or dissatisfaction with health care services at 12 months after stroke. METHODS: The participants (n = 175) received care at the stroke units at the Karolinska University Hospital, Sweden. The dependent variables "unfulfilled needs for rehabilitation" and "dissatisfaction with care" were collected using...

  1. Infant pain-related negative affect at 12 months of age: early infant and caregiver predictors.

    Science.gov (United States)

    Din Osmun, Laila; Pillai Riddell, Rebecca; Flora, David B

    2014-01-01

    To examine the predictive relationships of early infant and caregiver variables on expressed pain-related negative affect duration at the 12-month immunization. Infants and their caregivers (N = 255) were followed during immunization appointments over the first year of life. Latent growth curve modeling in a structural equation modeling context was used. Higher levels of initial infant pain reactivity at 2 months and caregiver emotional availability averaged across 2, 4, and 6 months of age were related to larger decreases in the duration of infant negative affect over the first 6 months of life. Longer duration of infant negative affect at 2 months and poorer regulation of infant negative affect over the first 6 months of life predicted longer durations of infant negative affect by 12 months. Infant negative affect at 12 months was a function of both infant factors and the quality of caregiver interactive behaviors (emotional availability) in early infancy.

  2. Time-course of exercise and its association with 12-month bone changes

    Directory of Open Access Journals (Sweden)

    Vainionpää Aki

    2009-11-01

    Full Text Available Abstract Background Exercise has been shown to have positive effects on bone density and strength. However, knowledge of the time-course of exercise and bone changes is scarce due to lack of methods to quantify and qualify daily physical activity in long-term. The aim was to evaluate the association between exercise intensity at 3, 6 and 12 month intervals and 12-month changes in upper femur areal bone mineral density (aBMD and mid-femur geometry in healthy premenopausal women. Methods Physical activity was continuously assessed with a waist-worn accelerometer in 35 healthy women (35-40 years participating in progressive high-impact training. To describe exercise intensity, individual average daily numbers of impacts were calculated at five acceleration levels (range 0.3-9.2 g during time intervals of 0-3, 0-6, and 0-12 months. Proximal femur aBMD was measured with dual x-ray absorptiometry and mid-femur geometry was evaluated with quantitative computed tomography at the baseline and after 12 months. Physical activity data were correlated with yearly changes in bone density and geometry, and adjusted for confounding factors and impacts at later months of the trial using multivariate analysis. Results Femoral neck aBMD changes were significantly correlated with 6 and 12 months' impact activity at high intensity levels (> 3.9 g, r being up to 0.42. Trochanteric aBMD changes were associated even with first three months of exercise exceeding 1.1 g (r = 0.39-0.59, p r = 0.38-0.52, p Conclusion The number of high acceleration impacts during 6 months of training was positively associated with 12-month bone changes at the femoral neck, trochanter and mid-femur. These results can be utilized when designing feasible training programs to prevent bone loss in premenopausal women. Trial registration Clinical trials.gov NCT00697957

  3. Prenatal Paracetamol Exposure and Wheezing in Childhood: Causation or Confounding?

    Directory of Open Access Journals (Sweden)

    Enrica Migliore

    Full Text Available Several studies have reported an increased risk of wheezing in the children of mothers who used paracetamol during pregnancy. We evaluated to what extent this association is explained by confounding.We investigated the association between maternal paracetamol use in the first and third trimester of pregnancy and ever wheezing or recurrent wheezing/asthma in infants in the NINFEA cohort study. Risks ratios (RR and 95% confidence intervals (CI were estimated after adjustment for confounders, including maternal infections and antibiotic use during pregnancy.The prevalence of maternal paracetamol use was 30.6% during the first and 36.7% during the third trimester of pregnancy. The prevalence of ever wheezing and recurrent wheezing/asthma was 16.9% and 5.6%, respectively. After full adjustment, the RR for ever wheezing decreased from 1.25 [1.07-1.47] to 1.10 [0.94-1.30] in the first, and from 1.26 [1.08-1.47] to 1.10 [0.93-1.29] in the third trimester. A similar pattern was observed for recurrent wheezing/asthma. Duration of maternal paracetamol use was not associated with either outcome. Further analyses on paracetamol use for three non-infectious disorders (sciatica, migraine, and headache revealed no increased risk of wheezing in children.The association between maternal paracetamol use during pregnancy and infant wheezing is mainly, if not completely explained by confounding.

  4. Objectively measured physical activity and 12-month trajectories of neck-shoulder pain in workers

    DEFF Research Database (Denmark)

    Hallman, David M.; Birk Jørgensen, Marie; Holtermann, Andreas

    2017-01-01

    Aims: This study aimed to investigate the association between objectively measured physical activity at work and leisure and the intensity (mean level and time course) of neck-shoulder pain (NSP) over 12 months among male and female blue collar workers. Methods: Data were obtained from 625 blue...... of NSP (numerical rating scale 0-10) were collected using text messages every fourth week over 12 months. Linear mixed models were used to investigate the associations between occupational physical activity (OPA) and leisure time physical activity (LTPA) and the trajectories of the intensity of NSP...

  5. The evaluation of a 12-month health service manager mentoring program in a corrections environment.

    Science.gov (United States)

    Cashin, Andrew J; Newman, Claire

    2010-01-01

    Mentoring programs are believed to positively influence the professional development of nurses where a system is provided to promote skill and knowledge base enhancement within a supportive relationship between mentor and mentee. This study aimed to evaluate a 12-month health manager mentoring program within a correctional facility in New South Wales, Australia. Over the period of the mentoring program, there was an improvement in professional behavior and a decline in the rating of supervisees. Work stress increased and job satisfaction decreased over the 12-month period, although not to a statistically significant level. Qualitative feedback suggested that participants found the program to be useful.

  6. Internet-based screening and brief intervention for illicit drug users: a randomized controlled trial with 12-month follow-up.

    Science.gov (United States)

    Sinadinovic, Kristina; Wennberg, Peter; Berman, Anne H

    2014-03-01

    This trial investigated the effects of access to an Internet-based screening and brief intervention site for illicit drug users. This article adds to previously published results from the 3- and 6-month follow-ups by extending the follow-up period to 12 months and reporting changes in substance use between the 6- and 12-month follow-ups. In total, 202 Internet help-seekers with illicit drug use, 15-70 years old, were randomly assigned to either an intervention group that received Internet-based screening and brief intervention via eScreen.se or to an assessment-only control group. The primary outcome measure was the Drug Use Disorders Identification Test consumption questions (DUDIT-C) score, and secondary outcome measures were the DUDIT, Alcohol Use Disorders Identification Test consumption questions (AUDIT-C), and AUDIT scores, as well as the proportion of drug abstainers and participants making a clinically significant change in their alcohol and other drug use. DUDIT-C, DUDIT, AUDIT-C, and AUDIT scores remained stable between the 6- and 12-month follow-ups. However, 12 months after recruitment, 34.3% of those who used eScreen.se had changed their alcohol use to a clinically lower level compared with the 21.8% of the controls. Also, none of the eScreen.se users increased their level of alcohol use during this 12-month period, whereas 5.0% in the control group did so. Despite no changes in illicit drug use from the 6- to 12-month follow-up for both the intervention and control group, eScreen.se seems to be more effective than assessment only for reducing alcohol use among illicit drug users over a 12-month period.

  7. Motor development curve from 0 to 12 months in infants born preterm.

    Science.gov (United States)

    Kayenne Martins Roberto Formiga, Cibelle; Linhares, Maria Beatriz Martins

    2011-03-01

    To trace a reference curve for motor development from birth up to 12 months of corrected chronological age in infants born preterm and low birth weight. This is a cross-sectional study with a sample of 308 preterm infants (53% boys) weighing Alberta Infant Motor Scale (AIMS) was used for motor development assessment. Comparing the motor performance of preterm infants with infants from a standardized sample on the AIMS, it was found that, except for the age group of the newborn, preterm infants showed lower motor development scores in comparison with the AIMS normative sample in all age groups between 1 and 12 months. The curve of motor development showed a continuous increase in the number of motor skills of preterm infants during their first 12 months of age. However, the average of motor acquisitions of preterm infants showed a nonlinear pattern with a standard indicator of stabilization between 8 and 10 months of age. Preterm infants, 1-12 months of age, showed motor development AIMS scores lower than the standards established in the normative sample. The findings may contribute as norm-reference for assessing the motor development of preterm infants in follow-up programmes in developing countries. © 2010 The Author(s)/Acta Paediatrica © 2010 Foundation Acta Paediatrica.

  8. 12-Month Follow-Up of Fluoxetine and Cognitive Behavioral Therapy for Binge Eating Disorder

    Science.gov (United States)

    Grilo, Carlos M.; Crosby, Ross D.; Wilson, G. Terence; Masheb, Robin M.

    2012-01-01

    Objective: The longer term efficacy of medication treatments for binge-eating disorder (BED) remains unknown. This study examined the longer term effects of fluoxetine and cognitive behavioral therapy (CBT) either with fluoxetine (CBT + fluoxetine) or with placebo (CBT + placebo) for BED through 12-month follow-up after completing treatments.…

  9. Description of the motor development of 3-12 month od infants with Down Syndrome

    NARCIS (Netherlands)

    Tudella, E.; Pereira, K.; Pedronongo Basso, R.; Savelsbergh, G.J.P.

    2011-01-01

    The purpose of the present study was to describe the rate of motor development in infants with Down syndrome in the age range of 3-12 months and identify the difficulties both in performance and acquiring motor skills in prone, supine, sitting and standing positions. Nineteen infants with Down

  10. Trends in, and predictors of, anxiety and specific worries following colposcopy: a 12-month longitudinal study.

    Science.gov (United States)

    O'Connor, Mairead; O'Leary, Eamonn; Waller, Jo; Gallagher, Pamela; D'arcy, Tom; Flannelly, Grainne; Martin, Cara M; McRae, Judith; Prendiville, Walter; Ruttle, Carmel; White, Christine; Pilkington, Loretto; O'Leary, John J; Sharp, Linda

    2016-05-01

    Little is known about which women are at greatest risk of adverse psychological after-effects following colposcopy. This study examined time trends in, and identified predictors of, anxiety and specific worries over 12 months. Women attending two hospital-based colposcopy clinics for abnormal cervical cytology were invited to complete psychosocial questionnaires at 4, 8 and 12 months following colposcopy. General anxiety and screening-specific worries (about cervical cancer, having sex and future fertility) were measured. Generalised estimating equations were used to assess associations between socio-demographic, lifestyle and clinical variables and risk of psychological outcomes. Of 584 women initially recruited, 429, 343 and 303 completed questionnaires at 4, 8 and 12 months, respectively. Screening-specific worries declined significantly over time but were still relatively high at 12 months: 23%, 39% and 18% for worries about cervical cancer, fertility and having sex, respectively. Anxiety remained stable (20%) over time. Risks of cervical cancer worry and anxiety were both almost double in women without private health insurance (cervical cancer worry: OR = 1.80, 95% CI 1.25-2.61; anxiety: OR = 1.84, 95% CI 1.20-2.84). Younger women (following colposcopy, with predictors varying between outcomes. Women in socio-demographically vulnerable groups were at greatest risk of adverse psychological outcomes. This information could inform development of interventions to alleviate psychological distress post-colposcopy. Copyright © 2015 John Wiley & Sons, Ltd.

  11. Pre implantation psychological functioning preserved in majority of implantable cardioverter defibrillator patients 12 months post implantation

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Hoogwegt, Madelein T; Jordaens, Luc

    2013-01-01

    The impact of ICD therapy on patient well being has typically focused on mean differences between groups, thereby neglecting changes within individuals. Using an intra-individual approach, we examined (i) the prevalence of implantable cardioverter defibrillator (ICD) patients maintaining their pre...... implantation level of psychological functioning at 12 months, and (ii) factors associated with deterioration in functioning....

  12. FedEx Express Gasoline Hybrid Electric Delivery Truck Evaluation: 12-Month Report

    Energy Technology Data Exchange (ETDEWEB)

    Barnitt, R.

    2011-01-01

    This report summarizes the data obtained in a 12-month comparison of three gasoline hybrid electric delivery vehicles with three comparable diesel vehicles. The data show that there was no statistical difference between operating cost per mile of the two groups of vehicles. As expected, tailpipe emissions were considerably lower across all drive cycles for the gHEV than for the diesel vehicle.

  13. Adherence to Glaucoma Medications Over 12 Months in Two US Community Pharmacy Chains

    Directory of Open Access Journals (Sweden)

    Michael Feehan

    2016-09-01

    Full Text Available This study determined the degree of adherence to medications for glaucoma among patients refilling prescriptions in community pharmacies. Methods: Data abstracted from the dispensing records for 3615 adult patients (18 years or older, predominantly over 45 receiving glaucoma medications from two retail pharmacy chains (64 stores in total were analyzed. From a 24-month historic data capture period, the 12-month levels of adherence were determined using standard metrics, the proportion of days covered (PDC and the medication possession ratio (MPR. The overall 12-month mean PDC was only 57%, and the mean MPR was 71%. Using a criterion by which 80% coverage was considered satisfactory adherence, only 30% had satisfactory overall 12-month PDC coverage, and only 37% had satisfactory overall 12-month MPR coverage. Refill adherence increased with age and was highest in the 65-and-older age group (p < 0.001. Differential adherence was found across medication classes, with the highest satisfactory coverage seen for those taking alpha2-adrenergic agonists (PDC = 36.0%; MPR = 47.6% down to those taking direct cholinergic agonists (PDC = 25.0%; MPR = 31.2% and combination products (PDC = 22.7%; MPR = 31.0%. Adherence to glaucoma medications in the community setting, as measured by pharmacy refill data, is very poor and represents a critical target for intervention. Community pharmacists are well positioned to monitor and reinforce adherence in this population.

  14. Predictors of depressive symptoms 12 months after surgical treatment of early-stage breast cancer

    NARCIS (Netherlands)

    den Oudsten, Brenda L.; van Heck, Guus L.; van der Steeg, Alida F. W.; Roukema, Jan A.; de Vries, Jolanda

    2009-01-01

    Nearly half of the women with breast cancer (BC) show depressive symptoms in the first year after diagnosis. This has a major impact on patients' lives. Therefore, the aim of this study was to identify predictors of depressive symptoms 12 months after surgical treatment. Furthermore, the stability

  15. [Absolute or relative isolation for fissure sealants? 12-month clinical study].

    Science.gov (United States)

    Llodra Calvo, J C; Baca García, P

    1991-03-01

    The purpose of this clinical study is to analyse the effectiveness of a sealant. Rubber dam and cotton roll methods of isolation where compared with respect to the effect of isolation method on retreatment and protection from caries during 12 months. We study the cost effectiveness ratio for both methods of isolation. The results could not be substantiated any differences between two methods.

  16. The outcome at 12 months of very-Iow-birth-weight infants ventilated ...

    African Journals Online (AJOL)

    Main outcome measures. Attrition rates for rural and urban babies, BPD, ROP, IVH and abnormal motor development. Study population and setting. All ventilated VLBW infants discharged from the neonatal intensive care unit at Tygerberg Hospital over a 1-year period were followed up at 3-monthly intervals for 12 months.

  17. Case fatality of patients with stroke over a 12-month period post ...

    African Journals Online (AJOL)

    Introduction. Stroke is among the top 4 causes of death in South Africa and the top 10 leading causes of disability worldwide. There is a dearth of literature on stroke incidence, prevalence and outcome in sub-Saharan Africa. We aimed to establish the case fatality of stroke patients over a 12-month period post discharge ...

  18. Increased wheeze but not bronchial hyperreactivity near power stations.

    Science.gov (United States)

    Halliday, J A; Henry, R L; Hankin, R G; Hensley, M J

    1993-08-01

    In a previous study a higher than expected prevalence of asthma was found in Lake Munmorah, a coastal town near two power stations, compared with another coastal control town. This study aimed to compare atopy, bronchial hyperreactivity, and reported symptoms of asthma in the power station town and a second control area with greater socioeconomic similarity. A cross sectional survey was undertaken. Lake Munmorah, a coastal town near two power stations, and Dungog, a country town in the Hunter Valley, NSW, Australia. All children attending kindergarten to year 6 at all schools in the two towns were invited to participate in 1990. The response rates for the questionnaire for reported symptoms and associated demographic data were 92% in Lake Munmorah and 93% in Dungog, with 84% and 90% of children respectively being measured for lung function, atopy, and bronchial reactivity. There were 419 boys and 432 girls aged 5 to 12 years. Main outcome measures were current wheeze and bronchial hyper-reactivity, defined as a fall in forced expiratory volume in 1 second (FEV1) or peak expiratory flow (PEF) of 20% or more. Current wheeze was reported in 24.8% of the Lake Munmorah children compared with 14.6% of the Dungog children. Bronchial hyper-reactivity was similar for both groups--25.2% in Lake Munmorah and 22.3% in Dungog. The mean baseline FEV1 was lower in Lake Munmorah than in Dungog (p power station town, but bronchial hyper-reactivity and skin test defined atopy were similar in the two communities. These results are consistent with the previous study and confirm the increased presence of reported symptomatic illness in the town near power stations.

  19. Distress after a psychosocial cancer rehabilitation course. Main effects and effect modification in a randomised trial at 12 months of follow-up

    DEFF Research Database (Denmark)

    Ross, Lone; Rottmann, Nina; Andersen, Klaus K

    2015-01-01

    in the control group provided data. RESULTS: No effect of the intervention was found on distress at 12 months of follow-up, even in subgroups with fewer psychosocial resources at baseline, i.e. greater baseline distress, poorer self-efficacy and less emotional support. CONCLUSION: Multidimensional rehabilitation......BACKGROUND: In 2002, the Danish Cancer Society opened a rehabilitation centre in which cancer patients were offered a free, six-day, multidimensional residential course. Our previous studies of the effects of this course at one and six months of follow-up showed no positive effect on distress. We....... Patients in both groups completed questionnaires at baseline and at one, six and 12 months of follow-up, including the 'Profile of Mood States short form', the 'General Self-efficacy' scale and a question on emotional support. At 12 months of follow-up, 179 participants in the intervention group and 195...

  20. Results of a Second Year of Therapy with the 12-Month Histrelin Implant for the Treatment of Central Precocious Puberty

    Directory of Open Access Journals (Sweden)

    Samar Rahhal

    2009-01-01

    Full Text Available Background. Gonadotropin releasing hormone analogs (GnRHas are standard of care for central precocious puberty (CPP. The histrelin subcutaneous implant is safe and effective in the treatment of CPP for one year. Objective. The study evaluates a second year of therapy in children with CPP who received a new implant after one year of treatment. Methods. A prospective one-year study following an initial 12-month treatment period was conducted. Results. Thirty-one patients (29 girls aged 7.7±1.5 years received a second implant. Eighteen were naïve to GnRHa therapy at first implantation. Peak LH declined from 0.92±0.58 mIU/mL at 12 months to 0.51±0.33 mIU/mL at 24 months (P < .0001 in naïve subjects, and from 0.74±0.50 mIU/mL at 12 months to 0.45±0.35 mIU/mL at 24 months (P=.0081 in previously treated subjects. Predicted adult height increased by 5.1 cm at 24 months (P=.0001. Minor implant site reactions occurred in 61%, while minor difficulties with explantation occurred in 32.2% of subjects. Conclusion. The histrelin implant demonstrates profound hypothalamic-pituitary-gonadal axis suppression when a new implant is placed for a second year of treatment. Prospective follow-up of this therapeutic modality for the treatment of CPP is needed.

  1. 12-Month naturalistic outcomes of depressive disorders in Hong Kong's primary care.

    Science.gov (United States)

    Chin, Weng Yee; Chan, Kit T Y; Lam, Cindy L K; Wan, Eric Y F; Lam, Tai Pong

    2015-06-01

    In Asia, the role of primary care physicians (PCPs) in mental health delivery is not clearly defined and what happens to patients following a depressive episode remains poorly understood. To examine the 12-month naturalistic outcomes of depression in primary care and the impact of PCP identification. A cohort study was conducted. A total of 10179 adults were consecutively recruited from the waiting rooms of 59 PCPs across Hong Kong to complete a survey which screened for depression. Blinded doctors provided data on their diagnosis and management; 539 screened-positive and 3819 screened-negative subjects consented to telephone follow-up at 3, 6 and 12 months. Study instruments included Patient Health Questionnaire-9, Centre for Epidemiologic Studies Depression Scale 20 and Short-Form Health Survey Version 2.0 (SF-12v2) and self-reported mental health and primary care service use. 12-month remission rate was 60.31%. PCP detection had no association with remission. Identified patients had poorer health-related quality of life (HRQOL) at baseline but a faster rate of recovery in SF-12v2 mental component scores. PCP detection was associated with greater mental health service use at 12, 26 and 52 weeks, while GP consultation rates were only increased at 12 weeks. Over 1 year, ~60% of depressed patients experience symptom resolution, while 40% continue to suffer a chronic or remitting course of illness. Identification of depression by a PCP does not appear to affect remission of mood symptoms at 12 months, but is associated with a faster rate of recovery of HRQOL. PCP detection raises GP consultation rates temporarily however appears to enable more patients to access mental health services over 12 months. © The Author 2015. Published by Oxford University Press.

  2. Percutaneous osseointegrated prostheses for amputees: Limb compensation in a 12-month ovine model.

    Science.gov (United States)

    Shelton, Trevor J; Beck, J Peter; Bloebaum, Roy D; Bachus, Kent N

    2011-10-13

    Percutaneous osseointegrated prostheses are being investigated as an alternative strategy to attach prosthetic limbs to patients. Although the use of these implants has shown to be promising in clinical trials, the ability to maintain a skin seal around an osseointegrated implant interface is a major challenge to prevent superficial and deep periprosthetic infections. The specific aim of this study was to establish a translational load-bearing ovine model to assess postoperative limb compensation and gait symmetry following a percutaneous osseointegrated implant. We tested the following hypotheses: (1) the animals would return to pre-amputation limb loads within 12-months; (2) the animals would return to a symmetrical gait pattern (stride length and time in stance) within 12-months. The results demonstrated that one month following surgery, the sheep loaded their amputated limb to a mean value of nearly 80% of their pre-amputation loading condition; by 12-months, this mean had dropped to approximately 74%. There was no statistical differences between the symmetry of the amputated forelimb and the contralateral forelimb at any time point for the animals stride length or the time spent in the stance phase of their gait cycle. Thus, the data showed that while the animals maintained symmetric gait patterns, they did not return to full weight-bearing after 12-months. The results of this study showed that a large animal load-bearing model had a symmetric gait and was weight bearing for up to 12 months. While the current investigation utilizes an ovine model, the data show that osseointegrated implant technology with postoperative follow-up can help our human patients return to symmetric gait and maintain an active lifestyle, leading to an improvement in their quality of life following amputation. Published by Elsevier Ltd.

  3. Personality dimensions in schizophrenia: associations with symptoms and coping concurrently and 12 months later.

    Science.gov (United States)

    Lysaker, Paul H; Taylor, Amanda C

    2007-01-01

    Research has indicated that stable individual differences in personality exist among persons with schizophrenia, and that they likely predate the onset of illness. Less is known about whether individual differences in personality are related to levels of psychopathology and function. This study tested the hypotheses that levels of neuroticism, extraversion and agreeableness are associated with symptomatology and coping in schizophrenia both concurrently and as measured 12 months later for 46 participants with schizophrenia or schizoaffective disorder. Baseline assessments were conducted, which included measurements of the personality dimensions of neuroticism, extraversion and agreeableness measured using the NEO, coping preferences using the Ways of Coping Questionnaire and symptoms using the Positive and Negative Syndrome Scale. The symptom and coping measures were repeated 12 months after the date of the baseline assessment. Univariate correlations comparing baseline assessments suggested that higher neuroticism and lower extraversion were concurrently linked to more emotional discomfort and avoidant coping. Agreeableness was linked only to positive symptoms. Correlations controlling for baseline levels revealed greater levels of neuroticism at baseline, predicted a preference for resigning when under stress and higher emotional discomfort 12 months later. Lesser levels of agreeableness continued to predict greater positive symptoms 12 months later. No long-term associations were found between coping and symptoms at 12 months with levels of extraversion. The results suggest individual differences in personality are associated with psychopathology in schizophrenia and may affect function over time. More research is needed with broader samples and with more frequent follow-up assessments. Copyright (c) 2007 S. Karger AG, Basel.

  4. Inhaled budesonide for treatment of recurrent wheezing in early childhood

    DEFF Research Database (Denmark)

    Bisgaard, H; Munck, Susanne; Nielsen, J P

    1990-01-01

    significantly improved symptom scores of wheezing, sleep disturbance, and patient happiness. The frequency of severe exacerbations that required a course of oral prednisolone was also significantly reduced. The treatment effect appeared to be fully established after 6-8 weeks and no side-effects could...... recurrent wheeze and dyspnoea, and possibly reduce their requirement for oral steroids....

  5. Long-term outcome of early childhood wheezing : Population data

    NARCIS (Netherlands)

    Strachan, D; Gerritsen, J

    The adult prognosis of early childhood wheezing is reviewed using data from three studies (in Melbourne, Tasmania and Britain) which have followed population-based samples of 7 year old children with a history of asthma or wheezing illness into their early thirties. About one quarter of these wheezy

  6. Sensitization predicts asthma development among wheezing toddlers in secondary healthcare

    NARCIS (Netherlands)

    Boersma, Nienke A.; Meijneke, Ruud W.H.; Kelder, Johannes C.; van der Ent, Cornelis K.; Balemans, Walter A.F.

    2017-01-01

    Introduction: Some wheezing toddlers develop asthma later in childhood. Sensitization is known to predict asthma in birth cohorts. However, its predictive value in secondary healthcare is uncertain. Aim: This study examines the predictive value of sensitization to inhalant allergens among wheezing

  7. Ambient air pollution triggers wheezing symptoms in infants

    DEFF Research Database (Denmark)

    Andersen, Zorana Jovanovic; Loft, S; Ketzel, Matthias

    2008-01-01

    There is limited evidence for the role of air pollution in the development and triggering of wheezing symptoms in young children. A study was undertaken to examine the effect of exposure to air pollution on wheezing symptoms in children under the age of 3 years with genetic susceptibility to asthma....

  8. Asthmatic/wheezing phenotypes in preschool children: Influential factors, health care and urban-rural differences.

    Science.gov (United States)

    Kutzora, Susanne; Weber, Alisa; Heinze, Stefanie; Hendrowarsito, Lana; Nennstiel-Ratzel, Uta; von Mutius, Erika; Fuchs, Nina; Herr, Caroline

    2018-03-01

    Different wheezing and asthmatic phenotypes turned out to indicate differences in etiology, risk factors and health care. We examined influential factors and urban-rural differences for different phenotypes. Parents of 4732 children filled out a questionnaire concerning children's health and environmental factors administered within the Health Monitoring Units (GME) in a cross-sectional study in Bavaria, Germany (2014/2015). To classify respiratory symptoms, five phenotype groups were built: episodic, unremitting and frequent wheeze, ISAAC (International Study of Asthma and Allergies in Children) - asthma and physician-diagnosed asthma (neither of the groups are mutually exclusive). For each phenotype, health care variables were presented and stratified for residence. Urban-rural differences were tested by Pearson's chi-squared tests. Multivariable logistic regression was performed to analyze associations between influential factors and belonging to a phenotype group, and to compare groups with regard to health care variables as outcome. Risk factors for wheezing phenotypes were male gender (OR = 2.02, 95%-CI = [1.65-2.48]), having older siblings (OR = 1.24, 95%-CI = [1.02-1.51]), and preterm delivery (OR = 1.61, 95%-CI = [1.13-2.29]) (ORs for unremitting wheeze). 57% of children with ISAAC asthma and 74% with physician-diagnosed asthma had performed allergy tests. Medication intake among all groups was more frequent in rural areas, and physician's asthma diagnoses were more frequent in urban areas. In accordance with previous research this study confirms that male gender, older siblings and preterm delivery are associated with several wheezing phenotypes. Overall, low numbers of allergy tests among children with physician's diagnoses highlight a discrepancy between common practice and current knowledge and guidelines. Residential differences in health care might encourage further research and interventions strategies. Copyright © 2017

  9. An independent association of prenatal depression with wheezing and anxiety with rhinitis in infancy.

    Science.gov (United States)

    Cheng, Tuck Seng; Chen, Helen; Lee, Theresa; Teoh, Oon Hoe; Shek, Lynette P; Lee, Bee Wah; Chee, Cornelia; Godfrey, Keith M; Gluckman, Peter D; Kwek, Kenneth; Saw, Seang Mei; Chong, Yap-Seng; Meaney, Michael; Broekman, Birit F P; Chay, Oh Moh; Van Bever, Hugo; Goh, Anne

    2015-12-01

    Different maternal psychological states during pregnancy have been associated with wheeze-rhinitis-eczema symptoms in children. However, previous studies were limited and it was unclear whether the type of prenatal psychological state was associated with a particular symptom. We examined the association of maternal depression and anxiety during pregnancy with wheeze-rhinitis-eczema symptoms in infancy. In a longitudinal birth cohort (GUSTO) of 1152 mother-child pairs, wheeze-rhinitis-eczema symptoms in the infants during the first year of life were collected by parental report. Maternal depressive and anxiety symptoms were assessed at 26 weeks of gestation using the Edinburgh Postnatal Depression Scale (EPDS) and State Trait Anxiety Inventory (STAI). Logistic regression analyses were performed with adjustment for potential confounders. An increased risk of wheezing was found in infants of pregnant women with probable depression (EPDS ≥ 15) [odds ratio (OR) = 1.85 (95% confidence interval (CI) 1.10-3.12)], and an increased risk of rhinitis was associated with maternal anxiety [STAI state ≥ 41: OR = 1.42 (95% CI 1.04-1.93); STAI trait ≥ 43: OR = 1.38 (95% CI 1.01-1.88)]. After adjusting for known risk factors for the development of allergic disease, these associations remained significant [EPDS ≥ 15: adjusted OR = 2.09 (95% CI 1.05-4.19); STAI state ≥ 41: adjusted OR = 1.82 (95% CI 1.17-2.82); STAI trait ≥ 43: adjusted OR = 1.70 (95% CI 1.10-2.61)]. However, maternal psychological states were not associated with infantile eczema. This study suggests that there may be an independent effect of prenatal depression on wheezing and anxiety on rhinitis in infancy. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Employment-based reinforcement of adherence to oral naltrexone in unemployed injection drug users: 12-month outcomes.

    Science.gov (United States)

    Dunn, Kelly; DeFulio, Anthony; Everly, Jeffrey J; Donlin, Wendy D; Aklin, Will M; Nuzzo, Paul A; Leoutsakos, Jeannie-Marie S; Umbricht, Annie; Fingerhood, Michael; Bigelow, George E; Silverman, Kenneth

    2015-06-01

    Oral naltrexone could be a promising relapse-prevention pharmacotherapy for recently detoxified opioid-dependent patients; however, interventions are often needed to promote adherence with this treatment approach. We recently conducted a study to evaluate a 26-week employment-based reinforcement intervention of oral naltrexone in unemployed injection drug users (Dunn et al., 2013). Participants were randomly assigned into a contingency (n = 35) group required to ingest naltrexone under staff observation to gain entry into a therapeutic workplace or a prescription (n = 32) group given a take-home supply of oral naltrexone and access to the workplace without observed ingestion. Monthly urine samples were collected and analyzed for evidence for naltrexone adherence, opioid use, and cocaine use. As previously reported, contingency participants provided significantly more naltrexone-positive urine samples than prescription participants during the 26-week intervention period. The goal of this current study is to report the 12-month outcomes, which occurred 6 months after the intervention ended. Results at the 12-month visit showed no between-groups differences in naltrexone-positive, opioid-negative, or cocaine-negative urine samples and no participant self-reported using naltrexone at the follow-up visit. These results show that even after a period of successfully reinforced oral naltrexone adherence, longer-term naltrexone use is unlikely to be maintained after reinforcement contingencies are discontinued. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  11. Motor training at three months affects object exploration 12 months later

    Science.gov (United States)

    Libertus, Klaus; Joh, Amy S.; Needham, Amy

    2015-01-01

    The development of new motor skills alters how infants interact with objects and people. Consequently, it has been suggested that motor skills may initiate a cascade of events influencing subsequent development. However, only correlational evidence for this assumption has been obtained thus far. The current study addressed this question experimentally by systematically varying reaching experiences in 40 three-month-old infants who were not reaching on their own yet and examining their object engagement in a longitudinal follow-up assessment 12 months later. Results revealed increased object exploration and attention focusing skills in 15-month-old infants who experienced active reaching at three months of age compared to untrained infants or infants who only passively experienced reaching. Further, grasping activity after – but not before – reaching training predicted infants’ object exploration 12 months later. These findings provide evidence for the long-term effects of reaching experiences and illustrate the cascading effects initiated by early motor skills. PMID:26689742

  12. Predictors of pain and physical function at 3 and 12 months after total hip arthroplasty

    DEFF Research Database (Denmark)

    Plews, Sarah; Løvlund Nielsen, Randi; Overgaard, Søren

    with primary hip osteoarthritis responded to Hip dysfunction and Osteoarthritis Outcome Score (HOOS) questionnaires prior to and 3 and 12 months after THA. Preoperative pain intensity; joint space width (JSW), age, gender, and body mass index (BMI) were used to predict changes in pain and physical function....... Conclusions: Preoperative pain predicted changes in pain and physical function up to one year after THA. Such knowledge should be taken into consideration, when assessing OA patients prior to surgery. This study provides useful insight for clinicians, regarding the overall improvement patients can expect......Background: Few studies have combined preoperative patient-reported and objective outcome measures to predict outcomes after total hip arthroplasty (THA). Purpose / Aim of Study: to identify predictors of outcome 3 and 12 months after THA Materials and Methods: A cohort of 107 consecutive patients...

  13. Lifetime and 12-Month Nonsuicidal Self-Injury and Academic Performance in College Freshmen.

    Science.gov (United States)

    Kiekens, Glenn; Claes, Laurence; Demyttenaere, Koen; Auerbach, Randy P; Green, Jennifer G; Kessler, Ronald C; Mortier, Philippe; Nock, Matthew K; Bruffaerts, Ronny

    2016-10-01

    We examined whether nonsuicidal self-injury (NSSI) is associated with academic performance in college freshmen, using census-based web surveys (N = 7,527; response = 65.4%). NSSI was assessed with items from the Self-Injurious Thoughts and Behaviors Interview and subsequently linked with the administratively recorded academic year percentage (AYP). Freshmen with lifetime and 12-month NSSI showed a reduction in AYP of 3.4% and 5.9%, respectively. The college environment was found to moderate the effect of 12-month NSSI, with more strongly reduced AYPs in departments with higher-than-average mean departmental AYPs. The findings suggest that overall stress and test anxiety are underlying processes between NSSI membership and academic performance. © 2016 The American Association of Suicidology.

  14. 12-month efficacy of a single radiofrequency ablation on autonomously functioning thyroid nodules.

    Science.gov (United States)

    Bernardi, Stella; Stacul, Fulvio; Michelli, Andrea; Giudici, Fabiola; Zuolo, Giulia; de Manzini, Nicolò; Dobrinja, Chiara; Zanconati, Fabrizio; Fabris, Bruno

    2017-09-01

    Radiofrequency ablation has been advocated as an alternative to radioiodine and/or surgery for the treatment of autonomously functioning benign thyroid nodules. However, only a few studies have measured radiofrequency ablation efficacy on autonomously functioning benign thyroid nodules. The aim of this work was to evaluate the 12-month efficacy of a single session of radiofrequency ablation (performed with the moving shot technique) on solitary autonomously functioning benign thyroid nodules. Thirty patients with a single, benign autonomously functioning benign thyroid nodules, who were either unwilling or ineligible to undergo surgery and radioiodine, were treated with radiofrequency ablation between April 2012 and May 2015. All the patients underwent a single radiofrequency ablation, performed with the 18-gauge needle and the moving shot technique. Clinical, laboratory, and ultrasound evaluations were scheduled at baseline, and after 1, 3, 6, and 12 months from the procedure. A single radiofrequency ablation reduced thyroid nodule volume by 51, 63, 69, and 75 % after 1, 3, 6, and 12 months, respectively. This was associated with a significant improvement of local cervical discomfort and cosmetic score. As for thyroid function, 33 % of the patients went into remission after 3 months, 43 % after 6 months, and 50 % after 12 months from the procedure. This study demonstrates that a single radiofrequency ablation allowed us to withdraw anti-thyroid medication in 50 % of the patients, who remained euthyroid afterwards. This study shows that a single radiofrequency ablation was effective in 50 % of patients with autonomously functioning benign thyroid nodules. Patients responded gradually to the treatment. It is possible that longer follow-up studies might show greater response rates.

  15. The 12-month prevalence of depression and health care utilization in the general population of Latvia.

    Science.gov (United States)

    Vrublevska, Jelena; Trapencieris, Marcis; Snikere, Sigita; Grinberga, Daiga; Velika, Biruta; Pudule, Iveta; Rancans, Elmars

    2017-03-01

    This cross-sectional study aims to assess the 12-month prevalence of major and minor depression in the Latvian population, and to evaluate associated health care utilization. Trained interviewers conducted face-to-face interviews with a multistage stratified probability sample of the Latvian general population, ages 15-64 (n=3003). Participants were interviewed using the depression module of the Mini International Neuropsychiatric Interview. Self-reported health care utilization and somatic illness were also assessed. Multinomial logistic regressions were applied. The 12-month prevalence of major depression was 7.9% (95%CI 7.0-8.9), while for minor depression it was 7.7% (95%CI 6.8-8.7). We did not find a substantial difference in the relative risk ratio (RRR 1.7 for female) for having major depression by gender. RRR of having major depression was higher for those who had used healthcare services six or more times (RRR 2.0), those who had three or more somatic disorders during the past 12 months (RRR 2.3), those who perceived their health status as being below average (RRR 8.3), and those who were occasional smokers (RRR 3.0). RRR of having minor depression was increased for those who had at least three somatic disorders (RRR 2.3), those who received disability pension (RRR 1.9), and those who perceived their health status to be below average (RRR 3.0). The study was cross-sectional. Other psychiatric comorbidity was not assessed. This is the first population based study reporting the 12-month prevalence of depression in Latvia. Certain factors associated with depression have been found. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Factors associated with breastfeeding maintenance for 12 months or more: a systematic review.

    Science.gov (United States)

    Santana, Géssica S; Giugliani, Elsa Regina J; Vieira, Tatiana de O; Vieira, Graciete O

    Synthesize the information about the factors associated with maintenance of breastfeeding for 12 months or more. A systematic review was conducted in the Pubmed/Medline, Scielo, and Lilacs databases, including articles published in Portuguese or English since 2004 on the factors associated with breastfeeding maintenance for at least 12 months; review articles and those with qualitative design were excluded. The factors were organized into four levels, according to the chronological proximity to the outcome: distal, distal intermediate, proximal intermediate, and proximal; nationality and place/area of residence were considered contextual factors. 1174 articles were identified, of which 19 were included in this review, comprising seven cohort studies and 12 cross-sectional studies. A total of 39 of the 75 assessed factors were associated with the outcome at least once. The factors with the highest percentages of associations with maintenance of breastfeeding for 12 months or more, considering the number of times they were tested were: children whose parents are the caregivers (100%), none type of maternal exposure to smoke (54%), children and/or parents are immigrants/foreigners (50%), live in urban areas (42.9%), older maternal age (40%), married women (37.5%), higher level of maternal education (31.3%), greater parity (30.8%), and lower income (30%). The maintenance of breastfeeding for 12 months or more is associated with multiple factors, emphasizing the contextual factors and those related to some maternal sociodemographic characteristics. Associations differ in effect and magnitude between the different populations studied. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  17. Quit and Smoking Reduction Rates in Vape Shop Consumers: A Prospective 12-Month Survey

    Directory of Open Access Journals (Sweden)

    Riccardo Polosa

    2015-03-01

    Full Text Available Aims: Here, we present results from a prospective pilot study that was aimed at surveying changes in daily cigarette consumption in smokers making their first purchase at vape shops. Modifications in products purchase were also noted. Design: Participants were instructed how to charge, fill, activate and use their e-cigarettes (e-cigs. Participants were encouraged to use these products in the anticipation of reducing the number of cig/day smoked. Settings: Staff from LIAF contacted 10 vape shops in the province of the city of Catania (Italy that acted as sponsors to the 2013 No Tobacco Day. Participants: 71 adult smokers (≥18 years old making their first purchase at local participating vape shops were asked by professional retail staff to complete a form. Measurements: Their cigarette consumption was followed-up prospectively at 6 and 12 months. Details of products purchase (i.e., e-cigs hardware, e-liquid nicotine strengths and flavours were also noted. Findings: Retention rate was elevated, with 69% of participants attending their final follow-up visit. At 12 month, 40.8% subjects could be classified as quitters, 25.4% as reducers and 33.8% as failures. Switching from standard refillables (initial choice to more advanced devices (MODs was observed in this study (from 8.5% at baseline to 18.4% at 12 month as well as a trend in decreasing thee-liquid nicotine strength, with more participants adopting low nicotine strength (from 49.3% at baseline to 57.1% at 12 month. Conclusions: We have found that smokers purchasing e-cigarettes from vape shops with professional advice and support can achieve high success rates.

  18. Quit and smoking reduction rates in vape shop consumers: a prospective 12-month survey.

    Science.gov (United States)

    Polosa, Riccardo; Caponnetto, Pasquale; Cibella, Fabio; Le-Houezec, Jacques

    2015-03-24

    Here, we present results from a prospective pilot study that was aimed at surveying changes in daily cigarette consumption in smokers making their first purchase at vape shops. Modifications in products purchase were also noted. Participants were instructed how to charge, fill, activate and use their e-cigarettes (e-cigs). Participants were encouraged to use these products in the anticipation of reducing the number of cig/day smoked. Staff from LIAF contacted 10 vape shops in the province of the city of Catania (Italy) that acted as sponsors to the 2013 No Tobacco Day. 71 adult smokers (≥18 years old) making their first purchase at local participating vape shops were asked by professional retail staff to complete a form. Their cigarette consumption was followed-up prospectively at 6 and 12 months. Details of products purchase (i.e., e-cigs hardware, e-liquid nicotine strengths and flavours) were also noted. Retention rate was elevated, with 69% of participants attending their final follow-up visit. At 12 month, 40.8% subjects could be classified as quitters, 25.4% as reducers and 33.8% as failures. Switching from standard refillables (initial choice) to more advanced devices (MODs) was observed in this study (from 8.5% at baseline to 18.4% at 12 month) as well as a trend in decreasing thee-liquid nicotine strength, with more participants adopting low nicotine strength (from 49.3% at baseline to 57.1% at 12 month). We have found that smokers purchasing e-cigarettes from vape shops with professional advice and support can achieve high success rates.

  19. Smoking cessation and depressive symptoms at 1-, 3-, 6-, and 12-months follow-up.

    Science.gov (United States)

    Rodríguez-Cano, Rubén; López-Durán, Ana; del Río, Elena Fernández; Martínez-Vispo, Carmela; Martínez, Úrsula; Becoña, Elisardo

    2016-02-01

    The relationship between tobacco and depressive symptoms has been examined. However, there is little information on the evolution of these symptoms when an individual quits. The aim of this study was to analyze the evolution of depressive symptoms over time (pre-, post-treatment, 1-, 3-, 6-, and 12-months follow-up) in relation to smoking status 12 months after having received a psychological treatment for smoking cessation. The sample was made up of 242 adults who received cognitive-behavioral treatment for smoking cessation (64.4% women; mean age=41.71 years). The BDI-II was used to assess depressive symptomatology. Participants were classified into three groups according to smoking status at 12-months follow-up (abstainers, relapsers, and smokers). There were no significant differences in depressive symptoms among the three groups at pretreatment. At the end of treatment, abstainers and relapsers presented less depressive symptomatology than smokers. At follow-up, abstainers continued to present less depressive symptomatology than smokers, whereas in relapsers, symptoms began to increase as the relapses occurred. Regarding the evolution of depressive symptomatology, the abstainer and relapser groups showed a significant reduction at the end of treatment. Only in the group of abstainers did the decrease continue during 12 months follow-up. The decrease of the initial sample size from 562 to 242 participants. Variables such as self-esteem and self-efficacy were not assessed. Smoking cessation is associated with a decrease in depressive symptomatology, that is maintained over time. In contrast, relapse is associated with an increase of such symptoms. These findings signify the potential importance of addressing depressive symptomatology in smoking cessation treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Aflibercept for clinically significant diabetic macular edema: 12-month results in daily clinical practice

    Science.gov (United States)

    Campos Polo, Rafael; Rubio Sánchez, Consuelo; García Guisado, Diego Manuel; Díaz Luque, María José

    2018-01-01

    Purpose To assess the effectiveness and safety of intravitreal aflibercept in clinically significant diabetic macular edema (DME) in daily clinical practice. Methods Prospective, open-label, single-center study. Anti-vascular endothelial growth factor naïve patients with clinically significant DME received intravitreal injections of aflibercept 2 mg, five monthly doses followed by a fixed schedule every 2 months for 12 months. The mean change in best-corrected visual acuity (BCVA) (Early Treatment Diabetic Retinopathy Study [ETDRS] letters) was the primary outcome. Results The mean BCVA improved significantly as compared with baseline at 12 months of treatment (47.3 [14.2] vs 62.2 [13.9] ETDRS letters, P<0.001). Significant improvement in BCVA was already observed at visit 2 after the loading doses of aflibercept. At 12 months, gains in ETDRS letters were documented in all eyes (100%), with gains ≥10 letters in 89.6%, ≥15 letters in 65.5%, and ≥20 letters in 6.9% (n=2). A significant reduction in central macular thickness from a mean of 460.5 (11.8) μm at baseline to 229.0 (43.8) μm at 12 months (P<0.001) was observed. Significant reductions of central macular thickness were already observed after the loading doses and continued lowering throughout the study period. No adverse events occurred. Conclusion Aflibercept as a first-line therapy was effective and well tolerated for treating clinically significant DME in naïve patients in daily practice. Successful results in terms of improvement of visual and reduction in central macular thickness contribute to provide evidence for the positioning of aflibercept as a first-line indication of newly diagnosed clinically significant DME. PMID:29386883

  1. Depression screening and referral in cardiac wards: A 12-month patient trajectory.

    Science.gov (United States)

    Ski, Chantal F; Worrall-Carter, Linda; Cameron, Jan; Castle, David J; Rahman, Muhammad A; Thompson, David R

    2017-02-01

    Depression is common among patients with coronary heart disease (CHD) and has a major impact on their quality of life, morbidity and mortality. The aim of this study was to map the 12-month psychosocial outcomes of patients with CHD who were screened positive for depression in an acute cardiac ward. A prospective cohort study was conducted of the psychosocial trajectory (depression, anxiety, wellbeing, social support, mental health service access) of 212 patients with CHD who were screened for depression after being admitted to acute cardiac wards of a major metropolitan hospital. Outcomes were assessed before hospital discharge and at one, three, six and 12 months post-discharge. Linear mixed models identified that those patients screened at 'moderate to high' risk of depression at baseline had higher levels of depression ( F(1,173)=53.93, ptrajectory. Surgical and medical treatment groups were of similar psychological composition over the 12-month period. These findings attest to the effectiveness and predictive validity of a simple nurse-administered screening tool designed to identify depression in hospital patients with CHD and also indicate that a screening and referral tool alone is not sufficient to achieve optimal disease management. A collaborative care model involving family members and integrated pathways to primary care is recommended.

  2. Assessing early communication skills at 12 months: a retrospective study of Autism Spectrum Disorder.

    Science.gov (United States)

    Swain, Nathaniel Robert; Eadie, Patricia Ann; Prior, Margot Ruth; Reilly, Sheena

    2015-07-01

    Early identification of Autism Spectrum Disorder (ASD) is currently limited by the absence of reliable biological markers for the disorder, as well as the reliability of screening and assessment tools for children aged between 6 and 18 months. Ongoing research has demonstrated the importance of early social communication skills in differentiating children later diagnosed with ASD from their typically developing (TD) peers, but researchers have not yet investigated whether these differences can be detected using community-ascertained systematic observation data as early as 12 months. To investigate whether differences in early social communication skills can be detected at 12 months of age, comparing children later diagnosed with ASD, and TD peers; and to determine whether differences remain when groupings are based on age of subsequent ASD diagnosis. From a prospective community-ascertained sample, we collected data on children in early life, then conducted retrospective analyses for those children who were later diagnosed with ASD by the age of 7 years, compared with matched TD peers. We analysed standardized observational data of early communication skills, collected using the Communication and Symbolic Behavior Scales-Developmental Profile (CSBS-DP) Behavior Sample, when participants were 12 months of age. Children in the ASD group exhibited significantly lower social communication skills than the TD group, including on the Total score and Social and Symbolic Composite scores of the CSBS-DP Behavior Sample. Differences on the Total score and Social Composite were also detected for both early and late ASD diagnosis groups when compared with the TD group. These findings give further support for the importance of social communication in assessing children at risk of ASD as early as 12 months of age. Future research could evaluate the sensitivity and specificity of direct observation of these early communication skills as diagnostic indicators for ASD at 12 months

  3. Northern Eurasia Earth Science Partnership Initiative in the past 12 months: An Update

    Science.gov (United States)

    Groisman, Pavel; Lowford, Richard

    2013-04-01

    Eight years ago Northern Eurasia Earth Science Partnership Initiative (NEESPI) was launched with the release of its Science Plan (http://neespi.org). Gradually, the Initiative was joined by numerous international projects launched in EU, Russia, the United States, Canada, Japan, and China. Throughout its duration, NEESPI served and is serving as an umbrella for more than 155 individual international research projects. Currently, the total number of the ongoing NEESPI projects (as on January 2013) is 48 and has changed but slightly compared to its peak (87 in 2008). The past 12 months (from the previous EGU Assembly) were extremely productive in the NEESPI outreach. We organized three Open Science Sessions at the three major Geoscience Unions/Assembly Meetings (JpGU, AGU, and this EGU Session) and three International NEESPI Workshops. The programs of two of these Workshops (in Yoshkar Ola and Irkutsk, Russia) included Summer Schools for early career scientists. More than 150 peer-reviewed papers, books, and/or book chapters were published in 2012 or are in press (this list was still incomplete at the time of preparation of this abstract). In particular, a suite of 25 peer-reviewed NEESPI articles was published in the Forth Special NEESPI Issue of "Environmental Research Letters" (ERL) http://iopscience.iop.org/1748-9326/focus/NEESPI3 (this is the third ERL Issue). In December 2012, the next Special ERL NEESPI Issue was launched http://iopscience.iop.org/1748-9326/focus/NEESPI4. Northern Eurasia is a large study domain. Therefore, it was decided to describe the latest findings related to its environmental changes in several regional monographs in English. Three books on Environmental Changes in the NEESPI domain were published by the University of Helsinki (Groisman et al. 2012), "Akademperiodyka" (Groisman and Lyalko 2012), and Springer Publishing House (Groisman and Gutman 2013) being devoted to the high latitudes of Eurasia, to Eastern Europe, and to Siberia

  4. Failure of human immunodeficiency virus enzyme immunoassay to rule out infection among polymerase chain reaction-negative Vietnamese infants at 12 months of age.

    Science.gov (United States)

    Sohn, Annette H; Thanh, Tran Chi; Thinh, Le Quoc; Khanh, Truong Huu; Thu, Huynh Khanh; Giang, Le Truong; Lien, Truong Xuan

    2009-04-01

    : Previous studies have demonstrated that >90% of HIV-uninfected infants serorevert, as seen in the results of enzyme immunoassay (EIA) testing by 12 months of age, making it feasible to confirm or rule out infection. We assessed the reliability of EIA in a cohort of Vietnamese infants. : HIV-exposed, uninfected infants enrolled in a parent diagnostic and monitoring study from February 2005 through August 2006 were eligible for inclusion in a prospective cohort study of HIV-EIA performance. Testing using 2 standard assays (Genscreen HIV 1/2 version 2, Bio-Rad; Murex 1.2.0, Murex Biotech) was initiated at 12 months of age. Infants were categorized as EIA-negative (seroreverted; negative Genscreen), EIA-indeterminate (positive Genscreen, negative Murex), or EIA-positive (Genscreen and Murex positive). : Of 273 infants included in the study, 59 (22%) were EIA-negative at 12 months, 131 (48%) were indeterminate, and 83 (30%) were EIA-positive; specificity 21.6 (95% confidence interval: 16.6, 26.3). Infants with positive EIAs at 12 months were 74% more likely than EIA-indeterminate infants to test indeterminate or positive at 18 months (risk ratio, 1.74, 95% confidence interval: 1.15, 2.64; P = 0.03). : Expectations regarding infant seroreversion by standard EIAs should be reassessed to reflect potential cross-regional differences in their performance.

  5. Weight loss after bariatric surgery and periodontal changes: a 12-month prospective study.

    Science.gov (United States)

    Sales-Peres, Silvia Helena de Carvalho; Sales-Peres, Matheus de Carvalho; Ceneviva, Reginaldo; Bernabé, Eduardo

    2017-04-01

    Several longitudinal studies have explored the association of obesity and weight gain with periodontal disease. However, the effect of weight loss on periodontal tissues remains unclear. To explore whether weight loss after bariatric surgery was associated with changes in periodontal measures over 12 months. Two public hospitals in São Paulo, Brazil. We used data from 110 morbidly obese patients (body mass index [BMI]>40 kg/m 2 or≥35 kg/m 2 with co-morbid conditions) who underwent bariatric surgery between April 2011 and March 2013. Data on demographic factors, BMI, smoking habits, and glucose levels were extracted from medical records preoperatively and after 6 and 12 months postsurgery. A full-mouth periodontal examination was conducted by trained examiners to assess probing pocket depth, clinical attachment loss, and bleeding on probing (BOP) at baseline and 6 and 12 months after surgery. Data were analyzed using linear mixed-effects models. BMI was not significantly related to the proportion of sites with BOP at baseline, but it was negatively associated with the rate of change in the proportion of sites with BOP. The greater the BMI loss, the higher the proportion of sites with BOP, particularly 6 months after surgery. However, BMI was not associated with baseline probing pocket depth and clinical attachment loss or rates of changes in these periodontal outcomes. The findings suggest that weight loss was associated with increased gingival bleeding, showing a peak at 6 months after bariatric surgery. Periodontal pocketing and attachment loss remained unchanged during the study period. Copyright © 2017. Published by Elsevier Inc.

  6. CUMULATIVE TRAUMAS AND RISK THRESHOLDS: 12-MONTH PTSD IN THE WORLD MENTAL HEALTH (WMH) SURVEYS

    Science.gov (United States)

    Karam, Elie G.; Friedman, Matthew J.; Hill, Eric D.; Kessler, Ronald C.; McLaughlin, Katie A.; Petukhova, Maria; Sampson, Laura; Shahly, Victoria; Angermeyer, Matthias C.; Bromet, Evelyn J.; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Ferry, Finola; Florescu, Silvia E.; Haro, Josep Maria; He, Yanling; Karam, Aimee N.; Kawakami, Norito; Kovess-Masfety, Viviane; Medina-Mora, María Elena; Browne, Mark A. Oakley; Posada-Villa, José A.; Shalev, Arieh Y.; Stein, Dan J.; Viana, Maria Carmen; Zarkov, Zahari; Koenen, Karestan C.

    2014-01-01

    Background Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue. Methods Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts. Results 19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyper-arousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs. Conclusions A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more “complex” clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. Depression and Anxiety 31:130–142, 2014. PMID:23983056

  7. Prognosis of the infected diabetic foot ulcer: a 12-month prospective observational study.

    Science.gov (United States)

    Ndosi, M; Wright-Hughes, A; Brown, S; Backhouse, M; Lipsky, B A; Bhogal, M; Reynolds, C; Vowden, P; Jude, E B; Nixon, J; Nelson, E A

    2018-01-01

    To determine clinical outcomes and explore prognostic factors related to ulcer healing in people with a clinically infected diabetic foot ulcer. This multicentre, prospective, observational study reviewed participants' data at 12 months after culture of a diabetic foot ulcer requiring antibiotic therapy. From participants' notes, we obtained information on the incidence of wound healing, ulcer recurrence, lower extremity amputation, lower extremity revascularization and death. We estimated the cumulative incidence of healing at 6 and 12 months, adjusted for lower extremity amputation and death using a competing risk analysis, and explored the relationship between baseline factors and healing incidence. In the first year after culture of the index ulcer, 45/299 participants (15.1%) had died. The ulcer had healed in 136 participants (45.5%), but recurred in 13 (9.6%). An ipsilateral lower extremity amputation was recorded in 52 (17.4%) and revascularization surgery in 18 participants (6.0%). Participants with an ulcer present for ~2 months or more had a lower incidence of healing (hazard ratio 0.55, 95% CI 0.39 to 0.77), as did those with a PEDIS (perfusion, extent, depth, infection, sensation) perfusion grade of ≥2 (hazard ratio 0.37, 95% CI 0.25 to 0.55). Participants with a single ulcer on their index foot had a higher incidence of healing than those with multiple ulcers (hazard ratio 1.90, 95% CI 1.18 to 3.06). Clinical outcomes at 12 months for people with an infected diabetic foot ulcer are generally poor. Our data confirm the adverse prognostic effect of limb ischaemia, longer ulcer duration and the presence of multiple ulcers. © 2017 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

  8. Effect of omega-3 supplementation on neuropathy in type 1 diabetes: A 12-month pilot trial.

    Science.gov (United States)

    Lewis, Evan J H; Perkins, Bruce A; Lovblom, Leif E; Bazinet, Richard P; Wolever, Thomas M S; Bril, Vera

    2017-06-13

    To test the hypothesis that 12 months of seal oil omega-3 polyunsaturated fatty acids (ω-3 PUFA) supplementation will stop the known progression of diabetic sensorimotor polyneuropathy (DSP) in type 1 diabetes mellitus (T1DM). Individuals with T1DM and evidence of DSP as determined by a Toronto Clinical Neuropathy Score ≥1 were recruited to participate in a single-arm, open-label trial of seal oil ω-3 PUFA supplementation (10 mL·d -1 ; 750 mg eicosapentaenoic acid, 560 mg docosapentaenoic acid, and 1,020 mg docosahexaenoic acid) for 1 year. The primary outcome was the 1-year change in corneal nerve fiber length (CNFL) measured by in vivo corneal confocal microscopy, with sensory and nerve conduction measures as secondary outcomes. Forty participants (53% female), aged 48 ± 14 years, body mass index 28.1 ± 5.8 with diabetes duration of 27 ± 18 years, were enrolled. At baseline, 23 participants had clinical DSP and 17 did not. Baseline CNFL was 8.3 ± 2.9 mm/mm 2 and increased 29% to 10.1 ± 3.7 mm/mm 2 ( p = 0.002) after 12 months of supplementation. There was no change in nerve conduction or sensory function. Twelve months of ω-3 supplementation was associated with increase in CNFL in T1DM. NCT02034266. This study provides Class IV evidence that for patients with T1DM and evidence of DSP, 12 months of seal oil omega-3 supplementation increases CNFL. © 2017 American Academy of Neurology.

  9. A 12-month multicenter, randomized study comparing the levonorgestrel intrauterine system with the etonogestrel subdermal implant.

    Science.gov (United States)

    Apter, Dan; Briggs, Paula; Tuppurainen, Marjo; Grunert, Julia; Lukkari-Lax, Eeva; Rybowski, Sarah; Gemzell-Danielsson, Kristina

    2016-07-01

    To compare the levonorgestrel intrauterine system (LNG-IUS 8), which has an average levonorgestrel release rate of ∼8 μg/24 hours during the first year (total levonorgestrel content 13.5 mg; Jaydess/Skyla), with the etonogestrel (ENG) subdermal implant (total content, 68 mg) with regard to the 12-month discontinuation rate (primary outcome). Randomized, open-label, phase III study. Thirty-eight centers in six European countries. Study population of 766 healthy nulliparous and parous women aged 18-35 years. The LNG-IUS 8 or the ENG implant. Discontinuation rate, by treatment group, at Month 12. The 12-month discontinuation rates were 19.6% and 26.8% in the LNG-IUS 8 and ENG implant groups, respectively. The -7.2% difference was statistically significant (95% confidence interval -13.2%, -1.2%). Fewer women in the LNG-IUS 8 group than in the ENG implant group discontinued because of increased bleeding (3.2% vs. 11.3%) or adverse events (14.3% vs. 21.8%). At 12 months, more women in the LNG-IUS 8 group than in the ENG implant group were "very/somewhat satisfied" with their bleeding pattern (60.9% vs. 33.6%) and reported a preference to use their study treatment after study completion (70.1% vs. 58.5%). The LNG-IUS 8 was associated with a significantly lower 12-month discontinuation rate compared with the ENG implant; mainly because ENG implant users frequently discontinued due to increased bleeding. More LNG-IUS 8 users than ENG implant users reported being "very/somewhat satisfied" with their bleeding pattern, and reported a preference to continue using their study treatment after the study. NCT01397097. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  10. Total and free iodothyronines profile in the donkey (Equus asinus over a 12-month period

    Directory of Open Access Journals (Sweden)

    Esterina Fazio

    2012-01-01

    Full Text Available Several studies show the correlation between thyroid function and reproductive activity in horses, but no data are available in donkeys. The aim of this study was to determine physiological thyroid changes occurring in 10 pregnant and 14 barren donkeys over a period of 12 months. Blood samples were collected monthly from the jugular vein of pregnant and barren donkeys from June 2008 to June 2009. No significant differences (P 4 and free triiodothyronine (fT3 patterns remained unmodified, regardless of physiological state, with the lowest T4 levels at September and the highest at February, and the lowest fT3 levels at June and the highest at July, in both pregnant and barren donkeys. Ranges of total triiodothyronine (T3 concentrations in pregnant donkeys over a 12 months period ranged from 1.57 to 2.90 nmol/l, T4 from 31.01 to 63.67 nmol/l, fT3 from 3.15 to 15.52 pmol/l and free thyroxine (fT4 from 22.47 to 33.69 pmol/l. Mean T3 concentrations in barren donkeys over a 12 months period ranged from 1.64 to 3.37 nmol/l, T4 from 42.95 nmol/l and 61.90 nmol/l, fT3 from 3.15 to 11.19 pmol/l and fT4 from 25.46 to 35.06 pmol/l. This is the first study that provided a seasonal thyroid hormonal profile in healthy barren and pregnant donkeys.

  11. Ospemifene 12-month safety and efficacy in postmenopausal women with vulvar and vaginal atrophy

    DEFF Research Database (Denmark)

    Goldstein, S R; Bachmann, G A; Koninckx, P R

    2014-01-01

    6 : 1 to ospemifene 60 mg/day or placebo. The primary objective was 12-month safety, particularly endometrial; 12-week efficacy was assessed. Safety assessments included endometrial histology and thickness, and breast and gynecological examinations. Efficacy evaluations included changes from...... resolved with progestogen treatment and dilatation and curettage. In six subjects (five ospemifene (1.4%), one placebo (1.6%)) endometrial polyps were found (histopathology); however, only one (ospemifene) was confirmed as a true polyp during additional expert review. Endometrial histology showed...

  12. Evaluation of radurizited and pasteurized fruits juices during 12 months of storage

    International Nuclear Information System (INIS)

    Wilska-Jeszka, J.; Skorupinska, A.

    1975-01-01

    Stability of radurized red and black currant, bilberry, plum and tomato juices, stored at a temperature of 20+-3 0 C, was investigated. With 60 Co as radiation source, doses of 0,5 to 1,5 Mrad were applied. In a 12-month period no significant changes in pH, total and volatile acidity were found. Anthocyanic pigment and ascorbic acid losses were greater in radurized than in pasteurized juices. No organoleptic changes occurred after irradiation with 1 Mrad in tomato juices, very little change in plum and bilberry juices and considerable unfavorable changes in currant juice

  13. Micropulse diode laser trabeculoplasty (MDLT: A phase II clinical study with 12 months follow-up

    Directory of Open Access Journals (Sweden)

    Antonio Maria Fea

    2008-06-01

    Full Text Available Antonio Maria Fea, Alex Bosone, Teresa Rolle, Beatrice Brogliatti, Federico Maria GrignoloIstituto di Fisiopatologia Clinica, Clinica Oculistica dell’ Università di Torino, Torino, ItalyObjective: This pilot study evaluates the pressure lowering potential of subthreshold micropulse diode laser trabeculoplasty (MDLT for a clinically meaningful duration in patients with medically uncontrolled open angle glaucoma (OAG.Design: prospective interventional case series.Participants: Thirty-two eyes of 20 consecutive patients with uncontrolled OAG (12 bilateral and 8 unilateral.Methods: Confluent subthreshold laser applications over the inferior 180° of the anterior TM using an 810 nm diode laser in a micropulse operating mode. The intraocular pressure (IOP was measured at baseline and at 1 hour, 1 day, 1 week, 3, 6, 9, and 12 months post-treatment. Flare was measured with a Kowa FM 500 flare-meter at baseline and at 3 hours, 1 day, 1 week, and 12 months post-treatment. After treatment, the patients were maintained on their pre-treatment drug regimen.Main outcome measures: Criteria for treatment response were IOP reduction ≥3 mm Hg and IOP ≤21 mm Hg within the first week after MDLT. Eyes not complying to the above criteria during the follow-up were considered treatment failure. Mean IOP change and percentage of IOP reduction during the follow-up were calculated.Results: One eye was analyzed for bilateral patients. A total of 20 eyes were thus included. Four eyes (20% did not respond to treatment during the first week. One additional eye failed at the 6 month visit. The treatment was successful in 15 eyes (75% at 12 months. The IOP was significantly lower throughout follow-up (p < 0.01. At 12 months, the mean percentage of IOP reduction in the 15 respondent eyes was 22.1% and 12 eyes (60% had IOP reduction higher than 20%. During the first two postoperative days, one eye with pigmentary glaucoma experienced a significant increase of flare

  14. An evaluation of the 18- and 12-month basic postgraduate training programmes in Denmark

    DEFF Research Database (Denmark)

    Kjaer, Niels Kristian; Qvesel, Dorte; Kodal, Troels

    2010-01-01

    INTRODUCTION: It was decided that the Danish 18-month internship training should be replaced by a 12-month postgraduate training period including six months of employment at a hospital ward and six months at a general practice/hospital ward. This study examines how the physicians from the old...... equipped and less ready for continued specialisation than doctors of the 18-month programme and they requested a downward adjustment of the learning objectives associated with the educational positions which follow their basic training. Physicians do not expect the increased focus on learning...

  15. Decrease in musculoskeletal pain after 4 and 12 months of an aerobic exercise intervention

    DEFF Research Database (Denmark)

    Korshøj, Mette; Jørgensen, Marie Birk; Lidegaard, Mark

    2018-01-01

    BACKGROUND: Prevalence of musculoskeletal pain is high in jobs with high physical work demands. An aerobic exercise intervention targeting cardiovascular health was evaluated for its long term side effects on musculoskeletal pain. OBJECTIVE: The objective was to investigate if aerobic exercise...... affects level of musculoskeletal pain from baseline to 4- and 12-months follow-up. METHODS: One-hundred-and-sixteen cleaners aged 18-65 years were cluster-randomized. The aerobic exercise group ( n = 57) received worksite aerobic exercise (30 min twice a week) and the reference group ( n = 59) lectures...

