Fracture Resistance of Pulpotomized Primary Molar Restored with Extensive Class II Amalgam Restorations

Directory of Open Access Journals (Sweden)

F. Mazhari

2008-06-01

Full Text Available Objective: The aim of the present study was to evaluate fracture resistance of pulpoto-mized primary molar teeth restored with extensive multisurface amalgam restorations.Materials and Methods: Eighty extracted carious human primary molar teeth were se-lected forpresent study. Teeth were divided in to eight groups of ten. Mesio- or disto-occlusal and Mesio-occluso-distal cavities with different cavity wall thickness (1.5 or 2.5mm were prepared in both first and second primary molar teeth. After restoring teeth with amalgam, all specimens were stored in distilled water at 37°C for 7 days. Then samples were thermocycled for 1000 cycles from 5°C to 55°C. The specimens then were subjected to a compressive load in a universal testing machine at a crosshead speed of 0.5 mm min-1. ANOVA and t-test were used for statistical analysis.Results: Mean fracture resistance of first and second molar teeth were 975.5 N (SD=368.8 and 1049.2 N (SD=540.1 respectively. In the first molar group, fracture resis-tance of two-surface cavities was significantly more than three-surface cavities (P<0.001, however this difference was not statistically significant in the second molar group. In both first and second molar group, fracture resistance incavities with 2.5 mm wall thickness, was significantly more than the group with 1.5 mm wall thickness.Conclusion: The mean fracture resistance in pulpotomized primary molar restored with amalgam restorations was higher than reported maximum bite force in primary teeth even in extensive multi-surface restorations. Therefore, the teeth with large proximal carious lesions in schoolchildren could be restored with amalgam.

Antibiotic resistance in primary care in Austria - a systematic review of scientific and grey literature

Science.gov (United States)

2011-01-01

Background Antibiotic resistance is an increasing challenge for health care services worldwide. While up to 90% of antibiotics are being prescribed in the outpatient sector recommendations for the treatment of community-acquired infections are usually based on resistance findings from hospitalized patients. In context of the EU-project called "APRES - the appropriateness of prescribing antibiotic in primary health care in Europe with respect to antibiotic resistance" it was our aim to gain detailed information about the resistance data from Austria in both the scientific and the grey literature. Methods A systematic review was performed including scientific and grey literature published between 2000 and 2010. Inclusion and exclusion criteria were defined and the review process followed published recommendations. Results Seventeen scientific articles and 23 grey literature documents could be found. In contrast to the grey literature, the scientific publications describe only a small part of the resistance situation in the primary health care sector in Austria. Merely half of these publications contain data from the ambulatory sector exclusively but these data are older than ten years, are very heterogeneous concerning the observed time period, the number and origin of the isolates and the kind of bacteria analysed. The grey literature yields more comprehensive and up-to-date information of the content of interest. These sources are available in German only and are not easily accessible. The resistance situation described in the grey literature can be summarized as rather stable over the last two years. For Escherichia coli e.g. the highest antibiotic resistance rates can be seen with fluorochiniolones (19%) and trimethoprim/sulfamethoxazole (27%). Conclusion Comprehensive and up-to-date antibiotic resistance data of different pathogens isolated from the community level in Austria are presented. They could be found mainly in the grey literature, only few are

Antibiotic resistance in primary care in Austria - a systematic review of scientific and grey literature.

Science.gov (United States)

Hoffmann, Kathryn; Wagner, Gernot; Apfalter, Petra; Maier, Manfred

2011-11-28

Antibiotic resistance is an increasing challenge for health care services worldwide. While up to 90% of antibiotics are being prescribed in the outpatient sector recommendations for the treatment of community-acquired infections are usually based on resistance findings from hospitalized patients. In context of the EU-project called "APRES - the appropriateness of prescribing antibiotic in primary health care in Europe with respect to antibiotic resistance" it was our aim to gain detailed information about the resistance data from Austria in both the scientific and the grey literature. A systematic review was performed including scientific and grey literature published between 2000 and 2010. Inclusion and exclusion criteria were defined and the review process followed published recommendations. Seventeen scientific articles and 23 grey literature documents could be found. In contrast to the grey literature, the scientific publications describe only a small part of the resistance situation in the primary health care sector in Austria. Merely half of these publications contain data from the ambulatory sector exclusively but these data are older than ten years, are very heterogeneous concerning the observed time period, the number and origin of the isolates and the kind of bacteria analysed. The grey literature yields more comprehensive and up-to-date information of the content of interest. These sources are available in German only and are not easily accessible. The resistance situation described in the grey literature can be summarized as rather stable over the last two years. For Escherichia coli e.g. the highest antibiotic resistance rates can be seen with fluorochiniolones (19%) and trimethoprim/sulfamethoxazole (27%). Comprehensive and up-to-date antibiotic resistance data of different pathogens isolated from the community level in Austria are presented. They could be found mainly in the grey literature, only few are published in peer-reviewed journals. The grey

Primary antibiotic resistance of Helicobacter pylori strains among adults and children in a tertiary referral centre in Lithuania

DEFF Research Database (Denmark)

Dargiene, Gintare; Kupcinskas, Juozas; Jonaitis, Laimas

2018-01-01

The study evaluated primary antibiotic resistance of Helicobacter pylori within the period 2013-2015 and trends of antibiotic consumption over the last decade in Lithuania; 242 adults and 55 children were included in the study. E-tests were performed for amoxicillin, metronidazole, clarithromycin......, ciprofloxacin, rifampicin and tetracycline. The presence of H. pylori and clarithromycin resistance was additionally tested by PCR. Helicobacter pylori culture was positive in 67 of 242 (28%) adult and in 12 of 55 (21.8%) children samples. Resistance rates among adults by E-tests were as follows: metronidazole......, while it has doubled from 1.10 to 2.22 DDD/1000/children/day in children within 2003-2015. There are no significant changes in the susceptibility of H. pylori to the most widely used antibiotics in adults over the last years in Lithuania; however, clarithromycin resistance among children exceeds 15...

Elevated Rate of Genome Rearrangements in Radiation-Resistant Bacteria.

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Repar, Jelena; Supek, Fran; Klanjscek, Tin; Warnecke, Tobias; Zahradka, Ksenija; Zahradka, Davor

2017-04-01

A number of bacterial, archaeal, and eukaryotic species are known for their resistance to ionizing radiation. One of the challenges these species face is a potent environmental source of DNA double-strand breaks, potential drivers of genome structure evolution. Efficient and accurate DNA double-strand break repair systems have been demonstrated in several unrelated radiation-resistant species and are putative adaptations to the DNA damaging environment. Such adaptations are expected to compensate for the genome-destabilizing effect of environmental DNA damage and may be expected to result in a more conserved gene order in radiation-resistant species. However, here we show that rates of genome rearrangements, measured as loss of gene order conservation with time, are higher in radiation-resistant species in multiple, phylogenetically independent groups of bacteria. Comparison of indicators of selection for genome organization between radiation-resistant and phylogenetically matched, nonresistant species argues against tolerance to disruption of genome structure as a strategy for radiation resistance. Interestingly, an important mechanism affecting genome rearrangements in prokaryotes, the symmetrical inversions around the origin of DNA replication, shapes genome structure of both radiation-resistant and nonresistant species. In conclusion, the opposing effects of environmental DNA damage and DNA repair result in elevated rates of genome rearrangements in radiation-resistant bacteria. Copyright © 2017 Repar et al.

Original Article Did salvage ICE chemotherapy improve the outcome in primary resistant/relapsing stage Ill/TV neuroblastoma

International Nuclear Information System (INIS)

Abdel Rahman, M.; Zekri, W.Z.K.; Moussa, E.A.M.; El Debawy, E.; Mostafa, N.E.; Yones, A.; Ezzat, S.; Rayan, A.

2011-01-01

Neuroblastoma is the most common extracranial and deadly solid tumor in children. It accounts for 15% of the deaths from cancer in the pediatric age group. Approximately half of the newly diagnosed children are at h igh risk o f treatment failure. The aim of this study is to evaluate the response rate of salvage chemotherapy by the ICE (Ifosfamide, Carboplatin, and Etoposide) regimen when administered to previously treated primary refractory or progressive high risk neuroblastoma patients. Patients and methods: Sixty-six patients from the National Cancer Institute (NCI), Cairo University and the Children Cancer Hospital Egypt (CCHE) received salvage chemotherapy (ICE) either due to primary resistance in 51/66 (77.2%) or due to disease progression on primary chemotherapy in 15/66 (22.8%). Results: They were 40 males (60.6%) and 26 females (39.4%). Patients' age ranged between 3 months and 12.5 years. The most common tumor site was suprarenal, followed by retroperitoneal mass. Two patients (3%)'died from chemotherapy toxicity during ICE administration. Evaluation of tumor response in the remaining 64 patients showed the following: CR/PR in 24 patients (36.5%), SD in 11 patients (16.6%), and PD in 29 patients (43.9%). Fourteen patients (21.2%) were considered eligible for auto BMT, while 50/64 patients (78.8%) failed this second line (salvage) chemotherapy and had palliative lines of therapy. By the end of the study (May 2010), 47/66 (71.2%) of the patients were still alive, while 19/66 (28.8%) were dead. Two out of 14 patients (14.2%) who underwent HSCT died from post transplantation disease progression, while 12/14 (85.8%) were in CCR. Conclusion: Chemotherapy by ICE for primary resistant or progressive stage III/IV NB seems well tolerated. With a 36.6% response rate, 18% CCR, and 3% treatment mortality rate, it could be considered a good salvage therapy in the category of patients who are condemned for palliation

Declining Rates of Inpatient Parathyroidectomy for Primary Hyperparathyroidism in the US

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Kim, Sun Moon; Shu, Aimee D.; Long, Jin; Montez-Rath, Maria E.; Leonard, Mary B.; Norton, Jeffrey A.; Chertow, Glenn M.

2016-01-01

Parathyroidectomy is the only curative therapy for patients with primary hyperparathyroidism. However, the incidence, correlates and consequences of parathyroidectomy for primary hyperparathyroidism across the entire US population are unknown. We evaluated temporal trends in rates of inpatient parathyroidectomy for primary hyperparathyroidism, and associated in-hospital mortality, length of stay, and costs. We used the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS) from 2002–2011. Parathyroidectomies for primary hyperparathyroidism were identified using International Classification of Diseases, Ninth Revision codes. Unadjusted and age- and sex- adjusted rates of inpatient parathyroidectomy for primary hyperparathyroidism were derived from the NIS and the annual US Census. We estimated 109,583 parathyroidectomies for primary hyperparathyroidism between 2002 and 2011. More than half (55.4%) of patients were younger than age 65, and more than three-quarters (76.8%) were female. The overall rate of inpatient parathyroidectomy was 32.3 cases per million person-years. The adjusted rate decreased from 2004 (48.3 cases/million person-years) to 2007 (31.7 cases/million person-years) and was sustained thereafter. Although inpatient parathyroidectomy rates declined over time across all geographic regions, a steeper decline was observed in the South compared to other regions. Overall in-hospital mortality rates were 0.08%: 0.02% in patients younger than 65 years and 0.14% in patients 65 years and older. Inpatient parathyroidectomy rates for primary hyperparathyroidism have declined in recent years. PMID:27529699

Extending the durability of cultivar resistance by limiting epidemic growth rates.

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Carolan, Kevin; Helps, Joe; van den Berg, Femke; Bain, Ruairidh; Paveley, Neil; van den Bosch, Frank

2017-09-27

Cultivar resistance is an essential part of disease control programmes in many agricultural systems. The use of resistant cultivars applies a selection pressure on pathogen populations for the evolution of virulence, resulting in loss of disease control. Various techniques for the deployment of host resistance genes have been proposed to reduce the selection for virulence, but these are often difficult to apply in practice. We present a general technique to maintain the effectiveness of cultivar resistance. Derived from classical population genetics theory; any factor that reduces the population growth rates of both the virulent and avirulent strains will reduce selection. We model the specific example of fungicide application to reduce the growth rates of virulent and avirulent strains of a pathogen, demonstrating that appropriate use of fungicides reduces selection for virulence, prolonging cultivar resistance. This specific example of chemical control illustrates a general principle for the development of techniques to manage the evolution of virulence by slowing epidemic growth rates. © 2017 The Author(s).

Reinforcer magnitude and rate dependency: evaluation of resistance-to-change mechanisms.

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Pinkston, Jonathan W; Ginsburg, Brett C; Lamb, Richard J

2014-10-01

Under many circumstances, reinforcer magnitude appears to modulate the rate-dependent effects of drugs such that when schedules arrange for relatively larger reinforcer magnitudes rate dependency is attenuated compared with behavior maintained by smaller magnitudes. The current literature on resistance to change suggests that increased reinforcer density strengthens operant behavior, and such strengthening effects appear to extend to the temporal control of behavior. As rate dependency may be understood as a loss of temporal control, the effects of reinforcer magnitude on rate dependency may be due to increased resistance to disruption of temporally controlled behavior. In the present experiments, pigeons earned different magnitudes of grain during signaled components of a multiple FI schedule. Three drugs, clonidine, haloperidol, and morphine, were examined. All three decreased overall rates of key pecking; however, only the effects of clonidine were attenuated as reinforcer magnitude increased. An analysis of within-interval performance found rate-dependent effects for clonidine and morphine; however, these effects were not modulated by reinforcer magnitude. In addition, we included prefeeding and extinction conditions, standard tests used to measure resistance to change. In general, rate-decreasing effects of prefeeding and extinction were attenuated by increasing reinforcer magnitudes. Rate-dependent analyses of prefeeding showed rate-dependency following those tests, but in no case were these effects modulated by reinforcer magnitude. The results suggest that a resistance-to-change interpretation of the effects of reinforcer magnitude on rate dependency is not viable.

Recurrence rate after thoracoscopic surgery for primary spontaneous pneumothorax.

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Dagnegård, Hanna H; Rosén, Alice; Sartipy, Ulrik; Bergman, Per

2017-08-01

There is an on-going discussion regarding the recurrence rate after surgery for primary spontaneous pneumothorax by video assisted thoracic surgery (VATS) or by thoracotomy access. This study aimed to describe the recurrence rate, and to identify a possible learning curve, following surgery for primary spontaneous pneumothorax by VATS. All patients who underwent surgery for primary spontaneous pneumothorax by VATS at Karolinska University Hospital 2004-2013 were reviewed. Preoperative and operative characteristics were obtained from medical records. Patients were followed-up through telephone interviews or questionnaires and by review of medical records. The primary outcome of interest was time to recurrence of pneumothorax requiring intervention. Outcomes were compared between patients operated during 2004-June 2010 and July 2010-2013. 219 patients who underwent 234 consecutive procedures were included. The mean follow-up times were 6.3 and 2.9 years in the early and late period, respectively. The postoperative recurrence rate in the early period was 16% (11%-25%), 18% (12%-27%), and 18% (12%-27%), at 1, 3 and 5 years, compared to 1.7% (0.4%-6.8%), 7.6% (3.7%-15%), and 9.8% (4.8%-19%) at 1, 3 and 5 years, in the late period (p = 0.016). We found that the recurrence rate after thoracoscopic surgery for primary spontaneous pneumothorax decreased significantly during the study period. Our results strongly suggest that thoracoscopic surgery for pneumothorax involve a substantial learning curve.

Rate effects in resistive plate chambers

International Nuclear Information System (INIS)

Lippmann, C.; Riegler, W.; Kalweit, A.

2006-01-01

The resistive plates in RPCs cause a drop of the electric field in the gas gap at high particle rates or large gas gain, which affects efficiency and time resolution. This effect is typically estimated by assuming the particle flux to be a DC current that causes a voltage drop when it passes through the resistive plate. In an improved model by Abbrescia (Nucl. Instr. Meth. A 533 (2004) 7), the fluctuation of the field in the gas gap is modelled by assuming that the avalanche partially discharges a small capacitor which gets recharged with a time constant characteristic for the given RPC. In our approach, the effect is calculated by using the exact analytic solution for the time dependent electric field of a point charge sitting on the surface of a resistive plate in an RPC. This is, by definition, the best possible approximation to reality. The solution is obtained using the quasi-static approximation of Maxwell's equations. The formulas are presented as integral representations with 'cured' integrands, which allow easy numerical evaluation for Monte Carlo simulations. The solutions show that the charges in RPCs are 'destroyed' with a continuous distribution of time constants which are related in a very intuitive way to some limiting cases. Using these formulas we present a Monte Carlo simulation of rate effects, proving the applicability of this approach. Finally, we compare the Monte Carlo results to analytical calculations, similar to the ones proposed by Gonzalez-Diaz et al. (see proceedings of this conference)

Surveillance of drug resistance for tuberculosis control: why and how?

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Chaulet, P; Boulahbal, F; Grosset, J

1995-12-01

The resistance of Mycobacterium tuberculosis to antibiotics, which reflects the quality of the chemotherapy applied in the community, is one of the elements of epidemiological surveillance used in national tuberculosis programmes. Measurement of drug resistance poses problems for biologists in standardization of laboratory methods and quality control. The definition of rates of acquired and primary drug resistance also necessitates standardization in the methods used to collect information transmitted by clinicians. Finally, the significance of the rates calculated depends on the choice of the patients sample on which sensitivity tests have been performed. National surveys of drug resistance therefore require multidisciplinary participation in order to select the only useful indicators: rates of primary resistance and of acquired resistance. These indicators, gathered in representative groups of patients over a long period, are a measurement of the impact of modern chemotherapy regimens on bacterial ecology.

Clinical Trichophyton rubrum Strain Exhibiting Primary Resistance to Terbinafine

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Mukherjee, Pranab K.; Leidich, Steven D.; Isham, Nancy; Leitner, Ingrid; Ryder, Neil S.; Ghannoum, Mahmoud A.

2003-01-01

The in vitro antifungal susceptibilities of six clinical Trichophyton rubrum isolates obtained sequentially from a single onychomycosis patient who failed oral terbinafine therapy (250 mg/day for 24 weeks) were determined by broth microdilution and macrodilution methodologies. Strain relatedness was examined by random amplified polymorphic DNA (RAPD) analyses. Data obtained from both broth micro- and macrodilution assays were in agreement and revealed that the six clinical isolates had greatly reduced susceptibilities to terbinafine. The MICs of terbinafine for these strains were >4 μg/ml, whereas they were terbinafine for all six strains were >128 μg/ml, whereas they were 0.0002 μg/ml for the reference strain. The MIC of terbinafine for the baseline strain (cultured at the initial screening visit and before therapy was started) was already 4,000-fold higher than normal, suggesting that this is a case of primary resistance to terbinafine. The results obtained by the broth macrodilution procedure revealed that the terbinafine MICs and MFCs for sequential isolates apparently increased during the course of therapy. RAPD analyses did not reveal any differences between the isolates. The terbinafine-resistant isolates exhibited normal susceptibilities to clinically available antimycotics including itraconazole, fluconazole, and griseofulvin. However, these isolates were fully cross resistant to several other known squalene epoxidase inhibitors, including naftifine, butenafine, tolnaftate, and tolciclate, suggesting a target-specific mechanism of resistance. This is the first confirmed report of terbinafine resistance in dermatophytes. PMID:12499173

Association between rising professional liability insurance premiums and primary cesarean delivery rates.

Science.gov (United States)

Murthy, Karna; Grobman, William A; Lee, Todd A; Holl, Jane L

2007-12-01

To estimate the association between changes in Illinois professional liability premiums for obstetrician-gynecologists and singleton primary cesarean delivery rates. Data from the National Center for Health Statistics were used to identify all singleton births between 37 weeks and 44 weeks of gestation occurring in Illinois from 1998 through 2003. Primary cesarean delivery rates for women delivered between 37 weeks and 44 weeks of gestation per 1,000 gravid women eligible to have a primary cesarean delivery were calculated for each Illinois county. The annual medical professional liability premium for each county in Illinois was represented by the reported professional liability insurance rate charges (adjusted to 2004 dollars) from the ISMIE Mutual Insurance Company. Separate analyses were conducted for nulliparous and multiparous women. The independent association between county-level primary cesarean delivery rates and the previous year's insurance premiums was evaluated using linear regression models. During the study period, 817,521 women were eligible for inclusion in the analysis. The county-level mean primary cesarean delivery rate increased from 126 to 163 per 1,000 (Pinsurance premiums also rose significantly (from $60,766 in 1997 to $83,167 in 2002, Pinsurance premium increase, the primary cesarean delivery rate increased by 15.7 per 1,000 for nulliparous women. This association also was evident for multiparous women, who had an increase in cesarean deliveries of 4.7 per 1,000 for every $10,000 increase. Higher rates of primary cesarean delivery are associated with increased medical professional liability premiums for obstetrician-gynecologists in Illinois. II.

Dose rate determining factors of PWR primary water

International Nuclear Information System (INIS)

Terachi, Takumi; Kuge, Toshiharu; Nakano, Nobuo

2014-01-01

The relationship between dose rate trends and water chemistry has been studied to clarify the determining factors on the dose rates. Therefore dose rate trends and water chemistry of 11 PWR plants of KEPCO (Kansai Electric Power Co., Inc.) were summarized. It is indicated that the chemical composition of the oxide film, behaviour of corrosion products and Co-58/Co-60 ratio in the primary system have effected dose rate trends based on plant operation experiences for over 40 years. According to plant operation experiences, the amount of Co-58 has been decreasing with the increasing duration of SG (Steam Generator) usage. It is indicated that the stable oxide film formation on the inner surface of SG tubing, is a major beneficial factor for radiation sources reduction. On the other hand, the reduction of the amount of Co-60 for the long term has been not clearly observed especially in particular high dose plants. The primary water parameters imply that considering release and purification balance on Co-59 is important to prevent accumulation of source term in primary water. In addition, the effect of zinc injection, which relates to the chemical composition of oxide film, was also assessed. As the results, the amount of radioactive Co has been clearly decreased. The decreasing trend seems to correlate to the half-life of Co-60, because it is considered that the injected zinc prevents the uptake of radioactive Co into the oxide film on the inner surface of the components and piping. In this paper, the influence of water chemistry and the replacement experiences of materials on the dose rates were discussed. (author)

First-Line Antimicrobial Resistance Patterns of Escherichia coli in Children With Urinary Tract Infection in Emergency Department and Primary Care Clinics.

Science.gov (United States)

Ahmed, M Nadeem; Vannoy, Debby; Frederick, Ann; Chang, Sandy; Lawler, Elisabeth

2016-01-01

To identify risk factors for antibiotic resistance to Escherichia coli (E. coli) in children with urinary tract infections (UTIs) in emergency room and primary care clinics. This is a cross-sectional study of children 0 to 18 years of age reported to have E coli-positive UTIs whose medical and laboratory records were systematically reviewed. Compared with girls, boys were 2.29 times (confidence interval [CI] = 1.30-4.02) more likely to have E coli isolates resistant to ampicillin and 2 times more likely (CI = 1.13-3.62) to have isolates resistant to trimethoprim-sulfamethoxazole (TMP/SMX). Patients with genitourinary abnormalities were 1.57 times more likely to be resistant to ampicillin (CI = 1.03-2.41) and 1.86 times to TMP/SMX (CI = 1.18-2.94). Higher rates of ampicillin and TMP/SMX resistant urinary E coli isolates were observed among boys and children with a history of genitourinary abnormality. Age and recent antibiotic prescription are also potential risk factors for resistance. © The Author(s) 2015.

Resistance profiles and adherence at primary virological failure in three different highly active antiretroviral therapy regimens: analysis of failure rates in a randomized study

DEFF Research Database (Denmark)

Røge, B T; Barfod, T S; Kirk, O

2004-01-01

OBJECTIVES: To investigate the interplay between resistance and adherence in the virological failure of three fundamentally different highly active antiretroviral therapy (HAART) regimens. METHODS: We retrospectively identified 56 verified primary virological failures (viral load >400 HIV-1 RNA...... copies/mL) among 293 patients randomized to two nucleoside reverse transcriptase inhibitors (NRTIs)+ritonavir+saquinavir (RS-arm) (n=115), two NRTIs+nevirapine+nelfinavir (NN-arm) (n=118), or abacavir+stavudine+didanosine (ASD-arm) (n=60) followed up for a median of 90 weeks. Data on adherence were...... collected from patient files, and genotyping was performed on plasma samples collected at time of failure. RESULTS: Treatment interruption or poor adherence was mainly caused by side effects and accounted for 74% of failures, and was associated with absence of resistance mutations. In the 30 failing...

Ciprofloxacin Resistance and Gonorrhea Incidence Rates in 17 Cities, United States, 1991–2006

Science.gov (United States)

Kirkcaldy, Robert D.; Gift, Thomas L.; Owusu-Edusei, Kwame; Weinstock, Hillard S.

2014-01-01

Antimicrobial drug resistance can hinder gonorrhea prevention and control efforts. In this study, we analyzed historical ciprofloxacin resistance data and gonorrhea incidence data to examine the possible effect of antimicrobial drug resistance on gonorrhea incidence at the population level. We analyzed data from the Gonococcal Isolate Surveillance Project and city-level gonorrhea incidence rates from surveillance data for 17 cities during 1991–2006. We found a strong positive association between ciprofloxacin resistance and gonorrhea incidence rates at the city level during this period. Their association was consistent with predictions of mathematical models in which resistance to treatment can increase gonorrhea incidence rates through factors such as increased duration of infection. These findings highlight the possibility of future increases in gonorrhea incidence caused by emerging cephalosporin resistance. PMID:24655615

Renovascular resistance of machine-perfused DCD kidneys is associated with primary nonfunction.

NARCIS (Netherlands)

Vries, E.E. de; Hoogland, E.R.; Winkens, B.; Snoeijs, M.G.; Heurn, L.W.E. van

2011-01-01

Donation after cardiac death (DCD) has shown to be a valuable extension of the donor pool despite a higher percentage of primary nonfunction (PNF). Limiting the incidence of PNF is of vital importance. Renovascular resistance is believed to predict graft outcome; however the literature is

Effect of microstructure on crack growth rate of alloy 690 in primary water

International Nuclear Information System (INIS)

Sakakibara, Y.; Hirano, T.; Nakayama, G.

2015-01-01

It was reported that the chemical composition and fabrication process of alloy 690 were important for the resistance to SCC in primary water. In this paper, we evaluated crack growth rate (CGR) of commercial thick plates (WT, XT) and forgings (FT, FM) made by some material manufacturers. Specimen WT showed the highest CGR in the thick plates. WT had coarse grain and film-like carbides which were assumed as eutectic M 23 C 6 . Forged alloy 690 MA and TT (FM and FT) showed no CGR. One of alloy 690 plates (XT) was cold rolled by 30% of reduction in our laboratory to investigate the effect of the orientation of the specimen on CGR. The specimens in the S-L and the S-T orientation showed higher CGRs than those in the T-L and the L-S orientation. (authors)

Helicobacter pylori Primary Antibiotic Resistance in 2015 in Morocco: A Phenotypic and Genotypic Prospective and Multicenter Study.

Science.gov (United States)

Bouihat, Najat; Burucoa, Christophe; Benkirane, Ahmed; Seddik, Hassan; Sentissi, Sara; Al Bouzidi, Abderrahmane; Elouennas, Mustapha; Benouda, Amina

2017-09-01

Knowledge of local antibiotic resistance is crucial to adaption of the choice of effective empirical first-line treatment for Helicobacter pylori infection. The aim of this study was to evaluate, for the first time in Morocco, the prevalence of the primary resistance of H. pylori to clarithromycin, metronidazole, amoxicillin, levofloxacin, tetracycline, and rifamycin. We conducted a 1-year prospective study (2015), including 255 Moroccan patients referred for gastro-duodenal endoscopy to two hospitals of Rabat (Morocco) and never previously treated for H. pylori infection. Three gastric biopsies were collected: one for histology, one for culture, and one for molecular detection of H. pylori and the mutations in 23S rRNA genes that confer resistance to clarithromycin. Antimicrobial susceptibility testing was performed on isolated strains by Etest and disk diffusion methods. One hundred seventy-seven patients were infected (69.4%). The prevalence of primary resistances of H. pylori to clarithromycin was 29%, 40% to metronidazole, 0% to amoxicillin, tetracycline, and rifamycin, and 11% to levofloxacin. Only four isolates (2%) were resistant to both clarithromycin and metronidazole. The high level of primary clarithromycin resistance in the H. pylori strains infecting the Moroccan population leads us to recommend the abandonment of the standard clarithromycin-based triple therapy as a first-line treatment in Morocco and to prefer a concomitant quadruple therapy.

Ultraviolet light-resistant primary transfectants of xeroderma pigmentosum cells are also DNA repair-proficient

International Nuclear Information System (INIS)

Stark, M.; Naiman, T.; Canaani, D.

1989-01-01

In a previous work, an immortal xeroderma pigmentosum cell line belonging to complementation group C was complemented to a UV-resistant phenotype by transfection with a human cDNA clone library. We now report that the primary transformants selected for UV-resistance also acquired normal levels of DNA repair. This was assessed both by measurement of UV-induced [ 3 H]thymidine incorporation and by equilibrium sedimentation analysis of repair-DNA synthesis. Therefore, the transduced DNA element which confers normal UV-resistance also corrects the excision repair defect of the xeroderma pigmentosum group C cell line

Primary drug resistance in a region with high burden of tuberculosis. A critical problem.

Science.gov (United States)

Villa-Rosas, Cecilia; Laniado-Laborín, Rafael; Oceguera-Palao, Lorena

2015-01-01

To determine rates of drug resistance in new cases of pulmonary tuberculosis in a region with a high burden of the disease. New case suspects were referred for drug susceptibility testing. 28.9% of new cases were resistant to at least one first line drug; 3.9% had a multidrug-resistant strain, 15.6% a monoresistant strain and 9.4% a polyresistant strain. Our rate of drug resistant tuberculosis in new cases is very high; this has important clinical implications, since even monoresistance can have a negative impact on the outcome of new cases treated empirically with a six month regimen.

Regulation of primary productivity rate in the equatorial Pacific

International Nuclear Information System (INIS)

Barber, R.T.; Chavez, F.P.

1991-01-01

Analysis of the Chl-specific rate of primary productivity (P B ) as a function of subsurface nutrient concentration at >300 equatorial stations provides an answer to the question: What processes regulate primary productivity rate in the high-nutrient, low-chlorophyll waters of the equatorial Pacific? In the western Pacific where there is a gradient in 60-m [NO 3 ] from 0 to ∼12 μM, the productivity rate is a linear function of nutrient concentration; in the eastern Pacific where the gradient is from 12 to 28 μM, the productivity rate is independent of nutrient concentration and limited to ∼36 mg C(mg Chl) -1 d -1 , or a mean euphotic zone C-specific growth rate (μ) of 0.47 d -1 . However, rates downstream of the Galapagos Islands are not limited; they are 46.4 mg C(mg Chl) -1 d -1 and μ = 0.57 d -1 , very close to the predicted nutrient-regulated rates in the absence of other limitation. This pattern of rate regulation can be accounted for by a combination of eolian Fe, subsurface nutrients, and sedimentary Fe derived from the Galapagos platform. In the low-nutrient western Pacific the eolian supply of Fe is adequate to allow productivity rate to be set by subsurface nutrient concentration. In the nutrient-rich easter equatorial region eolian Fe is inadequate to support productivity rates proportional to the higher nutrient concentrations, so in this region eolian Fe is rate limiting. Around the Galapagos Islands productivity rates reach levels consistent with nutrient concentrations; sedimentary Fe from the Galapagos platform seems adequate to support increased nutrient-regulated productivity rates in this region

Primary drug resistance in a region with high burden of tuberculosis. A critical problem

Directory of Open Access Journals (Sweden)

Cecilia Villa-Rosas

2015-03-01

Full Text Available Objective. To determine rates of drug resistance in new cases of pulmonary tuberculosis in a region with a high burden of the disease. Materials and methods. New case suspects were referred for drug susceptibility testing. Results. 28.9% of new cases were resistant to at least one first line drug; 3.9% had a multidrug-resistant strain, 15.6% a monoresistant strain and 9.4% a polyresistant strain. Conclusion. Our rate of drug resistant tuberculosis in new cases is very high; this has important clinical implications, since even monoresistance can have a negative impact on the outcome of new cases treated empirically with a six month regimen.

Influence of heating rate on corrosion behavior of Ni-base heat resistant alloys in simulated VHTR helium environment

International Nuclear Information System (INIS)

Kurata, Yuji; Kondo, Tatsuo

1985-04-01

The influence of heating rate on corrosion and carbon transfer was studied for Ni-base heat resistant alloys exposed to simulated VHTR(very high temperature reactor) coolant environment. Special attention was focused to relationship between oxidation and carburization at early stage of exposure. Tests were conducted on two heats of Hastelloy XR with different boron(B) content and the developmental alloys, 113MA and KSN. Two kinds of heating rates, i.e. 80 0 C/min and 2 0 C/min, were employed. Corrosion tests were carried out at 900 0 C up to 500 h in JAERI Type B helium, one of the simulated VHTR primary coolant specifications. Under higher heating rate, oxidation resistance of both heats of Hastelloy XR(2.8 ppmB and 40 ppmB) were equivalent and among the best, then KSN and 113MA followed in the order. Under lower heating rate only alloy, i.e. Hastelloy XR with 2.8 ppmB, showed some deteriorated oxidation resistance while all others being unaffected by the heating rate. On the other hand the carbon transfer behavior showed strong dependence on the heating rate. In case of higher heating rate, significant carburization occured at early stage of exposure and thereafter the progress of carburization was slow in all the alloys. On the other hand only slow carburization was the case throughout the exposure in case of lower heating rate. The carburization in VHTR helium environment was interpreted as to be affected by oxide film formation in the early stage of exposure. The carbon pick-up was largest in Hastelloy XR with 40 ppmB and it was followed by Hastelloy XR with 2.8 ppmB. 113MA and KSN were carburized only slightly. The observed difference of carbon pick-up among the alloys tested was interpreted to be attributed mainly to the difference of the carbon activity, the carbide precipitation characteristics among the alloys tested. (author)

Low resistance bakelite RPC study for high rate working capability

International Nuclear Information System (INIS)

Dai, T.; Han, L.; Hou, S.; Liu, M.; Li, Q.; Song, H.; Xia, L.; Zhang, Z.

2014-01-01

This paper presents series efforts to lower resistance of bakelite electrode plate to improve the RPC capability under high rate working condition. New bakelite material with alkali metallic ion doping has been manufactured and tested. This bakelite is found unstable under large charge flux and need further investigation. A new structure of carbon-embedded bakelite RPC has been developed, which can reduce the effective resistance of electrode by a factor of 10. The prototype of the carbon-embedded chamber could function well under gamma radiation source at event rate higher than 10 kHz/cm 2 . The preliminary tests show that this kind of new structure performs as efficiently as traditional RPCs

Field Test Evaluation of Effect on Cone Resistance Caused by Change in Penetration Rate

DEFF Research Database (Denmark)

Poulsen, Rikke; Nielsen, Benjaminn Nordahl; Ibsen, Lars Bo

2012-01-01

in the laboratory. A change in the measured cone resistance occurs by lowering the penetration rate. This is caused by the changes in drainage conditions. Compared to the normal penetration rate of 20 mm/s, this paper illustrates that lowering the penetration rate leads to an increase in the cone resistance from 1......This paper presents how a change in cone penetration rate affects the measured cone resistance during cone penetration testing in silty soils. Regardless of soil, type the standard rate of penetration is 20 mm/s and it is generally accepted that undrained penetration occurs in clay while drained...... penetration occurs in sand. In intermediate soils such as silty soils, the standard cone penetration rate may result in drainage conditions varying from undrained to partially or fully drained conditions. Field cone penetrations tests have been conducted with different penetration rates on a test site...

Acceptance of insulin therapy: a long shot? Psychological insulin resistance in primary care

NARCIS (Netherlands)

Woudenberg, Y. J. C.; Lucas, C.; Latour, C.; Scholte Op Reimer, W. J. M.

2012-01-01

Diabet. Med. 29, 796802 (2012) Abstract Aim To explore which factors are associated with psychological insulin resistance in insulin-naive patients with Type 2 diabetes in primary care. Methods A sample of 101 insulin-naive patients with Type 2 diabetes completed self-administered questionnaires

Real Exchange Rate Dynamics in a Small, Primary-Exporting Country

OpenAIRE

Mohsin S. Khan; Peter J. Montiel

1987-01-01

Although the nominal exchange rate is often used as a policy instrument in small, primary-commodity-exporting countries, the real exchange rate is an endogenous variable that responds to both exogenous and policyinduced shocks. This paper examines the dynamic effects on the real exchange rate of various shocks, such as devaluation, fiscal and trade policies, and changes in the terms of trade and foreign real interest rates. Because the path of the real exchange rate differs for different type...

Achievable data rate in spectrum-sharing channels with variable-rate variable-power primary users

KAUST Repository

Yang, Yuli; Aï ssa, Sonia

2012-01-01

In this work, we propose a transmission strategy for secondary users (SUs) within a cognitive radio network where primary users (PUs) exploit variable-rate variable-power modulation. By monitoring the PU's transmissions, the SU adjusts its transmit

Rates of Anovulation in Adolescents and Young Adults with Moderate to Severe Primary Dysmenorrhea and Those without Primary Dysmenorrhea.

Science.gov (United States)

Seidman, Laura C; Brennan, Kathleen M; Rapkin, Andrea J; Payne, Laura A

2018-04-01

To evaluate rates of presumptive anovulation in eumenorrheic adolescents and young adults with moderate to severe primary dysmenorrhea and those without primary dysmenorrhea. Participants completed luteinizing hormone surge ovulation predictor test kits. Anovulatory cycles were defined by never receiving a positive result before the next menstrual period; participants were grouped as anovulatory if they experienced at least 1 anovulatory cycle during study participation. Participants rated daily level of menstrual pain on a 0-10 numeric rating scale. A university-based clinical research laboratory. Thirty-nine adolescents and young adults (ages 16-24) with primary dysmenorrhea and 52 age-matched control girls. Rates of presumptive anovulation. One hundred sixty-eight cycles were monitored, 29.8% (N = 50) of which were anovulatory (37.1% [39/105] vs 17.5% [11/63] of cycles in control and dysmenorrhea groups, respectively). During study participation, control girls were significantly more likely to have had at least 1 anovulatory cycle than were girls with primary dysmenorrhea (44.2% [23/52] vs 17.9% [7/39] of participants, respectively; P dysmenorrhea group's maximum menstrual pain ratings did not differ between ovulatory and anovulatory cycles (4.77 and 4.36, respectively; P > .05). Our data support previous findings of increased rates of ovulation in primary dysmenorrhea. However, menstruation after anovulatory cycles can be as painful as menstruation after ovulatory cycles. These data support the idea that regular menses do not necessarily indicate that a normal ovulatory cycle has occurred. Previous implications that ovulation is necessary for the development of substantial menstrual pain are incomplete. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Vaporization Rate Analysis of Primary Cooling Water from Reactor PUSPATI TRIGA (RTP) Tank

International Nuclear Information System (INIS)

Tonny Anak Lanyau; Mohd Fazli Zakaria; Yahya Ismail

2011-01-01

Primary cooling system consists of pumps, heat exchangers, probes, a nitrogen-16 diffuser and associated valves is connected to the reactor TRIGA PUSPATI (RTP) tank by aluminium pipes. Both the primary cooling system and the reactor tank is filled with demineralized light water (H 2 O), which serves as a coolant, moderator as well as shielding. During reactor operation, vaporization in the reactor tank will reduce the primary water and contribute to the formation of vapor in the reactor hall. The vaporization may influence the function of the water subsequently may affect the safety of the reactor operation. It is essential to know the vaporization rate of the primary water to ensure its functionality. This paper will present the vaporization rate of the primary cooling water from the reactor tank and the influence of temperature of the water in the reactor tank to the vaporization rate. (author)

Reimbursement rates and policies for primary molar pit-and-fissure sealants across state Medicaid programs.

Science.gov (United States)

Chi, Donald L; Singh, Jennifer

2013-11-01

Little is known about Medicaid policies regarding reimbursement for placement of sealants on primary molars. The authors identified Medicaid programs that reimbursed dentists for placing primary molar sealants and hypothesized that these programs had higher reimbursement rates than did state programs that did not reimburse for primary molar sealants. The authors obtained Medicaid reimbursement data from online fee schedules and determined whether each state Medicaid program reimbursed for primary molar sealants (no or yes). The outcome measure was the reimbursement rate for permanent tooth sealants (calculated in 2012 U.S. dollars). The authors compared mean reimbursement rates by using the t test (α = .05). Seventeen Medicaid programs reimbursed dentists for placing primary molar sealants (34 percent), and the mean reimbursement rate was $27.57 (range, $16.00 [Maine] to $49.68 [Alaska]). All 50 programs reimbursed dentists for placement of sealants on permanent teeth. The mean reimbursement for permanent tooth sealants was significantly higher in programs that reimbursed for primary molar sealants than in programs that did not ($28.51 and $23.67, respectively; P = .03). Most state Medicaid programs do not reimburse dentists for placing sealants on primary molars, but programs that do so have significantly higher reimbursement rates. Medicaid reimbursement rates are related to dentists' participation in Medicaid and children's dental care use. Reimbursement for placement of sealants on primary molars is a proxy for Medicaid program generosity.

Egg positive rate of Enterobius vermicularis of primary school children in Geoje island

Science.gov (United States)

Kim, Bong Jin; Lee, Bo Young; Chung, Hyun Kee; Lee, Young Sun; Lee, Kun Hee; Chung, Hae Jin

2003-01-01

The status of pinworm (Enterobius vermicularis) egg positive rate of primary school children in Geoje island was investigated by using adhesive cellotape anal swap method, in September, 2002. Total egg positive rates of E. vermicularis were 9.8% (74/754) and those of male and female were 10.8% and 8.7%, respectively. Among three schools examined, Myeongsa primary school showed the highest egg positive rate (12.6%) followed by Yeoncho [9.8% (26/266)] and Geoje [9.1% (35/385)]. As for the age groups, the 2nd grade had the highest egg positive rate (15.3%), whereas the 5th grade showed the lowest egg positive rate (2.6%). The above result led us to confirm that the egg positive rates of E. vermicularis in primary school children in Geoje island were not significantly different from the those in the whole country including urban and rural areas, showing more than 10%. PMID:12666734

Density Dependence and Growth Rate: Evolutionary Effects on Resistance Development to Bt (Bacillus thuringiensis).

Science.gov (United States)

Martinez, Jeannette C; Caprio, Michael A; Friedenberg, Nicholas A

2018-02-09

It has long been recognized that pest population dynamics can affect the durability of a pesticide, but dose remains the primary component of insect resistance management (IRM). For transgenic pesticidal traits such as Bt (Bacillus thuringiensis Berliner (Bacillales: Bacillaceae)), dose (measured as the mortality of susceptibles caused by a toxin) is a relatively fixed characteristic and often falls below the standard definition of high dose. Hence, it is important to understand how pest population dynamics modify durability and what targets they present for IRM. We used a deterministic model of a generic arthropod pest to examine how timing and strength of density dependence interacted with population growth rate and Bt mortality to affect time to resistance. As in previous studies, durability typically reached a minimum at intermediate doses. However, high population growth rates could eliminate benefits of high dose. The timing of density dependence had a more subtle effect. If density dependence operated simultaneously with Bt mortality, durability was insensitive to its strengths. However, if density dependence was driven by postselection densities, decreasing its strength could increase durability. The strength of density dependence could affect durability of both single traits and pyramids, but its influence depended on the timing of density dependence and size of the refuge. Our findings suggest the utility of a broader definition of high dose, one that incorporates population-dynamic context. That maximum growth rates and timing and strength of interactions causing density dependent mortality can all affect durability, also highlights the need for ecologically integrated approaches to IRM research. © The Author(s) 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

INFLUENCE OF MORTGAGE RATES PRICE FORMATION ON THE PRIMARY HOUSING MARKET

Directory of Open Access Journals (Sweden)

Nikolay I. Kornilov

2015-01-01

Full Text Available The article considers relationship of pricesin the primary market, depending on theregional origin and type of home, with thevalue of mortgage rates. Assesses thestrength of such a relationship and thepossible effects of changes in such rates.

Achievable data rate in spectrum-sharing channels with variable-rate variable-power primary users

KAUST Repository

Yang, Yuli

2012-08-01

In this work, we propose a transmission strategy for secondary users (SUs) within a cognitive radio network where primary users (PUs) exploit variable-rate variable-power modulation. By monitoring the PU\\'s transmissions, the SU adjusts its transmit power based on the gap between the PU\\'s received effective signal-to-noise power ratio (SNR) and the lower SNR boundary for the modulation mode that is being used in the primary link. Thus, at the SU\\'s presence, the PU\\'s quality of service (QoS) is guaranteed without increasing its processing complexity thanks to no interference cancellation required in the PU\\'s operation. To demonstrate the advantage of our proposed transmission strategy, we analyze the secondary user\\'s achievable data rate by taking into account different transmission capabilities for the secondary transmitter. The corresponding numerical results not only prove the validity of our derivations but also provide a convenient tool for the network design with the proposed transmission strategy. © 2012 IEEE.

Primary Sjogren’s Syndrome Associated With Treatment-Resistant Obsessive–Compulsive Disorder

Directory of Open Access Journals (Sweden)

Lawrence T. C. Ong

2017-07-01

Full Text Available There is an increasing awareness that autoimmune diseases can present with neuropsychiatric manifestations. We present the case of a 17-year-old female requiring psychiatric hospitalization for obsessive–compulsive disorder and major depressive disorder with mixed affective features, who was subsequently diagnosed with primary Sjogren’s syndrome. Treatment with potent immunosuppression resulted in remission of psychiatric illness. Due to a lack of awareness and/or the lack of specific biomarkers, clinicians may not associate psychiatric symptoms with autoimmune disease, including primary Sjogren’s syndrome. This case demonstrates that Sjogren’s syndrome may be a causative or aggravating factor in mental disorders and that autoimmune diseases should be carefully considered in the differential diagnosis of psychiatric illness especially in cases of concurrent physical symptomatology and severity or treatment resistance of psychiatric disease.

Load and resistance factor rating (LRFR) in New York State : volume II.

Science.gov (United States)

2011-09-01

This report develops a Load and Resistance Factor Rating (NYS-LRFR) methodology : for New York bridges. The methodology is applicable for the rating of existing : bridges, the posting of under-strength bridges, and checking Permit trucks. The : propo...

Load and resistance factor rating (LRFR) in New York State : volume I.

Science.gov (United States)

2011-09-01

This report develops a Load and Resistance Factor Rating (NYS-LRFR) methodology : for New York bridges. The methodology is applicable for the rating of existing : bridges, the posting of under-strength bridges, and checking Permit trucks. The : propo...

A case report and literature review of primary resistant Hodgkin lymphoma: a response to anti-PD-1 after failure of autologous stem cell transplantation and brentuximab vedotin

Directory of Open Access Journals (Sweden)

Xu PP

2016-09-01

Full Text Available Peipei Xu, Fan Wang, Chaoyang Guan, Jian Ouyang, Xiaoyan Shao, Bing Chen Department of Hematology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, People’s Republic of China Abstract: Hodgkin lymphoma (HL is a highly curable hematologic malignancy, and ~70% of cases can be cured with combination chemotherapy with or without radiation. However, patients with primary resistant disease have a cure rate of <30%. For such patients, high-dose chemotherapy followed by autologous stem cell transplantation (ASCT is considered to be the standard treatment. If patients fail to respond to ASCT or relapse soon thereafter, they usually receive another ASCT, allogeneic stem cell transplantation or treatment with novel agents. This case report presents the case of a 54-year-old patient with primary resistant HL who received single-agent treatment, brentuximab vedotin, after ASCT relapse. Despite treatment with brentuximab vedotin, the disease continued to progress. In patients with such highly resistant disease, the treatment options are limited. Depending on the physical condition and the willingness of the patient, pembrolizumab, a programmed cell death protein-1 inhibitor, can be given as salvage therapy. But, out of our expectation, the patient achieved a very good partial response after four cycles of pembrolizumab. No serious adverse events were observed with pembrolizumab treatment. This case provides support for a new and effective strategy for treating primary resistant Hodgkin lymphoma. Keywords: Hodgkin lymphoma, autologous stem cell transplant, brentuximab vedotin, pembrolizumab, PD-1, good response

Meta-analysis and time series modeling allow a systematic review of primary HIV-1 drug-resistant prevalence in Latin America and Caribbean.

Science.gov (United States)

Coelho, Antonio Victor Campos; De Moura, Ronald Rodrigues; Da Silva, Ronaldo Celerino; Kamada, Anselmo Jiro; Guimarães, Rafael Lima; Brandão, Lucas André Cavalcanti; Coelho, Hemílio Fernandes Campos; Crovella, Sergio

2015-01-01

Here we review the prevalence of HIV-1 primary drug resistance in Latin America and Caribbean using meta-analysis as well as time-series modeling. We also discuss whether there could be a drawback to HIV/AIDS programs due to drug resistance in Latin America and Caribbean in the next years. We observed that, although some studies report low or moderate primary drug resistance prevalence in Caribbean countries, this evidence needs to be updated. In other countries, such as Brazil and Argentina, the prevalence of drug resistance appears to be rising. Mutations conferring resistance against reverse transcriptase inhibitors were the most frequent in the analyzed populations (70% of all mutational events). HIV-1 subtype B was the most prevalent in Latin America and the Caribbean, although subtype C and B/F recombinants have significant contributions in Argentina and Brazil. Thus, we suggest that primary drug resistance in Latin America and the Caribbean could have been underestimated. Clinical monitoring should be improved to offer better therapy, reducing the risk for HIV-1 resistance emergence and spread, principally in vulnerable populations, such as men who have sex with men transmission group, sex workers and intravenous drug users.

Primary drug-resistant tuberculosis in Hanoi, Viet Nam: present status and risk factors.

