Tailored cognitive-behavioural therapy and exercise training improves the physical fitness of patients with fibromyalgia.

Science.gov (United States)

van Koulil, S; van Lankveld, W; Kraaimaat, F W; van Helmond, T; Vedder, A; van Hoorn, H; Donders, A R T; Wirken, L; Cats, H; van Riel, P L C M; Evers, A W M

2011-12-01

Patients with fibromyalgia have diminished levels of physical fitness, which may lead to functional disability and exacerbating complaints. Multidisciplinary treatment comprising cognitive-behavioural therapy (CBT) and exercise training has been shown to be effective in improving physical fitness. However, due to the high drop-out rates and large variability in patients' functioning, it was proposed that a tailored treatment approach might yield more promising treatment outcomes. High-risk fibromyalgia patients were randomly assigned to a waiting list control group (WLC) or a treatment condition (TC), with the treatment consisting of 16 twice-weekly sessions of CBT and exercise training tailored to the patient's cognitive-behavioural pattern. Physical fitness was assessed with two physical tests before and 3 months after treatment and at corresponding intervals in the WLC. Treatment effects were evaluated using linear mixed models. The level of physical fitness had improved significantly in the TC compared with the WLC. Attrition rates were low, effect sizes large and reliable change indices indicated a clinically relevant improvement among the TC. A tailored multidisciplinary treatment approach for fibromyalgia consisting of CBT and exercise training is well tolerated, yields clinically relevant changes, and appears a promising approach to improve patients' physical fitness. ClinicalTrials.gov ID NCT00268606.

Obstructive pulmonary disease in patients with previous tuberculosis ...

African Journals Online (AJOL)

Obstructive pulmonary disease in patients with previous tuberculosis: Pathophysiology of a community-based cohort. B.W. Allwood, R Gillespie, M Galperin-Aizenberg, M Bateman, H Olckers, L Taborda-Barata, G.L. Calligaro, Q Said-Hartley, R van Zyl-Smit, C.B. Cooper, E van Rikxoort, J Goldin, N Beyers, E.D. Bateman ...

Response to deep TMS in depressive patients with previous electroconvulsive treatment.

Science.gov (United States)

Rosenberg, Oded; Zangen, Abraham; Stryjer, Rafael; Kotler, Moshe; Dannon, Pinhas N

2010-10-01

The efficacy of transcranial magnetic stimulation (TMS) in the treatment of major depression has already been shown. Novel TMS coils allowing stimulation of deeper brain regions have recently been developed and studied. Our study is aimed at exploring the possible efficacy of deep TMS in patients with resistant depression, who previously underwent electroconvalsive therapy (ECT). Using Brainsway's deep TMS H1 coil, six patients who previously underwent ECT, were treated with 120% power of the motor threshold at a frequency of 20 Hz. Patients underwent five sessions per week, up to 4 weeks. Before the study, patients were evaluated using the Hamilton depression rating scale (HDRS, 24 items), the Hamilton anxiety scale, and the Beck depression inventory and were again evaluated after 5, 10, 15, and 20 daily treatments. Response to treatment was considered a reduction in the HDRS of at least 50%, and remission was considered a reduction of the HDRS-24 below 10 points. Two of six patients responded to the treatment with deep TMS, including one who achieved full remission. Our results suggest the possibility of a subpopulation of depressed patients who may benefit from deep TMS treatment, including patients who did not respond to ECT previously. However, the power of the study is small and similar larger samples are needed. Copyright © 2010 Elsevier Inc. All rights reserved.

Radioiodine treatment of recurrent hyperthyroidism in patients previously treated for Graves' disease by subtotal thyroidectomy

DEFF Research Database (Denmark)

Vestergaard, H; Laurberg, P

1992-01-01

showed a higher sensitivity to radioiodine, with more cases of early hypothyroidism, than non-operated patients. However, after 50 months of follow-up the outcome was identical. The results indicate that frequent assessment is necessary after radioiodine treatment of previously operated patients, since......Radioiodine therapy is often employed for treatment of patients with relapse of hyperthyroidism due to Graves' disease, after previous thyroid surgery. Little is known about the outcome of this treatment compared to patients with no previous surgery. A total of 20 patients who had received surgical...... treatment for Graves' hyperthyroidism 1-46 years previously and with relapse of the hyperthyroidism, and 25 patients with hyperthyroidism due to Graves' disease and no previous thyroid surgery were treated with radioiodine, following the same protocol. Early after treatment the previously operated patients...

The prevalence of previous self-harm amongst self-poisoning patients in Sri Lanka

DEFF Research Database (Denmark)

Mohamed, Fahim; Perera, Aravinda; Wijayaweera, Kusal

2011-01-01

BACKGROUND: One of the most important components of suicide prevention strategies is to target people who repeat self-harm as they are a high risk group. However, there is some evidence that the incidence of repeat self-harm is lower in Asia than in the West. The objective of this study...... was to investigate the prevalence of previous self-harm among a consecutive series of self-harm patients presenting to hospitals in rural Sri Lanka. METHOD: Six hundred and ninety-eight self-poisoning patients presenting to medical wards at two hospitals in Sri Lanka were interviewed about their previous episodes...... of self-harm. RESULTS: Sixty-one (8.7%, 95% CI 6.7-11%) patients reported at least one previous episode of self-harm [37 (10.7%) male, 24 (6.8%) female]; only 19 (2.7%, 95% CI 1.6-4.2%) patients had made more than one previous attempt. CONCLUSION: The low prevalence of previous self-harm is consistent...

Health-Related Fitness Improvements in Morbid Obese Patients After Laparoscopic Sleeve Gastrectomy: a Cohort Study.

Science.gov (United States)

Gallart-Aragón, Tania; Fernández-Lao, Carolina; Castro-Martín, Eduardo; Cantarero-Villanueva, Irene; Cózar-Ibáñez, Antonio; Arroyo-Morales, Manuel

2017-05-01

Laparoscopic sleeve gastrectomy (LSG) has demonstrated high long-term effectiveness and major advantages over other techniques. The objective of this study was to analyze changes in physical fitness parameters in morbidly obese patients during 6 months after LSG. We conducted a descriptive observational study with 6-month follow-up in 72 LSG patients, evaluating changes in body mass index (BMI), functional capacity (6-min walking test), hand grip strength (manual dynamometry), flexibility (fingertip-to-floor test), balance (Flamingo test), physical activity level (International Physical Activity Questionnaire, IPAQ), and perception of general physical fitness (International Fitness Scale [IFIS] questionnaire). The ANOVA revealed significant improvements in BMI, functional capacity, flexibility, balance, and physical activity level (P fitness in most cases. No significant changes were found in dominant hand (P = 0.676) or non-dominant hand (P = 0.222) dynamometry. General physical fitness was positively correlated with BMI and distance in the 6-min test, and was negatively correlated with fingertip-to-floor distance. Morbidly obese patients showed major improvements at 6 months after LSG in functional capacity, balance, mobility, and physical activity, with no change in grip strength. These improvements were related to a better self-perception of general physical fitness.

Respiratory mechanics by least squares fitting in mechanically ventilated patients: application on flow-limited COPD patients.

Science.gov (United States)

Volta, Carlo A; Marangoni, Elisabetta; Alvisi, Valentina; Capuzzo, Maurizia; Ragazzi, Riccardo; Pavanelli, Lina; Alvisi, Raffaele

2002-01-01

Although computerized methods of analyzing respiratory system mechanics such as the least squares fitting method have been used in various patient populations, no conclusive data are available in patients with chronic obstructive pulmonary disease (COPD), probably because they may develop expiratory flow limitation (EFL). This suggests that respiratory mechanics be determined only during inspiration. Eight-bed multidisciplinary ICU of a teaching hospital. Eight non-flow-limited postvascular surgery patients and eight flow-limited COPD patients. Patients were sedated, paralyzed for diagnostic purposes, and ventilated in volume control ventilation with constant inspiratory flow rate. Data on resistance, compliance, and dynamic intrinsic positive end-expiratory pressure (PEEPi,dyn) obtained by applying the least squares fitting method during inspiration, expiration, and the overall breathing cycle were compared with those obtained by the traditional method (constant flow, end-inspiratory occlusion method). Our results indicate that (a) the presence of EFL markedly decreases the precision of resistance and compliance values measured by the LSF method, (b) the determination of respiratory variables during inspiration allows the calculation of respiratory mechanics in flow limited COPD patients, and (c) the LSF method is able to detect the presence of PEEPi,dyn if only inspiratory data are used.

Hearing aid fitting for visual and hearing impaired patients with Usher syndrome type IIa.

Science.gov (United States)

Hartel, B P; Agterberg, M J H; Snik, A F; Kunst, H P M; van Opstal, A J; Bosman, A J; Pennings, R J E

2017-08-01

Usher syndrome is the leading cause of hereditary deaf-blindness. Most patients with Usher syndrome type IIa start using hearing aids from a young age. A serious complaint refers to interference between sound localisation abilities and adaptive sound processing (compression), as present in today's hearing aids. The aim of this study was to investigate the effect of advanced signal processing on binaural hearing, including sound localisation. In this prospective study, patients were fitted with hearing aids with a nonlinear (compression) and linear amplification programs. Data logging was used to objectively evaluate the use of either program. Performance was evaluated with a speech-in-noise test, a sound localisation test and two questionnaires focussing on self-reported benefit. Data logging confirmed that the reported use of hearing aids was high. The linear program was used significantly more often (average use: 77%) than the nonlinear program (average use: 17%). The results for speech intelligibility in noise and sound localisation did not show a significant difference between type of amplification. However, the self-reported outcomes showed higher scores on 'ease of communication' and overall benefit, and significant lower scores on disability for the new hearing aids when compared to their previous hearing aids with compression amplification. Patients with Usher syndrome type IIa prefer a linear amplification over nonlinear amplification when fitted with novel hearing aids. Apart from a significantly higher logged use, no difference in speech in noise and sound localisation was observed between linear and nonlinear amplification with the currently used tests. Further research is needed to evaluate the reasons behind the preference for the linear settings. © 2016 The Authors. Clinical Otolaryngology Published by John Wiley & Sons Ltd.

If the shoe fits: development of an on-line tool to aid practitioner/patient discussions about 'healthy footwear'.

Science.gov (United States)

Farndon, Lisa; Robinson, Victoria; Nicholls, Emily; Vernon, Wesley

2016-01-01

A previous study highlighted the importance of footwear to individuals' sense of their identity, demonstrating that shoes must 'fit' someone socially, as well as functionally. However, unhealthy shoes can have a detrimental effect on both foot health and mobility. This project utilises qualitative social science methods to enable podiatrists to understand the broader contribution of footwear to patients' sense of themselves and from this an online toolkit was developed to aid footwear education. Semi-structured interviews were conducted with six podiatrists/shoe-fitters and 13 people with foot pathologies, some of whom also completed shoe diaries. These were supplemented with some follow-up interviews and photographs of participants' own shoes were taken to allow in-depth discussions. Four areas related to 'fit' were identified; practicalities, personal, purpose and pressures, all of which need to be considered when discussing changes in footwear. These were incorporated into an online toolkit which was further validated by service users and practitioners in a focus group. This toolkit can support podiatrists in partnership with patients to identify and address possible barriers to changing footwear towards a more suitable shoe. Enabling patients to make healthier shoe choices will help contribute to improvements in their foot health and mobility.

A randomized clinical trial comparing fitness and biofeedback training versus basic treatment in patients with fibromyalgia

NARCIS (Netherlands)

van Santen, Marijke; Bolwijn, Paulien; Verstappen, Frans; Bakker, Carla; Hidding, Alita; Houben, Harry; van der Heijde, Desiree; Landewé, Robert; van der Linden, Sjef

2002-01-01

To compare the therapeutic effects of physical fitness training or biofeedback training with the results of usual care in patients with fibromyalgia (FM). One hundred forty-three female patients with FM (American College of Rheumatology criteria) were randomized into 3 groups: a fitness program (n =

DiaFit: The Development of a Smart App for Patients with Type 2 Diabetes and Obesity.

Science.gov (United States)

Modave, François; Bian, Jiang; Rosenberg, Eric; Mendoza, Tonatiuh; Liang, Zhan; Bhosale, Ravi; Maeztu, Carlos; Rodriguez, Camila; Cardel, Michelle I

2016-01-01

Optimal management of chronic diseases, such as type 2 diabetes (T2D) and obesity, requires patient-provider communication and proactive self-management from the patient. Mobile apps could be an effective strategy for improving patient-provider communication and provide resources for self-management to patients themselves. The objective of this paper is to describe the development of a mobile tool for patients with T2D and obesity that utilizes an integrative approach to facilitate patient-centered app development, with patient and physician interfaces. Our implementation strategy focused on the building of a multidisciplinary team to create a user-friendly and evidence-based app, to be used by patients in a home setting or at the point-of-care. We present the iterative design, development, and testing of DiaFit, an app designed to improve the self-management of T2D and obesity, using an adapted Agile approach to software implementation. The production team consisted of experts in mobile health, nutrition sciences, and obesity; software engineers; and clinicians. Additionally, the team included citizen scientists and clinicians who acted as the de facto software clients for DiaFit and therefore interacted with the production team throughout the entire app creation, from design to testing. DiaFit (version 1.0) is an open-source, inclusive iOS app that incorporates nutrition data, physical activity data, and medication and glucose values, as well as patient-reported outcomes. DiaFit supports the uploading of data from sensory devices via Bluetooth for physical activity (iOS step counts, FitBit, Apple watch) and glucose monitoring (iHealth glucose meter). The app provides summary statistics and graphics for step counts, dietary information, and glucose values that can be used by patients and their providers to make informed health decisions. The DiaFit iOS app was developed in Swift (version 2.2) with a Web back-end deployed on the Health Insurance Portability and

Automatic lung lobe segmentation of COPD patients using iterative B-spline fitting

Science.gov (United States)

Shamonin, D. P.; Staring, M.; Bakker, M. E.; Xiao, C.; Stolk, J.; Reiber, J. H. C.; Stoel, B. C.

2012-02-01

We present an automatic lung lobe segmentation algorithm for COPD patients. The method enhances fissures, removes unlikely fissure candidates, after which a B-spline is fitted iteratively through the remaining candidate objects. The iterative fitting approach circumvents the need to classify each object as being part of the fissure or being noise, and allows the fissure to be detected in multiple disconnected parts. This property is beneficial for good performance in patient data, containing incomplete and disease-affected fissures. The proposed algorithm is tested on 22 COPD patients, resulting in accurate lobe-based densitometry, and a median overlap of the fissure (defined 3 voxels wide) with an expert ground truth of 0.65, 0.54 and 0.44 for the three main fissures. This compares to complete lobe overlaps of 0.99, 0.98, 0.98, 0.97 and 0.87 for the five main lobes, showing promise for lobe segmentation on data of patients with moderate to severe COPD.

Nintendo Wii Fit for balance rehabilitation in patients with Parkinson's disease: A comparative study.

Science.gov (United States)

Negrini, Stefano; Bissolotti, Luciano; Ferraris, Alessandro; Noro, Fulvia; Bishop, Mark D; Villafañe, Jorge Hugo

2017-01-01

Impaired postural stability places individuals with Parkinson's disease (PD) at an increased risk for falls. We evaluated the effectiveness of 10 vs. 15 sessions of Nintendo Wii Fit for balance recovery for outpatients PD. Twenty-seven patients, 48.1% female (66 ± 8 years), with PD. Patients with PD were consecutively assigned to one of two groups receiving either 10 or 15 sessions (low dose or high dose group, respectively) with Nintendo Wii Fit in recovering balancing ability. All outcome measures were collected at baseline, immediately following the intervention period, and 1-month following the end of the intervention. Falls risk test (FRT), Stability index (PST), Berg balance scale (BBS) and Tinetti scale. The patients undergoing the 10 sessions demonstrated significantly improvement on the balance performances (Tinetti balance and gait scales, BBS and BSF) (all, P Wii Fit, but no significant group effect or group-by-time interaction was detected for any of them, which suggests that both groups improved in the same way. The results suggest that functional improvement can be made in fewer visits during outpatient rehabilitation sessions with Nintendo Wii Fit improving the efficiency of intervention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Profile of obinutuzumab for the treatment of patients with previously untreated chronic lymphocytic leukemia

Directory of Open Access Journals (Sweden)

Hill BT

2015-08-01

Full Text Available Brian T Hill, Matt Kalaycio Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA Abstract: Chronic lymphocytic leukemia (CLL is a hematologic malignancy derived from a clonal population of mature B-lymphocytes characterized by relatively low CD20 antigen expression. Although the disease often takes an indolent course, the majority of patients will eventually require therapy. Standard treatment for medically fit patients includes purine analogs and/or alkylating agents in addition to the type I anti-CD20 monoclonal antibody, rituximab. This therapy is inherently myelosuppressive and can result in significant morbidity and even mortality in patients with impaired performance status due to age and/or medical comorbidities. Historically, treatment options for the elderly or frail patient population were limited to monotherapy with the oral alkylating agent, chlorambucil, rituximab, or another type I anti-CD20 monoclonal antibody ofatumumab. Recently, a newer-generation anti-CD20 monoclonal antibody, obinutuzumab, was developed for patients with CLL. Obinutuzumab is a humanized type II monoclonal antibody that appears to have more direct antibody-dependent cell-mediated cytotoxicity (ADCC and possibly more direct cytotoxicity in vitro than previously available type I antibodies. A large Phase III prospective randomized clinical trial for older patients with impaired renal function and/or significant medical comorbidities demonstrated that when compared to conventionally-dosed rituximab and chlorambucil, the combination of chlorambucil and obinutuzumab administered at a dose and schedule involving early loading doses improved response rates and progression-free survival without significantly increasing toxicity. Results of this pivotal trial led to the FDA (US Food and Drug Administration approval of obinutuzumab in combination with chlorambucil for frontline treatment of CLL. Obinutuzumab

The Effects of Aquatic Exercises on Physical Fitness and Muscle Function in Dialysis Patients

Directory of Open Access Journals (Sweden)

Wioletta Dziubek

2015-01-01

Full Text Available Purpose. The aim of this study was to assess the impact of a 3-month physical training program, conducted in an aquatic environment with end-stage renal disease patients (ESRD, on the physical fitness and functional parameters of the knee joint muscles. Patients and Methods. The study included 20 ESDR patients with mean age 64.2±13.1 y. treated with hemodialysis in Dialysis Center of the University Hospital in Wroclaw. Before and 3 months after the physical training in water, a test was performed to evaluate the physical fitness of each patient; additionally, a measurement was taken of force-velocity parameters. The 3-month training program took place on nonhemodialysis days, in the recreational pool of the University of Physical Education in Wroclaw. Results. After aquatic training cycle, an improvement was observed in all parameters measured using the Fullerton test. The value of peak torque and its relation to body mass increased in the movement of flexors and extensors of left and right lower extremities in all tested velocities. Conclusions. In assessing the physical fitness of studied women, the biggest improvement was achieved in tests assessing the strength of upper and lower extremities as well as lower body flexibility. Higher values of force-velocity parameters are conducive to women achieving better physical fitness test results.

Using a Non-Fit Message Helps to De-Intensify Negative Reactions to Tough Advice

Science.gov (United States)

Fridman, Ilona; Scherr, Karen; Glare, Paul; Higgins, E. Tory

2017-01-01

Sometimes physicians need to provide patients with potentially upsetting advice. For example, physicians may recommend hospice for a terminally ill patient because it best meets their needs, but the patient and their family dislike this advised option. We explore whether regulatory non-fit could be used to improve these types of situations. Across five studies in which participants imagined receiving upsetting advice from a physician, we demonstrate that regulatory non-fit between the form of the physician’s advice (emphasizing gains vs. avoiding losses) and the participants’ motivational orientation (promotion vs. prevention) improves participants’ evaluation of an initially disliked option. Regulatory non-fit de-intensifies participants’ initial attitudes by making them less confident in their initial judgments and motivating them to think more thoroughly about the arguments presented. Furthermore, consistent with previous research on regulatory fit, we showed that the mechanism of regulatory non-fit differs as a function of participants’ cognitive involvement in the evaluation of the option. PMID:27341845

Shoulder Injuries in Individuals Who Participate in CrossFit Training.

Science.gov (United States)

Summitt, Ryan J; Cotton, Ryan A; Kays, Adam C; Slaven, Emily J

CrossFit, a sport and fitness program, has become increasingly popular both nationally and internationally. Researchers have recently identified significant improvements in health and wellness due to CrossFit. However, some individuals assert that CrossFit poses an inherent risk of injury, specifically to the shoulder, due to the intensity of training. Currently, there is limited evidence to support this assertion. Exercises performed during CrossFit do not place the shoulder at greater risk for injury. Injury rates are comparable to other sports of similar intensity. Descriptive survey study. Level 5. An electronic survey was developed and dispersed to approximately 980 individuals who trained in CrossFit gyms. The survey identified demographic data, training characteristics, and the prevalence of injury over a 6-month period in individuals who participated in CrossFit training. A total of 187 (19.1%) individuals completed the survey. Forty-four (23.5%) indicated that they had experienced a shoulder injury during CrossFit training over the previous 6 months. Of those who reported injury, 17 (38.6%) stated that this injury was an exacerbation of a previous injury sustained prior to starting CrossFit. There was no significant relationship between several demographic and training variables and shoulder injury. All shoulder injuries occurred at a rate of 1.94 per 1000 hours training, while "new" shoulder injuries occurred at a rate of 1.18 per 1000 hours training. The most commonly attributed causes of injury were improper form (33.3%) and exacerbation of a previous injury (33.3%). Twenty-five (64.1%) of those who experienced injury reported 1 month or less of training reduction due to the injury. Shoulder injury rates during CrossFit training are comparable to other methods of recreational exercise. Clinicians should be aware of training demands of exercises in CrossFit and modifications for these exercises to safely progress their patients back to participation.

Brain Tuberculomas Mimicking Intracranial Metastasis in a Patient Presenting with Fits

International Nuclear Information System (INIS)

Gondal, M.; Hussain, T.; Mushtaq, S.

2013-01-01

Brain tuberculosis is still prevalent in many developing countries, especially Asian countries. Tuberculomas should always be considered in the differential diagnosis of enhancing intra-axial lesions of the brain. Brain tuberculomas can present in many different clinical and radiological patterns clinically like headache, fits, cranial nerve palsies and very rarely as brain tuberculomas. We describe the case of a 48 years old male patient presenting with persistent headache and fits, referred for workup of brain metastasis or primary brain neoplasm. On further imaging, it turned out to be multiple tuberculomas of brain which resolved on anti-tuberculous treatment along with symptoms relief. (author)

Coronary collateral vessels in patients with previous myocardial infarction

International Nuclear Information System (INIS)

Nakatsuka, M.; Matsuda, Y.; Ozaki, M.

1987-01-01

To assess the degree of collateral vessels after myocardial infarction, coronary angiograms, left ventriculograms, and exercise thallium-201 myocardial scintigrams of 36 patients with previous myocardial infarction were reviewed. All 36 patients had total occlusion of infarct-related coronary artery and no more than 70% stenosis in other coronary arteries. In 19 of 36 patients with transient reduction of thallium-201 uptake in the infarcted area during exercise (Group A), good collaterals were observed in 10 patients, intermediate collaterals in 7 patients, and poor collaterals in 2 patients. In 17 of 36 patients without transient reduction of thallium-201 uptake in the infarcted area during exercise (Group B), good collaterals were seen in 2 patients, intermediate collaterals in 7 patients, and poor collaterals in 8 patients (p less than 0.025). Left ventricular contractions in the infarcted area were normal or hypokinetic in 10 patients and akinetic or dyskinetic in 9 patients in Group A. In Group B, 1 patient had hypokinetic contraction and 16 patients had akinetic or dyskinetic contraction (p less than 0.005). Thus, patients with transient reduction of thallium-201 uptake in the infarcted area during exercise had well developed collaterals and preserved left ventricular contraction, compared to those in patients without transient reduction of thallium-201 uptake in the infarcted area during exercise. These results suggest that the presence of viable myocardium in the infarcted area might be related to the degree of collateral vessels

Analysis of previous screening examinations for patients with breast cancer

International Nuclear Information System (INIS)

Lee, Eun Hye; Cha, Joo Hee; Han, Dae Hee; Choi, Young Ho; Hwang, Ki Tae; Ryu, Dae Sik; Kwak, Jin Ho; Moon, Woo Kyung

2007-01-01

We wanted to improve the quality of subsequent screening by reviewing the previous screening of breast cancer patients. Twenty-four breast cancer patients who underwent previous screening were enrolled. All 24 took mammograms and 15 patients also took sonograms. We reviewed the screening retrospectively according to the BI-RADS criteria and we categorized the results into false negative, true negative, true positive and occult cancers. We also categorized the causes of false negative cancers into misperception, misinterpretation and technical factors and then we analyzed the attributing factors. Review of the previous screening revealed 66.7% (16/24) false negative, 25.0% (6/24) true negative, and 8.3% (2/24) true positive cancers. False negative cancers were caused by the mammogram in 56.3% (9/16) and by the sonogram in 43.7% (7/16). For the false negative cases, all of misperception were related with mammograms and this was attributed to dense breast, a lesion located at the edge of glandular tissue or the image, and findings seen on one view only. Almost all misinterpretations were related with sonograms and attributed to loose application of the final assessment. To improve the quality of breast screening, it is essential to overcome the main causes of false negative examinations, including misperception and misinterpretation. We need systematic education and strict application of final assessment categories of BI-RADS. For effective communication among physicians, it is also necessary to properly educate them about BI-RADS

HEART TRANSPLANTATION IN PATIENTS WITH PREVIOUS OPEN HEART SURGERY

Directory of Open Access Journals (Sweden)

R. Sh. Saitgareev

2016-01-01

Full Text Available Heart Transplantation (HTx to date remains the most effective and radical method of treatment of patients with end-stage heart failure. The defi cit of donor hearts is forcing to resort increasingly to the use of different longterm mechanical circulatory support systems, including as a «bridge» to the follow-up HTx. According to the ISHLT Registry the number of recipients underwent cardiopulmonary bypass surgery increased from 40% in the period from 2004 to 2008 to 49.6% for the period from 2009 to 2015. HTx performed in repeated patients, on the one hand, involves considerable technical diffi culties and high risks; on the other hand, there is often no alternative medical intervention to HTx, and if not dictated by absolute contradictions the denial of the surgery is equivalent to 100% mortality. This review summarizes the results of a number of published studies aimed at understanding the immediate and late results of HTx in patients, previously underwent open heart surgery. The effect of resternotomy during HTx and that of the specifi c features associated with its implementation in recipients previously operated on open heart, and its effects on the immediate and long-term survival were considered in this review. Results of studies analyzing the risk factors for perioperative complications in repeated recipients were also demonstrated. Separately, HTx risks after implantation of prolonged mechanical circulatory support systems were examined. The literature does not allow to clearly defi ning the impact factor of earlier performed open heart surgery on the course of perioperative period and on the prognosis of survival in recipients who underwent HTx. On the other hand, subject to the regular fl ow of HTx and the perioperative period the risks in this clinical situation are justifi ed as a long-term prognosis of recipients previously conducted open heart surgery and are comparable to those of patients who underwent primary HTx. Studies

A Survey of Patients' Preoperative Need for Information About Postoperative Pain-Effect of Previous Surgery Experience.

Science.gov (United States)

Mavridou, Paraskevi; Manataki, Adamantia; Arnaoutoglou, Elena; Damigos, Dimitrios

2017-10-01

The aim of this study was to determine the kind of information patients need preoperatively about postoperative pain (POP) and whether this is affected by previous surgery experience. A descriptive study design using preoperative questionnaires. Questionnaires with fixed questions related to POP and its management were distributed preoperatively to consenting, consecutive surgical patients. Patients were divided into two groups: patients with previous surgery experience (group A) and patients without previous surgery experience (group B). Of the patients who participated in the study, 94.2% wanted information about POP and 77.8% of them believe that they will feel calmer if they get the information they need. The patients' biggest concern relates to pain management issues after discharge. Next, in order of preference is information about the analgesics that they need to take. The patients want to be informed primarily with a personal interview (59.4%). Previous surgery experience has no effect on patients' needs for information. Most of the patients want to be informed about the management of the POP after being discharged. It is remarkable that patients who had previous surgery experience need the same information with those who had no previous surgery. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

Transcaval TIPS in patients with failed revision of occluded previous TIPS

Energy Technology Data Exchange (ETDEWEB)

Seong, Chang Kyu; Kim, Yong Joo; Shin, Tae Beom; Park, Hyo Yong; Kim, Tae Hun; Kang, Duk Sik [Kyungpook National University School of Medicine, Daegu (Korea, Republic of)

2001-12-01

To determine the feasibility of transcaval transjugular intrahepatic portosystemic shunt (TIPS) in patients with occluded previous TIPS. Between February 1996 and December 2000 we performed five transcaval TIPS procedures in four patients with recurrent gastric cardiac variceal bleeding. All four had occluded TIPS, which was between the hepatic and portal vein. The interval between initial TIPS placement and revisional procedures with transcaval TIPS varied between three and 31 months; one patient underwent transcaval TIPS twice, with a 31-month interval. After revision of the occluded shunt failed, direct cavoportal puncture at the retrohepatic segment of the IVC was attempted. Transcaval TIPS placement was technically successful in all cases. In three, tractography revealed slight leakage of contrast materials into hepatic subcapsular or subdiaphragmatic pericaval space. There was no evidence of propagation of extravasated contrast materials through the retroperitoneal space or spillage into the peritoneal space. After the tract was dilated by a bare stent, no patient experienced trans-stent bleeding and no serious procedure-related complications occurred. After successful shunt creation, variceal bleeding ceased in all patients. Transcaval TIPS placement is an effective and safe alternative treatment in patients with occluded previous TIPS and no hepatic veins suitable for new TIPS.

Effect of exercise versus cognitive behavioural therapy or no intervention on anxiety, depression, fitness and quality of life in adults with previous methamphetamine dependency: a systematic review.

Science.gov (United States)

Morris, Linzette; Stander, Jessica; Ebrahim, Wardah; Eksteen, Stephanie; Meaden, Orissa Anna; Ras, Ané; Wessels, Annemarie

2018-01-16

Methamphetamine (MA) is a highly addictive psychostimulant used by approximately 52 million people worldwide. Chronic MA abuse leads to detrimental physiological and neurological changes, as well as increases in anxiety and depression, and decreases in overall fitness and quality of life. Exercise has been reported to possibly reverse physiological and neurological damage caused by previous MA use, and to reduce anxiety and depression in this population. The aim of this systematic review was to identify, clinically appraise and synthesise the available evidence for the effectiveness of exercise, compared to cognitive behavioural therapy (CBT), standard care or no intervention, on decreasing anxiety and depression and improving fitness and quality of life in previous MA users. Seven computerised databases were searched from inception to May 2017, namely Scopus, Cochrane Library, PubMed/MEDLINE, PEDro, CINAHL, and ScienceDirect. Search terms included exercise, methamphetamine, fitness measures, depression, anxiety and quality of life. Randomised and non-randomised controlled- or clinical trials and pilot studies, published in English, were considered for inclusion. Methodological quality was critically appraised according to the PEDro scale. Heterogeneity across studies regarding control groups and assessment intervals rendered meta analyses inappropriate for this review and results were thus described narratively using text and tables. Two hundred and fifty-one titles were identified following the initial search, and 14 potentially-relevant titles were selected and the abstracts reviewed. Three studies (two randomised controlled trials and one quasi-experimental pilot) were included, with an average PEDro score of 6.66. Exercise resulted in significantly lower depression and anxiety scores versus CBT (p = 0.001). Balance also significantly improved following exercise versus standard care (p exercise is effective in reducing anxiety and depression and

[Parathyroid cancer in a patient with previous history of hypernephroma: a clinical case].

Science.gov (United States)

Martín Navarro, J; Mendoza, E; Mateos, P; Cereceda, A; Coca, S

2007-01-01

We report the clinical case of a 55 year-old male patient, with a previous history of nephrectomy by hypernephroma sixteen years ago, first presenting hypercalcemia and rising of intact parathyroid hormone (iPTH) levels. A localization study revealed an intrathyroid nodule with cystic appearance. After undergoing a hemi-thyroidectomy, the patient is diagnosed with parathyroid carcinoma. This article analyzes previously published cases presenting parathyroidal pathologies associated with hypernephroma. A broader differential diagnosis--including the screening of parathyroidal pathologies should be considered in patients with hypercalcemia and hypernephroma.

Preventive fraction of physical fitness on risk factors in cardiac patients: Retrospective epidemiological study.

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Caru, Maxime; Kern, Laurence; Bousquet, Marc; Curnier, Daniel

2018-04-26

To quantify the preventive fraction of physical fitness on the risk factors in patients with cardiovascular diseases (CVDs). A total of 249 subjects (205 men and 44 women) suffering from CVD were categorized into four groups, according to their percentage of physical fitness. We calculated the odds ratio to obtain the preventive fraction in order to evaluate the impact of the physical fitness level on the risk factors ( i.e ., abdominal obesity, depression, diabetes, dyslipidemia, hypertension, obesity, overweight and smoking). It is observed that a normal physical fitness level is sufficient to induce a preventive action on abdominal obesity (38%), diabetes (12%), hypertension (33%), obesity (12%) and overweight (11%). Also, the preventive fraction increases with the level of physical fitness, in particular for hypertension (36%) and overweight (16%). A high physical fitness level does not necessarily induce a preventive action in most risk factors, excluding depression. This is the first study which demonstrates that reaching a normal physical fitness level is enough to induce a protection for some risk factors, despite having a CVD.

Effects of comprehensive geriatric assessment on physical fitness in an acute medical setting for frail elderly patients.

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Åhlund, Kristina; Bäck, Maria; Öberg, Birgitta; Ekerstad, Niklas

2017-01-01

Frail elderly people often use emergency care. During hospitalization, physical decline is common, implying an increased risk of adverse health outcomes. Comprehensive Geriatric Assessment (CGA) has been shown to be beneficial for these patients in hospital care. However, there is very limited evidence about the effects on physical fitness. The aim was to compare effects on physical fitness in the acute care of frail elderly patients at a CGA unit versus conventional care, 3 months after discharge. A clinical, prospective, controlled trial with two parallel groups was conducted. Patients aged ≥75 years, assessed as frail and in need of inpatient care, were assigned to a CGA unit or conventional care. Measurements of physical fitness, including handgrip strength (HS), timed up-and-go (TUG), and the 6-minute walk test (6-MWT) were made twice, at the hospital index care period and at the 3-month follow-up. Data were analyzed as the mean change from index to the 3-month follow-up, and dichotomized as decline versus stability/improvement in physical fitness. In all, 408 participants, aged 85.7±5.4 years, were included. The intervention group improved significantly in all components of physical fitness. The controls improved in TUG and declined in HS and 6-MWT. When the changes were dichotomized the intervention group declined to a lesser extent; HS p elderly patients at a CGA unit is superior to conventional care in terms of preserving physical fitness at 3 months follow-up. CGA management may positively influence outcomes of great importance for these patients, such as mobility, strength, and endurance.

Promotion of physical activity and fitness in sedentary patients with Parkinson's disease: randomised controlled trial.

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van Nimwegen, Marlies; Speelman, Arlène D; Overeem, Sebastiaan; van de Warrenburg, Bart P; Smulders, Katrijn; Dontje, Manon L; Borm, George F; Backx, Frank J G; Bloem, Bastiaan R; Munneke, Marten

2013-03-01

To evaluate whether a multifaceted behavioural change programme increases physical activities in patients with Parkinson's disease. Multicentre randomised controlled trial. 32 community hospitals in the Netherlands, collaborating in a nationwide network (ParkinsonNet). 586 sedentary patients with idiopathic Parkinson's disease aged between 40 and 75 years with mild to moderate disease severity (Hoehn and Yahr stage ≤ 3). Patients were randomly assigned to the ParkFit programme or a matched general physiotherapy intervention. ParkFit is a multifaceted behavioural change programme, designed specifically to achieve an enduring increase in the level of physical activity (coaches using motivational strategies; ambulatory feedback). The primary endpoint was the level of physical activity, measured every six months with a standardised seven day recall (LASA physical activity questionnaire-LAPAQ). Secondary endpoints included two other measures of physical activity (activity diary and ambulatory activity monitor), quality of life (Parkinson's disease questionnaire-PDQ-39), and fitness (six minute walk test). 540 (92.2%) patients completed the primary outcome. During follow-up, overall time spent on physical activities (LAPAQ) was comparable between the groups (adjusted group difference 7%, 95% confidence interval -3 to 17%; P=0.19). Analyses of three secondary outcomes indicated increased physical activity in ParkFit patients, as suggested by the activity diary (difference 30%; Pactivity monitor (difference 12%; Pphysical activity, as measured with the LAPAQ. The analysis of the secondary endpoints justifies further work into the possible merits of behavioural change programmes to increase physical activities in daily life in Parkinson's disease. Clinical trials NCT00748488.

Association between cardiorespiratory fitness and metabolic risk factors in a population with mild to severe obesity.

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Do, Kathy; Brown, Ruth E; Wharton, Sean; Ardern, Chris I; Kuk, Jennifer L

2018-01-01

Previous literature suggests the beneficial effects of fitness on abdominal obesity may be attenuated in obesity and abolished in severe obesity. It is unclear whether the beneficial association between fitness and health is similarly present in those with mild and severe obesity. Patients from the Wharton Medical Clinic ( n  = 853) completed a clinical examination and maximal treadmill test. Patients were categorized into fit and unfit based on age- and sex-categories and body mass index (BMI) class (mild: ≤ 34.9 kg/m 2 , moderate: 35-39.9 kg/m 2 or severe obesity: ≥ 40 kg/m 2 ). Within the sample, 41% of participants with mild obesity had high fitness whereas only 25% and 11% of the participants with moderate and severe obesity, respectively, had high fitness. BMI category was independently associated with most of the metabolic risk factors, while fitness was only independently associated with systolic blood pressure and triglycerides ( P  fitness groups were only significantly different in their relative risk for prevalent pre-clinical hypertension within the severe obesity group ( p  = 0.03). High fitness was associated with smaller waist circumferences, with differences between high and low fitness being larger in those with severe obesity than mild obesity (Men: P  = 0.06, Women: P  = 0.0005). Thus, in contrast to previous observations, the favourable associations of having high fitness and health may be similar if not augmented in individuals with severe compared to mild obesity.

Thyroid abnormalities in patients previously treated with irradiation for acne vulgaris

International Nuclear Information System (INIS)

Thomson, D.B.; Grammes, C.F.; Starkey, R.H.; Monsaert, R.P.; Sunderlin, F.S.

1984-01-01

Of 1203 patients who received radiation treatment for acne vulgaris between 1940 and 1968, 302 were recalled and examined, 121 at Geisinger Medical Center and the remainder by their local physicians. Radiation records were reviewed on all patients. Lead-rubber and cones had been used as shielding. Mean age at the time of exposure was 21 years and mean total exposure was 692 R. Palpable nodular thyroid disease was found in eight patients (2.6%). Of these, thyroid carcinoma was detected in two patients (0.66%). Although the number of patients examined was small, the incidence of carcinomas was unexpectedly high. The authors conclude that follow-up examination is worthwhile for patients previously treated by irradiation for acne vulgaris

Thyroid abnormalities in patients previously treated with irradiation for acne vulgaris

International Nuclear Information System (INIS)

Thomson, D.B.; Grammes, C.F.; Starkey, R.H.; Monsaert, R.P.; Sunderlin, F.S.

1984-01-01

Of 1,203 patients who received radiation treatment for acne vulgaris between 1940 and 1968, 302 patients were recalled and examined, 121 at Geisinger Medical Center and the remainder by their local physicians. Radiation records were reviewed on all patients. Lead-rubber and cones had been used as shielding. Mean age at the time of exposure was 21 years and mean total exposure was 692 R. Palpable nodular thyroid disease was found in eight patients (2.6%). Of these, thyroid carcinoma was detected in two patients (0.66%). Although the number of patients examined was small, the incidence of carcinomas was unexpectedly high. We conclude that follow-up examination is worthwhile for patients previously treated by irradiation for acne vulgaris

Evaluation of an interdisciplinary re-isolation policy for patients with previous Clostridium difficile diarrhea.

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Boone, N; Eagan, J A; Gillern, P; Armstrong, D; Sepkowitz, K A

1998-12-01

Diarrhea caused by Clostridium difficile is increasingly recognized as a nosocomial problem. The effectiveness and cost of a new program to decrease nosocomial spread by identifying patients scheduled for readmission who were previously positive for toxin was evaluated. The Memorial Sloan-Kettering Cancer Center is a 410-bed comprehensive cancer center in New York City. Many patients are readmitted during their course of cancer therapy. In 1995 as a result of concern about the nosocomial spread of C difficile, we implemented a policy that all patients who were positive for C difficile toxin in the previous 6 months with no subsequent toxin-negative stool as an outpatient would be placed into contact isolation on readmission pending evaluation of stool specimens. Patients who were previously positive for C difficile toxin were identified to infection control and admitting office databases via computer. Admitting personnel contacted infection control with all readmissions to determine whether a private room was required. Between July 1, 1995, and June 30, 1996, 47 patients who were previously positive for C difficile toxin were readmitted. Before their first scheduled readmission, the specimens for 15 (32%) of these patients were negative for C difficile toxin. They were subsequently cleared as outpatients and were readmitted without isolation. Workup of the remaining 32 patients revealed that the specimens for 7 patients were positive for C difficile toxin and 86 isolation days were used. An additional 25 patients used 107 isolation days and were either cleared after a negative specimen was obtained in-house or discharged without having an appropriate specimen sent. Four patients (9%) had reoccurring C difficile after having toxin-negative stools. We estimate (because outpatient specimens were not collected) the cost incurred at $48,500 annually, including the incremental cost of hospital isolation and equipment. Our policy to control the spread of nosocomial C

Iodine-131 induced hepatotoxicity in previously healthy patients with Grave's disease.

Science.gov (United States)

Jhummon, Navina Priya; Tohooloo, Bhavna; Qu, Shen

2013-01-01

To describe the association of the rare and serious complication of liver toxicity in previously healthy Grave's disease (GD) patients after the treatment with radioactive iodine (131)I (RAI). We report the clinical, laboratory and pathologic findings of 2 cases of severe liver toxicity associated with the treatment with RAI in previously healthy patients with GD. Clinical examination and laboratory investigations excluded viral hepatitis, autoimmune hepatitis, granulomatous disease, primary biliary disease, extrahepatic biliary obstruction, and heart failure. Case 1: A previously healthy 52-years old man reportedly having a typical GD but following RAI treatment, concomitantly developed severe liver toxicity that required 1 week of treatment in hospital. Case 2: A previously healthy 34-years old woman is reported as having a typical GD but developed jaundice following RAI treatment that required several weeks of in hospital treatment in the hepato-biliary department. In both cases, the liver dysfunction resolved after intensive treatment with hepato-protective agents. In this report the therapeutic considerations as well as the pathogenetic possibilities are reviewed. To the best of our knowledge, this is the first description of the association observed, which is rare but may be severe and should be considered in any case of thyrotoxicosis where a liver dysfunction develops after the treatment with radioactive iodine (131)I.

Sustained fitness gains and variability in fitness trajectories in the long-term evolution experiment with Escherichia coli

Science.gov (United States)

Lenski, Richard E.; Wiser, Michael J.; Ribeck, Noah; Blount, Zachary D.; Nahum, Joshua R.; Morris, J. Jeffrey; Zaman, Luis; Turner, Caroline B.; Wade, Brian D.; Maddamsetti, Rohan; Burmeister, Alita R.; Baird, Elizabeth J.; Bundy, Jay; Grant, Nkrumah A.; Card, Kyle J.; Rowles, Maia; Weatherspoon, Kiyana; Papoulis, Spiridon E.; Sullivan, Rachel; Clark, Colleen; Mulka, Joseph S.; Hajela, Neerja

2015-01-01

Many populations live in environments subject to frequent biotic and abiotic changes. Nonetheless, it is interesting to ask whether an evolving population's mean fitness can increase indefinitely, and potentially without any limit, even in a constant environment. A recent study showed that fitness trajectories of Escherichia coli populations over 50 000 generations were better described by a power-law model than by a hyperbolic model. According to the power-law model, the rate of fitness gain declines over time but fitness has no upper limit, whereas the hyperbolic model implies a hard limit. Here, we examine whether the previously estimated power-law model predicts the fitness trajectory for an additional 10 000 generations. To that end, we conducted more than 1100 new competitive fitness assays. Consistent with the previous study, the power-law model fits the new data better than the hyperbolic model. We also analysed the variability in fitness among populations, finding subtle, but significant, heterogeneity in mean fitness. Some, but not all, of this variation reflects differences in mutation rate that evolved over time. Taken together, our results imply that both adaptation and divergence can continue indefinitely—or at least for a long time—even in a constant environment. PMID:26674951

The Impact of Person-Organization Fit on Nurse Job Satisfaction and Patient Care Quality.

Science.gov (United States)

Risman, K L; Erickson, Rebecca J; Diefendorff, James M

2016-08-01

In the current healthcare context, large health care organizations may increasingly emphasize profit, biomedicine, efficiency, and customer service in the delivery of care. This orientation toward nursing work by large organizations may be perceived by nurses as incompatible with professional caring. Ordinary Least Squares regression was used to explore the impact of person-organization fit (i.e., value congruence between self and employing organization) on nurses' general job satisfaction and quality of patient care (n=753). Nurses' perceived person-organization fit is a significant predictor of general job satisfaction and quality of patient care. The implications of our findings are discussed and recommendations for nursing leaders and future research are made. Copyright © 2015 Elsevier Inc. All rights reserved.

Educational Level Is Related to Physical Fitness in Patients with Type 2 Diabetes - A Cross-Sectional Study.

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Lara Allet

Full Text Available Low educational level (EL and low physical fitness are both predictors of increased morbidity and mortality in patients with type 2 diabetes. It is unknown if EL is related to physical fitness. This would have important implication for the treatment approach of patients of low EL.In 2011/12, we invited participants of a new nationwide Swiss physical activity program for patients with type 2 diabetes to participate in this study. EL was defined by self-report and categorized as low (mandatory education, middle (professional education or high (high school/university. Physical fitness was determined using 5 validated measures that assessed aerobic fitness, functional lower limb muscle strength, walking speed, balance and flexibility. Potential confounder variables such as other socio-cultural factors, physical activity level, body composition, diabetes-related parameters and complications/co-morbidities as well as well-being were assessed.All invited 185 participants (mean age 59.6 ±9.8 yrs, 76 women agreed to be included. Of all patients, 23.1% had a low, 32.7% a middle and 44.2% a high EL; 41.8% were professionally active. The study population had a mean BMI of 32.4±5.2 kg/m2 and an HbA1c of 7.3±1.3%. The mean diabetes duration was 8.8±7.4 years. In the baseline assessment, higher EL was associated with increased aerobic fitness, increased functional lower limb muscle strength, and increased walking speed using linear regression analysis (values for low, middle and high EL, respectively: 91.8 ± 27.9, 116.4 ± 49.7 and 134.9 ± 60.4 watts for aerobic fitness (p = 0.002, 15 ± 4.7, 13.9 ± 2.7, 12.6 ± 2.9 seconds for strength (p = 0.001 and 8.8 ± 1.6, 8.3 ± 1.4, 7.8 ± 1.4 seconds for walking speed (p = 0.004. These associations were independent of potential confounders. Overall, aerobic fitness was 46%, functional limb muscle strength 16%, and walking speed 11% higher in patients of high compared to those of low EL. EL was not related to

Educational Level Is Related to Physical Fitness in Patients with Type 2 Diabetes - A Cross-Sectional Study.

Science.gov (United States)

Allet, Lara; Giet, Olivier; Barral, Jérôme; Junod, Nicolas; Durrer, Dominique; Amati, Francesca; Sykiotis, Gerasimos P; Marques-Vidal, Pedro; Puder, Jardena J

2016-01-01

Low educational level (EL) and low physical fitness are both predictors of increased morbidity and mortality in patients with type 2 diabetes. It is unknown if EL is related to physical fitness. This would have important implication for the treatment approach of patients of low EL. In 2011/12, we invited participants of a new nationwide Swiss physical activity program for patients with type 2 diabetes to participate in this study. EL was defined by self-report and categorized as low (mandatory education), middle (professional education) or high (high school/university). Physical fitness was determined using 5 validated measures that assessed aerobic fitness, functional lower limb muscle strength, walking speed, balance and flexibility. Potential confounder variables such as other socio-cultural factors, physical activity level, body composition, diabetes-related parameters and complications/co-morbidities as well as well-being were assessed. All invited 185 participants (mean age 59.6 ±9.8 yrs, 76 women) agreed to be included. Of all patients, 23.1% had a low, 32.7% a middle and 44.2% a high EL; 41.8% were professionally active. The study population had a mean BMI of 32.4±5.2 kg/m2 and an HbA1c of 7.3±1.3%. The mean diabetes duration was 8.8±7.4 years. In the baseline assessment, higher EL was associated with increased aerobic fitness, increased functional lower limb muscle strength, and increased walking speed using linear regression analysis (values for low, middle and high EL, respectively: 91.8 ± 27.9, 116.4 ± 49.7 and 134.9 ± 60.4 watts for aerobic fitness (p = 0.002), 15 ± 4.7, 13.9 ± 2.7, 12.6 ± 2.9 seconds for strength (p = 0.001) and 8.8 ± 1.6, 8.3 ± 1.4, 7.8 ± 1.4 seconds for walking speed (p = 0.004)). These associations were independent of potential confounders. Overall, aerobic fitness was 46%, functional limb muscle strength 16%, and walking speed 11% higher in patients of high compared to those of low EL. EL was not related to balance or

Reirradiation, surgery and IORT for recurrent rectal cancer in previously irradiated patients

International Nuclear Information System (INIS)

Vermaas, Maarten; Nuyttens, Joost J.M.E.; Ferenschild, Floris T.J.; Verhoef, Cornelis; Eggermont, Alexander M.M.; Wilt, Johannes H.W. de

2008-01-01

A total of 11 patients with recurrent rectal cancer who had been previously irradiated were treated with preoperative reirradiation (median dose 30 Gy), surgery and IORT. This treatment was related with high morbidity, a short pain-free survival (5 months) and poor local control (27% after 3 years), although some patients have long-term distant control and survival

Emphysema and bronchiectasis in COPD patients with previous pulmonary tuberculosis: computed tomography features and clinical implications

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Jin J

2018-01-01

Full Text Available Jianmin Jin,1 Shuling Li,2 Wenling Yu,2 Xiaofang Liu,1 Yongchang Sun1,3 1Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, 2Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 3Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China Background: Pulmonary tuberculosis (PTB is a risk factor for COPD, but the clinical characteristics and the chest imaging features (emphysema and bronchiectasis of COPD with previous PTB have not been studied well.Methods: The presence, distribution, and severity of emphysema and bronchiectasis in COPD patients with and without previous PTB were evaluated by high-resolution computed tomography (HRCT and compared. Demographic data, respiratory symptoms, lung function, and sputum culture of Pseudomonas aeruginosa were also compared between patients with and without previous PTB.Results: A total of 231 COPD patients (82.2% ex- or current smokers, 67.5% male were consecutively enrolled. Patients with previous PTB (45.0% had more severe (p=0.045 and longer history (p=0.008 of dyspnea, more exacerbations in the previous year (p=0.011, and more positive culture of P. aeruginosa (p=0.001, compared with those without PTB. Patients with previous PTB showed a higher prevalence of bronchiectasis (p<0.001, which was more significant in lungs with tuberculosis (TB lesions, and a higher percentage of more severe bronchiectasis (Bhalla score ≥2, p=0.031, compared with those without previous PTB. The overall prevalence of emphysema was not different between patients with and without previous PTB, but in those with previous PTB, a higher number of subjects with middle (p=0.001 and lower (p=0.019 lobe emphysema, higher severity score (p=0.028, higher prevalence of panlobular emphysema (p=0.013, and more extensive centrilobular emphysema (p=0.039 were observed. Notably, in patients with

Current role of endovascular therapy in Marfan patients with previous aortic surgery

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Ibrahim Akin

2008-02-01

Full Text Available Ibrahim Akin, Stephan Kische, Tim C Rehders, Tushar Chatterjee, Henrik Schneider, Thomas Körber, Christoph A Nienaber, Hüseyin InceDepartment of Medicine, Division of Cardiology at the University Hospital Rostock, Rostock School of Medicine, Ernst-Heydemann-Str. 6, 18057 Rostock, GermanyAbstract: The Marfan syndrome is a heritable disorder of the connective tissue which affects the cardiovascular, ocular, and skeletal system. The cardiovascular manifestation with aortic root dilatation, aortic valve regurgitation, and aortic dissection has a prevalence of 60% to 90% and determines the premature death of these patients. Thirty-four percent of the patients with Marfan syndrome will have serious cardiovascular complications requiring surgery in the first 10 years after diagnosis. Before aortic surgery became available, the majority of the patients died by the age of 32 years. Introduction in the aortic surgery techniques caused an increase of the 10 year survival rate up to 97%. The purpose of this article is to give an overview about the feasibility and outcome of stent-graft placement in the descending thoracic aorta in Marfan patients with previous aortic surgery.Keywords: Marfan syndrome, aortic dissection, root replacement, stent-graft, previous aortic surgery

Culture and drug susceptibility testing among previously treated tuberculosis patients in the Dominican Republic, 2014

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Katia J. Romero Mercado

Full Text Available ABSTRACT Multidrug-resistant tuberculosis (MDR-TB is a major public health concern that threatens global progress toward effective TB control. The risk of MDR-TB is increased in patients who have received previous TB treatment. This article describes the performance of culture and drug susceptibility testing (DST in patients registered as previously treated TB patients in the Dominican Republic in 2014, based on operational research that followed a retrospective cohort design and used routine program data. Under the current system of TB culturing and DST, the majority of patients with previously treated TB do not undergo DST, and those who do often experience considerable delay in obtaining their results. The lack of DST and delay in receiving DST results leads to underestimation of the number of MDR-TB cases and hinders the timely initiation of MDR-TB treatment.

Factors associated with prevalence and types of 'may be fit' advice on fit notes: a cross-sectional primary care analysis.

Science.gov (United States)

Shiels, Chris; Gabbay, Mark; Hillage, Jim

2014-03-01

The 'fit note', with the opportunity for the GP to advise that a patient 'may be fit' to do some work, was introduced in April 2010. To estimate numbers of fit notes with 'may be fit' advice, the types of advice, and factors associated with any inclusion of such advice in the fit note. Cross-sectional analysis of fit note data from 68 general practices in eight regions of England, Wales and Scotland. Collection of practice fit note data via GP use of carbonised pads of fit notes for a period of 12 months. The 'may be fit' box was ticked on 5080 fit notes (6.4% of all fit notes in study). But there was a wide variation in completion rates across the 68 practices (from 1% to 15%). The most prevalent individual item of advice was to 'amend duties' of patient as a prerequisite for return to work (included in 42% of all notes containing any 'may be fit' advice). Advice was often incomplete or irrelevant, with some GPs failing to comply with official guidance. Inclusion of any 'may be fit' advice was independently associated with the patient being female, less socially deprived and having a physical health reason for receiving a fit note. Unlike other studies that have relied upon eliciting opinion, this study investigates how the fit note is being used in practice. Findings provide some evidence that the fit note is not yet being used to the optimum benefit of patients (and their employers).

Intraoperative irradiation for locally recurrent colorectal cancer in previously irradiated patients

Energy Technology Data Exchange (ETDEWEB)

Haddock, M G; Gunderson, L L; Nelson, H; Cha, S; Devine, R M; Dozois, R R; Wolff, B G

1995-07-01

Purpose/Objective: Little information exists in the literature on salvage treatment for patients with pelvic recurrences of colorectal cancer who have previously received high dose radiation therapy (RT). A retrospective review of such patients treated aggressively with surgical resection and intraoperative electrons (IOERT) was undertaken. Material and Methods: From 1981 through 1994, 52 previously irradiated patients with recurrent locally advanced colorectal cancer without evidence of distant metastatic disease were treated with surgical resection and intraoperative electrons (IOERT) {+-} additional external beam RT. Every attempt was made to achieve a gross total resection prior to IOERT if it could be safely accomplished. IOERT doses ranged from 1000-3000 cGy with a median of 2000 cGy. 37 patients received additional external beam radiotherapy either pre- or post-operatively with doses ranging from 500-5040 cGy (median 2520 cGy). 20 patients received 5FU {+-} leukovorin during external beam RT. Three patients received 5FU+leukovorin after completion of RT. Results: 31 males and 21 females with a median age of 55 years (range 31-73 years) were treated. 71% of patients have been followed until death or for > 2 years. The median, 2-year and 5-year actuarial overall survival is 23 months, 48% and 13%, respectively. Actuarial central disease control (IOERT field) at 2 and 4 years is 72 and 57%; pelvic control at 2 and 4 years is 60 and 34%. Pelvic control rates are better in patients who received {>=} 3000 cGy external beam RT in addition to IOERT as compared to patients who received no external beam RT or < 3000 cGy, with 2 year pelvic control rates of 81% vs. 54%. 25 patients have developed distant metastases. The actuarial rate of appearance of distant metastatic disease at 2 and 4 years is 60 and 80%. Late complications attributable to IOERT include neuropathies in 13 patients (5 mild, 5 moderate, 3 severe) and narrowing or obstruction of the ureter in four

Intraoperative irradiation for locally recurrent colorectal cancer in previously irradiated patients

International Nuclear Information System (INIS)

Haddock, M.G.; Gunderson, L.L.; Nelson, H.; Cha, S.; Devine, R.M.; Dozois, R.R.; Wolff, B.G.

1995-01-01

Purpose/Objective: Little information exists in the literature on salvage treatment for patients with pelvic recurrences of colorectal cancer who have previously received high dose radiation therapy (RT). A retrospective review of such patients treated aggressively with surgical resection and intraoperative electrons (IOERT) was undertaken. Material and Methods: From 1981 through 1994, 52 previously irradiated patients with recurrent locally advanced colorectal cancer without evidence of distant metastatic disease were treated with surgical resection and intraoperative electrons (IOERT) ± additional external beam RT. Every attempt was made to achieve a gross total resection prior to IOERT if it could be safely accomplished. IOERT doses ranged from 1000-3000 cGy with a median of 2000 cGy. 37 patients received additional external beam radiotherapy either pre- or post-operatively with doses ranging from 500-5040 cGy (median 2520 cGy). 20 patients received 5FU ± leukovorin during external beam RT. Three patients received 5FU+leukovorin after completion of RT. Results: 31 males and 21 females with a median age of 55 years (range 31-73 years) were treated. 71% of patients have been followed until death or for > 2 years. The median, 2-year and 5-year actuarial overall survival is 23 months, 48% and 13%, respectively. Actuarial central disease control (IOERT field) at 2 and 4 years is 72 and 57%; pelvic control at 2 and 4 years is 60 and 34%. Pelvic control rates are better in patients who received ≥ 3000 cGy external beam RT in addition to IOERT as compared to patients who received no external beam RT or < 3000 cGy, with 2 year pelvic control rates of 81% vs. 54%. 25 patients have developed distant metastases. The actuarial rate of appearance of distant metastatic disease at 2 and 4 years is 60 and 80%. Late complications attributable to IOERT include neuropathies in 13 patients (5 mild, 5 moderate, 3 severe) and narrowing or obstruction of the ureter in four patients

HRM and Fit: Survival of the fittest!?