  16. Aflibercept for clinically significant diabetic macular edema: 12-month results in daily clinical practice

    Directory of Open Access Journals (Sweden)

    Campos Polo R

    2018-01-01

    Full Text Available Rafael Campos Polo, Consuelo Rubio Sánchez, Diego Manuel García Guisado, María José Díaz Luque Unit of Retina, Department of Ophthalmology, Hospital Virgen del Puerto, Plasencia, Cáceres, Spain Purpose: To assess the effectiveness and safety of intravitreal aflibercept in clinically significant diabetic macular edema (DME in daily clinical practice. Methods: Prospective, open-label, single-center study. Anti-vascular endothelial growth factor naïve patients with clinically significant DME received intravitreal injections of aflibercept 2 mg, five monthly doses followed by a fixed schedule every 2 months for 12 months. The mean change in best-corrected visual acuity (BCVA (Early Treatment Diabetic Retinopathy Study [ETDRS] letters was the primary outcome. Results: The mean BCVA improved significantly as compared with baseline at 12 months of treatment (47.3 [14.2] vs 62.2 [13.9] ETDRS letters, P<0.001. Significant improvement in BCVA was already observed at visit 2 after the loading doses of aflibercept. At 12 months, gains in ETDRS letters were documented in all eyes (100%, with gains ≥10 letters in 89.6%, ≥15 letters in 65.5%, and ≥20 letters in 6.9% (n=2. A significant reduction in central macular thickness from a mean of 460.5 (11.8 µm at baseline to 229.0 (43.8 µm at 12 months (P<0.001 was observed. Significant reductions of central macular thickness were already observed after the loading doses and continued lowering throughout the study period. No adverse events occurred. Conclusion: Aflibercept as a first-line therapy was effective and well tolerated for treating clinically significant DME in naïve patients in daily practice. Successful results in terms of improvement of visual and reduction in central macular thickness contribute to provide evidence for the positioning of aflibercept as a first-line indication of newly diagnosed clinically significant DME. Keywords: aflibercept, central macular thickness, diabetic macular

  17. IL13 gene polymorphisms modify the effect of exposure to tobacco smoke on persistent wheeze and asthma in childhood, a longitudinal study

    Directory of Open Access Journals (Sweden)

    Kurukulaaratchy Ramesh

    2008-01-01

    Full Text Available Abstract Background Tobacco smoke and genetic susceptibility are risk factors for asthma and wheezing. The aim of this study was to investigate whether there is a combined effect of interleukin-13 gene (IL13 polymorphisms and tobacco smoke on persistent childhood wheezing and asthma. Methods In the Isle of Wight birth cohort (UK, 1989–1999, five IL13 single nucleotide polymorphisms (SNPs: rs1800925 (-1112C/T, rs2066960, rs1295686, rs20541 (R130Q and rs1295685 were genotyped. Parents were asked whether their children had wheezed in the last 12 months at ages 1, 2, 4 and 10 years. Children who reported wheeze in the first 4 years of life and also had wheezing at age 10 were classified as early-onset persistent wheeze phenotype; non-wheezers never wheezed up to age 10. Persistent asthma was defined as having a diagnosis of asthma both during the first four years of life and at age 10. Logistic regression methods were used to analyze data on 791 children with complete information. Potential confounders were gender, birth weight, duration of breast feeding, and household cat or dog present during pregnancy. Results Maternal smoking during pregnancy was associated with early-onset persistent wheeze (OR 2.93, p IL13 were not (OR 1.15, p = 0.60 for the common haplotype pair. However, the effect of maternal smoking during pregnancy was stronger in children with the common IL13 haplotype pair compared to those without it (OR 5.58 and OR 1.29, respectively; p for interaction = 0.014. Single SNP analysis revealed a similar statistical significance for rs20541 (p for interaction = 0.02. Comparable results were observed for persistent childhood asthma (p for interaction = 0.03. Conclusion This is the first report that shows a combined effect of in utero exposure to smoking and IL13 on asthma phenotypes in childhood. The results emphasize that genetic studies need to take environmental exposures into account, since they may explain contradictory findings.

  18. Preschool-based social communication treatment for children with autism: 12-month follow-up of a randomized trial.

    Science.gov (United States)

    Kaale, Anett; Fagerland, Morten W; Martinsen, Egil W; Smith, Lars

    2014-02-01

    This study reports 12-month follow-up data from a randomized controlled trial of preschool-based social communication treatment for young children with autism. A total of 61 children (48 males) with autism, 29 to 60 months of age, had earlier been randomized either to 8 weeks of preschool-based social communication treatment in addition to standard preschool program (n = 34) or to standard preschool program only (n = 27). Significant short-term effects on targeted social communication skills have previously been published. Long-term gains in social communication, language and global social functioning and communication were assessed from video-taped preschool teacher-child and mother-child interactions, Early Social Communication Scales, Reynell Developmental Language Scale, and Social Communication Questionnaire. Compared with those in the control group, the treated children achieved significantly larger improvements in joint attention and joint engagement from baseline to 12-month follow-up. However, no effects were detected on language and global ratings of social functioning and communication. The treatment effect on child initiation of joint attention increased with increasing level of sociability at baseline, whereas nonverbal IQ and expressive language had no moderating effect. This study is the first to show that, similar to specialist-delivered treatment, preschool-based treatment may produce small but possibly clinically important long-term changes in social communication in young children with autism. The treatment did not affect language and global ratings of social functioning and communication. More studies are needed to better understand whether treatment effects may be improved by increasing the intensity and duration of the treatment. Clinical trial registration information--Joint Attention Intervention and Young Children With Autism; http://clinicaltrials.gov/; NCT00378157. Copyright © 2014 American Academy of Child and Adolescent Psychiatry

  19. The effects of transoral incisionless fundoplication on chronic GERD patients: 12-month prospective multicenter experience.

    Science.gov (United States)

    Wilson, Erik B; Barnes, William E; Mavrelis, Peter G; Carter, Bart J; Bell, Reginald C W; Sewell, Robert W; Ihde, Glenn M; Dargis, David; Hoddinott, Kevin M; Shughoury, Ahmad B; Gill, Brian D; Fox, Mark A; Turgeon, Daniel G; Freeman, Katherine D; Gunsberger, Tanja; Hausmann, Mark G; Leblanc, Karl A; Deljkich, Emir; Trad, Karim S

    2014-02-01

    This study aimed to assess the impact of transoral incisionless fundoplication (TIF) on patients with chronic gastroesophageal reflux disease (GERD) at 12-month follow-up. Clinical outcomes of 100 consecutive patients with chronic GERD who underwent TIF between January 2010 and February 2011 were analyzed. There were no major complications reported. Esophageal acid exposure was normalized in 14/27 (52%) of patients who underwent 12-month pH testing. Seventy-four percent of all patients were off proton pump inhibitors versus 92% on daily proton pump inhibitors before TIF, Psymptoms were eliminated in 66/85 (78%) and 48/58 (83%) of patients. Median reflux symptom index score was reduced from 20 (0 to 41) to 5 (0 to 44), P<0.001. Two patients reported de novo dysphagia and 1 patient reported bloating (scores 0 to 3). Six patients underwent revision; 5 laparoscopic Nissen fundoplication and 1 TIF. TIF provided a safe and effective therapeutic option for carefully selected patients with chronic GERD.

  20. Incidence of Disability Among Children 12 Months After Traumatic Brain Injury

    Science.gov (United States)

    Koepsell, Thomas D.; Wang, Jin; Temkin, Nancy; Dorsch, Andrea; Vavilala, Monica S.; Durbin, Dennis; Jaffe, Kenneth M.

    2012-01-01

    Objectives. We examined the burden of disability resulting from traumatic brain injuries (TBIs) among children younger than 18 years. Methods. We derived our data from a cohort study of children residing in King County, Washington, who were treated in an emergency department for a TBI or for an arm injury during 2007–2008. Disabilities 12 months after injury were assessed according to need for specialized educational and community-based services and scores on standardized measures of adaptive functioning and social–community participation. Results. The incidence of children receiving new services at 12 months was about 10-fold higher among those with a mild TBI than among those with a moderate or severe TBI. The population incidence of disability (defined according to scores below the norm means on the outcome measures included) was also consistently much larger (2.8-fold to 28-fold) for mild TBIs than for severe TBIs. Conclusions. The burden of disability caused by TBIs among children is primarily accounted for by mild injuries. Efforts to prevent these injuries as well as to decrease levels of disability following TBIs are warranted. PMID:22994196

  1. Higher dynamic medial knee load predicts greater cartilage loss over 12 months in medial knee osteoarthritis.

    Science.gov (United States)

    Bennell, Kim L; Bowles, Kelly-Ann; Wang, Yuanyuan; Cicuttini, Flavia; Davies-Tuck, Miranda; Hinman, Rana S

    2011-10-01

    Mechanical factors, in particular increased medial knee joint load, are believed to be important in the structural progression of knee osteoarthritis. This study evaluated the relationship of medial knee load during walking to indices of structural disease progression, measured on MRI, in people with medial knee osteoarthritis. A longitudinal cohort design utilising a subset of participants (n=144, 72%) enrolled in a randomised controlled trial of lateral wedge insoles was employed. Medial knee load parameters including the peak knee adduction moment (KAM) and the KAM impulse were measured at baseline using three-dimensional gait analysis during walking. MRI at baseline and at 12 months was used to assess structural indices. Multiple regression with adjustment for covariates assessed the relationship between medial knee load parameters and the annual change in medial tibial cartilage volume. Binary logistic regression was used for the dichotomous variables of progression of medial tibiofemoral cartilage defects and bone marrow lesions (BML). A higher KAM impulse, but not peak KAM, at baseline was independently associated with greater loss of medial tibial cartilage volume over 12 months (β=29.9, 95% CI 6.3 to 53.5, p=0.01). No significant relationships were seen between medial knee load parameters and the progression of medial tibiofemoral cartilage defects or BML. This study suggests knee loading, in particular the KAM impulse, may be a risk factor for loss of medial tibial cartilage volume. As knee load is modifiable, load-modifying treatments may potentially slow disease progression.

  2. Replicating Reducing the Risk: 12-Month Impacts of a Cluster Randomized Controlled Trial

    Science.gov (United States)

    Blocklin, Michelle; Layzer, Jean; Price, Cristofer; Juras, Randall; Freiman, Lesley

    2016-01-01

    Objectives. To test the effectiveness of Reducing the Risk, an evidence-based sexual health curriculum designed to help prevent adolescent pregnancy and sexually transmitted infections, on youth sexual behavior and intermediate outcomes thought to lead to these behaviors. Methods. Classes within schools in St. Louis, Missouri; Austin, Texas; and San Diego, California; were randomly assigned to receive Reducing the Risk or “business as usual.” Youths completed Web-based surveys at baseline (preintervention, August 2012–January 2014) and 12 months later (August 2013–January 2015). Intent-to-treat analyses were conducted across sites; we tested for differences in impacts between sites and other subgroups. Results. The program had no overall impact on sexual behaviors. However, at 1 site, program participants were significantly less likely to have engaged in recent sexual intercourse than were control group members. There were positive overall impacts on intermediate outcomes (e.g., knowledge, attitudes). Conclusions. After 12 months, Reducing the Risk was unsuccessful at changing sexual behaviors. Other results were mixed, but promising evidence (e.g., behavioral impacts at 1 site, impacts on intermediate outcomes) suggests potential for more widespread behavioral impacts over a longer term. PMID:27689492

  3. Immediate loading of zygomatic implants using the intraoral welding technique: a 12-month case series.

    Science.gov (United States)

    Degidi, Marco; Nardi, Diego; Piattelli, Adriano; Malevez, Chantal

    2012-10-01

    The aim of this prospective study was to evaluate the concept of intraoral welding as a suitable technique for fabricating a fixed restoration for the edentulous maxilla the day of surgery using standard and zygomatic implants. Ten consecutive patients (four men, six women; mean age, 62.3 ± 11.6 years) were involved in this study, each of whom had an edentulous atrophic maxilla and received two standard and two zygomatic implants. All implants were loaded immediately with a fixed prosthesis supported by an intraorally welded titanium framework. Definitive abutments were connected to the implants, and a titanium bar was welded to them using an intraoral welding unit. This framework was used to support the definitive prosthesis, which was fitted the day of implant placement. Patients were checked for swelling, pain, and framework stability at 1, 3, 6, and 12 months. A total of 20 immediately loaded standard and 20 zygomatic implants were used. The cases included in this study achieved a 100% prosthetic success rate at the 12-month follow-up. No fracture or radiographically detectable alteration of the welded frameworks was noticed. It is possible to successfully rehabilitate the edentulous atrophic maxilla with a permanently fixed prosthesis supported by an intraorally welded titanium framework attached to standard and zygomatic implants the day of surgery.

  4. Predictors of self-rated health: a 12-month prospective study of IT and media workers.

    Science.gov (United States)

    Hasson, Dan; Arnetz, Bengt B; Theorell, Töres; Anderberg, Ulla Maria

    2006-07-31

    The aim of the present study was to determine health-related risk and salutogenic factors and to use these to construct prediction models for future self-rated health (SRH), i.e. find possible characteristics predicting individuals improving or worsening in SRH over time (0-12 months). A prospective study was conducted with measurements (physiological markers and self-ratings) at 0, 6 and 12 months, involving 303 employees (187 men and 116 women, age 23-64) from four information technology and two media companies. There were a multitude of statistically significant cross-sectional correlations (Spearman's Rho) between SRH and other self-ratings as well as physiological markers. Predictors of future SRH were baseline ratings of SRH, self-esteem and social support (logistic regression), and SRH, sleep quality and sense of coherence (linear regression). The results of the present study indicate that baseline SRH and other self-ratings are predictive of future SRH. It is cautiously implied that SRH, self-esteem, social support, sleep quality and sense of coherence might be predictors of future SRH and therefore possibly also of various future health outcomes.

  5. Predictors of self-rated health: a 12-month prospective study of IT and media workers

    Directory of Open Access Journals (Sweden)

    Arnetz Bengt B

    2006-07-01

    Full Text Available Abstract Objective The aim of the present study was to determine health-related risk and salutogenic factors and to use these to construct prediction models for future self-rated health (SRH, i.e. find possible characteristics predicting individuals improving or worsening in SRH over time (0–12 months. Methods A prospective study was conducted with measurements (physiological markers and self-ratings at 0, 6 and 12 months, involving 303 employees (187 men and 116 women, age 23–64 from four information technology and two media companies. Results There were a multitude of statistically significant cross-sectional correlations (Spearman's Rho between SRH and other self-ratings as well as physiological markers. Predictors of future SRH were baseline ratings of SRH, self-esteem and social support (logistic regression, and SRH, sleep quality and sense of coherence (linear regression. Conclusion The results of the present study indicate that baseline SRH and other self-ratings are predictive of future SRH. It is cautiously implied that SRH, self-esteem, social support, sleep quality and sense of coherence might be predictors of future SRH and therefore possibly also of various future health outcomes.

  6. Cognitive status is a determinant of health resource utilization among individuals with a history of falls: a 12-month prospective cohort study.

    Science.gov (United States)

    Davis, J C; Dian, L; Khan, K M; Bryan, S; Marra, C A; Hsu, C L; Jacova, P; Chiu, B K; Liu-Ambrose, T

    2016-03-01

    Falls are a costly public health problem worldwide. The literature is devoid of prospective data that identifies factors among fallers that significantly drive health care resource utilization. We found that cognitive function--specifically, executive functions--and cognitive status are significant determinants of health resource utilization among older fallers. Although falls are costly, there are no prospective data examining factors among fallers that drive health care resource utilization. We identified key determinants of health resource utilization (HRU) at 6 and 12 months among older adults with a history of falls. Specifically, with the increasing recognition that cognitive impairment is associated with increased falls risk, we investigated cognition as a potential driver of health resource utilization. This 12-month prospective cohort study at the Vancouver Falls Prevention Clinic (n = 319) included participants with a history of at least one fall in the previous 12 months. Based on their cognitive status, participants were divided into two groups: (1) no mild cognitive impairment (MCI) and (2) MCI. We constructed two linear regression models with HRU at 6 and 12 months as the dependent variables for each model, respectively. Predictors relating to mobility, global cognition, executive functions, and cognitive status (MCI versus no MCI) were examined. Age, sex, comorbidities, depression status, and activities of daily living were included regardless of statistical significance. Global cognition, comorbidities, working memory, and cognitive status (MCI versus no MCI ascertained using the Montreal Cognitive Assessment (MoCA)) were significant determinants of total HRU at 6 months. The number of medical comorbidities and global cognition were significant determinants of total HRU at 12 months. MCI status was a determinant of HRU at 6 months among older adults with a history of falls. As such, efforts to minimize health care resource use related to falls

  7. Management of Recurrent Preschool, Doctor-Diagnosed Wheeze.

    Science.gov (United States)

    Siu, Ka-Ka; Leung, Shuk-Yu; Kong, Sum-Yi; Ng, Daniel Kwok-Keung

    2018-01-08

    Preschool wheeze occurs in half of the children before they reach 6 y of age and recurrence is also common. Recurrent preschool wheeze is classified as either typical or atypical. For typical recurrent preschool wheeze, the diagnoses are either asthma or bronchiolitis/bronchitis. Responsiveness to a properly administered bronchodilator confirms asthma, atopic or otherwise. All atypical preschool wheeze should be referred to pediatric respirologist for assessment. Lung function test by impulse oscillometry (IOS) before and after bronchodilator is helpful to confirm airway hyperresponsiveness, an essential feature of asthma. Assessment of atopy is important by either skin prick test or serum IgE level. Treatment of acute wheeze includes standard supportive care, bronchodilator for those diagnosed with asthma and hypertonic saline for those diagnosed as having acute bronchiolitis. Other treatments included nebulized adrenaline for acute bronchiolitis and systemic steroids for asthma. For those with significant respiratory distress, continuous positive airway pressure (CPAP) or heated humidified high flow should be considered. Daily or intermittent inhaled corticosteroid or intermittent montelukast would reduce asthma exacerbation rate. A significant proportion of preschool wheeze persists till school age. An early diagnosis of asthma would be important to allow early optimal management.

  8. Identification of Infants at Risk for Autism Spectrum Disorder and Developmental Language Delay Prior to 12 Months

    Science.gov (United States)

    Samango-Sprouse, Carole A.; Stapleton, Emily J.; Aliabadi, Farhad; Graw, Robert; Vickers, Rebecca; Haskell, Kathryn; Sadeghin, Teresa; Jameson, Robert; Parmele, Charles L.; Gropman, Andrea L.

    2015-01-01

    Studies have shown an increased head circumference and the absence of the head tilt reflex as possible risk factors for autism spectrum disorder, allowing for early detection at 12 months in typically developing population of infants. Our aim was to develop a screening tool to identify infants prior to 12 months at risk for autism spectrum…

  9. Variation in the 12-Month Treatment Trajectories of Children and Adolescents After a Diagnosis of Depression.

    Science.gov (United States)

    Joyce, Nina R; Schuler, Megan S; Hadland, Scott E; Hatfield, Laura A

    2018-01-01

    Depression during childhood and adolescence is heterogeneous. Treatment patterns are often examined in aggregate, yet there is substantial variability across individual treatment trajectories. Understanding this variability can help identify treatment gaps among youths with depression. To characterize heterogeneity in 12-month trajectories of psychotherapy and antidepressant treatment in youths with depression. This is a longitudinal-cohort study of youths 18 years or younger with a new diagnosis of depression and at least 12 months of follow-up following diagnosis, as determined from commercial insurance claims filed from 2007 to 2014. Latent class models were fit to summary measures of psychotherapy and antidepressant use in the 12 months following the index diagnosis. We examined variation in baseline health, health care utilization, and health outcomes across classes with similar patterns of psychotherapy and antidepressant use. Data analysis took place between June 2016 and March 2017. Psychotherapy and antidepressant use. The cohort included 84 909 individuals with a mean (SD) age at index diagnosis of 15.0 (2.6) years, of whom 49 995 (59%) were female. Attention-deficit/hyperactivity disorder (n = 14 625; 17%) and anxiety (n = 12 358; 15%) were the most common comorbid diagnoses. During the assessment period, 59 023 individuals (70%) received psychotherapy at any point, and 33 997 individuals (40%) were dispensed antidepressants at any point. Eight classes with distinct treatment trajectories were identified, which we classified into 4 broad groups: 3 classes that received dual therapy (n = 18 710; 22%), 2 classes that received antidepressant monotherapy (n = 15 287; 18%), 2 classes that received psychotherapy monotherapy (n = 40 313; 48%) and 1 class that received no treatment (n = 10 599; 13%). The most common class received psychotherapy monotherapy (n = 35 243; 42%) and had the lowest incidence of

  10. Changes in knee joint load indices from before to 12 months after arthroscopic partial meniscectomy

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Holsgaard-Larsen, Anders; Creaby, M W

    2016-01-01

    OBJECTIVE: Patients undergoing arthroscopic partial meniscectomy (APM) are at increased risk of knee osteoarthritis (OA). Meniscal damage and/or surgery may alter knee joint loading to increase OA risk. We investigated changes in knee joint loading following medial APM surgery, compared...... with the contra-lateral leg. METHODS: We estimated indices of knee joint loading (external peak knee adduction moment (KAM), KAM impulse and peak knee flexion moment (KFM)) normalized to body size (i.e., body mass (BM) and height (HT)) using 3D gait analysis in 23 patients (17 men, mean (SD) 46.2 (6.4) years, BMI...... 25.8 (3.4) kg/m(2)) without radiographic knee OA before and 12 months after medial APM. Static alignment was assessed by radiography and self-reported outcomes by Knee injury and Osteoarthritis Outcome Score (KOOS). RESULTS: Peak KAM and KAM impulse increased in the APM leg compared to the contra...

  11. Acute hamstring injuries in Danish elite football: a 12-month prospective registration study among 374 players

    DEFF Research Database (Denmark)

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

    2010-01-01

    The purpose of the present study was to examine the incidence rates of acute hamstring injuries in Danish elite football sustained during training or match play. Furthermore, it was our intention to document details about the recurrence, severity and the injury seasonal distribution. Hamstring...... injuries among 374 elite football players were registered prospectively during a 12-month period. A total of 46 first-time and eight recurrent hamstring injuries were registered. The incidence rates for incurring a first-time hamstring injury showed a significantly (P28 days from injury to injury free......). Each team sustained a mean of 3.4 hamstring injuries per season, with a mean of 21.5 days missed per injury (range 3-136; median 16 days per injury). The seasonal distribution showed an accumulation of injuries in the first 2 months after a 3.5-month mid-season winter break....

  12. Lean on me: susceptibility to partner affect attenuates psychological distress over a 12-month period.

    Science.gov (United States)

    Randall, Ashley K; Schoebi, Dominik

    2015-04-01

    Symptoms of psychological distress are associated with the experience of heightened negative affect, and the inability to successfully regulate one's emotions. Romantic partners can, however, influence and regulate each other's emotional experiences, especially during times of distress. Using daily diary measures taken 4 times per day over a 10-day period, we examined whether susceptibility to partner affect was associated with levels and trajectories of psychological distress over 12 months. Results from both partners of 103 committed relationships (206 individuals) found that men and women showed decreased levels of distress over the year when they were more susceptible to their partner's positive affect, but the degree of susceptibility varied with respect to negative affect. Examining susceptibility to partner affect may be a valuable complementary approach to studying relational contributions to the social regulation of emotions, especially in understanding the progression of psychological distress. (c) 2015 APA, all rights reserved).

  13. Rehospitalisation for asthma within 12 months: unequal rates on the basis of gender in two hospitals.

    Science.gov (United States)

    Heard, A R; Campbell, D A; Ruffin, R E; Smith, B; Luke, C G; Roder, D M

    1997-12-01

    High asthma morbidity has been reported in certain demographic groups in geographical areas of low socioeconomic status (SES). We tested for an ecological association between the gender of people being frequently hospitalised for asthma and the SES of the area in which they lived, using a cross-sectional study. Women represented 75% of the readmission population at The Queen Elizabeth Hospital (TQEH--low SES hospital) and 55% at Modbury Hospital (moderate-high SES hospital). Women at TQEH were significantly more likely to have one readmission within 12 months and over 30 times more likely to have two or more readmissions than women at Modbury Hospital. The ecological association observed in this study needs to be confirmed elsewhere in Australia.

  14. Gender and discipline in 5-12-month-old infants: a longitudinal study.

    Science.gov (United States)

    Ahl, Richard Evan; Fausto-Sterling, Anne; García-Coll, Cynthia; Seifer, Ronald

    2013-04-01

    We examined the effects of infant age and gender on the behaviors of infants and mothers during discipline interactions using longitudinal, naturalistic, home-based, taped observations of 16 mother-infant dyads (eight males and eight females). These observations were conducted between the child ages of 5 and 12 months and used a devised Maternal Discipline Coding System to code for the occurrence of discipline events. During discipline interactions, mothers vocalized longer, used harsher tones, and used more explanations with older compared to younger infants. Male infants were more likely than female infants to cry or whine during discipline events. Mothers of male infants used longer vocalizations, more words, and more affectionate terms than mothers of female infants. Male infants were more difficult during discipline interactions than female infants, but it appeared that mothers of males responded to this difficulty by using milder discipline techniques. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Association Between Sleep Problems and Perceived Cognitive Dysfunction Over 12 Months in Individuals with Multiple Sclerosis.

    Science.gov (United States)

    Hughes, Abbey J; Turner, Aaron P; Alschuler, Kevin N; Atkins, David C; Beier, Meghan; Amtmann, Dagmar; Ehde, Dawn M

    2018-01-01

    Sleep problems are highly prevalent among individuals with multiple sclerosis (MS); however, the relationship between sleep problems and cognitive dysfunction is poorly understood in this population. In the present study, 163 individuals with MS and depression, fatigue, or pain completed self-report measures of sleep, cognitive dysfunction, and relevant demographic and clinical characteristics (e.g., disability severity, depressive symptomatology, pain intensity, fatigue impact) at four time points over 12 months. Mixed-effects regression demonstrated that poorer sleep was independently associated with worse perceived cognitive dysfunction (β = -0.05, p = .001), beyond the influence of depressive symptomatology. Fatigue impact was found to partially mediate this relationship. Results suggest that for individuals with MS and depression, fatigue, or pain, self-reported sleep problems are related to perceived cognitive dysfunction, and that fatigue impact accounts for part of this relationship.

  16. Evaluation of Protocol Biopsy Utility 12 Months after Renal Transplantation: A Multicenter Observational Analysis

    Directory of Open Access Journals (Sweden)

    Bruno Moulin

    2012-01-01

    Full Text Available The clinical merit of surveillance kidney graft biopsies remains controversial. A retrospective, multicenter analysis evaluated 12-month surveillance biopsies (SB, 154 patients versus no SB (NSB, 138 patients (11 with diagnostic biopsy in patients >18 months posttransplant with estimated GFR (eGFR ≥30 mL/min. The primary objective was to describe renal function at 18 months post-transplant in patients with or without SB at month 12. Globally, most recipients in both cohorts were at low immunological risk (<10% of patients with PRA ≥30%. The immunosuppressive regimen remained unchanged following more than half of SB that exhibited chronic lesions (18/33, 54.5%. Mean (SD eGFR at month 18 (primary endpoint was 56 (19 mL/min/1.73 m² with SB and 54 (15 mL/min/1.73 m² with NSB (=0.48. In the SB group, slight nonspecific changes were observed in 51 cases, rejection (acute or chronic in 6 cases, CNI-related toxicity in 15 cases, recurrence of initial disease in two cases, and interstitial fibrosis/tubular atrophy (IF/TA in 83 cases (71.6%, of which 35 cases (30.2% were grade II/III lesions. eGFR <50 mL/min/1.73 m² at month 6 predicted IF/TA grade II or III (OR 3.85, 95% CI 1.64, 9.05, <0.002. SB at 12 months posttransplant did not prompt significant modification of immunosuppression, and no renal benefit was observed.

  17. Services for adolescents with psychiatric disorders: 12-month data from the National Comorbidity Survey-Adolescent.

    Science.gov (United States)

    Costello, E Jane; He, Jian-ping; Sampson, Nancy A; Kessler, Ronald C; Merikangas, Kathleen Ries

    2014-03-01

    This study examined 12-month rates of service use for mental, emotional, and behavioral disorders among adolescents. Data were from the National Comorbidity Survey Adolescent Supplement (NCS-A), a survey of DSM-IV mental, emotional, and behavioral disorders and service use. In the past 12 months, 45.0% of adolescents with psychiatric disorders received some form of service. The most likely were those with ADHD (73.8%), conduct disorder (73.4%), or oppositional defiant disorder (71.0%). Least likely were those with specific phobias (40.7%) and any anxiety disorder (41.4%). Among those with any disorder, services were more likely to be received in a school setting (23.6%) or in a specialty mental health setting (22.8%) than in a general medical setting (10.1%). Youths with any disorder also received services in juvenile justice settings (4.5%), complementary and alternative medicine (5.3%), and human services settings (7.9%). Although general medical providers treated a larger proportion of youths with mood disorders than with behavior disorders, they were more likely to treat youths with behavior disorders because of the larger number of the latter (11.5% of 1,465 versus 13.9% of 820). Black youths were significantly less likely than white youths to receive specialty mental health or general medical services for mental disorders. Findings from this analysis of NCS-A data confirm those of earlier, smaller studies, that only a minority of youths with psychiatric disorders receive treatment of any sort. Much of this treatment was provided in service settings in which few providers were likely to have specialist mental health training.

  18. A survey of nutritional status of children 0-12 months in specialist hospital Gombe, Nigeria

    Directory of Open Access Journals (Sweden)

    Mela Danjin

    2015-01-01

    Full Text Available Background: This study was a cross-sectional survey of children and their mothers in specialist Hospital Gombe, Nigeria. Objective: Anthropometric assessment of nutritional status of the children (0-12 months and a survey of mothers′ opinion on malnutrition. Population: Children and mothers attending immunization sessions in specialist hospital Gombe, Nigeria. Materials and Methods: Hundred children (0-12 months attending immunization sessions were purposefully sampled and measured using sensitive anthropometric tools and techniques, while on the other arm of the study structured interviews were administered on the children′s consenting mothers (100 who turned in for their wards′ immunization. Only 97 out of 100 data collected on the children were used. Anthropometric indices used were height-for-age, weight-for-height, weight-for-age, and mid-upper arm circumference. Results: The study revealed a higher prevalence of moderate stunting in male (46.9% than in female (33.3% children (P 11 exhibited both severe and moderate forms of underweight. Among infants 3-5 months, moderate wasting was found to be less prevalent (4.2%. And despite the fact that 90% of their mothers showed a positive attitude toward exclusive breastfeeding, only 44% of them breastfed their infants exclusively from birth to the 6 th month of life. Conclusion: In order to address the various forms of nutritional derangements detected among the children, mothers should be targeted for infant nutritional education and authorities should institute poverty alleviation measures so as to address underlying causes of malnutrition.

  19. Risk factors associated with exertional medial tibial pain: a 12 month prospective clinical study.

    Science.gov (United States)

    Burne, S G; Khan, K M; Boudville, P B; Mallet, R J; Newman, P M; Steinman, L J; Thornton, E

    2004-08-01

    To investigate in a military setting the potential role of intrinsic biomechanical and anthropometric risk factors for, and the incidence of, exertional medial tibial pain (EMTP). A prospective clinical outcome study in a cohort of 122 men and 36 women at the Australian Defence Force Academy. Each cadet underwent measurements of seven intrinsic variables: hip range of motion, leg length discrepancy, lean calf girth, maximum ankle dorsiflexion range, foot type, rear foot alignment, and tibial alignment. Test-retest reliability was undertaken on each variable. A physician recorded any cadet presenting with diagnostic criteria of EMTP. Records were analysed at 12 months for EMTP presentation and for military fitness test results. 23 cadets (12 men, 11 women) met the criteria for EMTP after 12 months, with a cross gender (F/M) odds ratio of 3.1. In men, both internal and external range of hip motion was greater in those with EMTP: left internal (12 degrees, p = 0.000), right internal (8 degrees, p = 0.014), left external (8 degrees, p = 0.042), right external (9 degrees, p = 0.026). Lean calf girth was lower by 4.2% for the right leg (p = 0.040) but by only 2.9% for the left leg (p = 0.141). No intrinsic risk factor was associated with EMTP in women. EMTP was the major cause for non-completion of the run component of the ADFA fitness test in both men and women. Greater internal and external hip range of motion and lower lean calf girth were associated with EMTP in male military cadets. Women had high rates of injury, although no intrinsic factor was identified. Reasons for this sex difference need to be identified.

  20. 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...

  1. Risk factors for wheezing in infants born in Cuba.

    Science.gov (United States)

    Venero-Fernández, S J; Suárez-Medina, R; Mora-Faife, E C; García-García, G; Valle-Infante, I; Gómez-Marrero, L; Abreu-Suárez, G; González-Valdez, J; Fabró-Ortiz, D Dania; Fundora-Hernández, H; Venn, A; Britton, J; Fogarty, A W

    2013-11-01

    Cuba is a unique country, and despite limited economic development, has an excellent health system. However, the prevalence of asthma symptoms in children in Havana, Cuba, is unusually high. As early life exposures are critical to the aetiology of asthma, we have studied environmental influences on the risk of wheezing in Cuban infants. Cross-sectional study. A random sample of 2032 children aged 12-15 months living in Havana was selected for inclusion in the cohort. Data were collected using questionnaires administered by researchers. Of 2032 infants invited to participate, 1956 (96%) infants provided data. The prevalence of any wheeze was 45%, severe wheeze requiring use of emergency services was 30% and recurrent wheeze on three or more occasions was 20%. The largest adjusted risk factors for any wheeze were presence of eczema [odds ratio (OR) 2.09; 95% confidence interval (CI) 1.48-2.94], family history of asthma (OR 2.05; 95% CI 1.60-2.62), poor ventilation in the house (OR 1.99; 95% CI 1.48-2.67), attendance at nursery (OR 1.78; 95% CI 1.24-2.57), male sex (OR1.52; 95% CI 1.19-1.96) and the number of smokers in the house (P Cuba. As the prevalence of smoking in the house is high (51%), intervention studies are required to determine effective strategies to improve infant health.

  2. Switching of oral bisphosphonates to denosumab in chronic glucocorticoid users: a 12-month randomized controlled trial.

    Science.gov (United States)

    Mok, Chi Chiu; Ho, Ling Yin; Ma, Kwok Man

    2015-06-01

    To evaluate the effect of switching from oral bisphosphonates to denosumab on bone mineral density (BMD) in long-term glucocorticoid users. Adult patients who were receiving long-term prednisolone (≥2.5 mg/day for ≥1 year) and oral bisphosphonates (≥2 years) were recruited. Participants were randomized to either continue oral bisphosphonates or switch to denosumab (60 mg subcutaneously every 6 months) for 12 months. Serial BMD (lumbar spine, hip) and bone turnover markers (serum osteocalcin, P1NP, β-CTX) were measured. 42 women were recruited (age 54.7±12.9 years; 21 shifted to denosumab and 21 continued on bisphosphonates). The duration of prednisolone therapy was 101±66.3 months and the daily dose was 4.4±2.1 mg. Baseline demographic data, osteoporosis risk factors, and BMD at various sites were similar between the two groups of patients. At month 12, BMD of the spine and hip increased by +3.4±0.9% (p=0.002) and +1.4±0.6% (p=0.03), respectively, in the denosumab group; whereas the corresponding change was +1.5±0.4% (p=0.001) and +0.80±0.5% (p=0.12) in the bisphosphonate group. The spinal BMD at month 12 was significantly higher in the denosumab than bisphosphonate group after adjustment for baseline BMD and β-CTX values, and other confounding factors (p=0.01). Bone turnover markers (β-CTX and P1NP) were more strongly suppressed by denosumab than the bisphosphonates. Minor infections were more common in denosumab-treated patients while other adverse events occurred at similar frequencies between the two groups. In patients receiving long-term glucocorticoids, switching from oral bisphosphonates to denosumab resulted in greater gain of the spinal BMD and suppression of bone turnover markers after 12 months of therapy. The results have to be confirmed by a larger clinical trial with fracture as endpoint. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. VSRR - Provisional monthly and 12-month ending number of live births, deaths and infant deaths: United States

    Data.gov (United States)

    U.S. Department of Health & Human Services — https://www.cdc.gov/nchs/products/vsrr/provisional-tables.htm Monthly and 12 month-ending provisional counts of births, deaths and infant deaths are provided for the...

  4. African American community members sustain favorable blood pressure outcomes through 12-month telephone motivational interviewing (MI) maintenance

    Science.gov (United States)

    Community approaches offer promise for addressing disparities experienced by African Americans in hypertension prevalence, treatment, and control. HUB City Steps, a community-based participatory research lifestyle intervention, tracked participants through a 12-month MI maintenance phase following a...

  5. Wheeze as an Adverse Event in Pediatric Vaccine and Drug Randomized Controlled Trials: A Systematic Review

    Science.gov (United States)

    Marangu, Diana; Kovacs, Stephanie; Walson, Judd; Bonhoeffer, Jan; Ortiz, Justin R.; John-Stewart, Grace; Horne, David J.

    2016-01-01

    Introduction Wheeze is an important sign indicating a potentially severe adverse event in vaccine and drug trials, particularly in children. However, there are currently no consensus definitions of wheeze or associated respiratory compromise in randomized controlled trials (RCTs). Objective To identify definitions and severity grading scales of wheeze as an adverse event in vaccine and drug RCTs enrolling children Vaccines made up the majority (90%) of interventions, particularly influenza vaccines (65%). Only 15 trials provided explicit definitions of wheeze. Of 24 studies that described severity, 11 described wheeze severity in the context of an explicit wheeze definition. The remaining 13 studies described wheeze severity where wheeze was defined as part of a respiratory illness or a wheeze equivalent. Wheeze descriptions were elicited from caregiver reports (14%), physical examination by a health worker (45%) or a combination (41%). There were 21/58 studies in which wheeze definitions included combined caregiver report and healthcare worker assessment. The use of these two methods appeared to have the highest combined sensitivity and specificity. Conclusion Standardized wheeze definitions and severity grading scales for use in pediatric vaccine or drug trials are lacking. Standardized definitions of wheeze are needed for assessment of possible adverse events as new vaccines and drugs are evaluated. PMID:26319071

  6. Performance of a pilot scale microbial electrolysis cell fed on domestic wastewater at ambient temperatures for a 12 month period.

    Science.gov (United States)

    Heidrich, Elizabeth S; Edwards, Stephen R; Dolfing, Jan; Cotterill, Sarah E; Curtis, Thomas P

    2014-12-01

    A 100-L microbial electrolysis cell (MEC) was operated for a 12-month period fed on raw domestic wastewater at temperatures ranging from 1°C to 22°C, producing an average of 0.6 L/day of hydrogen. Gas production was continuous though decreased with time. An average 48.7% of the electrical energy input was recovered, with a Coulombic efficiency of 41.2%. COD removal was inconsistent and below the standards required. Limitations to the cell design, in particular the poor pumping system and large overpotential account for many of the problems. However these are surmountable hurdles that can be addressed in future cycles of pilot scale research. This research has established that the biological process of an MEC will to work at low temperatures with real wastewater for prolonged periods. Testing and demonstrating the robustness and durability of bioelectrochemical systems far beyond that in any previous study, the prospects for developing MEC at full scale are enhanced. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. The progression of 102 Brazilian patients with bipolar disorder: outcome of first 12 months of prospective follow-up

    Directory of Open Access Journals (Sweden)

    Fernanda Novis

    2014-03-01

    Full Text Available INTRODUCTION: Prospective studies have shown that the course of bipolar disorder (BD is characterized by the persistence of symptoms, predominantly depression, along most of the time. However, to our knowledge, no studies in Latin America have investigated it. OBJECTIVES: To replicate international studies using a Brazilian sample to prospectively analyze treatment outcomes in the first year and to determine potential chronicity factors. METHODS: We followed up 102 patients with BD for 12 months and evaluated the number of months with affective episodes and the intensity of manic and depressive symptoms using the Young Mania Rating Scale (YMRS and the Hamilton Depression Scale (HAM-D17. Sociodemographic and retrospective clinical data were examined to determine possible predictors of outcome. RESULTS: Almost 50% of the patients had symptoms about half of the time, and there was a predominance of depressive episodes. Disease duration and number of depressive episodes were predictors of chronicity. Depressive polarity of the first episode and a higher number of depressive episodes predicted the occurrence of new depressive episodes. CONCLUSION: In general, BD outcome seems to be poor in the first year of monitoring, despite adequate treatment. There is a predominance of depressive symptoms, and previous depressive episodes are a predictor of new depressive episodes and worse outcome.

  8. Day Hospital Treatment for Anorexia Nervosa: A 12-Month Follow-up Study.

    Science.gov (United States)

    Abbate-Daga, Giovanni; Marzola, Enrica; De-Bacco, Carlotta; Buzzichelli, Sara; Brustolin, Annalisa; Campisi, Stefania; Amianto, Federico; Migliaretti, Giuseppe; Fassino, Secondo

    2015-09-01

    Day hospitals (DHs) represent a treatment option for anorexia nervosa (AN), a mental disorder that is difficult to treat and has no evidence-based treatments available. We aimed to determine the effectiveness of a DH treatment that was specifically focused on the emotions of severe AN patients. Body mass index and eating psychopathology were the primary outcome measures. Fifty-six adult patients with AN were assessed upon admission, at the end of treatment (EOT) and at a 12-month follow-up evaluation (T18) using Eating Disorders Inventory-2, Beck Depression Inventory, Hamilton Rating Scale for Anxiety and Brief Social Phobia Scale. All participants received a multidisciplinary treatment programme that focused on psychodynamic psychotherapy. Seventy-eight per cent of participants reported positive outcomes at EOT and 68% at T18. Moreover, 82.1% and 65.4% of long-standing patients showed positive outcomes at EOT and T18, respectively. All measures of psychopathology were significantly improved at EOT and were maintained at follow-up. Our DH was effective at treating severe AN patients; however, further investigations of the processes of change are warranted. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

  9. Physical activity in Iranian older adults who experienced fall during the past 12 months.

    Science.gov (United States)

    Salehi, Leili; Shokrvash, Behjat; Jamshidi, Ensiyeh; Montazeri, Ali

    2014-10-31

    Physical activity may have several benefits for elderly people. However, the risk of falling might prevent this population from showing interest in physical activity. This research was aimed to explore facilitators and barriers to physical activity in older persons who have experienced at least one fall in the past 12 months. This cross sectional study was conducted in 2010-2011, in Tehran, Iran. Using a multistage sampling method a group of elderly people entered into the study. A multi-section questionnaire was used to collect data on demographic information, physical activity level, and different determinants that might influence physical activity. Several statistical tests including linear regression were used to analyze the data. In all, 180 old people from 40 elderly centers (49 men and 131 women) took part in the study. The mean age of participants was 65.9 ± 6.1 years. The result indicated that most participants experienced two or more falls during the last year (54.5%). Those who had more falls significantly scored lower on the Physical Activity Scale for Elderly (p falls, self-reported health and daily living activities. However, we observed inverse association between number of falls and physical activity. Indeed the findings suggest that we should reinforce benefits exist when designing programs to increase physical activity among elderly population.

  10. Early Development Standards for Children Aged 2 to 12 Months in a Low-Income Setting

    Directory of Open Access Journals (Sweden)

    Buddhi U. W. P. Lokuketagoda

    2016-10-01

    Full Text Available The aim of this study was to develop a screening tool to screen children for development problems in a low-income setting. Childhood development problems are a major health issue faced by low-income countries. A validated screening tool is needed for early identification of developmental delays. This article contains the first phase of a study that established a relatively simple tool to screen children for developmental problems. The aim of the first phase was to define a set of development indicators for the period of 2 to 12 months of life. The study methodology consisted of an extensive literature review, to develop a set of indicators to measure child development in infancy. The indicators were placed within a framework developed and used by experts in other countries. It consists of major domains, subdomains, specific aspects, and standards of development. This was followed by content validation of the indicators. Following review of literature, 171 indicators were compiled under the framework. At the end of content validation, 125 indicators were retained in the framework. These were pretested, and another 26 were removed following pretesting. The study developed a framework of indicators that could be used as a development tool following a reference-based validation. The second phase of the study that included the assessment of psychometric characteristics and reference-based validation would be published in a separate article.

  11. Language skills of children during the first 12 months after stuttering onset.

    Science.gov (United States)

    Watts, Amy; Eadie, Patricia; Block, Susan; Mensah, Fiona; Reilly, Sheena

    2017-03-01

    To describe the language development in a sample of young children who stutter during the first 12 months after stuttering onset was reported. Language production was analysed in a sample of 66 children who stuttered (aged 2-4 years). The sample were identified from a pre-existing prospective, community based longitudinal cohort. Data were collected at three time points within the first year after stuttering onset. Stuttering severity was measured, and global indicators of expressive language proficiency (length of utterances and grammatical complexity) were derived from the samples and summarised. Language production abilities of the children who stutter were contrasted with normative data. The majority of children's stuttering was rated as mild in severity, with more than 83% of participants demonstrating very mild or mild stuttering at each of the time points studied. The participants demonstrated developmentally appropriate spoken language skills comparable with available normative data. In the first year following the report of stuttering onset, the language skills of the children who were stuttering progressed in a manner that is consistent with developmental expectations. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. APPLICATION OF FILTEK SILORANE-INITIAL OBSERVATIONS AND PROSPECTIVE CLINICAL TRIAL FOR 12 MONTH

    Directory of Open Access Journals (Sweden)

    Lyubomir Vangelov

    2010-12-01

    Full Text Available Polymerization shrinkage and related adverse effects are still considered a major problem of dental composites. To solve this problem different approaches are offered. Currently, 3M ESPE developed a new monomer system based on cationic ring opening, the goal is to create a composite material with low polymerization shrinкage called siloran. Aim: To investigate the clinical presentation of Filtek д Silorane Low Shrink Posterior Restorative for an observation period of 12 months. Material and methods: The study included 36 patients. Total of 66 restorations are made. They were evaluated using modified USPHS criteria of Ryge and Cvar. After their assessment, restorations were captured with a digital camera and X-rays were taken in parallel technique. On control examination after one year, 31 patients (63 restorations were available for the study. Same parameters were assessed and new digital pictures and X-rays were made. The statistics was made with software SPSS version 17. For statistical analysis a Criterion Pirson (x2 was used. Results: With the exception of one of the criteria, it was shown that no statistically significant difference exists between the baseline and after one year (p> 0,05. Only the criterion surface of the filling was found to have statistically significant difference (p <0,05

  13. Comprehensive Nutritional and Dietary Intervention for Autism Spectrum Disorder—A Randomized, Controlled 12-Month Trial

    Directory of Open Access Journals (Sweden)

    James B. Adams

    2018-03-01

    Full Text Available This study involved a randomized, controlled, single-blind 12-month treatment study of a comprehensive nutritional and dietary intervention. Participants were 67 children and adults with autism spectrum disorder (ASD ages 3–58 years from Arizona and 50 non-sibling neurotypical controls of similar age and gender. Treatment began with a special vitamin/mineral supplement, and additional treatments were added sequentially, including essential fatty acids, Epsom salt baths, carnitine, digestive enzymes, and a healthy gluten-free, casein-free, soy-free (HGCSF diet. There was a significant improvement in nonverbal intellectual ability in the treatment group compared to the non-treatment group (+6.7 ± 11 IQ points vs. −0.6 ± 11 IQ points, p = 0.009 based on a blinded clinical assessment. Based on semi-blinded assessment, the treatment group, compared to the non-treatment group, had significantly greater improvement in autism symptoms and developmental age. The treatment group had significantly greater increases in EPA, DHA, carnitine, and vitamins A, B2, B5, B6, B12, folic acid, and Coenzyme Q10. The positive results of this study suggest that a comprehensive nutritional and dietary intervention is effective at improving nutritional status, non-verbal IQ, autism symptoms, and other symptoms in most individuals with ASD. Parents reported that the vitamin/mineral supplements, essential fatty acids, and HGCSF diet were the most beneficial.

  14. Predictors of clinical outcomes after periodontal treatment of aggressive periodontitis: 12-month randomized trial.

    Science.gov (United States)

    Haas, Alex Nogueira; Silva-Boghossian, Carina Maciel; Colombo, Ana Paula; Albandar, Jasim; Oppermann, Rui Vicente; Rösing, Cassiano Kuchenbecker; Susin, Cristiano

    2016-05-20

    Little is known about the factors that may be used in clinical practice to predict the therapeutic response of aggressive periodontitis patients. The aim of this study was to determine predictors of clinical outcomes after non-surgical treatment of aggressive periodontitis. A total of 24 patients (aged 13-26 years) received oral hygiene instructions, as well as subgingival scaling and root planing. Twelve subjects received systemic azithromycin at random. Clinical variables were assessed at baseline, 3, 6, 9, and 12 months. Baseline microbiological assessment was performed by checkerboard DNA-DNA hybridization. Multivariable models used generalized estimating equations. There were significant improvements in the entire sample in regard to pocket depth, clinical attachment level and bleeding on probing. Significant predictors of a reduction in mean pocket depth were: use of azithromycin, non-molar teeth, generalized disease and baseline pocket depth. Absence of plaque predicted a 0.22 mm higher attachment gain, whereas a baseline pocket depth ≥7 mm predicted a 1.36 mm higher attachment loss. Azithromycin, plaque, and baseline pocket depth were significant predictors of bleeding on probing. The concomitant presence of all three red complex species predicted a 0.78 mm higher attachment loss. It may be concluded that dental plaque, tooth type, disease extent, baseline pocket depth, and use of azithromycin were significant predictors of the clinical response to treatment for aggressive periodontitis in young individuals. Moreover, the presence of multiple periodontal pathogens may predict challenges in achieving a favorable outcome for aggressive periodontitis.

  15. Long-distance longitudinal prostate MRI quality assurance: from startup to 12 months.

    Science.gov (United States)

    Curci, Nicole E; Gartland, Patrick; Shankar, Prasad R; Montgomery, Jeffrey S; Miller, David C; George, Arvin K; Davenport, Matthew S

    2018-02-22

    To evaluate a 12-month long-distance prostate MRI quality assurance (QA) program. The need for IRB approval was waived for this prospective longitudinal QA effort. One academic institution experienced with prostate MRI [~ 1000 examinations/year (Site 2)] partnered with a private institution 240 miles away that was starting a new prostate MRI program (Site 1). Site 1 performed all examinations (N = 249). Four radiologists at Site 1 created finalized reports, then sent images and reports to Site 2 for review on a rolling basis. One radiologist at Site 2 reviewed findings and exam quality and discussed results by phone (~ 2-10 minutes/MRI). In months 1-6 all examinations were reviewed. In months 7-12 only PI-RADS ≤ 2 and 'difficult' cases were reviewed. Repeatability was assessed with intra-class correlation (ICC). 'Clinically significant cancer' was Gleason ≥ 7. Image quality significantly (p quality assurance of prostate MRI is feasible and useful, enabling new programs to gain durable skills with minimal risk to patients.

  16. A 12-Month-Old Healthy Girl with a New Oral Ulcer and Chronic Diaper Rash

    Directory of Open Access Journals (Sweden)

    Hannah Song

    2017-11-01

    Full Text Available A 12-month-old healthy girl presented with a chronic diaper rash. Physical examination demonstrated crusting of the scalp, erythematous papules with surrounding petechiae on the lower abdomen, and an intraoral palatal ulcer. Further imaging demonstrated bone involvement. Histopathologic examination of involved skin and the intraoral ulcer demonstrated epithelioid histiocytes with “coffee bean-shaped” nuclei, staining positive for CD1a and langerin by immunohistochemistry, consistent with Langerhans cell histiocytosis (LCH. LCH is a disease entity of unknown etiology characterized by histiocytic proliferation that most commonly presents in young children. The cutaneous findings of LCH include a seborrheic dermatitis-like and/or red-brown papular eruption. Intraoral examination is crucial as oral mucosal and maxillofacial skeletal disease can also be seen in LCH. When a child presents with a recalcitrant seborrheic dermatitis-like eruption or chronic diaper rash, the clinician should be alerted to the possibility of LCH. Timely recognition and diagnosis of LCH is important for oncologic referral, evaluation, and treatment.

  17. Comprehensive Nutritional and Dietary Intervention for Autism Spectrum Disorder-A Randomized, Controlled 12-Month Trial.

    Science.gov (United States)

    Adams, James B; Audhya, Tapan; Geis, Elizabeth; Gehn, Eva; Fimbres, Valeria; Pollard, Elena L; Mitchell, Jessica; Ingram, Julie; Hellmers, Robert; Laake, Dana; Matthews, Julie S; Li, Kefeng; Naviaux, Jane C; Naviaux, Robert K; Adams, Rebecca L; Coleman, Devon M; Quig, David W

    2018-03-17

    This study involved a randomized, controlled, single-blind 12-month treatment study of a comprehensive nutritional and dietary intervention. Participants were 67 children and adults with autism spectrum disorder (ASD) ages 3-58 years from Arizona and 50 non-sibling neurotypical controls of similar age and gender. Treatment began with a special vitamin/mineral supplement, and additional treatments were added sequentially, including essential fatty acids, Epsom salt baths, carnitine, digestive enzymes, and a healthy gluten-free, casein-free, soy-free (HGCSF) diet. There was a significant improvement in nonverbal intellectual ability in the treatment group compared to the non-treatment group (+6.7 ± 11 IQ points vs. -0.6 ± 11 IQ points, p = 0.009) based on a blinded clinical assessment. Based on semi-blinded assessment, the treatment group, compared to the non-treatment group, had significantly greater improvement in autism symptoms and developmental age. The treatment group had significantly greater increases in EPA, DHA, carnitine, and vitamins A, B2, B5, B6, B12, folic acid, and Coenzyme Q10. The positive results of this study suggest that a comprehensive nutritional and dietary intervention is effective at improving nutritional status, non-verbal IQ, autism symptoms, and other symptoms in most individuals with ASD. Parents reported that the vitamin/mineral supplements, essential fatty acids, and HGCSF diet were the most beneficial.

  18. Indexical and linguistic processing by 12-month-olds: Discrimination of speaker, accent and vowel differences.

    Directory of Open Access Journals (Sweden)

    Karen E Mulak

    Full Text Available Infants preferentially discriminate between speech tokens that cross native category boundaries prior to acquiring a large receptive vocabulary, implying a major role for unsupervised distributional learning strategies in phoneme acquisition in the first year of life. Multiple sources of between-speaker variability contribute to children's language input and thus complicate the problem of distributional learning. Adults resolve this type of indexical variability by adjusting their speech processing for individual speakers. For infants to handle indexical variation in the same way, they must be sensitive to both linguistic and indexical cues. To assess infants' sensitivity to and relative weighting of indexical and linguistic cues, we familiarized 12-month-old infants to tokens of a vowel produced by one speaker, and tested their listening preference to trials containing a vowel category change produced by the same speaker (linguistic information, and the same vowel category produced by another speaker of the same or a different accent (indexical information. Infants noticed linguistic and indexical differences, suggesting that both are salient in infant speech processing. Future research should explore how infants weight these cues in a distributional learning context that contains both phonetic and indexical variation.

  19. Fine Motor Development of Low Birth Weight Infants Corrected Aged 8 to 12 Months

    Directory of Open Access Journals (Sweden)

    Sepideh Nazi

    2012-10-01

    Full Text Available Objectives: The aim of this study was to compare the fine motor development between Low Birth Weight (LBW infants and Normal Birth Weight infants (NBW at the age of 8-12 months by using the Peabody Developmental Motor Scale-2 (PDMS-2 . Methods: This was a non experimental and cross sectional study which was conducted on the 18 LBW infants and 14 normal infants. By referring to the profile of infants in NICU of Aliasghar Hospital, those with defined inclusion criteria was recognized (case group. The normal weight infants, randomly selected from Health Center of that hospital, matched with case group for date of birth. After completing the questionnaire about demographic variables, their gross motor development was assessed with PDMS-2. Finally the scores of the motor quotient were analyzed by independent t-test statistical method. Results: There was a significant difference between Fine motor quotient of groups (P=0.007. Discussion: This study showed that LBW infants are significantly lower than normal weight infants in attaining Fine motor skills. It means that the LBW infants are more prone to developmental difficulties.

  20. Below the knee PTA in critical limb ischemia results after 12 months: Single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Balzer, Joern O., E-mail: balzerjo@t-online.d [Dept. for Radiology and Nuclear medicine, Catholic Clinic Mainz, An der Goldgrube 11, Mainz 55131 (Germany); Khan, Verena [Dept. of Diagnostic and Interventional Radiology, Clinic Nurnberg North (Germany); Thalhammer, Axel; Vogl, Thomas J.; Lehnert, Thomas [Dept. of Diagnostic and Interventional Radiology, Univ. Clinic, Johann Wolfgang Goethe-University Frankfurt/Main (Germany)

    2010-07-15

    Purpose: Evaluation of angioplasty with bare metal stents in infrapopliteal occlusions or severe stenoses in patients with critical limb ischemia. Material and methods: Percutaneous stent angioplasty was performed in 58 limbs in 47 patients with critical limb ischemia (CLI) in Rutherford stage 4-6. Lesions with up to 5 cm in length with at least one patent vessel below the obstruction were treated. 121 bare metal stents (diameter of 2.5-4 mm; length of 18-38 mm) were implanted. Follow-up examinations were performed up to 12 months postinterventionally using clinical examination, ABI calculation, and color-coded duplex sonography. Patency rates were calculated on the basis of the Kaplan-Meier analysis. Results: Technical success was achieved in 100%. Minor complications (hematoma, distal emboli, vessel dissection) were documented in 5.17% (n = 3) limbs, respectively. The 3-month, 6-month, and 1-year primary patency rate was 93.0%, 78.9% and 66.7%, respectively. 86.9% of the lesions healed postinterventionally. The cumulative limb salvage rate was 96.6%. Conclusion: Stent angioplasty in infrapopliteal arteries is a safe and effective technique for the treatment of patients with CLI. By consequent clinical monitoring high secondary patency rates can be achieved. The use of a bare metal stent seems to result in high limb salvage, primary and secondary patency rates in the mid-term follow-up.

  1. Efficacy and safety of dienogest in patients with endometriosis: A single-center observational study over 12 months

    OpenAIRE

    Park, So Yun; Kim, Sung Hoon; Chae, Hee Dong; Kim, Chung-Hoon; Kang, Byung Moon

    2016-01-01

    Objective To evaluate the efficacy and safety of dienogest treatment in patients who had received dienogest for 12 months or more to treat endometriosis. Methods We analyzed the clinical data of 188 women with endometriosis who had been treated with 2 mg of dienogest once a day for 12 months or more at a single institute. We evaluated changes in endometriosis-associated pain and endometrioma size, recurrence rate, and adverse events following dienogest administration. Bone mineral density (BM...

  2. Relationships between Breastfeeding Patterns and Maternal and Infant Body Composition over the First 12 Months of Lactation

    OpenAIRE

    Zoya Gridneva; Alethea Rea; Anna R. Hepworth; Leigh C. Ward; Ching T. Lai; Peter E. Hartmann; Donna T. Geddes

    2018-01-01

    Breastfeeding has been implicated in the establishment of infant appetite regulation, feeding patterns and body composition (BC). A holistic approach is required to elucidate relationships between infant and maternal BC and contributing factors, such as breastfeeding parameters. Associations between maternal and breastfed term infant BC (n = 20) and feeding parameters during first 12 months of lactation were investigated. BC was measured at 2, 5, 9 and/or 12 months postpartum with ultrasound ...

  3. Body composition, resting energy expenditure and inflammatory markers: impact in users of depot medroxyprogesterone acetate after 12 months follow-up.

    Science.gov (United States)

    Batista, Gisele Almeida; Souza, Aglécio Luiz de; Marin, Daniela Miguel; Sider, Marina; Melhado, Vaneska Carvalho; Fernandes, Arlete Maria; Alegre, Sarah Monte

    2017-01-01

    The aim of this study was to evaluate for 12 months the changes of body weight using Depot Medroxyprogesterone Acetate (DMPA) and if these changes are related to inflammatory markers. Twenty women of childbearing age who chose the DMPA, without previous use of this method, BMI HOMA-IR were assessed. After 12 months of evaluation, we could observe a significant increase in the DMPA group in weight (3,01 kg) and BMI, while the IUD group's only significant increase was observed in the BMI. Relative to REE there was an increase of basal metabolic rate (BMR) in both groups after one year. The sub-group DMPA that gained HOMA-IR and waist circumference, with RQ significantly reduced. Our study found significant changes in weight, body composition and metabolic profile of the population studied in the first 12 months of contraceptive use. These changes mainly increased body weight, leptin levels and HOMA-IR which can contribute to the development of some chronic complications, including obesity, insulin resistance and diabetes mellitus.

  4. 12-month follow-up of an exploratory ‘brief intervention’ for high-frequency cannabis users among Canadian university students

    Directory of Open Access Journals (Sweden)

    Fischer Benedikt

    2012-04-01

    Full Text Available Abstract Background One in three young people use cannabis in Canada. Cannabis use can be associated with a variety of health problems which occur primarily among intensive/frequent users. Availability and effectiveness of conventional treatment for cannabis use is limited. While Brief Interventions (BIs have been shown to result in short-term reductions of cannabis use risks or problems, few studies have assessed their longer-term effects. The present study examined 12-month follow-up outcomes for BIs in a cohort of young Canadian high-frequency cannabis users where select short-term effects (3 months had previously been assessed and demonstrated. Findings N = 134 frequent cannabis users were recruited from among university students in Toronto, randomized to either an oral or a written cannabis BI, or corresponding health controls, and assessed in-person at baseline, 3-months, and 12-months. N = 72 (54 % of the original sample were retained for follow-up analyses at 12-months where reductions in ‘deep inhalation/breathholding’ (Q = 13.1; p  Conclusions The results confirm findings from select other studies indicating the potential for longer-term and sustained risk reduction effects of BIs for cannabis use. While further research is needed on the long-term effects of BIs, these may be a valuable – and efficient – intervention tool in a public health approach to high-risk cannabis use.

  5. GLUT4 protein expression in obese and lean 12-month-old rats: insights from different types of data analysis

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    P.M. Seraphim

    2001-10-01

    Full Text Available GLUT4 protein expression in white adipose tissue (WAT and skeletal muscle (SM was investigated in 2-month-old, 12-month-old spontaneously obese or 12-month-old calorie-restricted lean Wistar rats, by considering different parameters of analysis, such as tissue and body weight, and total protein yield of the tissue. In WAT, a ~70% decrease was observed in plasma membrane and microsomal GLUT4 protein, expressed as µg protein or g tissue, in both 12-month-old obese and 12-month-old lean rats compared to 2-month-old rats. However, when plasma membrane and microsomal GLUT4 tissue contents were expressed as g body weight, they were the same. In SM, GLUT4 protein content, expressed as µg protein, was similar in 2-month-old and 12-month-old obese rats, whereas it was reduced in 12-month-old obese rats, when expressed as g tissue or g body weight, which may play an important role in insulin resistance. Weight loss did not change the SM GLUT4 content. These results show that altered insulin sensitivity is accompanied by modulation of GLUT4 protein expression. However, the true role of WAT and SM GLUT4 contents in whole-body or tissue insulin sensitivity should be determined considering not only GLUT4 protein expression, but also the strong morphostructural changes in these tissues, which require different types of data analysis.

  6. Post-thoracotomy pain syndrome and sensory disturbances following thoracotomy at 6- and 12-month follow-ups.

    Science.gov (United States)

    Hetmann, Fredrik; Kongsgaard, Ulf E; Sandvik, Leiv; Schou-Bredal, Inger

    2017-01-01

    Persistent pain affects a large proportion of patients after thoracotomy and is associated with sensory disturbances. The objective of this prospective study was to investigate the time course of pain and sensory disturbances over a 12-month period. Patients scheduled for thoracotomy were recruited. Data were collected on the day before surgery, including baseline characteristics and the presence of any preoperative pain. At 6- and 12-month follow-ups, data on pain were collected using the Brief Pain Inventory-Short Form, and perceived sensory disturbances around the thoracotomy scar were recorded from a self-exploration test. At 12 months after surgery, 97 patients had complete data including baseline and 6-and 12-month measurements. Almost half of the patients reported post-thoracotomy pain at the follow-ups. However, 20% of the patients not reporting post-thoracotomy pain at 6 months did report it at 12 months. Between 40% and 60% of patients experienced some kind of sensory disturbance at 6 months. A small decline in some kind of sensory disturbance was reported by 20%-50% of patients at 12 months. A proportion of patients experienced either resolved or delayed onset of pain. Sensory changes were strongly associated with post-thoracotomy pain syndrome, but were also present in a large proportion of patients without it.

  7. The Effect of Weaning Food on the Body Weight of 6-12 Months Infants in Posyandu Kutoharjo Village, Kaliwungu, Kendal

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    Nur Nahdloh

    2013-12-01

    Full Text Available According to Central Java Riskesdas in 2007 the severe malnutrition rate was 4.0%, while the rate in Kendal district was 3.1%. The age of 6-12 months is important because it is transition from liquid to solid foods. A purely breast milk diet is unsufficient to meet the nutritional needs of a fast growing baby growth. Weaning diet for baby is necessary to prevent growth disorder. The aim of the study was to assess the effect of weaning diet on weight gain of 6-12 month infant in posyandu (intergrated health center of Kutoharjo Kaliwungu Kendal. The study was an analytic observational study with a cross sectional design. 87 samples were taken from the visits of children aged 6-12 months in the posyandu consisted of 53 boys and 34 girls who met the inclusion and exclusion criteria. The informations of weaning diet was obtained by questionare and interview. The results classified the baby into two groups namely the appropiate groups and inappropriate groups. The infant’s growth was assessed using the growth chart for the previous two months. Data were analyzed by Chi-Square Test. 51 (58.6% infants fed of the appropriate solid foods, 44 (50.6% had a good weight gain growth and only 7 (8% infants has a bad weight gain. While of 36 (41.4% infants fed inappropriate weaning diet, 30 (34.5% infants had a bad weight gain and only 6 (6.9% infants had a good weight gain. The Chi-Square analysis showed p-value of 0.000 (p<0.05, which means that there was a significant difference between the two groups. The weaning food affect on weight gain of 6-12 month infants in posyandu Kutoharjo village Kaliwungu Kendal.

  8. Maternal complications in pregnancy and wheezing in early childhood

    DEFF Research Database (Denmark)

    Zugna, Daniela; Galassi, Claudia; Annesi-Maesano, Isabella

    2015-01-01

    complications and wheezing symptoms in the offspring. Exposures of interest included hypertension and preeclampsia, diabetes, as well as pre-pregnancy overweight (body mass index between 25 and 29.9) and obesity (body mass index ≥ 30) compared with normal weight (body mass index between 18.5 and 24.9). Outcomes.......04 (95% CI: 0.97-1.13) and 1.24 (95% CI: 0.86-1.79) for diabetes; 1.08 (95% CI: 1.05-1.11) and 1.19 (95% CI: 1.12-1.26) for overweight; 1.12 (95% CI: 1.08-1.17) and 1.16 (95% CI: 0.97-1.39) for obesity. No heterogeneity was found in RR estimates among the cohorts, except for diabetes and recurrent...... wheezing (P=0.027). CONCLUSIONS: Preeclampsia, maternal pre-pregnancy overweight and obesity are associated with an increase risk of wheezing in the offspring....

  9. Preconceptional exposure to oral contraceptive pills and the risk of wheeze, asthma and rhinitis in children

    Directory of Open Access Journals (Sweden)

    Kiwako Yamamoto-Hanada

    2016-07-01

    Conclusions: Our findings suggest that maternal OCP use has a role in the development of wheeze, asthma and rhinitis in children. Extended use of OCP is likely to increase the risk of wheeze and rhinitis.

  10. A young child with a history of wheeze

    DEFF Research Database (Denmark)

    Paton, James; Bindels, Patrick; McMurray, Ann

    2017-01-01

    The parents of a 3-year old boy are anxious about their son who has recurring episodes of wheezing. They are frustrated that no one seems to be able to give them answers to their questions and would like a referral to a specialist. Does their son have asthma and what is the prognosis; how can...... the recurrent wheezing be managed and can the risk of asthma be reduced; are there lifestyle changes that could improve the environment and avoid triggers? Communication and support from the family practice team were essential. Listening to the parents’ concerns, explaining the diagnostic uncertainty, being...

  11. A young child with a history of wheeze

    DEFF Research Database (Denmark)

    Paton, James; Bindels, Patrick; McMurray, Ann

    2017-01-01

    The parents of a 3-year old boy are anxious about their son who has recurring episodes of wheezing. They are frustrated that no one seems to be able to give them answers to their questions and would like a referral to a specialist. Does their son have asthma and what is the prognosis; how can the...... realistic about what drug treatments could achieve, and providing practical advice on inhaler use and trigger avoidance reassured the parents that there was a strategy for managing their son’s wheeze. The specialist referral was postponed....