Directory of Open Access Journals (Sweden)

Nguyen Thi Le Hang

Full Text Available INTRODUCTION: Resistance of Mycobacterium tuberculosis (MTB to anti-tuberculosis (TB drugs presents a serious challenge to TB control worldwide. We investigated the status of drug resistance, including multidrug-resistant (MDR TB, and possible risk factors among newly diagnosed TB patients in Hanoi, the capital of Viet Nam. METHODS: Clinical and epidemiological information was collected from 506 newly diagnosed patients with sputum smear- and culture-positive TB, and 489 (96.6% MTB isolates were subjected to conventional drug susceptibility testing, spoligotyping, and 15-locus variable numbers of tandem repeats typing. Adjusted odds ratios (aORs were calculated to analyze the risk factors for primary drug resistance. RESULTS: Of 489 isolates, 298 (60.9% were sensitive to all drugs tested. Resistance to isoniazid, rifampicin, streptomycin, ethambutol, and MDR accounted for 28.2%, 4.9%, 28.2%, 2.9%, and 4.5%, respectively. Of 24 isolates with rifampicin resistance, 22 (91.7% were MDR and also resistant to streptomycin, except one case. Factors associated with isoniazid resistance included living in old urban areas, presence of the Beijing genotype, and clustered strains [aOR = 2.23, 95% confidence interval (CI 1.15-4.35; 1.91, 1.18-3.10; and 1.69, 1.06-2.69, respectively. The Beijing genotype was also associated with streptomycin resistance (aOR = 2.10, 95% CI 1.29-3.40. Human immunodeficiency virus (HIV coinfection was associated with rifampicin resistance and MDR (aOR = 5.42, 95% CI 2.07-14.14; 6.23, 2.34-16.58, respectively. CONCLUSION: Isoniazid and streptomycin resistance was observed in more than a quarter of TB patients without treatment history in Hanoi. Transmission of isoniazid-resistant TB among younger people should be carefully monitored in urban areas, where Beijing strains and HIV coinfection are prevalent. Choosing an optimal treatment regimen on the basis of the results of drug susceptibility tests and monitoring of treatment

Antimicrobial resistance in Libya: 1970–2011

Directory of Open Access Journals (Sweden)

Khalifa Sifaw Ghenghesh

2013-03-01

Full Text Available Resistance to antimicrobial agents is a major health problem that affects the whole world. Providing information on the past state of antimicrobial resistance in Libya may assist the health authorities in addressing the problem more effectively in the future. Information was obtained mainly from Highwire Press (including PubMed search for the period 1970–2011 using the terms ‘antibiotic resistance in Libya’, ‘antimicrobial resistance in Libya’, ‘tuberculosis in Libya’, and ‘primary and acquired resistance in Libya’ in title and abstract. From 1970 to 2011 little data was available on antimicrobial resistance in Libya due to lack of surveillance and few published studies. Available data shows high resistance rates for Salmonella species in the late 1970s and has remained high to the present day. High prevalence rates (54–68% of methicillin-resistant Staphylococcus aureus (MRSA were reported in the last decade among S. aureus from patients with burns and surgical wound infections. No reports were found of vancomycin-resistant S. aureus (VRSA or vancomycin-intermediate-resistant S. aureus (VISA using standard methods from Libya up to the end of 2011. Reported rates of primary (i.e. new cases and acquired (i.e. retreatment cases multidrug-resistant tuberculosis (MDR-TB from the eastern region of Libya in 1971 were 16.6 and 33.3% and in 1976 were 8.6 and 14.7%, in western regions in 1984–1986 were 11 and 21.5% and in the whole country in 2011 were estimated at 3.4 and 29%, respectively. The problem of antibiotic resistance is very serious in Libya. The health authorities in particular and society in general should address this problem urgently. Establishing monitoring systems based on the routine testing of antimicrobial sensitivity and education of healthcare workers, pharmacists, and the community on the health risks associated with the problem and benefits of prudent use of antimicrobials are some steps that can be taken to

Characterization of ibrutinib-sensitive and -resistant mantle lymphoma cells.

Science.gov (United States)

Ma, Jiao; Lu, Pin; Guo, Ailin; Cheng, Shuhua; Zong, Hongliang; Martin, Peter; Coleman, Morton; Wang, Y Lynn

2014-09-01

Ibrutinib inhibits Bruton tyrosine kinase (BTK), a key component of early B-cell receptor (BCR) signalling pathways. A multicentre phase 2 trial of ibrutinib in patients with relapsed/refractory mantle cell lymphoma (MCL) demonstrated a remarkable response rate. However, approximately one-third of patients have primary resistance to the drug while other patients appear to lose response and develop secondary resistance. Understanding the molecular mechanisms underlying ibrutinib sensitivity is of paramount importance. In this study, we investigated cell lines and primary MCL cells that display differential sensitivity to ibrutinib. We found that the primary cells display a higher BTK activity than normal B cells and MCL cells show differential sensitivity to BTK inhibition. Genetic knockdown of BTK inhibits the growth, survival and proliferation of ibrutinib-sensitive but not resistant MCL cell lines, suggesting that ibrutinib acts through BTK to produce its anti-tumour activities. Interestingly, inhibition of ERK1/2 and AKT, but not BTK phosphorylation per se, correlates well with cellular response to BTK inhibition in cell lines as well as in primary tumours. Our study suggests that, to prevent primary resistance or to overcome secondary resistance to BTK inhibition, a combinatory strategy that targets multiple components or multiple pathways may represent the most effective approach. © 2014 John Wiley & Sons Ltd.

Primary care practice and facility quality orientation: influence on breast and cervical cancer screening rates.

Science.gov (United States)

Goldzweig, Caroline Lubick; Parkerton, Patricia H; Washington, Donna L; Lanto, Andrew B; Yano, Elizabeth M

2004-04-01

Despite the importance of early cancer detection, variation in screening rates among physicians is high. Insights into factors influencing variation can guide efforts to decrease variation and increase screening rates. To explore the association of primary care practice features and a facility's quality orientation with breast and cervical cancer screening rates. Cross-sectional study of screening rates among 144 Department of Veterans Affairs (VA) medical centers and for a national sample of women. We linked practice structure and quality improvement characteristics of individual VA medical centers from 2 national surveys (1 to primary care directors and 1 to a stratified random sample of employees) to breast and cervical cancer screening rates determined from a review of random medical records. We conducted bivariate analyses and multivariate logistic regression of primary care practice and facility features on cancer screening rates, above and below the median. While the national screening rates were high for breast (87%) and cervical cancer (90%), higher screening rates were more likely when primary care providers were consistently notified of specialty visits and when staff perceived a greater organizational commitment to quality and anticipated rewards and recognition for better performance. Organization and quality orientation of the primary care practice and its facility can enhance breast and cervical cancer screening rates. Internal recognition of quality performance and an overall commitment to quality improvement may foster improved prevention performance, with impact varying by clinical service.

Staphylococcus aureus carriage rates and antibiotic resistance patterns in patients with acne vulgaris.

Science.gov (United States)

Delost, Gregory R; Delost, Maria E; Armile, James; Lloyd, Jenifer

2016-04-01

Overuse of antibiotics has led to the development of antibiotic-resistant strains of Staphylococcus aureus, which are occurring more frequently within the community. We sought to determine whether long-term antibiotic therapy for acne alter the carriage rate and antibiotic resistance profiles of S aureus. This was a prospective, cross-sectional, quasiexperimental study. Samples of anterior nares were obtained from dermatology patients given a diagnosis of acne vulgaris (n = 263) who were treated with antibiotics (n = 142) or who were not treated with antibiotics (n = 121). Specimens were tested for the presence of S aureus by growth on mannitol salt agar and then isolated on 5% sheep blood agar. Identification was confirmed based on colonial morphology, Gram stain, catalase, and coagulase testing. Antibiotic susceptibility testing was performed using the VITEK 2 system (bioMerieux, Marcy-l'Étoile, France). The S aureus carriage rate was significantly lower in patients with acne treated with antibiotics (6.3%) compared with those not treated with antibiotics (15.7%; P = .016). The percentage of S aureus isolates resistant to 1 or more antibiotics did not significantly differ between the 2 groups (P = .434). Cross-sectional study, patient compliance, and effects of prior acne treatments are limitations. Treatment of patients with acne using antibiotics decreases the S aureus carriage rate but does not significantly alter the antibiotic resistance rates. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Value of sestamibi for the prediction of resistance to primary chemotherapy

International Nuclear Information System (INIS)

Maublant, J.; Cachin, F.; Mestas, D.

2002-01-01

organometallic, small lipophilic cation which had been shown to be a multidrug resistance Pgp transport substrate and can be utilized as a functional probe of Pgp transport activity in solid tumors. We have measured the 2-hr retention of 99m Tc-sestamibi and 3 H-daunomycin in MDR-sensitive and MDR-resistant cultured tumor cells (KB-3-1 and KB-A1, respectively). Retention of both radioactive molecules was decreased of 64 ± 11 % and 69 ± 5 % (N.S.), respectively, suggesting that the modification of intracellular level of 99m Tc-sestamibi induced by the overexpression of MDR closely reflects that of 3 H-daunomycin. This confirms that 99m Tc-sestamibi could be used as a surrogate to assess the tumor retention of anthracyclines. In another in vitro study, we have compared the cellular retention of the same two agents in the same cell lines now incubated with one of three recognized MDR-reversing agents, namely, verapamil, PSC833 and S9788. While a reversing effect on the retention of 3 H-daunomycin was observed with each reversing agent, there was either no effect or only a faint increase on the retention of 99m Tc-sestamibi. These results suggest that 99m Tc-sestamibi cannot be used as a faithful surrogate to assess the effect of MDR-reversing agents on the tumor retention of anthracyclines. At variance with these results, Tatsumi et al. have recently reported that, in mice resistant grafted tumors, 99m Tc-sestamibi washout rate could be totally reversed by a different reversing agent, MS-209. In humans, data mostly originate from Del Vecchio et al. who demonstrated that 4-hr residual tumor retention of 99m Tc-sestamibi was 56% in sensitive breast cancers vs. 25% in MDR-resistant tumors. Further studies have focused on the possible role of 99m Tc-sestamibi scintigraphy in the early detection of resistance during the first cycles of primary chemotherapy. In breast cancer, Maini et al. have reported a 100% specificity and Mankoff et al. a 100% specificity. For Tiling et al. (8

Outcomes with single agent LIPO-DOX in platinum-resistant ovarian and fallopian tube cancers and primary peritoneal adenocarcinoma - Chiang Mai University Hospital experience.

Science.gov (United States)

Suprasert, Prapaporn; Manopunya, Manatsawee; Cheewakriangkrai, Chalong

2014-01-01

Single pegylated liposomal doxorubicin (PLD) is commonly used as a salvage treatment in platinum-resistant ovarian cancer, fallopian tube cancer and primary peritoneal adenocarcinoma (PPA) with a satisfactory outcome. However, the data for second generation PLD administered in this setting are still limited. We conducted a retrospective study to evaluate the outcome of patients who received single-agent second generation PLD (LIPO-DOX) after the development of clinical platinum resistance. The study period was between March 2008 and March 2013. LIPO-DOX was administered intravenously 40 mg/m2 every 28 days until disease progression, but for not more than six cycles. The response rate was evaluated using the Gynecologic Cancer Intergroup (GCIG) criteria while the toxicity was evaluated according to WHO criteria. Twenty-nine patients met the inclusion criteria in the study period with an overall response rate of 13.8%. The median progression free survival and overall survival were three and eleven months, respectively. With the total of 96 cycles of chemotherapy, the patients developed grades 3 and 4 hematologic toxicity as follows: anemia, 0%, leukopenia, 9.6%, neutropenia, 32.3% and thrombocytopenia, 0%. In conclusion, the single agent second generation PLD demonstrated modest efficacy in patients with platinum-resistant ovarian cancer, fallopian tube cancer and PPA without serious toxicity.

High Rate of Resistance to Quinupristin-Dalfopristin in Enterococcus faecium Clinical Isolates from Korea

Science.gov (United States)

Oh, Won Sup; Ko, Kwan Soo; Song, Jae-Hoon; Lee, Mi Young; Park, Sulhee; Peck, Kyong Ran; Lee, Nam Yong; Kim, Choon-Kwan; Lee, Hyuck; Kim, Shin-Woo; Chang, Hyun-Ha; Kim, Yeon-Sook; Jung, Sook-In; Son, Jun Seong; Yeom, Joon-Sup; Ki, Hyun Kyun; Woo, Gun-Jo

2005-01-01

We tested the in vitro susceptibilities of 603 enterococcal isolates from eight tertiary-care hospitals in Korea. The quinupristin-dalfopristin resistance rate in Enterococcus faecium was very high (25 isolates, 10.0%). It was suggested that both clonal spread and the sporadic emergence of quinupristin-dalfopristin-resistant isolates may explain the high prevalence of quinupristin-dalfopristin resistance in Korea. PMID:16304198

Evolutionary Rate Heterogeneity of Primary and Secondary Metabolic Pathway Genes in Arabidopsis thaliana.

Science.gov (United States)

Mukherjee, Dola; Mukherjee, Ashutosh; Ghosh, Tapash Chandra

2015-11-10

Primary metabolism is essential to plants for growth and development, and secondary metabolism helps plants to interact with the environment. Many plant metabolites are industrially important. These metabolites are produced by plants through complex metabolic pathways. Lack of knowledge about these pathways is hindering the successful breeding practices for these metabolites. For a better knowledge of the metabolism in plants as a whole, evolutionary rate variation of primary and secondary metabolic pathway genes is a prerequisite. In this study, evolutionary rate variation of primary and secondary metabolic pathway genes has been analyzed in the model plant Arabidopsis thaliana. Primary metabolic pathway genes were found to be more conserved than secondary metabolic pathway genes. Several factors such as gene structure, expression level, tissue specificity, multifunctionality, and domain number are the key factors behind this evolutionary rate variation. This study will help to better understand the evolutionary dynamics of plant metabolism. © The Author(s) 2015. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

Strength training improves fatigue resistance and self-rated health in workers with chronic pain

DEFF Research Database (Denmark)

Sundstrup, Emil; Jakobsen, Markus Due; Brandt, Mikkel

2016-01-01

of a randomized controlled trial investigates the effect of strength training on muscular fatigue resistance and self-rated health among workers with chronic pain. Sixty-six slaughterhouse workers with chronic upper limb pain and work disability were randomly allocated to 10 weeks of strength training or usual...... (Spearman's rho = -0.40; P = 0.01). In conclusion, specific strength training improves muscular fatigue resistance and self-rated health and reduces pain of the hand/wrist in manual workers with chronic upper limb pain. This trial is registered with ClinicalTrials.gov NCT01671267.......-rated health and pain. Time to fatigue, muscle strength, hand/wrist pain, and self-rated health improved significantly more following strength training than usual care (all P

In vitro fracture resistance of three commercially available zirconia crowns for primary molars.

Science.gov (United States)

Townsend, Janice A; Knoell, Patrick; Yu, Qingzhao; Zhang, Jian-Feng; Wang, Yapin; Zhu, Han; Beattie, Sean; Xu, Xiaoming

2014-01-01

The purpose of this study was to measure the fracture resistance of primary mandibular first molar zirconia crowns from three different manufacturers-EZ Pedo (EZP), NuSmile (NSZ), and Kinder Krowns (KK)-and compare it with the thickness of the zirconia crowns and the measured fracture resistance of preveneered stainless steel crowns (SSCs). The thickness of 20 zirconia crowns from three manufacturers were measured. The mean force required to fracture the crowns was determined. Preveneered NuSmile (NSW) SSCs were tested as a control. EZP crowns were significantly thicker in three of the six measured locations. The force required to fracture the EZP crown was significantly higher than that required for NSZ and KK. There was a positive correlation between fracture resistance and crown thickness in the mesial, distal, mesioocclusal, and distoocclusal dimensions. None of the zirconia crowns proved to be as resistant to fracture as the preveneered SSCs. Statistically significant differences were found among the forces required to fracture zirconia crowns by three different manufacturers. The increase in force correlated with crown thickness. The forces required to fracture the preveneered stainless steel crowns were greater than the forces required to fracture all manufacturers' zirconia crowns.

Parasitism rate of Myzus persicae (Sulzer by Diaeretiella rapae (McIntosh in the presence of an alternative, resistant host

Directory of Open Access Journals (Sweden)

Samira Evangelista Ferreira

Full Text Available ABSTRACT The aphids Lipaphis pseudobrassicae (Davis and Myzus persicae (Sulzer (Hemiptera: Aphididae are important Brassicaceae pests, occurring worldwide and causing significant damage to crops. Interspecific variations in the resistance to natural enemies can potentially impact the interaction among aphid populations. Here we evaluated the hypothesis of associational resistance by determining if the presence of resistant aphids (L. pseudobrassicae reduces the rate of parasitism by Diaeretiella rapae (McIntosh on non-resistant aphids (M. persicae. The experiment was conducted using collard green plants infested with M. persicae and L. pseudobrassicae either resistant or susceptible to D. rapae. The percentage of parasitism by D. rapae was greater on L. pseudobrassicae in the susceptible than in the resistant treatment, but parasitism rates on M. persicae did not differ between the treatments. There was no difference in average growth rate between M. persicae and susceptible L. pseudobrassicae populations, but resistant L. pseudobrassicae had greater growth rate than M. persicae. These results suggest that over a short period of time the presence of resistant L. pseudobrassicae does not affect the rate of parasitism by D. rapae on M. persicae.

Survival and reproductive rate of mites in relation to resistance of their barn swallow hosts.

Science.gov (United States)

Møller, A P

2000-08-01

Parasite resistance may act via a number of different mechanisms that regulate or control the survival and the reproductive rate of parasites. Observations and experiments were used to test for effects of host resistance on parasite survival and rate of reproduction. Natural levels of infestation of barn swallow Hirundo rustica nests by the tropical fowl mite Ornithonyssus bursa were positively related to brood size, inversely related to the length of the outermost tail feathers of male nest owners (a secondary sexual character) and affected by time of reproduction by the host. A mite inoculation experiment, in which 50 adult mites were introduced into nests during the laying period of the host, was used to test for differential survival and reproduction of mites as a function of host resistance. The relationship between survival and reproduction of parasites, male tail length and host resistance was investigated. There was a negative relationship between mite numbers per nest after fledging of nestlings and male tail length. This relationship was mainly caused by a reduction in the number of mites in the first and second nymph stage with increasing tail length of male hosts, implying a reduction in rate of reproduction of mites. The proportion of mites that had recently fed was inversely related to tail length of male hosts. The proportion of nymph stages was positively related to the proportion of mites that had recently had a blood meal. Parasite resistance of barn swallows to the tropical fowl mite thus appeared to act through increased mortality rate of adult and nymph stages of mites, and through reduced reproductive rates of mites on resistant hosts. This is the first study demonstating a direct relationship between fitness components of a parasite and the expression of a secondary sexual character of a host.

Targeted sequencing identifies genetic alterations that confer primary resistance to EGFR tyrosine kinase inhibitor (Korean Lung Cancer Consortium).

Science.gov (United States)

Lim, Sun Min; Kim, Hye Ryun; Cho, Eun Kyung; Min, Young Joo; Ahn, Jin Seok; Ahn, Myung-Ju; Park, Keunchil; Cho, Byoung Chul; Lee, Ji-Hyun; Jeong, Hye Cheol; Kim, Eun Kyung; Kim, Joo-Hang

2016-06-14

Non-small-cell lung cancer (NSCLC) patients with activating epidermal growth factor receptor (EGFR) mutations may exhibit primary resistance to EGFR tyrosine kinase inhibitor (TKI). We aimed to examine genomic alterations associated with de novo resistance to gefitinib in a prospective study of NSCLC patients. One-hundred and fifty two patients with activating EGFR mutations were included in this study and 136 patients' tumor sample were available for targeted sequencing of genomic alterations in 22 genes using the Colon and Lung Cancer panel (Ampliseq, Life Technologies). All 132 patients with EGFR mutation were treated with gefitinib for their treatment of advanced NSCLC. Twenty patients showed primary resistance to EGFR TKI, and were classified as non-responders. A total of 543 somatic single-nucleotide variants (498 missense, 13 nonsense) and 32 frameshift insertions/deletions, with a median of 3 mutations per sample. TP53 was most commonly mutated (47%) and mutations in SMAD4 was also common (19%), as well as DDR2 (16%), PIK3CA (15%), STK11 (14%), and BRAF (7%). Genomic mutations in the PI3K/Akt/mTOR pathway were commonly found in non-responders (45%) compared to responders (27%), and they had significantly shorter progression-free survival and overall survival compared to patients without mutations (2.1 vs. 12.8 months, P=0.04, 15.7 vs. not reached, PAkt/mTOR pathway were commonly identified in non-responders and may confer resistance to EGFR TKI. Screening lung adenocarcinoma patients with clinical cancer gene test may aid in selecting out those who show primary resistance to EGFR TKI (NCT01697163).

Effect of Ni and Cr on IGSCC growth rate of Ni-Cr-Fe alloys in PWR primary water

International Nuclear Information System (INIS)

Arioka, K.; Yamada, T.; Aoki, M.; Miyamoto, T.

2015-01-01

The purpose of this research is to examine the dependence of SCC (Stress Corrosion Crack) growth on nickel and chromium in PWR primary water; the objective is to obtain the basic knowledge to understand SCC behavior of steam generator tubing materials. The second objective is to understand whether accelerated testing at higher temperatures is appropriate for predicting SCC initiation and growth at lower temperatures. For these objectives, SCC growth was measured in PWR primary water at 290, 320, 330, 340, and 360 C. degrees under static load conditions. Tests were performed using 0.5 T compact tension type specimen using 20%CW X%Ni-16%Cr-Fe alloys in the range of nickel concentration between 16 to 60% and laboratory melted nuclear grade 20% cold worked Alloy 800 (USN N08800, CW800NG). Four important patterns were observed. First, significant effect of nickel on IGSCC resistance was observed at 340 and 360 C. degrees. The rate of IGSCC growth decreases with increasing nickel concentration in the range of nickel concentration between 10% to 25% nickel; and then, the rate of IGSCC increases with increasing nickel concentration in the range of Ni content between 50% and 76%. This trend is quite similar to the results reported by Coriou and Staehle tested in deaerated pure water at 350 C. degrees. However, no significant dependence of Ni content on IGSCC in PWR water at 320 and 290 C. degrees was observed. The change in SCC growth dependence on nickel concentration suggested that the main rate limiting processes on IGSCC growth seems to change between 320 and 340 C. degrees. Secondly, significant beneficial effects of chromium in alloys were observed at 320 C. degrees. However, no beneficial effect of chromium addition in alloys was observed at 360 C. degrees. Thirdly, peak temperatures in growth rate of IGSCC were observed in almost all test materials except for 20%CW Alloy 600. Finally, intergranular attack was observed in some alloys at lower temperature, and the

Low methicillin-resistant Staphylococcus aureus carriage rate among Italian dental students

NARCIS (Netherlands)

Petti, S.; Kakisina, N.; Volgenant, C.M.C.; Messano, G.A.; Barbato, E.; Passariello, C.; de Soet, J.J.

2015-01-01

We assessed methicillin-resistant Staphylococcus aureus (MRSA) carriage rate among dental students from an Italian university. A total of 157 subjects participated (67 preclinical students and 90 clinical students); samples were collected from the nose, mouth, and skin. Five preclinical students and

High-Rate Glass Resistive Plate Chambers For LHC Muon Detectors Upgrade

CERN Document Server

Laktineh, I; Cauwenbergh, S; Combret, C; Crotty, I; Haddad, Y; Grenier, G; Guida, R; Kieffer, R; Lumb, N; Mirabito, L; Schirra, F; Seguin, N; Tytgat, M; Van der Donckt, M; Wang, Y; Zaganidis, N

2012-01-01

The limitation of the detection rate of standard bakelite resistive plate chambers (RPC) used as muon detector in LHC experiments is behind the absence of such detectors in the high TJ regions in both CMS and ATLAS detectors. RPCs made with low resistivity glass plates (10ID O.cm) could be an adequate solution to equip the high TJ regions extending thus both the trigger efficiency and the physics performance. Different beam tests with single and multi-gap configurations using the new glass have shown that such detectors can operate at few thousands Hzlcm2 with high efficiency( > 90%).

Technetium-99m-hexakis-2-methoxyisobutylisonitrile scintigraphy and multidrug resistance-related protein expression in human primary lung cancer

International Nuclear Information System (INIS)

Duan Xiaoyi; Wang Jiansheng; Liu Min; Guo Youmin

2008-01-01

The occurrence of multidrug resistance (MDR) is a major cause of resistance to chemotherapeutic agents in patients with lung cancer, in part owing to the overexpression of MDR-related proteins. Technetium-99m-hexakis-2-methoxyisobutylisonitrile ( 99m Tc-MIBI) has been shown to be a substrate for some MDR-related proteins. The aim of this study is to evaluate the role of 99m Tc-MIBI scintigraphy for functional imaging of MDR-related protein phenotypes. To determine the correlation between 99m Tc-MIBI scintigraphy and the expression level of P-glycoprotein (Pgp), multidrug-resistance protein (MRP), and glutathione-S-transferase Pi (GSTπ), 26 patients (17 men and 9 women, median age 57.5 years) with primary lung cancer were investigated. Following intravenous administration of 925 MBq 99m Tc-MIBI, single-photon emission computed tomography (SPECT) and computed tomography (CT) were performed at 15 min and 2 h. On the basis of the fused images, tumor to background (T/B) ratio of both early and delayed images, and washout rate (WR%) of 99m Tc-MIBI were calculated. The immunohistochemical staining of Pgp, MRP, and GSTπ was performed, and the expression level was semiquantitated using a pathoimage analysis system. The imaging results were compared with the status of Pgp, MRP, and GSTπ expression. The WR% of 99m Tc-MIBI showed a significant positive correlation with Pgp expression (r=0.560, P=0.003), as no correlation was observed between WR% and MRP or GSTπ (r=0.354, P=0.076; r=0.324, P=0.106). Neither early T/B nor delayed T/B correlated with the expression level of Pgp, MRP, and GSTπ. WR%, Pgp, and GSTπ expression showed significant differences between squamous cell carcinoma (group A) and adenocarcinoma (group B). There was no significant difference among Pgp, MRP, and GSTπ expression levels in any cases (P>0.05). Our data confirmed that 99m Tc-MIBI scintigraphy is useful for determining the MDR caused by Pgp in patients with primary lung cancer. (author)

Rate and Risk Factors for Periprosthetic Joint Infection Among 36,494 Primary Total Hip Arthroplasties.

Science.gov (United States)

Triantafyllopoulos, Georgios K; Soranoglou, Vasileios G; Memtsoudis, Stavros G; Sculco, Thomas P; Poultsides, Lazaros A

2018-04-01

As periprosthetic joint infections (PJIs) can have tremendous health and socioeconomic implications, recognizing patients at risk before surgery is of great importance. Therefore, we sought to determine the rate of and risk factors for deep PJI in patients undergoing primary total hip arthroplasty (THA). Clinical characteristics of patients treated with primary THA between January 1999 and December 2013 were retrospectively reviewed. These included patient demographics, comorbidities (including the Charlson/Deyo comorbidity index), length of stay, primary diagnosis, total/allogeneic transfusion rate, and in-hospital complications, which were grouped into local and systemic (minor and major). We determined the overall deep PJI rate, as well as the rates for early-onset (occurring within 2 years after index surgery) and late-onset PJI (occurring more than 2 years after surgery). A Cox proportional hazards regression model was constructed to identify risk factors for developing deep PJI. Significance level was set at 0.05. A deep PJI developed in 154 of 36,494 primary THAs (0.4%) during the study period. Early onset PJI was found in 122 patients (0.3%), whereas late PJI occurred in 32 patients (0.1%). Obesity, coronary artery disease, and pulmonary hypertension were identified as independent risk factors for deep PJI after primary THA. The rate of deep PJIs of the hip is relatively low, with the majority occurring within 2 years after THA. If the optimization of modifiable risk factors before THA can reduce the rate of this complication remains unknown, but should be attempted as part of good practice. Copyright © 2017 Elsevier Inc. All rights reserved.

Global Fluoroquinolone Resistance Epidemiology and Implictions for Clinical Use

Science.gov (United States)

Dalhoff, Axel

2012-01-01

This paper on the fluoroquinolone resistance epidemiology stratifies the data according to the different prescription patterns by either primary or tertiary caregivers and by indication. Global surveillance studies demonstrate that fluoroquinolone resistance rates increased in the past years in almost all bacterial species except S. pneumoniae and H. influenzae, causing community-acquired respiratory tract infections. However, 10 to 30% of these isolates harbored first-step mutations conferring low level fluoroquinolone resistance. Fluoroquinolone resistance increased in Enterobacteriaceae causing community acquired or healthcare associated urinary tract infections and intraabdominal infections, exceeding 50% in some parts of the world, particularly in Asia. One to two-thirds of Enterobacteriaceae producing extended spectrum β-lactamases were fluoroquinolone resistant too. Furthermore, fluoroquinolones select for methicillin resistance in Staphylococci. Neisseria gonorrhoeae acquired fluoroquinolone resistance rapidly; actual resistance rates are highly variable and can be as high as almost 100%, particularly in Asia, whereas resistance rates in Europe and North America range from 30% in established sexual networks. In general, the continued increase in fluoroquinolone resistance affects patient management and necessitates changes in some guidelines, for example, treatment of urinary tract, intra-abdominal, skin and skin structure infections, and traveller's diarrhea, or even precludes the use in indications like sexually transmitted diseases and enteric fever. PMID:23097666

Multiple Genetic Analysis System-Based Antibiotic Susceptibility Testing in Helicobacter pylori and High Eradication Rate With Phenotypic Resistance-Guided Quadruple Therapy.

Science.gov (United States)

Dong, Fangyuan; Ji, Danian; Huang, Renxiang; Zhang, Fan; Huang, Yiqin; Xiang, Ping; Kong, Mimi; Nan, Li; Zeng, Xianping; Wu, Yong; Bao, Zhijun

2015-11-01

Antibiotics resistance in Helicobacter pylori (H. pylori) is the major factor for eradication failure. Molecular tests including fluorescence in situ hybridization, PCR-restriction fragment length polymorphism, and dual priming oligonucleotide-PCR (DPO-PCR) play critical roles in the detection of antibiotic susceptibility; however, limited knowledge is known about application of multiple genetic analysis system (MGAS) in the area of H. pylori identification and antibiotics resistance detection.The aim of this study is to determine the antibiotics resistance using different molecular tests and evaluate the treatment outcomes of E-test-based genotypic resistance.A total of 297 patients with dyspepsia complaint were recruited for gastroscopies. Ninety patients with H. pylori culture positive were randomly divided into 2 groups (test group and control group). E-test, general PCR, and MGAS assay were performed in test group. Patients in control group were treated with empirical therapy (rabeprazole + bismuth potassium citrate + amoxicillin [AMX] + clarithromycin [CLR]), whereas patients in test group received quadruple therapy based on E-test results twice daily for 14 consecutive days. The eradication effect of H. pylori was confirmed by C-urea breath test after at least 4 weeks when treatment was finished.Rapid urease test showed 46.5% (128/297) patients with H. pylori infection, whereas 30.3% (90/297) patients were H. pylori culture positive. E-test showed that H. pylori primary resistance rate to CLR, AMX, metronidazole, tetracycline, and levofloxacin (LVX) was 40.0% (18/45), 4.4% (2/45), 53.3% (24/45), 0% (0/45), and 55.6% (25/45), respectively. In addition, there are many multidrug resistant (MDR) phenotypes, and the MDR strains have higher minimum inhibitory concentration than their single-drug resistant counterparts. Considering E-test as the reference test, the sensitivities of general PCR and MGAS in detecting CLR resistance were 83.3% (15/18) and 94.4% (17

Primary care treatment guidelines for skin infections in Europe: congruence with antimicrobial resistance found in commensal Staphylococcus aureus in the community

NARCIS (Netherlands)

van Bijnen, E.M.E.; Paget, W.J.; den Heijer, C.D.J.; Stobberingh, E.E.; Bruggeman, C.A.; Schellevis, F.G.

2014-01-01

Background: Over 90% of antibiotics for human use in Europe are prescribed in primary care. We assessed the congruence between primary care treatment guidelines for skin infections and commensal Staphylococcus aureus (S. aureus) antimicrobial resistance levels in community-dwelling persons. Methods:

Primary care treatment guidelines for skin infections in Europe: congruence with antimicrobial resistance found in commensal Staphylococcus aureus in the community.

NARCIS (Netherlands)

Bijnen, E.M.E. van; Paget, W.J.; Heijer, C.D.J. den; Stobberingh, E.E.; Bruggeman, C.A.; Schellevis, F.G.

2014-01-01

Background: Over 90% of antibiotics for human use in Europe are prescribed in primary care. We assessed the congruence between primary care treatment guidelines for skin infections and commensal Staphylococcus aureus (S. aureus) antimicrobial resistance levels in community-dwelling persons. Methods:

Conditioned Reinforcement Value and Resistance to Change

Science.gov (United States)

Shahan, Timothy A.; Podlesnik, Christopher A.

2008-01-01

Three experiments examined the effects of conditioned reinforcement value and primary reinforcement rate on resistance to change using a multiple schedule of observing-response procedures with pigeons. In the absence of observing responses in both components, unsignaled periods of variable-interval (VI) schedule food reinforcement alternated with…

Stainless Steel Foil with Improved Creep-Resistance for Use in Primary Surface Recuperators for Gas Turbine Engines

International Nuclear Information System (INIS)

Browning, P.F.; Fitzpatrick, M.; Grubb, J.F.; Klug, R.C.; Maziasz, P.J.; Montague, J.P.; Painter, R.A.; Swindeman, R.W.

1998-01-01

Primary surface recuperators (PSRs) are compact heat-exchangers made from thin-foil type 347 austenitic stainless steel, which boost the efficiency of land-based gas turbine engines. Solar Turbines uses foil folded into a unique corrugated pattern to maximize the primary surface area for efficient heat transfer between hot exhaust gas on one side, and the compressor discharge air on the other side of the foil. Allegheny-Ludlum produces 0.003 - 0.0035 in. thick foil for a range of current turbine engines using PSRs that operate at up to 660 degrees C. Laboratory-scale processing modification experiments recently have demonstrated that dramatic improvements can be achieved in the creep resistance of such typical 347 stainless steel foils. The modified processing enables fine NbC carbide precipitates to develop during creep at 650-700 degrees C, which provides strength even with a fine grain size. Such improved creep-resistance is necessary for advanced turbine systems that will demand greater materials performance and reliability at higher operating conditions. The next challenges are to better understand the nature of the improved creep resistance in these 347 stainless steel foil, and to achieve similar improvements with scale-up to commercial foil production

Resistance to Change and Frequency of Response-Dependent Stimuli Uncorrelated with Reinforcement

Science.gov (United States)

Podlesnik, Christopher A.; Jimenez-Gomez, Corina; Ward, Ryan D.; Shahan, Timothy A.

2009-01-01

Stimuli uncorrelated with reinforcement have been shown to enhance response rates and resistance to disruption; however, the effects of different rates of stimulus presentations have not been assessed. In two experiments, we assessed the effects of adding different rates of response-dependent brief stimuli uncorrelated with primary reinforcement…

Induced resistance: an enhancement of basal resistance?

NARCIS (Netherlands)

Vos, M. de; Robben, C.; Pelt, J.A. van; Loon, L.C. van; Pieterse, C.M.J.

2002-01-01

Upon primary pathogen attack, plants activate resistance mechanisms at the site of infection. Besides this so-called basal resistance, plants have also the ability to enhance their defensive capacity against future pathogen attack. There are at least two types of biologically induced resistance.

Hand-hygiene compliance does not predict rates of resistant infections in critically ill surgical patients.

Science.gov (United States)

Jayaraman, Sudha P; Klompas, Michael; Bascom, Molli; Liu, Xiaoxia; Piszcz, Regina; Rogers, Selwyn O; Askari, Reza

2014-10-01

Our institution had a major outbreak of multi-drug-resistant Acinetobacter (MDRA) in its general surgical and trauma intensive care units (ICUs) in 2011, requiring implementation of an aggressive infection-control response. We hypothesized that poor hand-hygiene compliance (HHC) may have contributed to the outbreak of MDRA. A response to the outbreak including aggressive environmental cleaning, cohorting, and increased hand hygiene compliance monitoring may have led to an increase in HHC after the outbreak and to a consequent decrease in the rates of infection by the nosocomial pathogens methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Clostridium difficile. Hand-hygiene compliance, tracked in monthly audits by trained and anonymous observers, was abstracted from an infection control database. The incidences of nosocomial MRSA, VRE, and C. difficile were calculated from a separate prospectively collected data base for 6 mo before and 12 mo after the 2011 outbreak of MDRA in the institution's general surgical and trauma ICUs, and data collected prospectively from two unaffected ICUs (the thoracic surgical ICU and medical intensive care unit [MICU]). We created a composite endpoint of "any resistant pathogen," defined as MRSA, VRE, or C. difficile, and compared incidence rates over time, using the Wilcoxon signed rank test and Pearson product-moment correlation coefficient to measure the correlations among these rates. Rates of HHC before and after the outbreak of MDRA were consistently high in both the general surgical (median rates: 100% before and 97.6% after the outbreak, p=0.93) and trauma ICUs (median rates: 90% before and 96.75% after the outbreak, p=0.14). In none of the ICUs included in the study did the rates of HHC increase in response to the outbreak of MDRA. The incidence of "any resistant pathogen" decreased in the general surgical ICU after the outbreak (from 6.7/1,000 patient-days before the outbreak to 2

Helicobacter pylori resistance to antibiotics in Europe and its relationship to antibiotic consumption

DEFF Research Database (Denmark)

Megraud, Francis; Coenen, Samuel; Versporten, Ann

2013-01-01

OBJECTIVE: Resistance to antibiotics is the major cause of treatment failure of Helicobacter pylori infection. A study was conducted to assess prospectively the antibacterial resistance rates of H pylori in Europe and to study the link between outpatient antibiotic use and resistance levels...... in different countries. DESIGN: Primary antibiotic resistance rates of H pylori were determined from April 2008 to June 2009 in 18 European countries. Data on yearly and cumulative use over several years of systemic antibacterial agents in ambulatory care for the period 2001-8 were expressed in Defined Daily...... Doses (DDD) per 1000 inhabitants per day. The fit of models and the degree of ecological association between antibiotic use and resistance data were assessed using generalised linear mixed models. RESULTS: Of 2204 patients included, H pylori resistance rates for adults were 17.5% for clarithromycin, 14...

Early and late rate of force development: differential adaptive responses to resistance training?

DEFF Research Database (Denmark)

Andersen, L L; Andersen, Jesper Løvind; Zebis, M K

2010-01-01

The objective of this study is to investigate the potentially opposing influence of qualitative and quantitative muscular adaptations in response to high-intensity resistance training on contractile rate of force development (RFD) in the early (200 ms) of rising muscle force. Fifteen healthy young......-intensity resistance training due to differential influences of qualitative and quantitative muscular adaptations on early and later phases of rising muscle force....... males participated in a 14-week resistance training intervention for the lower body and 10 matched subjects participated as controls. Maximal muscle strength (MVC) and RFD were measured during maximal voluntary isometric contraction of the quadriceps femoris muscle. Muscle biopsies were obtained from...

Mitochondrial dysfunction precedes depression of AMPK/AKT signaling in insulin resistance induced by high glucose in primary cortical neurons.

Science.gov (United States)

Peng, Yunhua; Liu, Jing; Shi, Le; Tang, Ying; Gao, Dan; Long, Jiangang; Liu, Jiankang

2016-06-01

Recent studies have demonstrated brain insulin signaling impairment and mitochondrial dysfunction in diabetes. Hyperinsulinemia and hyperlipidemia arising from diabetes have been linked to neuronal insulin resistance, and hyperglycemia induces peripheral sensory neuronal impairment and mitochondrial dysfunction. However, how brain glucose at diabetic conditions elicits cortical neuronal insulin signaling impairment and mitochondrial dysfunction remains unknown. In the present study, we cultured primary cortical neurons with high glucose levels and investigated the neuronal mitochondrial function and insulin response. We found that mitochondrial function was declined in presence of 10 mmol/L glucose, prior to the depression of AKT signaling in primary cortical neurons. We further demonstrated that the cerebral cortex of db/db mice exhibited both insulin resistance and loss of mitochondrial complex components. Moreover, we found that adenosine monophosphate-activated protein kinase (AMPK) inactivation is involved in high glucose-induced mitochondrial dysfunction and insulin resistance in primary cortical neurons and neuroblastoma cells, as well as in cerebral cortex of db/db mice, and all these impairments can be rescued by mitochondrial activator, resveratrol. Taken together, our results extend the finding that high glucose (≥10 mmol/L) comparable to diabetic brain extracellular glucose level leads to neuronal mitochondrial dysfunction and resultant insulin resistance, and targeting mitochondria-AMPK signaling might be a promising strategy to protect against diabetes-related neuronal impairment in central nerves system. We found that high glucose (≥10 mmol/L), comparable to diabetic brain extracellular glucose level, leads to neuronal mitochondrial dysfunction and resultant insulin resistance in an AMPK-dependent manner, and targeting mitochondria-AMPK signaling might be a promising strategy to protect against diabetes-related neuronal impairment in central

The change of macrolide resistance rates in group A Streptococcus isolates from children between 2002 and 2013 in Asahikawa city.

Science.gov (United States)

Sakata, Hiroshi

2015-05-01

This study targeted patients in the Department of Pediatrics, Asahikawa Kosei Hospital, between January 2002 and December 2013. In patients suspected of having hemolytic streptococcal infection, Group A Streptococcus (GAS) strains isolated from a throat swab were examined for antimicrobial susceptibility testing. The MICs were measured by the broth microdilution method. The annual number of GAS strains examined for antimicrobial susceptibility testing ranged from 28 to 65 strains, for a total of 574 strains. Some of the isolates obtained from 2006 to 2009 and from 2011 to 2013 were analyzed to determine their emm types. An erythromycin (EM) resistant strain was not detected until 2004, but one EM-resistant strain appeared in 2005. Subsequently, EM-resistant strains rapidly increased, and 48 of 65 strains (73.8%) examined in 2009 were resistant. In 2010, the number of EM-resistant strains decreased to 12 of 36 strains (33.3%). However, it gradually increased afterwards, and 37 of 60 strains (61.7%) were resistant in 2013. Out of 574 strains examined, 184 exhibited EM-resistance, and the overall resistance rate was 31.9%. Partitioning the 124 strains examined between 2006 and 2008 according to emm types, only emm28 strains, which exhibited a high resistance rate, and emm12 strains demonstrated resistance. For the 142 strains examined between 2011 and 2013, the resistance rate of emm28 strains was similarly high; the resistance of emm12 strains significantly increased, and emm1 strains exhibited a high resistance rate. The number of emm types associated with the resistant strains increased. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

The effect of delaying childbirth on primary cesarean section rates.

Science.gov (United States)

Smith, Gordon C S; Cordeaux, Yolande; White, Ian R; Pasupathy, Dharmintra; Missfelder-Lobos, Hannah; Pell, Jill P; Charnock-Jones, D Stephen; Fleming, Michael

2008-07-01

The relationship between population trends in delaying childbirth and rising rates of primary cesarean delivery is unclear. The aims of the present study were (1) to characterize the association between maternal age and the outcome of labor, (2) to determine the proportion of the increase in primary cesarean rates that could be attributed to changes in maternal age distribution, and (3) to determine whether the contractility of uterine smooth muscle (myometrium) varied with maternal age. We utilized nationally collected data from Scotland, from 1980 to 2005, and modeled the risk of emergency cesarean section among women delivering a liveborn infant in a cephalic presentation at term. We also studied isolated myometrial strips obtained from 62 women attending for planned cesarean delivery in Cambridge, England, from 2005 to 2007. Among 583,843 eligible nulliparous women, there was a linear increase in the log odds of cesarean delivery with advancing maternal age from 16 y upwards, and this increase was unaffected by adjustment for a range of maternal characteristics (adjusted odds ratio for a 5-y increase 1.49, 95% confidence interval [CI] 1.48-1.51). Increasing maternal age was also associated with a longer duration of labor (0.49 h longer for a 5-y increase in age, 95% CI 0.46-0.51) and an increased risk of operative vaginal birth (adjusted odds ratio for a 5-y increase 1.49, 95% CI 1.48-1.50). Over the period from 1980 to 2005, the cesarean delivery rate among nulliparous women more than doubled and the proportion of women aged 30-34 y increased 3-fold, the proportion aged 35-39 y increased 7-fold, and the proportion aged > or =40 y increased 10-fold. Modeling indicated that if the age distribution had stayed the same over the period of study, 38% of the additional cesarean deliveries would have been avoided. Similar associations were observed in multiparous women. When studied in vitro, increasing maternal age was associated with reduced spontaneous activity and

Acid-fast bacilli culture positivity and drug resistance in abdominal tuberculosis in Mumbai, India.

Science.gov (United States)

Samant, Hrishikesh; Desai, Devendra; Abraham, Philip; Joshi, Anand; Gupta, Tarun; Rodrigues, Camilla; George, Siji

2014-09-01

Culture positivity for Mycobacterium tuberculosis complex (MTB) in abdominal tuberculosis (TB) using Lowenstein Jensen medium and Bactec system varies from 25 % to 36 %. Data on the prevalence of drug resistance in primary abdominal TB is scant. Our aim was to study the acid-fast bacilli (AFB) culture positivity rate in primary abdominal TB using Bactec Mycobacterial Growth Indicator Tubes (MGIT) system and the prevalence of drug resistance in these patients. Records of patients with abdominal TB (diagnosed on clinical features, endoscopy, histology, microbiology) seen during the period 2008 to 2013 were retrieved from the Gastroenterology and Microbiology departments. Patients with extra-abdominal TB (five pulmonary, two nodal), adnexal (one), and HIV (one) were excluded from analysis. Of 61 patients, 31 (50.8 %) had a positive AFB culture. In the 30 culture-negative patients, histology showed non-caseating granulomas in 25 patients. Drug sensitivity pattern was analyzed in 18 patients; resistance was detected in eight (14.3 % of all patients and 44.4 % of patients in whom drug sensitivity was done) including three (5.4 % of all subjects and 16.6 % in whom drug sensitivity was available) who were multidrug-resistant. The rate of AFB culture positivity in primary abdominal TB was 50.8 % using Bactec MGIT. Likelihood of drug resistance was seen in 14.3 %, of whom 5.4 % were multidrug-resistant.

Efficiency of the pre-heater against flow rate on primary the beta test loop

International Nuclear Information System (INIS)

Edy Sumarno; Kiswanta; Bambang Heru; Ainur R; Joko P

2013-01-01

Calculation of efficiency of the pre-heater has been carried out against the flow rate on primary the BETA Test Loop. BETA test loop (UUB) is a facilities of experiments to study the thermal hydraulic phenomenon, especially for thermal hydraulic post-LOCA (Lost of Coolant Accident). Sequences removal on the BETA Test Loop contained a pre-heater that serves as a getter heat from the primary side to the secondary side, determination of efficiency is to compare the incoming heat energy with the energy taken out by a secondary fluid. Characterization is intended to determine the performance of a pre-heater, then used as tool for analysis, and as a reference design experiments. Calculation of efficiency methods performed by operating the pre-heater with fluid flow rate variation on the primary side. Calculation of efficiency on the results obtained that the efficiency change with every change of flow rate, the flow rate is 71.26% on 163.50 ml/s and 60.65% on 850.90 ml/s. Efficiency value can be even greater if the pre-heater tank is wrapped with thermal insulation so there is no heat leakage. (author)

A note on high discount rates and depletion of primary forests

NARCIS (Netherlands)

Bulte, E; vanSoest, D

1996-01-01

Conventional wisdom implies that high discount rates accelerate depletion of tropical forests. As shown in this article, this result does not necessarily hold in a two-state variable model that distinguishes between primary and secondary forest stocks. In the context of a fixed concession period and

CDK2 phosphorylation of Smad2 disrupts TGF-beta transcriptional regulation in resistant primary bone marrow myeloma cells.

Science.gov (United States)

Baughn, Linda B; Di Liberto, Maurizio; Niesvizky, Ruben; Cho, Hearn J; Jayabalan, David; Lane, Joseph; Liu, Fang; Chen-Kiang, Selina

2009-02-15

Resistance to growth suppression by TGF-beta1 is common in cancer; however, mutations in this pathway are rare in hematopoietic malignancies. In multiple myeloma, a fatal cancer of plasma cells, malignant cells accumulate in the TGF-beta-rich bone marrow due to loss of both cell cycle and apoptotic controls. Herein we show that TGF-beta activates Smad2 but fails to induce cell cycle arrest or apoptosis in primary bone marrow myeloma and human myeloma cell lines due to its inability to activate G(1) cyclin-dependent kinase (CDK) inhibitors (p15(INK4b), p21(CIP1/WAF1), p27(KIP1), p57(KIP2)) or to repress c-myc and Bcl-2 transcription. Correlating with aberrant activation of CDKs, CDK-dependent phosphorylation of Smad2 on Thr(8) (pT8), a modification linked to impaired Smad activity, is elevated in primary bone marrow myeloma cells, even in asymptomatic monoclonal gammopathy of undetermined significance. Moreover, CDK2 is the predominant CDK that phosphorylates Smad2 on T8 in myeloma cells, leading to inhibition of Smad2-Smad4 association that precludes transcriptional regulation by Smad2. Our findings provide the first direct evidence that pT8 Smad2 couples dysregulation of CDK2 to TGF-beta resistance in primary cancer cells, and they suggest that disruption of Smad2 function by CDK2 phosphorylation acts as a mechanism for TGF-beta resistance in multiple myeloma.

[Antituberculosis-drug resistance in the border of Brazil with Paraguay and Bolivia].