NARCIS (Netherlands)

C.T. Boon (Corine)

2008-01-01

textabstractWhat is the nature of ‘fit’ in strategic HRM? This is the question guiding this thesis. Although the idea of fit is theoretically convincing, empirical evidence to support the role of fit is limited. Previous studies on fit have mainly focused on the alignment between HRM and strategy

Rhabdomyosarcoma Arising in a Previously Irradiated Field: An Analysis of 43 Patients

Energy Technology Data Exchange (ETDEWEB)

Dang, Nguyen D. [Department of Radiation Oncology, Baylor College of Medicine, Houston, Texas (United States); Teh, Bin S. [Department of Radiation Oncology, The Methodist Hospital and Methodist Hospital Research Institute, Houston, Texas (United States); Paulino, Arnold C., E-mail: apaulino@tmhs.org [Department of Radiation Oncology, The Methodist Hospital and Methodist Hospital Research Institute, Houston, Texas (United States)

2013-03-01

Patients with soft tissue sarcomas that arise from previously irradiated fields have traditionally been reported to have a poor prognosis. In this report, we examined the characteristics and outcomes of patients who developed a rhabdomyosarcoma in a previously irradiated field (RMS-RIF); we hypothesize that these patients should have a better outcome compared to other postradiation soft tissue sarcomas as these tumors are chemosensitive and radiosensitive. A PubMed search of the literature from 1961-2010 yielded 33 studies with data for patients with RMS-RIF. The study included 43 patients with a median age of 6.5 years at the time of radiation therapy (RT) for the initial tumor. The median RT dose was 48 Gy. The median latency period, the time from RT to development of RMS-RIF, was 8 years. The 3-year overall survival for RMS-RIF was 42%. The 3-year overall survival was 66% for patients receiving chemotherapy and local treatment (surgery and/or RT) compared to 29% for those who had systemic treatment only or local treatment only (P=.049). Other factors associated with increased 3-year overall survival included retinoblastoma initial diagnosis (P<.001), age ≤18 years at diagnosis of RMS-RIF (P=.003), favorable site (P=.008), and stage 1 disease (P=.002). Age at time of RMS-RIF, retinoblastoma initial tumor, favorable site, stage 1 disease, and use of both systemic and local treatment were found to be favorable prognostic factors for 3-year overall survival.

Intraoperative irradiation for locally recurrent colorectal cancer in previously irradiated patients

International Nuclear Information System (INIS)

Haddock, Michael G.; Gunderson, Leonard L.; Nelson, Heidi; Cha, Stephen S.; Devine, Richard M.; Dozois, Roger R.; Wolff, Bruce G.

2001-01-01

Purpose: Information in the literature regarding salvage treatment for patients with locally recurrent colorectal cancer who have previously been treated with high or moderate dose external beam irradiation (EBRT) is scarce. A retrospective review was therefore performed in our institution to determine disease control, survival, and tolerance in patients treated aggressively with surgical resection and intraoperative electron irradiation (IOERT) ± additional EBRT and chemotherapy. Methods and Materials: From 1981 through 1994, 51 previously irradiated patients with recurrent locally advanced colorectal cancer without evidence of distant metastatic disease were treated at Mayo Clinic Rochester with surgical resection and IOERT ± additional EBRT. An attempt was made to achieve a gross total resection before IOERT if it could be safely accomplished. The median IOERT dose was 20 Gy (range, 10-30 Gy). Thirty-seven patients received additional EBRT either pre- or postoperatively with doses ranging from 5 to 50.4 Gy (median 25.2 Gy). Twenty patients received 5-fluorouracil ± leucovorin during EBRT. Three patients received additional cycles of 5-fluorouracil ± leucovorin as maintenance chemotherapy. Results: Thirty males and 21 females with a median age of 55 years (range 31-73 years) were treated. Thirty-four patients have died; the median follow-up in surviving patients is 21 months. The median, 2-yr, and 5-yr actuarial overall survivals are 23 months, 48% and 12%, respectively. The 2-yr actuarial central control (within IOERT field) is 72%. Local control at 2 years has been maintained in 60% of patients. There is a trend toward improved local control in patients who received ≥30 Gy EBRT in addition to IOERT as compared to those who received no EBRT or <30 Gy with 2-yr local control rates of 81% vs. 54%. Distant metastatic disease has developed in 25 patients, and the actuarial rate of distant progression at 2 and 4 years is 56% and 76%, respectively. Peripheral

Educational Level Is Related to Physical Fitness in Patients with Type 2 Diabetes – A Cross-Sectional Study

Science.gov (United States)

Allet, Lara; Giet, Olivier; Barral, Jérôme; Junod, Nicolas; Durrer, Dominique; Amati, Francesca; Sykiotis, Gerasimos P.; Marques-Vidal, Pedro; Puder, Jardena J.

2016-01-01

Introduction Low educational level (EL) and low physical fitness are both predictors of increased morbidity and mortality in patients with type 2 diabetes. It is unknown if EL is related to physical fitness. This would have important implication for the treatment approach of patients of low EL. Materials and Methods In 2011/12, we invited participants of a new nationwide Swiss physical activity program for patients with type 2 diabetes to participate in this study. EL was defined by self-report and categorized as low (mandatory education), middle (professional education) or high (high school/university). Physical fitness was determined using 5 validated measures that assessed aerobic fitness, functional lower limb muscle strength, walking speed, balance and flexibility. Potential confounder variables such as other socio-cultural factors, physical activity level, body composition, diabetes-related parameters and complications/co-morbidities as well as well-being were assessed. Results All invited 185 participants (mean age 59.6 ±9.8 yrs, 76 women) agreed to be included. Of all patients, 23.1% had a low, 32.7% a middle and 44.2% a high EL; 41.8% were professionally active. The study population had a mean BMI of 32.4±5.2 kg/m2 and an HbA1c of 7.3±1.3%. The mean diabetes duration was 8.8±7.4 years. In the baseline assessment, higher EL was associated with increased aerobic fitness, increased functional lower limb muscle strength, and increased walking speed using linear regression analysis (values for low, middle and high EL, respectively: 91.8 ± 27.9, 116.4 ± 49.7 and 134.9 ± 60.4 watts for aerobic fitness (p = 0.002), 15 ± 4.7, 13.9 ± 2.7, 12.6 ± 2.9 seconds for strength (p = 0.001) and 8.8 ± 1.6, 8.3 ± 1.4, 7.8 ± 1.4 seconds for walking speed (p = 0.004)). These associations were independent of potential confounders. Overall, aerobic fitness was 46%, functional limb muscle strength 16%, and walking speed 11% higher in patients of high compared to those

Incidence of cancer in adolescent idiopathic scoliosis patients treated 25 years previously

DEFF Research Database (Denmark)

Simony, Ane; Hansen, Emil Jesper; Christensen, Steen Bach

2016-01-01

, is comparable to modern equipment. This is to our knowledge the first study to report increased rates of endometrial cancers in a cohort of AIS patients, and future attention is needed to reduce the radiation dose distributed to the AIS patients both pre-operatively and during surgery.......PURPOSE: To report the incidence of cancer in a cohort of adolescent idiopathic scoliosis (AIS) patients treated 25 years previously. METHODS: 215 consecutive AIS patients treated between 1983 and 1990 were identified and requested to return for clinical and radiographic examination. The incidence....... RESULTS: From the original cohort of 215 consecutive AIS patients, radiation information was available in 211 of the patients, and medical charts were available in 209 AIS patients. 170 (83 %) of the 205 AIS patients participated in the follow-up study with questionnaires. The calculated mean total...

Central venous stenosis in haemodialysis patients without a previous history of catheter placement.

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Oguzkurt, Levent; Tercan, Fahri; Yildirim, Sedat; Torun, Dilek

2005-08-01

To evaluate dialysis history, imaging findings and outcome of endovascular treatment in six patients with central venous stenosis without a history of previous catheter placement. Between April 2000 and June 2004, six (10%) of 57 haemodialysis patients had stenosis of a central vein without a previous central catheter placement. Venography findings and outcome of endovascular treatment in these six patients were retrospectively evaluated. Patients were three women (50%) and three men aged 32-60 years (mean age: 45 years) and all had massive arm swelling as the main complaint. The vascular accesses were located at the elbow in five patients and at the wrist in one patient. Three patients had stenosis of the left subclavian vein and three patients had stenosis of the left brachiocephalic vein. The mean duration of the vascular accesses from the time of creation was 25.1 months. Flow volumes of the vascular access were very high in four patients who had flow volume measurement. The mean flow volume was 2347 ml/min. One of three patients with brachiocephalic vein stenosis had compression of the vein by the brachiocephalic artery. All the lesions were first treated with balloon angioplasty and two patients required stent placement on long term. Number of interventions ranged from 1 to 4 (mean: 2.1). Symptoms resolved in five patients and improved in one patient who had a stent placed in the left BCV. Central venous stenosis in haemodialysis patients without a history of central venous catheterization tends to occur or be manifested in patients with a proximal permanent vascular access with high flow rates. Balloon angioplasty with or without stent placement offers good secondary patency rates in mid-term.

Iodine-131 induced hepatotoxicity in previously healthy patients with Grave’s disease

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2013-01-01

Objective To describe the association of the rare and serious complication of liver toxicity in previously healthy Grave’s disease (GD) patients after the treatment with radioactive iodine 131I (RAI). Case presentation We report the clinical, laboratory and pathologic findings of 2 cases of severe liver toxicity associated with the treatment with RAI in previously healthy patients with GD. Clinical examination and laboratory investigations excluded viral hepatitis, autoimmune hepatitis, granulomatous disease, primary biliary disease, extrahepatic biliary obstruction, and heart failure. Case 1: A previously healthy 52-years old man reportedly having a typical GD but following RAI treatment, concomitantly developed severe liver toxicity that required 1 week of treatment in hospital. Case 2: A previously healthy 34-years old woman is reported as having a typical GD but developed jaundice following RAI treatment that required several weeks of in hospital treatment in the hepato-biliary department. In both cases, the liver dysfunction resolved after intensive treatment with hepato-protective agents. In this report the therapeutic considerations as well as the pathogenetic possibilities are reviewed. Conclusion To the best of our knowledge, this is the first description of the association observed, which is rare but may be severe and should be considered in any case of thyrotoxicosis where a liver dysfunction develops after the treatment with radioactive iodine 131I. PMID:23497434

Central venous stenosis in haemodialysis patients without a previous history of catheter placement

International Nuclear Information System (INIS)

Oguzkurt, Levent; Tercan, Fahri; Yildirim, Sedat; Torun, Dilek

2005-01-01

Objective: To evaluate dialysis history, imaging findings and outcome of endovascular treatment in six patients with central venous stenosis without a history of previous catheter placement. Material and methods: Between April 2000 and June 2004, six (10%) of 57 haemodialysis patients had stenosis of a central vein without a previous central catheter placement. Venography findings and outcome of endovascular treatment in these six patients were retrospectively evaluated. Patients were three women (50%) and three men aged 32-60 years (mean age: 45 years) and all had massive arm swelling as the main complaint. The vascular accesses were located at the elbow in five patients and at the wrist in one patient. Results: Three patients had stenosis of the left subclavian vein and three patients had stenosis of the left brachiocephalic vein. The mean duration of the vascular accesses from the time of creation was 25.1 months. Flow volumes of the vascular access were very high in four patients who had flow volume measurement. The mean flow volume was 2347 ml/min. One of three patients with brachiocephalic vein stenosis had compression of the vein by the brachiocephalic artery. All the lesions were first treated with balloon angioplasty and two patients required stent placement on long term. Number of interventions ranged from 1 to 4 (mean: 2.1). Symptoms resolved in five patients and improved in one patient who had a stent placed in the left BCV. Conclusion: Central venous stenosis in haemodialysis patients without a history of central venous catheterization tends to occur or be manifested in patients with a proximal permanent vascular access with high flow rates. Balloon angioplasty with or without stent placement offers good secondary patency rates in mid-term

Coronary Flow Reserve Predicts Cardiopulmonary Fitness in Patients with Coronary Artery Disease Independently of Systolic and Diastolic Function

DEFF Research Database (Denmark)

Snoer, Martin; Olsen, Rasmus Huan; Monk-Hansen, Tea

2014-01-01

Aims Despite revascularization and optimal medical treatment, patients with coronary artery disease (CAD) have reduced exercise capacity. In the absence of coronary artery stenosis, coronary flow reserve (CFR) is a measure of coronary microvascular function, and a marker of future poor outcome...... in CAD patients. The aim of this study was to examine the relationship among CFR, systolic and diastolic function, peripheral vascular function, and cardiopulmonary fitness in CAD patients. Methods and Results Forty patients with median left ventricular ejection fraction (LVEF) 49 (interquartile 46....... Conclusions Coronary flow reserve measured noninvasively predicts cardiopulmonary fitness independently of resting systolic and diastolic function in CAD patients, indicating that cardiac output during maximal exercise is dependent on the ability of the coronary circulation to adapt to the higher metabolic...

Clinical outcomes of Laparoscopically Assisted Vaginal Hysterectomy at patients who had previous abdominopelvic surgery

Directory of Open Access Journals (Sweden)

Ali Riza Odabasi

2007-03-01

Full Text Available OBJECTIVE: To determine clinical outcomes of Laparoscopically Assisted Vaginal Hysterectomy (LAVH at patients who had previous abdominopelvic surgery.\tDesign: A clinical observational, prospective, non randomised trial comparing outcomes of 13 patients who had previous abdominopelvic surgery with outcomes of 19 patients who had not surgery.\tSetting: Adnan Menderes University Faculty of Medicine, Department of Obstetrics and Gynecology.\tPatients: Thirty-two subjects [average age 51,1±6,9 (37-66] who had indication of total abdominal hysterectomy and bilateral\tsalpingooferectomy due to benign pathologies.\tInterventions: According to ACOG, LAVH was performed by using the Garry technique at the trocar insertions, the Reich technique\tat the laparoscopic phase and the Heaney technique at the vaginal phase by the same operator. After adhesiolysis and diagnostic procedures, ureters were dissected medially. By coagulating, bilateral round and infundibulopelvic ligaments were cut after the\tmobilisation of bladder. The operation was completed by the same operation team by vaginal approach consequently. At all operations, 80 W unipolar or 150 W bipolar diathermic dissection and 25-35 W unipolar diathermic cutting were performed.\tMain outcome measures: Age, parity, menopausal status, preoperative indications, type of previous abdominopelvic surgey and incision, intraoperative indications, adhesion scores, rate of unintended laparotomy, operative time, uterus weight, loss of blood,\tcomplications, postoperative pain scores and analgesic requirements, time necessary for returning to normal intestinal function, length of hospitalisation and rate of readmission to hospital.\tRESULTS: When compared with the patients who had not previous abdominopelvic surgery, all adhesion scores, uterus weight, operative time and the number of total postoperative complications were found significantly high at patients who had previous\tsurgery. Loss of blood, the rate

Bilateral custom-fit total knee arthroplasty in a patient with poliomyelitis.

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Tardy, Nicolas; Chambat, Pierre; Murphy, Colin G; Fayard, Jean-Marie

2014-09-01

In limbs affected by poliomyelitis, total knee arthroplasty results in satisfactory pain relief. However, the risk of failure is high, especially if the preoperative quadriceps power is low. Therefore, treating osteoarthritis in the current patient represented a challenging procedure. A 66-year-old man presented with tricompartmental osteoarthritis of both knees, with valgus deformity of 14° on the left knee and 11° on the right knee. He walked with a bilateral knee recurvatum of 30° and a grade 1 quadriceps power. The authors treated both knees with cemented custom-fit hinged total knee arthroplasty with 30° of recurvatum in the tibial keel. Clinical scores showed good results 1 year postoperatively, especially on the subjective data of quality of life and function. At follow-up, radiographs showed good total knee arthroplasty positioning on the right side and a small mechanical loosening at the end of the tibial keel on the left side. Only 5 studies (Patterson and Insall; Moran; Giori and Lewallen; Jordan et al; and Tigani et al) have reported total knee arthroplasty results in patients with poliomyelitis. This study reports an original case of bilateral custom-fit hinged total knee arthroplasty in a patient with poliomyelitis. To the authors' knowledge, this is the first report of this type of procedure in the literature. The key point is the degree of recurvatum that is needed to allow walking, avoiding excessive constraints on the implants that can lead to early mechanical failure. Copyright 2014, SLACK Incorporated.

An fMRI study of neuronal activation in schizophrenia patients with and without previous cannabis use

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Else-Marie eLøberg

2012-10-01

Full Text Available Previous studies have mostly shown positive effects of cannabis use on cognition in patients with schizophrenia, which could reflect lower neurocognitive vulnerability. There are however no studies comparing whether such cognitive differences have neuronal correlates. Thus, the aim of the present study was to compare whether patients with previous cannabis use differ in brain activation from patients who has never used cannabis. The patients groups were compared on the ability to up-regulate an effort mode network during a cognitive task and down-regulate activation in the same network during a task-absent condition. Task-present and task-absent brain activation was measured by functional magnetic resonance neuroimaging (fMRI. Twenty-six patients with a DSM-IV and ICD-10 diagnosis of schizophrenia were grouped into a previous cannabis user group and a no-cannabis group. An auditory dichotic listening task with instructions of attention focus on either the right or left ear stimulus was used to tap verbal processing, attention and cognitive control, calculated as an aggregate score. When comparing the two groups, there were remaining activations in the task-present condition for the cannabis group, not seen in the no-cannabis group, while there was remaining activation in the task-absent condition for the no-cannabis group, not seen in the cannabis group. Thus, the patients with previous cannabis use showed increased activation in an effort mode network and decreased activation in the default mode network as compared to the no-cannabis group. It is concluded that the present study show some differences in brain activation to a cognitively challenging task between previous cannabis and no-cannabis schizophrenia patients.

Repeated Surgical or Endoscopic Myotomy for Recurrent Dysphagia in Patients After Previous Myotomy for Achalasia.

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Fumagalli, Uberto; Rosati, Riccardo; De Pascale, Stefano; Porta, Matteo; Carlani, Elisa; Pestalozza, Alessandra; Repici, Alessandro

2016-03-01

Surgical myotomy of the lower esophageal sphincter has a 5-year success rate of approximately 91 %. Peroral endoscopic myotomy can provide similar results for controlling dysphagia. Some patients experience either persistent or recurrent dysphagia after myotomy. We present here a retrospective analysis of our experience with redo myotomy for recurrent dysphagia in patients with achalasia. From March 1996 to February 2015, 234 myotomies for primary or recurrent achalasia were performed in our center. Fifteen patients (6.4 %) had had a previous myotomy and were undergoing surgical redo myotomy (n = 9) or endoscopic redo myotomy (n = 6) for recurrent symptoms. Patients presented at a median of 10.4 months after previous myotomy. Median preoperative Eckardt score was 6. Among the nine patients undergoing surgical myotomy, three esophageal perforations occurred intraoperatively (all repaired immediately). Surgery lasted 111 and 62 min on average (median) in the surgical and peroral endoscopic myotomy (POEM) groups, respectively. No postoperative complications occurred in either group. Median postoperative stay was 3 and 2.5 days in the surgical and POEM groups, respectively. In the surgical group, Eckardt score was dysphagia. Preliminary results using POEM indicate that the technique can be safely used in patients who have undergone previous surgical myotomy.

Clinical presentation of acute coronary syndrome in patients previously treated with nitrates.

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Latour-Pérez, Jaime; Gómez-Tello, Vicente; Fuset-Cabanes, María Paz; Balsa, Eva de Miguel; Sáez, Frutos Del Nogal; Orts, Francisco Javier Coves; Rodríguez, Carmen Martín; Pino-Izquierdo, Karel; Pesquera, María de la Concepción Pavía; Rodríguez, Antonio José Montón

2013-11-01

Several reports have suggested that nitrates limit acute ischaemic damage by a mechanism similar to preconditioning. This study aims to evaluate the effect of chronic oral nitrates on the clinical presentation and short-term outcomes of patients admitted with acute coronary syndrome (ACS). A retrospective cohort study was conducted in patients with ACS admitted to 62 acute care units from 2010 to 2011. A propensity score-matched samples analysis was performed. We analysed 3171 consecutive patients, of whom 298 (9.4%) were chronically treated with nitrates. Patients previously treated with nitrates had higher comorbidity and disease severity at admission, lower prevalence of ACS with ST elevation, lower troponin elevation, higher prevalence of initial Killip class 2-4 and higher hospital mortality. The propensity score-matched analysis confirmed that previous use of nitrates is independently associated with a lower prevalence of ST-elevation ACS [odds ratio (OR) 0.53, 95% confidence interval (CI) 0.36-0.78; P = 0.0014] and a lower troponin elevation (OR 0.61, 95% CI 0.41-0.92) but not with Killip class on admission (OR 1.18, 95% CI 0.83-1.67, P = 0.3697) or mortality (OR 0.71, 95% CI 0.37-1.38, P = 0.3196). The results support the hypothesis that nitrates have a protective effect on acute ischaemic injury.

Books average previous decade of economic misery.

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Bentley, R Alexander; Acerbi, Alberto; Ormerod, Paul; Lampos, Vasileios

2014-01-01

For the 20(th) century since the Depression, we find a strong correlation between a 'literary misery index' derived from English language books and a moving average of the previous decade of the annual U.S. economic misery index, which is the sum of inflation and unemployment rates. We find a peak in the goodness of fit at 11 years for the moving average. The fit between the two misery indices holds when using different techniques to measure the literary misery index, and this fit is significantly better than other possible correlations with different emotion indices. To check the robustness of the results, we also analysed books written in German language and obtained very similar correlations with the German economic misery index. The results suggest that millions of books published every year average the authors' shared economic experiences over the past decade.

Risks of cardiovascular adverse events and death in patients with previous stroke undergoing emergency noncardiac, nonintracranial surgery

DEFF Research Database (Denmark)

Christiansen, Mia N.; Andersson, Charlotte; Gislason, Gunnar H.

2017-01-01

Background: The outcomes of emergent noncardiac, nonintracranial surgery in patients with previous stroke remain unknown. Methods: All emergency surgeries performed in Denmark (2005 to 2011) were analyzed according to time elapsed between previous ischemic stroke and surgery. The risks of 30-day...... mortality and major adverse cardiovascular events were estimated as odds ratios (ORs) and 95% CIs using adjusted logistic regression models in a priori defined groups (reference was no previous stroke). In patients undergoing surgery immediately (within 1 to 3 days) or early after stroke (within 4 to 14...... and general anesthesia less frequent in patients with previous stroke (all P Risks of major adverse cardiovascular events and mortality were high for patients with stroke less than 3 months (20.7 and 16.4% events; OR = 4.71 [95% CI, 4.18 to 5.32] and 1.65 [95% CI, 1.45 to 1.88]), and remained...

Aerobic fitness in patients with fibrositis. A controlled study of respiratory gas exchange and 133-xenon clearance from exercising muscle

International Nuclear Information System (INIS)

Bennett, R.M.; Clark, S.R.; Goldberg, L.; Nelson, D.; Bonafede, R.P.; Porter, J.; Specht, D.

1989-01-01

Aerobic fitness was evaluated in 25 women with fibrositis, by having them exercise to volitional exhaustion on an electronically braked cycle ergometer. Compared with published standards, greater than 80% of the fibrositis patients were not physically fit, as assessed by maximal oxygen uptake. Compared with matched sedentary controls, fibrositis patients accurately perceived their level of exertion in relation to oxygen consumption and attained a similar level of lactic acidosis, as assessed by their respiratory quotient and ventilatory threshold. Exercising muscle blood flow was estimated by 133-xenon clearance in a subgroup of 16 fibrositis patients and compared with that in 16 matched sedentary controls; the fibrositis patients exhibited reduced 133-xenon clearance. These results indicate a need to include aerobic fitness as a matched variable in future controlled studies of fibrositis and suggest that the detraining phenomenon may be of relevance to the etiopathogenesis of the disease

Patient's anxiety and fear of anesthesia: effect of gender, age, education, and previous experience of anesthesia. A survey of 400 patients.

Science.gov (United States)

Mavridou, Paraskevi; Dimitriou, Varvara; Manataki, Adamantia; Arnaoutoglou, Elena; Papadopoulos, Georgios

2013-02-01

Patients express high anxiety preoperatively, because of fears related to anesthesia and its implications. The purpose of this survey was to gain insight into these fears and to study whether they are affected by patients' sex, age, education, or previous experience of anesthesia. Questionnaires with fixed questions were distributed to consenting, consecutive surgical patients before the pre-anesthetic visit. The questionnaires included patients' demographics and questions related to their fears about anesthesia. Four-hundred questionnaires were collected and analyzed. Eighty-one percent of patients experience preoperative anxiety. The main sources of their anxiety were fear of postoperative pain (84 %), of not waking up after surgery (64.8 %), of being nauseous or vomiting (60.2 %), and of drains and needles (59.5 %). Patients are less concerned about being paralyzed because of anesthesia (33.5 %) or of revealing personal issues (18.8 %). Gender seems to affect patients fears, with women being more afraid (85.3 vs. 75.6 % of men, p = 0.014). The effects of patients' age, level of education, and previous experience of anesthesia are minor, except for individual questions. Sixty-three percent of our patients (mostly women 67.4 vs. 57.4 % of men, p = 0.039) talk about these fears with their relatives, although a vast majority of 95.5 % would prefer to talk with the anesthesiologist and be reassured by him. All patients, mostly women, express fears about anesthesia; this fear leads to preoperative anxiety. Slight differences are observed for some individual questions among patients of different sex, education level, and previous experience of anesthesia.

The neural network approach to parton fitting

International Nuclear Information System (INIS)

Rojo, Joan; Latorre, Jose I.; Del Debbio, Luigi; Forte, Stefano; Piccione, Andrea

2005-01-01

We introduce the neural network approach to global fits of parton distribution functions. First we review previous work on unbiased parametrizations of deep-inelastic structure functions with faithful estimation of their uncertainties, and then we summarize the current status of neural network parton distribution fits

Immediate breast reconstruction after skin- or nipple-sparing mastectomy for previously augmented patients: a personal technique.

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Salgarello, Marzia; Rochira, Dario; Barone-Adesi, Liliana; Farallo, Eugenio

2012-04-01

Breast reconstruction for previously augmented patients differs from breast reconstruction for nonaugmented patients. Many surgeons regard conservation therapy as not feasible for these patients because of implant complications, whether radiotherapy-induced or not. Despite this, most authors agree that mastectomy with immediate breast reconstruction is the most suitable choice, ensuring both a good cosmetic result and a low complication rate. Implant retention or removal remains a controversial topic in addition to the best available surgical technique. This study reviewed the authors' experience with immediate breast reconstruction after skin-sparing mastectomy (SSM) and nipple-sparing mastectomy (NSM) with anatomically definitive implants. The retrospective records of 12 patients were examined (group A). These patients were among 254 patients who underwent SSM or NSM for breast carcinoma. The control group comprised 12 of the 254 patients submitted to SSM or NSM (group B) who best matched the 12 patients in the studied group. All of them underwent immediate breast reconstruction, with an anatomically definitive implant placed in a submuscular-subfascial pocket. The demographic, technical, and oncologic data of the two groups were compared as well as the aesthetic outcomes using the Breast Q score. The proportion of complications, the type of implant, the axillary lymph node procedure, and the histology were compared between the two groups using Fisher's exact test. Student's t test was used to compare the scores for the procedure-specific modules of the breast Q questionnaire in the two groups. A validated patient satisfaction score was obtained using the breast Q questionnaire after breast reconstruction. The demographic, technical, and oncologic characteristics were not significantly different between the two groups. The previously augmented patients reported a significantly higher level of satisfaction with their breast than the control patients. The scores

Clinical usefulness of single-balloon endoscopy in patients with previously incomplete colonoscopy

Science.gov (United States)

Kobayashi, Kiyonori; Mukae, Miyuki; Ogawa, Taishi; Yokoyama, Kaoru; Sada, Miwa; Koizumi, Wasaburo

2013-01-01

AIM: To evaluate the clinical usefulness of single-balloon endoscopy (SBE) in patients in whom a colonoscope was technically difficult to insert previously. METHODS: The study group comprised 15 patients (8 men and 7 women) who underwent SBE for colonoscopy (30 sessions). The number of SBE sessions was 1 in 7 patients, 2 in 5 patients, 3 in 1 patient, 4 in 1 patient, and 6 in 1 patient. In all patients, total colonoscopy was previously unsuccessful. The reasons for difficulty in scope passage were an elongated colon in 6 patients, severe intestinal adhesions after open surgery in 4, an elongated colon and severe intestinal adhesions in 2, a left inguinal hernia in 2, and multiple diverticulosis of the sigmoid colon in 1. Three endoscopists were responsible for SBE. The technique for inserting SBE in the colon was basically similar to that in the small intestine. The effectiveness of SBE was assessed on the basis of the success rate of total colonoscopy and the presence or absence of complications. We also evaluated the diagnostic and treatment outcomes of colonoscopic examinations with SBE. RESULTS: Total colonoscopy was successfully accomplished in all sessions. The mean insertion time to the cecum was 22.9 ± 8.9 min (range 9 to 40). Abnormalities were found during 21 sessions of SBE. The most common abnormality was colorectal polyps (20 sessions), followed by radiation colitis (3 sessions) and diverticular disease of the colon (3 sessions). Colorectal polyps were resected endoscopically in 15 sessions. A total of 42 polyps were resected endoscopically, using snare polypectomy in 32 lesions, hot biopsy in 7 lesions, and endoscopic mucosal resection in 3 lesions. Fifty-six colorectal polyps were newly diagnosed on colonoscopic examination with SBE. Histopathologically, these lesions included 2 intramucosal cancers, 42 tubular adenomas, and 2 tubulovillous adenomas. The mean examination time was 48.2 ± 20.0 min (range 25 to 90). Colonoscopic examination or

Tailored cognitive-behavioural therapy and exercise training improves the physical fitness of patients with fibromyalgia

NARCIS (Netherlands)

Spillekom-van Koulil, S.; Lankveld, W.G.J.M. van; Kraaimaat, F.W.; Helmond, T. van; Vedder, A.; Hoorn, H. van; Donders, A.R.T.; Wirken, L.; Cats, H.; Riel, P.L.C.M. van; Evers, A.W.M.

2011-01-01

OBJECTIVES: Patients with fibromyalgia have diminished levels of physical fitness, which may lead to functional disability and exacerbating complaints. Multidisciplinary treatment comprising cognitive-behavioural therapy (CBT) and exercise training has been shown to be effective in improving

Influence of previous breast surgery in sentinel lymph node biopsy in patients with breast cancer.

Science.gov (United States)

López-Prior, V; Díaz-Expósito, R; Casáns Tormo, I

The aim of this study was to review the feasibility of selective sentinel lymph node biopsy in patients with previous surgery for breast cancer, as well as to examine the factors that may interfere with sentinel node detection. A retrospective review was performed on 91 patients with breast cancer and previous breast surgery, and who underwent sentinel lymph node biopsy. Patients were divided into two groups according to their previous treatment: aesthetic breast surgery in 30 patients (group I) and breast-conserving surgery in 61 (group II). Lymphoscintigraphy was performed after an intra-tumour injection in 21 cases and a peri-areolar injection in 70 cases. An analysis was made of lymphatic drainage patterns and overall sentinel node detection according to clinical, pathological and surgical variables. The overall detection of the sentinel lymph node in the lymphoscintigraphy was 92.3%, with 7.7% of extra-axillary drainages. The identification rate was similar after aesthetic breast surgery (93.3%) and breast-conserving surgery (91.8%). Sentinel lymph nodes were found in the contralateral axilla in two patients (2.2%), and they were included in the histopathology study. The non-identification rate in the lymphoscintigraphy was 7.7%. There was a significantly higher non-detection rate in the highest histological grade tumours (28.6% grade III, 4.5% grade I and 3.6% grade II). Sentinel lymph node biopsy in patients with previous breast surgery is feasible and deserves further studies to assess the influence of different aspects in sentinel node detection in this clinical scenario. A high histological grade was significantly associated with a lower detection. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

Treatment response with mepolizumab in severe eosinophilic asthma patients with previous omalizumab treatment.

Science.gov (United States)

Magnan, A; Bourdin, A; Prazma, C M; Albers, F C; Price, R G; Yancey, S W; Ortega, H

2016-09-01

We performed post hoc analyses to evaluate the effect of humanized monoclonal antibody mepolizumab in patients with severe eosinophilic asthma previously treated with omalizumab. Data were collected from two randomized double-blind, placebo-controlled studies: MENSA (NCT01691521: 32-week treatment phase) and SIRIUS (NCT01691508: 24-week treatment phase). Active treatment was 75 mg intravenous mepolizumab (MENSA) or 100 mg subcutaneous mepolizumab (MENSA, SIRIUS). Patients had evidence of eosinophilic inflammation ≥150 cells/μl (at screening) or ≥300 cells/μl (during the previous year). Primary outcomes were the rate of exacerbations (MENSA) and the percentage reduction in oral corticosteroid (OCS) dose (SIRIUS). Other outcomes included lung function (forced expiratory volume in 1 s and morning peak expiratory flow), Asthma Control Questionnaire (ACQ-5), St George's Respiratory Questionnaire (SGRQ) scores, and safety. Overall, 576 patients were included from MENSA and 135 from SIRIUS, with 13% and 33% previously receiving omalizumab, respectively. In MENSA, mepolizumab reduced the rate of exacerbations by 57% (prior omalizumab) and 47% (no prior omalizumab) vs placebo. In SIRIUS, reductions in OCS use were comparable regardless of prior omalizumab use. Despite reducing chronic OCS use, mepolizumab also resulted in similar reductions in exacerbation rate relative to placebo in both subgroups. Asthma control and quality of life improved with mepolizumab vs placebo in both studies independent of prior omalizumab use, as shown by ACQ-5 and SGRQ scores. Adverse events were also comparable irrespective of prior omalizumab use. These post hoc analyses indicate that patients with severe eosinophilic asthma respond positively to mepolizumab regardless of prior use of omalizumab. © 2016 The Authors. Allergy Published by John Wiley & Sons Ltd.

Books Average Previous Decade of Economic Misery

Science.gov (United States)

Bentley, R. Alexander; Acerbi, Alberto; Ormerod, Paul; Lampos, Vasileios

2014-01-01

For the 20th century since the Depression, we find a strong correlation between a ‘literary misery index’ derived from English language books and a moving average of the previous decade of the annual U.S. economic misery index, which is the sum of inflation and unemployment rates. We find a peak in the goodness of fit at 11 years for the moving average. The fit between the two misery indices holds when using different techniques to measure the literary misery index, and this fit is significantly better than other possible correlations with different emotion indices. To check the robustness of the results, we also analysed books written in German language and obtained very similar correlations with the German economic misery index. The results suggest that millions of books published every year average the authors' shared economic experiences over the past decade. PMID:24416159

Indiana pouch continent urinary reservoir in patients with previous pelvic irradiation

International Nuclear Information System (INIS)

Mannel, R.S.; Braly, P.S.; Buller, R.E.

1990-01-01

Little information exists on the use of continent urinary reservoirs in patients with previous pelvic irradiation. We report the use of the Indiana pouch urinary reservoir in ten women with a history of pelvic irradiation for cervical cancer, of whom eight underwent a total pelvic exenteration for recurrent pelvic tumor and two had diversion for radiation-induced vesicovaginal fistula. All ten women achieved daytime continence, with a median time between catheterizations of 4.5 hours and a median pouch capacity of 500 mL. There was no evidence of leakage from the reservoir or significant ureteral reflux or obstruction on postoperative radiographic evaluation. No patient has required reoperation or had significant postoperative complications with the technique described

Effectiveness of sound therapy in patients with tinnitus resistant to previous treatments: importance of adjustments

Directory of Open Access Journals (Sweden)

Flavia Alencar de Barros Suzuki

Full Text Available ABSTRACT INTRODUCTION: The difficulty in choosing the appropriate therapy for chronic tinnitus relates to the variable impact on the quality of life of affected patients and, thus, requires individualization of treatment. OBJECTIVE: To evaluate the effectiveness of using sound generators with individual adjustments to relieve tinnitus in patients unresponsive to previous treatments. METHODS: A prospective study of 10 patients with chronic tinnitus who were unresponsive to previous drug treatments, five males and five females, with ages ranging from 41 to 78 years. Bilateral sound generators (Reach 62 or Mind 9 models were used daily for at least 6 h during 18 months. The patients were evaluated at the beginning, after 1 month and at each 3 months until 18 months through acuphenometry, minimum masking level, the Tinnitus Handicap Inventory, visual analog scale, and the Hospital Anxiety and Depression Scale. The sound generators were adjusted at each visit. RESULTS: There was a reduction of Tinnitus Handicap Inventory in nine patients using a protocol with a customized approach, independent of psychoacoustic characteristics of tinnitus. The best response to treatment occurred in those with whistle-type tinnitus. A correlation among the adjustments and tinnitus loudness and minimum masking level was found. Only one patient, who had indication of depression by Hospital Anxiety and Depression Scale, did not respond to sound therapy. CONCLUSION: There was improvement in quality of life (Tinnitus Handicap Inventory, with good response to sound therapy using customized settings in patients who did not respond to previous treatments for tinnitus.

In elderly patients with AML, which patients should be considered fit or unfit for standard induction therapy?

Science.gov (United States)

Swords, Ronan; Santini, Valeria

2012-01-01

A 75-year-old man visits his primary care physician for a routine checkup and a complete blood count reveals pancytopenia. BM examination confirms the diagnosis of acute myeloid leukemia. No dysplastic features were noted and his karyotype results are pending. The patient has well-controlled hypertension and his last hospital admission was 20 years ago for repair of a rotator cuff injury. His Eastern Cooperative Oncology Group performance status is 0/4 and he has no cognitive impairment. You believe the patient is fit for standard acute myeloid leukemia induction, but you are concerned because of his older age and you are considering less-intensive approaches.

Cheilitis in acne vulgaris patients with no previous use of systemic retinoid products.

Science.gov (United States)

Balighi, Kamran; Daneshpazhooh, Maryam; Lajevardi, Vahideh; Talebi, Shahin; Azizpour, Arghavan

2017-08-01

Isotretinoin is commonly used in the treatment of acne vulgaris. While one of the more common side-effects is cheilitis, we have observed an increased incidence of cheilitis prior to the commencement of systemic isotretinoin. The aim of this study was to assess the prevalence of cheilitis among acne vulgaris patients. A non-interventional cross-sectional study of patients with acne vulgaris. Patients with previous use of systemic retinoids were excluded. The patients were examined for signs and symptoms of cheilitis. Of a total of 400 patients, 134 (34%) had evidence of cheilitis at initial presentation. Two-thirds (63%) were female (P acne excorie, compared with only 8% of patients with no signs of cheilitis. Our findings suggest that cheilitis is quite common among acne vulgaris patients even before treatment with isotretinoin. © 2016 The Australasian College of Dermatologists.

Impact of CrossFit-Related Spinal Injuries.

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Hopkins, Benjamin S; Cloney, Michael B; Kesavabhotla, Kartik; Yamaguchi, Jonathon; Smith, Zachary A; Koski, Tyler R; Hsu, Wellington K; Dahdaleh, Nader S

2017-11-16

Exercise-related injuries (ERIs) are a common cause of nonfatal emergency department and hospital visits. CrossFit is a high-intensity workout regimen whose popularity has grown rapidly. However, ERIs due to CrossFit remained under investigated. All patients who presented to the main hospital at a major academic center complaining of an injury sustained performing CrossFit between June 2010 and June 2016 were identified. Injuries were classified by anatomical location (eg, knee, spine). For patients with spinal injuries, data were collected including age, sex, body mass index (BMI), CrossFit experience level, symptom duration, type of symptoms, type of clinic presentation, cause of injury, objective neurological examination findings, imaging type, number of clinic visits, and treatments prescribed. Four hundred ninety-eight patients with 523 CrossFit-related injuries were identified. Spine injuries were the most common injuries identified, accounting for 20.9%. Among spine injuries, the most common location of injury was the lumbar spine (83.1%). Average symptom duration was 6.4 months ± 15.1, and radicular complaints were the most common symptom (53%). A total of 30 (32%) patients had positive findings on neurologic examination. Six patients (6.7%) required surgical intervention for treatment after failing an average of 9.66 months of conservative treatment. There was no difference in age, sex, BMI, or duration of symptoms of patients requiring surgery with those who did not. CrossFit is a popular, high-intensity style workout with the potential to injure its participants. Spine injuries were the most common type of injury observed and frequently required surgical intervention.

Ibrutinib versus previous standard of care: an adjusted comparison in patients with relapsed/refractory chronic lymphocytic leukaemia.

Science.gov (United States)

Hansson, Lotta; Asklid, Anna; Diels, Joris; Eketorp-Sylvan, Sandra; Repits, Johanna; Søltoft, Frans; Jäger, Ulrich; Österborg, Anders

2017-10-01

This study explored the relative efficacy of ibrutinib versus previous standard-of-care treatments in relapsed/refractory patients with chronic lymphocytic leukaemia (CLL), using multivariate regression modelling to adjust for baseline prognostic factors. Individual patient data were collected from an observational Stockholm cohort of consecutive patients (n = 144) diagnosed with CLL between 2002 and 2013 who had received at least second-line treatment. Data were compared with results of the RESONATE clinical trial. A multivariate Cox proportional hazards regression model was used which estimated the hazard ratio (HR) of ibrutinib versus previous standard of care. The adjusted HR of ibrutinib versus the previous standard-of-care cohort was 0.15 (p ibrutinib in the RESONATE study were significantly longer than with previous standard-of-care regimens used in second or later lines in routine healthcare. The approach used, which must be interpreted with caution, compares patient-level data from a clinical trial with outcomes observed in a daily clinical practice and may complement results from randomised trials or provide preliminary wider comparative information until phase 3 data exist.

Evolutionary Graphs with Frequency Dependent Fitness

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Nie, Pu-Yan; Zhang, Pei-Ai

Evolutionary graph theory was recently proposed by Lieberman et al. in 2005. In the previous papers about evolutionary graphs (EGs), the fitness of the residents in the EGs is in general assumed to be unity, and the fitness of a mutant is assumed to be a constant r. We aim to extend EG to general cases in this paper, namely, the fitness of a mutant is heavily dependent upon frequency. The corresponding properties for these new EGs are analyzed, and the fixation probability is obtained for large population.

Assessment and Reporting of Driving Fitness in Patients with Dementia in Clinical Practice: Data from SveDem, the Swedish Dementia Registry.

Science.gov (United States)

Lovas, Joel; Fereshtehnejad, Seyed-Mohammad; Cermakova, Pavla; Lundberg, Catarina; Johansson, Björn; Johansson, Kurt; Winblad, Bengt; Eriksdotter, Maria; Religa, Dorota

2016-05-05

Driving constitutes a very important aspect of daily life and is dependent on cognitive functions such as attention, visuo-spatial skills and memory, which are often compromised in dementia. Therefore, the driving fitness of patients with dementia needs to be addressed by physicians and those that are deemed unfit should not be allowed to continue driving. We aimed at investigating to what extent physicians assess driving fitness in dementia patients and determinant factors for revoking of their licenses. This study includes 15113 patients with newly diagnosed dementia and driver's license registered in the Swedish Dementia Registry (SveDem). The main outcomes were reporting to the licensing authority and making an agreement about driving eligibility with the patients. Physicians had not taken any action in 16% of dementia patients, whereas 9% were reported to the authority to have their licenses revoked. Males (OR = 3.04), those with an MMSE score between 20-24 (OR = 1.35) and 10-19 (OR = 1.50), patients with frontotemporal (OR = 3.09) and vascular dementia (OR = 1.26) were more likely to be reported to the authority. For the majority of patients with dementia, driving fitness was assessed. Nevertheless, physicians did not address the issue in a sizeable proportion of dementia patients. Type of dementia, cognitive status, age, sex and burden of comorbidities are independent factors associated with the assessment of driving fitness in patients with dementia. Increased knowledge on how these factors relate to road safety may pave the way for more specific guidelines addressing the issue of driving in patients with dementia.

Effect of previous exposure to hbv on liver histology and treatment response in chc patients

International Nuclear Information System (INIS)

Khan, H.A.

2015-01-01

Objective: To analyze the influence of previous exposure to HBV on liver histology and treatment outcomes in chronic hepatitis C (CHC) patients. Study Design: Case control study. Place and Duration of Study: Rawalian Liver Clinic, Department of Medicine, Holy Family Hospital, Rawalpindi, from January 2011 to December 2012. Methodology: Medical records of CHC patients attending the Rawalian Liver Clinic were retrospectively analyzed. Virological and treatment responses along with histological changes were compared between cases (anti-HBc positive) and controls (anti-HBc negative). Significance was determined through chi-square test at p < 0.05. Results: Among the 592 CHC patients, 254 (42.9%) had serological evidence of a positive anti-HBc (cases) and 338 (57.1%), patients had negative anti-HBc (controls). No significant difference was found between ETR, SVR and treatment responses (n=220) between the two groups. Out of 65 patients whose liver biopsy data was available, cases were more likely to respond in the absence of fibrosis (63.2%, (n=24) vs. 36.8%, (n=14), p=0.001). The controls responded more in the presence of fibrosis (100% (n=9) vs. 0, p=0.001). There was no significant effect of anti-HBc positivity on grades of inflammation and consequent treatment response (p=0.14). Conclusion: There are a significant number of CHC patients with markers of previous HBV infection in Pakistani population. Previous HBV (anti-HBc positive) does not seem to have an adverse effect on liver histology and treatment responses in HBV infection. (author)

Automatic treatment planning implementation using a database of previously treated patients

International Nuclear Information System (INIS)

Moore, J A; Evans, K; Yang, W; Herman, J; McNutt, T

2014-01-01

Purpose: Using a database of prior treated patients, it is possible to predict the dose to critical structures for future patients. Automatic treatment planning speeds the planning process by generating a good initial plan from predicted dose values. Methods: A SQL relational database of previously approved treatment plans is populated via an automated export from Pinnacle 3 . This script outputs dose and machine information and selected Regions of Interests as well as its associated Dose-Volume Histogram (DVH) and Overlap Volume Histograms (OVHs) with respect to the target structures. Toxicity information is exported from Mosaiq and added to the database for each patient. The SQL query is designed to ask the system for the lowest achievable dose for a specified region of interest (ROI) for each patient with a given volume of that ROI being as close or closer to the target than the current patient. Results: The additional time needed to calculate OVHs is approximately 1.5 minutes for a typical patient. Database lookup of planning objectives takes approximately 4 seconds. The combined additional time is less than that of a typical single plan optimization (2.5 mins). Conclusions: An automatic treatment planning interface has been successfully used by dosimetrists to quickly produce a number of SBRT pancreas treatment plans. The database can be used to compare dose to individual structures with the toxicity experienced and predict toxicities before planning for future patients.

Emergency diagnosis of cancer and previous general practice consultations: insights from linked patient survey data.

Science.gov (United States)

Abel, Gary A; Mendonca, Silvia C; McPhail, Sean; Zhou, Yin; Elliss-Brookes, Lucy; Lyratzopoulos, Georgios

2017-06-01

Emergency diagnosis of cancer is common and aetiologically complex. The proportion of emergency presenters who have consulted previously with relevant symptoms is uncertain. To examine how many patients with cancer, who were diagnosed as emergencies, have had previous primary care consultations with relevant symptoms; and among those, to examine how many had multiple consultations. Secondary analysis of patient survey data from the 2010 English Cancer Patient Experience Survey (CPES), previously linked to population-based data on diagnostic route. For emergency presenters with 18 different cancers, associations were examined for two outcomes (prior GP consultation status; and 'three or more consultations' among prior consultees) using logistic regression. Among 4647 emergency presenters, 1349 (29%) reported no prior consultations, being more common in males (32% versus 25% in females, P <0.001), older (44% in ≥85 versus 30% in 65-74-year-olds, P <0.001), and the most deprived (35% versus 25% least deprived, P = 0.001) patients; and highest/lowest for patients with brain cancer (46%) and mesothelioma (13%), respectively ( P <0.001 for overall variation by cancer site). Among 3298 emergency presenters with prior consultations, 1356 (41%) had three or more consultations, which were more likely in females ( P <0.001), younger ( P <0.001), and non-white patients ( P = 0.017) and those with multiple myeloma, and least likely for patients with leukaemia ( P <0.001). Contrary to suggestions that emergency presentations represent missed diagnoses, about one-third of emergency presenters (particularly those in older and more deprived groups) have no prior GP consultations. Furthermore, only about one-third report multiple (three or more) consultations, which are more likely in 'harder-to-suspect' groups. © British Journal of General Practice 2017.

Laparoscopy After Previous Laparotomy

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Zulfo Godinjak

2006-11-01

Full Text Available Following the abdominal surgery, extensive adhesions often occur and they can cause difficulties during laparoscopic operations. However, previous laparotomy is not considered to be a contraindication for laparoscopy. The aim of this study is to present that an insertion of Veres needle in the region of umbilicus is a safe method for creating a pneumoperitoneum for laparoscopic operations after previous laparotomy. In the last three years, we have performed 144 laparoscopic operations in patients that previously underwent one or two laparotomies. Pathology of digestive system, genital organs, Cesarean Section or abdominal war injuries were the most common causes of previouslaparotomy. During those operations or during entering into abdominal cavity we have not experienced any complications, while in 7 patients we performed conversion to laparotomy following the diagnostic laparoscopy. In all patients an insertion of Veres needle and trocar insertion in the umbilical region was performed, namely a technique of closed laparoscopy. Not even in one patient adhesions in the region of umbilicus were found, and no abdominal organs were injured.

The effect of metformin on the recurrence of colorectal adenoma in diabetic patients with previous colorectal adenoma.

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Han, Min Seok; Lee, Hyun Jung; Park, Soo Jung; Hong, Sung Pil; Cheon, Jae Hee; Kim, Won Ho; Kim, Tae Il

2017-08-01

Existing studies suggest that metformin lowers the risk and mortality of colorectal cancer. However, the effect of metformin on the suppression and prevention of colorectal adenomas is not clear. The aim of this study was to evaluate the effect of metformin on the recurrence of colorectal adenoma in diabetic patients with previous colorectal adenoma. Among 423 diabetic patients who underwent surveillance colonoscopy after resection of colorectal adenoma between 2005 and 2011, 257 patients were retrospectively reviewed. The patients were divided into two groups: one group comprising 106 patients who took metformin and another group comprising 151 patients who did not take metformin. The clinical characteristics, colorectal adenoma recurrence, and valuable factors for adenoma recurrence were analyzed. At surveillance colonoscopy after colonoscopic polypectomy for adenoma, 38 patients (35.8%) exhibited colorectal adenoma among 106 patients who took metformin, compared with 85 patients (56.3%) with colorectal adenoma among 151 patients who did not take metformin (odds ratio 0.434, 95% confidence interval 0.260-0.723, P = 0.001). Multivariate Cox analysis showed that metformin was associated with decreased recurrence of colorectal adenoma (hazard ratio 0.572, 95% confidence interval 0.385-0.852, P = 0.006) in diabetic patients with previous colorectal adenoma. The cumulative probability of colorectal adenoma recurrence was significantly lower in the metformin group than in the non-metformin group (P = 0.001). Metformin use in diabetic patients with previous colorectal adenoma is associated with a lower risk of colorectal adenoma recurrence.

Outcome after arthroscopic labral surgery in patients previously treated with periacetabular osteotomy

DEFF Research Database (Denmark)

Hartig-Andreasen, Charlotte; Nielsen, Torsten G; Lund, Bent

2017-01-01

To identify factors predicting failure after hip arthroscopy in patients with previous periacetabular osteotomy (PAO) defined as a conversion to total hip replacement (THR) and to evaluate the patient reported outcome scores. Of 55 hips treated with hip arthroscopy after PAO from Aug 2008 to 2012....... Nine hips were converted to a THR. Kaplan-Meier survival rate was 52.8% (95% CI, 10%-83.8%) at 6.5 years follow-up. Statistically significant predictors of failure: joint space width after PAO ...% of the hips. In 42% of the hips cartilage lesions of Becks grade >3 were found. Mean mHHS and HOS were 65.7 and 68.8 respectively at follow-up. A NRS pain score of >3 in rest and during activity were present in respectively, 43% and 62% of the patients. Hip arthroscopy after PAO demonstrated limited clinical...

CrossFit-related cervical internal carotid artery dissection.

Science.gov (United States)

Lu, Albert; Shen, Peter; Lee, Paul; Dahlin, Brian; Waldau, Ben; Nidecker, Anna E; Nundkumar, Anoop; Bobinski, Matthew

2015-08-01

CrossFit is a high-intensity strength and conditioning program that has gained popularity over the past decade. Potential injuries associated with CrossFit training have been suggested in past reports. We report three cases of cervical carotid dissection that are associated with CrossFit workouts. Patient 1 suffered a distal cervical internal carotid artery (ICA) dissection near the skull base and a small infarct in Wernicke's area. He was placed on anticoagulation and on follow-up has near complete recovery. Patient 2 suffered a proximal cervical ICA dissection that led to arterial occlusion and recurrent middle cerebral artery territory infarcts and significant neurological sequelae. Patient 3 had a skull base ICA dissection that led to a partial Horner's syndrome but no cerebral infarct. While direct causality cannot be proven, intense CrossFit workouts may have led to the ICA dissections in these patients.

Trephine Transverse Colostomy Is Effective for Patients Who Have Previously Undergone Rectal Surgery

Science.gov (United States)

Yeom, Seung-Seop; Jung, Sung Woo; Oh, Se Heon; Lee, Jong Lyul; Yoon, Yong Sik; Park, In Ja; Lim, Seok-Byung; Yu, Chang Sik; Kim, Jin Cheon

2018-01-01

Purpose Colostomy creation is an essential procedure for colorectal surgeons, but the preferred method of colostomy varies by surgeon. We compared the outcomes of trephine colostomy creation with open those for the (laparotomy) and laparoscopic methods and evaluated appropriate indications for a trephine colostomy and the advantages of the technique. Methods We retrospectively evaluated 263 patients who had undergone colostomy creation by trephine, open and laparoscopic approaches between April 2006 and March 2016. We compared the clinical features and the operative and postoperative outcomes according to the approach used for stoma creation. Results One hundred sixty-three patients (62%) underwent colostomy surgery for obstructive causes and 100 (38%) for fistulous problems. The mean operative time was significantly shorter with the trephine approach (trephine, 46.0 ± 1.9 minutes; open, 78.7 ± 3.9 minutes; laparoscopic, 63.5 ± 5.0 minutes; P colostomy was feasible for a diversion colostomy (P colostomy is safe and can be implemented quickly in various situations, and compared to other colostomy procedures, the patient’s recovery is faster. Previous laparotomy history was not a contraindication for a trephine colostomy, and a trephine transverse colostomy is feasible for patients who have undergone previous rectal surgery. PMID:29742862

'Vague Oviedo': autonomy, culture and the case of previously competent patients.

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Pascalev, Assya; Vidalis, Takis

2010-03-01

The paper examines the ethical and legal challenges of making decisions for previously competent patients and the role of advance directives and legal representatives in light of the Oviedo Convention. The paper identifies gaps in the Convention that result in conflicting instructions in cases of a disagreement between the expressed prior wishes of a patient, and the legal representative. The authors also examine the legal and moral status of informally expressed prior wishes of patients unable to consent. The authors argue that positivist legal reasoning is insufficient for a consistent interpretation of the relevant provisions of the Convention and argue that ethical argumentation is needed to provide guidance in such cases. Based on the ethical arguments, the authors propose a way of reconciling the apparent inconsistencies in the Oviedo Convention. They advance a culturally sensitive approach to the application of the Convention at the national level. This approach understands autonomy as a broader, relational consent and emphasizes the social and cultural embeddedness of the individual. Based on their approach, the authors argue that there exists a moral obligation to respect the prior wishes of the patient even in countries without advance directives. Yet it should be left to the national legislations to determine the extent of this obligation and its concrete forms.

Contact lenses fitting after intracorneal ring segments implantation in keratoconus

Directory of Open Access Journals (Sweden)

Luciane Bugmann Moreira

2013-08-01

Full Text Available PURPOSE: Evaluate contact lenses fitting after intracorneal ring implantation for keratoconus, its visual acuity and comfort. METHODS: Retrospective study of patients undergoing contact lenses fitting, after intracorneal ring for keratoconus. The criterion for contact lens fitting was unsatisfactory visual acuity with spectacle correction as referred by the patients. All patients were intolerants to contact lenses prior to intracorneal implantation. Visual acuity analysis was done by conversion of Snellen to logMAR scales. The comfort was evaluated according subjective questioning of good, medium or poor comfort. RESULTS: Nineteen patients were included in the study. Two patients (10.5% did not achieved good comfort with contact lenses and underwent penetrating keratoplasties. All the others 17 patients showed good or medium comfort. Four rigid gas-permeable contact lenses were fitted, one piggyback approach, 3 toric soft contact lenses, 2 soft lenses specially design for keratoconus and 7 disposable soft lenses. The average visual acuity improved from 0.77 ± 0.37 to 0.19 ± 0.13 logMAR units after contact lenses fitting. CONCLUSION: Contact lens fitting after intracorneal ring is possible, provides good comfort, improves visual acuity, and therefore, may postpone the need for penetrating keratoplasty.

A new non-iterative method for fitting Lorentzian to Moessbauer spectra

International Nuclear Information System (INIS)

Mukoyama, T.; Vegh, J.

1980-01-01

A new method for fitting a Lorentzian function without an iterative procedure is presented. The method is quicker and simpler than the previously proposed method of non-iterative fitting. Comparison with the previous method and with the conventional iterative method has been made. It is shown that the present method gives satisfactory results. (orig.)

Benefits of awake uniportal pulmonary resection in a patient with a previous contralateral lobectomy.