  12. Endotoxin as a determinant of asthma and wheeze among rural dwelling children and adolescents: A case–control study

    Directory of Open Access Journals (Sweden)

    Lawson Joshua A

    2012-09-01

    Full Text Available Abstract Background The association between endotoxin exposure and asthma is complex and has been associated with rural living. We examined the relationship between domestic endotoxin and asthma or wheeze among rural school-aged children (6–18 years and assessed the interaction between endotoxin and other characteristics with these outcomes. Methods Between 2005 and 2007 we conducted a case–control study of children 6–18 years in the rural region of Humboldt, Canada. Cases (n = 102 reported doctor-diagnosed asthma or wheeze in the past year. Controls (n = 208 were randomly selected from children without asthma or wheeze. Data were collected to ascertain symptoms, asthma history and indoor environmental exposures (questionnaire, endotoxin (dust collection from the play area floor and child’s mattress, and tobacco smoke exposure (saliva collection. Statistical testing was completed using multiple logistic regression to account for potential confounders and to assess interaction between risk factors. A stratified analysis was also completed to examine the effect of personal history of allergy. Results Among children aged 6–12 years, mattress endotoxin concentration (EU/mg and load (EU/m2 were inversely associated with being a case [odds ratio (OR = 0.44, 95% confidence interval (CI = 0.20-0.98; and OR = 0.38, 95% CI = 0.20-0.75, respectively]. These associations were not observed in older children or with play area endotoxin. Conclusions Our results suggest that endotoxin exposure might be protective for asthma or wheeze. The protective effect is found in younger school-aged, non-allergic children. These results may help explain the inconsistencies in previous studies and suggest that the protective effects of endotoxin in the prevention of atopy and asthma or wheeze are most effective earlier in life.

  13. Frequency of cardiovascular risk factors before and 6 and 12 months after bariatric surgery.

    Science.gov (United States)

    Silva, Maria Alayde Mendonça da; Rivera, Ivan Romero; Barbosa, Emília Maria Wanderley de Gusmão; Crispim, Maria Angélica Correia; Farias, Guilherme Costa; Fontan, Alberto Jorge Albuquerque; Bezerra, Rodrigo Azavedo; Sá, Larissa Gabriella de Souza

    2013-01-01

    To compare the frequency of cardiovascular risk factors (CVRFs) in obese patients of the Brazilian Unified Health System (Sistema Único de Saúde - SUS) with indication of bariatric surgery during the preoperative period and after the sixth month and the first year of the procedure. An observational, longitudinal, prospective, and analytical study was performed, with consecutive selection of obese patients with indication for surgery referred to preoperative cardiac evaluation. The protocol consisted of: medical history, physical examination, electrocardiogram, echocardiogram, and biochemical analysis. This study analyzed the following variables: weight, body mass index (BMI), waist circumference (WC), systemic arterial hypertension (SAH), diabetes mellitus type 2(DM), dyslipidemia (high LDL cholesterol; low HDL cholesterol; hypertriglyceridemia), and metabolic syndrome (MS). The chi-squared test and the Tukey-Kramer method were used for statistical analysis. The sample was composed of 96 obese people, among which 86 were women, aged between 18 and 58 years old (median 35 years old). At the end of six months, significant reductions of 88%, 95%, 71%, 89%, and 80% in the frequency of SAH, high LDL cholesterol, hypertriglyceridemia, DM, and MS could already be observed. A significant and small reduction in the frequency of low HDL cholesterol (24%) and abnormal WC (31%) was observed only at the end of 12 months. After six months and one year, weight and BMI experienced reductions of 33.4kg and 44.3kg, and 13.1kg/m(2) and 17.2kg/m(2), respectively. The positive impact on weight loss and the reduction in BMI, WC, and in the frequency of CVRFs are already extremely significant after six months and remain so one year after bariatric surgery. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

  14. Do Patient Demographics and Patient-Reported Outcomes Predict 12-Month Loss to Follow-Up After Spine Surgery?

    Science.gov (United States)

    Sielatycki, J Alex; Parker, Scott L; Godil, Saniya S; McGirt, Matthew J; Devin, Clinton J

    2015-12-01

    Analysis of patients in a prospective registry. To determine the association between patient demographics, outcomes, and loss to follow-up 12 months after spine surgery. Obtaining outcomes 12 months after spine surgery remains a challenge. Loss to follow-up is believed to introduce biases and portend poor outcomes. Associations between follow-up, patient demographics, and outcomes in the degenerative spine population have not been studied. Patients undergoing surgery for degenerative spine disease at a single institution over a 2-year period were enrolled in a prospective registry. Patient demographics, comorbidities, treatment variables, readmissions/reoperations, and all 90-day surgical morbidity were collected. Patient-reported outcomes were recorded at baseline, 3-months, and 12-months after surgery. Multivariate logistic regression analysis was done to identify predictors of loss to follow-up. A total of 1484 patients with baseline and 3-month outcomes were included. Two hundred thirty-three (15.7%) patients were lost to follow-up at 12 months. There was no difference in the baseline demographics (Sex: P = 0.46) and comorbidities (American Society of Anesthesiologists Grade: P = 0.06) of patients who had follow-up at 12-months versus those who did not, except age and employment status. Patients lost to follow-up at 12 months were younger (51.0 vs. 57.1 years; P 0.05). There was no difference in 90-day morbidity (17.2% vs. 16.2%; P = 0.70) and 3-month pain, disability, quality of life, and patient satisfaction (85.0% vs. 88.3%; P = 0.63) (P > 0.05). In multivariate model, only younger age (P spine registry the 12-month loss to follow-up rate is approximately 15%. The only independent predictor of loss to follow-up is younger age and preoperative employment. 3.

  15. Antibiotic therapy versus no antibiotic therapy for children aged two to 59 months with WHO-defined non-severe pneumonia and wheeze.

    Science.gov (United States)

    Lassi, Zohra S; Kumar, Rohail; Das, Jai K; Salam, Rehana A; Bhutta, Zulfiqar A

    2014-05-26

    Worldwide, pneumonia is the leading cause of death among children under five years of age and accounts for approximately two million deaths annually. The World Health Organization (WHO) has developed case management guidelines based on simple clinical signs to help clinicians decide on the appropriate pneumonia treatment. Children and infants who exhibit fast breathing (50 breaths per minute or more in infants two months to 12 months of age and 40 or more in children 12 months to five years of age) and cough are presumed to have non-severe pneumonia and the WHO recommends antibiotics. Implementation of these guidelines to identify and manage pneumonia at the community level has been shown to reduce acute respiratory infection (ARI)-related mortality by 36%, although apprehension exists regarding these results due to the questionable quality of evidence. As WHO guidelines do not make a distinction between viral and bacterial pneumonia, these children continue to receive antibiotics because of the concern that it may not be safe to do otherwise. Therefore, it is essential to explore the role of antibiotics in children with WHO-defined non-severe pneumonia and wheeze and to develop effective guidelines for initial antibiotic treatment. To evaluate the efficacy of antibiotic therapy versus no antibiotic therapy for children aged two to 59 months with WHO-defined non-severe pneumonia and wheeze. We searched CENTRAL (2014, Issue 1), MEDLINE (1946 to March week 3, 2014), EMBASE (January 2010 to March 2014), CINAHL (1981 to March 2014), LILACS (1982 to March 2014), Networked Digital Library of Theses and Dissertations (23 July 2013) and Web of Science (1985 to March 2014). Randomised controlled trials (RCTs) evaluating the efficacy of antibiotic therapy versus no antibiotic therapy for children aged two to 59 months with non-severe pneumonia and wheeze. We considered studies that defined non-severe pneumonia as cough or difficulty in breathing with a respiratory rate above

  16. Recurrent wheezing in relation to environmental risk factors in infancy. A prospective study of 276 infants

    DEFF Research Database (Denmark)

    Halken, S; Høst, A; Husby, S

    1991-01-01

    Clinical course and environmental factors were recorded in a prospective study of 276 unselected infants followed from birth to the age of 18 months. The study was performed with a questionnaire at the age of 6 and 12 months and a physical examination at 18 months. Fifty-nine (21%) of the children...... had greater than or equal to 2 episodes of wheezing before they were 18 months old. A total of 58 (21%) of the children belonged to the lowest social class V, 182 (66%) were daily exposed to passive tobacco smoking at home and/or in daycare, 164 (59%) were breastfed greater than or equal to 3 months......, 192 (70%) were in daycare, 62 (22%) lived in flats and 167 (61%) were in daily contact with furred pets at home and/or in daycare. In social class V a preponderance of children were exposed to passive tobacco smoking, a majority were living in flats and a minority were breastfed greater than or equal...

  17. Hepatitis C Virus (HCV) Vertical Transmission in 12-Month-Old Infants Born to HCV-Infected Women and Assessment of Maternal Risk Factors

    OpenAIRE

    Jhaveri, Ravi; Hashem, Mohamed; El-Kamary, Samer S.; Saleh, Doa'a A.; Sharaf, Sahar A.; El-Mougy, Fatma; Abdelsalam, Lobna; Ehab, Mohamed; El-Ghazaly, Hesham

    2015-01-01

    Background. ?Hepatitis C virus (HCV) is an underappreciated cause of pediatric liver disease, most frequently acquired by vertical transmission (VT). Current guidelines that include the option of screening infants for HCV RNA at 1?2 months are based on data prior to current real-time polymerase chain reaction (PCR)-based testing. Previous studies have demonstrated VT rates of 4%?15% and an association with high maternal viral load. We evaluated HCV RNA in infants with HCV VT and assessed mate...

  18. Effect of Linear Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction-12-Month Follow-Up of a Randomized, Double-Blinded, Sham-Controlled Study.

    Science.gov (United States)

    Fojecki, Grzegorz Lukasz; Tiessen, Stefan; Osther, Palle Jørn Sloth

    2018-03-01

    Short-term data on the effect of low-intensity extracorporeal shockwave therapy (Li-ESWT) on erectile dysfunction (ED) have been inconsistent. The suggested mechanisms of action of Li-ESWT on ED include stimulation of cell proliferation, tissue regeneration, and angiogenesis, which can be processes with a long generation time. Therefore, long-term data on the effect of Li-ESWT on ED are strongly warranted. To assess the outcome at 6 and 12 months of linear Li-ESWT on ED from a previously published randomized, double-blinded, sham-controlled trial. Subjects with ED (N = 126) who scored lower than 25 points in the erectile function domain of the International Index of Erectile Function (IIEF-EF) were eligible for the study. They were allocated to 1 of 2 groups: 5 weekly sessions of sham treatment (group A) or linear Li-ESWT (group B). After a 4-week break, the 2 groups received active treatment once a week for 5 weeks. At baseline and 6 and 12 months, subjects were evaluated by the IIEF-EF, the Erectile Hardness Scale (EHS), and the Sexual Quality of Life in Men. The primary outcome measure was an increase of at least 5 points in the IIEF-EF (ΔIIEF-EF score). The secondary outcome measure was an increase in the EHS score to at least 3 in men with a score no higher than 2 at baseline. Data were analyzed by linear and logistic regressions. Linear regression of the ΔIIEF-EF score from baseline to 12 months included 95 patients (dropout rate = 25%). Adjusted for the IIEF-EF score at baseline, the difference between groups B and A was -1.30 (95% CI = -4.37 to 1.77, P = .4). The success rate based on the main outcome parameter (ΔIIEF-EF score ≥ 5) was 54% in group A vs 47% in group B (odds ratio = 0.67, P = .28). Improvement based on changes in the EHS score in groups A and B was 34% and 24%, respectively (odds ratio = 0.47, P = .82). Exposure to 2 cycles of linear Li-ESWT for ED is not superior to 1 cycle at 6- and 12-month follow-ups. Fojecki GL, Tiessen S

  19. Classification and pharmacological treatment of preschool wheezing: changes since 2008

    DEFF Research Database (Denmark)

    Brand, P. L. P.; Caudri, D.; Eber, E.

    2014-01-01

    Since the publication of the European Respiratory Society Task Force report in 2008, significant new evidence has become available on the classification and management of preschool wheezing disorders. In this report, an international consensus group reviews this new evidence and proposes some...

  20. Nutritional status and childhood wheezing in rural Bangladesh.

    Science.gov (United States)

    Hawlader, Mohammad Delwer Hossain; Noguchi, Emiko; El Arifeen, Shams; Persson, Lars Åke; Moore, Sophie E; Raqib, Rubhana; Wagatsuma, Yukiko

    2014-07-01

    To investigate the association between current childhood nutritional status and current wheezing among pre-school children in rural Bangladesh. Cross-sectional study. Matlab region, rural Bangladesh. Children (n 912) aged 4·5 years. Anthropometric measurements of the mothers and their children were taken during a 1-year period from December 2007 to November 2008. Current wheezing was identified using the International Study of Asthma and Allergies in Childhood questionnaire. Serum total IgE was measured by human IgE quantitative ELISA. IgE specific antibody to dust mites (Dermatophagoides pteronyssinus) was measured by the CAP-FEIA system (Phadia AB, Uppsala, Sweden). Wheezing at 4·5 years old was significantly associated with stunting (OR = 1·58; 95 % CI 1·13, 2·22) and underweight (OR = 1·39; 95 % CI 1·00, 1·94). The association with stunting remained significant after adjustment for sex, birth weight, birth length, gestational age at birth, mother's parity, maternal BMI, family history of asthma, socio-economic status, season of birth and intervention trial arm (OR = 1·74; 95 % CI 1·19, 2·56). Stunting was a significant risk factor for wheezing among rural Bangladeshi children. Further studies will be required to confirm the relationship between nutritional status and allergic illnesses in developing countries.

  1. Classification and pharmacological treatment of preschool wheezing : changes since 2008

    NARCIS (Netherlands)

    Brand, Paul L. P.; Caudri, Daan; Eber, Ernst; Gaillard, Erol A.; Garcia-Marcos, Luis; Hedlin, Gunilla; Henderson, John; Kuehni, Claudia E.; Merkus, Peter J. F. M.; Pedersen, Soren; Valiuis, Arunas; Wennergren, Goeran; Bush, Andrew

    Since the publication of the European Respiratory Society Task Force report in 2008, significant new evidence has become available on the classification and management of preschool wheezing disorders. In this report, an international consensus group reviews this new evidence and proposes some

  2. Classification and pharmacological treatment of preschool wheezing: changes since 2008

    NARCIS (Netherlands)

    Brand, P.L.P.; Caudri, D.; Eber, E.; Gaillard, E.A.; Garcia-Marcos, L.; Hedlin, G.; Henderson, J.; Kuehni, C.E.; Merkus, P.J.F.M.; Pedersen, S.; Valiulis, A.; Wennergren, G.; Bush, A.

    2014-01-01

    Since the publication of the European Respiratory Society Task Force report in 2008, significant new evidence has become available on the classification and management of preschool wheezing disorders. In this report, an international consensus group reviews this new evidence and proposes some

  3. The clinical use of exhaled nitric oxide in wheezing children

    Directory of Open Access Journals (Sweden)

    Pedro Martins

    2008-03-01

    Full Text Available The body of published work on the role of exhaled nitric oxide (FENO in the study of bronchial inflammation allows it to be classed as a simple, non-invasive measurement that is very useful in evaluating asthmatic patients.During a prospective study into the effects of air pollution on the health of the population of Viseu (Saud’AR Project, children with a clinical history of wheezing were identified through using the International Study of Asthma and Allergy in Childhood (ISAAC questionnaire. Children later filled in a new standardised questionnaire and underwent skin-prick-tests, spirometry and FENO measurement. Their mean age was 7.8 ± 1.1 years. Comparing those who wheezed in the 6 months before evaluation (n = 27 with those who didn’t, statistical differences for ΔFEV1 (8% median versus 4.5%, p = 0.0399 and for FENO (23 ppb median versus 12 ppb, p = 0.0195, respectively were observed. Concerning children who needed a bronchodilator in the six previous months (n = 19 and those who didn’t, there was also a statistically significant difference in FENO: 27 ppb median versus 11 ppb median, respectively; p < 0.0001. When comparing children who needed an unscheduled medical appointment in the six months previous to the evaluation (n = 9 and those who didn’t, there was also significant differences for FENO: 28 ppb median versus 13 ppb median, p = 0.0029. In conclusion, the existence of symptoms seems to be better related to FENO than spirometry. Resumo: Encontram-se publicados múltiplos trabalhos sobre o papel das determinações do óxido nítrico no ar exalado (FENO no âmbito do estudo da inflamação brônquica que nos permitem afirmar que se trata duma medição simples, não invasiva e de grande utilidade na avaliação do doente asmático.No decurso de um estudo prospectivo sobre o impacto da poluição do ar sobre a saúde da

  4. Double-blind randomized 12-month soy intervention had no effects on breast MRI fibroglandular tissue density or mammographic density

    Science.gov (United States)

    Wu, Anna H.; Spicer, Darcy; Garcia, Agustin; Tseng, Chiu-Chen; Hovanessian-Larsen, Linda; Sheth, Pulin; Martin, Sue Ellen; Hawes, Debra; Russell, Christy; McDonald, Heather; Tripathy, Debu; Su, Min-Ying; Ursin, Giske; Pike, Malcolm C.

    2015-01-01

    Soy supplementation by breast cancer patients remains controversial. No controlled intervention studies have investigated the effects of soy supplementation on mammographic density in breast cancer patients. We conducted a double-blind, randomized, placebo-controlled intervention study in previously treated breast cancer patients (n=66) and high-risk women (n=29). We obtained digital mammograms and breast magnetic resonance imaging (MRI) scans at baseline and after 12 months of daily soy (50 mg isoflavones per day) (n=46) or placebo (n=49) tablet supplementation. The total breast area (MA) and the area of mammographic density (MD) on the mammogram was measured using a validated computer-assisted method, and mammographic density percent (MD% = 100 × MD/MA) was determined. A well-tested computer algorithm was used to quantitatively measure the total breast volume (TBV) and fibroglandular tissue volume (FGV) on the breast MRI, and the FGV percent (FGV% = 100 × FGV/TBV) was calculated. On the basis of plasma soy isoflavone levels, compliance was excellent. Small decreases in MD% measured by the ratios of month 12 to baseline levels, were seen in the soy (0.95) and the placebo (0.87) groups; these changes did not differ between the treatments (P=0.38). Small decreases in FGV% were also found in both the soy (0.90) and the placebo (0.92) groups; these changes also did not differ between the treatments (P=0.48). Results were comparable in breast cancer patients and high-risk women. We found no evidence that soy supplementation would decrease mammographic density and that MRI might be more sensitive to changes in density than mammography. PMID:26276750

  5. Analysis of correlation between initial alveolar bone density and apical root resorption after 12 months of orthodontic treatment without extraction

    Directory of Open Access Journals (Sweden)

    Paula Cabrini Scheibel

    2014-10-01

    Full Text Available OBJECTIVE: The aim of the present study was to investigate the correlation between initial alveolar bone density of upper central incisors (ABD-UI and external apical root resorption (EARR after 12 months of orthodontic movement in cases without extraction. METHODS: A total of 47 orthodontic patients 11 years old or older were submitted to periapical radiography of upper incisors prior to treatment (T1 and after 12 months of treatment (T2. ABD-UI and EARR were measured by means of densitometry. RESULTS: No statistically significant correlation was found between initial ABD-UI and EARR at T2 (r = 0.149; p = 0.157. CONCLUSION: Based on the present findings, alveolar density assessed through periapical radiography is not predictive of root resorption after 12 months of orthodontic treatment in cases without extraction.

  6. The 12-month effects of structured lifestyle advice and pelvic floor muscle training for pelvic organ prolapse

    DEFF Research Database (Denmark)

    Due, Ulla; Brostrøm, Søren; Lose, Gunnar

    2016-01-01

    INTRODUCTION: We evaluated the 12-month effects of adding pelvic floor muscle training to a lifestyle advice program in women with symptomatic pelvic organ prolapse stage II-III and the number of women who had sought further treatment. MATERIAL AND METHODS: This study was a 12-month follow up...... of a randomized controlled trial comparing a structured lifestyle advice program alone (lifestyle group) or in combination with pelvic floor muscle training (training and lifestyle group). Both programs consisted of six separate group sessions within 12 weeks. RESULTS: Data were available from 83 (76%) of the 109...... surgery. More severe anterior prolapse and more bladder symptoms at the 3-month follow up were significantly associated with having sought further treatment in both groups. CONCLUSIONS: At 12-month follow up, the effects of adding pelvic floor muscle training to a structured lifestyle advice program were...

  7. Objectively measured physical activity and 12-month trajectories of neck-shoulder pain in workers: A prospective study in DPHACTO.

    Science.gov (United States)

    Hallman, David M; Birk Jørgensen, Marie; Holtermann, Andreas

    2017-05-01

    This study aimed to investigate the association between objectively measured physical activity at work and leisure and the intensity (mean level and time course) of neck-shoulder pain (NSP) over 12 months among male and female blue collar workers. Data were obtained from 625 blue collar workers from the Danish cohort DPHACTO. Physical activity was measured objectively at baseline using accelerometers. The percentage of time spent in physical activity (walking, climbing stairs, running and cycling) was calculated for both work and leisure time. Longitudinal data on the intensity of NSP (numerical rating scale 0-10) were collected using text messages every fourth week over 12 months. Linear mixed models were used to investigate the associations between occupational physical activity (OPA) and leisure time physical activity (LTPA) and the trajectories of the intensity of NSP, adjusted for individual, biomechanical and psychosocial factors, and baseline pain. OPA was not associated with the mean intensity of NSP over 12 months. LTPA was negatively associated with the mean intensity of NSP both among men ( B=-0.71, 95% CI -1.31 to -0.11) and women ( B=-0.85, 95% CI -1.57 to -0.13). Sex interactions on the 12-month trajectories of NSP showed that higher physical activity was associated with a slower reduction in NSP among men for OPA only ( B=0.03, 95% CI 0.01-0.05) and women for LTPA only ( B=0.05, 95% CI 0.00-0.09). We found that more time in LTPA was associated with a lower overall intensity of NSP over 12 months among blue collar workers. However, depending on sex and domain, high physical activity had an unfavourable effect on the course of NSP over 12 months.

  8. Histological analysis and identification of spermatogenesis-related genes in 2-, 6-, and 12-month-old sheep testes

    Science.gov (United States)

    Bai, Man; Sun, Limin; Zhao, Jia; Xiang, Lujie; Cheng, Xiaoyin; Li, Jiarong; Jia, Chao; Jiang, Huaizhi

    2017-10-01

    Testis development and spermatogenesis are vital factors that influence male animal fertility. In order to identify spermatogenesis-related genes and further provide a theory basis for finding biomarkers related to male sheep fertility, 2-, 6-, and 12-month-old Small Tail Han Sheep testes were selected to investigate the dynamic changes of sheep testis development. Hematoxylin-eosin routine staining and RNA-Seq technique were used to perform histological and transcriptome analysis for these testes. The results showed that 630, 102, and 322 differentially expressed genes (DEGs) were identified in 2- vs 6-month-old, 6- vs 12-month-old, and 2- vs 12-month-old testes, respectively. GO and KEGG analysis showed the following: DEGs in 2- vs 6-month-old testes were mainly related to the GO terms of sexual maturation and the pathways of multiple metabolism and biosynthesis; in 6- vs 12-month-old testes, most of the GO terms that DEGs involved in were related to metabolism and translation processes; the most significantly enriched pathway is the ribosome pathway. The union of DEGs in 2- vs 6-month-old, 6- vs 12-month-old, and 2- vs 12-month-old testes was categorized into eight profiles by series cluster. Subsequently, the eight profiles were classified into four model profiles and four co-expression networks were constructed based on the DEGs in these model profiles. Finally, 29 key regulatory genes related to spermatogenesis were identified in the four co-expression networks. The expression of 13 DEGs (CA3, APOH, MYOC, CATSPER4, SYT6, SERPINA10, DAZL, ADIPOR2, RAB13, CEP41, SPAG4, ODF1, and FRG1) was validated by RT-PCR.

  9. Indoor environmental factors associated with wheezing illness and asthma in South Korean children: phase III of the International Study of Asthma and Allergies in Childhood.

    Science.gov (United States)

    Chae, Yoomi; Hahm, Myung-Il; Ahn, Kangmo; Kim, Jihyun; Kim, Woo Kyung; Lee, So-Yeon; Park, Yong Mean; Han, Man Yong; Lee, Kee-Jae; Kwon, Ho-Jang

    2014-11-01

    The relationship between exposure to indoor environmental pollutants and incidence of asthma and wheezing illness in children is unclear. This study aimed to clarify this relationship by identifying the risk factors associated with these conditions in South Korean children aged 6-7 years. The parents or guardians of 3810 children aged 6-7 years who had participated in the International Study of Asthma and Allergies in Childhood and met the study criteria completed validated questionnaires regarding their children's asthma and wheezing illness, risk factors and exposure to indoor pollutants. The data were subjected to chi-square and multivariate logistic regression analysis to identify the factors significantly associated with asthma and wheezing illness. Parental history of allergic disease (odds ratio [OR]: 1.729; 95% confidence interval [CI]: 1.447-2.066), living on the basement or semi-basement floor (OR: 1.891; 95% CI: 1.194-2.996) and living in housing that had been remodeled within the last 12 months (OR: 1.376; 95% CI: 1.101-1.720) were found to be significantly associated with wheezing illness. Parental history of allergic disease (OR: 2.189; 95% CI: 1.483-3.231), male sex (OR: 1.971; 95% CI: 1.369-2.838) and positive skin prick test (SPT) result (OR: 1.583; 95% CI: 1.804-3.698) were found to be significantly associated with current asthma. Although the risk factors for current asthma appear to be more related to the non-modifiable risk factors like sex, parental history of allergic diseases, SPT, the two groups are associated with exposure to modifiable indoor environmental factors.

  10. Primary mucoepidermoid carcinoma at the carina of trachea presenting with wheezing in an asthmatic child mimicking an attack of asthma: A case report.

    Science.gov (United States)

    Lin, Chien-Heng; Chao, Yu-Hua; Wu, Kang-Hsi; Lin, Wei-Ching

    2016-11-01

    Asthma is a very common disease, but primary tracheal tumors are extremely rare in children. Wheezing is not pathognomonic, but is the typical presentation of asthma and could also be found in patients with tracheal tumors. This report describes a 12-year-old boy with a previous history of frequent asthma attacks and experienced responses to antiasthma treatment. He was admitted to the hospital due to persistent wheezing and progressive dyspnea. Hyperinflation in the bilateral lungs was detected on chest x-ray, but without other significant findings. Chest computed tomography revealed a mass at the carina. Tracheal mucoepidermoid carcinoma was diagnosed by histopathological assessment. Despite the rarity of tracheal tumors, chest computed tomography scans should be performed in the first place for children presenting persistent wheezing and having poor response to antiasthma treatment to rule out the other alternative diagnosis. Coexistence of other diseases such as tracheal tumor in asthmatic patients should be considered.

  11. Health-related quality of life among Danish patients 3 and 12 months after TIA or mild stroke

    DEFF Research Database (Denmark)

    Muus, Ingrid; Petzold, Max; Ringsberg, Karin C

    2010-01-01

    This paper aimed to describe health related quality of life three and 12 months after mild stroke or transient ischemic attack, TIA, to describe the perceived changes from pre to post stroke status and to examine sociodemographic determinants for health related quality of life.......This paper aimed to describe health related quality of life three and 12 months after mild stroke or transient ischemic attack, TIA, to describe the perceived changes from pre to post stroke status and to examine sociodemographic determinants for health related quality of life....

  12. Exercise-induced wheeze, urgent medical visits, and neighborhood asthma prevalence.

    Science.gov (United States)

    Mainardi, Timothy R; Mellins, Robert B; Miller, Rachel L; Acosta, Luis M; Cornell, Alexandra; Hoepner, Lori; Quinn, James W; Yan, Beizhan; Chillrud, Steven N; Olmedo, Omar E; Perera, Frederica P; Goldstein, Inge F; Rundle, Andrew G; Jacobson, Judith S; Perzanowski, Matthew S

    2013-01-01

    Exercise-induced wheeze (EIW) may identify a distinct population among asthmatics and give insight into asthma morbidity etiology. The prevalence of pediatric asthma and associated urgent medical visits varies greatly by neighborhood in New York City and is highest in low-income neighborhoods. Although increased asthma severity might contribute to the disparities in urgent medical visits, when controlling for health insurance coverage, we previously observed no differences in clinical measures of severity between asthmatic children living in neighborhoods with lower (3%-9%) versus higher (11%-19%) asthma prevalence. Among these asthmatics, we hypothesized that EIW would be associated with urgent medical visits and a child's neighborhood asthma prevalence. Families of 7- to 8-year-old children were recruited into a case-control study of asthma through an employer-based health insurance provider. Among the asthmatics (n = 195), prevalence ratios (PRs) for EIW were estimated. Final models included children with valid measures of lung function, seroatopy, and waist circumference (n = 140). EIW was associated with urgent medical visits for asthma (PR, 2.29; P = .021), independent of frequent wheeze symptoms. In contrast to frequent wheeze, EIW was not associated with seroatopy or exhaled NO, suggesting a distinct mechanism. EIW prevalence among asthmatics increased with increasing neighborhood asthma prevalence (PR, 1.09; P = .012), after adjustment for race, ethnicity, maternal asthma, environmental tobacco smoke, household income, and neighborhood income. EIW may contribute to the disparities in urgent medical visits for asthma between high- and low-income neighborhoods. Physicians caring for asthmatics should consider EIW an indicator of risk for urgent medical visits.

  13. 76 FR 6383 - Endangered and Threatened Species; 12-Month Finding on a Petition To Delist Coho Salmon South of...

    Science.gov (United States)

    2011-02-04

    ... near the edge of a species' range provide potential genetic benefits by fostering evolution in a.... 100323162-0595-02] RIN 0648-XV30 Endangered and Threatened Species; 12-Month Finding on a Petition To Delist... the Endangered Species Act (ESA) of 1973, as amended. Coho salmon populations in this region are...

  14. 75 FR 19592 - Endangered and Threatened Wildlife and Plants; 12-Month Finding on a Petition to List the Wyoming...

    Science.gov (United States)

    2010-04-15

    ... flows, plant diversity, and competitive interactions of plants (Tilman 1983, pp. 290-292; Huntly and...-0127] [MO 92210-0-0008-B2] Endangered and Threatened Wildlife and Plants; 12-Month Finding on a... business hours at the U.S. Fish and Wildlife Service, Wyoming Ecological Services Field Office, 5353...

  15. Clinical evaluation of fiber-reinforced composite crowns in pulp-treated primary molars: 12-month results.

    Science.gov (United States)

    Mohammadzadeh, Zahra; Parisay, Iman; Mehrabkhani, Maryam; Madani, Azam Sadat; Mazhari, Fatemeh

    2016-01-01

    The aim of this study was to evaluate the clinical performance of tooth-colored fiber-reinforced composite (FRC) crowns in pulp-treated second primary mandibular teeth. This split-mouth randomized, clinical trial performed on 67 children between 3 and 6 years with two primary mandibular second molars requiring pulp treatment. After pulp therapy, the teeth were randomly assigned to stainless steel crown (SSC) or FRC crown groups. Modified United States Public Health Service criteria were used to evaluate marginal integrity, marginal discoloration, and secondary caries in FRC crowns at intervals of 3, 6, and 12 months. Retention rate and gingival health were also compared between the two groups. The data were analyzed using Friedman, Cochran, and McNemar's tests at a significance level of 0.05. Intact marginal integrity in FRC crowns at 3, 6, and 12 months were 93.2%, 94.8%, and 94.2%, respectively. Marginal discoloration and secondary caries were not found at any of the FRC crowns. The retention rates of the FRC crowns were 100%, 98.3%, and 89.7% at 3, 6 and 12 months, respectively, whereas all the SSCs were found to be present and intact after 12 months ( P = 0.016). There was no statistically significant difference between the two groups in gingival health. According to the results of this study, it seems that when esthetics is a concern, in cooperative patients with good oral hygiene, FRC crowns can be considered as a valuable procedure.

  16. Health-related quality of life is related to cytokine levels at 12 months in patients with chronic heart failure

    DEFF Research Database (Denmark)

    Mommersteeg, Paula M C; Kupper, Nina; Schoormans, Dounya

    2010-01-01

    and change in MCS were related to increased 12-month sTNFR1 levels. All significant findings relate a worse HRQoL at baseline or a deterioration over time to increased sTNFR1/2 levels. These findings suggest that immune activation may be one of the pathways underlying the relationship between poor HRQo...

  17. Validity of the Fine Motor Area of the 12-Month Ages and Stages Questionnaire in Infants Following Major Surgery

    Science.gov (United States)

    Smith, Cally; Wallen, Margaret; Walker, Karen; Bundy, Anita; Rolinson, Rachel; Badawi, Nadia

    2012-01-01

    The Ages and Stages Questionnaires (ASQ) are parent-report screening tools to identify infants at risk of developmental difficulties. The purpose of this study was to examine validity and internal reliability of the fine motor developmental area of the ASQ, 2nd edition (ASQ2-FM) for screening 12-month-old infants following major surgery. The…

  18. Failure to Regain Function at 3 months After Acute Hospital Admission Predicts Institutionalization Within 12 Months in Older Patients

    NARCIS (Netherlands)

    Portegijs, Erja; Buurman, Bianca M.; Essink-Bot, Marie-Louise; Zwinderman, Aeilko H.; de Rooij, Sophia E.

    2012-01-01

    Objectives: To study the effects of functional decline on admission to long-term institutionalized care within 12 months from acute hospital admission. Design: Pooled analyses of 3 longitudinal cohorts. Setting: Tertiary and secondary hospital. Participants: A total of 1085 community-dwelling

  19. Effectiveness and Predictors of Continuation of Paliperidone Palmitate Long-Acting Injection Treatment: A 12-Month Naturalistic Cohort Study.

    Science.gov (United States)

    Whale, Richard; Pereira, Marco; Cuthbert, Sharon; Fialho, Renata

    2015-10-01

    Antipsychotic long-acting injectable (LAI) medication has an important place as a treatment option in schizophrenia with evolving evidence to support clinical benefit over oral medication. Paliperidone palmitate is recently licensed as an LAI. We studied a naturalistic cohort of all identifiable patients who initiated paliperidone LAI in a specific United Kingdom region (Sussex) from first availability up to January 2013 (n = 179). Favorably, 60% of the cohort continued paliperidone LAI beyond 12 months from initiation. Schizophrenia diagnosis was significantly associated with 12-month continuation on univariate analysis (65% continuation rate at 12 months in this diagnostic subgroup). No baseline variables were identified as independently associated with 12-month continuation. However, fewer inpatient days after initiation (odds ratio [OR], 1.01; 95% confidence interval [CI], 1.003-1.011; P = 0.002), dose adjustment up or down (OR, 3.46; 95% CI, 1.26-9.51; P = 0.016), and a higher maintenance dose (OR, 8.31; 95% CI, 1.84-37.51; P = 0.006) during treatment course were all independently associated with continuation on multivariate analysis. Our findings support the importance of a collaborative approach with the LAI recipient in treatment decision making to enhance treatment effectiveness.

  20. Evaluation of 6- and 12-month supervised exercise training on strength and endurance parameters in patients with peripheral arterial disease.

    Science.gov (United States)

    Pilz, Magdalena; Kandioler-Honetz, Elisabeth; Wenkstetten-Holub, Alfa; Doerrscheidt, Waltraud; Mueller, Rudolf; Kurz, Robert Wolfgang

    2014-06-01

    The classic symptom of peripheral arterial disease is the intermittent claudication (IC). Generally, endurance training is recommended to improve patients' walking performance. A potential benefit of the combination with strength training and the optimal duration of such an exercise program remain unclear. We evaluated the effects of a supervised exercise program combining endurance and strength training lasting 6 or 12 months in patients with IC. A total of 94 patients joined this study; 42 completed the 6-month training program (group A), whereas 52 patients completed the 12-month protocol (group B). Both groups exhibited a significant increase in all parameters evaluated, but greater benefit was found in the 12-month training group. The absolute claudication distance increased similarly by 27.5 and 29.5 %, respectively, in both groups (not significant); however, group B exhibited a greater increase in walking speed (12.1 vs. 5.3 %, p program significantly increases walking speed, absolute claudication distance, and muscle strength parameters. A greater benefit seems to result from a 12-month training program.

  1. 76 FR 63093 - Endangered and Threatened Wildlife and Plants; 12-Month Finding for a Petition To List the...

    Science.gov (United States)

    2011-10-11

    ... finding within the statutory timeframe. This 12-month finding resolves that issue. Subspecies Information... issue. Consequently, in our evaluation of whether or not to include introduced populations in the... Buckhouse 1985, p. 378; Armour et al. 1994, pp. 7-10). In some cases, excessive livestock grazing has...

  2. 75 FR 8601 - Endangered and Threatened Wildlife and Plants; 12-Month Finding on a Petition To List the Sonoran...

    Science.gov (United States)

    2010-02-25

    ... all available scientific and commercial information, we find that the Sonoran Desert Area population... remove this population from the List of Threatened and Endangered Wildlife once the District Court for... commercial information that listing may be warranted, we make a finding within 12 months of the date of our...

  3. 75 FR 30338 - Endangered and Threatened Wildlife and Plants; 12-month Finding on a Petition to List the White...

    Science.gov (United States)

    2010-06-01

    ... by available food resources (Clark 1977, p. 60). In warm weather, even in mid-winter, white-tailed... Petition to List the White-tailed Prairie Dog as Endangered or Threatened AGENCY: Fish and Wildlife Service... announce a 12-month finding on a petition to list the white-tailed prairie dog (Cynomys leucurus) as...

  4. Disruptions in brain networks of older fallers are associated with subsequent cognitive decline: a 12-month prospective exploratory study.

    Directory of Open Access Journals (Sweden)

    Chun Liang Hsu

    Full Text Available Cognitive impairment and impaired mobility are major public health concerns. There is growing recognition that impaired mobility is an early biomarker of cognitive impairment and dementia. The neural basis for this association is currently unclear. We propose disrupted functional connectivity as a potential mechanism. In this 12-month prospective exploratory study, we compared functional connectivity of four brain networks- the default mode network (DMN, fronto-executive network (FEN, fronto-parietal network (FPN, and the primary motor sensory network (SMN--between community-dwelling older adults with ≥ two falls in the last 12 months and their non-falling counterparts (≤ one fall in the last 12 months. Functional connectivity was examined both at rest and during a simple motor tapping task. Compared with non-fallers, fallers showed more connectivity between the DMN and FPN during right finger tapping (p  = 0.04, and significantly less functional connectivity between the SMN and FPN during rest (p ≤ 0.05. Less connectivity between the SMN and FPN during rest was significantly associated with greater decline in both cognitive function and mobility over the12-month period (r =  -0.32 and 0.33 respectively; p ≤ 0.04. Thus, a recent history of multiple falls among older adults without a diagnosis of dementia may indicate sub-clinical changes in brain function and increased risk for subsequent decline.

  5. Disruptions in brain networks of older fallers are associated with subsequent cognitive decline: a 12-month prospective exploratory study.

    Science.gov (United States)

    Hsu, Chun Liang; Voss, Michelle W; Handy, Todd C; Davis, Jennifer C; Nagamatsu, Lindsay S; Chan, Alison; Bolandzadeh, Niousha; Liu-Ambrose, Teresa

    2014-01-01

    Cognitive impairment and impaired mobility are major public health concerns. There is growing recognition that impaired mobility is an early biomarker of cognitive impairment and dementia. The neural basis for this association is currently unclear. We propose disrupted functional connectivity as a potential mechanism. In this 12-month prospective exploratory study, we compared functional connectivity of four brain networks- the default mode network (DMN), fronto-executive network (FEN), fronto-parietal network (FPN), and the primary motor sensory network (SMN)--between community-dwelling older adults with ≥ two falls in the last 12 months and their non-falling counterparts (≤ one fall in the last 12 months). Functional connectivity was examined both at rest and during a simple motor tapping task. Compared with non-fallers, fallers showed more connectivity between the DMN and FPN during right finger tapping (p  = 0.04), and significantly less functional connectivity between the SMN and FPN during rest (p ≤ 0.05). Less connectivity between the SMN and FPN during rest was significantly associated with greater decline in both cognitive function and mobility over the12-month period (r =  -0.32 and 0.33 respectively; p ≤ 0.04). Thus, a recent history of multiple falls among older adults without a diagnosis of dementia may indicate sub-clinical changes in brain function and increased risk for subsequent decline.

  6. The effects of anti-depressants on depression symptom scores at 12 months follow-up in patients with cardiometabolic disease: Results from a large primary care cohort

    Directory of Open Access Journals (Sweden)

    Bhautesh Dinesh Jani

    2015-01-01

    Full Text Available Background: Evidence on the long-term usefulness of anti-depressants in managing depression in cardiometabolic disease is limited. Aim: We examined the effects of anti-depressant prescribing on depressive symptoms at 12 months follow-up in patients with cardiometabolic disease and a positive depression screening result at baseline. Design and Setting: We retrospectively reviewed routine UK primary care data for patients with coronary heart disease, diabetes and previous stroke for the year 2008-2009. 35,537 patients with one of the three above diseases underwent depression screening using the Hospital Anxiety and Depression Scale (HADS-D. Of 7080 patients with a positive screening result (HADS-D ≥ 8, 3933 (55.5% patients had a repeat HADS-D recorded at 12 months follow-up. Methods: We compared the change in HADS-D at follow-up and remission rate in those who were prescribed anti-depressants (n = 223 against those who were not (n = 3710. Results: The mean change in HADS-D from baseline, for the nonprescribed group was similar to the reduction observed in patients who were continuously prescribed (n = 93 with anti-depressants during follow-up. Patients who were prescribed intermittently (n = 72 or only one (n = 58 prescription during follow-up had a lower reduction in HADS-D compared to the nonprescribed group. There was no difference in remission rates between continuously prescribed and the nonprescribed group, but remission was lower in patients prescribed intermittently and single prescription. Conclusion: Improvement in depressive symptoms in patients with cardiometabolic disease at 12 months was not any better in patients prescribed with anti-depressants compared to the nonprescribed group. The role of anti-depressants in the management of depression in cardiometabolic disease merits further investigation.

  7. The effects of anti-depressants on depression symptom scores at 12 months follow-up in patients with cardiometabolic disease: Results from a large primary care cohort.

    Science.gov (United States)

    Jani, Bhautesh Dinesh; Purves, David; Barry, Sarah J E; McCowan, Colin; Cavanagh, Jonathan; Mair, Frances S

    2015-01-01

    Evidence on the long-term usefulness of anti-depressants in managing depression in cardiometabolic disease is limited. We examined the effects of anti-depressant prescribing on depressive symptoms at 12 months follow-up in patients with cardiometabolic disease and a positive depression screening result at baseline. We retrospectively reviewed routine UK primary care data for patients with coronary heart disease, diabetes and previous stroke for the year 2008-2009. 35,537 patients with one of the three above diseases underwent depression screening using the Hospital Anxiety and Depression Scale (HADS-D). Of 7080 patients with a positive screening result (HADS-D ≥ 8), 3933 (55.5%) patients had a repeat HADS-D recorded at 12 months follow-up. We compared the change in HADS-D at follow-up and remission rate in those who were prescribed anti-depressants (n = 223) against those who were not (n = 3710). The mean change in HADS-D from baseline, for the nonprescribed group was similar to the reduction observed in patients who were continuously prescribed (n = 93) with anti-depressants during follow-up. Patients who were prescribed intermittently (n = 72) or only one (n = 58) prescription during follow-up had a lower reduction in HADS-D compared to the nonprescribed group. There was no difference in remission rates between continuously prescribed and the nonprescribed group, but remission was lower in patients prescribed intermittently and single prescription. Improvement in depressive symptoms in patients with cardiometabolic disease at 12 months was not any better in patients prescribed with anti-depressants compared to the nonprescribed group. The role of anti-depressants in the management of depression in cardiometabolic disease merits further investigation.

  8. Factors that mediate treatment outcome of sexually abused preschool children: six- and 12-month follow-up.

    Science.gov (United States)

    Cohen, J A; Mannarino, A P

    1998-01-01

    The role of familial, demographic, developmental, and treatment-mediating factors on treatment outcome of sexually abused preschool children was evaluated 6 and 12 months after treatment. Forty-three sexually abused preschool children and their parents who were evaluated shortly after disclosure of sexual abuse and then were provided with one of two treatment interventions were reevaluated at the completion of treatment and 6 and 12 months after treatment. Parents completed the Child Behavior Checklist, the Child Sexual Behavior Inventory, and the Weekly Behavior Report to measure a variety of emotional and behavioral symptoms in children. Parents also completed the Beck Depression Inventory, the Family Adaptability and Cohesion Evaluation Scales-III, the Parent Emotional Reaction Questionnaire, the Parental Support Questionnaire, and the Maternal Social Support Index. Children completed the Battelle Developmental Inventory and the Peabody Picture Vocabulary Test at pretreatment to assess developmental levels. Correlational and stepwise multiple regression analyses were conducted to analyze the role of the hypothesized mediating variables in predicting scores on outcome measures across the two treatment groups. While the Parent Emotional Reaction Questionnaire was the strongest familial predictor of treatment outcome at posttreatment, parental support became a stronger predictor of outcome at the 6- and 12-month follow-up points. Treatment group was the strongest overall predictor of outcome at posttreatment and at 12-month follow-up. Demographic and developmental factors did not strongly predict outcome. Findings indicate the strong impact of parental support on treatment outcome in sexually abused preschool children over the course of a 12-month follow-up and emphasize the importance of including parental interventions in treating sexually abused preschool children. They also support the superior effectiveness of cognitive-behavioral therapy over supportive

  9. The effect of persistence of cocaine use on 12-month outcomes for the treatment of heroin dependence.

    Science.gov (United States)

    Williamson, Anna; Darke, Shane; Ross, Joanne; Teesson, Maree

    2006-02-28

    To determine the effects of cocaine use across the study period on outcomes of treatment for heroin dependence 12 months post-treatment entry. Longitudinal cohort (12 months). Interviews were conducted at baseline, 3 and 12 months. Sydney, Australia. Four hundred ninety-five heroin users recruited for the Australian Treatment Outcome Study and re-interviewed at 12-month follow-up. Cocaine was widely used among treatment entrants in NSW, with almost all having a lifetime history of cocaine use and almost half having used in the month preceding baseline. While there was an overall decline in cocaine use across the study period, individual use patterns varied widely. Approximately half of the cohort did not report cocaine use at any data point, with the remainder reporting having used at one (29%), two (12%), or at all three (5%) points. Cocaine use across the study period was an independent predictor of most major treatment outcomes, with more cocaine use points predicting poorer outcome. Persistent cocaine use predicted a higher prevalence of homelessness, heroin use, daily injecting, needle sharing and injection-related health problems at 12 months as well as more extensive recent polydrug use. Cocaine use was common among individuals seeking treatment for primary heroin dependence in NSW. Any cocaine use over the study period was associated with poorer outcomes in virtually all areas. Persistent cocaine use over the study period, however, appeared particularly detrimental. Cocaine use among clients should evidently be a cause for concern amongst treatment providers and may warrant being specifically targeted during treatment.

  10. Progressive wheeze: atrial myxoma masquerading as chronic obstructive pulmonary disease.

    Science.gov (United States)

    Sinha, Aish; Apps, Andrew; Liong, Wei Chuen; Firoozan, Soroosh

    2015-07-23

    Atrial myxoma, the commonest primary cardiac neoplasm, presents with symptoms of heart failure, embolic phenomena or constitutional upset. We present an atypical case, with wheeze and symptomatic exacerbations typical of chronic obstructive pulmonary disease. With no early clinical evidence of heart failure, the patient was managed with inhaled steroids and bronchodilators, with little relief. Only when the patient was in extremis requiring intubation, due to respiratory failure, did clinical evidence of left heart failure become apparent, with echocardiography demonstrating a massive left atrial myxoma obstructing the mitral valve annulus. Following successful surgical resection, the patient's symptoms fully abated. This case highlights the importance of considering cardiac wheeze in those initially managed as obstructive airway disease not responding in a typical fashion to initial bronchodilator therapy, and particularly in those with rapidly progressive symptoms. Such patients should be referred early for cardiac imaging. The excellent prognosis and quick recovery after timely surgical resection of a myxoma are also highlighted. 2015 BMJ Publishing Group Ltd.

  11. Factors associated with the time to the first wheezing episode in infants : a cross-sectional study from the International Study of Wheezing in Infants (EISL)

    NARCIS (Netherlands)

    Pacheco-Gonzalez, Rosa M.; Mallol, Javier; Sole, Dirceu; Brand, Paul L. P.; Perez-Fernandez, Virginia; Sanchez-Solis, Manuel; Garcia-Marcos, Luis

    2016-01-01

    Male gender, asthmatic heredity, perinatal tobacco smoke exposure and respiratory infections have been associated with wheeze in the first years of life, among other risk factors. However, information about what factors modify the time to the first episode of wheeze in infants is lacking. The

  12. Prevalence of asthma and wheeze in the Highlands of Scotland.

    OpenAIRE

    Austin, J B; Russell, G; Adam, M G; Mackintosh, D; Kelsey, S; Peck, D F

    1994-01-01

    To establish the prevalence of asthma and wheeze in 12 year old children in a region with low background pollution levels, a population of children resident in the Highland Region of Scotland was studied by questionnaire supported by objective data. A respiratory questionnaire was distributed to the parents of 1919 children aged from 12-13 years and attending secondary schools in the educational divisions of Lochaber, Ross and Cromarty, and Inverness including Skye in Highland Region to ascer...

  13. Human rhinovirus infection in young African children with acute wheezing

    Directory of Open Access Journals (Sweden)

    Zar Heather J

    2011-03-01

    Full Text Available Abstract Background Infections caused by human rhinoviruses (HRVs are important triggers of wheezing in young children. Wheezy illness has increasingly been recognised as an important cause of morbidity in African children, but there is little information on the contribution of HRV to this. The aim of this study was to determine the role of HRV as a cause of acute wheezing in South African children. Methods Two hundred and twenty children presenting consecutively at a tertiary children's hospital with a wheezing illness from May 2004 to November 2005 were prospectively enrolled. A nasal swab was taken and reverse transcription PCR used to screen the samples for HRV. The presence of human metapneumovirus, human bocavirus and human coronavirus-NL63 was assessed in all samples using PCR-based assays. A general shell vial culture using a pool of monoclonal antibodies was used to detect other common respiratory viruses on 26% of samples. Phylogenetic analysis to determine circulating HRV species was performed on a portion of HRV-positive samples. Categorical characteristics were analysed using Fisher's Exact test. Results HRV was detected in 128 (58.2% of children, most (72% of whom were under 2 years of age. Presenting symptoms between the HRV-positive and negative groups were similar. Most illness was managed with ambulatory therapy, but 45 (35% were hospitalized for treatment and 3 (2% were admitted to intensive care. There were no in-hospital deaths. All 3 species of HRV were detected with HRV-C being the most common (52% followed by HRV-A (37% and HRV-B (11%. Infection with other respiratory viruses occurred in 20/128 (16% of HRV-positive children and in 26/92 (28% of HRV-negative samples. Conclusion HRV may be the commonest viral infection in young South African children with acute wheezing. Infection is associated with mild or moderate clinical disease.

  14. Outcomes of ≤6-month versus 12-month dual antiplatelet therapy after drug-eluting stent implantation

    Science.gov (United States)

    Villablanca, Pedro A.; Massera, Daniele; Mathew, Verghese; Bangalore, Sripal; Christia, Panagiota; Perez, Irving; Wan, Ningxin; Schulz-Schüpke, Stefanie; Briceno, David F.; Bortnick, Anna E.; Garcia, Mario J.; Lucariello, Richard; Menegus, Mark; Pyo, Robert; Wiley, Jose; Ramakrishna, Harish

    2016-01-01

    Abstract Background: The benefit of ≤6-month compared with 12-month dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) placement remains controversial. We performed a meta-analysis and meta-regression of ≤6-month versus 12-month DAPT in patients undergoing PCI with DES placement. Methods: We conducted electronic database searches of randomized controlled trials (RCTs) comparing DAPT durations after DES placement. For studies with longer follow-up, outcomes at 12 months were identified. Odds ratios and 95% confidence intervals were computed with the Mantel–Haenszel method. Fixed-effect models were used; if heterogeneity (I2) > 40 was identified, effects were obtained with random models. Results: Nine RCTs were included with total n = 19,224 patients. No significant differences were observed between ≤6-month compared with 12-month DAPT in all-cause mortality (OR 0.87; 95% confidence interval (CI): 0.69–1.11), cardiovascular (CV) mortality (OR 0.89; 95% CI: 0.66–1.21), non-CV mortality (OR 0.85; 95% 0.58–1.24), myocardial infarction (OR 1.10; 95% CI: 0.89–1.37), stroke (OR 0.97; 95% CI: 0.67–1.42), stent thrombosis (ST) (OR 1.37; 95% CI: 0.89–2.10), and target vessel revascularization (OR 0.95; 95% CI: 0.77–1.18). No significant difference in major bleeding (OR 0.72; 95% CI: 0.49–1.05) was observed, though the all-bleeding event rate was significantly lower in the ≤6-month DAPT group (OR 0.76; 95% CI: 0.59–0.96). In the meta-regression analysis, a significant association between bleeding events and non-CV mortality with 12-month DAPT was found, as well as between ST and mortality in addition to MI with ≤6-month DAPT. Conclusion: DAPT for ≤6 months is associated with similar mortality and ischemic outcomes but less bleeding events compared with 12-month DAPT after PCI with DES. PMID:28033306

  15. Effects of Miniscalpel-Needle Release on Chronic Neck Pain: A Retrospective Analysis with 12-Month Follow-Up.

    Directory of Open Access Journals (Sweden)

    Shuming Li

    Full Text Available Chronic neck pain is a highly prevalent condition, and is often treated with non-steroidal anti-inflammatory drugs. Limited clinical studies with short-term follow-up have shown promising efficacy of acupuncture as well as miniscalpel-needle (MSN release. In this retrospective study, we examined whether MSN release could produce long-lasting relief in patients with chronic neck pain.We retrieved the medical records of all patients receiving weekly MSN release treatment for chronic neck pain at this institution during a period from May 2012 to December 2013. Only cases with the following information at prior to, and 1, 6, and 12 months after the treatment, were included in the analysis: neck disability index (NDI, numerical pain rating scale (NPRS, and active cervical range of motion (CROM. The primary analysis of interest is comparison of the 12-month measures with the baseline. Patients who took analgesic drugs or massage within 2 weeks prior to assessment were excluded from the analysis. For MSN release, tender points were identified manually by an experienced physician, and did not necessarily follow the traditional acupuncture system. MSN was inserted vertically (parallel to the spine until breaking through resistance and patient reporting of distention, soreness or heaviness. The depth of the needling ranged from 10 to 50 mm. The release was carried out by moving the MSN up and down 3-5 times without rotation.A total of 559 cases (patients receiving weekly MSN release treatment for chronic neck pain were screened. The number of cases with complete information (NDI, NPRS, and CROM at baseline, 1, 6 and 12 months after last treatment was 180. After excluding the cases with analgesic treatment or massage within 2 weeks of assessment (n = 53, a total of 127 cases were included in data analysis. The number of MSN release session was 7 (range: 4-11. At 12 months after the treatment, both NPRS and NDI were significantly lower [3 (0, 9 vs. 7 (5, 10

  16. Mid- and long-term effects of family constellation seminars in a general population sample: 8- and 12-month follow-up.

    Science.gov (United States)

    Hunger, Christina; Weinhold, Jan; Bornhäuser, Annette; Link, Leoni; Schweitzer, Jochen

    2015-06-01

    In a previous randomized controlled trial (RCT), short-term efficacy of family constellation seminars (FCSs) in a general population sample was demonstrated. In this article, we examined mid- and long-term stability of these effects. Participants were 104 adults (M = 47 years; SD = 9; 84% female) who were part of the intervention group in the original RCT (3-day FCS; 64 active participants and 40 observing participants). FCSs were carried out according to manuals. It was predicted that FCSs would improve psychological functioning (Outcome Questionnaire OQ-45.2) at 8- and 12-month follow-up. Additionally, we assessed the effects of FCSs on psychological distress, motivational incongruence, individuals' experience in their personal social systems, and overall goal attainment. Participants yielded significant improvement in psychological functioning (d = 0.41 at 8-month follow-up, p = .000; d = 0.40 at 12-month follow-up, p = .000). Results were confirmed for psychological distress, motivational incongruence, the participants' experience in their personal social systems, and overall goal attainment. No adverse events were reported. This study provides first evidence for the mid- and long-term efficacy of FCSs in a nonclinical population. The implications of the findings are discussed. © 2014 Family Process Institute.

  17. Automatic detection of wheezes by evaluation of multiple acoustic feature extraction methods and C-weighted SVM

    Science.gov (United States)

    Sosa, Germán. D.; Cruz-Roa, Angel; González, Fabio A.

    2015-01-01

    This work addresses the problem of lung sound classification, in particular, the problem of distinguishing between wheeze and normal sounds. Wheezing sound detection is an important step to associate lung sounds with an abnormal state of the respiratory system, usually associated with tuberculosis or another chronic obstructive pulmonary diseases (COPD). The paper presents an approach for automatic lung sound classification, which uses different state-of-the-art sound features in combination with a C-weighted support vector machine (SVM) classifier that works better for unbalanced data. Feature extraction methods used here are commonly applied in speech recognition and related problems thanks to the fact that they capture the most informative spectral content from the original signals. The evaluated methods were: Fourier transform (FT), wavelet decomposition using Wavelet Packet Transform bank of filters (WPT) and Mel Frequency Cepstral Coefficients (MFCC). For comparison, we evaluated and contrasted the proposed approach against previous works using different combination of features and/or classifiers. The different methods were evaluated on a set of lung sounds including normal and wheezing sounds. A leave-two-out per-case cross-validation approach was used, which, in each fold, chooses as validation set a couple of cases, one including normal sounds and the other including wheezing sounds. Experimental results were reported in terms of traditional classification performance measures: sensitivity, specificity and balanced accuracy. Our best results using the suggested approach, C-weighted SVM and MFCC, achieve a 82.1% of balanced accuracy obtaining the best result for this problem until now. These results suggest that supervised classifiers based on kernel methods are able to learn better models for this challenging classification problem even using the same feature extraction methods.

  18. Serum cholinesterase activities distinguish between stroke patients and controls and predict 12-month mortality

    DEFF Research Database (Denmark)

    Ben Assayag, Einor; Shenhar-Tsarfaty, Shani; Ofek, Keren

    2010-01-01

    To date there is no diagnostic biomarker for mild stroke, although elevation of inflammatory biomarkers has been reported at early stages. Previous studies implicated acetylcholinesterase (AChE) involvement in stroke, and circulating AChE activity reflects inflammatory response, since acetylcholine...... suppresses inflammation. Therefore, carriers of polymorphisms that modify cholinergic activity should be particularly susceptible to inflammatory damage. Our study sought diagnostic values of AChE and Cholinergic Status (CS, the total capacity for acetylcholine hydrolysis) in suspected stroke patients....... For this purpose, serum cholinesterase activities, butyrylcholinesterase-K genotype and inflammatory biomarkers were determined in 264 ischemic stroke patients and matched controls during the acute phase. AChE activities were lower (P...

  19. 12-month Success of Cracked Teeth Treated with Orthograde Root Canal Treatment.

    Science.gov (United States)

    Krell, Keith V; Caplan, Daniel J

    2018-02-08

    Long-term studies examining the treatment outcomes of "cracked teeth" that received orthograde root canal treatment in the United States do not exist. The purpose of the present study was to examine the distribution and 1-year treatment outcomes of cracked teeth receiving orthograde root canal treatment in 1 private endodontic practice over a 25-year period. A total of 3038 cracked teeth were initially examined, and data from 2086 unique patients were analyzed. Pulpal and periapical diagnoses, year of treatment, tooth type, restorative material, and number of restored surfaces at the time of examination were recorded for all patients. Periodontal probing depths were also recorded. The patients' age and sex were added retrospectively for all patients whose data were available. Univariate frequency distributions for all collected variables were evaluated. Bivariate associations were analyzed between explanatory variables and the success of the root canal therapy. Of the 2086 cracked teeth observed among unique patients, the most common were mandibular second molars (36%) followed by mandibular first molars (27%) and maxillary first molars (18%). Among the 363 teeth eligible for multivariable regression analysis, 296 (82%) were deemed successes after 1 year. There were no statistically significant differences in success based on pulpal diagnosis (irreversible pulpitis, 85%; necrosis, 80%; previously treated, 74%), patients' age, sex, year of treatment, tooth type, restorative material, or number of restored surfaces at the time of examination. The 3 factors most significant in bivariate analyses were pocket depth, distal marginal ridge crack, and periapical diagnosis, which were used to generate a prognostic index for success of orthograde root canal therapy in cracked teeth called the Iowa Staging Index. The results of this study suggest that cracked teeth that received root canal treatment can have prognoses at higher success rates than previously reported. The

  20. Effects of 12 months aerobic exercise intervention on work ability, need for recovery, productivity and rating of exertion among cleaners

    DEFF Research Database (Denmark)

    Lidegaard, Mark; Søgaard, Karen; Krustrup, Peter

    2018-01-01

    PURPOSE: This study assessed the effects of a worksite aerobic exercise intervention among cleaners on: work ability, need for recovery, productivity, and rating of exertion. METHODS: In a monocentric randomised controlled trial in Denmark, 116, of 250 invited, cleaners were cluster-randomised (w......PURPOSE: This study assessed the effects of a worksite aerobic exercise intervention among cleaners on: work ability, need for recovery, productivity, and rating of exertion. METHODS: In a monocentric randomised controlled trial in Denmark, 116, of 250 invited, cleaners were cluster......-reported data on outcomes and sociodemographic information were collected at baseline, and at 4 and 12 month follow-up. All outcomes were analysed in a linear repeated-measures 2 × 2 mixed-model by an intention-to-treat analysis approach. RESULTS: Drop-out was 26 and 33% at 4 and 12 months, respectively...

  1. Development of socio-communicative skills in 9- to 12-month-old individuals with fragile X syndrome.

    Science.gov (United States)

    Marschik, Peter B; Bartl-Pokorny, Katrin D; Sigafoos, Jeff; Urlesberger, Leo; Pokorny, Florian; Didden, Robert; Einspieler, Christa; Kaufmann, Walter E

    2014-03-01

    We investigated the early socio-communicative development of individuals with fragile X syndrome (FXS) by undertaking a retrospective analysis of family videos. Videos were analyzed to identify existing communicative forms and functions. Analyses were undertaken on seven children who were later diagnosed with FXS. The children were filmed when they were 9-12 months old and before being diagnosed. Fourteen different communicative forms and six different communicative functions were observed. All participants were observed to express the functions of 'Attention to self' and 'Answering', but none indicated 'Requesting action', 'Requesting information', 'Choice making', or 'Imitating'. Results suggest that children with FXS may have a limited range of communicative forms and functions when they are from 9 to 12 months of age. However, further research is necessary to gain a specific developmental profile of socio-communicative forms and functions in FXS. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Efficacy and safety of dienogest in patients with endometriosis: A single-center observational study over 12 months.

    Science.gov (United States)

    Park, So Yun; Kim, Sung Hoon; Chae, Hee Dong; Kim, Chung-Hoon; Kang, Byung Moon

    2016-12-01

    To evaluate the efficacy and safety of dienogest treatment in patients who had received dienogest for 12 months or more to treat endometriosis. We analyzed the clinical data of 188 women with endometriosis who had been treated with 2 mg of dienogest once a day for 12 months or more at a single institute. We evaluated changes in endometriosis-associated pain and endometrioma size, recurrence rate, and adverse events following dienogest administration. Bone mineral density (BMD) was measured in patients who were prescribed dienogest for more than 18 months. Pain was significantly reduced at 12 months after dienogest medication. In those treated with dienogest due to recurrent endometrioma, the size of the endometrioma was significantly decreased at the 12-month and 18-month follow-ups. We found only one case of sonographic recurrence during dienogest administration among those who were treated postoperatively to prevent recurrence (1 of 114, 0.9%). The most common adverse drug reaction was uterine bleeding (3.2%), and other adverse events were generally tolerable and associated with low discontinuation rates (5.2%). Among the 50 patients in whom BMD was measured, 10 patients (20%) had a Z-score below the expected range for age. The administration of dienogest for a year or more seems to be highly effective in preventing recurrence after surgery, reducing endometriosis-associated pain, and decreasing the size of recurrent endometrioma, with a favorable safety and tolerability profile. However, BMD should be checked in patients on long-term medication due to possible bone loss in some women.

  3. Relationship between blood lead concentration and dietary intakes of infants from 3 to 12 months of age

    International Nuclear Information System (INIS)

    Schell, L.M.; Denham, Melinda; Stark, A.D.; Ravenscroft, Julia; Parsons, Patrick; Schulte, Elaine

    2004-01-01

    Data from a study of mother-infant pairs of low socioeconomic status living in Albany County, NY, were analyzed to determine the influence of diet and nutrition on the blood lead level of infants during the first year of life. Children's diets were assessed at 3-month intervals using a 24-h diet recall as reported by the primary caregiver. The potential impact of dietary consumption of protein, iron, zinc, calcium, vitamin D, and fat, as well as serum vitamin D and ferritin on blood lead levels at 6 and 12 months of age was examined with multivariable statistical analyses, controlling for other influences on lead levels. Neonates' blood lead levels were low at birth (geometric mean=1.6 μg/dL), and none were elevated (≥10 μg/dL). By 12 months, the mean blood lead for this sample was 5.1 μg/dL, and 18% of the sample had an elevated blood lead level. We observed significant inverse relationships between infants' 6-month lead level and their intake of zinc, iron, and calcium. At 12 months, low iron intake continued to be associated with higher lead levels, although zinc and calcium did not. Protein had a paradoxical effect, being associated with lower lead at 6 months, but higher lead at 12 months. Serum vitamin D and ferritin were not associated with lead levels, nor was vitamin supplement use. The results reported here emphasize the value of key minerals in the diet to reduce lead absorption during early infancy

  4. A Systematic Review to Define the Speech and Language Benefit of Early (<12 Months) Pediatric Cochlear Implantation.

    Science.gov (United States)

    Bruijnzeel, Hanneke; Ziylan, Fuat; Stegeman, Inge; Topsakal, Vedat; Grolman, Wilko

    2016-01-01

    This review aimed to evaluate the additional benefit of pediatric cochlear implantation before 12 months of age considering improved speech and language development and auditory performance. We conducted a search in PubMed, EMBASE and CINAHL databases and included studies comparing groups with different ages at implantation and assessing speech perception and speech production, receptive language and/or auditory performance. We included studies with a high directness of evidence (DoE). We retrieved 3,360 articles. Ten studies with a high DoE were included. Four articles with medium DoE were discussed in addition. Six studies compared infants implanted before 12 months with children implanted between 12 and 24 months. Follow-up ranged from 6 months to 9 years. Cochlear implantation before the age of 2 years is beneficial according to one speech perception score (phonetically balanced kindergarten combined with consonant-nucleus-consonant) but not on Glendonald auditory screening procedure scores. Implantation before 12 months resulted in better speech production (diagnostic evaluation of articulation and phonology and infant-toddler meaningful auditory integration scale), auditory performance (Categories of Auditory Performance-II score) and receptive language scores (2 out of 5; Preschool Language Scale combined with oral and written language skills and Peabody Picture Vocabulary Test). The current best evidence lacks level 1 evidence studies and consists mainly of cohort studies with a moderate to high risk of bias. Included studies showed consistent evidence that cochlear implantation should be performed early in life, but evidence is inconsistent on all speech and language outcome measures regarding the additional benefit of implantation before the age of 12 months. Long-term follow-up studies are necessary to provide insight on additional benefits of early pediatric cochlear implantation. © 2016 S. Karger AG, Basel.

  5. Percutaneous Stabilization System Osseofix® for Treatment of Osteoporotic Vertebral Compression Fractures - Clinical and Radiological Results after 12 Months.