Science.gov (United States)

Marques, Marli; Cunha, Eunice Atsuko Totumi; Evangelista, Maria do Socorro Nantua; Basta, Paulo Cesar; Marques, Ana Maria Campos; Croda, Julio; de Andrade, Sonia Maria Oliveira

2017-04-20

To estimate the rate of drug resistance among pulmonary tuberculosis (PTB) cases in the state of Mato Grosso do Sul, Brazil, and specifically in the border areas with Paraguay and Bolivia, as well as to identify associated risk factors. The present cross-sectional, epidemiological study focused on PTB cases recorded between January 2007 and December 2010 in the State Reportable Disease Information System with results of susceptibility tests to rifampicin, isoniazid, ethambutol, and streptomycin. Dependent variables were development of resistance to a single drug or any combination of drugs. Independent variables were being a new or treated case, living in border areas, presence/absence of diabetes, and history of alcoholism. There were 789 TBP cases with susceptibility testing. The following characteristics were associated with resistance: treated case (P = 0.0001), border region (P = 0.0142), alcoholism (P = 0.0451), and diabetes (P = 0.0708). The rates of combined, primary, and acquired resistance for the state were 16.3%, 10.6%, and 39.0%, vs. 22.3%, 19.2%, and 37.5% for the border region. The rates of combined, primary, and acquired multidrug resistance for the state were 1.8%, 0.6%, and 6.3%, vs. 3.1%, 1.2%, and 12.5% for the border region. In the border region, the state should investigate drug resistance in all patients with respiratory symptoms, determine the pattern of resistance in confirmed cases, adopt directly observed treatment for cases of PTB, and develop health actions together with neighboring countries. Across the state, the levels of acquired resistance should be monitored, with investigation of resistance in all treated cases and implementation of directly observed treatment especially among patients with diabetes or alcoholism.

Cost-effectiveness of different strategies for diagnosis of uncomplicated urinary tract infections in women presenting in primary care

NARCIS (Netherlands)

Bosmans, Judith E; Coupé, Veerle M H; Knottnerus, Bart J; Geerlings, Suzanne E; Moll van Charante, Eric P; Ter Riet, Gerben

2017-01-01

BACKGROUND: Uncomplicated Urinary Tract Infections (UTIs) are common in primary care resulting in substantial costs. Since antimicrobial resistance against antibiotics for UTIs is rising, accurate diagnosis is needed in settings with low rates of multidrug-resistant bacteria. OBJECTIVE: To compare

Cost-effectiveness of different strategies for diagnosis of uncomplicated urinary tract infections in women presenting in primary care

NARCIS (Netherlands)

Bosmans, Judith E.; Coupé, Veerle M. H.; Knottnerus, Bart J.; Geerlings, Suzanne E.; Moll van Charante, Eric P.; ter Riet, Gerben

2017-01-01

Uncomplicated Urinary Tract Infections (UTIs) are common in primary care resulting in substantial costs. Since antimicrobial resistance against antibiotics for UTIs is rising, accurate diagnosis is needed in settings with low rates of multidrug-resistant bacteria. To compare the cost-effectiveness

Parallel Evolution of High-Level Aminoglycoside Resistance in Escherichia coli Under Low and High Mutation Supply Rates

Directory of Open Access Journals (Sweden)

Claudia Ibacache-Quiroga

2018-03-01

Full Text Available Antibiotic resistance is a major concern in public health worldwide, thus there is much interest in characterizing the mutational pathways through which susceptible bacteria evolve resistance. Here we use experimental evolution to explore the mutational pathways toward aminoglycoside resistance, using gentamicin as a model, under low and high mutation supply rates. Our results show that both normo and hypermutable strains of Escherichia coli are able to develop resistance to drug dosages > 1,000-fold higher than the minimal inhibitory concentration for their ancestors. Interestingly, such level of resistance was often associated with changes in susceptibility to other antibiotics, most prominently with increased resistance to fosfomycin. Whole-genome sequencing revealed that all resistant derivatives presented diverse mutations in five common genetic elements: fhuA, fusA and the atpIBEFHAGDC, cyoABCDE, and potABCD operons. Despite the large number of mutations acquired, hypermutable strains did not pay, apparently, fitness cost. In contrast to recent studies, we found that the mutation supply rate mainly affected the speed (tempo but not the pattern (mode of evolution: both backgrounds acquired the mutations in the same order, although the hypermutator strain did it faster. This observation is compatible with the adaptive landscape for high-level gentamicin resistance being relatively smooth, with few local maxima; which might be a common feature among antibiotics for which resistance involves multiple loci.

Resistance training intensity and volume affect changes in rate of force development in resistance-trained men.

Science.gov (United States)

Mangine, Gerald T; Hoffman, Jay R; Wang, Ran; Gonzalez, Adam M; Townsend, Jeremy R; Wells, Adam J; Jajtner, Adam R; Beyer, Kyle S; Boone, Carleigh H; Miramonti, Amelia A; LaMonica, Michael B; Fukuda, David H; Ratamess, Nicholas A; Stout, Jeffrey R

2016-12-01

To compare the effects of two different resistance training programs, high intensity (INT) and high volume (VOL), on changes in isometric force (FRC), rate of force development (RFD), and barbell velocity during dynamic strength testing. Twenty-nine resistance-trained men were randomly assigned to either the INT (n = 15, 3-5 RM, 3-min rest interval) or VOL (n = 14, 10-12 RM, 1-min rest interval) training group for 8 weeks. All participants completed a 2-week preparatory phase prior to randomization. Measures of barbell velocity, FRC, and RFD were performed before (PRE) and following (POST) the 8-week training program. Barbell velocity was determined during one-repetition maximum (1RM) testing of the squat (SQ) and bench press (BP) exercises. The isometric mid-thigh pull was used to assess FRC and RFD at specific time bands ranging from 0 to 30, 50, 90, 100, 150, 200, and 250 ms. Analysis of covariance revealed significant (p velocity. Results indicate that INT is more advantageous than VOL for improving FRC and RFD, while changes in barbell velocity during dynamic strength testing are similarly improved by both protocols in resistance-trained men.

Primary completion rates across socio-religious communities in West Bengal

OpenAIRE

Husain, Zakir; Chatterjee, Amrita

2009-01-01

Primary completion rates of Muslims in West Bengal are substantially lower than that of upper caste communities as well as backward castes, scheduled castes and tribes. Further, analysis of age-specific pcr indicates that differences in pcr between Muslims and other communities may have actually increased in recent years. An econometric analysis reveals that age, gender, household size and expenditure levels, education and gender of decision-maker, etc, are importan...

High prevalence and resistance rates to antibiotics in anaerobic bacteria in specimens from patients with chronic balanitis.

Science.gov (United States)

Boyanova, Lyudmila; Mitev, Angel; Gergova, Galina; Mateev, Grisha; Mitov, Ivan

2012-08-01

Aim of the study was to assess both prevalence and antibiotic resistance in anaerobic bacteria from glans penis skin of 70 adults. Strain susceptibility was determined by breakpoint susceptibility test or E test. In 9 asymptomatic, 48 untreated and 13 treated symptomatic patients, anaerobes were found in 22.2%, 70.8% and 53.3%, respectively. Gram-positive strains (GPAs) were 2.2-fold more common than Gram-negative ones. Prevalent Gram-negative (GNAs) and GPAs were Prevotella spp. and anaerobic cocci, respectively. Clostridium difficile strain was found in an untreated patient. In GNAs, resistance rates to amoxicillin, metronidazole, clindamycin, tetracycline, levofloxacin, and amoxicillin/clavulanate were 42.1, 0, 52.6, 53.3, 86.7 and 5.2%, respectively. In GPAs, the resistance rates to metronidazole, clindamycin, tetracycline, levofloxacin and amoxicillin/clavulanate were 18.2, 34.1, 52.6, 36.8 and 0%, respectively. In conclusion, anaerobes were 1.6-fold more frequent in untreated symptomatic patients compared with other patients, suggesting their participation in development of chronic balanitis. GPAs were more common than GNAs. The resistance rates to amoxicillin, clindamycin, tetracycline, and levofloxacin were high. Most active agents were metronidazole and amoxicillin/clavulanate. Resistance in anaerobes varies according to sites of specimens and years of study. Copyright © 2012 Elsevier Ltd. All rights reserved.

Rate and rhythm control strategies for apraxia of speech in nonfluent primary progressive aphasia.

Science.gov (United States)

Beber, Bárbara Costa; Berbert, Monalise Costa Batista; Grawer, Ruth Siqueira; Cardoso, Maria Cristina de Almeida Freitas

2018-01-01

The nonfluent/agrammatic variant of primary progressive aphasia is characterized by apraxia of speech and agrammatism. Apraxia of speech limits patients' communication due to slow speaking rate, sound substitutions, articulatory groping, false starts and restarts, segmentation of syllables, and increased difficulty with increasing utterance length. Speech and language therapy is known to benefit individuals with apraxia of speech due to stroke, but little is known about its effects in primary progressive aphasia. This is a case report of a 72-year-old, illiterate housewife, who was diagnosed with nonfluent primary progressive aphasia and received speech and language therapy for apraxia of speech. Rate and rhythm control strategies for apraxia of speech were trained to improve initiation of speech. We discuss the importance of these strategies to alleviate apraxia of speech in this condition and the future perspectives in the area.

The effect of delaying childbirth on primary cesarean section rates.

Directory of Open Access Journals (Sweden)

Gordon C S Smith

2008-07-01

Full Text Available The relationship between population trends in delaying childbirth and rising rates of primary cesarean delivery is unclear. The aims of the present study were (1 to characterize the association between maternal age and the outcome of labor, (2 to determine the proportion of the increase in primary cesarean rates that could be attributed to changes in maternal age distribution, and (3 to determine whether the contractility of uterine smooth muscle (myometrium varied with maternal age.We utilized nationally collected data from Scotland, from 1980 to 2005, and modeled the risk of emergency cesarean section among women delivering a liveborn infant in a cephalic presentation at term. We also studied isolated myometrial strips obtained from 62 women attending for planned cesarean delivery in Cambridge, England, from 2005 to 2007. Among 583,843 eligible nulliparous women, there was a linear increase in the log odds of cesarean delivery with advancing maternal age from 16 y upwards, and this increase was unaffected by adjustment for a range of maternal characteristics (adjusted odds ratio for a 5-y increase 1.49, 95% confidence interval [CI] 1.48-1.51. Increasing maternal age was also associated with a longer duration of labor (0.49 h longer for a 5-y increase in age, 95% CI 0.46-0.51 and an increased risk of operative vaginal birth (adjusted odds ratio for a 5-y increase 1.49, 95% CI 1.48-1.50. Over the period from 1980 to 2005, the cesarean delivery rate among nulliparous women more than doubled and the proportion of women aged 30-34 y increased 3-fold, the proportion aged 35-39 y increased 7-fold, and the proportion aged > or =40 y increased 10-fold. Modeling indicated that if the age distribution had stayed the same over the period of study, 38% of the additional cesarean deliveries would have been avoided. Similar associations were observed in multiparous women. When studied in vitro, increasing maternal age was associated with reduced spontaneous

Helicobacter pylori resistance rates for levofloxacin, tetracycline and rifabutin among Irish isolates at a reference centre.

LENUS (Irish Health Repository)

O'Connor, A

2013-04-27

INTRODUCTION: Helicobacter pylori eradication rates using conventional triple therapies are falling, making viable second-line and rescue regimens necessary. Levofloxacin, tetracycline and rifabutin are three efficacious antibiotics for rescue therapy. AIM: We aimed to assess the resistance rates for H. pylori against these antibiotics in an Irish cohort. METHODS: Gastric biopsies were collected from 85 patients infected with H. pylori (mean age 46 years) in the Adelaide and Meath Hospital, Dublin in 2008 and 2009. Susceptibility to antibiotics was tested using the Etest. Clinical information was obtained from endoscopy reports and chart review. RESULTS: 50.6 % of patients were females. Mean age was 47 years. Ten had prior attempts at eradication therapy with amoxicillin-clarithromycin-PPI, two had levofloxacin-based second-line therapy. 11.7 % [95 % CI (6.5-20.3 %)] (N = 10) had strains resistant to levofloxacin. There were no strains resistant to rifabutin or tetracycline. Levofloxacin resistance in the under 45 age group was 2.6 % (1\\/38) compared to 19.1 % (9\\/47) of above 45 age group (p = 0.02). DISCUSSION: The levofloxacin rates illustrated in this study are relatively low by European standards and in line with other studies from the United Kingdom and Germany, with younger patients having very low levels of resistance. Levofloxacin, tetracycline and rifabutin are all valid options for H. pylori eradication in Irish patients but the importance of compliance cannot be underestimated.

Rate and rhythm control strategies for apraxia of speech in nonfluent primary progressive aphasia

Directory of Open Access Journals (Sweden)

Bárbara Costa Beber

Full Text Available ABSTRACT The nonfluent/agrammatic variant of primary progressive aphasia is characterized by apraxia of speech and agrammatism. Apraxia of speech limits patients' communication due to slow speaking rate, sound substitutions, articulatory groping, false starts and restarts, segmentation of syllables, and increased difficulty with increasing utterance length. Speech and language therapy is known to benefit individuals with apraxia of speech due to stroke, but little is known about its effects in primary progressive aphasia. This is a case report of a 72-year-old, illiterate housewife, who was diagnosed with nonfluent primary progressive aphasia and received speech and language therapy for apraxia of speech. Rate and rhythm control strategies for apraxia of speech were trained to improve initiation of speech. We discuss the importance of these strategies to alleviate apraxia of speech in this condition and the future perspectives in the area.

Association of helicobacter pylori dupA with the failure of primary eradication.

Science.gov (United States)

Shiota, Seiji; Nguyen, Lam Tung; Murakami, Kazunari; Kuroda, Akiko; Mizukami, Kazuhiro; Okimoto, Tadayoshi; Kodama, Masaaki; Fujioka, Toshio; Yamaoka, Yoshio

2012-04-01

To determine whether the presence of dupA Helicobacter pylori (H. pylori) influences the cure rate of primary eradication therapy. Several virulence factors of H. pylori have been reported to affect the efficacy of the eradication rate. However, no study has investigated whether the presence of dupA affects eradication failure. The presence of dupA was evaluated in 142 H. pylori strains isolated from 142 patients with gastrointestinal diseases. Of these patients, 104 received primary eradication therapy for 1 week. The risk factors for eradication failure were determined using univariate and multivariate analyses. Among 142 strains, 44 (31.0%) were dupA positive. There was no association between dupA status and gastroduodenal diseases (P>0.05). The clarithromycin (CLR) resistance rate was generally lower in the dupA-positive than in the dupA-negative group (20.4% vs. 35.7%, P=0.06). However, dupA prevalence was higher in the eradication failure group than in the success group (36.3% vs. 21.9%). Among the CLR-resistant H. pylori infected group, the successful eradication rate was significantly lower in patients infected with dupA-positive H. pylori than dupA-negative H. pylori (P=0.04). In multivariate analysis adjusted for age, sex, and type of disease, not only CLR resistance but also dupA presence was independent risk factors for eradication failure (adjusted odds ratio=3.71; 95% confidence interval,1.07-12.83). Although CLR resistant was more reliable predictor, the presence of dupA may also be an independent risk factor for eradication failure.

Combination therapy of apatinib with icotinib for primary acquired icotinib resistance in patients with advanced pulmonary adenocarcinoma with EGFR mutation.

Science.gov (United States)

Xia, Pinghui; Cao, Jinlin; Lv, Xiayi; Wang, Luming; Lv, Wang; Hu, Jian

2018-05-01

Multi-targeted agents represent the next generation of targeted therapies for solid tumors, and patients with acquired resistance to EGFR-tyrosine kinase inhibitors (TKIs) may also benefit from their combination with TKI therapy. Third-generation targeted drugs, such as osimertinib, are very expensive, thus a more economical solution is required. The aim of this study was to explore the use of apatinib combined with icotinib therapy for primary acquired resistance to icotinib in three patients with advanced pulmonary adenocarcinoma with EGFR mutations. We achieved favorable oncologic outcomes in all three patients, with progression-free survival of four to six months. Unfortunately, the patients ultimately had to cease combination therapy because of intolerable adverse effects of hand and foot syndrome and oral ulcers. Combination therapy of apatinib with icotinib for primary acquired resistance to icotinib may be an option for patients with advanced pulmonary adenocarcinoma with EGFR mutations, but physicians must also be aware of the side effects caused by such therapy. © 2018 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

[Antibiotic susceptibility of Staphylococcus aureus and Streptococcus pneumoniae in healthy carrier individuals in primary care in Barcelona area].

Science.gov (United States)

Llor, Carles; Boada, Albert; Pons-Vigués, Mariona; Grenzner, Elisabet; Juvé, Rosa; Almeda, Jesús

2018-01-01

The information available on antibiotic resistance patterns are generally based on specimens from hospitalised individuals. This study was aimed at evaluating the antibiotic resistance rate of nasal carriage strains of Staphylococcus aureus and Streptococcus pneumoniae in healthy individuals, in accordance with age and gender, attended in Primary Care Centres (PCC). Cross-sectional study. Seven PCC in the Barcelona area. Healthy nasal carriers aged 4years or more who did not present with any sign of infectious disease, and had not taken any antibiotic or had been hospitalised in the previous 3months. A total of 3,969 nasal swabs valid for identification were collected between 2010 and 2011 and were sent to one central microbiological laboratory for isolation of both pathogens. Resistance to common antibiotics was determined on the basis of the current European Committee on Antimicrobial Susceptibility Testing guidelines on cut-off points. The prevalence of methicillin-resistant S.aureus was 1.3% (95%CI: 0.5-2.1%), with resistance rates of 87.1% to phenoxymethylpenicillin and 11.6% to azithromycin, with no significant differences with age and gender. A total of 2.4% (95CI%: 0.1-4.7%) of the pneumococcal strains were highly resistant to both phenoxymethylpenicillin and macrolides, whereas the highest resistance rates were to cefaclor (53.3%), followed by tetracycline (20%) and cefuroxime (12.1%). These pathogens have lower resistance rates in the community than in the hospital setting. Primary Care physicians must be more aware of the current antimicrobial resistance, in order to ensure prudent use of antibiotics. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

PET-CT detection rate of primary breast cancer lesions. Correlation with the clinicopathological factors

International Nuclear Information System (INIS)

Ogawa, Tomoko; Tozaki, Mitsuhiro; Fukuma, Eisuke

2008-01-01

One hundred and forty lesions of primary breast cancer underwent positron emission tomography (PET)-CT between June 2006 and May 2007. The PET-CT detection rate of primary breast cancer lesions was 72.1%. The detection rate was 52.1% for invasive cancer ≤20 mm, 92.8% for invasive breast cancers >20 mm, and these results were significant. In the present study, no significant relationship was observed between tumor types, however, invasive lobular carcinoma showed a lower detection rate, 58.3%. The PET-CT results were not significantly affected by either estrogen and progesterone receptors or distant metastasis. A significant correlation regarding the detection rate of PET-CT was found with HER2 status, tumor grade, and axillary lymph node status. The detection rate was 100% for invasive cancer ≤20 mm when the interval between prior diagnostic Mammotome biopsies and PET-CT was less than 3 weeks, 18.8% for invasive cancer ≤20 mm when the interval was more than 3 weeks, and these results were significant. Mammotome biopsies may therefore affect the detection rate of PET-CT. Invasive cancers ≤20 mm showed a low detection rate, therefore, it is considered to be insufficient to use PET-CT for the detection of early breast cancer. (author)

Impact of restricted amoxicillin/clavulanic acid use on Escherichia coli resistance--antibiotic DU90% profiles with bacterial resistance rates: a visual presentation.

Science.gov (United States)

Mimica Matanovic, Suzana; Bergman, Ulf; Vukovic, Dubravka; Wettermark, Björn; Vlahovic-Palcevski, Vera

2010-10-01

High use of amoxicillin/clavulanic acid (AMC) at the University Hospital Osijek (Croatia) contributed to high rates of resistance in Enterobacteriaceae, in particular Escherichia coli (50%). Thus, in order to decrease bacterial resistance, AMC use was restricted. We present results of the restriction on resistance amongst antibiotics accounting for 90% of antibiotic use [drug utilisation 90% (DU90%)]. Data were analysed on antibiotic use and microbiological susceptibility of E. coli during two 9-month periods, before and after the restriction of AMC use. Drug use was presented as numbers of defined daily doses (DDDs) and DDDs/100 bed-days. Resistance of E. coli to antibiotics was presented as percentages of isolated strains in the DU90% segment. Use of AMC was 16 DDDs/100 bed-days or 30% of all antibiotics before the intervention. Use of AMC fell to 2 DDDs/100 bed-days or 4% after the intervention, and resistance of E. coli fell from 37% to 11%. In conclusion, restricted use of AMC resulted in a significant decrease of E. coli resistance. DU90% resistance profiles are simple and useful tools in highlighting problems in antibiotic use and resistance but may also be useful in long-term follow-up of antibiotic policy. Copyright 2010 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

High rates of multidrug resistance among uropathogenic Escherichia coli in children and analyses of ESBL producers from Nepal

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Narayan Prasad Parajuli

2017-01-01

Full Text Available Abstract Background Emergence of Extended-spectrum beta-lactamase producing Escherichia coli causing urinary tract infections (UTI among pediatric patients is an increasing problem worldwide. However, very little is known about pediatric urinary tract infections and antimicrobial resistance trend from Nepal. This study was conducted to assess the current antibiotic resistance rate and ESBL production among uropathogenic Escherichia coli in pediatric patients of a tertiary care teaching hospital of Nepal. Methods A total of 5,484 urinary tract specimens from children suspected with UTI attending a teaching hospital of Nepal over a period of one year were processed for the isolation of bacterial pathogens and their antimicrobial susceptibility testing. Escherichia coli (n = 739, the predominant isolate in pediatric UTI, was further selected for the detection of ESBL-production by phenotypic combination disk diffusion test. Results Incidence of urinary tract infection among pediatric patients was found to be 19.68% and E coli (68.4% was leading pathogen involved. Out of 739 E coli isolates, 64.9% were multidrug resistant (MDR and 5% were extensively drug resistant (XDR. Extended spectrum beta lactamase (ESBL was detected in 288 (38.9% of the E coli isolates. Conclusion Alarming rate of drug resistance among pediatric uropathogens and high rate of ESBL-producing E. coli was observed. It is extremely necessary to routinely investigate the drug resistance among all isolates and formulate strict antibiotics prescription policy in our country.

Excision and primary closure of pilonidal sinus disease: worthwhile option with an acceptable recurrence rate.

LENUS (Irish Health Repository)

Gilani, S N S

2012-01-31

BACKGROUND: Treatment of pilonidal sinus disease is controversial. Many claim policy of marsupialisation and healing by secondary intention. This is demanding in terms of nursing care and time lost from work. AIMS: To examine outcome of excision and primary closure of chronic pilonidal disease on recurrence rate and patient\\'s daily activities. PATIENTS AND METHODS: One hundred and fourteen consecutive elective patients who had excision and primary closure of pilonidal sinus disease were reviewed. The demographic data and the post-operative outcome were studied. RESULTS: The recurrence of pilonidal sinus was noted in 9% of patients, wound breakdown occasioning delayed healing in 9%, patients able to drive by day 16 on average. The mean time to return to work was 20.5 days; duration of analgesia, 2.4 days; and duration of antibiotic treatment, 4.7 days. CONCLUSION: Excision and primary closure of chronic pilonidal sinus has low recurrence rate with early return to activities. Primary closure appears to be a cost-effective option for uncomplicated pilonidal sinus disease.

Success Rate of Formocresol Pulpotomy versus Mineral Trioxide Aggregate in Human Primary Molar Tooth

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S E Jabbarifar

2004-12-01

Full Text Available Background: In spite of long time and broad use of formaldehyde derivates (Fixation agent in primary tooth pulp treatment, There is some concerns about these derivates such as variability, inconsistency success rate, mutagenicity, cytotoxicity, alergenicity, and some other potential health hazards of them. Therefore other alternative pulpotomy procedures like Bioactive glass (BAG, Glutaraldehyde (2%, Hydroxyappetite (HA, Bone dried freezed (BDF, ferric sulfate (15%, laser, Electrosurgery (ES, Bone Morphogenic proteins (BMP, recombinant protein-1 (RP1, and Mineral Trioxide Aggregate (MTA have been compared. The purpose of this clinical trial is to assess radiographic and clinical success rate of Formocresol (FC pulpotomy in compare with MTA in human primary molar teeth. Methods: 64 molars were pulpotomized equally and randomly with mineral trioxide Aggregate and Formocresol. Prior to trial, we defined a case as failure, when one or more of the events such as external root resorption, internal root resorption, periapical and furca lucency, pain, swelling, mobility, dental abscess, or early extraction appeared. Every treated tooth was defined as successful, if any noted evident was not shown. Results: Totally, 60 teeth treatment (92.2 percent were successful and 7.8 percent were failed. Failure and success rates for MTA group were 6.3 and 93.7 percent, respectively. Failure and success rates in FC group were 8.4 and 90.2 percent respectively. The difference between MTA and FC treatment methods was not significant (Fisher Exact test. Conclusion: Findings of this study show that mineral trioxide aggregate can be an alternative procedure for FC pulpotomy of primary tooth. Keywords: Mineral trioxide aggregate, formocresol, pulpotomy, success and failure rate.

Penicillin-susceptible Staphylococcus aureus: susceptibility testing, resistance rates and outcome of infection.

Science.gov (United States)

Hagstrand Aldman, Malin; Skovby, Annette; I Påhlman, Lisa

2017-06-01

Staphylococcus aureus (SA) is an important human pathogen that causes both superficial and invasive infections. Penicillin is now rarely used in the treatment of SA infections due to widespread resistance and a concern about the accuracy of existing methods for penicillin susceptibility testing. The aims of the present study were to determine the frequency of penicillin-susceptible SA isolates from blood and wound cultures in Lund, Sweden, and to evaluate methods for penicillin testing in SA. We also wanted to investigate if penicillin-susceptible isolates are associated with higher mortality. Hundred blood culture isolates collected 2008/2009, 140 blood culture isolates from 2014/2015, and 141 superficial wound culture strains from 2015 were examined. Penicillin susceptibility was tested with disk diffusion according to EUCAST guidelines, and results were confirmed with a cloverleaf assay and PCR amplification of the BlaZ gene. Patient data for all bacteraemia cases were extracted from medical records. The disk diffusion method with assessment of both zone size and zone edge appearance had high accuracy in our study. About 57% of bacteraemia isolates from 2008/2009 were sensitive to penicillin compared to 29% in 2014/2015 (p penicillin susceptible. There was no difference in co-morbidity or mortality rates between patients with penicillin resistant and penicillin sensitive SA bacteraemia. Disk-diffusion is a simple and reliable method to detect penicillin resistance in SA, and susceptibility rates are significant. Penicillin has many theoretical advantages and should be considered in the treatment of SA bacteraemia when susceptible.

Awareness of antibiotic resistance and antibiotic prescribing in UTI treatment: a qualitative study among primary care physicians in Sweden.

Science.gov (United States)

Björkman, Ingeborg; Berg, Johanna; Viberg, Nina; Stålsby Lundborg, Cecilia

2013-03-01

To improve education and information for general practitioners in relation to rational antibiotic prescribing for urinary tract infection (UTI), it is important to be aware of GPs' views of resistance and how it influences their choice of UTI treatment. The aim of this study was to explore variations in views of resistance and UTI treatment decisions among general practitioners (GPs) in a county in Sweden. Qualitative, semi-structured interviews were analysed with a phenomenographic approach and content analysis. Primary care in Kronoberg, a county in southern Sweden. Subjects. A purposeful sample of 20 GPs from 15 of 25 health centres in the county. The variation of perceptions of antibiotic resistance in UTI treatment. How UTIs were treated according to the GPs. Three different ways of viewing resistance in UTI treatment were identified. These were: (A) No problem, I have never seen resistance, (B) The problem is bigger somewhere else, and (C) The development of antibiotic resistance is serious and we must be careful. Moreover, GPs' perceptions of antibiotic resistance were mirrored in how they reported their treatment of UTIs in practice. There was a hierarchal scale of how GPs viewed resistance as an issue in UTI treatment. Only GPs who expressed concerns about resistance followed prescribing guidelines completely. This offers valuable insights into the planning and most likely the outcome of awareness or educational activities aimed at changed antibiotic prescribing behaviour.

What is the impact of primary care model type on specialist referral rates? A cross-sectional study.

Science.gov (United States)

Liddy, Clare; Singh, Jatinderpreet; Kelly, Ryan; Dahrouge, Simone; Taljaard, Monica; Younger, Jamie

2014-02-03

Several new primary care models have been implemented in Ontario, Canada over the past two decades. These practice models differ in team structure, physician remuneration, and group size. Few studies have examined the impact of these models on specialist referrals. We compared specialist referral rates amongst three primary care models: 1) Enhanced Fee-for-service, 2) Capitation- Non-Interdisciplinary (CAP-NI), 3) Capitation - Interdisciplinary (CAP-I). We conducted a cross-sectional study using health administrative data from primary care practices in Ontario from April 1st, 2008 to March 31st, 2010. The analysis included all family physicians providing comprehensive care in one of the three models, had at least 100 patients, and did not have a prolonged absence (eight consecutive weeks). The primary outcome was referral rate (# of referrals to all medical specialties/1000 patients/year). A multivariable clustered Poisson regression analysis was used to compare referral rates between models while adjusting for provider (sex, years since graduation, foreign trained, time in current model) and patient (age, sex, income, rurality, health status) characteristics. Fee-for-service had a significantly lower adjusted referral rate (676, 95% CI: 666-687) than the CAP-NI (719, 95% confidence interval (CI): 705-734) and CAP-I (694, 95% CI: 681-707) models and the interdisciplinary CAP-I group had a 3.5% lower referral rate than the CAP-NI group (RR = 0.965, 95% CI: 0.943-0.987, p = 0.002). Female and Canadian-trained physicians referred more often, while female, older, sicker and urban patients were more likely to be referred. Primary care model is significantly associated with referral rate. On a study population level, these differences equate to 111,059 and 37,391 fewer referrals by fee-for-service versus CAP-NI and CAP-I, respectively - a difference of $22.3 million in initial referral appointment costs. Whether a lower rate of referral is more appropriate or not is not

Influence of mass transfer resistance on overall nitrate removal rate in upflow sludge bed reactors.

Science.gov (United States)

Ting, Wen-Huei; Huang, Ju-Sheng

2006-09-01

A kinetic model with intrinsic reaction kinetics and a simplified model with apparent reaction kinetics for denitrification in upflow sludge bed (USB) reactors were proposed. USB-reactor performance data with and without sludge wasting were also obtained for model verification. An independent batch study showed that the apparent kinetic constants k' did not differ from the intrinsic k but the apparent Ks' was significantly larger than the intrinsic Ks suggesting that the intra-granule mass transfer resistance can be modeled by changes in Ks. Calculations of the overall effectiveness factor, Thiele modulus, and Biot number combined with parametric sensitivity analysis showed that the influence of internal mass transfer resistance on the overall nitrate removal rate in USB reactors is more significant than the external mass transfer resistance. The simulated residual nitrate concentrations using the simplified model were in good agreement with the experimental data; the simulated results using the simplified model were also close to those using the kinetic model. Accordingly, the simplified model adequately described the overall nitrate removal rate and can be used for process design.

Nasal Carriage Rate of Methicillin Resistant Staphylococcus aureus among Health Care Workers at a Tertiary Care Hospital in Kathmandu, Nepal.

Science.gov (United States)

Khatri, S; Pant, N D; Bhandari, R; Shrestha, K L; Shrestha, C D; Adhikari, N; Poudel, A

2017-01-01

Methicillin-resistant Staphylococcus aureus is one of the most common causes of nosocomial infections. Due to its multidrug resistant nature; infections due to Methicillin-resistant Staphylococcus aureus are often very difficult to treat. Colonized health care workers are the important sources of Methicillin-resistant Staphylococcus aureus. The objectives of this study were to determine the nasal carriage rate of Methicillin-resistant Staphylococcus aureus among health care workers at Kathmandu Medical College and Teaching Hospital, Nepal and to assess their antimicrobial susceptibility patterns. A cross sectional study was conducted among 252 health care workers from July to November 2013. Mannitol salt agar was used to culture the nasal swabs. Antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion technique following Clinical and Laboratory Standards Institute guidelines. Methicillin-resistant Staphylococcus aureus strains were confirmed by using cefoxitin disc and by determining the minimum inhibitory concentration of oxacillin by agar dilution method. Of 252 healthcare workers, 46(18.3%) were positive for Staphylococcus aureus among which 19(41.3%) were Methicillin-resistant Staphylococcus aureus carriers. Overall rate of nasal carriage of Methicillin-resistant Staphylococcus aureus was 7.5% (19/252).The higher percentages of lab personnel were nasal carriers of S. aureus (31.6%) and Methicillin-resistant Staphylococcus aureus (10.5%).The percentages of nasal carriage of S. aureus (35.7%) and Methicillin-resistant Staphylococcus aureus (14.3%) were highest in the health care workers from post operative department. Higher percentage of Methicillin-resistant Staphylococcus aureus were susceptible toward amikacin (100%) and vancomycin (100%) followed by cotrimoxazole (84.2%). High rates of nasal carriage of S. aureus and Methicillin-resistant Staphylococcus aureus were observed among the healthcare workers, which indicate the need of

Evidence to Support a Putative Role for Insulin Resistance in ...

African Journals Online (AJOL)

Introduction: The primary cause of morbidity and mortality in the renal patient is a cardiovascular event. Insulin resistance (IR) contributes to this event by increasing cardiovascular disease (CVD) and accelerating rates of decline in kidney function. Here we review the historical background of IR in patients with chronic ...

Patients harboring EGFR mutation after primary resistance to crizotinib and response to EGFR-tyrosine kinase inhibitor

Directory of Open Access Journals (Sweden)

Wang WX

2016-01-01

Full Text Available Wenxian Wang,1 Xiaowen Jiang,1 Zhengbo Song,1,2 Yiping Zhang1,2 1Department of Chemotherapy, Zhejiang Cancer Hospital, 2Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Hangzhou, Zhejiang, People’s Republic of China Abstract: Anaplastic lymphoma kinase (ALK rearrangement lung cancer responds to ALK tyrosine kinase inhibitors. It is known that many cases ultimately acquired resistance to crizotinib. However, a case of primary resistance is rare. We present a case of harboring exon 19 deletion in epidermal growth factor receptor in ALK rearranged lung adenocarcinoma, who experienced a partial tumor response to icotinib after failure with crizotinib therapy and chemotherapy. Considering the partial response, we conclude that it is important to find the cause of resistance to crizotinib. We detected gene mutations with plasma by the next-generation sequencing; the next-generation sequencing demonstrates an attractive system to identify mutations improving the outcome of patients with a deadly disease. Keywords: non-small cell lung cancer, anaplastic lymphoma kinase, crizotinib, epidermal growth factor receptor

Definitive radiotherapy for primary vaginal cancer. Correlation between treatment patterns and recurrence rate

International Nuclear Information System (INIS)

Kanayama, Naoyuki; Isohashi, Fumiaki; Yoshioka, Yasuo

2015-01-01

The purpose of this study was to determine the outcomes and optimal practice patterns of definitive radiotherapy for primary vaginal cancer. Between 1993 and 2012, 49 patients were treated with definitive radiotherapy for primary vaginal cancer in three hospitals. Of these, 15 patients (31%) had clinically positive regional lymph node metastasis. A total of 34 patients (70%) received external beam radiotherapy with high-dose-rate brachytherapy (interstitial or intracavitary), and 8 (16%) (with small superficial Stage I tumors) were treated with local radiotherapy. The median follow-up was 33 months (range: 1–169 months). The 3-year overall survival (OS), disease-free survival (DFS), and loco-regional control (LRC) rates were 83%, 59% and 71%, respectively. In multivariate analysis, the histological type (P = 0.044) was significant risk factors for LRC. In Federation of Gynecology and Obstetrics (FIGO) Stage I cases, 3 of 8 patients (38%) who did not undergo prophylactic lymph node irradiation had lymph node recurrence, compared with 2 of 12 patients (17%) who underwent prophylactic pelvic irradiation. For Stage III–IV tumors, the local recurrence rate was 50% and the lymph node recurrence rate was 40%. Patients with FIGO Stage I/II or clinical Stage N1 had a higher recurrence rate with treatment using a single modality compared with the recurrence rate using combined modalities. In conclusion, our treatment outcomes for vaginal cancer were acceptable, but external beam radiotherapy with brachytherapy (interstitial or intracavitary) was needed regardless of FIGO stage. Improvement of treatment outcomes in cases of FIGO Stage III or IV remains a significant challenge. (author)

Success Rate of Trabeculectomy in Primary Glaucoma at Cicendo Eye Hospital on January–December 2013

Directory of Open Access Journals (Sweden)

Erva Monica Saputro

2016-03-01

Full Text Available Background: Trabeculectomy is a surgical therapy for glaucoma to preserve visual function by lowering intraocular pressure (IOP. In some studies, the success of trabeculectomy in lowering IOP is greater than medication. Success is defined by IOP <21 mmHg, with or without glaucoma medication. Primary glaucoma based on the mechanism of aquous humor outflow is divided into primary open-angle glaucoma (POAG and primary angle-closure glaucoma (PACG. This study aimed to know the success rate of trabeculectomy in POAG and PACG. Methods: This study was a descriptive study conducted at Cicendo Eye Hospital using medical record of POAG and PACG patients who underwent trabeculectomy surgery on January–December 2013 with minimal one month follow-up. Data collection was conducted during September 2014. Data processed in this study were 100 eyes from 76 patients with diagnosis POAG and PACG. Results: The success rate for trabeculectomy in POAG was 79% and PACG was 86%, failure (IOP ≥ 21 mmHg 21% in POAG, and 14% in PACG for period 2013 at Cicendo Eye Hospital. Conclusions: The success rate of trabeculectomy at Cicendo Eye Hospital is good in one month, with or without glaucoma medication after surgery.

Fracture resistance of 3 types of primary esthetic stainless steel crowns.

Science.gov (United States)

Beattie, Sean; Taskonak, Burak; Jones, James; Chin, Judith; Sanders, Brian; Tomlin, Angela; Weddell, James

2011-01-01

Demand is increasing for esthetic restorations in pediatric dentistry. When full coverage is indicated, one option is to use esthetic stainless steel crowns (SSCs). However, this type of crown is prone to fracture. The purpose of this study was to evaluate the fracture resistance of 3 types of esthetic SSCs. Esthetic SSCs for first primary mandibular molars were cemented to idealized epoxy dies with glass ionomer cement. The die-crown units were fractured on a universal testing machine. The force was delivered by a stainless steel ball fixture, set in a uniaxial lever to replicate a cusp contact, with a crosshead speed of 1 mm/min. The differences among the 3 types of crown, in terms of force required to fracture, were compared statistically by 1-way analysis of variance. Pairwise comparisons were performed with Fisher's protected least significant difference test, at an overall significance level of 5%. The force required to fracture, expressed as average ± standard error, did not differ significantly among the 3 brands of esthetic SSCs: 1730 N ± 50 N, 1826 N ± 62 N and 1671 N ± 68 N, respectively (p = 0.19), well below the maximum bite force of pediatric patients determined in a previous study. Esthetic SSCs should be able to resist occlusal forces over short clinical periods. However, long-term occlusal loading and fatigue failures should be taken into account when evaluating the success of this type of crown.

Influence of chemistry on steam generator primary-to-secondary stabilized low leak flow rate

International Nuclear Information System (INIS)

Hervouet, C.; Pages, D.; Fauchon, C.; Bretelle, J.L.; Bus, F.

2002-01-01

The comparison of the leak flow rate behavior between the previous and the new boron/lithium coordination, the second one corresponding to an higher pH during the cycle than the first one, leads to the following conclusions, confirmed by the experimental and theoretical studies: Low leak flow rate is extremely sensitive to pH in the zone of pH of primary water because the behavior of metallic oxide is changing drastically in that range of pH (from precipitation to dissolution); Leak flow rate is often maintained lower with low pH. Let's recall however that pH can not reach a too low value which could enhance corrosion product deposition, increase dose rates along the primary circuit, and lead to reactor outages due to problems on fuel assemblies. The understanding of the governing phenomena led to adapt in 2000 the reactor cooling system chemical conditioning for the French Pressurized Water reactors facing problems with the management of the stabilized leak flow rate fluctuations, once no degradation of tube bundle integrity is proved. Each part of the cycle and operating conditions lead to an advised operating action. In general, the new recommendations for the reactors facing problems with the management of low leak flow rate are based on the principle of helping the precipitation of metallic oxide within the crack and preventing their dissolution. (authors)

Effects of grain size on the corrosion resistance of pure magnesium by cooling rate-controlled solidification

Science.gov (United States)

Liu, Yichi; Liu, Debao; You, Chen; Chen, Minfang

2015-09-01

The aim of this study was to investigate the effect of grain size on the corrosion resistance of pure magnesium developed for biomedical applications. High-purity magnesium samples with different grain size were prepared by the cooling rate-controlled solidification. Electrochemical and immersion tests were employed to measure the corrosion resistance of pure magnesium with different grain size. The electrochemical polarization curves indicated that the corrosion susceptibility increased as the grain size decrease. However, the electrochemical impedance spectroscopy (EIS) and immersion tests indicated that the corrosion resistance of pure magnesium is improved as the grain size decreases. The improvement in the corrosion resistance is attributed to refine grain can produce more uniform and density film on the surface of sample.

Dose rates modeling of pressurized water reactor primary loop components with SCALE6.0

International Nuclear Information System (INIS)

Matijević, Mario; Pevec, Dubravko; Trontl, Krešimir

2015-01-01

Highlights: • Shielding analysis of the typical PWR primary loop components was performed. • FW-CADIS methodology was thoroughly investigated using SCALE6.0 code package. • Versatile ability of SCALE6.0/FW-CADIS for deep penetration models was proved. • The adjoint source with focus on specific material can improve MC modeling. - Abstract: The SCALE6.0 simulation model of a typical PWR primary loop components for effective dose rates calculation based on hybrid deterministic–stochastic methodology was created. The criticality sequence CSAS6/KENO-VI of the SCALE6.0 code package, which includes KENO-VI Monte Carlo code, was used for criticality calculations, while neutron and gamma dose rates distributions were determined by MAVRIC/Monaco shielding sequence. A detailed model of a combinatorial geometry, materials and characteristics of a generic two loop PWR facility is based on best available input data. The sources of ionizing radiation in PWR primary loop components included neutrons and photons originating from critical core and photons from activated coolant in two primary loops. Detailed calculations of the reactor pressure vessel and the upper reactor head have been performed. The efficiency of particle transport for obtaining global Monte Carlo dose rates was further examined and quantified with a flexible adjoint source positioning in phase-space. It was demonstrated that generation of an accurate importance map (VR parameters) is a paramount step which enabled obtaining Monaco dose rates with fairly uniform uncertainties. Computer memory consumption by the S N part of hybrid methodology represents main obstacle when using meshes with large number of cells together with high S N /P N parameters. Detailed voxelization (homogenization) process in Denovo together with high S N /P N parameters is essential for precise VR parameters generation which will result in optimized MC distributions. Shielding calculations were also performed for the reduced PWR

Predictive analysis of the radiation exposure for the primary cooling system of the rated power operation of MONJU

International Nuclear Information System (INIS)

Matuo, Youichirou; Miyahara, Shinya; Hasegawa, Masanori; Maegawa, Yoshiharu

2011-01-01

Radioactive corrosion products (CP) are main source of personal radiation exposure during maintenance without fuel-failure accident in the Liquid-Metal Fast Breeder Reactor (LMFBR) plants. In order to establish the techniques of radiation dose estimation for personnel, program system 'DORE' has been developed. The DORE system is constructed by PSYCHE code and QAD code system. The density of each deposited CP of primary coolant system in MONJU was estimated by using the PSYCHE. Moreover, the QAD-CGGP2R code is applied to dose rate calculations for the primary coolant system in MONJU. The dose rate around primary piping system was visualized using AVS software. The predicted values were estimated to be saturated at 2-3 mSv/h in twenty years after the start of operation, and the dose rate reaches 4 mSv/h in domains near the IHX and the cold-leg piping. It has been assumed that the main radiation source is 54 Mn in the IHX, primary pump and cold-leg piping region. On the other hand, it was indicated that the contribution to dose rate of the 60 Co accounted for approximately 23% in the hot-leg piping region. (author)

Rigidity in routines and the development of resistance to change in individuals with Prader-Willi syndrome.

Science.gov (United States)

Haig, E L; Woodcock, K A

2017-05-01

Individuals with Prader-Willi syndrome (PWS) commonly show debilitating resistance to change, which has been linked to cognitive deficits in task switching. Anecdotal reports suggest that exposure to flexibility in routines during development may be beneficial for limiting subsequent resistance to change in people with PWS, which is consistent with a beneficial role of such exposure on the development of task switching, highlighted in typical children. Here, we aim to investigate the development of resistance to change in individuals with PWS and hypothesise that exposure to increased rigidity in routines will be associated with increased subsequent resistance to change. An author-compiled informant report interview and two previously validated questionnaires were administered to the caregivers of 10 individuals with PWS (5-23 years). The interview examined rigidity in routines and resistance to change across life stages defined by easily distinguishable events (before school, during primary school, during secondary school, after school, currently), using open-ended and structured yes/no and 5-point Likert questions. Open-ended data were coded using an author-compiled system. Responses from two additional informants and data from the questionnaires were used to assess inter-informant reliability and concurrent validity of the structured questions. The validity of the interview was supported by acceptable inter-rater reliability of the open-ended coding system and inter-informant reliability, internal consistency and concurrent validity of structured questions. Descriptive analyses of ratings of behaviour change showed a pattern of increasing resistance to change over the life course for the four oldest individuals, who had all been exposed to substantial rigidity in routines before and during primary school. Furthermore, only one individual - currently in primary school - was exposed to very little rigidity in routines before and during primary school, and he had

Drug-resistant tuberculosis in Sindh

International Nuclear Information System (INIS)

Almani, S.A.; Memon, N.M.; Qureshi, A.F.

2002-01-01

Objective: To assess the prevalence of primary and secondary drug resistance amongst the clinical isolates of M.tuberculosis, to identify risk factors and how to overcome this problem. Design: A case series of 50 indoor patients with sputum smear-positive pulmonary tuberculosis. Place and duration of Study: Department of Medicine, Liaquat University of Medical and Health Sciences Jamshoro, Sindh, (Pakistan) from January 1999 to December 2000. Patients and methods: Four first line anti-tuberculous drugs rifampicine, ethambutol and streptomycin were tested for sensitivity pattern. Results: Twelve (26.66%) were sensitive to all four drugs, 12(26.66%) were resistant to one drug, 14 (31.11%) were resistant to two drugs, 2 (4.44%) were resistant to three drugs, and 5(11.11%) were resistant to all four drugs. Resistance to isoniazid was the most common in 27 cases (60%) with primary resistance in 6(13.33%) and secondary resistance in 21(46.66%), followed by resistance to streptomycin in 17 cases (37.77%) with primary resistance in 5(11.11%) and secondary resistance in 12 (26.66%). Resistance to ethambutol in 10 cases (22.22%) and rifampicine in 11 (24.44%) and all cases were secondary. Similarly multi-drugs resistance (MRD) TB was found in 11(24.44%) isolates. Conclusion: This study showed high prevalence of drug resistance among clinical isolates of M. tuberculosis. Their is a need to establish centers at number of places with adequate facilities for susceptibility testing so that the resistant pattern could be ascertained and treatment regimens tailored accordingly. (author)

Degradation rates and mechanisms of acid-resistant coatings in copper-leaching tanks

DEFF Research Database (Denmark)

Møller, Victor Buhl

coating where the lifetime was estimated to 1:6 ± 0:2 and 1:4 ± 0:1 years, respectively. Part IV A series of newly designed and constructed diffusion cells were used to measure sulfuric acid diffusion rates through the coatings. A mathematical model was developed to simulate the experimental data...... potential in the mineral industry has not yet been thoroughly investigated. This particular industry poses unique challenges, with high operational temperatures (around 75 °C) and combined acidicerosive environments. The use of organic coatings to protect tanks, pipes, and secondary exposure areas, may....... Part I An in-depth literature study was performed to uncover and review uses and limitations ofacid-resistant coatings in the chemical industry, with a comparison to alternative resistant materialsbased on metals and ceramics. In addition, coating degradation phenomena caused by acid exposure, were...

Effects of febuxostat on insulin resistance and expression of high-sensitivity C-reactive protein in patients with primary gout.

Science.gov (United States)

Meng, Juan; Li, Yanchun; Yuan, Xiaoxu; Lu, Yuewu

2017-02-01

We aimed to investigate the effects of febuxostat on IR and the expression of high-sensitivity C-reactive protein (hs-CRP) in patients with primary gout. Forty-two cases of primary gout patients without uric acid-lowering therapy were included in this study. After a physical examination, 20 age- and sex-matched patients were included as normal controls. The levels of fasting insulin (INS), fasting blood glucose (FBG), and hs-CRP were determined. IR was assessed using the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Gout patients had higher levels of UA, INS, HOMA-IR, and hs-CRP than normal controls (P gout patients and implicate that febuxostat can effectively control the level of serum UA and increase insulin sensitivity in primary gout patients.