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Galvez, Carlos; Navarro-Martinez, Jose; Bolufer, Sergio; Lirio, Francisco; Mafe, Juan Jose; Rivera, Maria Jesus; Roca, Joaquin; Baschwitz, Benno

2014-09-01

Surgical resection of a contralateral recurrence of non-small cell lung cancer (NSCLC) is indicated in patients without evidence of disseminated disease and considered functionally operable. General anesthesia and double-lumen intubation involves one lobe ventilation in a patient treated with a previous lobectomy, thus increasing the risks of ventilator-induced injuries and the morbidity. Awake procedures facilitate the surgery decreasing the anesthetic and surgical times, keeping the diaphragm motion and diminishing the ventilator-induced injuries into the remaining contralateral lobe. We present a 43-year-old woman with a previous left-lower lobectomy for a 3.1-cm mucinous adenocarcinoma 15 months before without nodal involvement, who presents a right-lower lobe 8-mm cavitated nodule, with evident radiological growth and fine-needle aspiration concordant with mucinous adenocarcinoma. We suggest an awake procedure with locoregional epidural anesthesia.

Predicting Radiation Pneumonitis After Stereotactic Ablative Radiation Therapy in Patients Previously Treated With Conventional Thoracic Radiation Therapy

International Nuclear Information System (INIS)

Liu Hui; Zhang Xu; Vinogradskiy, Yevgeniy Y.; Swisher, Stephen G.; Komaki, Ritsuko; Chang, Joe Y.

2012-01-01

Purpose: To determine the incidence of and risk factors for radiation pneumonitis (RP) after stereotactic ablative radiation therapy (SABR) to the lung in patients who had previously undergone conventional thoracic radiation therapy. Methods and Materials: Seventy-two patients who had previously received conventionally fractionated radiation therapy to the thorax were treated with SABR (50 Gy in 4 fractions) for recurrent disease or secondary parenchymal lung cancer (T 10 and mean lung dose (MLD) of the previous plan and the V 10 -V 40 and MLD of the composite plan were also related to RP. Multivariate analysis revealed that ECOG PS scores of 2-3 before SABR (P=.009), FEV1 ≤65% before SABR (P=.012), V 20 ≥30% of the composite plan (P=.021), and an initial PTV in the bilateral mediastinum (P=.025) were all associated with RP. Conclusions: We found that severe RP was relatively common, occurring in 20.8% of patients, and could be predicted by an ECOG PS score of 2-3, an FEV1 ≤65%, a previous PTV spanning the bilateral mediastinum, and V 20 ≥30% on composite (previous RT+SABR) plans. Prospective studies are needed to validate these predictors and the scoring system on which they are based.

Firefighter health and fitness assessment: a call to action.

Science.gov (United States)

Storer, Thomas W; Dolezal, Brett A; Abrazado, Marlon L; Smith, Denise L; Batalin, Maxim A; Tseng, Chi-Hong; Cooper, Christopher B

2014-03-01

Sudden cardiac deaths experienced by firefighters in the line of duty account for the largest proportion of deaths annually. Several fire service standards for fitness and wellness have been recommended but currently only 30% of U.S. fire departments are implementing programs for this purpose. The Department of Homeland Security Science and Technology Directorate has initiated the Physiological Health Assessment System for Emergency Responders (PHASER) program aiming to reduce these line-of-duty deaths through an integration of medical science and sensor technologies. Confirming previous reports, PHASER comprehensive risk assessment has identified lack of physical fitness with propensity for overexertion as a major modifiable risk factor. We sought to determine if current levels of fitness and cardiovascular disease (CVD) risk factors in a contemporary cohort of firefighters were better than those reported over the past 30 years. Fifty-one firefighters from a Southern California department were characterized for physical fitness and CVD risk factors using standard measures. Overall, physical fitness and risk factors were not different from previous reports of firefighter fitness and most subjects did not achieve recommended fitness standards. Considering the lack of widespread implementation of wellness/fitness programs in the U.S. fire service together with our findings that low physical fitness and the presence of CVD risk factors persist, we issue a call to action among health and fitness professionals to assist the fire service in implementing programs for firefighters that improve fitness and reduce CVD risk factors. Fitness professionals should be empowered to work with fire departments lending their expertise to guide programs that achieve these objectives, which may then lead to reduced incidence of sudden cardiac death or stroke.

The social negotiation of fitness for work: tensions in doctor-patient relationships over medical certification of chronic pain.

Science.gov (United States)

Wainwright, Elaine; Wainwright, David; Keogh, Edmund; Eccleston, Christopher

2015-01-01

The UK government is promoting the health benefits of work, in order to change doctors' and patients' behaviour and reduce sickness absence. The rationale is that many people 'off sick' would have better outcomes by staying at work; but reducing the costs of health care and benefits is also an imperative. Replacement of the 'sick note' with the 'fit note' and a national educational programme are intended to reduce sickness-certification rates, but how will these initiatives impact on doctor-patient relationships and the existing tension between the doctor as patient advocate and gate-keeper to services and benefits? This tension is particularly acute for problems like chronic pain where diagnosis, prognosis and work capacity can be unclear. We interviewed 13 doctors and 30 chronic pain patients about their experiences of negotiating medical certification for work absence and their views of the new policies. Our findings highlight the limitations of naïve rationalist approaches to judgements of work absence and fitness for work for people with chronic pain. Moral, socio-cultural and practical factors are invoked by doctors and patients to contest decisions, and although both groups support the fit note's focus on capacity, they doubt it will overcome tensions in the consultation. Doctors value tacit skills of persuasion and negotiation that can change how patients conceptualise their illness and respond to it. Policy-makers increasingly recognise the role of this tacit knowledge and we conclude that sick-listing can be improved by further developing these skills and acknowledging the structural context within which protagonists negotiate sick-listing. © The Author(s) 2014.

Successful Fitting of a Complete Maxillary Denture in a Patient with Severe Alzheimer’s Disease Complicated by Oral Dyskinesia

Directory of Open Access Journals (Sweden)

Hiromitsu Morita

2016-01-01

Full Text Available There is an increasing population of elderly patients suffering from Alzheimer’s disease (AD, the most common form of dementia. In dentistry, a critical problem associated with these patients is the use of a new denture, as AD patients often refuse dental management and are disturbed by minor changes in their oral environment. Some AD patients have further complications associated with oral dyskinesia, a movement disorder that can make dental management difficult, including the stability of a complete denture. In this case, we successfully fitted a complete maxillary denture using modified bilateral balanced occlusion after multiple tooth extractions under intravenous sedation in a 66-year-old woman with severe AD complicated by oral dyskinesia. Following treatment, her appetite and food intake greatly improved. Providing a well-fitting complete denture applied by modified bilateral balanced occlusion, which removes lateral interference using zero-degree artificial teeth for movement disorder of the jaw in patients with severe AD complicated by oral dyskinesia, helps improve oral function.

Cardiopulmonary fitness and muscle strength in patients with osteogenesis imperfecta type I.

Science.gov (United States)

Takken, Tim; Terlingen, Heike C; Helders, Paul J M; Pruijs, Hans; Van der Ent, Cornelis K; Engelbert, Raoul H H

2004-12-01

To evaluate cardiopulmonary function, muscle strength, and cardiopulmonary fitness (VO 2 peak) in patients with osteogenesis imperfecta (OI). In 17 patients with OI type I (mean age 13.3 +/- 3.9 years) cardiopulmonary function was assessed at rest using spirometry, plethysmography, electrocardiography, and echocardiography. Exercise capacity was measured using a maximal exercise test on a bicycle ergometer and an expired gas analysis system. Muscle strength in shoulder abductors, hip flexors, ankle dorsal flexor, and grip strength were measured. All results were compared with reference values. Cardiopulmonary function at rest was within normal ranges, but when it was compared with normal height for age and sex, vital capacities were reduced. Mean absolute and relative VO 2 peak were respectively -1.17 (+/- 0.67) and -1.41 (+/- 1.52) standard deviations lower compared with reference values ( P exercise tolerance and muscle strength were significantly reduced in patients with OI, which might account for their increased levels of fatigue during activities of daily living.

Investigation into the Factors that Dtermine Shoe Fitting Using MRI

OpenAIRE

吉田, 宏昭

2014-01-01

It is essential to purchase suitable shoes that fit the size of users' feet in order to prevent foot injuries in daily life. Although shoe fitting significantly affects the performance of shoes, there are few studies that have either investigated the factors that control shoe fitting or established a method to evaluate shoe fitting. While, the shape of each foot and shoe was measured to estimate shoe fitting in previous studies, the deformation of feet when wearing shoes had not been taken in...

vFitness: a web-based computing tool for improving estimation of in vitro HIV-1 fitness experiments

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Demeter Lisa

2010-05-01

Full Text Available Abstract Background The replication rate (or fitness between viral variants has been investigated in vivo and in vitro for human immunodeficiency virus (HIV. HIV fitness plays an important role in the development and persistence of drug resistance. The accurate estimation of viral fitness relies on complicated computations based on statistical methods. This calls for tools that are easy to access and intuitive to use for various experiments of viral fitness. Results Based on a mathematical model and several statistical methods (least-squares approach and measurement error models, a Web-based computing tool has been developed for improving estimation of virus fitness in growth competition assays of human immunodeficiency virus type 1 (HIV-1. Conclusions Unlike the two-point calculation used in previous studies, the estimation here uses linear regression methods with all observed data in the competition experiment to more accurately estimate relative viral fitness parameters. The dilution factor is introduced for making the computational tool more flexible to accommodate various experimental conditions. This Web-based tool is implemented in C# language with Microsoft ASP.NET, and is publicly available on the Web at http://bis.urmc.rochester.edu/vFitness/.

Maternal and foetal outcome in term patients with previous one lower segment cesarean section

OpenAIRE

Meena Naresh Satia; Kimaya A. Mali; Rakhi Sikarwar

2016-01-01

Background: In modern day obstetric practice we encounter increasing number of patients with history of caesarean section because of rise in primary caesarean due to changing trends in their indications. There is increasing fear and anxiety by obstetricians for managing these cases from medico legal point of view. Present study was done to look at the feto-maternal outcome and for appropriate mode of delivery and overall to conduct the proper management of patients with previous one lower...

FIREFLY (Fitting IteRativEly For Likelihood analYsis): a full spectral fitting code

Science.gov (United States)

Wilkinson, David M.; Maraston, Claudia; Goddard, Daniel; Thomas, Daniel; Parikh, Taniya

2017-12-01

We present a new spectral fitting code, FIREFLY, for deriving the stellar population properties of stellar systems. FIREFLY is a chi-squared minimization fitting code that fits combinations of single-burst stellar population models to spectroscopic data, following an iterative best-fitting process controlled by the Bayesian information criterion. No priors are applied, rather all solutions within a statistical cut are retained with their weight. Moreover, no additive or multiplicative polynomials are employed to adjust the spectral shape. This fitting freedom is envisaged in order to map out the effect of intrinsic spectral energy distribution degeneracies, such as age, metallicity, dust reddening on galaxy properties, and to quantify the effect of varying input model components on such properties. Dust attenuation is included using a new procedure, which was tested on Integral Field Spectroscopic data in a previous paper. The fitting method is extensively tested with a comprehensive suite of mock galaxies, real galaxies from the Sloan Digital Sky Survey and Milky Way globular clusters. We also assess the robustness of the derived properties as a function of signal-to-noise ratio (S/N) and adopted wavelength range. We show that FIREFLY is able to recover age, metallicity, stellar mass, and even the star formation history remarkably well down to an S/N ∼ 5, for moderately dusty systems. Code and results are publicly available.1

Preoperative screening: value of previous tests.

Science.gov (United States)

Macpherson, D S; Snow, R; Lofgren, R P

1990-12-15

To determine the frequency of tests done in the year before elective surgery that might substitute for preoperative screening tests and to determine the frequency of test results that change from a normal value to a value likely to alter perioperative management. Retrospective cohort analysis of computerized laboratory data (complete blood count, sodium, potassium, and creatinine levels, prothrombin time, and partial thromboplastin time). Urban tertiary care Veterans Affairs Hospital. Consecutive sample of 1109 patients who had elective surgery in 1988. At admission, 7549 preoperative tests were done, 47% of which duplicated tests performed in the previous year. Of 3096 previous results that were normal as defined by hospital reference range and done closest to the time of but before admission (median interval, 2 months), 13 (0.4%; 95% CI, 0.2% to 0.7%), repeat values were outside a range considered acceptable for surgery. Most of the abnormalities were predictable from the patient's history, and most were not noted in the medical record. Of 461 previous tests that were abnormal, 78 (17%; CI, 13% to 20%) repeat values at admission were outside a range considered acceptable for surgery (P less than 0.001, frequency of clinically important abnormalities of patients with normal previous results with those with abnormal previous results). Physicians evaluating patients preoperatively could safely substitute the previous test results analyzed in this study for preoperative screening tests if the previous tests are normal and no obvious indication for retesting is present.

Apixaban compared with warfarin in patients with atrial fibrillation and previous stroke or transient ischaemic attack

DEFF Research Database (Denmark)

Easton, J Donald; Lopes, Renato D; Bahit, M Cecilia

2012-01-01

In the ARISTOTLE trial, the rate of stroke or systemic embolism was reduced by apixaban compared with warfarin in patients with atrial fibrillation (AF). Patients with AF and previous stroke or transient ischaemic attack (TIA) have a high risk of stroke. We therefore aimed to assess the efficacy ...

Vitamin D deficiency in medical patients at a central hospital in Malawi: a comparison with TB patients from a previous study.

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Yamikani Mastala

Full Text Available OBJECTIVES: To determine the prevalence of vitamin D deficiency (VDD in adult medical, non-tuberculous (non-TB patients. To investigate associations with VDD. To compare the results with a similar study in TB patients at the same hospital. DESIGN: Cross-sectional sample. SETTING: Central hospital in Malawi. PARTICIPANTS: Adult non-TB patients (n = 157, inpatients and outpatients. OUTCOME MEASURES: The primary outcome was the prevalence of VDD. Potentially causal associations sought included nutritional status, in/outpatient status, HIV status, anti-retroviral therapy (ART and, by comparison with a previous study, a diagnosis of tuberculosis (TB. RESULTS: Hypovitaminosis D (≤75 nmol/L occurred in 47.8% (75/157 of patients, 16.6% (26/157 of whom had VDD (≤50 nmol/L. None had severe VDD (≤25 nmol/L. VDD was found in 22.8% (23/101 of in-patients and 5.4% (3/56 of out-patients. In univariable analysis in-patient status, ART use and low dietary vitamin D were significant predictors of VDD. VDD was less prevalent than in previously studied TB patients in the same hospital (68/161 = 42%. In multivariate analysis of the combined data set from both studies, having TB (OR 3.61, 95%CI 2.02-6.43 and being an in-patient (OR 2.70, 95%CI 1.46-5.01 were significant independent predictors of VDD. CONCLUSIONS: About half of adult medical patients without TB have suboptimal vitamin D status, which is more common in in-patients. VDD is much more common in TB patients than non-TB patients, even when other variables are controlled for, suggesting that vitamin D deficiency is associated with TB.

Multiple organ definition in CT using a Bayesian approach for 3D model fitting

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Boes, Jennifer L.; Weymouth, Terry E.; Meyer, Charles R.

1995-08-01

Organ definition in computed tomography (CT) is of interest for treatment planning and response monitoring. We present a method for organ definition using a priori information about shape encoded in a set of biometric organ models--specifically for the liver and kidney-- that accurately represents patient population shape information. Each model is generated by averaging surfaces from a learning set of organ shapes previously registered into a standard space defined by a small set of landmarks. The model is placed in a specific patient's data set by identifying these landmarks and using them as the basis for model deformation; this preliminary representation is then iteratively fit to the patient's data based on a Bayesian formulation of the model's priors and CT edge information, yielding a complete organ surface. We demonstrate this technique using a set of fifteen abdominal CT data sets for liver surface definition both before and after the addition of a kidney model to the fitting; we demonstrate the effectiveness of this tool for organ surface definition in this low-contrast domain.

Thiopurines, a previously unrecognised cause for fatigue in patients with inflammatory bowel disease.

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Lee, Thomas W T; Iser, John H; Sparrow, Miles P; Newnham, Evan D; Headon, Belinda J; Gibson, Peter R

2009-09-01

Active inflammatory bowel disease, anaemia, iron deficiency and depression, alone or in combination, are known contributing factors of fatigue in inflammatory bowel disease. However, in some patients, fatigue cannot be attributed to known causes. Thiopurines are not a recognized cause. To describe the clinical scenario of a series of patients where thiopurines were the likely cause of fatigue. The clinical scenario of 5 patients was examined with specific reference to the temporal association of thiopurine therapy with fatigue, the effect of its withdrawal and rechallenge, and drug specificity. The onset of severe fatigue was related to the introduction of azathioprine or 6-mercaptopurine, rapid relief was experienced on its withdrawal in all patients, and fatigue rapidly occurred on rechallenge. The speed of onset was rapid in two patients and in the context of gradual withdrawal of moderate steroid dose, but recurred rapidly on rechallenge when not on steroids. Marked fatigue is a previously unrecognized adverse effect of thiopurines. It does not appear to be drug-specific. Its onset might be masked by concurrent steroid therapy.

Spinal Anesthesia with Isobaric Tetracaine in Patients with Previous Lumbar Spinal Surgery

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Kim, Soo Hwan; Jeon, Dong-Hyuk; Chang, Chul Ho; Lee, Sung-Jin

2009-01-01

Purpose Previous lumbar spinal surgery (PLSS) is not currently considered as a contraindication for regional anesthesia. However, there are still problems that make spinal anesthesia more difficult with a possibility of worsening the patient's back pain. Spinal anesthesia using combined spinal-epidural anesthesia (CSEA) in elderly patients with or without PLSS was investigated and the anesthetic characteristics, success rates, and possible complications were evaluated. Materials and Methods Fifty patients without PLSS (Control group) and 45 patients with PLSS (PLSS group) who were scheduled for total knee arthroplasty were studied prospectively. A CSEA was performed with patients in the left lateral position, and 10 mg of 0.5% isobaric tetracaine was injected through a 27 G spinal needle. An epidural catheter was then inserted for patient controlled analgesia. Successful spinal anesthesia was defined as adequate sensory block level more than T12. The number of skin punctures and the onset time were recorded, and maximal sensory block level (MSBL), time to 2-segment regression, success rate and complications were observed. Results The success rate of CSEA in Control group and PLSS group was 98.0%, and 93.3%, respectively. The median MSBL in PLSS group was higher than Control group [T4 (T2-L1) vs. T6 (T3-T12)] (p < 0.001). There was a significant difference in the number of patients who required ephedrine for the treatment of hypotension in PLSS group (p = 0.028). Conclusion The success rate of CSEA in patients with PLSS was 93.3%, and patients experienced no significant neurological complications. The MSBL can be higher in PLSS group than Control group. PMID:19430559

Impact of a community-based exercise programme on physical fitness in middle-aged and older patients with type 2 diabetes.

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Mendes, Romeu; Sousa, Nelson; Themudo-Barata, José; Reis, Victor

2016-01-01

Physical fitness is related to all-cause mortality, quality of life and risk of falls in patients with type 2 diabetes. This study aimed to analyse the impact of a long-term community-based combined exercise program (aerobic+resistance+agility/balance+flexibility) developed with minimum and low-cost material resources on physical fitness in middle-aged and older patients with type 2 diabetes. This was a non-experimental pre-post evaluation study. Participants (N=43; 62.92±5.92 years old) were engaged in a community-based supervised exercise programme (consisting of combined aerobic, resistance, agility/balance and flexibility exercises; three sessions per week; 70min per session) of 9 months' duration. Aerobic fitness (6-Minute Walk Test), muscle strength (30-Second Chair Stand Test), agility/balance (Timed Up and Go Test) and flexibility (Chair Sit and Reach Test) were assessed before (baseline) and after the exercise intervention. Significant improvements in the performance of the 6-Minute Walk Test (Δ=8.20%, p<0.001), 30-Second Chair Stand Test (Δ=28.84%, p<0.001), Timed Up and Go Test (Δ=14.31%, p<0.001), and Chair Sit and Reach Test (Δ=102.90%, p<0.001) were identified between baseline and end-exercise intervention time points. A long-term community-based combined exercise programme, developed with low-cost exercise strategies, produced significant benefits in physical fitness in middle-aged and older patients with type 2 diabetes. This supervised group exercise programme significantly improved aerobic fitness, muscle strength, agility/balance and flexibility, assessed with field tests in community settings. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

Pegaptanib: choroidal neovascularization in patients with age-related macular degeneration and previous arterial thromboembolic events.

Science.gov (United States)

Battaglia Parodi, Maurizio; Di Bartolo, Emanuele; Brue, Claudia; Cappello, Ezio; Furino, Claudio; Giuffrida, Sebastiano; Imparato, Manuela; Reibaldi, Michele

2018-01-01

To evaluate the efficacy and the rate of side effects of the pegylated aptamer pegaptanib in the treatment of patients with choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) and a history of previous arterial thromboembolic events (ATEs). Twenty-three eyes of 23 patients with subfoveal CNV due to AMD and cerebrovascular accidents (n = 12) and myocardial infarction (n = 11) in the previous 6 months received intravitreal pegaptanib 0.3 mg according to a pro re nata regimen and were followed for 12 months. The paired Student t test was used to evaluate mean changes in best-corrected visual acuity (BCVA; primary outcome measure) and central foveal thickness (CFT). The mean patient age was 71.5 ± 4.6 years; there were 14 women and 9 men. The CNV was type 1, 2, and 3 in 18, 3, and 2 eyes, respectively. The mean BCVA improved from 0.67 ± 0.23 logMAR at baseline to 0.52 ± 0.31 logMAR at the end of 12-month follow-up (p = 0.044). Thirty-five percent of patients achieved ≥3 Early Treatment Diabetic Retinopathy Study lines improvement at 12 months. Mean CFT at baseline (381 ± 111 µm) decreased to 304 ± 82 µm at 12 months (p = 0.008). Patients received a mean of 4.3 ± 1.3 (range 3-7) injections. No systemic or ocular side effects occurred; no patient experienced further ATEs. Intravitreal pegaptanib can be considered a viable treatment option for patients with AMD-related CNV who are at high risk of ATEs.

Cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy: A longitudinal cohort study.

Science.gov (United States)

Libert, Yves; Borghgraef, Cindy; Beguin, Yves; Delvaux, Nicole; Devos, Martine; Doyen, Chantal; Dubruille, Stéphanie; Etienne, Anne-Marie; Liénard, Aurore; Merckaert, Isabelle; Reynaert, Christine; Slachmuylder, Jean-Louis; Straetmans, Nicole; Van Den Neste, Eric; Bron, Dominique; Razavi, Darius

2017-12-01

Despite the well-known negative impacts of cancer and anticancer therapies on cognitive performance, little is known about the cognitive compensatory processes of older patients with cancer. This study was designed to investigate the cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy. We assessed 89 consecutive patients (age ≥ 65 y) without severe cognitive impairment and 89 age-, sex-, and education level-matched healthy controls. Cognitive compensatory processes were investigated by (1) comparing cognitive performance of patients and healthy controls in novel (first exposure to cognitive tasks) and non-novel (second exposure to the same cognitive tasks) contexts, and (2) assessing psychological factors that may facilitate or inhibit cognitive performance, such as motivation, psychological distress, and perceived cognitive performance. We assessed cognitive performance with the Trail-Making, Digit Span and FCSR-IR tests, psychological distress with the Hospital Anxiety and Depression Scale, and perceived cognitive performance with the FACT-Cog questionnaire. In novel and non-novel contexts, average cognitive performances of healthy controls were higher than those of patients and were associated with motivation. Cognitive performance of patients was not associated with investigated psychological factors in the novel context but was associated with motivation and psychological distress in the non-novel context. Older, clinically fit patients with hematologic malignancies undergoing chemotherapy demonstrated lower cognitive compensatory processes compared to healthy controls. Reducing distress and increasing motivation may improve cognitive compensatory processes of patients in non-novel contexts. Copyright © 2017 John Wiley & Sons, Ltd.

Insertion of central venous catheters for hemodialysis using angiographic techniques in patients with previous multiple catheterizations

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Kotsikoris, Ioannis, E-mail: gkotsikoris@gmail.com [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Zygomalas, Apollon, E-mail: azygomalas@upatras.gr [Department of General Surgery, University Hospital of Patras (Greece); Papas, Theofanis, E-mail: pfanis@otenet.gr [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Maras, Dimitris, E-mail: dimmaras@gmail.com [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Pavlidis, Polyvios, E-mail: polpavlidis@yahoo.gr [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Andrikopoulou, Maria, E-mail: madric@gmail.com [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Tsanis, Antonis, E-mail: atsanis@gmail.com [Department of Interventional Radiology, “Erythros Stauros” General Hospital (Greece); Alivizatos, Vasileios, E-mail: valiviz@hol.gr [Department of General Surgery and Artificial Nutrition Unit, “Agios Andreas” General Hospital of Patras (Greece); Bessias, Nikolaos, E-mail: bessias@otenet.gr [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece)

2012-09-15

Introduction: Central venous catheter placement is an effective alternative vascular access for dialysis in patients with chronic renal failure. The purpose of this study was to evaluate the insertion of central venous catheters for hemodialysis using angiographic techniques in patients with previous multiple catheterizations in terms of efficacy of the procedure and early complications. Materials and methods: Between 2008 and 2010, the vascular access team of our hospital placed 409 central venous catheters in patients with chronic renal failure. The procedure was performed using the Seldinger blind technique. In 18 (4.4%) cases it was impossible to advance the guidewire, and so the patients were transported to the angiography suite. Results: Using the angiographic technique, the guidewire was advanced in order to position the central venous catheter. The latter was inserted into the subclavian vein in 12 (66.6%) cases, into the internal jugular vein in 4 (22.2%) and into the femoral vein in 2 (11.1%) cases. There was only one complicated case with severe arrhythmia in 1 (5.5%) patient. Conclusion: Our results suggest that insertion of central venous catheters using angiographic techniques in hemodialysis patients with previous multiple catheterizations is a safe and effective procedure with few complications and high success rates.

Insertion of central venous catheters for hemodialysis using angiographic techniques in patients with previous multiple catheterizations

International Nuclear Information System (INIS)

Kotsikoris, Ioannis; Zygomalas, Apollon; Papas, Theofanis; Maras, Dimitris; Pavlidis, Polyvios; Andrikopoulou, Maria; Tsanis, Antonis; Alivizatos, Vasileios; Bessias, Nikolaos

2012-01-01

Introduction: Central venous catheter placement is an effective alternative vascular access for dialysis in patients with chronic renal failure. The purpose of this study was to evaluate the insertion of central venous catheters for hemodialysis using angiographic techniques in patients with previous multiple catheterizations in terms of efficacy of the procedure and early complications. Materials and methods: Between 2008 and 2010, the vascular access team of our hospital placed 409 central venous catheters in patients with chronic renal failure. The procedure was performed using the Seldinger blind technique. In 18 (4.4%) cases it was impossible to advance the guidewire, and so the patients were transported to the angiography suite. Results: Using the angiographic technique, the guidewire was advanced in order to position the central venous catheter. The latter was inserted into the subclavian vein in 12 (66.6%) cases, into the internal jugular vein in 4 (22.2%) and into the femoral vein in 2 (11.1%) cases. There was only one complicated case with severe arrhythmia in 1 (5.5%) patient. Conclusion: Our results suggest that insertion of central venous catheters using angiographic techniques in hemodialysis patients with previous multiple catheterizations is a safe and effective procedure with few complications and high success rates

Assessing the accuracy of algorithm-derived cardiorespiratory fitness in surgical patients: a prospective cohort study.

Science.gov (United States)

Hammal, Fadi; Quaife, Tanis; Purich, Kieran; Haennel, Robert; Gragasin, Ferrante S; Martin-Feeney, Daniella San; Finegan, Barry A

2017-04-01

To determine if a non-exercise algorithm-derived assessment of cardiorespiratory fitness (CRF A ) accurately predicted estimated values obtained using a six-minute walk test (CRF 6MWD ) and the Duke Activity Status Index (CRF DASI ). Following research ethics board approval, an observational cohort study was conducted in selected, consenting patients undergoing elective surgery. Participants completed questionnaires assessing their self-reported exercise capacity. Their height, weight, waist circumference, and vital signs were measured. A six-minute walk test was performed twice with a 45-min rest interval between tests. The correlation between CRF A and both CRF 6MWD and CRF DASI was determined. Two hundred forty-two participants were included. Mean age was 62 (range 45-88 yr); 150 (62%) were male, 87 (36%) self-reported walking or jogging > 16 km per week, and 49 (20%) were current smokers. The CRF A and CRF 6MWD were highly correlated (Pearson r = 0.878; P 427 m in the six-minute walk test, CRF A , CRF 6MWD , and CRF DASI were equivalent. A non-exercise algorithm can estimate cardiorespiratory fitness in patients presenting for elective surgery. The variables required to compute CRF A can be obtained in a clinic setting without the need to engage in formal exercise testing. Further evaluation of CRF A as a predictor of long-term outcome in patients is warranted.

The influence of general anesthesia on the brain in aged patients with previous ischemic cerebrovascular disease

International Nuclear Information System (INIS)

Kokubo, Yasuaki; Kayama, Takamasa; Kondo, Rei; Oki, Masato; Takaoka, Seiji

2008-01-01

Whenever we discuss the overall results of surgical treatment for unruptured cerebral aneurysms, especially in aged patients, we tend to consider advanced age or general anesthesia as causes for unfavorable results. There are no reports concerning ischemic stroke events following general anesthesia in aged patients with a prior history of cerebrovascular disease. The purpose of this study is to clarify the influence of general anesthesia on the brats in aged patients with a previous history of ischemic cerebrovascular disease. The subjects were 30 consecutive patients over 70 years of age with previous ischemic cerebrovascular disease who underwent various surgeries except brain and cardiac surgery under general anesthesia. The patients were 70 to 85 years old, with a mean age of 76. Twenty-three were men and 7 were women. Surgical procedures were 12 gastrointestinal, 6 orthopedic and 4 urogenital and others. The type of cerebrovascular disease evaluated by neuroradiologist and anesthesiologist based on MR imaging was devided as follows: 16 patients had minor stroke, 7 had transient ischemic attack/reversible ischemic neurological deficit (TIA/RIND) and 7 had asymptomatic cerebral infarction. MR angiography was also assessed to evaluate the main artery in the brain. Blood pressure and arterial blood gas (PaCO 2 ) during general anesthesia were analyzed, and the rate of systemic and neurological complications following general anesthesia were evaluated. MR angiography revealed no occlusion or severe stenosis of the main artery in the brain of any of the patients. The minimum systolic blood pressure showed less than 100 mmHg transiently for 5-20 minutes in 28 of 30 patients during general anesthesia. The minimum value was 65 mmHg maintained for 5 minutes. The minimum PaCO 2 during general anesthesia was as follows: 1 case 36 mmHg. There were no neurological complications following general anesthesia in this study. One of 30 patients (3.3%) had suffered from pneumonia

Full-scale tank car rollover tests - survivability of top fittings and top fittings protective structures : final report.

Science.gov (United States)

2016-05-01

Full-scale rollover crash tests were performed on three non-pressure tank carbodies to validate previous analytical work and : determine the effectiveness of two different types of protective structures in protecting the top fittings. The tests were ...

Stress thallium-201 myocardial scintigraphy for the detection of individual coronary arterial lesions in patients with and without previous myocardial infarction

International Nuclear Information System (INIS)

Rigo, P.; Bailey, I.K.; Griffith, L.S.; Pitt, B.; Wagner, H.N. Jr.; Becker, L.C.

1981-01-01

The value of stress thallium-201 scintigraphy for detecting individual coronary arterial stenoses was analyzed in 141 patients with angiographically proved coronary artery disease, 101 with and 40 without a previous myocardial infarction. In patients without infarction, the sensitivity for detecting greater than 50 percent narrowing in the left anterior descending, the right and the left circumflex coronary artery was 66, 53 and 24 percent, respectively. In those with a previous infarction, the sensitivity for demonstrating disease in the artery corresponding to the site of infarction was 100 percent for the left anterior descending, 79 percent for the right and 63 percent for the left circumflex coronary artery. In patients with a prior anterior infarction, concomitant right or left circumflex coronary arterial lesions were detected in only 1 of 12 cases, whereas in those with previous inferior or inferolateral infarction, the sensitivity for left anterior descending coronary artery disease was 69 percent. Because of the reasonably high sensitivity for detecting left anterior descending arterial disease, irrespective of the presence and location of previous infarction, myocardial scintigraphy was useful in identifying multivessel disease in patients with a previous inferior infarction. However, because of its relative insensitivity for right or left circumflex coronary artery disease, scintigraphy proved to be a poor predictor of multivessel disease in patients with a prior anterior infarction and in patients without previous myocardial infarction

Functional MRI of the visual cortex and visual testing in patients with previous optic neuritis

DEFF Research Database (Denmark)

Langkilde, Annika Reynberg; Frederiksen, J.L.; Rostrup, Egill

2002-01-01

of the activated area and the signal change following ON, and compared the results with results of neuroophthalmological testing. We studied nine patients with previous acute ON and 10 healthy persons served as controls using fMRI with visual stimulation. In addition to a reduced activated volume, patients showed...... a reduced blood oxygenation level dependent (BOLD) signal increase and a greater asymmetry in the visual cortex, compared with controls. The volume of visual cortical activation was significantly correlated to the result of the contrast sensitivity test. The BOLD signal increase correlated significantly......The volume of cortical activation as detected by functional magnetic resonance imaging (fMRI) in the visual cortex has previously been shown to be reduced following optic neuritis (ON). In order to understand the cause of this change, we studied the cortical activation, both the size...

Serological biomarkers in triage of FIT-positive subjects?

DEFF Research Database (Denmark)

Nielsen, Hans J; Christensen, Ib Jarle; Andersen, Berit

2017-01-01

with neoplastic lesions missed by increased cut-off levels appears to be much higher than expected. Therefore, tests that identify those patients missed by increased FIT cut-off levels must be developed. Preliminary results of determination of one of several biomarker entities currently under investigation show...... that nucleosome blood tests may be one option for identifying some of these patients. Implementation of a triage test consisting of FIT, blood-based biomarkers and plus/minus colonoscopy is suggested to identify subjects with FIT levels between the initial and the increased cut-off level that must be offered...

Endovascular intervention for central venous cannulation in patients with vascular occlusion after previous catheterization.

Science.gov (United States)

Pikwer, Andreas; Acosta, Stefan; Kölbel, Tilo; Åkeson, Jonas

2010-01-01

This study was designed to assess endovascular intervention for central venous cannulation in patients with vascular occlusion after previous catheterization. Patients referred for endovascular management of central venous occlusion during a 42-month period were identified from a regional endovascular database, providing prospective information on techniques and clinical outcome. Corresponding patient records, angiograms, and radiographic reports were analyzed retrospectively. Sixteen patients aged 48 years (range 0.5-76), including 11 females, were included. All patients but 1 had had multiple central venous catheters with a median total indwelling time of 37 months. Eleven patients cannulated for hemodialysis had had significantly fewer individual catheters inserted compared with 5 patients cannulated for nutritional support (mean 3.6 vs. 10.2, pvenous occlusions. Patients were subjected to recanalization (n=2), recanalization and percutaneous transluminal angioplasty (n=5), or stenting for vena cava superior syndrome (n=1) prior to catheter insertion. The remaining 8 patients were cannulated by avoiding the occluded route. Central venous occlusion occurs particularly in patients under hemodialysis and with a history of multiple central venous catheterizations with large-diameter catheters and/or long total indwelling time periods. Patients with central venous occlusion verified by CT or MRT venography and need for central venous access should be referred for endovascular intervention.

Physical fitness reference standards in fibromyalgia: The al-Ándalus project.

Science.gov (United States)

Álvarez-Gallardo, I C; Carbonell-Baeza, A; Segura-Jiménez, V; Soriano-Maldonado, A; Intemann, T; Aparicio, V A; Estévez-López, F; Camiletti-Moirón, D; Herrador-Colmenero, M; Ruiz, J R; Delgado-Fernández, M; Ortega, F B

2017-11-01

We aimed (1) to report age-specific physical fitness levels in people with fibromyalgia of a representative sample from Andalusia; and (2) to compare the fitness levels of people with fibromyalgia with non-fibromyalgia controls. This cross-sectional study included 468 (21 men) patients with fibromyalgia and 360 (55 men) controls. The fibromyalgia sample was geographically representative from southern Spain. Physical fitness was assessed with the Senior Fitness Test battery plus the handgrip test. We applied the Generalized Additive Model for Location, Scale and Shape to calculate percentile curves for women and fitted mean curves using a linear regression for men. Our results show that people with fibromyalgia reached worse performance in all fitness tests than controls (P fitness levels among patients with fibromyalgia and controls in a large sample of patients with fibromyalgia from southern of Spain. Physical fitness levels of people with fibromyalgia from Andalusia are very low in comparison with age-matched healthy controls. This information could be useful to correctly interpret physical fitness assessments and helping health care providers to identify individuals at risk for losing physical independence. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Cardiorespiratory Fitness and Incidence of Type 2 Diabetes in United States Veterans on Statin Therapy.

Science.gov (United States)

Kokkinos, Peter; Faselis, Charles; Narayan, Puneet; Myers, Jonathan; Nylen, Eric; Sui, Xuemei; Zhang, Jiajia; Lavie, Carl J

2017-10-01

Impact of cardiorespiratory fitness on statin-related incidence of type 2 diabetes has not been assessed. We assessed the cardiorespiratory fitness and diabetes incidence association in dyslipidemic patients on statins. We identified dyslipidemic patients with a normal exercise test performed during 1986 and 2014 at the Veterans Affairs Medical Centers in Washington, DC or Palo Alto, Calif. The statin-treated patients (n = 4092; age = 58.8 ± 10.9 years) consisted of 2701 Blacks and 1391 Whites. None had evidence of type 2 diabetes prior to statin therapy. We formed 4 fitness categories based on age and peak metabolic equivalents achieved: Least-fit (n = 954), Low-fit (n = 1201), Moderate-fit (n = 1242), and High-fit (n = 695). The non-statin-treated cohort (n = 3001; age = 57.2 ± 11.2 years) with no evidence of type 2 diabetes prior to the exercise test served as controls. Diabetes incidence was 24% higher in statin-treated compared with non-statin-treated patients (P fit, adjusted risk decreased progressively with increasing fitness and was 34% lower for High-fit patients (hazard ratio [HR] 0.66; 95% confidence interval [CI], 0.53-0.82; P fit (HR 1.50; 95% CI, 1.30-1.73; P fit patients (HR 1.22; 95% CI, 1.06-1.41; P = .006). Risk of diabetes in statin-treated dyslipidemic patients was inversely and independently associated with cardiorespiratory fitness. The increased risk was evident only in relatively low-fitness patients. Improving fitness may modulate the potential diabetogenic effects of statins. Published by Elsevier Inc.

Fitness landscape complexity and the emergence of modularity in neural networks

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Lowell, Jessica

Previous research has shown that the shape of the fitness landscape can affect the evolution of modularity. We evolved neural networks to solve different tasks with different fitness landscapes, using NEAT, a popular neuroevolution algorithm that quantifies similarity between genomes in order to divide them into species. We used this speciation mechanism as a means to examine fitness landscape complexity, and to examine connections between fitness landscape complexity and the emergence of modularity.

Exercise training program based on minimum weekly frequencies: effects on blood pressure and physical fitness in elderly hypertensive patients.

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Moraes, Wilson M De; Souza, Pamella R M; Pinheiro, Mônica H N P; Irigoyen, Maria C; Medeiros, Alessandra; Koike, Marcia K

2012-04-01

Exercise training (ET) can reduce blood pressure (BP) and prevent functional disability. However, the effects of low volumes of training have been poorly studied, especially in elderly hypertensive patients. To investigate the effects of a multi-component ET program (aerobic training, strength, flexibility, and balance) on BP, physical fitness, and functional ability of elderly hypertensive patients. Thirty-six elderly hypertensive patients with optimal clinical treatment underwent a multi-component ET program: two 60-minute sessions a week for 12 weeks at a Basic Health Unit. Compared to pre-training values, systolic and diastolic BP were reduced by 3.6% and 1.2%, respectively (ptest and elbow flexor test; ptest (unipedal stance test; ptest; ptest). Moreover, there was a reduction in the time required to perform two functional ability tests: "put on sock" and "sit down, stand up, and move around the house" (p<0.001). Lower volumes of ET improved BP, metabolic parameters, and physical fitness and reflected in the functional ability of elderly hypertensive patients. Trial Registration RBR-2xgjh3.

Effectiveness of various sterilization methods of contaminated post-fitted molar band

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Anggia Tridianti

2013-06-01

Full Text Available Background: Molar band as anchoring device may be contaminated during the fitting process. Thus, decontamination process is essential to prevent cross-infection between patients. Purpose: The objective of this research was to determine the amount of bacteria in molar band post-fitted on the patient teeth, after previously undergone pre-sterilization using alcohol and ultrasonic cleaning bath followed by sterilization using dry heat oven and steam autoclave, in order to find the best method in decontamination of post-fitted molar band. Methods: Four molar bands which already fitted on one patient then divided evenly into two groups. The first group was pre-sterilized using alcohol. One of the bands then sterilized using dry heat oven, while the other one was sterilized using steam autoclave. The second group was pre-sterilized using ultrasonic cleaning bath. One band from this group then sterilized using dry heat oven and the other was sterilized using steam autoclave. The next step was to immerse all the bands in a phosphate-buffered saline solution. Using micropipette, the solution was retrieved and dropped upon a petri dish containing Brain Heart Infusion broth. The dish was then stored in an incubator for 24 hours, prior to counting the number of bacteria existed. The same methods were used to the rest of the patients, with total 128 molar bands from 32 patients. Results: There was a profound difference in numbers of bacteria found between those methods of sterilization. However, there was a non significant difference between the two groups which were at the alcohol-steam autoclave group and at the ultrasonic cleaning bath-steam autoclave group. Conclusion: This study showed that steam autoclave is better than for sterilizing molar band, as it left the minimal amount of bacteria in post-fitted molar band.Latar belakang: Molar band merupakan suatu alat penjangkaran yang dapat mengalami kontaminasi selama proses fitting band, sehingga perlu

The Benefits and Risks of CrossFit: A Systematic Review.

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Meyer, Jena; Morrison, Janet; Zuniga, Julie

2017-12-01

With the increase in popularity of the CrossFit exercise program, occupational health nurses may be asked questions about the appropriateness of CrossFit training for workers. This systematic literature review was conducted to analyze the current research on CrossFit, and assess the benefits and risks of this exercise strategy. Thirteen studies ( N = 2,326 participants) examined the use of CrossFit training among adults; CrossFit is comparable to other exercise programs with similar injury rates and health outcomes. Occupational health nurses should assess previous injuries prior to recommending this form of exercise. Ideal candidates for CrossFit are adults who seek high-intensity exercise with a wide variety of exercise components.

Long-term outcome of peroral endoscopic myotomy for esophageal achalasia in patients with previous Heller myotomy.

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Kristensen, Helle Ø; Kirkegård, Jakob; Kjær, Daniel Willy; Mortensen, Frank Viborg; Kunda, Rastislav; Bjerregaard, Niels Christian

2017-06-01

Peroral endoscopic myotomy (POEM) is an emerging procedure in the treatment of esophageal achalasia, a primary motility disorder. However, the long-term outcome of POEM in patients, who have previously undergone a Heller myotomy, is unknown. Using a local database, we identified patients with esophageal achalasia, who underwent POEM. We compared patients with a previous Heller myotomy to those, who had received none or only non-surgical therapy prior to the POEM procedure. We conducted follow-up examinations at 3, 12, and 24 months following the procedure. We included 66 consecutive patients undergoing POEM for achalasia, of which 14 (21.2 %) had undergone a prior Heller myotomy. In both groups, the preoperative Eckardt score was 7. Postoperatively, the non-Heller group experienced a more pronounced symptom relief at both 3-, 12-, and 24-month follow-up compared with the Heller group, and there was a tendency for the effect of POEM to reduce over time. We suggest that there is a correlation between preoperative measurements of gastroesophageal sphincter pressures and the chance of a successful POEM. POEM has a place in the treatment of esophageal achalasia in patients with a prior Heller myotomy and persistent symptoms as it is a safe procedure with acceptable long-term results.

FitSKIRT: genetic algorithms to automatically fit dusty galaxies with a Monte Carlo radiative transfer code

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De Geyter, G.; Baes, M.; Fritz, J.; Camps, P.

2013-02-01

We present FitSKIRT, a method to efficiently fit radiative transfer models to UV/optical images of dusty galaxies. These images have the advantage that they have better spatial resolution compared to FIR/submm data. FitSKIRT uses the GAlib genetic algorithm library to optimize the output of the SKIRT Monte Carlo radiative transfer code. Genetic algorithms prove to be a valuable tool in handling the multi- dimensional search space as well as the noise induced by the random nature of the Monte Carlo radiative transfer code. FitSKIRT is tested on artificial images of a simulated edge-on spiral galaxy, where we gradually increase the number of fitted parameters. We find that we can recover all model parameters, even if all 11 model parameters are left unconstrained. Finally, we apply the FitSKIRT code to a V-band image of the edge-on spiral galaxy NGC 4013. This galaxy has been modeled previously by other authors using different combinations of radiative transfer codes and optimization methods. Given the different models and techniques and the complexity and degeneracies in the parameter space, we find reasonable agreement between the different models. We conclude that the FitSKIRT method allows comparison between different models and geometries in a quantitative manner and minimizes the need of human intervention and biasing. The high level of automation makes it an ideal tool to use on larger sets of observed data.

Efficacy of a preservative-free formulation of fixed-combination bimatoprost and timolol (Ganfort PF in treatment-naïve patients vs previously treated patients

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Cordeiro MF

2015-08-01

Full Text Available M Francesca Cordeiro,1 Ivan Goldberg,2 Rhett Schiffman,3 Paula Bernstein,3 Marina Bejanian31Western Eye Hospital, Imperial College Healthcare NHS Trust, London, UK; 2Discipline of Ophthalmology, University of Sydney, Sydney, NSW, Australia; 3Allergan, Inc., Irvine, CA, USAPurpose: To evaluate, using subgroup analysis, the effect of treatment status on the intraocular pressure (IOP-lowering efficacy of a preservative-free formulation of fixed-combination bimatoprost 0.03%/timolol 0.5% (FCBT PF.Methods: A primary, multicenter, randomized, double-masked, 12-week study compared the efficacy and safety of FCBT PF with preserved FCBT (Ganfort® in 561 patients diagnosed with glaucoma or ocular hypertension. For this analysis, eligible patients were treatment-naïve or had inadequate IOP lowering and underwent a washout of previous treatment. IOP (8 am, 10 am, and 4 pm was measured at baseline and weeks 2, 6, and 12. Subgroup analysis of the FCBT PF arm assessed changes in average eye IOP from baseline in treatment-naïve vs previously treated patients. To evaluate the effect of treatment status at baseline (treatment-naïve vs previously treated on IOP reduction in the FCBT PF treatment group, an analysis of covariance model was used with treatment status and investigator as fixed effects, and baseline average eye IOP, age, glaucoma diagnosis, and baseline average eye corneal thickness as covariates. P-values and the 95% confidence intervals were determined using the model.Results: In the FCBT PF arm, IOP mean changes from baseline ranged from -8.7 mmHg to -9.8 mmHg in treatment-naïve patients (N=50, compared with -7.3 mmHg to -8.5 mmHg in previously treated patients (N=228. Baseline IOP, age, glaucoma diagnosis, and corneal thickness significantly affected IOP reduction in the FCBT PF group. Adjusting for these covariates, FCBT PF had a greater IOP-lowering effect (0.8–1.7 mmHg in treatment-naïve patients than previously treated patients

Functional MRI of the visual cortex and visual testing in patients with previous optic neuritis

DEFF Research Database (Denmark)

Langkilde, Annika Reynberg; Frederiksen, J.L.; Rostrup, Egill

2002-01-01

to both the results of the contrast sensitivity test and to the Snellen visual acuity. Our results indicate that fMRI is a useful method for the study of ON, even in cases where the visual acuity is severely impaired. The reduction in activated volume could be explained as a reduced neuronal input......The volume of cortical activation as detected by functional magnetic resonance imaging (fMRI) in the visual cortex has previously been shown to be reduced following optic neuritis (ON). In order to understand the cause of this change, we studied the cortical activation, both the size...... of the activated area and the signal change following ON, and compared the results with results of neuroophthalmological testing. We studied nine patients with previous acute ON and 10 healthy persons served as controls using fMRI with visual stimulation. In addition to a reduced activated volume, patients showed...

Cost-effectiveness of abiraterone treatment in patients with castration-resistant prostate cancer who previously received docetaxel therapy

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A. V. Rudakova

2014-01-01

Full Text Available Background. Therapy for metastatic castration-resistant prostate cancer (CRPC is a serious problem that requires significant public health care expenditures.Objective: to evaluate the cost-effectiveness of abiraterone treatment in patients with metastatic CRPC who previously received docetaxel under the conditions of the budgetary public health system of the Russian Federation.Material and methods. Markovian simulation based on the COU-AA-301 randomized placebo-controlled Phase III study was used. Survival analysis was made in 70-year-old patients. The cost of abiraterone therapy corresponded to that of the 2013 auctions.Results. Abiraterone therapy in patients who have previously received docetaxel therapy causes an increase in average life expectancy by an average of 4.6 months and progression-free survival by 2.0 months. Moreover, the cost calculated with reference to one year of additional life will account for about 3.6 million rubles and that to one additional quality-adjusted life year will be about 5.45 million rubles.Conclusion. The cost-effectiveness of abiraterone therapy for metastatic CRPC in patients who have previously received docetaxel therapy is similar to that of other medicaments used in oncological practice under the conditions of the budgetary public health system of the Russian Federation. In this connection, abiraterone may be considered as an economically acceptable medical intervention in this clinical situation.

Cost-effectiveness of abiraterone treatment in patients with castration-resistant prostate cancer who previously received docetaxel therapy

Directory of Open Access Journals (Sweden)

A. V. Rudakova

2014-11-01

Full Text Available Background. Therapy for metastatic castration-resistant prostate cancer (CRPC is a serious problem that requires significant public health care expenditures.Objective: to evaluate the cost-effectiveness of abiraterone treatment in patients with metastatic CRPC who previously received docetaxel under the conditions of the budgetary public health system of the Russian Federation.Material and methods. Markovian simulation based on the COU-AA-301 randomized placebo-controlled Phase III study was used. Survival analysis was made in 70-year-old patients. The cost of abiraterone therapy corresponded to that of the 2013 auctions.Results. Abiraterone therapy in patients who have previously received docetaxel therapy causes an increase in average life expectancy by an average of 4.6 months and progression-free survival by 2.0 months. Moreover, the cost calculated with reference to one year of additional life will account for about 3.6 million rubles and that to one additional quality-adjusted life year will be about 5.45 million rubles.Conclusion. The cost-effectiveness of abiraterone therapy for metastatic CRPC in patients who have previously received docetaxel therapy is similar to that of other medicaments used in oncological practice under the conditions of the budgetary public health system of the Russian Federation. In this connection, abiraterone may be considered as an economically acceptable medical intervention in this clinical situation.

Fitness

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... gov home http://www.girlshealth.gov/ Home Fitness Fitness Want to look and feel your best? Physical ... are? Check out this info: What is physical fitness? top Physical fitness means you can do everyday ...

When fit fosters favoring : The role of private self-focus

NARCIS (Netherlands)

Fransen, Marieke L.; Fennis, Bob M.; Pruyn, Ad Th. H.; Vohs, Kathleen D.

The present research extends work on the 'the value from fit' principle by showing that regulatory fit effects on persuasion and behavioral compliance are stronger for people high, as opposed to low, in private self-focus. Previous research has shown that people high in private self-focus are

Left ventricular assist device implantation in a patient who had previously undergone apical myectomy for hypertrophic cardiomyopathy.

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Cho, Yang Hyun; Deo, Salil V; Topilsky, Yan; Grogan, Martha A; Park, Soon J

2012-03-01

Apical hypertrophy is a rare variant of hypertropic cardiomyopathy. These patients may present with end-stage congestive heart failure subsequent to long standing diastolic dysfunction. We report the technique for left ventricular assist device insertion in a patient with previous apical myectomy for hypertrophic cardiomyopathy. © 2012 Wiley Periodicals, Inc.

Hamiltonian inclusive fitness: a fitter fitness concept.

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Costa, James T

2013-01-01

In 1963-1964 W. D. Hamilton introduced the concept of inclusive fitness, the only significant elaboration of Darwinian fitness since the nineteenth century. I discuss the origin of the modern fitness concept, providing context for Hamilton's discovery of inclusive fitness in relation to the puzzle of altruism. While fitness conceptually originates with Darwin, the term itself stems from Spencer and crystallized quantitatively in the early twentieth century. Hamiltonian inclusive fitness, with Price's reformulation, provided the solution to Darwin's 'special difficulty'-the evolution of caste polymorphism and sterility in social insects. Hamilton further explored the roles of inclusive fitness and reciprocation to tackle Darwin's other difficulty, the evolution of human altruism. The heuristically powerful inclusive fitness concept ramified over the past 50 years: the number and diversity of 'offspring ideas' that it has engendered render it a fitter fitness concept, one that Darwin would have appreciated.

Previous PICC Placement May Be Associated With Catheter-Related Infections in Hemodialysis Patients

International Nuclear Information System (INIS)

Butler, Philip J.; Sood, Shreya; Mojibian, Hamid; Tal, Michael G.

2011-01-01

Background: Catheter-related infections (CRIs) are a significant source of morbidity and mortality in hemodialysis patients. The identification of novel, modifiable risk factors for CRIs may lead to improved outcomes in this population. Peripherally inserted central catheters (PICCs) have been hypothesized to compromise vascular access due to vascular damage and venous thrombosis, whereas venous thrombosis has been linked to the development of CRIs. Here we examine the association between PICC placement and CRIs. Methods: A retrospective review was performed of all chronic hemodialysis catheter placements and exchanges performed at a large university hospital from September 2003 to September 2008. History of PICC line use was determined by examining hospital radiologic records from December 1993 to September 2008. Catheter-related complications were assessed and correlated with PICC line history. Results: One hundred eighty-five patients with 713 chronic tunneled hemodialysis catheter placements were identified. Thirty-eight of those patients (20.5%) had a history of PICC placement; these patients were more likely to have CRIs (odds ratio = 2.46, 95% confidence interval = 1.71–3.53, p < .001) compared with patients without a history of PICC placement. There was no difference between the two groups in age or number of catheters placed. Conclusion: Previous PICC placement may be associated with catheter-related infections in hemodialysis patients.

Fitness plus American Society of Anesthesiologists grade improve outcome prediction after endovascular aneurysm repair.

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Boult, Margaret; Cowled, Prue; Barnes, Mary; Fitridge, Robert A

2017-09-01

Although the American Society of Anesthesiologists (ASA) grade was established for statistical purposes, it is often used prognostically. However, older patients undergoing elective surgery are typically ASA III, which limits patient stratification. We look at the prognostic effect on early complications and survival of using ASA and self-reported physical fitness to stratify patients undergoing endovascular repair of abdominal aortic aneurysms. Data were extracted from a trial database. All patients were assigned a fitness level (A (fit) or B (unfit)) based on their self-reported ability to walk briskly for 1 km or climb two flights of stairs. Fitness was used to stratify ASA III patients, with fitter patients assigned ASA IIIA and less fit patients ASA IIIB. Outcomes assessed included survival, reinterventions, endoleak, all early and late complications and early operative complications. A combined ASA/fitness scale (II, IIIA, IIIB and IV) correlated with 1- and 3-year survival (1-year P = 0.001, 3-year P = 0.001) and early and late complications (P = 0.001 and P = 0.05). On its own, ASA predicted early complications (P = 0.0004) and survival (1-year P = 0.01, 3-year P = 0.01). Fitness alone was predictive for survival (1-year P = 0.001, 3-year P = 0.001) and late complications (P = 0.009). This study shows that even a superficial assessment of fitness is reflected in surgical outcomes, with fitter ASA III patients showing survival patterns similar to ASA II patients. Physicians should be alert to differences in fitness between patients in the ASA III group, despite similarities based on preexisting severe systemic disease. © 2017 Royal Australasian College of Surgeons.

Patients with musculoskeletal conditions do less vigorous physical activity and have poorer physical fitness than population controls: a cross-sectional study.

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Moseng, T; Tveter, A T; Holm, I; Dagfinrud, H

2014-12-01

To compare physical activity and physical fitness in patients with various musculoskeletal conditions receiving physiotherapy in primary care with population controls. Cross-sectional. One hundred and sixty-seven patients with musculoskeletal conditions receiving physiotherapy in primary care and 313 population controls from various settings and geographical areas. Physical activity was measured with the International Physical Activity Questionnaire short-form (IPAQ-sf) and reported in metabolic equivalents (METs). The 6-minute walk test and 30-second sit-to-stand test reflected cardiorespiratory endurance and muscular strength, respectively. Differences in physical activity between the groups were explored using the Mann-Whitney U-test. The patient group reported significantly less vigorous activity compared with the control group {median 0 [interquartile range (IQR) 0 to 960] vs median 240 [IQR 0 to 1440] MET minutes/week, respectively)} (P=0.001). A similar proportion of patients (68%) and controls (75%) reached the recommended level of health-enhancing physical activity (P=0.11). Linear regression analyses adjusted for age, body mass index and gender showed significantly poorer fitness in the patient group compared with the control group, reflected by the 6-minute walk test and the 30-second sit-to-stand test {mean difference 69m [95% confidence interval (CI) 52 to 85; P≤0.001] and six repetitions [95% CI 5 to 7; P≤0.001], respectively}. Patients with various long-term musculoskeletal conditions receiving physiotherapy in primary care had significantly poorer physical fitness and reported less vigorous physical activity compared with population controls. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Reoperative sentinel lymph node biopsy after previous mastectomy.

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Karam, Amer; Stempel, Michelle; Cody, Hiram S; Port, Elisa R

2008-10-01

Sentinel lymph node (SLN) biopsy is the standard of care for axillary staging in breast cancer, but many clinical scenarios questioning the validity of SLN biopsy remain. Here we describe our experience with reoperative-SLN (re-SLN) biopsy after previous mastectomy. Review of the SLN database from September 1996 to December 2007 yielded 20 procedures done in the setting of previous mastectomy. SLN biopsy was performed using radioisotope with or without blue dye injection superior to the mastectomy incision, in the skin flap in all patients. In 17 of 20 patients (85%), re-SLN biopsy was performed for local or regional recurrence after mastectomy. Re-SLN biopsy was successful in 13 of 20 patients (65%) after previous mastectomy. Of the 13 patients, 2 had positive re-SLN, and completion axillary dissection was performed, with 1 having additional positive nodes. In the 11 patients with negative re-SLN, 2 patients underwent completion axillary dissection demonstrating additional negative nodes. One patient with a negative re-SLN experienced chest wall recurrence combined with axillary recurrence 11 months after re-SLN biopsy. All others remained free of local or axillary recurrence. Re-SLN biopsy was unsuccessful in 7 of 20 patients (35%). In three of seven patients, axillary dissection was performed, yielding positive nodes in two of the three. The remaining four of seven patients all had previous modified radical mastectomy, so underwent no additional axillary surgery. In this small series, re-SLN was successful after previous mastectomy, and this procedure may play some role when axillary staging is warranted after mastectomy.