    Directory of Open Access Journals (Sweden)

    Stephan Albrecht Ender

    Full Text Available A prospective consecutive cohort study (follow-up study.Our study investigated whether implantation of an expandable titanium mesh cage (Osseofix® is a successful and safe minimally invasive therapy for osteoporotic vertebral compression fractures (VCF. Our experiences, clinical and radiological findings after 12 months follow-up are presented. Kypho- and vertebroplasty are well-established minimally invasive procedures for the treatment of osteoporotic VCF. The main complications associated with both procedures are uncontrolled bone cement leakage. Therefore a suitable alternative has been investigated.During June 2010 to May 2011 24 patients were included with 32 osteoporotic VCF (T6 to L4. All of them were stabilized with the Osseofix® system. Preinterventionally we performed X-ray, MRI, and bone density measurements (DXA. Clinical and radiological results were evaluated preop., postop. and after 12 months postop. based on the Oswestry Disability Index (ODI and the Visual Analogue Scale (VAS, X-ray (Beck Index, Cobb-angle and CT.There was a significant improvement in the mean ODI (70,6% to 30,1% as well as a significant reduction in pain intensity (VAS (7,7 to 1,4 after 12 month. The mean kyphotic angle according to Cobb showed significant improvements (11,7° to 10,4° after 12 months. Postinterventional imaging showed only one case of loss of height in a stabilized vertebral body (3.1%. We saw no changes in posterior vertebral wall or adjacent fractures. Except for one pronounced postoperative hematoma we saw no surgical complications including no cement leakage.Stabilization of symptomatic osteoporotic VCF with Osseofix® system is a safe and effective procedure, even in fractures with posterior wall involvement. The clinical mid-term results are good at a very low complication rate. The Osseofix® system is an interesting alternative to the established procedures of cement augmentation.

  6. Employment 12 months after kidney transplantation: An in-depth bio-psycho-social analysis of the Swiss Transplant Cohort.

    Directory of Open Access Journals (Sweden)

    Brigitta Danuser

    Full Text Available Return to work with or after a chronic disease is a dynamic process influenced by a variety of interactions between personal, work, societal and medical resources or constraints. The aim of this study was to identify predictors for employment 12 months after transplantation in kidney patients, applying a bio-psycho-social model.All kidney patients followed in the Swiss Transplant Cohort between May 2008 and December 2012, aged 18 to 65 were assessed before, 6 and 12 months after transplantation.Of the 689 included patients, 56.2% worked 12 months post- transplantation compared to 58.9% pre-transplantation. Age, education, self-perceived health (6 months post- transplantation, pre- transplantation employment and receiving an organ from a living donor are significant predictors of employment post- transplantation. Moreover, while self-perceived health increased post- transplantation, depression score decreased only among those employed 12 months post- transplantation. Pre- transplantation employment status was the main predictor for post- transplantation employment (OR = 18.6 and was associated with sex, age, education, depression and duration of dialysis. An organ from a living donor (42.1% was more frequent in younger patients, with higher education, no diabetes and shorter waiting time to surgery.Transplantation did not increase employment in end-stage kidney disease patients but helped maintaining employment. Pre-transplantation employment has been confirmed to be the most important predictor of post-transplantation employment. Furthermore, socio-demographic and individual factors predicted directly and indirectly the post-transplantation employment status. With living donor, an additional predictor linked to social factors and the medical procedure has been identified.

  7. Reasons for cannabis use in first-episode psychosis: does strength of endorsement change over 12 months?

    Science.gov (United States)

    Kolliakou, A; Castle, D; Sallis, H; Joseph, C; O'Connor, J; Wiffen, B; Gayer-Anderson, C; McQueen, G; Taylor, H; Bonaccorso, S; Gaughran, F; Smith, S; Greenwood, K; Murray, R M; Di Forti, M; Atakan, Z; Ismail, K

    2015-01-01

    Why patients with psychosis use cannabis remains debated. The self-medication hypothesis has received some support but other evidence points towards an alleviation of dysphoria model. This study investigated the reasons for cannabis use in first-episode psychosis (FEP) and whether strength in their endorsement changed over time. FEP inpatients and outpatients at the South London and Maudsley, Oxleas and Sussex NHS Trusts UK, who used cannabis, rated their motives at baseline (n=69), 3 months (n=29) and 12 months (n=36). A random intercept model was used to test the change in strength of endorsement over the 12 months. Paired-sample t-tests assessed the differences in mean scores between the five subscales on the Reasons for Use Scale (enhancement, social motive, coping with unpleasant affect, conformity and acceptance and relief of positive symptoms and side effects), at each time-point. Time had a significant effect on scores when controlling for reason; average scores on each subscale were higher at baseline than at 3 months and 12 months. At each time-point, patients endorsed 'enhancement' followed by 'coping with unpleasant affect' and 'social motive' more highly for their cannabis use than any other reason. 'Conformity and acceptance' followed closely. 'Relief of positive symptoms and side effects' was the least endorsed motive. Patients endorsed their reasons for use at 3 months and 12 months less strongly than at baseline. Little support for the self-medication or alleviation of dysphoria models was found. Rather, patients rated 'enhancement' most highly for their cannabis use. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  8. Polymorphisms in inflammation genes, tobacco smoke and furred pets and wheeze in children

    DEFF Research Database (Denmark)

    Sorensen, M.; Allermann, L.; Vogel, Ulla Birgitte

    2009-01-01

    Persistent wheeze in childhood is associated with airway inflammation. The present study investigated relationships between polymorphisms in inflammatory genes, exposure to tobacco smoke and furred pets and risk of recurrent wheeze in children. Within a birth cohort of 101,042 children we...... on number of episodes with wheeze (18 months), exposure to tobacco smoke and pet-keeping. Recurrent wheeze was defined as at least four episodes of wheeze before the child was 18 months old. There was a statistically significant association between the IL-13 Arg144Gln polymorphism and risk of recurrent...... wheeze (p = 0.01). Furthermore, there was a statistically significant interaction between this polymorphism and exposure to tobacco smoke during pregnancy, though this was probably a chance finding. There were no other statistically significant effects of the polymorphisms or interactions with exposure...

  9. [Risk factors for iron deficiency anemia in infants aged 6 to 12 months and its effects on neuropsychological development].

    Science.gov (United States)

    Xu, Kang; Zhang, Cui-Mei; Huang, Lian-Hong; Fu, Si-Mao; Liu, Yu-Ling; Chen, Ang; Ou, Jun-Bin

    2015-08-01

    To study the risk factors for moderate and severe iron deficiency anemia (IDA) in infants aged 6-12 months, and to preliminarily investigate the effects of IDA on the neuromotor development and temperament characteristics of infants. A total of 326 infants aged 6-12 months with IDA were classified into three groups: mild IDA (n=176), moderate IDA (n=111), and severe IDA (n=39) according to the severity of anemia. The risk factors for moderate or severe IDA were investigated by multivariate logistic regression analysis. Three hundred and forty-six infants without IDA who showed matched age, sex, and other backgrounds were selected as the control group. The Gesell Development Diagnosis Scale was used to evaluate children's mental development. The Temperament Scale for infants was used for evaluating children's temperament. The univariate analysis showed that the severity of IDA was associated with sex, birth weight, gestational age, multiple birth, maternal anemia during pregnancy, and mother's lack of knowledge about IDA (Panemia during pregnancy, breast feeding, and mother's lack of knowledge about IDA were the risk factors for severe IDA (OR>1; P1; Panemia during pregnancy and mother's lack of knowledge about IDA in infants aged 6-12 months. Infants with IDA have delayed neuromotor development and most of them have negative temperaments. More attention should be paid to mental and behavior problems for the infants. It is necessary to provide guidance for their parents in feeding and education.

  10. [Risk factors for anemia in infants aged 6-12 months from rural areas of southern Shaanxi Province, China].

    Science.gov (United States)

    Luo, Ren-Fu; Liang, Xia; Liu, Cheng-Fang; Zhang, Lin-Xiu; Yue, Ai

    2016-08-01

    To investigate the prevalence of anemia and related risk factors in infants aged 6-12 months from rural areas of southern Shaanxi Province. A questionnaire survey was used to collect the basic information on infants aged 6-12 months and their families from rural areas of southern Shaanxi Province, China. The content of hemoglobin was measured in these infants. A multivariate logistic stepwise regression analysis was performed to determine the risk factors for the development of anemia in infants. A total of 1 802 infants and their families participated in the survey, and there were 1 770 valid samples. A total of 865 infants (865/1 770, 48.87%) were found to have anemia. The multivariate logistic stepwise regression analysis showed that breastfeeding after birth (lack of scientific supplementary food) increased the risk of anemia in infants (OR=1.768, Panemia in infants. In the rural areas in southern Shaanxi Province, anemia in infants aged 6-12 months is still a serious public health problem. Improper feeding can increase the risk of anemia in infants, and scientific addition of supplementary food is the key to reducing anemia in infants.

  11. Incidence and 12-month outcome of non-transient childhood conversion disorder in the U.K. and Ireland.

    Science.gov (United States)

    Ani, Cornelius; Reading, Richard; Lynn, Richard; Forlee, Simone; Garralda, Elena

    2013-06-01

    Little is known about conversion disorder in childhood. To document clinical incidence, features, management and 12-month outcome of non-transient conversion disorder in under 16-year-olds in the U.K. and Ireland. Surveillance through the British Paediatric Surveillance Unit and Child and Adolescent Psychiatry Surveillance System. In total, 204 cases (age range 7-15 years) were reported, giving a 12-month incidence of 1.30/100 000 (95% CI 1.11-1.52). The most common symptoms were motor weakness and abnormal movements. Presentation with multiple symptoms was the norm. Antecedent stressors were reported for 80.8%, most commonly bullying in school. Most children required in-patient admission with frequent medical investigations. Follow-up at 12 months was available for 147 children, when all conversion disorder symptoms were reported as improved. Most families (91%) accepted a non-medical explanation of the symptoms either fully or partially. Childhood conversion disorder represents an infrequent but significant clinical burden in the UK and Ireland.

  12. Assessment of the effect of an oscillating/rotating electric toothbrush on oral health. A 12-month longitudinal study.

    Science.gov (United States)

    Ainamo, J; Xie, Q; Ainamo, A; Kallio, P

    1997-01-01

    The aim of this 12-month parallel design controlled clinical trial was to assess the effect of the Braun Oral-B Plak Control electric toothbrush on supragingival plaque and gingival health, and to compare it with a conventional soft manual toothbrush (Jordan). A total of 111 patients aged between 20 and 63 years, from a general population, with bleeding on probing at 30% or more of all sites examined were entered into the study. At baseline, immediately after periodontal examination, all volunteers received a thorough scaling of their teeth. Volunteers in both groups were told to brush their teeth for 2 min 2 x a day. Oral hygiene instruction was given at the start of the study and was not repeated. At 3, 6 and 12 months, assessments were carried out by a single clinician who was not aware which group the volunteers belonged to. Analysis of results demonstrated that over the 12 months of the study, the Braun Oral-B Plak Control was significantly more effective in improving gingival health than the manual toothbrush. There was, however, no difference between the 2 groups in terms of plaque removal, with the number of sites with visible plaque decreasing by a similar amount in both groups. In conclusion, results indicate that the Braun Oral-B Plak Control toothbrush is safe and more effective than a manual toothbrush in improving gingival health.

  13. Pivotal ERIVANCE basal cell carcinoma (BCC) study: 12-month update of efficacy and safety of vismodegib in advanced BCC.

    Science.gov (United States)

    Sekulic, Aleksandar; Migden, Michael R; Lewis, Karl; Hainsworth, John D; Solomon, James A; Yoo, Simon; Arron, Sarah T; Friedlander, Philip A; Marmur, Ellen; Rudin, Charles M; Chang, Anne Lynn S; Dirix, Luc; Hou, Jeannie; Yue, Huibin; Hauschild, Axel

    2015-06-01

    Primary analysis from the pivotal ERIVANCE BCC study resulted in approval of vismodegib, a Hedgehog pathway inhibitor indicated for treatment of adults with metastatic or locally advanced basal cell carcinoma (BCC) that has recurred after surgery or for patients who are not candidates for surgery or radiation. An efficacy and safety analysis was conducted 12 months after primary analysis. This was a multinational, multicenter, nonrandomized, 2-cohort study in patients with measurable and histologically confirmed locally advanced or metastatic BCC taking oral vismodegib (150 mg/d). Primary outcome measure was objective response rate (complete and partial responses) assessed by independent review facility. After 12 months of additional follow-up, median duration of exposure to vismodegib was 12.9 months. Objective response rate increased from 30.3% to 33.3% in patients with metastatic disease, and from 42.9% to 47.6% in patients with the locally advanced form. Median duration of response in patients with locally advanced BCC increased from 7.6 to 9.5 months. No new safety signals emerged with extended treatment duration. Limitations include low prevalence of advanced BCC and challenges of designing a study with heterogenous manifestations. The 12-month update of the study confirms the efficacy and safety of vismodegib in management of advanced BCC. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  14. Healing predictors of stable juvenile osteochondritis dissecans knee lesions after 6 and 12 months of nonoperative treatment.

    Science.gov (United States)

    Krause, Matthias; Hapfelmeier, Alexander; Möller, Melanie; Amling, Michael; Bohndorf, Klaus; Meenen, Norbert M

    2013-10-01

    Nonoperative treatment of stable juvenile osteochondritis dissecans (JOCD) lesions of the knee fails in up to 50% of cases. Healing predictors are needed to identify potential failures and thus determine treatment options. A predictive model for healing potential after 6 and 12 months of nonoperative treatment of stable JOCD lesions based on sensitive magnetic resonance imagining (MRI) follow-up measurements was developed. Cohort study (diagnosis); Level of evidence, 2. A retrospective cross-sectional study was conducted to analyze 62 white patients (76 stable JOCD lesions) who were initially treated by restriction of activity until they were free of pain. The primary end point was healing investigated on MRI with follow-up measurements after 6 and 12 months of nonoperative treatment. Multivariate logistic regression was used to determine the influence of age, sex, JOCD lesion size, clinical symptoms, and the occurrence of cystlike lesions (CLLs) on healing potential. Additionally, optimal prognostic cutoffs were defined to differentiate failures from nonfailures. After 6 months of nonoperative treatment, 51 (67%) of 76 stable JOCD lesions showed no progression toward healing or showed signs of instability. Normalized lesion width and area and CLL occurrence differed significantly between failures and nonfailures (P treatment with or without casting might be appropriate if the healing potential is >48%. A 12-month period of nonoperative treatment may be successful if the CLL is <1.3 mm in length as assessed on MRI.

  15. 12-month follow-up study of drug treatment in pathological gamblers: a primary outcome study.

    Science.gov (United States)

    Dannon, Pinhas N; Lowengrub, Katherine; Musin, Ernest; Gonopolsky, Yehudit; Kotler, Moshe

    2007-12-01

    Pathological gambling (PG) is a relatively common and highly disabling impulse control disorder. A range of psychotherapeutic agents including selective serotonin reuptake inhibitors, antiepileptic drugs, and opioid antagonists are shown to be effective in the short-term treatment of PG. The use of a wide range of pharmacological treatments for PG is consistent with the observation that PG shares features of obsessive-compulsive spectrum disorders, impulse control disorders, and addictive disorders. The aim of the study is to assess the rate of relapse in treatment-responder pathological gamblers after discontinuation of the active treatment. Our study sample was composed of 43 male pathological gamblers who had been full responders to 1 of 4 drug treatment regimens (fluvoxamine, topiramate, bupropion SR, or naltrexone) from several previous acute open-label (12-week) comparison studies. Full response was defined as the absence of gambling for a 1-month duration together with improvement on the Clinical Global Improvement scale. The 43 full responders were then followed prospectively for an additional 9 months, which included a 3-month open-label continuation phase and a 6-month medication-free follow-up phase. Follow-up visits were performed on a monthly basis throughout the duration of study. At every follow-up visit, a comprehensive psychiatric diagnostic evaluation was performed on all patients, and patients were assessed for symptoms of gambling using a self-report instrument and collateral family reports. The Clinical Global Impression Improvement scale was also administered at every follow-up visit. Raters were blind to the previous drug treatment. Most patients did not relapse during the 6-month medication-free follow-up phase. Three of 6 patients with fluvoxamine, 3 of 9 with topiramate, 7 of 18 with bupropion SR, and 4 of 10 with naltrexone relapsed. Relapse was strictly defined as gambling behavior at any time during the 6-month medication-free follow

  16. Disrupted Prenatal Maternal Cortisol, Maternal Obesity, and Childhood Wheeze. Insights into Prenatal Programming

    Science.gov (United States)

    Fisher, Kate; Chiu, Yueh-Hsiu Mathilda; Wright, Robert O.; Fein, Rebecca; Cohen, Sheldon; Coull, Brent A.

    2013-01-01

    Rationale: Exploring prenatal factors influencing childhood wheeze may inform programming mechanisms. Objectives: We examined associations among prenatal maternal cortisol profiles, maternal obesity, and repeated wheeze up to age 2 years (n = 261). Methods: Salivary cortisol was collected five times per day over 3 days at 29.0 ± 4.9 weeks gestation. Mothers were categorized as obese (body mass index ≥ 30 kg/m2) versus nonobese (body mass index cortisol metrics (level at each time point, morning rise, diurnal and afternoon slopes) and obesity on wheeze adjusting for covariates. Linear mixed models were implemented to examine associations between cortisol trajectories and wheezing. Interactions between maternal cortisol and obesity were considered. Measurements and Main Results: Mothers were primarily minority (56.5% Hispanic, 24.1% African American), 61% had less than or equal to 12 years of education, 34% were obese, and 8.4% of children had repeated wheeze. An interquartile range increase in mean log cortisol at bedtime (odds ratio, 2.2; 95% confidence interval, 1.09–4.09) and maternal obesity (odds ratio, 3.43; 95% confidence interval, 1.26–9.35) were independently associated with wheeze. Linear mixed models revealed an association between a flatter afternoon slope (slower decline in log cortisol per hour) and repeated wheeze in children of obese mothers (children with [−0.017 change] and without [−0.061 change] wheeze [P = 0.009 for time × wheeze interaction]), but not in children of nonobese mothers (with [−0.050 change] and without [−0.061 change] wheeze [P = 0.51]). Conclusions: Maternal prenatal cortisol disruption and obesity were independently associated with children’s wheeze. Obese women with adverse cortisol profiles were most likely to have children with repeated wheeze. PMID:23590260

  17. Feasibility and indicative results from a 12-month low-energy liquid diet treatment and maintenance programme for severe obesity

    Science.gov (United States)

    Lean, Michael; Brosnahan, Naomi; McLoone, Philip; McCombie, Louise; Higgs, Anna Bell; Ross, Hazel; Mackenzie, Mhairi; Grieve, Eleanor; Finer, Nick; Reckless, John; Haslam, David; Sloan, Billy; Morrison, David

    2013-01-01

    Background There is no established primary care solution for the rapidly increasing numbers of severely obese people with body mass index (BMI) > 40 kg/m2. Aim This programme aimed to generate weight losses of ≥15 kg at 12 months, within routine primary care. Design and setting Feasibility study in primary care. Method Patients with a BMI ≥40 kg/m2 commenced a micronutrient-replete 810–833 kcal/day low-energy liquid diet (LELD), delivered in primary care, for a planned 12 weeks or 20 kg weight loss (whichever was the sooner), with structured food reintroduction and then weight-loss maintenance, with optional orlistat to 12 months. Result Of 91 patients (74 females) entering the programme (baseline: weight 131 kg, BMI 48 kg/m2, age 46 years), 58/91(64%) completed the LELD stage, with a mean duration of 14.4 weeks (standard deviation [SD] = 6.0 weeks), and a mean weight loss of 16.9 kg (SD = 6.0 kg). Four patients commenced weight-loss maintenance omitting the food-reintroduction stage. Of the remaining 54, 37(68%) started and completed food reintroduction over a mean duration of 9.3 weeks (SD = 5.7 weeks), with a further mean weight loss of 2.1 kg (SD = 3.7 kg), before starting a long-term low-fat-diet weight-loss maintenance plan. A total of 44/91 (48%) received orlistat at some stage. At 12 months, weight was recorded for 68/91 (75%) patients, with a mean loss of 12.4 kg (SD = 11.4 kg). Of these, 30 (33% of all 91 patients starting the programme) had a documented maintained weight loss of ≥15 kg at 12 months, six (7%) had a 10–15 kg loss, and 11 (12%) had a 5–10 kg loss. The indicative cost of providing this entire programme for wider implementation would be £861 per patient entered, or £2611 per documented 15 kg loss achieved. Conclusion A care package within routine primary care for severe obesity, including LELD, food reintroduction, and weight-loss maintenance, was well accepted and achieved a 12-month-maintained weight loss of ≥15 kg for one

  18. Service providers' experiences of using a telehealth network 12 months after digitisation of a large Australian rural mental health service.

    Science.gov (United States)

    Newman, Lareen; Bidargaddi, Niranjan; Schrader, Geoffrey

    2016-10-01

    Despite evidence of benefits of telehealth networks in increasing access to, or providing, previously unavailable mental health services, care providers still prefer traditional approaches. For psychiatric assessment, digital technology can offer improvements over analog systems for the technical and, subsequently, the social quality of provider-client interaction. This is in turn expected to support greater provider uptake and enhanced patient benefits. Within the framework of Innovation Diffusion Theory, to study service providers' experiences of an existing regional telehealth network for mental health care practice twelve months after digitisation in order to identify the benefits of digital telehealth over an analog system for mental health care purposes in rural Australia. Qualitative interviews and focus groups were conducted with over 40 service providers from June to September 2013 in South Australia, ranging from the metropolitan central operations to health providers located up to 600km away in rural and remote areas of the same state. Participants included rural mental health teams, directors of nursing at rural hospitals, metropolitan-based psychiatrists and registrars, the metropolitan-based mental health team dedicated to rural provider support, rural GPs, administrative staff, and the executive group of the state rural health department. Fieldwork was conducted 12 months after the analog system was digitised. The interview and focus group data were analysed using thematic analysis, focusing on three key areas of innovation diffusion theory: relative advantage, technical complexity and technical compatibility. Five themes with 11 sub-themes were identified: (1) "Existing Uses", with three sub-themes: current mental health use, use by GPs, and use for staff support; (2) "Relative Advantage", with four sub-themes: improved technical quality, improved clinical practice, time and cost benefits for providers, and improved patient care; (3) "Technical

  19. Effect of Linear Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction-12-Month Follow-Up of a Randomized, Double-Blinded, Sham-Controlled Study

    DEFF Research Database (Denmark)

    Fojecki, Grzegorz Lukasz; Tiessen, Stefan; Sloth Osther, Palle Jørn

    2018-01-01

    INTRODUCTION: Short-term data on the effect of low-intensity extracorporeal shockwave therapy (Li-ESWT) on erectile dysfunction (ED) have been inconsistent. The suggested mechanisms of action of Li-ESWT on ED include stimulation of cell proliferation, tissue regeneration, and angiogenesis, which...... can be processes with a long generation time. Therefore, long-term data on the effect of Li-ESWT on ED are strongly warranted. AIM: To assess the outcome at 6 and 12 months of linear Li-ESWT on ED from a previously published randomized, double-blinded, sham-controlled trial. METHODS: Subjects with ED...... (N = 126) who scored lower than 25 points in the erectile function domain of the International Index of Erectile Function (IIEF-EF) were eligible for the study. They were allocated to 1 of 2 groups: 5 weekly sessions of sham treatment (group A) or linear Li-ESWT (group B). After a 4-week break, the 2...

  20. Zilver PTX Post-Market Surveillance Study of Paclitaxel-Eluting Stents for Treating Femoropopliteal Artery Disease in Japan: 12-Month Results.

    Science.gov (United States)

    Yokoi, Hiroyoshi; Ohki, Takao; Kichikawa, Kimihiko; Nakamura, Masato; Komori, Kimihiro; Nanto, Shinsuke; O'Leary, Erin E; Lottes, Aaron E; Snyder, Scott A; Dake, Michael D

    2016-02-08

    This multicenter, prospective, post-market surveillance study in Japan evaluates the paclitaxel-coated Zilver PTX stent in real-world patients with complex lesions. The Zilver PTX stent is the first drug-eluting stent (DES) approved for the superficial femoral artery. Previously, results from a large randomized study and a complementary, large single-arm study supported the safety and effectiveness of the DES. There were no exclusion criteria, and consecutive patients with symptomatic peripheral artery disease (PAD) treated with the DES were enrolled in the study. Clinically driven target lesion revascularization (TLR) was defined as reintervention performed for ≥50% diameter stenosis after recurrent clinical symptoms of PAD. Clinical benefit was defined as freedom from persistent or worsening symptoms of ischemia. Patency was evaluated by duplex ultrasound where physicians considered this standard of care. In this study, 907 patients were enrolled at 95 institutions in Japan. There were numerous comorbidities including high incidences of diabetes (58.8%), chronic kidney disease (43.8%), and critical limb ischemia (21.5%). Lesions were also complex, with an average length of 14.7 cm, 41.6% total occlusions, and 18.6% in-stent restenosis. In total, 1,861 DES were placed in 1,075 lesions. Twelve-month follow-up was obtained for >95% of eligible patients. Freedom from TLR was 91.0%, and clinical benefit was 87.7% through 12 months. The 12-month primary patency rate was 86.4%. Despite more challenging lesions, results from the current study are similar to outcomes from the previous Zilver PTX studies, confirming the benefit of the Zilver PTX DES in a real-world patient population. (Zilver PTX Post-Market Study in Japan; NCT02254837). Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  1. Household conditions, eczema symptoms and rhinitis symptoms: relationship with wheeze and severe wheeze in children living in the Polokwane area, South Africa

    DEFF Research Database (Denmark)

    Wichmann, Janine; Wolvaardt, Jacqueline E; Maritz, Chantelle

    2009-01-01

    BACKGROUND: This is the fifth study that applied the International Study of Asthma and Allergies in Childhood (ISAAC) methodology in the Southern African Development Community (SADC region). However, it is the first ISAAC study that focused on 6- to 7-year-old children living in South Africa...... and the presence of eczema symptoms and rhinoconjunctivitis symptoms increased the likelihood of wheeze by 77%, 104% and 226%, respectively. Only the presence of rhinoconjunctivitis symptoms increased the likelihood of severe wheeze by 107%. CONCLUSION: Wheeze appears to be an emerging public health problem...

  2. Sensitization predicts asthma development among wheezing toddlers in secondary healthcare.

    Science.gov (United States)

    Boersma, Nienke A; Meijneke, Ruud W H; Kelder, Johannes C; van der Ent, Cornelis K; Balemans, Walter A F

    2017-06-01

    Some wheezing toddlers develop asthma later in childhood. Sensitization is known to predict asthma in birth cohorts. However, its predictive value in secondary healthcare is uncertain. This study examines the predictive value of sensitization to inhalant allergens among wheezing toddlers in secondary healthcare for the development of asthma at school age (≥6 years). Preschool children (1-3 years) who presented with wheezing in secondary healthcare were screened on asthma at school age with the International Study of Asthma and Allergies in Childhood questionnaire. The positive and negative predictive value (PPV and NPV) of specific IgE to inhalant allergens (cut-off concentration 0.35 kU/L) and several non-invasive variables from a child's history (such as hospitalization, eczema, and parental atopy) were calculated. The additional predictive value of sensitization when combined with non-invasive predictors was examined in multivariate analysis and by ROC curves. Of 116 included children, 63% developed asthma at school age. Sensitization to inhalant allergens was a strong asthma predictor. The odds ratio (OR), PPV and NPV were 7.4%, 86%, and 55%, respectively. Eczema (OR 3.4) and hospital admission (OR 2.6) were significant non-invasive determinants. Adding sensitization to these non-invasive predictors in multivariate analysis resulted in a significantly better asthma prediction. The area under the ROC curve increased from 0.70 with only non-invasive predictors to 0.79 after adding sensitization. Sensitization to inhalant allergens is a strong predictor of school age asthma in secondary healthcare and has added predictive value when combined with non-invasive determinants. Pediatr Pulmonol. 2017;52:729-736. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  3. TVT-Secur mini-sling for stress urinary incontinence: a review of outcomes at 12 months.

    Science.gov (United States)

    Walsh, Colin A

    2011-09-01

    • Synthetic mid-urethral slings (MUSs) are considered the first choice surgical procedure for stress urinary incontinence. Recent publications have raised concerns about the efficacy of third generation single-incision mini-slings. The present paper is a systematic review of studies reporting 12-month outcomes after the TVT-Secur (TVT-S) procedure. • Pubmed/Medline online databases, abstracts from recent International Continence Society and International Urogynecological Association annual scientific meetings and the Clinicaltrials.gov and Controlled-trials.com online trial registries were searched for English-language articles containing the terms 'TVT-Secur', 'TVT Secur' or 'mini-sling'. The primary outcomes were objective and subjective cure rates at 12 months. Secondary outcomes included peri-operative (vaginal perforation, urinary retention, urinary tract infection [UTI]) and postoperative (mesh exposure, de novo overactive bladder (OAB), dyspareunia and return to theatre) complication rates. • Among 1178 women undergoing the TVT-S procedure, from 10 studies, both objective and subjective cure rate at 12 months was 76%, with objective cure significantly higher in women undergoing the 'U-type' approach. Vaginal perforation was a complication in 1.5% of cases, with a 2.4% incidence of mesh exposure in the first year. The incidence of de novo OAB symptoms was 10%. Rates of urinary retention (2.3%), UTI (4.4%), dyspareunia (1%) and return to theatre for complications (0.8%) were low. In the first year after a TVT-S procedure 5% of women required repeat continence surgery. • Longer-term studies and randomized comparisons with more established MUSs are required before TVT-S should be routinely used in the surgical treatment of stress urinary incontinence. © 2011 THE AUTHOR. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

  4. Prime Time: 12-Month Sexual Health Outcomes of a Clinic-Based Intervention to Prevent Pregnancy Risk Behaviors

    Science.gov (United States)

    Sieving, Renee E.; McMorris, Barbara J.; Beckman, Kara J.; Pettingell, Sandra L.; Secor-Turner, Molly; Kugler, Kari; Garwick, Ann W.; Resnick, Michael D.; Bearinger, Linda H.

    2010-01-01

    Purpose Prime Time, a youth development intervention, aims to reduce pregnancy risk among adolescent girls seeking clinic services who are at high risk for pregnancy. This paper examines sexual risk behaviors and hypothesized psychosocial mediators after 12 months of the Prime Time intervention. Methods Randomized controlled trial with 253 girls ages 13-17 years meeting specified risk criteria. Intervention participants were involved in Prime Time programming plus usual clinic services for 18 months, control participants received usual clinic services. The intervention employed a combination of case management and peer leadership programs. Participants in this interim outcomes study completed self-report surveys at baseline and 12 months following enrollment. Surveys assessed sexual risk behaviors and psychosocial factors targeted for change by Prime Time. Results At the 12-month interim, the intervention group reported more consistent use of condoms, hormonal contraception and dual contraceptive methods with their most recent partner than did the control group. The intervention group also reported greater stress management skills with trends towards higher levels of pro-social connectedness at school and with family. No between-group differences were noted in psychosocial measures specific to sex and contraceptive use. Conclusions Preventing early pregnancy among high-risk adolescents requires multifaceted, sustained approaches. An important research focus involves testing youth development interventions offered through clinic settings, where access to high-risk adolescents is plentiful and few efforts have emphasized a dual approach of building protective factors while addressing risk. Findings suggest that youth development interventions through clinic settings hold promise in reducing pregnancy risk among high-risk youth. PMID:21783050

  5. Effectiveness of Eye Movement Desensitization and Reprocessing on Anxiety in Children with Thalassemia in a 12-month follow up

    Directory of Open Access Journals (Sweden)

    A Shahnavazi

    2016-02-01

    Full Text Available Background and  Objective: Thalassemia is the most common genetic diseases in the world and especially in our country. For many reasons, including chronic disease, health care costs, the expected mortality Ray disease states such as anxiety, psychological and social problems in thalassemia. The aim of the present study was to assess the efficacy of Eye Movement Desensitization and Reprocessing (EMDR on anxiety of children with thalassemia in a 12-month follow up..  Methods: It was a clinical trial study, which was performed on 60 patients with Thalassemia in 2013-2014. A total of 60 thalassemic patients based on Beck anxiety inventory, selected using sampling and were randomly divided into experimental and Control groups. in experimental group, eye movement desensitization and reprocessing therapy was perfomed in five sessions and The control group received no intervention. In order to collect information on demographic questionnaire and Beck Anxiety Inventory were used. data were gathered on anxiety symptoms at pretreatment, posttreatment and 12 month follow up and were analyzed using descriptive statistics, repeated measures and chi square. Results: The average age of the participants was 15.22±1.93  years old. This study shows that the mean or average level of anxiety children with thalassemia in the experimental group before and after intervention and in a 12-month follow up group 34.73 ± 5.62, 19.90 ± 2.48 and 19.23 ± 2.48 respectively; repeated measures ANOVA showed significant statistical difference (p.05 Conclusion: This study shows that Method of eye movement desensitization and reprocessing as an alternative method to treat or reduce anxiety, aggressive children with thalassemia .Trained Nurses can use this new method is effective in the treatment of anxiety.

  6. Neuropsychological performance of youth with secondary attention-deficit/hyperactivity disorder 6- and 12-months after traumatic brain injury.

    Science.gov (United States)

    Ornstein, Tisha J; Sagar, Sanya; Schachar, Russell J; Ewing-Cobbs, Linda; Chapman, Sandra B; Dennis, Maureen; Saunders, Ann E; Yang, Tony T; Levin, Harvey S; Max, Jeffrey E

    2014-11-01

    The present study compared executive dysfunction among children with attention-deficit/hyperactivity disorder (ADHD) after traumatic brain injury (TBI), also called secondary ADHD (S-ADHD), pre-injury ADHD and children with TBI only (i.e., no ADHD). Youth aged 6-16 years admitted for TBI to five trauma centers were enrolled (n=177) and evaluated with a semi-structured psychiatric interview scheduled on three occasions (within 2 weeks of TBI, i.e., baseline assessment for pre-injury status; 6-months and 12-months post-TBI). This permitted the determination of 6- and 12-month post-injury classifications of membership in three mutually exclusive groups (S-ADHD; pre-injury ADHD; TBI-only). Several executive control measures were administered. Unremitted S-ADHD was present in 17/141 (12%) children at the 6-month assessment, and in 14/125 (11%) children at 12-months post-injury. The study found that children with S-ADHD exhibited deficient working memory, attention, and psychomotor speed as compared to children with pre-injury ADHD. Furthermore, the children with S-ADHD and the children with TBI-only were impaired compared to the children with pre-injury ADHD with regard to planning. No group differences related to response inhibition emerged. Age, but not injury severity, gender, or adaptive functioning was related to executive function outcome. Neuropsychological sequelae distinguish among children who develop S-ADHD following TBI and those with TBI only. Moreover, there appears to be a different pattern of executive control performance in those who develop S-ADHD than in children with pre-injury ADHD suggesting that differences exist in the underlying neural mechanisms that define each disorder, underscoring the need to identify targeted treatment interventions.

  7. The Influence of Back Pain and Urinary Incontinence on Daily Tasks of Mothers at 12 Months Postpartum

    Science.gov (United States)

    McDonald, Sheila W.; Tough, Suzanne C.

    2015-01-01

    Objective The present study examined back pain (BP) and/or urinary incontinence (UI) impact on the ability to perform daily tasks at 12 months after childbirth in healthy reproductive women who sought maternity care in community based family practice clinics. Methods This study is a secondary analysis from the All Our Babies Study, a prospective, community-based pregnancy cohort in Calgary, Alberta. Maternal self-reported information on demographics, lifestyle, experiences with pregnancy and childbirth, occurrence of BP, UI and consequent impairment of daily tasks were collected by questionnaires administered before 25 weeks, at 34-36 weeks gestation and at 4 and 12 months postpartum. The occurrence and severity of BP and UI at one year after childbirth was assessed using descriptive and bivariate analyses. Logistic regression models examined the association between demographic and obstetrical variables and the severity of functional impairment due to UI and BP. Results From 1574 women with singleton pregnancies included in the study, 1212 (77%) experienced BP, 773 (49%) UI, and 620 (40%) both BP and UI. From the 821 women reporting impairment of daily tasks due to BP, 199 (24 %) were moderately and 90 (11%) severely affected with the remainder, 532 (64%) being mildly affected. From 267 women with functional impairment due to UI, 52 (19%) reported moderately to severe impairment in their ability to perform daily tasks. Obesity and parity were risk factors for impairment of daily functioning due to BP, whereas obesity and vaginal delivery increased the risk of moderate to severe impairment due to UI. Conclusions BP and UI are common occurrences 1 year after childbirth. Maternal performance of daily tasks and women’s health and quality of life are more often impaired due to BP than UI. Our study brings new evidence of the risk factors that predict severity and impact of these conditions on women functioning at 12 months postpartum. PMID:26083252

  8. The Influence of Back Pain and Urinary Incontinence on Daily Tasks of Mothers at 12 Months Postpartum.

    Directory of Open Access Journals (Sweden)

    Cynthia A Mannion

    Full Text Available The present study examined back pain (BP and/or urinary incontinence (UI impact on the ability to perform daily tasks at 12 months after childbirth in healthy reproductive women who sought maternity care in community based family practice clinics.This study is a secondary analysis from the All Our Babies Study, a prospective, community-based pregnancy cohort in Calgary, Alberta. Maternal self-reported information on demographics, lifestyle, experiences with pregnancy and childbirth, occurrence of BP, UI and consequent impairment of daily tasks were collected by questionnaires administered before 25 weeks, at 34-36 weeks gestation and at 4 and 12 months postpartum. The occurrence and severity of BP and UI at one year after childbirth was assessed using descriptive and bivariate analyses. Logistic regression models examined the association between demographic and obstetrical variables and the severity of functional impairment due to UI and BP.From 1574 women with singleton pregnancies included in the study, 1212 (77% experienced BP, 773 (49% UI, and 620 (40% both BP and UI. From the 821 women reporting impairment of daily tasks due to BP, 199 (24 % were moderately and 90 (11% severely affected with the remainder, 532 (64% being mildly affected. From 267 women with functional impairment due to UI, 52 (19% reported moderately to severe impairment in their ability to perform daily tasks. Obesity and parity were risk factors for impairment of daily functioning due to BP, whereas obesity and vaginal delivery increased the risk of moderate to severe impairment due to UI.BP and UI are common occurrences 1 year after childbirth. Maternal performance of daily tasks and women's health and quality of life are more often impaired due to BP than UI. Our study brings new evidence of the risk factors that predict severity and impact of these conditions on women functioning at 12 months postpartum.

  9. Locomotor Performance During Rehabilitation of People With Lower Limb Amputation and Prosthetic Nonuse 12 Months After Discharge.

    Science.gov (United States)

    Roffman, Caroline E; Buchanan, John; Allison, Garry T

    2016-07-01

    It is recognized that multifactorial assessments are needed to evaluate balance and locomotor function in people with lower limb amputation. There is no consensus on whether a single screening tool could be used to identify future issues with locomotion or prosthetic use. The purpose of this study was to determine whether different tests of locomotor performance during rehabilitation were associated with significantly greater risk of prosthetic abandonment at 12 months postdischarge. This was a retrospective cohort study. Data for descriptive variables and locomotor tests (ie, 10-Meter Walk Test [10MWT], Timed "Up & Go" Test [TUGT], Six-Minute Walk Test [6MWT], and Four Square Step Test [FSST]) were abstracted from the medical records of 201 consecutive participants with lower limb amputation. Participants were interviewed and classified as prosthetic users or nonusers at 12 months postdischarge. The Mann-Whitney U test was used to analyze whether there were differences in locomotor performance. Receiver operating characteristic curves were generated to determine performance thresholds, and relative risk (RR) was calculated for nonuse. At 12 months postdischarge, 18% (n=36) of the participants had become prosthetic nonusers. Performance thresholds, area under the curve (AUC), and RR of nonuse (95% confidence intervals [CI]) were: for the 10MWT, if walking speed was ≤0.44 ms(-1) (AUC=0.743), RR of nonuse=2.76 (95% CI=1.83, 3.79; Pprosthetic nonuse. It may be implied that the 10MWT has the greatest clinical utility as a single screening tool for prosthetic nonuse, given the highest proportion of participants were able to perform this test early in rehabilitation. However, as locomotor skills improve, other tests (in particular, the 6MWT) have specific clinical utility. To fully enable implementation of these locomotor criteria for prosthetic nonuse into clinical practice, validation is warranted. © 2016 American Physical Therapy Association.

  10. Effect of Brazil nut supplementation on plasma levels of selenium in hemodialysis patients: 12 months of follow-up.

    Science.gov (United States)

    Stockler-Pinto, Milena B; Lobo, Julie; Moraes, Cristiane; Leal, Viviane O; Farage, Najla E; Rocha, Ariana V; Boaventura, Gilson T; Cozzolino, Silvia M F; Malm, Olaf; Mafra, Denise

    2012-07-01

    Large amounts of reactive oxygen species are produced in hemodialysis (HD) patients, and, at higher concentrations, reactive oxygen species are thought to be involved in the pathogenesis of cardiovascular disease. It has been proposed that selenium (Se) may exert an antiatherogenic influence by reducing oxidative stress. The richest known food source of Se is the Brazil nut (Bertholletia excelsa, family Lecythidaceae), found in the Amazon region. The objective of this work was to determine if Se plasma levels in HD patients submitted to a program of supplementation during 3 months with 1 Brazil nut by day could be sustained after 12 months. A total of 21 HD patients (54.2 ± 15.2 years old; average time on dialysis, 82.3 ± 51.6 months; body mass index, 24.4 ± 3.8 kg/m(2)) from the RenalCor Clinic in Rio de Janeiro, Brazil, were followed up 12 months after the supplementation study ended. The Se plasma levels were determined by atomic absorption spectrophotometry with hydride generation. The Se Plasma levels (17.3 ± 19.9 μg/L) were below the normal range (60 to 120 μg/L) before nut supplementation, and after 3 months of supplementation, the levels increased to 106.8 ± 50.3 μg/L (P nutritional status. Se levels 12 months after the supplementation period were not as low as presupplementation levels but yet significantly lower, and we needed to motivate patients to adopt different dietary intake patterns. Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  11. 12-month generic health status and psychological distress outcomes following an Australian natural disaster experience: 2009 Black Saturday Wildfires.

    Science.gov (United States)

    Wasiak, J; Mahar, P; Lee, S; Paul, E; Spinks, A; Pfitzer, B; Cleland, H; Gabbe, B

    2013-11-01

    To describe the generic health status, health-related quality of life and psychological distress over a 12-month period of burns patients affected by the 2009 Black Saturday Wildfires. Cohort study with retrospective assessment of pre-injury status and prospective assessment of physical and psychosocial functioning in the Black Saturday Wildfires burns patients across time. Generic health status and burn specific quality of life using the 36-item Short Form Health Survey (SF-36) and Burn Specific Health Scale (BSHS) were collected at three, six and twelve months post-burn injury. In addition, similar time points were used to measure level of psychological distress and the presence of pain using the Kessler-10 questionnaire (K-10) and the McGill Pain Questionnaire. At 12 months post-injury, patients reported a mean 16.4 (standard error, SE: 3.2) reduction in physical health and a 5.3 (SE 2.5) reduction in mental health scores of the SF-36 as compared to their pre-injury scores, with significant decreases observed in the "bodily pain", "physical functioning", "role physical" and "vitality" subscales. High levels of psychological distress and persistent pain were experienced, with no significant changes during the study period to the overall burns specific quality of life. Even 12 months post-burn injury, patients affected by the 2009 Victorian Wildfires still experienced a significant reduction in generic health, increased psychological distress and persistent pain. The need for early and ongoing identification of physical and psychosocial impairments during hospital admission and upon discharge could be helpful to establish systematic interdisciplinary goals for long-term rehabilitation after severe burn injury. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Effects of a 12-Month Educational Intervention on Clinicians' Attitudes/Practices Regarding the Screening Spiritual History.

    Science.gov (United States)

    Koenig, Harold G; Perno, Kathleen; Erkanli, Alaattin; Hamilton, Ted

    2017-06-01

    Patients' spiritual values, beliefs, and preferences are identified in outpatient medical settings by the taking of a screening spiritual history (SSH). We report the impact of an educational/training program on the attitudes/practices of physicians (MDs) and midlevel practitioners (MLPs). A convenience sample of 1082 MDs or MLPs in outpatient practices was approached to participate in a 12-month educational/training program in this single-group experimental study. Of the 1082 professionals, 48% (427 physicians, 93 MLPs) agreed to complete a questionnaire assessing demographics, practice characteristics, religiosity, and attitudes/practices regarding the SSH. Changes in attitudes/practices over time were examined and baseline predictors identified using mixed-effects regression. Of the 520 participants completing questionnaires at baseline, 436 were assessed at 1 month (83.8%) and 432 were assessed at 12 months (83.1%). The belief that MDs should take a SSH did not significantly change over time (B = -0.022, standard error [SE] 0.028, P = 0.426). However, those who took an SSH often/always increased from 16.7% at baseline to 34.8% at 12-month follow-up (B = 0.328, SE 0.030, P SSH taking across time among MDs were older age, female sex, family medicine specialty, prior training, and importance of religion; older age was the only predictor in MLPs. Although attitudes toward taking an SSH were not affected, taking an SSH increased initially and was sustained over time, as did the sense that patients accepted/appreciated this practice. Educational programs of this type may be used to increase SSH taking by outpatient MDs and MLPs.

  13. Treatment of infrapopliteal post-PTA dissection with tack implants: 12-month results from the TOBA-BTK study.

    Science.gov (United States)

    Brodmann, Marianne; Wissgott, Christian; Holden, Andrew; Staffa, Robert; Zeller, Thomas; Vasudevan, Thodur; Schneider, Peter

    2018-03-24

    The Tack implant is designed for focal, minimal metal management of dissections. This study evaluated Tacks for treating postpercutaneous transluminal angioplasty (PTA) dissection in patients with below-the-knee (BTK) arterial occlusive disease. PTA is the most commonly used endovascular treatment for patients with occlusive disease of the BTK vessels. Post-PTA dissection is a significant clinical problem that results in poor outcomes, but currently there are limited treatment options for managing dissections. This prospective, single-arm study evaluated patients with CLI and BTK lesions; 11.4% were Rutherford category (RC) 4 and 88.6% were RC 5. BTK occlusive disease was treated with standard PTA and post-PTA dissections were treated with Tack placement. The primary safety endpoint was a composite of major adverse limb events (MALE) and perioperative death (POD) at 30 days. Other endpoints included: device success; procedure success (vessel patency in the absence of MALE); freedom from clinically driven target lesion revascularization (CD-TLR); primary patency; and changes in RC. Data through 12 months are presented. Thirty-two of 35 (91.4%) patients had post-PTA dissection and successful deployment of Tacks. Procedural success was achieved in 34/35 (97.1%) patients with no MALEs at 30 days. The 12-month patency rate was 78.4% by vessel, 77.4% by patient, and freedom from CD-TLR was 93.5%. Significant (P < .0001) improvement from baseline was observed in RC (75% of patients improved 4 or 5 steps). Tack implant treatment of post-PTA dissection was safe and effective for treatment of BTK dissections and resulted in reasonable 12-month patency and low rates of CD-TLR. © 2018 The Authors Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc.

  14. [Coughing and wheezing children: improvement after parents stop smoking].

    Science.gov (United States)

    Brand, P L; Duiverman, E J

    1998-04-11

    Three children, boys aged 6, 4 and 4 years presented with recurrent cough and (or) wheeze. Exposure to tobacco smoke at home was considered an aggravating factor. Symptoms in all three cases improved considerably or resolved completely when the patients' (grand)parent(s) stopped smoking. There is little literature on the beneficial effect of parents' giving up smoking on symptoms of childhood asthma. These cases, however, illustrate that advising parents of children with recurrent respiratory symptoms to give up smoking can be a rewarding and successful form of therapy.

  15. Variations in the prevalence of childhood asthma and wheeze in MeDALL cohorts in Europe

    Directory of Open Access Journals (Sweden)

    Eleonora P. Uphoff

    2017-07-01

    Full Text Available While there is evidence for variations in prevalence rates of childhood wheeze and asthma between countries, longitudinal, individual-level data are needed to understand these differences. The aim of this study was to examine variations in prevalence rates of childhood asthma, wheeze and wheeze with asthma in Europe. We analysed datasets from 10 MeDALL (Mechanisms of the Development of ALLergy cohorts in eight countries, representing 26 663 children, to calculate prevalence rates of wheeze and asthma by child age and wheeze with asthma at age 4 years. Harmonised variables included outcomes parent-reported wheeze and parent-reported doctor-diagnosed asthma, and covariates maternal education, parental smoking, pets, parental asthma, doctor-diagnosed allergic rhinitis, doctor-diagnosed eczema and wheeze severity. At age 4 years, asthma prevalence varied from 1.72% in Germany to 13.48% in England and the prevalence of wheeze varied from 9.82% in Greece to 55.37% in Spain. Adjusted estimates of the proportion of 4-year-old children with wheeze diagnosed with asthma remained highest in England (38.14%, 95% CI 31.38–44.90% and lowest in Spain (15.94%, 95% CI 6.16–25.71%. The large differences in prevalence rates of asthma, wheeze and wheeze with asthma at age 4 years between European cohorts may indicate that childhood asthma is more readily diagnosed in some countries while going unrecognised elsewhere.

  16. Struggling for Independence: A Grounded Theory Study on Convalescence of ICU-survivors 12 Months Post ICU Discharge

    DEFF Research Database (Denmark)

    Ågård, Anne Sophie; Egerod, Ingrid; Tønnesen, Else Kirstine

    2012-01-01

    Objectives: To explore and explain the challenges, concerns and coping modalities in ICU-survivors living with a partner or spouse during the first 12 months post ICU discharge. Design: Qualitative, longitudinal grounded theory study. Settings: Five ICUs in Denmark, four general, one neurosurgical...... of getting well. Conclusion: The study offers new insight into post-ICU convalescence emphasising patients’ motivation for training to recover. The findings may contribute to defining the best supportive measures and timing of rehabilitation interventions in ICU and post ICU that may help ICU...

  17. A Comparison of the Batterer Intervention and Prevention Program With Alternative Court Dispositions on 12-Month Recidivism.

    Science.gov (United States)

    Boots, Denise Paquette; Wareham, Jennifer; Bartula, Aaron; Canas, Roberto

    2016-08-01

    Studies of batterer intervention and prevention programs (BIPPs) offer mixed results regarding their effect on recidivism. The purpose of this study was to examine the effectiveness of BIPP for cases assigned to a misdemeanor family court. This study focused on determining whether BIPP cases, compared with alternative sanctions, had significantly lower recidivism rates 12 months after program involvement. Findings indicated that BIPP was more effective than jail or regular dismissal in reducing the likelihood of future arrests, but not plea deferred adjudication and conditional dismissal. Results argue toward the efficacy of some form of treatment versus simply receiving jail time. © The Author(s) 2015.

  18. Kidney function during 12 months of strict metabolic control in insulin-dependent diabetic patients with incipient nephropathy

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, B; Mathiesen, E R; Hegedüs, L

    1986-01-01

    Thirty-six patients with insulin-dependent diabetes mellitus who had Albustix-negative urine but elevated urinary albumin excretion (30 to 300 mg per 24 hours) were matched in pairs according to their urinary albumin level, blood glycosylated hemoglobin level, and sex and assigned randomly...... in all patients during insulin infusion, but no consistent change was observed in the control group. No significant change was observed in the glomerular filtration rate. Our data suggest that the pathologic processes causing microalbuminuria in early renal disease are not reversed during 12 months...

  19. Food and Nutrient Intake among 12-Month-Old Norwegian-Somali and Norwegian-Iraqi Infants

    OpenAIRE

    Grewal, Navnit Kaur; Andersen, Lene Frost; Kolve, Cathrine Solheim; Kverndalen, Ingrid; Torheim, Liv Elin

    2016-01-01

    The aim of the present paper was to describe food and nutrient intake among 12-month-old Norwegian-Somali and Norwegian-Iraqi infants, with a focus on iron and vitamin D intake. A cross-sectional survey was conducted from August 2013 through September 2014. Eighty-nine mothers/infants of Somali origin and 77 mothers/infants of Iraqi origin residing in Eastern Norway participated in the study. Data were collected using two 24-h multiple-pass recalls. Forty percent of the Norwegian-Somali infan...

  20. Over-imaging in uncomplicated low back pain: a 12-month audit of a general medical unit.

    Science.gov (United States)

    Rego, M H; Nagiah, S

    2016-12-01

    Low back pain is frequently encountered in hospitals and is a leading cause of disability, often involving costly imaging that exposes a patient to radiation. A retrospective 12-month audit at a South Australian tertiary hospital aimed to evaluate the frequency, modality and appropriateness of imaging in patients with low back pain. Results showed that the general medical unit was unnecessarily ordering imaging in 40% of patients who exhibited no indications warranting such a procedure. A standardised protocol is required to preventing clinicians from requesting imaging solely for the purposes of self-reassurance, patient reassurance or fear of litigation. © 2016 Royal Australasian College of Physicians.

  1. Early in-session cognitive-emotional problem-solving predicts 12-month outcomes in depression with personality disorder.

    Science.gov (United States)

    McCarthy, Kye L; Mergenthaler, Erhard; Grenyer, Brin F S

    2014-01-01

    Therapist-patient verbalizations reveal complex cognitive-emotional linguistic data. How these variables contribute to change requires further research. Emotional-cognitive text analysis using the Ulm cycles model software was applied to transcripts of the third session of psychotherapy for 20 patients with depression and personality disorder. Results showed that connecting cycle sequences of problem-solving in the third hour predicted 12-month clinical outcomes. Therapist-patient dyads most improved spent significantly more time early in session in connecting cycles, whilst the least improved moved into connecting cycles late in session. For this particular sample, it was clear that positive emotional problem-solving in therapy was beneficial.

  2. Changes in Bone Mineral Density, Body Composition, Vitamin D Status, and Mineral Metabolism in Urban HIV-Positive South African Women Over 12 Months.

    Science.gov (United States)

    Hamill, Matthew M; Pettifor, John M; Ward, Kate A; Norris, Shane A; Prentice, Ann

    2017-08-01

    Human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) are associated with bone loss and poor vitamin D status in white populations, though their relative roles are not known. No previous studies have examined longitudinal changes in areal bone mineral density (aBMD), measured by dual-energy X-ray absorptiometry (DXA), or in vitamin D status in HIV-positive African women. Of 247 premenopausal, urban, black African women from Soweto, South Africa, initially recruited, 187 underwent anthropometry, DXA scanning and blood and urine collections at both baseline and 12 months. Of these, 67 were HIV-negative throughout (Nref), 60 were HIV-positive with preserved CD4 counts at baseline (Ppres), and 60 were HIV-positive with low CD4 counts at baseline, eligible for ART by South African standards of care at the time (Plow). No participant had been exposed to ART at baseline. By 12 months, 51 Plow women had initiated ART, >85% of whom took combined tenofovir disoproxil fumarate (TDF), lamivudine, and efavirenz. By 12 months, Plow and Nref, but not Ppres, increased in body weight and fat mass (group-by-timepoint p ≤ 0.001, p = 0.002, respectively). Plow had significant decreases in aBMD of 2% to 3%, before and after size adjustment, at the femoral neck (p ≤ 0.002) and lumbar spine (p ≤ 0.001), despite significant weight gain. These decreases were associated with increased bone turnover but there were no significant differences or changes over time in vitamin D status, serum phosphate concentrations, or renal phosphate handling. Excluding data from nine Plow women unexposed to ART and 11 Ppres women who had initiated ART accentuated these findings, suggesting the bone loss in Plow was related to ART exposure. This is the first study describing DXA-defined bone loss in HIV-positive Sub-Saharan African women in association with ART. Further work is required to establish if bone loss continues with ongoing ART and, if so, whether this

  3. Drug-eluting balloon versus standard balloon angioplasty for infrapopliteal arterial revascularization in critical limb ischemia: 12-month results from the IN.PACT DEEP randomized trial.

    Science.gov (United States)

    Zeller, Thomas; Baumgartner, Iris; Scheinert, Dierk; Brodmann, Marianne; Bosiers, Marc; Micari, Antonio; Peeters, Patrick; Vermassen, Frank; Landini, Mario; Snead, David B; Kent, K Craig; Rocha-Singh, Krishna J

    2014-10-14

    Drug-eluting balloons (DEB) may reduce infrapopliteal restenosis and reintervention rates versus percutaneous transluminal angioplasty (PTA) and improve wound healing/limb preservation. The goal of this clinical trial was to assess the efficacy and safety of IN.PACT Amphirion drug-eluting balloons (IA-DEB) compared to PTA for infrapopliteal arterial revascularization in patients with critical limb ischemia (CLI). Within a prospective, multicenter, randomized, controlled trial with independent clinical event adjudication and angiographic and wound core laboratories 358 CLI patients were randomized 2:1 to IA-DEB or PTA. The 2 coprimary efficacy endpoints through 12 months were clinically driven target lesion revascularization (CD-TLR) and late lumen loss (LLL). The primary safety endpoint through 6 months was a composite of all-cause mortality, major amputation, and CD-TLR. Clinical characteristics were similar between the 2 groups. Significant baseline differences between the IA-DEB and PTA arms included mean lesion length (10.2 cm vs. 12.9 cm; p = 0.002), impaired inflow (40.7% vs. 28.8%; p = 0.035), and previous target limb revascularization (32.2% vs. 21.8%; p = 0.047). Primary efficacy results of IA-DEB versus PTA were CD-TLR of 9.2% versus 13.1% (p = 0.291) and LLL of 0.61 ± 0.78 mm versus 0.62 ± 0.78 mm (p = 0.950). Primary safety endpoints were 17.7% versus 15.8% (p = 0.021) and met the noninferiority hypothesis. A safety signal driven by major amputations through 12 months was observed in the IA-DEB arm versus the PTA arm (8.8% vs. 3.6%; p = 0.080). In patients with CLI, IA-DEB had comparable efficacy to PTA. While primary safety was met, there was a trend towards an increased major amputation rate through 12 months compared to PTA. (Study of IN.PACT Amphirion™ Drug Eluting Balloon vs. Standard PTA for the Treatment of Below the Knee Critical Limb Ischemia [INPACT-DEEP]; NCT00941733). Copyright © 2014 American College of Cardiology Foundation. Published

  4. Toxocara seropositivity, atopy and wheezing in children living in poor neighbourhoods in urban Latin American.

    Directory of Open Access Journals (Sweden)

    Lívia Ribeiro Mendonça

    Full Text Available Toxocara canis and T. cati are parasites of dogs and cats, respectively, that infect humans and cause human toxocariasis. Infection may cause asthma-like symptoms but is often asymptomatic and is associated with a marked eosinophilia. Previous epidemiological studies indicate that T. canis infection may be associated with the development of atopy and asthma.To investigate possible associations between Toxocara spp. seropositivity and atopy and childhood wheezing in a population of children living in non-affluent areas of a large Latin American city.The study was conducted in the city of Salvador, Brazil. Data on wheezing symptoms were collected by questionnaire, and atopy was measured by the presence of aeroallergen-specific IgE (sIgE. Skin prick test (SPT, total IgE and peripheral eosinophilia were measured. Toxocara seropositivity was determined by the presence of anti-Toxocara IgG antibodies, and intestinal helminth infections were determined by stool microscopy.Children aged 4 to 11 years were studied, of whom 47% were seropositive for anti-Toxocara IgG; eosinophilia >4% occurred in 74.2% and >10% in 25.4%; 59.6% had elevated levels of total IgE; 36.8% had sIgE≥0.70 kU/L and 30.4% had SPT for at least one aeroallergen; 22.4% had current wheezing symptoms. Anti-Toxocara IgG was positively associated with elevated eosinophils counts, total IgE and the presence of specific IgE to aeroallergens but was inversely associated with skin prick test reactivity.The prevalence of Toxocara seropositivity was high in the studied population of children living in conditions of poverty in urban Brazil. Toxocara infection, although associated with total IgE, sIgE and eosinophilia, may prevent the development of skin hypersensitivity to aeroallergens, possibly through increased polyclonal IgE and the induction of a modified Th2 immune reaction.

  5. Toxocara Seropositivity, Atopy and Wheezing in Children Living in Poor Neighbourhoods in Urban Latin American

    Science.gov (United States)

    Mendonça, Lívia Ribeiro; Veiga, Rafael Valente; Dattoli, Vitor Camilo Cavalcante; Figueiredo, Camila Alexandrina; Fiaccone, Rosemeire; Santos, Jackson; Cruz, Álvaro Augusto; Rodrigues, Laura Cunha; Cooper, Philip John; Pontes-de-Carvalho, Lain Carlos; Barreto, Maurício Lima; Alcantara-Neves, Neuza Maria

    2012-01-01

    Background Toxocara canis and T. cati are parasites of dogs and cats, respectively, that infect humans and cause human toxocariasis. Infection may cause asthma-like symptoms but is often asymptomatic and is associated with a marked eosinophilia. Previous epidemiological studies indicate that T. canis infection may be associated with the development of atopy and asthma. Objectives To investigate possible associations between Toxocara spp. seropositivity and atopy and childhood wheezing in a population of children living in non-affluent areas of a large Latin American city. Methods The study was conducted in the city of Salvador, Brazil. Data on wheezing symptoms were collected by questionnaire, and atopy was measured by the presence of aeroallergen-specific IgE (sIgE). Skin prick test (SPT), total IgE and peripheral eosinophilia were measured. Toxocara seropositivity was determined by the presence of anti-Toxocara IgG antibodies, and intestinal helminth infections were determined by stool microscopy. Findings Children aged 4 to 11 years were studied, of whom 47% were seropositive for anti-Toxocara IgG; eosinophilia >4% occurred in 74.2% and >10% in 25.4%; 59.6% had elevated levels of total IgE; 36.8% had sIgE≥0.70 kU/L and 30.4% had SPT for at least one aeroallergen; 22.4% had current wheezing symptoms. Anti-Toxocara IgG was positively associated with elevated eosinophils counts, total IgE and the presence of specific IgE to aeroallergens but was inversely associated with skin prick test reactivity. Conclusion The prevalence of Toxocara seropositivity was high in the studied population of children living in conditions of poverty in urban Brazil. Toxocara infection, although associated with total IgE, sIgE and eosinophilia, may prevent the development of skin hypersensitivity to aeroallergens, possibly through increased polyclonal IgE and the induction of a modified Th2 immune reaction. PMID:23133689

  6. The B-cell response to a primary and booster course of MenACWY-CRM₁₉₇ vaccine administered at 2, 4 and 12 months of age.

    Science.gov (United States)

    Blanchard-Rohner, Geraldine; Snape, Matthew D; Kelly, Dominic F; O'Connor, Daniel; John, Tessa; Clutterbuck, Elizabeth A; Ohene-Kena, Brigitte; Klinger, Chaam L; Odrljin, Tatjana; Pollard, Andrew J

    2013-05-07

    A quadrivalent meningococcal vaccine conjugated to CRM197 (MenACWY-CRM197) is immunogenic in young infants. We assessed the memory B-cell and antibody responses after a primary and booster course of MenACWY-CRM197 in children. At 5 months of age, following primary immunisation, serogroup-specific memory B-cells were detectable in fewer than 25% of children, although protective antibody titres (hSBA ≥ 4) were detectable in 69% of children against serogroup A and more than 95% against the other serogroups. At 12 months, before booster immunisation the percentages with hSBA ≥ 4 were 5% for serogroup A, and between 44 and 70% for the other serogroups. One month after booster immunisation with MenACWY-CRM197 over 50% of children had detectable memory B-cells, and 91% had hSBA ≥ 4 against serogroup A and more than 99% against the other serogroups. These data show that few antigen-specific anticapsular memory B-cells can be detected after two-doses priming with MenACWY-CRM197. For MenC and CRM197, the antigens with the highest number of B-cells at 5 months, there was a definite (p ≤0 .02) but weak correlation with antibody persistence at 12 months. Although previous studies suggest that measuring memory B-cell responses after priming immunisations in infancy can be used to predict antibody persistence and memory responses, this may not be suitable for all antigens in young children. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Relationships between Breastfeeding Patterns and Maternal and Infant Body Composition over the First 12 Months of Lactation

    Directory of Open Access Journals (Sweden)

    Zoya Gridneva

    2018-01-01

    Full Text Available Breastfeeding has been implicated in the establishment of infant appetite regulation, feeding patterns and body composition (BC. A holistic approach is required to elucidate relationships between infant and maternal BC and contributing factors, such as breastfeeding parameters. Associations between maternal and breastfed term infant BC (n = 20 and feeding parameters during first 12 months of lactation were investigated. BC was measured at 2, 5, 9 and/or 12 months postpartum with ultrasound skinfolds (US; infants only and bioimpedance spectroscopy (infants and mothers. 24-h milk intake (MI and feeding frequency (FFQ were measured. Higher FFQ was associated with larger 24-h MI (p ≤ 0.003. Higher 24-h MI was associated with larger infant fat mass (FM (US: p ≤ 0.002, greater percentage FM (US: p ≤ 0.008, greater FM index (FMI (US: p ≤ 0.001 and lower fat-free mass index (FFMI (US: p = 0.015. Lower FFQ was associated with both larger FFM (US: p ≤ 0.001 and FFMI (US: p < 0.001. Greater maternal adiposity was associated with smaller infant FFM measured with US (BMI: p < 0.010; %FM: p = 0.004; FMI: p < 0.011. Maternal BC was not associated with FFQ or 24-h MI. These results reinforce that early life is a critical window for infant programming and that breastfeeding may influence risk of later disease via modulation of BC.

  8. Protein and amino acid status before and after bariatric surgery: a 12-month follow-up study.

    Science.gov (United States)

    Nicoletti, Carolina Ferreira; Morandi Junqueira-Franco, Marcia Varella; dos Santos, Jose Ernesto; Marchini, Julio Sergio; Salgado, Wilson; Nonino, Carla Barbosa

    2013-01-01

    Patients with obesity submitted to bariatric surgery present altered ingestion of macronutrient and micronutrient levels and nutrients deficiency. The objective of this study was to evaluate the protein and amino acid nutritional status of obese adults before and after bariatric surgery, with emphasis on plasma free amino acids. Thirty obese women were submitted to Roux-en-Y gastric shunt (bariatric surgery). Food and protein intake, anthropometric and bioimpedance data (body composition analysis), and serum total protein, albumin, and plasma amino acids levels were collected before the surgery (preoperative) and 3, 6, and 12 months after the surgical procedure. The mean protein intake was 47±2 g/day. The total weight loss during the study period was 39±8 kg; the fat-free mass decreased 7±5 kg. The amino acid profile showed increased concentrations of most amino acids 3 months after surgery; at 6 months, glutamic acid, serine, arginine, alanine, methionine, valine, phenylalanine, isoleucine, and tyrosine concentrations decreased. The total protein and albumin concentrations dropped along the 12-month follow-up. The amino acid profile changes after RYGB are evidence that total protein and albumin levels may not be good indicators of protein profile after the surgery. © 2013 Published by American Society for Metabolic and Bariatric Surgery on behalf of American Society for Bariatric Surgery.

  9. Factors affecting the occurrence of enteritis in 10- to 12-month-old eastern grey kangaroos (Macropus giganteus).

    Science.gov (United States)

    Kido, Nobuhide; Tanaka, Sohei; Wada, Yuko; Sato, Sumito

    2018-02-16

    Eastern grey kangaroos (Macropus giganteus) younger than 19 months at Kanazawa Zoological Gardens, Japan, frequently died of enteritis. The main cause of death was coccidiosis. This study aimed to reveal retrospectively the clinical features of enteritis and factors contributing to its high occurrence. In addition, haematological and serum biochemical parameters in kangaroos younger than 24 months were analyzed. The findings suggested that enteritis occurrence was higher in 10- to 12-month-old kangaroos than other ages and during seasons with high temperature and humidity than during seasons with low temperature and humidity. The haematological and serum biochemical analyses showed decreases in glucose, total cholesterol, calcium, and triglyceride levels at approximately 10 months of age. Joeys emerge from their mother's pouch at 8 months of age and permanently leave it at approximately 10 months of age. Subsequently, the joeys are exposed to the external environment and infectious agents. Although the joeys continue suckling until 13-19 months of age, the joeys start to eat the similar feed to the adult and their nutritional status may change at approximately 10 months of age. Seasonal influences, species behavior, and shifts in dietary composition are proposed to be contributory to the increased occurrence of enteritis between 10 and 12 months of age. © 2018 Wiley Periodicals, Inc.