Tick resistance and heat tolerance characteristics in cattle. III. Sweating rate

Directory of Open Access Journals (Sweden)

Cecília José Veríssimo

2012-12-01

Full Text Available Cattle in a sustainable tropical livestock should be heat tolerant and resistant to ticks. The relationship between Rhipicephalus (Boophilus microplus infestation and sweating rate, an important heat tolerance characteristic, was studied in six Nellore and four Holstein steers of seven-month-old. They were artificial infested (a.i. with 10,000 (Holstein and 20,000 (Nellore larvae in 16/Apr/2011. In days 20, 23 and 24 after the infestation, the 10 bigger females ticks found in whole animal were weighed and put in a chamber (27 oC and 80% RH, weighing the egg mass of each female tick fourteen days after. The sweating rate (SRskin, measured by Scheleger and Turner, 1963, method, in a shaved area of shoulder skin was evaluated in 14/Apr (2 days before the a.i. and in 05/May (19 days after a.i.. In 14/Apr the Scheleger and Turner, 1963, method was done on the coat not shaved (SRcoat. The sweating rate was measured in the afternoon (from 2 P.M., after 30 minutes of direct sunlight, on April. On May, the animals remained 60 minutes in direct sunlight because this day was colder. The experimental design was a non-probability sample restricted to the 10 available animals. Data from the steers’ sweating rate were analyzed using the General linear models of the SPSS® statistical package (version 12.0 using SRskin as dependent variable and breed and sampling date as independent variables. For SRcoat breed was the independent variable. Nellore, a tropical cattle breed, had higher SRskin (1,000.82 ± 64.59 g m-2 h-1, P< 0.001 than Holstein (620.45 ± 79.10 g m-2 h-1. SRskin was higher on May (1,187.33 ± 71.49 g m-2 h-1, P< 0.001 than on April (433.93 ± 71.49 g m-2 h-1. The correlation between the two different measurements of SR was positive and significant (r= 0,545, P<0,01, Pearson correlation. But in SRcoat the breed effect disappeared because the Holstein SRcoat increased (Holstein: 884.95 ± 472.12 g m-2 h-1 and Nellore: 1,060.72 ± 318.21 g m-2 h-1

Proliferation Rates of Bovine Primary Muscle Cells Relate to Liveweight and Carcase Weight in Cattle

Science.gov (United States)

Coles, Chantal A.; Wadeson, Jenny; Leyton, Carolina P.; Siddell, Jason P.; Greenwood, Paul L.; White, Jason D.; McDonagh, Matthew B.

2015-01-01

Muscling in cattle is largely influenced by genetic background, ultimately affecting beef yield and is of major interest to the beef industry. This investigation aimed to determine whether primary skeletal muscle cells isolated from different breeds of cattle with a varying genetic potential for muscling differ in their myogenic proliferative capacity. Primary skeletal muscle cells were isolated and cultured from the Longissimus muscle (LM) of 6 month old Angus, Hereford and Wagyu X Angus cattle. Cells were assessed for rate of proliferation and gene expression of PAX7, MYOD, MYF5, and MYOG. Proliferation rates were found to differ between breeds of cattle whereby myoblasts from Angus cattle were found to proliferate at a greater rate than those of Hereford and Wagyu X Angus during early stages of growth (5–20 hours in culture) in vitro (P cattle (P cattle (P cattle. PMID:25875203

Genetic variation for growth rate, feed conversion efficiency, and disease resistance exists within a farmed population of rainbow trout

DEFF Research Database (Denmark)

Henryon, Mark; Jokumsen, Alfred; Berg, Peer

2002-01-01

The objective of this study was to test that additive genetic (co)variation for survival, growth rate, feed conversion efficiency, and resistance to viral haemorrhagic septicaemia (VHS) exists within a farmed population of rainbow trout. Thirty sires and 30 dams were mated by a partly factorial...... the predicted breeding values for VHS resistance and the predicted breeding values for the body weights, body length, and feed conversion efficiencies. These results demonstrate that additive genetic (co)variation for growth rate, feed conversion efficiency, and VHS resistance does exist within the farmed...... mating design. Each sire was mated to two dams, and each dam was mated to two sires, producing 50 viable full-sib families (29 sires, 25 dams). The fish from these families were reared for a 215-day growout period, and were assessed for survival between days 52 and 215, growth rate (i.e., body weight...

Increased Resistance of Skin Flora to Antimicrobial Prophylaxis in Patients Undergoing Hip Revision Arthroplasty.

Science.gov (United States)

Mühlhofer, Heinrich M L; Deiss, Lukas; Mayer-Kuckuk, Philipp; Pohlig, Florian; Harrasser, Norbert; Lenze, Ulrich; Gollwitzer, Hans; Suren, Christian; Prodinger, Peter; VON Eisenhart-Rothe, Rüdiger; Schauwecker, Johannes

2017-01-01

Prosthetic joint infection (PJI) remains a major complication after total joint replacement and is the primary indication for revision arthroplasty. Specifically, coagulase-negative Staphylococci (CNS) can cause low-grade infections. Despite the use of cephalosporin-based antimicrobial prophylaxis (AMP) and antiseptic treatment at the surgical site, evidence suggests that a significant number of cases of dermal CNS results in low-grade PJI. Thus, this study examined the bacterial colonization and resistance patterns at the surgical site. We hypothesized that the bacteria developed resistance to antibiotics that are frequently used in primary and revision total hip arthroplasty (THA) procedures. Ninety patients, including 63 primary and 27 revision THA patients, were enrolled in this study. For each patient, a single swab of the skin at the surgical site was subjected to clinical microbiology to assess bacterial colonization. Furthermore, resistance to a sentinel panel of antibiotics (benzylpenicillin, erythromycin, tetracycline, oxacillin, fusidic acid, clindamycin, gentamicin, levofloxacin/moxifloxacin, rifampicin, linezolid and vancomycin) was tested. In 96.7% of the patients, at least one bacterial strain was identified at the surgical site, with CNS strains comprising 93.1% of the total. The sentinel panel showed that 30.7% of the CNS strains exhibited maximal resistance to oxacillin, a commonly used cephalosporin. Additionally, oxacillin resistance increased 1.9-fold (p=0.042) between primary and revision THA. Notably, 8.1% of the CNS stains found on patients undergoing primary THA were resistant to gentamicin, an aminoglycoside, and this rate increased 4.7-fold (p=0.001) for patients undergoing revision THA. CNS strains have significant resistance to standard AMP, particularly in individuals undergoing revision THA. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Measurement of Dynamic Resistance in Resistance Spot Welding

DEFF Research Database (Denmark)

Wu, Pei; Zhang, Wenqi; Bay, Niels

Through years, the dynamic resistance across the electrodes has been used for weld quality estimation and contact resistance measurement. However, the previous methods of determining the dynamic resistance were mostly based on measuring the voltage and current on the secondary side of the transfo......Through years, the dynamic resistance across the electrodes has been used for weld quality estimation and contact resistance measurement. However, the previous methods of determining the dynamic resistance were mostly based on measuring the voltage and current on the secondary side...... of the transformer in resistance welding machines, implying defects from induction noise and interference with the leads connected to the electrodes for measuring the voltage. In this study, the dynamic resistance is determined by measuring the voltage on the primary side and the current on the secondary side...

Helicobacter pylori strains from a Nigerian cohort show divergent antibiotic resistance rates and a uniform pathogenicity profile.

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Ute Harrison

Full Text Available Antibiotic resistance in Helicobacter pylori is a factor preventing its successful eradication. Particularly in developing countries, resistance against commonly used antibiotics is widespread. Here, we present an epidemiological study from Nigeria with 111 isolates. We analyzed the associated disease outcome, and performed a detailed characterization of these isolated strains with respect to their antibiotic susceptibility and their virulence characteristics. Furthermore, statistical analysis was performed on microbiological data as well as patient information and the results of the gastroenterological examination. We found that the variability concerning the production of virulence factors between strains was minimal, with 96.4% of isolates being CagA-positive and 92.8% producing detectable VacA levels. In addition, high frequency of bacterial resistance was observed for metronidazole (99.1%, followed by amoxicillin (33.3%, clarithromycin (14.4% and tetracycline (4.5%. In conclusion, this study indicated that the infection rate of H. pylori infection within the cohort in the present study was surprisingly low (36.6%. Furthermore, an average gastric pathology was observed by histological grading and bacterial isolates showed a uniform pathogenicity profile while indicating divergent antibiotic resistance rates.

Clostridium difficile Infection and Patient-Specific Antimicrobial Resistance Testing Reveals a High Metronidazole Resistance Rate.

Science.gov (United States)

Barkin, Jodie A; Sussman, Daniel A; Fifadara, Nimita; Barkin, Jamie S

2017-04-01

Clostridium difficile (CD) infection (CDI) causes marked morbidity and mortality, accounting for large healthcare expenditures annually. Current CDI treatment guidelines focus on clinical markers of patient severity to determine the preferred antibiotic regimen of metronidazole versus vancomycin. The antimicrobial resistance patterns for patients with CD are currently unknown. The aim of this study was to define the antimicrobial resistance patterns for CD. This study included all patients with stools sent for CD testing to a private laboratory (DRG Laboratory, Alpharetta, Georgia) in a 6-month period from across the USA. Patient data was de-identified, with only age, gender, and zip-code available per laboratory protocol. All samples underwent PCR testing followed by hybridization for CD toxin regions A and B. Only patients with CD-positive PCR were analyzed. Antimicrobial resistance testing using stool genomic DNA evaluated presence of imidazole- and vancomycin-resistant genes using multiplex PCR gene detection. Of 2743, 288 (10.5%) stool samples were positive for CD. Six were excluded per protocol. Of 282, 193 (69.4%) were women, and average age was 49.4 ± 18.7 years. Of 282, 62 were PCR positive for toxins A and B, 160 for toxin A positive alone, and 60 for toxin B positive alone. Antimicrobial resistance testing revealed 134/282 (47.5%) patients resistant to imidazole, 17 (6.1%) resistant to vancomycin, and 9 (3.2%) resistant to imidazole and vancomycin. CD-positive patients with presence of imidazole-resistant genes from stool DNA extract was a common phenomenon, while vancomycin resistance was uncommon. Similar to treatment of other infections, antimicrobial resistance testing should play a role in CDI clinical decision-making algorithms to enable more expedited and cost-effective delivery of patient care.

TRIMETHOPRIM-SULFAMETHOXAZOLE RESISTANCE AND FOSFOMYCIN SUSCEPTIBILITY RATES IN UNCOMPLICATED URINARY TRACT INFECTIONS: TIME TO CHANGE THE ANTIMICROBIAL PREFERENCES.

Science.gov (United States)

Guneysel, Ozlem; Suman, Enes; Ozturk, Tuba Cimilli

2016-03-01

Urinary tract infections (UTIs) are among the most common bacterial infections in adult population. They are prevalent in all age groups both in women and men. Also, UTIs are the most frequent indication for empirical antibiotic treatment in emergency department. The aim of this study was to determine the antibiotic resistance rates in the treatment of uncomplicated UTIs. Adult patients admitted to emergency department with uncomplicated UTIs were included in this cross-sectional study. Mid-stream urine samples were obtained under sterile conditions and cultured quantitatively. After 24 hours, the samples showing 10(5) colony forming unit per milliliter (CFU/mL) were tested for antibiotic susceptibility. Resistance to fosfomycin-trometamol (FT), amoxicillin-clavulanic acid (AC), ciprofloxacin (CIP), trimethoprim-sulfamethoxazole (TMP-SMX) and cefpodoxime (CEF) was tested by Kirby-Bauer disc diffusion system. Escherichia (E.) coli accounted for the vast majority (93.4%) of the organisms isolated in the study. Among the E. coli positive patients, resistance to TMP-SMX was the most common antibiotic resistance. The E. coli species detected in our study group were least resistant to FT (2.4%). The resistance rates, especially to CEF, AC and CIP, were significantly higher in patients over 50 years of age. In conclusion, in the treatment of uncomplicated UTIs, TMP-SMX should be excluded from empirical treatment, while fosfomycin could be a viable option in all age groups.

Glucocorticoids promote a glioma stem cell-like phenotype and resistance to chemotherapy in human glioblastoma primary cells

DEFF Research Database (Denmark)

Kostopoulou, Ourania N; Mohammad, Abdul-Aleem; Bartek, Jiri

2018-01-01

Glioma stem cells (GSCs) are glioblastoma (GBM) cells that are resistant to therapy and can give rise to recurrent tumors. The identification of patient-related factors that support GSCs is thus necessary to design effective therapies for GBM patients. Glucocorticoids (GCs) are used to treat GBM......-associated edema. However, glucocorticoids participate in the physiological response to psychosocial stress, which has been linked to poor cancer prognosis. This raises concern that glucocorticoids affect the tumor and GSCs. Here, we treated primary human GBM cells with dexamethasone and evaluated GC......-driven changes in cell morphology, proliferation, migration, gene expression, secretory activity and growth as neurospheres. Dexamethasone treatment of GBM cells appeared to promote the development of a GSC-like phenotype and conferred resistance to physiological stress and chemotherapy. We also analyzed...

Studies on the infection process by Erysiphe polygoni in resistant and susceptible peas

International Nuclear Information System (INIS)

Cirulli, M.; Montemurro, G.; Ciccarese, F.; Smilari, F.

1976-01-01

The infection of pea by Erysiphe polygoni was investigated. The susceptible cultivar ''Sprinter'' and the resistant varieties ''Stratagem Resistant'' (er 1 er 1 Er 2 Er 2 ) and ''Mexique-4'' (er 1 er 1 er 2 er 2 ) were used. Observations of germination of conidia, formation of primary appressoria, differentiation of secondary hyphae, number of secondary hyphae per conidium, and number of branches on the longest hyphae per conidium were made at different times from inoculation. The rate of conidial germination was not affected by the host genotypes. The formation of short germ tubes with primary appressoria were found to be similar on the susceptible ''Sprinter'' as well as on the ''Stratagem Resistant'' and ''Mexique-4''. No statistical difference in the growth of germ tubes with appressorium between susceptible and resistant peas was observed at 2, 4, 6, 10 and 12 hrs after inoculation. In resistant peas formation of primary appressoria was not followed by further mycelial growth. Conversely, in the susceptible pea, germinating conidia produced multiple germ tubes and branching hyphae. The establishment of a compatible relationship between host and pathogen appears to occur at or near the stage of formation of the primary appressorium. Most conidia on the leaves formed primary appressoria as early as 2 hrs after inoculation. The Course of the host/pathogen relationship is apparently decided at a very early stage after pathogen contact with the host, such as the length of the longest hyphae, number of germ tubes per conidium and branching of the longest, and the difference in the macroscopic fungal fructification. E. polygoni activity in susceptible pea is evidently influenced by temperature whereas the gene action of the genetic factors remains unaffected in resistant pea

A comparison of antimicrobial resistance rates in Gram-positive pathogens isolated in the UK from October 1996 to January 1997 and October 1997 to January 1998.

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Andrews, J; Ashby, J; Jevons, G; Marshall, T; Lines, N; Wise, R

2000-03-01

Rates of resistance for two consecutive years for 28 centres (10 Teaching, nine Associate Teaching and nine District General hospitals) in the UK were compared. Combined rates of resistance for each of the hospital types of Staphylococcus aureus to methicillin revealed an increase in the rate of resistance in Teaching hospitals (12.5% year 1, 23.5% year 2), but, for Associate Teaching and District General hospitals rates fell (Associate Teaching 19.1% year 1, 11.9% year 2; District General 16.5% year 1 and 11.3% year 2). Using conventional methodology to determine MICs, no strain was considered to have reduced susceptibility to vancomycin. Among coagulase-negative staphylococci, increased resistance was observed for Staphylococcus epidermidis to rifampicin, for Staphylococcus haemolyticus to clindamycin, for Staphylococcus saprophyticus to penicillin and for Staphylococcus spp. to clindamycin, methicillin and rifampicin. For Streptococcus pneumoniae an upward trend in low-level resistance to penicillin was observed (18 of the 28 centres), however, for high-level resistance the trend was in the opposite direction (only four centres showed an increase). For Enterococcus faecalis there was a trend to a fall in levels of resistance, the only exception being an increase in high-level gentamicin resistance (10.5% year 1, 15.1% year 2, P = 0.0388). For Enterococcus faecium rates of resistance were not significantly different except for increases in resistance to nitrofurantoin and rifampicin.

Infection rates of Enterobius vermicularis and Clonorchis sinensis of primary school children in Hamyang-gun, Gyeongsangnam-do (Province), Korea

Science.gov (United States)

Kim, Bong Jin; Yeon, Je Wook

2001-01-01

The egg positive rate of Enterobius vermicularis and Clonorchis sinensis of school children in the rural area was studied in Hamyang-gun. Gyeongsangnam-do in Korea. Cellotape anal swab and formalin ether concentration methods were performed one time to 720 primary school children. The total egg positive rate of E. vermicularis was 12.6% in two schools (Baekjeon and Wiseong). In the Baekjeon and Wiseong primary school, the egg positive rate of E. vermicularis was 4.6% and 13.4%, respectively. Pinworm egg positive rate was 17.6% in the lower grades (1st. 2nd and 3rd), and 7.7% in higher grades (4th, 5th and 6th). The total egg positive rate of male and female was 12.6% and 12.7%, respectively. The egg positive rate of C. sinensis of Baekjeon and Wiseong primary school was 1.5% and 0.46%, respectively. The total egg positive rate of C. sinensis was 0.56%. This survey showed that continuous education and chemotherapy is necessary to treat and prevent reinfection of E. vermicularis. In the case of C. sinensis, health education for school children is recommended to prevent potential infection of adolescents. PMID:11775334

Mass extinctions: Ecological selectivity and primary production

Science.gov (United States)

Rhodes, Melissa Clark; Thayer, Charles W.

1991-09-01

If mass extinctions were caused by reduced primary productivity, then extinctions should be concentrated among animals with starvation-susceptible feeding modes, active lifestyles, and high-energy budgets. The stratigraphic ranges (by stage) of 424 genera of bivalves and 309 genera of articulate brachiopods suggest that there was an unusual reduction of primary productivity at the Cretaceous/Tertiary (K/T) boundary extinction. For bivalves at the K/T, there were (1) selective extinction of suspension feeders and other susceptible trophic categories relative to deposit feeders and other resistant categories, and (2) among suspension feed-ers, selective extinction of bivalves with active locomotion. During the Permian-Triassic (P/Tr) extinction and Jurassic background time, extinction rates among suspension feeders were greater for articulate brachiopods than for bivalves. But during the K/T event, extinction rates of articulates and suspension-feeding bivalves equalized, possibly because the low-energy budgets of articulates gave them an advantage when food was scarce.

Molecular mechanisms of bortezomib resistant adenocarcinoma cells.

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Erika Suzuki

Full Text Available Bortezomib (Velcade™ is a reversible proteasome inhibitor that is approved for the treatment of multiple myeloma (MM. Despite its demonstrated clinical success, some patients are deprived of treatment due to primary refractoriness or development of resistance during therapy. To investigate the role of the duration of proteasome inhibition in the anti-tumor response of bortezomib, we established clonal isolates of HT-29 adenocarcinoma cells adapted to continuous exposure of bortezomib. These cells were ~30-fold resistant to bortezomib. Two novel and distinct mutations in the β5 subunit, Cys63Phe, located distal to the binding site in a helix critical for drug binding, and Arg24Cys, found in the propeptide region were found in all resistant clones. The latter mutation is a natural variant found to be elevated in frequency in patients with MM. Proteasome activity and levels of both the constitutive and immunoproteasome were increased in resistant cells, which correlated to an increase in subunit gene expression. These changes correlated with a more rapid recovery of proteasome activity following brief exposure to bortezomib. Increased recovery rate was not due to increased proteasome turnover as similar findings were seen in cells co-treated with cycloheximide. When we exposed resistant cells to the irreversible proteasome inhibitor carfilzomib we noted a slower rate of recovery of proteasome activity as compared to bortezomib in both parental and resistant cells. Importantly, carfilzomib maintained its cytotoxic potential in the bortezomib resistant cell lines. Therefore, resistance to bortezomib, can be overcome with irreversible inhibitors, suggesting prolonged proteasome inhibition induces a more potent anti-tumor response.

Operation of a RPC with low resistivity bakelite for the endcap region of CMS in a high-rate environment

CERN Document Server

Ahn, S H; Hong, B; Hong, S J; Kang, D H; Kim, T J; Lee, K S; Park, S; Park, W J; Ryu, M S; Shim, H H; Sim, K S; Youn, S W; Kim, Y J; Kim, Y U; Nam, S K; Jung, S R; Lee, Y L; Rhee, J T; Lee, S J; Koo, D G; Bahk, S Y

2002-01-01

We present the beam-test results for a real-size prototype resistive plate chamber (RPC) for the endcap region of the Compact Muon Solenoid (CMS) experiment at CERN Large Hadron Collider (LHC). The chamber built with relatively low resistivity bakelite was tested at the Gamma Irradiation Facility (GIF) at CERN under a high photon-flux environment with an effective cluster rate up to about 1.2 kHz/cm/sup 2/. The characteristics of the present chamber are compatible with the previous results for the muon detection efficiency, time resolution, mean travel time, and rate capability, which were obtained using a higher resistivity bakelite. The present beam-test results ensure that the RPC made of relatively low resistivity bakelite is also suitable for the CMS muon trigger detector. In addition, we study the position resolution of the endcap RPC of the CMS. By using the median position of the cluster strips, the position resolution can be reduced to only half of the strip width. (15 refs).

Screening for fecal carriage of MCR-producing Enterobacteriaceae in healthy humans and primary care patients

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Katrin Zurfluh

2017-03-01

Full Text Available Abstract Background The extent of the occurrence of the plasmid-encoded colistin resistance genes mcr-1 and mcr-2 among humans is currently sparsely studied in Western Europe. Objectives To determine the occurrence of MCR-producing Enterobacteriaceae in fecal samples of healthy humans with high occupational exposure to food and primary care patients in Switzerland. Methods Stool samples from 1091 healthy individuals and fecal swabs from 53 primary care patients were screened for polymyxin-resistant Enterobacteriaceae using LB agar containing 4 mg/L colistin. Minimal inhibitory concentrations (MICs of colistin were determined for non-intrinsic colistin-resistant isolates. Isolates were screened by PCR for the presence of mcr-1 and mcr-2 genes. Results The fecal carriage rate of colistin resistant (MIC value >2 mg/l Enterobacteriaceae was 1.5% for healthy people and 3.8% for primary care patients. Isolates included Hafnia alvei (n = 9, Escherichia coli (n = 3, Enterobacter cloacae (n = 4, Klebsiella pneumoniae (n = 1 and Raoultella ornithinolytica (n = 1. None of the isolates harbored the mcr-1 or mcr-2 genes. Conclusions There is no evidence for the presence of MCR-producers in the fecal flora of healthy people or primary care patients. Therefore, the risk of transfer of mcr genes from animals, food or the environment to humans is likely to be low in Switzerland.

Oppositional Defiant Disorder: prevalence based on parent and teacher ratings of Malaysian primary school children.

Science.gov (United States)

Gomez, Rapson; Hafetz, Nina; Gomez, Rashika Miranjani

2013-08-01

This study examined the prevalence rate of Oppositional Defiant Disorder (ODD) in Malaysian primary school children. In all 934 Malaysian parents and teachers completed ratings of their children using a scale comprising DSM-IV-TR ODD symptoms. Results showed rates of 3.10%, 3.85%, 7.49% and 0.64% for parent, teacher, parent or teacher ("or-rule"), and parent and teacher ("and-rule") ratings, respectively. When the functional impairment criterion was not considered, the rate reported by parents was higher at 13.28%. The theoretical, diagnostic and cultural implications of the findings are discussed. Copyright © 2013 Elsevier B.V. All rights reserved.

Nocturnal polyuria is related to absent circadian rhythm of glomerular filtration rate.

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De Guchtenaere, A; Vande Walle, C; Van Sintjan, P; Raes, A; Donckerwolcke, R; Van Laecke, E; Hoebeke, P; Vande Walle, J

2007-12-01

Monosymptomatic nocturnal enuresis is frequently associated with nocturnal polyuria and low urinary osmolality during the night. Initial studies found decreased vasopressin levels associated with low urinary osmolality overnight. Together with the documented desmopressin response, this was suggestive of a primary role for vasopressin in the pathogenesis of enuresis in the absence of bladder dysfunction. Recent studies no longer confirm this primary role of vasopressin. Other pathogenetic factors such as disordered renal sodium handling, hypercalciuria, increased prostaglandins and/or osmotic excretion might have a role. So far, little attention has been given to abnormalities in the circadian rhythm of glomerular filtration rate. We evaluated the circadian rhythm of glomerular filtration rate and diuresis in children with desmopressin resistant monosymptomatic nocturnal enuresis and nocturnal polyuria. We evaluated 15 children (9 boys) 9 to 14 years old with monosymptomatic nocturnal enuresis and nocturnal polyuria resistant to desmopressin treatment. The control group consisted of 25 children (12 boys) 9 to 16 years old with monosymptomatic nocturnal enuresis without nocturnal polyuria. Compared to the control population, children with nocturnal polyuria lost their circadian rhythm not only for diuresis and sodium excretion but also for glomerular filtration rate. Patients with monosymptomatic nocturnal enuresis and nocturnal polyuria lack a normal circadian rhythm for diuresis and sodium excretion, and the circadian rhythm of glomerular filtration rate is absent. This absence of circadian rhythm of glomerular filtration rate and/or sodium handling cannot be explained by a primary role of vasopressin, but rather by a disorder in circadian rhythm of renal glomerular and/or tubular functions.

Recombination Rate Heterogeneity within Arabidopsis Disease Resistance Genes.

Science.gov (United States)

Choi, Kyuha; Reinhard, Carsten; Serra, Heïdi; Ziolkowski, Piotr A; Underwood, Charles J; Zhao, Xiaohui; Hardcastle, Thomas J; Yelina, Nataliya E; Griffin, Catherine; Jackson, Matthew; Mézard, Christine; McVean, Gil; Copenhaver, Gregory P; Henderson, Ian R

2016-07-01

Meiotic crossover frequency varies extensively along chromosomes and is typically concentrated in hotspots. As recombination increases genetic diversity, hotspots are predicted to occur at immunity genes, where variation may be beneficial. A major component of plant immunity is recognition of pathogen Avirulence (Avr) effectors by resistance (R) genes that encode NBS-LRR domain proteins. Therefore, we sought to test whether NBS-LRR genes would overlap with meiotic crossover hotspots using experimental genetics in Arabidopsis thaliana. NBS-LRR genes tend to physically cluster in plant genomes; for example, in Arabidopsis most are located in large clusters on the south arms of chromosomes 1 and 5. We experimentally mapped 1,439 crossovers within these clusters and observed NBS-LRR gene associated hotspots, which were also detected as historical hotspots via analysis of linkage disequilibrium. However, we also observed NBS-LRR gene coldspots, which in some cases correlate with structural heterozygosity. To study recombination at the fine-scale we used high-throughput sequencing to analyze ~1,000 crossovers within the RESISTANCE TO ALBUGO CANDIDA1 (RAC1) R gene hotspot. This revealed elevated intragenic crossovers, overlapping nucleosome-occupied exons that encode the TIR, NBS and LRR domains. The highest RAC1 recombination frequency was promoter-proximal and overlapped CTT-repeat DNA sequence motifs, which have previously been associated with plant crossover hotspots. Additionally, we show a significant influence of natural genetic variation on NBS-LRR cluster recombination rates, using crosses between Arabidopsis ecotypes. In conclusion, we show that a subset of NBS-LRR genes are strong hotspots, whereas others are coldspots. This reveals a complex recombination landscape in Arabidopsis NBS-LRR genes, which we propose results from varying coevolutionary pressures exerted by host-pathogen relationships, and is influenced by structural heterozygosity.

Natural history of the classical form of primary growth hormone (GH) resistance (Laron syndrome).

Science.gov (United States)

Laron, Z

1999-04-01

A description of the clinical, biochemical and endocrinological features of the classical form of the syndrome of primary growth hormone (GH) resistance (Laron syndrome) is presented including the progressive changes during follow-up from infancy into adulthood. The main diagnostic features are: severe growth retardation, acromicria, small gonads and genitalia, and obesity. Serum GH levels are elevated and insulin-like growth factor-I (IGF-I) values are low and do not rise upon stimulation by exogenous hGH. The pathogenesis of this syndrome is due to various molecular defects from exon deletion to nonsense, frameshift, splice and missense mutations in the GH receptor (GH-R) gene or in its post-receptor pathways.

Effects of fast-velocity eccentric resistance training on early and late rate of force development

DEFF Research Database (Denmark)

Oliveira, Anderson S.C.; Corvino, Rogério Bulhões; Caputo, Fabrizio

2016-01-01

This study examined whether short-term maximal resistance training employing fast-velocity eccentric knee extensor actions would induce improvements in maximal isometric torque and rate of force development (RFD) at early (phases (>100 ms) of rising torque. Twenty healthy men were......, no changes in the late phase of incremental RFD were observed in TG. No changes were found in the CG. In summary, we have demonstrated, in active individuals, that a short period of resistance training performed with eccentric fast-velocity isokinetic muscle contractions is able to enhance RFDINC and RFDREL...... assigned to two experimental groups: eccentric resistance training (TG) or control (CG). Participants on the TG trained three days a week for a total of eight weeks. Training consisted of maximal unilateral eccentric knee extensors actions performed at 180°s-1. Maximal isometric knee extensor torque (MVC...

A Meta-Analysis of Adult-Rated Child Personality and Academic Performance in Primary Education

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Poropat, Arthur E.

2014-01-01

Background: Personality is reliably associated with academic performance, but personality measurement in primary education can be problematic. Young children find it difficult to accurately self-rate personality, and dominant models of adult personality may be inappropriate for children. Aims: This meta-analysis was conducted to determine the…

Antibiotic resistance and trend of urinary pathogens in general outpatients from a major urban city

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Carlos R. Kiffer

2007-02-01

Full Text Available OBJECTIVE: We assessed the antimicrobial resistance patterns of pathogens responsible for urinary tract infections (UTI in outpatients in São Paulo, Brazil, as well as the Escherichia coli antimicrobial resistance trend. MATERIALS AND METHODS: Outpatients urine cultures were collected from January 2000 to December 2003. Statistical analysis considered positive results for one bacterial species with colony count > 100,000 CFU/mL. Stratification was done on age group and gender. Statistical tests used included chi-square and the chi-square test for trend to evaluate differences between susceptibility rates among age groups and ordering in the E. coli resistance rates per year, respectively. RESULTS: There were 37,261 positive results with Enterobacteriaceae isolated in 32,530 (87.3% and Gram-positive cocci in 2,570 (6.9% cultures. E. coli had the highest prevalence (71.6%. Susceptibility tests were performed in 31,716 cultures. E. coli had elevated resistance rates (> 30% to ampicillin, trimethoprim-sulfamethoxazole, and tetracycline. Significant differences between age groups and ordering among years were observed. CONCLUSIONS: The use of trimethoprim-sulfamethoxazole is precluded in the population studied due to elevated resistance rates (> 30% among most prevalent pathogens. Significant resistance rate differences among age groups and years were observed, particularly for fluoroquinolones. Fluoroquinolones should be used with caution. Nitrofurantoin should be used as empirical therapy for primary, non-complicated urinary tract infections.

Long-Term Outcome of Steroid-Resistant Nephrotic Syndrome in Children.

Science.gov (United States)

Trautmann, Agnes; Schnaidt, Sven; Lipska-Ziętkiewicz, Beata S; Bodria, Monica; Ozaltin, Fatih; Emma, Francesco; Anarat, Ali; Melk, Anette; Azocar, Marta; Oh, Jun; Saeed, Bassam; Gheisari, Alaleh; Caliskan, Salim; Gellermann, Jutta; Higuita, Lina Maria Serna; Jankauskiene, Augustina; Drozdz, Dorota; Mir, Sevgi; Balat, Ayse; Szczepanska, Maria; Paripovic, Dusan; Zurowska, Alexandra; Bogdanovic, Radovan; Yilmaz, Alev; Ranchin, Bruno; Baskin, Esra; Erdogan, Ozlem; Remuzzi, Giuseppe; Firszt-Adamczyk, Agnieszka; Kuzma-Mroczkowska, Elzbieta; Litwin, Mieczyslaw; Murer, Luisa; Tkaczyk, Marcin; Jardim, Helena; Wasilewska, Anna; Printza, Nikoleta; Fidan, Kibriya; Simkova, Eva; Borzecka, Halina; Staude, Hagen; Hees, Katharina; Schaefer, Franz

2017-10-01

We investigated the value of genetic, histopathologic, and early treatment response information in prognosing long-term renal outcome in children with primary steroid-resistant nephrotic syndrome. From the PodoNet Registry, we obtained longitudinal clinical information for 1354 patients (disease onset at >3 months and children, respectively, with the highest remission rates achieved with calcineurin inhibitor-based protocols. Ten-year ESRD-free survival rates were 43%, 94%, and 72% in children with IIS resistance, complete remission, and partial remission, respectively; 27% in children with a genetic diagnosis; and 79% and 52% in children with histopathologic findings of minimal change glomerulopathy and FSGS, respectively. Five-year ESRD-free survival rate was 21% for diffuse mesangial sclerosis. IIS responsiveness, presence of a genetic diagnosis, and FSGS or diffuse mesangial sclerosis on initial biopsy as well as age, serum albumin concentration, and CKD stage at onset affected ESRD risk. Our findings suggest that responsiveness to initial IIS and detection of a hereditary podocytopathy are prognostic indicators of favorable and poor long-term outcome, respectively, in children with steroid-resistant nephrotic syndrome. Children with multidrug-resistant sporadic disease show better renal survival than those with genetic disease. Furthermore, histopathologic findings may retain prognostic relevance when a genetic diagnosis is established. Copyright © 2017 by the American Society of Nephrology.

Resistance profiles to antimicrobial agents in bacteria isolated from acute endodontic infections: systematic review and meta-analysis.

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Lang, Pauline M; Jacinto, Rogério C; Dal Pizzol, Tatiane S; Ferreira, Maria Beatriz C; Montagner, Francisco

2016-11-01

Infected root canal or acute apical abscess exudates can harbour several species, including Fusobacterium, Porphyromonas, Prevotella, Parvimonas, Streptococcus, Treponema, Olsenella and not-yet cultivable species. A systematic review and meta-analysis was performed to assess resistance rates to antimicrobial agents in clinical studies that isolated bacteria from acute endodontic infections. Electronic databases and the grey literature were searched up to May 2015. Clinical studies in humans evaluating the antimicrobial resistance of primary acute endodontic infection isolates were included. PRISMA guidelines were followed. A random-effect meta-analysis was employed. The outcome was described as the pooled resistance rates for each antimicrobial agent. Heterogeneity and sensitivity analyses were performed. Subgroup analyses were conducted based upon report or not of the use of antibiotics prior to sampling as an exclusion factor (subgroups A and B, respectively). Data from seven studies were extracted. Resistance rates for 15 different antimicrobial agents were evaluated (range, 3.5-40.0%). Lower resistance rates were observed for amoxicillin/clavulanic acid and amoxicillin; higher resistance rates were detected for tetracycline. Resistance rates varied according to previous use of an antimicrobial agent as demonstrated by the subgroup analyses. Heterogeneity was observed for the resistance profiles of penicillin G in subgroup A and for amoxicillin, clindamycin, metronidazole and tetracycline in subgroup B. Sensitivity analyses demonstrated that resistance rates changed for metronidazole, clindamycin, tetracycline and amoxicillin. These findings suggest that clinical isolates had low resistance to β-lactams. Further well-designed studies are needed to clarify whether the differences in susceptibility among the antimicrobial agents may influence clinical responses to treatment. Copyright © 2016 Elsevier B.V. and International Society of Chemotherapy. All rights

Time trends in Staphylococcus aureus bacteremia, 1988-2010, in a tertiary center with high methicillin resistance rates.

Science.gov (United States)

Yahav, Dafna; Shaked, Hila; Goldberg, Elad; Yassin, Sharief; Eliakim-Raz, Noa; Paul, Mical; Bishara, Jihad; Leibovici, Leonard

2017-02-01

Changes in the epidemiology of Staphylococcus aureus bacteremia (SAB) have been described in recent decades. Decreased mortality has been reported over time, mostly from countries with low methicillin resistance rates. We aimed to describe time trends in SAB in a tertiary center with high methicillin resistance rates. We retrospectively analyzed 1692 patients with SAB, and compared between three time periods: 1988-1994 (342 patients), 1998-2004 (597 patients) and 2005-2010 (753 patients). In our cohort, 30 days mortality increased significantly with time, reaching 42.9 % during 2005-2010. The latter period was characterized by higher rates of older patients (35.1 % aged 80 years and older), with lower functional capacity (46.5 % bedridden) and higher rates of comorbidities (33.6 % renal disease, 24.8 % heart failure, 19.0 % dementia). These patients were more likely to be ventilated (18.7 %) and carry a urinary catheter at presentation (46.6 %); present with septic shock (15.9 %) and have pneumonia (20.5 %) or endocarditis (7.2 %) as source. Similar characteristics were found among patients younger than 50 years and with independent functional status. No significant increase in methicillin resistant Staph aureus (MRSA) rates or inappropriate empirical therapy was demonstrated during 2005-2010. In our cohort, increased mortality in recent years in patients with SAB can be explained by baseline condition of patients. MRSA or inappropriate empiric therapy did not explain the increase in mortality. The patients afflicted with SAB changed over time. Epidemiology and outcomes of SAB vary with time and according to geographical location. External validity of studies should be taken into consideration.

Variation in Primary Cesarean Delivery Rates by Individual Physician within a Single Hospital Laborist Model

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METZ, Torri D.; ALLSHOUSE, Amanda A.; GILBERT, Sara A Babcock; DOYLE, Reina; TONG, Angie; CAREY, J. Christopher

2016-01-01

Background Laborist practice models are associated with lower cesarean delivery rates than individual private practice models in several studies; however, this effect is not uniform. Further exploration of laborist models may help us better understand the observed reduction in cesarean delivery rates in some hospitals with implementation of a laborist model. Objective Our objective was to evaluate the degree of variation in primary cesarean delivery rates by individual laborists within a single institution employing a laborist model. In addition, we sought to evaluate whether differences in cesarean delivery rates resulted in different maternal or short-term neonatal outcomes. Study Design At this teaching institution, one laborist (either a generalist or maternal-fetal medicine attending physician) is directly responsible for labor and delivery management during each shift. No patients are followed in a private practice model nor are physicians incentivized to perform deliveries. We retrospectively identified all laborists who delivered nulliparous, term women with cephalic singletons at this institution from 2007-14. Overall and individual primary cesarean delivery rates were reported as percentages with exact Pearson 95% CI. Laborists were grouped by tertile as having low, medium or high cesarean delivery rates. Characteristics of the women delivered, indications for cesarean delivery, and short-term neonatal outcomes were compared between these groups. A binomial regression model of cesarean delivery was estimated, where the relative rates of each laborist compared to the lowest-unadjusted laborist rate were calculated; a second model was estimated to adjust for patient-level maternal characteristics. Results Twenty laborists delivered 2,224 nulliparous, term women with cephalic singletons. The overall cesarean delivery rate was 24.1% (95% CI 21.4-26.8). In an unadjusted binomial model, the overall effect of individual laborist was significant (pcesarean

Drug resistance in Mycobacterium leprae from patients with leprosy in China.

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Liu, D; Zhang, Q; Sun, Y; Wang, C; Zhang, Y; Fu, X; Chen, M; Zhou, G; Yu, X; Wang, J; Liu, H; Zhang, F

2015-12-01

Previous studies of drug resistance have shown that mutations in the drug resistance-determining region (DRDR) in the Folp1, RpoB and GyrA genes of Mycobacterium leprae are responsible for resistance to dapsone, rifampin and ofloxacin, respectively. To investigate the prevalence of mutations in genes associated with drug resistance in M. leprae isolates from patients with leprosy in Shandong Province. The DRDR in the FolP1, RpoB and GyrA genes was analysed by direct sequencing of the PCR product from 85 isolates of M. leprae sampled from patients with leprosy in Shandong, China. Sequencing results were obtained for FolP1, RpoB and GyrA in 67, 57 and 81 of the 85 samples, with mutation rates of 1.5% (1/67), 8.8% 5/57 and 25.9% (21/81). Three multidrug-resistant samples were found among the new cases: one had a mutation in both Folp1 and RpoB, while the other two had a mutation in both RpoB and GyrA. Primary resistance appears to be to either single drugs or combinations of two drugs. The resistance rate to dapsone seems to be low. To our knowledge, this is the first case of multidrug-resistant M. leprae from China. © 2015 British Association of Dermatologists.

Study of resistance to deformation dependence on temperature and strain degree during working with different rates for ABM-1 alloy

International Nuclear Information System (INIS)

Kharlamov, V.V.; Dvinskij, V.M.; Vashlyaev, Eh.V.; Dyblenko, Z.A.; Khamatov, R.I.; Zverev, K.P.

1981-01-01

On the basis of approximation of the experimental curves partial differential equations relating ABM-1 alloy deformation resistance to the deformation parameters are obtained. Using statistical processing of the experimental data the regression equations of the dependence of the deformation resistance on temperature rate and relative reduction of the samples are found. In the 2.1-23.6 1/c deformation rate range hardening and weakening rates of the AMB-1 alloy increases with the increase of the latter. The data obtained permit to calculate the deformation parameters of the studied alloy for different processes of metal plastic working in the studied temperature range [ru

Measurement of Dynamic Resistance in Resistance Spot Welding

DEFF Research Database (Denmark)

Wu, Pei; Lu, J.; Zhang, Wenqi

2007-01-01

is influenced by inductive noise caused by the high welding current. In this study, the dynamic resistance is determined by measuring the voltage at primary side and current at secondary side. This increases the accuracy of measurement because of higher signal-noise ratio, and allows to apply to in-process......The conventional methods of determining the dynamic resistance were mostly done by measuring the voltage and current at secondary side of transformer in resistance welding machines, in which the measuring set-up normally interferes with the movement of electrode, and the measuring precision...

Induction of resistance to gray mold with benzothiadiazole modifies amino acid profile and increases proanthocyanidins in grape: primary versus secondary metabolism.

Science.gov (United States)

Iriti, Marcello; Rossoni, Mara; Borgo, Michele; Ferrara, Luigia; Faoro, Franco

2005-11-16

Field treatments of grapevine (cv. Merlot) with the plant activator benzothiadiazole (BTH, 0.3 mM) induced resistance against gray mold caused by Botrytis cinerea. Both incidence and severity of the disease were reduced. The resistance was associated with an increase of total polyphenols in berry skins, in particular, the proanthocyanidin fraction, that increased up to 36%. The amino acid profile of leaves was also modified by treatments, particularly lysine, that augmented 4-fold. Other amino acids involved in resistance mechanisms to either biotic or abiotic stress increased as well. These results indicate that BTH treatments can be used to control gray mold, thereby limiting an excessive use of fungicides, and could be exploited to increase the content of micronutrients of high nutritional value, arising from both primary and secondary metabolisms.

High prevalence of multidrug resistant tuberculosis in Djibouti: a retrospective study.

Science.gov (United States)

Boyer-Cazajous, Géraldine; Martinaud, Christophe; Déhan, Céline; Hassan, Mohammed Osman; Gaas, Yassin; Chenilleau-Vidal, Marie-Caroline; Soler, Charles

2014-02-13

The Republic of Djibouti is an African country that exhibits one of the highest incidence rate of tuberculosis in the world. The aim of this study was to evaluate the prevalence of multidrug-resistant tuberculosis among new cases. We studied retrospectively every tuberculosis case diagnosed over a 12-month period in patients hospitalized at the French Military Hospital of Bouffard. During this period, 1,274 samples from 675 patients were tested. We isolated 266 mycobacteria corresponding to 180 cases of tuberculosis. Thirty-three were fully susceptible and 57% met the tuberculosis criteria, with 46% primary resistance. No extensively-drug-resistant tuberculosis was found. Our results highlight a major concern about the situation in this part of the world.

Primary standards for measuring flow rates from 100 nl/min to 1 ml/min - gravimetric principle.

Science.gov (United States)

Bissig, Hugo; Petter, Harm Tido; Lucas, Peter; Batista, Elsa; Filipe, Eduarda; Almeida, Nelson; Ribeiro, Luis Filipe; Gala, João; Martins, Rui; Savanier, Benoit; Ogheard, Florestan; Niemann, Anders Koustrup; Lötters, Joost; Sparreboom, Wouter

2015-08-01

Microflow and nanoflow rate calibrations are important in several applications such as liquid chromatography, (scaled-down) process technology, and special health-care applications. However, traceability in the microflow and nanoflow range does not go below 16 μl/min in Europe. Furthermore, the European metrology organization EURAMET did not yet validate this traceability by means of an intercomparison between different National Metrology Institutes (NMIs). The NMIs METAS, Centre Technique des Industries Aérauliques et Thermiques, IPQ, Danish Technological Institute, and VSL have therefore developed and validated primary standards to cover the flow rate range from 0.1 μl/min to at least 1 ml/min. In this article, we describe the different designs and methods of the primary standards of the gravimetric principle and the results obtained at the intercomparison for the upper flow rate range for the various NMIs and Bronkhorst High-Tech, the manufacturer of the transfer standards used.

Dichromatic and monochromatic laser radiation effects on antibiotic resistance, biofilm formation, and division rate of Pantoea agglomerans

Science.gov (United States)

Thomé, A. M. C.; Souza, B. P.; Mendes, J. P. M.; Cardoso, A. F. R.; Soares, L. C.; Trajano, E. T. L.; Fonseca, A. S.

2018-06-01

Since infection is a common cause of delayed wound healing, it is important to understand the effect of low-level laser therapy (LLLT) in bacterial mechanisms. In this study we evaluated the effects of LLLT on antibiotic resistance, division rate, and biofilm formation of Pantoea agglomerans. P. agglomerans samples were isolated from human pressure injuries in humans and cultures were exposed to low-level monochromatic and simultaneous dichromatic laser radiation to study the susceptibility of an antimicrobial to ampicillin and piperacillin  +  tazobactam, quantification of areas of bacterial colonies, and biofilm formation of bacterial cells. Fluence, wavelength, and emission mode were used in the therapeutic protocols for wound healing. The data showed no changes in the areas of the colonies, but dichromatic laser radiation decreased biofilm formation, while a monochromatic red laser at low dose increased biofilm formation and infrared at high dose decreased antibiotic resistance to ampicillin. LLLT modulates antibiotic resistance and biofilm formation of P. agglomerans, but these depend on the laser irradiation parameters, since dichromatic laser radiation induces biological effects that differ from those induced by monochromatic laser radiation. Thus, simultaneous dichromatic low-level red and infrared lasers could be a new option for the treatment of infected wounds, reducing biofilm formation, without altering antibiotic resistance and the division rate of P. agglomerans cultures.

Antibacterial resistance and the success of tailored triple therapy in Helicobacter pylori strains isolated from Slovenian children.

Science.gov (United States)

Butenko, Tita; Jeverica, Samo; Orel, Rok; Homan, Matjaž

2017-10-01

Primary Helicobacter pylori (H. pylori) infection occurs predominantly in childhood. Antimicrobial resistance is the leading cause for H. pylori eradication failure. The aims of this study were (i) to establish for the first time the antimicrobial resistance of H. pylori strains in infected Slovenian children not previously treated for H. pylori infection and (ii) to evaluate the effectiveness of tailored triple therapy, assuming that eradication rate with tailored triple therapy will be >90%. Data on all treatment-naive children 1-18 years old and treated for H. pylori infection according to susceptibility testing were retrospectively analyzed. All relevant clinical information and demographical information were retrospectively collected from the hospital information systems and/or patients' medical documentation. The inclusion criteria were met by 107 children (64.5% girls) with a median age of 12.0 years (range 2.0-17.6 years). Primary antimicrobial resistance rates of H. pylori were 1.0% to amoxicillin (AMO), 23.4% to clarithromycin (CLA), 20.2% to metronidazole (MET), 2.8% to levofloxacin (LEV), and 0.0% to tetracycline (TET). Dual resistances were detected to CLA and MET in 11.5% (n=12) of strains, to CLA and LEV in 2.8% (n=3), and to MET and LEV in 2.9% (n=3). Results of treatment success were available for 71 patients (66.2% girls). Eradication of H. pylori was evaluated using the 13C-urea breath test, monoclonal stool antigen test or in some cases with repeated upper GI endoscopy with histology and cultivation/molecular tests. Eradication was achieved in 61 of 71 (85.9%) patients. The primary resistance rates of H. pylori to CLA and MET in Slovenia are high. Our data strongly support the fact that in countries with high prevalence of resistant H. pylori strains susceptibility testing and tailored therapy is essential. © 2017 The Authors Helicobacter Published by John Wiley & Sons Ltd.

Primary Multidrug Resistant Tuberculosis and Utility of Line Probe Assay for Its Detection in Smear-Positive Sputum Samples in a Tertiary Care Hospital in South India

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Fahmiya Leena Yacoob

2016-01-01

Full Text Available In a high tuberculosis burdened country like India, rapid, cost-effective, and reliable diagnostic tools for tuberculosis are an urgent need of the hour to prevent inappropriate treatment strategies and further spread of resistance. This study aimed to estimate the proportion of new smear-positive tuberculosis cases with primary resistance to rifampicin and/or isoniazid as well as identify the common mutations associated with it. Sputum of 200 newly diagnosed smear-positive cases of 1+ score and above was directly subjected to Line Probe Assay using the GenoType MTBDRplus assay kit. All samples were inoculated onto solid media and 61 samples were inoculated in automated liquid culture also. The Line Probe Assay gave hundred percent interpretable results with 2.5% of the study population showing resistant pattern. Only 1% of the cases were primary multidrug resistant tuberculosis and 1.5% showed isoniazid monoresistance. S531L and C15T were the most common genetic mutations seen for rifampicin and isoniazid resistance, respectively. 40% had absent rpoB wild type 8 band indicating probable silent mutation after clinical correlation. The average turnaround time for Line Probe Assay was far less (3.8 days as compared to solid and liquid cultures (35.6 days and 13.5 days, resp..

Primary Multidrug Resistant Tuberculosis and Utility of Line Probe Assay for Its Detection in Smear-Positive Sputum Samples in a Tertiary Care Hospital in South India.