Impact of previous vascular burden on in-hospital and long-term mortality in patients with ST-segment elevation myocardial infarction.

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Consuegra-Sánchez, Luciano; Melgarejo-Moreno, Antonio; Galcerá-Tomás, José; Alonso-Fernández, Nuria; Díaz-Pastor, Angela; Escudero-García, Germán; Jaulent-Huertas, Leticia; Vicente-Gilabert, Marta

2014-06-01

Patients with a current acute coronary syndrome and previous ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease are reported to have a poorer outcome than those without these previous conditions. It is uncertain whether this association with outcome is observed at long-term follow-up. Prospective observational study, including 4247 patients with ST-segment elevation myocardial infarction. Detailed clinical data and information on previous ischemic heart disease, peripheral arterial disease, and cerebrovascular disease ("vascular burden") were recorded. Multivariate models were performed for in-hospital and long-term (median, 7.2 years) all-cause mortality. One vascular territory was affected in 1131 (26.6%) patients and ≥ 2 territories in 221 (5.2%). The total in-hospital mortality rate was 12.3% and the long-term incidence density was 3.5 deaths per 100 patient-years. A background of previous ischemic heart disease (odds ratio = 0.83; P = .35), peripheral arterial disease (odds ratio = 1.30; P = .34), or cerebrovascular disease (stroke) (odds ratio = 1.15; P = .59) was not independently predictive of in-hospital death. In an adjusted model, previous cerebrovascular disease and previous peripheral arterial disease were both predictors of mortality at long-term follow-up (hazard ratio = 1.57; P cerebrovascular disease and peripheral arterial disease were predictors of mortality at long-term after hospital discharge. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Visual pathway abnormalities were found in most multiple sclerosis patients despite history of previous optic neuritis

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Stella Maris Costa Castro

2013-07-01

Full Text Available Objective It was to investigate visual field (VF abnormalities in a group of multiple sclerosis (MS patients in the remission phase and the presence of magnetic resonance imaging (MRI lesions in the optic radiations. Methods VF was assessed in 60 participants (age range 20-51 years: 35 relapsing-remitting MS patients [20 optic neuritis (+, 15 optic neuritis (-] and 25 controls. MRI (3-Tesla was obtained in all patients. Results Visual parameters were abnormal in MS patients as compared to controls. The majority of VF defects were diffuse. All patients except one had posterior visual pathways lesions. No significant difference in lesion number, length and distribution was noted between patients with and without history of optic neuritis. One patient presented homonymous hemianopsia. Conclusion Posterior visual pathway abnormalities were found in most MS patients despite history of previous optic neuritis.

Remote hearing aid fitting: Tele-audiology in the context of Brazilian Public Policy

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Penteado, Silvio Pires; Ramos, Sueli de Lima; Battistella, Linamara Rizzo; Marone, Silvio Antonio Monteiro; Bento, Ricardo Ferreira

2012-01-01

Summary Introduction: Currently, the Brazilian government has certificated nearly 140 specialized centers in hearing aid fittings through the Brazilian National Health System (SUS). Remote fitting through the Internet can allow a broader and more efficient coverage with a higher likelihood of success for patients covered by the SUS, as they can receive fittings from their own homes instead of going to the few and distant specialized centers. Aim: To describe a case of remote fitting between 2 cities, with revision of the literature. Method: Computer gears, a universal interface, and hearing aids were used. Case study: An audiologist located in a specialized center introduced a new hearing aid and its fitting procedure to a remote center (200 km away). The specialized center helped the remote center in fitting a hearing aid in 2 patients, and performed fitting in one of its own patients. The whole process was done through the Internet with audio and video in real time. Results: Three patients were fitted remotely. Three audiologists were remotely trained on how to fit the hearing aids. Conclusions: Remote fitting of hearing aids is possible through the Internet, as well as further supplying technical training to a remote center about the fitting procedures. Such a technological approach can help the government advance public policies on hearing rehabilitation, as patients can be motivated about maintaining their use of hearing aids with the option to ask for help in the comfort of their own homes. PMID:25991960

Second primary cancers in subsites of colon and rectum in patients with previous colorectal cancer

NARCIS (Netherlands)

Liu, L.; Lemmens, V.E.; de Hingh, I.H.J.T.; de Vries, E.; Roukema, J.A.; van Leerdam, M.E.; Coebergh, J.W.; Soerjomataram, I.

Background: Compared with the general population, patients with a previous colorectal cancer are at higher risk for a second colorectal cancer, but detailed risk analysis by subsite is scarce. Objective: Our goal was to investigate the risk of a second cancer in relation to subsite as a basis for

Test-retest reliability and four-week changes in cardiopulmonary fitness in stroke patients: evaluation using a robotics-assisted tilt table.

Science.gov (United States)

Saengsuwan, Jittima; Berger, Lucia; Schuster-Amft, Corina; Nef, Tobias; Hunt, Kenneth J

2016-09-06

Exercise testing devices for evaluating cardiopulmonary fitness in patients with severe disability after stroke are lacking, but we have adapted a robotics-assisted tilt table (RATT) for cardiopulmonary exercise testing (CPET). Using the RATT in a sample of patients after stroke, this study aimed to investigate test-retest reliability and repeatability of CPET and to prospectively investigate changes in cardiopulmonary outcomes over a period of four weeks. Stroke patients with all degrees of disability underwent 3 separate CPET sessions: 2 tests at baseline (TB1 and TB2) and 1 test at follow up (TF). TB1 and TB2 were at least 24 h apart. TB2 and TF were 4 weeks apart. A RATT equipped with force sensors in the thigh cuffs, a work rate estimation algorithm and a real-time visual feedback system was used to guide the patients' exercise work rate during CPET. Test-retest reliability and repeatability of CPET variables were analysed using paired t-tests, the intraclass correlation coefficient (ICC), the coefficient of variation (CoV), and Bland and Altman limits of agreement. Changes in cardiopulmonary fitness during four weeks were analysed using paired t-tests. Seventeen sub-acute and chronic stroke patients (age 62.7 ± 10.4 years [mean ± SD]; 8 females) completed the test sessions. The median time post stroke was 350 days. There were 4 severely disabled, 1 moderately disabled and 12 mildly disabled patients. For test-retest, there were no statistically significant differences between TB1 and TB2 for most CPET variables. Peak oxygen uptake, peak heart rate, peak work rate and oxygen uptake at the ventilatory anaerobic threshold (VAT) and respiratory compensation point (RCP) showed good to excellent test-retest reliability (ICC 0.65-0.94). For all CPET variables, CoV was 4.1-14.5 %. The mean difference was close to zero in most of the CPET variables. There were no significant changes in most cardiopulmonary performance parameters during the 4-week period

Previously undiagnosed hemophilia patient with intracerebral hemorrhage

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Eray Atalay

2015-09-01

Full Text Available Intracranial bleeding in hemophilia patients is a rare but a mortal complication. Diagnosis of hemophilia in adulthood is an uncommon occurrence. In this case report an adult patient with intracranial hemorrhage is presented.

Stevens-Johnson Syndrome Induced by Carbamazepine Treatment in a Patient Who Previously Had Carbamazepine Induced Pruritus - A Case Report -

OpenAIRE

Bae, Hyun Min; Park, Yoo Jung; Kim, Young Hoon; Moon, Dong Eon

2013-01-01

Stevens-Johnson syndrome (SJS) is a rare but life-threatening skin reaction disease and carbamazepine is one of its most common causes. We report a case of SJS secondary to carbamazepine in a patient with previous pruritus due to carbamazepine which was given for treatment of trigeminal neuralgia. We would like to caution all providers that carbamazepine readministration should be avoided in the patient with a previous history of SJS or adverse skin reaction. In addition, we strongly recommen...

[The loss of work fitness and the course of invalidism in patients with limb vessel lesions].

Science.gov (United States)

Chernenko, V F; Goncharenko, A G; Shuvalov, A Iu; Chernenko, V V; Tarasov, I V

2005-01-01

The growth of the sick rate of limb peripheral vessels associated with a severe outcome (trophic ulcers, amputation) exerts an appreciable effect on the lowering of quality of life in patients. This manifests by the prolonged loss of work fitness, change of the habitual occupation and disability establishment. Objective analytical information on this problem will be of help in the delineation of the tendencies in this direction and potential approaches to the prevention of social losses. The present work is based on an analysis of 2115 statements of medicosocial expert evaluation (MSEE) of invalids suffering from diseases of limb vessels, performed over recent 8 years in the Altai region. The decisions made by the MSEE were based on the results of the clinical examination of patients using the current diagnostic modalities (ultrasonography, duplex scanning, angiography, etc). It has been established that among persons who had undergone MSEE, over the half (64.1%) were under 60 years, i.e. in the age of work fitness. It is noteworthy that the overwhelming number of invalids were men (83%) and workers (84.2%). As for special vascular pathologies, the majority of patients presented with obliterative arterial diseases (OAD) of the lower limbs, accounting for 76.3% whereas patients with venous pathology ranked second in number (15.9%). The highest severity of invalidism (groups I and II) was also recorded in OAD (77.5%), especially in atherosclerosis obliterans (AO) which accounted for 84%. Of note, these diseases were marked by no tendency toward reduction of their incidence. The time of temporary disability (from 3 to 9 months) was also most frequently recorded in OAD of the limbs. In OAD, the temporary or persistent loss of work fitness were caused by critical ischemia and amputations whereas in venous pathology, namely in varicosity and post-thrombophlebotic syndrome, the cause was progressing CVI complicated by trophic ulcers. On the whole, the lack of changes in

Wii Fit balance training or progressive balance training in patients with chronic stroke: a randomised controlled trial

Science.gov (United States)

Yatar, Gozde Iyigun; Yildirim, Sibel Aksu

2015-01-01

[Purpose] The aim of this study was to compare the effects of Wii Fit balance training (WBT) and progressive balance training (PBT) approaches on balance functions, balance confidence, and activities of daily living in chronic stroke patients. [Subjects] A total of 30 patients were randomized into the WBT (n=15) and PBT (n=15) groups. [Methods] All of the subjects received exercise training based on a neurodevelopemental approach in addition to either Wii Fit or progressive balance training for total of 1 hour a day, 3 days per week for 4 weeks. Primary measurements were static balance function measured with a Wii Balance Board and dynamic balance function assessed with the Berg Balance Scale, Timed Up and Go test, Dynamic Gait Index, and Functional Reach Test. Secondary measures were balance confidence assessed with the Activities-specific Balance Confidence scale and activities of daily living evaluated with the Frenchay Activity Index. [Results] There was not remarkable difference between the two treatments in dynamic balance functions, balance confidence, and activities of daily living. [Conclusion] Although both of the approaches were found to be effective in improving the balance functions, balance confidence, and activities of daily living, neither of them were more preferable than the other for the treatment of balance in patients with chronic stroke. PMID:25995576

Wii Fit balance training or progressive balance training in patients with chronic stroke: a randomised controlled trial.

Science.gov (United States)

Yatar, Gozde Iyigun; Yildirim, Sibel Aksu

2015-04-01

[Purpose] The aim of this study was to compare the effects of Wii Fit balance training (WBT) and progressive balance training (PBT) approaches on balance functions, balance confidence, and activities of daily living in chronic stroke patients. [Subjects] A total of 30 patients were randomized into the WBT (n=15) and PBT (n=15) groups. [Methods] All of the subjects received exercise training based on a neurodevelopemental approach in addition to either Wii Fit or progressive balance training for total of 1 hour a day, 3 days per week for 4 weeks. Primary measurements were static balance function measured with a Wii Balance Board and dynamic balance function assessed with the Berg Balance Scale, Timed Up and Go test, Dynamic Gait Index, and Functional Reach Test. Secondary measures were balance confidence assessed with the Activities-specific Balance Confidence scale and activities of daily living evaluated with the Frenchay Activity Index. [Results] There was not remarkable difference between the two treatments in dynamic balance functions, balance confidence, and activities of daily living. [Conclusion] Although both of the approaches were found to be effective in improving the balance functions, balance confidence, and activities of daily living, neither of them were more preferable than the other for the treatment of balance in patients with chronic stroke.

How "fun/importance" fit affects performance: relating implicit theories to instructions.

Science.gov (United States)

Bianco, Amy T; Higgins, E Tory; Klem, Adena

2003-09-01

People experience a regulatory fit when they employ means of goal pursuit that fit their regulatory orientation, and this fit increases motivation that can enhance performance. The present studies extend previous research on regulatory fit to the classic motivational variables of fun and importance. They also examine for the first time the effect on performance of the fit between individuals' implicit theories about a task's fun or importance and their strategic engagement of the task as fun or important as induced by task instructions. In all three studies, task performance was better when the external task instructions "fit" rather than did not fit participants' implicit theory for the task. The implications of these findings for understanding the motivational effects of fun and importance are discussed.

Using Person Fit Statistics to Detect Outliers in Survey Research

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John M. Felt

2017-05-01

Full Text Available Context: When working with health-related questionnaires, outlier detection is important. However, traditional methods of outlier detection (e.g., boxplots can miss participants with “atypical” responses to the questions that otherwise have similar total (subscale scores. In addition to detecting outliers, it can be of clinical importance to determine the reason for the outlier status or “atypical” response.Objective: The aim of the current study was to illustrate how to derive person fit statistics for outlier detection through a statistical method examining person fit with a health-based questionnaire.Design and Participants: Patients treated for Cushing's syndrome (n = 394 were recruited from the Cushing's Support and Research Foundation's (CSRF listserv and Facebook page.Main Outcome Measure: Patients were directed to an online survey containing the CushingQoL (English version. A two-dimensional graded response model was estimated, and person fit statistics were generated using the Zh statistic.Results: Conventional outlier detections methods revealed no outliers reflecting extreme scores on the subscales of the CushingQoL. However, person fit statistics identified 18 patients with “atypical” response patterns, which would have been otherwise missed (Zh > |±2.00|.Conclusion: While the conventional methods of outlier detection indicated no outliers, person fit statistics identified several patients with “atypical” response patterns who otherwise appeared average. Person fit statistics allow researchers to delve further into the underlying problems experienced by these “atypical” patients treated for Cushing's syndrome. Annotated code is provided to aid other researchers in using this method.

Effects of High-Intensity Interval Training versus Continuous Training on Physical Fitness, Cardiovascular Function and Quality of Life in Heart Failure Patients.

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Nathalie M M Benda

Full Text Available Physical fitness is an important prognostic factor in heart failure (HF. To improve fitness, different types of exercise have been explored, with recent focus on high-intensity interval training (HIT. We comprehensively compared effects of HIT versus continuous training (CT in HF patients NYHA II-III on physical fitness, cardiovascular function and structure, and quality of life, and hypothesize that HIT leads to superior improvements compared to CT.Twenty HF patients (male:female 19:1, 64±8 yrs, ejection fraction 38±6% were allocated to 12-weeks of HIT (10*1-minute at 90% maximal workload-alternated by 2.5 minutes at 30% maximal workload or CT (30 minutes at 60-75% of maximal workload. Before and after intervention, we examined physical fitness (incremental cycling test, cardiac function and structure (echocardiography, vascular function and structure (ultrasound and quality of life (SF-36, Minnesota living with HF questionnaire (MLHFQ.Training improved maximal workload, peak oxygen uptake (VO2peak related to the predicted VO2peak, oxygen uptake at the anaerobic threshold, and maximal oxygen pulse (all P<0.05, whilst no differences were present between HIT and CT (N.S.. We found no major changes in resting cardiovascular function and structure. SF-36 physical function score improved after training (P<0.05, whilst SF-36 total score and MLHFQ did not change after training (N.S..Training induced significant improvements in parameters of physical fitness, although no evidence for superiority of HIT over CT was demonstrated. No major effect of training was found on cardiovascular structure and function or quality of life in HF patients NYHA II-III.Nederlands Trial Register NTR3671.

Real-time patient-specific finite element analysis of internal stresses in the soft tissues of a residual limb: a new tool for prosthetic fitting.

Science.gov (United States)

Portnoy, S; Yarnitzky, G; Yizhar, Z; Kristal, A; Oppenheim, U; Siev-Ner, I; Gefen, A

2007-01-01

Fitting of a prosthetic socket is a critical stage in the process of rehabilitation of a trans-tibial amputation (TTA) patient, since a misfit may cause pressure ulcers or a deep tissue injury (DTI: necrosis of the muscle flap under intact skin) in the residual limb. To date, prosthetic fitting typically depends on the subjective skills of the prosthetist, and is not supported by biomedical instrumentation that allows evaluation of the quality of fitting. Specifically, no technology is presently available to provide real-time continuous information on the internal distribution of mechanical stresses in the residual limb during fitting of the prosthesis, or while using it and this severely limits patient evaluations. In this study, a simplified yet clinically oriented patient-specific finite element (FE) model of the residual limb was developed for real-time stress analysis. For this purpose we employed a custom-made FE code that continuously calculates internal stresses in the residual limb, based on boundary conditions acquired in real-time from force sensors, located at the limb-prosthesis interface. Validation of the modeling system was accomplished by means of a synthetic phantom of the residual limb, which allowed simultaneous measurements of interface pressures and internal stresses. Human studies were conducted subsequently in five TTA patients. The dimensions of bones and soft tissues were obtained from X-rays of the residual limb of each patient. An indentation test was performed in order to obtain the effective elastic modulus of the soft tissues of the residual limb. Seven force sensors were placed between the residual limb and the prosthetic liner, and subjects walked on a treadmill during analysis. Generally, stresses under the shinbones were approximately threefold higher than stresses at the soft tissues behind the bones. Usage of a thigh corset decreased the stresses in the residual limb during gait by approximately 80%. Also, the stresses

A Data Forward Stepwise Fitting Algorithm Based on Orthogonal Function System

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Li Han-Ju

2017-01-01

Full Text Available Data fitting is the main method of functional data analysis, and it is widely used in the fields of economy, social science, engineering technology and so on. Least square method is the main method of data fitting, but the least square method is not convergent, no memory property, big fitting error and it is easy to over fitting. Based on the orthogonal trigonometric function system, this paper presents a data forward stepwise fitting algorithm. This algorithm takes forward stepwise fitting strategy, each time using the nearest base function to fit the residual error generated by the previous base function fitting, which makes the residual mean square error minimum. In this paper, we theoretically prove the convergence, the memory property and the fitting error diminishing character for the algorithm. Experimental results show that the proposed algorithm is effective, and the fitting performance is better than that of the least square method and the forward stepwise fitting algorithm based on the non-orthogonal function system.

Human Papilloma Virus Identification in Breast Cancer Patients with Previous Cervical Neoplasia.

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Lawson, James S; Glenn, Wendy K; Salyakina, Daria; Clay, Rosemary; Delprado, Warick; Cheerala, Bharathi; Tran, Dinh D; Ngan, Christopher C; Miyauchi, Shingo; Karim, Martha; Antonsson, Annika; Whitaker, Noel J

2015-01-01

Women with human papilloma virus (HPV)-associated cervical neoplasia have a higher risk of developing breast cancer than the general female population. The purpose of this study was to (i) identify high-risk HPVs in cervical neoplasia and subsequent HPV positive breast cancers which developed in the same patients and (ii) determine if these HPVs were biologically active. A range of polymerase chain reaction and immunohistochemical techniques were used to conduct a retrospective cohort study of cervical precancers and subsequent breast cancers in the same patients. The same high-risk HPV types were identified in both the cervical and breast specimens in 13 (46%) of 28 patients. HPV type 18 was the most prevalent. HPVs appeared to be biologically active as demonstrated by the expression of HPV E7 proteins and the presence of HPV-associated koilocytes. The average age of these patients diagnosed with breast cancer following prior cervical precancer was 51 years, as compared to 60 years for all women with breast cancer (p for difference = 0.001). These findings indicate that high-risk HPVs can be associated with cervical neoplasia and subsequent young age breast cancer. However, these associations are unusual and are a very small proportion of breast cancers. These outcomes confirm and extend the observations of two similar previous studies and offer one explanation for the increased prevalence of serious invasive breast cancer among young women.

Human papilloma virus identification in breast cancer patients with previous cervical neoplasia

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James Sutherland Lawson

2016-01-01

Full Text Available Purpose: Women with human papilloma virus (HPV associated cervical neoplasia have a higher risk of developing breast cancer than the general female population. The purpose of this study was to (i identify high risk for cancer HPVs in cervical neoplasia and subsequent HPV positive breast cancers which developed in the same patients and (ii determine if these HPVs were biologically active.Methods: A range of polymerase chain reaction (PCR and immunohistochemical techniques were used to conduct a retrospective cohort study of cervical precancers and subsequent breast cancers in the same patients. Results: The same high risk HPV types were identified in both the cervical and breast specimens in 13 (46% of 28 patients. HPV type 18 was the most prevalent. HPVs appeared to be biologically active as demonstrated by the expression of HPV E7 proteins and the presence of HPV associated koilocytes. The average age of these patients diagnosed with breast cancer following prior cervical precancer was 51 years, as compared to 60 years for all women with breast cancer (p for difference = 0.001. Conclusions: These findings indicate that high risk HPVs can be associated with cervical neoplasia and subsequent young age breast cancer. However these associations are unusual and are a very small proportion of breast cancers. These outcomes confirm and extend the observations of 2 similar previous studies and offer one explanation for the increased prevalence of serious invasive breast cancer among young women.

Fractal Image Coding Based on a Fitting Surface

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Sheng Bi

2014-01-01

Full Text Available A no-search fractal image coding method based on a fitting surface is proposed. In our research, an improved gray-level transform with a fitting surface is introduced. One advantage of this method is that the fitting surface is used for both the range and domain blocks and one set of parameters can be saved. Another advantage is that the fitting surface can approximate the range and domain blocks better than the previous fitting planes; this can result in smaller block matching errors and better decoded image quality. Since the no-search and quadtree techniques are adopted, smaller matching errors also imply less number of blocks matching which results in a faster encoding process. Moreover, by combining all the fitting surfaces, a fitting surface image (FSI is also proposed to speed up the fractal decoding. Experiments show that our proposed method can yield superior performance over the other three methods. Relative to range-averaged image, FSI can provide faster fractal decoding process. Finally, by combining the proposed fractal coding method with JPEG, a hybrid coding method is designed which can provide higher PSNR than JPEG while maintaining the same Bpp.

‘Fit for charity’: the moderating role of private self-focus in the persuasiveness of regulatory fit

NARCIS (Netherlands)

Fransen, M.L.; Fennis, B.M.; Vohs, K.D.; Pruyn, A.T.H.

2009-01-01

The present research extends work on the ‘the value from fit’ principle by showing that regulatory fit effects on charitable behavior are stronger for consumers high in private self-focus. Based on previous research showing that individuals high in private self-focus are more affected by external

Deep brain stimulation of the subthalamic nucleus: effectiveness in advanced Parkinson's disease patients previously reliant on apomorphine

OpenAIRE

Varma, T; Fox, S; Eldridge, P; Littlechild, P; Byrne, P; Forster, A; Marshall, A; Cameron, H; McIver, K; Fletcher, N; Steiger, M

2003-01-01

Objectives: To assess the efficacy of bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) in patients with advanced Parkinson's disease previously reliant on apomorphine as their main antiparkinsonian medication.

Erlotinib-induced rash spares previously irradiated skin

International Nuclear Information System (INIS)

Lips, Irene M.; Vonk, Ernest J.A.; Koster, Mariska E.Y.; Houwing, Ronald H.

2011-01-01

Erlotinib is an epidermal growth factor receptor inhibitor prescribed to patients with locally advanced or metastasized non-small cell lung carcinoma after failure of at least one earlier chemotherapy treatment. Approximately 75% of the patients treated with erlotinib develop acneiform skin rashes. A patient treated with erlotinib 3 months after finishing concomitant treatment with chemotherapy and radiotherapy for non-small cell lung cancer is presented. Unexpectedly, the part of the skin that had been included in his previously radiotherapy field was completely spared from the erlotinib-induced acneiform skin rash. The exact mechanism of erlotinib-induced rash sparing in previously irradiated skin is unclear. The underlying mechanism of this phenomenon needs to be explored further, because the number of patients being treated with a combination of both therapeutic modalities is increasing. The therapeutic effect of erlotinib in the area of the previously irradiated lesion should be assessed. (orig.)

Safety of {sup 90}Y Radioembolization in Patients Who Have Undergone Previous External Beam Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Lam, Marnix G.E.H. [Division of Interventional Radiology, Stanford University School of Medicine, Stanford, California (United States); Department of Radiology and Nuclear Medicine, University Medical Center Utrecht (Netherlands); Abdelmaksoud, Mohamed H.K. [Division of Interventional Radiology, Stanford University School of Medicine, Stanford, California (United States); Chang, Daniel T.; Eclov, Neville C.; Chung, Melody P.; Koong, Albert C. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Louie, John D. [Division of Interventional Radiology, Stanford University School of Medicine, Stanford, California (United States); Sze, Daniel Y., E-mail: dansze@stanford.edu [Division of Interventional Radiology, Stanford University School of Medicine, Stanford, California (United States)

2013-10-01

Purpose: Previous external beam radiation therapy (EBRT) is theoretically contraindicated for yttrium-90 ({sup 90}Y) radioembolization (RE) because the liver has a lifetime tolerance to radiation before becoming vulnerable to radiation-induced liver disease. We analyzed the safety of RE as salvage treatment in patients who had previously undergone EBRT. Methods and Materials: Between June 2004 and December 2010, a total of 31 patients who had previously undergone EBRT were treated with RE. Three-dimensional treatment planning with dose–volume histogram (DVH) analysis of the liver was used to calculate the EBRT liver dose. Liver-related toxicities including RE-induced liver disease (REILD) were reviewed and classified according to Common Terminology Criteria for Adverse Events version 4.02. Results: The mean EBRT and RE liver doses were 4.40 Gy (range, 0-23.13 Gy) and 57.9 Gy (range, 27.0-125.9 Gy), respectively. Patients who experienced hepatotoxicity (≥grade2; n=12) had higher EBRT mean liver doses (7.96 ± 8.55 Gy vs 1.62 ± 3.39 Gy; P=.037), the only independent predictor in multivariate analysis. DVH analysis showed that the fraction of liver exposed to ≥30 Gy (V30) was the strongest predictor of hepatotoxicity (10.14% ± 12.75% vs 0.84% ± 3.24%; P=.006). All patients with V30 >13% experienced hepatotoxicity. Fatal REILD (n=2) occurred at the 2 highest EBRT mean liver doses (20.9 Gy and 23.1 Gy) but also at the highest cumulative liver doses (91.8 Gy and 149 Gy). Conclusions: Prior exposure of the liver to EBRT may lead to increased liver toxicity after RE treatment, depending on fractional liver exposure and dose level. The V30 was the strongest predictor of toxicity. RE appears to be safe for the treatment of hepatic malignancies only in patients who have had limited hepatic exposure to prior EBRT.

When the model fits the frame: the impact of regulatory fit on efficacy appraisal and persuasion in health communication.

Science.gov (United States)

Bosone, Lucia; Martinez, Frédéric; Kalampalikis, Nikos

2015-04-01

In health-promotional campaigns, positive and negative role models can be deployed to illustrate the benefits or costs of certain behaviors. The main purpose of this article is to investigate why, how, and when exposure to role models strengthens the persuasiveness of a message, according to regulatory fit theory. We argue that exposure to a positive versus a negative model activates individuals' goals toward promotion rather than prevention. By means of two experiments, we demonstrate that high levels of persuasion occur when a message advertising healthy dietary habits offers a regulatory fit between its framing and the described role model. Our data also establish that the effects of such internal regulatory fit by vicarious experience depend on individuals' perceptions of response-efficacy and self-efficacy. Our findings constitute a significant theoretical complement to previous research on regulatory fit and contain valuable practical implications for health-promotional campaigns. © 2015 by the Society for Personality and Social Psychology, Inc.

Time course of changes in cerebral blood flow velocity after tourniquet deflation in patients with diabetes mellitus or previous stroke under sevoflurane anesthesia.

Science.gov (United States)

Hinohara, Hiroshi; Kadoi, Yuji; Takahashi, Kenichiro; Saito, Shigeru; Kawauchi, Chikara; Mizutani, Akio

2011-06-01

We observed an increase in mean middle cerebral artery blood flow velocity (V(mca)) after tourniquet deflation during orthopedic surgery under sevoflurane anesthesia in patients with diabetes mellitus or previous stroke. Eight controls, seven insulin-treated diabetic patients, and eight previous stroke patients were studied. Arterial blood pressure, heart rate, V(mca), arterial blood gases, and plasma lactate levels were measured every minute for 10 min after tourniquet release in all patients. V(mca) was measured using a transcranial Doppler probe. V(mca) in all three groups increased after tourniquet deflation, the increase lasting for 4 or 5 min. However, the degree of increase in V(mca) in the diabetic patients was smaller than that in the other two groups after tourniquet deflation (at 2 min after tourniquet deflation: control 58.5 ± 3.3, previous stroke 58.4 ± 4.6, diabetes 51.7 ± 2.3; P < 0.05 compared with the other two groups). In conclusion, the degree of increase in V (mca) in diabetic patients is smaller than that in controls and patients with previous stroke.

The Escherichia coli transcriptome linked to growth fitness

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Bei-Wen Ying

2016-03-01

Full Text Available A series of Escherichia coli strains with varied genomic sequences were subjected to high-density microarray analyses to elucidate the fitness-correlated transcriptomes. Fitness, which is commonly evaluated by the growth rate during the exponential phase, is not only determined by the genome but is also linked to growth conditions, e.g., temperature. We previously reported genetic and environmental contributions to E. coli transcriptomes and evolutionary transcriptome changes in thermal adaptation. Here, we describe experimental details on how to prepare microarray samples that truly represent the growth fitness of the E. coli cells. A step-by-step record of sample preparation procedures that correspond to growing cells and transcriptome data sets that are deposited at the GEO database (GSE33212, GSE52770, GSE61739 are also provided for reference. Keywords: Transcriptome, Growth fitness, Escherichia coli, Microarray

Clinical significance of stress-induced ST segment changes in patients with previous myocardial infarction

International Nuclear Information System (INIS)

Futagami, Yasuo; Hamada, Masayuki; Makino, Katsutoshi; Ichikawa, Takehiko; Konishi, Tokuji

1984-01-01

To explain the clinical significance of stress(st)-induced ST-segment (ST) changes postinfarction, 93 patients with previous myocardial infarction (MI) were performed st- 201 Tl myocardial single photon emission computed tomography (SPECT) and compared ST changes with SPECT, coronary arteriographic and left ventriculographic findings. 30 out of 93 cases (32%) had ST depression, 20 (21.5%) had ST elevation, 9 (10%) had both ST depression and elevation and remaining 34 (36.5 %) had no significant ST changes. In single vessel disease, ST depression were noted in 29% (12/42), while in multivessel disease, 53% (27/51). 35 out of 39 cases (90%) with ST depression had transient perfusion defect but no apparent relation was noted between location of ST depression on ECG and region of transient perfusion defect in SPECT. All of 28 cases with ST elevation were noted in anterior MI cases, and 26 out of these showed severe LV wall motion abnormality in contrast left ventriculography and broad anterior permanent defect in SPECT. Only 15 cases (54%) showed slight redistribution. Thus, we conclude that in patients with previous MI, st-induced ST depression seems to reflect myocardial ischemia and ST elevation possibly related abnormal LV wall motion. (author)

Reoperative Aortic Root Replacement in Patients with Previous Aortic Root or Aortic Valve Procedures

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Byung Kwon Chong

2016-08-01

Full Text Available Background: Generalization of standardized surgical techniques to treat aortic valve (AV and aortic root diseases has benefited large numbers of patients. As a consequence of the proliferation of patients receiving aortic root surgeries, surgeons are more frequently challenged by reoperative aortic root procedures. The aim of this study was to evaluate the outcomes of redo-aortic root replacement (ARR. Methods: We retrospectively reviewed 66 patients (36 male; mean age, 44.5±9.5 years who underwent redo-ARR following AV or aortic root procedures between April 1995 and June 2015. Results: Emergency surgeries comprised 43.9% (n=29. Indications for the redo-ARR were aneurysm (n=12, pseudoaneurysm (n=1, or dissection (n=6 of the residual native aortic sinus in 19 patients (28.8%, native AV dysfunction in 8 patients (12.1%, structural dysfunction of an implanted bioprosthetic AV in 19 patients (28.8%, and infection of previously replaced AV or proximal aortic grafts in 30 patients (45.5%. There were 3 early deaths (4.5%. During follow- up (median, 54.65 months; quartile 1–3, 17.93 to 95.71 months, there were 14 late deaths (21.2%, and 9 valve-related complications including reoperation of the aortic root in 1 patient, infective endocarditis in 3 patients, and hemorrhagic events in 5 patients. Overall survival and event-free survival rates at 5 years were 81.5%±5.1% and 76.4%±5.4%, respectively. Conclusion: Despite technical challenges and a high rate of emergency conditions in patients requiring redo-ARR, early and late outcomes were acceptable in these patients.

Effects of aerobic exercise on the resting heart rate, physical fitness, and arterial stiffness of female patients with metabolic syndrome.

Science.gov (United States)

Kang, Seol-Jung; Kim, Eon-Ho; Ko, Kwang-Jun

2016-06-01

[Purpose] The purpose of this study was to investigate the effects of aerobic exercise on the resting heart rate, physical fitness, and arterial stiffness or female patients with metabolic syndrome. [Subjects and Methods] Subjects were randomly assigned to an exercise group (n=12) or a control group (n=11). Subjects in the exercise group performed aerobic exercise at 60-80% of maximum heart rate for 40 min 5 times a week for 12 weeks. The changes in metabolic syndrome risk factors, resting heart rate, physical fitness, and arterial stiffness were measured and analyzed before and after initiation of the exercise program to determine the effect of exercise. Arterial stiffness was assessed based on brachial-ankle pulse wave velocity (ba-PWV). [Results] Compared to the control group; The metabolic syndrome risk factors (weight, % body fat, waist circumference, systolic blood pressure, diastolic blood pressure, and HDL-Cholesterol) were significantly improved in the exercise: resting heart rate was significantly decreased; VO2max, muscle strength and muscle endurance were significantly increased; and ba-PWV was significantly decreased. [Conclusion] Aerobic exercise had beneficial effects on the resting heart rate, physical fitness, and arterial stiffness of patients with metabolic syndrome.

Inside the fitness for work consultation: a qualitative study.

Science.gov (United States)

Cohen, D A; Aylward, M; Rollnick, S

2009-08-01

Evidence now suggests that work is generally good for physical and mental health and well-being. Worklessness for whatever reason can lead to poorer physical and mental health. The role of the general practitioner (GP) in the management of fitness for work is pivotal. To understand the interaction between GP and patient in the fitness for work consultation. This study forms part of a larger research project to develop a learning programme for GPs around the fitness for work consultation based on behaviour change methodology. A qualitative study set in South Wales. Structured discussion groups with seven GPs. Two sessions each lasting 3 h were conducted to explore the GP and patient interaction around the fitness for work consultation. Multiple methods were used to enhance engagement. Thematic analysis was used to analyse the data. Four major themes emerged from the meetings: role legitimacy, negotiation, managing the patient and managing the systems. Within these, subthemes emerged around role legitimacy. 'It's not my job', 'It's not what I trained for' and the 'shifting agenda' Negotiation was likened to 'A polite tug of war' and subthemes around decision making, managing the agenda and dealing with uncertainty emerged. This study starts to unravel the complexity of the fitness for work consultation. It illustrates how GPs struggle with the 'importance' of their role and 'confidence' in managing the fitness for work consultation. It addresses the skillful negotiation that is required to manage the consultation effectively.

Central venous stenosis among hemodialysis patients is often not associated with previous central venous catheters.

Science.gov (United States)

Kotoda, Atsushi; Akimoto, Tetsu; Kato, Maki; Kanazawa, Hidenori; Nakata, Manabu; Sugase, Taro; Ogura, Manabu; Ito, Chiharu; Sugimoto, Hideharu; Muto, Shigeaki; Kusano, Eiji

2011-01-01

It is widely assumed that central venous stenosis (CVS) is most commonly associated with previous central venous catheterization among the chronic hemodialysis (HD) patients. We evaluated the validity of this assumption in this retrospective study. The clinical records from 2,856 consecutive HD patients with vascular access failure during a 5-year period were reviewed, and a total of 26 patients with symptomatic CVS were identified. Combined with radiological findings, their clinical characteristics were examined. Only seven patients had a history of internal jugular dialysis catheterization. Diagnostic multidetector row computed tomography angiography showed that 7 of the 19 patients with no history of catheterization had left innominate vein stenosis due to extrinsic compression between the sternum and arch vessels. These patients had a shorter period from the time of creation of the vascular access to the initial referral (9.2 ± 7.6 months) than the rest of the patients (35.5 ± 18.6 months, p = 0.0017). Our findings suggest that cases without a history of central venous catheterization may not be rare among the HD patients with symptomatic CVS. However, those still need to be confirm by larger prospective studies of overall chronic HD patients with symptomatic CVS.

Determining the Relationship Between Physical Fitness, Gender, and Life Satisfaction

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Kyle Busing

2016-11-01

Full Text Available Previous research has suggested a positive effect of physical activity on life satisfaction. Little research exists that has investigated the relationship between physical fitness and life satisfaction. For this purpose, this research was done to determine the relationship between physical fitness and life satisfaction in a sample of university men and women. Participants (N = 28, Mage = 22.18 completed multiple indicators of physical fitness including cardiovascular fitness, muscular fitness, body composition and flexibility, and life satisfaction (SWLS. Descriptive and one-way between-groups ANOVAs were performed to determine gender differences on measures of life satisfaction and measures of fitness. In addition, the relationship between the five health-related components of fitness and life satisfaction were investigated using Pearson’s product–moment correlation coefficient. Analyses indicated there were no significant correlations between any of the health-related components of fitness and scores on the SWLS. There were significant gender differences on all physical fitness measures, except partial curl-ups, but no significant gender differences on life satisfaction. Our findings suggest that improved physical fitness does not have a relationship with higher life satisfaction measures. Further tests, utilizing larger sample sizes, are recommended.

RATES OF FITNESS DECLINE AND REBOUND SUGGEST PERVASIVE EPISTASIS

Science.gov (United States)

Perfeito, L; Sousa, A; Bataillon, T; Gordo, I

2014-01-01

Unraveling the factors that determine the rate of adaptation is a major question in evolutionary biology. One key parameter is the effect of a new mutation on fitness, which invariably depends on the environment and genetic background. The fate of a mutation also depends on population size, which determines the amount of drift it will experience. Here, we manipulate both population size and genotype composition and follow adaptation of 23 distinct Escherichia coli genotypes. These have previously accumulated mutations under intense genetic drift and encompass a substantial fitness variation. A simple rule is uncovered: the net fitness change is negatively correlated with the fitness of the genotype in which new mutations appear—a signature of epistasis. We find that Fisher's geometrical model can account for the observed patterns of fitness change and infer the parameters of this model that best fit the data, using Approximate Bayesian Computation. We estimate a genomic mutation rate of 0.01 per generation for fitness altering mutations, albeit with a large confidence interval, a mean fitness effect of mutations of −0.01, and an effective number of traits nine in mutS− E. coli. This framework can be extended to confront a broader range of models with data and test different classes of fitness landscape models. PMID:24372601

Are previous episodes of bacterial vaginosis a predictor for vaginal symptoms in breast cancer patients treated with aromatase inhibitors?

DEFF Research Database (Denmark)

Gade, Malene R; Goukasian, Irina; Panduro, Nathalie

2018-01-01

Objective To estimate the prevalence of vaginal symptoms in postmenopausal women with breast cancer exposed to aromatase inhibitors, and to investigate if the risk of vaginal symptoms is associated with previous episodes of bacterial vaginosis. Methods Patients from Rigshospitalet and Herlev...... University Hospital, Denmark, were identified through the register of Danish Breast Cancer Cooperation Group and 78 patients participated in the study. Semiquantitave questionnaires and telephone interview were used to assess the prevalence of vaginal symptoms and previous episode(s) of bacterial vaginosis....... Multivariable logistic regression models were used to assess the association between vaginal symptoms and previous episodes of bacterial vaginosis. Results Moderate to severe symptoms due to vaginal itching/irritation were experienced by 6.4% (95% CI: 2.8-14.1%), vaginal dryness by 28.4% (95% CI: 19...

Effect of preoperative angina pectoris on cardiac outcomes in patients with previous myocardial infarction undergoing major noncardiac surgery (data from ACS-NSQIP).

Science.gov (United States)

Pandey, Ambarish; Sood, Akshay; Sammon, Jesse D; Abdollah, Firas; Gupta, Ena; Golwala, Harsh; Bardia, Amit; Kibel, Adam S; Menon, Mani; Trinh, Quoc-Dien

2015-04-15

The impact of preoperative stable angina pectoris on postoperative cardiovascular outcomes in patients with previous myocardial infarction (MI) who underwent major noncardiac surgery is not well studied. We studied patients with previous MI who underwent elective major noncardiac surgeries within the American College of Surgeons-National Surgical Quality Improvement Program (2005 to 2011). Primary outcome was occurrence of an adverse cardiac event (MI and/or cardiac arrest). Multivariable logistic regression models evaluated the impact of stable angina on outcomes. Of 1,568 patients (median age 70 years; 35% women) with previous MI who underwent major noncardiac surgery, 5.5% had postoperative MI and/or cardiac arrest. Patients with history of preoperative angina had significantly greater incidence of primary outcome compared to those without anginal symptoms (8.4% vs 5%, p = 0.035). In secondary outcomes, reintervention rates (22.5% vs 11%, p angina. In multivariable analyses, preoperative angina was a significant predictor for postoperative MI (odds ratio 2.49 [1.20 to 5.58]) and reintervention (odds ratio 2.40 [1.44 to 3.82]). In conclusion, our study indicates that preoperative angina is an independent predictor for adverse outcomes in patients with previous MI who underwent major noncardiac surgery, and cautions against overreliance on predictive tools, for example, the Revised Cardiac Risk Index, in these patients, which does not treat stable angina and previous MI as independent risk factors during risk prognostication. Copyright © 2015 Elsevier Inc. All rights reserved.

Computer-aided detection system performance on current and previous digital mammograms in patients with contralateral metachronous breast cancer

International Nuclear Information System (INIS)

Kim, Seung Ja; Moon, Woo Kyung; Cho, Nariya; Chang, Jung Min

2012-01-01

Background: The computer-aided detection (CAD) system is widely used for screening mammography. The performance of the CAD system for contralateral breast cancer has not been reported for women with a history of breast cancer. Purpose: To retrospectively evaluate the performance of a CAD system on current and previous mammograms in patients with contralateral metachronous breast cancer. Material and Methods: During a 3-year period, 4945 postoperative patients had follow-up examinations, from whom we selected 55 women with contralateral breast cancers. Among them, 38 had visible malignant signs on the current mammograms. We analyzed the sensitivity and false-positive marks of the system on the current and previous mammograms according to lesion type and breast density. Results: The total visible lesion components on the current mammograms included 27 masses and 14 calcifications in 38 patients. The case-based sensitivity for all lesion types was 63.2% (24/38) with false-positive marks of 0.71 per patient. The lesion-based sensitivity for masses and calcifications was 59.3% (16/27) and 71.4% (10/14), respectively. The lesion-based sensitivity for masses in fatty and dense breasts was 68.8% (11/16) and 45.5% (5/11), respectively. The lesion-based sensitivity for calcifications in fatty and dense breasts was 100.0% (3/3) and 63.6% (7/11), respectively. The total visible lesion components on the previous mammograms included 13 masses and three calcifications in 16 patients, and the sensitivity for all lesion types was 31.3% (5/16) with false-positive marks of 0.81 per patient. On these mammograms, the sensitivity for masses and calcifications was 30.8% (4/13) and 33.3% (1/3), respectively. The sensitivity in fatty and dense breasts was 28.6% (2/7) and 33.3% (3/9), respectively. Conclusion: In the women with a history of breast cancer, the sensitivity of the CAD system in visible contralateral breast cancer was lower than in most previous reports using the same CAD

Differences in aerobic fitness between inpatients and outpatients with severe mental disorders

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Helene Daae-Qvale Holmemo

2014-08-01

Full Text Available AbstractBackgroundPatients with severe mental disorders have increased mortality, and cardiovascular disease (CVD accounts for a large part. Physical inactivity and low aerobic fitness have been recognized as significant risk factors for CVD. In this study, we investigated the differences in aerobic fitness and physical activity between in- and outpatients with severe mental disorders. Method and subjectsFifty in- and outpatients from a regional psychiatric department were included. The patients filled in a questionnaire on physical activity and completed a clinical examination. An estimation of aerobic fitness was calculated for each patient, using gender, age, waist circumference, resting heart rate and physical activity level as variables.ResultsInpatients had lower estimated aerobic fitness than outpatients (VO₂peak 42 vs 50 mL•kg-1•min-1, p<0.001. Compared to population data matched for age and gender, inpatients had lower aerobic fitness, while outpatients were not different from the population average.ConclusionInpatients at a psychiatric department had lower estimated aerobic fitness than outpatients, and a lower aerobic fitness compared to the general population. Our findings suggest that inpatients with severe mental disorders should be considered a high risk group for CVD.

Person-job fit: an exploratory cross-sectional analysis of hospitalists.

Science.gov (United States)

Hinami, Keiki; Whelan, Chad T; Miller, Joseph A; Wolosin, Robert J; Wetterneck, Tosha B

2013-02-01

Person-job fit is an organizational construct shown to impact the entry, performance, and retention of workers. Even as a growing number of physicians work under employed situations, little is known about how physicians select, develop, and perform in organizational settings. Our objective was to validate in the hospitalist physician workforce features of person-job fit observed in workers of other industries. The design was a secondary survey data analysis from a national stratified sample of practicing US hospitalists. The measures were person-job fit; likelihood of leaving practice or reducing workload; organizational climate; relationships with colleagues, staff, and patients; participation in suboptimal patient care activities. Responses to the Hospital Medicine Physician Worklife Survey by 816 (sample response rate 26%) practicing hospitalists were analyzed. Job attrition and reselection improved job fit among hospitalists entering the job market. Better job fit was achieved through hospitalists engaging a variety of personal skills and abilities in their jobs. Job fit increased with time together with socialization and internalization of organizational values. Hospitalists with higher job fit felt they performed better in their jobs. Features of person-job fit for hospitalists conformed to what have been observed in nonphysician workforces. Person-job fit may be a useful complementary survey measure related to job satisfaction but with a greater focus on function. Copyright © 2012 Society of Hospital Medicine.

Nuts for Physical Health and Fitness: A Review

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Hidetaka Hamasaki

2017-11-01

Full Text Available Nuts are rich in various nutrients. Recent evidence suggests that nut consumption has beneficial effects on blood pressure, lipid profile, obesity, inflammation, and oxidative stress, which reduce the risk of cardiovascular disease. Previous studies have shown that nut consumption improves body composition without causing weight gain, despite total energy intake increases. However, evidence regarding nut consumption and physical fitness is limited. The aim of this mini review is to summarize the evidence regarding effects of nuts on physical health, fitness, and exercise performance. Almond supplementation improves exercise performance, but pistachio supplementation does not. The effect of nuts on exercise performance was controversial. On the other hand, unsaturated fatty acid-enriched nuts had a beneficial effect on skeletal muscle mass and oxygen consumption. A diet enriched with nuts also improved physical fitness, which was enhanced by exercise. Although the characteristics of the study participants and the interventions used in the studies are heterogeneous, nuts have a potential to improve physical fitness. However, further studies are required to reveal the effects of nuts on physical fitness, exercise performance, and endurance capacity.

Recognizing Banknote Fitness with a Visible Light One Dimensional Line Image Sensor

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Tuyen Danh Pham

2015-08-01

Full Text Available In general, dirty banknotes that have creases or soiled surfaces should be replaced by new banknotes, whereas clean banknotes should be recirculated. Therefore, the accurate classification of banknote fitness when sorting paper currency is an important and challenging task. Most previous research has focused on sensors that used visible, infrared, and ultraviolet light. Furthermore, there was little previous research on the fitness classification for Indian paper currency. Therefore, we propose a new method for classifying the fitness of Indian banknotes, with a one-dimensional line image sensor that uses only visible light. The fitness of banknotes is usually determined by various factors such as soiling, creases, and tears, etc. although we just consider banknote soiling in our research. This research is novel in the following four ways: first, there has been little research conducted on fitness classification for the Indian Rupee using visible-light images. Second, the classification is conducted based on the features extracted from the regions of interest (ROIs, which contain little texture. Third, 1-level discrete wavelet transformation (DWT is used to extract the features for discriminating between fit and unfit banknotes. Fourth, the optimal DWT features that represent the fitness and unfitness of banknotes are selected based on linear regression analysis with ground-truth data measured by densitometer. In addition, the selected features are used as the inputs to a support vector machine (SVM for the final classification of banknote fitness. Experimental results showed that our method outperforms other methods.

Recognizing Banknote Fitness with a Visible Light One Dimensional Line Image Sensor.

Science.gov (United States)

Pham, Tuyen Danh; Park, Young Ho; Kwon, Seung Yong; Nguyen, Dat Tien; Vokhidov, Husan; Park, Kang Ryoung; Jeong, Dae Sik; Yoon, Sungsoo

2015-08-27

In general, dirty banknotes that have creases or soiled surfaces should be replaced by new banknotes, whereas clean banknotes should be recirculated. Therefore, the accurate classification of banknote fitness when sorting paper currency is an important and challenging task. Most previous research has focused on sensors that used visible, infrared, and ultraviolet light. Furthermore, there was little previous research on the fitness classification for Indian paper currency. Therefore, we propose a new method for classifying the fitness of Indian banknotes, with a one-dimensional line image sensor that uses only visible light. The fitness of banknotes is usually determined by various factors such as soiling, creases, and tears, etc. although we just consider banknote soiling in our research. This research is novel in the following four ways: first, there has been little research conducted on fitness classification for the Indian Rupee using visible-light images. Second, the classification is conducted based on the features extracted from the regions of interest (ROIs), which contain little texture. Third, 1-level discrete wavelet transformation (DWT) is used to extract the features for discriminating between fit and unfit banknotes. Fourth, the optimal DWT features that represent the fitness and unfitness of banknotes are selected based on linear regression analysis with ground-truth data measured by densitometer. In addition, the selected features are used as the inputs to a support vector machine (SVM) for the final classification of banknote fitness. Experimental results showed that our method outperforms other methods.

Laparoscopic assisted ventriculoperitoneal shunt revisions as an option for pediatric patients with previous intraabdominal complications

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Fernanda O. de Carvalho

2014-04-01

Full Text Available Multiple shunt failure is a challenge in pediatric neurosurgery practice and one of the most feared complications of hydrocephalus. Objective: To demonstrate that laparoscopic procedures for distal ventriculoperitoneal shunt failure may be an effective option for patients who underwent multiple revisions due to repetitive manipulation of the peritoneal cavity, abdominal pseudocyst, peritonitis or other situations leading to a “non reliable” peritoneum. Method: From March 2012 to February 2013, the authors reviewed retrospectively the charts of six patients born and followed up at our institution, which presented with previous intra-peritoneal complications and underwent ventriculoperitoneal shunt revision assisted by video laparoscopy. Results: After a mean follow-up period of nine months, all patients are well and no further shunt failure was identified so far. Conclusion: Laparoscopy assisted shunt revision in children may be, in selected cases, an effective option for patients with multiple peritoneal complications due to ventriculo-peritoneal shunting.

On analytical fits for electron impact ionisation cross sections

International Nuclear Information System (INIS)

Godunov, A.L.; Ivanov, P.B.

1999-01-01

The problem of providing accurate recommended analytical fits for electron impact ionisation cross sections is discussed, and a number of approaches are considered on the sample case of neon and its ions. The previously known fits are being reassessed using complete experimental and theoretical data, with the preference for experiment, to avoid systematic shifts introduced by the present calculation methods. The feasibility of the standard BELI formula is investigated in detail, and a number of other analytical expressions is suggested, approximating single-ionization cross sections in the whole range of energies. The factors influencing the accuracy of the fits and the physical meaning of the parameters obtained are discussed. (orig.)

High-resolution melting (HRM) re-analysis of a polyposis patients cohort reveals previously undetected heterozygous and mosaic APC gene mutations.

Science.gov (United States)

Out, Astrid A; van Minderhout, Ivonne J H M; van der Stoep, Nienke; van Bommel, Lysette S R; Kluijt, Irma; Aalfs, Cora; Voorendt, Marsha; Vossen, Rolf H A M; Nielsen, Maartje; Vasen, Hans F A; Morreau, Hans; Devilee, Peter; Tops, Carli M J; Hes, Frederik J

2015-06-01

Familial adenomatous polyposis is most frequently caused by pathogenic variants in either the APC gene or the MUTYH gene. The detection rate of pathogenic variants depends on the severity of the phenotype and sensitivity of the screening method, including sensitivity for mosaic variants. For 171 patients with multiple colorectal polyps without previously detectable pathogenic variant, APC was reanalyzed in leukocyte DNA by one uniform technique: high-resolution melting (HRM) analysis. Serial dilution of heterozygous DNA resulted in a lowest detectable allelic fraction of 6% for the majority of variants. HRM analysis and subsequent sequencing detected pathogenic fully heterozygous APC variants in 10 (6%) of the patients and pathogenic mosaic variants in 2 (1%). All these variants were previously missed by various conventional scanning methods. In parallel, HRM APC scanning was applied to DNA isolated from polyp tissue of two additional patients with apparently sporadic polyposis and without detectable pathogenic APC variant in leukocyte DNA. In both patients a pathogenic mosaic APC variant was present in multiple polyps. The detection of pathogenic APC variants in 7% of the patients, including mosaics, illustrates the usefulness of a complete APC gene reanalysis of previously tested patients, by a supplementary scanning method. HRM is a sensitive and fast pre-screening method for reliable detection of heterozygous and mosaic variants, which can be applied to leukocyte and polyp derived DNA.

Value of computed tomography pelvimetry in patients with a previous cesarean section

International Nuclear Information System (INIS)

Yamani, Tarik Y.; Rouzi, Abdulrahim A.

1998-01-01

A case-control study was conducted at the Department of Obstetrics and Gynaecology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia to determine the value of computed tomography pelivimetry in patients with a previous cesarean section. Between January 1993 and December 1995, 219 pregnant women with one previous cesarean had antenatal CT pelvimetry for assessment of the pelvis. One hundred and nineteen women did not have CT pelvimetry and served as control. Fifty-one women (51%) in the CT pelvimetry group were delivered by cesarean section. Twenty-three women (23%) underwent elective cesarean section for contracted pelvis based upon the findings of CT pelvimetry and 28 women (28%) underwent emergency cesarean section after trial of labor. In the group who did not have CT pelvimetry, 26 women (21.8%) underwent emergency cesarean section. This was a statistically significant difference (P=0.02). There were no statistically significant differences in birthweight and Apgar scores either group. There was no prenatal or maternal mortality in this study. Computed tomography pelvimetry increased the rate of cesarean delivery without any benefit in the immediate delivery outcomes. Therefore, the practice of documenting the adequacy of the pelvis by CT pelvimetry before vaginal birth after cesarean should be abandoned. (author)

Treatment satisfaction with paliperidone extended-release tablets: open-label study in schizophrenia patients dissatisfied with previous antipsychotic medication

Directory of Open Access Journals (Sweden)

Yang FD

2017-04-01

Full Text Available Fu De Yang,1 Juan Li,1 Yun Long Tan,1 Wei Ye Liang,1 Rongzhen Zhang,1 Ning Wang,1 Wei Feng,1 Shangli Cai,2 Jian Min Zhuo,2 Li Li Zhang2 1Beijing Hui-Long-Guan Hospital, 2Department of Medical Affairs, Xian Janssen Pharmaceutical Ltd, Beijing, People’s Republic of China Objective: The aim of this study was to evaluate the changes in treatment satisfaction after switching to paliperidone extended-release (ER in Chinese schizophrenia patients dissatisfied with their previous antipsychotic treatment.Methods: In this 8-week, open-label, single-arm, multicenter, prospective study, 1,693 patients dissatisfied with previous antipsychotic medication were enrolled and switched to paliperidone ER tablets (3–12 mg/d based on clinical judgment. The primary efficacy end point was change in Medication Satisfaction Questionnaire (MSQ score from baseline to week 8. The secondary end points included percentage of patients with MSQ score ≥4, as well as changes in Clinical Global Improvement-Severity (CGI-S and Personal and Social Performance (PSP scores.Results: MSQ scores increased significantly from baseline (mean [standard deviation {SD}]: 2.48 [0.55] to week 8 (5.47 [0.89], P<0.0001; primary end point, full analysis set. The percentage of patients with MSQ score ≥4 was 95.9% at week 8, indicating that most of the patients were satisfied with their treatment. Significant (P<0.0001 improvements from baseline to week 8 were noted in CGI-S score (2.37 [1.20] and PSP score (25.5 [15.0]. A total of 174 (10.28% patients experienced adverse events (AEs. The most common (>10 patients events were extrapyramidal disorder (n=84, 4.96%, poor quality sleep (n=18, 1.06% and akathisia (n=13, 0.77%. The majority of AEs were mild to moderate in severity. No deaths occurred.Conclusion: Treatment satisfaction improved after switching to paliperidone ER from the previous antipsychotic in Chinese patients with schizophrenia. Keywords: atypical antipsychotics, open label

Migration of a ventriculo-peritoneal shunt catheter into a back incision of a patient with previous spinal fusion.

Science.gov (United States)

Suryadevara, Raviteja; Lieber, Bryan A; Garcia, Erick; Sood, Sandeep; Haridas, Abilash; Ham, Steven

2018-04-01

This case examines a unique, longitudinal presentation of an abandoned, migrating VP shunt which presents as multiple complications, including a weeping abscess in the patients back. We believe that the latter complication was potentially caused by the wound from the patient's previous history of spinal fusion surgery. The patient presents with an associated type 2 Chiari malformation, hydrocephalus, and a previous history of posterior spinal fusion (T4-L5 anterior fusion and T2-L5 posterior fusion) at age 11. The patient had undergone shunt revisions in early adolescence as well. At 22, the patient is admitted into emergency care due to recurrent infections caused by a migrating VP shunt. Due to complications in corrective surgery at the time, the shunt was forced to be abandoned. This resulted in the most recent presentation of a weeping abscess at the patient's spinal fusion surgery wound; the culprit was the abandoned, migrating VP shunt.. An initial course of broad-spectrum antibiotics was started. However, the abscess continued to recur. Eventually, the catheter was surgically removed, a tailored antibiotic regiment was started, and a 6-month patient follow-up was performed. The patient is no longer symptomatic and off of antibiotics. In abandoned VP shunts, migration into a non-sterile cavity dictates prompt removal, especially after symptoms of infection present. Additionally, careful monitoring for signs of peritonitis or other symptoms for a dedicated period of time is necessary. To the authors' best knowledge, this is the first case of an occult shunt migration through the patient's back that presented with a weeping abscess.