  10. Food and Nutrient Intake among 12-Month-Old Norwegian-Somali and Norwegian-Iraqi Infants

    Directory of Open Access Journals (Sweden)

    Navnit Kaur Grewal

    2016-09-01

    Full Text Available The aim of the present paper was to describe food and nutrient intake among 12-month-old Norwegian-Somali and Norwegian-Iraqi infants, with a focus on iron and vitamin D intake. A cross-sectional survey was conducted from August 2013 through September 2014. Eighty-nine mothers/infants of Somali origin and 77 mothers/infants of Iraqi origin residing in Eastern Norway participated in the study. Data were collected using two 24-h multiple-pass recalls. Forty percent of the Norwegian-Somali infants and 47% of the Norwegian-Iraqi infants were breastfed at 12 months of age (p = 0.414. Median energy percentages (E% from protein, fat and carbohydrates were within the recommended intake ranges, except the level of saturated fats (12–13 E%. Median intakes of almost all micronutrients were above the recommended daily intakes. Most of the infants consumed iron-enriched products (81% and received vitamin D supplements (84%. The median intakes of iron and vitamin D were significantly higher among infants receiving iron-enriched products and vitamin D supplements compared to infants not receiving such products (p < 0.001. The findings indicate that the food and nutrient intake of this group of infants in general seems to be in accordance with Norwegian dietary recommendations. Foods rich in iron and vitamin D supplements were important sources of the infants’ intake of iron and vitamin D and should continue to be promoted.

  11. Maladaptive cognitions predict changes in problematic gaming in highly-engaged adults: A 12-month longitudinal study.

    Science.gov (United States)

    Forrest, Cameron J; King, Daniel L; Delfabbro, Paul H

    2017-02-01

    Understanding the role of maladaptive gaming-related cognitions may assist in screening and interventions for problematic gaming, including Internet gaming disorder (IGD). Cognitive-behavioural interventions that target specific cognitions related to gaming may be more effective than more general approaches that focus only on preoccupation with games. Although past research has identified cross-sectional associations between maladaptive cognitions and problematic gaming, it is less clear whether these cognitions can predict future changes in problematic gaming behaviour. The present study employed an 18-item measure of gaming cognition, assessing perfectionism, cognitive salience, regret, and behavioural salience, to investigate potential changes in problematic gaming over a 12-month period. The sample included 465 Australian adults (84% male, M age =26.2years). It was found that individuals who became problematic gamers over 12months had higher baseline scores on perfectionism (d=1.20), cognitive salience (d=0.74) and regret (d=0.69) than those who remained non-problematic gamers. Problematic gamers who became non-problematic gamers had lower baseline perfectionism scores (d=0.62) than those who remained problematic gamers. Cognitive change accounted for an additional 28% of variance in problematic gaming scores beyond gender, age, and frequency of gaming. These findings suggest that maladaptive gaming-related cognitions could be screened in clinical trials to aid in case formulation and inform decisions on needed interventions to deliver optimal client outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Food and Nutrient Intake among 12-Month-Old Norwegian-Somali and Norwegian-Iraqi Infants.

    Science.gov (United States)

    Grewal, Navnit Kaur; Andersen, Lene Frost; Kolve, Cathrine Solheim; Kverndalen, Ingrid; Torheim, Liv Elin

    2016-09-28

    The aim of the present paper was to describe food and nutrient intake among 12-month-old Norwegian-Somali and Norwegian-Iraqi infants, with a focus on iron and vitamin D intake. A cross-sectional survey was conducted from August 2013 through September 2014. Eighty-nine mothers/infants of Somali origin and 77 mothers/infants of Iraqi origin residing in Eastern Norway participated in the study. Data were collected using two 24-h multiple-pass recalls. Forty percent of the Norwegian-Somali infants and 47% of the Norwegian-Iraqi infants were breastfed at 12 months of age ( p = 0.414). Median energy percentages (E%) from protein, fat and carbohydrates were within the recommended intake ranges, except the level of saturated fats (12-13 E%). Median intakes of almost all micronutrients were above the recommended daily intakes. Most of the infants consumed iron-enriched products (81%) and received vitamin D supplements (84%). The median intakes of iron and vitamin D were significantly higher among infants receiving iron-enriched products and vitamin D supplements compared to infants not receiving such products ( p food and nutrient intake of this group of infants in general seems to be in accordance with Norwegian dietary recommendations. Foods rich in iron and vitamin D supplements were important sources of the infants' intake of iron and vitamin D and should continue to be promoted.

  13. Trajectory and predictors of depression in a 12-month prospective study after the Madrid March 11 terrorist attacks.

    Science.gov (United States)

    Salguero, J M; Cano-Vindel, A; Iruarrizaga, I; Fernández-Berrocal, P; Galea, S

    2011-10-01

    Few longitudinal studies have examined the trajectory of and the risk factors for depression in a representative sample of the population exposed to terrorism. A 12 month prospective study was conducted among a sample of Madrid city residents after the March 11, 2004 terrorist attacks. We aimed to document the trajectories of depressive symptoms and determine the risk factors associated with these trajectories. We conducted telephone surveys among a representative sample of Madrid citizens (N = 1589) to recruit baseline respondents approximately 1 month after the March 11 terrorist attacks. Participants were re-contacted at 6 and 12 months after baseline for further telephone interviews. Findings reveal heterogeneity in the longitudinal trajectories of depression ranging from the absence of depressive symptoms over time, to transient or chronic depression. Life and recent stressors, experiencing direct exposure to the attacks, personality traits, poor physical health and other psychological disorders were principally associated with a worse trajectory of depression after this event. Consistent with a stress diathesis model, ongoing stressors and intense event exposure are key drivers of a chronic depression trajectory after a mass traumatic event. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Risk factors for wheezing during infancy. A study of 5,953 infants

    DEFF Research Database (Denmark)

    Bisgaard, H; Dalgaard, P; Nyboe, J

    1987-01-01

    Risk factors for the development of wheezing during infancy were studied in 5,953 children. The data for the study were collected from a large prospective investigation of children born in 1959-61, who had attended a one-year follow-up examination. Wheezing was diagnosed when the symptom had been...

  15. Maternal Smoking during Pregnancy, Prematurity and Recurrent Wheezing in Early Childhood

    Science.gov (United States)

    Robison, Rachel G; Kumar, Rajesh; Arguelles, Lester M; Hong, Xiumei; Wang, Guoying; Apollon, Stephanie; Bonzagni, Anthony; Ortiz, Kathryn; Pearson, Colleen; Pongracic, Jacqueline A; Wang, Xiaobin

    2013-01-01

    Summary Background Prenatal maternal smoking and prematurity independently affect wheezing and asthma in childhood. Objective We sought to evaluate the interactive effects of maternal smoking and prematurity upon the development of early childhood wheezing. Methods We evaluated 1448 children with smoke exposure data from a prospective urban birth cohort in Boston. Maternal antenatal and postnatal exposure was determined from standardized questionnaires. Gestational age was assessed by the first day of the last menstrual period and early prenatal ultrasound (pretermprematurity and maternal antenatal smoking on recurrent wheeze, controlling for relevant covariates. Results In the cohort, 90 (6%) children had recurrent wheezing, 147 (10%) were exposed to in utero maternal smoke and 419 (29%) were premature. Prematurity (odds ratio [OR] 2.0; 95% CI, 1.3-3.1) was associated with an increased risk of recurrent wheezing, but in utero maternal smoking was not (OR 1.1, 95% CI 0.5-2.4). Jointly, maternal smoke exposure and prematurity caused an increased risk of recurrent wheezing (OR 3.8, 95% CI 1.8-8.0). There was an interaction between prematurity and maternal smoking upon episodes of wheezing (p=0.049). Conclusions We demonstrated an interaction between maternal smoking during pregnancy and prematurity on childhood wheezing in this urban, multiethnic birth cohort. PMID:22290763

  16. Lack of effect of zinc sulfate on wheezing after bronchiolitis in infants less than two years

    Directory of Open Access Journals (Sweden)

    R Abasi

    2014-10-01

    Full Text Available Backgrounds & aim: Wheezing after bronchiolitis is known as a risk factor for asthma. No cure or effective vaccine has been identified for such disease. The purpose of this study was to determine the effects of zinc sulfate on persistent wheezing after bronchiolitis in infants less than two years. Methods: The present randomized clinical trial study was conducted on 90 infants under two years of age suffering from the first attack with a clinical diagnosis of bronchiolitis wheezing hospitalized in Imam Sajjad Hospital, Yasuj. All infants were equally placed in test groups and control group. In addition to bronchiolitis usual treatment, test group received 20 mg of elemental zinc for seven days. Patient information including risk factors associated with wheezing and persistent wheezing were compared 48 hours and two weeks after treatment. Data were analyzed using chi-square and t tests. Results: In all 90 infants diagnosed with bronchiolitis, wheezing was observed. After 48 hours and two weeks wheezing was continued in 67 patients (74.4% and 54 patients (60% respectively Conclusion: The results showed Zinc sulfate had no effect on the improvement of wheezing after bronchiolitis.

  17. Airflow limitation during respiratory syncytial virus lower respiratory tract infection predicts recurrent wheezing

    NARCIS (Netherlands)

    Bont, L.; van Aalderen, W. M.; Versteegh, J.; Brus, F.; Draaisma, J. T.; Pekelharing-Berghuis, M.; van Diemen-Steenvoorde, R. A.; Kimpen, J. L.

    2001-01-01

    Respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) is frequently followed by recurrent wheezing. Thus far no clinical risk factors have been identified to predict which infants will have wheezing episodes subsequent to RSV LRTI. To determine clinical predictors for airway

  18. Respiratory syncytial virus neutralizing antibodies in cord blood, respiratory syncytial virus hospitalization, and recurrent wheeze

    DEFF Research Database (Denmark)

    Stensballe, Lone Graff; Ravn, Henrik; Kristensen, Kim

    2008-01-01

    Cohort, we selected a subcohort of 459 randomly selected children, 408 children with RSV hospitalization, 408 children with recurrent wheeze, and all 289 children who experienced both RSV hospitalization and recurrent wheeze. The influence of cord blood RSV neutralizing antibodies was examined...

  19. Prevalence and Risk Factors of Wheeze in Dutch Infants in Their First Year of Life

    NARCIS (Netherlands)

    Visser, Chantal A. N.; Garcia-Marcos, Luis; Eggink, Jenny; Brand, Paul L. P.

    Factors operating in the first year of life are critical in determining the onset and persistence of wheezing in preschool children. This study was designed to examine the prevalence and risk factors of wheeze in the first year of life in Dutch infants. This was a population-based survey of

  20. Impact of wheezing after respiratory syncytial virus infection on health-related quality of life

    NARCIS (Netherlands)

    Bont, Louis; Steijn, Marijke; van Aalderen, Wim M. C.; Kimpen, Jan L. L.

    2004-01-01

    Background: Respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) is often followed by recurrent wheezing episodes during childhood. The effect of postbronchiolitis wheezing on the well-being of the child is not known. This study aimed to determine the impact of RSV LRTI

  1. A meta-analysis of montelukast for recurrent wheeze in preschool children.

    Science.gov (United States)

    Hussein, Hasan R; Gupta, Atul; Broughton, Simon; Ruiz, Gary; Brathwaite, Nicola; Bossley, Cara J

    2017-07-01

    There is conflicting evidence of the effectiveness of montelukast in preschool wheeze. A recent Cochrane review focused on its use in viral-induced wheeze; however, such subgroups are unlikely to exist in real life and change with time, recently highlighted in an international consensus report. We have therefore sought to investigate the effectiveness of montelukast in all children with preschool wheeze (viral-induced and multiple-trigger wheeze). The PubMed, Cochrane Library, Ovid Medline and Ovid EMBASE were screened for randomised controlled trials (RCTs), examining the efficacy of montelukast compared with placebo in children with the recurrent preschool wheeze. The primary endpoint examined was frequency of wheezing episodes. Five trials containing 3960 patients with a preschool wheezing disorder were analysed. Meta-analyses of studies of intermittent montelukast showed no benefit in preventing episodes of wheeze (mean difference (MD) 0.07, 95% confidence interval (CI) -0.14 to 0.29; mean for montelukast 2.68 vs placebo 2.54 (p = 0.5)), reducing unscheduled medical attendances (MD -0.13, 95% CI -0.33 to 0.07; mean for montelukast 1.62 vs placebo 1.78 (p = 0.21)) and reducing oral corticosteroids (MD -0.06, 95% CI -0.16 to 0.02; mean for montelukast 0.35 vs placebo 0.36 (p = 0.25)). The pooled results of the continuous regimen showed no significant difference in the number of wheezing episodes between the montelukast and placebo groups (MD -0.40, 95% CI -1.00 to 0.19; mean for montelukast 2.05 vs placebo 2.37 (p = 0.18)). This review highlights that the currently available evidence does not support the use of montelukast in preschool children with recurrent wheeze. We recommend further studies to investigate if a 'montelukast responder' phenotype exists, and how these can be easily identified in the clinical setting. What is Known: • Current guidelines recommend montelukast use in preschool children with recurrent wheeze. • A recent Cochrane review

  2. The effect of 12-month participation in osteogenic and non-osteogenic sports on bone development in adolescent male athletes. The PRO-BONE study

    DEFF Research Database (Denmark)

    Vlachopoulos, Dimitris; Barker, Alan R; Ubago-Guisado, Esther

    2018-01-01

    OBJECTIVES: Research investigating the longitudinal effects of the most popular sports on bone development in adolescent males is scarce. The aim is to investigate the effect of 12-month participation in osteogenic and non-osteogenic sports on bone development. DESIGN: A 12-month study...

  3. Management of preschool recurrent wheezing and asthma: a phenotype-based approach.

    Science.gov (United States)

    Beigelman, Avraham; Bacharier, Leonard B

    2017-04-01

    The purpose of this review is to summarize the recent evidence on the management of preschool children with wheezing and asthma, and to propose a phenotype-based approach to the management of these children. Recent studies have begun to identify populations of preschool children that are likely to benefit from inhaled corticosteroids (ICS) therapy and defined ICS regimens: daily ICS in preschool children with persistent asthma, and pre-emptive high-dose intermittent ICS among preschool children with intermittent disease reduce the risk of exacerbation. In addition, among preschool children with mild persistent asthma, the presence of aeroallergen sensitivity and/or blood eosinophil counts of 300/μL or greater are predictors of good response to daily ICS therapy. Other studies identified intermittent azithromycin as a therapy to prevent, and potentially to treat, acute exacerbations.The uncertainty of the role of oral corticosteroids (OCS) as a therapy for acute exacerbations continues, as a recent meta-analysis showed that OCS did not prevent hospitalizations or urgent visits, and did not reduce the need for additional courses of OCS. Whereas previous epidemiologic studies suggested acetaminophen may increase risk of exacerbations, a clinical trial clearly demonstrated acetaminophen use, compared to ibuprofen use,does not increase exacerbation risk among preschool children with mild-persistent asthma. Recent studies have shown potential for phenotypic-driven therapies for the management of preschool children with asthma. Targeting airway bacteria has emerged as a promising therapeutic approach, but its effect on antibiotic resistance still needs to be investigated. Finally, more studies are required to evaluate if oral corticosteroids provide any benefits for acute episodic wheeze.

  4. [Recurrent wheezing: prevalence and associated factors in infants from Buenos Aires City, Argentina].

    Science.gov (United States)

    Szulman, Gabriela Aída; Freilij, Héctor; Behrends, Ilse; Gentile, Ángela; Mallol, Javier

    The episodes of bronchial obstruction at early age constitute a frequent problem in Pediatrics. The aim of this study was to evaluate the prevalence of recurrent wheezing in infants in Buenos Aires City, as well as to identify any associated factors. Cross-sectional study performed from 2011 to 2012 in the Children Hospital Ricardo Gutiérrez, Buenos Aires City, as part of the International Study of Wheezing in Infants. A validated questionnaire was applied to parents of infants aged between 12 and 15 months. The prevalence of wheezing, mostly the recurrent episodes (three or more), and their probable associated factors were evaluated. Data were statistically analyzed with χ 2 , Fisher's test, binary and logistics multiple regression analysis. The significance level was 0.05. Over 1063 infants, 58.9% (confidence interval (CI) 95% 55.9-61.9) presented at least one episode of wheezing and 26.3% (CI95% 23.8-29.9) three or more episodes (recurrent wheezing). Risk factors associated to wheezing were male gender (p=0.001), six or more episodes of cold during the first year of life (p <0.0001), age at first cold <4 months (p <0.0001); pneumonia (p <0.0001) and smoking during pregnancy (tobacco) (p=0.01). For recurrent wheezing, risk factors we considered as six or more episodes of cold during the first year of life (p <0.0001), early (< 4 month of age) onset wheezing (p <0.0001) and nocturnal wheezing (p <0.0001). The prevalence of recurrent wheezing among infants in Buenos Aires Ciy was high (26.3%). Some identified associated factors can be preventable. Copyright © 2017 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  5. A test of cognitive mediation in a 12-month physical activity workplace intervention: does it explain behaviour change in women?

    Directory of Open Access Journals (Sweden)

    Pickering Michael A

    2010-05-01

    Full Text Available Abstract Background Attempts to demonstrate the efficacy of interventions aimed at increasing physical activity (PA have been mixed. Further, studies are seldom designed in a manner that facilitates the understanding of how or why a treatment is effective or ineffective and PA intervention designs should be guided by a heavier reliance upon behavioral theory. The use of a mediating variable framework offers a systematic methodological approach to testing the role of theory, and could also identify the effectiveness of specific intervention components. The primary purpose of this paper was to test the mediating role that cognitive constructs may have played in regards to the positive effect that a workplace behavioral intervention had on leisure-time PA for women. A subsidiary purpose was to examine the cross-sectional relationships of these cognitive constructs with PA behavior. Methods The Physical Activity Workplace Study was a randomized controlled trial which compared the effects of stage-matched and standard print materials upon self-reported leisure-time PA, within a workplace sample at 6 and 12-months. In this secondary analysis we examined the mediation effects of 14 psychosocial constructs across 3 major social-cognitive theories which were operationalized for the intervention materials and measured at baseline, 6 and 12-months. We examined change in PA and change in the psychological constructs employing a mediation strategy proposed by Baron and Kenny for: (1 the first 6-months (i.e., initial change, (2 the second 6-months (i.e., delayed change, and (3 the entire 12-months (overall change of the study on 323 women (n = 213 control/standard materials group; n = 110 stage-matched materials group. Results Of the 14 constructs and 42 tests (including initial, delayed and overall change two positive results were identified (i.e., overall change in pros, initial change in experiential powerful intervention approaches processes, with very

  6. Help-seeking intentions and subsequent 12-month mental health service use in Chinese primary care patients with depressive symptoms.

    Science.gov (United States)

    Chin, Weng Yee; Chan, Kit T Y; Lam, Cindy L K; Lam, T P; Wan, Eric Y F

    2015-01-28

    To identify the factors associated with 12-month mental health service use in primary care patients with depressive symptoms. Cross-sectional followed by 12-month cohort study. 10 179 adult patients were recruited from the waiting rooms of 59 primary care clinics across Hong Kong to complete a questionnaire which screened for depression. 518 screened-positive participants formed the cohort and were telephoned at 3, 6 and 12 months to monitor mental health service use. ▸ Help-seeking preferences; ▸ Intention to seek help from a healthcare professional; ▸ 12-month mental health service use. At baseline, when asked who they would seek help from if they thought they were depressed, respondents preferred using friends and family (46.5%) over a psychiatrist (24.9%), psychologist (22.8%) or general practitioner (GP; 19.9%). The presence of depressive symptoms was associated with a lower intention to seek help from family and friends but had no effect on intention to seek help from a healthcare professional. Over 12 months, 24.3% of the screened-positive cohort reported receiving services from a mental health professional. Factors associated with service use included identification of depression by the GP at baseline, having a past history of depression or other mental illness, and being a public sector patient. Having a positive intention to seek professional help or more severe depressive symptoms at baseline was not associated with a greater likelihood of receiving treatment. Mental health service use appears to be very low in this setting with only one in four primary care patients with depressive symptoms receiving treatment from a psychiatrist, GP or psychologist over a year. To help reduce the burden of illness, better detection of depressive disorders is needed especially for patients who may be undertreated such as those with no prior diagnosis of depression and those with more severe symptoms. Published by the BMJ Publishing Group Limited. For

  7. Psychiatric disorders in students in six French universities: 12-month prevalence, comorbidity, impairment and help-seeking.

    Science.gov (United States)

    Verger, Pierre; Guagliardo, Valérie; Gilbert, Fabien; Rouillon, Frédéric; Kovess-Masfety, Viviane

    2010-02-01

    Few studies have explored the prevalence of psychiatric disorders (PD) among university students. This article aims to study 12-month prevalence of PD in university students, their socio-economic correlates, impairment in daily life and help-seeking behaviours. Cross-sectional study of randomly selected first-year students aged 18-24 years, enrolled in one of the six universities in south-eastern France in 2005-2006. We used the WHO CIDI-Short Form to derive DSM-IV diagnoses and the Sheehan disability scale to evaluate impairment. We studied their correlates with multiple logistic regressions. The 12-month prevalence of major depressive disorder (MDD), anxiety disorders (AD) and substance use disorders (SUD) were 8.9% (95% CI: 7.2-10.9), 15.7% (95% CI: 13.5-18.2) and 8.1% (95% CI: 6.7-9.8), respectively. MDD was associated with precarious economic situation (OR = 1.83; 95% CI: 1.03-3.23), AD with a precarious job or unemployment of the father (OR = 2.08; 95% CI: 1.04-4.14) and SUD with higher educational level of father (OR = 2.17; 95% CI: 1.28-3.67) or having a paid job (OR = 1.82; 95% CI: 1.06-3.13). "Marked" or "extreme" impairment (score > or =7 for at least one of the domains in the Sheehan scale) was noted for 51.7% of students presenting a PD and was even more frequent in the presence of MDD/AD comorbidity. Only 30.5% of the students with a PD had sought professional help in the past 12 months. This study provides new results regarding university students suggesting a link between precarious economic situations and MDD. The frequent impairment arising from PD alongside low rates of help-seeking suggests that PD could be one of the factors in academic failure in first year of university. These results should be used to improve prevention and care of PD in university students in France.

  8. THE FIRST RUSSIAN STRATEGIC STUDY OF PHARMACOTHERAPY FOR RHEUMATOID ARTHRITIS (REMARCA TRIAL: RESULTS OF 12-MONTH TREATMENT IN 130 PATIENTS

    Directory of Open Access Journals (Sweden)

    D. E. Karateev

    2014-01-01

    Full Text Available To introduce treat-to-target recommendations is an important task of modern rheumatology; however, there is still a diversity of serious problems relating to a scientific rationale and a clinical one for this strategy and to the possibilities of its implementation in real clinical practice, in the rheumatology service of the Russian Federation in particular, by taking into account the specific features of funding for high-tech medical care.Objective: to determine the efficiency and safety of combined therapy with subcutaneous methotrexate (MT and biological agents (BA when using the treat-to-target strategy in patients with active early and extended-stage rheumatoid arthritis (RA who have risk factors for a poor prognosis.Subjects and methods.The results of the REMARCA (Russian InvEstigation of MethotrexAte and biologicals in eaRly aCtive inflammatory Arthritis trial of 130 patients followed up for 12 months or more were given. There was a female preponderance; mean age 48.9±13.9 years, rheumatoid factor positivity (86.9%; anti-cyclic citrullinated peptide antibody positivity (89.2%. Seventy patients formed a subgroup of early RA (disease duration ≤6 months (mean 4.17±1.39 months; 60 patients were a subgroup of advanced-stage RA (disease duration >6 months (mean 30.8±32.7 months. In all the patients, therapy was initiated by using subcutaneous MT with its rapid dose escalation up to 20–30 mg/week and the achievement of the treatment goal (low disease activity or remission was checked every 3 months and depending on the result a decision had been taken to add or not to add a biological agent (BA (a tumor necrosis factor inhibitor or abatacept. If the former was insufficiently effective, it was substituted for a BA from another class.Results. Subcutaneous MT monotherapy provided remission or low disease activity in 49 (37.7% patients; a BA was given to 81 (62.3% patients. Following 6 and 12 months, low activity or remission

  9. Use of deuterium oxide to measure breast milk intake in children aged 7-12 months receiving complementary foods

    International Nuclear Information System (INIS)

    Creed-Kanashiro, H.

    2000-01-01

    In the present study we performed a pilot study using deuterium oxide method to determine the breast-milk intake in children 7-12 months of age receiving complementary food. This is applied to a community efficacy study to determine the effects on total energy and nutrient intake and on breast-milk consumption of an intensive education intervention using locally available, culturally acceptable complementary foods. We determined the washout period for the deuterium finding a value of 21 days for the mother and child. This measurement was performed using the infrared spectrometer of the Instituto de Investigacion Nutricional and compared with the values obtained with the IR Mass Spectrometer of INTA Chile. The test weighing was conduced on 14 children and compared with the values obtained using the deuterium methodology. Our result suggest that the breast milk intake determined by the weighing test was lower with regard to the value obtained with the deuterium methodology. (author)

  10. Development of Metabolic Syndrome in Drug-Naive Adolescents After 12 Months of Second-Generation Antipsychotic Treatment

    DEFF Research Database (Denmark)

    Sjo, Christina Power; Stenstrøm, Anne Dorte; Bojesen, Anders Bo

    2017-01-01

    if obesity or metabolic aberration starts in childhood or adolescence. METHODS: Drug-naive adolescents were recruited after contact with an outpatient Psychosis Team. Changes relative to baseline in body mass index (BMI), waist circumference (WC), blood pressure (BP), fasting blood glucose (FBG...... months the participants' BMI had increased from 0.5 to 1.57 standard deviation (SD) above the 50th percentile for age and gender (p = 0.0001). CONCLUSION: To our knowledge, this is the first study to include all the aspects of MetS in a sample of drug-naive adolescents followed over the first 12 months...... after starting SGA treatment. A significant shift in all parameters (except BP) toward MetS was found, presumably due to SGA use. Therefore, these adolescents will need proper follow-up, consisting of not only monitoring but also preventive measures to diminish these effects of SGA use....

  11. Dietary Pattern Trajectories from 6 to 12 Months of Age in a Multi-Ethnic Asian Cohort.

    Science.gov (United States)

    Lim, Geraldine Huini; Toh, Jia Ying; Aris, Izzuddin M; Chia, Ai-Ru; Han, Wee Meng; Saw, Seang Mei; Godfrey, Keith M; Gluckman, Peter D; Chong, Yap-Seng; Yap, Fabian; Lee, Yung Seng; Kramer, Michael S; Chong, Mary Foong-Fong

    2016-06-15

    Little is known about the dietary patterns of Asian infants in the first year of life, nor of their associations with maternal socio-demographic factors. Based on the Growing Up in Singapore towards healthy Outcomes (GUSTO) mother-offspring cohort, cross-sectional dietary patterns were derived by factor analysis using 24-h recalls and food diaries of infants at 6-, 9- and 12-months of age. Dietary pattern trajectories were modeled by mapping similar dietary patterns across each age using multilevel mixed models. Associations with maternal socio-demographic variables, collected through questionnaires during pregnancy, were assessed using general linear models. In n = 486 infants, four dietary pattern trajectories were established from 6- to 12-months. Predominantly breastmilk: mainly breastmilk and less formula milk, rice porridge, vegetables, fruits and low-fat fish and meat, Easy-to-prepare foods: infant cereals, juices, cakes and biscuits and Noodles (in soup) and seafood: noodle and common accompaniments. In adjusted models, higher maternal education attainment was correlated with higher start scores on Predominantly breastmilk, but lowest education attainment increased its adherence over time. Older mothers had higher start scores on Easy-to-prepare foods, but younger mothers had increased adherence over time. Chinese mothers had higher start scores on Predominantly breastmilk but greater adherence to GUIDELINES over time, while Indian mothers had higher start scores on Easy-to-prepare foods but greater adherence to Predominantly breastmilk with time (p dietary patterns established during weaning are strongly influenced by maternal socio-demographic factors and remain stable over the first year of life.

  12. HPV infection, cervical abnormalities, and cancer in HIV-infected women in Mumbai, India: 12-month follow-up.

    Science.gov (United States)

    Isaakidis, Petros; Pimple, Sharmila; Varghese, Bhanumati; Khan, Samsuddin; Mansoor, Homa; Ladomirska, Joanna; Sharma, Neelakumari; Silva, Esdras Da; Metcalf, Carol; Caluwaerts, Severine; Alders, Petra; Ntzani, Evangelia E; Reid, Tony

    2013-01-01

    HIV-infected women are at a higher risk of cervical intraepithelial neoplasia (CIN) and cancer than women in the general population, partly due to a high prevalence of persistent human papillomavirus (HPV) infection. The aim of the study was to assess the burden of HPV infection, cervical abnormalities, and cervical cancer among a cohort of HIV-infected women as part of a routine screening in an urban overpopulated slum setting in Mumbai, India. From May 2010 to October 2010, Médecins Sans Frontières and Tata Memorial Hospital Mumbai offered routine annual Pap smears and HPV DNA testing of women attending an antiretroviral therapy (ART) clinic and a 12-month follow-up. Women with abnormal test results were offered cervical biopsy and treatment, including treatment for sexually transmitted infections (STIs). Ninety-five women were screened. Median age was 38 years (IQR: 33-41); median nadir CD4-count 143 cells/μL (IQR: 79-270); and median time on ART 23 months (IQR:10-41). HPV DNA was detected in 30/94 women (32%), and 18/94 (19%) showed either low-grade or high-grade squamous intraepithelial lesions (LSIL/HSIL) on Pap smear. Overall, >50% had cervical inflammatory reactions including STIs. Of the 43 women with a cervical biopsy, eight (8.4%) had CIN-1, five (5.3%) CIN-2, and two (2.1%) carcinoma in situ. All but one had HPV DNA detected (risk ratio: 11, 95% confidence interval: 3.3-34). By October 2011, 56 women had completed the 12-month follow-up and had been rescreened. No new cases of HPV infection/LSIL/HSIL were detected. The high prevalence of HPV infection, STIs, and cervical lesions among women attending an ART clinic demonstrates a need for routine screening. Simple, one-stop screening strategies are needed. The optimal screening interval, especially when resources are limited, needs to be determined.

  13. Six-and 12-month follow-up of an interdisciplinary fibromyalgia treatment programme: results of a randomised trial.

    Science.gov (United States)

    Martín, Josune; Torre, Fernando; Padierna, Angel; Aguirre, Urko; González, Nerea; García, Susana; Matellanes, Begoña; Quintana, José M

    2012-01-01

    To assess the efficacy of a 6-week interdisciplinary treatment that combines coordinated psychological, medical, educational, and physiotherapeutic components (PSYMEPHY) over time compared to standard pharmacologic care. Randomised controlled trial with follow-up at 6 months for the PSYMEPHY and control groups and 12 months for the PSYMEPHY group. Participants were 153 outpatients with FM recruited from a hospital pain management unit. Patients randomly allocated to the control group (CG) received standard pharmacologic therapy. The experimental group (EG) received an interdisciplinary treatment (12 sessions). The main outcome was changes in quality of life, and secondary outcomes were pain, physical function, anxiety, depression, use of pain coping strategies, and satisfaction with treatment as measured by the Fibromyalgia Impact Questionnaire, the Hospital Anxiety and Depression Scale, the Coping with Chronic Pain Questionnaire, and a question regarding satisfaction with the treatment. Six months after the intervention, significant improvements in quality of life (p=0.04), physical function (p=0.01), and pain (p=0.03) were seen in the PSYMEPHY group (n=54) compared with controls (n=56). Patients receiving the intervention reported greater satisfaction with treatment. Twelve months after the intervention, patients in the PSYMEPHY group (n=58) maintained statistically significant improvements in quality of life, physical functioning, pain, and symptoms of anxiety and depression, and were less likely to use maladaptive passive coping strategies compared to baseline. An interdisciplinary treatment for FM was associated with improvements in quality of life, pain, physical function, anxiety and depression, and pain coping strategies up to 12 months after the intervention.

  14. Retention of fissure sealants in young permanent molars affected by dental fluorosis: a 12-month clinical study.

    Science.gov (United States)

    Hasanuddin, S; Reddy, E R; Manjula, M; Srilaxmi, N; Rani, S T; Rajesh, A

    2014-10-01

    To evaluate and compare retention and caries occurance following placement of Clinpro and FUJI VII fissure sealants, by two different techniques simultaneously in unsealed, contralateral young permanent molars of 7- to 10-year-old children affected by mild to moderate dental fluorosis at various recall intervals of 1 week, 1, 3, 6 and 12 months. 80 schoolchildren with mild to moderate dental fluorosis were assigned to Group A and Group B with 40 children in each group. In Group A Clinpro fissure sealant and in Group B Fuji VII fissure sealant was used. In both the groups fissure sealants were applied by conventional fissure sealant technique (CST) on one side and enameloplasty sealant technique (EST) on the other side of the same arch. The applied fissure sealants were evaluated clinically for retention and caries incidence. Clinpro fissure sealant showed a retention rate of 95% when compared with Fuji VII (57.5%) at the end of 12 months, which was statistically significant. Regarding techniques, EST showed better results than CST in both the groups. Comparison of groups with respect to retention and techniques at different time periods was performed using Mann-Whitney U test (p < 0.05). Comparison of different time periods with respect to retention and technique in all the groups was performed using Wilcoxon matched pairs test by ranks (p < 0.05). Clinpro fissure sealant showed better retention at all treatment intervals, when compared with Fuji VII. Further follow-up is required to study the efficacy of the fissure sealant placement techniques.

  15. Recovery of episodic memory subprocesses in mild and complicated mild traumatic brain injury at 1 and 12 months post injury.

    Science.gov (United States)

    Tayim, Fadi M; Flashman, Laura A; Wright, Matthew J; Roth, Robert M; McAllister, Thomas W

    2016-11-01

    Episodic memory complaints are commonly reported after traumatic brain injury (TBI). The contributions of specific memory subprocesses (encoding, consolidation, and retrieval), however, are not well understood in mild TBI (mTBI). In the present study, we evaluated subprocesses of episodic memory in patients with mTBI using the item-specific deficit approach (ISDA), which analyzes responses on list learning tasks at an item level. We also conducted exploratory analyses to evaluate the effects of complicated mTBI (comp-mTBI) on memory. We compared episodic verbal memory performance in mTBI (n = 92) at approximately 1 and 12 months post TBI, as well as in a healthy comparison (HC) group (n = 40) at equivalent time points. Episodic memory was assessed using the California Verbal Learning Test-2nd Edition (CVLT-II), and both standard CVLT-II scores and ISDA indices were evaluated. Compared to the HC group, the mTBI group showed significantly poorer encoding and learning across time, as measured by ISDA and CVLT-II. Further analyses of these mTBI subgroups [(noncomplicated mTBI (NC-mTBI, n = 77) and comp-mTBI (n = 15)], indicated that it was the comp-mTBI group who continued to demonstrate poorer encoding ability than the HC group. When the patient groups were directly compared, the NC-mTBI group improved slightly on the ISDA Encoding Deficit Index. While the comp-mTBI group worsened slightly over time, their poorer encoding ability was not likely clinically meaningful. These findings indicate that, while the NC-mTBI and HC groups' performances were comparable by 12 months, a primary, long-term deficit in encoding of auditory verbal information remained problematic in the comp-mTBI group.

  16. Oral hygiene and gingival health in patients with fixed prosthodontic appliances--a 12-month follow-up.

    Science.gov (United States)

    Ortolan, Sladana Milardović; Viskić, Josko; Stefancić, Sanja; Sitar, Ksenija Rener; Vojvodić, Denis; Mehulić, Ketij

    2012-03-01

    The aim of this study was to assess and observe the oral hygiene and gingival condition in patients before and after fixed prosthodontic therapy through a 12-month period in combination with oral hygiene instructions. It was also analysed how factors, such as type of fixed prosthodontic appliance, constructive material, the position of a fixed partial denture (FPD) in the mouth, age and gender influenced oral hygiene. The dental arches were divided into three segments each and teeth and gingiva were examined using the Plaque and Gingiva Index by Silness and Löe, and for the mineralized deposits assessment the Calculus Index by Green and Vermillion was employed. The preliminary examination was conducted before the prosthodontic therapy, and the reexaminations were carried out 14 days, 1, 6 and 12 months after crown and/or FPD placement. A total of 93 subjects from the original study group of 146 patients attended all clinical examinations, while the rest was excluded. The sample consisted of 60 women, 33 men at age between 21 and 95 (average 51.8). A total of 39 patients had single crowns (C), 50 FPDs and 5 C+FPD. The frequency of plaque found during the preliminary visit was higher than that found in the other periods (p oral hygiene levels than patients with FPDs or C+FPDs (p = 0.001). Our results revealed no significant difference in oral hygiene status among patients with FPDs made of different materials (p = 0.083). The worst hygiene levels were found in patients with fixed prosthodontic appliances in both jaws (p = 0.012). Younger patients showed better hygiene levels than the older ones (p = 0.002). Our research showed that appropriate educational and motivational measures can lead to improved oral hygiene, even after FPD placement. Presumably, the oral health in a group of adult patients can be kept acceptable by providing a prophylactic oral hygiene program.

  17. Rapid response predicts 12-month post-treatment outcomes in binge-eating disorder: theoretical and clinical implications

    Science.gov (United States)

    Grilo, C. M.; White, M. A.; Wilson, G. T.; Gueorguieva, R.; Masheb, R. M.

    2011-01-01

    Background We examined rapid response in obese patients with binge-eating disorder (BED) in a clinical trial testing cognitive behavioral therapy (CBT) and behavioral weight loss (BWL). Method Altogether, 90 participants were randomly assigned to CBT or BWL. Assessments were performed at baseline, throughout and post-treatment and at 6- and 12-month follow-ups. Rapid response, defined as ≥70% reduction in binge eating by week four, was determined by receiver operating characteristic curves and used to predict outcomes. Results Rapid response characterized 57% of participants (67% of CBT, 47% of BWL) and was unrelated to most baseline variables. Rapid response predicted greater improvements across outcomes but had different prognostic significance and distinct time courses for CBT versus BWL. Patients receiving CBT did comparably well regardless of rapid response in terms of reduced binge eating and eating disorder psychopathology but did not achieve weight loss. Among patients receiving BWL, those without rapid response failed to improve further. However, those with rapid response were significantly more likely to achieve binge-eating remission (62% v. 13%) and greater reductions in binge-eating frequency, eating disorder psychopathology and weight loss. Conclusions Rapid response to treatment in BED has prognostic significance through 12-month follow-up, provides evidence for treatment specificity and has clinical implications for stepped-care treatment models for BED. Rapid responders who receive BWL benefit in terms of both binge eating and short-term weight loss. Collectively, these findings suggest that BWL might be a candidate for initial intervention in stepped-care models with an evaluation of progress after 1 month to identify non-rapid responders who could be advised to consider a switch to a specialized treatment. PMID:21923964

  18. 12-month trajectories of depressive symptoms among nurses-Contribution of personality, job characteristics, coping, and burnout.

    Science.gov (United States)

    Duan-Porter, Wei; Hatch, Daniel; Pendergast, Jane F; Freude, Gabriele; Rose, Uwe; Burr, Hermann; Müller, Grit; Martus, Peter; Pohrt, Anne; Potter, Guy

    2018-07-01

    Job related factors have been associated with higher risk for developing depression, but past studies lacked full consideration of individual factors such as personality and coping. We sought to evaluate associations of personality, coping, job characteristics, and burnout with 12-month trajectories of depressive symptoms among nursing workers. Cohort of nursing workers (N = 281) in a private hospital system, with baseline assessments of personality, job characteristics, and coping. Burnout and depression were measured at baseline and during monthly follow-ups. Linear mixed modeling was used to examine contributions to between- and within-individual variation in monthly depressive symptoms. Personality trait of negative affectivity accounted for 36% of between-individual variation in depressive symptoms over 12 months, while job characteristics and coping explained an additional 5% and 8% of this variation, respectively. Exhaustion dimension of burnout was associated with between-individual variation in depressive symptoms (fixed effect β coefficient 2.44, p individual variation in symptoms. Disengagement dimension of burnout was not associated with between-individual variation in depressive symptoms, but contributed to within-individual variation in depressive symptoms over time (fixed effect β coefficient 0.52, p = 0.01). Participants were nursing workers within a single hospital system. Participants who were excluded due to missing baseline data were more likely of non-white race, which may also limit the generalizability of our results. We used latent variables to represent certain job and coping characteristics, which may make our results less comparable with other studies examining the role of these factors in work-associated depression. Future interventions to prevent depression in healthcare workers should consider multiple job and individual factors. Potential components include strategies to manage negative affectivity and reduce avoidant

  19. Level of agreement between patient and proxy responses to the EQ-5D health questionnaire 12 months after injury.

    Science.gov (United States)

    Gabbe, Belinda J; Lyons, Ronan A; Sutherland, Ann M; Hart, Melissa J; Cameron, Peter A

    2012-04-01

    Health-related quality of life represents a patient's experiences and expectations and should be collected from the patient. In trauma, collection of information from the patient can be challenging, particularly for subgroups where cognitive impairment is prevalent, increasing reliance on proxy reporting. This study assessed the agreement between patient and proxy reporting of health-related quality of life 12 months after injury. The Victorian State Trauma Registry and Victorian Orthopaedic Trauma Outcomes Registry collect EQ-5D data at 12 months after injury. Cases where data were collected from the patient and proxy were extracted. Agreement between patient and proxy responses was compared using kappa (K) coefficients for the individual EQ-5D items, and Bland-Altman plots and Wilcoxon signed-rank tests for the EQ-5D summary score and visual analog scale (VAS). Agreement between patient and proxy respondents was substantial for the mobility (K = 0.61) and personal care items (K = 0.67) and moderate for the usual activities (K = 0.50), pain/discomfort (K = 0.42), and anxiety/depression items (K = 0.47). The mean difference between proxy and patient-reported scores for the VAS (0.74, 95% confidence interval: -2.73, 4.21) and the EQ-5D summary score (-0.02, 95% confidence interval: -0.07, 0.03) was small, but the limits of agreement were wide (-34.22 to 35.71 for VAS and -0.55 to 0.51 for summary score), suggesting no systematic bias. Although proxy and patient responses for the EQ-5D VAS may differ, the differences show random variability rather than systematic bias. Group comparisons using proxy responses are unlikely to be biased, but proxy responses should be used with caution when assessing individual patient recovery.

  20. Psychosocial intervention for family caregivers of people with dementia reduces caregiver's burden: development and effect after 6 and 12 months.

    Science.gov (United States)

    Signe, Andrén; Elmståhl, Sölve

    2008-03-01

    A number of different intervention programmes have been described in the literature for caregivers of people with dementia, but the nature of intervention has varied widely. The aim of the present study was to evaluate the efficacy of psychosocial intervention on family caregiver's level of burden and satisfaction, and possible influence of the caregiver's relationship and health and the patient's severity of the disease on the effects of intervention. All persons, 70 years and older, from two districts of a municipality (2721 individuals) who were in receipt of any form of social services were invited to participate in a screening of cognitive decline, and 1656 home visits were made. Those with symptoms of cognitive decline, and having a family caregiver, were invited for a further medical examination. Data were analysed from 308 family caregivers: 153 caregivers who underwent intervention and 155 control caregivers who did not. Repeated measures were carried out 6 and 12 months later. Outcomes were measured using instruments that had been tested for reliability and validity, and all patients were diagnosed according to DSM-IV dementia criteria. Caregivers who underwent the psychosocial intervention (5-week programme and 3-month conversation group) reported significantly lower strain and disappointment after 6 months, and this trend remained after 12 months. Satisfaction, measured in terms of purpose, increased in the intervention group and decreased in the control group. The best effect on caregivers in the intervention group was found early in the progression of dementia and in caregivers with impaired health. These findings emphasize the importance of identifying family caregivers early in the caring process to optimize well-being. This study demonstrates that psychosocial intervention with a clearly defined aim that includes giving information and having a conversation group have significant, positive effects on burden and satisfaction for caregivers of people

  1. Complementary foods consumed by 6-12-month-old rural infants in South Africa are inadequate in micronutrients.

    Science.gov (United States)

    Faber, Mieke

    2005-06-01

    To determine the nutrient composition of complementary foods consumed by 6-12-month-old South African infants. Nutrient intake was determined for infants who were recruited to participate in a randomised controlled trial using a single 24-hour dietary recall. Infants aged 6-12 months (n=475) residing in The Valley of a Thousand Hills, a rural area in KwaZulu-Natal, South Africa. Energy and protein intakes from complementary foods were adequate. Infants who consumed infant products (commercially available fortified infant cereals/ready-to-eat canned baby foods/formula milk powder) had significantly higher intakes of calcium, iron, zinc, vitamin A, thiamine, riboflavin, niacin, vitamin B6, vitamin B12 and vitamin C than infants who did not consume any infant products. For infants who consumed infant cereals (n=142), these cereals provided 51% of total iron intake. Infant cereals provided more than 25% of total intake for magnesium, thiamine, niacin and vitamin B12. For infants consuming ready-to-eat canned baby foods (n=77), these products contributed less than 15% of total intake for all the micronutrients. The nutrient density of the complementary diet was less than half the desired density for calcium, iron and zinc. Animal products were consumed by 17% of infants, 26% consumed dairy products and 18% consumed vitamin-A-rich fruit and vegetables during the 24-hour recall period. The nutrient composition of complementary foods among rural South African infants was inadequate, especially for iron, zinc and calcium. Strategies should be developed to improve the nutritional quality of their diets.

  2. Factors promoting health-related quality of life in people with rheumatic diseases: a 12 month longitudinal study

    Directory of Open Access Journals (Sweden)

    Arvidsson Barbro

    2011-05-01

    Full Text Available Abstract Background Rheumatic diseases have a significant adverse impact on the individual from physical, mental and social aspects, resulting in a low health-related quality of life (HRQL. There is a lack of longitudinal studies on HRQL in people with rheumatic diseases that focus on factors promoting HRQL instead of risk factors. The aim of this study was to investigate the associations between suggested health promoting factors at baseline and outcome in HRQL at a 12 month follow-up in people with rheumatic diseases. Methods A longitudinal cohort study was conducted in 185 individuals with rheumatic diseases with questionnaires one week and 12 months after rehabilitation in a Swedish rheumatology clinic. HRQL was assessed by SF-36 together with suggested health factors. The associations between SF-36 subscales and the health factors were analysed by multivariable logistic regressions. Results Factors predicting better outcome in HRQL in one or several SF-36 subscales were being younger or middle-aged, feeling painless, having good sleep structure, feeling rested after sleep, performing low effort of exercise more than twice per week, having strong sense of coherence (SOC, emotional support and practical assistance, higher educational level and work capacity. The most important factors were having strong SOC, feeling rested after sleep, having work capacity, being younger or middle-aged, and having good sleep structure. Conclusions This study identified several factors that promoted a good outcome in HRQL to people with rheumatic diseases. These health factors could be important to address in clinical work with rheumatic diseases in order to optimise treatment strategies.

  3. Factors promoting health-related quality of life in people with rheumatic diseases: a 12 month longitudinal study

    Science.gov (United States)

    2011-01-01

    Background Rheumatic diseases have a significant adverse impact on the individual from physical, mental and social aspects, resulting in a low health-related quality of life (HRQL). There is a lack of longitudinal studies on HRQL in people with rheumatic diseases that focus on factors promoting HRQL instead of risk factors. The aim of this study was to investigate the associations between suggested health promoting factors at baseline and outcome in HRQL at a 12 month follow-up in people with rheumatic diseases. Methods A longitudinal cohort study was conducted in 185 individuals with rheumatic diseases with questionnaires one week and 12 months after rehabilitation in a Swedish rheumatology clinic. HRQL was assessed by SF-36 together with suggested health factors. The associations between SF-36 subscales and the health factors were analysed by multivariable logistic regressions. Results Factors predicting better outcome in HRQL in one or several SF-36 subscales were being younger or middle-aged, feeling painless, having good sleep structure, feeling rested after sleep, performing low effort of exercise more than twice per week, having strong sense of coherence (SOC), emotional support and practical assistance, higher educational level and work capacity. The most important factors were having strong SOC, feeling rested after sleep, having work capacity, being younger or middle-aged, and having good sleep structure. Conclusions This study identified several factors that promoted a good outcome in HRQL to people with rheumatic diseases. These health factors could be important to address in clinical work with rheumatic diseases in order to optimise treatment strategies. PMID:21599884

  4. Effects of Different Dietary and Lifestyle Modification Therapies on Metabolic Syndrome in Prediabetic Arab Patients: A 12-Month Longitudinal Study

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    Hanan A. Alfawaz

    2018-03-01

    Full Text Available This three-arm, randomized, controlled study aimed to determine the differences in the effects of general advice (GA on lifestyle change, intensive lifestyle modification programme (ILMP and GA + metformin (GA + Met in reducing the prevalence of full metabolic syndrome (MetS in subjects with prediabetes; 294 Saudis with prediabetes (fasting glucose 5.6–6.9 mmol/L were initially randomized, 263 completed 6 months and 237 completed 12 months. They were allocated into three groups: GA group which received a standard lifestyle change education; ILMP which followed a rigorous lifestyle modification support on diet and physical activity; and a GA + Met group. Anthropometric and biochemical estimations were measured. Full MetS (primary endpoint and its components (secondary endpoint were screened at baseline, 6 and 12 months. Full MetS in the ILMP group decreased by 26% (p < 0.001; in GA + Met group by 22.4% (p = 0.01 and in GA group by 8.2% (p = 0.28. The number of MetS components decreased significantly in the ILMP and GA + Met groups (mean change 0.81, p < 0.001 and 0.35, p = 0.05, respectively. Between-group comparison revealed a clinically significant decrease in MetS components in favor of the ILMP group (−0.58 (−0.88–0.28, p < 0.001. This study highlights the clinical potency of ILMP versus other diabetes prevention options in reducing MetS in Saudi adults with elevated fasting glucose.

  5. The presence of serum anti-Ascaris lumbricoides IgE antibodies and of Trichuris trichiura infection are risk factors for wheezing and/or atopy in preschool-aged Brazilian children.

    Science.gov (United States)

    Alcântara-Neves, Neuza M; Badaró, Samuel J; dos Santos, Mariese C A; Pontes-de-Carvalho, Lain; Barreto, Maurício L

    2010-08-23

    associated with atopy [adjusted OR = 7.29; CI = 3.90; 13.4]. On the other hands, reports of wheezing were not significantly associated with atopy. These data corroborate previous studies showing that wheezing is predominantly associated with infection in early childhood and shows that anti-A. lumbricoides IgE antibodies, but not active Ascaris infections, are associated with wheezing and atopy. Additionally, the data demonstrate that T. trichiura infection may play a role in the pathogenesis of atopic wheezing in early childhood.

  6. The presence of serum anti-Ascaris lumbricoides IgE antibodies and of Trichuris trichiura infection are risk factors for wheezing and/or atopy in preschool-aged Brazilian children

    Directory of Open Access Journals (Sweden)

    Alcântara-Neves Neuza M

    2010-08-01

    -atopic children [adjusted OR = 3.07; CI = 1.13;8.35] and it was also associated with atopy [adjusted OR = 7.29; CI = 3.90; 13.4]. On the other hands, reports of wheezing were not significantly associated with atopy. Conclusions These data corroborate previous studies showing that wheezing is predominantly associated with infection in early childhood and shows that anti-A. lumbricoides IgE antibodies, but not active Ascaris infections, are associated with wheezing and atopy. Additionally, the data demonstrate that T. trichiura infection may play a role in the pathogenesis of atopic wheezing in early childhood.

  7. Large observer variation of clinical assessment of dyspnoeic wheezing children.

    Science.gov (United States)

    Bekhof, Jolita; Reimink, Roelien; Bartels, Ine-Marije; Eggink, Hendriekje; Brand, Paul L P

    2015-07-01

    In children with acute dyspnoea, the assessment of severity of dyspnoea and response to treatment is often performed by different professionals, implying that knowledge of the interobserver variation of this clinical assessment is important. To determine intraobserver and interobserver variation in clinical assessment of children with dyspnoea. From September 2009 to September 2010, we recorded a convenience sample of 27 acutely wheezing children (aged 3 months-7 years) in the emergency department of a general teaching hospital in the Netherlands, on video before and after treatment with inhaled bronchodilators. These video recordings were independently assessed by nine observers scoring wheeze, prolonged expiratory phase, retractions, nasal flaring and a general assessment of dyspnoea on a Likert scale (0-10). Assessment was repeated after 2 weeks to evaluate intraobserver variation. We analysed 972 observations. Intraobserver reliability was the highest for supraclavicular retractions (κ 0.84) and moderate-to-substantial for other items (κ 0.49-0.65). Interobserver reliability was considerably worse, with κ3 points) was larger than the minimal important change (meaning that in 69% of observations a clinically important change after treatment cannot be distinguished from measurement error. Intraobserver variation is modest, and interobserver variation is large for most clinical findings in children with dyspnoea. The measurement error induced by this variation is too large to distinguish potentially clinically relevant changes in dyspnoea after treatment in two-thirds of observations. The poor interobserver reliability of clinical dyspnoea assessment in children limits its usefulness in clinical practice and research, and highlights the need to use more objective measurements in these patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Both environmental tobacco smoke and personal smoking is related to asthma and wheeze in teenagers.

    Science.gov (United States)

    Hedman, Linnéa; Bjerg, Anders; Sundberg, Sigrid; Forsberg, Bertil; Rönmark, Eva

    2011-01-01

    Environmental tobacco smoke (ETS) has been reported as a significant risk factor for childhood asthma. Among adults, personal smoking is a major cause of respiratory symptoms and diseases. The effects of these exposures on the prevalence of asthma and wheeze among teenagers are less well known. The aim was to study the independent and combined effects of ETS and personal smoking on the prevalence of asthma and wheeze in teenagers. A longitudinal study of asthma and allergic diseases in schoolchildren has been in progress in Northern Sweden since 1996. All children aged 7-8 years in three municipalities were invited and 3430 (97%) participants have been followed by annual questionnaires. At the age 16-17 years, 82% of the initial participants took part in the 2005 survey. Prevalence of physician-diagnosed asthma, ever wheeze and current wheeze was significantly higher among those exposed to maternal ETS and among daily smokers. In multivariate analyses, maternal ETS was a significant risk factor for physician-diagnosed asthma and ever wheeze (OR 1.3-1.5) and personal daily smoking for current wheeze (OR 2.0). ORs for asthma and ever wheeze were highest among daily smokers who were also exposed to maternal ETS with ORs of 1.7 and 2.5, respectively. A significant dose-response association between number of cigarettes/day and the prevalence of wheeze was also found. Both ETS and personal smoking were significantly related to asthma and wheeze in teenagers. Maternal ETS exposure was associated with lifetime symptoms, but daily smoking among the teenagers was more strongly related to current symptoms.

  9. Pesticides are Associated with Allergic and Non-Allergic Wheeze among Male Farmers.

    Science.gov (United States)

    Hoppin, Jane A; Umbach, David M; Long, Stuart; London, Stephanie J; Henneberger, Paul K; Blair, Aaron; Alavanja, Michael; Freeman, Laura E Beane; Sandler, Dale P

    2017-04-01

    Growing evidence suggests that pesticide use may contribute to respiratory symptoms. We evaluated the association of currently used pesticides with allergic and non-allergic wheeze among male farmers. Using the 2005-2010 interview data of the Agricultural Health Study, a prospective study of farmers in North Carolina and Iowa, we evaluated the association between allergic and non-allergic wheeze and self-reported use of 78 specific pesticides, reported by ≥ 1% of the 22,134 men interviewed. We used polytomous regression models adjusted for age, BMI, state, smoking, and current asthma, as well as for days applying pesticides and days driving diesel tractors. We defined allergic wheeze as reporting both wheeze and doctor-diagnosed hay fever ( n = 1,310, 6%) and non-allergic wheeze as reporting wheeze but not hay fever ( n = 3,939, 18%); men without wheeze were the referent. In models evaluating current use of specific pesticides, 19 pesticides were significantly associated ( p pesticides with non-allergic wheeze (19 positive, 2 negative); 11 pesticides were associated with both. Seven pesticides (herbicides: 2,4-D and simazine; insecticides: carbaryl, dimethoate, disulfoton, and zeta-cypermethrin; and fungicide pyraclostrobin) had significantly different associations for allergic and non-allergic wheeze. In exposure-response models with up to five exposure categories, we saw evidence of an exposure-response relationship for several pesticides including the commonly used herbicides 2,4-D and glyphosate, the insecticides permethrin and carbaryl, and the rodenticide warfarin. These results for farmers implicate several pesticides that are commonly used in agricultural and residential settings with adverse respiratory effects.

  10. Risk factors for non-atopic asthma/wheeze in children and adolescents: a systematic review

    OpenAIRE

    Strina, Agostino; Barreto, Mauricio L; Cooper, Philip J; Rodrigues, Laura C

    2014-01-01

    BACKGROUND: The study of non-atopic asthma/wheeze in children separately from atopic asthma is relatively recent. Studies have focused on single risk factors and had inconsistent findings.\\ud \\ud OBJECTIVE: To review evidence on factors associated with non-atopic asthma/wheeze in children and adolescents.\\ud \\ud METHODS: A review of studies of risk factors for non-atopic asthma/wheeze which had a non-asthmatic comparison group, and assessed atopy by skin-prick test or allergen-specific IgE.\\u...

  11. HPV infection, cervical abnormalities, and cancer in HIV-infected women in Mumbai, India: 12-month follow-up

    Directory of Open Access Journals (Sweden)

    Isaakidis P

    2013-08-01

    Full Text Available Petros Isaakidis,1,2 Sharmila Pimple,3 Bhanumati Varghese,1 Samsuddin Khan,1 Homa Mansoor,1 Joanna Ladomirska,1 Neelakumari Sharma,1 Esdras Da Silva,1 Carol Metcalf,4 Severine Caluwaerts,4 Petra Alders,4 Evangelia E Ntzani,2 Tony Reid41Médecins Sans Frontières, Mumbai, India; 2Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece; 3Preventive Oncology Department, Tata Memorial Hospital, Mumbai, India; 4Médecins Sans Frontières, Brussels, BelgiumBackground: HIV-infected women are at a higher risk of cervical intraepithelial neoplasia (CIN and cancer than women in the general population, partly due to a high prevalence of persistent human papillomavirus (HPV infection. The aim of the study was to assess the burden of HPV infection, cervical abnormalities, and cervical cancer among a cohort of HIV-infected women as part of a routine screening in an urban overpopulated slum setting in Mumbai, India.Methods: From May 2010 to October 2010, Médecins Sans Frontières and Tata Memorial Hospital Mumbai offered routine annual Pap smears and HPV DNA testing of women attending an antiretroviral therapy (ART clinic and a 12-month follow-up. Women with abnormal test results were offered cervical biopsy and treatment, including treatment for sexually transmitted infections (STIs.Results: Ninety-five women were screened. Median age was 38 years (IQR: 33–41; median nadir CD4-count 143 cells/µL (IQR: 79–270; and median time on ART 23 months (IQR:10–41. HPV DNA was detected in 30/94 women (32%, and 18/94 (19% showed either low-grade or high-grade squamous intraepithelial lesions (LSIL/HSIL on Pap smear. Overall, >50% had cervical inflammatory reactions including STIs. Of the 43 women with a cervical biopsy, eight (8.4% had CIN-1, five (5.3% CIN-2, and two (2.1% carcinoma in situ. All but one had HPV DNA detected (risk ratio: 11, 95% confidence interval: 3.3–34. By

  12. Effects of a 12-month educational intervention on outpatient clinicians’ attitudes and behaviors concerning spiritual practices with patients

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    Koenig HG

    2017-02-01

    Full Text Available Harold G Koenig,1–4 Kathleen Perno,5 Ted Hamilton5 1Department of Psychiatry, 2Department of Medicine, Duke University Medical Center, Durham, NC, USA; 3Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 4School of Public Health, Ningxia Medical University, Yinchuan, People’s Republic of China; 5Medical Mission Integration, Adventist Health System, Orlando, FL, USA Objective: We report here the impact of an educational training program on attitudes and practices of physicians (MDs and mid-level practitioners (MLPs toward controversial spiritual practices, such as practitioner-led prayer, sharing personal religious beliefs, and encouraging patients’ religious beliefs.Methods: In this single-group experimental study, 427 physicians and 93 MLPs affiliated with the Adventist Health System agreed to complete a questionnaire assessing demographics, practice characteristics, religiosity, and attitudes and behaviors at baseline, 1 month, and 12 months. Changes in attitudes and practices over time were examined and baseline predictors were identified using mixed-effects regression models.Results: For the most part, attitudes regarding praying with patients, sharing faith with patients, and encouraging patients’ own religious faith did not change much during the 12-month ­educational training program. However, significant increases were found in frequency of praying with patients (MDs and MLPs, willingness to pray with patients (MDs, sharing their faith with patients (MDs, and encouraging patient’s own religious faith (MDs and MLPs. Among physicians, predictors of praying with patients across time were older age, Christian affiliation, and importance of religion, and among MLPs, they were older age, non-White race, and importance of religion. No interaction between time and religiosity was found.Conclusion: Although attitudes toward these mostly controversial practices were largely unaffected, the frequency of praying with

  13. Introduction of standardised tobacco packaging during a 12-month transition period: Findings from small retailers in the United Kingdom.

    Science.gov (United States)

    Critchlow, Nathan; Stead, Martine; Moodie, Crawford; Eadie, Douglas; MacKintosh, Anne Marie

    2018-01-12

    Factory-made cigarettes (FMC) and roll-your-own (RYO) tobacco have had to be produced in standardised packaging since 20th May 2016 in the United Kingdom, with a minimum pack size of 20 sticks for FMC and 30 grams for RYO. Manufacturers and retailers were given a 12-month transition period. An observational study was conducted using monthly Electronic Point of Sale data from 500 small retailers in England, Scotland, and Wales, between May 2016 and May 2017. The 20 top selling tobacco products (15 FMC, 5 RYO) were monitored to observe when standardised packs were first introduced, the proportion of retailers selling each fully branded and standardised product, and the average number of monitored fully branded and standardised products sold by each retailer. The number of unique tobacco-related product codes sold by each retailer was also recorded each month. Eighteen of the fully branded products continued to be sold throughout the transition period and no standardised variants were sold in the first five months. It was not until month eleven that the average number of standardised products sold by retailers exceeded the fully branded products. The average number of unique tobacco-related product codes sold by each retailer decreased by a third over the transition period. Tobacco companies used the transition period to delay the removal of fully branded products and gradually introduce standardised variants. This staggered introduction may have mitigated some of the immediate intended effects of the legislation by desensitising consumers to new pack designs. Evaluation research from countries which have introduced standardised packaging for tobacco products is key to help inform future implementation. This is the first study to monitor the transition from fully branded to standardised products using real-time retail data. The findings demonstrate that tobacco companies delayed the introduction of standardised products and removal of fully branded packaging

  14. Effect of progressive high-impact exercise on femoral neck structural strength in postmenopausal women with mild knee osteoarthritis: a 12-month RCT.

    Science.gov (United States)

    Multanen, J; Rantalainen, T; Kautiainen, H; Ahola, R; Jämsä, T; Nieminen, M T; Lammentausta, E; Häkkinen, A; Kiviranta, I; Heinonen, A

    2017-04-01

    It is uncertain whether subjects with mild knee osteoarthritis, and who may be at risk of osteoporosis, can exercise safely with the aim of improving hip bone strength. This RCT showed that participating in a high-impact exercise program improved femoral neck strength without any detrimental effects on knee cartilage composition. No previous studies have examined whether high-impact exercise can improve bone strength and articular cartilage quality in subjects with mild knee osteoarthritis. In this 12-month RCT, we assessed the effects of progressive high-impact exercise on femoral neck structural strength and biochemical composition of knee cartilage in postmenopausal women. Eighty postmenopausal women with mild knee radiographic osteoarthritis were randomly assigned into the exercise (n = 40) or control (n = 40) group. Femoral neck structural strength was assessed with dual-energy X-ray absorptiometry. The knee cartilage region exposed to exercise loading was measured by the quantitative MRI techniques of T2 mapping and delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). Also, an accelerometer-based body movement monitor was used to evaluate the total physical activity loading on the changes of femoral neck strength in all participants. Training effects on the outcome variables were estimated by the bootstrap analysis of covariance. A significant between-group difference in femoral neck bending strength in favor of the trainees was observed after the 12-month intervention (4.4%, p strength remained significant after adjusting for baseline value, age, height, and body mass (4.0%, p = 0.020). In all participants, the change in bending strength was associated with the total physical activity loading (r = 0.29, p = 0.012). The exercise participation had no effect on knee cartilage composition. The high-impact training increased femoral neck strength without having any harmful effect on knee cartilage in women with mild knee osteoarthritis. These

  15. Assessing early communication behaviours: structure and validity of the Communication and Symbolic Behaviour Scales-Developmental Profile (CSBS-DP) in 12-month-old infants.

    Science.gov (United States)

    Eadie, Patricia Ann; Ukoumunne, Obioha; Skeat, Jemma; Prior, Margot Ruth; Bavin, Edith; Bretherton, Lesley; Reilly, Sheena

    2010-01-01

    Parent report instruments are frequently used for the identification of both 'at-risk' children and to support the diagnosis of communication delay. Whilst the evidence is strong for the accuracy of parent report of vocabulary between 2 and 3 years, there are fewer studies that have considered the ability of parents to report on early communication behaviours in 12-month-old infants. To investigate the validity of the underlying structure of the Communication and Symbolic Behaviour Scales-Developmental Profile (CSBS-DP) for each of the direct observation and parent reports of communication behaviour in infants at 12 months of age. Participants were 1725 infants, already participating in a longitudinal study of language development, whose parents completed the Infant-Toddler Checklist from the CSBS-DP. Seven hundred and twenty-eight (728) of these infants also completed the Behaviour Sample from the CSBS-DP. The structure of the CSBS-DP was examined using confirmatory factor analyses (CFA) of the Behaviour Sample and the Infant-Toddler Checklist. Correlations between the Infant-Toddler Checklist and the Behaviour Sample on the total, composite, and subscale scores were also calculated. Confirmatory factor analysis of the CSBS-DP Behaviour Sample replicated previous work conducted during the development of the instrument, but on a larger and younger cohort of Australian infants. The data provided support for at least three factors, broadly representing Social, Speech, and Symbolic communication skills, with some evidence that the speech factor could be further split into sub-factors representing Sounds and Words. There was support for a three-factor structure for the Infant-Toddler Checklist. Moderate correlations were found between results from the Behaviour Sample and the Infant-Toddler Checklist. As measures of early communication skill for young infants, the CSBS-DP Behaviour Sample and the Infant-Toddler Checklist are valid clinical tools for measuring

  16. Cortisol changes interact with the effects of a cognitive behavioural psychological preparation for surgery on 12-month outcomes for surgical heart patients.

    Science.gov (United States)

    Shelley, Michael; Pakenham, Kenneth Ian; Frazer, Ian

    2009-12-01

    Previous studies offer contradictory evidence regarding the effects of cortisol changes on health outcomes for surgical heart patients. Increased cortisol and inflammation have been related to psychological stress while separate studies have found an inverse relation between cortisol and inflammation. Psychological preparations for surgery can reduce stress and improve outcomes and may interact with cortisol changes. Following from these relationships, we hypothesised that a preparation for surgery will interact with changes in cortisol to affect outcomes. Measures were the SF 36 General Health and Activities, medical visits and satisfaction. Eighty-five patients were randomly assigned to standard care plus a psychological preparation or standard care alone using a single-blind methodology. Data on psychological and biological functioning were collected at admission, 1 day prior and 5 days post-surgery, and 12-months after hospital discharge. General health and activities, and medical visits were related to the interaction of cortisol change and psychological preparation in support of the hypothesis. Patients were more satisfied in the preparation group than controls. Based on these findings, some outcomes from psychological preparations may be affected by changes in levels of cortisol. These results caution against a one-size-fits-all approach to psychological preparations.

  17. Predictors of mental health service utilization in the 12 months before imprisonment: analysis of results from a national prisons survey.

    Science.gov (United States)

    Farrell, Michael; Boys, Annabel; Singleton, Nicola; Meltzer, Howard; Brugha, Traolach; Bebbington, Paul; Jenkins, Rachel; Coid, Jeremy; Lewis, Glyn; Marsden, John

    2006-01-01

    To describe the self-reported history of health service utilization and help-seeking to those who are drug-dependent in the period of time prior to imprisonment. A cross-section survey of 3142 sentenced or remand prisoners in English prisons completed private, face-to-face interviews with trained Office for National Statistics staff covering a full structured psychiatric assessment interview. Specific questions about service utilization prior to imprisonment were included, as were questions on patterns of drug use and dependence prior to imprisonment. Receipt of any form of help was demographically most strongly associated with being older, white and female. Women were about twice as likely as men to report having received help for mental or emotional problems. Older age was also consistently associated with greater levels of reporting having received help, for both genders but only for use of general practitioners. Being black was strongly associated with reduced likelihood of receiving help and this was maintained after adjusting for other sociodemographic variables. Opioid dependence alone or opioid dependence with stimulant dependence, psychiatric disorder alone and probable psychosis were all most predictive of service use in the 12 months prior to imprisonment. In the year prior to imprisonment, the majority of mental health needs of these individual prisoners were not able to access help prior to imprisonment. Future strategies should aim for better health access before, during and after imprisonment.