Science.gov (United States)

Yacoob, Fahmiya Leena; Philomina Jose, Beena; Karunakaran Lelitha, Sarada Devi; Sreenivasan, Sreelatha

2016-01-01

In a high tuberculosis burdened country like India, rapid, cost-effective, and reliable diagnostic tools for tuberculosis are an urgent need of the hour to prevent inappropriate treatment strategies and further spread of resistance. This study aimed to estimate the proportion of new smear-positive tuberculosis cases with primary resistance to rifampicin and/or isoniazid as well as identify the common mutations associated with it. Sputum of 200 newly diagnosed smear-positive cases of 1+ score and above was directly subjected to Line Probe Assay using the GenoType MTBDRplus assay kit. All samples were inoculated onto solid media and 61 samples were inoculated in automated liquid culture also. The Line Probe Assay gave hundred percent interpretable results with 2.5% of the study population showing resistant pattern. Only 1% of the cases were primary multidrug resistant tuberculosis and 1.5% showed isoniazid monoresistance. S531L and C15T were the most common genetic mutations seen for rifampicin and isoniazid resistance, respectively. 40% had absent rpoB wild type 8 band indicating probable silent mutation after clinical correlation. The average turnaround time for Line Probe Assay was far less (3.8 days) as compared to solid and liquid cultures (35.6 days and 13.5 days, resp.).

Community-based primary prevention programs decrease the rate of metabolic syndrome among socioeconomically disadvantaged women.

Science.gov (United States)

Gilstrap, Lauren Gray; Malhotra, Rajeev; Peltier-Saxe, Donna; Slicas, Donna; Pineda, Eliana; Culhane-Hermann, Catherine; Cook, Nakela; Fernandez-Golarz, Carina; Wood, Malissa

2013-04-01

Metabolic Syndrome (MetSyn) is one of the strongest predictors of type 2 diabetes (DM2) and cardiovascular disease (CVD). It is associated with a 4- to 10-fold increased risk of DM2 and a 2- to 3-fold increased risk of CVD. Low income and minority women have some of the highest rates of MetSyn. This study examines the effect of a unique, community based, primary prevention program on the rates of MetSyn and health habits. Sixty-four low income and minority women were enrolled in the HAPPY (Health Awareness and Primary Prevention in Your neighborhood) Heart Program in an eastern suburb of Boston. Over these 2 years, patients were evaluated by an interdisciplinary medical team: their primary physician, cardiologist, nutritionist, physical therapist, and health coach. The rate of MetSyn was measured at baseline, year 1, and year 2. Comparisons were made either using the paired t test for normally distributed variables or the Wilcoxon Sign test for non-normal variables. The rate of MetSyn fell from 64.7% at baseline to 34.9% at year 1 (p=0.01) and 28.2% at year 2 (p<0.001). This was driven by increases in high-density lipoprotein (HDL-C) (p<0.001) and decreases in blood pressure (p=0.05). Fasting blood glucose trended down, but the hemoglobin A1c (HbA1c) reached significance (decreasing from 6 to 5.8, p<0.01). Nutrition and exercise habits trended toward improvement. There were significant decreases in anxiety (p<0.001), depression (p=0.006) and stress (p=0.002). This lifestyle intervention program is effective at decreasing MetSyn in a socioeconomically disadvantaged, largely minority, female population. This program also decreases anxiety, stress, and depression among participants.

Optimization of Nitrogen Rate and Planting Density for Improving Yield, Nitrogen Use Efficiency, and Lodging Resistance in Oilseed Rape

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Shahbaz Khan

2017-05-01

Full Text Available Yield and lodging related traits are essential for improving rapeseed production. The objective of the present study was to investigate the influence of plant density (D and nitrogen (N rates on morphological and physiological traits related to yield and lodging in rapeseed. We evaluated Huayouza 9 for two consecutive growing seasons (2014–2016 under three plant densities (LD, 10 plants m−2; MD, 30 plants m−2; HD, 60 plants m−2 and four N rates (0, 60, 120, and 180 kg ha−1. Experiment was laid out in split plot design using density as a main factor and N as sub-plot factor with three replications each. Seed yield was increased by increasing density and N rate, reaching a peak at HD with 180 kg N ha−1. The effect of N rate was consistently positive in increasing the plant height, pod area index, 1,000 seed weight, shoot and root dry weights, and root neck diameter, reaching a peak at 180 kg N ha−1. Plant height was decreased by increasing D, whereas the maximum radiation interception (~80% and net photosynthetic rate were recorded at MD at highest N. Lodging resistance and nitrogen use efficiency significantly increased with increasing D from 10 to 30 plants m−2, and N rate up to 120 kg ha−1, further increase of D and N decreased lodging resistance and NUE. Hence, our study implies that planting density 30 plants m−2 can improve yield, nitrogen use efficiency, and enhance lodging resistance by improving crop canopy.

Nalidixic acid-resistant Salmonella enterica serotype Typhi presenting as a primary psoas abscess: case report and review of the literature.

Science.gov (United States)

Shakespeare, William A; Davie, Daniel; Tonnerre, Claude; Rubin, Michael A; Strong, Michael; Petti, Cathy A

2005-02-01

We report an unusual case of Salmonella enterica serotype Typhi presenting as a primary psoas abscess. The isolate tested susceptible to ciprofloxacin but resistant to nalidixic acid in vitro, a pattern associated with fluoroquinolone therapeutic failures. We review the literature for serovar Typhi psoas abscess in the absence of bacteremia and discuss the importance of identifying isolates with reduced susceptibility to fluoroquinolones.

Crystal Structure of the Zorbamycin-Binding Protein ZbmA, the Primary Self-Resistance Element in Streptomyces flavoviridis ATCC21892

Energy Technology Data Exchange (ETDEWEB)

Rudolf, Jeffrey D. [Scripps Research Inst., Jupiter, FL (United States); Bigelow, Lance [Argonne National Lab. (ANL), Argonne, IL (United States); Chang, Changsoo [Argonne National Lab. (ANL), Argonne, IL (United States); Cuff, Marianne E. [Argonne National Lab. (ANL), Argonne, IL (United States); Lohman, Jeremy R. [Scripps Research Inst., Jupiter, FL (United States); Chang, Chin-Yuan [Scripps Research Inst., Jupiter, FL (United States); Ma, Ming [Scripps Research Inst., Jupiter, FL (United States); Yang, Dong [Scripps Research Inst., Jupiter, FL (United States); Clancy, Shonda [Argonne National Lab. (ANL), Argonne, IL (United States); Babnigg, Gyorgy [Argonne National Lab. (ANL), Argonne, IL (United States); Joachimiak, Andrzej [Argonne National Lab. (ANL), Argonne, IL (United States); Phillips, George N. [Rice Univ., Houston, TX (United States); Shen, Ben [Scripps Research Inst., Jupiter, FL (United States)

2015-11-17

The bleomycins (BLMs), tallysomycins (TLMs), phleomycin, and zorbamycin (ZBM) are members of the BLM family of glycopeptide-derived antitumor antibiotics. The BLM-producing Streptomyces verticillus ATCC15003 and the TLM-producing Streptoalloteichus hindustanus E465-94 ATCC31158 both possess at least two self-resistance elements, an N-acetyltransferase and a binding protein. The N-acetyltransferase provides resistance by disrupting the metal-binding domain of the antibiotic that is required for activity, while the binding protein confers resistance by sequestering the metal-bound antibiotic and preventing drug activation via molecular oxygen. We recently established that the ZBM producer, Streptomyces flavoviridis ATCC21892, lacks the N-acetyltransferase resistance gene and that the ZBM-binding protein, ZbmA, is sufficient to confer resistance in the producing strain. To investigate the resistance mechanism attributed to ZbmA, we determined the crystal structures of apo and Cu(II)-ZBM-bound ZbmA at high resolutions of 1.90 and 1.65 angstrom, respectively. A comparison and contrast with other structurally characterized members of the BLM-binding protein family revealed key differences in the protein ligand binding environment that fine-tunes the ability of ZbmA to sequester metal-bound ZBM and supports drug sequestration as the primary resistance mechanism in the producing organisms of the BLM family of antitumor antibiotics.

Selection of anthracnose resistant common beans using detached leaves in partially controlled environment

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Alisson Campos Pereira

2014-08-01

Full Text Available The objectives of this study were to evaluate the possibility of selecting anthracnose resistant common bean plants using detached primary leaves in partially controlled environment of a greenhouse and identify differences in the reaction of genotypes to anthracnose. The common bean cultivars Ouro Negro, OuroVermelho, ManteigãoFosco 11, Rudá, Rudá-R, VP8, BRSMG Madrepérola, Pérola, MeiaNoite and BRSMG Talismãwere characterizedfor resistance to the races 65, 81 and 453 of Colletotrichum lindemuthianum and the method of detached primary leaves was compared to the method with the traditional inoculation of plants at the phenological stage V2. The lines Rudá, Rudá-R and Pérola were inoculated with the races 65 and 453 of C. lindemuthianum, aiming to assess the rate of coincidence of anthracnose severity by both inoculation methods. In general, the two methods presented similar results for the reaction of the cultivars. The use of detached primary leaves of common bean plants in the partially controlled environment was feasible for selection of plants resistant to anthracnose and has the advantages of low-needed infrastructure and reduction of resources, space and time.

Nasal and hand carriage rate of methicillin resistant Staphylococcus aureus (MRSA) among health care workers in Mekelle Hospital, North Ethiopia.

Science.gov (United States)

Gebreyesus, Araya; Gebre-Selassie, Solomon; Mihert, Adane

2013-01-01

Methicillin resistant Staphylococcus aureus (MRSA) is significant major pathogen responsible for hospital and community based infections. The aim of this study was to assess the nasal and hand carriage of methicillin resistant Staphylococcus aureus in health care workers of Mekelle Hospital The study was carried out during November 2010 to January 2011. Swab samples from both anterior nares and hands were taken. The samples were cultured on mannitol salt agar and incubated aerobically at 37 degrees C for 48 hours. Staphylococcus aureus was identified as nmannitol fermenter and coagulase test positive. Antimicrobial susceptibility test for MRSA was done by disk diffusion method using oxacillin disks. Data were analysed using SPSS version 16 software. Out of the 177 health care workers screened, 36 (20.3%) of them were methicillin resistant Staphylococcus aureus carriers in their hand and anterior nares. More females, 25(14.1%) were colonized by methicillin resistant Staphylococcus aureus than males 11 (6.2%) (P = 0.044). Nasal carriage of MRSA of 25 (14.1%) was higher than hand carriage 11 (6.2%) (p resistant Staphylococcus aureus carriage rates of 26 (13.6%) and 4 (2.3%), respectively. The isolated MRSA were resistant to multiple antibiotics. The highest resistance was observed for ampicillin (88.9%) and tetracycline (86.1%). Two (5.6%) of the nasal isolates were vancomycin resistant. Methicillin resistant Staphylococcus aureus carriage among health care workers in this study was high. The carriage rate was higher among nurses and doctors. The MRSA isolates were multi drug resistant to other antibiotics. So, the result of this study emphasizes the need of regular surveillance of health care workers. It also calls a need for an effective infection prevention and control program.

Regional changes over time in initial virologic response rates to combination antiretroviral therapy across Europe

DEFF Research Database (Denmark)

Bannister, Wendy P; Kirk, Ole; Gatell, Jose M

2006-01-01

BACKGROUND: Changes in virologic response to initial combination antiretroviral therapy (cART) over calendar time may indicate improvements in cART or emergence of primary resistance. Regional variations may identify differences in available antiretroviral drugs or patient management. METHODS: Vi...... rates Udgivelsesdato: 2006/6...

Discordance Rate of HER2 Status in Primary Gastric Carcinomas and Synchronous Lymph Node Metastases: A Multicenter Retrospective Analysis

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Antonio Ieni

2014-12-01

Full Text Available Background: The assessment of human epidermal growth factor receptor 2 (HER2 gene amplification is essential in order to identify those patients affected by advanced gastric cancer who may benefit from Trastuzumab targeted therapy. Materials and Methods: With the aim to investigate the concordance rate in HER2 status between primary gastric carcinoma (GC and synchronous lymphnode metastases, we investigated HER2 status in a cohort of 108 surgical formalin-fixed paraffin-embedded specimens of GC and matched synchronous metastatic lymph nodes collected from three different units of Anatomic Pathology in southern of Italy. Fleiss-Cohen weighted k statistics were used to assess the concordance rate of HER2 status. Results: HER2 amplification was observed in 17% of primary GCs and the overall concordance rate with corresponding nodal metastases was 90.74%. Changes in HER2 status between primary GC and matched synchronous metastases were evidenced in 10 (9.26% cases. Of these, 6 cases were HER2 amplified in the primary GC and not amplified in the metastases, while 4 were HER2 not amplified in the primary tumour and amplified in the lymph node metastases. Conclusions: Although at present the simultaneous determination of HER2 in advanced gastric cancer and corresponding metastatic lymph nodes is not mandatory, the possibility that the synchronous metastases of GC have a different HER2 status from that of the primary tumour is of remarkable significance; Indeed this may have influence on the therapeutic management and prognosis of the patients.

Influence of primary α-phase volume fraction on the mechanical properties of Ti-6Al-4V alloy at different strain rates and temperatures

Science.gov (United States)

Ren, Yu; Zhou, Shimeng; Luo, Wenbo; Xue, Zhiyong; Zhang, Yajing

2018-03-01

Bimodal microstructures with primary α-phase volume fractions ranging from 14.3% to 57.1% were gained in Ti-6Al-4V (Ti-64) alloy through annealed in two-phase region at various temperatures below the β-transus point. Then the influence of the primary α-phase volume fraction on the mechanical properties of Ti-64 were studied. The results show that, at room temperature and a strain rate of 10‑3 s‑1, the yield stress decreases but the fracture strain augments with added primary α-phase volume fraction. The equiaxed primary α-phase possesses stronger ability to coordinate plastic deformation, leading to the improvement of the ductile as well as degradation of the strength of Ti-64 with higher primary α-phase volume fraction. As the temperature goes up to 473 K, the quasi-static yield stress and ultimate strength decrease first and then increase with the incremental primary α-phase volume fraction, due to the interaction between the work hardening and the softening caused by the DRX and the growth of the primary α-phase. At room temperature and a strain rate of 3×103 s‑1, the varying pattern of strength with the primary α-phase volume fraction resembles that at a quasi-static strain rate. However, the flow stress significantly increases but the strain-hardening rate decreases compared to those at quasi-static strain rate due to the competition between the strain rate hardening and the thermal softening during dynamic compression process.

Ectopic expression of a horseradish peroxidase enhances growth rate and increases oxidative stress resistance in hybrid aspen.

Science.gov (United States)

Kawaoka, Akiyoshi; Matsunaga, Etsuko; Endo, Saori; Kondo, Shinkichi; Yoshida, Kazuya; Shinmyo, Atsuhiko; Ebinuma, Hiroyasu

2003-07-01

We previously demonstrated that overexpression of the horseradish (Armoracia rusticana) peroxidase prxC1a gene stimulated the growth rate of tobacco (Nicotiana tabacum) plants. Here, the cauliflower mosaic virus 35S::prxC1a construct was introduced into hybrid aspen (Populus sieboldii x Populus grandidentata). The growth rate of these transformed hybrid aspen plants was substantially increased under greenhouse conditions. The average stem length of transformed plants was 25% greater than that of control plants. There was no other obvious phenotypic difference between the transformed and control plants. Fast-growing transformed hybrid aspen showed high levels of expression of prxC1a and had elevated peroxidase activities toward guaiacol and ascorbate. However, there was no increase of the endogenous class I ascorbate peroxidase activities in the transformed plants by separate assay and activity staining of native polyacrylamide gel electrophoresis. Furthermore, calli derived from the transformed hybrid aspen grew faster than those from control plants and were resistant to the oxidative stress imposed by hydrogen peroxide. Therefore, enhanced peroxidase activity affects plant growth rate and oxidative stress resistance.

Nalidixic Acid-Resistant Salmonella enterica Serotype Typhi Presenting as a Primary Psoas Abscess: Case Report and Review of the Literature

Science.gov (United States)

Shakespeare, William A.; Davie, Daniel; Tonnerre, Claude; Rubin, Michael A.; Strong, Michael; Petti, Cathy A.

2005-01-01

We report an unusual case of Salmonella enterica serotype Typhi presenting as a primary psoas abscess. The isolate tested susceptible to ciprofloxacin but resistant to nalidixic acid in vitro, a pattern associated with fluoroquinolone therapeutic failures. We review the literature for serovar Typhi psoas abscess in the absence of bacteremia and discuss the importance of identifying isolates with reduced susceptibility to fluoroquinolones. PMID:15695728

A wheat cold resistance mutant derived from space mutagenesis

International Nuclear Information System (INIS)

Li Peng; Sun Mingzhu; Zhang Fengyun; Gao Guoqiang; Qiu Denglin; Li Xinhua

2012-01-01

A cold resistance mutant, obtained by spaceflight mutagenesis on the seeds of wheat variety Han6172, and the DNA of cold resistance mutant and contrast Han6172 were compared by SRAP technique. 380 pairs of primers were screened, 6 pairs of them had polymorphisms between mutant and contrast, the rate was 1.58%, and this data indicated that there are no obvious DNA differences between mutant and contrast Six specific fragments were obtained, 3 fragments of them were amplified in mutant. Homology analysis in GenBank showed that Me3-Em7-Mt, Me4-Em11-CK, Me7-Em19-CK and Me6-Em9-Mt all had homologous sequences with wheat chromosome 3B-specific BAC library, and this result indicated that the gene and regulator sequences associated with mutant cold resistance might locate on 3B chromosome. It was speculated that space mutation induced the mutation of 3B chromosome primary structure, and influenced the expressions of cold resistance genes, which resulted in the mutation of cold resistance ability. (authors)

A wheat cold resistance mutant derived from space mutagenesis

International Nuclear Information System (INIS)

Li Peng; Sun Mingzhu; Zhang Fengyun; Gao Guoqiang; Qiu Denglin; Li Xinhua

2011-01-01

A cold resistance mutant, obtained by spaceflight mutagenesis on the seeds of wheat variety Han6172, and the DNA of cold resistance mutant and contrast Han6172 were compared by SRAP technique. 380 pairs of primers were screened, 6 pairs of them had polymorphisms between mutant and contrast, the rate was 1.58%, and this data indicated that there are no obvious DNA differences between mutant and contrast. Six specific fragments were obtained, 3 fragments of them were amplified in mutant. Homology analysis in GenBank showed that Me3-Em7-Mt, Me4-Em11-CK, Me7-Em19-CK and Me6-Em9-Mt all had homologous sequences with wheat chromosome 3B-specific BAC library, and this result indicated that the gene and regulator sequences associated with mutant cold resistance might locate on 3B chromosome. It was speculated that space mutation induced the mutation of 3B chromosome primary structure, and influenced the expressions of cold resistance genes, which resulted in the mutation of cold resistance ability. (authors)

Effect of the resistive wall on the growth rate of weakly unstable external kink mode in general 3D configurations

International Nuclear Information System (INIS)

Chu, M.S.; Ichiguchi, K.

2005-05-01

Formation of a method for the systematic computation of the growth rate of the weakly unstable RWM in 3D configurations by using results from ideal stability codes is presented. It is shown that the growth rate of the RWM is approximately given by the rate at which the available free energy for the ideal external kink mode can be dissipated by the resistive wall. The eigenfunction is also approximated by that of the external kink mode. This formulation is demonstrated by coupling to the ideal MHD code KSTEP with computation of the dissipation on the resistive wall. Results of the stability of the RWM in LHD plasmas and discussion on the validity and improvement to the computation are also included. (author)

Acute resistance exercise with blood flow restriction in elderly hypertensive women: haemodynamic, rating of perceived exertion and blood lactate.

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Pinto, Roberta R; Karabulut, Murat; Poton, Roberto; Polito, Marcos D

2018-01-01

This study aimed to compare haemodynamic, rating of perceived exertion and blood lactate responses during resistance exercise with blood flow restriction (BFR) compared with traditional high-intensity resistance exercise in hypertensive older women. Eighteen hypertensive women (age = 67·0 ± 1·7 years.) undertook three random sessions: (i) three sets; 10 repetitions; 20% of one repetition maximum (1RM) with BFR; (ii) three sets; 10 repetitions; 65% of 1RM; without BFR; and (iii) no-exercise with BFR. The exercise sessions were performed on knee extension equipment. Systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), stroke volume (SV) and cardiac output (CO) were significantly higher (P<0·05) in all sets of exercise sessions than the control. No statistically significant differences were detected between exercise sessions. However, SBP, DBP and systemic vascular resistance were higher (P<0·05) and SV and CO were lower (P<0·05) during the rest intervals in the session with BFR. The perceived exertion was significantly higher (P<0·01) in the 1st (4·8 ± 0·4 versus 3·1 ± 0·3), 2nd (7·3 ± 0·4 versus 5·7 ± 0·4) and 3rd sets (8·6 ± 0·5 versus 7·5 ± 0·4) of the traditional high-intensity resistance exercise compared with the exercise with BFR. Blood lactate was higher (P<0·05) in the traditional high-intensity resistance exercise (6·2 ± 0·7 mmol) than in the exercise with BFR (4·5 ± 0·4 mmol). In comparison with high-intensity resistance exercise, low-intensity resistance exercise with BFR can elicit: (i) same haemodynamic values during exercise; (ii) lower rating of perceived exertion; (iii) lower blood lactate; (iv) higher haemodynamic demand during the rest intervals. © 2016 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Thermal shock resistance behavior of a functionally graded ceramic: Effects of finite cooling rate

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Zhihe Jin

2014-01-01

Full Text Available This work presents a semi-analytical model to explore the effects of cooling rate on the thermal shock resistance behavior of a functionally graded ceramic (FGC plate with a periodic array of edge cracks. The FGC is assumed to be a thermally heterogeneous material with constant elastic modulus and Poisson's ratio. The cooling rate applied at the FGC surface is modeled using a linear ramp function. An integral equation method and a closed form asymptotic temperature solution are employed to compute the thermal stress intensity factor (TSIF. The thermal shock residual strength and critical thermal shock of the FGC plate are obtained using the SIF criterion. Thermal shock simulations for an Al2O3/Si3N4 FGC indicate that a finite cooling rate leads to a significantly higher critical thermal shock than that under the sudden cooling condition. The residual strength, however, is relatively insensitive to the cooling rate.

High-dose rate brachytherapy (HDRB) for primary or recurrent cancer in the vagina

International Nuclear Information System (INIS)

Beriwal, Sushil; Heron, Dwight E; Mogus, Robert; Edwards, Robert P; Kelley, Joseph L; Sukumvanich, Paniti

2008-01-01

The purpose of this study was to evaluate the efficacy of HDR brachytherapy for primary or recurrent vaginal cancer. Between the years 2000 to 2006, 18 patients with primary or recurrent vaginal cancer were treated with brachytherapy (HDRB). Six patients had primary vaginal cancer (stage II to IVA) while 12 were treated for isolated vaginal recurrence (primary cervix = 4, vulva = 1 and endometrium = 7). Five patients had previous pelvic radiation therapy. All except one patient received external beam radiation therapy to a median dose of 45 Gy (range 31.2–55.8 Gy). The HDRB was intracavitary using a vaginal cylinder in 5 patients and interstitial using a modified Syed-Nesblett template in 13 patients. The dose of interstitial brachytherapy was 18.75 Gy in 5 fractions delivered twice daily. The median follow-up was 18 months (range 6–66 months). Complete response (CR) was achieved in all but one patient (94%). Of these 17 patients achieving a CR, 1 had local recurrence and 3 had systemic recurrence at a median time of 6 months (range 6–22 months). The 2-year actuarial local control and cause-specific survival for the entire group were 88% and 82.5%, respectively. In subset analysis, the crude local control was 100% for primary vaginal cancer, 100% for the group with recurrence without any prior radiation and 67% for group with recurrence and prior radiation therapy. Two patients had late grade 3 or higher morbidity (rectovaginal fistula in one patient and chronic vaginal ulcer resulting in bleeding in one patient). Both these patients had prior radiation therapy. Our small series suggests that HDRB is efficacious for primary or recurrent vaginal cancer. Patients treated with primary disease and those with recurrent disease without prior irradiation have the greatest benefit from HDRB in this setting. The salvage rate for patients with prior radiation therapy is lower with a higher risk of significant complications. Additional patients and follow-up are ongoing

[BACTERIA WITHOUT BORDERS: A HIGH CARRIAGE RATE OF ANTIBIOTIC-RESISTANT BACTERIA AMONG SYRIAN CHILDREN HOSPITALIZED IN GALILEE MEDICAL CENTER].

Science.gov (United States)

Faour Kassem, Diana; Shahar, Naama; Ocampo, Smadar; Bader, Tarif; Zonis, Zeev; Glikman, Daniel

2017-05-01

As the civil war in Syria enters its fifth year, the Israeli government continues to provide humanitarian aid to Syrian civilians in Israeli hospitals. Many wounded Syrian children are treated at the Galilee Medical Center (GMC). Due to the patients' incomplete medical history and increasing infection rates in Syria, contact isolation and screening cultures for multi-drug resistant bacteria (MDR's) are conducted upon admission for all Syrian children. To describe the rate of MDR carriage in Syrian children and compare it to hospitalized Israeli children. Prospective collection of screening culture data of Syrian patients admitted to GMC between 6/2013-11/2014 and comparison with Israeli children admitted between 1-3/2014. Extended-spectrum beta- lactamase-producing Enterobateriaceae (ESBL), Vancomycin-resistant Enterococcus (VRE), Carbapenem-resistant Enterobacteriaceae (CRE), and Methicillin-resistant Staphylococcus aureus (MRSA) were considered MDR's. Of 47 pediatric Syrian patients, 41 were severely wounded. MDR's were found in 37 (79%) children; most of the isolates were ESBL+ Escherichia coli. Over half of the ESBL's were resistant to additional antibiotics such as sulfa and quinolones; no resistance to amikacin was found. In comparison, in 6 of 40 (15%) Israeli children, MDR's (all ESBL's) were found (p<0.001). In hospitalized Syrian children, contact isolation and screening cultures for MDR's have an important role in the prevention of nosocomial transmission and establishment of empiric antimicrobial protocols. In suspected infections in Syrian children, amikacin and carbapenems are the antimicrobials of choice. MDR's are carried to a lesser extent in Israeli children but due to their importance, further largescale research is needed.

Stainless steels: general considerations and rates of crack growth

International Nuclear Information System (INIS)

Chator, T.

1992-05-01

This report describes the different types of stainless steels, and presents the laws governing the rates of crack growth for several stainless steels extensively used for the manufacture of structures in nuclear power plants. The laws are not discussed in detail in the report. After a brief review of the development of stainless steels, the main categories of stainless steels, their mechanical characteristics and corrosion resistance, are presented. Finally, the rates of crack growth are presented for various stainless steels, mainly austenitic. The study overall aim is an investigation of the cracking in the 900 MWe primary pump thermal barriers and shafts

Duration of slip-resistant shoe usage and the rate of slipping in limited-service restaurants: results from a prospective and crossover study.

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Verma, Santosh K; Zhao, Zhe; Courtney, Theodore K; Chang, Wen-Ruey; Lombardi, David A; Huang, Yueng-Hsiang; Brennan, Melanye J; Perry, Melissa J

2014-01-01

Several studies have indicated that slip-resistant shoes may have a positive effect on reducing the risk of slips and falls, a leading cause of injury at work. Few studies, however, have examined how duration of shoe usage affects their slip-resistance properties. This study examined the association between the duration of slip-resistant shoes usage and the self-reported rate of slipping in limited-service restaurant workers. A total of 475 workers from 36 limited-service restaurants in the USA were recruited to participate in a 12-week prospective study of workplace slipping. Of the 475 participants, 83 reported changing to a new pair of shoes at least once during the 12-week follow-up. The results show that slip-resistant shoes worn for less than six months were moderately more effective than those worn for more than six months. Changing to a new pair of shoes among those wearing slip-resistant shoes at baseline was associated with a 55% reduction in the rate of slipping (RR = 0.45, 95% CI = 0.23-0.89). Further research is needed to develop criteria for the replacement of slip-resistant shoes.

HIV-1 drug resistance in recently HIV-infected pregnant mother's naïve to antiretroviral therapy in Dodoma urban, Tanzania.

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Vairo, Francesco; Nicastri, Emanuele; Liuzzi, Giuseppina; Chaula, Zainab; Nguhuni, Boniface; Bevilacqua, Nazario; Forbici, Federica; Amendola, Alessandra; Fabeni, Lavinia; De Nardo, Pasquale; Perno, Carlo Federico; Cannas, Angela; Sakhoo, Calistus; Capobianchi, Maria Rosaria; Ippolito, Giuseppe

2013-09-21

HIV resistance affects virological response to therapy and efficacy of prophylaxis in mother-to-child-transmission. The study aims to assess the prevalence of HIV primary resistance in pregnant women naïve to antiretrovirals. Cross sectional baseline analysis of a cohort of HIV + pregnant women (HPW) enrolled in the study entitled Antiretroviral Management of Antenatal and Natal HIV Infection (AMANI, peace in Kiswahili language). The AMANI study began in May 2010 in Dodoma, Tanzania. In this observational cohort, antiretroviral treatment was provided to all women from the 28th week of gestation until the end of the breastfeeding period. Baseline CD4 cell count, viral load and HIV drug-resistance genotype were collected. Drug-resistance analysis was performed on 97 naïve infected-mothers. The prevalence of all primary drug resistance and primary non-nucleoside reverse-transcriptase inhibitors resistance was 11.9% and 7.5%, respectively. K103S was found in two women with no M184V detection. HIV-1 subtype A was the most commonly identified, with a high prevalence of subtype A1, followed by C, D, C/D recombinant, A/C recombinant and A/D recombinant. HIV drug- resistance mutations were detected in A1 and C subtypes. Our study reports an 11.9% prevalence rate of primary drug resistance in naïve HIV-infected pregnant women from a remote area of Tanzania. Considering that the non-nucleoside reverse-transcriptase inhibitors are part of the first-line antiretroviral regimen in Tanzania and all of Africa, resistance surveys should be prioritized in settings where antiretroviral therapy programs are scaled up.

Systematic review of influenza resistance to the neuraminidase inhibitors

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Boivin Guy

2011-05-01

Full Text Available Abstract Background Antivirals play a critical role in the prevention and the management of influenza. One class of antivirals, neuraminidase inhibitors (NAIs, is effective against all human influenza viruses. Currently there are two NAI drugs which are licensed worldwide: oseltamivir (Tamiflu® and zanamivir (Relenza®; and two drugs which have received recent approval in Japan: peramivir and laninamivir. Until recently, the prevalence of antiviral resistance has been relatively low. However, almost all seasonal H1N1 strains that circulated in 2008-09 were resistant to oseltamivir whereas about 1% of tested 2009 pandemic H1N1 viruses were found to be resistant to oseltamivir. To date, no studies have demonstrated widespread resistance to zanamivir. It seems likely that the literature on antiviral resistance associated with oseltamivir as well as zanamivir is now sufficiently comprehensive to warrant a systematic review. The primary objectives were to systematically review the literature to determine the incidence of resistance to oseltamivir, zanamivir, and peramivir in different population groups as well as assess the clinical consequences of antiviral resistance. Methods We searched MEDLINE and EMBASE without language restrictions in September 2010 to identify studies reporting incidence of resistance to oseltamivir, zanamivir, and peramivir. We used forest plots and meta-analysis of incidence of antiviral resistance associated with the three NAIs. Subgroup analyses were done across a number of population groups. Meta-analysis was also performed to evaluate associations between antiviral resistance and clinical complications and symptoms. Results We identified 19 studies reporting incidence of antiviral resistance. Meta-analysis of 15 studies yielded a pooled incidence rate for oseltamivir resistance of 2.6% (95%CI 0.7% to 5.5%. The incidence rate for all zanamivir resistance studies was 0%. Only one study measured incidence of antiviral

Loss of MutL Disrupts CHK2-Dependent Cell-Cycle Control through CDK4/6 to Promote Intrinsic Endocrine Therapy Resistance in Primary Breast Cancer.

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Haricharan, Svasti; Punturi, Nindo; Singh, Purba; Holloway, Kimberly R; Anurag, Meenakshi; Schmelz, Jacob; Schmidt, Cheryl; Lei, Jonathan T; Suman, Vera; Hunt, Kelly; Olson, John A; Hoog, Jeremy; Li, Shunqiang; Huang, Shixia; Edwards, Dean P; Kavuri, Shyam M; Bainbridge, Matthew N; Ma, Cynthia X; Ellis, Matthew J

2017-10-01

Significant endocrine therapy-resistant tumor proliferation is present in ≥20% of estrogen receptor-positive (ER + ) primary breast cancers and is associated with disease recurrence and death. Here, we uncover a link between intrinsic endocrine therapy resistance and dysregulation of the MutL mismatch repair (MMR) complex ( MLH1/3 , PMS1/2 ), and demonstrate a direct role for MutL complex loss in resistance to all classes of endocrine therapy. We find that MutL deficiency in ER + breast cancer abrogates CHK2-mediated inhibition of CDK4, a prerequisite for endocrine therapy responsiveness. Consequently, CDK4/6 inhibitors (CDK4/6i) remain effective in MutL-defective ER + breast cancer cells. These observations are supported by data from a clinical trial where a CDK4/6i was found to strongly inhibit aromatase inhibitor-resistant proliferation of MutL-defective tumors. These data suggest that diagnostic markers of MutL deficiency could be used to direct adjuvant CDK4/6i to a population of patients with breast cancer who exhibit marked resistance to the current standard of care. Significance: MutL deficiency in a subset of ER + primary tumors explains why CDK4/6 inhibition is effective against some de novo endocrine therapy-resistant tumors. Therefore, markers of MutL dysregulation could guide CDK4/6 inhibitor use in the adjuvant setting, where the risk benefit ratio for untargeted therapeutic intervention is narrow. Cancer Discov; 7(10); 1168-83. ©2017 AACR. This article is highlighted in the In This Issue feature, p. 1047 . ©2017 American Association for Cancer Research.

High third-generation cephalosporin resistant Enterobacteriaceae prevalence rate among neonatal infections in Dakar, Senegal

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Sebastien Breurec

2016-10-01

Full Text Available Abstract Background Neonatal infection constitutes one of Senegal’s most important public health problems, with a mortality rate of 41 deaths per 1,000 live births. Methods Between January 2007 and March 2008, 242 neonates with suspected infection were recruited at three neonatal intensive care units in three major tertiary care centers in Dakar, the capital of Senegal. Neonatal infections were confirmed by positive bacterial blood or cerebrospinal fluid culture. The microbiological pattern of neonatal infections and the antibiotic susceptibility of the isolates were characterized. In addition, the genetic basis for antibiotic resistance and the genetic background of third-generation cephalosporin-resistant (3GC-R Enterobacteriaceae were studied. Results A bacteriological infection was confirmed in 36.4 % (88/242 of neonates: 22.7 % (30/132 during the early-onset and 52.7 % (58/110 during the late-onset periods (p > 0.20. Group B streptococci accounted for 6.8 % of the 88 collected bacterial isolates, while most of them were Enterobacteriaceae (n = 69, 78.4 %. Of these, 55/69 (79.7 % were 3GC-R. The blaCTX-M-15 allele, the blaSHV and the blaTEM were highly prevalent (63.5, 65.4 and 53.8 %, respectively, usually associated with qnr genes (65.4 %. Clonally related strains of 3GC-R Klebsiella pneumoniae and 3GC-R Enterobacter cloacae, the two most commonly recovered 3GC-R Enterobacteriaceae (48/55, were detected at the three hospitals, underlining the role of cross-transmission in their spread. The overall case fatality rate was 18.6 %. Conclusions Measures should be taken to prevent nosocomial infections and the selection of resistant bacteria.

Laron syndrome (primary growth hormone resistance or insensitivity): the personal experience 1958-2003.

Science.gov (United States)

Laron, Zvi

2004-03-01

Clinical and laboratory investigations starting in 1958 of a group of dwarfed children resembling isolated GH deficiency but who had very high serum levels of GH led to the description of the syndrome of primary GH resistance or insensitivity (Laron syndrome) and subsequently to the discovery of its molecular defects residing in the GH receptor and leading to an inability of IGF-I generation. With the biosynthesis of IGF-I in 1986, therapeutic trials started. Continuously more and more patients are being diagnosed in many parts of the world with a variety of molecular defects. This syndrome proved to be a unique model that enables the study of the consequences of GH receptor defects, the physiopathology of GH-IGF-I disruption, and comparison of the GH-independent IGF-I effects. This review presents the personal experience gained from the study follow-up and treatment of the 60 patients followed up for many years in the Israeli cohort.

Effects of Metformin on Ovulation and Pregnancy Rate in Women with Clomiphene Resistant Poly Cystic Ovary Syndrome

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Mahnaz Ashrafi

2007-01-01

Full Text Available Background: To evaluate the effect of metformin on ovulation and pregnancy rate in clomiphene citrateresistant women with polycystic ovary syndrome (PCOS.Material & Methods: In this clinical trial each patient, regarding her previous resistance to Clomiphene,served as her own control. A total of 35 clomiphene citrate resistant PCOS patients, referring to Royan institutewere studied. Clomiphene citrate resistance was defined as having failure of ovulation during at least threecycles using clomiphene citrate doses up to 200 mg/day on cycle days 3-7 after a withdrawal bleeding withprogesterone. Metformin was used alone or in combination with clomiphene citrate. First, the patients receivedmetformin up to 1500 mg/day for 8 weeks. During the next 2-3 cycle if the patients did not become pregnant,clomiphene was added with increments of 100 mg (up to 150 mg/day. Follicular development and ovulationwere monitored by ultrasound scans and mid-luteal progesterone level. Menstrual pattern, ovulation, andpregnancy rate were evaluated during the two stages of treatment.Results: After 8 weeks of meformin monotherapy, ovulation occurred in 23 cases (65.7% and 7 patients (20%became pregnant. Among other patients (28/35 who were treated with Clomiphene Cirate and metformin for64 cycles, 19 patients (67.8% had proper ovulation and five of them (17.8% became pregnant. Totally,metformin induced ovulation in 31 of 35 patients (88.6% and twelve (34.3% of them achieved pregnancy.Conclusion: Metformin alone or in combination with clomiphene is a very effective treatment in inducingovulation and pregnancy in clomiphene resistant women with PCOS.

Resistance in Everyday Life

DEFF Research Database (Denmark)

This book is about resistance in everyday life, illustrated through empirical contexts from different parts of the world. Resistance is a widespread phenomenon in biological, social and psychological domains of human cultural development. Yet, it is not well articulated in the academic literature....... The contributors deal with strategies for handling dissent by individuals or groups, specifically dissent through resistance. Resistance can be a location of intense personal, interpersonal and cultural negotiation, and that is the primary reason for interest in this phenomenon. Ordinary life events contain...

Obesity detection rate among primary school students in the People's Republic of China: a meta-analysis

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Jin Y

2013-10-01

Full Text Available Yue-long Jin,* Ling-ling Ding,* Ying-shui Yao, Xiu-li Song, Hui Tang, Lian-ping He, Yan ChenFaculty of Epidemiology and Statistics, School of Public Health, Wannan Medical College, Anhui, People's Republic of China*These authors contributed equally to this workBackground: Obesity has become a major public health problem worldwide. The prevalence of obesity is rising alarmingly among children and adolescents in the People's Republic of China, with an estimated 120 million now in the obese range. It is estimated that 8% of children in the People's Republic of China are obese and 12% are overweight.Methods: Eligible papers on the prevalence of obesity among primary school students in the People's Republic of China and published between 2006 and 2011 were retrieved from PubMed and from online Chinese periodicals, ie, the full-text databases of VIP, the Chinese National Knowledge Infrastructure, and Wan Fang. Meta-Analyst software was used to collate and analyze the detection rates cited in the papers retrieved.Results: After evaluation of the quality of the papers, 25 were finally included, giving a total sample population size for investigation of obesity of 219,763, in which 28,121 cases were detected. Meta-analysis showed that the combined obesity detection rate was 10.4% (95% confidence interval 8.6–12.6 among primary school students in the People's Republic of China, with a higher detection rate in boys (12.6% than in girls (7.2%. The prevalence of obesity was higher in the north (11.8% than in the south (9.5%, east (11.6%, and mid-west (8.0% regions. Obesity defined according to the World Health Organization weight-for-height standard (14.3% was higher than that using age-specific and gender-specific cutoff points for body mass index (9.0%.Conclusion: Our meta-analysis found an obesity prevalence rate of 10.4%, which does not seem as high as previous reports of childhood obesity rates in other countries. However, the prevalence of childhood

Elemental depth profiles and plasma etching rates of positive-tone electron beam resists after sequential infiltration synthesis of alumina

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Ozaki, Yuki; Ito, Shunya; Hiroshiba, Nobuya; Nakamura, Takahiro; Nakagawa, Masaru

2018-06-01

By scanning transmission electron microscopy and energy dispersive X-ray spectroscopy (STEM–EDS), we investigated the elemental depth profiles of organic electron beam resist films after the sequential infiltration synthesis (SIS) of inorganic alumina. Although a 40-nm-thick poly(methyl methacrylate) (PMMA) film was entirely hybridized with alumina, an uneven distribution was observed near the interface between the substrate and the resist as well as near the resist surface. The uneven distribution was observed around the center of a 100-nm-thick PMMA film. The thicknesses of the PMMA and CSAR62 resist films decreased almost linearly as functions of plasma etching period. The comparison of etching rate among oxygen reactive ion etching, C3F8 reactive ion beam etching (RIBE), and Ar ion beam milling suggested that the SIS treatment enhanced the etching resistance of the electron beam resists to chemical reactions rather than to ion collisions. We proposed oxygen- and Ar-assisted C3F8 RIBE for the fabrication of silica imprint molds by electron beam lithography.

Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial.

Science.gov (United States)

Courneya, Kerry S; Segal, Roanne J; Mackey, John R; Gelmon, Karen; Reid, Robert D; Friedenreich, Christine M; Ladha, Aliya B; Proulx, Caroline; Vallance, Jeffrey K H; Lane, Kirstin; Yasui, Yutaka; McKenzie, Donald C

2007-10-01

Breast cancer chemotherapy may cause unfavorable changes in physical functioning, body composition, psychosocial functioning, and quality of life (QOL). We evaluated the relative merits of aerobic and resistance exercise in blunting these effects. We conducted a multicenter randomized controlled trial in Canada between 2003 and 2005 that randomly assigned 242 breast cancer patients initiating adjuvant chemotherapy to usual care (n = 82), supervised resistance exercise (n = 82), or supervised aerobic exercise (n = 78) for the duration of their chemotherapy (median, 17 weeks; 95% CI, 9 to 24 weeks). Our primary end point was cancer-specific QOL assessed by the Functional Assessment of Cancer Therapy-Anemia scale. Secondary end points were fatigue, psychosocial functioning, physical fitness, body composition, chemotherapy completion rate, and lymphedema. The follow-up assessment rate for our primary end point was 92.1%, and adherence to the supervised exercise was 70.2%. Unadjusted and adjusted mixed-model analyses indicated that aerobic exercise was superior to usual care for improving self-esteem (P = .015), aerobic fitness (P = .006), and percent body fat (adjusted P = .076). Resistance exercise was superior to usual care for improving self-esteem (P = .018), muscular strength (P exercise groups but did not reach statistical significance. Exercise did not cause lymphedema or adverse events. Neither aerobic nor resistance exercise significantly improved cancer-specific QOL in breast cancer patients receiving chemotherapy, but they did improve self-esteem, physical fitness, body composition, and chemotherapy completion rate without causing lymphedema or significant adverse events.

Effect of current compliance and voltage sweep rate on the resistive switching of HfO2/ITO/Invar structure as measured by conductive atomic force microscopy

International Nuclear Information System (INIS)

Wu, You-Lin; Liao, Chun-Wei; Ling, Jing-Jenn

2014-01-01

The electrical characterization of HfO 2 /ITO/Invar resistive switching memory structure was studied using conductive atomic force microscopy (AFM) with a semiconductor parameter analyzer, Agilent 4156C. The metal alloy Invar was used as the metal substrate to ensure good ohmic contact with the substrate holder of the AFM. A conductive Pt/Ir AFM tip was placed in direct contact with the HfO 2 surface, such that it acted as the top electrode. Nanoscale current-voltage (I-V) characteristics of the HfO 2 /ITO/Invar structure were measured by applying a ramp voltage through the conductive AFM tip at various current compliances and ramp voltage sweep rates. It was found that the resistance of the low resistance state (RLRS) decreased with increasing current compliance value, but resistance of high resistance state (RHRS) barely changed. However, both the RHRS and RLRS decreased as the voltage sweep rate increased. The reasons for this dependency on current compliance and voltage sweep rate are discussed.

Primary water stress corrosion cracking resistance of alloy 690 heat affected zones of butt welds

International Nuclear Information System (INIS)

Fournier, L.; Calonne, O.; Toloczko, M.B.; Bruemmer, S.M.; Massoud, J.P.; Lemaire, E.; Gerard, R.; Somville, F.; Richnau, A.; Lagerstrom, J.

2015-01-01

A wide V-groove butt weld was fabricated from Alloy 690 plates using Alloy 152 filler material, maximum allowable heat input, and very stiff strong-backs. Alloy 690 heat affected zones (HAZ) was characterized in terms of microstructure and plastic strains induced by weld shrinkage. Crack initiation tests were carried out in pure hydrogenated steam at 400 C. degrees for 4000 h. Crack growth rate tests were performed in simulated PWR primary water at a temperature of 360 C. degrees. A maximum plastic strain around 5% was measured in the vicinity of the fusion line, which decreased almost linearly with the distance from the fusion line. Crack initiation tests on Alloy 690 HAZ specimens as well as on 30% cold-rolled Alloy 690 specimens were performed in pure hydrogenated steam at 400 C. degrees (partial pressure of hydrogen = 0.7 bar) for a total of 4000 h using cylindrical notched tensile specimens, reverse U-bends and flat micro-tensile specimens. No crack initiation was detected. Stress corrosion propagation rates revealed extremely low SCC (Stress Corrosion Cracking) growth rates both in the base metal and in the HAZ region whose magnitudes are of no engineering significance. Overall, the results indicated limited plastic strain induced by weld shrinkage in butt weld HAZ, and to no particular susceptibility of primary water stress corrosion cracking. (authors)

Investigation on wear resistance and corrosion resistance of electron beam cladding co-alloy coating on Inconel617

Science.gov (United States)

Liu, Hailang; Zhang, Guopei; Huang, Yiping; Qi, Zhengwei; Wang, Bo; Yu, Zhibiao; Wang, Dezhi

2018-04-01

To improve surface properties of Inconel 617 alloy (referred to as 617 alloy), co-alloy coating metallurgically bonded to substrate was prepared on the surface of 617 alloy by electron beam cladding. The microstructure, phase composition, microhardness, tribological properties and corrosion resistance of the coatings were investigated. The XRD results of the coatings reinforced by co-alloy (Co800) revealed the presence of γ-Co, CoCx and Cr23C6 phase as matrix and new metastable phases of Cr2Ni3 and Co3Mo2Si. These hypoeutectic structures contain primary dendrites and interdendritic eutectics. The metallurgical bonding forms well between the cladding layer and the matrix of 617 alloy. In most studied conditions, the co-alloy coating displays a better hardness, tribological performance, i.e., lower coefficient of frictions and wear rates, corrosion resistance in 1 mol L‑1 HCl solution, than the 617 alloy.

Development of a method to rate the primary safety of vehicles using linked New Zealand crash and vehicle licensing data.

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Keall, Michael D; Newstead, Stuart

2016-01-01

Vehicle safety rating systems aim firstly to inform consumers about safe vehicle choices and, secondly, to encourage vehicle manufacturers to aspire to safer levels of vehicle performance. Primary rating systems (that measure the ability of a vehicle to assist the driver in avoiding crashes) have not been developed for a variety of reasons, mainly associated with the difficult task of disassociating driver behavior and vehicle exposure characteristics from the estimation of crash involvement risk specific to a given vehicle. The aim of the current study was to explore different approaches to primary safety estimation, identifying which approaches (if any) may be most valid and most practical, given typical data that may be available for producing ratings. Data analyzed consisted of crash data and motor vehicle registration data for the period 2003 to 2012: 21,643,864 observations (representing vehicle-years) and 135,578 crashed vehicles. Various logistic models were tested as a means to estimate primary safety: Conditional models (conditioning on the vehicle owner over all vehicles owned); full models not conditioned on the owner, with all available owner and vehicle data; reduced models with few variables; induced exposure models; and models that synthesised elements from the latter two models. It was found that excluding young drivers (aged 25 and under) from all primary safety estimates attenuated some high risks estimated for make/model combinations favored by young people. The conditional model had clear biases that made it unsuitable. Estimates from a reduced model based just on crash rates per year (but including an owner location variable) produced estimates that were generally similar to the full model, although there was more spread in the estimates. The best replication of the full model estimates was generated by a synthesis of the reduced model and an induced exposure model. This study compared approaches to estimating primary safety that could mimic

Cost effectiveness of amoxicillin for lower respiratory tract infections in primary care: an economic evaluation accounting for the cost of antimicrobial resistance.