Psychological impact of von Hippel-Lindau genetic screening in patients with a previous history of hemangioblastoma of the central nervous system.

Science.gov (United States)

Rochette, Claire; Baumstarck, Karine; Canoni-Zattara, Hélène; Abdullah, Ahmad Esmaeel; Figarella-Branger, Dominique; Pertuit, Morgane; Barlier, Anne; Castinetti, Frédéric; Pacak, Karel; Metellus, Philippe; Taïeb, David

2018-05-15

Von Hippel-Lindau (VHL) syndrome is a hereditary cancer syndrome characterized by a high risk of developing benign and malignant tumors, including central nervous system hemangioblastomas (CNS HBs). For an early diagnosis of VHL, before the occurrence of cancers (especially renal cell carcinoma), it is of huge importance to initiate VHL genetic testing in at-risk patients. The aim of the study was to assess the psychological impact of VHL genetic testing in patients previously diagnosed with a CNS HB. From 1999 until 2015, 55 patients underwent surgery for CNS HBs. Eleven patients were already screened for VHL mutations and 3 patients deceased before the start of the study. From the remaining 42 patients, 24 were accepted to be enrolled in the study. Assessment of psychological impact of VHL genetic testing was performed by measuring anxiety levels, mood disorders, quality of life, and psychological consequences of genetic screening. Twenty-one of the enrolled 24 patients underwent VHL genetic testing and 12 patients came back for the communication of positive genetic results. The baseline psychological status did not differ between these 2 groups. Patients who attended the visit of communication of genetic results had similar anxiety levels compared to those who had not. Furthermore, they also experienced an improvement in the level of anxiety and two QoL dimension scores compared to their baseline status. In summary, there is no evidence of a negative psychosocial impact of VHL genetic testing in patients with a previous history of CNS HB. We, therefore, recommend the recall of patients who have not been previously screened.

Impact of ibrutinib dose adherence on therapeutic efficacy in patients with previously treated CLL/SLL.

Science.gov (United States)

Barr, Paul M; Brown, Jennifer R; Hillmen, Peter; O'Brien, Susan; Barrientos, Jacqueline C; Reddy, Nishitha M; Coutre, Steven; Mulligan, Stephen P; Jaeger, Ulrich; Furman, Richard R; Cymbalista, Florence; Montillo, Marco; Dearden, Claire; Robak, Tadeusz; Moreno, Carol; Pagel, John M; Burger, Jan A; Suzuki, Samuel; Sukbuntherng, Juthamas; Cole, George; James, Danelle F; Byrd, John C

2017-05-11

Ibrutinib, an oral inhibitor of Bruton's tyrosine kinase (BTK), at a once-daily dose of 420 mg achieved BTK active-site occupancy in patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) that was maintained at 24 hours. It is unknown if intermittent interruption of ibrutinib therapy contributes to altered clinical outcomes. We therefore evaluated the effect of ibrutinib dose adherence on patient outcomes in the phase 3 RESONATE trial. The overall mean dose intensity (DI) was 95% with median treatment duration of ∼9 months. Pharmacokinetic assessment of ibrutinib exposure at 420-mg dose suggested similar exposure regardless of patient weight or age. As assessed by independent review committee, patients with higher DI experienced longer median progression-free survival (PFS) compared with those with lower DI regardless of del17p and/or TP53 status. Of 79 patients requiring a drug hold, treatment was restarted at the original dose in 73 (92%) patients. Mean duration of a missed-dose event was 18.7 days (range, 8-56). Patients missing ≥8 consecutive days of ibrutinib had a shorter median PFS vs those missing ibrutinib dosing at 420 mg as clinically feasible to achieve optimal outcomes in patients with previously treated CLL. The trial was registered at www.clinicaltrials.gov as #NCT01578707. © 2017 by The American Society of Hematology.

Dexamethasone intravitreal implant in previously treated patients with diabetic macular edema : Subgroup analysis of the MEAD study

OpenAIRE

Augustin, A.J.; Kuppermann, B.D.; Lanzetta, P.; Loewenstein, A.; Li, X.; Cui, H.; Hashad, Y.; Whitcup, S.M.; Abujamra, S.; Acton, J.; Ali, F.; Antoszyk, A.; Awh, C.C.; Barak, A.; Bartz-Schmidt, K.U.

2015-01-01

Background Dexamethasone intravitreal implant 0.7?mg (DEX 0.7) was approved for treatment of diabetic macular edema (DME) after demonstration of its efficacy and safety in the MEAD registration trials. We performed subgroup analysis of MEAD study results to evaluate the efficacy and safety of DEX 0.7 treatment in patients with previously treated DME. Methods Three-year, randomized, sham-controlled phase 3 study in patients with DME, best-corrected visual acuity (BCVA) of 34?68 Early Treatment...

Surgical Results of Trabeculectomy and Ahmed Valve Implantation Following a Previous Failed Trabeculectomy in Primary Congenital Glaucoma Patients

OpenAIRE

Lee, Naeun; Ma, Kyoung Tak; Bae, Hyoung Won; Hong, Samin; Seong, Gong Je; Hong, Young Jae; Kim, Chan Yun

2015-01-01

Purpose To compare the surgical results of trabeculectomy and Ahmed glaucoma valve implantation after a previous failed trabeculectomy. Methods A retrospective comparative case series review was performed on 31 eye surgeries in 20 patients with primary congenital glaucoma who underwent trabeculectomy or Ahmed glaucoma valve implantation after a previous failed trabeculectomy with mitomycin C. Results The preoperative mean intraocular pressure was 25.5 mmHg in the trabeculectomy group and 26.9...

Visual feedback training using WII Fit improves balance in Parkinson's disease.

Science.gov (United States)

Zalecki, Tomasz; Gorecka-Mazur, Agnieszka; Pietraszko, Wojciech; Surowka, Artur D; Novak, Pawel; Moskala, Marek; Krygowska-Wajs, Anna

2013-01-01

Postural instability including imbalance is the most disabling long term problem in Parkinson's disease (PD) that does not respond to pharmacotherapy. This study aimed at investigating the effectiveness of a novel visual-feedback training method, using Wii Fit balance board in improving balance in patients with PD. Twenty four patients with moderate PD were included in the study which comprised of a 6-week home-based balance training program using Nintendo Wii Fit and balance board. The PD patients significantly improved their results in Berg Balance Scale, Tinnet's Performance-Oriented Mobility Assessment, Timed Up-and-Go, Sit-to-stand test, 10-Meter Walk test and Activities-specific Balance Confidence scale at the end of the programme. This study suggests that visual feedback training using Wii-Fit with balance board could improve dynamic and functional balance as well as motor disability in PD patients.

Fitting PAC spectra with stochastic models: PolyPacFit

Energy Technology Data Exchange (ETDEWEB)

Zacate, M. O., E-mail: zacatem1@nku.edu [Northern Kentucky University, Department of Physics and Geology (United States); Evenson, W. E. [Utah Valley University, College of Science and Health (United States); Newhouse, R.; Collins, G. S. [Washington State University, Department of Physics and Astronomy (United States)

2010-04-15

PolyPacFit is an advanced fitting program for time-differential perturbed angular correlation (PAC) spectroscopy. It incorporates stochastic models and provides robust options for customization of fits. Notable features of the program include platform independence and support for (1) fits to stochastic models of hyperfine interactions, (2) user-defined constraints among model parameters, (3) fits to multiple spectra simultaneously, and (4) any spin nuclear probe.

A Large-Scale Initiative Inviting Patients to Share Personal Fitness Tracker Data with Their Providers: Initial Results.

Directory of Open Access Journals (Sweden)

Joshua M Pevnick

Full Text Available Personal fitness trackers (PFT have substantial potential to improve healthcare.To quantify and characterize early adopters who shared their PFT data with providers.We used bivariate statistics and logistic regression to compare patients who shared any PFT data vs. patients who did not.A patient portal was used to invite 79,953 registered portal users to share their data. Of 66,105 users included in our analysis, 499 (0.8% uploaded data during an initial 37-day study period. Bivariate and regression analysis showed that early adopters were more likely than non-adopters to be younger, male, white, health system employees, and to have higher BMIs. Neither comorbidities nor utilization predicted adoption.Our results demonstrate that patients had little intrinsic desire to share PFT data with their providers, and suggest that patients most at risk for poor health outcomes are least likely to share PFT data. Marketing, incentives, and/or cultural change may be needed to induce such data-sharing.

Effects of chair yoga therapy on physical fitness in patients with psychiatric disorders: A 12-week single-blind randomized controlled trial.

Science.gov (United States)

Ikai, Saeko; Uchida, Hiroyuki; Mizuno, Yuya; Tani, Hideaki; Nagaoka, Maki; Tsunoda, Kenichi; Mimura, Masaru; Suzuki, Takefumi

2017-11-01

Since falls may lead to fractures and have serious, potentially fatal outcomes, prevention of falls is an urgent public health issue. We examined the effects of chair yoga therapy on physical fitness among psychiatric patients in order to reduce the risk of falls, which has not been previously reported in the literature. In this 12-week single-blind randomized controlled trial with a 6-week follow-up, inpatients with mixed psychiatric diagnoses were randomly assigned to either chair yoga therapy in addition to ongoing treatment, or treatment-as-usual. Chair yoga therapy was conducted as twice-weekly 20-min sessions over 12 weeks. Assessments included anteflexion in sitting, degree of muscle strength, and Modified Falls Efficacy Scale (MFES) as well as QOL, psychopathology and functioning. Fifty-six inpatients participated in this study (36 men; mean ± SD age, 55.3 ± 13.7 years; schizophrenia 87.5%). In the chair yoga group, significant improvements were observed in flexibility, hand-grip, lower limb muscle endurance, and MFES at week 12 (mean ± SD: 55.1 ± 16.6 to 67.2 ± 14.0 cm, 23.6 ± 10.6 to 26.8 ± 9.7 kg, 4.9 ± 4.0 to 7.0 ± 3.9 kg, and 114.9 ± 29.2 to 134.1 ± 11.6, respectively). Additionally, these improvements were observable six weeks after the intervention was over. The QOL-VAS improved in the intervention group while no differences were noted in psychopathology and functioning between the groups. The intervention appeared to be highly tolerable without any notable adverse effects. The results indicated sustainable effects of 20-min, 12-week, 24-session chair yoga therapy on physical fitness. Chair yoga therapy may contribute to reduce the risk of falls and their unwanted consequences in psychiatric patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Clinical evaluation of postural posture of patients with previous stroke subjected to early rehabilitation

Directory of Open Access Journals (Sweden)

Anna Sagan

2018-02-01

Full Text Available Introduction: Impairment disorders are often found in patients with stroke and impairment of motor and cognitive functions. This is a very serious complication because, by imposing a motor impairment, it aggravates the condition of disability and makes it difficult to conduct physical rehabilitation.The resulting neurological deficits due to stroke determine functional disorders. The possibility of locomotion is usually compromised, therefore the risk of falls increases significantly. The aim of the work is to present Postural Assesment Scale for Strock PASS with the postural stroke assessment scale, the impact of early rehabilitation of patients staying in the neurology ward.Material and methods: Postural examination was carried out among 17 people, of which 8 were women, and 9 were male. The study was divided into two stages. The first stage occurred immediately after the stroke and the second one before the patient was discharged from the ward. Research was carried out at the Biegański Specialist Hospital in Grudziądz in the Department of Neurology and Clinical Neuroimmunology and Impact Department.Conclusions: The results of the postural studies carried out in people with previous stroke subjected to early physiotherapy have a beneficial effect of the conducted therapy. There are positive changes between the first and the final examination of the patients.

Assessment of Cardiovascular Fitness of Patients with Pulmonary Tuberculosis Using Six Minute Walk Test

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Taofeek Oluwole Awotidebe

2010-04-01

Full Text Available AIM: Patients with pulmonary tuberculosis (TB tends to have limited exercise tolerance and a significant disability affecting their activities of daily living. The importance of exercise in the management of these patients has not been well investigated. This study was designed to assess the cardiovascular fitness of patients with pulmonary TB using the six-minute walk test (6-MWT. METHOD: Sixty five consented patients with Pulmonary TB were consecutively recruited into the study. The patients performed 6-MWT over a 30 meter course on a level walkway at a speed as fast as they could. Data were obtained on participants’ physical characteristics, pre and post exercise blood pressure and heart rate, and maximum oxygen consumption. Data were analyzed using descriptive statistics of mean and standard deviation and paired t-test. RESULTS: The post walk test cardiovascular parameters were significantly higher than the resting cardiovascular parameters. The mean VO2 max and MET of the participants were 11.7±0.97 (ml O2kg -1min-1 and 3.35±0.28 (mL/Kg respectively. The means 6-MWT distance for male and female participants were 502.0±43.0m 481.7±68.3m respectively. CONCLUSION: The result implies that the 6-MWT is capable of evoking a significant cardiovascular change among patients with pulmonary TB. The 6-MWT may be useful in the assessment of functional capacity of patients with pulmonary TB. [TAF Prev Med Bull 2010; 9(2.000: 99-106

High or low intensity aerobic fitness training in fibromyalgia: does it matter?

NARCIS (Netherlands)

van Santen, Marijke; Bolwijn, Paulien; Landewé, Robert; Verstappen, Frans; Bakker, Carla; Hidding, Alita; van der Kemp, Désirée; Houben, Harry; van der Linden, Sjef

2002-01-01

To determine the efficacy of training in fibromyalgia (FM), we compared the effects of high intensity fitness training (HIF) and low intensity fitness training (LIF). Thirty-seven female patients with FM were randomly allocated to either a HIF group (n = 19) or a LIF group (n = 18). Four patients (1

Multiple-hook fixation in revision spinal deformity surgery for patients with a previous multilevel fusion mass: technical note and preliminary outcomes.

Science.gov (United States)

Liu, Ning; Wood, Kirkham B

2017-03-01

OBJECTIVE A previous multilevel fusion mass encountered during revision spinal deformity surgery may obscure anatomical landmarks, making instrumentation unworkable or incurring substantial blood loss and operative time. This study introduced a surgical technique of multiple-hook fixation for fixating previous multilevel fusion masses in revision spinal deformity surgeries and then evaluated its outcomes. METHODS Patients with a previous multilevel fusion mass who underwent revision corrective surgery down to the lumbosacral junction were retrospectively studied. Multiple hooks were used to fixate the fusion mass and linked to distal pedicle screws in the lumbosacral-pelvic complex. Radiological and clinical outcomes were evaluated. RESULTS The charts of 8 consecutive patients with spinal deformity were retrospectively reviewed (7 women, 1 man; mean age 56 years). The primary diagnoses included flat-back deformity (6 cases), thoracolumbar kyphoscoliosis (1 case), and lumbar spondylosis secondary to a previous scoliosis fusion (1 case). The mean follow-up duration was 30.1 months. Operations were performed at T3/4-ilium (4 cases), T7-ilium (1 case), T6-S1 (1 case), T12-S1 (1 case), and T9-L5 (1 case). Of 8 patients, 7 had sagittal imbalance preoperatively, and their mean C-7 plumb line improved from 10.8 ± 2.9 cm preoperatively to 5.3 ± 3.6 cm at final follow-up (p = 0.003). The mean lumbar lordosis of these patients at final follow-up was significantly greater than that preoperatively (35.2° ± 12.6° vs 16.8° ± 11.8°, respectively; p = 0.005). Two perioperative complications included osteotomy-related leg weakness in 1 patient and a stitch abscess in another. CONCLUSIONS The multiple-hook technique provides a viable alternative option for fixating a previous multilevel fusion mass in revision spinal deformity surgery.

Diagnosis of Beta-thalassaemia major in previously transfused patients

International Nuclear Information System (INIS)

Ahmed, S.; Rehman, Z.; Karamat, K.A.

2003-01-01

Objective: The study was conducted to evaluate the effects of blood transfusion(s) on the haematological picture of beta-thalassaemia major. Results: Out of the 280 patients 109 (39%) had received one or more blood transfusions (cases). The remaining 171 patients who did not receive any transfusion served as controls. The mean MCV, MCH and Hb-F in cases were significantly higher than in the controls (p 4 transfusions (17%) (p=0.016). In the occasionally transfused patients Hb-F level was directly related to the time since last transfusion. In 44/109 (40%) transfused patients (Hb-F>30%) the diagnosis of thalassaemia was not difficult. In 54/109 (50%) patients (Hb-:5-30%) the diagnosis was aided by parent's study, while PCR for thalassaemia mutation was required in 11/109 (10%) patients (Hb-F <5%). Conclusion: In most transfused patients of thalassaemia major MCV and MCH were significantly higher while Hb-F was lower than in the un-transfused patients. There was a linear correlation between Hb-F level and time since last transfusion in the occasionally transfused patients. However, the reduction in Hb-F level was more marked and sustained in multipally transfused patients. Parent's study and PCR are useful aids in establishing the correct diagnosis in these patients. (author)

Empirical Fit to Precision Inclusive Electron-Proton Cross Sections in the Resonance Region

International Nuclear Information System (INIS)

M.E. Christy; Peter Bosted

2007-01-01

An empirical fit is described to measurements of inclusive inelastic electron-proton cross sections in the kinematic range of four-momentum transfer 0 (le) Q 2 2 and final state invariant mass 1.1 2 ∼ 7.5 GeV 2 , and photoproduction data at Q 2 = 0. Compared to previous fits, the present fit covers a wider kinematic range, fits both transverse and longitudinal cross sections, and features smooth transitions to the photoproduction data at Q 2 =0 and DIS data at high Q 2 and W

Identifying the Best-Fitting Factor Structure of the Experience of Close Relations

DEFF Research Database (Denmark)

Esbjørn, Barbara Hoff; Breinholst, Sonja; Niclasen, Janni

2015-01-01

. The present study used a Danish sample with the purpose of addressing limitations in previous studies, such as the lack of diversity in cultural back- ground, restricted sample characteristics, and poorly fitting structure models. Participants consisted of 253 parents of children between the ages of 7 and 12...... years, 53% being moth- ers. The parents completed the paper version of the questionnaire. Confirmatory Factor Analyses were carried out to determine whether theoretically and empirically established models including one and two factors would also provide adequate fits in a Danish sample. A previous...... study using the original ECR suggested that Scandinavian samples may best be described using a five-factor solution. Our results indicated that the one- and two-factor models of the ECR-R did not fit the data well. Exploratory Factor Analysis revealed a five- factor model. Our study provides evidence...

Prosthetic fitting in a patient with a transtibial amputation due to a congenital vascular malformation of the right leg.

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Simmelink, Elisabeth K; Rommers, Gerardus M; Gardeniers, Jean W M; Zijlstra, Henk

2014-04-01

The problems of prescribing a prosthesis for a young girl with severe congenital vascular malformation deformity leading to a transtibial amputation. Due to the high risk of recurrent bleeding and limitations regarding full weight bearing of the stump, a normal socket fitting process was not possible. Using a multidisciplinary approach, a prosthesis was designed to enable full weight bearing in a flexed knee position with ischial tuberosity support to prevent full weight bearing on the tibial part of the stump. After training and adjustments to the design, a definitive prosthesis with a free motion mechanical knee joint could be used. During the training with this prosthesis, no skin problems were observed, and at the end of the rehabilitation, the patient had a high level of activities of daily living and sports. The above prosthetic solution with an adjusted socket design proved to be successful in this case. Clinical relevance In a patient with severe congenital vascular malformation deformity leading to a transtibial amputation, fitting of a good prosthesis without full weight bearing of the stump proved to be successful.

Combining heart rate and accelerometer data to estimate physical fitness

NARCIS (Netherlands)

Tönis, Thijs; Vollenbroek-Hutten, Miriam Marie Rosé; Hermens, Hermanus J.

2013-01-01

Monitoring changes in physical fitness is relevant in many conditions and groups of patients, but its determination demands substantial effort from the person, personnel and equipment. Besides that, present (sub) maximal exercise tests give a momentary fitness score, which depends on many (external)

Combining heart rate and accelerometer data to estimate physical fitness

NARCIS (Netherlands)

Tönis, Thijs; Vollenbroek-Hutten, Miriam Marie Rosé; Hermens, Hermanus J.

2012-01-01

Monitoring changes in physical fitness is relevant in many conditions and groups of patients, but its estimation demands substantial effort from the person, personnel and equipment. Besides that, present (sub) maximal exercise tests give a momentary fitness score, which depends on many (external)

Effects on the Treatments in Physical Therapy with the Wii Fit Plus Balance Board Concerning the Postural Changes on Children Suffering Spastics Hemiparesis. Case Report

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Luisa Fernanda Córdoba Castillo

2015-05-01

Full Text Available Introduction: This study tried to determine the effects on the treatments in physical therapy with the Wii Balance Board and Wii Fit Plus __both of Wii, Nintendo Company Limited__ concerning the postural changes on children suffering spastics hemiparesis. Material and methods: Longitudinal cohort case studies done with two children, from the municipality of Popayán, suffering cerebral palsy type spastic hemiparesis. This children had a test on static posture with the software APIC v. 2.0, previously, It was executed an exercises program using Wii Fit plus Balance Board for 20 sessions. Results: Both of the patients had remarkable changes on lateralization of the center of gravity. This change can subserve the postural changes later. Conclusions: The application of the game with Wii Fit Plus with Wii Balance Board in physical therapy is a useful alternative in rehabilitation of hemi paretic patients related to a better distribution of the center of gravity. It is advisable to avoid weight overload and compensations.

Retreatment with sofosbuvir/velpatasvir in cirrhotic patients with genotype-4 who failed a previous interferon-free regimen: a case series.

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Boglione, Lucio; Pinna, Simone Mornese; Lupia, Tommaso; Cariti, Giuseppe; Di Perri, Giovanni

2018-02-14

The novel available interferon (IFN)-free regimens significantly improved the sustained virological response (SVR) in patients with chronic hepatitis C (CHC), without important side effects and with shorter duration of treatment. In a subset of patients, however, the treatment failure (TF) was due to the presence of resistance-associated substitutions (RAS) that lead to virological breakthrough (BT) or relapse. We analysed in this case series the role of RAS on the TF in cirrhotic patients with genotype (GT)4, treated with a previous IFN-free regimen, and retreated with the combination of sofosbuvir (SOF)/velpatasvir (VEL) for 12 or 24 weeks, without ribavirin (RBV). We included in this analysis all patients with GT4 who failed a previous IFN-free treatment, with the presence of RAS at BT or relapse. All patients were retreated with a fixed combination of SOF/VEL for 12/24 weeks, without RBV. We evaluated the SVR and the MELD score change after the treatment. Seven patients were described. All were cirrhotic, Child-Pugh A (n=5), B (n=2); baseline RAS were detected in 4/7 subjects; at post-treatment detection, NS5 RAS were: F28S (n=1), Q30K (n=2), S30G (n=1), NS3 were: S122R (n=1), S122G (n=2), D168V (n=3). All retreated patients gained SVR. MELD score improved in all subjects with a median change of 3 points. No significant side effects or adverse events were reported. The combination SOF/VEL could be considered for the retreatment of cirrhotic GT4 patients who failed a previous IFN-free treatment with the presence of RAS in NS3 or NS5 regions.

Retreatment with sofosbuvir/velpatasvir in cirrhotic patients with genotype 4 who failed a previous interferon-free regimen: a case series.

Science.gov (United States)

Boglione, Lucio; Pinna, Simone Mornese; Lupia, Tommaso; Cariti, Giuseppe; Di Perri, Giovanni

2018-02-14

The novel available interferon (IFN)-free regimens significantly improved the sustained virological response (SVR) in patients with chronic hepatitis C (CHC), without important side-effects and with shorter duration of treatment. In a subset of patients, however, the treatment failure (TF) was due to the presence of resistance-associated substitutions (RAS) that lead to virological breakthrough (BT) or relapse. We analyzed in this case-series the role of RAS on the TF in cirrhotic patients with GT4, treated with a previous IFN-free regimen, and retreated with the combination of sofosbuvir (SOF)/velpatasvir (VEL) for 12 or 24 weeks, without ribavirin (RBV). We included in this analysis all patients with GT4 who failed a previous IFN-free treatment, with the presence of RAS at BT or relapse. All patients were retreated with a fixed combination of SOF/VEL for 12/24 weeks, without RBV. We evaluated the SVR and the MELD score change after the treatment. Seven patients were described. All were cirrhotic, Child-Pug A (n=5), B (n=2); baseline RAS were detected in 4/7 subjects; at post-treatment detection, NS5 RAS were: F28S (n=1), Q30K (n=2), S30G (n=1), NS3 were: S122R (n=1), S122G (n=2), D168V (n=3). All retreated patients gained the SVR. MELD score improved in all subjects with a median change of 3 points. No significant side-effects or adverse events were reported. The combination SOF/VEL could be considered for the retreatment of cirrhotic GT4 patients who failed a previous IFN-free treatment with the presence of RAS in NS3 or NS5 regions.

Genes Contributing to Porphyromonas gingivalis Fitness in Abscess and Epithelial Cell Colonization Environments

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Daniel P. Miller

2017-08-01

Full Text Available Porphyromonas gingivalis is an important cause of serious periodontal diseases, and is emerging as a pathogen in several systemic conditions including some forms of cancer. Initial colonization by P. gingivalis involves interaction with gingival epithelial cells, and the organism can also access host tissues and spread haematogenously. To better understand the mechanisms underlying these properties, we utilized a highly saturated transposon insertion library of P. gingivalis, and assessed the fitness of mutants during epithelial cell colonization and survival in a murine abscess model by high-throughput sequencing (Tn-Seq. Transposon insertions in many genes previously suspected as contributing to virulence showed significant fitness defects in both screening assays. In addition, a number of genes not previously associated with P. gingivalis virulence were identified as important for fitness. We further examined fitness defects of four such genes by generating defined mutations. Genes encoding a carbamoyl phosphate synthetase, a replication-associated recombination protein, a nitrosative stress responsive HcpR transcription regulator, and RNase Z, a zinc phosphodiesterase, showed a fitness phenotype in epithelial cell colonization and in a competitive abscess infection. This study verifies the importance of several well-characterized putative virulence factors of P. gingivalis and identifies novel fitness determinants of the organism.

Genes Contributing to Porphyromonas gingivalis Fitness in Abscess and Epithelial Cell Colonization Environments

Science.gov (United States)

Miller, Daniel P.; Hutcherson, Justin A.; Wang, Yan; Nowakowska, Zuzanna M.; Potempa, Jan; Yoder-Himes, Deborah R.; Scott, David A.; Whiteley, Marvin; Lamont, Richard J.

2017-01-01

Porphyromonas gingivalis is an important cause of serious periodontal diseases, and is emerging as a pathogen in several systemic conditions including some forms of cancer. Initial colonization by P. gingivalis involves interaction with gingival epithelial cells, and the organism can also access host tissues and spread haematogenously. To better understand the mechanisms underlying these properties, we utilized a highly saturated transposon insertion library of P. gingivalis, and assessed the fitness of mutants during epithelial cell colonization and survival in a murine abscess model by high-throughput sequencing (Tn-Seq). Transposon insertions in many genes previously suspected as contributing to virulence showed significant fitness defects in both screening assays. In addition, a number of genes not previously associated with P. gingivalis virulence were identified as important for fitness. We further examined fitness defects of four such genes by generating defined mutations. Genes encoding a carbamoyl phosphate synthetase, a replication-associated recombination protein, a nitrosative stress responsive HcpR transcription regulator, and RNase Z, a zinc phosphodiesterase, showed a fitness phenotype in epithelial cell colonization and in a competitive abscess infection. This study verifies the importance of several well-characterized putative virulence factors of P. gingivalis and identifies novel fitness determinants of the organism. PMID:28900609

Genes Contributing to Porphyromonas gingivalis Fitness in Abscess and Epithelial Cell Colonization Environments.

Science.gov (United States)

Miller, Daniel P; Hutcherson, Justin A; Wang, Yan; Nowakowska, Zuzanna M; Potempa, Jan; Yoder-Himes, Deborah R; Scott, David A; Whiteley, Marvin; Lamont, Richard J

2017-01-01

Porphyromonas gingivalis is an important cause of serious periodontal diseases, and is emerging as a pathogen in several systemic conditions including some forms of cancer. Initial colonization by P. gingivalis involves interaction with gingival epithelial cells, and the organism can also access host tissues and spread haematogenously. To better understand the mechanisms underlying these properties, we utilized a highly saturated transposon insertion library of P. gingivalis , and assessed the fitness of mutants during epithelial cell colonization and survival in a murine abscess model by high-throughput sequencing (Tn-Seq). Transposon insertions in many genes previously suspected as contributing to virulence showed significant fitness defects in both screening assays. In addition, a number of genes not previously associated with P. gingivalis virulence were identified as important for fitness. We further examined fitness defects of four such genes by generating defined mutations. Genes encoding a carbamoyl phosphate synthetase, a replication-associated recombination protein, a nitrosative stress responsive HcpR transcription regulator, and RNase Z, a zinc phosphodiesterase, showed a fitness phenotype in epithelial cell colonization and in a competitive abscess infection. This study verifies the importance of several well-characterized putative virulence factors of P. gingivalis and identifies novel fitness determinants of the organism.

Fitness club

CERN Multimedia

Fitness club

2011-01-01

General fitness Classes Enrolments are open for general fitness classes at CERN taking place on Monday, Wednesday, and Friday lunchtimes in the Pump Hall (building 216). There are shower facilities for both men and women. It is possible to pay for 1, 2 or 3 classes per week for a minimum of 1 month and up to 6 months. Check out our rates and enrol at: http://cern.ch/club-fitness Hope to see you among us! CERN Fitness Club fitness.club@cern.ch  

Persistence of transmitted HIV-1 drug resistance mutations associated with fitness costs and viral genetic backgrounds.

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Wan-Lin Yang

2015-03-01

Full Text Available Transmission of drug-resistant pathogens presents an almost-universal challenge for fighting infectious diseases. Transmitted drug resistance mutations (TDRM can persist in the absence of drugs for considerable time. It is generally believed that differential TDRM-persistence is caused, at least partially, by variations in TDRM-fitness-costs. However, in vivo epidemiological evidence for the impact of fitness costs on TDRM-persistence is rare. Here, we studied the persistence of TDRM in HIV-1 using longitudinally-sampled nucleotide sequences from the Swiss-HIV-Cohort-Study (SHCS. All treatment-naïve individuals with TDRM at baseline were included. Persistence of TDRM was quantified via reversion rates (RR determined with interval-censored survival models. Fitness costs of TDRM were estimated in the genetic background in which they occurred using a previously published and validated machine-learning algorithm (based on in vitro replicative capacities and were included in the survival models as explanatory variables. In 857 sequential samples from 168 treatment-naïve patients, 17 TDRM were analyzed. RR varied substantially and ranged from 174.0/100-person-years;CI=[51.4, 588.8] (for 184V to 2.7/100-person-years;[0.7, 10.9] (for 215D. RR increased significantly with fitness cost (increase by 1.6[1.3,2.0] per standard deviation of fitness costs. When subdividing fitness costs into the average fitness cost of a given mutation and the deviation from the average fitness cost of a mutation in a given genetic background, we found that both components were significantly associated with reversion-rates. Our results show that the substantial variations of TDRM persistence in the absence of drugs are associated with fitness-cost differences both among mutations and among different genetic backgrounds for the same mutation.

Rib cage deformity during two-stage tissue expander breast reconstruction in patient with previous radiotherapy: a case report

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Aleš Porčnik

2016-02-01

Full Text Available Patients undergoing two-stage breast reconstruction with tissue expander and a history of previous irradiation are predisposed to a various chest-wall deformations more than non-irradiated patients. If chest-wall depression with/without rib fracture is found intra-operatively, bigger implant should be used, with a subsequent radiologic evaluation. In the future, the development of a new, modified expander with a harder base could minimise such complications.

Timing of elective repeated cesarean delivery in patients with previous two or more cesarean section.

Science.gov (United States)

Mohammed, Abdel-Baset F; Bayo, Arabo I; Abu-Jubara, Mahmoud F

2013-01-01

To assess the maternal and neonatal consequences of scheduling elective repeated cesarean section (ERCS) at 39 weeks rather than 38 weeks and to assess the impacts of delivering by emergency cesarean section (CS) before the planned date. Retrospective Cohort study. Patients with previous two or more CS planned for ERCS at term during the period from January to June 2011. Medical records were reviewed for demographic and clinical data, planned timing of CS, emergency cesarean and any adverse maternal or neonatal outcome. Adverse maternal or neonatal outcome. Four hundred and twenty women were included, 71.4% of cases were posted <39 weeks and 28.6% were posted at ≥39 weeks. Patients posted ≥ 39 weeks were more prone to deliver by emergency CS (16.6 vs. 10.6%) and the neonates were less prone to RDS and NICU admission (p < 0.05). Our data support the justification to book patients for ERCS at ≥39 weeks.

A Flexible-Dose Study of Paliperidone ER in Patients With Nonacute Schizophrenia Previously Treated Unsuccessfully With Oral Olanzapine.

Science.gov (United States)

Kotler, Moshe; Dilbaz, Nesrin; Rosa, Fernanda; Paterakis, Periklis; Milanova, Vihra; Smulevich, Anatoly B; Lahaye, Marjolein; Schreiner, Andreas

2016-01-01

The goal of this study was to explore the tolerability, safety, and treatment response of switching from oral olanzapine to paliperidone extended release (ER). Adult patients with nonacute schizophrenia who had been treated unsuccessfully with oral olanzapine were switched to flexible doses of paliperidone ER (3 to 12 mg/d). The primary efficacy outcome was a ≥ 20% improvement in Positive and Negative Syndrome Scale (PANSS) total scores from baseline to endpoint for patients who switched medications because of lack of efficacy with olanzapine and noninferiority versus previous olanzapine treatment (mean endpoint change in PANSS total scores vs. baseline of ≤ 5 points) for patients who switched for reasons other than lack of efficacy. Safety and tolerability were assessed by monitoring adverse events, extrapyramidal symptoms, and weight change. Of 396 patients, 65.2% were men, mean age was 40.0 ± 12.0 years, and 75.5% had paranoid schizophrenia. Among the patients whose main reason for switching was lack of efficacy, an improvement in the PANSS total score of ≥ 20% occurred in 57.4% of patients. Noninferiority was confirmed for each subgroup of patients whose main reason for switching was something other than lack of efficacy. Paliperidone ER was generally well tolerated. Extrapyramidal symptoms as measured by total Extrapyramidal Symptom Rating Scale scores showed statistically significant and clinically relevant improvements at endpoint, the average weight decreased by 0.8 ± 5.2 kg at endpoint, and a clinically relevant weight gain of ≥ 7% occurred in 8.0% of patients. Paliperidone ER flexibly-dosed over 6 months was well tolerated and associated with a meaningful clinical response in patients with nonacute schizophrenia who had previously been unsuccessfully treated with oral olanzapine.

Development of 1-Mile Walk Tests to Estimate Aerobic Fitness in Children

Science.gov (United States)

Sung, Hoyong; Collier, David N.; DuBose, Katrina D.; Kemble, C. David; Mahar, Matthew T.

2018-01-01

To examine the reliability and validity of 1-mile walk tests for estimation of aerobic fitness (VO[subscript 2max]) in 10- to 13-year-old children and to cross-validate previously published equations. Participants (n = 61) walked 1-mile on two different days. Self-reported physical activity, demographic variables, and aerobic fitness were used in…

An Epidemiological Profile of CrossFit Athletes in Brazil.

Science.gov (United States)

Sprey, Jan W C; Ferreira, Thiago; de Lima, Marcos V; Duarte, Aires; Jorge, Pedro B; Santili, Claudio

2016-08-01

CrossFit is a conditioning and training program that has been gaining recognition and interest among the physically active population. Approximately 440 certified and registered CrossFit fitness centers and gyms exist in Brazil, with approximately 40,000 athletes. To date, there have been no epidemiological studies about the CrossFit athlete in Brazil. To evaluate the profile, sports history, training routine, and presence of injuries among athletes of CrossFit. Descriptive epidemiological study. This cross-sectional study was based on a questionnaire administered to CrossFit athletes from various specialized fitness centers in Brazil. Data were collected from May 2015 to July 2015 through an electronic questionnaire that included demographic data, level of sedentary lifestyle at work, sports training history prior to starting CrossFit, current sports activities, professional monitoring, and whether the participants experienced any injuries while practicing CrossFit. A total of 622 questionnaires were received, including 566 (243 women [42.9%] and 323 men [57.1%]) that were completely filled out and met the inclusion criteria and 9% that were incompletely filled out. Overall, 176 individuals (31.0%) mentioned having experienced some type of injury while practicing CrossFit. We found no significant difference in injury incidence rates regarding demographic data. There was no significant difference regarding previous sports activities because individuals who did not practice prior physical activity showed very similar injury rates to those who practiced at any level. CrossFit injury rates are comparable to those of other recreational or competitive sports, and the injuries show a profile similar to weight lifting, power lifting, weight training, Olympic gymnastics, and running, which have an injury incidence rate nearly half that of soccer.

[Fitness and quality of life in kidney transplant recipients: case-control study].

Science.gov (United States)

Hernández Sánchez, Sonsoles; Carrero, Juan J; García López, David; Herrero Alonso, Juan Azael; Menéndez Alegre, Héctor; Ruiz, Jonatan R

2016-04-15

We analyzed the levels of fitness, muscle structure and quality of life of adults after kidney transplant and healthy adults. A total of 16 kidney transplant patients and 21 healthy controls performed several fitness test, isokinetic evaluation of knee flexion and extension and ultrasonography muscle thickness assessment. They also completed the quality of life questionnaire SF-36. Physical fitness, muscle structure and quality of life of the kidney transplant recipients were significantly poorer than the controls. The transplant patients performed less well in the "get up and go" and "sit to stand" test (p<.001) as well as in assessments of muscle structure, strength and power. The patients had a poorer score in their quality of life assessments, differing from the controls in domains of physical function, physical role, general health and social function (p<.001). Fitness, strength and muscle mass are diminished in kidney transplant patients, resulting in a poorer quality of life which might entail an increased risk to their health. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

GANODERMA LUCIDUM IMPROVES PHYSICAL FITNESS IN WOMEN WITH FIBROMYALGIA.

Science.gov (United States)

Collado Mateo, Daniel; Pazzi, Francesco; Domínguez Muñoz, Francisco J; Martín Martínez, Juan Pedro; Olivares, Pedro R; Gusi, Narcis; Adsuar, José C

2015-11-01

fibromyalgia is a chronic disease characterized by generalized pain, stiffness, poor physical conditioning, non-restorative sleep and poor health-related quality of life. Ganoderma lucidum a type of mushroom that has demonstrated several benefits in different populations. Ceratonia siliqua is a natural therapy rich in antioxidants with potential benefits on health. to evaluate the effects of 6-week treatment of Ganoderma lucidum and Ceratonia siliqua on physical fitness in patients suffering from fibromyalgia. sixty-four women with fibromyalgia participated in the study. They took 6 g of Ganoderma lucidum or Ceratonia siliqua per day for 6 weeks. Different fitness tests were selected in order to evaluate functional capacity. after the 6-week treatment period, Ganoderma lucidum significantly improved aerobic endurance, lower body flexibility, and velocity (p Ganoderma lucidum may improve physical fitness in women with fibromyalgia, whereas, Ceratonia siliqua seemed to be ineffective at increasing physical fitness. These results may indicate that Ganoderma lucidum might be a useful dietary supplement to enhance physical performance of the patients suffering from fibromyalgia. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Kalman Filter Track Fits and Track Breakpoint Analysis

CERN Document Server

Astier, Pierre; Cousins, R D; Letessier-Selvon, A A; Popov, B A; Vinogradova, T G; Astier, Pierre; Cardini, Alessandro; Cousins, Robert D.; Letessier-Selvon, Antoine; Popov, Boris A.; Vinogradova, Tatiana

2000-01-01

We give an overview of track fitting using the Kalman filter method in the NOMAD detector at CERN, and emphasize how the wealth of by-product information can be used to analyze track breakpoints (discontinuities in track parameters caused by scattering, decay, etc.). After reviewing how this information has been previously exploited by others, we describe extensions which add power to breakpoint detection and characterization. We show how complete fits to the entire track, with breakpoint parameters added, can be easily obtained from the information from unbroken fits. Tests inspired by the Fisher F-test can then be used to judge breakpoints. Signed quantities (such as change in momentum at the breakpoint) can supplement unsigned quantities such as the various chisquares. We illustrate the method with electrons from real data, and with Monte Carlo simulations of pion decays.

The effect of neoadjuvant chemoradiotherapy on whole-body physical fitness and skeletal muscle mitochondrial oxidative phosphorylation in vivo in locally advanced rectal cancer patients--an observational pilot study.

Directory of Open Access Journals (Sweden)

Malcolm A West

Full Text Available In the United Kingdom, patients with locally advanced rectal cancer routinely receive neoadjuvant chemoradiotherapy. However, the effects of this on physical fitness are unclear. This pilot study is aimed to investigate the effect of neoadjuvant chemoradiotherapy on objectively measured in vivo muscle mitochondrial function and whole-body physical fitness.We prospectively studied 12 patients with rectal cancer who completed standardized neoadjuvant chemoradiotherapy, recruited from a large tertiary cancer centre, between October 2012 and July 2013. All patients underwent a cardiopulmonary exercise test and a phosphorus magnetic resonance spectroscopy quadriceps muscle exercise-recovery study before and after neoadjuvant chemoradiotherapy. Data were analysed and reported blind to patient identity and clinical course. Primary variables of interest were the two physical fitness measures; oxygen uptake at estimated anaerobic threshold and oxygen uptake at Peak exercise (ml.kg-1.min-1, and the post-exercise phosphocreatine recovery rate constant (min-1, a measure of muscle mitochondrial capacity in vivo.Median age was 67 years (IQR 64-75. Differences (95%CI in all three primary variables were significantly negative post-NACRT: Oxygen uptake at estimated anaerobic threshold -2.4 ml.kg-1.min-1 (-3.8, -0.9, p = 0.004; Oxygen uptake at Peak -4.0 ml.kg-1.min-1 (-6.8, -1.1, p = 0.011; and post-exercise phosphocreatine recovery rate constant -0.34 min-1 (-0.51, -0.17, p<0.001.The significant decrease in both whole-body physical fitness and in vivo muscle mitochondrial function raises the possibility that muscle mitochondrial mechanisms, no doubt multifactorial, may be important in deterioration of physical fitness following neoadjuvant chemoradiotherapy. This may have implications for targeted interventions to improve physical fitness pre-surgery.Clinicaltrials.gov registration NCT01859442.

Mobility, strength, and fitness after a graded activity program for patients with subacute low back pain. A randomized prospective clinical study with a behavioral therapy approach.

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Lindström, I; Ohlund, C; Eek, C; Wallin, L; Peterson, L E; Nachemson, A

1992-06-01

Patients with nonspecific mechanical low back pain (n = 103), examined by an orthopaedic surgeon and a social worker, were randomized to an activity group (n = 51) and a control group (n = 52). Patients with defined orthopaedic, medical, or psychiatric diagnoses were excluded before randomization. No patients were excluded due to place of birth or difficulties in speaking or understanding the Swedish language. The purpose of the study was to compare mobility, strength and fitness after traditional care and after traditional care plus a graded activity program with a behavioral therapy approach. A graded activity program, with a behavioral therapy approach was given under the guidance of a physical therapist. The endpoint of the graded activity program was return to work. This program significantly increased mobility, strength, and fitness more than could be explained by only a time recovery effect, especially in males. The patients in the activity group returned to work earlier than did the patients in the control group. Spinal rotation, abdominal muscle endurance time and lifting capacity were significantly correlated to rate of return to work. Traditional care plus a graded activity program were superior to only traditional care, evaluated in terms of mobility, strength and fitness. The graded activity program proved to be a successful method of restoring occupational function and facilitating return to work in subacute low back pain patients. The patients in the graded activity program learned that it is safe to move, while regaining function.

Outcomes of LASIK and PRK in previous penetrating corneal transplant recipients.

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Kovoor, Timmy A; Mohamed, Engy; Cavanagh, H Dwight; Bowman, R Wayne

2009-09-01

To evaluate the safety and efficacy of excimer laser refractive surgery in correcting refractive error in eyes that have undergone previous penetrating keratoplasty (PK). Twenty-three keratorefractive procedures on 16 eyes from 16 consecutive subjects were evaluated between 2002 and 2008. Each patient presented a previous history of a PK with subsequent postoperative myopia and astigmatism. Keratometric value, manifest refraction, best-corrected visual acuity, uncorrected visual acuity, and complications were determined. There were a total of 14 photorefractive keratectomy (PRK) procedures performed on 11 eyes and 9 laser in situ keratomileusis (LASIK) procedures performed on 5 eyes. In the PRK group, the preoperative post-PK manifest refractive spherical equivalent and cylindrical error were -6.22 +/- 6.23 diopter and 5.23 +/- 2.26 D, respectively. The PRK postoperative manifest refractive spherical equivalent and cylindrical error were -3.61 +/- 4.23 D (P=0.25) and 3.21 +/- 1.78 D (P=0.02), respectively. In the LASIK group, the preoperative post-PK manifest refractive spherical equivalent and cylindrical error were -3.05 +/- 3.29 D and 4.11 +/- 2.38 D, respectively. The LASIK postoperative manifest refractive spherical equivalent and cylindrical error were -1.51 +/- 2.02 D (P=0.24) and 2.08 +/- 1.26 D (P=0.03), respectively. There was a 2-line or greater improvement of uncorrected visual acuity in 8 of the 14 PRK treatments and 5 of the 9 LASIK treatments. There were two episodes of acute graft rejection. One of the episodes resolved with topical and oral corticosteroids, and the other episode required a repeat corneal transplantation. PRK and LASIK are effective tools in reducing surgically induced astigmatism after penetrating corneal transplantation in most patients in this case series. The reduction of astigmatism may allow improved contact lens or spectacle fitting to achieve best-corrected binocular visual acuity.

Definition of the Flexible Image Transport System (FITS), version 3.0

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Pence, W. D.; Chiappetti, L.; Page, C. G.; Shaw, R. A.; Stobie, E.

2010-12-01

The Flexible Image Transport System (FITS) has been used by astronomers for over 30 years as a data interchange and archiving format; FITS files are now handled by a wide range of astronomical software packages. Since the FITS format definition document (the “standard”) was last printed in this journal in 2001, several new features have been developed and standardized, notably support for 64-bit integers in images and tables, variable-length arrays in tables, and new world coordinate system conventions which provide a mapping from an element in a data array to a physical coordinate on the sky or within a spectrum. The FITS Working Group of the International Astronomical Union has therefore produced this new version 3.0 of the FITS standard, which is provided here in its entirety. In addition to describing the new features in FITS, numerous editorial changes were made to the previous version to clarify and reorganize many of the sections. Also included are some appendices which are not formally part of the standard. The FITS standard is likely to undergo further evolution, in which case the latest version may be found on the FITS Support Office Web site at http://fits.gsfc.nasa.gov/, which also provides many links to FITS-related resources.

Definition of the Flexible Image Transport System (FITS), Version 3.0

Science.gov (United States)

Pence, W. D.; Chiapetti, L.; Page, C. G.; Shaw, R. A.; Stobie, E.

2010-01-01

The Flexible Image Transport System (FITS) has been used by astronomers for over 30 years as a data interchange and archiving format; FITS files are now handled by a wide range of astronomical software packages. Since the FITS format definition document (the "standard") was last printed in this journal in 2001, several new features have been developed and standardized, notably support for 64-bit integers in images and tables, variable-length arrays in tables, and new world coordinate system conventions which provide a mapping from an element in a data array to a physical coordinate on the sky or within a spectrum. The FITS Working Group of the International Astronomical Union has therefore produced this new Version 3.0 of the FITS standard, which is provided here in its entirety. In addition to describing the new features in FITS, numerous editorial changes were made to the previous version to clarify and reorganize many of the sections. Also included are some appendices which are not formally part of the standard. The FITS standard is likely to undergo further evolution, in which case the latest version may be found on the FITS Support Office Web site at http://fits.gsfc.nasa.gov/, which also provides many links to FITS-related resources.

Left thoracotomy HeartWare implantation with outflow graft anastomosis to the descending aorta: a simplified bridge for patients with multiple previous sternotomies.

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Umakanthan, Ramanan; Haglund, Nicholas A; Stulak, John M; Joyce, Lyle D; Ahmad, Rashid; Keebler, Mary E; Maltais, Simon

2013-01-01

Advances in mechanical circulatory support have been critical in bridging patients awaiting heart transplantation. In addition, improvement in device durability has enabled left ventricular assist device therapy to be applied as destination therapy in those not felt to be transplant candidate. Because of the increasing complexity of patients, there continues to be a need for alternative strategies for device implantation to bridge high-risk patients awaiting heart transplantation, wherein the risks of numerous previous sternotomies may be prohibitive. We present a unique technique for placement of the HeartWare ventricular assist device via left anterior thoracotomy to the descending aorta in a patient awaiting heart transplantation with a history of multiple previous sternotomies.

Driving Safety and Fitness to Drive in Sleep Disorders.

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Tippin, Jon; Dyken, Mark Eric

2017-08-01

Driving an automobile while sleepy increases the risk of crash-related injury and death. Neurologists see patients with sleepiness due to obstructive sleep apnea, narcolepsy, and a wide variety of neurologic disorders. When addressing fitness to drive, the physician must weigh patient and societal health risks and regional legal mandates. The Driver Fitness Medical Guidelines published by the National Highway Traffic Safety Administration (NHTSA) and the American Association of Motor Vehicle Administrators (AAMVA) provide assistance to clinicians. Drivers with obstructive sleep apnea may continue to drive if they have no excessive daytime sleepiness and their apnea-hypopnea index is less than 20 per hour. Those with excessive daytime sleepiness or an apnea-hypopnea index of 20 per hour or more may not drive until their condition is effectively treated. Drivers with sleep disorders amenable to pharmaceutical treatment (eg, narcolepsy) may resume driving as long as the therapy has eliminated excessive daytime sleepiness. Following these guidelines, documenting compliance to recommended therapy, and using the Epworth Sleepiness Scale to assess subjective sleepiness can be helpful in determining patients' fitness to drive.

Completion pancreatectomy and islet cell autotransplantation as salvage therapy for patients failing previous operative interventions for chronic pancreatitis.

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Wilson, Gregory C; Sutton, Jeffrey M; Smith, Milton T; Schmulewitz, Nathan; Salehi, Marzieh; Choe, Kyuran A; Levinsky, Nick C; Brunner, John E; Abbott, Daniel E; Sussman, Jeffrey J; Edwards, Michael J; Ahmad, Syed A

2015-10-01

Traditional decompressive and/or pancreatic resection procedures have been the cornerstone of operative therapy for refractory abdominal pain secondary to chronic pancreatitis. Management of patients that fail these traditional interventions represents a clinical dilemma. Salvage therapy with completion pancreatectomy and islet cell autotransplantation (CPIAT) is an emerging treatment option for this patient population; however, outcomes after this procedure have not been well-studied. All patients undergoing CPIAT after previous decompressive and/or pancreatic resection for the treatment of chronic pancreatitis at our institution were identified for inclusion in this single-center observational study. Study end points included islet yield, narcotic requirements, glycemic control, and quality of life (QOL). QOL was assessed using the Short Form (SF)-36 health questionnaire. Sixty-four patients underwent CPIAT as salvage therapy. The median age at time of CPIAT was 38 years (interquartile range [IQR], 14.7-65.4). The most common etiology of chronic pancreatitis was idiopathic pancreatitis (66%; n = 42) followed by genetically linked pancreatitis (9%; n = 6) and alcoholic pancreatitis (8%; n = 5). All of these patients had previously undergone prior limited pancreatic resection or decompressive procedure. The majority of patients (50%; n = 32) underwent prior pancreaticoduodenectomy, whereas the remainder had undergone distal pancreatectomy (17%; n = 11), Frey (13%; n = 8), Puestow (13%; n = 8), or Berne (8%; n = 5) procedures. Median time from initial surgical intervention to CPIAT was 28.1 months (IQR, 13.6-43.0). All of these patients underwent a successful CPIAT. Mean operative time was 502.2 minutes with average hospital duration of stay of 13 days. Islet cell isolation was feasible despite previous procedures with a mean islet yield of 331,304 islet cell equivalents, which totaled an islet cell autotransplantation of 4,737 ± 492 IEQ/kg body weight. Median

EFFECTS OF PLYOMETRIC EXERCISE ON CONCOMITANTS OF FITNESS AND METABOLIC PROFILE IN TYPE 2 DIABETES PATIENTS

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Mukadas Akindele

2016-04-01

Full Text Available Background: The prevalence of type 2 diabetes mellitus has been on the increase both in high and medium/low income countries. This increase is associated with health and economic consequences, especially in low sub-Saharan Africa that is resource stricken. Availability of affordable and easy to implement treatment intervention will surely reduce these health and economic sequealae of type 2 diabetes mellitus. This study was carried out to investigate the effects of plyometric exercise on concomitants of fitness and metabolic profile in type 2 diabetes patients. Methods: Simple random sampling technique was employed to recruit participants (n=27 for this study after meeting the inclusion criteria. Physical and physiological measurements were taken from the participants before and after six weeks of plyometric exercise for the experimental group and the control who did not participate in plyometric exercise. Results: A total number of twenty seven (control= 13 participated in the study and there are not significant differences in the physical and physiological parameters of the two groups. There are significant differences in the physiological parameter after six (6 weeks of plyometric exercise among the experimental groups while there are no significant differences among the control group. The eta squared statistics of few parameters show that the effect sizes range between medium and large association. Conclusion: It is concluded that among the concomitants of fitness, plyometric exercise is effective only in improving muscle fitness and body composition.

Influence of aerobic fitness on vasoreactivity in young men.

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Bell, Preston L; Kelley, Edward T; McCoy, Stephanie M; Credeur, Daniel P

2017-10-01

Previous work has demonstrated a direct relationship between aerobic fitness and vasodilatory function (i.e., flow-mediated dilation; FMD); however, the relation between aerobic fitness and vasoconstrictor responsiveness (i.e., low flow-mediated constriction; L-FMC), and the overall vasoactive range (FMD + L-FMC) is unclear. To test the hypothesis that L-FMC and the overall vasoactive range (FMD + L-FMC) will be related to aerobic fitness in young, healthy men. Twenty men (age: 23 ± 5 years) were recruited, and divided evenly into a higher (HF) vs. lower (LF) aerobic fitness group, quantified via YMCA cycle ergometry (VO 2 peak extrapolation), and a 3-min step test (1-min heart rate recovery). Duplex Doppler-ultrasound was used to assess brachial artery FMD and L-FMC. Estimated VO 2 peak (HF = 55 ± 10 vs. LF = 38 ± 5 mL/kg/min) and heart rate recovery (HF = 36 ± 10 vs. LF = 25 ± 8 beats) were greater in the HF group (P aerobic fitness in young, healthy men. Longitudinal or interventional studies are warranted to support causality, and to distinguish whether L-FMC is more sensitive to changes in aerobic fitness than FMD.

Validity and Reliability of Nintendo Wii Fit Balance Scores

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Wikstrom, Erik A.

2012-01-01

Context: Interactive gaming systems have the potential to help rehabilitate patients with musculoskeletal conditions. The Nintendo Wii Balance Board, which is part of the Wii Fit game, could be an effective tool to monitor progress during rehabilitation because the board and game can provide objective measures of balance. However, the validity and reliability of Wii Fit balance scores remain unknown. Objective: To determine the concurrent validity of balance scores produced by the Wii Fit game and the intrasession and intersession reliability of Wii Fit balance scores. Design: Descriptive laboratory study. Setting: Sports medicine research laboratory. Patients or Other Participants: Forty-five recreationally active participants (age  =  27.0 ± 9.8 years, height  =  170.9 ± 9.2 cm, mass  =  72.4 ± 11.8 kg) with a heterogeneous history of lower extremity injury. Intervention(s): Participants completed a single-limb–stance task on a force plate and the Star Excursion Balance Test (SEBT) during the first test session. Twelve Wii Fit balance activities were completed during 2 test sessions separated by 1 week. Main Outcome Measure(s): Postural sway in the anteroposterior (AP) and mediolateral (ML) directions and the AP, ML, and resultant center-of-pressure (COP) excursions were calculated from the single-limb stance. The normalized reach distance was recorded for the anterior, posteromedial, and posterolateral directions of the SEBT. Wii Fit balance scores that the game software generated also were recorded. Results: All 96 of the calculated correlation coefficients among Wii Fit activity outcomes and established balance outcomes were interpreted as poor (r Wii Fit balance activity scores ranged from good (intraclass correlation coefficient [ICC]  =  0.80) to poor (ICC  =  0.39), with 8 activities having poor intrasession reliability. Similarly, 11 of the 12 Wii Fit balance activity scores demonstrated poor intersession reliability, with

Fitness-valley crossing with generalized parent-offspring transmission.

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Osmond, Matthew M; Otto, Sarah P

2015-11-01

Simple and ubiquitous gene interactions create rugged fitness landscapes composed of coadapted gene complexes separated by "valleys" of low fitness. Crossing such fitness valleys allows a population to escape suboptimal local fitness peaks to become better adapted. This is the premise of Sewall Wright's shifting balance process. Here we generalize the theory of fitness-valley crossing in the two-locus, bi-allelic case by allowing bias in parent-offspring transmission. This generalization extends the existing mathematical framework to genetic systems with segregation distortion and uniparental inheritance. Our results are also flexible enough to provide insight into shifts between alternate stable states in cultural systems with "transmission valleys". Using a semi-deterministic analysis and a stochastic diffusion approximation, we focus on the limiting step in valley crossing: the first appearance of the genotype on the new fitness peak whose lineage will eventually fix. We then apply our results to specific cases of segregation distortion, uniparental inheritance, and cultural transmission. Segregation distortion favouring mutant alleles facilitates crossing most when recombination and mutation are rare, i.e., scenarios where crossing is otherwise unlikely. Interactions with more mutable genes (e.g., uniparental inherited cytoplasmic elements) substantially reduce crossing times. Despite component traits being passed on poorly in the previous cultural background, small advantages in the transmission of a new combination of cultural traits can greatly facilitate a cultural transition. While peak shifts are unlikely under many of the common assumptions of population genetic theory, relaxing some of these assumptions can promote fitness-valley crossing. Copyright © 2015 Elsevier Inc. All rights reserved.