  18. INFLUENCE OF DIFFERENT TYPES OF NUTRITION ON PHYSICAL AND NEUROPSYCHICAL DEVELOPMENT OF INFANTS: RESULTS OF 12-MONTHS OBSERVATION

    Directory of Open Access Journals (Sweden)

    T. I. Legon’kova

    2011-01-01

    Full Text Available The basic ingredient of normal nutrition in infants is breast milk. If breast feeding is impossible the choice of artificial feeding formula should be made taking into account the qualities of formula which must be extremely close to that ones of breast milk. Objectives: to evaluate of state of health of infants having breast and artificial feeding. Methods: effectiveness and tolerance to adopted formula «Nutrilon Comfort» compared to standard milk formula and breast milk were analyzed. Dynamics of physical and neuro-psychical development of children was observed during 12 months. The cases of infectious diseases and tolerance to artificial feeding formulas were estimated. Results: prolonged observation of children from the group of adopted formula with immunomodulatory factors (long-chain polyunsaturated fatty acids and prebiotics showed its complex action (influence on physical, neuro-psychical development and infectious morbidity is similar to that one of breast feeding. Acute respiratory infections and atopic dermatitis in children having breast feeding and adopted formula developed rarely than in children from group of standard formula (p < 0.05. Conclusion: nutrition with «Nutrilon Comfort» formula in cases when breast feeding is impossible allows child’s development similar to children with breast feeding.

  19. Outcomes after foot surgery in people with a diabetic foot ulcer and a 12-month follow-up.

    Science.gov (United States)

    Lenselink, E; Holloway, S; Eefting, D

    2017-05-02

    The aim of this study was to retrospectively measure the outcomes of foot-sparing surgery at one year follow-up for patients with diabetic foot ulcers (DFUs). We assessed wound healing and the need for further surgery in relation to the variables that influence healing. Data were retrospectively collected by reviewing the electronic files of patients attending the Wound Expert Clinic (WEC). Outcomes of surgical debridement, toe, ray and transmetatarsal amputations were assessed. A total of 129 cases in 121 patients were identified for inclusion. The results demonstrated that complete wound healing was reached in 52% (61/117) of the patients within 12 months. The need for additional surgery or for major amputation was 56% (n=72/129) and 30% (n=39/129) respectively. The need for an additional procedure was particularly high after surgical debridement (75%, 33/44) and transmetatarsal amputation (64%, 7/11). Risk factors for non-healing or for a major amputation were: infection (p=0.01), ischaemia (p=0.01), a history of peripheral arterial occlusive disease (p<0.01) and smoking (p=0.01). Additional findings were that not all patients underwent vascular assessment and in half of the patients there was a delay in undergoing revascularisation. The results of the study reveal some areas for improvement including timely revascularisation and performance of multiple debridement procedures if needed in order to save a limb.

  20. Cognition, function, and caregiving time patterns in patients with mild-to-moderate Alzheimer disease: a 12-month analysis.

    Science.gov (United States)

    Feldman, Howard H; Van Baelen, Bart; Kavanagh, Shane M; Torfs, Koen E L

    2005-01-01

    Placebo data were pooled from two 1-year, randomized, double-blind, placebo-controlled trials of sabeluzole in patients with mild-to-moderate Alzheimer disease (AD). Cognition was assessed using the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) and activities of daily living (ADL) with the Disability Assessment in Dementia (DAD). Time spent assisting with ADL was estimated according to the caregiver for each DAD domain in the 2 weeks before assessment. Progressive annual decline was seen on ADAS-cog (5.6 +/- 7.3 [mean +/- SD]) and DAD (-12.4 +/- 17.8), with greater decline in moderate patients (Mini-Mental State Examination [MMSE] 18). An MMSE score of 16 appeared to be a key transition point at which most instrumental ADL were lost and major losses of basic ADL began to occur over the next 12 months. Caregivers spent, on average, 14 hours more assisting with ADL over 2 weeks at the end of 1 year. The proportion of care provided by paid caregivers increased relative to the time spent by informal caregivers. Patients with mild-to-moderate AD experience predictable annual decline in cognition and daily functioning, with measurably increased caregiver time. Small changes in ADAS-cog are nevertheless associated with a substantial measurable effect on the daily lives of both patients and caregivers.

  1. Use of deuterium oxide to measure breast-milk intake in children aged 7 to 12 months receiving complementary foods

    International Nuclear Information System (INIS)

    Creed-Kanashiro, H.

    1999-01-01

    The present study is being conducted to pilot the use of the deuterium oxide method for the measurement of breast-milk intake in children 7 - 12 months of age receiving complementary foods. This will be applied to a community efficacy study to determine the effects on total energy and nutrient intake and on breast-milk consumption of an intensive education intervention using locally available, culturally acceptable complementary foods. In order to apply the methodology to this evaluation the washout period of deuterium from the mother and the child after the administration of a dose to the mother is being determined and the comparison of this methodology with the test weighing technique for breast-milk intake. The measurement of deuterium oxide using the infrared spectrometer of the Instituto de Investigacion Nutricional [IIN] is being compared with the IR Mass Spectrometer of INTA Chile. During the present period we have conducted a pilot study to measure breast-milk intake using deuterium oxide in 9 mother-child pairs of children aged 7 - 11 months of age; samples of saliva have been taken for analyses. One child has completed the 28 days of the study and 8 children are in process. Test weighing for 48 hours has been conducted on 5 children; unadjusted breast-milk intake ranges from 589 to 682 g per 24 hours. The samples are awaiting analysis for deuterium oxide. (author)

  2. Comparison of Bone Loss around Bone Platform Shift and Non-Bone Platform Shift Implants After 12 Months

    Directory of Open Access Journals (Sweden)

    AmirReza Rokn

    2015-10-01

    Full Text Available Objectives: The aim of the present randomized clinical trial was to evaluate marginal bone loss around two types of implants modified at the neck area: Nobel Active and Nobel Replace Groovy, both manufactured by Nobel Biocare.Materials and Methods: A total of 25 Nobel Active and 21 Nobel Replace Groovy implants were included in the present study. The implants were placed based on the relevant protocol and patient inclusion and exclusion criteria. The amount of bone loss around implants was compared at 6 and 12-month intervals using digital periapical radiographs.Results: The mean bone loss values in the Nobel Active and Nobel Replace Groovy groups were 0.682 mm and 0.645 mm, respectively, with no statistically significant difference based on the results of independent t-test (P=0.802.Conclusion: Use of both implant types yielded favorable results, with high durability.The two implant types exhibited no superiority over each other in terms of bone loss.

  3. Baseline Shoulder Ultrasonography Is Not a Predictive Marker of Response to Glucocorticoids in Patients with Polymyalgia Rheumatica: A 12-month Followup Study.

    Science.gov (United States)

    Miceli, Maria Concetta; Zoli, Angelo; Peluso, Giusy; Bosello, Silvia; Gremese, Elisa; Ferraccioli, Gianfranco

    2017-02-01

    In this study, we evaluated whether ultrasound (US) subdeltoid bursitis (SB) and/or biceps tenosynovitis (BT) presence at baseline could represent a predictive marker of response to standard therapy after 12 months of followup, and whether a positive US examination could highlight the need of higher maintenance dosage of glucocorticoids (GC) at 6 and 12 months in patients with polymyalgia rheumatica (PMR). Sixty-six consecutive patients with PMR underwent bilateral shoulder US evaluations before starting therapy and after 12 months of followup. Absence of girdle pain and morning stiffness (clinical remission) and laboratory variables were evaluated. After diagnosis, all patients were treated with prednisone. At baseline, SB and/or BT were present in 46 patients (70%), of whom 33 (72%) became negative while 13 (28%) remained positive at the 12-month US evaluation. All patients rapidly achieved a clinical remission, and at 6 months 26 (39%) also achieved a laboratory variable normalization. According to US positivity at baseline, no difference was found in remission or relapse rate after 12 months. Thirty patients (46%) at 6 months and 7 (11%) at 12 months were still taking more than 5 mg/day of prednisone. According to the US pattern at baseline, no difference was found in the mean GC dose at 6 and 12 months. In patients with PMR, the presence of SB and/or BT on US at diagnosis is not a predictive marker of GC response or of a higher GC dosage to maintain remission in a 12-month prospective followup study.

  4. Infant Respiratory Tract Infections or Wheeze and Maternal Vitamin D in Pregnancy

    DEFF Research Database (Denmark)

    Christensen, Nikolas; Søndergaard, Jens; Fisker, Niels

    2017-01-01

    Respiratory tract infections (RTIs) are a common cause of morbidity and mortality in young children and can be associated with wheeze. Vitamin D can have a protective role against RTI. MATERIALS AND METHODS: A systematic search of Pubmed, Embase and the Cochrane library was performed. Titles and ....... Future intervention studies may need to exceed current recommendations of vitamin D supplementation during pregnancy to show benefit against childhood wheeze or infections.......Respiratory tract infections (RTIs) are a common cause of morbidity and mortality in young children and can be associated with wheeze. Vitamin D can have a protective role against RTI. MATERIALS AND METHODS: A systematic search of Pubmed, Embase and the Cochrane library was performed. Titles...... and abstracts were evaluated and selected articles were reviewed by two authors. We included randomized controlled trials (RCTs) investigating the effect of vitamin D supplementation during pregnancy on RTIs or wheeze in children of 5 years of age or younger. Observational studies on the association between...

  5. Factors predicting persistence of early wheezing through childhood and adolescence: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Rodriguez-Martinez CE

    2017-03-01

    Full Text Available Carlos E Rodríguez-Martínez,1,2 Monica P Sossa-Briceño,3 Jose A Castro-Rodriguez4 1Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia; 2Department of Pediatric Pulmonology and Pediatric Critical Care Medicine, School of Medicine, Universidad El Bosque, Bogota, Colombia; 3Department of Internal Medicine, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia; 4Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile Background: For the early identification of persistent asthma symptoms among young children with recurrent wheezing, it would be helpful to identify all available studies that have identified at least one factor for predicting the persistence of early wheezing. The objective of the present study was to perform a systematic review of all studies that have identified factors that predict the persistence of symptoms among young patients with recurring wheezing. Methods: A systematic review of relevant studies was conducted through searching in MEDLINE, EMBASE, CINHAL, and SCOPUS databases up to June 2016. Studies that identified predictors of persistence of wheezing illness among young children with recurrent wheezing were retrieved. Two independent reviewers screened the literature and extracted relevant data. Results: The literature search returned 649 references, 619 of which were excluded due to their irrelevance. Five additional studies were identified from reference lists, and 35 studies were finally included in the review. Among all the identified predictors, the most frequently identified ones were the following: family asthma or atopy; personal history of atopic diseases; allergic sensitization early in life; and frequency, clinical pattern, or severity of wheezing/symptoms. Conclusion: Parental asthma (especially maternal, parental allergy, eczema, allergic rhinitis, persistent wheezing, wheeze without colds, exercise

  6. Associations of tonsillar hypertrophy and snoring with history of wheezing in childhood.

    Science.gov (United States)

    Kaditis, Athanasios G; Kalampouka, Efthimia; Hatzinikolaou, Souzana; Lianou, Loukia; Papaefthimiou, Maria; Gartagani-Panagiotopoulou, Polytimi; Zintzaras, Elias; Chrousos, George

    2010-03-01

    Reports in adults and children have correlated history of wheezing or asthma with the presence of obstructive sleep-disordered breathing but the mechanism of this epidemiologic association is unknown. The goal of the present study was to examine whether tonsillar hypertophy can explain this association. Children were recruited from the Emergency Department and the Pediatric Pulmonology Clinic. History of wheezing requiring treatment (explanatory variable) and snoring > or = 1 night/week (outcome) were recorded and presence of tonsillar hypertrophy (outcome) was assessed. Four hundred forty-two children were recruited (mean age: 7.6 + or - 3.6 years) and 210 of them had history of wheezing. History of wheezing was significantly associated with the presence of tonsillar hypertrophy and snoring even after adjustment for age, gender, obesity, and passive smoking [odds ratio (95% confidence interval): 2.23 (1.37-3.63); P = 0.001 and 1.73 (1.12-2.67); P = 0.013, respectively]. When only children with tonsillar hypertrophy were considered (n = 92), history of wheezing was significantly related to the presence of snoring, whereas in subjects without tonsillar hypertrophy (n = 350) wheezing did not affect snoring [odds ratio: 2.76 (1.10-6.93); P = 0.031 and 1.49 (0.92-2.43); P = 0.107, respectively]. Children with history of wheezing have more frequently tonsillar hypertrophy than those without wheezing. Tonsillar hypertrophy may mediate at least in part the reported association between asthma and obstructive sleep-disordered breathing in childhood.

  7. Wheeze and asthma in children: associations with body mass index, sports, television viewing, and diet.

    Science.gov (United States)

    Corbo, Giuseppe M; Forastiere, Francesco; De Sario, Manuela; Brunetti, Luigia; Bonci, Enea; Bugiani, Massimiliano; Chellini, Elisabetta; La Grutta, Stefania; Migliore, Enrica; Pistelli, Riccardo; Rusconi, Franca; Russo, Antonio; Simoni, Marzia; Talassi, Fiorella; Galassi, Claudia

    2008-09-01

    Obesity, physical activity, and dietary habits are distinct but strongly interrelated lifestyle factors that may be relevant to the prevalence of wheeze and asthma in children. Our goal was to analyze the relationship of body mass index (BMI), regular sports participation, TV viewing, and diet with current wheezing and asthma. We investigated 20,016 children, aged 6-7 years, who were enrolled in a population-based study. Parents completed standardized questionnaires. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), while adjusting for several confounders and simultaneously considering BMI, regular sports activity, TV viewing and selected dietary items. A total of 1575 children (7.9%) reported current wheezing and 1343 (6.7%) reported current asthma. In a multivariate model, an elevated BMI was associated with wheeze and current asthma: children from the highest quintile (compared with the lowest quintile) had an increased risk of wheeze (OR = 1.47; CI = 1.20-1.82) or current asthma (1.61; 1.28-2.01). Wheeze or asthma was not associated with regular sports activity. Subjects who spent 5 or more hours per day watching television were more likely to experience wheeze (1.53; 1.08-2.17) or current asthma (1.51; 1.04-2.2) compared with those who viewed TV less than 1 hour a day. Adding salt to food was strongly and independently associated with current wheeze (2.58; 1.41-4.71) and current asthma (2.68; 1.41-5.09). Our data support the hypothesis that high body weight, spending a lot of time watching television, and a salty diet each independently increase the risk of asthma symptoms in children.

  8. Decreased lung function after preschool wheezing rhinovirus illnesses in children at risk to develop asthma.

    Science.gov (United States)

    Guilbert, Theresa W; Singh, Anne Marie; Danov, Zoran; Evans, Michael D; Jackson, Daniel J; Burton, Ryan; Roberg, Kathy A; Anderson, Elizabeth L; Pappas, Tressa E; Gangnon, Ronald; Gern, James E; Lemanske, Robert F

    2011-09-01

    Preschool rhinovirus (RV) wheezing illnesses predict an increased risk of childhood asthma; however, it is not clear how specific viral illnesses in early life relate to lung function later on in childhood. To determine the relationship of virus-specific wheezing illnesses and lung function in a longitudinal cohort of children at risk for asthma. Two hundred thirty-eight children were followed prospectively from birth to 8 years of age. Early life viral wheezing respiratory illnesses were assessed by using standard techniques, and lung function was assessed annually by using spirometry and impulse oscillometry. The relationships of these virus-specific wheezing illnesses and lung function were assessed by using mixed-effect linear regression. Children with RV wheezing illness demonstrated significantly decreased spirometry values, FEV(1) (P = .001), FEV(0.5) (P Children who wheezed with respiratory syncytial virus or other viral illnesses did not have any significant differences in spirometric or impulse oscillometry indices when compared with children who did not. Children diagnosed with asthma at ages 6 or 8 years had significantly decreased FEF(25-75) (P = .05) compared with children without asthma. Among outpatient viral wheezing illnesses in early childhood, those caused by RV infections are the most significant predictors of decreased lung function up to age 8 years in a high-risk birth cohort. Whether low lung function is a cause and/or effect of RV wheezing illnesses is yet to be determined. Copyright © 2011 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  9. EARLY WHEEZING PHENOTYPES AND COGNITIVE DEVELOPMENT OF 3-YEAR OLDS. COMMUNITY-RECRUITED BIRTH COHORT STUDY

    Science.gov (United States)

    Jedrychowski, Wieslaw; Perera, Frederica P.; Jankowski, Jeffery; Maugeri, Umberto; Mrozek-Budzyn, Dorota; Mroz, Elzbieta; Flak, Elzbieta; Skarupa, Anita; Edwards, Susan; Lisowska-Miszczyk, Ilona

    2013-01-01

    The main purpose of the study was to answer the question whether young children without clinical diagnosis of asthma but experiencing early wheezing disorders and therefore being at high risk of developing asthma may have cognitive deficits. In the ongoing birth cohort study wheezing symptoms were recorded postpartum over two first years of age and subsequently cognitive status of children at the age of 3 years was assessed with the Bayley Mental Development Index (MDI). In the statistical analysis a wide range of modifying and confounding factors (maternal education, gender of children, prenatal exposure to lead and environmental tobacco smoke (ETS) were considered to assess the independent effect of early wheezing phenotypes on cognitive development of children. The MDI score correlated inversely with the number of wheezing days recorded over 24 months (r = −0.13, p=0.007), lead cord blood concentration (r = − 0.12, p = − 0.02), number of siblings (r = − 0.17, p = 0.0006) and the number of cigarettes smoked daily by other household members at home over the pregnancy period (r = − 0.18, p = 0.0002). While the children who experienced wheezing over the first year of age showed deficit of 2 MDI scores (beta coeff. = −2.31, 95%CI: −4.63 to 0.02), those with persistent wheezing had the score deficit of 4 points (beta coeff. = − 4.41, 95%CI: −8.27 to −0.55). To our knowledge, it is the first report in the literature showing that early wheezing is associated the cognitive deficit in a community-recruited very young children. Observed cognitive deficit in early wheezers may be caused by RSV infections or can be related to lower lung function attributed to persistent wheezing, which reducing oxygen supply would affect rapidly developing brain. PMID:19548966

  10. Factors associated with the time to the first wheezing episode in infants: a cross-sectional study from the International Study of Wheezing in Infants (EISL).

    Science.gov (United States)

    Pacheco-Gonzalez, Rosa M; Mallol, Javier; Solé, Dirceu; Brand, Paul L P; Perez-Fernandez, Virginia; Sanchez-Solis, Manuel; Garcia-Marcos, Luis

    2016-01-21

    Male gender, asthmatic heredity, perinatal tobacco smoke exposure and respiratory infections have been associated with wheeze in the first years of life, among other risk factors. However, information about what factors modify the time to the first episode of wheeze in infants is lacking. The present study analyses which factors are associated with shorter time to the first episode of wheeze in infants. Parents of 11- to 24-month-old children were surveyed when attending their health-care centres for a control visit. They answered a questionnaire including the age in months when a first wheeze episode (if any) had occurred (outcome variable). The study was performed in 14 centres in Latin America (LA) and in 8 centres in Europe (EU) (at least 1,000 infants per centre). Factors known to be associated with wheezing in the cohort were included in a survival analysis (Cox proportional hazards model). Summary hazard ratios adjusted for all risk factors (aHR) were calculated using the meta-analysis approach with random effects. A total of 15,067 infants had experienced wheezing at least once, out of 35,049 surveyed. Male gender in LA (aHR 1.05, 95% confidence interval (CI) 1.00-1.10, P=0.047), parental asthma in LA and EU (aHR 1.05, 95% CI 1.00-1.11, P=0.037), infant eczema in EU (aHR 1.25, 95% CI 1.12-1.39, P<0.001) and having a cold during the first 3 months in LA and EU (aHR 1.97, 95% CI 1.90-2.04, P<0.001), in LA (aHR 1.98, 95% CI 1.90-2.06, P<0.001) and in EU (aHR 1.91, 95% CI 1.75-2.09, P<0.001) were associated with a shorter period of time to the first episode. Breast feeding for at least 3 months was associated with a longer period, only in LA (aHR 0.91, 95% CI 0.86-0.96, P<0.001). Cold symptoms during the first 3 months is the most consistent factor shortening the time to the first episode of wheezing; breast feeding for ⩾3 months delays it only in LA, whereas eczema shortens it only in EU. Avoiding a common cold in the first months of life could be a good

  11. Indoor risk factors for cough and their relation to wheeze and sensitization in Chilean young adults.

    Science.gov (United States)

    Potts, James F; Rona, Roberto J; Oyarzun, Manuel J; Amigo, Hugo; Bustos, Patricia

    2008-04-01

    We assessed the effects of indoor risk factors, including smoking, on different types of cough and on cough and wheeze in combination. Our sample was composed of 1232 men and women residing in a semirural area of Chile. We used a standardized questionnaire, sensitization to 8 allergens, and bronchial hyperresponsiveness to methacholine to assess cough and wheeze characteristics. Information was gathered on dampness, mold, ventilation, heating, housing quality, smoking, and environmental tobacco smoke exposure. Most exposures were associated with cough alone or cough in combination with wheeze. Smoking, past smoking, and environmental tobacco smoke exposure were strongly associated with dry cough and wheeze. The use of coal for heating was associated with dry cough. Leaks, mold, and lack of kitchen ventilation were associated with cough and wheeze. Nocturnal cough and productive cough were associated with specific types of sensitization, but dry cough was not. Productive cough was associated with hyperresponsiveness to methacholine. Several different types of indoor exposures, including environmental tobacco smoke exposure, are important contributors to morbidity associated with cough and wheeze. A vigorous preventive strategy designed to lower exposures to indoor risk factors would lower rates of respiratory morbidity.

  12. Indoor risk factors for cough and their relation to wheeze and sensitization in Chilean young adults

    Energy Technology Data Exchange (ETDEWEB)

    Potts, J.F.; Rona, R.J.; Oyarzun, M.J.; Amigo, H.; Bustos, P. [Kings College London, London (United Kingdom). Dept. for Public Health Science

    2008-04-15

    We assessed the effects of indoor risk factors, including smoking, on different types of cough and on cough and wheeze in combination. Our sample was composed of 1232 men and women residing in a semi-rural area of Chile. We used a standardized questionnaire, sensitization to 8 allergens, and bronchial hyperresponsiveness to methacholine to assess cough and wheeze characteristics. Information was gathered on dampness, mold, ventilation, heating, housing quality, smoking, and environmental tobacco smoke exposure. Most exposures were associated with cough alone or cough in combination with wheeze. Smoking, past smoking, and environmental tobacco smoke exposure were strongly associated with dry cough and wheeze. The use of coal for heating was associated with dry cough. Leaks, mold, and lack of kitchen ventilation were associated with cough and wheeze. Nocturnal cough and productive cough were associated with specific types of sensitization, but dry cough was not. Productive cough was associated with hyperresponsiveness to methacholine. Several different types of indoor exposures, including environmental tobacco smoke exposure, are important contributors to morbidity associated with cough and wheeze. A vigorous preventive strategy designed to lower exposures to indoor risk factors would lower rates of respiratory morbidity.

  13. Indoor Risk Factors for Cough and Their Relation to Wheeze and Sensitization in Chilean Young Adults

    Science.gov (United States)

    Potts, James F.; Rona, Roberto J.; Oyarzun, Manuel J.; Amigo, Hugo; Bustos, Patricia

    2008-01-01

    Objectives. We assessed the effects of indoor risk factors, including smoking, on different types of cough and on cough and wheeze in combination. Methods. Our sample was composed of 1232 men and women residing in a semirural area of Chile. We used a standardized questionnaire, sensitization to 8 allergens, and bronchial hyperresponsiveness to methacholine to assess cough and wheeze characteristics. Information was gathered on dampness, mold, ventilation, heating, housing quality, smoking, and environmental tobacco smoke exposure. Results. Most exposures were associated with cough alone or cough in combination with wheeze. Smoking, past smoking, and environmental tobacco smoke exposure were strongly associated with dry cough and wheeze. The use of coal for heating was associated with dry cough. Leaks, mold, and lack of kitchen ventilation were associated with cough and wheeze. Nocturnal cough and productive cough were associated with specific types of sensitization, but dry cough was not. Productive cough was associated with hyperresponsiveness to methacholine. Conclusions. Several different types of indoor exposures, including environmental tobacco smoke exposure, are important contributors to morbidity associated with cough and wheeze. A vigorous preventive strategy designed to lower exposures to indoor risk factors would lower rates of respiratory morbidity. PMID:17666696

  14. Long-term safety and efficacy of budesonide nasal aerosol in perennial rhinitis. A 12-month multicentre study.

    Science.gov (United States)

    Lindqvist, N; Balle, V H; Karma, P; Kärjä, J; Lindström, D; Mäkinen, J; Pukander, J; Ruoppi, P; Suonpää, J; Ostlund, W

    1986-04-01

    A long-term safety study of intranasally administered budesonide, a topical glucocorticoid, has been performed. 104 patients with perennial rhinitis, allergic or non-allergic, participated in a multicentre study in seven ENT-clinics utilising an identical protocol. A budesonide dosage of 400 micrograms/day was used as starting dose, but the patients were at liberty to reduce the daily dose to 200 micrograms. The patients were observed at intervals up to 12 months. At the entry and follow-up visits the following parameters were recorded: rhinoscopic findings, nasal symptom scores, blood chemistry, hematology, urinalysis and determination of plasma cortisol levels before and after stimulation with ACTH (Synacthen). Nasal biopsies taken from 50 of the patients at the beginning and completion of the study were examined in a blinded way by an independent pathologist. The analysis revealed no histopathological changes of the nasal mucosa. At rhinoscopy no signs of atrophy or candida were reported. Lividity of the nasal mucosa was significantly reduced during the trial, which was also the case for nasal congestion and secretion. All nasal symptom parameters assessed by the patients were significantly reduced from baseline during the follow-up period. No clinically significant changes in the hematological and blood chemistry parameters were observed. Plasma cortisol analysis before and after challenge with ACTH revealed no influence on the hypothalamic pituitary adrenal axis. No tachyphylaxis was observed; on the contrary, there was a clear tendency for reduction of the daily dose of budesonide necessary to keep the patients symptom-free.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Drug resistance mutations after the first 12 months on antiretroviral therapy and determinants of virological failure in Rwanda.

    Science.gov (United States)

    Ndahimana, Jean d'Amour; Riedel, David J; Mwumvaneza, Mutagoma; Sebuhoro, Dieudone; Uwimbabazi, Jean Claude; Kubwimana, Marthe; Mugabo, Jules; Mulindabigwi, Augustin; Kirk, Catherine; Kanters, Steve; Forrest, Jamie I; Jagodzinski, Linda L; Peel, Sheila A; Ribakare, Muhayimpundu; Redfield, Robert R; Nsanzimana, Sabin

    2016-07-01

    To evaluate HIV drug resistance (HIVDR) and determinants of virological failure in a large cohort of patients receiving first-line tenofovir-based antiretroviral therapy (ART) regimens. A nationwide retrospective cohort from 42 health facilities was assessed for virological failure and development of HIVDR mutations. Data were collected at ART initiation and at 12 months of ART on patients with available HIV-1 viral load (VL) and ART adherence measurements. HIV resistance genotyping was performed on patients with VL ≥1000 copies/ml. Multiple logistic regression was used to determine factors associated with treatment failure. Of 828 patients, 66% were women, and the median age was 37 years. Of the 597 patients from whom blood samples were collected, 86.9% were virologically suppressed, while 11.9% were not. Virological failure was strongly associated with age CD4 counts <200 cells/μl (aOR 3.4; 95% CI: 1.9-6.2). Overall, 9.1% of all patients on ART had drug resistance mutations after 1 year of ART; 27% of the patients who failed treatment had no evidence of HIVDR mutations. HIVDR mutations were not observed in patients on the recommended second-line ART regimen in Rwanda. The last step of the UNAIDS 90-90-90 target appears within grasp, with some viral failures still due to non-adherence. Nonetheless, youth and late initiators are at higher risk of virological failure. Youth-focused programmes could help prevent further drug HIVDR development. © 2016 John Wiley & Sons Ltd.

  16. Perceived injustice after traumatic injury: Associations with pain, psychological distress, and quality of life outcomes 12 months after injury.

    Science.gov (United States)

    Trost, Zina; Agtarap, Stephanie; Scott, Whitney; Driver, Simon; Guck, Adam; Roden-Foreman, Kenleigh; Reynolds, Megan; Foreman, Michael L; Warren, Ann Marie

    2015-08-01

    There is growing recognition that individuals who experience traumatic injuries perceive themselves as victims of injustice and that elevated levels of perceived injustice are associated with problematic physical and psychological outcomes. To date, research regarding injustice perception and injury outcomes has been restricted to a small number of musculoskeletal pain conditions. No research to date has examined the potential impact of perceived injustice among individuals admitted for trauma care. As part of this cross-sectional study, individuals (n = 155) admitted to a Level-1 trauma center completed measures of perceived injustice, pain, depression, posttraumatic stress, and health related (physical and mental/emotional) quality of life (HRQoL) outcomes 12 months after trauma admission. Bivariate analyses revealed significant associations between perceived injustice and demographic variables (education, income, race, and age) as well as injury-related variables (type of injury and length of hospital stay). Perceived injustice was correlated with greater pain intensity, depression, and PTSD symptoms, as well as poorer physical and mental HRQoL. Controlling for relevant demographic and injury-related variables, perceived injustice accounted for unique variance in pain intensity, depression severity, the presence and intensity of PTSD symptoms, mental HRQoL, and was marginally significant for physical HRQoL. This is the first study to examine perceived injustice in a trauma sample. Results support the presence of injustice perception in this group and its associations with pain and quality of life outcomes. Additional research is suggested to explore the impact of perceived injustice on recovery outcomes among individuals who have sustained traumatic injury. (c) 2015 APA, all rights reserved).

  17. Controlled clinical trial addressing teeth whitening with hydrogen peroxide in adolescents: a 12-month follow-up

    Directory of Open Access Journals (Sweden)

    Marcelo Mendes Pinto

    Full Text Available OBJECTIVES: To evaluate the colorimetric change in incisors and canines of adolescents aged 12 to 20 years submitted to at-home whitening and to evaluate satisfaction, sensitivity and discomfort during the procedures through a questionnaire. METHOD: Thirty adolescents were randomly assigned to the following groups: 1 6.0% hydrogen peroxide (White Class with calcium - FGM; 2 7.5% hydrogen peroxide (White Class with calcium - FGM; 3 10% hydrogen peroxide (Oral B 3D White - Oral-B; 4 Control group - placebo. Assessments were performed prior to treatment as well as at 7, 30, 180 and 360 days after treatment. Friedman’s ANOVA was used to analyze color. The Kruskal-Wallis test followed by Dunn’s post hoc test was used to compare the groups at the different evaluation times. Answers on the questionnaires were ranked, and non-parametrical tests were employed. The groups were compared in each period using the Kruskal-Wallis test followed by the Student-Newman-Keuls test. Categorical data were analyzed using Fisher's exact test, and the Wilcoxon test was used for the analysis of different periods. P-values were corrected using the Hyan-Holm step-down Bonferroni procedure. Clinicaltrials.gov: NCT01998386. RESULTS: Similar results were obtained one month after treatment with both tooth whitening gels and whitening strips. Patients were partially satisfied with the treatment after the first and second weeks and would recommend it. All products demonstrated color stability after 12 months of follow-up. CONCLUSIONS: The bleaching procedure was efficient, and the patients could perceive its result. Further investigations are needed to determine the effects of bleaching on young teeth.

  18. Effects of Motor Development Stimulation on Anthropometric Indices of Infants Aged 1-12 Months in Foster Care Homes

    Directory of Open Access Journals (Sweden)

    Arezou NikNezhad Jalali

    2015-12-01

    Full Text Available Background: The first three years of life have a pivotal role in growth and development of infants. Extra-uterine environment largely affects brain development of infants during the first year of life.However,no specific programs are available for brain development stimulation in foster homes. Aim: This study aimed to evaluate the effects of motor development stimulation package on anthropometric indices of infants staying in foster homes. Method: This experimental study was conducted on 50 infants aged 1-12 months at Ali Asghar foster home of Mashhad, Iran in 2013. Infants were randomly divided into two groups of intervention (n=25 and control (n=25. Motor development stimulation packages were used for intervention group three times a week for eight consecutive weeks (24 sessions, two hours each. Anthropometric indices of infants were evaluated using standard instruments before and after intervention. Data analysis was performed in SPSS V.11.5 using independent T-test and Mann-Whitney U test. Results: In this study, mean age of infants in intervention and control groups was 6.04±3.48 and 4.3±3.70 months, respectively. In total, 68% of infants were male, and 32% were female. After intervention, Mann-Whitney test results showed no statistically significant difference in height (P=0.47 and head circumference (P=0.11 of infants between the groups. However, independent T-test showed a statistically significant difference in body weight of infants (P=0.007 between the groups after intervention with the stimulation care package. Implications for Practice: According to the results of this study, use of evidence-based motor development stimulation package for eight weeks resulted in increased weight of infants, while it had no effect on height and head circumference. Therefore, it is recommended that complementary studies be conducted in this regard.

  19. Metabolic parameters and adipokine profile in growth hormone deficient (GHD) children before and after 12-month GH treatment.

    Science.gov (United States)

    Meazza, C; Elsedfy, H H; Pagani, S; Bozzola, E; El Kholy, M; Bozzola, M

    2014-03-01

    It is a common knowledge that GH exhibits a large number of metabolic effects, involving lipid and glucose homeostasis. The aim of the study was to investigate the effect of one year GH therapy on metabolic parameters and adipokines in GH deficient (GHD) children. Sixteen prepubertal children (11 M and 5 F) with complete GHD (age range: 3.4-14.7 years) and 20 (13 M and 7 F) age and sex-matched healthy children (age range: 4.6-12.3 years) were studied. Blood was collected from patients before starting GH therapy (0.025 mg/kg/day) and one year later, and from healthy children to measure adiponectin, leptin, osteoprotegerin, resistin, interleukin (IL)-6, tumor necrosis factor (TNF)-α levels, and other glucose and lipid metabolism parameters. Adiponectin and resistin levels were significantly higher (49980 ng/ml vs. 14790 ng/ml and 11.0 pg/ml vs. 6.3, respectively) in GHD children before GH therapy than in controls. Serum IGF-I levels (p=0.0001) and height SDS (pGH therapy. There was a loss of body fat reflected by a significant decline in tricep (p=0.0003) and subscapular skinfold thickness SDS (p=0.0023). After 12 months, there was a significant rise in insulin (p=0.0052) and leptin levels (p=0.0048) and a significant decrease in resistin (p=0.0312) and TNF-α (p=0.0137). We observed that lipid and glucose metabolisms are only slightly affected in GHD children. Growth hormone replacement therapy affects some factors, such as leptin, resistin and fat mass, suggesting that also in children, GH treatment has a role in the regulation of factors secreted by adipose tissue. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Effects of a 12-month exercise program on cardiorespiratory health indicators of Vietnam War veterans resident in the tropics.

    Science.gov (United States)

    Kerr, Rebecca M; Leicht, Anthony S; Spinks, Warwick L

    2008-06-01

    To measure the effect of a combined aerobic and resistance exercise program on key cardiovascular disease risk factors (i.e. body composition or anthropometry and cardiorespiratory function) of Australian male, Vietnam War veterans living in the tropics. Twelve-month exercise program with assessments at commencement, 3, 6 and 12 months. North Queensland regional centre. Australian male, Vietnam War veterans (n = 164) resident in north Queensland. Measurement of heart rate, blood pressure, skinfold and girth measurements, exercise heart rate response and estimated aerobic capacity to determine whether the implementation of a simple aerobic and resistance exercise program could positively change selected cardiovascular disease risk factors in Vietnam Veterans. Significant improvements were reported for systolic blood pressure (131.1 (SD 15.7) reduced to 122.7 (12.4) mmHg), diastolic blood pressure (82.7 (9.1) reduced to 76.3 (10.3) mmHg), resting heart rate (73 (11) reduced to 69 (11) bpm), sum of skinfolds (127.5 (40.3) reduced to 99.5 (32.1) mm), waist girth (103.2 (12.0) reduced to 100.5 (12.1) cm), hip girth (105.3 (9.6) reduced to 103.7 (10.4) cm) and aerobic capacity (2.17 (0.39) increased to 2.36 (0.34) L min(-1)). Participation in a combined aerobic and resistance training program elicited significant anthropometric and cardiorespiratory benefits that might lead to a decreased risk of developing cardiovascular disease for male Vietnam War veterans resident in rural and regional areas.

  1. The Course of Quality of Life in Patients on Peritoneal Dialysis: A 12-month Prospective Observational Cohort Study.

    Science.gov (United States)

    Lim, Haikel A; Yu, Zhenli; Kang, Augustine W C; Foo, Marjorie W Y; Griva, Konstadina

    2016-08-01

    Quality of life (QOL) impairments are common in patients undergoing dialysis, and have been strongly associated with significant clinical outcomes like mortality and morbidity. Despite this, little is known about the course of QOL over time, especially for patients on peritoneal dialysis (PD). This prospective study was set to explore course and determinants of QOL over 12 months in PD patients. A total of 115 PD patients completed the SF-12 and Kidney Disease Quality of Life Short Form (KDQOL-SF) at baseline and 12 months later. Intra-individual changes in physical (physical component summary, PCS), mental (mental component summary, MCS), and Kidney Disease Component Summary scores (KDCS) were identified based on the minimally important clinical difference threshold. Clinical information was extracted from medical records. Of the patients, 74-80 % reported physical QOL impairments, as compared to 29-33 % who reported mental/emotional QOL impairments. PCS and MCS scores remained stable across 12 months. Significant deterioration was noted in the domains of patient satisfaction, staff encouragement, and social support, while there were significant increases in the perceived effects of kidney disease. Intra-individual trajectory analyses indicated that one in three patients reported deteriorating QOL. No sociodemographic or clinical variables were found to be associated with course of outcomes. Although PD offers the convenience of home-based care, it is associated with persisting QOL impairments and diminishing QOL over time, especially in domains related to quality of care and support. This highlights the need for improving or maintaining standards of care and support for PD patients as they become increasingly established on their regimes.

  2. Self-rated health, symptoms of depression and general symptoms at 3 and 12 months after a first-ever stroke: a municipality-based study in Sweden

    Directory of Open Access Journals (Sweden)

    Hassler Ejda

    2007-10-01

    Full Text Available Abstract Background Self-rated health is an important indicator of quality of life as well as a good predictor of future health. The purpose of the study was to follow up the self-rated health and the prevalence of symptoms of depression and general symptoms in a population of first-ever stroke patients 3 and 12 months after stroke. Methods All patients surviving their first-ever stroke and residing in Nacka municipality in Stockholm County Council were included using a multiple overlapping search strategy during an 18-month period (n = 187. Our study group comprised the 145 patients who survived the first 3 months after stroke. Three and 12 months after their stroke, the patients were assessed regarding self-rated health and general symptoms using parts of the Göteborg Quality of Life Instrument (GQLI, and regarding symptoms of depression using the Montgomery Asberg Depression Scale (MADRS-S. Results Self-rated health was rated as very good or rather good by 62% at 3 months after stroke and by 78% at 12 months after stroke. More than half of the patients suffered from symptoms of depression, with no significant improvement at 12 months. The most common general symptoms at 3 months after stroke were fatigue, sadness, pain in the legs, dizziness and irritability. Fatigue and sadness were still common at 12 months. Twelve months after stroke the prevalences of crying easily, irritability, impaired concentration, nausea and loss of weight were significantly lower. Conclusion The majority of patients rated their health as rather good or very good at 3 and 12 months after stroke. However, the majority suffered from fatigue and from symptoms of depression after both 3 and 12 months. In continued care of stroke survivors, it is important to consider the fact that many patients who rate their health as good may nevertheless have symptoms of depression, and some of them may benefit from anti-depressive treatment.

  3. Anterior Cruciate Ligament Reconstruction Does Not Fully Restore Normal 3D Knee Kinematics at 12 Months During Walking and Walk-Pivoting: A Longitudinal Gait Analysis Study.

    Science.gov (United States)

    Hasegawa, Takayuki; Otani, Toshiro; Takeda, Kentaro; Matsumoto, Hideo; Harato, Kengo; Toyama, Yoshiaki; Nagura, Takeo

    2015-10-01

    The purpose of the current study was to longitudinally evaluate how preoperative knee kinematics change after ACL reconstruction. Three-dimensional gait analysis using the point cluster method was undertaken on the same subjects preoperatively and at 3, 6, and 12 months after ACL reconstructive surgery. Thirteen subjects (7 males, 6 females) were examined while performing 2 different activities at self-selected speeds: walking and walk-pivoting (walking, pivoting toward the landed limb side and walking away). The contralateral knees of subjects at 12 months postoperatively were selected as control knees. Flexion range in the stance phase increased with time after surgery, but remained lower than in the contralateral knee, even at 12 months postoperatively (P walking and walk-pivoting. The rotation pattern during walking and walk-pivoting showed an offset toward external rotation by 6 months postoperatively compared with control knees, while at 12 months postoperatively the offset had nearly disappeared and the movement pattern resembled that in control knees. These findings suggest that a return to sport participation by 6 months after ACL reconstruction requires careful consideration. Depending on the type of sport, activity restriction even after 12 months may need to be considered to allow complete kinematic restoration.

  4. Traditional Baby Care Practices of Mothers of Children Aged 6-12 Months in The Provincial Centre of Trabzon, Turkey

    Directory of Open Access Journals (Sweden)

    Ilknur Kahriman

    2011-02-01

    Full Text Available Aim: To evaluate traditional baby care practices employed by mothers in the Turkish province of Trabzon. Materials and methods: This descriptive study was planned around babies born in the provincial center of Trabzon between 1 June and 31 December, 2005, and aged 6-12 months at the time of the research. Data were collected in July-September 2006. In order to determine sampling size the prevalence of mothers using traditional practices was calculated at 50%, with a deviation of 0.05, giving a sample size of 384 mothers, the final number being put at 400. The study was performed at six clinics selected on the basis of settlement location and socioeconomic level out of 11 health clinics in the city center of the province of Trabzon. Data in the study are presented as numbers, and percentage distributions as mean±standard deviation. Results: It was determined that 69.8% of mothers breastfed their babies immediately and that 91.3% gave them colostrum. It was also determined that 3.7% of mothers resorted to various practices in order to ensure a male or female baby, 44.5% in order to facilitate labor, 25% in order to avoid puerperal fever, 63.5% in order eliminate postnatal pain, 88% to prevent their babies smelling, 86.2% for the shedding of the umbilical cord, 54.2% to protect their babies against jaundice, 73.7% to protect their babies from the evil eye, 26.2% so their babies would be good-looking and 40.7% to safely complete the first 40 days after childbirth. The main practices having a harmful effect on health in the study were swaddling, salting the baby, waiting for the call to prayer before breastfeeding the baby after birth and not giving colostrum. Conclusions: Traditions were observed to have an impact and to be persisting in child care in Trabzon. This suggests it will be useful for health personnel working in the field of infant care to evaluate the traditional characteristics in the locations where they work and to correct negative

  5. A multicenter, 12-month randomized study comparing dexamethasone intravitreal implant with ranibizumab in patients with diabetic macular edema.

    Science.gov (United States)

    Callanan, David G; Loewenstein, Anat; Patel, Sunil S; Massin, Pascale; Corcóstegui, Borja; Li, Xiao-Yan; Jiao, Jenny; Hashad, Yehia; Whitcup, Scott M

    2017-03-01

    To evaluate whether treatment with dexamethasone intravitreal implant (DEX implant) 0.7 mg every 5 months provides a similar average change in best-corrected visual acuity (BCVA) from baseline as ranibizumab 0.5 mg administered as per its European Summary of Product Characteristics in patients with diabetic macular edema (DME). This was a multicenter, open-label, 12-month, randomized, parallel-group, noninferiority study in patients with DME (one eye/patient). The primary efficacy measure was BCVA using the Early Treatment Diabetic Retinopathy Study (ETDRS) method. Secondary efficacy measures included area of leakage on fluorescein angiography and central retinal thickness (CRT) on optical coherence tomography. Baseline patient characteristics were similar in the two treatment groups (DEX implant, n = 181; ranibizumab, n = 182); mean DME duration was ∼33 months. The mean average BCVA change from baseline over 12 months was 4.34 letters with DEX implant and 7.60 letters with ranibizumab. The lower limit of the 95 % confidence interval of the between-group difference was -4.74 letters, and therefore, DEX was demonstrated to be noninferior to ranibizumab based on the prespecified noninferiority margin of 5 letters. At monthly follow-up visits, the percentage of patients with ≥15-letter BCVA gain from baseline ranged from 7.2 to 17.7 % with DEX implant and 4.4 to 26.9 % with ranibizumab. Both DEX implant and ranibizumab effectively reduced CRT and reduced the area of fluorescein leakage. Between-group differences in change from baseline CRT favored DEX implant at 1, 2, 6, and 7 months (p ≤ 0.007) and ranibizumab at 4, 5, 9, and 10 months (p medication. Both DEX implant and ranibizumab were well tolerated and improved BCVA and anatomic outcomes in patients with DME. DEX implant met the a priori criterion for noninferiority to ranibizumab in average change from baseline BCVA over 12 months. Noninferiority was achieved with an average of 2

  6. Asthma and Wheeze Prevalence among Nursing Professionals in Western Japan: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Jun Kurai

    2015-12-01

    Full Text Available Although adult asthma is attributable to occupational factors, few reports are available on asthma prevalence among health care workers in Japan. The objective of this study was to estimate the prevalence of asthma and wheeze among Japanese nursing professionals. A cross-sectional study was conducted by postal survey using a translated version of the European Community Respiratory Health Survey questionnaire from April to June 2013. The analysis included 4634 nursing professionals (257 men and 4377 women and the overall response rate was 84.8%. The prevalence of current asthma and wheeze were 10.7% (95% confidence interval (CI, 9.9%–11.7% and 15.6% (95% CI, 14.5%–16.6%, respectively. More than one year of work experience as a nursing professional and more than one year of experience with bed-making tasks were associated with odds ratios (ORs of 1.95 (95% CI, 1.12–3.39 and 1.64 (95% CI, 1.15–2.23 for wheeze, respectively. Current smoking was significantly associated with the presence of wheeze, with ORs of 2.27 for men (95% CI, 1.11–4.64 and 2.01 for women (95% CI, 1.54–2.64. Among female nurses, latex allergy was associated with wheeze (OR, 1.87; 95% CI, 1.56–2.23, as was body mass index ≥30 (OR, 2.76; 95% CI, 1.65–4.62. This study has provided the prevalence of asthma and wheeze among Japanese nursing professionals. Employment period, bed-making tasks, latex allergy, obesity, and smoking may be risk factors for prevalent wheeze among nursing professionals.

  7. Survival analysis of banding and bonding molar tubes in adult patients over a 12-month period: a split-mouth randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Valéria Jacques OEIRAS

    Full Text Available Abstract: This split-mouth randomized clinical trial aimed to compare the survival rate of bonding and banding molar tubes in adult orthodontic patients. Eligibility criteria included adults (aged >18 years, no active caries, restorations, or fractures in the upper and lower molars. The main outcome was any type of first-time failure in molar tubes. A computer-generated randomization scheme was used in a 1:1 ratio. The survival rate was estimated for 32 adult patients, in whom a tube was bonded to a molar tooth using composite resin on one side and a band was cemented with glass ionomer onto the same tooth in the contralateral arch. A total of 59 banded and 59 bonded molars were followed up for 12 months. Blinding was not applicable. Survival analysis including Cox regression was used at p < 0.05. The survival rate of bonded molars was not statistically different from that of banded molars (log-rank test, p = 0.97. Hazard ratio (HR was 0.72 (95%CI, 0.38-1.31. Bonded upper molars yielded a survival rate of 81.25% (26 out of 32 compared to 71.87% (23 out of 32 for banded upper molars. The survival rate was 66.66% (18 out of 27 for banded lower molars and 59.25% for bonded lower molars (16 out of 27. The HR for lower vs. upper arch was 2.16 (95%CI, 1.18-3.98. No serious problem was observed other than gingivitis associated with plaque accumulation. In contrast to previous studies in young patients, in adults, bonding orthodontic tubes to molars is similar to molar banding. However, both procedures had a high failure rate in the lower arch.

  8. Comparison of the population excess fraction of Chlamydia trachomatis infection on pelvic inflammatory disease at 12-months in the presence and absence of Chlamydia testing and treatment

    DEFF Research Database (Denmark)

    Davies, Bethan; Turner, Katy M.E.; Leung, Stella

    2017-01-01

    Background: The impact of Chlamydia trachomatis (chlamydia) control on the incidence of pelvic inflammatory disease (PID) is theoretically limited by the proportion of PID caused by chlamydia. We estimate the population excess fraction (PEF) of treated chlamydia infection on PID at 12-months...... chlamydia on PID at 12-months. We undertook a systematic review to identify further studies that reported the risk of PID in women who were tested for chlamydia (infected and uninfected). We used the same method to calculate the PEF in eligible studies then compared all estimates of PEF. Results......: The systematic review identified a single study, a randomised controlled trial of chlamydia screening (POPI-RCT). In the presence of testing and treatment PID at 12-months was attributable to treated (baseline) chlamydia infections (Manitoba: 8.86%(95%CI 7.15-10.75); Denmark: 3.84%(3.26-4.45); screened...

  9. Body composition is improved during 12 months' treatment with metformin alone or combined with oral contraceptives compared with treatment with oral contraceptives in polycystic ovary syndrome

    DEFF Research Database (Denmark)

    Glintborg, Dorte; Altinok, Magda Lambaa; Mumm, Hanne

    2014-01-01

    Context: Central obesity in polycystic ovary syndrome (PCOS) is associated with increased inflammatory markers and increased risk for type 2 diabetes. Objective: The objective of the study was to evaluate whether treatment with metformin (M) or M combined with oral contraceptive pills (OCPs......) resulted in a more advantageous body composition than treatment with OCP alone. Setting: The study was conducted at an outpatient clinic. Patients and Interventions: This was a randomized, controlled clinical trial. Ninety patients with PCOS were randomized to 12 months' treatment with M (2 g/d), M + OCP...... months and changes in regional fat mass estimates at 12 months were measured. Results: Dropout rates between intervention groups were not significantly different. Treatment with M and M+OCP were superior to OCP regarding weight and regional fat mass. The median (quartiles) weight changes during 12 months...

  10. Validity of the Test of Infant Motor Performance for prediction of 6-, 9- and 12-month scores on the Alberta Infant Motor Scale.

    Science.gov (United States)

    Campbell, Suzann K; Kolobe, Thubi H A; Wright, Benjamin D; Linacre, John Michael

    2002-04-01

    The Test of Infant Motor Performance (TIMP) is a test of functional movement in infants from 32 weeks' post-conceptional age to 4 months postterm. The purpose of this study was to assess in 96 infants (44 females, 52 males) with varying risk, the relation between measures on the TIMP at 7, 30, 60, and 90 days after term age and percentile ranks (PR) on the Alberta Infant Motor Scale (AIMS). Correlation between scores on the TIMP and the AIMS was highest for TIMP tests at 90 days and AIMS testing at 6 months (r=0.67, p=0.0001), but all comparisons were statistically significant except those between the TIMP at 7 days and AIMS PR at 9 months. In a multiple regression analysis combining a perinatal risk score and 7-day TIMP measures to predict 12-month AIMS PR, risk, but not TIMP, predicted outcome (21% of variance explained). At older ages TIMP measures made increasing contributions to prediction of 12-month AIMS PR (30% of variance explained by 90-day TIMP). The best TIMP score to maximize specificity and correctly identify 84% of the infants above versus below the 10th PR at 6 months was a cut-off point of 1 SD below the mean. The same cut-off point correctly identified 88% of the infants at 12 months. A cut-off of -0.5 SD, however, maximized sensitivity at 92%. A negative test result, i.e. score above -0.5 SD at 3 months, carried only a 2% probability of a poor 12-month outcome. We conclude that TIMP scores significantly predict AIMS PR 6 to 12 months later, but the TIMP at 3 months of age has the greatest degree of validity for predicting motor performance on the AIMS at 12 months and can be used clinically to identify infants likely to benefit from intervention.

  11. Stressful life events, perceived stress, and 12-month course of geriatric depression: direct effects and moderation by the 5-HTTLPR and COMT Val158Met polymorphisms.

    Science.gov (United States)

    Zannas, Anthony S; McQuoid, Douglas R; Steffens, David C; Chrousos, George P; Taylor, Warren D

    2012-07-01

    Although the relation between stressful life events (SLEs) and risk of major depressive disorder is well established, important questions remain about the effects of stress on the course of geriatric depression. Our objectives were (1) to examine how baseline stress and change in stress is associated with course of geriatric depression and (2) to test whether polymorphisms of serotonin transporter (5-HTTLPR) and catechol-O-methyltransferase (COMT Val158Met) genes moderate this relation. Two-hundred and sixteen depressed subjects aged 60 years or older were categorized by remission status (Montgomery-Asberg depression rating scale≤6) at 6 and 12 months. At 6 months, greater baseline numbers of self-reported negative and total SLEs and greater baseline perceived stress severity were associated with lower odds of remission. At 12 months, only baseline perceived stress predicted remission. When we examined change in stress, 12-month decrease in negative SLEs and level of perceived stress were associated with improved odds of 12-month remission. When genotype data were included, COMT Val158Met genotype did not influence these relations. However, when compared with 5-HTTLPR L/L homozygotes, S allele carriers with greater baseline numbers of negative SLEs and with greater decrease in negative SLEs were more likely to remit at 12 months. This study demonstrates that baseline SLEs and perceived stress severity may influence the 12-month course of geriatric depression. Moreover, changes in these stress measures over time correlate with depression outcomes. 5-HTTLPR S carriers appear to be more susceptible to both the effects of enduring stress and the benefit of interval stress reduction.

  12. Risk of Knee Osteoarthritis Over 24 Months in Individuals Who Decrease Walking Speed During a 12-Month Period: Data from the Osteoarthritis Initiative.

    Science.gov (United States)

    Herzog, Mackenzie M; Driban, Jeffrey B; Cattano, Nicole M; Cameron, Kenneth L; Tourville, Timothy W; Marshall, Stephen W; Pietrosimone, Brian

    2017-08-01

    To assess the association between change in walking speed over a 12-month period and risk of developing radiographic knee osteoarthritis (rKOA) over a 24-month period. We included participants without rKOA from the Osteoarthritis Initiative. Change in walking speed was determined from a 20-m walk assessment, calculated using walking speed at 12-month followup minus baseline speed and/or 24-month followup walking speed minus 12-month speed. Incident rKOA was defined as progressing to Kellgren-Lawrence arthritis grading scale ≥ 2 within 24 months (i.e., incidence between 12 and 36 mos or 24 and 48 mos). Self-reported significant knee injury during the exposure period, age, body mass index (BMI), and Physical Activity Scale for the Elderly (PASE) score were adjusted for analytically. We included 2638 observations among 1460 unique participants (58% women; aged 59 ± 9 yrs, range 45-79). The mean change in walking speed over 12 months was 0.001 ± 0.13 m/s (range -0.6271 to 1.4968). About 5% of the sample (n = 122) developed rKOA over a 24-month period. After controlling for significant knee injury, age, BMI, and PASE score, we found an 8% relative increase in risk of developing rKOA for every 0.1 m/s decrease in walking speed over a 12-month period (risk ratio 1.08, 95% CI 1.00-1.15, p = 0.05). Evaluating change in speed over a 12-month period using a 20-m walk test may be useful in identifying individuals at increased risk of developing rKOA over the subsequent 24 months. Identification of patients at high risk for developing rKOA would allow medical providers to implement early interventions to maximize joint health.

  13. Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion: The DIETFITS Randomized Clinical Trial.

    Science.gov (United States)

    Gardner, Christopher D; Trepanowski, John F; Del Gobbo, Liana C; Hauser, Michelle E; Rigdon, Joseph; Ioannidis, John P A; Desai, Manisha; King, Abby C

    2018-02-20

    Dietary modification remains key to successful weight loss. Yet, no one dietary strategy is consistently superior to others for the general population. Previous research suggests genotype or insulin-glucose dynamics may modify the effects of diets. To determine the effect of a healthy low-fat (HLF) diet vs a healthy low-carbohydrate (HLC) diet on weight change and if genotype pattern or insulin secretion are related to the dietary effects on weight loss. The Diet Intervention Examining The Factors Interacting with Treatment Success (DIETFITS) randomized clinical trial included 609 adults aged 18 to 50 years without diabetes with a body mass index between 28 and 40. The trial enrollment was from January 29, 2013, through April 14, 2015; the date of final follow-up was May 16, 2016. Participants were randomized to the 12-month HLF or HLC diet. The study also tested whether 3 single-nucleotide polymorphism multilocus genotype responsiveness patterns or insulin secretion (INS-30; blood concentration of insulin 30 minutes after a glucose challenge) were associated with weight loss. Health educators delivered the behavior modification intervention to HLF (n = 305) and HLC (n = 304) participants via 22 diet-specific small group sessions administered over 12 months. The sessions focused on ways to achieve the lowest fat or carbohydrate intake that could be maintained long-term and emphasized diet quality. Primary outcome was 12-month weight change and determination of whether there were significant interactions among diet type and genotype pattern, diet and insulin secretion, and diet and weight loss. Among 609 participants randomized (mean age, 40 [SD, 7] years; 57% women; mean body mass index, 33 [SD, 3]; 244 [40%] had a low-fat genotype; 180 [30%] had a low-carbohydrate genotype; mean baseline INS-30, 93 μIU/mL), 481 (79%) completed the trial. In the HLF vs HLC diets, respectively, the mean 12-month macronutrient distributions were 48% vs 30% for carbohydrates

  14. Use of complementary and alternative medicines associated with a 30% lower ongoing pregnancy/live birth rate during 12 months of fertility treatment

    DEFF Research Database (Denmark)

    Boivin, J; Schmidt, L

    2009-01-01

    BACKGROUND There seems to be little discussion between patient and physician about the use of complementary and alternative medicines (CAMs), perhaps because they are not perceived to have adverse effects on fertility. We therefore compared ongoing pregnancy and live birth rate in spontaneous users...... and non-users of CAM during a 12-month period of assisted reproduction technique (ART) treatment. Consent was by questionnaire return. METHOD This was a prospective observational cohort study with a 12-month follow-up period, sampling consecutive patients attending five ART clinics in Denmark. N = 728...

  15. 75 FR 60515 - Endangered and Threatened Wildlife and Plants; 12-Month Finding on a Petition to List the Pygmy...

    Science.gov (United States)

    2010-09-30

    ... previous CNORs, species matching this definition were known as category 1 candidates for listing. Thus, the... occurred at night. Pygmy rabbits maintain a low stance, have a deliberate gait, and are relatively slow and...

  16. Fish Oil-Derived Fatty Acids in Pregnancy and Wheeze and Asthma in Offspring

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Stokholm, Jakob; Chawes, Bo L.

    2016-01-01

    Background: Reduced intake of n-3 long-chain polyunsaturated fatty acids (LCPUFAs) may be a contributing factor to the increasing prevalence of wheezing disorders. We assessed the effect of supplementation with n-3 LCPUFAs in pregnant women on the risk of persistent wheeze and asthma in their off......Background: Reduced intake of n-3 long-chain polyunsaturated fatty acids (LCPUFAs) may be a contributing factor to the increasing prevalence of wheezing disorders. We assessed the effect of supplementation with n-3 LCPUFAs in pregnant women on the risk of persistent wheeze and asthma...... in their offspring. Methods: We randomly assigned 736 pregnant women at 24 weeks of gestation to receive 2.4 g of n-3 LCPUFA (fish oil) or placebo (olive oil) per day. Their children formed the Copenhagen Prospective Studies on Asthma in Childhood2010 (COPSAC2010) cohort and were followed prospectively...... end point was persistent wheeze or asthma, and the secondary end points included lower respiratory tract infections, asthma exacerbations, eczema, and allergic sensitization. Results: A total of 695 children were included in the trial, and 95.5% completed the 3-year, double-blind follow-up period...

  17. Is parent-child bed-sharing a risk for wheezing and asthma in early childhood?

    Science.gov (United States)

    Luijk, Maartje P C M; Sonnenschein-van der Voort, Agnes M M; Mileva-Seitz, Viara R; Jansen, Pauline W; Verhulst, Frank C; Hofman, Albert; Jaddoe, Vincent W V; de Jongste, Johan C; van IJzendoorn, Marinus H; Duijts, Liesbeth; Tiemeier, Henning

    2015-03-01

    Household crowding can place young children at risk for respiratory infections which subsequently provoke asthma symptoms. However, crowding might also protect against asthma, in accordance with the hygiene hypothesis. We tested if parent-infant bed-sharing, an important dimension of household crowding, increases or decreases the risk for asthma. In a population-based prospective cohort (N = 6160) we assessed bed-sharing at 2 and 24 months; wheezing between 1 and 6 years of age; and asthma at 6 years of age. Generalised estimating equation models were used to assess repeated measures of wheezing and asthma. We found no association between bed-sharing in early infancy and wheezing or diagnosis of asthma. By contrast, we found a positive association between bed-sharing in toddlerhood and both wheezing (OR 1.42, 95% CI 1.15-1.74) and asthma (OR 1.57, 95% CI 1.03-2.38). Wheezing was not associated with bed-sharing when using cross-lagged modelling. This study suggests that bed-sharing in toddlerhood is associated with an increased risk of asthma at later ages, and not vice versa. Further studies are needed to explore the underlying causal mechanisms. Copyright ©ERS 2015.

  18. A 12-month follow-up of an influenza vaccination campaign based on voluntary adherence: report on upper-respiratory symptoms among volunteers and non-volunteers

    Directory of Open Access Journals (Sweden)

    Páris Ali Ramadan

    Full Text Available CONTEXT: Routine immunization of groups at high risk for influenza has been progressively implemented as a matter of Brazilian public health policy. Although the benefits of the vaccination for healthy young adults are still controversial, it has been offered yearly to hundreds of thousands of Brazilian workers, generally as part of wellness initiatives in the workplace. OBJECTIVE: To study the characteristics of subjects that accepted or refused to be vaccinated against influenza and to report on respiratory symptoms in both groups, one year after the campaign date. DESIGN: A prospective observational study. SETTING: Workers at a subsidiary of an international bank in São Paulo, Brazil. PARTICIPANTS: 124 persons that did not accept and 145 that voluntarily accepted the vaccine completed 12 months of follow-up. MAIN MEASUREMENTS: Data concerning gender, age, tobacco use, and any history of chronic respiratory illness such as asthma, bronchitis, rhinitis, and repetitive upper-respiratory infections, were recorded at the time of vaccination. After that, workers were asked monthly by questionnaire or telephone about respiratory symptoms, days of work lost and medical consultations. RESULTS: The results showed statistically significant differences regarding age (P = 0.004 with the vaccinated group (V being younger than the non-vaccinated (NV one, and with reference to previous repetitive upper-respiratory infections being higher among the V group (P < 0.0001. During the follow-up, the V group reported more occurrences of upper respiratory symptoms (P < 0.0001, due to both non-influenza (P < 0.0001 and influenza-like illness (P = 0.045. Differences were also found between V and NV groups concerning days off work and number of medical consultations due to upper-respiratory symptoms and non-influenza illness. Gender and history of repetitive upper-respiratory infections were the best predictors of influenza-like illness-related events. CONCLUSIONS

  19. Reduction of unnecessary right ventricular pacing by managed ventricular pacing and search AV+ algorithms in pacemaker patients: 12-month follow-up results of a randomized study.

    Science.gov (United States)

    Chen, Silin; Chen, Keping; Tao, Qianmin; Zheng, Liangrong; Shen, Farong; Wu, Shulin; Fan, Jie; Xu, Geng; Wang, Li; Zhou, Xiaohong; Zhang, Shu

    2014-11-01

    The present study was to assess the reduction of right ventricular pacing (RVP) by pacemaker algorithms of Managed Ventricular Pacing (MVP) and Search AV+ (SAV+) interval over a period of 12 months. A total of 385 patients indicated for a dual-chamber pacemaker (DC-PM) were enrolled in the prospective, randomized COMPARE study at 29 centres in China between June 2009 and April 2011. Patients implanted with DC-PMs were randomized in a 1 : 1 ratio to the MVP group or the SAV+ group. The percentage of VP (%VP) was obtained from the device diagnostic data at 1-, 6-, and 12-month follow-ups and was expressed as the median %VP over all beats in patients with sinus node dysfunction (SND) and atrioventricular block (AVB) excluding persistent third-degree AVB. Of 385 enrolled patients, 253 had SND and 72 had AVB. The %VP in the MVP group was significantly lower than that in the SAV+ group at 1-, 6-, and 12-month follow-ups, respectively. At 12-month follow-up, the median %VP in SND patients was 0.20% in the MVP group and 1.4% in the SAV+ group (P sustainable %VP reduction has potential implications in reducing the development of heart failure and/or atrial arrhythmia morbidity. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  20. Effect on health-related quality of life of ongoing feedback during a 12-month maintenance walking programme in patients with COPD: a randomized controlled trial.

    Science.gov (United States)

    Wootton, Sally L; McKeough, Zoe; Ng, Cindy L W; Jenkins, Sue; Hill, Kylie; Eastwood, Peter R; Hillman, David; Jenkins, Christine; Cecins, Nola; Spencer, Lissa; Alison, Jennifer

    2018-01-01

    In patients with COPD, this study evaluated the effect on health-related quality of life (HRQoL) of adding ongoing feedback to a 12-month unsupervised maintenance walking programme. Participants were randomized to either an intervention group (IG) or control group (CG). Both groups completed the same 2-month supervised, walking training programme followed by a 12-month unsupervised maintenance walking programme. During the maintenance programme, the IG received ongoing feedback (telephone calls, biofeedback and progressive goal setting) and the CG received no feedback. A total of 75 participants completed the study (mean (SD): age 69 (8) years; forced expiratory volume in 1 s (FEV 1 ) 43 (15) % predicted). There was no between-group differences in the magnitude of change in HRQoL when data collected on completion of the 12-month maintenance programme were compared with that collected either before the 2-month supervised programme (mean between-group difference (MD) in total St George's Respiratory Questionnaire change scores: 1 point, 95% CI: -9 to 7) or on completion of the 2-month supervised programme (MD: 4 points, 95% CI -2 to 10). Following a 2-month supervised walking training programme, ongoing feedback was no more effective than no feedback in maintaining HRQoL during a 12-month unsupervised walking programme. © 2017 Asian Pacific Society of Respirology.

  1. A 12-Month Prospective, Observational Study of Treatment Regimen and Quality of Life Associated with ADHD in Central and Eastern Europe and Eastern Asia

    Science.gov (United States)

    Goetz, Michal; Yeh, Chin-Bin; Ondrejka, Igor; Akay, Aynur; Herczeg, Ilona; Dobrescu, Iuliana; Kim, Boong Nyun; Jin, Xingming; Riley, Anne W.; Martenyi, Ferenc; Harrison, Gavan; Treuer, Tamas

    2012-01-01

    Objectives: This prospective, observational, non-randomized study aimed to describe the relationship between treatment regimen prescribed and the quality of life (QoL) of ADHD patients in countries of Central and Eastern Europe (CEE) and Eastern Asia over 12 months. Methods: 977 Male and female patients aged 6-17 years seeking treatment for…

  2. Lifetime and 12-month prevalence of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition disorders among older African Americans: findings from the National Survey of American Life.