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Oppong, Raymond; Smith, Richard D; Little, Paul; Verheij, Theo; Butler, Christopher C; Goossens, Herman; Coenen, Samuel; Moore, Michael; Coast, Joanna

2016-09-01

Lower respiratory tract infections (LRTIs) are a major disease burden and are often treated with antibiotics. Typically, studies evaluating the use of antibiotics focus on immediate costs of care, and do not account for the wider implications of antimicrobial resistance. This study sought to establish whether antibiotics (principally amoxicillin) are cost effective in patients with LRTIs, and to explore the implications of taking into account costs associated with resistance. Multinational randomised double-blinded trial in 2060 patients with acute cough/LRTIs recruited in 12 European countries. A cost-utility analysis from a health system perspective with a time horizon of 28 days was conducted. The primary outcome measure was the quality-adjusted life year (QALY). Hierarchical modelling was used to estimate incremental cost-effectiveness ratios (ICERs). Amoxicillin was associated with an ICER of €8216 (£6540) per QALY gained when the cost of resistance was excluded. If the cost of resistance is greater than €11 (£9) per patient, then amoxicillin treatment is no longer cost effective. Including possible estimates of the cost of resistance resulted in ICERs ranging from €14 730 (£11 949) per QALY gained - when only multidrug resistance costs and health care costs are included - to €727 135 (£589 856) per QALY gained when broader societal costs are also included. Economic evaluation of antibiotic prescribing strategies that do not include the cost of resistance may provide misleading results that could be of questionable use to policymakers. However, further work is required to estimate robust costs of resistance. © British Journal of General Practice 2016.

Comparison ginger and resistance training on primary dysmenorrhea in female students of Shiraz university

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Nafiseh Saadat nejad

2015-04-01

Full Text Available Background: Although some remedies have been suggested for treatment of primary dysmenorrhea, some free of side effects treatment methods such as herbal drugs and exercise are especially important .The purpose of this study was to compare the effect of ginger and resistance training on physical and psychological symptoms of dysmenorrhea. Materials and Methods: 60 nonathletic female collegiate students of Shiraz university participated in this study voluntarily and were divided randomly to 4 groups including 15 persons ( exercise +placebo, exercise + ginger, ginger, and placebo. Ginger groups were prescribed 250 mg of ginger, four times a day for 3 days from beginning of menstruation and placebo groups were recommended the same prescription with 250 mg of placebo drug. Exercise with ginger or placebo groups participated in 2 months of progressive resistance training (3 times a week besides consuming Ginger or placebo drugs. Menstrual symptoms were recorded with using validated questionnaire, before intervention and during two consecutive periods of menstruation. The analysis was performed with using Covariate analysis of variance with repeated measures by SPSS version 16 . Results: A significant reduction was found in physical symptoms of dysmenorrhea in groups of Ginger but no significant statistically changes were found within other groups. Comparison of four groups indicated more significant reduction of physical symptoms in ginger groups compared with other groups. There were no significant difference in psychologic symptoms within and between groups (P>0.05. Conclusion: Ginger is recommended for treatment of physical symptoms of dysmenorrhea.

Enhancement of viability of radiosensitive (PBMC and resistant (MDA-MB-231 clones in low-dose-rate cobalt-60 radiation therapy

Directory of Open Access Journals (Sweden)

Patrícia Lima Falcão

2015-06-01

Full Text Available Abstract Objective: In the present study, the authors investigated the in vitro behavior of radio-resistant breast adenocarcinoma (MDA-MB-231 cells line and radiosensitive peripheral blood mononuclear cells (PBMC, as a function of different radiation doses, dose rates and postirradiation time kinetics, with a view to the interest of clinical radiotherapy. Materials and Methods: The cells were irradiated with Co-60, at 2 and 10 Gy and two different exposure rates, 339.56 cGy.min–1 and the other corresponding to one fourth of the standard dose rates, present over a 10-year period of cobalt therapy. Post-irradiation sampling was performed at pre-established kinetics of 24, 48 and 72 hours. The optical density response in viability assay was evaluated and a morphological analysis was performed. Results: Radiosensitive PBMC showed decrease in viability at 2 Gy, and a more significant decrease at 10 Gy for both dose rates. MDAMB- 231 cells presented viability decrease only at higher dose and dose rate. The results showed MDA-MB-231 clone expansion at low dose rate after 48–72 hours post-radiation. Conclusion: Low dose rate shows a possible potential clinical impact involving decrease in management of radio-resistant and radiosensitive tumor cell lines in cobalt therapy for breast cancer.

Primary coolant pipe rupture study AT(49-24)-0202

International Nuclear Information System (INIS)

Hale, D.A.; Clarke, W.L. Jr.

1977-01-01

Fatigue crack growth rate tests were conducted on 304 stainless steel and 516 carbon steel in a simulated BWR primary water environment. A study was carried out to determine the feasibility of measuring sensitization in type 304 SS by use of an Electrochemical Potentiokinetic Reactivation (EPR) technique, develop correlations between degree of sensitization (as measured electrochemically) and the intergranular stress corrosion cracking (IGSCC) resistance of type 304 SS, and provide technical data for evaluating the degree of sensitization and IGSCC susceptibility of welded components. 27 figures, 8 tables

In nondiabetic, human immunodeficiency virus-infected patients with lipodystrophy, hepatic insulin extraction and posthepatic insulin clearance rate are decreased in proportion to insulin resistance

DEFF Research Database (Denmark)

Haugaard, Steen B; Andersen, Ove; Hansen, Birgitte R

2005-01-01

In healthy, nondiabetic individuals with insulin resistance, fasting insulin is inversely correlated to the posthepatic insulin clearance rate (MCRi) and the hepatic insulin extraction (HEXi). We investigated whether similar early mechanisms to facilitate glucose homeostasis exist in nondiabetic...... > .1). Our data suggest that HEXi and MCRi are decreased in proportion to the degree of insulin resistance in nondiabetic HIV-infected patients with lipodystrophy....... insulin clearance rate was estimated as the ratio of posthepatic insulin appearance rate to steady-state plasma insulin concentration during a euglycemic hyperinsulinemic clamp (40 mU.m-2 .min-1). Posthepatic insulin appearance rate during the clamp was calculated, taking into account the remnant...

Elevated Rate of Genome Rearrangements in Radiation-Resistant Bacteria

OpenAIRE

Repar, Jelena; Supek, Fran; Klanjscek, Tin; Warnecke, Tobias; Zahradka, Ksenija; Zahradka, Davor

2017-01-01

A number of bacterial, archaeal, and eukaryotic species are known for their resistance to ionizing radiation. One of the challenges these species face is a potent environmental source of DNA double-strand breaks, potential drivers of genome structure evolution. Efficient and accurate DNA double-strand break repair systems have been demonstrated in several unrelated radiation-resistant species and are putative adaptations to the DNA damaging environment. Such adaptations are expected to compen...

Effect of Dietary Omega-3 Polyunsaturated Fatty Acids on Heart Rate and Heart Rate Variability in Animals Susceptible or Resistant to Ventricular Fibrillation

Directory of Open Access Journals (Sweden)

George E Billman

2012-03-01

Full Text Available The consumption of omega-3 polyunsaturated fatty acids (n-3 PUFAs has been reported to reduce cardiac mortality following myocardial infarction as well as to decrease resting heart rate (HR and increase heart rate variability (HRV. However, it has not been established whether n-3 PUFAs exhibit the same actions on HR and HRV in individuals known to be either susceptible or resistant to ventricular fibrillation (VF. Therefore, HR and HRV (high frequency and total R-R interval variability were evaluated before and 3 months after n-3 PUFA treatment in dogs with healed myocardial infarction that were either susceptible (VF+, n = 31 or resistant (VF-, n = 31 to ventricular tachyarrhythmias induced by a 2 min coronary artery occlusion during the last minute of a submaximal exercise test. HR and HRV were evaluated at rest, during submaximal exercise and in response to acute myocardial ischemia at rest before and after either placebo (1 g/day, corn oil, VF+, n = 9; VF- n = 8 or n-3 PUFA (docosahexaenoic acid + eicosapentaenoic acid ethyl esters, 1-4g/day, VF+, n = 22; VF-, n = 23 treatment for 3 months. The n-3 PUFA treatment elicited similar increases in red blood cell membrane, right atrial, and left ventricular n-3 PUFA levels in both the VF+ and VF- dogs. The n-3 PUFA treatment also provoked similar reductions in baseline HR and increases in baseline HRV in both groups that resulted in parallel shifts in the response to either exercise or acute myocardial ischemia (that is, the change in these variables induced by physiological challenges was not altered after n-3 PUFA treatment. These data demonstrate that dietary n-3 PUFA decreased HR and increased HRV to a similar extent in animals known to be prone to or resistant to malignant cardiac tachyarrhythmias.

Influence of the cavity-size on the survival rate of proximal ART restorations in primary molars

NARCIS (Netherlands)

Kemoli, A.M.; van Amerongen, W.E.

2009-01-01

Aim.  To evaluate the influence of the size of proximal cavities on the survival rate of the atraumatic restorative treatment (ART) restorations. Design.  A total of 804 children, aged 6-8 years, from a low socio-economic community, with an ART restorable proximal carious lesion in their primary

Metallurgical and mechanical parameters controlling alloy 718 stress corrosion cracking resistance in PWR primary water; Facteurs metallurgiques et mecaniques controlant l'amorcage de defauts de corrosion sous contrainte dans l'alliage 718 en milieu primaire des reacteurs a eau sous pression

Energy Technology Data Exchange (ETDEWEB)

Deleume, J

2007-11-15

Improving the performance and reliability of the fuel assemblies of the pressurized water reactors requires having a perfect knowledge of the operating margins of both the components and the materials. The choice of alloy 718 as reference material for this study is justified by the industrial will to identify the first order parameters controlling the excellent resistance of this alloy to Stress Corrosion Cracking (SCC). For this purpose, a specific slow strain rate (SSR) crack initiation test using tensile specimen with a V-shaped hump in the middle of the gauge length was developed and modeled. The selectivity of such SSR tests in simulated PWR primary water at 350 C was clearly established by characterizing the SCC resistance of nine alloy 718 thin strip heats. Regardless of their origin and in spite of a similar thermo-mechanical history, they did not exhibit the same susceptibility to SCC crack initiation. All the characterized alloy 718 heats develop oxide scale of similar nature for various exposure times to PWR primary medium in the temperature range [320 C - 360 C]. {delta} phase precipitation has no impact on alloy 718 SCC initiation behavior when exposed to PWR primary water, contrary to interstitial contents and the triggering of plastic instabilities (PLC phenomenon). (author)

Clonal emergence of Klebsiella pneumoniae ST14 co-producing OXA-48-type and NDM carbapenemases with high rate of colistin resistance in Dubai, United Arab Emirates.

Science.gov (United States)

Moubareck, Carole Ayoub; Mouftah, Shaimaa F; Pál, Tibor; Ghazawi, Akela; Halat, Dalal H; Nabi, Anju; AlSharhan, Mouza A; AlDeesi, Zulfa O; Peters, Christabel C; Celiloglu, Handan; Sannegowda, Manjunath; Sarkis, Dolla K; Sonnevend, Ágnes

2018-03-09

Few studies have addressed the molecular epidemiology of carbapenem resistant Enterobacteriaceae (CRE) isolates in the Arabian Peninsula, and such investigations have been missing from Dubai, a major economical, tourism and medical centre of the region. The antibiotic susceptibility, the carbapenemase type produced, and the clonality of 89 CRE strains isolated in five major Dubai hospitals in June 2015 - June 2016 were determined. Thirty three percent of the collection of 70 K. pneumoniae, 13 E. coli and 6 other Enterobacteriaceae were extremely drug resistant, 27% were resistant to colistin, and 4.5% (four K. pneumoniae isolates) were resistant to all antibiotics tested. The colistin resistance rate in K. pneumoniae was 31.4%. None of the isolates carried mobile colistin resistance genes. Seventy-seven isolates produced carbapenemase: 53.3% OXA-48-like, 24.7% NDM, and 22.1% both OXA-48-like and NDM, respectively. PFGE clustered 50% of K. pneumoniae into a 35-membered group, which showed significant association with double carbapenemase production, with extreme drug resistance, and with being isolated from Emirati patients. Members of the cluster belonged to sequence type ST14. The rate of colistin resistance in K. pneumoniae ST14 was 37.1% vs. 27.1% of K. pneumoniae isolates outside of the cluster. Two of the panresistant K. pneumoniae isolates also belonged to ST14, whereas the other two were ST15 and ST231, respectively. In conclusion, beyond the overall high colistin resistance rate in CRE, the emergence of a highly resistant clone of K. pneumoniae ST14 in all Dubai hospitals investigated is a serious problem requiring immediate attention. Copyright © 2018. Published by Elsevier B.V.

Cost effectiveness of amoxicillin for lower respiratory tract infections in primary care: an economic evaluation accounting for the cost of antimicrobial resistance

Science.gov (United States)

Oppong, Raymond; Smith, Richard D; Little, Paul; Verheij, Theo; Butler, Christopher C; Goossens, Herman; Coenen, Samuel; Moore, Michael; Coast, Joanna

2016-01-01

Background Lower respiratory tract infections (LRTIs) are a major disease burden and are often treated with antibiotics. Typically, studies evaluating the use of antibiotics focus on immediate costs of care, and do not account for the wider implications of antimicrobial resistance. Aim This study sought to establish whether antibiotics (principally amoxicillin) are cost effective in patients with LRTIs, and to explore the implications of taking into account costs associated with resistance. Design and setting Multinational randomised double-blinded trial in 2060 patients with acute cough/LRTIs recruited in 12 European countries. Method A cost-utility analysis from a health system perspective with a time horizon of 28 days was conducted. The primary outcome measure was the quality-adjusted life year (QALY). Hierarchical modelling was used to estimate incremental cost-effectiveness ratios (ICERs). Results Amoxicillin was associated with an ICER of €8216 (£6540) per QALY gained when the cost of resistance was excluded. If the cost of resistance is greater than €11 (£9) per patient, then amoxicillin treatment is no longer cost effective. Including possible estimates of the cost of resistance resulted in ICERs ranging from €14 730 (£11 949) per QALY gained — when only multidrug resistance costs and health care costs are included — to €727 135 (£589 856) per QALY gained when broader societal costs are also included. Conclusion Economic evaluation of antibiotic prescribing strategies that do not include the cost of resistance may provide misleading results that could be of questionable use to policymakers. However, further work is required to estimate robust costs of resistance. PMID:27402969

Resistent tuberkulose i Danmark

DEFF Research Database (Denmark)

Thomsen, V O; Johansen, I S; Bauer, J O

2001-01-01

INTRODUCTION: Increased rates of multidrug-resistant (MDR) tuberculosis (TB) has been reported from countries close to Denmark. We evaluated the incidence of drug resistance in Denmark in order to determine the magnitude of the problem. MATERIALS AND METHODS: Susceptibility testing was performed......-cluster. Among all patients with isoniazid- and streptomycin-resistance, 77.0% had clustered strains. DISCUSSION: In conclusion, although drug resistance among untreated Danes was close to the rate estimated in good national programmes, close monitoring is needed in future years, as active transmission...

The Primary Origin of Dose Rate Effects on Microstructural Evolution of Austenitic Alloys During Neutron Irradiation

International Nuclear Information System (INIS)

Okita, Taira; Sato, Toshihiko; Sekimura, Naoto; Garner, Francis A.; Greenwood, Lawrence R.

2002-01-01

The effect of dose rate on neutron-induced microstructural evolution was experimentally estimated. Solution-annealed austenitic model alloys were irradiated at approximately 400 degrees C with fast neutrons at seven different dose rates that vary more than two orders difference in magnitude, and two different doses were achieved at each dose rate. Both cavity nucleation and growth were found to be enhanced at lower dose rate. The net vacancy flux is calculated from the growth rate of cavities that had already nucleated during the first cycle of irradiation and grown during the second cycle. The net vacancy flux was found to be proportional to (dpa/sec) exp (1/2) up to 28.8 dpa and 8.4 x 10 exp (-7) dpa/sec. This implies that mutual recombination dominates point defect annihilation, in this experiment even though point defect sinks such as cavities and dislocations were well developed. Thus, mutual recombination is thought to be the primary origin of the effect of dose rate on microstructural evolution

Study on drug resistance of mycobacterium tuberculosis in patients with pulmonary tuberculosis by drug resistance gene detecting

International Nuclear Information System (INIS)

Wang Wei; Li Hongmin; Wu Xueqiong; Wang Ansheng; Ye Yixiu; Wang Zhongyuan; Liu Jinwei; Chen Hongbing; Lin Minggui; Wang Jinhe; Li Sumei; Jiang Ping; Feng Bai; Chen Dongjing

2004-01-01

To investigate drug resistance of mycobacterium tuberculosis in different age group, compare detecting effect of two methods and evaluate their the clinical application value, all of the strains of mycobacterium tuberculosis were tested for resistance to RFP, INH SM PZA and EMB by the absolute concentration method on Lowenstein-Jensen medium and the mutation of the rpoB, katG, rpsL, pncA and embB resistance genes in M. tuberculosis was tested by PCR-SSCP. In youth, middle and old age group, the rate of acquired drug resistance was 89.2%, 85.3% and 67.6% respectively, the gene mutation rate was 76.2%, 81.3% and 63.2% respectively. The rate of acquired drug resistance and multiple drug resistance in youth group was much higher than those in other groups. The gene mutation was correlated with drug resistance level of mycobacterium tuberculosis. The gene mutation rate was higher in strains isolated from high concentration resistance than those in strains isolated from low concentration resistance. The more irregular treatment was longer, the rate of drug resistance was higher. Acquired drug resistance varies in different age group. It suggested that surveillance of drug resistence in different age group should be taken seriously, especially in youth group. PCR - SSCP is a sensitive and specific method for rapid detecting rpoB, katG, rpsL, pncA and embB genes mutations of MTB. (authors)

Prevalence and occurrence rate of Mycobacterium tuberculosis Haarlem family multi-drug resistant in the worldwide population: A systematic review and meta-analysis

Science.gov (United States)

Ramazanzadeh, Rashid; Roshani, Daem; Shakib, Pegah; Rouhi, Samaneh

2015-01-01

Background: Transmission of Mycobacterium tuberculosis (M. tuberculosis) can occur in different ways. Furthermore, drug resistant in M. tuberculosis family is a major problem that creates obstacles in treatment and control of tuberculosis (TB) in the world. One of the most prevalent families of M. tuberculosis is Haarlem, and it is associated with drug resistant. Our objectives of this study were to determine the prevalence and occurrence rate of M. tuberculosis Haarlem family multi-drug resistant (MDR) in the worldwide using meta-analysis based on a systematic review that performed on published articles. Materials and Methods: Data sources of this study were 78 original articles (2002-2012) that were published in the literatures in several databases including PubMed, Science Direct, Google Scholar, Biological abstracts, ISI web of knowledge and IranMedex. The articles were systematically reviewed for prevalence and rate of MDR. Data were analyzed using meta-analysis and random effects models with the software package Meta R, Version 2.13 (P < 0.10). Results: Final analysis included 28601 persons in 78 articles. The highest and lowest occurrence rate of Haarlem family in M. tuberculosis was in Hungary in 2006 (66.20%) with negative MDR-TB and in China in 2010 (0.8%), respectively. From 2002 to 2012, the lowest rate of prevalence was in 2010, and the highest prevalence rate was in 2012. Also 1.076% were positive for MDR and 9.22% were negative (confidence interval: 95%).0020. Conclusion: Many articles and studies are performed in this field globally, and we only chose some of them. Further studies are needed to be done in this field. Our study showed that M. tuberculosis Haarlem family is prevalent in European countries. According to the presence of MDR that was seen in our results, effective control programs are needed to control the spread of drug-resistant strains, especially Haarlem family. PMID:25767526

High Heating Rates Affect Greatly the Inactivation Rate of Escherichia coli

Science.gov (United States)

Huertas, Juan-Pablo; Aznar, Arantxa; Esnoz, Arturo; Fernández, Pablo S.; Iguaz, Asunción; Periago, Paula M.; Palop, Alfredo

2016-01-01

Heat resistance of microorganisms can be affected by different influencing factors. Although, the effect of heating rates has been scarcely explored by the scientific community, recent researches have unraveled its important effect on the thermal resistance of different species of vegetative bacteria. Typically heating rates described in the literature ranged from 1 to 20°C/min but the impact of much higher heating rates is unclear. The aim of this research was to explore the effect of different heating rates, such as those currently achieved in the heat exchangers used in the food industry, on the heat resistance of Escherichia coli. A pilot plant tubular heat exchanger and a thermoresistometer Mastia were used for this purpose. Results showed that fast heating rates had a deep impact on the thermal resistance of E. coli. Heating rates between 20 and 50°C/min were achieved in the heat exchanger, which were much slower than those around 20°C/s achieved in the thermoresistometer. In all cases, these high heating rates led to higher inactivation than expected: in the heat exchanger, for all the experiments performed, when the observed inactivation had reached about seven log cycles, the predictions estimated about 1 log cycle of inactivation; in the thermoresistometer these differences between observed and predicted values were even more than 10 times higher, from 4.07 log cycles observed to 0.34 predicted at a flow rate of 70 mL/min and a maximum heating rate of 14.7°C/s. A quantification of the impact of the heating rates on the level of inactivation achieved was established. These results point out the important effect that the heating rate has on the thermal resistance of E. coli, with high heating rates resulting in an additional sensitization to heat and therefore an effective food safety strategy in terms of food processing. PMID:27563300

Panitumumab and pegylated liposomal doxorubicin in platinum-resistant epithelial ovarian cancer with KRAS wild-type

DEFF Research Database (Denmark)

Dahl Steffensen, Karina; Waldstrøm, Marianne; Lund, Bente

, and head and neck cancer. No previous studies have evaluated the effect of panitumumab in OC based on KRAS mutation status. Methods: Eligibility criteria are confirmed stage I-IV primary epithelial ovarian/fallopian/peritoneal cancer patients with progression either during or within 6 months after end...... to a total of 33 patients. At present, 15 patients have been enrolled. The primary endpoint is to investigate the response rate in platinum-resistant, KRAS wild- type OC patients treated with PLD supplemented with panitumumab. Translational research is included as a secondary endpoint and tumor tissue...

Prevalence and resistance of commensal Staphylococcus aureus, including meticillin-resistant Staphylococcus aureus: a European cross-sectional study.

NARCIS (Netherlands)

Heijer, C.D.J. den; Bijnen, E.M.E. van; Paget, W.J.; Pringle, M.; Goossen, H.; Bruggeman, C.A.; Schellevis, F.G.; Stobberingh, E.E.

2014-01-01

Background: Information on the prevalence of Staphylococcus aureus resistance has mainly been obtained from invasive strains, although the commensal flora is considered an important reservoir of resistance. Within ‘The Appropriateness of prescribing antibiotics in primary health care in Europe with

Familial isolated primary hyperparathyroidism associated with germline GCM2 mutations is more aggressive and has a lesser rate of biochemical cure.

Science.gov (United States)

El Lakis, Mustapha; Nockel, Pavel; Guan, Bin; Agarwal, Sunita; Welch, James; Simonds, William F; Marx, Stephen; Li, Yulong; Nilubol, Naris; Patel, Dhaval; Yang, Lily; Merkel, Roxanne; Kebebew, Electron

2018-01-01

Hereditary primary hyperparathyroidism may be syndromic or nonsyndromic (familial isolated hyperparathyroidism). Recently, germline activating mutations in the GCM2 gene were identified in a subset of familial isolated hyperparathyroidism. This study examined the clinical and biochemical characteristics and the treatment outcomes of GCM2 mutation-positive familial isolated hyperparathyroidism as compared to sporadic primary hyperparathyroidism. We performed a retrospective analysis of clinical features, parathyroid pathology, and operative outcomes in 18 patients with GCM2 germline mutations and 457 patients with sporadic primary hyperparathyroidism. Age at diagnosis, sex distribution, race/ethnicity, and preoperative serum calcium concentrations were similar between the 2 groups. The preoperative serum levels of intact parathyroid hormone was greater in patients with GCM2-associated primary hyperparathyroidism (239 ± 394 vs 136 ± 113, P = .005) as were rates of multigland disease and parathyroid carcinoma in the GCM2 group (78% vs 14.3%, P hyperparathyroidism patients have greater preoperative parathyroid hormone levels, a greater rate of multigland disease, a lesser rate of biochemical cure, and a substantial risk of parathyroid carcinoma. Knowledge of these clinical characteristics could optimize the surgical management of GCM2-associated familial isolated hyperparathyroidism. Published by Elsevier Inc.

Study of interaction of fatigue damage and ratcheting. Effect of a tensile primary load on torsion fatigue resistance of stainless steel 304 L at ambient temperature

International Nuclear Information System (INIS)

Hakem, N.S.

1987-01-01

Effect of ratcheting on fatigue resistance of a stainless steel 304 L, used for reactor vessels, is studied experimentally. Lifetime of samples is reduced if a static constant tensile load (primary loading) is superimposed to cyclic torsion deformations (secondary loading). An equivalent deformation concept is developed to express a criterion of fatigue rupture under primary loading. No effect is noted on the curve of cyclic strain hardening. This fatigue analysis gives no information on cumulated axial deformation. Progressive elongation, observed during testing, is dependent of primary and secondary loading. Rupture is produced by fatigue because cumulated axial deformation is limited ( 4 cycles at rupture cumulated deformation is [fr

Prevalence of plasmid-mediated quinolone resistance determinants among oxyiminocephalosporin-resistant Enterobacteriaceae in Argentina

Directory of Open Access Journals (Sweden)

Giovanna Rincon Cruz

2013-11-01

Full Text Available High quinolone resistance rates were observed among oxyiminocephalosporin-resistant enterobacteria. In the present study, we searched for the prevalence of plasmid-mediated quinolone resistance (PMQR genes within the 55 oxyiminocephalosporin-resistant enterobacteria collected in a previous survey. The main PMQR determinants were aac(6'-Ib-cr and qnrB, which had prevalence rates of 42.4% and 33.3%, respectively. The aac(6'-Ib-cr gene was more frequently found in CTX-M-15-producing isolates, while qnrB was homogeneously distributed among all CTX-M producers.

Stable overall referral rates of primary radiotherapy for newly diagnosed cancer patients in the ageing population of South-Eastern Netherlands, 1975-1998

International Nuclear Information System (INIS)

Lybeert, Marnix L.M.; Louwman, Marieke; Coebergh, Jan-Willem W.

2004-01-01

Background and purpose: To determine the primary radiotherapy (RT) consumption in a population of almost one million inhabitants, served by one RT centre. Primary RT was defined as being planned, started or finished within 4-6 months of diagnosis. Application was evaluated according to tumour category, stage and year of diagnosis during three 8-year periods: 1975-1982, 1983 -1990 and 1991-1998. Results: Most patients were between 60 and 75 years. The number of patients receiving primary RT increased with 3% annually over the whole studied period, but remained proportionally stable for males at 30% and decreased for females from 36.2 to 34.6%. A decrease of referral rates for patients with gynaecological cancer was observed. The introduction of breast-conserving therapy in 1981 and of population screening for women aged 50-69 years in 1992 led to a considerable increase of primary RT. The eightfold increase in number of irradiated patients with localised prostate cancer rather reflected a higher detection rate than an increased referral rate. Except for an important increase of irradiated patients with rectal cancer, largely due to the shift to preoperative RT since 1994, and of patients with brain cancer, only slight alterations in referral rates were observed for the other cancers. Conclusions: Use of primary RT remained proportionally steady and modest. The marked increase in workload was mainly due to more and earlier detection of breast and prostate cancer and treatment changes in rectal cancer. Decreases were observed for each of the gynecological cancers

Obesity and Prader-Willi Syndrome Affect Heart Rate Recovery from Dynamic Resistance Exercise in Youth

Directory of Open Access Journals (Sweden)

Diobel M. Castner

2016-01-01

Full Text Available Following exercise, heart rate decline is initially driven by parasympathetic reactivation and later by sympathetic withdrawal. Obesity delays endurance exercise heart rate recovery (HRR in both children and adults. Young people with Prader-Willi Syndrome (PWS, a congenital cause for obesity, have shown a slower 60-s endurance exercise HRR compared to lean and obese children, suggesting compromised regulation. This study further evaluated effects of obesity and PWS on resistance exercise HRR at 30 and 60 s in children. PWS (8–18 years and lean and obese controls (8–11 years completed a weighted step-up protocol (six sets x 10 reps per leg, separated by one-minute rest, standardized using participant stature and lean body mass. HRR was evaluated by calculated HRR value (HRRV = difference between HR at test termination and 30 (HRRV30 and 60 (HRRV60 s post-exercise. PWS and obese had a smaller HRRV30 than lean (p < 0.01 for both. Additionally, PWS had a smaller HRRV60 than lean and obese (p = 0.01 for both. Obesity appears to delay early parasympathetic reactivation, which occurs within 30 s following resistance exercise. However, the continued HRR delay at 60 s in PWS may be explained by either blunted parasympathetic nervous system reactivation, delayed sympathetic withdrawal and/or poor cardiovascular fitness.

PWR primary system chemistry control during hot functional testing

International Nuclear Information System (INIS)

Reid, Richard D.; Little, Michael J.

2014-01-01

Hot Functional Testing (HFT) involves a number of pre-operational exercises performed to confirm the operability of plant systems at conditions expected during both normal and off-normal operation of a pressurized water reactor (PWR), including operability of safety systems. While the primary purposes of HFT are to demonstrate operability of plant systems and satisfy regulatory requirements, chemistry control during HFT is important to long-term integrity and performance of plant systems. Specifically, HFT is the first time plant equipment is exposed to high temperature water and the chemistry maintained during HFT can impact the passivation layers that form on wetted surfaces and long-term release of metals from these surfaces. Metals released from the inner surfaces of steam generator tubing and reactor coolant loop piping become activated in the core and can redeposit on ex-core surfaces. Because HFT is performed before fuel is loaded in the core, HFT provides an opportunity to produce a passive layer on primary surfaces that is free of activated corrosion products, resistant to metals release during subsequent plant operation, and also resistant to incorporation of activated corrosion products (once fuel is loaded in the core). Thus, maintaining desirable primary chemistry control during HFT is important for source term management, minimization of future shutdown activity releases, minimization of dose rates, and asset preservation. This paper presents an overview of passive film formation in the austenitic stainless steel and high nickel alloys that make up the majority of the primary circuit in advanced PWR designs. Based on this information, a summary is provided of the effects on passive film formation of key chemistry parameters that may be controlled during HFT. (author)

Antibiotic resistance genes in anaerobic bacteria isolated from primary dental root canal infections.

Science.gov (United States)

Rôças, Isabela N; Siqueira, José F

2012-12-01

Fourty-one bacterial strains isolated from infected dental root canals and identified by 16S rRNA gene sequence were screened for the presence of 14 genes encoding resistance to beta-lactams, tetracycline and macrolides. Thirteen isolates (32%) were positive for at least one of the target antibiotic resistance genes. These strains carrying at least one antibiotic resistance gene belonged to 11 of the 26 (42%) infected root canals sampled. Two of these positive cases had two strains carrying resistance genes. Six out of 7 Fusobacterium strains harbored at least one of the target resistance genes. One Dialister invisus strain was positive for 3 resistance genes, and 4 other strains carried two of the target genes. Of the 6 antibiotic resistance genes detected in root canal strains, the most prevalent were blaTEM (17% of the strains), tetW (10%), and ermC (10%). Some as-yet-uncharacterized Fusobacterium and Prevotella isolates were positive for blaTEM, cfxA and tetM. Findings demonstrated that an unexpectedly large proportion of dental root canal isolates, including as-yet-uncharacterized strains previously regarded as uncultivated phylotypes, can carry antibiotic resistance genes. Copyright © 2012 Elsevier Ltd. All rights reserved.

Cellular metabolic rates from primary dermal fibroblast cells isolated from birds of different body masses.

Science.gov (United States)

Jimenez, Ana Gabriela; Williams, Joseph B

2014-10-01

The rate of metabolism is the speed at which organisms use energy, an integration of energy transformations within the body; it governs biological processes that influence rates of growth and reproduction. Progress at understanding functional linkages between whole organism metabolic rate and underlying mechanisms that influence its magnitude has been slow despite the central role this issue plays in evolutionary and physiological ecology. Previous studies that have attempted to relate how cellular processes translate into whole-organism physiology have done so over a range of body masses of subjects. However, the data still remains controversial when observing metabolic rates at the cellular level. To bridge the gap between these ideas, we examined cellular metabolic rate of primary dermal fibroblasts isolated from 49 species of birds representing a 32,000-fold range in body masses to test the hypothesis that metabolic rate of cultured cells scales with body size. We used a Seahorse XF-96 Extracellular flux analyzer to measure cellular respiration in fibroblasts. Additionally, we measured fibroblast size and mitochondrial content. We found no significant correlation between cellular metabolic rate, cell size, or mitochondrial content and body mass. Additionally, there was a significant relationship between cellular basal metabolic rate and proton leak in these cells. We conclude that metabolic rate of cells isolated in culture does not scale with body mass, but cellular metabolic rate is correlated to growth rate in birds. Copyright © 2014 Elsevier Inc. All rights reserved.

Projected future impact of HPV vaccination and primary HPV screening on cervical cancer rates from 2017-2035: Example from Australia.

Science.gov (United States)

Hall, Michaela T; Simms, Kate T; Lew, Jie-Bin; Smith, Megan A; Saville, Marion; Canfell, Karen

2018-01-01

Many countries are transitioning from cytology-based to longer-interval HPV screening. Trials comparing HPV-based screening to cytology report an increase in CIN2/3 detection at the first screen, and longer-term reductions in CIN3+; however, population level year-to-year transitional impacts are poorly understood. We undertook a comprehensive evaluation of switching to longer-interval primary HPV screening in the context of HPV vaccination. We used Australia as an example setting, since Australia will make this transition in December 2017. Using a model of HPV vaccination, transmission, natural history and cervical screening, Policy1-Cervix, we simulated the planned transition from recommending cytology every two years for sexually-active women aged 18-20 to 69, to recommending HPV screening every five years for women aged 25-74 years. We estimated rates of CIN2/3, cervical cancer incidence, and mortality for each year from 2005 to 2035, considering ranges for HPV test accuracy and screening compliance in the context of HPV vaccination (current coverage ~82% in females; ~76% in males). Transient increases are predicted to occur in rates of CIN2/3 detection and invasive cervical cancer in the first two to three years following the screening transition (of 16-24% and 11-14% in respectively, compared to 2017 rates). However, by 2035, CIN2/3 and invasive cervical cancer rates are predicted to fall by 40-44% and 42-51%, respectively, compared to 2017 rates. Cervical cancer mortality rates are predicted to remain unchanged until ~2020, then decline by 34-45% by 2035. Over the period 2018-2035, switching to primary HPV screening in Australia is expected to avert 2,006 cases of invasive cervical cancer and save 587 lives. Transient increases in detected CIN2/3 and invasive cancer, which may be detectable at the population level, are predicted following a change to primary HPV screening. This is due to improved test sensitivity bringing forward diagnoses, resulting in

Embedded Artificial Neuval Network-Based Real-Time Half-Wave Dynamic Resistance Estimation during the A.C. Resistance Spot Welding Process

Directory of Open Access Journals (Sweden)

Liang Gong

2013-01-01

Full Text Available Online monitoring of the instantaneous resistance variation during the A.C. resistance spot welding is of paramount importance for the weld quality control. On the basis of the welding transformer circuit model, a new method is proposed to measure the transformer primary-side signal for estimating the secondary-side resistance in each 1/4 cycle. The tailored computing system ensures that the measuring method possesses a real-time computational capacity with satisfying accuracy. Since the dynamic resistance cannot be represented via an explicit function with respect to measurable parameters from the primary side of the welding transformer, an offline trained embedded artificial neural network (ANN successfully realizes the real-time implicit function calculation or estimation. A DSP-based resistance spot welding monitoring system is developed to perform ANN computation. Experimental results indicate that the proposed method is applicable for measuring the dynamic resistance in single-phase, half-wave controlled rectifier circuits.

Study on Co-free amorphous material cladding using a laser beam to improve the resistance of primary system parts in NPPs to wear/erosion-corrosion

International Nuclear Information System (INIS)

Kim, J. S.; Woo, S. S.; Seo, J. H.

2001-01-01

A study on Co-free amorphous material, ARMACOR M, cladding using a laser beam has been performed to improve resistance of the primary system main parts on nuclear power plants to wear/erosion-corrosion. The wear/erosion-corrosion properties of ARMACRO M cladded speciemens were characterized in air at room temperature and 300 .deg. C and in air at room temperature, and compared to those of other hardfacing materials, such as Stellite 6, NOREM 02, Deloro 50, TIG-welde or laer cladded. According to the results, ARMACOR M laser-cladded specimen showed to have the highest resistance to wear/erosion-corrosion

Assessing outcomes of adult oncology patients treated with linezolid versus daptomycin for bacteremia due to vancomycin-resistant Enterococcus.

Science.gov (United States)

Patel, Khilna; Kabir, Rubiya; Ahmad, Samrah; Allen, Steven L

2016-04-01

The incidence and severity of vancomycin-resistant Enterococcus blood stream infections continue to rise and is a significant burden in the healthcare setting. Literature thus far is minimal regarding treatment outcomes in patients with malignancy and vancomycin-resistant Enterococcus bacteremia. Appropriate antibiotic selection is vital to treatment success due to high rates of resistance, limited antimicrobials and mortality in this patient population. We conducted this study to determine whether treatment outcomes differed between cancer patients treated with linezolid and those treated with daptomycin for vancomycin-resistant Enterococcus bacteremia. This single-center, retrospective study included adult patients hospitalized on the oncology service with documented vancomycin-resistant Enterococcus faecium or Enterococcus faecalis bacteremia who received at least 48 h of either linezolid or daptomycin as primary treatment. A total of 65 patients were included in the analysis. Thirty-two patients received daptomycin as primary treatment, and 33 patients received linezolid as primary treatment. Twenty-six (76.5%) patients in the linezolid cohort versus 22 (71%) patients in the daptomycin cohort achieved microbiological cure (p = 0.6141). Median length of stay in days (30 vs. 42, p = 0.0714) and mortality (7/32 (20.6%) vs. 8/33 (25.8%), p = 0.6180) were also similar between the linezolid and daptomycin treated patients, respectively. No differences in microbiological cure, length of stay or mortality were identified between the groups. This study suggests that linezolid and daptomycin are each reasonable options for treating vancomycin-resistant Enterococcus bacteremia in oncology patients. Further prospective, randomized controlled trials are needed to assess the optimal treatment for vancomycin-resistant Enterococcus bacteremia in this patient population. © The Author(s) 2014.

Linear growth rates of resistive tearing modes with sub-Alfvénic streaming flow

International Nuclear Information System (INIS)

Wu, L. N.; Ma, Z. W.

2014-01-01

The tearing instability with sub-Alfvénic streaming flow along the external magnetic field is investigated using resistive MHD simulation. It is found that the growth rate of the tearing mode instability is larger than that without the streaming flow. With the streaming flow, there exist two Alfvén resonance layers near the central current sheet. The larger perturbation of the magnetic field in two closer Alfvén resonance layers could lead to formation of the observed cone structure and can largely enhance the development of the tearing mode for a narrower streaming flow. For a broader streaming flow, a larger separation of Alfvén resonance layers reduces the magnetic reconnection. The linear growth rate decreases with increase of the streaming flow thickness. The growth rate of the tearing instability also depends on the plasma beta (β). When the streaming flow is embedded in the current sheet, the growth rate increases with β if β  s , but decreases if β > β s . The existence of the specific value β s can be attributed to competition between the suppressing effect of β and the enhancing effect of the streaming flow on the magnetic reconnection. The critical value β s increases with increase of the streaming flow strength

Primary and acquired resistance to biologic therapies in gastrointestinal cancers.

Science.gov (United States)

Lubner, Sam J; Uboha, Nataliya V; Deming, Dustin A

2017-06-01

Improvements in the understanding of cancer biology have led to therapeutic advances in the treatment of gastrointestinal cancers. Drugs which target the vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) pathways have led the way in colon cancer. Monoclonal antibodies (mAbs) such as bevacizumab, ramucirumab, cetuximab, and panitumumab, have improved progression free survival and overall survival (OS) for colorectal cancers and were quickly adopted. Human epidermal growth factor receptor 2 (HER2) has demonstrated significant benefit for gastroesophageal cancers and in the setting of HER2 amplification, trastuzumab in combination with chemotherapy has become the standard of care. However, responses have not been as durable nor as robust as once hoped. Mechanisms of resistance for each of these biologic compounds have been hypothesized and are in the process of being better elucidated. This review will approach the innate and acquired mechanisms of resistance of the above compounds. Additionally, we will explore some ongoing clinical trials to capitalize on the mechanisms of resistance in the hopes of retaining the promise of targeting these pathways.

Antibiotic-resistant bacteria: a challenge for the food industry.

Science.gov (United States)

Capita, Rosa; Alonso-Calleja, Carlos

2013-01-01

Antibiotic-resistant bacteria were first described in the 1940s, but whereas new antibiotics were being discovered at a steady rate, the consequences of this phenomenon were slow to be appreciated. At present, the paucity of new antimicrobials coming into the market has led to the problem of antibiotic resistance fast escalating into a global health crisis. Although the selective pressure exerted by the use of antibiotics (particularly overuse or misuse) has been deemed the major factor in the emergence of bacterial resistance to these antimicrobials, concerns about the role of the food industry have been growing in recent years and have been raised at both national and international levels. The selective pressure exerted by the use of antibiotics (primary production) and biocides (e.g., disinfectants, food and feed preservatives, or decontaminants) is the main driving force behind the selection and spread of antimicrobial resistance throughout the food chain. Genetically modified (GM) crops with antibiotic resistance marker genes, microorganisms added intentionally to the food chain (probiotic or technological) with potentially transferable antimicrobial resistance genes, and food processing technologies used at sub-lethal doses (e.g., alternative non-thermal treatments) are also issues for concern. This paper presents the main trends in antibiotic resistance and antibiotic development in recent decades, as well as their economic and health consequences, current knowledge concerning the generation, dissemination, and mechanisms of antibacterial resistance, progress to date on the possible routes for emergence of resistance throughout the food chain and the role of foods as a vehicle for antibiotic-resistant bacteria. The main approaches to prevention and control of the development, selection, and spread of antibacterial resistance in the food industry are also addressed.

Characterization of Cefotaxime- and Ciprofloxacin-Resistant Commensal Escherichia coli Originating from Belgian Farm Animals Indicates High Antibiotic Resistance Transfer Rates.

Science.gov (United States)

Lambrecht, Ellen; Van Meervenne, Eva; Boon, Nico; Van de Wiele, Tom; Wattiau, Pierre; Herman, Lieve; Heyndrickx, Marc; Van Coillie, Els

2017-11-17

Food-producing animals represent one of the sources of antibiotic resistant commensal bacteria. There is an increasing awareness that these bacteria might have the potential to transfer their resistance genes to other (pathogenic) bacteria. In this study, 50 commensal Escherichia coli strains originating from food-producing animals and resistant to the "highest priority, critically important antibiotics" cefotaxime and/or ciprofloxacin, were selected for further characterization. For each strain (i) an antibiogram, (ii) the phylogenetic group, (iii) plasmid replicon type, (iv) presence and identification of integrons, and (v) antibiotic resistance transfer ratios were determined. Forty-five of these strains were resistant to 5 or more antibiotics, and 6 strains were resistant to 10 or more antibiotics. Resistance was most common to ampicillin (100%), sulfamethoxazole, ciprofloxacin (82%), trimethoprim, tetracycline (74%), cefotaxime, (70%) and ceftazidime (62%). Phylogenetic groups A (62%) and B1 (26%) were most common, followed by C (8%) and E (4%). In 43 strains, more than 1 replicon type was detected, with FII (88%), FIB (70%), and I1 (48%) being the most encountered types. Forty strains, positive for integrons, all harbored a class I integron and seven of them contained an additional class II integron. No class III integrons were detected. The antibiotic resistance transfer was assessed by liquid mating experiments. The transfer ratio, expressed as the number of transconjugants per recipient, was between 10 -5 and 10 0 for cefotaxime resistance and between 10 -7 and 10 -1 for ciprofloxacin resistance. The results of the current study prove that commensal E. coli in food-production animals can be a source of multiple resistance genes and that these bacteria can easily spread their ciprofloxacin and cefotaxime resistance.

Hedging against antiviral resistance during the next influenza pandemic using small stockpiles of an alternative chemotherapy.

Directory of Open Access Journals (Sweden)

Joseph T Wu

2009-05-01

Full Text Available The effectiveness of single-drug antiviral interventions to reduce morbidity and mortality during the next influenza pandemic will be substantially weakened if transmissible strains emerge which are resistant to the stockpiled antiviral drugs. We developed a mathematical model to test the hypothesis that a small stockpile of a secondary antiviral drug could be used to mitigate the adverse consequences of the emergence of resistant strains.We used a multistrain stochastic transmission model of influenza to show that the spread of antiviral resistance can be significantly reduced by deploying a small stockpile (1% population coverage of a secondary drug during the early phase of local epidemics. We considered two strategies for the use of the secondary stockpile: early combination chemotherapy (ECC; individuals are treated with both drugs in combination while both are available; and sequential multidrug chemotherapy (SMC; individuals are treated only with the secondary drug until it is exhausted, then treated with the primary drug. We investigated all potentially important regions of unknown parameter space and found that both ECC and SMC reduced the cumulative attack rate (AR and the resistant attack rate (RAR unless the probability of emergence of resistance to the primary drug p(A was so low (less than 1 in 10,000 that resistance was unlikely to be a problem or so high (more than 1 in 20 that resistance emerged as soon as primary drug monotherapy began. For example, when the basic reproductive number was 1.8 and 40% of symptomatic individuals were treated with antivirals, AR and RAR were 67% and 38% under monotherapy if p(A = 0.01. If the probability of resistance emergence for the secondary drug was also 0.01, then SMC reduced AR and RAR to 57% and 2%. The effectiveness of ECC was similar if combination chemotherapy reduced the probabilities of resistance emergence by at least ten times. We extended our model using travel data between 105

Primary non-transecting bulbar urethroplasty long-term success rates are similar to transecting urethroplasty.

Science.gov (United States)

Anderson, Kirk M; Blakely, Stephen A; O'Donnell, Colin I; Nikolavsky, Dmitriy; Flynn, Brian J

2017-01-01

To review the long-term outcomes of transecting versus non-transecting urethroplasty to repair bulbar urethral strictures. A retrospective review was conducted of 342 patients who underwent anterior urethroplasty performed by a single surgeon from 2003 to 2014. Patients were excluded from further analysis if there had been prior urethroplasty, stricture location outside the bulbous urethra, or age urethroplasty. In the non-transecting group, surgical techniques used included non-transecting anastomotic urethroplasty and dorsal and/or ventral buccal grafting. The primary endpoint was stricture resolution in transecting vs. non-transecting bulbar urethroplasty. Success was defined as freedom from secondary procedures including dilation, urethrotomy, or repeat urethroplasty. One hundred and fifty-two patients met inclusion criteria. At a mean follow-up of 65 months (range: 10-138 months), stricture-free recurrence in the transecting and non-transecting groups was similar, 83% (n = 85/102) and 82% (n = 41/50), respectively (p = 0.84). Surgical technique (p = 0.91), stricture length (p = 0.8), and etiology (p = 0.6) did not affect stricture recurrence rate on multivariate analysis. There was no difference detected in time to stricture recurrence (p = 0.21). In this retrospective series, transecting and non-transecting primary bulbar urethroplasty resulted in similar long-term stricture resolution rate. Prospective studies are needed to determine what differences may present in outcomes related to sexual function and long-term success.

Efficacy of a hospital-wide environmental cleaning protocol on hospital-acquired methicillin-resistant Staphylococcus aureus rates.

Science.gov (United States)

Watson, Paul Andrew; Watson, Luke Robert; Torress-Cook, Alfonso

2016-07-01

Environmental contamination has been associated with over half of methicillin-resistant Staphylococcus aureus (MRSA) outbreaks in hospitals. We explored if a hospital-wide environmental and patient cleaning protocol would lower hospital acquired MRSA rates and associated costs. This study evaluates the impact of implementing a hospital-wide environmental and patient cleaning protocol on the rate of MRSA infection and the potential cost benefit of the intervention. A retrospective, pre-post interventional study design was used. The intervention comprised a combination of enhanced environmental cleaning of high touch surfaces, daily washing of patients with benzalkonium chloride, and targeted isolation of patients with active infection. The rate of MRSA infection per 1000 patient days (PD) was compared with the rate after the intervention (Steiros Algorithm ® ) was implemented. A cost-benefit analysis based on the number of MRSA infections avoided was conducted. The MRSA rates decreased by 96% from 3.04 per 1000 PD to 0.11 per 1000 PD ( P reduction in MRSA infections, avoided an estimated $1,655,143 in healthcare costs. Implementation of this hospital-wide protocol appears to be associated with a reduction in the rate of MRSA infection and therefore a reduction in associated healthcare costs.

Phylogeographic variation in recombination rates within a global clone of Methicillin-Resistant Staphylococcus aureus (MRSA)

DEFF Research Database (Denmark)

Castillo-Ramirez, Santiago; Corander, Jukka; Marttinen, Pekka

2012-01-01

by employing a recently developed Bayesian approach, BRATNextGen, for detecting recombination on an expanded NGS dataset of the globally disseminated methicillin-resistant Staphylococcus aureus (MRSA) clone ST239. RESULTS: The data confirm strong geographical clustering at continental, national and city scales...... that the rapid global dissemination of a single pathogenic bacterial clone results in local variation in measured recombination rates. Possible explanatory variables include the size and time since emergence of each defined sub-population (as determined by the sampling frame), variation in transmission dynamics...