The influence of childhood aerobic fitness on learning and memory.

Directory of Open Access Journals (Sweden)

Lauren B Raine

Full Text Available There is a growing trend of inactivity among children, which may not only result in poorer physical health, but also poorer cognitive health. Previous research has shown that lower fitness has been related to decreased cognitive function for tasks requiring perception, memory, and cognitive control as well as lower academic achievement.To investigate the relationship between aerobic fitness, learning, and memory on a task that involved remembering names and locations on a fictitious map. Different learning strategies and recall procedures were employed to better understand fitness effects on learning novel material.Forty-eight 9-10 year old children (n = 24 high fit; HF and n = 24 low fit; LF performed a task requiring them to learn the names of specific regions on a map, under two learning conditions in which they only studied (SO versus a condition in which they were tested during study (TS. The retention day occurred one day after initial learning and involved two different recall conditions: free recall and cued recall.There were no differences in performance at initial learning between higher fit and lower fit participants. However, during the retention session higher fit children outperformed lower fit children, particularly when the initial learning strategy involved relatively poor recall performance (i.e., study only versus test-study strategy.We interpret these novel data to suggest that fitness can boost learning and memory of children and that these fitness-associated performance benefits are largest in conditions in which initial learning is the most challenging. Such data have important implications for both educational practice and policy.

QualiCOP: real-world effectiveness, tolerability, and quality of life in patients with relapsing-remitting multiple sclerosis treated with glatiramer acetate, treatment-naïve patients, and previously treated patients.

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Ziemssen, Tjalf; Calabrese, Pasquale; Penner, Iris-Katharina; Apfel, Rainer

2016-04-01

Treatment of symptoms and signs beyond the expanded disability status scale remains a major target in multiple sclerosis. QualiCOP was an observational, non-interventional, open-label study conducted at 170 sites in Germany. Of the 754 enrolled patients, 96 % had relapsing-remitting multiple sclerosis (MS) and were either disease-modifying therapy naïve (de novo, n = 481) or previously treated (n = 237) with once-daily, subcutaneous 20-mg/mL glatiramer acetate (GA). Assessments of relapse rate, disease progression, overall functioning, quality of life (QoL), cognition, fatigue, and depression were performed over 24 months. GA treatment over 24 months was associated with reduced annual relapse rate for previously treated (from 0.98 to 0.54 relapses) and de novo (from 0.81 to 0.48 relapses) patients. Multiple Sclerosis Functional Composite scores showed slight improvement in both cohorts (all p Multiple Sclerosis Inventory Cognition scale scores showed robust improvement in cognition among previously treated and de novo cohorts (all p treatment in important QoL parameters beyond standard measures of relapse and disease severity.

Retinal Detachment due to CrossFit Training Injury.

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Joondeph, Stephanie A; Joondeph, Brian C

2013-01-01

The purpose of this paper is to describe a traumatic retinal detachment occurring as a result of CrossFit training using an elastic exercise band. The patient sustained an ocular injury from an elastic band during CrossFit training, resulting in a giant retinal dialysis and retinal detachment, which were successfully repaired. Trainers and athletes need to be aware of the potential for ocular injury from elastic exercise bands and take appropriate precautions.

Retinal Detachment due to CrossFit Training Injury

OpenAIRE

Joondeph, Stephanie A.; Joondeph, Brian C.

2013-01-01

The purpose of this paper is to describe a traumatic retinal detachment occurring as a result of CrossFit training using an elastic exercise band. The patient sustained an ocular injury from an elastic band during CrossFit training, resulting in a giant retinal dialysis and retinal detachment, which were successfully repaired. Trainers and athletes need to be aware of the potential for ocular injury from elastic exercise bands and take appropriate precautions.

77 FR 33622 - Airworthiness Directives; Alpha Aviation Concept Limited (Type Certificate Previously Held by...

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2012-06-07

... Airworthiness Directives; Alpha Aviation Concept Limited (Type Certificate Previously Held by Alpha Aviation... Aviation Concept Limited Model R2160 Airplanes. This AD results from mandatory continuing airworthiness... condition on an aviation product. The MCAI describes the unsafe condition as oil lines fitted to affected...

Total knee arthroplasty in patients with a previous patellectomy.

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Maslow, Jed; Zuckerman, Joseph D; Immerman, Igor

2013-01-01

Post-patellectomy patients represent a specific subgroup of patients that may develop arthritis and persistent knee pain and potentially require treatment with total knee arthroplasty. This article reviews the treatment and functional outcomes following total knee arthroplasty in patients with prior patellectomy. A case report is presented as an example of the clinical management of a post-patellectomy patient with significant knee pain and disability treated with total knee arthroplasty. Emphasis will be placed in decision- making, specifically with the use of a posterior stabilized implant. In addition, postoperative strengthening of the quadriceps is essential to compensate for the lack of the patella and increase the success of total knee arthroplasty in this subgroup of patients.

Maternal condition and previous reproduction interact to affect offspring sex in a wild mammal.

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Douhard, Mathieu; Festa-Bianchet, Marco; Pelletier, Fanie

2016-08-01

Trivers and Willard proposed that offspring sex ratio should vary with maternal condition when condition, meant as maternal capacity to care, has different fitness consequences for sons and daughters. In polygynous and dimorphic species, mothers in good condition should preferentially produce sons, whereas mothers in poor condition should produce more daughters. Despite its logical appeal, support for this hypothesis has been inconsistent. Sex-ratio variation may be influenced by additional factors, such as environmental conditions and previous reproduction, which are often ignored in empirical studies. We analysed 39 years of data on bighorn sheep (Ovis canadensis) that fit all the assumptions of the Trivers-Willard hypothesis. Production of sons increased with maternal condition only for mothers that weaned a son the previous year. This relationship likely reflects a mother's ability to bear the higher reproductive costs of sons. The interaction between maternal condition and previous weaning success on the probability of producing a son was independent of the positive effect of paternal reproductive success. Maternal and paternal effects accounted for similar proportions of the variance in offspring sex. Maternal reproductive history should be considered in addition to current condition in studies of sex allocation. © 2016 The Author(s).

Left ventricular mechanics in humans with high aerobic fitness: adaptation independent of structural remodelling, arterial haemodynamics and heart rate

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Stöhr, Eric J; McDonnell, Barry; Thompson, Jane; Stone, Keeron; Bull, Tom; Houston, Rory; Cockcroft, John; Shave, Rob

2012-01-01

Individuals with high aerobic fitness have lower systolic left ventricular strain, rotation and twist (‘left ventricular (LV) mechanics’) at rest, suggesting a beneficial reduction in LV myofibre stress and more efficient systolic function. However, the mechanisms responsible for this functional adaptation are not known and the influence of aerobic fitness on LV mechanics during dynamic exercise has never been studied. We assessed LV mechanics, LV wall thickness and dimensions, central augmentation index (AIx), aortic pulse wave velocity (aPWV), blood pressure and heart rate in 28 males (age: 21 ± 2 years SD) with a consistent physical activity level (no change >6 months). Individuals were examined at rest and during exercise (40% peak exercise capacity) and separated post hoc into a moderate and high aerobic fitness group (: 49 ± 5 and 63 ± 7 ml kg−1 min−1, respectively, P 0.05). However, for the same AIx, the high group had significantly lower LV apical rotation (P = 0.002) and LV twist (P = 0.003) while basal rotation and strain indices did not differ between groups (P > 0.05). We conclude that young males with high aerobic fitness have lower LV apical rotation at rest and during submaximal exercise that can occur without changes in gross LV structure, arterial haemodynamics or heart rate. The findings suggest a previously unknown type of physiological adaptation of the left ventricle that may have important implications for exercise training in older individuals and patient populations in which exercise training has previously failed to show clear benefits for LV function. PMID:22431336

Fitness Club

CERN Multimedia

Fitness Club

2012-01-01

Open to All: http://cern.ch/club-fitness  fitness.club@cern.ch Boxing Your supervisor makes your life too tough ! You really need to release the pressure you've been building up ! Come and join the fit-boxers. We train three times a week in Bd 216, classes for beginners and advanced available. Visit our website cern.ch/Boxing General Fitness Escape from your desk with our general fitness classes, to strengthen your heart, muscles and bones, improve you stamina, balance and flexibility, achieve new goals, be more productive and experience a sense of well-being, every Monday, Wednesday and Friday lunchtime, Tuesday mornings before work and Thursday evenings after work – join us for one of our monthly fitness workshops. Nordic Walking Enjoy the great outdoors; Nordic Walking is a great way to get your whole body moving and to significantly improve the condition of your muscles, heart and lungs. It will boost your energy levels no end. Pilates A body-conditioning technique de...

Rates and risk factors of injury in CrossFitTM: a prospective cohort study.

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Moran, Sebastian; Booker, Harry; Staines, Jacob; Williams, Sean

2017-09-01

CrossFitTM is a strength and conditioning program that has gained widespread popularity since its inception approximately 15 years ago. However, at present little is known about the level of injury risk associated with this form of training. Movement competency, assessed using the Functional Movement ScreenTM (FMS), has been identified as a risk factor for injury in numerous athletic populations, but its role in CrossFit participants is currently unclear. The aim of this study was to evaluate the level of injury risk associated with CrossFit training, and examine the influence of a number of potential risk factors (including movement competency). A cohort of 117 CrossFit participants were followed prospectively for 12 weeks. Participants' characteristics, previous injury history and training experience were recorded at baseline, and an FMS assessment was conducted. The overall injury incidence rate was 2.10 per 1000 training hours (90% confidence limits: 1.32-3.33). A multivariate Poisson regression model identified males (rate ratio [RR]: 4.44 ×/÷ 3.30, very likely harmful) and those with previous injuries (RR: 2.35 ×/÷ 2.37, likely harmful) as having a higher injury risk. Inferences relating to FMS variables were unclear in the multivariate model, although number of asymmetries was a clear risk factor in a univariate model (RR per two additional asymmetries: 2.62 ×/÷ 1.53, likely harmful). The injury incidence rate associated with CrossFit training was low, and comparable to other forms of recreational fitness activities. Previous injury and gender were identified as risk factors for injury, whilst the role of movement competency in this setting warrants further investigation.

FITS: a function-fitting program

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Balestrini, S.J.; Chezem, C.G.

1982-01-01

FITS is an iterating computer program that adjusts the parameters of a function to fit a set of data points according to the least squares criterion and then lists and plots the results. The function can be programmed or chosen from a library that is provided. The library can be expanded to include up to 99 functions. A general plotting routine, contained in the program but useful in its own right, is described separately in an Appendix.

Long-term clinical outcomes and survivorship of press-fit condylar sigma fixed-bearing and mobile-bearing total knee prostheses in the same patients.

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Kim, Young-Hoo; Park, Jang-Won; Kim, Jun-Shik; Kulkarni, Sourabh S; Kim, Yoon-Hong

2014-10-01

We are aware of no study that has compared press-fit condylar Sigma fixed-bearing and mobile-bearing total knee prostheses in the same patients after more than ten years of follow-up. The purpose of the current study was to compare these two implants with respect to the functional and radiographic results, prevalence of osteolysis, and overall revision rates at a mean of 12.1 years of follow-up. The study consisted of a consecutive series of 444 patients (mean age [and standard deviation], 66.5 ± 7.4 years) who underwent simultaneous bilateral total knee arthroplasty, with one side treated immediately after the other. All of the patients received a press-fit condylar Sigma mobile-bearing prosthesis on one side and a press-fit condylar Sigma fixed-bearing prosthesis on the contralateral side. The minimum duration of follow-up was ten years (mean, 12.1 years; range, ten to thirteen years). At the time of each follow-up visit, the patients were assessed clinically and radiographically. Postoperative total knee scores (95 and 94 points), Western Ontario and McMaster Universities Osteoarthritis Index (19 and 18 points), University of California, Los Angeles activity score (both prostheses, 5 points), range of motion (129° ± 6.3° and 127° ± 6.8°), and radiographic findings did not differ significantly between the press-fit condylar Sigma mobile and fixed-bearing designs at the final follow-up. The prevalence of aseptic loosening (1.4% and 1.8%) did not differ significantly between the mobile and fixed-bearing implant designs. No knee in either group had osteolysis. The estimated survival rate with revision as the end point was 98.2% (95% confidence interval, 91% to 99%) and 97.5% (95% confidence interval, 91% to 99%) at 12.1 years for the mobile and fixed-bearing implant groups, respectively. The results of the present long-term clinical study suggest that excellent clinical and radiographic results were achieved with both the press-fit condylar Sigma mobile and

Barriers to Enrollment in a Pharmacist-Led Fitness, Nutrition, and Weight Management Coaching Program

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Matthew J Lengel

2017-01-01

Full Text Available Objectives: To investigate barriers to utilization of a pharmacist-led fitness, nutrition, and weight management coaching program, as well as describe patient reported expectations and explore the patient characteristics potentially associated with a higher willingness to participate in the future. Design: Cross-sectional, descriptive study using an anonymous, electronic survey. Setting: A large, national, grocery store chain. Participants: Employee benefit plan members, eligible for a pharmacist-led fitness, nutrition, and weight management (FNWM coaching program, who were not currently or previously enrolled in the program, and met coaching program qualifications. Intervention: Peer-reviewed, electronic survey administered and collected using an Internet survey analysis software. Main Outcome Measures: Barriers to enrollment in the pharmacist-led fitness, nutrition, and weight management coaching program. Results: Of 1,130 emailed employees, 352 responded and 133 met study inclusion criteria and completed the whole survey. Of those who fit inclusion criteria, the majority (53.4% of the respondents were aware of the coaching program (75.2% and expressed interest in future participation (53.4%. “I am already taking steps to improve my health” and “I do not have time to participate in the program” were the highest rated barriers for both those interested and not interested in participating in the coaching program. The majority of participants believed pharmacists were qualified to provide the coaching service (78.2% and preferred one-on-one coaching with the pharmacist (67.7%. Key topics respondents wanted the pharmacist to cover included general diet and nutrition, weight management strategies, and vitamins and supplements. Conclusion: The two major barriers reported in the study were lack of time and the use of other health improvement methods; however, a large number of respondents indicated future interest in participating. Future

77 FR 15980 - Airworthiness Directives; Alpha Aviation Concept Limited (Type Certificate Previously Held by...

Science.gov (United States)

2012-03-19

... Concept Limited (Type Certificate Previously Held by Alpha Aviation Design Limited) Airplanes AGENCY... rulemaking (NPRM). SUMMARY: We propose to adopt a new airworthiness directive (AD) for Alpha Aviation Concept... condition on an aviation product. The MCAI describes the unsafe condition as oil lines fitted to affected...

Fitness Club

CERN Multimedia

Fitness Club

2011-01-01

The CERN Fitness Club is organising Zumba Classes on the first Wednesday of each month, starting 7 September (19.00 – 20.00). What is Zumba®? It’s an exhilarating, effective, easy-to-follow, Latin-inspired, calorie-burning dance fitness-party™ that’s moving millions of people toward joy and health. Above all it’s great fun and an excellent work out. Price: 22 CHF/person Sign-up via the following form: https://espace.cern.ch/club-fitness/Lists/Zumba%20Subscription/NewForm.aspx For more info: fitness.club@cern.ch

Retinal Detachment due to CrossFit Training Injury

Directory of Open Access Journals (Sweden)

Stephanie A. Joondeph

2013-01-01

Full Text Available The purpose of this paper is to describe a traumatic retinal detachment occurring as a result of CrossFit training using an elastic exercise band. The patient sustained an ocular injury from an elastic band during CrossFit training, resulting in a giant retinal dialysis and retinal detachment, which were successfully repaired. Trainers and athletes need to be aware of the potential for ocular injury from elastic exercise bands and take appropriate precautions.

Physical fitness reference standards in fibromyalgia : The al-Ándalus project

NARCIS (Netherlands)

Álvarez-Gallardo, Inmaculada C; Carbonell-Baeza, A; Segura-Jiménez, V.; Soriano-Maldonado, Alberto; Intemann, T; Aparicio, Virgina A; Estévez-López, F|info:eu-repo/dai/nl/412501031; Camiletti-Moirón, Daniel; Herrador-Colmenero, Manuel; Ruiz, Jonatan R; Delgado-Fernández, M.; Ortega, Francisco B

2017-01-01

We aimed (1) to report age-specific physical fitness levels in people with fibromyalgia of a representative sample from Andalusia; and (2) to compare the fitness levels of people with fibromyalgia with non-fibromyalgia controls. This cross-sectional study included 468 (21 men) patients with

Fitting an MSD (mini scleral design) rigid contact lens in advanced keratoconus with INTACS.

Science.gov (United States)

Dalton, Kristine; Sorbara, Luigina

2011-12-01

Keratoconus is a bilateral degenerative disease characterized by a non-inflammatory, progressive central corneal ectasia (typically asymmetric) and decreased vision. In its early stages it may be managed with spectacles and soft contact lenses but more commonly it is managed with rigid contact lenses. In advanced stages, when contact lenses can no longer be fit, have become intolerable, or corneal damage is severe, a penetrating keratoplasty is commonly performed. Alternative surgical techniques, such as the use of intra-stromal corneal ring segments (INTACS) have been developed to try and improve the fit of rigid contact lenses in keratoconic patients and avoid penetrating keratoplasties. This case report follows through the fitting of rigid contact lenses in an advanced keratoconic cornea after an INTACS procedure and discusses clinical findings, treatment options, and the use of mini-scleral and scleral lens designs as they relate to the challenges encountered in managing such a patient. Mini-scleral and scleral lenses are relatively easy to fit, and can be of benefit to many patients, including advanced keratoconic patients, post-INTAC patients and post-penetrating keratoplasty patients. 2011 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Design and baseline characteristics of the ParkFit study, a randomized controlled trial evaluating the effectiveness of a multifaceted behavioral program to increase physical activity in Parkinson patients

Directory of Open Access Journals (Sweden)

van Nimwegen Marlies

2010-08-01

Full Text Available Abstract Background Many patients with Parkinson's disease (PD lead a sedentary lifestyle. Promotion of physical activities may beneficially affect the clinical presentation of PD, and perhaps even modify the course of PD. However, because of physical and cognitive impairments, patients with PD require specific support to increase their level of physical activity. Methods We developed the ParkFit Program: a PD-specific and multifaceted behavioral program to promote physical activity. The emphasis is on creating a behavioral change, using a combination of accepted behavioral motivation techniques. In addition, we designed a multicentre randomized clinical trial to investigate whether this ParkFit Program increases physical activity levels over two years in sedentary PD patients. We intended to include 700 sedentary patients. Primary endpoint is the time spent on physical activities per week, which will be measured every six months using an interview-based 7-day recall. Results In total 3453 PD patients were invited to participate. Ultimately, 586 patients - with a mean (SD age of 64.1 (7.6 years and disease duration of 5.3 (4.5 years - entered the study. Study participants were younger, had a shorter disease duration and were less sedentary compared with eligible PD patients not willing to participate. Discussion The ParkFit trial is expected to yield important new evidence about behavioral interventions to promote physical activity in sedentary patients with PD. The results of the trial are expected in 2012. Trial registration http://clinicaltrials.gov (nr NCT00748488.

A cross-sectional study of tuberculosis drug resistance among previously treated patients in a tertiary hospital in Accra, Ghana: public health implications of standardized regimens.

Science.gov (United States)

Forson, Audrey; Kwara, Awewura; Kudzawu, Samuel; Omari, Michael; Otu, Jacob; Gehre, Florian; de Jong, Bouke; Antonio, Martin

2018-04-02

Mycobacterium tuberculosis drug resistance is a major challenge to the use of standardized regimens for tuberculosis (TB) therapy, especially among previously treated patients. We aimed to investigate the frequency and pattern of drug resistance among previously treated patients with smear-positive pulmonary tuberculosis at the Korle-Bu Teaching Hospital Chest Clinic, Accra. This was a cross-sectional survey of mycobacterial isolates from previously treated patients referred to the Chest Clinic Laboratory between October 2010 and October 2013. The Bactec MGIT 960 system for mycobactrerial culture and drug sensitivity testing (DST) was used for sputum culture of AFB smear-positive patients with relapse, treatment failure, failure of smear conversion, or default. Descriptive statistics were used to summarize patient characteristics, and frequency and patterns of drug resistance. A total of 112 isolates were studied out of 155 from previously treated patients. Twenty contaminated (12.9%) and 23 non-viable isolates (14.8%) were excluded. Of the 112 studied isolates, 53 (47.3%) were pan-sensitive to all first-line drugs tested Any resistance (mono and poly resistance) to isoniazid was found in 44 isolates (39.3%) and any resistance to streptomycin in 43 (38.4%). Thirty-one (27.7%) were MDR-TB. Eleven (35.5%) out of 31 MDR-TB isolates were pre-XDR. MDR-TB isolates were more likely than non-MDR isolates to have streptomycin and ethambutol resistance. The main findings of this study were the high prevalence of MDR-TB and streptomycin resistance among previously treated TB patients, as well as a high prevalence of pre-XDR-TB among the MDR-TB patients, which suggest that first-line and second-line DST is essential to aid the design of effective regimens for these groups of patients in Ghana.

Multispecies Coevolution Particle Swarm Optimization Based on Previous Search History

Directory of Open Access Journals (Sweden)

Danping Wang

2017-01-01

Full Text Available A hybrid coevolution particle swarm optimization algorithm with dynamic multispecies strategy based on K-means clustering and nonrevisit strategy based on Binary Space Partitioning fitness tree (called MCPSO-PSH is proposed. Previous search history memorized into the Binary Space Partitioning fitness tree can effectively restrain the individuals’ revisit phenomenon. The whole population is partitioned into several subspecies and cooperative coevolution is realized by an information communication mechanism between subspecies, which can enhance the global search ability of particles and avoid premature convergence to local optimum. To demonstrate the power of the method, comparisons between the proposed algorithm and state-of-the-art algorithms are grouped into two categories: 10 basic benchmark functions (10-dimensional and 30-dimensional, 10 CEC2005 benchmark functions (30-dimensional, and a real-world problem (multilevel image segmentation problems. Experimental results show that MCPSO-PSH displays a competitive performance compared to the other swarm-based or evolutionary algorithms in terms of solution accuracy and statistical tests.

Evaluation of a cancer exercise program: patient and physician beliefs.

Science.gov (United States)

Peeters, C; Stewart, A; Segal, R; Wouterloot, E; Scott, C G; Aubry, T

2009-08-01

Participation in an exercise intervention during cancer treatment diminishes the side effects associated with cancer therapies, although such benefits vary according to the disease and the patient characteristics. A structured exercise program providing an individualized fitness program tailored to the patients' illness, treatment, and fitness level would address this variability. However, the need, desired components, and anticipated barriers of such a program have not been systematically explored from either the point of view of cancer patients or treating oncologists. Sixty-six cancer patients and 18 medical and radiation oncologists were surveyed on the above variables. Cancer patients and oncologists alike perceived a need for a structured exercise program during and after medical treatment for cancer. Among cancer patients, the most commonly preferred feature was access to consultation with an exercise specialist who could take into account the patient's previous exercise and medical history. Over a third of patients reported interest in a hospital-based fitness program. Oncologists were in favor of appropriate supervision of patients during exercise, and noted insufficient time to discuss exercise in their practice. Respondents noted time and parking as barriers to participation. Overall, results support the need for a supervised exercise program during active treatment for cancer and highlight the desired features of such a program.

An automated patient recognition method based on an image-matching technique using previous chest radiographs in the picture archiving and communication system environment

International Nuclear Information System (INIS)

Morishita, Junji; Katsuragawa, Shigehiko; Kondo, Keisuke; Doi, Kunio

2001-01-01

An automated patient recognition method for correcting 'wrong' chest radiographs being stored in a picture archiving and communication system (PACS) environment has been developed. The method is based on an image-matching technique that uses previous chest radiographs. For identification of a 'wrong' patient, the correlation value was determined for a previous image of a patient and a new, current image of the presumed corresponding patient. The current image was shifted horizontally and vertically and rotated, so that we could determine the best match between the two images. The results indicated that the correlation values between the current and previous images for the same, 'correct' patients were generally greater than those for different, 'wrong' patients. Although the two histograms for the same patient and for different patients overlapped at correlation values greater than 0.80, most parts of the histograms were separated. The correlation value was compared with a threshold value that was determined based on an analysis of the histograms of correlation values obtained for the same patient and for different patients. If the current image is considered potentially to belong to a 'wrong' patient, then a warning sign with the probability for a 'wrong' patient is provided to alert radiology personnel. Our results indicate that at least half of the 'wrong' images in our database can be identified correctly with the method described in this study. The overall performance in terms of a receiver operating characteristic curve showed a high performance of the system. The results also indicate that some readings of 'wrong' images for a given patient in the PACS environment can be prevented by use of the method we developed. Therefore an automated warning system for patient recognition would be useful in correcting 'wrong' images being stored in the PACS environment

Squamous cell carcinoma arising in previously burned or irradiated skin

International Nuclear Information System (INIS)

Edwards, M.J.; Hirsch, R.M.; Broadwater, J.R.; Netscher, D.T.; Ames, F.C.

1989-01-01

Squamous cell carcinoma (SCC) arising in previously burned or irradiated skin was reviewed in 66 patients treated between 1944 and 1986. Healing of the initial injury was complicated in 70% of patients. Mean interval from initial injury to diagnosis of SCC was 37 years. The overwhelming majority of patients presented with a chronic intractable ulcer in previously injured skin. The regional relapse rate after surgical excision was very high, 58% of all patients. Predominant patterns of recurrence were in local skin and regional lymph nodes (93% of recurrences). Survival rates at 5, 10, and 20 years were 52%, 34%, and 23%, respectively. Five-year survival rates in previously burned and irradiated patients were not significantly different (53% and 50%, respectively). This review, one of the largest reported series, better defines SCC arising in previously burned or irradiated skin as a locally aggressive disease that is distinct from SCC arising in sunlight-damaged skin. An increased awareness of the significance of chronic ulceration in scar tissue may allow earlier diagnosis. Regional disease control and survival depend on surgical resection of all known disease and may require radical lymph node dissection or amputation

Efficacy of peg-interferon based treatment in patients with hepatitis C refractory to previous conventional interferon-based treatment

International Nuclear Information System (INIS)

Shaikh, S.; Devrajani, B.R.; Kalhoro, M.

2012-01-01

Objective: To determine the efficacy of peg-interferon-based therapy in patients refractory to previous conventional interferon-based treatment and factors predicting sustained viral response (SVR). Study Design: Analytical study. Place and Duration of Study: Medical Unit IV, Liaquat University Hospital, Jamshoro, from July 2009 to June 2011. Methodology: This study included consecutive patients of hepatitis C who were previously treated with conventional interferon-based treatment for 6 months but were either non-responders, relapsed or had virologic breakthrough and stage = 2 with fibrosis on liver biopsy. All eligible patients were provided peg-interferon at the dosage of 180 mu g weekly with ribavirin thrice a day for 6 months. Sustained Viral Response (SVR) was defined as absence of HCV RNA at twenty four week after treatment. All data was processed on SPSS version 16. Results: Out of 450 patients enrolled in the study, 192 were excluded from the study on the basis of minimal fibrosis (stage 0 and 1). Two hundred and fifty eight patients fulfilled the inclusion criteria and 247 completed the course of peg-interferon treatment. One hundred and sixty one (62.4%) were males and 97 (37.6%) were females. The mean age was 39.9 +- 6.1 years, haemoglobin was 11.49 +- 2.45 g/dl, platelet count was 127.2 +- 50.6 10/sup 3/ /mm/sup 3/, ALT was 99 +- 65 IU/L. SVR was achieved in 84 (32.6%). The strong association was found between SVR and the pattern of response (p = 0. 001), degree of fibrosis and early viral response (p = 0.001). Conclusion: Peg-interferon based treatment is an effective and safe treatment option for patients refractory to conventional interferon-based treatment. (author)

Impact of CMS Multi-jets and Missing Energy Search on CMSSM Fits

CERN Document Server

Allanach, B C

2011-01-01

Recent CMS data significantly extend the direct search exclusion for supersymmetry. We examine the impact of such data on global fits of the constrained minimal supersymmetric standard model (CMSSM) to indirect and cosmological data. By simulating supersymmetric signal events at the LHC, we construct a likelihood map for the recent CMS data, validating it against the exclusion region calculated by the experiment itself. A previous CMSSM global fit is then re-weighted by our likelihood map. The CMS results nibble away at the high fit probability density region, transforming probability distributions for the scalar and gluino masses. The CMS search has a with non-trivial effect on tan \\beta due to correlations between the parameters implied by the fits to indirect data.

Abiraterone in metastatic prostate cancer without previous chemotherapy

NARCIS (Netherlands)

Ryan, Charles J.; Smith, Matthew R.; de Bono, Johann S.; Molina, Arturo; Logothetis, Christopher J.; de Souza, Paul; Fizazi, Karim; Mainwaring, Paul; Piulats, Josep M.; Ng, Siobhan; Carles, Joan; Mulders, Peter F. A.; Basch, Ethan; Small, Eric J.; Saad, Fred; Schrijvers, Dirk; van Poppel, Hendrik; Mukherjee, Som D.; Suttmann, Henrik; Gerritsen, Winald R.; Flaig, Thomas W.; George, Daniel J.; Yu, Evan Y.; Efstathiou, Eleni; Pantuck, Allan; Winquist, Eric; Higano, Celestia S.; Taplin, Mary-Ellen; Park, Youn; Kheoh, Thian; Griffin, Thomas; Scher, Howard I.; Rathkopf, Dana E.; Boyce, A.; Costello, A.; Davis, I.; Ganju, V.; Horvath, L.; Lynch, R.; Marx, G.; Parnis, F.; Shapiro, J.; Singhal, N.; Slancar, M.; van Hazel, G.; Wong, S.; Yip, D.; Carpentier, P.; Luyten, D.; de Reijke, T.

2013-01-01

Abiraterone acetate, an androgen biosynthesis inhibitor, improves overall survival in patients with metastatic castration-resistant prostate cancer after chemotherapy. We evaluated this agent in patients who had not received previous chemotherapy. In this double-blind study, we randomly assigned

Fitness cost

DEFF Research Database (Denmark)

Nielsen, Karen L.; Pedersen, Thomas M.; Udekwu, Klas I.

2012-01-01

phage types, predominantly only penicillin resistant. We investigated whether isolates of this epidemic were associated with a fitness cost, and we employed a mathematical model to ask whether these fitness costs could have led to the observed reduction in frequency. Bacteraemia isolates of S. aureus...... from Denmark have been stored since 1957. We chose 40 S. aureus isolates belonging to phage complex 83A, clonal complex 8 based on spa type, ranging in time of isolation from 1957 to 1980 and with varyous antibiograms, including both methicillin-resistant and -susceptible isolates. The relative fitness...... of each isolate was determined in a growth competition assay with a reference isolate. Significant fitness costs of 215 were determined for the MRSA isolates studied. There was a significant negative correlation between number of antibiotic resistances and relative fitness. Multiple regression analysis...

Impact of a walking intervention on cardiorespiratory fitness, self-reported physical function, and pain in patients undergoing treatment for solid tumors.

Science.gov (United States)

Griffith, Kathleen; Wenzel, Jennifer; Shang, JingJing; Thompson, Carol; Stewart, Kerry; Mock, Victoria

2009-10-15

Cancer treatment is associated with decline in measured and self-reported physical function and increased pain. In the current study, the authors evaluated the impact of a walking intervention on these outcomes during chemotherapy/radiation. Patients with breast, prostate, and other cancers (N=126) were randomized to a home-based walking intervention (exercise) or usual care (control). Exercise dose during the intervention was assessed using a 5-item Physical Activity Questionnaire. Outcome measures were cardiorespiratory fitness, expressed as peak oxygen uptake (VO2) measured during treadmill testing (n=85) or estimated by 12-minute walk (n=27), and self-reported physical function, role limitations, and pain derived from Medical Outcomes Study Short Form 36. Linear regression was used to evaluate pre-to-post intervention change outcomes between groups. The mean (standard deviation) age of the patients was 60.2 (10.6) years. Diagnoses included prostate (55.6%) and breast (32.5%) cancer. Treatment included external beam radiotherapy (52.3%) and chemotherapy (34.9%). Exercise patients reported worsening Medical Outcomes Study physical function role limitations by the end of cancer treatment (P=.037). Younger age was associated with improved Medical Outcomes Study physical function (P=.048). In all patients, increased exercise dose was associated with decreased Medical Outcomes Study pain (P=.046), regardless of diagnosis. The percent change of VO2 between prostate and nonprostate cancer patients when adjusted for baseline VO2 and Physical Activity Questionnaire values was 17.45% (P=.008), with better VO2 maintenance in the prostate group. Exercise during cancer treatment improves cardiorespiratory fitness and self-reported physical function in prostate cancer patients and in younger patients, regardless of diagnosis, and may attenuate loss of those capacities in patients undergoing chemotherapy. Exercise also reduces the pain experience. Copyright (c) 2009 American

Signal intensity change on unenhanced T1-weighted images in dentate nucleus following gadobenate dimeglumine in patients with and without previous multiple administrations of gadodiamide

Energy Technology Data Exchange (ETDEWEB)

Ramalho, Joana [University of North Carolina Hospital, Chapel Hill, NC (United States); Centro Hospitalar de Lisboa Central, Lisbon (Portugal); Semelka, Richard C.; Castillo, Mauricio [University of North Carolina Hospital, Chapel Hill, NC (United States); AlObaidy, Mamdoh [University of North Carolina Hospital, Chapel Hill, NC (United States); King Faisal Specialist Hospital and Research Center, Riyadh (Saudi Arabia); Ramalho, Miguel [University of North Carolina Hospital, Chapel Hill, NC (United States); Hospital Garcia de Orta, Almada (Portugal); Nunes, Renato H. [University of North Carolina Hospital, Chapel Hill, NC (United States); Santa Casa de Misericordia de Sao Paulo, Sao Paulo (Brazil)

2016-11-15

To evaluate the impact of previous administration of gadodiamide and neural tissue gadolinium deposition in patients who received gadobenate dimeglumine. Our population included 62 patients who underwent at least three administrations of gadobenate dimeglumine, plus an additional contrast-enhanced last MRI for reference, divided into two groups: group 1, patients who in addition to gadobenate dimeglumine administrations had prior exposure to multiple doses of gadodiamide; group 2, patients without previous exposure to other gadolinium-based contrast agent (GBCAs). Quantitative analysis was performed on the first and last gadobenate dimeglumine MRIs in both groups. Dentate nucleus-to-middle cerebellar peduncle signal intensity ratios (DN/MCP) and relative change (RC) in signal over time were calculated and compared between groups using generalized additive model. Group 1 showed significant increase in baseline and follow-up DN/MCP compared to group 2 (p < 0.0001). The RC DN/MCP showed a non-statistically significant trend towards an increase in patients who underwent previous gadodiamide (p = 0.0735). There is increased T1 signal change over time in patients who underwent gadobenate dimeglumine and had received prior gadodiamide compared to those without known exposure to previous gadodiamide. A potentiating effect from prior gadodiamide on subsequent administered gadobenate dimeglumine may occur. (orig.)

When previously expressed wishes conflict with best interests.

Science.gov (United States)

Smith, Alexander K; Lo, Bernard; Sudore, Rebecca

2013-07-08

Rising use of advance directives has made surrogate decision making both easier and harder. In many cases, these directives help guide decision making for patients who have lost decision-making capacity. In some cases, however, directives may conflict with what physicians or surrogates view as what is in the patient's best interest. These conflicts can place substantial emotional and moral burdens on physicians and surrogates, and there is little practical guidance for how to address them. We propose a 5-question framework for untangling the conflict between advance directives and best interests of a patient with a surrogate decision maker: (1) Is the clinical situation an emergency? (2) In view of the patient's values and goals, how likely is it that the benefits of the intervention will outweigh the burdens? (3) How well does the advance directive fit the situation at hand? (4) How much leeway did the patient provide the surrogate for overriding the advance directive? (5) How well does the surrogate represent the patient's best interests? We use 2 clinical cases with contrasting outcomes to demonstrate how this framework can help resolve common dilemmas.

The FitTrack Index as fitness indicator: A pilot study | van Rensburg ...

African Journals Online (AJOL)

Conclusions: These results suggest that the web-based FitTrack Index may be considered an appropriate tool to evaluate exercise capacity and cardiovascular fitness in healthy individuals following an aerobic training programme. Keywords: Aerobic fitness, Exercise ability, Recreational fitness, Cardiovascular fitness, ...

Survey of the temporal changes in HIV-1 replicative fitness in the Amsterdam Cohort

NARCIS (Netherlands)

Gali, Youssef; Berkhout, Ben; Vanham, Guido; Bakker, Margreet; Back, Nicole K. T.; Arien, Kevin K.

2007-01-01

Changes in virulence and fitness during an epidemic are common among pathogens. Several studies have shown that HIV fitness increases within a patient during disease progression, while bottlenecks, such as sexual transmission, immune pressure and drug treatment can reduce fitness. In this study, we

FITS: a function-fitting program

Energy Technology Data Exchange (ETDEWEB)

Balestrini, S.J.; Chezem, C.G.

1982-08-01

FITS is an iterating computer program that adjusts the parameters of a function to fit a set of data points according to the least squares criterion and then lists and plots the results. The function can be programmed or chosen from a library that is provided. The library can be expanded to include up to 99 functions. A general plotting routine, contained in the program but useful in its own right, is described separately in Appendix A. An example problem file and its solution is given in Appendix B.

Physical Fitness Assessment.

Science.gov (United States)

Valdes, Alice

This document presents baseline data on physical fitness that provides an outline for assessing the physical fitness of students. It consists of 4 tasks and a 13-item questionnaire on fitness-related behaviors. The fitness test evaluates cardiorespiratory endurance by a steady state jog; muscular strength and endurance with a two-minute bent-knee…

Induced prismatic effects due to poorly fitting spectacle frames

Directory of Open Access Journals (Sweden)

V. R. Moodley

2011-12-01

toms were reported by 50% of subjects experiencing base-out, 0% base-in and 47% vertical induced prismatic effects.  However, no correlation existed between those subjects experiencing induced prism and symptoms reported.  Prism adaptation may account for some participants being asymptomatic.  Sixty three percent of subjects were not aware of the importance of properly fitted spectacle frames.  Proper optical dispensing with associated patient education is necessary to achieve optimal optical benefits of spectacles and careful attention should be given to this aspect by practitioners.  It is recommended that patients return periodically to their optometrists to have the frame alignment assessed and the fit modified if necessary. (S Afr Optom 2011 70(4 168-174

An Introduction to Goodness of Fit for PMU Parameter Estimation

Energy Technology Data Exchange (ETDEWEB)

Riepnieks, Artis; Kirkham, Harold

2017-10-01

New results of measurements of phasor-like signals are presented based on our previous work on the topic. In this document an improved estimation method is described. The algorithm (which is realized in MATLAB software) is discussed. We examine the effect of noisy and distorted signals on the Goodness of Fit metric. The estimation method is shown to be performing very well with clean data and with a measurement window as short as a half a cycle and as few as 5 samples per cycle. The Goodness of Fit decreases predictably with added phase noise, and seems to be acceptable even with visible distortion in the signal. While the exact results we obtain are specific to our method of estimation, the Goodness of Fit method could be implemented in any phasor measurement unit.

Fitting monthly Peninsula Malaysian rainfall using Tweedie distribution

Science.gov (United States)

Yunus, R. M.; Hasan, M. M.; Zubairi, Y. Z.

2017-09-01

In this study, the Tweedie distribution was used to fit the monthly rainfall data from 24 monitoring stations of Peninsula Malaysia for the period from January, 2008 to April, 2015. The aim of the study is to determine whether the distributions within the Tweedie family fit well the monthly Malaysian rainfall data. Within the Tweedie family, the gamma distribution is generally used for fitting the rainfall totals, however the Poisson-gamma distribution is more useful to describe two important features of rainfall pattern, which are the occurrences (dry months) and the amount (wet months). First, the appropriate distribution of the monthly rainfall was identified within the Tweedie family for each station. Then, the Tweedie Generalised Linear Model (GLM) with no explanatory variable was used to model the monthly rainfall data. Graphical representation was used to assess model appropriateness. The QQ plots of quantile residuals show that the Tweedie models fit the monthly rainfall data better for majority of the stations in the west coast and mid land than those in the east coast of Peninsula. This significant finding suggests that the best fitted distribution depends on the geographical location of the monitoring station. In this paper, a simple model is developed for generating synthetic rainfall data for use in various areas, including agriculture and irrigation. We have showed that the data that were simulated using the Tweedie distribution have fairly similar frequency histogram to that of the actual data. Both the mean number of rainfall events and mean amount of rain for a month were estimated simultaneously for the case that the Poisson gamma distribution fits the data reasonably well. Thus, this work complements previous studies that fit the rainfall amount and the occurrence of rainfall events separately, each to a different distribution.

Fitness to drive after traumatic brain injury

NARCIS (Netherlands)

Brouwer, WH; Withaar, FK

This paper deals with the issue of fitness to drive in patients suffering from traumatic brain injury (TBI). Guidelines for assessment are proposed and three types of studies are reviewed: studies about impairments of attention and information processing, studies of driving competence, and driver

Previous dropout from diabetic care as a predictor of patients' willingness to use mobile applications for self-management: A cross-sectional study.

Science.gov (United States)

Yamaguchi, Satoko; Waki, Kayo; Tomizawa, Nobuko; Waki, Hironori; Nannya, Yasuhito; Nangaku, Masaomi; Kadowaki, Takashi; Ohe, Kazuhiko

2017-07-01

Preventing dropout is crucial in managing diabetes. Accordingly, we investigated whether patients who had dropped out of diabetic care are suitable candidates for the use of mobile technologies - such as smartphone applications - to support self-management (mHealth), which might help prevent dropout. We carried out a cross-sectional study in Tokyo, Japan. Patients aged 20 years or older who were clinically diagnosed as diabetic and who regularly visited the outpatient unit at the University of Tokyo Hospital were recruited between August 2014 and March 2015. Data were collected through face-to-face structured interviews, physical measurements and medical records. Participants were asked whether they were willing to use mHealth after being shown DialBetics - an mHealth application for diabetics - as an example, and about their history of dropout and previous mHealth experience. Data were analyzed by multivariate logistic regression models. Of 307 patients with type 1 and type 2 diabetes, 34 (11.1%) had previously dropped out from diabetic care. Multivariate analysis identified previous mHealth experience as a negative predictor of dropout (odds ratio 0.211, P = 0.023). Of those 34 patients, 27 (79.4%) expressed willingness to use mHealth, a significantly higher percentage than for those who had never dropped out (51.5%, P = 0.002). After adjusting for confounders, history of dropout remained a strong predictor of willingness (odds ratio 3.870, P = 0.004). Patients who previously dropped out of diabetic care are suitable candidates for mHealth. Future studies must evaluate whether mHealth is effective for preventing repeated dropout and improving glycemic control among this population. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

Aerobic fitness in children and young adults with primary ciliary dyskinesia

DEFF Research Database (Denmark)

Madsen, Astrid Hellerup; Green, Kent; Buchvald, Frederik

2013-01-01

BACKGROUND: Although aerobic fitness is regarded as an overall prognostic measure of morbidity and mortality, its evaluation in the chronic progressive sinopulmonary disease primary ciliary dyskinesia (PCD) has been infrequently and inconsistently reported. Here we assessed peak oxygen uptake (VO2...... multiple breath inert gas washout (N2 MBW) were assessed in a cross-sectional, single-occasion study of clinically stable children and young adults with PCD. We used a questionnaire including self-reported physical limitations in everyday life or in vigorous activities, and estimation of weekly hours...... patients. CONCLUSION: One-third of PCD patients exhibited substantially lower aerobic fitness than healthy subjects. Aerobic fitness correlated with FEV1, DLCO/VA and self-reported complaints of limitations in vigorous physical activity. These findings are most likely explained by PCD pulmonary disease...

Dabrafenib plus trametinib in patients with previously untreated BRAFV600E-mutant metastatic non-small-cell lung cancer: an open-label, phase 2 trial.

Science.gov (United States)

Planchard, David; Smit, Egbert F; Groen, Harry J M; Mazieres, Julien; Besse, Benjamin; Helland, Åslaug; Giannone, Vanessa; D'Amelio, Anthony M; Zhang, Pingkuan; Mookerjee, Bijoyesh; Johnson, Bruce E

2017-10-01

BRAF V600E mutation occurs in 1-2% of lung adenocarcinomas and acts as an oncogenic driver. Dabrafenib, alone or combined with trametinib, has shown substantial antitumour activity in patients with previously treated BRAF V600E -mutant metastatic non-small-cell lung cancer (NSCLC). We aimed to assess the activity and safety of dabrafenib plus trametinib treatment in previously untreated patients with BRAF V600E -mutant metastatic NSCLC. In this phase 2, sequentially enrolled, multicohort, multicentre, non-randomised, open-label study, adults (≥18 years of age) with previously untreated metastatic BRAF V600E -mutant NSCLC were enrolled into cohort C from 19 centres in eight countries within North America, Europe, and Asia. Patients received oral dabrafenib 150 mg twice per day plus oral trametinib 2 mg once per day until disease progression, unacceptable adverse events, consent withdrawal, or death. The primary endpoint was investigator-assessed overall response, defined as the percentage of patients who achieved a confirmed complete response or partial response per Response Evaluation Criteria In Solid Tumors version 1.1. The primary and safety analyses were by intention to treat in the protocol-defined population (previously untreated patients). The study is ongoing, but no longer recruiting patients. This trial is registered with ClinicalTrials.gov, number NCT01336634. Between April 16, 2014, and Dec 28, 2015, 36 patients were enrolled and treated with first-line dabrafenib plus trametinib. Median follow-up was 15·9 months (IQR 7·8-22·0) at the data cutoff (April 28, 2017). The proportion of patients with investigator-assessed confirmed overall response was 23 (64%, 95% CI 46-79), with two (6%) patients achieving a complete response and 21 (58%) a partial response. All patients had one or more adverse event of any grade, and 25 (69%) had one or more grade 3 or 4 event. The most common (occurring in more than two patients) grade 3 or 4 adverse events were

Bevacizumab plus chemotherapy in elderly patients with previously untreated metastatic colorectal cancer: single center experience

International Nuclear Information System (INIS)

Ocvirk, Janja; Moltara, Maja Ebert; Mesti, Tanja; Boc, Marko; Rebersek, Martina; Volk, Neva; Benedik, Jernej; Hlebanja, Zvezdana

2016-01-01

Metastatic colorectal cancer (mCRC) is mainly a disease of elderly, however, geriatric population is underrepresented in clinical trials. Patient registries represent a tool to assess and follow treatment outcomes in this patient population. The aim of the study was with the help of the patients’ register to determine the safety and efficacy of bevacizumab plus chemotherapy in elderly patients who had previously untreated metastatic colorectal cancer. The registry of patients with mCRC was designed to prospectively evaluate the safety and efficacy of bevacizumab-containing chemotherapy as well as selection of patients in routine clinical practice. Patient baseline clinical characteristics, pre-specified bevacizumab-related adverse events, and efficacy data were collected, evaluated and compared according to the age categories. Between January 2008 and December 2010, 210 patients with mCRC (median age 63, male 61.4%) started bevacizumab-containing therapy in the 1 st line setting. Majority of the 210 patients received irinotecan-based chemotherapy (68%) as 1 st line treatment and 105 patients (50%) received bevacizumab maintenance therapy. Elderly (≥ 70 years) patients presented 22.9% of all patients and they had worse performance status (PS 1/2, 62.4%) than patients in < 70 years group (PS 1/2, 35.8%). Difference in disease control rate was mainly due to inability to assess response in elderly group (64.6% in elderly and 77.8% in < 70 years group, p = 0.066). The median progression free survival was 10.2 (95% CI, 6.7–16.2) and 11.3 (95% CI, 10.2–12.6) months in elderly and < 70 years group, respectively (p = 0.58). The median overall survival was 18.5 (95% CI, 12.4–28.9) and 27.4 (95% CI, 22.7–31.9) months for elderly and < 70 years group, respectively (p = 0.03). Three-year survival rate was 26% and 37.6% in elderly vs. < 70 years group (p = 0.03). Overall rates of bevacizumab-related adverse events were similar in both groups: proteinuria 21

The Association Between Self-Rated Fitness and Cardiorespiratory Fitness in Adults

DEFF Research Database (Denmark)

Jensen, Karina Gregersen; Rosthøj, Susanne; Linneberg, Allan

2018-01-01

To assess criterion validity of a single item question on self-rated physical fitness against objectively measured cardiorespiratory fitness. From the Health2008 study 749 men and women between 30 and 60 years of age rated their fitness as excellent, very good, good, fair or poor. Cardiorespiratory...... fitness was estimated with the watt-max test. Agreement between self-rated and objectively measured physical fitness was assessed by Cohen's weighted kappa coefficient. Correlation was determined by Goodman & Kruskal's gamma correlation coefficient. All analyses were stratified according to gender. Data...... from 323 men and 426 women were analysed. There was a slight agreement between self-rated and objectively measured fitness in men (weighted kappa: 0.18, [95%CI: 0.13;0.23]) and a fair agreement in women (weighted kappa: 0.27, [95%CI: 0.22;0.32]). In both genders, self-rated fitness was positively...

Physical fitness, injuries, and team performance in soccer.

Science.gov (United States)

Arnason, Arni; Sigurdsson, Stefan B; Gudmundsson, Arni; Holme, Ingar; Engebretsen, Lars; Bahr, Roald

2004-02-01

To investigate the relationship between physical fitness and team success in soccer, and to test for differences in physical fitness between different player positions. Participants were 306 male soccer players from 17 teams in the two highest divisions in Iceland. Just before the start of the 1999 soccer season, the following variables were tested: height and weight, body composition, flexibility, leg extension power, jump height, and peak O2 uptake. Injuries and player participation in matches and training were recorded through the 4-month competitive season. Team average physical fitness was compared with team success (final league standing) using a linear regression model. Physical fitness was also compared between players in different playing positions. A significant relationship was found between team average jump height (countermovement jump and standing jump) and team success (P = 0.009 and P = 0.012, respectively). The same trend was also found for leg extension power (P = 0.097), body composition (% body fat, P = 0.07), and the total number of injury days per team (P = 0.09). Goalkeepers demonstrated different fitness characteristics from outfield players. They were taller and heavier, more flexible in hip extension and knee flexion, and had higher leg extension power and a lower peak O2 uptake. However, only minor differences were observed between defenders, midfield players, and attackers. Coaches and medical support teams should pay more attention to jump and power training, as well as preventive measures and adequate rehabilitation of previous injuries to increase team success.

The association between cardiorespiratory fitness and risk of all-cause mortality among women with impaired fasting glucose or undiagnosed diabetes mellitus.

Science.gov (United States)

Lyerly, G William; Sui, Xuemei; Lavie, Carl J; Church, Timothy S; Hand, Gregory A; Blair, Steven N

2009-09-01

To evaluate the independent and joint associations among cardiorespiratory fitness (CRF), body mass index, and risk of mortality from any cause among women with impaired fasting glucose (IFG) or undiagnosed diabetes mellitus (DM). Female patients (N=3044; mean age, 47.4 years) with IFG or undiagnosed DM completed a maximal exercise treadmill test (between January 26, 1971, and March 21, 2001). The women had no history of a cardiovascular disease event or diagnosed DM at baseline. Cardiorespiratory fitness was defined categorically as low (bottom 20%), moderate (middle 40%), or high (upper 40%) according to previously published Aerobics Center Longitudinal Study guidelines. Body mass index was calculated as the weight in kilograms divided by the height in meters squared (kg/m(2)). During a 16-year follow-up period, 171 deaths occurred. There was an inverse association between CRF and all-cause mortality risk. Women with moderate or high CRF were at lower risk of mortality (moderate CRF, 35% lower; high CRF, 36% lower; P(trend)=.03) than those with low CRF. An exercise capacity lower than 7 metabolic equivalents was associated with a 1.5-fold higher risk of death than an exercise capacity of 9 metabolic equivalents or higher (P(trend)=.05). The multivariate adjusted hazard ratios (HRs), including adjustments for CRF, were higher for heavier patients than for patients of normal weight (overweight patients: HR, 0.86; 95% confidence interval, 0.57-1.30; obese patients: HR, 1.19; 95% confidence interval, 0.70-2.03; P(trend)=.84). Combined analyses showed that women who were overweight or obese and unfit (low CRF) were at more than twice the risk of death than women who were of normal weight and fit (moderate or high CRF). Cardiorespiratory fitness, not body mass index, is a significant predictor of all-cause mortality among women with IFG or undiagnosed DM. Assessing CRF levels provides important prognostic information independent of traditional risk factors.

FItness programy a individuální přístup ve fitness

OpenAIRE

Rambous, Milan

2008-01-01

Souhrn: Tato diplomová práce se zabývá problematikou fitness programů a individuálru'ho přístupu ve fitness centrech. Celé téma zahrnuje rozpracování postupu při vytváření fitness programů a roli osobního trenéra ve fitness. Dále jsou zde uvedeny specifika některých fitness programů a v empirické části pak příklad dvou individuálních fitness programů. Název práce: Fitness programy a individuálnípřístup ve fitness Title: FITNESS PROGRAMS AND INDIVIDUAL CARE IN FITNESS Cíle práce: 1. podrobný p...

Are Fit Indices Biased in Favor of Bi-Factor Models in Cognitive Ability Research?: A Comparison of Fit in Correlated Factors, Higher-Order, and Bi-Factor Models via Monte Carlo Simulations

Directory of Open Access Journals (Sweden)

Grant B. Morgan

2015-02-01

Full Text Available Bi-factor confirmatory factor models have been influential in research on cognitive abilities because they often better fit the data than correlated factors and higher-order models. They also instantiate a perspective that differs from that offered by other models. Motivated by previous work that hypothesized an inherent statistical bias of fit indices favoring the bi-factor model, we compared the fit of correlated factors, higher-order, and bi-factor models via Monte Carlo methods. When data were sampled from a true bi-factor structure, each of the approximate fit indices was more likely than not to identify the bi-factor solution as the best fitting. When samples were selected from a true multiple correlated factors structure, approximate fit indices were more likely overall to identify the correlated factors solution as the best fitting. In contrast, when samples were generated from a true higher-order structure, approximate fit indices tended to identify the bi-factor solution as best fitting. There was extensive overlap of fit values across the models regardless of true structure. Although one model may fit a given dataset best relative to the other models, each of the models tended to fit the data well in absolute terms. Given this variability, models must also be judged on substantive and conceptual grounds.

Fitness, but not physical activity, is related to functional integrity of brain networks associated with aging.

Science.gov (United States)

Voss, Michelle W; Weng, Timothy B; Burzynska, Agnieszka Z; Wong, Chelsea N; Cooke, Gillian E; Clark, Rachel; Fanning, Jason; Awick, Elizabeth; Gothe, Neha P; Olson, Erin A; McAuley, Edward; Kramer, Arthur F

2016-05-01

Greater physical activity and cardiorespiratory fitness are associated with reduced age-related cognitive decline and lower risk for dementia. However, significant gaps remain in the understanding of how physical activity and fitness protect the brain from adverse effects of brain aging. The primary goal of the current study was to empirically evaluate the independent relationships between physical activity and fitness with functional brain health among healthy older adults, as measured by the functional connectivity of cognitively and clinically relevant resting state networks. To build context for fitness and physical activity associations in older adults, we first demonstrate that young adults have greater within-network functional connectivity across a broad range of cortical association networks. Based on these results and previous research, we predicted that individual differences in fitness and physical activity would be most strongly associated with functional integrity of the networks most sensitive to aging. Consistent with this prediction, and extending on previous research, we showed that cardiorespiratory fitness has a positive relationship with functional connectivity of several cortical networks associated with age-related decline, and effects were strongest in the default mode network (DMN). Furthermore, our results suggest that the positive association of fitness with brain function can occur independent of habitual physical activity. Overall, our findings provide further support that cardiorespiratory fitness is an important factor in moderating the adverse effects of aging on cognitively and clinically relevant functional brain networks. Copyright © 2015 Elsevier Inc. All rights reserved.

Fitness, but not physical activity, is related to functional integrity of brain networks associated with aging

Science.gov (United States)

Voss, Michelle W.; Weng, Timothy B.; Burzynska, Agnieszka Z.; Wong, Chelsea N.; Cooke, Gillian E.; Clark, Rachel; Fanning, Jason; Awick, Elizabeth; Gothe, Neha P.; Olson, Erin A.; McAuley, Edward; Kramer, Arthur F.

2015-01-01

Greater physical activity and cardiorespiratory fitness are associated with reduced age-related cognitive decline and lower risk for dementia. However, significant gaps remain in the understanding of how physical activity and fitness protect the brain from adverse effects of brain aging. The primary goal of the current study was to empirically evaluate the independent relationships between physical activity and fitness with functional brain health among healthy older adults, as measured by the functional connectivity of cognitively and clinically relevant resting state networks. To build context for fitness and physical activity associations in older adults, we first demonstrate that young adults have greater within-network functional connectivity across a broad range of cortical association networks. Based on these results and previous research, we predicted that individual differences in fitness and physical activity would be most strongly associated with functional integrity of the networks most sensitive to aging. Consistent with this prediction, and extending on previous research, we showed that cardiorespiratory fitness has a positive relationship with functional connectivity of several cortical networks associated with age-related decline, and effects were strongest in the Default Mode Network (DMN). Furthermore, our results suggest that the positive association of fitness with brain function can occur independent of habitual physical activity. Overall, our findings provide further support that cardiorespiratory fitness is an important factor in moderating the adverse effects of aging on cognitively and clinically relevant functional brain networks. PMID:26493108

Autologous osteochondral mosaicplasty or TruFit plugs for cartilage repair.

Science.gov (United States)

Hindle, Paul; Hendry, Jane L; Keating, John F; Biant, Leela C

2014-06-01

Autologous osteochondral mosaicplasty and TruFit Bone graft substitute plugs are methods used to repair symptomatic articular cartilage defects in the adult knee. There have been no comparative studies of the two techniques. This retrospective study assessed functional outcome of patients using the EQ-5D, Knee Injury and Osteoarthritis Outcome Score (KOOS) and Modified Cincinnati scores at follow-up of 1-5 years. There were 66 patients in the study (35 TruFit and 31 Mosaicplasty): 44 males and 22 females with a mean age of 37.3 years (SD 12.6). The mean BMI was 26.8. Thirty-six articular cartilage lesions were due to trauma, twenty-six due to osteochondritis dissecans and three due to non-specific degenerative change or unknown. There was no difference between the two groups age (n.s.), sex (n.s.), BMI (n.s.), defect location (n.s.) or aetiology (n.s.). The median follow-up was 22 months for the TruFit cohort and 30 months for the mosaicplasty group. There was no significant difference in the requirement for re-operation (n.s). Patients undergoing autologous mosaicplasty had a higher rate of returning to sport (p = 0.006), lower EQ-5D pain scores (p = 0.048) and higher KOOS activities of daily living (p = 0.029) scores. Sub-group analysis showed no difference related to the number of cases the surgeon performed. Patients requiring re-operation had lower outcome scores regardless of their initial procedure. This study demonstrated significantly better outcomes using two validated outcome scores (KOOS, EQ-5D), and an ability to return to sport in those undergoing autologous mosaicplasty compared to those receiving TruFit plugs. IV.