    Science.gov (United States)

    Ford, Briggett C; Bullard, Kai McKeever; Taylor, Robert Joseph; Toler, Amanda K; Neighbors, Harold W; Jackson, James S

    2007-08-01

    The purpose of this study was to estimate lifetime and 12-month prevalence of 13 psychiatric disorders for older African Americans. Data are from the older African American subsample of the National Survey of American Life. Selected measures of lifetime and 12-month Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) psychiatric disorders were examined (i.e., panic disorder, agoraphobia, social phobia, generalized anxiety disorder, obsessive compulsive disorder, posttraumatic stress disorder (PTSD), major depressive disorder, dysthymia, bipolar I and II disorders, alcohol abuse/dependence, and drug abuse/dependence). Twenty-three percent of older African Americans reported at least one lifetime disorder and 8.54% reported at least one 12-month disorder. Alcohol abuse, PTSD, and major depression were the most prevalent lifetime disorders. The most prevalent 12-month disorders were PTSD, major depression, and social phobia. Age, sex, education, and region were significantly associated with the odds of having a lifetime disorder. This is the first study of prevalence rates of serious mental disorders for older African Americans based on a national sample. Demographic correlates of the prevalence of disorders are discussed with an emphasis on age and regional differences.

  3. Control of the lumbar neutral zone decreases low back pain and improves self-evaluated work ability: a 12-month randomized controlled study.

    Science.gov (United States)

    Suni, Jaana; Rinne, Marjo; Natri, Antero; Statistisian, Matti Pasanen; Parkkari, Jari; Alaranta, Hannu

    2006-08-15

    A randomized controlled study with 12 months intervention. To study the effectiveness of a training intervention with emphases on the control of lumbar neutral zone (NZ) and behavior modeling as secondary prevention of low back pain (LBP) and disability. Improving the control of lumbar NZ and enhancing muscle activation patterns ensuring spinal stability have been proposed as means for secondary prevention of LBP and disability. In addition, cognitive behavior interventions have been shown to lower the risk of recurrence of LBP and long-term disability. Middle-aged working men with recent LBP but without severe disability were randomly allocated to either a training (TG, n = 52) or control group (CG, n = 54). The aim was to exercise twice a week for 12 months, once guided and once independently. The outcome measures were the changes in intensity of LBP, disability, self-evaluated future work ability, and neuromuscular fitness. The intensity of LBP decreased significantly more (39%) in the TG than in CG at 12 months. The proportion of subjects with negative expectations about their future work ability decreased in both groups at 6 and 12 months; however, the proportion was significantly bigger in TG compared with CG (P = 0.028). There effects on disability indexes and fitness were not statistically significant. Controlling lumbar NZ is a specific form of exercise and daily self-care with potential for prevention of recurrent nonspecific LBP and disability among middle aged working men.

  4. Effect of 12-month treatment with metformin and/or oral contraceptives on health-related quality of life in polycystic ovary syndrome

    DEFF Research Database (Denmark)

    Altinok, Magda Lambaa; Ravn, Pernille; Andersen, Marianne

    2018-01-01

    Health-related quality of life (HRQoL) is impaired in polycystic ovary syndrome (PCOS), but the effect of treatment with metformin (M) and/or oral contraceptives (OCP) is undetermined. To assess changes in HRQoL during 12-month randomized treatment with M, OCP or M + OCP in PCOS. Ninety women...

  5. Nutritional status of breastfed infants in rural Zambia : comparison of the National Center for Health Statistics growth reference versus the WHO 12-month breastfed pooled data set

    NARCIS (Netherlands)

    Hautvast, J.L.A.; Pandor, A.; Burema, J.; Tolboom, J.J.M.; Chishimba, N.; Monnens, L.A.H.; Staveren, van W.A.

    2000-01-01

    Cross-sectional data for breastfed infants in rural Zambia were used to evaluate the effect of applying two different data sets as a reference, i.e. the WHO 12-month breastfed pooled data set and the National Center for Health Statistics (NCHS) growth reference in terms of prevalence of malnutrition

  6. Description of the Motor Development of 3-12 Month Old Infants with Down Syndrome: The Influence of the Postural Body Position

    Science.gov (United States)

    Tudella, Eloisa; Pereira, Karina; Basso, Renata Pedrolongo; Savelsbergh, Geert J. P.

    2011-01-01

    The purpose of the present study was to describe the rate of motor development in infants with Down syndrome in the age range of 3-12 months and identify the difficulties both in performance and acquiring motor skills in prone, supine, sitting and standing positions. Nineteen infants with Down syndrome and 25 healthy full term typical infants were…

  7. Time to virological failure, treatment change and interruption for individuals treated within 12 months of HIV seroconversion and in chronic infection

    NARCIS (Netherlands)

    Zugna, Daniela; Geskus, Ronald B.; de Stavola, Bianca; Rosinska, Magdalena; Bartmeyer, Barbara; Boufassa, Faroudy; Chaix, Marie-Laure; Babiker, Abdel; Porter, Kholoud; del Amo, Julia; Meyer, Lawrence; Bucher, Heiner C.; Chêne, Geneviève; Hamouda, Osamah; Pillay, Deenan; Prins, Maria; Rosinska, Magda; Sabin, Caroline; Touloumi, Giota; Olson, Ashley; Coughlin, Kate; Walker, Sarah; de Luca, Andrea; Fisher, Martin; Muga, Robert; Zangerle, Robert; Kelleher, Tony; Cooper, David; Grey, Pat; Finlayson, Robert; Bloch, Mark; Ramacciotti, Tim; Gelgor, Linda; Smith, Don; Gill, John; Lutsar, Irja; Dabis, Francois; Thiebaut, Rodolphe; Masquelier, Bernard; Costagliola, Dominique; Guiguet, Marguerite; Vanhems, Philippe; Ghosn, Jade; Kücherer, Claudia; Paparizos, V.; Gargalianos-Kakolyris, P.; Lazanas, M.; Pantazis, Nikos; Katsarou, Olga; Rezza, Giovanni; Dorrucci, Maria; D'Arminio Monforte, Antonella; van der Helm, Jannie; Schuitemaker, Hanneke; Sannes, Mette; Brubakk, Oddbjorn; Kran, Anne-Marte Bakken; Tor, Jordi; Garcia de Olalla, Patricia; Cayla, Joan; Moreno, Santiago; Monge, Susana; del Romero, Jorge; Pérez-Hoyos, Santiago; Rickenbach, Martin; Francioli, Patrick; Malyuta, Ruslan; Murphy, Gary; Johnson, Anne; Phillips, Andrew; Morrison, Charles; Salata, Robert; Mugerwa, Roy; Chipato, Tsungai; Amornkul, Pauli N.; Gilmour, Jill; Kamali, Anatoli; Karita, Etienne; Giaquinto, Carlo; Gibb, Di; Grarup, Jesper; Kirk, Ole; Ledergerber, Bruno; Panteleev, Alex; Thorne, Claire; Welch, Stephen; Aboulker, Jean-Pierre; Albert, Jan; Asandi, Silvia; de Wit, Stéphane; de Wolf, Frank; Gatell, José; Karpov, Igor; Lundgren, Jens; Møller, Claus; Rakhmanova, Aza; Rockstroh, Jürgen; Anne, Alain Volny; Dedes, Nikos; Fenton, Kevin; Pizzuti, David; Vitoria, Marco; Ellefson, Michelle; Faggion, Silvia; Fradette, Lorraine; Frost, Richard; Schwimmer, Christine; Scott, Martin

    2012-01-01

    Background: Estimates of treatment failure, change and interruption are lacking for individuals treated in early HIV infection. Methods: Using CASCADE data, we compared the effect of treatment in early infection (within 12 months of seroconversion) with that seen in chronic infection on risk of

  8. Effect of Linear Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction—12-Month Follow-Up of a Randomized, Double-Blinded, Sham-Controlled Study

    Directory of Open Access Journals (Sweden)

    Grzegorz Lukasz Fojecki, MD

    2018-03-01

    Fojecki GL, Tiessen S, Osther PJS. Effect of Linear Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction—12-Month Follow-Up of a Randomized, Double-Blinded, Sham-Controlled Study. Sex Med 2018;6:1–7.

  9. Physical therapy plus general practitioners' care versus general practitioners' care alone for sciatica: a randomised clinical trial with a 12-month follow-up.

    NARCIS (Netherlands)

    Luijsterburg, P.A.; Verhagen, A.P.; Ostelo, R.W.J.G.; Hoogen, H.J.M. van den; Peul, W.C.; Avezaat, C.J.; Koes, B.W.

    2008-01-01

    A randomised clinical trial in primary care with a 12-months follow-up period. About 135 patients with acute sciatica (recruited from May 2003 to November 2004) were randomised in two groups: (1) the intervention group received physical therapy (PT) added to the general practitioners' care, and (2)

  10. On the Relationship between Solar Wind Speed, Earthward-Directed Coronal Mass Ejections, Geomagnetic Activity, and the Sunspot Cycle Using 12-Month Moving Averages

    Science.gov (United States)

    Wilson, Robert M.; Hathaway, David H.

    2008-01-01

    For 1996 .2006 (cycle 23), 12-month moving averages of the aa geomagnetic index strongly correlate (r = 0.92) with 12-month moving averages of solar wind speed, and 12-month moving averages of the number of coronal mass ejections (CMEs) (halo and partial halo events) strongly correlate (r = 0.87) with 12-month moving averages of sunspot number. In particular, the minimum (15.8, September/October 1997) and maximum (38.0, August 2003) values of the aa geomagnetic index occur simultaneously with the minimum (376 km/s) and maximum (547 km/s) solar wind speeds, both being strongly correlated with the following recurrent component (due to high-speed streams). The large peak of aa geomagnetic activity in cycle 23, the largest on record, spans the interval late 2002 to mid 2004 and is associated with a decreased number of halo and partial halo CMEs, whereas the smaller secondary peak of early 2005 seems to be associated with a slight rebound in the number of halo and partial halo CMEs. Based on the observed aaM during the declining portion of cycle 23, RM for cycle 24 is predicted to be larger than average, being about 168+/-60 (the 90% prediction interval), whereas based on the expected aam for cycle 24 (greater than or equal to 14.6), RM for cycle 24 should measure greater than or equal to 118+/-30, yielding an overlap of about 128+/-20.

  11. Wheezing as a sign of cor triatriatum sinister culminating in multiple organ failure.

    Science.gov (United States)

    Lee, Meng-Luen; Chen, Ying-Cheng; Lee, Ming-Sheng; Chien, Jien-Wen

    2014-12-01

    Cardiac asthma or cardiac wheezing (CW) refers to a syndrome of dyspnea and wheezing that mimicks asthma clinically. Reported herein is the case of a 2-month-old boy who presented with refractory wheezing as a sign of cor triatriatum sinister (CTS) that culminated in overwhelming multiple organ failure in a short time. On the day of admission, oxygen saturation (SpO2 ) was 20,000 pg/mL. Two-dimensional echocardiography with Doppler showed CTS, which was complicated with severe pulmonary arterial hypertension due to flagrant pulmonary venous obstruction. Cardiac surgery was undertaken, after which pulmonary edema subsided, SpO2 increased to ≥96%, and NTproBNP dropped to normal. He was discharged 11 days later, and was free of cardiac, pulmonary, renal, and neurological sequelae at 24 month follow up. © 2014 Japan Pediatric Society.

  12. Sibilancias recurrentes en el niño Recurrent wheezes in the child

    Directory of Open Access Journals (Sweden)

    Israel Valcárcel Vidal

    2008-12-01

    characteristics and risk factors in children with recurrent wheezes 10 years after the first episode of acute bronchiolitis caused by respiratory syncytial virus. METHODS. A descriptive retrospective longitudinal study was conducted among 34 children that were classified as transient wheezing and persistent wheezing. Risk, socioeconomic and environmental factors were identified. Skin sensitive tests with aeroallergens were performed. RESULTS. Persistent wheezes were observed in 22 patients (64.7 % and transient wheezes in 12 (35.3 %. The most common atopic family history was bronchial asthma with predominance in children with persistent wheezes (68.1 %. Early weaning was the most frequent personal history. Smoking and the attendance to day care centers were the prevailing socioeconomic and environmental risk factors (63.6 % and 59 %, respectively, specially in children with persistent wheezes. Six persistent wheezing children (27.2 % required attention at the Polivalent Intensive Care Unit, whereas only one transient wheezing child (8.3 % had to be admitted in that unit. The aeroallergen skin-prick tests yielded positive in 7 permanent wheezing children (31.8 % and in 1 transient wheezing child (8.3 %. CONCLUSIONS. The recurrent wheezes in the child after a first episode of bronchiolitis due to respiratory syncytial virus are generally associated with risk factors, particularly to the atopic family history and smoking. It is very important to early identify the children at risk for presenting atopic persistent asthma and to take therapeutic measures in order to prevent the deterioration of the pulmonary function.

  13. Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood

    DEFF Research Database (Denmark)

    Wolsk, Helene M; Chawes, Bo L; Litonjua, Augusto A

    2017-01-01

    BACKGROUND: We recently published two independent randomized controlled trials of vitamin D supplementation during pregnancy, both indicating a >20% reduced risk of asthma/recurrent wheeze in the offspring by 3 years of age. However, neither reached statistical significance. OBJECTIVE: To perform......) or placebo. All women also received a prenatal vitamin containing 400 IU/d vitamin D3. The primary outcome was asthma/recurrent wheeze from 0-3yrs. Secondary end-points were specific IgE, total IgE, eczema and lower respiratory tract infections (LRTI). We conducted random effects combined analyses......-points. CONCLUSIONS: This combined analysis shows that vitamin D supplementation during pregnancy results in a significant reduced risk of asthma/recurrent wheeze in the offspring, especially among women with 25(OH)D level ≥ 30 ng/ml at randomization, where the risk was almost halved. Future studies should examine...

  14. Effect of a Multidirectional Power Toothbrush and a Manual Toothbrush in Individuals Susceptible to Gingival Recession: A 12-Month Randomized Controlled Clinical Study.

    Science.gov (United States)

    Sälzer, Sonja; Graetz, Christian; Plaumann, Anna; Heinevetter, Nora; Grender, Julie; Klukowska, Malgorzata; Schneider, Christian Andres; Springer, Claudia; Van der Weijden, Fridus A; Dörfer, Christof E

    2016-05-01

    Clinical studies have explored the relationship between toothbrushing and development of gingival recession (GR), but relevant GR data for the multidirectional power toothbrush (PT) are lacking. The aim of this study is to evaluate the effect of brushing with either a multidirectional PT or American Dental Association reference manual toothbrush (MT) on mid-buccal preexisting GR (PreGR) during 12 months. This was a 12-month prospective, single-masked, parallel-group, randomized, controlled clinical study. Healthy participants without periodontitis with at least two teeth showing PreGR ≥2 mm were randomized to a group brushing with either an MT or PT. The primary outcome parameter was change at sites with PreGR ≥2 mm. All clinically based GR measurements were performed by one calibrated examiner at baseline, 6, and 12 months. Secondary outcomes were changes of GR at all mid-buccal sites (with or without PreGR), changes in percentage of GR sites demonstrating a change of ≥1 mm, and changes in probing depths. A total of 107 participants completed the study (PT: 55, MT: 52). During the 12-month study period the mean recession at sites with PreGR ≥2 mm decreased significantly from 2.2 to 2.1 mm in both groups (P <0.05). The extent of GR parameters did not differ between MT and PT groups at any time point. GR evaluated clinically and on stone casts was well correlated. Neither the PT nor MT led to an increase in PreGR during 12 months of daily use.

  15. The DSM-5 nonsuicidal self-injury disorder among incoming college students: Prevalence and associations with 12-month mental disorders and suicidal thoughts and behaviors.

    Science.gov (United States)

    Kiekens, Glenn; Hasking, Penelope; Claes, Laurence; Mortier, Philippe; Auerbach, Randy P; Boyes, Mark; Cuijpers, Pim; Demyttenaere, Koen; Green, Jennifer G; Kessler, Ronald C; Nock, Matthew K; Bruffaerts, Ronny

    2018-04-26

    Approximately one in five college students report a history of nonsuicidal self-injury. However, it is unclear how many students meet criteria for the recently proposed DSM-5 nonsuicidal self-injury disorder (NSSI-D). In this study, we used full NSSI-D criteria to identify those students most in need of clinical care. Using data from the Leuven College Surveys (n = 4,565), we examined the 12-month prevalence of DSM-5 NSSI-D in a large and representative sample of incoming college students. We also explored the optimal frequency threshold as a function of interference in functioning due to NSSI, and examined comorbidity patterns with other 12-month mental disorders (i.e., major depressive disorder, broad mania, generalized anxiety disorder, panic disorder, and alcohol dependence) and suicidal thoughts and behaviors (STB). Twelve-month NSSI-D prevalence was 0.8% and more common among females (1.1%) than males (0.4%). The proposed 5+ diagnostic threshold was confirmed as yielding highest discrimination between threshold and subthreshold cases in terms of distress or disability due to NSSI. A dose-response relationship was observed for NSSI recency-severity (i.e., 12-month NSSI-D, subthreshold 12-month NSSI-D, past NSSI, no history of NSSI) with number of 12-month mental disorders and STB. NSSI-D occurred without comorbid disorders for one in five individuals, and remained associated with severe role impairment when controlling for the number of comorbid disorders. These findings offer preliminary evidence that DSM-5 NSSI-D is uncommon among incoming college students, but may help to improve the deployment of targeted resource allocation to those most in need of services. More work examining the validity of NSSI-D is required. © 2018 Wiley Periodicals, Inc.

  16. Introduction of various allergenic foods during infancy reduces risk of IgE sensitization at 12 months of age: a birth cohort study.

    Science.gov (United States)

    Hua, Man-Chin; Yao, Tsung-Chieh; Chen, Chien-Chang; Tsai, Ming-Han; Liao, Sui-Ling; Lai, Shen-Hao; Chiu, Chih-Yung; Su, Kuan-Wen; Yeh, Kuo-Wei; Huang, Jing-Long

    2017-11-01

    BackgroundIn this study, we aimed to determine whether introducing various allergenic foods during infancy is associated with IgE sensitization at 12 months of age.MethodsDetailed information on feeding practices regarding six possible allergenic foods (fruits, egg white, egg yolk, fish, shellfish, and peanuts) was obtained by administering age-specific questionnaires to parents of infants at ages 6 and 12 months. Fecal secretory IgA (sIgA), fecal eosinophil cationic protein (ECP), and serum levels of total IgE and IgE specific to 20 foods, and IgE specific to 20 inhalant allergens were also quantified at 12 months of age.ResultsAt 12 months of age, infants with IgE sensitization had been introduced to fewer allergenic food items during infancy (3.2±1.4 vs. 3.7±1.3 items). Compared with infants who were given 0-2 allergenic food items, infants introduced to 3-4 or ≥5 allergenic food items showed a significantly lower risk of IgE sensitization (odds ratios (ORs) 0.62 and 0.61, respectively) and lower total IgE levels. In addition, non-introduction of egg white or egg yolk was significantly related to IgE sensitization (ORs 1.41 and 1.26, respectively).ConclusionIncreasing the diversity of allergenic foods in infancy, including fruits, egg white, egg yolk, fish, shellfish, and peanuts, may protect infants from IgE sensitization at 12 months of age.

  17. Physical health after childbirth and maternal depression in the first 12 months post partum: results of an Australian nulliparous pregnancy cohort study.

    Science.gov (United States)

    Woolhouse, Hannah; Gartland, Deirdre; Perlen, Susan; Donath, Susan; Brown, Stephanie J

    2014-03-01

    to investigate the relationship between maternal physical health problems and depressive symptoms in the first year after childbirth. prospective pregnancy cohort study. Melbourne, Victoria, Australia. 1507 nulliparous women. women were recruited from six public hospitals between six and 24 weeks gestation. Written questionnaires were completed at recruitment and at three, six and 12 months post partum. Edinburgh Postnatal Depression Scale (EPDS); standardised measures of urinary and faecal incontinence, a checklist of symptoms for other physical health problems. overall, 16.1% of women reported depressive symptoms during the first 12 months post partum, with point prevalence at three, six and 12 months post partum of 6.9%, 8.8% and 7.8% respectively. The most commonly reported physical health problems in the first three months were tiredness (67%), back pain (47%), breast problems (37%), painful perineum (30%), and urinary incontinence (29%). Compared with women reporting 0-2 health problems in the first three months post partum, women reporting 5 or more health problems had a six-fold increase in likelihood of reporting concurrent depressive symptoms at three months post partum (Adjusted OR=6.69, 95% CI=3.0-15.0) and a three-fold increase in likelihood of reporting subsequent depressive symptoms at 6-12 months post partum (Adjusted OR=3.43, 95% CI 2.1-5.5). poor physical health in the early postnatal period is associated with poorer mental health throughout the first 12 months post partum. Early intervention to promote maternal mental health should incorporate assessment and intervention to address common postnatal physical health problems. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. "Cancer Put My Life on Hold": Work-Related Challenges Among Middle-aged Adults 12 Months After a Diagnosis of Colorectal Cancer.

    Science.gov (United States)

    McGrath, Catherine; Mihala, Gabor; Beesley, Vanessa L; Lynch, Brigid M; Graves, Nicholas; Gordon, Louisa G

    Colorectal cancer affects a wide range of working-age people. Little is known about the consequent work limitations. The aim of this study was to understand the extent and changing nature of work-related limitations of middle-aged (45-64 years) people over the first 12 months of colorectal cancer. Surveys were administered to participants recruited via the Queensland Cancer Registry, at 6 and 12 months after diagnosis. Among those who returned to work, the Work Limitations Questionnaire measured 4 job performance domains (time management, physical, mental-interpersonal, and output demands) and an overall productivity score. Open-ended questions supplemented the Work Limitations Questionnaire, and responses were thematically analyzed. Of 239 participants, 8% did not continue in the study, and 20% left employment by 12 months, leaving 171 participants eligible for this analysis. Open-ended responses for why participants stopped work included bowel problems and stoma, loss of strength, and medication adverse effects. At 12 months, 22% to 39% of participants reported work limitations, but there was no overall significant change in work limitations between 6 and 12 months. Qualitative data highlighted the key work-related issues were changes in work functioning, attitudes of employers and colleagues, financial pressures, and emotional responses. While a significant proportion left work because of treatment-related problems, and the majority of participants did not experience workplace limitations, some reported considerable work-related challenges. Discussions with health professionals about the possible impact of treatment adverse effects on employment, good communication with employers, and workplace flexibility may facilitate return to work for this population.

  19. Neuromuscular coordination deficit persists 12 months after ACL reconstruction but can be modulated by 6 weeks of kettlebell training

    DEFF Research Database (Denmark)

    Zebis, Mette K.; Andersen, Christoffer H.; Bencke, Jesper

    2017-01-01

    The aim of the present single-case study was to investigate the effect of 6 weeks' kettlebell training on the neuromuscular risk profile for ACL injury in a high-risk athlete returning to sport after ACL reconstruction. A female elite soccer player (age 21 years) with no previous history of ACL i...

  20. 76 FR 9991 - Endangered and Threatened Wildlife and Plants; 12-Month Finding on a Petition To List Thorne's...

    Science.gov (United States)

    2011-02-23

    .... For more information on the taxonomy, biology, and ecology of Thorne's hairstreak butterfly, please... known to occur). Results from a previous hairstreak butterfly movement study also support the hypothesis of natural colonization. Specifically, Robbins and Small (1981, p. 308) studied movement of...

  1. Neuromuscular Coordination Deficit Persists 12 Months after ACL Reconstruction But Can Be Modulated by 6 Weeks of Kettlebell Training

    DEFF Research Database (Denmark)

    Zebis, Mette K; Andersen, Christoffer H; Bencke, Jesper

    2017-01-01

    The aim of the present single-case study was to investigate the effect of 6 weeks' kettlebell training on the neuromuscular risk profile for ACL injury in a high-risk athlete returning to sport after ACL reconstruction. A female elite soccer player (age 21 years) with no previous history of ACL i...

  2. Hygiene, atopy and wheeze-eczema-rhinitis symptoms in schoolchildren from urban and rural Ecuador.

    Science.gov (United States)

    Cooper, Philip J; Vaca, Maritza; Rodriguez, Alejandro; Chico, Martha E; Santos, Darci N; Rodrigues, Laura C; Barreto, Mauricio L

    2014-03-01

    Rural residence is protective against atopy and wheeze-rhinitis-eczema symptoms in developed countries, an effect attributed to farming and poor hygiene exposures. There are few data from developing countries addressing this question. We compared atopy and wheeze-rhinitis-eczema symptoms between urban and rural Ecuador, and explored the effects of farming and poor hygiene exposures. We performed cross sectional studies of schoolchildren living in rural and urban Ecuador. Data on symptoms and farming/hygiene exposures were collected by parental questionnaire, atopy by allergen skin prick test reactivity and geohelminth infections by stool examinations. Among 2526 urban and 4295 rural schoolchildren, prevalence was: atopy (10.0% vs 12.5%, p=0.06), wheeze (9.4% vs 10.1%, p=0.05), rhinitis (8.1% vs 6.4%, p=0.02) and eczema (5.9% vs 4.7%, p=0.06). A small proportion of symptoms were attributable to atopy (range 3.9-10.7%) with greater attributable fractions for respiratory symptoms observed in urban schoolchildren. Respiratory symptoms were associated with poor hygiene/farming exposures: wheeze with lack of access to potable water; and rhinitis with household pets, no bathroom facilities and contact with large farm animals. Birth order was inversely associated with respiratory symptoms. Area of residence and atopy had few effects on these associations. Urban schoolchildren living in Ecuador have a similar prevalence of atopy, eczema and wheeze but a higher prevalence of rhinitis compared with rural children. Some farming and poor hygiene exposures were associated with an increase in the prevalence of wheeze or rhinitis while birth order was inversely associated with these symptoms.

  3. Risk of Readmission for Wheezing during Infancy in Children with Congenital Diaphragmatic Hernia.

    Directory of Open Access Journals (Sweden)

    Gregoire Benoist

    Full Text Available Congenital diaphragmatic hernia (CDH is associated with a high incidence of respiratory problems, even after initial hospital discharge. These problems are likely to lead to re-hospitalization during infancy, although actual frequency of readmissions is unknown.We aimed to determine the rate of hospitalization for wheezing in infants with CDH between the time of initial discharge and 24 months of age, and to identify factors associated with readmission.Data about infants with CDH born in three French reference tertiary centers between January 2009 and March 2013 who were alive at hospital discharge, were extracted from a prospective national database.Ninety-two children were identified, and 86 were included in the analysis. In total, 116 wheezing episodes requiring a doctor's visit occurred in 50 infants (58% before 24 months of age. Twenty-two children (26% were readmitted at least once for wheezing exacerbations. RSV was present in 6 of 15 (40% of children with available nasal samples at first readmission, and 1 of 5 (20% at second readmission. Thoracic herniation of the liver, low gestational age, longer initial hospitalization, need for oxygen therapy at home, and eczema were all significantly associated with readmission for wheezing exacerbations. Fifty-three infants (62% received palivizumab prophylaxis, but there was no association with the overall rate of readmission for wheezing exacerbations or RSV-related hospitalization.The rate of readmission for wheezing among infants with CDH is high, and significantly influenced by several prenatal and neonatal factors. Palivizumab prophylaxis was not associated with the rate of readmission.

  4. Presence of Eosinophils in Nasal Secretion during Acute Respiratory Tract Infection in Young Children Predicts Subsequent Wheezing within Two Months

    Directory of Open Access Journals (Sweden)

    Miwa Shinohara

    2008-01-01

    Conclusions: Our findings not only suggest that nasal eosinophil testing may serve as a convenient clinical marker for identifying young children at risk for subsequent wheezing, but also shed new light on the role of eosinophils in the onset of wheezing in young children.

  5. Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood

    DEFF Research Database (Denmark)

    Wolsk, Helene M; Chawes, Bo L; Litonjua, Augusto A

    2017-01-01

    BACKGROUND: We recently published two independent randomized controlled trials of vitamin D supplementation during pregnancy, both indicating a >20% reduced risk of asthma/recurrent wheeze in the offspring by 3 years of age. However, neither reached statistical significance. OBJECTIVE: To perform......) or placebo. All women also received a prenatal vitamin containing 400 IU/d vitamin D3. The primary outcome was asthma/recurrent wheeze from 0-3yrs. Secondary end-points were specific IgE, total IgE, eczema and lower respiratory tract infections (LRTI). We conducted random effects combined analyses...

  6. Prevention and treatment of respiratory syncytial virus bronchiolitis and postbronchiolitic wheezing

    Directory of Open Access Journals (Sweden)

    Kimpen Jan LL

    2002-06-01

    Full Text Available Abstract Respiratory syncytial virus (RSV is the primary cause of hospitalization for acute respiratory tract illness in general and specifically for bronchiolitis in young children. The link between RSV bronchiolitis and reactive airway disease is not completely understood, even though RSV bronchiolitis is frequently followed by recurrent episodes of wheezing. Therapy with ribavirin does not appear to significantly reduce long-term respiratory outcome of RSV lower respiratory tract infection, and corticosteroid or bronchodilator therapy may possibly improve outcomes only on a short-term basis. No vaccine against RSV is yet available. It is not known whether prophylaxis with RSV intravenous immune globulin or palivizumab can reduce postbronchiolitic wheezing.

  7. A Comparison of Risk Factors for Wheeze and Recurrent Cough in Preschool Children

    DEFF Research Database (Denmark)

    Hermann, Christian; Westergaard, T.; Pedersen, B. V.

    2005-01-01

    the same etiology. Data were obtained 1) by a mailed parental questionnaire (International Study of Asthma and Allergies in Childhood questions and supplementary questions on cough, sociodemography, perinatal factors, and environmental exposure); 2) through general practitioners (familial allergic disease......In a study of 2,978 Danish children aged 5 years from two suburban counties of Copenhagen, carried out in 1998, the authors compared risk factor profiles for wheeze and recurrent cough without wheeze by using polytomous logistic regression to clarify whether the two conditions are likely to have...

  8. Alcohol Use Disorders in Argentinian Girls and Women 12 Months Before Delivery: Comparison of DSM-IV, DSM-5, and ICD-10 Diagnostic Criteria.

    Science.gov (United States)

    López, Mariana B; Conde, Karina; Cremonte, Mariana

    The evidence of important problems related to prenatal alcohol exposure has faced researchers with the problem of understanding and screening alcohol use in this population. Although any alcohol use should be considered risky during pregnancy, identifying alcohol-drinking problems (ADPs) could be especially important because women with ADPs could not benefit from a simple advice of abstinence and because their offsprings are subjected to a higher risk of problems related with prenatal alcohol exposure. In this context, we aim to study the prevalence and characteristics of ADPs in pregnant women, evaluating the performance of different diagnostic systems in this population. The aims of the study were to describe the prevalence of ADPs obtained with the criteria of the Diagnostic and Statistical Manual of Mental Disorders in its fourth (DSM-IV) and fifth edition (DSM-5), and the International Classification of Diseases (ICD)-10, in Argentinean females aged 13 to 44 years, 12 months before delivery; to evaluate the level of agreement between these classification systems; and to analyze the performance of each diagnosis criterion in this population. Data were collected through personal interviews of a probability sample of puerperal women (N = 641) in the city of Santa Fe (Argentina), between October 2010 and February 2011. Diagnoses compatible with DSM-IV, DSM-5, and ICD-10 were obtained through the Composite International Diagnostic Interview. Agreement among diagnostic systems was measured through Cohen kappa. Diagnosis criteria performance were analyzed considering their prevalence and discriminating ability (D value). Total ADP prevalence was 6.4% for DSM-IV (4.2% abuse and 2.2% dependence), 8.1% for DSM-5 (6.4% mild, 0.8% moderate, and 0.9% severe alcohol use disorder), and 14.1% for the ICD-10 (11.9% harmful use and 2.2% dependence). DSM-5 modifications improved agreement between DSM and ICD. The least prevalent and worst discriminating ability diagnostic

  9. Outcomes of ≤6-month versus 12-month dual antiplatelet therapy after drug-eluting stent implantation: A meta-analysis and meta-regression.

    Science.gov (United States)

    Villablanca, Pedro A; Massera, Daniele; Mathew, Verghese; Bangalore, Sripal; Christia, Panagiota; Perez, Irving; Wan, Ningxin; Schulz-Schüpke, Stefanie; Briceno, David F; Bortnick, Anna E; Garcia, Mario J; Lucariello, Richard; Menegus, Mark; Pyo, Robert; Wiley, Jose; Ramakrishna, Harish

    2016-12-01

    The benefit of ≤6-month compared with 12-month dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) placement remains controversial. We performed a meta-analysis and meta-regression of ≤6-month versus 12-month DAPT in patients undergoing PCI with DES placement. We conducted electronic database searches of randomized controlled trials (RCTs) comparing DAPT durations after DES placement. For studies with longer follow-up, outcomes at 12 months were identified. Odds ratios and 95% confidence intervals were computed with the Mantel-Haenszel method. Fixed-effect models were used; if heterogeneity (I) > 40 was identified, effects were obtained with random models. Nine RCTs were included with total n = 19,224 patients. No significant differences were observed between ≤6-month compared with 12-month DAPT in all-cause mortality (OR 0.87; 95% confidence interval (CI): 0.69-1.11), cardiovascular (CV) mortality (OR 0.89; 95% CI: 0.66-1.21), non-CV mortality (OR 0.85; 95% 0.58-1.24), myocardial infarction (OR 1.10; 95% CI: 0.89-1.37), stroke (OR 0.97; 95% CI: 0.67-1.42), stent thrombosis (ST) (OR 1.37; 95% CI: 0.89-2.10), and target vessel revascularization (OR 0.95; 95% CI: 0.77-1.18). No significant difference in major bleeding (OR 0.72; 95% CI: 0.49-1.05) was observed, though the all-bleeding event rate was significantly lower in the ≤6-month DAPT group (OR 0.76; 95% CI: 0.59-0.96). In the meta-regression analysis, a significant association between bleeding events and non-CV mortality with 12-month DAPT was found, as well as between ST and mortality in addition to MI with ≤6-month DAPT. DAPT for ≤6 months is associated with similar mortality and ischemic outcomes but less bleeding events compared with 12-month DAPT after PCI with DES.

  10. Lifetime and 12-month prevalence, severity and unmet need for treatment of common mental disorders in Japan: results from the final dataset of World Mental Health Japan Survey.

    Science.gov (United States)

    Ishikawa, H; Kawakami, N; Kessler, R C

    2016-06-01

    The aim of this study is to estimate the lifetime and 12-month prevalence, severity and treatment of Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) mental disorders in Japan based on the final data set of the World Mental Health Japan Survey conducted in 2002-2006. Face-to-face household interviews of 4130 respondents who were randomly selected from Japanese-speaking residents aged 20 years or older were conducted from 2002 to 2006 in 11 community populations in Japan (overall response rate, 56%). The World Mental Health version of the World Health Organization Composite International Diagnostic Interview (WMH-CIDI), a fully structured, lay administered psychiatric diagnostic interview, was used for diagnostic assessment. Lifetime/12-month prevalence of any DSM-IV common mental disorders in Japan was estimated to be 20.3/7.6%. Rank-order of four classes of mental disorders was anxiety disorders (8.1/4.9%), substance disorders (7.4/1.0%), mood disorders (6.5/2.3%) and impulse control disorders (2.0/0.7%). The most common individual disorders were alcohol abuse/dependence (7.3/0.9%), major depressive disorder (6.1/2.2%), specific phobia (3.4/2.3%) and generalized anxiety disorder (2.6/1.3%). While the lifetime prevalence of any mental disorder was greater for males and the middle-aged, the persistence (proportion of 12-month cases among lifetime cases) of any mental disorder was greater for females and younger respondents. Among those with any 12-month disorder, 15.3% were classified as severe, 44.1% moderate and 40.6% mild. Although a strong association between severity and service use was found, only 21.9% of respondents with any 12-month disorder sought treatment within the last 12 months; only 37.0% of severe cases received medical care. The mental health specialty sector was the most common resource used in Japan. Although the prevalence of mental disorders were quite low, mental disorders were the second most prevalent cause of

  11. 12-month effects of once-weekly sustained-release growth hormone treatment in adults with GH deficiency.

    Science.gov (United States)

    Biller, Beverly M K; Ji, Hyi-Jeong; Ahn, Hyunji; Savoy, Conrad; Siepl, E Christine; Popovic, Vera; Coculescu, Mihail; Roemmler, Josefine; Gavrila, Catalin; Cook, David M; Strasburger, Christian J

    2013-09-01

    The weekly sustained-release recombinant human GH formulation LB03002, showed beneficial effects in GH-deficient (GHD) adults in a previous 26-week double-blind study. Prior studies of long-acting GH preparations in adults have only been conducted for 6 or 8 months, so the effects of longer-term use are unknown; this is important to address, as replacement is given for many years in GHD adults. This open-label, 26-week study extension evaluated longer-term safety and efficacy of LB03002 over 52 weeks in adults with GHD who had previously been randomized to GH, and provides additional safety and efficacy data over 26 weeks in the cohort who had previously been randomized to placebo. Of 147 adults with GHD who completed a preceding study, 136 patients continued in this open-label study to receive LB03002 over an additional 26 weeks. This represented a continuation of long-acting GH for 26 weeks in the cohort who took this medication in the prior study (LB03002 Throughout group), and describes the first use of long-acting GH in the cohort that was randomized to placebo in the prior study (Switched to LB03002 group). The LB03002 dose was adjusted according to serum insulin-like growth factor-I (IGF-I) levels. LB03002 treatment demonstrated mean significant decreases from baseline in fat mass (FM) for both 26 (Switched group, P = 0.001) and 52 weeks (Throughout group, P = 0.002) of 1.11 (1.95) kg and 1.06 (3.16) kg, respectively. Prolonged GH treatment was effective in sustaining the increase in lean body mass (LBM), serum IGF-I and IGFBP-3 levels achieved during the first 26 weeks. Long-term treatment with the sustained-release weekly GH preparation over both 26 and 52 weeks in adults with GHD demonstrated a sustained reduction of FM with a favorable safety profile. This study extends prior knowledge about long-acting GH because it reports the most prolonged treatment of adults with any long-acting GH preparation, thereby confirming the value and safety of such agents

  12. Post-trauma ratings of pre-collision pain and psychological distress predict poor outcome following acute whiplash trauma: a 12-month follow-up study

    DEFF Research Database (Denmark)

    Carstensen, Tina B W; Frostholm, Lisbeth; Oernboel, Eva

    2008-01-01

    Patients with acute whiplash trauma were followed to examine if post-trauma ratings of pre-collision pain and psychological distress were associated with reduced work capability and neck pain at 12 months follow-up. The study included 740 consecutive patients (474 females, 266 males) referred from...... emergency departments or primary care after car accidents in four counties in Denmark. After the collision patients received a questionnaire on psychological distress, unspecified pain and socio-demographics and 12 months later a follow-up on work capability and neck pain was performed. Risk factors were...... with poor recovery and high accumulation of pre-collision psychological distress is associated with considerable neck pain at follow-up. However, no conclusions on causality can be drawn. Personal characteristics before the collision are important for recovery and attention to pre-collision characteristics...

  13. Long term effects on risk factors for cardiovascular disease after 12-months of aerobic exercise intervention - A worksite RCT among cleaners

    DEFF Research Database (Denmark)

    Korshøj, Mette; Lidegaard, Mark; Krustrup, Peter

    2016-01-01

    was to evaluate the 12-months effects of worksite aerobic exercise on risk factors for CVD among cleaners. METHODS: One hundred and sixteen cleaners aged 18-65 years were randomized to a group performing aerobic exercise and a reference group receiving lectures. Outcomes were collected at baseline and after 12......-months. A repeated measures 2×2 multi-adjusted mixed-model design was applied to compare the between-group differences using intention-to-treat analysis. RESULTS: Between-group differences (paerobic exercise group: cardiorespiratory fitness 2.15 (SE 1.03) mlO2/min...... to impose a notable adverse effect on resting and ambulatory blood pressure. CONCLUSION: This long-term worksite aerobic exercise intervention among cleaners led to several beneficial effects, but also potential adverse effects among those with high relative aerobic workloads. TRIAL REGISTRATION: Controlled...

  14. Communication and coping as predictors of fertility problem stress: cohort study of 816 participants who did not achieve a delivery after 12 months of fertility treatment

    DEFF Research Database (Denmark)

    Schmidt, L; Holstein, B E; Christensen, Ulla

    2005-01-01

    BACKGROUND: We investigated coping strategies and communication strategies as predictors of fertility problem stress 12 months after start of fertility treatment. METHODS: We used a prospective, longitudinal cohort design including 2250 people beginning fertility treatment with a 12-month follow...... participants (n = 816, men and women) who had not achieved pregnancy by assisted reproduction or delivery at follow-up. RESULTS: Among both men and women, difficulties in partner communication predicted high fertility problem stress (odds ratio for women, 3.47, 95% confidence interval 2.09-5.76; odds ratio...... in the personal and marital domain. CONCLUSION: The study provides information about where to intervene with fertility patients in order to reduce their stress after medically unsuccessful treatment....

  15. The Pattern of Fatty Acids Displaced by EPA and DHA Following 12 Months Supplementation Varies between Blood Cell and Plasma Fractions

    OpenAIRE

    Walker, Celia G.; West, Annette L.; Browning, Lucy M.; Madden, Jackie; Gambell, Joanna M.; Jebb, Susan A.; Calder, Philip C.

    2015-01-01

    Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are increased in plasma lipids and blood cell membranes in response to supplementation. Whilst arachidonic acid (AA) is correspondingly decreased, the effect on other fatty acids (FA) is less well described and there may be site-specific differences. In response to 12 months EPA + DHA supplementation in doses equivalent to 0–4 portions of oily fish/week (1 portion: 3.27 g EPA+DHA) multinomial regression analysis was used to identify...

  16. Association of serum hs-CRP and lipids with obesity in school children in a 12-month follow-up study in Japan.

    Science.gov (United States)

    Nishide, Ritsuko; Ando, Michiko; Funabashi, Hidemitsu; Yoda, Yoshiko; Nakano, Masataka; Shima, Masayuki

    2015-03-01

    To investigate the association of serum lipids and high-sensitivity C-reactive protein (hs-CRP) with obesity in school children and to explore whether hs-CRP levels could be used to predict the presence or absence of obesity 12 months later. The subjects were school children (6-11 years old) in Japan. Blood sampling and physical measurements were performed in school (2001); low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and hs-CRP levels were measured. Data from children who could be followed 12 months later were analyzed. Subjects weighing 20% or more over his/her standard weight were regarded as obese, and the association of obesity with serum parameters was analyzed. Data from 612 subjects were analyzed (follow-up rate, 75.4%). The mean of each serum parameter was significantly higher (inverse for HDL-C; lower) in obese than that in non-obese children. Logistic regression analysis for obesity at baseline showed that the odds ratio (OR) of hs-CRP was the highest [OR, 2.15; 95% confidence interval (CI), 1.65-2.78 for an interquartile rage (IQR) increase]; the association with triglycerides and LDL-C/HDL-C was significant. At the 12-month follow-up, the OR of high hs-CRP remained the highest of all serum parameters (2.09; 95% CI, 1.63-2.69 for an IQR increase). High levels of triglycerides, LDL-C/HDL-C, and hs-CRP increased the risk of obesity in school children. Hs-CRP is considered to be a better predictor of obesity 12 months later than is LDL-C/HDL-C.

  17. Post-trauma ratings of pre-collision pain and psychological distress predict poor outcome following acute whiplash trauma: A 12-month follow-up study

    DEFF Research Database (Denmark)

    Carstensen, Tina

    2008-01-01

    emergency departments or primary care after car accidents in four counties in Denmark. After the collision patients received a questionnaire on psychological distress, unspecified pain and socio-demographics and 12months later a follow-up on work capability and neck pain was performed. Risk factors were....... Factors associated with considerable neck pain at follow-up were pre-collision unspecified pain (OR=3.5, p4years. Pre-collision neck pain and severity of accident...

  18. Clinical comparison between an opaque and a clear pit and fissures sealants: a 12-month split-mouth, randomized controlled study.

    Science.gov (United States)

    Nardi, G M; Mazur, M; Corridore, D; Capocci, M; Rinaldo, F Md; Maruotti, A; Ottolenghi, L; Guerra, F

    2018-01-01

    We design a clinical splith-mouth, randomized controlled study, in which the retention of an opaque and clear pit and fissures sealants were evaluated and their effectiveness compared at 6 and 12 months of follow up. A secondary aim was to evaluate the possibility of using a fluorescence based intra-oral camera through the clear sealant to monitor enamel demineralization. Consecutive young adolescents with at least two molars with code 0, 1, 2 caries evidenced following the International Caries Detection and Assessment System (ICDAS II) were enrolled. A split-mouth randomized allocation was carried out. One skilled operator applied the sealant under 3.5 X magnification. A second operator evaluated clinical retention and performed the intra-oral camera assessments at 6 and 12 months follow up. A total of 42 patients, (20 males and 22 females, mean age 14.25) with 176 dental lesions were enrolled. Nine patients dropped out accounting for 26 teeth lost during follow up. Overall, a total of 150 sealed teeth were evaluated in the study. In 77 cases the clear sealant was used, while in 73 the opaque sealant was utilized. The opaque sealant rated 100% complete retention at 6 months, and 97.3% at 12 months, while the clear selant 91.8% and 85.9% respectively. Demineralization under clear selant was registered when sealant partial detachment occurred. The overall retention rate of an opaque sealant was higher than that of a clear sealant after 12 months of follow-up. This difference may partly be due to difficulty in clinical detection of clear sealants during follow-up. Fluorescence based intra-oral camera seems useful to monitor enamel demineralization in clear sealant.

  19. Early wheeze as reported by mothers and lung function in 4-year-olds. Prospective cohort study in Krakow.

    Science.gov (United States)

    Jedrychowski, Wieslaw; Maugeri, Umberto; Perera, Frederica P; Mroz, Elzbieta; Klimaszewska-Rembiasz, Maria; Flak, Elzbieta; Edwards, Susan; Majewska, Renata; Sowa, Agata

    2010-09-01

    The purpose of the study was to check the hypothesis that early wheezing as reported by mothers would be associated with reduced lung function in 4-year olds. Study participants were recruited prenatally, as part of a prospective cohort study on the respiratory health of young children exposed to various ambient air pollutants. After delivery, infants were followed over 4 years and the interviewers visited participants at their home to record respiratory symptoms every 3 months in the child's first 2 years of life and every 6 months in the 3rd and 4th years. In the 4th year of follow-up, children were invited for standard lung function testing by spirometry quantified by forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV(1)), and forced expiratory volume in 0.5 sec (FEV(0.5)) levels. Out of 258 children attending spirometry testing 139 performed at least two acceptable exhalation efforts. Cohort children with acceptable spirometric measurements did not differ with respect to wheezing experience and exposure characteristics from those without. The study shows that episodic wheeze was reported in 28.1% of 4-year olds, 6.5% had transient wheeze, and 4.3% had recurrent wheeze. There was an increased frequency of wheezing symptoms and their duration in transient and recurrent wheezers. Adjusted multivariable regression models for gender and height showed that children who reported more than two episodes of wheezing at any point over the follow-up had FVC values lower by 120.5 ml (P = 0.016) and FEV(1) values lower by 98.3 ml (P = 0.034) compared to those who did not report any wheezing; children experiencing more than 10 wheezing days by age 4 showed FVC deficit of 87.4 ml (P = 0.034) and FEV(1) values of 65.7 ml (P = 0.066). The ratios of FEV(1)/FVC%, and FEV(0.5)/FVC% were neither associated with wheezing episodes nor wheezing days. In recurrent wheezers, lung function decrement amounted to 207 ml of FVC, 175 ml of FEV(1), and 104 ml of FEV(0.5). In

  20. EARLY WHEEZE AS REPORTED BY MOTHERS AND LUNG FUNCTION IN FOUR-YEAR-OLDS. PROSPECTIVE COHORT STUDY IN KRAKOW

    Science.gov (United States)

    Jedrychowski, Wieslaw; Maugeri, Umberto; Perera, Frederica P.; Mroz, Elzbieta; Klimaszewska-Rembiasz, Maria; Flak, Elzbieta; Edwards, Susan; Majewska, Renata; Sowa, Agata

    2013-01-01

    The purpose of the study was to check the hypothesis that early wheezing as reported by mothers would be associated with reduced lung function in 4-year-olds. Study participants were recruited prenatally, as part of a prospective cohort study on the respiratory health of young children exposed to various ambient air pollutants. After delivery, infants were followed over four years and the interviewers visited participants at their home to record respiratory symptoms every three months in the child’s first two years of life and every 6 months in the third and fourth years. In the fourth year of follow-up, children were invited for standard lung function testing by spirometry quantified by FVC, FEV1 and FEV05 levels. Out of 258 children attending spirometry testing 139 performed at least two acceptable exhalation efforts. Cohort children with acceptable spirometric measurements did not differ with respect to wheezing experience and exposure characteristics from those without. The study shows that episodic wheeze was reported in 28.1% of 4-year-olds, 6.5% had transient wheeze and 4.3% had recurrent wheeze. There was an increased frequency of wheezing symptoms and their duration in transient and recurrent wheezers. Adjusted multivariable regression models for gender and height showed that children who reported more than 2 episodes of wheezing at any point over the follow-up had FVC values lower by 120.5 mL (p = 0.016) and FEV1 values lower by 98.3 mL (p = 0.034) compared to those who did not report any wheezing; children experiencing more than 10 wheezing days by age 4 showed FVC deficit of 87.4 mL (p = 0.034) and FEV1 values of 65.7 mL (p = 0.066) The ratios of FEV1/FVC% and FEV05/FVC% were neither associated with wheezing episodes nor wheezing days. In recurrent wheezers lung function decrement amounted to 207 mL of FVC, 175 mL of FEV1 and 104 mL of FEV05. In conclusion, our findings show that wheezing experience during early postnatal life may be associated with

  1. Secondhand tobacco smoke and severity in wheezing children: Nasal oxidant stress and inflammation.

    Science.gov (United States)

    Yilmaz, Ozge; Turkeli, Ahmet; Onur, Ece; Bilge, Sema; Yuksel, Hasan

    2018-05-01

    Prenatal and postnatal smoke exposures are associated with many lung diseases in children due to impaired lung function, increased inflammation, and oxidative stress. We aimed to determine the influence of secondhand tobacco smoke exposure on the levels of nasal glutathione, IL-8, IL-17, MMP-9, and TIMP-1, as well as serum surfactant protein-D (SP-D) in wheezy children. We enrolled 150 children with recurrent wheezing and recorded wheezing characteristics at enrollment. We measured the levels of serum cotinine, SP-D, nasal glutathione, IL-8, IL-17, MMP-9, and TIMP-1. Serum cotinine levels between 3 and 12 ng/mL, and above 12 ng/mL were defined as lower and higher level secondhand tobacco smoke exposure, respectively. The ANOVA test, Pearson's correlation analysis and multivariate analysis with a linear regression test were used for the statistical analysis. Ninety-one children had been exposed to lower level secondhand tobacco smoke, while 24 children were exposed to higher level secondhand tobacco smoke. Thirty-five children were not exposed to cigarette smoke. Wheezing symptom scores were higher in exposed children (p = 0.03). Levels of other biomarkers showed no significant difference. Secondhand tobacco smoke exposure is associated with more severe respiratory symptoms in wheezing children. However, levels of nasal or serum inflammatory markers fail to explain this association, either because of different mechanical factors in the process or due to low levels of the biomarkers especially in nasal secretions.

  2. Rhinovirus Wheezing Illness and Genetic Risk of Childhood-Onset Asthma

    DEFF Research Database (Denmark)

    Calışkan, Minal; Bochkov, Yury A; Kreiner-Møller, Eskil

    2013-01-01

    Background Both genetic variation at the 17q21 locus and virus-induced respiratory wheezing illnesses are associated with the development of asthma. Our aim was to determine the effects of these two factors on the risk of asthma in the Childhood Origins of Asthma (COAST) and the Copenhagen Prospe...

  3. Effects of prenatal community violence and ambient air pollution on childhood wheeze in an urban population

    Science.gov (United States)

    Mathilda Chiu, Yueh-Hsiu; Coull, Brent A.; Sternthal, Michelle J.; Kloog, Itai; Schwartz, Joel; Cohen, Sheldon; Wright, Rosalind J.

    2013-01-01

    Background: Prenatal exposures to stress and physical toxins influence children’s respiratory health, albeit few studies consider these factors together. Objectives: To concurrently examine effects of prenatal community-level psychosocial (exposure to community violence, ECV) and physical (air pollution) stressors on repeated wheeze in 708 urban children followed to age 2 years. Methods: Multi-item ECV reported by mothers in pregnancy was summarized into a continuous score using Rasch modeling. Prenatal black carbon (BC) exposure was estimated using land-use regression (LUR) modeling; particulate matter (PM2.5) was estimated using LUR incorporating satellite data. Mothers reported child’s wheeze every 3 months. Effects of ECV and air pollutants on repeated wheeze (≥2 episodes) were examined using logistic regression. Interactions between ECV and pollutants were examined. Results: Mothers were primarily Black (29%) and Hispanic (55%) with lower education (62% with ≤12 years); 87 children (12%) wheezed repeatedly. In models examining concurrent exposures, ECV [OR=1.95 (95% CI: 1.13-3.36), highest vs. lowest tertile] and BC [OR=1.84 (95% CI: 1.08-3.12), ≥median vs. pollution levels was suggested. Conclusions: These findings suggest that both prenatal community violence and air pollution may contribute to respiratory health in these urban children. Moreover, place-based psychosocial stressors may impact host resistance such that physical pollutants may have adverse effects, even at relatively lower levels. PMID:24200349

  4. Differential effects of risk factors on infant wheeze and atopic dermatitis emphasize a different etiology

    DEFF Research Database (Denmark)

    Linneberg, Allan René; Simonsen, Jacob B; Petersen, Janne

    2005-01-01

    regression models. RESULTS: The following variables had significantly differential effects on infant wheezing and AD: parental hay fever, parental asthma, parental AD, sex, maternal age, maternal occupation, smoking during pregnancy, season of birth, birth weight, gestational age, head circumference, breast-feeding...

  5. Long-term exposure to indoor air pollution and wheezing symptoms in infants

    DEFF Research Database (Denmark)

    Raaschou-Nielsen, O.; Hermansen, M.N.; Loland, L.

    2010-01-01

    wheezing symptoms in diaries for a birth cohort of 411 infants. We measured long-term exposure to nitrogen oxides (NO(x)), NO(2), formaldehyde, PM(2.5) and black smoke in the infants' bedrooms and analyzed risk associations during the first 18 months of life by logistic regression with the dichotomous end...

  6. High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence.

    Science.gov (United States)

    Bradshaw, Catriona S; Morton, Anna N; Hocking, Jane; Garland, Suzanne M; Morris, Margaret B; Moss, Lorna M; Horvath, Leonie B; Kuzevska, Irene; Fairley, Christopher K

    2006-06-01

    We wished to determine recurrences of bacterial vaginosis (BV) after treatment over the course of 12 months and to establish factors associated with recurrence. Women with symptomatic BV (a Nugent score [NS] of 7-10 or of 4-6 with >or=3 Amsel criteria) were enrolled. BV was treated with 400 mg of oral metronidazole twice a day for 7 days. Participants completed a questionnaire and vaginal swabs were collected at 1, 3, 6, and 12 months; the study end point was an NS of 7-10. A total of 121 (87%) women with an NS of 7-10 and 18 (13%) with an NS of 4-6 and >or=3 Amsel criteria were enrolled; 130 (94%) returned >or=1 vaginal samples. Sixty-eight women (58% [95% confidence interval {CI}, 49%-66%]) had a recurrence of BV (NS 7-10), and 84 (69% [95% CI, 61%-77%]) had a recurrence of abnormal vaginal flora (NS 4-10) by 12 months. A past history of BV, a regular sex partner throughout the study, and female sex partners were significantly associated with recurrence of BV and abnormal vaginal flora by multivariate analysis; the use of hormonal contraception had a negative association with recurrence. Current recommended treatment is not preventing the recurrence of BV or abnormal vaginal flora in the majority of women; factors associated with recurrence support a possible role for sexual transmission in the pathogenesis of recurrent BV.

  7. Cognitive and brain reserve in conversion and reversion in patients with mild cognitive impairment over 12 months of follow-up.

    Science.gov (United States)

    Osone, Akira; Arai, Reiko; Hakamada, Rina; Shimoda, Kazutaka

    2016-12-01

    Two reserve hypotheses have been proposed to account for the observed disjunction between the degree of brain pathology and its clinical manifestations. This study investigated whether cognitive reserve (CR), taken here as educational attainment and premorbid IQ, or brain reserve (BR; i.e., brain volume) is associated with progression and regression in patients with mild cognitive impairment (MCI) over a 12-month follow-up. Patients with MCI (n = 123) were prospectively enrolled. The Mini-Mental State Examination, the Japanese version of the Cognitive subscale of the Alzheimer's Disease Assessment Scale, the Clinical Dementia Rating (CDR), the Frontal Assessment Battery, the Neuropsychiatric Inventory, magnetic resonance imaging (MRI), and quantitative single-photon emission computed tomography were performed at intake and again at 12-month follow-up. Patients were classified into three groups: no change, conversion, and reversion. Conversion was defined as a change in CDR from 0.5 to 1, and reversion as a change from 0.5 to 0. Voxel-based morphometry MRI revealed no significant differences in entorhinal and hippocampal gray matter loss among the groups. Patients with reversion had higher premorbid IQ (p = .03, ηp(2) = .35) as measured by the Japanese version of the National Adult Reading Test, higher atrophy ratio (hippocampal volume/whole brain volume; p = .04, ηp(2) = .89) at baseline, and better cognitive performance (p cognitive decline during the 12-month follow-up, whereas higher BR at baseline was the strongest predictor for reversion and conversion.

  8. Dry Eye Disease following Refractive Surgery: A 12-Month Follow-Up of SMILE versus FS-LASIK in High Myopia

    Directory of Open Access Journals (Sweden)

    Bingjie Wang

    2015-01-01

    Full Text Available Purpose. To compare dry eye disease following SMILE versus FS-LASIK. Design. Prospective, nonrandomised, observational study. Patients. 90 patients undergoing refractive surgery for myopia were included. 47 eyes underwent SMILE and 43 eyes underwent FS-LASIK. Methods. Evaluation of dry eye disease was conducted preoperatively and at 1, 3, 6, and 12 months postoperatively, using the Salisbury Eye Evaluation Questionnaire (SEEQ and TBUT. Results. TBUT reduced following SMILE at 1 and 3 months (p<0.001 and at 1, 3, and 6 months following FS-LASIK (p<0.001. TBUT was greater following SMILE than FS-LASIK at 3, 6, and 12 months (p<0.001, p<0.001, and p=0.009, resp.. SEEQ scores increased (greater symptoms following SMILE at 1 month (p<0.001 and 3 months (p=0.003 and at 1, 3, and 6 months following FS-LASIK (p<0.001. SMILE produced lower SEEQ scores (fewer symptoms than FS-LASIK at 1, 3, and 6 months (p<0.001. Conclusion. SMILE produces less dry eye disease than FS-LASIK at 6 months postoperatively but demonstrates similar degrees of dry eye disease at 12 months.

  9. Risk factor assessment and counselling for 12 months reduces metabolic and cardiovascular risk in overweight or obese patients with schizophrenia spectrum disorders: The CRESSOB study.

    Science.gov (United States)

    Gutiérrez-Rojas, Luis; Pulido, Susana; Azanza, Jose R; Bernardo, Miguel; Rojo, Luis; Mesa, Francisco J; Martínez-Ortega, Jose M

    2016-01-01

    Metabolic syndrome (MS) and cardiovascular risk factors (CRF) have been associated with patients with schizophrenia. The main objective is to assess the evolution of CRF and prevalence of MS for 12 months in a cohort of overweight patients diagnosed with schizophrenia schizophreniform disorder or schizoaffective disorder in which the recommendations for the assessment and control of metabolic and cardiovascular risk were applied. The Control of Metabolic and Cardiovascular Risk in Patients with Schizophrenia and Overweight (CRESSOB) study is a 12-month, observational, prospective, open-label, multicentre, naturalistic study including 109 community mental health clinics of Spain. The study included a total of 403 patients, of whom we could collect all variables related to CRF and MS in 366 patients. Of these 366 patients, 286 completed the follow-up, (baseline, months 3, 6 and 12) where they underwent a complete physical examination and a blood test (glucose, cholesterol and triglycerides), they were asked about their health-related habits (smoking, diet and exercise) and they were given a series of recommendations to prevent cardiovascular risk and MS. A total of 403 patients were included, 63% men, mean age (mean; (SD)) 40.5 (10.5) years. After 12 months, the study showed statistically significant decrease in weight (prisk of heart disease at 10 years (p=0.0353). Overweight patients with schizophrenia who receive appropriate medical care, including CRF monitoring and control of health-related habits experience improvements with regard to most CRFs.

  10. [Comparison of two techniques used in immediate postplacental insertion of TCu 380A intrauterine device: 12 month follow-up of 910 cases].

    Science.gov (United States)

    Xu, J; Zhuang, L; Yu, G

    1997-06-01

    To compare the efficacy of hand-insertion and ring forceps-insertion of TCu 380A intrauterine device (IUD) in immediate postplacental insertion (IPPI). 910 vaginal delivery women in Shanghai received a TCu 380A IUD inserted within 10 minutes after delivery of the placenta. Among them, 97.7% were primipara. The women were randomly divided into two groups: 470 cases in hand-insertion group and 440 in ring forceps-insertion group. Using life-tale method and X2 test, we compared the expulsion rates and other causes of removal after follow-up for 12 months in the two groups. The follow-up rate at 6 and 12 months were 95.16% and 92.64%, respectively. No uterine perforation and infection occurred in the 910 cases, and only one pregnancy in the hand-insertion group. Expulsions were the main reason for discontinuation. The 12-month gross cumulative expulsion rates were 15.86 and 15.88 per 100 women in the hand-insertion group and ring forceps-insertion group, respectively, and the removal rates due to bleeding and (or) pain were 2.11 and 1.57, respectively. No difference was statistically significant (P > 0.05). The two different insertion techniques do not significantly affect discontinuation rates in vaginal IPPI using the TCu 38)A IUD; the TCu 380A IUD appears to be suitable for postpartum insertion in Chinese women.

  11. The influence of maternal optimality and infant temperament on parenting stress at 12 months among mothers with substance abuse and psychiatric problems.

    Science.gov (United States)

    Siqveland, Torill S; Olafsen, Kåre S; Moe, Vibeke

    2013-10-01

    The present prospective longitudinal study aimed to investigate the long-term impact of maternal optimality assessed during pregnancy on parenting stress at infant age 12 months. In this study the concept of optimality was utilized to investigate maternal variations regarding resources during pregnancy in relation to later parenting stress, among three different groups of mothers that were recruited from substance abuse treatment, psychiatric outpatient treatment and well-baby clinics respectively. The influence of infant temperament on parenting stress was also examined. All mothers were interviewed during pregnancy. At 12 months, infant temperament (Colorado Childhood Temperament Inventory; Rowe & Plomin, 1977) and stress in the parent and child domain (Parenting Stress Index; Abidin, 1955) were assessed. Results demonstrated higher levels of parenting stress among mothers in the clinical groups, compared to the non-clinical group. Furthermore, it was the maternal psychiatric optimality index in combination with child temperament characteristics (child emotionality) that contributed uniquely to stress in the parent domain, while stress in the child domain was significantly associated only with child temperament characteristics (both child emotionality and soothability). The association between maternal psychiatric optimality assessed in pregnancy, infant temperament and parenting stress when the infants were 12 months old, points to the importance of simultaneously addressing the mothers' own psychological distress, and to support positive mother-infant interactions. Each woman's individual optimality profile may be used to display needs of follow-up in order to prevent enduring effects of non-optimality on parenting stress. © 2013 The Scandinavian Psychological Associations.

  12. Food Sources of Energy and Macronutrient Intakes among Infants from 6 to 12 Months of Age: The Growing Up in Singapore Towards Healthy Outcomes (GUSTO Study

    Directory of Open Access Journals (Sweden)

    Shan-Xuan Lim

    2018-03-01

    Full Text Available Adequate nutrition during complementary feeding is important for the growth, development and well-being of children. We aim to examine the energy and macronutrient intake composition and their main food sources in a mother–offspring cohort study in Singapore. The diets of infants were assessed by 24 h dietary recalls or food diaries collected from mothers when their offspring were 6 (n = 760, 9 (n = 893 and 12 (n = 907 months of age. Food sources of energy and macronutrients were determined using the population proportion methodology. Energy intakes per day (kcal; mean (standard deviation, SD of these infants were 640 (158 at 6 months, 675 (173 at 9 months, and 761 (208 at 12 months. Infant formula, breastmilk and infant cereals were the top three food sources of energy and macronutrient intakes in infants through the period 6 to 12 months. Other main energy and carbohydrate sources at 9 and 12 months of age were rice porridge, infant biscuits and fresh fruits, while fish, red meat and eggs were the other main protein and total fat sources. Breast-fed and mixed-fed infants had a more varied diet as compared to formula-fed infants. Formula-fed infants had consistently higher protein and lower total fat consumption compared to those who were breastfed. An understanding of these main food sources during complementary feeding can inform local dietary recommendations and policies.

  13. Factors influencing oral hygiene behaviour and gingival outcomes 3 and 12 months after initial periodontal treatment: an exploratory test of an extended Theory of Reasoned Action.

    Science.gov (United States)

    Jönsson, Birgitta; Baker, Sarah R; Lindberg, Per; Oscarson, Nils; Ohrn, Kerstin

    2012-02-01

    The aim was to empirically test the extended Theory of Reasoned Action (TRA) and the prospective direct and indirect role of attitudes, beliefs, subjective norms, self-efficacy, and a cognitive behavioural intervention in adult's oral hygiene behaviour and gingival outcomes at 3- and 12-month follow-up. Data were derived from an RCT evaluating the effectiveness of oral hygiene educational programs integrated in non-surgical periodontal treatment (n = 113). Before baseline examination, participants completed a self-report questionnaire. Structural equation modelling using maximum likelihood estimation with bootstrapping was used to test the direct and indirect (mediated) pathways within the extended TRA model. The extended TRA model explained a large amount of variance in gingival outcome scores at 12 months (56%). A higher level of self-efficacy at baseline was associated with higher frequencies of oral hygiene behaviour at 3 months. Being female was linked to more normative beliefs that, in turn, related to greater behavioural beliefs and self-efficacy. Gender was also related to behavioural beliefs, attitudes and subjective norms. Both frequency of oral hygiene behaviour at 3 months and the cognitive behavioural intervention predicted gingival outcome at 12 months. The model demonstrated that self-efficacy, gender and a cognitive behavioural intervention were important predictors of oral hygiene behavioural change. © 2011 John Wiley & Sons A/S.

  14. Comparative Evaluation of Fresh Aloe barbadensis Plant Extract and Mineral Trioxide Aggregate as Pulpotomy Agents in Primary Molars: A 12-month Follow-up Study

    Science.gov (United States)

    Kalra, Mehak; Garg, Nishita; Rallan, Mandeep; Pathivada, Lumbini; Yeluri, Ramakrishna

    2017-01-01

    Background: The purpose of this study was to compare the clinical and radiographic outcomes of fresh Aloe vera barbadensis plant extract and mineral trioxide aggregate (MTA) as pulpotomy agents in primary molar teeth. Materials and Methods: Pulpotomy procedure was performed in sixty primary molar teeth which were randomly allocated to two groups, i.e., Aloe vera pulpotomy (Group A) and MTA pulpotomy (Group B). All the pulpotomized teeth were evaluated clinically and radiographically at 1, 3, 6, 9, and 12 months of time interval using predetermined criteria. Results: The success rates between Groups A and B at the end of the 1st month were 24.1% and 96.4%, at the end of 3rd month were 57.1% and 100%, at the end of 6th month were 75% and 100%, at the end of 9th month were 66.6% and 100%, and at the end of 12 months were 100% and 100% respectively. The overall success rates at the end of 12-month follow-up period were 6.9% and 71.4%, respectively, after taking dropout patients into consideration, and the difference was statistically significant (P < 0.001). Conclusions: MTA pulpotomy was found to be superior when compared to fresh A. barbadensis plant extract pulpotomy in primary molars. PMID:28566860

  15. Effect on Insulin, Glucose and Lipids in Overweight/Obese Australian Adults of 12 Months Consumption of Two Different Fibre Supplements in a Randomised Trial.