Assessing the nosocomial infections' rate and the antibiotic resistance pattern among the patient hospitalized in beheshti hospital during 2013

Directory of Open Access Journals (Sweden)

Manijeh Kadkhodaei

2018-01-01

Full Text Available Aims: Nosocomial infection is associated with increased mortality, morbidity, and length of stay. Detection of infection, identify the etiology of bacterial antibiotic resistance pattern, is necessary given the widespread use of antibiotics and antibiotic-resistant organisms. Materials and Methods: This cross-sectional study was done on 288 patients admitted to the Beheshti Hospitals in Kashan based on NNIS definitions according to the state of Health and Medical education. In this study infections and antibiotic resistance symptoms were found. Data analyses were performed with Chi-square test. Results: Among the 288 patients studied, with mean out of hospital infection was 0.80%. Most cases of infection associated were pneumonia. The highest rates of infection were in the Intensive Care Unit (ICU with 51.7%. Nosocomial infection in ICU wards was associated with increased mortality and morbidity. The most common types were ventilator-associated pneumonia. Among the microorganisms, negative Gram was seen more. The common pathogens were including Acinetobacter, Escherichia coli, and Klebsiella. Antimicrobial resistance was generally increasing and had emerged from selective pressure from antibiotic use and transmission through health staff. Conclusion: This study showed a correlation between antibiotic use and resistance of microorganisms is significant. Hence, it seems that reducing aggressive acts and conduct hygiene education and monitoring act of antibiotics is necessary to prevent antibiotic resistance.

Evaluation of Tumor Viability for Primary and Bone Metastases in Metastatic Castration-Resistant Prostate Cancer Using Whole-Body Magnetic Resonance Imaging

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Hiromichi Iwamura

2018-01-01

Full Text Available In contrast to bone scan and computed tomography (CT, which depend on osteoblastic response to detect bone metastasis, whole-body magnetic resonance imaging (WB-MRI may be able to directly detect viable tumors. A 75-year-old male who had progressive metastatic prostate cancer during primary androgen deprivation therapy was referred to our hospital. Although bone scan and CT showed multiple bone metastases, WB-MRI suggested nonviable bone metastasis and viable tumor of the primary lesion. Prostate needle biopsy demonstrated viable prostate cancer cells from 10 of 12 cores. In contrast, CT-guided needle biopsy from bone metastasis of the lumbar vertebra revealed no malignant cells. Based on these findings, we reasoned that viable tumor cells inducing disease progression may primarily exist in the primary lesions and not in the metastatic lesions, and combined prostate radiotherapy and systemic hormonal therapy resulted in successful clinical response and disease control. The use of WB-MRI to detect viable disease lesions may enable us to design optimal treatment strategies for patients with metastatic castration-resistant prostate cancer.

Reducing Resistance

DEFF Research Database (Denmark)

Lindell, Johanna

care may influence decisions on antibiotic use. Based on video-and audio recordings of physician-patient consultations it is investigated how treatment recommendations are presented, can be changed, are forecast and explained, and finally, how they seemingly meet resistance and how this resistance......Antibiotic resistance is a growing public health problem both nationally and internationally, and efficient strategies are needed to reduce unnecessary use. This dissertation presents four research studies, which examine how communication between general practitioners and patients in Danish primary...... is responded to.The first study in the dissertation suggests that treatment recommendations on antibiotics are often done in a way that encourages patient acceptance. In extension of this, the second study of the dissertation examines a case, where acceptance of such a recommendation is changed into a shared...

Expression of multidrug resistance proteins in retinoblastoma

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Swati Shukla

2017-11-01

Full Text Available AIM: To elucidate the mechanism of multidrug resistance in retinoblastoma, and to acquire more insights into in vivo drug resistance. METHODS: Three anticancer drug resistant Y79 human RB cells were generated against vincristine, etoposide or carboplatin, which are used for conventional chemotherapy in RB. Primary cultures from enucleated eyes after chemotherapy (PCNC were also prepared. Their chemosensitivity to chemotherapeutic agents (vincristine, etoposide and carboplatin were measured using MTT assay. Western blot analysis was performed to evaluate the expression of p53, Bcl-2 and various multidrug resistant proteins in retinoblastoma cells. RESULTS: Following exposure to chemotherapeutic drugs, PCNC showed less sensitivity to drugs. No significant changes observed in the p53 expression, whereas Bcl-2 expression was found to be increased in the drug resistant cells as well as in PCNC. Increased expression of P-glycoprotein (P-gp was observed in drug resistant Y79 cells; however there was no significant change in the expression of P-gp found between primary cultures of primarily enucleated eyes and PCNC. Multidrug resistance protein 1 (Mrp-1 expression was found to be elevated in the drug resistant Y79 cells as well as in PCNC. No significant change in the expression of lung resistance associated protein (Lrp was observed in the drug resistant Y79 cells as well as in PCNC. CONCLUSION: Our results suggest that multidrug resistant proteins are intrinsically present in retinoblastoma which causes treatment failure in managing retinoblastoma with chemotherapy.

Expression of multidrug resistance proteins in retinoblastoma.

Science.gov (United States)

Shukla, Swati; Srivastava, Arpna; Kumar, Sunil; Singh, Usha; Goswami, Sandeep; Chawla, Bhavna; Bajaj, Mandeep Singh; Kashyap, Seema; Kaur, Jasbir

2017-01-01

To elucidate the mechanism of multidrug resistance in retinoblastoma, and to acquire more insights into in vivo drug resistance. Three anticancer drug resistant Y79 human RB cells were generated against vincristine, etoposide or carboplatin, which are used for conventional chemotherapy in RB. Primary cultures from enucleated eyes after chemotherapy (PCNC) were also prepared. Their chemosensitivity to chemotherapeutic agents (vincristine, etoposide and carboplatin) were measured using MTT assay. Western blot analysis was performed to evaluate the expression of p53, Bcl-2 and various multidrug resistant proteins in retinoblastoma cells. Following exposure to chemotherapeutic drugs, PCNC showed less sensitivity to drugs. No significant changes observed in the p53 expression, whereas Bcl-2 expression was found to be increased in the drug resistant cells as well as in PCNC. Increased expression of P-glycoprotein (P-gp) was observed in drug resistant Y79 cells; however there was no significant change in the expression of P-gp found between primary cultures of primarily enucleated eyes and PCNC. Multidrug resistance protein 1 (Mrp-1) expression was found to be elevated in the drug resistant Y79 cells as well as in PCNC. No significant change in the expression of lung resistance associated protein (Lrp) was observed in the drug resistant Y79 cells as well as in PCNC. Our results suggest that multidrug resistant proteins are intrinsically present in retinoblastoma which causes treatment failure in managing retinoblastoma with chemotherapy.

Expression of multidrug resistance proteins in retinoblastoma

Science.gov (United States)

Shukla, Swati; Srivastava, Arpna; Kumar, Sunil; Singh, Usha; Goswami, Sandeep; Chawla, Bhavna; Bajaj, Mandeep Singh; Kashyap, Seema; Kaur, Jasbir

2017-01-01

AIM To elucidate the mechanism of multidrug resistance in retinoblastoma, and to acquire more insights into in vivo drug resistance. METHODS Three anticancer drug resistant Y79 human RB cells were generated against vincristine, etoposide or carboplatin, which are used for conventional chemotherapy in RB. Primary cultures from enucleated eyes after chemotherapy (PCNC) were also prepared. Their chemosensitivity to chemotherapeutic agents (vincristine, etoposide and carboplatin) were measured using MTT assay. Western blot analysis was performed to evaluate the expression of p53, Bcl-2 and various multidrug resistant proteins in retinoblastoma cells. RESULTS Following exposure to chemotherapeutic drugs, PCNC showed less sensitivity to drugs. No significant changes observed in the p53 expression, whereas Bcl-2 expression was found to be increased in the drug resistant cells as well as in PCNC. Increased expression of P-glycoprotein (P-gp) was observed in drug resistant Y79 cells; however there was no significant change in the expression of P-gp found between primary cultures of primarily enucleated eyes and PCNC. Multidrug resistance protein 1 (Mrp-1) expression was found to be elevated in the drug resistant Y79 cells as well as in PCNC. No significant change in the expression of lung resistance associated protein (Lrp) was observed in the drug resistant Y79 cells as well as in PCNC. CONCLUSION Our results suggest that multidrug resistant proteins are intrinsically present in retinoblastoma which causes treatment failure in managing retinoblastoma with chemotherapy. PMID:29181307

Resistance mechanisms of linezolid-nonsusceptible enterococci in Korea: low rate of 23S rRNA mutations in Enterococcus faecium.

Science.gov (United States)

Lee, Sae-Mi; Huh, Hee Jae; Song, Dong Joon; Shim, Hyang Jin; Park, Kyung Sun; Kang, Cheol-In; Ki, Chang-Seok; Lee, Nam Yong

2017-12-01

To investigate linezolid-resistance mechanisms in linezolid-nonsusceptible enterococci (LNSE) isolated from a tertiary hospital in Korea. Enterococcal isolates exhibiting linezolid MICs ≥4 mg l -1 that were isolated between December 2011 and May 2016 were investigated by PCR and sequencing for mutations in 23S rRNA or ribosomal proteins (L3, L4 and L22) and for the presence of cfr, cfr(B) and optrA genes.Results/Key findings. Among 135 LNSE (87 Enterococcus faecium and 48 Enterococcus faecalis isolates), 39.1 % (34/87) of E. faecium and 18.8 % (9/48) of E. faecalis isolates were linezolid-resistant. The optrA carriage was the dominant mechanism in E. faecalis: 13 isolates, including 10 E. faecalis [70 % (7/10) linezolid-resistant and 30 % (3/10) linezolid-intermediate] and three E. faecium [33.3 % (1/3) linezolid-resistant and 66.7 % (2/3) linezolid-intermediate], contained the optrA gene. G2576T mutations in the 23S rRNA gene were detected only in E. faecium [14 isolates; 71.4 % (10/14) linezolid-resistant and 28.6 % (4/14) linezolid-intermediate]. One linezolid-intermediate E. faecium harboured a L22 protein alteration (Ser77Thr). No isolates contained cfr or cfr(B) genes and any L3 or L4 protein alterations. No genetic mechanism of resistance was identified for 67.6 % (23/34) of linezolid-resistant E. faecium. A low rate of 23S rRNA mutations and the absence of known linezolid-resistance mechanisms in the majority of E. faecium isolates suggest regional differences in the mechanisms of linezolid resistance and the possibility of additional mechanisms.

Prevalence and occurrence rate of Mycobacterium tuberculosis Haarlem family multi-drug resistant in the worldwide population: A systematic review and meta-analysis

Directory of Open Access Journals (Sweden)

Rashid Ramazanzadeh

2015-01-01

Full Text Available Background: Transmission of Mycobacterium tuberculosis (M. tuberculosis can occur in different ways. Furthermore, drug resistant in M. tuberculosis family is a major problem that creates obstacles in treatment and control of tuberculosis (TB in the world. One of the most prevalent families of M. tuberculosis is Haarlem, and it is associated with drug resistant. Our objectives of this study were to determine the prevalence and occurrence rate of M. tuberculosis Haarlem family multi-drug resistant (MDR in the worldwide using meta-analysis based on a systematic review that performed on published articles. Materials and Methods: Data sources of this study were 78 original articles (2002-2012 that were published in the literatures in several databases including PubMed, Science Direct, Google Scholar, Biological abstracts, ISI web of knowledge and IranMedex. The articles were systematically reviewed for prevalence and rate of MDR. Data were analyzed using meta-analysis and random effects models with the software package Meta R, Version 2.13 (P < 0.10. Results: Final analysis included 28601 persons in 78 articles. The highest and lowest occurrence rate of Haarlem family in M. tuberculosis was in Hungary in 2006 (66.20% with negative MDR-TB and in China in 2010 (0.8%, respectively. From 2002 to 2012, the lowest rate of prevalence was in 2010, and the highest prevalence rate was in 2012. Also 1.076% were positive for MDR and 9.22% were negative (confidence interval: 95%.0020. Conclusion: Many articles and studies are performed in this field globally, and we only chose some of them. Further studies are needed to be done in this field. Our study showed that M. tuberculosis Haarlem family is prevalent in European countries. According to the presence of MDR that was seen in our results, effective control programs are needed to control the spread of drug-resistant strains, especially Haarlem family.

Primary resistance to integrase strand-transfer inhibitors in Europe.

NARCIS (Netherlands)

M. Casadellá; P.M. van Ham (Petra); M. Noguera-Julian; A. van Kessel; C. Pou; L.M. Hofstra (Marije); G.A. Metcalf (Ginger A.); F. Garcia; D. Struck (Daniel); I. Alexiev (Ivailo); A.M. Bakken Kran; A.I.M. Hoepelman; L.G. Kostrikis (Leondios); S. Somogyi; K. Liitsola (Kirsi); M. Linka (Marek); C. Nielsen; D. Otelea (Dan); D. Paraskevis (Dimitrios); M. Poljak (Mario); E. Puchhammer-Stöckl (Elisabeth); D. Stanekova (Danica); M. Stanojevic (Maja); K. Van Laethem (Kristel); S. Zidovec Lepej (Snjezana); B. Clotet; C.A.B. Boucher (Charles); R. Paredes (Roger); A.M.J. Wensing (Annemarie)

2015-01-01

markdownabstractThe objective of this study was to define the natural genotypic variation of the HIV-1 integrase gene across Europe for epidemiological surveillance of integrase strand-transfer inhibitor (InSTI) resistance. This was a multicentre, cross-sectional study within the European SPREAD

Primary resistance to integrase strand-transfer inhibitors in Europe

NARCIS (Netherlands)

Casadella, M.; van Ham, P. M.; Noguera-Julian, M.; van Kessel, A.; Pou, C.; Hofstra, L. M.; Santos, J. R.; Garcia, F.; Struck, D.; Alexiev, I.; Kran, A. M. Bakken; Hoepelman, A. I.; Kostrikis, L. G.; Somogyi, S.; Liitsola, K.; Linka, M.; Nielsen, C.; Otelea, D.; Paraskevis, D.; Poljak, M.; Puchhammer-Stoeckl, E.; Stanekova, D.; Stanojevic, M.; Van Laethem, K.; Lepej, S. Zidovec; Clotet, B.; Boucher, C. A. B.; Paredes, R.; Wensing, A. M. J.; Schuurman, R

2015-01-01

Objectives: The objective of this study was to define the natural genotypic variation of the HIV-1 integrase gene across Europe for epidemiological surveillance of integrase strand-transfer inhibitor (InSTI) resistance. Methods: This was a multicentre, cross-sectional study within the European

Reduction in hospital-associated methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus with daily chlorhexidine gluconate bathing for medical inpatients.

Science.gov (United States)

Lowe, Christopher F; Lloyd-Smith, Elisa; Sidhu, Baljinder; Ritchie, Gordon; Sharma, Azra; Jang, Willson; Wong, Anna; Bilawka, Jennifer; Richards, Danielle; Kind, Thomas; Puddicombe, David; Champagne, Sylvie; Leung, Victor; Romney, Marc G

2017-03-01

Daily bathing with chlorhexidine gluconate (CHG) is increasingly used in intensive care units to prevent hospital-associated infections, but limited evidence exists for noncritical care settings. A prospective crossover study was conducted on 4 medical inpatient units in an urban, academic Canadian hospital from May 1, 2014-August 10, 2015. Intervention units used CHG over a 7-month period, including a 1-month wash-in phase, while control units used nonmedicated soap and water bathing. Rates of hospital-associated methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) colonization or infection were the primary end point. Hospital-associated S. aureus were investigated for CHG resistance with a qacA/B and smr polymerase chain reaction (PCR) and agar dilution. Compliance with daily CHG bathing was 58%. Hospital-associated MRSA and VRE was decreased by 55% (5.1 vs 11.4 cases per 10,000 inpatient days, P = .04) and 36% (23.2 vs 36.0 cases per 10,000 inpatient days, P = .03), respectively, compared with control cohorts. There was no significant difference in rates of hospital-associated Clostridium difficile. Chlorhexidine resistance testing identified 1 isolate with an elevated minimum inhibitory concentration (8 µg/mL), but it was PCR negative. This prospective pragmatic study to assess daily bathing for CHG on inpatient medical units was effective in reducing hospital-associated MRSA and VRE. A critical component of CHG bathing on medical units is sustained and appropriate application, which can be a challenge to accurately assess and needs to be considered before systematic implementation. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

How to measure and monitor antimicrobial consumption and resistance.

Science.gov (United States)

Grau, Santiago; Bou, Germán; Fondevilla, Esther; Nicolás, Jordi; Rodríguez-Maresca, Manuel; Martínez-Martínez, Luis

2013-09-01

Collateral damage caused by antibiotic use includes resistance, which could be reduced if the global inappropriate use of antibiotics, especially in low-income countries, could be prevented. Surveillance of antimicrobial consumption can identify and target practice areas for quality improvement, both in the community and in healthcare institutions. The defined daily dose, the usual adult dose of an antimicrobial for treating one patient for one day, has been considered useful for measuring antimicrobial prescribing trends within a hospital. Various denominators from hospital activity including beds, admissions and discharges have been used to obtain some standard ratios for comparing antibiotic consumption between hospitals and countries. Laboratory information systems in Clinical Microbiology Services are the primary resource for preparing cumulative reports on susceptibility testing results. This information is useful for planning empirical treatment and for adopting infection control measures. Among the supranational initiatives on resistance surveillance, the EARS-Net provides information about trends on antimicrobial resistance in Europe. Resistance is the consequence of the selective pressure of antibiotics, although in some cases these agents also promote resistance by favouring the emergence of mutations that are subsequently selected. Multiple studies have shown a relationship between antimicrobial use and emergence or resistance. While in some cases a decrease in antibiotic use was associated with a reduction in resistance rates, in many other situations this has not been the case, due to co-resistance and/or the low biological cost of the resistance mechanisms involved. New antimicrobial agents are urgently needed, which coupled with infection control measures will help to control the current problem of antimicrobial resistance. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Seasonal rates of benthic primary production in a Greenland fjord measured by aquatic eddy correlation

DEFF Research Database (Denmark)

M. Attard, Karl; Glud, Ronnie; McGinnis, Daniel F.

2014-01-01

-quality multiple-day EC data sets document the presence of a year-round productive benthic phototrophic community. The shallow-water sites were on average autotrophic during the spring and summer months, up to 43.6 mmol O2 m22 d21, and heterotrophic or close to metabolic balance during the autumn and winter....... Substantial benthic gross primary production (GPP) was measured year-round. The highest GPP rates were measured during the spring, up to 5.7 mmol O2 m22 h21 (136.8 mmol O2 m22 d21), and even at low light levels (, 80 mmol quanta m22 s21) during late autumn and winter we measured rates of up to 1.8 mmol O2 m22...

[Resistance risk, cross-resistance and biochemical resistance mechanism of Laodelphax striatellus to buprofezin].

Science.gov (United States)

Mao, Xu-lian; Liu, Jin; Li, Xu-ke; Chi, Jia-jia; Liu, Yong-jie

2016-01-01

In order to investigate the resistance development law and biochemical resistance mechanism of Laodelphax striatellus to buprofezin, spraying rice seedlings was used to continuously screen resistant strains of L. striatellus and dipping rice seedlings was applied to determine the toxicity and cross-resistance of L. striatellus to insecticides. After 32-generation screening with buprofezin, L. striatellus developed 168.49 folds resistance and its reality heritability (h2) was 0.11. If the killing rate was 80%-90%, L. striatellus was expected to develop 10-fold resistance to buprofezin only after 5 to 6 generations breeding. Because the actual reality heritability of field populations was usually lower than that of the resistant strains, the production of field populations increasing with 10-fold resistance would need much longer time. The results of cross-resistance showed that resistant strain had high level cross-resistance with thiamethoxam and imidacloprid, low level cross-resistance with acetamiprid, and no cross-resistance with pymetrozine and chlorpyrifos. The activity of detoxification enzymes of different strains and the syergism of synergist were measured. The results showed that cytochrome P450 monooxygenase played a major role in the resistance of L. striatellus to buprofezin, the esterase played a minor role and the GSH-S-transferase had no effect. Therefore, L. striatellus would have high risk to develop resistance to buprofezin when used in the field and might be delayed by using pymetrozine and chlorpyrifos.

Failure of the Nernst-Einstein equation to correlate electrical resistances and rates of ionic self-exchange across certain fixed charge membranes.

Science.gov (United States)

Gottlieb, M H; Sollner, K

1968-05-01

The electrical resistances and rates of self-exchange of univalent critical ions across several types of collodion matrix membranes of high ionic selectivity were studied over a wide range of conditions. The relationship which was observed between these quantities with membranes of a certain type, namely those activated with poly-2-vinyl-N-methyl pyridinium bromide, cannot be explained on the basis of current concepts of the movement of ions across ion exchange membranes. Rates of self-exchange across these membranes were several times greater than those calculated from the electrical resistances of the membranes on the basis of an expression derived by the use of the Nernst-Einstein equation. The magnitude of the discrepancy was greatest at low concentrations of the ambient electrolyte solution and was independent of the species of both critical and noncritical ions. The data obtained with other types of collodion matrix membranes were, at least approximately, in agreement with the predictions based on the Nernst-Einstein equation. Self-exchange rates across the anion permeable protamine collodion membranes, and across the cation permeable polystyrene sulfonic acid collodion membranes, were about 20% less than those calculated from the electrical resistances. The direction and magnitude of these differences, also observed by other investigators, are qualitatively understood as an electroosmotic effect. With cation permeable membranes prepared by the oxidation of preformed collodion membranes, almost exact agreement was obtained between measured and calculated self-exchange rates; the cause of the apparent absence of an electroosmotic effect with these membranes is unknown.

Superficial inflammatory and primary neoplastic lymphadenopathy: diagnostic accuracy of power-doppler sonography

International Nuclear Information System (INIS)

Magarelli, N.; Guglielmi, G.; Savastano, M.; Toro, V.; Sborgia, M.; Fioritoni, G.; Mattei, P.A.; Steinbach, L.; Bonomo, L.

2004-01-01

Objective: To evaluate the sensitivity, specificity and diagnostic accuracy of a cut-off of the resistive index of 0.5 for the differentiation between inflammatory and neoplastic primary lymphadenopathies. Subjects and methods: We measured the resistive index of superficial enlarged lymph nodes in a total of 50 patients (29 males and 21 females; age range 12-72 years, mean age 41.6 year) using an ATL 5000 HDI. A resistive index greater than or equal to 0.5 indicated an inflammatory lymph node and a resistive index <0.5 was consistent with neoplastic primary lymphadenopathies. The gold standard was either surgical biopsy or lymph-node reduction seen with ultrasound examination after antibiotic therapy. Results: The sensitivity of the resistive index for distinguishing inflammatory from neoplastic lymphadenopathy was 84.6%, the specificity 100% and the diagnostic accuracy 95.7% (P<0.001, statistically significant). Conclusion: The results of this study indicate that power-Doppler using a resistive index cut-off of 0.5 was a valid technique for distinguising between inflammatory and primary neoplastic lymph nodes in patients with superficial lymphadenopathies

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.

Projected future impact of HPV vaccination and primary HPV screening on cervical cancer rates from 2017-2035: Example from Australia.

Directory of Open Access Journals (Sweden)

Michaela T Hall

Full Text Available Many countries are transitioning from cytology-based to longer-interval HPV screening. Trials comparing HPV-based screening to cytology report an increase in CIN2/3 detection at the first screen, and longer-term reductions in CIN3+; however, population level year-to-year transitional impacts are poorly understood. We undertook a comprehensive evaluation of switching to longer-interval primary HPV screening in the context of HPV vaccination. We used Australia as an example setting, since Australia will make this transition in December 2017.Using a model of HPV vaccination, transmission, natural history and cervical screening, Policy1-Cervix, we simulated the planned transition from recommending cytology every two years for sexually-active women aged 18-20 to 69, to recommending HPV screening every five years for women aged 25-74 years. We estimated rates of CIN2/3, cervical cancer incidence, and mortality for each year from 2005 to 2035, considering ranges for HPV test accuracy and screening compliance in the context of HPV vaccination (current coverage ~82% in females; ~76% in males.Transient increases are predicted to occur in rates of CIN2/3 detection and invasive cervical cancer in the first two to three years following the screening transition (of 16-24% and 11-14% in respectively, compared to 2017 rates. However, by 2035, CIN2/3 and invasive cervical cancer rates are predicted to fall by 40-44% and 42-51%, respectively, compared to 2017 rates. Cervical cancer mortality rates are predicted to remain unchanged until ~2020, then decline by 34-45% by 2035. Over the period 2018-2035, switching to primary HPV screening in Australia is expected to avert 2,006 cases of invasive cervical cancer and save 587 lives.Transient increases in detected CIN2/3 and invasive cancer, which may be detectable at the population level, are predicted following a change to primary HPV screening. This is due to improved test sensitivity bringing forward diagnoses

Effect of contraction mode of slow-speed resistance training on the maximum rate of force development in the human quadriceps

DEFF Research Database (Denmark)

Blazevich, Anthony J; Horne, Sara; Cannavan, Dale

2008-01-01

This study examined the effects of slow-speed resistance training involving concentric (CON, n = 10) versus eccentric (ECC, n = 11) single-joint muscle contractions on contractile rate of force development (RFD) and neuromuscular activity (EMG), and its maintenance through detraining. Isokinetic...

Long-Term Primary Patency Rate After Nitinol Self-Expandable Stents Implantation in Long, Totally Occluded Femoropopliteal (TASC II C & D) Lesions.

Science.gov (United States)

Elmahdy, Mahmoud Farouk; Buonamici, Piergiovanni; Trapani, Maurizio; Valenti, Renato; Migliorini, Angela; Parodi, Guido; Antoniucci, David

2017-06-01

Endovascular therapy for long femoropopliteal lesions using percutaneous transluminal balloon angioplasty or first-generation of peripheral stents has been associated with unacceptable one-year restenosis rates. However, with recent advances in equipment and techniques, a better primary patency rate is expected. This study was conducted to detect the long-term primary patency rate of nitinol self-expandable stents implanted in long, totally occluded femoropopliteal lesions TransAtlantic Inter-Society Census (TASC II type C & D), and determine the predictors of reocclusion or restenosis in the stented segments. The demographics, clinical, anatomical, and procedural data of 213 patients with 240 de novo totally occluded femoropopliteal (TASC II type C & D) lesions treated with nitinol self-expandable stents were retrospectively analysed. Of these limbs, 159 (66.2%) presented with intermittent claudication, while 81 (33.8%) presented with critical limb ischaemia. The mean-time of follow-up was 36±22.6 months, (range: 6.3-106.2 months). Outcomes evaluated were, primary patency rate and predictors of reocclusion or restenosis in the stented segments. The mean age of the patients was 70.9±9.3 years, with male gender 66.2%. Mean pre-procedural ABI was 0.45±0.53. One-hundred-and-seventy-five (73%) lesions were TASC II type C, while 65 (27%) were type D lesions. The mean length of the lesions was 17.9±11.3mm. Procedure related complications occurred in 10 (4.1%) limbs. There was no periprocedural mortality. Reocclusion and restenosis were detected during follow-up in 45 and 30 limbs respectively, and all were re-treated by endovascular approach. None of the patients required major amputation. Primary patency rates were 81.4±1.1%, 77.7±1.9% and 74.4±2.8% at 12, 24, and 36 months respectively. Male gender, severe calcification, and TASC II D lesion were independent predictors for reocclusion, while predictors of restenosis were DM, smoking and TASC II D lesions

Rates of Amyloid Imaging Positivity in Patients With Primary Progressive Aphasia

Science.gov (United States)

Santos-Santos, Miguel A.; Rabinovici, Gil D.; Iaccarino, Leonardo; Ayakta, Nagehan; Tammewar, Gautam; Lobach, Iryna; Henry, Maya L.; Hubbard, Isabel; Mandelli, Maria Luisa; Spinelli, Edoardo; Miller, Zachary A.; Pressman, Peter S.; O’Neil, James P.; Ghosh, Pia; Lazaris, Andreas; Meyer, Marita; Watson, Christa; Yoon, Soo Jin; Rosen, Howard J.; Grinberg, Lea; Seeley, William W.; Miller, Bruce L.; Jagust, William J.; Gorno-Tempini, Maria Luisa

2018-01-01

IMPORTANCE The ability to predict the pathology underlying different neurodegenerative syndromes is of critical importance owing to the advent of molecule-specific therapies. OBJECTIVE To determine the rates of positron emission tomography (PET) amyloid positivity in the main clinical variants of primary progressive aphasia (PPA). DESIGN, SETTING, AND PARTICIPANTS This prospective clinical-pathologic case series was conducted at a tertiary research clinic specialized in cognitive disorders. Patients were evaluated as part of a prospective, longitudinal research study between January 2002 and December 2015. Inclusion criteria included clinical diagnosis of PPA; availability of complete speech, language, and cognitive testing; magnetic resonance imaging performed within 6 months of the cognitive evaluation; and PET carbon 11–labeled Pittsburgh Compound-B or florbetapir F 18 brain scan results. Of 109 patients referred for evaluation of language symptoms who underwent amyloid brain imaging, 3 were excluded because of incomplete language evaluations, 5 for absence of significant aphasia, and 12 for presenting with significant initial symptoms outside of the language domain, leaving a cohort of 89 patients with PPA. MAIN OUTCOMES AND MEASURES Clinical, cognitive, neuroimaging, and pathology results. RESULTS Twenty-eight cases were classified as imaging-supported semantic variant PPA (11 women [39.3%]; mean [SD] age, 64 [7] years), 31 nonfluent/agrammatic variant PPA (22 women [71.0%]; mean [SD] age, 68 [7] years), 26 logopenic variant PPA (17 women [65.4%]; mean [SD] age, 63 [8] years), and 4 mixed PPA cases. Twenty-four of 28 patients with semantic variant PPA (86%) and 28 of 31 patients with nonfluent/agrammatic variant PPA (90%) had negative amyloid PET scan results, while 25 of 26 patients with logopenic variant PPA (96%) and 3 of 4 mixed PPA cases (75%) had positive scan results. The amyloid positive semantic variant PPA and nonfluent/agrammatic variant PPA cases

Estimating Rate of Insulin Resistance in Patients with Preeclampsia Using HOMA-IR Index and Comparison with Nonpreeclampsia Pregnant Women

Directory of Open Access Journals (Sweden)

Farideh Rezaei Abhari

2014-01-01

Full Text Available Women with preeclampsia, independent of obesity and glucose intolerance, exhibit insulin resistance during pregnancy. The purpose of the present study is to determine whether early diagnosis of insulin resistance during pregnancy can predict preeclampsia. Through a case-control study, 675 pregnant women were selected and their first trimester blood was taken. Their fasting blood glucose and insulin were also measured after diagnosis of preeclampsia by 20 weeks of pregnancy. Based on the experiments conducted on 675 women who were 20 weeks past their pregnancy, 375 cases with preeclampsia were selected and assigned to the case group. 35 other pregnant women were put in the control group. Diagnosis criteria for the participants included blood pressure above 140/90 and proteinuria above 300 mg or above +1. Both groups were matched according to age, parity, gestational age, and BMI. Homa-Irand rate of insulin resistance was calculated by HOMA-IR and patients were followed up. Homeostatic model assessments (HOMA-IR revealed that the average insulin resistance increased during pregnancy among both the case and control groups. There was a significant difference between insulin resistance of these two groups in both first trimester and third trimester and after developing preeclampsia (P < 0.001, P = 0.021. Insulin-resistance of the group with preeclampsia was higher in first trimester prior to diagnosis as well as the third trimester after diagnosis compared to natural pregnancy under similar conditions. Measurement of insulin resistance in first trimester may be useful in predicting the risk of preeclampsia.

Estimating rate of insulin resistance in patients with preeclampsia using HOMA-IR index and comparison with nonpreeclampsia pregnant women.

Science.gov (United States)

Abhari, Farideh Rezaei; Ghanbari Andarieh, Maryam; Farokhfar, Asadollah; Ahmady, Soleiman

2014-01-01

Women with preeclampsia, independent of obesity and glucose intolerance, exhibit insulin resistance during pregnancy. The purpose of the present study is to determine whether early diagnosis of insulin resistance during pregnancy can predict preeclampsia. Through a case-control study, 675 pregnant women were selected and their first trimester blood was taken. Their fasting blood glucose and insulin were also measured after diagnosis of preeclampsia by 20 weeks of pregnancy. Based on the experiments conducted on 675 women who were 20 weeks past their pregnancy, 375 cases with preeclampsia were selected and assigned to the case group. 35 other pregnant women were put in the control group. Diagnosis criteria for the participants included blood pressure above 140/90 and proteinuria above 300 mg or above +1. Both groups were matched according to age, parity, gestational age, and BMI. Homa-Irand rate of insulin resistance was calculated by HOMA-IR and patients were followed up. Homeostatic model assessments (HOMA-IR) revealed that the average insulin resistance increased during pregnancy among both the case and control groups. There was a significant difference between insulin resistance of these two groups in both first trimester and third trimester and after developing preeclampsia (P < 0.001, P = 0.021). Insulin-resistance of the group with preeclampsia was higher in first trimester prior to diagnosis as well as the third trimester after diagnosis compared to natural pregnancy under similar conditions. Measurement of insulin resistance in first trimester may be useful in predicting the risk of preeclampsia.

A typology and analysis of drug resistance strategies of rural Native Hawaiian youth.

Science.gov (United States)

Okamoto, Scott K; Helm, Susana; Giroux, Danielle; Kaliades, Alexis; Kawano, Kaycee Nahe; Kulis, Stephen

2010-12-01

This study examines the drug resistance strategies described by Native Hawaiian youth residing in rural communities. Sixty-four youth from 7 middle and intermediate schools on the Island of Hawai'i participated in a series of gender-specific focus groups. Youth responded to 15 drug-related problem situations developed and validated from prior research. A total of 509 responses reflecting primary or secondary drug resistance strategies were identified by the youth, which were qualitatively collapsed into 16 different categories. Primary drug resistance strategies were those that participants listed as a single response, or the first part of a two-part response, while secondary drug resistance strategies were those that were used in tandem with primary drug resistance strategies. Over half of the responses reflecting primary drug resistance strategies fell into three different categories ("refuse," "explain," or "angry refusal"), whereas over half of the responses reflecting secondary drug resistance strategies represented one category ("explain"). Significant gender differences were found in the frequency of using different strategies as well as variations in the frequency of using different strategies based on the type of drug offerer (family versus friends/peers). Implications for prevention practice are discussed.

Primary Hyperparathyroidism: The Influence of Bone Marrow Adipose Tissue on Bone Loss and of Osteocalcin on Insulin Resistance

Directory of Open Access Journals (Sweden)

Maira L. Mendonça

Full Text Available OBJECTIVES: Bone marrow adipose tissue has been associated with low bone mineral density. However, no data exist regarding marrow adipose tissue in primary hyperparathyroidism, a disorder associated with bone loss in conditions of high bone turnover. The objective of the present study was to investigate the relationship between marrow adipose tissue, bone mass and parathyroid hormone. The influence of osteocalcin on the homeostasis model assessment of insulin resistance was also evaluated. METHODS: This was a cross-sectional study conducted at a university hospital, involving 18 patients with primary hyperparathyroidism (PHPT and 21 controls (CG. Bone mass was assessed by dual-energy x-ray absorptiometry and marrow adipose tissue was assessed by 1H magnetic resonance spectroscopy. The biochemical evaluation included the determination of parathyroid hormone, osteocalcin, glucose and insulin levels. RESULTS: A negative association was found between the bone mass at the 1/3 radius and parathyroid hormone levels (r = -0.69; p<0.01. Marrow adipose tissue was not significantly increased in patients (CG = 32.8±11.2% vs PHPT = 38.6±12%. The serum levels of osteocalcin were higher in patients (CG = 8.6±3.6 ng/mL vs PHPT = 36.5±38.4 ng/mL; p<0.005, but no associations were observed between osteocalcin and insulin or between insulin and both marrow adipose tissue and bone mass. CONCLUSION: These results suggest that the increment of adipogenesis in the bone marrow microenvironment under conditions of high bone turnover due to primary hyperparathyroidism is limited. Despite the increased serum levels of osteocalcin due to primary hyperparathyroidism, these patients tend to have impaired insulin sensitivity.

Differences Between Colon Cancer Primaries and Metastases Using a Molecular Assay for Tumor Radiation Sensitivity Suggest Implications for Potential Oligometastatic SBRT Patient Selection

International Nuclear Information System (INIS)

Ahmed, Kamran A.; Fulp, William J.; Berglund, Anders E.; Hoffe, Sarah E.; Dilling, Thomas J.; Eschrich, Steven A.; Shridhar, Ravi; Torres-Roca, Javier F.

2015-01-01

Purpose: We previously developed a multigene expression model of tumor radiation sensitivity index (RSI) with clinical validation in multiple independent cohorts (breast, rectal, esophageal, and head and neck patients). The purpose of this study was to assess differences between RSI scores in primary colon cancer and metastases. Methods and Materials: Patients were identified from our institutional review board–approved prospective observational protocol. A total of 704 metastatic and 1362 primary lesions were obtained from a de-identified metadata pool. RSI was calculated using the previously published rank-based algorithm. An independent cohort of 29 lung or liver colon metastases treated with 60 Gy in 5 fractions stereotactic body radiation therapy (SBRT) was used for validation. Results: The most common sites of metastases included liver (n=374; 53%), lung (n=116; 17%), and lymph nodes (n=40; 6%). Sixty percent of metastatic tumors, compared with 54% of primaries, were in the RSI radiation-resistant peak, suggesting metastatic tumors may be slightly more radiation resistant than primaries (P=.01). In contrast, when we analyzed metastases based on anatomical site, we uncovered large differences in RSI. The median RSIs for metastases in descending order of radiation resistance were ovary (0.48), abdomen (0.47), liver (0.43), brain (0.42), lung (0.32), and lymph nodes (0.31) (P<.0001). These findings were confirmed when the analysis was restricted to lesions from the same patient (n=139). In our independent cohort of treated lung and liver metastases, lung metastases had an improved local control rate compared to that in patients with liver metastases (2-year local control rate of 100% vs 73.0%, respectively; P=.026). Conclusions: Assessment of radiation sensitivity between primary and metastatic tissues of colon cancer histology revealed significant differences based on anatomical location of metastases. These initial results warrant validation in a larger

Differences Between Colon Cancer Primaries and Metastases Using a Molecular Assay for Tumor Radiation Sensitivity Suggest Implications for Potential Oligometastatic SBRT Patient Selection

Energy Technology Data Exchange (ETDEWEB)

Ahmed, Kamran A. [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Fulp, William J.; Berglund, Anders E. [Department of Biostatistics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Hoffe, Sarah E.; Dilling, Thomas J. [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Eschrich, Steven A. [Department of Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Shridhar, Ravi [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Torres-Roca, Javier F., E-mail: javier.torresroca@moffitt.org [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States)

2015-07-15

Purpose: We previously developed a multigene expression model of tumor radiation sensitivity index (RSI) with clinical validation in multiple independent cohorts (breast, rectal, esophageal, and head and neck patients). The purpose of this study was to assess differences between RSI scores in primary colon cancer and metastases. Methods and Materials: Patients were identified from our institutional review board–approved prospective observational protocol. A total of 704 metastatic and 1362 primary lesions were obtained from a de-identified metadata pool. RSI was calculated using the previously published rank-based algorithm. An independent cohort of 29 lung or liver colon metastases treated with 60 Gy in 5 fractions stereotactic body radiation therapy (SBRT) was used for validation. Results: The most common sites of metastases included liver (n=374; 53%), lung (n=116; 17%), and lymph nodes (n=40; 6%). Sixty percent of metastatic tumors, compared with 54% of primaries, were in the RSI radiation-resistant peak, suggesting metastatic tumors may be slightly more radiation resistant than primaries (P=.01). In contrast, when we analyzed metastases based on anatomical site, we uncovered large differences in RSI. The median RSIs for metastases in descending order of radiation resistance were ovary (0.48), abdomen (0.47), liver (0.43), brain (0.42), lung (0.32), and lymph nodes (0.31) (P<.0001). These findings were confirmed when the analysis was restricted to lesions from the same patient (n=139). In our independent cohort of treated lung and liver metastases, lung metastases had an improved local control rate compared to that in patients with liver metastases (2-year local control rate of 100% vs 73.0%, respectively; P=.026). Conclusions: Assessment of radiation sensitivity between primary and metastatic tissues of colon cancer histology revealed significant differences based on anatomical location of metastases. These initial results warrant validation in a larger

Effect of Recruitment Methods on Response Rate in a Web-Based Study for Primary Care Physicians: Factorial Randomized Controlled Trial.

Science.gov (United States)

So, Ryuhei; Shinohara, Kiyomi; Aoki, Takuya; Tsujimoto, Yasushi; Suganuma, Aya M; Furukawa, Toshi A

2018-02-08

Low participation rates are one of the most serious disadvantages of Web-based studies. It is necessary to develop effective strategies to improve participation rates to obtain sufficient data. The objective of this trial was to investigate the effect of emphasizing the incentive in the subject line of the invitation email and the day of the week of sending the invitation email on the participation rate in a Web-based trial. We conducted a 2×2 factorial design randomized controlled trial. We contacted 2000 primary care physicians from members of the Japan Primary Care Association in January 2017 and randomly allocated them to 1 of 4 combinations of 2 subject lines (presence or absence of an emphasis on a lottery for an Amazon gift card worth 3000 yen or approximately US $30) and 2 delivery days (sending the invitation email on Tuesday or Friday). The primary outcome was the response rate defined as the number of participants answering the first page of the questionnaire divided by the number of invitation emails delivered. All outcomes were collected between January 17, 2017, and February 8, 2017. We analyzed data from 1943 out of 2000 participants after excluding those whose email addresses were invalid. The overall response rate was 6.3% (123/1943). There was no significant difference in the response rates between the 2 groups regarding incentive in the subject line: the risk ratio was 1.12 (95% CI 0.80 to 1.58) and the risk difference was 0.7% (95% CI -1.5% to 2.9%). Similarly, there was no significant difference in the response rates between the 2 groups regarding sending the email on Tuesday or Friday: the risk ratio was 0.98 (95% CI 0.70 to 1.38) and the risk difference was -0.1% (95% CI -2.3% to 2.1%). Neither emphasizing the incentive in the subject line of the invitation email nor varying the day of the week the invitation email was sent led to a meaningful increase in response rates in a Web-based trial with primary care physicians. University Hospital

Drug Resistance of Mycobacterium tuberculosis Complex among ...

African Journals Online (AJOL)

BACKGROUND: In Burkina Faso, there is no recent data about the level of drug resistance in Mycobacterium tuberculosis strains among newly diagnosed tuberculosis cases. OBJECTIVE: To provide an update of the primary drug resistance of mycobacterium tuberculosis among patients in Burkina faso. METHODS: ...

Anti - microbial resistance stratified by risk factor among Escherichia coli strains isolated from the urinary tract at a rural clinic in Central India

Directory of Open Access Journals (Sweden)

Chatterjee B

2009-01-01

Full Text Available Background: The failure of empirical therapy is frequently observed, even in community-acquired urinary tract infections. We, therefore, conducted a prospective, clinic-based study in 2004-2005 to document anti-microbial resistance rates and correlate them with possible risk factors to assist empirical decision-making. Materials and Methods: Symptomatic patients with pyuria underwent urine culture. Isolates were identified using standard methods and anti-microbial resistance was determined by disk-diffusion. Ultrasonography was used to detect complicating factors. Patients were stratified by the presence of complicating factors and history of invasive procedures for comparison of resistance rates. Statistical Method Used: Chi-square or Fisher exact tests, as appropriate. Results: There were 156 E. coli isolates, of which 105 were community-acquired. Twenty-three community-acquired isolates were from patients with complicating factors while 82 were from patients without any. Fifty-one isolates were from patients who had recently undergone invasive procedures on the urinary tract. Thirty-two community-acquired isolates from reproductive-age women without apparent complicating factors had resistance rates of 50% or above against tetracyclines, Co-trimoxazole, aminopenicillins, Nalidixic acid, Ciprofloxacin and 1 st generation cephalosporins. Resistance rates were significantly higher among isolates from patients subjected to invasive procedures, except against Co-trimoxazole, tetracyclines and Amikacin. Conclusion: High rates of anti-microbial resistance in community-acquired uropathogens have made antimicrobial sensitivity testing necessary even in a rural, primary-care setting.

Prevalence of antimicrobial resistant Escherichia coli from patients with suspected urinary tract infection in primary care, Denmark

DEFF Research Database (Denmark)

Cordoba, Gloria; Holm, Anne; Hansen, Frank

2017-01-01

Background: Escherichia coli is the most common pathogen causing Urinary Tract Infections (UTI). Data from the current National Surveillance program in Denmark (DANMAP) may not accurately represent the prevalence of resistant E. coli in primary care, because only urine samples from complicated......: Observational study carried out from December 2014 to December 2015. Thirty-nine general practices from The Capital Region of Denmark included adult patients with urinary tract symptoms and suspected UTI. All urine samples were sent to the central laboratory Statens Serum Institut (SSI). Significant bacteriuria...... 485 (96%) patients. According to the European Urinalysis Standards, 261 (54%) patients had positive bacteriuria. The most common uropathogen in patients with uncomplicated (uUTI) and complicated (cUTI) urinary tract infection was E. coli 105 (69%) and 76 (70%), respectively. Eighty-two (45%) of 181 E...

Transmission of Drug-Resistant Leprosy in Guinea-Conakry Detected Using Molecular Epidemiological Approaches.

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Avanzi, Charlotte; Busso, Philippe; Benjak, Andrej; Loiseau, Chloé; Fomba, Abdoulaye; Doumbia, Glodia; Camara, Idrissa; Lamou, André; Sock, Gouressy; Drame, Tiguidanké; Kodio, Mamadou; Sakho, Fatoumata; Sow, Samba O; Cole, Stewart T; Johnson, Roch Christian

2016-12-01

Molecular drug susceptibility testing was performed on skin biopsies from 24 leprosy patients from Guinea-Conakry for the first time. We identified primary drug resistance in 4 cases and a dapsone-resistant cluster caused by the same strain. Primary transmission of drug-resistant Mycobacterium leprae, including a rifampicin-resistant strain, is reported. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Rate of Speech and Reading in Second and Fifth Grade Primary Students in Tehran

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Hourieh Ahadi

2007-12-01

Full Text Available Background and Aim: The purpose of this research is to study the standardization of speaking and reading rates in a group of normal speaker of female students, and to compare them. As the rate of speech is an important variable in the evaluation and treatment of stuttering, cluttering, dysarthria and apraxia. Materials and Method: One hundred of second grade students of primary school and an equal number of fifth grade students participated in this study. All subjects were native speakers of Farsi, who passed an informal, screening test of articulation and speech. None of the subjects had a history of speech, hearing, or neurological disorders. The subjects were asked to read from the 180 words portion of their Farsi book and tell story. Their speech was recorded by using a tape recorder. Then the data were analyzed for word and syllable rate. In transcribing the samples, single morpheme was counted as single word and compound words were counted as two words if they had two free morphemes. Non-word interjections were excluded from word and syllable counts while word interjections and repeated words were included in the count. Independent t-test and paired t-test were used for analyzing. Results: In the second grade students the reading rate is, on the average, 189.4 syllable per minute (SPM(94.9 word per minute(WPM, 3.1 syllable per second(SPS and the talking rate is 189.8 SPM (99.1 WPM, 3.1 SPS and in the fifth grade student the reading rate is 223.9 SPM (119.0 WPM, 3.7SPS and the talking rate is 210.26 SPM (109.5 WPM , 3.4 SPS. Conclusion: The result highlight that in the fifth grade students, reading rates are higher than talking rates while in the second grade they are not, because they do not have enough skills for whole word reading. A remarkable finding in this research is that, reading and talking rates in the fifth grade students are higher than the second grade students.

Drug resistance patterns in pulmonary tuberculosis

International Nuclear Information System (INIS)

Khoharo, H.K.; Shaikh, I.A.

2011-01-01

Objective: To determine the resistance patterns of mycobacterium tuberculosis (MTB) isolates among category I and II patients of pulmonary tuberculosis. Methods: This cross sectional study was conducted at the Department of Medicine, Liaquat University of Medical and Health Sciences Jamshoro, from November 2008 to September 2009. Patients were divided into category I and II. The sputa were collected, stained with Ziehl-Nielsen (Z-N) staining and ultimately inoculated on Lowenstein-Jensen (L-J) media for six weeks. Out of 890 pulmonary tuberculosis (PTB) patients, the growth was obtained in 285 cases. The Drug sensitivity testing (DST) for Isoniazid (INH), Rifampicin (RIF), Ethambutol (EMB) Pyrazinamide (PZA) and Streptomycin (SM) were performed. The data was analyzed on SPSS 10.0. A p-value of <0.05 was taken as significant. Result: Out of 285 cases, 176 (61.75%) were male and 109 (38.24%) female. The mean age was 37 +- 19.90 years. The DST showed drug sensitive and drug resistant isolates in 80 (28.05%) and 205 (71.92%) cases respectively (p=0.001). The drug resistant tuberculosis (DR-TB) rates for individual drugs; INH, RIF, EMB, PZA and SM were 51,22%, 15.4%, 13.33%, 9%12, and 3.85% respectively (p=0.03). The MDR-TB isolates were detected in 120 (42.10%) cases, including 5 (5.88%) in category I and 115 (57.50%) in category II patients (p=0.0001). Conclusion: Drug resistant and multidrug resistant tuberculosis was observed mainly in category II patients. However, primary MDR was also observed in category I patients and reflects dissemination of MDR cases within the community. (author)

Collection of radiation resistant characteristics reports for instruments and materials in high dose rate environment

International Nuclear Information System (INIS)

Kusano, Joichi

2008-03-01

This document presents the collected official reports of radiation irradiation study for the candidate materials to be used in high dose rate environment as J-PARC facility. The effect of radiation damage by loss-beam or secondary particle beam of the accelerators influences the performance and the reliability of various instruments. The knowledge on the radiation resistivity of the materials is important to estimate the life of the equipments, the maintenance interval and dose evaluation for the personnel at the maintenance period. The radiation damage consists with mechanical property, electrical property and gas-evolution property. (author)

Rapid-rate paired associative stimulation over the primary somatosensory cortex.