Constant scattering length fits to low energy K-p interactions

International Nuclear Information System (INIS)

Conboy, J.E.

1985-10-01

The paper concerns the data on low energy K - p interactions analysed using the constant scattering length (C.S.L.) approximation. The scattering lengths are found to differ significantly from those required to fit data from previous K -1 p experiments, and these differences are discussed. The data indicate an Tspin=1 P- wave interaction, from the production angle distributions of the K-bar 0 n, Σ +- π -+ and Λπ 0 channels. However the authors have been unable to fit both the P-wave and K 0 sub(L)p data with the simple C.S.L. model. (U.K.)

Outcome Of Pregnancy Following A Previous Lower Segment ...

African Journals Online (AJOL)

Background: A previous ceasarean section is an important variable that influences patient management in subsequent pregnancies. A trial of vaginal delivery in such patients is a feasible alternative to a secondary section, thus aiding to reduce the ceasarean section rate and its associated co-morbidities. Objective: To ...

Computer code FIT

International Nuclear Information System (INIS)

Rohmann, D.; Koehler, T.

1987-02-01

This is a description of the computer code FIT, written in FORTRAN-77 for a PDP 11/34. FIT is an interactive program to decude position, width and intensity of lines of X-ray spectra (max. length of 4K channels). The lines (max. 30 lines per fit) may have Gauss- or Voigt-profile, as well as exponential tails. Spectrum and fit can be displayed on a Tektronix terminal. (orig.) [de

Natural priors, CMSSM fits and LHC weather forecasts

International Nuclear Information System (INIS)

Allanach, Benjamin C.; Cranmer, Kyle; Lester, Christopher G.; Weber, Arne M.

2007-01-01

Previous LHC forecasts for the constrained minimal supersymmetric standard model (CMSSM), based on current astrophysical and laboratory measurements, have used priors that are flat in the parameter tan β, while being constrained to postdict the central experimental value of M Z . We construct a different, new and more natural prior with a measure in μ and B (the more fundamental MSSM parameters from which tan β and M Z are actually derived). We find that as a consequence this choice leads to a well defined fine-tuning measure in the parameter space. We investigate the effect of such on global CMSSM fits to indirect constraints, providing posterior probability distributions for Large Hadron Collider (LHC) sparticle production cross sections. The change in priors has a significant effect, strongly suppressing the pseudoscalar Higgs boson dark matter annihilation region, and diminishing the probable values of sparticle masses. We also show how to interpret fit information from a Markov Chain Monte Carlo in a frequentist fashion; namely by using the profile likelihood. Bayesian and frequentist interpretations of CMSSM fits are compared and contrasted

The FORCE Fitness Profile--Adding a Measure of Health-Related Fitness to the Canadian Armed Forces Operational Fitness Evaluation.

Science.gov (United States)

Gagnon, Patrick; Spivock, Michael; Reilly, Tara; Mattie, Paige; Stockbrugger, Barry

2015-11-01

In 2013, the Canadian Armed Forces (CAF) implemented the Fitness for Operational Requirements of Canadian Armed Forces Employment (FORCE), a field expedient fitness test designed to predict the physical requirements of completing common military tasks. Given that attaining this minimal physical fitness standard may not represent a challenge to some personnel, a fitness incentive program was requested by the chain of command to recognize and reward fitness over and above the minimal standard. At the same time, it was determined that the CAF would benefit from a measure of general health-related fitness, in addition to this measure of operational fitness. The resulting incentive program structure is based on gender and 8 age categories. The results on the 4 elements of the FORCE evaluation were converted to a point scale from which normative scores were derived, where the median score corresponds to the bronze level, and silver, gold, and platinum correspond to a score which is 1, 2, and 3 SDs above this median, respectively. A suite of rewards including merit board point toward promotions and recognition on the uniform and material rewards was developed. A separate group rewards program was also tabled, to recognize achievements in fitness at the unit level. For general fitness, oxygen capacity was derived from FORCE evaluation results and combined with a measure of abdominal circumference. Fitness categories were determined based on relative risks of mortality and morbidity for each age and gender group. Pilot testing of this entire program was performed with 624 participants to assess participants' reactions to the enhanced test, and also to verify logistical aspects of the electronic data capture, calculation, and transfer system. The newly dubbed fitness profile program was subsequently approved by the senior leadership of the CAF and is scheduled to begin a phased implementation in June 2015.

Adherence to headache treatment and profile of previous health professional seeking among patients with chronic headache: a retrospective analysis.

Science.gov (United States)

Krymchantowski, Abouch Valenty; Adriano, Marcus Vinicius; de Góes, Renemilda; Moreira, Pedro Ferreira; da Cunha Jevoux, Carla

2007-04-26

Chronic headache is common among patients in neurology clinics. Patients may suffer important economic and social losses because of headaches, which may result in high expectations for treatment outcomes. When their treatment goals are not reached quickly, treatment may be difficult to maintain and patients may consult with numerous health professionals. This retrospective study evaluated the relationship between treatment and the profiles of previous health professionals consulted by patients in a tertiary headache center. The records were reviewed of all patients from a headache center who were seen in initial consultation between January 2000 and June 2003. Data related to patient demographic characteristics (sex and age), headache diagnosis, and the profile (quality and quantity) of previous healthcare consultations exclusively related to headache, were collected. The headache diagnoses were confirmed according to the IHS criteria (1988) and to the Silberstein criteria (1994,1996). Although adherence includes taking the prescribed medicines, discontinuing overused symptomatic medications, and changing behavior, among other things, for this study, adherence was defined as when the patient returned at least 2 times within a 3- to 3.5-month period. Patients were separated into groups depending on the number of different healthcare professionals they had consulted, from none to more than 7. Data from 495 patients were analyzed; 357 were women and 138 were men (ages 6 to 90 years; mean, 41.1 +/- 15.05 years). The headache diagnoses included migraine without aura (43.2%), chronic (transformed) migraine (40%), cluster headache (6.5%), episodic tension-type headache (0.8%), and hemicrania continua (0.4%). The 24.2% of patients who sought care from no more than 1 health professional showed a 59.8% adherence rate; 29% of the total had consulted 7 or more health professionals and showed an adherence rate of 74.3% (P = .0004). In Brazil, the belief is widespread that

Cardiorespiratory fitness, cognition and brain structure after TIA or minor ischemic stroke.

Science.gov (United States)

Boss, H Myrthe; Van Schaik, Sander M; Witkamp, Theo D; Geerlings, Mirjam I; Weinstein, Henry C; Van den Berg-Vos, Renske M

2017-10-01

Background It is not known whether cardiorespiratory fitness is associated with better cognitive performance and brain structure in patients with a TIA or minor ischemic stroke. Aims To examine the association between cardiorespiratory fitness, cognition and brain structure in patients with a TIA and minor stroke. Methods The study population consisted of patients with a TIA or minor stroke with a baseline measurement of the peak oxygen consumption, a MRI scan of brain and neuropsychological assessment. Composite z-scores were calculated for the cognitive domains attention, memory and executive functioning. White matter hyperintensities, microbleeds and lacunes were rated visually. The mean apparent diffusion coefficient was measured in regions of interest in frontal and occipital white matter and in the centrum semiovale as a marker of white matter structure. Normalized brain volumes were estimated by use of Statistical Parametric Mapping. Results In 84 included patients, linear regression analysis adjusted for age, sex and education showed that a higher peak oxygen consumption was associated with higher cognitive z-scores, a larger grey matter volume (B = 0.15 (95% CI 0.05; 0.26)) and a lower mean apparent diffusion coefficient (B = -.004 (95% CI -.007; -.001)). We found no association between the peak oxygen consumption and severe white matter hyperintensities, microbleeds, lacunes and total brain volume. Conclusions These data suggest that cardiorespiratory fitness is associated with better cognitive performance, greater grey matter volume and greater integrity of the white matter in patients with a TIA or minor ischemic stroke. Further prospective trials are necessary to define the effect of cardiorespiratory fitness on cognition and brain structure in patients with TIA or minor stroke.

Clinical marginal fit of zirconia crowns and patients' preferences for impression techniques using intraoral digital scanner versus polyvinyl siloxane material.

Science.gov (United States)

Sakornwimon, Nawapat; Leevailoj, Chalermpol

2017-09-01

The use of digital intraoral scanners is increasing; however, evidence of its precision in making crown impressions clinically remains scarce. Patients should also feel more comfortable with digital impressions, but only a few studies evaluating this subject have been performed. The purpose of this clinical study was to evaluate the marginal fit of monolithic zirconia crowns and patients' preferences for digital impressions versus polyvinyl siloxane (PVS) impressions. Sixteen participants with indications for single molar crowns were included. After crown preparation, digital impressions by intraoral scanner and PVS impressions were made. The participants were asked to complete a 6-item questionnaire with a visual analog scale related to perceptions of each of the following topics: time involved, taste/smell, occlusal registration, size of impression tray/scanner, gag reflex, and overall preference. Computer-aided design and computer-aided manufacturing monolithic zirconia crowns were fabricated from both impressions. The crowns were evaluated intraorally, and a blinded examiner measured the marginal discrepancy of silicone replicas under a stereomicroscope. Intraexaminer reliability was evaluated by calculating the intraclass correlation coefficient. Data for patients' preferences and marginal discrepancies were analyzed using the paired t test (α=.05). Visual analog scale scores for digital impressions were statistically significantly higher than those for PVS impressions in every topic (Pdigital group on all sides (P>.05). No differences were found in the clinical marginal fit of zirconia crowns fabricated from either digital impressions compared with PVS impressions. Furthermore, patients' satisfaction with digital impressions was significantly higher than with conventional impressions. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Different impact of aspirin on renal progression in patients with predialysis advanced chronic kidney disease with or without previous stroke.

Science.gov (United States)

Hsiao, Kuang-Chih; Huang, Jing-Yang; Lee, Chun-Te; Hung, Tung-Wei; Liaw, Yung-Po; Chang, Horng-Rong

2017-04-01

The benefit of reducing the risk of stroke against increasing the risk of renal progression associated with antiplatelet therapy in patients with advanced chronic kidney disease (CKD) is controversial. We enrolled 1301 adult patients with advanced CKD treated with erythropoiesis stimulating agents from January 1, 2002 to June 30, 2009 from the 2005 Longitudinal Health Insurance Database in Taiwan. All of the patients were followed until the development of the primary or secondary endpoints, or the end of the study (December 31, 2011). The primary endpoint was the development of ischemic stroke, and the secondary endpoints included hospitalization for bleeding events, cardiovascular mortality, all-cause mortality, and renal failure. The adjusted cumulative probability of events was calculated using multivariate Cox proportional regression analysis. Adjusted survival curves showed that the usage of aspirin was not associated with ischemic stroke, hospitalization for bleeding events, cardiovascular mortality or all-cause mortality, however, it was significantly associated with renal failure. In subgroup analysis, aspirin use was associated with renal failure in the patients with no history of stroke (HR, 1.41; 95% CI, 1.14-1.73), and there was a borderline interaction between previous stroke and the use of aspirin on renal failure (interaction p=0.0565). There was no significant benefit in preventing ischemic stroke in the patients with advanced CKD who received aspirin therapy. Furthermore, the use of aspirin was associated with the risk of renal failure in the patients with advanced CKD without previous stroke. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

High rates of ofloxacin resistance in Mycobacterium tuberculosis among both new and previously treated patients in Tamil Nadu, South India.

Science.gov (United States)

Selvakumar, N; Kumar, Vanaja; Balaji, S; Prabuseenivasan, S; Radhakrishnan, R; Sekar, Gomathi; Chandrasekaran, V; Kannan, T; Thomas, Aleyamma; Arunagiri, S; Dewan, Puneet; Swaminathan, Soumya

2015-01-01

Periodic drug resistance surveillance provides useful information on trends of drug resistance and effectiveness of tuberculosis (TB) control measures. The present study determines the prevalence of drug resistance among new sputum smear positive (NSP) and previously treated (PT) pulmonary TB patients, diagnosed at public sector designated microscopy centers (DMCs) in the state of Tamil Nadu, India. In this single-stage cluster-sampling prevalence survey, 70 of 700 DMCs were randomly selected using a probability-proportional to size method. A cluster size of 24 for NSP and a varying size of 0 to 99 for PT cases were fixed for each selected DMC. Culture and drug susceptibility testing was done on Lowenstein-Jensen medium using the economic variant of proportion sensitivity test for isoniazid (INH), rifampicin (RMP), ofloxacin (OFX) and kanamycin (KAN). Human Immunodeficiency Virus (HIV) status was collected from patient records. From June 2011 to August 2012, 1524 NSP and 901 PT patients were enrolled. Any RMP resistance and any INH resistance were observed in 2.6% and 15.1%, and in 10.4% and 30% respectively in NSP and PT cases. Among PT patients, multi drug resistant TB (MDR-TB) was highest in the treatment failure (35%) group, followed by relapse (13%) and treatment after default (10%) groups. Extensively drug resistant TB (XDRTB) was seen in 4.3% of MDR-TB cases. Any OFX resistance was seen in 10.4% of NSP, 13.9% of PT and 29% of PT MDR-TB patients. The HIV status of the patient had no impact on drug resistance levels. RMP resistance was present in 2.6% of new and 15.1% of previously treated patients in Tamil Nadu. Rates of OFX resistance were high among NSP and PT patients, especially among those with MDR-TB, a matter of concern for development of new treatment regimens for TB.

Is drug-resistant Mycobacterium leprae a real cause for concern?: First approach to molecular monitoring of multibacillary Colombian patients with and without previous leprosy treatment.

Science.gov (United States)

Guerrero, Martha Inírida; Colorado, Claudia Lucía; Torres, José Fernando; León, Clara Inés

2014-04-01

There is no information in Colombia on Mycobacterium leprae primary and secondary drug resistance in regards to the WHO-multidrug therapy regime. On the other hand, public health authorities around the world have issued various recommendations, one of which prompts for the immediate organization of resistance surveillance through simple molecular methods. To determine the prevalence of Mycobacterium leprae drug resistance to rifampicin, ofloxacin and dapsone in untreated and previously treated patients at the Centro Dermatológico Federico Lleras Acosta during the 1985-2004 period. We conducted a retrospective study which included multibacillary patient biopsies through elective sampling: 381 of them from new patients and 560 from previously treated patients. Using a microtome, we obtained six slides from each skin biopsy preserved in paraffin, and we extracted M. leprae DNA. We amplified three molecular targets through PCR and obtained the patterns of drug resistance to dapsone, rifampicin and ofloxacin by reverse hybridization. Finally, we collected epidemiological, clinical and demographical data for analyses. From 941 samples under study, 4.14% of them were resistant to one or more drugs, and 5.77 and 3.04% had resistant genotypes in new and previously treated patients, respectively. Total resistance for each drug was 0.43% for dapsone, 3.19% for rifampicin and 1.17% for ofloxacin. We found statistically significant differences for rifampicin and for the total population when comparing the results from untreated versus previously treated patients. Two thirds of the resistant samples were resistant to rifampicin alone or combined. The standard multidrug therapy schemes continue being effective for leprosy cases; however, it is necessary to guarantee adherence and regularity. Surveillance to drug resistance in new and previously treated leprosy cases should be established.

Positive effects of football on fitness, lipid profile, and insulin resistance in Brazilian patients with type 2 diabetes

DEFF Research Database (Denmark)

de Sousa, M V; Fukui, R; Krustrup, Peter

2014-01-01

We evaluated the effects of recreational football training combined with calorie-restricted diet (football + diet) vs calorie-restricted diet alone (diet) on aerobic fitness, lipid profile, and insulin resistance indicators in type 2 diabetes (T2D) patients. Forty-four T2D patients aged 48-68 years...... (27 females, 17 males) were randomly allocated to the football + diet group (FDG; n = 22) or to the diet group (DG; n = 22), of whom 19 FDG and 15 DG subjects completed the study. The football training was performed for 3 × 40 min/week for 12 weeks. Dual-energy X-ray absorptiometry scanning, treadmill...... testing, and fasting blood samplings were performed pre and post-intervention. After 12 weeks, maximal oxygen uptake (VO2max ) was elevated (P 

Quality of Life and Fitness in Children and Adolescents with Epilepsy (EpiFit).

Science.gov (United States)

Rauchenzauner, Markus; Hagn, Claudia; Walch, Romana; Baumann, Matthias; Haberlandt, Edda; Frühwirth, Martin; Rostasy, Kevin

2017-06-01

Objective  The objective of this study was to evaluate the correlation between fitness and health-related quality of life (HRQoL) in children with idiopathic epilepsy compared with a healthy matched control group. Methods  In this study, 107 children conducted a 6-minute walk test, anthropometric parameters were measured, and HRQoL was assessed using a standardized questionnaire (KINDL-R). Children were divided into two groups: (1) the patient group ( n  = 48) and (2) the healthy control group ( n  = 59). Results  HRQoL of children with focal epilepsy was greater when compared with healthy children and children with generalized epilepsy. A significant association could be demonstrated for the 6-minute walk distance and mental wellbeing in children with epilepsy but not in healthy children. Furthermore, a negative correlation between the HRQoL and the amount of time spent in front of TV and computer in children with epilepsy and healthy children was seen. In children with focal epilepsy, a significant negative correlation could be shown between school sport and mental wellbeing as well as between school sport and self-esteem. Conclusion  HRQoL in children with idiopathic epilepsy is significantly associated with physical fitness and might be positively influenced by an adequate education of patients and parents, a reduction of consumption of computer and TV in combination with age- and disease-adapted physical activity and sports. Georg Thieme Verlag KG Stuttgart · New York.

Tests of fit of historically-informed models of African American Admixture.

Science.gov (United States)

Gross, Jessica M

2018-02-01

African American populations in the U.S. formed primarily by mating between Africans and Europeans over the last 500 years. To date, studies of admixture have focused on either a one-time admixture event or continuous input into the African American population from Europeans only. Our goal is to gain a better understanding of the admixture process by examining models that take into account (a) assortative mating by ancestry in the African American population, (b) continuous input from both Europeans and Africans, and (c) historically informed variation in the rate of African migration over time. We used a model-based clustering method to generate distributions of African ancestry in three samples comprised of 147 African Americans from two published sources. We used a log-likelihood method to examine the fit of four models to these distributions and used a log-likelihood ratio test to compare the relative fit of each model. The mean ancestry estimates for our datasets of 77% African/23% European to 83% African/17% European ancestry are consistent with previous studies. We find admixture models that incorporate continuous gene flow from Europeans fit significantly better than one-time event models, and that a model involving continuous gene flow from Africans and Europeans fits better than one with continuous gene flow from Europeans only for two samples. Importantly, models that involve continuous input from Africans necessitate a higher level of gene flow from Europeans than previously reported. We demonstrate that models that take into account information about the rate of African migration over the past 500 years fit observed patterns of African ancestry better than alternative models. Our approach will enrich our understanding of the admixture process in extant and past populations. © 2017 Wiley Periodicals, Inc.

There is no fitness but fitness, and the lineage is its bearer

Science.gov (United States)

2016-01-01

Inclusive fitness has been the cornerstone of social evolution theory for more than a half-century and has matured as a mathematical theory in the past 20 years. Yet surprisingly for a theory so central to an entire field, some of its connections to evolutionary theory more broadly remain contentious or underappreciated. In this paper, we aim to emphasize the connection between inclusive fitness and modern evolutionary theory through the following fact: inclusive fitness is simply classical Darwinian fitness, averaged over social, environmental and demographic states that members of a gene lineage experience. Therefore, inclusive fitness is neither a generalization of classical fitness, nor does it belong exclusively to the individual. Rather, the lineage perspective emphasizes that evolutionary success is determined by the effect of selection on all biological and environmental contexts that a lineage may experience. We argue that this understanding of inclusive fitness based on gene lineages provides the most illuminating and accurate picture and avoids pitfalls in interpretation and empirical applications of inclusive fitness theory. PMID:26729925

There is no fitness but fitness, and the lineage is its bearer.

Science.gov (United States)

Akçay, Erol; Van Cleve, Jeremy

2016-02-05

Inclusive fitness has been the cornerstone of social evolution theory for more than a half-century and has matured as a mathematical theory in the past 20 years. Yet surprisingly for a theory so central to an entire field, some of its connections to evolutionary theory more broadly remain contentious or underappreciated. In this paper, we aim to emphasize the connection between inclusive fitness and modern evolutionary theory through the following fact: inclusive fitness is simply classical Darwinian fitness, averaged over social, environmental and demographic states that members of a gene lineage experience. Therefore, inclusive fitness is neither a generalization of classical fitness, nor does it belong exclusively to the individual. Rather, the lineage perspective emphasizes that evolutionary success is determined by the effect of selection on all biological and environmental contexts that a lineage may experience. We argue that this understanding of inclusive fitness based on gene lineages provides the most illuminating and accurate picture and avoids pitfalls in interpretation and empirical applications of inclusive fitness theory. © 2016 The Author(s).

Late tamoxifen in patients previously operated for breast cancer without postoperative tamoxifen: 5-year results of a single institution randomised study

International Nuclear Information System (INIS)

Veronesi, Andrea; Miolo, GianMaria; Magri, Maria D; Crivellari, Diana; Scalone, Simona; Bidoli, Ettore; Lombardi, Davide

2010-01-01

A population of breast cancer patients exists who, for various reasons, never received adjuvant post-operative tamoxifen (TAM). This study was aimed to evaluate the role of late TAM in these patients. From 1997 to 2003, patients aged 35 to 75 years, operated more than 2 years previously for monolateral breast cancer without adjuvant TAM, with no signs of metastases and no contraindication to TAM were randomized to TAM 20 mg/day orally for 2 years or follow-up alone. Events were categorized as locoregional relapse, distant metastases, metachronous breast cancer, tumours other than breast cancer and death from any causes, whichever occurred first. The sample size (197 patients per arm, plus 10% allowance) was based on the assumption of a 30% decrease in the number of events occurring at a rate of 5% annually in the 10 years following randomization. Four hundred and thirty-three patients were randomized in the study (TAM 217, follow-up 216). Patients characteristics (TAM/follow-up) included: median age 55/55 years, median time from surgery 25/25 months (range, 25-288/25-294), in situ carcinoma 18/24, oestrogen receptor (ER) positive in 75/68, negative in 70/57, unknown in 72/91 patients. Previous adjuvant treatment included chemotherapy in 131/120 and an LHRH analogue in 11/13 patients. Thirty-six patients prematurely discontinued TAM after a median of 1 month, mostly because of subjective intolerance. Eighty-three events (TAM 39, follow-up 44) occurred: locoregional relapse in 10/8, distant metastases in 14/16, metachronous breast cancer in 4/10, other tumours in 11/10 patients. Less ER-positive secondary breast cancers occurred in the TAM treated patients than in follow-up patients (1 vs 10, p = 0.005). Event-free survival was similar in both groups of patients. This 5-year analysis revealed significantly less metachronous ER-positive breast cancers in the TAM treated patients. No other statistically significant differences have emerged thus far

Survival Prediction in Patients Undergoing Open-Heart Mitral Valve Operation After Previous Failed MitraClip Procedures.

Science.gov (United States)

Geidel, Stephan; Wohlmuth, Peter; Schmoeckel, Michael

2016-03-01

The objective of this study was to analyze the results of open heart mitral valve operations for survival prediction in patients with previously unsuccessful MitraClip procedures. Thirty-three consecutive patients who underwent mitral valve surgery in our institution were studied. At a median of 41 days, they had previously undergone one to five futile MitraClip implantations. At the time of their operations, patients were 72.6 ± 10.3 years old, and the calculated risk, using the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II, was a median of 26.5%. Individual outcomes were recorded, and all patients were monitored postoperatively. Thirty-day mortality was 9.1%, and the overall survival at 2.2 years was 60.6%. Seven cardiac-related and six noncardiac deaths occurred. Univariate survival regression models demonstrated a significant influence of the following variables on survival: EuroSCORE II (p = 0.0022), preoperative left ventricular end-diastolic dimension (p = 0.0052), left ventricular ejection fraction (p = 0.0249), coronary artery disease (p = 0.0385), and severe pulmonary hypertension (p = 0.0431). Survivors showed considerable improvements in their New York Heart Association class (p < 0.0001), left ventricular ejection fraction (p = 0.0080), grade of mitral regurgitation (p = 0.0350), and mitral valve area (p = 0.0486). Survival after mitral repair was not superior to survival after replacement. Indications for surgery after failed MitraClip procedures must be considered with the greatest of care. Variables predicting postoperative survival should be taken into account regarding the difficult decision as to whether to operate or not. Our data suggest that replacement of the pretreated mitral valve is probably the more reasonable concept rather than complex repairs. When the EuroSCORE II at the time of surgery exceeds 30%, conservative therapy is advisable. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc

Fitness Club

CERN Multimedia

Fitness Club

2010-01-01

Nordic Walking Please note that the subscriptions for the general fitness classes from July to December are open: Subscriptions general fitness classes Jul-Dec 2010 Sign-up to the Fitness Club mailing list here Nordic Walking: Sign-up to the Nordic Walking mailing list here Beginners Nordic walking lessons Monday Lunchtimes (rdv 12:20 for 12:30 departure) 13.09/20.09/27.09/04.10 11.10/18.10/08.11/15.11 22.11/29.11/06.12/20.12 Nordic walking lessons Tuesday evenings (rdv 17:50 for 18:00 departure) 07.09/14.09/21.09/28.09 05.10/12.10/19.10/26.10 Intermediate/Advanced Nordic walking outings (follow the nordic walking lessons before signing up for the outings) every Thursday from 16.09 - 16.12, excluding 28.10 and 09.12 Subscriptions and info: fitness.club@cern.ch  

FitKids360: Design, Conduct, and Outcomes of a Stage 2 Pediatric Obesity Program

Directory of Open Access Journals (Sweden)

Jared M. Tucker

2014-01-01

Full Text Available This paper describes FitKids360, a stage 2 pediatric weight management program. FitKids360 is a physician-referred, multicomponent, low-cost healthy lifestyle program for overweight and obese youth 5–16 years of age and their families. FitKids360 provides an evidence-based approach to the treatment of pediatric overweight by targeting patients’ physical activity, screen time, and dietary behaviors using a family-centered approach. The intervention begins with a two-hour orientation and assessment period followed by six weekly sessions. Assessments include lifestyle behaviors, anthropometry, and the Family Nutrition and Physical Activity (FNPA survey, which screens for obesogenic risk factors in the home environment. Outcomes are presented from 258 patients who completed one of 33 FitKids360 classes. After completing FitKids360, patients increased moderate to vigorous physical activity by 14 minutes (P=0.019, reduced screen time by 44 minutes (P<0.001, and improved key dietary behaviors. Overall, FNPA scores increased by 9% (P<0.001 and 69% of patients with “high risk” FNPA scores at baseline dropped below the “high risk” range by followup. Patients also lowered BMIs (P=0.011 and age- and sex-adjusted BMI z-scores (P<0.001 after completing the 7-week program. We hope this report will be useful to medical and public health professionals seeking to develop stage 2 pediatric obesity programs.

Clinical Fit of Partial Removable Dental Prostheses Based on Alginate or Polyvinyl Siloxane Impressions.

Science.gov (United States)

Fokkinga, Wietske A; Witter, Dick J; Bronkhorst, Ewald M; Creugers, Nico H

The aim of this study was to analyze the clinical fit of metal-frame partial removable dental prostheses (PRDPs) based on custom trays used with alginate or polyvinyl siloxane impression material. Fifth-year students of the Nijmegen Dental School made 25 correct impressions for 23 PRDPs for 21 patients using alginate, and 31 correct impressions for 30 PRDPs for 28 patients using polyvinyl siloxane. Clinical fit of the framework as a whole and of each retainer separately were evaluated by calibrated supervisors during framework try-in before (first evaluation) and after (second evaluation) possible adjustments (score 0 = poor fit, up to score 3 = good fit). Framework fit and fit of the denture base were evaluated at delivery (third evaluation). Finally, postinsertion sessions were evaluated and total number of sessions needed, sore spots, adjustments to the denture base, and reported food-impaction were recorded. No significant differences in clinical fit (of the framework as a whole, for the retainers, or for the denture base) were found between the groups in the three evaluation sessions. Differences were not found for postinsertion sessions with one exception: in the alginate group, four subjects reported food impaction, versus none in the polyvinyl siloxane group. Clinical fit of metal-frame PRDPs based on impressions with custom trays combined with alginate or polyvinyl siloxane was similar.

Fitness for duty in the nuclear power industry: A review of technical issues

International Nuclear Information System (INIS)

Moore, C.; Barnes, V.; Hauth, J.

1989-05-01

This report presents information gathered and analyzed in support of the US Nuclear Regulatory Commission's (NRC's) efforts to develop a rule that will ensure that workers with unescorted access to protected areas of nuclear power plants are fit for duty. This report supplements information previously published in NUREG/CR-5227, Fitness for Duty in the Nuclear Power Industry: A Review of Technical Issues (Barnes et al., 1988). The primary potential fitness-for-duty concern addressed in both of these reports is impairment caused by substance abuse, although other fitness concerns are discussed. This report addresses issues pertaining to workers' use and misuse of alcohol, prescription drugs, and over-the-counter drugs as fitness-for-duty concerns; responds to several questions raised by NRC Commissioners; discusses subversion of the chemical testing process and methods of preventing such subversion; and examines concerns about the urinalysis cutoff levels used when testing for marijuana metabolites, amphetamines, and phencyclidine

Physical demands at work, physical fitness, and 30-year ischaemic heart disease and all-cause mortality in the Copenhagen Male Study

DEFF Research Database (Denmark)

Holtermann, Andreas; Mortensen, Ole Steen; Burr, Hermann

2010-01-01

No previous long-term prospective studies have examined if workers with low cardiorespiratory fitness have an increased risk of cardiovascular mortality due to high physical work demands. We tested this hypothesis.......No previous long-term prospective studies have examined if workers with low cardiorespiratory fitness have an increased risk of cardiovascular mortality due to high physical work demands. We tested this hypothesis....

Phase II trial of veliparib in patients with previously treated BRCA-mutated pancreas ductal adenocarcinoma.

Science.gov (United States)

Lowery, Maeve A; Kelsen, David P; Capanu, Marinela; Smith, Sloane C; Lee, Jonathan W; Stadler, Zsofia K; Moore, Malcolm J; Kindler, Hedy L; Golan, Talia; Segal, Amiel; Maynard, Hannah; Hollywood, Ellen; Moynahan, MaryEllen; Salo-Mullen, Erin E; Do, Richard Kinh Gian; Chen, Alice P; Yu, Kenneth H; Tang, Laura H; O'Reilly, Eileen M

2018-01-01

BRCA-associated cancers have increased sensitivity to poly(ADP-ribose) polymerase inhibitors (PARPis). This single arm, non-randomised, multicentre phase II trial evaluated the response rate of veliparib in patients with previously treated BRCA1/2- or PALB2-mutant pancreatic adenocarcinoma (PDAC). Patients with stage III/IV PDAC and known germline BRCA1/2 or PALB2 mutation, 1-2 lines of treatment, Eastern Cooperative Oncology Group 0-2, were enrolled. Veliparib was dosed at a volume of 300 mg twice-daily (N = 3), then 400 mg twice-daily (N = 15) days 1-28. The primary end-point was to determine the response rate of veliparib; secondary end-points included progression-free survival (PFS), duration of response, overall survival (OS) and safety. Sixteen patients were enrolled; male N = 8 (50%). Median age was 52 years (range 43-77). Five (31%) had a BRCA1 and 11 (69%) had a BRCA2 mutation. Fourteen (88%) patients had received prior platinum-based therapy. No confirmed partial responses (PRs) were seen: one (6%) unconfirmed PR was observed at 4 months with disease progression (PD) at 6 months; four (25%) had stable disease (SD), whereas 11 (69%) had PD as best response including one with clinical PD. Median PFS was 1.7 months (95% confidence interval [CI] 1.57-1.83) and median OS was 3.1 months (95% CI 1.9-4.1). Six (38%) patients had grade III toxicity, including fatigue (N = 3), haematology (N = 2) and nausea (N = 1). Veliparib was well tolerated, but no confirmed response was observed although four (25%) patients remained on study with SD for ≥ 4 months. Additional strategies in this population are needed, and ongoing trials are evaluating PARPis combined with chemotherapy (NCT01585805) and as a maintenance strategy (NCT02184195). Copyright © 2017 Elsevier Ltd. All rights reserved.

Current indirect fitness and future direct fitness are not incompatible.

Science.gov (United States)

Brahma, Anindita; Mandal, Souvik; Gadagkar, Raghavendra

2018-02-01

In primitively eusocial insects, many individuals function as workers despite being capable of independent reproduction. Such altruistic behaviour is usually explained by the argument that workers gain indirect fitness by helping close genetic relatives. The focus on indirect fitness has left open the question of whether workers are also capable of getting direct fitness in the future in spite of working towards indirect fitness in the present. To investigate this question, we recorded behavioural profiles of all wasps on six naturally occurring nests of Ropalidia marginata , and then isolated all wasps in individual plastic boxes, giving them an opportunity to initiate nests and lay eggs. We found that 41% of the wasps successfully did so. Compared to those that failed to initiate nests, those that did were significantly younger, had significantly higher frequency of self-feeding behaviour on their parent nests but were not different in the levels of work performed in the parent nests. Thus ageing and poor feeding, rather than working for their colonies, constrain individuals for future independent reproduction. Hence, future direct fitness and present work towards gaining indirect fitness are not incompatible, making it easier for worker behaviour to be selected by kin selection or multilevel selection. © 2018 The Author(s).

Unge, sundhed og fitness

DEFF Research Database (Denmark)

Jensen, Jens-Ole

2003-01-01

Artiklen redegør for udbredelsen af fitness blandt unge og diskuterer, hvor det er blevet så populært at dyrke fitness.......Artiklen redegør for udbredelsen af fitness blandt unge og diskuterer, hvor det er blevet så populært at dyrke fitness....

The relationship between sustained attention and aerobic fitness in a group of young adults.

Science.gov (United States)

Ciria, Luis F; Perakakis, Pandelis; Luque-Casado, Antonio; Morato, Cristina; Sanabria, Daniel

2017-01-01

A growing set of studies has shown a positive relationship between aerobic fitness and a broad array of cognitive functions. However, few studies have focused on sustained attention, which has been considered a fundamental cognitive process that underlies most everyday activities. The purpose of this study was to investigate the role of aerobic fitness as a key factor in sustained attention capacities in young adults. Forty-four young adults (18-23 years) were divided into two groups as a function of the level of aerobic fitness (high-fit and low-fit). Participants completed the Psychomotor Vigilance Task (PVT) and an oddball task where they had to detect infrequent targets presented among frequent non-targets. The analysis of variance (ANOVA) showed faster responses for the high-fit group than for the low-fit group in the PVT, replicating previous accounts. In the oddball task, the high-fit group maintained their accuracy (ACC) rate of target detection over time, while the low-fit group suffered a significant decline of response ACC throughout the task. Importantly, the results show that the greater sustained attention capacity of high-fit young adults is not specific to a reaction time (RT) sustained attention task like the PVT, but it is also evident in an ACC oddball task. In sum, the present findings point to the important role of aerobic fitness on sustained attention capacities in young adults.

Transcending the Curricular Barrier between Fitness and Reading with FitLit

Science.gov (United States)

Opitz, Michael F.

2011-01-01

The author discusses how FitLit, children's literature that spotlights the multiple aspects of health and well-being, offers a vehicle for integrating reading and fitness into existing classroom routines such as guided reading, read-alouds, independent reading, and reading and writing workshop. Sample FitLit titles are provided as well as a…

mBEEF-vdW: Robust fitting of error estimation density functionals

DEFF Research Database (Denmark)

Lundgård, Keld Troen; Wellendorff, Jess; Voss, Johannes

2016-01-01

. The functional is fitted within the Bayesian error estimation functional (BEEF) framework [J. Wellendorff et al., Phys. Rev. B 85, 235149 (2012); J. Wellendorff et al., J. Chem. Phys. 140, 144107 (2014)]. We improve the previously used fitting procedures by introducing a robust MM-estimator based loss function...... catalysis, including datasets that were not used for its training. Overall, we find that mBEEF-vdW has a higher general accuracy than competing popular functionals, and it is one of the best performing functionals on chemisorption systems, surface energies, lattice constants, and dispersion. We also show...

Descriptive analysis of the type and design of contact lenses fitted according to keratoconus severity and morphology

Directory of Open Access Journals (Sweden)

Letícia Helena Lunardi

2016-04-01

Full Text Available ABSTRACT Purpose: Keratoconus is characterized by bilateral asymmetrical corneal ectasia that leads to inferior stromal thinning and corneal protrusion. There is currently a lack of consensus regarding the most efficacious method for fitting contact lenses in patients with keratoconus, given the various topographical patterns and evolution grades observed in affected populations. The purpose of the present study was to evaluate the association between keratoconus evolution grade and topography pattern and the type and design of fitted contact lens. Methods: We performed a retrospective analysis of contact lenses fitted in a total of 185 patients with keratoconus (325 eyes. Keratoconus was classified as either grade I, II, III, or IV based on keratometry and cone morphology (nipple, oval, globus, or indeterminate results. Results: A total of 325 eyes were evaluated in the present study. Of the 62 eyes classified as grade I, 66.1% were fitted with monocurve contact lenses. Of the 162 eyes classified as grade I and II, 51%, 30%, and 19% were fitted with adapted monocurve rigid gas-permeable contact lenses (RGPCL, bicurve lenses, and others lens types, respectively. Bicurve lenses were fitted in 52.1% and 62.2% of eyes classified as grade III and IV, respectively. Of the eyes classified as grade III and IV, monocurve and bicurve RGPCL were fitted in 26% and 55%, respectively. In eyes with oval keratoconus, 45%, 35%, and 20% were fitted with monocurve lenses, bicurve lenses, and other lens types, respectively. In eyes with round cones (nipple morphology, 55%, 30%, and 15% were fitted with bicurve lenses, monocurve lenses, and other lens types, respectively. Conclusion: Monocurve RGPCL were most frequently fitted in patients with mild to moderate keratoconus and oval cones morphology, while bicurve lenses were more frequently fitted in patients with severe and advanced keratoconus. This was probably because bicurve lenses are more appropriate for

Local Fitness Landscapes Predict Yeast Evolutionary Dynamics in Directionally Changing Environments.

Science.gov (United States)

Gorter, Florien A; Aarts, Mark G M; Zwaan, Bas J; de Visser, J Arjan G M

2018-01-01

The fitness landscape is a concept that is widely used for understanding and predicting evolutionary adaptation. The topography of the fitness landscape depends critically on the environment, with potentially far-reaching consequences for evolution under changing conditions. However, few studies have assessed directly how empirical fitness landscapes change across conditions, or validated the predicted consequences of such change. We previously evolved replicate yeast populations in the presence of either gradually increasing, or constant high, concentrations of the heavy metals cadmium (Cd), nickel (Ni), and zinc (Zn), and analyzed their phenotypic and genomic changes. Here, we reconstructed the local fitness landscapes underlying adaptation to each metal by deleting all repeatedly mutated genes both by themselves and in combination. Fitness assays revealed that the height, and/or shape, of each local fitness landscape changed considerably across metal concentrations, with distinct qualitative differences between unconditionally (Cd) and conditionally toxic metals (Ni and Zn). This change in topography had particularly crucial consequences in the case of Ni, where a substantial part of the individual mutational fitness effects changed in sign across concentrations. Based on the Ni landscape analyses, we made several predictions about which mutations had been selected when during the evolution experiment. Deep sequencing of population samples from different time points generally confirmed these predictions, demonstrating the power of landscape reconstruction analyses for understanding and ultimately predicting evolutionary dynamics, even under complex scenarios of environmental change. Copyright © 2018 by the Genetics Society of America.

Endovascular approach to treat ascending aortic pseudoaneurysm in a patient with previous CABG and very high surgical risk.

Science.gov (United States)

Zago, Alexandre C; Saadi, Eduardo K; Zago, Alcides J

2011-10-01

Pseudoaneurysm of the ascending aorta is an uncommon pathology and a challenge in high-risk patients who undergo conventional surgery because of high operative morbidity and mortality. Endovascular exclusion of an aortic pseudoaneurysm using an endoprosthesis is a less invasive approach, but few such cases have been reported. Moreover, the use of this approach poses unique therapeutic challenges because there is no specific endoprosthesis for ascending aortic repair, particularly to treat patients with previous coronary artery bypass graft (CABG). We describe the case of a 74-year-old patient who had undergone CABG and later presented with an iatrogenic ascending aortic pseudoaneurysm that occurred during an angiography. This patient was at very high risk for surgical treatment and, therefore, an endovascular approach was adopted: percutaneous coronary intervention for the left main coronary artery, left anterior descending and left circumflex native coronary arteries followed by endovascular endoprosthesis deployment in the ascending aorta to exclude the pseudoaneurysm. Both procedures were successfully performed, and the patient was discharged without complications 4 days later. At 5 months' clinical follow-up, his clinical condition was good and he had no complications. Copyright © 2011 Wiley-Liss, Inc.

Intraabdominal pressure in women during CrossFit exercises and the effect of age and parity.

Science.gov (United States)

Gephart, Laura Faye; Doersch, Karen M; Reyes, Michelle; Kuehl, Thomas J; Danford, Jill M

2018-07-01

To determine intraabdominal pressure (IAP) in women during CrossFit and to determine whether parity, age, or CrossFit experience affects IAP during CrossFit exercises, we evaluated 10 women: 5 experienced and active CrossFitters and 5 who were not regularly engaged in CrossFit. A Laborie urodynamics abdominal pressure probe with the Goby wireless system measured IAP during 10 repetitions of 13 different CrossFit exercises. Women had a mean age of 36 years. A significant difference was found between mean peak IAP of the 5 parous vs the 5 nulliparous women ( P = 0.009). Experience with CrossFit did not affect mean peak IAP achieved with exercise. In some exercises, there was a significant change in IAP as participants progressed through repetitions ( P = 0.003 for back squats and 0.04 for sit-ups). Participants achieved IAP values that were markedly higher than those previously published.

"Numb-Leg" in a CrossFit Athlete: A Case Presentation.

Science.gov (United States)

Esser, Stephan; Thurston, Mckennan; Nalluri, Krishna; Muzaurieta, Aurelio

2017-08-01

Participation in CrossFit athletics and Olympic-style lifting by the general populace has rapidly increased in the last 10 years. Such athletic engagement poses unique, inadequately defined risks to the participant. We describe the case of a 36-year-old man who presented to an outpatient sports medicine clinic with 6 weeks of numbness and tingling in the lateral right proximal thigh. After thorough examination and electromyographic testing, he was found to have a lateral femoral cutaneous neuropathy caused by performing supine gluteal bridges with a weighted barbell resting across his anterior thighs. His case exemplifies the unique exercise demands and injury risks of CrossFit-style exercise. Sports medicine providers should be familiar with both trends in sports/fitness participation and the associated unique risks that such sports pose, so as to adequately counsel patients on safety of participation and to correctly identify the cause of injury when evaluating patients in the clinical setting. V. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Fodbold Fitness

DEFF Research Database (Denmark)

Bennike, Søren

Samfundet forandrer sig og ligeså gør danskernes idrætsmønstre. Fodbold Fitness, der er afhandlingens omdrejningspunkt, kan iagttages som en reaktion på disse forandringer. Afhandlingen ser nærmere på Fodbold Fitness og implementeringen af dette, der ingenlunde er nogen let opgave. Bennike bidrager...

Validity and reliability of Nintendo Wii Fit balance scores.

Science.gov (United States)

Wikstrom, Erik A

2012-01-01

Interactive gaming systems have the potential to help rehabilitate patients with musculoskeletal conditions. The Nintendo Wii Balance Board, which is part of the Wii Fit game, could be an effective tool to monitor progress during rehabilitation because the board and game can provide objective measures of balance. However, the validity and reliability of Wii Fit balance scores remain unknown. To determine the concurrent validity of balance scores produced by the Wii Fit game and the intrasession and intersession reliability of Wii Fit balance scores. Descriptive laboratory study. Sports medicine research laboratory. Forty-five recreationally active participants (age = 27.0 ± 9.8 years, height = 170.9 ± 9.2 cm, mass = 72.4 ± 11.8 kg) with a heterogeneous history of lower extremity injury. Participants completed a single-limb-stance task on a force plate and the Star Excursion Balance Test (SEBT) during the first test session. Twelve Wii Fit balance activities were completed during 2 test sessions separated by 1 week. Postural sway in the anteroposterior (AP) and mediolateral (ML) directions and the AP, ML, and resultant center-of-pressure (COP) excursions were calculated from the single-limb stance. The normalized reach distance was recorded for the anterior, posteromedial, and posterolateral directions of the SEBT. Wii Fit balance scores that the game software generated also were recorded. All 96 of the calculated correlation coefficients among Wii Fit activity outcomes and established balance outcomes were interpreted as poor (r Wii Fit balance activity scores ranged from good (intraclass correlation coefficient [ICC] = 0.80) to poor (ICC = 0.39), with 8 activities having poor intrasession reliability. Similarly, 11 of the 12 Wii Fit balance activity scores demonstrated poor intersession reliability, with scores ranging from fair (ICC = 0.74) to poor (ICC = 0.29). Wii Fit balance activity scores had poor concurrent validity relative to COP outcomes and SEBT

Survival, Durable Response, and Long-Term Safety in Patients With Previously Treated Advanced Renal Cell Carcinoma Receiving Nivolumab.

Science.gov (United States)

McDermott, David F; Drake, Charles G; Sznol, Mario; Choueiri, Toni K; Powderly, John D; Smith, David C; Brahmer, Julie R; Carvajal, Richard D; Hammers, Hans J; Puzanov, Igor; Hodi, F Stephen; Kluger, Harriet M; Topalian, Suzanne L; Pardoll, Drew M; Wigginton, Jon M; Kollia, Georgia D; Gupta, Ashok; McDonald, Dan; Sankar, Vindira; Sosman, Jeffrey A; Atkins, Michael B

2015-06-20

Blockade of the programmed death-1 inhibitory cell-surface molecule on immune cells using the fully human immunoglobulin G4 antibody nivolumab mediates tumor regression in a portion of patients with advanced treatment-refractory solid tumors. We report clinical activity, survival, and long-term safety in patients with advanced renal cell carcinoma (RCC) treated with nivolumab in a phase I study with expansion cohorts. A total of 34 patients with previously treated advanced RCC, enrolled between 2008 and 2012, received intravenous nivolumab (1 or 10 mg/kg) in an outpatient setting once every two weeks for up to 96 weeks and were observed for survival and duration of response after treatment discontinuation. Ten patients (29%) achieved objective responses (according to RECIST [version 1.0]), with median response duration of 12.9 months; nine additional patients (27%) demonstrated stable disease lasting > 24 weeks. Three of five patients who stopped treatment while in response continued to respond for ≥ 45 weeks. Median overall survival in all patients (71% with two to five prior systemic therapies) was 22.4 months; 1-, 2-, and 3-year survival rates were 71%, 48%, and 44%, respectively. Grade 3 to 4 treatment-related adverse events occurred in 18% of patients; all were reversible. Patients with advanced treatment-refractory RCC treated with nivolumab demonstrated durable responses that in some responders persisted after drug discontinuation. Overall survival is encouraging, and toxicities were generally manageable. Ongoing randomized clinical trials will further assess the impact of nivolumab on overall survival in patients with advanced RCC. © 2015 by American Society of Clinical Oncology.

Staging the Axilla with selective sentinel node biopsy in patients with previous excision of non-palpable and palpable breast cancer

International Nuclear Information System (INIS)

Ruano, R.; Garcia-Talavera, J.R.; Arriba, A. de; Ramos, M.; Gonzalez-Orus, J.; Iglesias, M.; Serrano, E.; Macias, M.C.

2008-01-01

To present our experience in the therapeutic approach of the sentinel node biopsy (SNB) in patients with previous excision of the breast cancer, divided in non-palpable and palpable lesions, in comparison with time treatment and stagement of breast cancer. In the period 2001-2006, 138 patients with prior diagnostic excisional biopsy (96 non-palpable and 42 palpable breast cancer) and 328 without previous surgery (32 non-palpable; 296 palpable cancer) were treated. The combined technique ( 99m Tc-colloidal rhenium and isosulfan blue dye) was the approach for sentinel lymph node (SLN) detection. Axillary lymph node dissection (ALND) was completed only when the SLN was positive for metastasis or not located. Detection rate, if there was prior surgery, was 95% for non-palpable and 98% for palpable cancer, and 99% for one-time treatment group. Metastasis rate in the SLN was 15% in non-palpable cancer (14/91), significantly smaller than in palpable breast cancer (39% if prior surgery and 37% in one-time surgery). According to tumoral size, ALND metastasis rate was similar for T1 and T2 tumors (43-44%). In the follow-up of the groups with prior diagnostic biopsy or surgery of the breast cancer we have not found any false negative in the axilla. The detection of the SLN is also feasible in patients with previous surgery of breast cancer. Because SLN metastasis rates are significantly smaller in non-palpable lesions, the effort in screening programs for early detection of breast cancer and also in improving histopathological confirmation of malignancy with ultrasound or stereotactic guided core biopsies must continue. (orig.)

Evaluation of Three Cases Using a Novel Titanium Mesh System-Skull-Fit with Orbital Wall (Skull-Fit WOW)-For Cranial Base Reconstructions.

Science.gov (United States)

Hattori, Noriko; Nakajima, Hideo; Tamada, Ikkei; Sakamoto, Yoshiaki; Ohira, Takayuki; Yoshida, Kazunari; Kawase, Takeshi; Kishi, Kazuo

2011-09-01

Cranial base reconstructions associated with tumor resections around the orbital wall often require that both the upper and lateral orbital walls be reconstructed during a single procedure. Previously, we used titanium mesh plates that were preoperatively fabricated based on three-dimensional models. Although these plates are precise and do not increase the probability of infection, we still had to use autologous bones to reconstruct the orbital walls. Recently, we developed a new titanium mesh plate-called Skull-Fit(®)-with orbital wall (Skull-Fit WOW(®)), enabling us to reconstruct the cranial base and orbital walls without bone grafts. Here, we report on three reconstruction cases in which the novel titanium mesh-orbital wall system was used. In all three cases, the customized titanium mesh system performed satisfactorily with little, if any, complications.

A comparison of morbidity associated with placenta previa with and without previous caesarean sections

International Nuclear Information System (INIS)

Baqai, S.; Siraj, A.; Noor, N.

2018-01-01

To compare the morbidity associated with placenta previa with and without previous caesarean sections. Study Design: Retrospective comparative study. Place and Duration of Study: From March 2014 till March 2016 in the department of Obstetrics and Gynaecology at PNS Shifa hospital Karachi. Material and Methods: After the approval from hospital ethical committee, antenatal patients with singleton pregnancy of gestational age >32 weeks, in the age group of 20-40 years diagnosed to have placenta previa included in the study. All patients with twin pregnancy less than 20 years and more than 40 years of age were excluded. The records of all patients fulfilling the inclusion criteria were reviewed. Data had been collected for demographic and maternal variables, placenta previa, history of previous lower segment caesarean section (LSCS), complications associated with placenta previa and techniques used to control blood loss were recorded. Results: During the study period, 6879 patients were delivered in PNS Shifa, out of these, 2060 (29.9%) had caesarean section out of these, 47.3% patients had previous history of LSCS. Thirty three (1.6%) patients were diagnosed to have placenta previa and frequency of placenta previa was significantly higher in patients with previous history of LSCS than previous normal delivery of LSCS i.e. 22 vs. 11 (p=0.023). It was observed that the frequency of morbidly adherent placenta (MAP) and Intensive care unit (ICU) stay were significantly higher in patients with previous history of LSCS than previous history of normal delivery. Conclusion: Frequency of placenta previa was significantly higher in patients with history of LSCS. Also placenta previa remains a major risk factor for various maternal complications. (author)

The challenge of preserving cardiorespiratory fitness in physically inactive patients with colon or breast cancer during adjuvant chemotherapy: a randomised feasibility study

DEFF Research Database (Denmark)

Møller, Tom; Lillelund, Christian; Andersen, Christina

2015-01-01

Introduction Anti-neoplastic treatment is synonymous with an inactive daily life for a substantial number of patients. It remains unclear what is the optimal setting, dosage and combination of exercise and health promoting components that best facilitate patient adherence and symptom management...... in order to support cardio-respiratory fitness and lifestyle changes in an at-risk population of pre-illness physically inactive cancer patients.Methods Patients with breast or colon cancer referred to adjuvant chemotherapy and by the oncologists pre-screening verified as physically inactive were eligible...... to enter a randomised three-armed feasibility study comparing a 12-week supervised hospital-based moderate to high intensity exercise intervention or alternate an instructive home-based12-week pedometer intervention, with usual care.Results Using a recommendation based physical activity screening...

Comparing Person Organization Fit and Person Job Fit

Directory of Open Access Journals (Sweden)

Kadir Ardıç

2016-07-01

Full Text Available Although there have been many studies conducted to analyze the effects of person-organization fit (POF and person-job fit (PJF on individual outcomes, little is known about which of these fit associates stronger with individual variables (i.e., intention to quit job, IQJ, and perceived individual performance, PIP. Therefore the purpose of the study is to compare the relationships of PJF and POF with IQJ and PIP. The sample of the study consists of security guards working at a private company's civil aviation safety department. Totally 98 security guards participated to the research. Results indicated that, the relationships of PJF and POF with IQJ and PIP were not significantly different. Consequently the results indicate that POF and PJF associate similarly with critical individual outcomes.

A natural fit: home healthcare and biomedical engineering.

Science.gov (United States)

Damasco, Nestor; Abe, Chris

2010-01-01

The involvement of Biomed in management of home care equipment has become a natural fit for Rady Children's Hospital. Managing all aspects of home care equipment through an in-house biomedical engineering department is cost-effective, efficient, provides excellent customer service, and enhances the relationship with the clinical staff and patients. It develops a sense of security for patients and staff that home care equipment is tested and maintained in a stringent manner that promotes safety.

Fitness club

CERN Multimedia

Fitness club

2013-01-01

  Nordic Walking Classes Come join the Nordic walking classes and outings offered by the CERN Fitness Club starting September 2013. Our licensed instructor Christine offers classes for people who’ve never tried Nordic Walking and who would like to learn the technique, and outings for people who have completed the classes and enjoy going out as a group. Course 1: Tuesdays 12:30 - 13:30 24 September, 1 October, 8 October, 15 October Course 2: Tuesdays 12:30 - 13:30 5 November, 12 November, 19 November, 26 November Outings will take place on Thursdays (12:30 to 13:30) from 12 September 2013. We meet at the CERN Club Barracks car park (close to Entrance A) 10 minutes before departure. Prices: 50 CHF for 4 classes, including the 10 CHF Club membership. Payments made directly to instructor. Renting Poles: Poles can be rented from Christine at 5 CHF / hour. Subscription: Please subscribe at: http://cern.ch/club-fitness Looking forward to seeing you among us! Fitness Club FitnessClub@c...

Fitness Club

CERN Multimedia

Fitness Club

2012-01-01

Get in Shape for Summer with the CERN Fitness Club Saturday 23 June 2012 from 14:30 to 16.30 (doors open at 14.00) Germana’s Fitness Workshop. Build strength and stamina, sculpt and tone your body and get your heart pumping with Germana’s workout mixture of Cardio Attack, Power Pump, Power Step, Cardio Combat and Cross-Training. Where: 216 (Pump room – equipped with changing rooms and showers). What to wear: comfortable clothes and indoor sports shoes + bring a drink! How much: 15 chf Sign up here: https://espace.cern.ch/club-fitness/Lists/Test_Subscription/NewForm.aspx? Join the Party and dance yourself into shape at Marco + Marials Zumba Masterclass. Saturday 30 June 2012 from 15:00 to 16:30 Marco + Mariel’s Zumba Masterclass Where: 216 (Pump room – equipped with changing rooms and showers). What to wear: comfortable clothes and indoor sports shoes + bring a drink! How much: 25 chf Sign up here: https://espace.cern.ch/club-fitness/Lists/Zumba%20...

Fitness Club

CERN Multimedia

Fitness Club

2012-01-01

  The CERN Fitness Club is pleased to announce its new early morning class which will be taking place on: Tuesdays from 24th April 07:30 to 08:15 216 (Pump Hall, close to entrance C) – Facilities include changing rooms and showers. The Classes: The early morning classes will focus on workouts which will help you build not only strength and stamina, but will also improve your balance, and coordination. Our qualified instructor Germana will accompany you throughout the workout  to ensure you stay motivated so you achieve the best results. Sign up and discover the best way to start your working day full of energy! How to subscribe? We invite you along to a FREE trial session, if you enjoy the activity, please sign up via our website: https://espace.cern.ch/club-fitness/Activities/SUBSCRIBE.aspx. * * * * * * * * Saturday 28th April Get in shape for the summer at our fitness workshop and zumba dance party: Fitness workshop with Germana 13:00 to 14:30 - 216 (Pump Hall) Price...

Cholesterol turnover and metabolism in two patients with abetalipoproteinemia

International Nuclear Information System (INIS)

Goodman, D.S.; Deckelbaum, R.J.; Palmer, R.H.; Dell, R.B.; Ramakrishnan, R.; Delpre, G.; Beigel, Y.; Cooper, M.