    Science.gov (United States)

    Pal, Sebely; Ho, Suleen; Gahler, Roland J; Wood, Simon

    2017-01-29

    Higher fibre intakes are associated with risk reduction for chronic diseases. This study investigated the effects of supplementation with PolyGlycopleX ® (PGX), a complexed polysaccharide, on insulin, glucose and lipids in overweight and obese individuals. In this double-blind 12 months study, participants were randomised into three groups: control (rice flour); PGX or psyllium (PSY). Participants followed their usual lifestyle and diet but consumed 5 g of their supplement before meals. Insulin was significantly lower in the PGX and PSY groups compared to control at 3 and 6 months and in the PSY group compared to control at 12 months. Serum glucose was significantly lower in the PGX group at 3 months compared to control. Total cholesterol was significantly lower in the PGX and PSY groups compared to control at 3 and 6 months. High density lipoprotein (HDL) cholesterol was significantly increased in the PGX group compared to control at 12 months. low density lipoprotein (LDL) cholesterol was significantly lower in the PGX group at 3 and 6 months compared to control and in the PSY group at 3 months compared to control. A simple strategy of fibre supplementation may offer an effective solution to glucose, insulin and lipid management without the need for other nutrient modification.

  16. The Prevalence of Past 12-Month and Lifetime DSM-IV Eating Disorders by BMI Category in US Men and Women.

    Science.gov (United States)

    Duncan, Alexis E; Ziobrowski, Hannah N; Nicol, Ginger

    2017-05-01

    This study aims to determine whether the prevalence of lifetime and past 12-month DSM-IV eating disorders (ED) diagnoses differed by body mass index category among men and women in a general population sample. Data from the Collaborative Psychiatric Epidemiology Surveys (n = 12 337 adults) were analysed using logistic regression. Analyses were conducted separately by gender. Lifetime ED prevalence was 2.22% in men and 4.93% in women. In both genders, the prevalence of any lifetime and past 12-month ED, binge eating disorder and recurrent binge eating was highest among obese individuals. Among obese men and women, lifetime and past 12-month ED prevalence was highest among those with class III obesity. Eating disorders were most prevalent among high-weight individuals. This information is important for planning targeted public health ED and obesity prevention and intervention activities, as well as for informing the clinical care of obese individuals. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

  17. Food Sources of Energy and Macronutrient Intakes among Infants from 6 to 12 Months of Age: The Growing Up in Singapore Towards Healthy Outcomes (GUSTO) Study

    Science.gov (United States)

    Lim, Shan-Xuan; Toh, Jia-Ying; Han, Wee-Meng; Shek, Lynette Pei-Chi; Yap, Fabian; Chong, Yap-Seng; Chong, Mary Foong-Fong

    2018-01-01

    Adequate nutrition during complementary feeding is important for the growth, development and well-being of children. We aim to examine the energy and macronutrient intake composition and their main food sources in a mother–offspring cohort study in Singapore. The diets of infants were assessed by 24 h dietary recalls or food diaries collected from mothers when their offspring were 6 (n = 760), 9 (n = 893) and 12 (n = 907) months of age. Food sources of energy and macronutrients were determined using the population proportion methodology. Energy intakes per day (kcal; mean (standard deviation, SD)) of these infants were 640 (158) at 6 months, 675 (173) at 9 months, and 761 (208) at 12 months. Infant formula, breastmilk and infant cereals were the top three food sources of energy and macronutrient intakes in infants through the period 6 to 12 months. Other main energy and carbohydrate sources at 9 and 12 months of age were rice porridge, infant biscuits and fresh fruits, while fish, red meat and eggs were the other main protein and total fat sources. Breast-fed and mixed-fed infants had a more varied diet as compared to formula-fed infants. Formula-fed infants had consistently higher protein and lower total fat consumption compared to those who were breastfed. An understanding of these main food sources during complementary feeding can inform local dietary recommendations and policies. PMID:29534442

  18. Randomized, Single-Blind, Parallel Clinical Trial on Efficacy of Oral Prednisolone Versus Intramuscular Corticotropin: A 12-Month Assessment of Spasm Control in West Syndrome.

    Science.gov (United States)

    Wanigasinghe, Jithangi; Arambepola, Carukshi; Ranganathan, Shalini Sri; Sumanasena, Samanmali

    2017-11-01

    We earlier completed a single-blind, parallel-group, randomized clinical trial to test the null hypothesis that adrenocorticotropic hormone (ACTH) is not superior to high-dose prednisolone for short-term control of West syndrome. We now present long-term follow-up data for spasm control for individuals who completed this earlier trial. Infants with untreated West syndrome were randomized to receive 14 days of prednisolone (40 to 60 mg/day) or intramuscular long-acting ACTH (40 to 60 IU every other day). They were evaluated at three, six, and 12 months to evaluate long-term spasm control. The total number of infants treated was 97 (48 prednisolone; 49 ACTH). All completed the treatment course. Eighty-five, 82, and 76 children were available for follow-up at three, six, and 12 months. The number lost to follow-up at each interval was not statistically different. Likelihood of spasm freedom at three months was significantly higher for prednisolone (64.6%) than for ACTH (38.8%) (P = 0.01; odds ratio = 2.9; 95% confidence interval = 1.3 to 6.6). At six months (P = 0.19) and twelve months (P = 0.13), the control of spasms was not statistically different, although a trend in favor of prednisolone was documented at both of these time points (58.3% versus 44.9% for ACTH at six months and 56.2% versus 40.8% with ACTH at 12 months). After initial remission by day 14 (n = 46), the likelihood of a relapse within the next 12 months was not statistically different between the two treatment groups (P = 0.1). Control of spasms at three months was significantly better if initially treated with prednisolone. Control of spasms at six and 12 months was not significantly different despite a trend favoring prednisolone. Risk of relapse following initial remission was similar in the two groups. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. In utero exposure to pets is associated with asthma and wheezing in Mexican American children.

    Science.gov (United States)

    Eldeirawi, Kamal; Kunzweiler, Colin; Combs, Angela M T; Persky, Victoria W

    2016-01-01

    To examine the associations of in utero and early life exposure to cats/dogs and birds with the risk of lifetime doctor-diagnosed asthma and other respiratory conditions in a sample of Mexican American (MA) children 4-18 years of age. This study is a population-based cross-sectional investigation of 1816 MA children. We conducted multiple logistic models examining the relationship of asthma and wheezing with exposures to cats/dogs and birds in utero, infancy and at the time of the survey adjusted for country of birth, family history of asthma/allergies, antibiotics use in infancy and other covariates. In adjusted analyses, in utero exposure to cats/dogs and birds jointly was associated with increased odds of asthma (adjusted odds ratio (aOR): 2.89; 95% confidence interval (CI): 1.34-6.23), ever wheezing (aOR: 1.96; 95% CI: 1.11-3.46) and current exercise-induced wheezing (aOR: 3.16; 95% CI: 1.27-7.85) compared to children not exposed to these pets in utero. Children who were exposed to both cats/dogs and birds in utero had an elevated, albeit statistically non-significant, odds of current wheezing. Exposures in infancy and at the time of the survey to cats/dogs and birds were not associated with asthma or wheezing. In utero exposure to pets might be associated with an increased risk of asthma and respiratory conditions in a sample of non-affluent MA children.

  20. DNA hypomethylation at ALOX12 is associated with persistent wheezing in childhood.

    Science.gov (United States)

    Morales, Eva; Bustamante, Mariona; Vilahur, Nadia; Escaramis, Georgia; Montfort, Magda; de Cid, Rafael; Garcia-Esteban, Raquel; Torrent, Maties; Estivill, Xavier; Grimalt, Joan O; Sunyer, Jordi

    2012-05-01

    Epigenetic changes may play a role in the occurrence of asthma-related phenotypes. To identify epigenetic marks in terms of DNA methylation of asthma-related phenotypes in childhood, and to assess the effect of prenatal exposures and genetic variation on these epigenetic marks. Data came from two cohorts embedded in the Infancia y Medio Ambiente (INMA) PROJECT: Menorca (n = 122) and Sabadell (n = 236). Wheezing phenotypes were defined at age 4-6 years. Cytosine-guanine (CpG) dinucleotide site DNA methylation differences associated with wheezing phenotypes were screened in children of the Menorca study using the Illumina GoldenGate Panel I. Findings were validated and replicated using pyrosequencing. Information on maternal smoking and folate supplement use was obtained through questionnaires. Dichlorodiphenyldichloroethylene was measured in cord blood or maternal serum. Genotypes were extracted from genome-wide data. Screening identified lower DNA methylation at a CpG site in the arachidonate 12-lipoxygenase (ALOX12) gene in children having persistent wheezing compared with those never wheezed (P = 0.003). DNA hypomethylation at ALOX12 loci was associated with higher risk of persistent wheezing in the Menorca study (odds ratio per 1% methylation decrease, 1.13; 95% confidence interval, 0.99-1.29; P = 0.077) and in the Sabadell study (odds ratio, 1.16; 95% confidence interval, 1.03-1.37; P = 0.017). Higher levels of prenatal dichlorodiphenyldichloroethylene were associated with DNA hypomethylation of ALOX12 in the Menorca study (P = 0.033), but not in the Sabadell study (P = 0.377). ALOX12 DNA methylation was strongly determined by underlying genetic polymorphisms. DNA methylation of ALOX12 may be an epigenetic biomarker for the risk of asthma-related phenotypes.

  1. Patterns of immune development in urban preschoolers with recurrent wheeze and/or atopy.

    Science.gov (United States)

    Gern, James E; Calatroni, Agustin; Jaffee, Katy F; Lynn, Henry; Dresen, Amy; Cruikshank, William W; Lederman, Howard M; Sampson, Hugh A; Shreffler, Wayne; Bacharier, Leonard B; Gergen, Peter J; Gold, Diane R; Kattan, Meyer; O'Connor, George T; Sandel, Megan T; Wood, Robert A; Bloomberg, Gordon R

    2017-09-01

    Disadvantaged urban children have high rates of allergic diseases and wheezing, which are diseases associated with type 2-biased immunity. We sought to determine whether environmental exposures in early life influence cytokine responses that affect the development of recurrent wheezing illnesses and allergic sensitization. A birth cohort of 560 urban families was recruited from neighborhoods with high rates of poverty, and 467 (83%) children were followed until 3 years of age. Cytokine responses were measured in blood cell samples obtained at birth (cord blood) and ages 1 and 3 years. Cytokine responses were examined in relation to personal characteristics and environmental exposures to allergens and endotoxin and to the development of allergic sensitization and recurrent wheeze assessed at age 3 years. Cytokine responses generally increased with age, but responses at birth were poorly predictive for those at ages 1 and 3 years. Exposure to certain allergens (cockroach, mouse, dust mite) was significantly associated with enhanced cytokine responses at age 3 years, including IFN-α and IL-10 responses to certain stimulants and responses to phytohemagglutinin. Regarding the clinical outcomes, reduced LPS-induced IL-10 responses at birth were associated with recurrent wheeze. In contrast, reduced respiratory syncytial virus-induced IL-8 responses and increased 5'-cytosine-phosphate-guanine-3' (CpG)-induced IL-12p40 and allergen-induced IL-4 responses were associated with atopy. These findings suggest that diverse biologic exposures, including allergens and endotoxin, in urban homes stimulate the development of cytokine responses in early life, and that cytokine responses to specific microbial and viral stimuli are associated with the development of allergic sensitization and recurrent wheeze. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. All rights reserved.

  2. Household environmental tobacco smoke and risks of asthma, wheeze and bronchitic symptoms among children in Taiwan

    Directory of Open Access Journals (Sweden)

    Hwang Bing-Fang

    2010-01-01

    Full Text Available Abstract Background Although studies show that maternal smoking during pregnancy increases the risks of respiratory outcomes in childhood, evidence concerning the effects of household environmental tobacco smoke (ETS exposure remains inconsistent. Methods We conducted a population-based study comprised of 5,019 seventh and eighth-grade children in 14 Taiwanese communities. Questionnaire responses by parents were used to ascertain children's exposure and disease status. Logistic regression models were fitted to estimate the effects of ETS exposures on the prevalence of asthma, wheeze, and bronchitic symptoms. Results The lifetime prevalence of wheeze was 11.6% and physician-diagnosed asthma was 7.5% in our population. After adjustment for potential confounders, in utero exposure showed the strongest effect on all respiratory outcomes. Current household ETS exposure was significantly associated with increased prevalence of active asthma, ever wheeze, wheeze with nighttime awakening, and bronchitis. Maternal smoking was associated with the increased prevalence of a wide range of wheeze subcategories, serious asthma, and chronic cough, but paternal smoking had no significant effects. Although maternal smoking alone and paternal smoking alone were not independently associated with respiratory outcomes, joint exposure appeared to increase the effects. Furthermore, joint exposure to parental smoking showed a significant effect on early-onset asthma (OR, 2.01; 95% CI, 1.00-4.02, but did not show a significant effect on late-onset asthma (OR, 1.17; 95% CI, 0.36-3.87. Conclusion We concluded that prenatal and household ETS exposure had significant adverse effects on respiratory health in Taiwanese children.

  3. An update on the efficacy of oral corticosteroids in the treatment of wheezing episodes in preschool children.

    Science.gov (United States)

    Collins, Andrew D; Beigelman, Avraham

    2014-12-01

    Traditionally, oral corticosteroids (OCSs) have been the mainstay of treatment for acute wheezing episodes among preschool children with a history of recurrent wheezing. Although there is substantial evidence for the efficacy of OCSs as a treatment for asthma exacerbations in school-aged children and adolescents, recent clinical studies questioned the benefits of OCSs as a treatment for acute wheezing in preschool children. This review summarizes the current evidence on the efficacy of OCSs as a treatment for acute wheezing episodes among preschool age children with episodic wheezing, focusing on studies performed in three different settings: OCS treatment initiated by parents in the outpatient setting, OCS treatment initiated in the emergency department (ED), and OCS treatment among hospitalized preschool children. The results of most studies reviewed in this paper do not support the efficacy of OCS treatment among preschool children with recurrent wheezing. The heterogeneity of early childhood wheezing and asthma might be part of the explanation for lack of efficacy of this intervention noted in multiple studies. © The Author(s), 2014.

  4. Motor function deficits in the 12 month-old female 5xFAD mouse model of Alzheimer's disease.

    Science.gov (United States)

    O'Leary, T P; Robertson, A; Chipman, P H; Rafuse, V F; Brown, R E

    2018-01-30

    Motor problems occur early in some patients with Alzheimer's disease (AD) and as the disease progresses many patients develop motor dysfunction. Motor dysfunction has been reported in some mouse models of AD, including the 5xFAD mouse, thus this model may be particularly useful for studying motor dysfunction in AD. In order to determine the extent of motor dysfunction in these mice, we tested 11-13 month old female 5xFAD and wildtype (WT) control mice in a battery of motor behaviour tasks. The 5xFAD mice showed hind limb clasping, weighed less and had slower righting reflexes than WT mice. In the open field, the 5xFAD mice travelled a shorter distance than the WT mice, spent less time moving and had a slower movement speed. The 5xFAD mice fell faster than the WT mice from the balance beam, wire suspension, grid suspension and rotarod tasks, indicating dysfunctions in balance, grip strength, motor co-ordination and motor learning. The 5xFAD mice had a short, shuffling gait with a shorter stride length than WT mice and had a slower swim speed. The 5xFAD mice also failed to show an acoustic startle response, likely due to motor dysfunction and previously reported hearing impairment. The 5xFAD mice did not show deficits in the ability of peripheral motor nerves to drive muscle output, suggesting that motor impairments are not due to dysfunction in peripheral motor nerves. These results indicate that the aged 5xFAD mice are deficient in numerous motor behaviours, and suggest that these mice may prove to be a good model for studying the mechanisms of motor dysfunction in AD, and motor behaviour might prove useful for assessing the efficacy of AD therapeutics. Motor dysfunction in 5xFAD mice must also be considered in behavioural tests of sensory and cognitive function so that performance is not confounded by impaired locomotor or swimming behaviour. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Intrauterine exposure to polycyclic aromatic hydrocarbons, fine particulate matter and early wheeze. Prospective birth cohort study in 4-year olds.

    Science.gov (United States)

    Jedrychowski, Wieslaw A; Perera, Frederica P; Maugeri, Umberto; Mrozek-Budzyn, Dorota; Mroz, Elzbieta; Klimaszewska-Rembiasz, Maria; Flak, Elzbieta; Edwards, Susan; Spengler, John; Jacek, Ryszard; Sowa, Agata

    2010-06-01

    The main goal of the study was to determine the relationship between prenatal exposure to polycyclic aromatic hydrocarbons (PAHs) measured by PAH-DNA adducts in umbilical cord blood and early wheeze. The level of PAH-DNA adducts in the cord blood is assumed to reflect the cumulative dose of PAHs absorbed by the foetus over the prenatal period. The effect of prenatal PAH exposure on respiratory health measured by the incidence rate ratio (IRR) for the number of wheezing days in the subsequent 4 yr follow-up was adjusted for potential confounding factors such as personal prenatal exposure to fine particulate matter (PM(2.5)), environmental tobacco smoke (ETS), gender of child, maternal characteristics (age, education and atopy), parity and mould/dampness in the home. The study sample includes 339 newborns of non-smoking mothers 18-35 yr of age and free from chronic diseases, who were recruited from ambulatory prenatal clinics in the first or second trimester of pregnancy. The number of wheezing days during the first 2 yr of life was positively associated with prenatal level of PAH-DNA adducts (IRR = 1.69, 95%CI = 1.52-1.88), prenatal particulate matter (PM(2.5)) level dichotomized by the median (IRR = 1.38; 95%CI: 1.25-1.51), maternal atopy (IRR = 1.43; 95%CI: 1.29-1.58), mouldy/damp house (IRR = 1.43; 95%CI: 1.27-1.61). The level of maternal education and maternal age at delivery was inversely associated with the IRRs for wheeze. The significant association between frequency of wheeze and the level of prenatal environmental hazards (PAHs and PM(2.5)) was not observed at ages 3 or 4 yrs. Although the frequency of wheezing at ages 3 or 4 was no longer associated with prenatal exposure to PAHs and PM(2.5), its occurrence depended on the presence of wheezing in the first 2 yr of life, which nearly tripled the risk of wheezing in later life. In conclusion, the findings may suggest that driving force for early wheezing (<24 months of age) is different to those leading to

  6. Effects of Delayed Umbilical Cord Clamping vs Early Clamping on Anemia in Infants at 8 and 12 Months: A Randomized Clinical Trial.

    Science.gov (United States)

    Kc, Ashish; Rana, Nisha; Målqvist, Mats; Jarawka Ranneberg, Linda; Subedi, Kalpana; Andersson, Ola

    2017-03-01

    Delayed umbilical cord clamping has been shown to improve iron stores in infants to 6 months of age. However, delayed cord clamping has not been shown to prevent iron deficiency or anemia after 6 months of age. To investigate the effects of delayed umbilical cord clamping, compared with early clamping, on hemoglobin and ferritin levels at 8 and 12 months of age in infants at high risk for iron deficiency anemia. This randomized clinical trial included 540 late preterm and term infants born vaginally at a tertiary hospital in Kathmandu, Nepal, from October 2 to November 21, 2014. Follow-up included blood levels of hemoglobin and ferritin at 8 and 12 months of age. Follow-up was completed on December 11, 2015. Analysis was based on intention to treat. Infants were randomized to delayed umbilical cord clamping (≥180 seconds after delivery) or early clamping (≤60 seconds after delivery). Main outcomes included hemoglobin and anemia levels at 8 months of age with the power estimate based on the prevalence of anemia. Secondary outcomes included hemoglobin and anemia levels at 12 months of age and ferritin level, iron deficiency, and iron deficiency anemia at 8 and 12 months of age. In this study of 540 infants (281 boys [52.0%] and 259 girls [48.0%]; mean [SD] gestational age, 39.2 [1.1] weeks), 270 each were randomized to the delayed and early clamping groups. At 8 months of age, 212 infants (78.5%) from the delayed group and 188 (69.6%) from the early clamping group returned for blood sampling. After multiple imputation analysis, infants undergoing delayed clamping had higher levels of hemoglobin (10.4 vs 10.2 g/dL; difference, 0.2 g/dL; 95% CI, 0.1 to 0.4 g/dL). Delayed cord clamping also reduced the prevalence of anemia (hemoglobin level infants (relative risk, 0.89; 95% CI, 0.81-0.98; number needed to treat [NNT], 11; 95% CI, 6-54). At 8 months, the risk for iron deficiency was reduced in the delayed clamping group in 60 (22.2%) vs 103 (38.1%) patients

  7. Treatment outcomes after initiation of exenatide twice daily or insulin in clinical practice: 12-month results from CHOICE in six European countries

    Directory of Open Access Journals (Sweden)

    Ostenson CG

    2013-04-01

    Full Text Available Claes-Göran Östenson,1 Stephan Matthaei,2 Matthew Reaney,3 Thure Krarup,4 Bruno Guerci,5 Jacek Kiljanski,6 Carole Salaun-Martin,7 Hélène Sapin,7 David Bruhn,8 Chantal Mathieu,9 Michael Theodorakis10 1Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; 2Diabetes-Center Quakenbrück, Quakenbrück, Germany; 3Eli Lilly, Windlesham, Surrey, UK; 4Department of Endocrinology I, Bispebjerg Hospital, Copenhagen, Denmark; 5Diabetology, Metabolic Diseases and Nutrition, Brabois Hospital, CHU Nancy, and INSERM CIC, ILCV, Vandoeuvre Lès Nancy, France; 6Eli Lilly, Warsaw, Poland; 7Eli Lilly, Neuilly Cedex, France; 8Eli Lilly, San Diego, California, USA; 9Department of Endocrinology, UZ Gasthuisberg, Leuven, Belgium; 10Department of Clinical Therapeutics, University of Athens School of Medicine, Athens, Greece* *Michael Theodorakis was affiliated with the institution shown at the time of the study, but has since left this institution Objective: The CHanges to treatment and Outcomes in patients with type 2 diabetes initiating InjeCtablE therapy (CHOICE study assessed time to, and reasons for, significant treatment change after patients with type 2 diabetes (T2DM initiated their first injectable glucose-lowering therapy (exenatide twice daily [BID] or insulin in routine clinical practice, and these patients’ clinical outcomes, in six European countries. This paper reports interim data from the first 12 months of the study. Research design and methods: CHOICE (NCT00635492 is a prospective, noninterventional, observational study. Clinical data were collected at initiation of first injectable therapy and after approximately 3, 6, and 12 months. Results: Of 2497 patients enrolled in CHOICE, 1096 in the exenatide BID and 1239 in the insulin cohorts had ≥1 post-baseline assessment and were included in this analysis. Overall, 32.2% of the exenatide BID cohort and 29.1% of the insulin cohort (Kaplan–Meier estimates had

  8. Maintenance of remission of ulcerative colitis: a comparison between balsalazide 3 g daily and mesalazine 1.2 g daily over 12 months. ABACUS Investigator group.

    Science.gov (United States)

    Green, J R; Gibson, J A; Kerr, G D; Swarbrick, E T; Lobo, A J; Holdsworth, C D; Crowe, J P; Schofield, K J; Taylor, M D

    1998-12-01

    Despite widespread use of aminosalicylates as maintenance treatment for ulcerative colitis (UC), patients still report troublesome symptoms, often nocturnally. To compare the efficacy and safety of balsalazide (Colazide) with mesalazine (Asacol) in maintaining UC remission. A randomized, double-blind comparison of balsalazide 3 g daily (1.04 g 5-ASA) and mesalazine 1.2 g daily for 12 months, in 99 (95 evaluable) patients in UC remission. Balsalazide patients experienced more asymptomatic nights (90% vs. 77%, P=0.0011) and days (58% vs. 50%, N.S.) during the first 3 months. Balsalazide patients experienced more symptom-free nights per week (6.4+/-1.7 vs. 4.7+/-2.8; P=0.0006) and fewer nights per week with blood on their stools or on the toilet paper, mucus with their stools or with sleep disturbance resulting from symptoms or lavatory visits (each P < 0.05). Fewer balsalazide patients relapsed within 3 months (10% vs. 28%; P=0.0354). Remission at 12 months was 58%, in both groups. Similar proportions of patients reported adverse events (61% balsalazide vs. 65% mesalazine). There were five serious adverse events (two balsalazide, three mesalazine) and four withdrawals due to unacceptable adverse events (three balsalazide, one mesalazine), of which one in each group was also a serious adverse event. Balsalazide 3 g/day and mesalazine 1.2 g/ day effectively maintain UC remission and are equally well tolerated over 12 months. At this dose balsalazide prevents more relapses during the first 3 months of treatment and controls nocturnal symptoms more effectively.

  9. Lifetime and 12-month prevalence of eating disorders amongst women in mid-life: a population-based study of diagnoses and risk factors.

    Science.gov (United States)

    Micali, Nadia; Martini, Maria G; Thomas, Jennifer J; Eddy, Kamryn T; Kothari, Radha; Russell, Ellie; Bulik, Cynthia M; Treasure, Janet

    2017-01-17

    Eating disorders (EDs) are common amongst women; however, no research has specifically investigated the lifetime/12-month prevalence of eating disorders amongst women in mid-life (i.e., fourth and fifth decade of life) and the relevant longitudinal risk factors. We aimed to investigate the lifetime and 12-month prevalence of EDs and lifetime health service use and to identify childhood, parenting, and personality risk factors. This is a two-phase prevalence study, nested within an existing longitudinal community-based sample of women in mid-life. A total of 5658 women from the UK Avon Longitudinal Study of Parents and Children (ALSPAC; enrolled 20 years earlier) participated. ED diagnoses were obtained using validated structured interviews. Weighted analyses were carried out accounting for the two-phase methodology to obtain prevalence figures and to carry out risk factor regression analyses. By mid-life, 15.3% (95% confidence intervals, 13.5-17.4%) of women had met criteria for a lifetime ED. The 12-month prevalence of EDs was 3.6%. Childhood sexual abuse was prospectively associated with all binge/purge type disorders and an external locus of control was associated with binge-eating disorder. Better maternal care was protective for bulimia nervosa. Childhood life events and interpersonal sensitivity were associated with all EDs. By mid-life a significant proportion of women will experience an ED, and few women accessed healthcare. Active EDs are common in mid-life, both due to new onset and chronic disorders. Increased awareness of the full spectrum of EDs in this stage of life and adequate service provision is important. This is the first study to investigate childhood and personality risk factors for full threshold and sub-threshold EDs and to identify common predictors for full and sub-threshold EDs. Further research should clarify the role of preventable risk factors on both full and sub-threshold EDs.

  10. Lay health worker led intervention for depressive and anxiety disorders in India: impact on clinical and disability outcomes over 12 months.

    Science.gov (United States)

    Patel, Vikram; Weiss, Helen A; Chowdhary, Neerja; Naik, Smita; Pednekar, Sulochana; Chatterjee, Sudipto; Bhat, Bhargav; Araya, Ricardo; King, Michael; Simon, Gregory; Verdeli, Helena; Kirkwood, Betty R

    2011-12-01

    Depressive and anxiety disorders (common mental disorders) are the most common psychiatric condition encountered in primary healthcare. To test the effectiveness of an intervention led by lay health counsellors in primary care settings (the MANAS intervention) to improve the outcomes of people with common mental disorders. Twenty-four primary care facilities (12 public, 12 private) in Goa (India) were randomised to provide either collaborative stepped care or enhanced usual care to adults who screened positive for common mental disorders. Participants were assessed at 2, 6 and 12 months for presence of ICD-10 common mental disorders, the severity of symptoms of depression and anxiety, suicidal behaviour and disability levels. All analyses were intention to treat and carried out separately for private and public facilities and adjusted for the design. The trial has been registered with clinical trials.gov (NCT00446407). A total of 2796 participants were recruited. In public facilities, the intervention was consistently associated with strong beneficial effects over the 12 months on all outcomes. There was a 30% decrease in the prevalence of common mental disorders among those with baseline ICD-10 diagnoses (risk ratio (RR) = 0.70, 95% CI 0.53-0.92); and a similar effect among the subgroup of participants with depression (RR = 0.76, 95% CI 0.59-0.98). Suicide attempts/plans showed a 36% reduction over 12 months (RR=0.64, 95% CI0.42–0.98) among baseline ICD-10 cases. Strong effects were observed on days out of work and psychological morbidity, and modest effects on overall disability [corrected]. In contrast, there was little evidence of impact of the intervention on any outcome among participants attending private facilities. Trained lay counsellors working within a collaborative-care model can reduce prevalence of common mental disorders, suicidal behaviour, psychological morbidity and disability days among those attending public primary care facilities.

  11. Changes in mental and physical well-being among problematic alcohol and drug users in 12-month Internet-based intervention trials.

    Science.gov (United States)

    Berman, Anne H; Wennberg, Peter; Sinadinovic, Kristina

    2015-03-01

    Twelve-month well-being outcomes were investigated for 835 participants in 1 of 2 randomized controlled trials offering online assessment and brief intervention for either problematic alcohol (n = 633) or drug use (n = 202). The well-being of participants who had reduced their substance use to a less problematic level (regardless of intervention) over 12 months was compared with that of participants who had maintained or increased their use. At a 12-month follow-up, the 227 alcohol trial participants with reduced use showed better well-being in comparison to the 406 with stable or increased use, in physical health and sleep quality, as well as general well-being, ability to concentrate, lower stress, better social life satisfaction and sense of control, and a lower rate of depressed mood. Among the 70 drug trial participants who had reduced their drug use over 12 months, 80% had ceased all drug use, and at follow-up they had fewer alcohol-related problems than the stable group. No differences in well-being between these groups were identified. Self-reported access to additional treatment modalities beyond the trial interventions (e.g., speaking to someone about problematic use and accessing additional Internet-based interventions) was higher among participants in both cohorts with reduced substance use in comparison to those with stable/increased use. Drug users who reduced their use accessed prescribed medication to a larger extent than those whose use remained stable or increased. Points to consider when conducting future research on well-being and problematic substance use are discussed. (c) 2015 APA, all rights reserved).

  12. Predictors of changes in physical, psychosocial, sexual quality of life, and comfort with food after obesity surgery: a 12-month follow-up study.

    Science.gov (United States)

    Brunault, Paul; Frammery, Julie; Couet, Charles; Delbachian, Irène; Bourbao-Tournois, Céline; Objois, Martine; Cosson, Patricia; Réveillère, Christian; Ballon, Nicolas

    2015-02-01

    Although obesity surgery provides significant postoperative improvement in quality of life (QoL), it is still unclear which factors might predict improvement in QoL after surgery. We aimed to determine which factors might predict changes in physical, psychosocial, sexual QoL, and comfort with food 12 months after surgery, by putting to the test a QoL model based on Wilson and Cleary's model. We included 126 obese patients (48.4% had gastric banding, 34.1% had sleeve gastrectomy, and 17.5% had gastric bypass). At baseline, we assessed QoL (Quality of Life, Obesity and Dietetics rating scale), BMI, depression (Beck Depression Inventory), and binge eating (Bulimic Investigatory Test, Edinburgh). At 12 months, we assessed QoL and BMI. To determine the predictors for changes in each QoL dimension after surgery, we used linear mixed models adjusted for preoperative age, BMI, time, type of surgery, preoperative binge eating severity, and preoperative depression severity. After 12 months, we found significant improvement in physical, psychosocial, sexual QoL, but not in comfort with food. Increased weight loss was associated with better improvement in physical and psychosocial QoL. Higher preoperative depression severity predicted poorer improvement in physical, psychosocial, and sexual QoL. Higher preoperative binge eating severity predicted poorer improvement in psychosocial, sexual QoL, and comfort with food. In addition to weight loss, preoperative levels of binge eating and depression should be considered as important predictors for QoL changes after bariatric surgery. Screening and treatment for preoperative depression and binge eating might improve QoL after bariatric surgery.

  13. Possible clinical effects of molecular hydrogen (H2 delivery during hemodialysis in chronic dialysis patients: Interim analysis in a 12 month observation.

    Directory of Open Access Journals (Sweden)

    Masaaki Nakayama

    Full Text Available It is supposed that enhanced oxidative stress and inflammation are involved with the poor clinical outcomes in patients on chronic dialysis treatment. Recent studies have shown that molecular hydrogen (H2 is biologically active as an anti-inflammatory agent. Thus, we developed a novel hemodialysis (E-HD system which delivers H2 (30 to 80 ppb-enriched dialysis solution, to conduct a prospective observational study (UMIN000004857 in order to compare the long-term outcomes between E-HD and conventional-HD (C-HD in Japan. The present interim analysis aimed to look at potential clinical effects of E-HD during the first 12 months observation.262 patients (140, E-HD; 122, C-HD were subjected for analysis for comprehensive clinical profiles. They were all participating in the above mentioned study, and they had been under the respective HD treatment for 12 consecutive months without hospitalization. Collected data, such as, physical and laboratory examinations, medications, and self-assessment questionnaires on subjective symptoms (i.e., fatigue and pruritus were compared between the two groups.In a 12-month period, no clinical relevant differences were found in dialysis-related parameters between the two groups. However, there were differences in the defined daily dose of anti-hypertensive agents, and subjective symptoms, such as severe fatigue, and pruritus, which were all less in the E-HD group. Multivariate analysis revealed E-HD was an independent significant factor for the reduced use of anti-hypertensive agents as well as the absence of severe fatigue and pruritus at 12 months after adjusting for confounding factors.The data indicates E-HD could have substantial clinical benefits beyond conventional HD therapy, and support the rationale to conduct clinical trials of H2 application to HD treatment.

  14. Periapical radiography and cone beam computed tomography for assessment of the periapical bone defect 1 week and 12 months after root-end resection.

    Science.gov (United States)

    Christiansen, R; Kirkevang, L-L; Gotfredsen, E; Wenzel, A

    2009-12-01

    Our aim was to compare periapical radiography and cone beam CT (CBCT) for assessment of the periapical bone defect 1 week and 12 months after root-end resection. 50 patients (58 teeth) with a persisting apical periodontitis in a root-filled tooth (incisor, canine or premolar) were treated with root-end resection. 1 week and 12 months post-operatively, a CBCT scan (NewTom 3G) and a periapical radiograph (Digora) were obtained. Three observers detected and measured the periapical bone defects on periapical radiographs and CBCT images (coronal and sagittal sections). 1 week post-operatively, a periapical bone defect area was measured in all teeth by all observers. The defect was 10% smaller on periapical radiographs (mean = 12.4 mm2, SD = 8.2) than on the CBCT images measured in the coronal plane (mean = 13.0 mm2, SD = 7.8), a difference which was not statistically significant (P = 0.58). 12 months post-operatively (n = 52), there was considerable variation between the observers' detection of a remaining defect on the periapical radiographs and the CBCT images. The average agreement between the periapical radiograph and the CBCT images in the coronal sections was 67%, and more defects were detected on CBCT than on periapical radiographs. On average, the periapical bone defect measured on periapical radiographs was approximately 10% smaller than on coronally sectioned CBCT images 1 week post-operatively. More remaining defects were detected 1 year after periapical surgery on CBCT images than on periapical radiographs, but it is uncertain how this information is related to success or failure after root-end resection.

  15. Supervised training and home-based rehabilitation in patients with stabilized ankylosing spondylitis on TNF inhibitor treatment: a controlled clinical trial with a 12-month follow-up.

    Science.gov (United States)

    Masiero, Stefano; Poli, Patrizia; Bonaldo, Lara; Pigatto, Maurizia; Ramonda, Roberta; Lubrano, Ennio; Punzi, Leonardo; Maffulli, Nicola

    2014-06-01

    To assess the 12-month's follow-up effects on pain, mobility, and physical function outcomes of a supervised training and home-based rehabilitation for ankylosing spondylitis patients stabilized with TNF-inhibitor therapy. Controlled clinical trial (sequentially determined allocation) with 12-months' follow-up. Patients' homes. A total of 69 subjects were allocated to either a rehabilitation programme (rehabilitation group, n = 22), an educational-behavioural programme (educational group, n = 24), and to neither programme (control group, n = 23). Rehabilitation programme included supervised training and home exercises (stretching, strengthening, aerobic, chest, and spine/hip joint flexibility exercises); educational-behavioural programme included information on ankylosing spondylitis, pain and stress mechanisms, and control. Spinal pain intensity, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index, chest expansion, and cervical and lumbar spine active range of motion measured by a pocket goniometer. At baseline, the three groups exhibited comparable demographic characteristics and basal evaluations. Intra-group changes in the rehabilitation group from baseline to 12 months yielded statistically significant gains (p Ankylosing Spondylitis Disease Activity Index (p = 0.012 and p = 0.050), and in some goniometric measurements as cervical rotation (p = 0.007 and p = 0.014), toraco-lumbar rotation (p = 0.009 and p = 0.050), and total cervical movements (p = 0.009 and p = 0.001). In comparison with the educational-behavioural programme or no intervention, supervised training and home exercises improved long-term outcome in patients with ankylosing spondylitis. © The Author(s) 2013.

  16. 12-Month safety and effectiveness of once-daily hydrocodone tablets formulated with abuse-deterrent properties in patients with moderate to severe chronic pain.

    Science.gov (United States)

    Wen, Warren; Taber, Louise; Lynch, Shau Yu; He, Ellie; Ripa, Steven

    2015-01-01

    To characterize the long-term safety and effectiveness of Hysingla™ ER, single-entity, once-daily, extended-release hydrocodone bitartrate tablets formulated with abuse-deterrent properties (HYD), offering a new treatment option for appropriate patients with chronic pain. An open-label study with a dose-titration period (up to 45 days) and a maintenance period (12 months). A total of 922 patients with chronic nonmalignant and non-neuropathic moderate to severe pain received open-label HYD tablets 20-120 mg; 728 of these achieved a stabilized dose of HYD at the end of dose-titration and entered the maintenance period. The safety profile was similar to that of other oral opioid analgesics, without new or unexpected safety concerns. The most frequent treatment-emergent adverse events (AEs; ≥ 5 percent) were those commonly associated with the use of systemic µ-opioid analgesics, including nausea, constipation, vomiting, fatigue, dizziness, somnolence, and headache. There were 77 (8 percent) patients with a total of 109 nonfatal treatment-emergent serious AEs. Few patients discontinued due to lack of therapeutic effect overall (6 percent), especially during the 12-month maintenance period (4 percent). Pain relief, sleep, functional health, and activities of daily living all improved at the end of the dose-titration period with HYD. These improvements were maintained through the 12-month maintenance period with stable HYD doses and without increase in concomitant supplemental analgesic medications. This long-term study demonstrated the safety and long-term maintenance of analgesic effect of HYD without continued need for dose increase.

  17. Effect of 12 months of recombinant human growth hormone replacement therapy on insulin sensitivity in GH-deficient adults as determined by different methods.

    Directory of Open Access Journals (Sweden)

    Micic D

    2002-10-01

    Full Text Available BACKGROUND: Controversial results have been obtained in measuring insulin sensitivity (S(I during recombinant human growth hormone (rhGH treatment in adult growth hormone deficient (GH-deficient patients. AIMS: The aim of our study was to estimate S(I before and during treatment using three different methods for quantifying insulin sensitivity in GH-deficient adults treated with rhGH. SETTINGS AND DESIGN: Twenty-one GH-deficient adults were treated with rhGH during 12 months. S(I was estimated using Minimal model analysis, Homeostatic Model of Assessment (HOMA and Quantitative Insulin Sensitivity Check Index (QUICKI before and after 3, 6, 9 and 12 months of rhGH therapy. MATERIAL AND METHODS: Oral Glucose Tolerance Test (OGTT and Frequently Sampled Intravenous Glucose Tolerance Test (FSIGT were performed in each patient at respective time intervals. QUICKI and HOMA were calculated using basal values of glucose and insulin from FSIGT. Minimal model computer analysis was calculated from glucose and insulin data obtained during FSIGT. STATISTICAL ANALYSIS: Area under the curve for glucose, insulin and C-peptide were calculated using trapezoidal rule from OGTT data. Differences and correlations were tested using ANOVA for repeated measures, Wilcoxon′s matched-paired test, paired t-test, Pearson′s correlation and Bland Altman plot. RESULTS: There were no significant changes in S(I using Minimal model analysis and QUICKI during rhGH treatment. On the contrary, HOMA analysis indicated significant deterioration in S(I after 12 months of therapy. CONCLUSION: Our study did not demonstrate any changes in S(I using Minimal model and QUICKI analysis, while there was significant increase in insulin resistance using HOMA model. We suggest that the choice of method for the determination of S(I may influence the interpretation of results concerning the effect of rhGH therapy on S(I in GH-deficient adults.

  18. The impact of prenatal exposure to air pollution on childhood wheezing and asthma: A systematic review.

    Science.gov (United States)

    Hehua, Zhang; Qing, Chang; Shanyan, Gao; Qijun, Wu; Yuhong, Zhao

    2017-11-01

    There has been no clear consensus about whether prenatal exposure to air pollution contributes to the development of wheezing and asthma in children. We conducted a systematic review to analyze the association between exposure to different pollutants during pregnancy and the development of childhood wheezing and asthma. We systematically reviewed epidemiological studies published through June 6, 2017 available in the MEDLINE and Web of Science databases. We included studies that examined the association between prenatal exposure to any air pollutants except tobacco smoke and the incidence or prevalence of "wheezing" or "asthma" from birth to 14 years of age. We extracted key characteristics of each included study using a template of predefined data items. We used the Critical Appraisal Skills Programme checklists to assess the validity of each included study. We conducted overall and subgroup meta-analyses for each summary exposure-outcome association. Pooled odds ratios (OR) with 95% confidence intervals (CI) were estimated by using a random effects model. Eighteen studies met our eligibility criteria. There was notable variability in exposure assessment methods. The overall random effects risk estimates (95% CI) of different pollutants were 1.04 (0.94-1.15) aromatic hydrocarbons (PAH), 1.04 (1.01-1.07) NO 2 , 1.4 (0.97-2.03) PM 2.5 for childhood wheeze and 1.07 (1.01-1.14) NO 2 , 1 (0.97-1.03) PM 2.5 , 1.02 (0.98-1.07) SO 2 , 1.08 (1.05-1.12) PM 10 for childhood asthma. Minimal heterogeneity was seen for PAH and SO 2 , while some heterogeneity was observed for PM 10 , PM 2.5 and NO 2 . The overall and subgroup risk estimates from the meta-analyses showed statistically significant associations between prenatal exposures to NO 2 , SO 2 , and PM 10 and the risk of wheezing and asthma development in childhood. There is insufficient evidence to show an effect of prenatal exposure to BC, CO, and O 3 on childhood wheezing and asthma. Further studies are needed to

  19. Development of Category Formation for Faces Differing by Age in 9- to 12-month-olds: An Effect of Experience with Infant Faces

    OpenAIRE

    Damon, Fabrice; Quinn, Paul C.; Heron-Delaney, Michelle; Lee, Kang; Pascalis, Olivier

    2016-01-01

    We examined category formation for faces differing in age in 9- and 12-month-olds, and the influence of exposure to infant faces on such ability. Infants were familiarized with adult or infant faces, and then tested with a novel exemplar from the familiarized category paired with a novel exemplar from a novel category (Experiment 1). Both age groups formed discrete categories of adult and infant faces, but exposure to infant faces in everyday life did not modulate performance. The same task w...

  20. Post-trauma ratings of pre-collision pain and psychological distress predict poor outcome following acute whiplash trauma: A 12-month follow-up study

    DEFF Research Database (Denmark)

    Carstensen, Tina; Frostholm, Lisbeth; Ørnbøl, Eva

    2008-01-01

    emergency departments or primary care after car accidents in four counties in Denmark. After the collision patients received a questionnaire on psychological distress, unspecified pain and socio-demographics and 12 months later a follow-up on work capability and neck pain was performed. Risk factors were...... of accident were not associated with poor outcome. In conclusion unspecified as opposed to specified pain (neck pain) before the collision is associated with poor recovery and high accumulation of pre-collision psychological distress is associated with considerable neck pain at follow-up. However...

  1. Lethal pneumatosis coli in a 12-month-old child caused by acute intestinal gas gangrene after prolonged artificial nutrition: a case report.

    Science.gov (United States)

    Kircher, Stefan; Wössner, Rupert; Müller-Hermelink, Hans-Konrad; Völker, Hans-Ullrich

    2008-07-24

    Pneumatosis coli is a rare disease with heterogeneous symptoms which can be detected in the course of various acute and chronic intestinal diseases in children, such as necrotizing enterocolitis, intestinal obstruction and intestinal bacteriological infections. We report the case of a 12-month-old boy who died of pneumatosis coli caused by an acute intestinal gas gangrene after prolonged artificial alimentation. While intestinal gas gangrene is a highly uncommon cause of pneumatosis coli, it is important to consider it as a differential diagnosis, especially in patients receiving a prolonged artificial food supply. These patients may develop intestinal gas gangrene due to a dysfunctional intestinal barrier.

  2. Your Baby's Growth: 12 Months

    Science.gov (United States)

    ... concerned your baby has slowed growth or a drop in weight, the doctor may ask these questions: Has your ... Crawling, cruising, and walking will burn calories, so weight gain might not be as ... the spoon on the floor than eating? The world is a fascinating place, ...

  3. Developmental milestones record - 12 months

    Science.gov (United States)

    ... and may cling to parents May make brief journeys away from parents to explore in familiar settings ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

  4. PREVIOUS SECOND TRIMESTER ABORTION

    African Journals Online (AJOL)

    PNLC

    PREVIOUS SECOND TRIMESTER ABORTION: A risk factor for third trimester uterine rupture in three ... for accurate diagnosis of uterine rupture. KEY WORDS: Induced second trimester abortion - Previous uterine surgery - Uterine rupture. ..... scarred uterus during second trimester misoprostol- induced labour for a missed ...

  5. Lung Function in Wheezing Infants after Acute Lower Respiratory Tract Infection and Its Association with Respiratory Outcome

    Directory of Open Access Journals (Sweden)

    Yuan-Yuan Qi

    2017-01-01

    Conclusions: Impaired lung function was present in wheezing infants with ALRTI and the deficits persisted. In addition, the lower level of TPTEF/TE and VPTEF/VE was a risk factor for poor respiratory outcome.

  6. Effects of a 17q21 chromosome gene variant, tobacco smoke and furred pets on infant wheeze

    DEFF Research Database (Denmark)

    Bräuner, E V; Loft, S; Raaschou-Nielsen, O

    2012-01-01

    investigated associations between the rs7216389 polymorphism in the 17q21 locus affecting ORMDL3 expression and the risk for recurrent wheeze and interactions with exposure to tobacco smoke and furred pets during pregnancy and infancy using a birth cohort of 101¿042 infants. Rs7216389 was significantly...... association between pets and wheeze among homozygous wild-type carriers and a negative association among homozygous variant allele carriers. There was no interaction between rs7216389 and tobacco smoke exposure....

  7. Maternal prepregnancy obesity is an independent risk factor for frequent wheezing in infants by age 14 months.

    Science.gov (United States)

    Guerra, Stefano; Sartini, Claudio; Mendez, Michelle; Morales, Eva; Guxens, Mònica; Basterrechea, Mikel; Arranz, Leonor; Sunyer, Jordi

    2013-01-01

    Maternal prepregnancy obesity has been linked to the offspring's risk for subsequent asthma. We determined whether maternal obesity is associated with increased risk of wheezing phenotypes early in life. We used data on 1107 mother-child pairs from two birth cohorts from the INMA-INfancia y Medio Ambiente project. Maternal height was measured and prepregnancy weight self-reported at enrolment (on average at 13.7 ± 2 weeks of gestation). Maternal prepregnancy body mass index was categorised as underweight, normal, overweight and obese according to WHO recommendations. Information on child's wheezing was obtained through questionnaires up to the age of 14 (± 1) months. Wheezing was classified as infrequent (<4 reported wheezing episodes) or frequent (≥ 4 episodes). Weight and length of infants were measured by trained study staff at 14.6 (± 1) months of age and weight-for-length z-scores computed. Although maternal obesity did not increase the risk of the child to have any or infrequent wheezing, children of obese mothers were more likely to have frequent wheezing than children of normal-weight mothers (11.8% vs. 3.8%; P = 0.002). In fully adjusted multinomial logistic regression models, including infants' weight-for-length z-scores and other covariates, maternal prepregnancy obesity was associated with increased risk of frequent [adjusted relative risk (RR) 4.18, 95% confidence interval (CI) 1.55, 11.3] but not infrequent (RR 1.05 [95% CI 0.55, 2.01]) wheezing in their children. Maternal prepregnancy obesity is independently associated with an increased risk of frequent wheezing in the infant by the age of 14 months. These findings add evidence on the potential effects of in utero exposures on asthma-related phenotypes. © 2012 Blackwell Publishing Ltd.

  8. Associations of Pet Ownership with Wheezing and Lung Function in Childhood: Findings from a UK Birth Cohort.

    Science.gov (United States)

    Collin, Simon M; Granell, Raquel; Westgarth, Carri; Murray, Jane; Paul, Elizabeth S; Sterne, Jonathan A C; Henderson, A John

    2015-01-01

    Asthma is a heterogeneous condition and differential effects of pet ownership on non-atopic versus atopic asthma have been reported. The aim of this study was to investigate whether pet ownership during pregnancy and early childhood was associated with wheezing from birth to age 7 years and with lung function at age 8 years in a UK population-based birth cohort. Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) were used to investigate associations of pet ownership at six time-points from pregnancy to age 7 years with concurrent episodes of wheezing, wheezing trajectories (phenotypes) and lung function at age 8 years using logistic regression models adjusted for child's sex, maternal history of asthma/atopy, maternal smoking during pregnancy, and family adversity. 4,706 children had complete data on pet ownership and wheezing. From birth to age 7 years, cat ownership was associated with an overall 6% lower odds of wheezing (OR=0.94 (0.89-0.99)). Rabbit and rodent ownership was associated with 21% (OR=1.21 (1.12-1.31)) and 11% (OR=1.11 (1.02-1.21)) higher odds of wheezing, respectively, with strongest effects evident during infancy. Rabbit and rodent ownership was positively associated with a 'persistent wheeze' phenotype. Pet ownership was not associated with lung function at age 8 years, with the exception of positive associations of rodent and bird ownership with better lung function. Cat ownership was associated with reduced risk, and rabbit and rodent ownership with increased risk, of wheezing during childhood. The mechanisms behind these differential effects warrant further investigation.

  9. Associations of Pet Ownership with Wheezing and Lung Function in Childhood: Findings from a UK Birth Cohort.

    Directory of Open Access Journals (Sweden)

    Simon M Collin

    Full Text Available Asthma is a heterogeneous condition and differential effects of pet ownership on non-atopic versus atopic asthma have been reported. The aim of this study was to investigate whether pet ownership during pregnancy and early childhood was associated with wheezing from birth to age 7 years and with lung function at age 8 years in a UK population-based birth cohort.Data from the Avon Longitudinal Study of Parents and Children (ALSPAC were used to investigate associations of pet ownership at six time-points from pregnancy to age 7 years with concurrent episodes of wheezing, wheezing trajectories (phenotypes and lung function at age 8 years using logistic regression models adjusted for child's sex, maternal history of asthma/atopy, maternal smoking during pregnancy, and family adversity.4,706 children had complete data on pet ownership and wheezing. From birth to age 7 years, cat ownership was associated with an overall 6% lower odds of wheezing (OR=0.94 (0.89-0.99. Rabbit and rodent ownership was associated with 21% (OR=1.21 (1.12-1.31 and 11% (OR=1.11 (1.02-1.21 higher odds of wheezing, respectively, with strongest effects evident during infancy. Rabbit and rodent ownership was positively associated with a 'persistent wheeze' phenotype. Pet ownership was not associated with lung function at age 8 years, with the exception of positive associations of rodent and bird ownership with better lung function.Cat ownership was associated with reduced risk, and rabbit and rodent ownership with increased risk, of wheezing during childhood. The mechanisms behind these differential effects warrant further investigation.

  10. Rural to urban migration is associated with increased prevalence of childhood wheeze in a Latin-American city.

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    Rodriguez, Alejandro; Vaca, Maritza G; Chico, Martha E; Rodrigues, Laura C; Barreto, Mauricio L; Cooper, Philip J

    2017-01-01

    The urbanisation process has been associated with increases in asthma prevalence in urban and rural areas of low-income and middle-income countries (LMICs). However, although rural to urban migration and migration between cities are considered important determinants of this process, few studies have evaluated the effects of internal migration on asthma in urban populations of LMICs. The present study evaluated the effects of internal migration on the prevalence of wheeze in an urban area of Latin America. We did a cross-sectional analysis of 2510 schoolchildren living in the city of Esmeraldas, Ecuador. Logistic regression was used to analyse associations between childhood wheeze and different aspects of migration among schoolchildren. 31% of schoolchildren were migrants. Rural to urban migrants had a higher prevalence of wheeze, (adj.OR=2.01,95% CI1.30 to 3.01, p=0.001) compared with non-migrants. Age of migration and time since migration were associated with wheeze only for rural to urban migrants but not for urban to urban migrants. Children who had migrated after 3 years of age had a greater risk of wheeze (OR 2.51, 95% CI 1.56 to 3.97, p=0.001) than non-migrants while migrants with less than 5 years living in the new residence had a higher prevalence of wheeze than non-migrants (migration is associated with an increase in the prevalence of wheeze among schoolchildren living in a Latin-American city. Age of migration and time since migration were important determinants of wheeze only among migrants from rural areas. A better understanding of the social and environmental effects of internal migration could improve our understanding of the causes of the increase in asthma and differences in prevalence between urban and rural populations.

  11. Early wheezing phenotypes and cognitive development of 3-yr-olds. Community-recruited birth cohort study.

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    Jedrychowski, Wieslaw; Perera, Frederica P; Jankowski, Jeffery; Maugeri, Umberto; Mrozek-Budzyn, Dorota; Mroz, Elzbieta; Flak, Elzbieta; Skarupa, Anita; Edwards, Susan; Lisowska-Miszczyk, Ilona

    2010-05-01

    The main purpose of the study was to answer the question whether young children without clinical diagnosis of asthma but experiencing early wheezing disorders and therefore being at high risk of developing asthma may have cognitive deficits. In the ongoing birth cohort study wheezing symptoms were recorded postpartum over two first years of age and subsequently cognitive status of children at the age of 3 yr was assessed with the Bayley Mental Development Index (MDI). In the statistical analysis a wide range of modifying and confounding factors (maternal education, gender of children, prenatal exposure to lead and environmental tobacco smoke (ETS) were considered to assess the independent effect of early wheezing phenotypes on cognitive development of children. The MDI score correlated inversely with the number of wheezing days recorded over 24 months (r = -0.13, p = 0.007), lead cord blood concentration (r = -0.12, p = -0.02), number of siblings (r = -0.17, p = 0.0006) and the number of cigarettes smoked daily by other household members at home over the pregnancy period (r = -0.18, p = 0.0002). While the children who experienced wheezing over the first year of age showed deficit of 2 MDI scores (beta coeff. = -2.31, 95%CI: -4.63 to 0.02), those with persistent wheezing had the score deficit of 4 points (beta coeff. = -4.41, 95%CI: -8.27 to -0.55). To our knowledge, it is the first report in the iterature showing that early wheezing is associated the cognitive deficit in a community-recruited very young children. Observed cognitive deficit in early wheezers may be caused by RSV infections or can be related to lower lung function attributed to persistent wheezing, which reducing oxygen supply would affect rapidly developing brain.

  12. Persistence, adherence, and medication-taking behavior in women with postmenopausal osteoporosis receiving denosumab in routine practice in Germany, Austria, Greece, and Belgium: 12-month results from a European non-interventional study.

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    Hadji, P; Papaioannou, N; Gielen, E; Feudjo Tepie, M; Zhang, E; Frieling, I; Geusens, P; Makras, P; Resch, H; Möller, G; Kalouche-Khalil, L; Fahrleitner-Pammer, A

    2015-10-01

    Persistence with and adherence to osteoporosis therapy are critical for fracture reduction. This non-interventional study is evaluating medication-taking behavior of women with postmenopausal osteoporosis (PMO) receiving denosumab in Germany, Austria, Greece, and Belgium. Patients were representative of the PMO population and highly persistent with and adherent to denosumab at 12 months. Persistence with and adherence to osteoporosis therapy are important for optimal treatment efficacy, namely fracture reduction. This ongoing, non-interventional study will evaluate medication-taking behavior of women with postmenopausal osteoporosis (PMO) receiving denosumab in routine practice in four European countries. The study enrolled women who had been prescribed subcutaneous denosumab (60 mg every 6 months) in accordance with prescribing information and local guidelines. Persistence was defined as receiving the subsequent injection within 6 months + 8 weeks of the previous injection. Adherence was defined as receiving two consecutive injections within 6 months ± 4 weeks of each other. Medication coverage ratio (MCR) was calculated using the time a patient was covered with denosumab, as assessed from prescription records. Treatment was assigned prior to and independently of enrollment; outcomes are recorded during routine practice. These planned 12-month interim analyses included data from 1500 patients from 141 sites. Mean age was 66.4-72.4 years, mean baseline total hip T-scores ranged from -2.0 to -2.1 and femoral neck T-scores from -2.2 to -2.6, and 30.7-62.1% of patients had prior osteoporotic fracture. Persistence was 87.0-95.3%, adherence 82.7-89.3%, and MCR 91.3-95.4%. In a univariate analysis, increased age, decreased mobility, and increased distance to the clinic were associated with significantly decreased persistence; parental history of hip fracture was associated with significantly increased persistence. These data extend the real-world evidence regarding

  13. Annual cost of relapses and relapse-related hospitalizations in adults with schizophrenia: results from a 12-month, double-blind, comparative study of lurasidone vs quetiapine extended-release.

    Science.gov (United States)

    Rajagopalan, Krithika; O'Day, Ken; Meyer, Kellie; Pikalov, Andrei; Loebel, Antony

    2013-08-01

    To model the economic impact of annual relapses/relapse-related hospitalizations among adults with schizophrenia treated with lurasidone or quetiapine extended-release (XR). A probabilistic model estimating per-patient-per-year (PPPY) direct mental healthcare (MH) cost differences due to relapses/relapse-related hospitalizations was developed using relapse and relapse-related hospitalization rates from a 12-month, double-blind, parallel-group, global comparison study of lurasidone vs quetiapine XR (all patients previously treated with lurasidone or quetiapine XR for 6 weeks). Analyses were conducted for both all subjects and clinical responders. Direct costs associated with inpatient and outpatient mental healthcare-related services were obtained from a large, prospective, observational study of schizophrenia treatment in usual-care settings for relapsing and non-relapsing patients, including psychiatric hospitalizations, emergency services, medication management, and outpatient individual therapy. Model robustness was tested using univariate and probabilistic sensitivity analyses. Model-estimated PPPY MH cost savings associated with relapse-related hospitalization rates in all subjects were $3276 for lurasidone vs quetiapine XR. Lurasidone resulted in PPPY MH cost savings of $2702 vs quetiapine XR in all subjects, using relapse rates. Sensitivity analyses indicated lurasidone had lower 1-year MH costs than quetiapine XR in 100% and 99.7% of simulations, using relapse-related hospitalization rates and relapse rates, respectively, in all subjects. Similar results were seen in clinical responders. The model represents a simplification of treatment patterns and response to treatment. Cost of treatment with lurasidone and quetiapine XR was not included in the model. Estimates of cost savings are likely conservative, as the model did not assess the impact of long-term cardiometabolic consequences. Indirect costs associated with relapses and non-mental health

  14. Description of the motor development of 3-12 month old infants with Down syndrome: the influence of the postural body position.

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    Tudella, Eloisa; Pereira, Karina; Basso, Renata Pedrolongo; Savelsbergh, Geert J P

    2011-01-01

    The purpose of the present study was to describe the rate of motor development in infants with Down syndrome in the age range of 3-12 months and identify the difficulties both in performance and acquiring motor skills in prone, supine, sitting and standing positions. Nineteen infants with Down syndrome and 25 healthy full term typical infants were assessed using the Alberta Infant Motor Scale (AIMS) monthly from 3 to 12 months of age. The infants with Down syndrome achieved significant later the level of motor performance of the typical infants. In the supine posture, the performance was significantly lesser for the Down syndrome infants in comparison to the typical infants from the 3rd to 6th month and in the 8th month. In the prone, sitting and standing postures this difference is found for all the months. In conclusion, the sequence of motor development of the Down syndrome is the same as the typical infants. However infants with Down syndrome need more time to acquire skills, mainly antigravitational ones, among them the standing position. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. The early detection and management of unstable concentric closed reduction of DDH with percutaneous K-wire fixation in infants 6 to 12 months of age.

    Science.gov (United States)

    Alsiddiky, Abdul Monem Mohamed; Bakarman, Khalid Abdulla; Alzain, Kholoud Omar; Aljassir, Fawzi Fahad; Al-Ahaideb, Abdulaziz Suliman; Kremli, Mamoun Khalid; Zamzam, Mohammed Medhat; Mervyn Letts, Robert

    2012-01-01

    In some infants with developmental dysplasia of the hip, concentric closed reduction, although initially achievable, cannot be maintained even by casting because of a deficient posterior acetabular wall. Usually, these hips will redislocate in the cast and a rereduction will be necessary, often requiring an open reduction subsequently. A 3-year retrospective review of 88 infants, (M/F; 14/74) 6 to 12 months of age with 124 dislocated hips, was conducted to assess the efficacy of percutaneous Kirschner wire fixation in achieving permanent hip stability. A "hip-at-risk" instability test was developed to detect potentially unstable hips at the time of closed reduction that might redislocate in the hip spica cast, and these hips were stabilized with a percutaneous K-wire through the greater trochanter into the pelvic bone. The hip instability test was positive in 27 hips and negative in 97. Percutaneous K-wire fixation was used to stabilize 21 hips with a positive hip instability test. All 21 unstable hips that were stabilized with the K-wire technique maintained their concentric reduction and went on to stable development. No K-wire breakage was encountered and only 1 superficial pin tract infection occurred. K-wire stabilization of unstable closed reductions is a safe, reliable technique for maintaining concentric hip reduction in infants 6 to 12 months of age with developmental dislocation of the hips. Level II retrospective study.

  16. The Pattern of Fatty Acids Displaced by EPA and DHA Following 12 Months Supplementation Varies between Blood Cell and Plasma Fractions

    Directory of Open Access Journals (Sweden)

    Celia G. Walker

    2015-08-01

    Full Text Available Eicosapentaenoic acid (EPA and docosahexaenoic acid (DHA are increased in plasma lipids and blood cell membranes in response to supplementation. Whilst arachidonic acid (AA is correspondingly decreased, the effect on other fatty acids (FA is less well described and there may be site-specific differences. In response to 12 months EPA + DHA supplementation in doses equivalent to 0–4 portions of oily fish/week (1 portion: 3.27 g EPA+DHA multinomial regression analysis was used to identify important FA changes for plasma phosphatidylcholine (PC, cholesteryl ester (CE and triglyceride (TAG and for blood mononuclear cells (MNC, red blood cells (RBC and platelets (PLAT. Dose-dependent increases in EPA + DHA were matched by decreases in several n-6 polyunsaturated fatty acids (PUFA in PC, CE, RBC and PLAT, but were predominantly compensated for by oleic acid in TAG. Changes were observed for all FA classes in MNC. Consequently the n-6:n-3 PUFA ratio was reduced in a dose-dependent manner in all pools after 12 months (37%–64% of placebo in the four portions group. We conclude that the profile of the FA decreased in exchange for the increase in EPA + DHA following supplementation differs by FA pool with implications for understanding the impact of n-3 PUFA on blood lipid and blood cell biology.

  17. Predictors of outcome after 6 and 12 months following anthroposophic therapy for adult outpatients with chronic disease: a secondary analysis from a prospective observational study

    Directory of Open Access Journals (Sweden)

    Willich Stefan N

    2010-08-01

    Full Text Available Abstract Background Anthroposophic medicine is a physician-provided complementary therapy system involving counselling, artistic and physical therapies, and special medications. The purpose of this analysis was to identify predictors of symptom improvement in patients receiving anthroposophic treatment for chronic diseases. Methods 913 adult outpatients from Germany participated in a prospective cohort study. Patients were starting anthroposophic treatment for mental (30.4% of patients, n = 278/913, musculoskeletal (20.2%, neurological (7.6%, genitourinary (7.4% or respiratory disorders (7.2% or other chronic indications. Stepwise multiple linear regression analysis was performed with the improvement of Symptom Score (patients' assessment, 0: not present, 10: worst possible after 6 and 12 months as dependent variables. 61 independent variables pertaining to socio-demographics, life style, disease status, co-morbidity, health status (SF-36, depression, and therapy factors were analysed. Results Compared to baseline, Symptom Score improved by average 2.53 points (95% confidence interval 2.39-2.68, p Conclusion In adult outpatients receiving anthroposophic treatment for chronic diseases, symptom improvement after 6 and 12 months was predicted by baseline symptoms, health status, disease duration, education, and therapy goal. Other variables were not associated with the outcome. This secondary predictor analysis of data from a pre-post study does not allow for causal conclusions; the results are hypothesis generating and need verification in subsequent studies.

  18. Transobturator vaginal tape in comparison to tension-free vaginal tape: A prospective trial with a minimum 12 months follow-up

    Directory of Open Access Journals (Sweden)

    R B Nerli

    2009-01-01

    Full Text Available Background: The tension-free vaginal tape (TVT procedure is based on the integral theory that the midurethra has an important role in the continence mechanism. Transobturator vaginal tape (TOT is the same in concept as TVT but it differs from TVT in that, rather than passing through the retropubic space, sling materials are drawn through the obturator foramina. We prospectively compared TVT with TOT with respect to operation-related morbidity and surgical outcomes at a minimum follow up of 12 months. Materials and Methods: A total of 36 women with stress urinary incontinence (SUI were alternatively assigned to the TVT group (18 or the TOT group. Preoperative evaluation included urodynamic study and I-QOL questionnaire. One year after operation the surgical result, patient satisfaction, incontinence quality-of-life questionnaire, long-term complications, and uroflowmetry were evaluated in both groups. Results: The patient characteristics in both the TVT and TOT group were similar. Mean operating time was significantly shorter in the TOT group likened to the TVT group. Conclusions: Both the TVT and TOT procedures are minimally invasive and similar in operation-related morbidity. TOT appears to be as effective as TVT, and safer than TVT for the surgical treatment of SUI in women at 12 months follow-up.

  19. The effect of 12-month dehydroepiandrosterone supplementation on the menstrual pattern, ovarian reserve markers, and safety profile in women with premature ovarian insufficiency.

    Science.gov (United States)

    Wong, Queenie Ho Yan; Yeung, Tracy Wing Yee; Yung, Sofie Shuk Fei; Ko, Jennifer Ka Yee; Li, Hang Wun Raymond; Ng, Ernest Hung Yu

    2018-03-09

    To evaluate the effect of 12-month DHEA supplementation on menstrual pattern and ovarian reserve markers in women with premature ovarian insufficiency (POI) METHODS: This is a prospective observational study. Women with POI were given DHEA supplements (25 mg three times daily) for 12 months. Sonographic assessment for ovarian volume and antral follicle count (AFC) and serum measurement for anti-Mullerian hormone (AMH), follicle stimulating hormone (FSH), estradiol, testosterone, liver function, and hemoglobin level were performed at baseline and monthly for 13 months after the supplementation. Menstrual pattern, ovarian reserve markers, and side-effects were recorded. Between August 2011 and July 2014, 38 women with POI were recruited and 31 completed the study. The median age of women was 36 years, and the median baseline FSH and AMH concentrations were 82.2 IU/L and 0.01 ng/ml, respectively. No women had resumption of regular menstruation after DHEA supplementation. AMH, FSH, and AFC did not change significantly. No serious side effects were reported. Our results do not support any significant improvement in ovarian function by 12-month DHEA supplementation in women with POI.

  20. Self-reported moderate-to-vigorous leisure time physical activity predicts less pain and disability over 12 months in chronic and persistent low back pain.

    Science.gov (United States)

    Pinto, R Z; Ferreira, P H; Kongsted, A; Ferreira, M L; Maher, C G; Kent, P

    2014-09-01

    Physical deconditioning in combination with societal and emotional factors has been hypothesized to compromise complete recovery from low back pain (LBP). However, there is a lack of longitudinal studies designed to specifically investigate physical activity as an independent prognostic factor. We conducted a prognostic study to investigate whether levels of leisure time physical activity are independently associated with clinical outcomes in people seeking care for chronic and persistent LBP. A total of 815 consecutive patients presenting w