1983-01-01

Total body turnover of cholesterol was studied in two patients with abetalipoproteinemia, a 32-year-old man and a 31-year-old woman. The patients received [14C]cholesterol intravenously, and the resulting specific activity-time curves (for 40 and 30 weeks, respectively) were fitted with a three-pool model. Parameters were compared with those from studies of cholesterol turnover in 82 normal and hyperlipidemic subjects. A three-pool model gave the best fit for the abetalipoproteinemic patients, as well as for the 82 previously studied subjects, suggesting general applicability of this model. Cholesterol production rates in the two abetalipoproteinemic subjects (0.82 and 0.89 g/day) were close to values predicted for persons of their body weight. Thus, total body turnover rate of cholesterol was quite normal in abetalipoproteinemia, confirming previous reports. Very low values (9.2 and 8.4 g) were found for M1, the size of the rapidly exchanging compartment pool 1, in the two abetalipoproteinemic subjects. These values were well below the values predicted (from the comparison study population) for normal persons of this size with low plasma cholesterol levels. For one patient, total body exchangeable cholesterol was very low, although not significantly below the predicted values for a person of his size. In the second patient, the observed estimate for total body exchangeable cholesterol was well within the range of values predicted for persons of her size with low to extremely low cholesterol levels

Trashepatic left gastric vein embolization in the treatment of recurrent hemorrhaging in patients with schistosomiasis previously submitted to non-derivative surgery

Directory of Open Access Journals (Sweden)

Paulo Fernandes Saad

2012-12-01

Full Text Available CONTEXT: Non-derivative surgical techniques are the treatment of choice for the control of upper digestive tract hemorrhages after schistosomotic portal hypertension. However, recurrent hemorrhaging due to gastroesophagic varices is frequent. OBJECTIVE: To evaluate the outcome of treatment based on embolization of the left gastric vein to control the reoccurrence of hemorrhages caused by gastroesophagic varices in patients with schistosomiasis previously submitted to non-derivative surgery. METHODS: Rates of reoccurrence of hemorrhages and the qualitative and quantitative reduction of gastroesophagic varices in patients undergoing transhepatic embolization of the left gastric vein between December 1999 and January 2009 were studied based on medical charts and follow-up reports. RESULTS: Seven patients with a mean age of 39.3 years underwent percutaneous transhepatic embolization of the left gastric vein. The mean time between azigoportal disconnections employed in combination with splenectomy and the percutaneous approach was 8.4 ± 7.3 years, and the number of episodes of digestive hemorrhaging ranged from 1 to 7 years. No episodes of reoccurrence of hemorrhaging were found during a follow-up period which ranged from 6 months to 7 years. Endoscopic postembolization studies revealed reductions in gastroesophagic varices in all patients compared to preembolization endoscopy. CONCLUSIONS: Percutaneous transhepatic embolization of the left gastric vein in patients with schistosomiasis previously submitted to surgery resulted in a decrease in gastroesophagic varices and was shown to be effective in controlling hemorrhage reoccurrence.

Medication and physical activity and physical fitness in severe mental illness.

Science.gov (United States)

Perez-Cruzado, David; Cuesta-Vargas, Antonio; Vera-Garcia, Elisa; Mayoral-Cleries, Fermín

2018-05-23

Anti-psychotic medication has emerged as the primary medical treatment for people with severe mental illness, despite the great risks involved in the use of this medication. In addition, this population suffers from problems of obesity, sedentary lifestyle and poor physical fitness, which is aggravated by the use of this type of medication. The objective of this study is to explore the influence of the most commonly used antipsychotics in this population (Olanzapine and Risperidone) on physical activity and the physical fitness of people with severe mental illness. Sixty-two people between 26 and 61 years of age with severe mental illness were assessed. All participants were evaluated with a battery of 11 physical tests to assess their physical fitness and with the IPAQ-short version questionnaire to determine their level of physical activity. The doses of Risperidone and Olanzapine were also evaluated in all participants. Significant differences were found for physical activity, with higher levels reported in those patients with severe mental illness who did not take any of these medications. Regarding physical fitness, significant differences were only found for the consumption of Risperidone, with better physical fitness levels seen in patients who did not consume this medication; on the other hand, for the consumption of Olanzapine, differences were found in muscular strength, balance and aerobic condition with better values in non-Olanzapine consumers compared with Olanzapine consumers. Copyright © 2018 Elsevier B.V. All rights reserved.

Analysis of Surface Plasmon Resonance Curves with a Novel Sigmoid-Asymmetric Fitting Algorithm

Directory of Open Access Journals (Sweden)

Daeho Jang

2015-09-01

Full Text Available The present study introduces a novel curve-fitting algorithm for surface plasmon resonance (SPR curves using a self-constructed, wedge-shaped beam type angular interrogation SPR spectroscopy technique. Previous fitting approaches such as asymmetric and polynomial equations are still unsatisfactory for analyzing full SPR curves and their use is limited to determining the resonance angle. In the present study, we developed a sigmoid-asymmetric equation that provides excellent curve-fitting for the whole SPR curve over a range of incident angles, including regions of the critical angle and resonance angle. Regardless of the bulk fluid type (i.e., water and air, the present sigmoid-asymmetric fitting exhibited nearly perfect matching with a full SPR curve, whereas the asymmetric and polynomial curve fitting methods did not. Because the present curve-fitting sigmoid-asymmetric equation can determine the critical angle as well as the resonance angle, the undesired effect caused by the bulk fluid refractive index was excluded by subtracting the critical angle from the resonance angle in real time. In conclusion, the proposed sigmoid-asymmetric curve-fitting algorithm for SPR curves is widely applicable to various SPR measurements, while excluding the effect of bulk fluids on the sensing layer.

Cardiorespiratory fitness and age-related arterial stiffness in women with systemic lupus erythematosus.

Science.gov (United States)

Montalbán-Méndez, Cristina; Soriano-Maldonado, Alberto; Vargas-Hitos, José A; Sáez-Urán, Luis M; Rosales-Castillo, Antonio; Morillas-de-Laguno, Pablo; Gavilán-Carrera, Blanca; Jiménez-Alonso, Juan

2018-03-01

The aim of this study was twofold: (i) to examine the association of cardiorespiratory fitness with arterial stiffness in women with systemic lupus erythematosus; (ii) to assess the potential interaction of cardiorespiratory fitness with age on arterial stiffness in this population. A total of 49 women with systemic lupus erythematosus (mean age 41.3 [standard deviation 13.8] years) and clinical stability during the previous 6 months were included in the study. Arterial stiffness was assessed through pulse wave velocity (Mobil-O-Graph® 24 hours pulse wave velocity monitor). Cardiorespiratory fitness was estimated with the Siconolfi step test and the 6-minute walk test. Cardiorespiratory fitness was inversely associated with pulse wave velocity in crude analyses (P fitness × age interaction effect on pulse wave velocity, regardless of the test used to estimate cardiorespiratory fitness (P fitness was associated with a lower increase in pulse wave velocity per each year increase in age. The results of this study suggest that cardiorespiratory fitness might attenuate the age-related arterial stiffening in women with systemic lupus erythematosus and might thus contribute to the primary prevention of cardiovascular disease in this population. As the cross-sectional design precludes establishing causal relationships, future clinical trials should confirm or contrast these findings. © 2018 Stichting European Society for Clinical Investigation Journal Foundation.

Resultados de revisão de artroplastia total do joelho com haste não cimentada "Press-fit" Results of revision total knee arthroplasty using press-fit cementless stem

Directory of Open Access Journals (Sweden)

Maurício Masasi Iamaguchi

2013-02-01

Full Text Available OBJETIVO: Mostrar nossa experiência com haste não-cimentadas press-fit e fixação metafisária com cimento em série selecionada de pacientes que realizaram revisão de artroplastia total do joelho. MÉTODOS: Trinta e quatro pacientes (35 joelhos foram submetidos a revisão de artroplastia total do joelho usando técnica "press-fit". Seguimento mínimo foi de um ano (média de 2,2 anos e máximo de três anos. RESULTADOS: Dos 34 pacientes, 20 foram mulheres e 14 foram homens. Houve um óbito por causa não relacionada a artroplastia e perda de seguimento de um paciente. Não houve nenhum caso em que fosse necessária nova revisão. Os pacientes que foram submetidos à revisão apresentaram melhora clínica e funcional demonstrado pelos resultados do KSS, resultados do questionário de qualidade de vida SF-36, através do ganho de amplitude de movimento e da melhora no alinhamento do membro. CONCLUSÃO: Houve melhora clínica e funcional no pós-operatório em relação ao pré-operatório na revisão de artroplastia total do Joelho com haste não cimentada "press-fit". Nível de Evidência IV, Série de casos.OBJECTIVE: To show our experience with press-fit cementless stem and metaphyseal fixation with cement in a selected series of patients who underwent revision total knee arthroplasty. METHODS: Thirty-four patients (35 knees underwent revision total knee arthroplasty using the press-fit technique. Minimum follow-up was one year (mean 2.2 years with a maximum length of three years. RESULTS: Of 34 patients, 20 were women and 14 were men. There was one death due to causes not related to arthroplasty and one patient dropout. There were no cases in which further review was necessary. Patients who underwent revision had clinical and functional improvement demonstrated by the results of the KSS, results of the SF-36 quality of life questionnaire, through gains in range of motion and improved limb alignment. CONCLUSION: There was postoperative

Better together: reduced compliance after sequential versus simultaneous bilateral hearing aids fitting.

Science.gov (United States)

Lavie, Limor; Banai, Karen; Attias, Joseph; Karni, Avi

2014-03-01

The purpose of this study was to determine the effects of sequential versus simultaneous bilateral hearing aids fitting on patient compliance. Thirty-six older adults with hearing impairment participated in this study. Twelve were fitted with bilateral hearing aids simultaneously. The remaining participants were fitted sequentially: One hearing aid (to the left or to the right ear) was used initially; 1 month later, the other ear was also fitted with a hearing aid for bilateral use. Self-reports on usefulness and compliance were elicited after the first and second months of hearing aid use. In addition, the number of hours the hearing aids were used was extracted from the data loggings of each device. Simultaneous fitting resulted in high levels of compliance and consistent usage throughout the study period. Sequential fitting resulted in abrupt reduction in compliance and hours of use once the second hearing aid was added, both in the clinical scoring and in the data loggings. Simultaneous fitting of bilateral hearing aids results in better compliance compared with sequential fitting. The addition of a second hearing aid after a relatively short period of monaural use may lead to inconsistent use of both hearing aids.

The relationship between sustained attention and aerobic fitness in a group of young adults

Directory of Open Access Journals (Sweden)

Luis F. Ciria

2017-09-01

Full Text Available Background A growing set of studies has shown a positive relationship between aerobic fitness and a broad array of cognitive functions. However, few studies have focused on sustained attention, which has been considered a fundamental cognitive process that underlies most everyday activities. The purpose of this study was to investigate the role of aerobic fitness as a key factor in sustained attention capacities in young adults. Methods Forty-four young adults (18–23 years were divided into two groups as a function of the level of aerobic fitness (high-fit and low-fit. Participants completed the Psychomotor Vigilance Task (PVT and an oddball task where they had to detect infrequent targets presented among frequent non-targets. Results The analysis of variance (ANOVA showed faster responses for the high-fit group than for the low-fit group in the PVT, replicating previous accounts. In the oddball task, the high-fit group maintained their accuracy (ACC rate of target detection over time, while the low-fit group suffered a significant decline of response ACC throughout the task. Discussion Importantly, the results show that the greater sustained attention capacity of high-fit young adults is not specific to a reaction time (RT sustained attention task like the PVT, but it is also evident in an ACC oddball task. In sum, the present findings point to the important role of aerobic fitness on sustained attention capacities in young adults.

Autism as the Low-Fitness Extreme of a Parentally Selected Fitness Indicator.

Science.gov (United States)

Shaner, Andrew; Miller, Geoffrey; Mintz, Jim

2008-12-01

Siblings compete for parental care and feeding, while parents must allocate scarce resources to those offspring most likely to survive and reproduce. This could cause offspring to evolve traits that advertise health, and thereby attract parental resources. For example, experimental evidence suggests that bright orange filaments covering the heads of North American coot chicks may have evolved for this fitness-advertising purpose. Could any human mental disorders be the equivalent of dull filaments in coot chicks-low-fitness extremes of mental abilities that evolved as fitness indicators? One possibility is autism. Suppose that the ability of very young children to charm their parents evolved as a parentally selected fitness indicator. Young children would vary greatly in their ability to charm parents, that variation would correlate with underlying fitness, and autism could be the low-fitness extreme of this variation. This view explains many seemingly disparate facts about autism and leads to some surprising and testable predictions.

Combined effects of water, nutrient, and UV-B stress on female fitness in Brassica (Brassicaceae)

International Nuclear Information System (INIS)

Conner, J.K.; Zangori, L.A.

1998-01-01

Our knowledge of the effects of increased levels of ultraviolet-B radiation (UV-B) on plant fitness is limited mainly to yield studies in a few crop species. Previous greenhouse and garden studies of Brassica have found greater detrimental effects of UV-B on fitness in gardens than in the greenhouse, suggesting the possibility that additional stresses in the field decrease the ability of Brassica to cope with UV-B. Possible interactions between UV-B and water/nutrient stress in determining plant fitness have rarely, if ever, been studied experimentally. Here we report measurements of female fitness in two species of Brassica in an experiment in which both UV-B and levels of water and nutrients were varied in a 2 X 2 factorial design. Water and nutrient stress reduced female fitness in both species, while UV-B caused fitness reductions in only one of the species. There was evidence for interactions between UV-B and water/nutrient stress for only a few of the traits measured; most traits, including those closely related to fitness, showed no evidence of an interaction

Is the Universe More Transparent to Gamma Rays than Previously Thought?

Science.gov (United States)

Stecker, Floyd W.; Scully, Sean T.

2009-01-01

The MAGIC collaboration has recently reported the detection of the strong gamma-ray blazar 3C279 during a 1-2 day flare. They have used their spectral observations to draw conclusions regarding upper limits on the opacity of the Universe to high energy gamma-rays and, by implication, upper limits on the extragalactic mid-infrared background radiation. In this paper we examine the effect of gamma-ray absorption by the extragalactic infrared radiation on intrinsic spectra for this blazar and compare our results with the observational data on 3C279. We find agreement with our previous results, contrary to the recent assertion of the MAGIC group that the Universe is more transparent to gamma-rays than our calculations indicate. Our analysis indicates that in the energy range between approx. 80 and approx. 500 GeV, 3C279 has a best-fit intrinsic spectrum with a spectral index approx. 1.78 using our fast evolution model and approx. 2.19 using our baseline model. However, we also find that spectral indices in the range of 1.0 to 3.0 are almost as equally acceptable as the best fit spectral indices. Assuming the same intrinsic spectral index for this flare as for the 1991 flare from 3C279 observed by EGRET, viz., 2.02, which lies between our best fit indeces, we estimate that the MAGIC flare was approx.3 times brighter than the EGRET flare observed 15 years earlier.

Weighted fit of parametric functions to distributions: The new interface of HOBOOK with MINUIT

International Nuclear Information System (INIS)

Lessner, E.S.

1989-08-01

The fitting routines of the HBOOK package allow weighted fit of parametric functions to the contents of a one, two or N-dimensional distribution, and analysis of the function in the neighborhood of its minimum, through an interface with the MINUIT package. These routines have been rewritten so as to interface the new version of MINUIT and to allow for smooth transitions to future versions of both packages. We discuss the interface and its capabilities: it is more stable than the previous version and presents a more accurate error analysis. The fitting algorithm is based on the Fletcher method, known for its reliability. Exponential, Gaussian and polynomial fitting are provided, as well as arbitrary user-defined fitting, to one, two and N-dimensional distributions. For the latter, the user is required to provide a smooth parametric function and is given the ability to guide the algorithm in finding the desired minimum. Examples are given. 6 refs., 1 fig

The association between aerobic fitness and language processing in children: implications for academic achievement.

Science.gov (United States)

Scudder, Mark R; Federmeier, Kara D; Raine, Lauren B; Direito, Artur; Boyd, Jeremy K; Hillman, Charles H

2014-06-01

Event-related brain potentials (ERPs) have been instrumental for discerning the relationship between children's aerobic fitness and aspects of cognition, yet language processing remains unexplored. ERPs linked to the processing of semantic information (the N400) and the analysis of language structure (the P600) were recorded from higher and lower aerobically fit children as they read normal sentences and those containing semantic or syntactic violations. Results revealed that higher fit children exhibited greater N400 amplitude and shorter latency across all sentence types, and a larger P600 effect for syntactic violations. Such findings suggest that higher fitness may be associated with a richer network of words and their meanings, and a greater ability to detect and/or repair syntactic errors. The current findings extend previous ERP research explicating the cognitive benefits associated with greater aerobic fitness in children and may have important implications for learning and academic performance. Published by Elsevier Inc.

The Fitness Consequences of Aneuploidy Are Driven by Condition-Dependent Gene Effects

Science.gov (United States)

Sunshine, Anna B.; Payen, Celia; Ong, Giang T.; Liachko, Ivan; Tan, Kean Ming; Dunham, Maitreya J.

2015-01-01

Aneuploidy is a hallmark of tumor cells, and yet the precise relationship between aneuploidy and a cell’s proliferative ability, or cellular fitness, has remained elusive. In this study, we have combined a detailed analysis of aneuploid clones isolated from laboratory-evolved populations of Saccharomyces cerevisiae with a systematic, genome-wide screen for the fitness effects of telomeric amplifications to address the relationship between aneuploidy and cellular fitness. We found that aneuploid clones rise to high population frequencies in nutrient-limited evolution experiments and show increased fitness relative to wild type. Direct competition experiments confirmed that three out of four aneuploid events isolated from evolved populations were themselves sufficient to improve fitness. To expand the scope beyond this small number of exemplars, we created a genome-wide collection of >1,800 diploid yeast strains, each containing a different telomeric amplicon (Tamp), ranging in size from 0.4 to 1,000 kb. Using pooled competition experiments in nutrient-limited chemostats followed by high-throughput sequencing of strain-identifying barcodes, we determined the fitness effects of these >1,800 Tamps under three different conditions. Our data revealed that the fitness landscape explored by telomeric amplifications is much broader than that explored by single-gene amplifications. As also observed in the evolved clones, we found the fitness effects of most Tamps to be condition specific, with a minority showing common effects in all three conditions. By integrating our data with previous work that examined the fitness effects of single-gene amplifications genome-wide, we found that a small number of genes within each Tamp are centrally responsible for each Tamp’s fitness effects. Our genome-wide Tamp screen confirmed that telomeric amplifications identified in laboratory-evolved populations generally increased fitness. Our results show that Tamps are mutations that

The fitness consequences of aneuploidy are driven by condition-dependent gene effects.

Directory of Open Access Journals (Sweden)

Anna B Sunshine

2015-05-01

Full Text Available Aneuploidy is a hallmark of tumor cells, and yet the precise relationship between aneuploidy and a cell's proliferative ability, or cellular fitness, has remained elusive. In this study, we have combined a detailed analysis of aneuploid clones isolated from laboratory-evolved populations of Saccharomyces cerevisiae with a systematic, genome-wide screen for the fitness effects of telomeric amplifications to address the relationship between aneuploidy and cellular fitness. We found that aneuploid clones rise to high population frequencies in nutrient-limited evolution experiments and show increased fitness relative to wild type. Direct competition experiments confirmed that three out of four aneuploid events isolated from evolved populations were themselves sufficient to improve fitness. To expand the scope beyond this small number of exemplars, we created a genome-wide collection of >1,800 diploid yeast strains, each containing a different telomeric amplicon (Tamp, ranging in size from 0.4 to 1,000 kb. Using pooled competition experiments in nutrient-limited chemostats followed by high-throughput sequencing of strain-identifying barcodes, we determined the fitness effects of these >1,800 Tamps under three different conditions. Our data revealed that the fitness landscape explored by telomeric amplifications is much broader than that explored by single-gene amplifications. As also observed in the evolved clones, we found the fitness effects of most Tamps to be condition specific, with a minority showing common effects in all three conditions. By integrating our data with previous work that examined the fitness effects of single-gene amplifications genome-wide, we found that a small number of genes within each Tamp are centrally responsible for each Tamp's fitness effects. Our genome-wide Tamp screen confirmed that telomeric amplifications identified in laboratory-evolved populations generally increased fitness. Our results show that Tamps are

Improved parametric fits for the HeH2 ab initio energy surface

International Nuclear Information System (INIS)

Muchnick, P.

1992-01-01

A brief history of the development of ab initio calculations for the HeH 2 quasi-molecule energy surface, and the parametric fits to these ab initio calculations, is presented. The concept of 'physical reasonableness' of the parametric fit is discussed. Several new improved parametric fits for the energy surface, meeting these requirements, are then proposed. One fit extends the Russek-Garcia parametric fit for the deep repulsion region to include r-dependent parameters, resulting in a more physically reasonable fit with smaller average error. This improved surface fit is applied to quasi-elastic collisions of He on H 2 in the impulse approximation. Previous classical calculations of the scaled inelastic vibrorotational excitation energy distributions are improved with this more accurate parametric fit of the energy surface and with the incorporation of quantum effects in vibrational excitation. It is shown that Sigmund's approach in developing his scaling law is incomplete in the contribution of the three-body interactions to vibrational excitation of the H 2 molecule is concerned. The Sigmund theory is extended to take into account for r-dependency of three-body interactions. A parametric fit for the entire energy surface from essentially 0 ≤R≤∞ and 1.2≤r≤1.6 a.u., where R is the intermolecular spacing and r is the hydrogen bonding length, is also presented. This fit is physically reasonable in all asymptotic limits. This first, full surface parametric fit is based primarily upon a composite of ab initio studies by Russek and Garcia and Meyer, Hariharan and Kutzelnigg. Parametric fits for the H 2 (1sσ g ) 2 , H 2 + (1sσ g ), H 2 + (2pσ u ) and (LiH 2 ) + energy surfaces are also presented. The new parametric fits for H 2 , H 2 + (1sσ g ) are shown to be improvements over the well-known Morse potentials for these surfaces

Acute hepatitis B virus infection with simultaneous high HBsAg and high anti-HBs signals in a previously HBV vaccinated HIV-1 positive patient.

Science.gov (United States)

van Dommelen, Laura; Verbon, Annelies; van Doorn, H Rogier; Goossens, Valère J

2010-03-01

We present a case of a clinical manifest hepatitis B virus infection and a potentially misleading HBV serological profile in an HIV-1 positive patient despite previous HBV vaccination. The patient presented with an acute hepatitis B and there was no indication of chronic HBV infection or the presence of a mutation in the 'a' determinant. Remarkably, simultaneously with high HBV surface antigen and HBV viral load, high anti-HBs antibodies were present. If, due to previous HBV vaccination only anti-HBs was tested in this patient, the result of the high anti-HBs antibodies could be very misleading and offering a false sense of security. Our findings contribute to the ongoing discussion on how to assess HBV specific immunological memory and determining the role of HBV booster vaccinations in immunocompromised individuals.

Five adjustable parameter fit of quark and lepton masses and mixings

International Nuclear Information System (INIS)

Nielsen, H.B.; Takanishi, Y.

2002-05-01

We develop a model of ours fitting the quark and lepton masses and mixing angles by removing from the model a Higgs field previously introduced to organise a large atmospheric mixing angle for neutrino oscillations. Due to the off-diagonal elements dominating in the see-saw neutrino mass matrix the large atmospheric mixing angle comes essentially by itself. It turns out that we have now only five adjustable Higgs field vacuum expectation values needed to fit all the masses and mixings order of magnitudewise taking into account the renormalisation group runnings in all sectors. The CHOOZ angle comes out close to the experimental bound. (orig.)

Linear time algorithms to construct populations fitting multiple constraint distributions at genomic scales.

Science.gov (United States)

Siragusa, Enrico; Haiminen, Niina; Utro, Filippo; Parida, Laxmi

2017-10-09

Computer simulations can be used to study population genetic methods, models and parameters, as well as to predict potential outcomes. For example, in plant populations, predicting the outcome of breeding operations can be studied using simulations. In-silico construction of populations with pre-specified characteristics is an important task in breeding optimization and other population genetic studies. We present two linear time Simulation using Best-fit Algorithms (SimBA) for two classes of problems where each co-fits two distributions: SimBA-LD fits linkage disequilibrium and minimum allele frequency distributions, while SimBA-hap fits founder-haplotype and polyploid allele dosage distributions. An incremental gap-filling version of previously introduced SimBA-LD is here demonstrated to accurately fit the target distributions, allowing efficient large scale simulations. SimBA-hap accuracy and efficiency is demonstrated by simulating tetraploid populations with varying numbers of founder haplotypes, we evaluate both a linear time greedy algoritm and an optimal solution based on mixed-integer programming. SimBA is available on http://researcher.watson.ibm.com/project/5669.

Cardiovascular Fitness is Associated with Altered Cortical Glucose Metabolism During Working Memory in ε4 Carriers

Science.gov (United States)

Deeny, Sean P.; Winchester, Jeanna; Nichol, Kathryn; Roth, Stephen M.; Wu, Joseph C.; Dick, Malcolm; Cotman, Carl W.

2012-01-01

Background The possibility that ε4 may modulate the effects of fitness in the brain remains controversial. The present exploratory FDG-PET study aimed to better understand the relationship among ε4, fitness and cerebral metabolism in 18 healthy aged females (9 Carriers, 9 Non-carriers) during working memory. Methods Participants underwent VO2 max, CVLT and FDG-PET, collected at rest and during completion of the Sternberg Working Memory Task. Results Resting FDG-PET did not differ between carriers and non-carriers. Significant effects of fitness on FDG-PET during working memory was noted in the ε4 carriers only. High Fit ε4 carriers had greater glucose uptake than the Low Fit in the temporal lobe, but Low Fit had greater glucose uptake in the frontal and parietal lobes. Conclusion(s) We demonstrate that fitness differentially affects cerebral metabolism in ε4 carriers only, consistent with previous findings that the effects of fitness may be more pronounced in populations genetically at risk for cognitive decline. PMID:22226798

Cardiovascular fitness is associated with altered cortical glucose metabolism during working memory in ɛ4 carriers.

Science.gov (United States)

Deeny, Sean P; Winchester, Jeanna; Nichol, Kathryn; Roth, Stephen M; Wu, Joseph C; Dick, Malcolm; Cotman, Carl W

2012-07-01

The possibility that ɛ4 may modulate the effects of fitness in the brain remains controversial. The present exploratory FDG-PET study aimed to better understand the relationship among ɛ4, fitness, and cerebral metabolism in 18 healthy aged women (nine carriers, nine noncarriers) during working memory. Participants were evaluated using maximal level of oxygen consumption, California Verbal Learning Test, and FDG-PET, which were collected at rest and during completion of the Sternberg working memory task. Resting FDG-PET did not differ between carriers and noncarriers. Significant effects of fitness on FDG-PET during working memory were noted in the ɛ4 carriers only. High fit ɛ4 carriers had greater glucose uptake in the temporal lobe than the low fit ɛ4 carriers, but low fit ɛ4 carriers had greater glucose uptake in the frontal and parietal lobes. We demonstrate that fitness differentially affects cerebral metabolism in ɛ4 carriers only, consistent with previous findings that the effects of fitness may be more pronounced in populations genetically at risk for cognitive decline. Published by Elsevier Inc.

Passerine birds breeding under chronic noise experience reduced fitness.

Directory of Open Access Journals (Sweden)

Julia Schroeder

Full Text Available BACKGROUND: Fitness in birds has been shown to be negatively associated with anthropogenic noise, but the underlying mechanisms remain obscure. It is however crucial to understand the mechanisms of how urban noise impinges on fitness to obtain a better understanding of the role of chronic noise in urban ecology. Here, we examine three hypotheses on how noise might reduce reproductive output in passerine birds: (H1 by impairing mate choice, (H2 by reducing territory quality and (H3 by impeding chick development. METHODOLOGY/PRINCIPAL FINDINGS: We used long-term data from an island population of house sparrows, Passer domesticus, in which we can precisely estimate fitness. We found that nests in an area affected by the noise from large generators produced fewer young, of lower body mass, and fewer recruits, even when we corrected statistically for parental genetic quality using a cross-fostering set-up, supporting H3. Also, individual females provided their young with food less often when they bred in the noisy area compared to breeding attempts by the same females elsewhere. Furthermore, we show that females reacted flexibly to increased noise levels by adjusting their provisioning rate in the short term, which suggests that noise may be a causal factor that reduces reproductive output. We rejected H1 and H2 because nestbox occupancy, parental body mass, age and reproductive investment did not differ significantly between noisy and quiet areas. CONCLUSIONS/SIGNIFICANCE: OUR RESULTS SUGGEST A PREVIOUSLY UNDESCRIBED MECHANISM TO EXPLAIN HOW ENVIRONMENTAL NOISE CAN REDUCE FITNESS IN PASSERINE BIRDS: by acoustically masking parent-offspring communication. More importantly, using a cross-fostering set-up, our results demonstrate that birds breeding in a noisy environment experience significant fitness costs. Chronic noise is omnipresent around human habitation and may produces similar fitness consequences in a wide range of urban bird species.

Function's evaluation, perfusion and metabolism by positron emission tomography associated with multislice tomography (PET/CT) in patient with previous diagnosis to myocardial necrosis

International Nuclear Information System (INIS)

Campisi, Roxana; Aramayo, Natalia; Osorio, Amilcar

2010-01-01

A 64-years-old male patient with previous diagnosis of myocardial necrosis as assessed by myocardial perfusion gated single photon emission computed tomography (gSPECT) with 3-vessel-disease, left ventricular dysfunction and symptomatic by epigastric pain. The patient was referred for myocardial viability assessment by positron emission tomography (PET) to define clinical management decision. (authors) [es

Draft Genome Sequence of Lactobacillus delbrueckii Strain #22 Isolated from a Patient with Short Bowel Syndrome and Previous d-Lactic Acidosis and Encephalopathy.

Science.gov (United States)

Domann, Eugen; Fischer, Florence; Glowatzki, Fabian; Fritzenwanker, Moritz; Hain, Torsten; Zechel-Gran, Silke; Giffhorn-Katz, Susanne; Neubauer, Bernd A

2016-07-28

d-Lactic acidosis with associated encephalopathy caused by overgrowth of intestinal lactic acid bacteria is a rarely diagnosed neurological complication of patients with short bowel syndrome. Here, we report the draft genome sequence of Lactobacillus delbrueckii strain #22 isolated from a patient with short bowel syndrome and previous d-lactic acidosis/encephalopathy. Copyright © 2016 Domann et al.

Effects of a 6-Week Aquatic Treadmill Exercise Program on Cardiorespiratory Fitness and Walking Endurance in Subacute Stroke Patients: A PILOT TRIAL.

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Han, Eun Young; Im, Sang Hee

2017-03-15

To assess the feasibility and safety of a 6-week course of water walking performed using a motorized aquatic treadmill in individuals with subacute stroke for cardiorespiratory fitness, walking endurance, and activities of daily living. Twenty subacute stroke patents were randomly assigned to aquatic treadmill exercise (ATE) or land-based exercise (LBE). The ATE group (n = 10) performed water-based aerobic exercise on a motorized aquatic treadmill, and the LBE group (n = 10) performed land-based aerobic exercise on a cycle ergometer. Both groups performed aerobic exercise for 30 minutes, 5 times per week for 6 weeks. Primary outcome measures were 6-minute walk test for walking endurance and cardiopulmonary fitness parameters of a symptom-limited exercise tolerance test, and secondary measures were Korean version of the Modified Barthel Index (K-MBI) for activities of daily living. All variables were assessed at baseline and at the end of the intervention. The ATE group showed significant improvements in 6-minute walk test (P = .005), peak oxygen uptake (V·o2peak; P = .005), peak heart rate (P = .007), exercise tolerance test duration (P = .005), and K-MBI (P = .008). The LBE group showed a significant improvement only in K-MBI (P = .012). In addition, improvement in V·o2peak was greater in the ATE than in the LBE group. This preliminary study showed that a 6-week ATE program improved peak aerobic capacity and walking endurance in patients with subacute stroke. The improvement in V·o2peak after an ATE exercise program was greater than that observed after an LBE program. Therefore, ATE effectively improves cardiopulmonary fitness in patients with subacute stroke.

Limitations of inclusive fitness.

Science.gov (United States)

Allen, Benjamin; Nowak, Martin A; Wilson, Edward O

2013-12-10

Until recently, inclusive fitness has been widely accepted as a general method to explain the evolution of social behavior. Affirming and expanding earlier criticism, we demonstrate that inclusive fitness is instead a limited concept, which exists only for a small subset of evolutionary processes. Inclusive fitness assumes that personal fitness is the sum of additive components caused by individual actions. This assumption does not hold for the majority of evolutionary processes or scenarios. To sidestep this limitation, inclusive fitness theorists have proposed a method using linear regression. On the basis of this method, it is claimed that inclusive fitness theory (i) predicts the direction of allele frequency changes, (ii) reveals the reasons for these changes, (iii) is as general as natural selection, and (iv) provides a universal design principle for evolution. In this paper we evaluate these claims, and show that all of them are unfounded. If the objective is to analyze whether mutations that modify social behavior are favored or opposed by natural selection, then no aspect of inclusive fitness theory is needed.

Shunt malfunction causing acute neurological deterioration in 2 patients with previously asymptomatic Chiari malformation Type I. Report of two cases.

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Elliott, Robert; Kalhorn, Stephen; Pacione, Donato; Weiner, Howard; Wisoff, Jeffrey; Harter, David

2009-08-01

Patients with symptomatic Chiari malformation Type I (CM-I) typically exhibit a chronic, slowly progressive disease course with evolution of symptoms. However, some authors have reported acute neurological deterioration in the setting of CM-I and acquired Chiari malformations. Although brainstem dysfunction has been documented in patients with CM-II and hydrocephalus or shunt malfunction, to the authors' knowledge only 1 report describing ventriculoperitoneal (VP) shunt malfunction causing neurological deterioration in a patient with CM-I exists. The authors report on their experience with the treatment of previously asymptomatic CM-I in 2 children who experienced quite different manifestations of acute neurological deterioration secondary to VP shunt malfunction. Presumably, VP shunt malfunction created a positive rostral pressure gradient across a stenotic foramen magnum, resulting in tetraparesis from foramen magnum syndrome in 1 patient and acute ataxia and cranial nerve deficits from syringobulbia in the other. Although urgent shunt revisions yielded partial recovery of neurological function in both patients, marked improvement occurred only after posterior fossa decompression.

Getting CSR communication fit

DEFF Research Database (Denmark)

Schmeltz, Line

2017-01-01

Companies experience increasing legal and societal pressure to communicate about their corporate social responsibility (CSR) engagements from a number of different publics. One very important group is that of young consumers who are predicted to be the most important and influential consumer group...... in the near future. From a value- theoretical base, this article empirically explores the role and applicability of ‘fit’ in strategic CSR communication targeted at young consumers. Point of departure is taken in the well-known strategic fit (a logical link between a company’s CSR commitment and its core...... values) and is further developed by introducing two additional fits, the CSR- Consumer fit and the CSR-Consumer-Company fit (Triple Fit). Through a sequential design, the three fits are empirically tested and their potential for meeting young consumers’ expectations for corporate CSR messaging...

Automated ligand fitting by core-fragment fitting and extension into density

International Nuclear Information System (INIS)

Terwilliger, Thomas C.; Klei, Herbert; Adams, Paul D.; Moriarty, Nigel W.; Cohn, Judith D.

2006-01-01

An automated ligand-fitting procedure has been developed and tested on 9327 ligands and (F o − F c )exp(iϕ c ) difference density from macromolecular structures in the Protein Data Bank. A procedure for fitting of ligands to electron-density maps by first fitting a core fragment of the ligand to density and then extending the remainder of the ligand into density is presented. The approach was tested by fitting 9327 ligands over a wide range of resolutions (most are in the range 0.8-4.8 Å) from the Protein Data Bank (PDB) into (F o − F c )exp(iϕ c ) difference density calculated using entries from the PDB without these ligands. The procedure was able to place 58% of these 9327 ligands within 2 Å (r.m.s.d.) of the coordinates of the atoms in the original PDB entry for that ligand. The success of the fitting procedure was relatively insensitive to the size of the ligand in the range 10–100 non-H atoms and was only moderately sensitive to resolution, with the percentage of ligands placed near the coordinates of the original PDB entry for fits in the range 58–73% over all resolution ranges tested

Patterns and Determinants of Treatment Seeking among Previously Untreated Psychotic Patients in Aceh Province, Indonesia: A Qualitative Study

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Marthoenis Marthoenis

2016-01-01

Full Text Available Immediate treatment of first-episode psychosis is essential in order to achieve a positive outcome. However, Indonesian psychiatric patients often delay accessing health services, the reason for which is not yet fully understood. The current study aimed to understand patterns of treatment seeking and to reveal determinants of the delay in accessing psychiatric care among first-time user psychotic patients. Qualitative interviews were conducted with sixteen family members who accompanied the patients to a psychiatric hospital. Many families expressed beliefs that mental illness appertains to village sickness and not hospital sickness; therefore, they usually take the patients to traditional or religious healers before taking them to a health professional. They also identified various factors that potentially delay accessing psychiatric treatment: low literacy and beliefs about the cause of the illness, stigmatisation, the role of extended family, financial problems, and long distance to the psychiatric hospital. On the other hand, the family mentioned various factors related to timely help seeking, including being a well-educated family, living closer to health facilities, previous experience of successful psychotic therapy, and having more positive symptoms of psychosis. The findings call for mental health awareness campaigns in the community.

Validity and reliability of self-assessed physical fitness using visual analogue scales

DEFF Research Database (Denmark)

Strøyer, Jesper; Essendrop, Morten; Jensen, Lone Donbaek

2007-01-01

To test the validity and reliability of self-assessed physical fitness samples included healthcare assistants working at a hospital (women=170, men=17), persons working with physically and mentally handicapped patients (women=530, men= 123), and two separate groups of healthcare students (a) women...... except for flexibility among men. The reliability was moderate to good (ICC = .62 - .80). Self-assessed aerobic fitness, muscle strength, and flexibility showed moderate construct validity and moderate to good reliability using visual analogues.......=91 and men=5 and (b) women=159 and men=10. Five components of physical fitness were self-assessed by Visual Analogue Scales with illustrations and verbal anchors for the extremes: aerobic fitness, muscle strength, endurance, flexibility, and balance. Convergent and divergent validity were evaluated...

A review of cardiorespiratory fitness-related neuroplasticity in the aging brain

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Scott M Hayes

2013-07-01

Full Text Available The literature examining the relationship between cardiorespiratory fitness and the brain in older adults has increased rapidly, with 30 of 34 studies published since 2008. Here we review cross-sectional and exercise intervention studies in older adults examining the relationship between cardiorespiratory fitness and brain structure and function, typically assessed using Magnetic Resonance Imaging (MRI. Studies of patients with Alzheimer’s disease are discussed when available. The structural MRI studies revealed a consistent positive relationship between cardiorespiratory fitness and brain volume in cortical regions including anterior cingulate, lateral prefrontal, and lateral parietal cortex. Support for a positive relationship between cardiorespiratory fitness and medial temporal lobe volume was less consistent, although evident when a region-of-interest approach was implemented. In fMRI studies, cardiorespiratory fitness in older adults was associated with activation in similar regions as those identified in the structural studies, including anterior cingulate, lateral prefrontal, and lateral parietal cortex, despite heterogeneity among the functional tasks implemented. This comprehensive review highlights the overlap in brain regions showing a positive relationship with cardiorespiratory fitness in both structural and functional imaging modalities. The findings suggest that aerobic exercise and cardiorespiratory fitness contribute to healthy brain aging, although additional studies in Alzheimer’s disease are needed.

Childhood cardiorespiratory fitness, muscular fitness and adult measures of glucose homeostasis.

Science.gov (United States)

Fraser, Brooklyn J; Blizzard, Leigh; Schmidt, Michael D; Juonala, Markus; Dwyer, Terence; Venn, Alison J; Magnussen, Costan G

2018-02-14

To assess whether childhood cardiorespiratory fitness (CRF) and muscular fitness phenotypes (strength, power, endurance) predict adult glucose homeostasis measures. Prospective longitudinal study. Study examining participants who had physical fitness measured in childhood (aged 7-15 years) and who attended follow-up clinics approximately 20 years later and provided a fasting blood sample which was tested for glucose and insulin. Physical fitness measurements included muscular strength (right and left grip, shoulder flexion, shoulder and leg extension), power (standing long jump distance) and endurance (number of push-ups in 30s), and CRF (1.6km run duration). In adulthood, fasting glucose and insulin levels were used to derive glucose homeostasis measures of insulin resistance (HOMA2-IR) and beta cell function (HOMA2-β). A standard deviation increase in childhood CRF or muscular strength (males) was associated with fasting glucose (CRF: β=-0.06mmol/L), fasting insulin (CRF: β=-0.73mU/L; strength: β=-0.40mU/L), HOMA2-IR (CRF: β=-0.06; strength: β=-0.05) and HOMA2-β (CRF: β=-3.06%; strength: β=-2.62%) in adulthood, independent of the alternative fitness phenotype (all p0.06). CRF and muscular fitness in childhood were inversely associated with measures of fasting insulin, insulin resistance and beta cell function in adulthood. Childhood CRF and muscular fitness could both be potential independent targets for strategies to help reduce the development of adverse glucose homeostasis. Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Acute hepatitis B virus infection with simultaneous high HBsAg and high anti-HBs signals in a previously HBV vaccinated HIV-1 positive patient

NARCIS (Netherlands)

van Dommelen, Laura; Verbon, Annelies; van Doorn, H. Rogier; Goossens, Valère J.

2010-01-01

We present a case of a clinical manifest hepatitis B virus infection and a potentially misleading HBV serological profile in an HIV-1 positive patient despite previous HBV vaccination. The patient presented with an acute hepatitis B and there was no indication of chronic HBV infection or the

Metastatic papillary carcinoma of the thyroid in a patient previously ...

African Journals Online (AJOL)

Incidental papillary carcinoma of the thyroid in patients treated surgically for benign thyroid diseases including Graves' disease is a known phenomenon. However, the management of these patients remains an issue of concern and controversy for those who care for them. We report a case of metastatic paillary carcinoma of ...

Left ventricular asynergy score as an indicator of previous myocardial infarction

International Nuclear Information System (INIS)

Backman, C.; Jacobsson, K.A.; Linderholm, H.; Osterman, G.

1986-01-01

Sixty-eight patients with coronary heart disease (CHD) i.e. a hisotry of angina of effort and/or previous 'possible infarction' were examined inter alia with ECG and cinecardioangiography. A system of scoring was designed which allowed a semiquantitative estimate of the left ventricular asynergy from cinecardioangiography - the left ventricular motion score (LVMS). The LVMS was associated with the presence of a previous myocardial infarction (MI), as indicated by the history and ECG findings. The ECG changes specific for a previous MI were associated with high LVMS values and unspecific or absent ECG changes with low LVMS values. Decision thresholds for ECG changes and asynergy in diagnosing a previous MI were evaluated by means of a ROC analysis. The accuracy of ECG in detecting a previous MI was slightly higher when asynergy indicated a 'true MI' than when autopsy result did so in a comparable group. Therefore the accuracy of asynergy (LVMS ≥ 1) in detecting a previous MI or myocardial fibrosis in patients with CHD should be at least comparable with that of autopsy (scar > 1 cm). (orig.)

Induced-fit Mechanism for Prolyl Endopeptidase

Energy Technology Data Exchange (ETDEWEB)

Li, Min; Chen, Changqing; Davies, David R.; Chiu, Thang K. (NIH); (LSU); (Chinese Aca. Sci.)

2010-11-15

Prolyl peptidases cleave proteins at proline residues and are of importance for cancer, neurological function, and type II diabetes. Prolyl endopeptidase (PEP) cleaves neuropeptides and is a drug target for neuropsychiatric diseases such as post-traumatic stress disorder, depression, and schizophrenia. Previous structural analyses showing little differences between native and substrate-bound structures have suggested a lock-and-key catalytic mechanism. We now directly demonstrate from seven structures of Aeromonus punctata PEP that the mechanism is instead induced fit: the native enzyme exists in a conformationally flexible opened state with a large interdomain opening between the {beta}-propeller and {alpha}/{beta}-hydrolase domains; addition of substrate to preformed native crystals induces a large scale conformational change into a closed state with induced-fit adjustments of the active site, and inhibition of this conformational change prevents substrate binding. Absolute sequence conservation among 28 orthologs of residues at the active site and critical residues at the interdomain interface indicates that this mechanism is conserved in all PEPs. This finding has immediate implications for the use of conformationally targeted drug design to improve specificity of inhibition against this family of proline-specific serine proteases.

Clinical observation of phacoemulsification in patients with previous trabeculectomy

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Li Li

2013-09-01

Full Text Available AIM: To observe the clinical effect of transparent corneal incision phacoemulsification in cataract patients who had undergone different kinds of glaucoma filtration surgeries.METHODS: Totally 43 cases(50 eyes, in which 23 patients with primary angle-closure glaucoma(group A, 26 eyesand 20 patients with primary open angle glaucoma(group B, 24 eyes, all had undergone glaucoma filtration surgery for more than 6 months. Visual acuity, intraocular pressure, slit lamp, gonioscope, corneal endothelial cell counts, etc., were done before surgery.And transparent corneal incision phacoemulsification combined with artificial lens implantation operation were preformed, postoperative follow-up of 3 to 12 months, visual acuity, intraocular pressure, corneal endothelial cell counts and vision field, etc. were observed and recorded.RESULTS: The visual acuity of 50 eyes(100%increased with different degree postoperatively, 41 eyes(82%with postoperative visual acuity ≥0.3; average preoperative intraocular pressure: group A 18.08±5.08mmHg(1mmHg=0.133kpa, group B 14.48±3.52mmHg; Postoperative follow-up average intraocular pressure: group A 13.65±3.51mmHg, group B 14.28±3.41 mmHg, intraocular pressure changed significantly pre and post-operation in group A(PP>0.05; Postoperative intraocular pressure of 1 eye in group A and 3 eyes in group B rose within three days post-operation, the intraocular pressure fluctuated between 21-33mmHg, with drug therapy and drug withdral when intraocular pressure epistrophy; Intraocular pressure was stable in the follow-up process.Corneal endothelial cell density: pre-operation group A was 2 293.57±352.24(cells/mm2, group B 2 658.14±458.69(cells/mm2, post- operation group A 2 175.95±379.16(cells/mm2, group B 2 442.97±477.30(cells/mm2, cell loss rate: 5.13% in group A, and 8.10% in group B. Postoperative visual acuity was related to vision field damage in patients, the more visual field damage, the longer the duration

Impacts of previous crops on Fusarium foot and root rot, and on yields of durum wheat in North West Tunisia

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Samia CHEKALI

2016-07-01

Full Text Available The impacts of ten previous crop rotations (cereals, legumes and fallow on Fusarium foot and root rot of durum wheat were investigated for three cropping seasons in a trial established in 2004 in Northwest Tunisia. Fungi isolated from the roots and stem bases were identified using morphological and molecular methods, and were primarily Fusarium culmorum and F. pseudograminearum. Under low rainfall conditions, the previous crop affected F. pseudograminearum incidence on durum wheat roots but not F. culmorum. Compared to continuous cropping of durum wheat, barley as a previous crop increased disease incidence more than fivefold, while legumes and fallow tended to reduce incidence.  Barley as a previous crop increased wheat disease severity by 47%, compared to other rotations. Grain yield was negatively correlated with the incidence of F. culmorum infection, both in roots and stem bases, and fitted an exponential model (R2 = -0.61 for roots and -0.77 for stem bases, P<0.0001. Fusarium pseudograminearum was also negatively correlated with yield and fitted an exponential model (R2 = -0.53 on roots and -0.71 on stem bases, P < 0.0001 but was not correlated with severity.

Bilateral Orchidopexy in a Hypochondriacal (Somatic Symptom Disorder) Patient and Determination of Fitness for Bilateral Orchidectomy.

Science.gov (United States)

Nwaopara, A U; Allagoa, Erefagha Leonardo P

2016-01-01

Introduction. DSM-5 identifies two disorders: somatic symptom disorder and illness anxiety disorder, to replace hypochondriasis in DSM-IV. Patients with both disorders are intensely anxious about the possibility of an undiagnosed illness or devote excessive time and energy to health concerns and are not easily reassured. Both disorders cause considerable distress and life disruption, even at moderate levels. However, hypochondriasis (DSM-IV) is an indication for neither orchidopexy nor orchidectomy. This is the rationale for this report which is the first of its kind to the best of available literature. This is an original case report of interest to a particular clinical specialty of mental health but it will have a broader clinical impact across medicine. Case Presentation. A 30-year-old black male presented to a primary care clinic with multiple internet searches on the topic of testicular pain and its differential diagnosis. He had a bilateral orchidopexy for a suspected torsion. He was referred to mental health unit, to determine fitness for further surgery. Conclusions. If hypochondriasis is suspected in a medical or surgical inpatient, a psychological medicine consultation should be performed, to elucidate the diagnosis, to avoid unnecessary procedures, and to optimize patient's care.

Drug-Induced QT Prolongation as a Result of an Escitalopram Overdose in a Patient with Previously Undiagnosed Congenital Long QT Syndrome

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Paul Singh

2014-01-01

Full Text Available We present a case of drug-induced QT prolongation caused by an escitalopram overdose in a patient with previously undiagnosed congenital LQTS. A 15-year-old Caucasian female presented following a suicide attempt via an escitalopram overdose. The patient was found to have a prolonged QT interval with episodes of torsades de pointes. The patient was admitted to the telemetry unit and treated. Despite the resolution of the torsades de pointes, she continued to demonstrate a persistently prolonged QT interval. She was seen by the cardiology service and diagnosed with congenital long QT syndrome. This case illustrates the potential for an escitalopram overdose to cause an acute QT prolongation in a patient with congenital LQTS and suggests the importance of a screening electrocardiogram prior to the initiation of SSRIs, especially in patients at high risk for QT prolongation.

Fitness: Tips for Staying Motivated

Science.gov (United States)

Healthy Lifestyle Fitness Fitness is for life. Motivate yourself with these practical tips. By Mayo Clinic Staff Have ... 27, 2015 Original article: http://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/fitness/art-20047624 . Mayo Clinic ...

FDA Approval: Ibrutinib for Patients with Previously Treated Mantle Cell Lymphoma and Previously Treated Chronic Lymphocytic Leukemia.

Science.gov (United States)

de Claro, R Angelo; McGinn, Karen M; Verdun, Nicole; Lee, Shwu-Luan; Chiu, Haw-Jyh; Saber, Haleh; Brower, Margaret E; Chang, C J George; Pfuma, Elimika; Habtemariam, Bahru; Bullock, Julie; Wang, Yun; Nie, Lei; Chen, Xiao-Hong; Lu, Donghao Robert; Al-Hakim, Ali; Kane, Robert C; Kaminskas, Edvardas; Justice, Robert; Farrell, Ann T; Pazdur, Richard

2015-08-15

On November 13, 2013, the FDA granted accelerated approval to ibrutinib (IMBRUVICA capsules; Pharmacyclics, Inc.) for the treatment of patients with mantle cell lymphoma (MCL) who have received at least one prior therapy. On February 12, 2014, the FDA granted accelerated approval for the treatment of patients with chronic lymphocytic leukemia (CLL) who have received at least one prior therapy. Ibrutinib is a first-in-class Bruton's tyrosine kinase (BTK) inhibitor that received all four expedited programs of the FDA: Fast-Track designation, Breakthrough Therapy designation, Priority Review, and Accelerated Approval. Both approvals were based on overall response rate (ORR) and duration of response (DOR) in single-arm clinical trials in patients with prior treatment. In MCL (N = 111), the complete and partial response rates were 17.1% and 48.6%, respectively, for an ORR of 65.8% [95% confidence interval (CI), 56.2%-74.5%]. The median DOR was 17.5 months (95% CI, 15.8-not reached). In CLL (N = 48), the ORR was 58.3% (95% CI, 43.2%-72.4%), and the DOR ranged from 5.6 to 24.2 months. The most common adverse reactions (≥ 30% in either trial) were thrombocytopenia, diarrhea, neutropenia, bruising, upper respiratory tract infection, anemia, fatigue, musculoskeletal pain, peripheral edema, and nausea. ©2015 American Association for Cancer Research.

A person-environment fit approach to volunteerism : Volunteer personality fit and culture fit as predictors of affective outcomes

NARCIS (Netherlands)

Van Vianen, Annelies E. M.; Nijstad, Bernard A.; Voskuijl, Olga F.

2008-01-01

This study employed a person-environment (P-E) fit approach to explaining volunteer satisfaction, affective commitment, and turnover intentions. It was hypothesized that personality fit would explain additional variance in volunteer affective outcomes above and beyond motives to volunteer. This

A person-environment fit approach to volunteerism: Volunteer personality-fit and culture-fit as predictors of affective outcomes

NARCIS (Netherlands)

van Vianen, A.E.M.; Nijstad, B.A.; Voskuijl, O.F.

2008-01-01

This study employed a person-environment (P-E) fit approach to explaining volunteer satisfaction, affective commitment, and turnover intentions. It was hypothesized that personality fit would explain additional variance in volunteer affective outcomes above and beyond motives to volunteer. This

Physical Fitness: Get Your Body Moving

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Competitive Fitness of Fluconazole-Resistant Clinical Candida albicans Strains.

Science.gov (United States)

Popp, Christina; Hampe, Irene A I; Hertlein, Tobias; Ohlsen, Knut; Rogers, P David; Morschhäuser, Joachim

2017-07-01

The pathogenic yeast Candida albicans can develop resistance to the widely used antifungal agent fluconazole, which inhibits ergosterol biosynthesis. Resistance is often caused by gain-of-function mutations in the transcription factors Mrr1 and Tac1, which result in constitutive overexpression of multidrug efflux pumps, and Upc2, which result in constitutive overexpression of ergosterol biosynthesis genes. However, the deregulated gene expression that is caused by hyperactive forms of these transcription factors also reduces the fitness of the cells in the absence of the drug. To investigate whether fluconazole-resistant clinical C. albicans isolates have overcome the fitness costs of drug resistance, we assessed the relative fitness of C. albicans isolates containing resistance mutations in these transcription factors in competition with matched drug-susceptible isolates from the same patients. Most of the fluconazole-resistant isolates were outcompeted by the corresponding drug-susceptible isolates when grown in rich medium without fluconazole. On the other hand, some resistant isolates with gain-of-function mutations in MRR1 did not exhibit reduced fitness under these conditions. In a mouse model of disseminated candidiasis, three out of four tested fluconazole-resistant clinical isolates did not exhibit a significant fitness defect. However, all four fluconazole-resistant isolates were outcompeted by the matched susceptible isolates in a mouse model of gastrointestinal colonization, demonstrating that the effects of drug resistance on in vivo fitness depend on the host niche. Collectively, our results indicate that the fitness costs of drug resistance in C. albicans are not easily remediated, especially when proper control of gene expression is required for successful adaptation to life within a mammalian host. Copyright © 2017 American Society for Microbiology.

Fitness Level Modulates Intraocular Pressure Responses to Strength Exercises.

Science.gov (United States)

Vera, Jesús; Jiménez, Raimundo; Redondo, Beatríz; Cárdenas, David; García-Ramos, Amador

2018-06-01

Purpose/Aim: The execution of strength exercises has demonstrated to increase the intraocular pressure (IOP) levels, and it may have a negative impact on the ocular health. We aimed to explore the influence of fitness level on the acute IOP response to strength exercises performed under different loading conditions, as well as to test whether the IOP responses differ between the bench press and jump squat when performed against the same relative loads. Forty military personnel males were divided in two subgroups (20 high-fit and 20 low-fit) based on their relative to body mass one-repetition maximum (1-RM). Participants performed an incremental loading test in the bench press and jump squat exercises, and IOP was assessed before and after each repetition by rebound tonometry. IOP increased immediately after executing both exercises (p e., high-fit and low-fit) and in both exercises (R 2 range: 0.81-1.00). Higher fitness level attenuated the IOP rise produced by both exercises (p < 0.01 in both cases). The bench press induced higher IOP increments than the jump squat for both groups at relative loads of ~50%1-RM and ~60%1-RM (p < 0.01 in all cases). These data indicate that IOP increases as a consequence of performing strength exercises, being the increment accentuated with the increase of the load and in the bench press compared to the jump squat exercise. Of special importance would be that the IOP responses were significantly reduced in high-fit individuals. These findings should be addressed in glaucoma patients.

The FITS model office ergonomics program: a model for best practice.

Science.gov (United States)

Chim, Justine M Y

2014-01-01

An effective office ergonomics program can predict positive results in reducing musculoskeletal injury rates, enhancing productivity, and improving staff well-being and job satisfaction. Its objective is to provide a systematic solution to manage the potential risk of musculoskeletal disorders among computer users in an office setting. A FITS Model office ergonomics program is developed. The FITS Model Office Ergonomics Program has been developed which draws on the legislative requirements for promoting the health and safety of workers using computers for extended periods as well as previous research findings. The Model is developed according to the practical industrial knowledge in ergonomics, occupational health and safety management, and human resources management in Hong Kong and overseas. This paper proposes a comprehensive office ergonomics program, the FITS Model, which considers (1) Furniture Evaluation and Selection; (2) Individual Workstation Assessment; (3) Training and Education; (4) Stretching Exercises and Rest Break as elements of an effective program. An experienced ergonomics practitioner should be included in the program design and implementation. Through the FITS Model Office Ergonomics Program, the risk of musculoskeletal disorders among computer users can be eliminated or minimized, and workplace health and safety and employees' wellness enhanced.

Direct fitness of group living mammals varies with breeding strategy, climate and fitness estimates.

Science.gov (United States)

Ebensperger, Luis A; Rivera, Daniela S; Hayes, Loren D

2012-09-01

1. Understanding how variation in fitness relates to variation in group living remains critical to determine whether this major aspect of social behaviour is currently adaptive. 2. Available evidence in social mammals aimed to examine this issue remains controversial. Studies show positive (i.e. potentially adaptive), neutral or even negative fitness effects of group living. 3. Attempts to explain this variation rely on intrinsic and extrinsic factors to social groups. Thus, relatively more positive fitness effects are predicted in singularly breeding as opposed to plural breeding species. Fitness effects of sociality in turn may depend on ecological conditions (i.e. extrinsic factors) that influence associated benefits and costs. 4. We used meta-analytic tools to review how breeding strategy or ecological conditions influence the effect size associated with direct fitness-sociality relationships reported in the mammalian literature. Additionally, we determined how taxonomic affiliation of species studied, different fitness and sociality measures used, and major climatic conditions of study sites explained any variation in direct fitness effect size. 5. We found group living had modest, yet positive effects on direct fitness. This generally adaptive scenario was contingent not only upon breeding strategy and climate of study sites, but also on fitness measures examined. Thus, positive and significant effects characterized singular as opposed to plural breeding strategies. 6. We found more positive fitness effects on studies conducted in tropical as opposed to temperate or arid climates. More positive and significant effects were noted on studies that relied on group fecundity, male fecundity and offspring survival as measures of fitness. 7. To conclude, direct fitness consequences of mammalian group living are driven by interspecific differences in breeding strategy and climate conditions. Other factors not examined in this study, namely individual variation in

Long work hours and physical fitness: 30-year risk of ischaemic heart disease and all-cause mortality among middle-aged Caucasian men