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Philemon Tsang

Full Text Available Rapid-rate paired associative stimulation (rPAS involves repeat pairing of peripheral nerve stimulation and Transcranial magnetic stimulation (TMS pulses at a 5 Hz frequency. RPAS over primary motor cortex (M1 operates with spike-timing dependent plasticity such that increases in corticospinal excitability occur when the nerve and TMS pulse temporally coincide in cortex. The present study investigates the effects of rPAS over primary somatosensory cortex (SI which has not been performed to date. In a series of experiments, rPAS was delivered over SI and M1 at varying timing intervals between the nerve and TMS pulse based on the latency of the N20 somatosensory evoked potential (SEP component within each participant (intervals for SI-rPAS: N20, N20-2.5 ms, N20 + 2.5 ms, intervals for M1-rPAS: N20, N20+5 ms. Changes in SI physiology were measured via SEPs (N20, P25, N20-P25 and SEP paired-pulse inhibition, and changes in M1 physiology were measured with motor evoked potentials and short-latency afferent inhibition. Measures were obtained before rPAS and at 5, 25 and 45 minutes following stimulation. Results indicate that paired-pulse inhibition and short-latency afferent inhibition were reduced only when the SI-rPAS nerve-TMS timing interval was set to N20-2.5 ms. SI-rPAS over SI also led to remote effects on motor physiology over a wider range of nerve-TMS intervals (N20-2.5 ms - N20+2.5 ms during which motor evoked potentials were increased. M1-rPAS increased motor evoked potentials and reduced short-latency afferent inhibition as previously reported. These data provide evidence that, similar to M1, rPAS over SI is spike-timing dependent and is capable of exerting changes in SI and M1 physiology.

Novos pontos de corte de sensibilidade nas taxas de resistência antimicrobiana de cepas invasivas de pneumococo New susceptibility breakpoints in antimicrobial resistance rates of invasive pneumococcal strains

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Paula Carolina Bejo Wolkers

2009-10-01

Full Text Available OBJETIVO: Avaliar impacto dos novos pontos de corte de sensibilidade à penicilina nas taxas de resistência de cepas de pneumococo obtidas de crianças com pneumonia. MÉTODOS: Cepas de pneumococo isoladas no laboratório de análises clínicas do Hospital de Clínicas de Uberlândia, Uberlândia (MG, a partir de amostras de pacientes internados foram enviadas ao Instituto Adolfo Lutz, Sao Paulo (SP, para confirmação da identificação, sorotipagem e determinação da sensibilidade aos antimicrobianos. RESULTADOS: De abril de 1999 a dezembro de 2008 foram enviadas ao Instituto Adolfo Lutz 330 cepas de pneumococo, sendo 195 (59% provenientes de pacientes com diagnóstico de pneumonia. Destas, foram analisadas 100 cepas de pacientes com idade ≤ 12 anos; a idade dos pacientes variou de 1 a 12,6 anos, com média de 2,4 e mediana de 1,7 anos; 47 pacientes eram do sexo masculino; as fontes de recuperação foram sangue (42% e líquido pleural (58%. Foram detectadas 35 cepas oxacilina-resistentes: segundo os critérios do Clinical and Laboratory Standards Institute (CLSI de 2007 [concentração inibitória mínima (CIM ≤ 0,06 µg/mL para sensibilidade (S, 0,12 a 1 µg/mL para resistência intermediária (RI e ≥ 2 µg/mL para resistência plena (RP], 22 cepas apresentaram RI e 11, RP para penicilina. De acordo com os critérios atuais do CLSI de 2008 (≤ 2 µg/mL para S, 4 µg/mL para RI e ≥ 8 µg/mL para RP apenas uma cepa confirmou RI à penicilina. Detectou-se resistência a cotrimoxazol (80%, tetraciclina (21%, eritromicina (13%, clindamicina (13% e ceftriaxona (uma cepa, simultaneamente resistente a penicilina. CONCLUSÕES: Com a aplicação dos novos pontos de corte para sensibilidade in vitro, as taxas de resistência a penicilina caíram 97%, de 33 para 1%.OBJECTIVE: To evaluate the impact of new penicillin susceptibility breakpoints on resistance rates of pneumococcal strains collected from children with pneumonia. METHODS

Effect of resistance training on muscle strength and rate of force development in healthy older adults: A systematic review and meta-analysis.

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Guizelini, Pedrode Camargo; de Aguiar, Rafael Alves; Denadai, Benedito Sérgio; Caputo, Fabrizio; Greco, Camila Coelho

2018-02-01

Rapid force capacity, identified by rate of rise in contractile force at the onset of contraction, i.e., the rate of force development (RFD), has been considered an important neuromuscular parameter of physical fitness in elderly individuals. Randomized control studies conducted in adults have found that resistance training may elicit different outcomes in terms of RFD and muscle strength. Thus, the main purpose of this study was to review systematically the literature for studies regarding the influence of resistance training on muscle strength and RFD in elderly persons. A literature search was performed in major electronic databases from inception to March 2017. Studies including health individuals with a mean age≥60years, describing the effect of resistance training on RFD and muscle strength were found eligible. The outcomes were calculated as the difference in percentage change between control and experimental groups (% change) and data were presented as mean±95% confidence limits. Meta-analyses were performed using a random-effects model and, in addition, simple and multiple meta-regression analyses were used to identify effects of age, training type, sessions per week and training duration on % change in RFD and muscle strength. Thirteen training effects were collected from 10 studies included in the meta-analysis. The resistance training program had a moderate beneficial effect on both muscle strength (% change=18.40%, 95% CL 13.69-23.30, pchange=26.68, 95% CL 14.41-35.52, pchanges in muscle strength and RFD. It can be concluded that explosive training and heavy strength training are effective resistance training methods aiming to improve both muscle strength and RFD after short-to-medium training period. However, muscle strength and RFD seem to adapt differently to resistance training programs, suggesting caution for their interchangeable use in clinical assessments of the elderly. Copyright © 2017 Elsevier Inc. All rights reserved.

The Efficacy of Inositol and N-Acetyl Cysteine Administration (Ovaric HP) in Improving the Ovarian Function in Infertile Women with PCOS with or without Insulin Resistance.

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Sacchinelli, Angela; Venturella, Roberta; Lico, Daniela; Di Cello, Annalisa; Lucia, Antonella; Rania, Erika; Cirillo, Roberto; Zullo, Fulvio

2014-01-01

Objective. Substances such as inositol and N-acetylcysteine (NAC) have been recently shown to be effective in treatment of PCOS patients. The aim of this prospective trial is to evaluate the efficacy of NAC + Inositol + folic acid on ovulation rate and menstrual regularity in PCOS patients with and without insulin resistance. Methods. Among the 91 PCOS patients treated with NAC + Inositol + folic, insulin resistance was present in 44 subjects (A) and absent in 47 (B). The primary endpoint was the ovulation rate/year, determined by menstrual diary, serum progesterone performed between 21° and 24° days, ultrasound findings of growth follicular or luteal cysts, and luteal ratio. HOMA-index assessment after 6 and 12 months of treatment was evaluated as secondary endpoint. Results. In both groups there was a significant increase in ovulation rate and no significant differences were found in the primary outcome between two groups. In group A, a significant reduction of HOMA-index was observed. Conclusions. The association NAC + Inositol + folic, regardless of insulin-resistance state, seems to improve ovarian function in PCOS patients. Therefore, inositol and NAC may have additional noninsulin-related mechanisms of action that allow achieving benefits also in those patients with negative HOMA-index.

The Efficacy of Inositol and N-Acetyl Cysteine Administration (Ovaric HP in Improving the Ovarian Function in Infertile Women with PCOS with or without Insulin Resistance

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Angela Sacchinelli

2014-01-01

Full Text Available Objective. Substances such as inositol and N-acetylcysteine (NAC have been recently shown to be effective in treatment of PCOS patients. The aim of this prospective trial is to evaluate the efficacy of NAC + Inositol + folic acid on ovulation rate and menstrual regularity in PCOS patients with and without insulin resistance. Methods. Among the 91 PCOS patients treated with NAC + Inositol + folic, insulin resistance was present in 44 subjects (A and absent in 47 (B. The primary endpoint was the ovulation rate/year, determined by menstrual diary, serum progesterone performed between 21° and 24° days, ultrasound findings of growth follicular or luteal cysts, and luteal ratio. HOMA-index assessment after 6 and 12 months of treatment was evaluated as secondary endpoint. Results. In both groups there was a significant increase in ovulation rate and no significant differences were found in the primary outcome between two groups. In group A, a significant reduction of HOMA-index was observed. Conclusions. The association NAC + Inositol + folic, regardless of insulin-resistance state, seems to improve ovarian function in PCOS patients. Therefore, inositol and NAC may have additional noninsulin-related mechanisms of action that allow achieving benefits also in those patients with negative HOMA-index.

Resistance of stored-product insects to phosphine

International Nuclear Information System (INIS)

Pimentel, Marco Aurelio Guerra; Faroni, Leda Rita D'Antonino; Batista, Maurilio Duarte; Silva, Felipe Humberto da

2008-01-01

The objectives of this work were to assess phosphine resistance in insect populations (Tribolium castaneum, Rhyzopertha dominica, Sitophilus zeamais and Oryzaephilus surinamensis) from different regions of Brazil and to verify if the prevailing mechanism of phosphine resistance in these populations involves reduced respiration rates. Sixteen populations of T. castaneum, 15 of R. dominica, 27 of S. zeamais and eight of O. surinamensis were collected from 36 locations over seven Brazilian states. Each population was tested for resistance to phosphine, based on the response of adults to discriminating concentrations, according to FAO standard method. For each insect species, the production of carbon dioxide of the most resistant and of the most susceptible populations was inversely related to their phosphine resistance. The screening tests identified possible phosphine resistant populations. R. dominica and O. surinamensis were less susceptible to phosphine than the other two species. The populations with lower respiration rate showed a lower mortality at discriminating concentration, possibly related to a phosphine resistance mechanism. Phosphine resistance occurs in stored-product insects, in different regions of Brazil, and the resistance mechanism involves reduced respiration rate. (author)

Rate of primary refractory disease in B and T-cell non-Hodgkin's lymphoma: correlation with long-term survival.

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Corrado Tarella

Full Text Available BACKGROUND: Primary refractory disease is a main challenge in the management of non-Hodgkin's Lymphoma (NHL. This survey was performed to define the rate of refractory disease to first-line therapy in B and T-cell NHL subtypes and the long-term survival of primary refractory compared to primary responsive patients. METHODS: Medical records were reviewed of 3,106 patients who had undergone primary treatment for NHL between 1982 and 2012, at the Hematology Centers of Torino and Bergamo, Italy. Primary treatment included CHOP or CHOP-like regimens (63.2%, intensive therapy with autograft (16.9%, or other therapies (19.9%. Among B-cell NHL, 1,356 (47.8% received first-line chemotherapy with rituximab. Refractory disease was defined as stable/progressive disease, or transient response with disease progression within six months. RESULTS: Overall, 690 (22.2% patients showed primary refractory disease, with a higher incidence amongst T-cell compared to B-cell NHL (41.9% vs. 20.5%, respectively, p<0.001. Several other clinico-pathological factors at presentation were variably associated with refractory disease, including histological aggressive disease, unfavorable clinical presentation, Bone Marrow involvement, low lymphocyte/monocyte ration and male gender. Amongst B-cell NHL, the addition of rituximab was associated with a marked reduction of refractory disease (13.6% vs. 26.7% for non-supplemented chemotherapy, p<0.001. Overall, primary responsive patients had a median survival of 19.8 years, compared to 1.3 yr. for refractory patients. A prolonged survival was consistently observed in all primary responsive patients regardless of the histology. The long life expectancy of primary responsive patients was documented in both series managed before and after 2.000. Response to first line therapy resulted by far the most predictive factor for long-term outcome (HR for primary refractory disease: 16.52, p<0.001. CONCLUSION: Chemosensitivity to primary

Longitudinal adoption rates of complex decision support tools in primary care.

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McCullagh, Lauren; Mann, Devin; Rosen, Lisa; Kannry, Joseph; McGinn, Thomas

2014-12-01

Translating research findings into practice promises to standardise care. Translation includes the integration of evidence-based guidelines at the point of care, discerning the best methods to disseminate research findings and models to sustain the implementation of best practices.By applying usability testing to clinical decision support(CDS) design, overall adoption rates of 60% can be realised.What has not been examined is how long adoption rates are sustained and the characteristics associated with long-term use. We conducted secondary analysis to decipher the factors impacting sustained use of CD Stools. This study was a secondary data analysis from a clinical trial conducted at an academic institution in New York City. Study data was identified patients electronic health records (EHR). The trial was to test the implementation of an integrated clinical prediction rule(iCPR) into the EHR. The primary outcome variable was iCPR tool acceptance of the tool. iCPR tool completion and iCPR smartest completion were additional outcome variables of interest. The secondary aim was to examine user characteristics associated with iCPR tool use in later time periods. Characteristics of interest included age, resident year, use of electronic health records (yes/no) and use of best practice alerts (BPA) (yes/no). Generalised linear mixed models (GLiMM) were used to compare iCPR use over time for each outcome of interest: namely, iCPR acceptance, iCPR completion and iCPR smartset completion.GLiMM was also used to examine resident characteristics associated with iCPR tool use in later time periods; specifically, intermediate and long-term (ie, 90+days). The tool was accepted, on average, 82.18% in the first 90 days (short-term period). The use decreases to 56.07% and 45.61% in intermediate and long-term time periods, respectively. There was a significant association between iCPR tool completion and time periods(pknowledge of the clinical prediction rule, or gained clinical

The Trend of Antibiotic Resistance in Shigellosis and the Diagnostic Value of Erythrocyte Sedimentation Rate for Its Differentiation from Viral Gastroenteritides in Aliasghar Children Hospital, Tehran (1996-2006

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A.R. Nateghian

2007-07-01

Full Text Available Background and objectives As a common infectious disease in childhood, shigellosis has a variety of seasonal and microbiologic patterns and there is a concerning trend of resistance in various parts of the world and even a single country. Inappropriate empiric therapy for any acute episode of gastroenteritis, which might be based on lab studies, could potentially lead to even further resistance. In this report, the erythrocyte sedimentation rate was studied in patients with acute gastroenteritis. Methods Medical records of 117 patients were reviewed in this study. The mean and standard deviation of some of the acute phase inflammatory indicators were compared in two groups of shigellosis and viral gastroenteritides using independent samples t test. Results The mean age of the patients was 49 months, and almost half of them were male. Shigella sonnei was the commonest species isolated from these patients. Shigellosis was found to be more frequent during August to October. After 2001, resistance to ampicillin and cotrimoxazole was observed in 75% and 90% of isolates respectively. A few cases were resistant to third generation of cephalosporins (< 3%. In shigellosis, the erythrocyte sedimentation rate was significantly higher than viral gastroenteritis. Conclusion Empiric use of cotrimoxazole is no longer recommended in children suspicious of contracting shigellosis in Tehran. To avoid unnecessary prescription of antibiotics for acute gastroenteritis, a normal result of erythrocyte sedimentation rate might be helpful.Keywords: Gastroenteritis, Shigella, Bacterial Antibiotic Resistance, Antibiotics, Erythrocyte Sedimentation Rate

Ten years of antibiotic consumption in ambulatory care: Trends in prescribing practice and antibiotic resistance in Austria

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Apfalter Petra

2009-05-01

Full Text Available Abstract Background The primary aims of this study were (i to determine the quantity and pattern of antibiotic use in Austria between 1998 and 2007 and (ii to analyze antibiotic resistance rates in relation to antibiotic consumption in important clinical situations in order to provide data for empirical therapeutic regimens for key indications. Methods Consumption data and resistance data were obtained via the Austrian surveillance networks European Antimicrobial Resistance Surveillance System (EARSS and European Surveillance on Antimicrobial Consumption (ESAC. The EARSS collects data on isolates from blood and cerebrospinal fluid obtained predominantly in the hospital setting. The Anatomical Therapeutic Chemical (ATC classification and the Defined Daily Dose (DDD measurement units were assigned to the data. The number of DDDs and packages per 1,000 inhabitants (PID were used to calculate the level of antibiotic consumption. Antibiotic resistance was expressed in resistance rates, i.e., the percentage of resistant isolates compared to all isolates of one bacterial species. Results The overall antibiotic consumption measured in DIDs increased by 10% between 1998 and 2007, whereas PIDs decreased by 3%. The consumption of substances within the drug utilization 90% segment (measured in PID increased for ciprofloxacin (+118.9, clindamycin (+76.3, amoxicillin/clavulanic acid (+61.9%, cefpodoxime (+31.6, azithromycin (+24.7; and decreased for erythromycin (-79.5%, trimethoprim (-56,1%, norfloxacin (-48.8%, doxycycline (-44.6, cefaclor (-35.1%, penicillin (-34.0%, amoxicillin (-22.5, minocycline (-21.9% and clarithromycin (-9.9%. Starting in 2001, an increase in the percentage of invasive E. coli isolates resistant to aminopenicillins (from 35% to 53%, fluoroquinolones (from 7% to 25.5% and third-generation cephalosporins (from 0% to 8.8% was observed. The percentage of nonsusceptible or intermediate penicillin-resistant pneumococcal isolates remained

[Primary glucocorticoid resistance syndrome presenting as pseudo-precocious puberty and galactorrhea].

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Xiang, Shu-lin; He, Li-ping; Ran, Xing-wu; Tian, Hao-ming; Li, Xiu-jun; Liang, Jin-zhong

2008-09-01

Primary glucocorticoid resistance syndrome (PGRS) is a rare condition characterized by hypercortisolism without Cushing's syndrome. This report describes a 7-year-old boy of PGRS with pseudo-precocious puberty and galactorrhea as the main manifestation. His height was 135 cm and body weight was 31 kg. Pigmentation could be seen in the skin, mammary areola and penis. He had hirsutism, low hair line, coarse voice, Tanner stage 3 pubic hair, penis in adult form, accelerated linear growth, and advanced bone age (13 yr.), but normal (for age) testes. Furthermore, he had mammoplasia and galactorrhea. There were no features of glucocorticoid (GC) excess. Hepatic function was impaired (ALT 1426 IU/L, AST 611 IU/L) with no definite causes. Serum cortisol concentration was 1294 nmol/L, 777 nmol/L, 199.3 nmol/L at 8:00, 16:00 and 24:00 respectively. Plasma adrenocorticotropic hormone (ACTH) was normal or a little higher (43.9-80 ng/L). Urinary-free cortisol (UFC) was normal (55.5-62.4 microg/24 h). Serum estradiol (E2), progesterone (P), testosterone (T), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were normal. Serum dehydroepiandrosterone sulfate (DHEAS, 60 microg/dL) and serum prolactin (PRL, 58.7-183.9 ng/mL) level were high, urinary dehydroepiandrosterone (DHEA) level was also elevated (0.96-3.2 mg/mL). Gonadotrophin hormone-releasing hormone (GnRH) stimulation test was negative. Serum cortisol responded normally to insulin-induced hypoglycemia. However, serum cortisol and plasma ACTH concentration was suppressed to more than 50% by 0.5 mg dexamethasone (DEX). The diagnosis of PGRS was made. TREATMENT AND FOLLOW-UP: The patient received a treatment of 0.75-1.0 mg/d DEX. Because of galactorrhea, bromocriptine was given by 1.25-3.75 mg/d. After 24 months follow-up, the pigmentation was relieved and galactorrhea disappeared. No advanced development of the external genitalia and breast was found. The acceleration of the bone age was also slowed down. But

Drought resistance across California ecosystems: Evaluating changes in carbon dynamics using satellite imagery

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Malone, Sparkle; Tulbure, Mirela; Pérez-Luque, Antonio J.; Assal, Timothy J.; Bremer, Leah; Drucker, Debora; Hillis, Vicken; Varela, Sara; Goulden, Michael

2016-01-01

Drought is a global issue that is exacerbated by climate change and increasing anthropogenic water demands. The recent occurrence of drought in California provides an important opportunity to examine drought response across ecosystem classes (forests, shrublands, grasslands, and wetlands), which is essential to understand how climate influences ecosystem structure and function. We quantified ecosystem resistance to drought by comparing changes in satellite-derived estimates of water-use efficiency (WUE = net primary productivity [NPP]/evapotranspiration [ET]) under normal (i.e., baseline) and drought conditions (ΔWUE = WUE2014 − baseline WUE). With this method, areas with increasing WUE under drought conditions are considered more resilient than systems with declining WUE. Baseline WUE varied across California (0.08 to 3.85 g C/mm H2O) and WUE generally increased under severe drought conditions in 2014. Strong correlations between ΔWUE, precipitation, and leaf area index (LAI) indicate that ecosystems with a lower average LAI (i.e., grasslands) also had greater C-uptake rates when water was limiting and higher rates of carbon-uptake efficiency (CUE = NPP/LAI) under drought conditions. We also found that systems with a baseline WUE ≤ 0.4 exhibited a decline in WUE under drought conditions, suggesting that a baseline WUE ≤ 0.4 might be indicative of low drought resistance. Drought severity, precipitation, and WUE were identified as important drivers of shifts in ecosystem classes over the study period. These findings have important implications for understanding climate change effects on primary productivity and C sequestration across ecosystems and how this may influence ecosystem resistance in the future.

The rf-power dependences of the deposition rate, the hardness and the corrosion-resistance of the chromium nitride film deposited by using a dual ion beam sputtering system

International Nuclear Information System (INIS)

Lim, Jongmin; Lee, Chongmu

2006-01-01

The hexavalent chromium used in chromium plating is so toxic that it is very hazardous to human body and possibly causes cancer in humans. Therefore, it is indispensable to develop an alternative deposition technique. Dependences of the deposition rate, the phases, the hardness, the surface roughness and the corrosion-resistance of CrN x deposited on the high speed steel substrate by using a dual ion beam sputtering system on the rf-power were investigated to see the feasibility of sputtering as an alternative technique for chromium plating. The dual ion beam sputtering system used in this study was designed in such a way as the primary argon ion beam and the secondary nitrogen ion beam are injected toward the target and the substrate, respectively so that the chromium atoms at the chromium target surface may not nearly react with nitrogen atoms. The hardness and the surface roughness were measured by a micro-Vicker's hardness tester and an atomic force microscope (AFM), respectively. X-ray diffraction analyses were performed to identify phases in the films. The deposition rate of CrN x depends more strongly upon the rf-power for argon ion beam than that for nitrogen ion beam. The hardness of the CrN x film is highest when the volume percent of the Cr 2 N phase in the film is highest. Amorphous films are obtained when the rf-power for nitrogen ion beam is much higher than that for argon ion beam. The CrN x film deposited by using the sputtering technique under the optimal condition provides corrosion-resistance comparable to that of the electroplated chromium

Effects of segregation of primary alloying elements on the creep response in magnesium alloys

DEFF Research Database (Denmark)

Huang, Y.D.; Dieringa, H.; Hort, N.

2008-01-01

The segregation of primary alloying elements deteriorates the high temperature creep resistance of magnesium alloys. Annealing at high temperatures alleviating their segregations can improve the creep resistance. Present investigation on the effect of segregation of primary alloying elements...... on the creep response may provide some useful information about how to improve the creep resistance of magnesium alloys in the future. (c) 2008 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved....

Microstructure and Corrosion Resistance Property of a Zn-AI-Mg Alloy with Different Solidification Processes

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Jiang Guang-rui

2017-01-01

Full Text Available Zn-Al-Mg alloy coating attracted much attention due to its high corrosion resistance properties, especially high anti-corrosion performance at the cut edge. As the Zn-Al-Mg alloy coating was usually produced by hot-dip galvanizing method, solidification process was considered to influence its microstructure and corrosion properties. In this work, a Zn-Al-Mg cast alloy was melted and cooled to room temperature with different solidification processes, including water quench, air cooling and furnace cooling. Microstructure of the alloy with different solidification processes was characterized by scanning electron microscopy (SEM. Result shows that the microstructure of the Zn-Al-Mg alloy are strongly influenced by solidification process. With increasing solidification rate, more Al is remained in the primary crystal. Electrochemical analysis indicates that with lowering solidification rate, the corrosion current density of the Zn-Al-Mg alloy decreases, which means higher corrosion resistance.

The incidence rate of HIV type-1 drug resistance in patients on antiretroviral therapy: a nationwide population-based Danish cohort study 1999-2005

DEFF Research Database (Denmark)

Audelin, A.M.; Lohse, N.; Obel, N.

2009-01-01

BACKGROUND: Newer antiretroviral treatment regimens for HIV carry a lower risk of inducing drug resistance mutations. We estimated changes in incidence rates (IRs) of new mutations in HIV-infected individuals receiving highly active antiretroviral therapy (HAART). METHODS: Population-based data...... were obtained from the Danish HIV Cohort Study and the Danish HIV Sequence Database. We included treatment-naive patients initiating HAART after December 1997 and computed time to first drug resistance mutation, identified as new mutations detected within 1 year after a 60-day period of treatment.......077). The IR of PI resistance decreased from 7.5 (1.4-21.8) in 1999 to 2.9 (0.7-11.4) in 2002-2003 (P=0.148). The IRs were low for specific resistance mutations, except for M184V (IR 5.6 [4.0-7.9]) and K103N (IR 8.2 [5.6-12.0]). CONCLUSIONS: The incidence of acquired drug resistance has decreased among HIV...

Effects of lowered pH on marine phytoplankton growth rates

DEFF Research Database (Denmark)

Berge, Terje; Daugbjerg, Niels; Andersen, Betinna Balling

2010-01-01

concentration of seawater. Ocean acidification may potentially both stimulate and reduce primary production by marine phytoplankton. Data are scarce on the response of marine phytoplankton growth rates to lowered pH/increased CO2. Using the acid addition method to lower the seawater pH and manipulate...... the carbonate system, we determined in detail the lower pH limit for growth rates of 2 model species of common marine phytoplankton. We also tested whether growth and production rates of 6 other common species of phytoplankton were affected by ocean acidification (lowered to pH 7.0). The lower pH limits...... statistically similar in the pH range of ~7.0 to 8.5. Our results and literature reports on growth at lowered pH indicate that marine phytoplankton in general are resistant to climate change in terms of ocean acidification, and do not increase or decrease their growth rates according to ecological relevant...

Mechanisms of resistance to decitabine in the myelodysplastic syndrome.

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Taichun Qin

Full Text Available The DNA methylation inhibitor 5-aza-2'-deoxycytidine (DAC is approved for the treatment of myelodysplastic syndromes (MDS, but resistance to DAC develops during treatment and mechanisms of resistance remain unknown. Therefore, we investigated mechanisms of primary and secondary resistance to DAC in MDS.We performed Quantitative Real-Time PCR to examine expression of genes related to DAC metabolism prior to therapy in 32 responders and non-responders with MDS as well as 14 patients who achieved a complete remission and subsequently relapsed while on therapy (secondary resistance. We then performed quantitative methylation analyses by bisulfite pyrosequencing of 10 genes as well as Methylated CpG Island Amplification Microarray (MCAM analysis of global methylation in secondary resistance.Most genes showed no differences by response, but the CDA/DCK ratio was 3 fold higher in non-responders than responders (P<.05, suggesting that this could be a mechanism of primary resistance. There were no significant differences at relapse in DAC metabolism genes, and no DCK mutations were detected. Global methylation measured by the LINE1 assay was lower at relapse than at diagnosis (P<.05. On average, the methylation of 10 genes was lower at relapse (16.1% compared to diagnosis (18.1% (P<.05. MCAM analysis showed decreased methylation of an average of 4.5% (range 0.6%-9.7% of the genes at relapse. By contrast, new cytogenetic changes were found in 20% of patients.Pharmacological mechanisms are involved in primary resistance to DAC, whereas hypomethylation does not prevent a relapse for patients with DAC treatment.

Associations between self-rated health, sickness behaviour and inflammatory markers in primary care patients with allergic asthma: a longitudinal study.

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Lodin, Karin; Lekander, Mats; Syk, Jörgen; Alving, Kjell; Andreasson, Anna

2017-12-18

Allergic asthma is a chronic inflammatory disorder associated with elevated levels of immunoglobulin E (IgE), serum eosinophilic cationic protein (S-ECP), plasma eosinophil-derived neurotoxin (P-EDN) and fraction of exhaled nitric oxide (F E NO). Poor self-rated health and sickness behaviour has repeatedly been associated with inflammatory markers, but the nature of this relationship in chronic inflammatory disease is not known. Likewise, such findings largely rely on cross-sectional investigations. Self-rated health (How would you rate your general state of health?), sickness behaviour (mean rating of satisfaction with energy, sleep, fitness, appetite and memory), IgE, S-ECP, P-EDN, and F E NO were assessed in 181 non-smoking primary care patients with asthma in a 1-year longitudinal study. Associations between repeated measurements were calculated using mixed regression models and Spearman's correlations for change scores. Poor self-rated health was associated with high levels of seasonal IgE (p = 0.05) and food IgE (p = 0.04), but not total IgE or inflammatory markers. An increase over 1 year in perennial IgE was associated with a worsening of self-rated health (ρ = 0.16, p = 0.04). Poor self-rated health was associated with more pronounced sickness behaviour (p sickness behaviour was associated with a worsening of self-rated health over time (ρ = 0.21, p = 0.007). The study corroborates the importance of sickness behaviour as a determinant of self-rated health by showing that these factors co-vary over a 1-year period in a group of patients with allergic asthma. The importance of specific IgE for perceived health in primary care patients with mild to moderate asthma needs further investigation.

Cuticle thickening associated with pyrethroid resistance in the major malaria vector Anopheles funestus

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Coetzee M

2010-08-01

Full Text Available Abstract Background Malaria in South Africa is primarily transmitted by Anopheles funestus Giles. Resistance to pyrethroid insecticides in An. funestus in northern Kwazulu/Natal, South Africa, and in neighbouring areas of southern Mozambique enabled populations of this species to increase their ranges into areas where pyrethroids were being exclusively used for malaria control. Pyrethroid resistance in southern African An. funestus is primarily conferred by monooxygenase enzyme metabolism. However, selection for this resistance mechanism is likely to have occurred in conjunction with other factors that improve production of the resistance phenotype. A strong candidate is cuticle thickening. This is because thicker cuticles lead to slower rates of insecticide absorption, which is likely to increase the efficiency of metabolic detoxification. Results Measures of mean cuticle thickness in laboratory samples of female An. funestus were obtained using scanning electron microscopy (SEM. These females were drawn from a laboratory colony carrying the pyrethroid resistance phenotype at a stable rate, but not fixed. Prior to cuticle thickness measurements, these samples were characterised as either more or less tolerant to permethrin exposure in one experiment, and either permethrin resistant or susceptible in another experiment. There was a significant and positive correlation between mean cuticle thickness and time to knock down during exposure to permethrin. Mean cuticle thickness was significantly greater in those samples characterised either as more tolerant or resistant to permethrin exposure compared to those characterised as either less tolerant or permethrin susceptible. Further, insecticide susceptible female An. funestus have thicker cuticles than their male counterparts. Conclusion Pyrethroid tolerant or resistant An. funestus females are likely to have thicker cuticles than less tolerant or susceptible females, and females generally have

Epidemiology meets econometrics: using time-series analysis to observe the impact of bed occupancy rates on the spread of multidrug-resistant bacteria.

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Kaier, K; Meyer, E; Dettenkofer, M; Frank, U

2010-10-01

Two multivariate time-series analyses were carried out to identify the impact of bed occupancy rates, turnover intervals and the average length of hospital stay on the spread of multidrug-resistant bacteria in a teaching hospital. Epidemiological data on the incidences of meticillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum beta-lactamase (ESBL)-producing bacteria were collected. Time-series of bed occupancy rates, turnover intervals and the average length of stay were tested for inclusion in the models as independent variables. Incidence was defined as nosocomial cases per 1000 patient-days. This included all patients infected or colonised with MRSA/ESBL more than 48h after admission. Between January 2003 and July 2008, a mean incidence of 0.15 nosocomial MRSA cases was identified. ESBL was not included in the surveillance until January 2005. Between January 2005 and July 2008 the mean incidence of nosocomial ESBL was also 0.15 cases per 1000 patient-days. The two multivariate models demonstrate a temporal relationship between bed occupancy rates in general wards and the incidence of nosocomial MRSA and ESBL. Similarly, the temporal relationship between the monthly average length of stay in intensive care units (ICUs) and the incidence of nosocomial MRSA and ESBL was demonstrated. Overcrowding in general wards and long periods of ICU stay were identified as factors influencing the spread of multidrug-resistant bacteria in hospital settings. Copyright 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

High rate of mutation K103N causing resistance to nevirapine in Indian children with acquired immunodeficiency syndrome

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Sehgal S

2008-01-01

Full Text Available In north India the number of paediatric cases with acquired immunodeficiency syndrome (AIDS is on the rise. Most drug combinations used for treatment of AIDS incorporate nevirapine, resistance to which develops very fast if given singly or because of unplanned interruptions. This paper investigates presence of mutations at codon 103 and codon 215 of the HIV pol gene causing resistance to nevirapine and zidovudine (AZT respectively in 25 children with AIDS. Mutations T215Y and K103N were detected by a nested cum amplification refractory mutation system polymerase chain reaction (ARMS PCR and the results were confirmed by direct sequencing in five randomly selected cases. Nineteen patients had received nevirapine containing regimen and six were drug naive. Mutation K103N was observed in 56% (14/25 of the children while mutation T215Y was found in none. Two of the six drug naοve children also showed K103N mutation. Thus, Indian children drug naοve or treated with nevirapine containing regimens show a high rate of mutation conferring resistance to nevirapine which calls for a judicious use of nevirapine both in antenatal and postnatal setting.

Autolysis of methicillin-resistant and -susceptible Staphylococcus aureus.

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Gustafson, J E; Berger-Bächi, B; Strässle, A; Wilkinson, B J

1992-01-01

The autolytic activities, including unstimulated, Triton X-100-stimulated, and daptomycin-induced, of various sets of methicillin-resistant and related methicillin-susceptible strains were compared. Faster rates of autolysis were noted in two heterogeneous methicillin-resistant transductants than in their methicillin-susceptible parental recipients, in a heterogeneous resistant strain than in a susceptible derivative created by chemical mutagenesis, and in a homogeneous resistant strain than in a derivative that had decreased methicillin resistance and was created by transposon Tn551 mutagenesis. These results suggest that the presence of the methicillin resistance region, mec, either directly or indirectly through an interaction with other host genes, confers a faster rate of autolysis on strains. Various auxilliary genes are known to affect methicillin resistance expression, and one of these genes, femA, was necessary for the expression of this faster rate of autolysis. These differences in autolytic activities were not observed in isolated crude cell walls retaining autolytic activities, suggesting different modes of regulation of autolysins in intact cells and isolated walls. In contrast, one homogeneous, highly resistant strain, DU4916, had a lower autolytic activity than did derived heterogeneous resistant and susceptible strains created by chemical mutagenesis and a strain that had decreased resistance and was created by transposon mutagenesis. Our observations suggest that methicillin resistance expression is associated with an enhanced rate of autolysis, in heterogeneous resistant strains at least. Images PMID:1320363

Resistance exercise-induced rhabdomyolysis: Need for immediate intervention and proper counselling.

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Khalil, Maysaa A; Saab, Basem R

2016-12-01

Rhabdomyolysis results from damage to skeletal muscle. Improper resistance training may result in rhabdomyolysis, which can cause acute kidney injury, serious metabolic abnormalities, compartmental syndrome and even death. Proper counselling for athletes may prevent this condition. We present two patients with unilateral swelling after resistance exercise. The workup revealed rhabdomyolysis. We highlight the importance of counselling to prevent rhabdomyolysis secondary to resistance exercise. Trainers and primary care physicians need to be educated about the main features of rhabdomyolysis and urgently refer trainees suspected of having this condition. Treatment consists mainly of hydration and correction of metabolic abnormalities. Primary care physicians need to counsel patients on ways to prevent rhabdomyolysis. Trainers and primary care physicians should instruct novice trainees who are performing resistance exercise to start low and gradually increase the load. Training with loads of 60-70% of one repetition maximum for 8-12 repetitions and use of one to three sets per exercise is recommended.

Nasal carriage rate of methicillin resistant Staphylococcus aureus among Iranian healthcare workers: a systematic review and meta-analysis.

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Emaneini, Mohammad; Jabalameli, Fereshteh; Rahdar, Hosseinali; Leeuwen, Willem B van; Beigverdi, Reza

2017-01-01

Globally, methicillin-resistant Staphylococcus aureus (MRSA) remains a major cause of healthcare-associated infections. Healthcare workers (HCWs), patients and the environment may act as reservoirs for the spread of MRSA to patients and other HCWs. Screening and eradication of MRSA colonization is an effective method of reducing the MRSA infection rate. There are limited data on the prevalence of MRSA among Iranian HCWs. We performed a systematic search by using different electronic databases including Medline (via PubMed), Embase, Web of Science, and Iranian Databases (from January 2000 to July 2016). Meta-analysis was performed using the Comprehensive Meta-Analysis (Biostat V2.2) software. The meta-analyses showed that the prevalence of S. aureus and MRSA among HCWs were 22.7% [95% confidence interval (CI): 19.3-26.6] and 32.8% (95% CI: 26.0-40.4) respectively. The high rate of nasal MRSA carriage among Iranian HCWs has been attributed to poor compliance to hand hygiene, injudicious use of antibiotics, and ineffective infection control and prevention measures. The rational use of antibiotics plus strict infection control are the main pillars for controlling multidrug resistant microorganisms such as MRSA in the hospital setting. These measurements should be applied nationally.

Oral primary care: an analysis of its impact on the incidence and mortality rates of oral cancer.

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Rocha, Thiago Augusto Hernandes; Thomaz, Erika Bárbara Abreu Fonseca; da Silva, Núbia Cristina; de Sousa Queiroz, Rejane Christine; de Souza, Marta Rovery; Barbosa, Allan Claudius Queiroz; Thumé, Elaine; Rocha, João Victor Muniz; Alvares, Viviane; de Almeida, Dante Grapiuna; Vissoci, João Ricardo Nickenig; Staton, Catherine Ann; Facchini, Luiz Augusto

2017-10-30

Oral cancer is a potentially fatal disease, especially when diagnosed in advanced stages. In Brazil, the primary health care (PHC) system is responsible for promoting oral health in order to prevent oral diseases. However, there is insufficient evidence to assess whether actions of the PHC system have some effect on the morbidity and mortality from oral cancer. The purpose of this study was to analyze the effect of PHC structure and work processes on the incidence and mortality rates of oral cancer after adjusting for contextual variables. An ecological, longitudinal and analytical study was carried out. Data were obtained from different secondary data sources, including three surveys that were nationally representative of Brazilian PHC and carried out over the course of 10 years (2002-2012). Data were aggregated at the state level at different times. Oral cancer incidence and mortality rates, standardized by age and gender, served as the dependent variables. Covariables (sociodemographic, structure of basic health units, and work process in oral health) were entered in the regression models using a hierarchical approach based on a theoretical model. Analysis of mixed effects with random intercept model was also conducted (alpha = 5%). The oral cancer incidence rate was positively association with the proportion of of adults over 60 years (β = 0.59; p = 0.010) and adult smokers (β = 0.29; p = 0.010). The oral cancer related mortality rate was positively associated with the proportion of of adults over 60 years (β = 0.24; p oral cancer (β = 0.02; p = 0.002). Mortality was inversely associated with the coverage of primary care teams (β = -0.01; p oral cancer, but not the incidence rate of the disease. We recommend expanding investments in PHC in order to prevent oral cancer related deaths.

Measuring hunger and satiety in primary school children. Validation of a new picture rating scale.

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Bennett, Carmel; Blissett, Jackie

2014-07-01

Measuring hunger and satiety in children is essential to many studies of childhood eating behaviour. Few validated measures currently exist that allow children to make accurate and reliable ratings of hunger/satiety. Three studies aimed to validate the use of a new categorical rating scale in the context of estimated and real eating episodes. Forty-seven 6- to 8-year-olds participated in Study 1, which used a between-participant design. Results indicated that the majority of children were able to make estimated hunger/satiety ratings for a story character using the scale. No significant differences in the ratings of hunger/satiety of children measured before and after lunch were observed and likely causes are discussed. To account for inter-individual differences in hunger/satiety perceptions Study 2 employed a within-participant design. Fifty-four 5- to 7-year-olds participated and made estimated hunger/satiety ratings for a story character and real hunger/satiety ratings before and after lunch. The results indicated that the majority of children were able to use the scale to make estimated and real hunger and satiety ratings. Children were found to be significantly hungrier before compared to after lunch. As it was not possible to establish the types and quantities of food children ate for lunch a third study was carried out in a controlled laboratory environment. Thirty-six 6- to 9-year-olds participated in Study 3 and made hunger/satiety ratings before and after ingesting an ad libitum snack of known composition and quantity. Results indicated that children felt hungrier before than after the snack and that pre-snack hunger/satiety, and changes in hunger/satiety, were associated with snack intake. Overall, the studies indicate that the scale has potential for use with primary school children. Implications of the findings are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Evaluation of fatigue crack growth and fracture resistance of SA350 LF2 material

International Nuclear Information System (INIS)

Singh, P.K.; Dubey, J.S.; Chakrabarty, J.K.; Vaze, K.K.; Kushwaha, H.S.

2003-01-01

The aim of the present paper is to evaluate the tensile and fracture mechanics properties of the SA350 LF2 carbon steel material used as the Header material in the primary heat transport (PHT) system piping of the Indian pressurized heavy water reactors (PHWR). Tensile, fatigue crack growth rate and fracture toughness tests have been carried out on specimens machined from the Header of the actual PHT pipes. The effect of temperature on tensile properties has been discussed. The effect of temperature and notch orientation on fracture resistance behavior of the material and fatigue crack growth rate dependence on the notch orientation and stress ratio has also been discussed. (author)

Within-Subject Testing of the Signaled-Reinforcement Effect on Operant Responding as Measured by Response Rate and Resistance to Change

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Reed, Phil; Doughty, Adam H.

2005-01-01

Response rates under random-interval schedules are lower when a brief (500 ms) signal accompanies reinforcement than when there is no signal. The present study examined this signaled-reinforcement effect and its relation to resistance to change. In Experiment 1, rats responded on a multiple random-interval 60-s random-interval 60-s schedule, with…

Genetic structure and evolved malaria resistance in Hawaiian honeycreepers

Science.gov (United States)

Foster, J.T.; Woodworth, B.L.; Eggert, L.E.; Hart, P.J.; Palmer, D.; Duffy, D.C.; Fleischer, R.C.

2007-01-01

Infectious diseases now threaten wildlife populations worldwide but population recovery following local extinction has rarely been observed. In such a case, do resistant individuals recolonize from a central remnant population, or do they spread from small, perhaps overlooked, populations of resistant individuals? Introduced avian malaria (Plasmodium relictum) has devastated low-elevation populations of native birds in Hawaii, but at least one species (Hawaii amakihi, Hemignathus virens) that was greatly reduced at elevations below about 1000 m tolerates malaria and has initiated a remarkable and rapid recovery. We assessed mitochondrial and nuclear DNA markers from amakihi and two other Hawaiian honeycreepers, apapane (Himatione sanguinea) and iiwi (Vestiaria coccinea), at nine primary study sites from 2001 to 2003 to determine the source of re-establishing birds. In addition, we obtained sequences from tissue from amakihi museum study skins (1898 and 1948-49) to assess temporal changes in allele distributions. We found that amakihi in lowland areas are, and have historically been, differentiated from birds at high elevations and had unique alleles retained through time; that is, their genetic signature was not a subset of the genetic variation at higher elevations. We suggest that high disease pressure rapidly selected for resistance to malaria at low elevation, leaving small pockets of resistant birds, and this resistance spread outward from the scattered remnant populations. Low-elevation amakihi are currently isolated from higher elevations (> 1000 m) where disease emergence and transmission rates appear to vary seasonally and annually. In contrast to results from amakihi, no genetic differentiation between elevations was found in apapane and iiwi, indicating that slight variation in genetic or life-history attributes can determine disease resistance and population recovery. Determining the conditions that allow for the development of resistance to disease is

Effect of root temperature on the uptake and metabolism of anions by the root system of Zea mays L. I. Uptake of sulphate by resistant and non-resistant plants

Energy Technology Data Exchange (ETDEWEB)

Holobrada, M; Mistrik, I; Kolek, J [Institute of Experimental Biology and Ecology of the Slovak Academy of Sciences, Bratislava (Czechoslovakia)

1980-01-01

The effect of root temperature upon the uptake of /sup 35/S-sulfate by intact 21 days old maize roots was discussed. The plant roots grown at 20 degC were cooled in steps down to 15 degC or 5 degC. The rate of /sup 35/S uptake was studied both in the whole root system and separately in the individual roots (primary seminal root, seminal adventitious roots and nodal roots). Differences were ascertained at lower uptakes by various root samples from resistant and nonresistant maize cultivars.

Recent advances in biochemical and molecular diagnostics for the rapid detection of antibiotic-resistant Enterobacteriaceae: a focus on ß-lactam resistance.

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Decousser, Jean-Winoc; Poirel, Laurent; Nordmann, Patrice

2017-04-01

The rapid detection of resistance is a challenge for clinical microbiologists who wish to prevent deleterious individual and collective consequences such as (i) delaying efficient antibiotic therapy, which worsens the survival rate of the most severely ill patients, or (ii) delaying the isolation of the carriers of multidrug-resistant bacteria and promoting outbreaks; this last consequence is of special concern, and there are an increasing number of approaches and market-based solutions in response. Areas covered: From simple, cheap biochemical tests to whole-genome sequencing, clinical microbiologists must select the most adequate phenotypic and genotypic tools to promptly detect and confirm β-lactam resistance from cultivated bacteria or from clinical specimens. Here, the authors review the published literature from the last 5 years about the primary technical approaches and commercial laboratory reagents for these purposes, including molecular, biochemical and immune assays. Furthermore, the authors discuss their intrinsic and relative performance, and we challenge their putative clinical impact. Expert commentary: Until the availability of fully automated wet and dry whole genome sequencing solutions, microbiologists should focus on inexpensive biochemical tests for cultured isolates or monomicrobial clinical specimen and on using the expensive molecular PCR-based strategies for the targeted screening of complex biological environments.

Progressive resistance training in head and neck cancer patients undergoing concomitant chemoradiotherapy

DEFF Research Database (Denmark)

Lonkvist, Camilla K; Vinther, Anders; Zerahn, Bo

2017-01-01

was feasibility measured as attendance to training sessions. Secondary endpoints included changes in functional performance, muscle strength, and body composition measured by Dual-energy X-ray Absorptiometry (DXA) scans. Furthermore, sarcomeric protein content, pentose phosphate pathway (PPP) activity......, and glycolysis were determined in muscle biopsies. Results: Twelve patients with p16 positive oropharyngeal cancer were enrolled. The primary endpoint was met with 9 of the 12 patients completing at least 25 of 36 planned training sessions. The mean attendance rate was 77%. Functional performance was maintained...... resistance training (PRT) program during CCRT is feasible in the clinical setting before planning initiation of a larger randomized study which is the long-term goal. Study design: Prospective pilot study. Methods: Twelve patients receiving CCRT were planned to attend a 12-week PRT program. Primary endpoint...

Effect of physiological age on radiation resistance of some bacteria that are highly radiation resistant

International Nuclear Information System (INIS)

Keller, L.C.; Maxcy, R.B.

1984-01-01

Physiological age-dependent variation in radiation resistance was studied for three bacteria that are highly radiation resistant: Micrococcus radiodurans, Micrococcus sp. isolate C-3, and Moraxella sp. isolate 4. Stationary-phase cultures of M. radiodurans and isolate C-3 were much more resistant to gamma radiation than were log-phase cultures. This pattern of relative resistance was reversed for isolate 4. Resistance of isolate 4 to UV light was also greater during log phase, although heat resistance and NaCl tolerance after heat stresses were greater during stationary phase. Radiation-induced injury of isolate 4 compared with injury of Escherichia coli B suggested that the injury process, as well as the lethal process, was affected by growth phase. The hypothesis that growth rate affects radiation resistance was tested, and results were interpreted in light of the probable confounding effect of methods used to alter growth rates of bacteria. These results indicate that dose-response experiments should be designed to measure survival during the most resistant growth phase of the organism under study. The timing is particularly important when extrapolations of survival results might be made to potential irradiation processes for foods. 17 references

Cognitively impaired elderly exhibit insulin resistance and no memory improvement with infused insulin.

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Morris, Jill K; Vidoni, Eric D; Mahnken, Jonathan D; Montgomery, Robert N; Johnson, David K; Thyfault, John P; Burns, Jeffrey M

2016-03-01

Insulin resistance is a risk factor for Alzheimer's disease (AD), although its role in AD etiology is unclear. We assessed insulin resistance using fasting and insulin-stimulated measures in 51 elderly subjects with no dementia (ND; n = 37) and with cognitive impairment (CI; n = 14). CI subjects exhibited either mild CI or AD. Fasting insulin resistance was measured using the homeostatic model assessment of insulin resistance (HOMA-IR). Insulin-stimulated glucose disposal was assessed using the hyperinsulinemic-euglycemic clamp to calculate glucose disposal rate into lean mass, the primary site of insulin-stimulated glucose disposal. Because insulin crosses the blood-brain barrier, we also assessed whether insulin infusion would improve verbal episodic memory compared to baseline. Different but equivalent versions of cognitive tests were administered in counterbalanced order in the basal and insulin-stimulated state. Groups did not differ in age or body mass index. Cognitively impaired subjects exhibited greater insulin resistance as measured at fasting (HOMA-IR; ND: 1.09 [1.1] vs. CI: 2.01 [2.3], p = 0.028) and during the hyperinsulinemic clamp (glucose disposal rate into lean mass; ND: 9.9 (4.5) vs. AD 7.2 (3.2), p = 0.040). Cognitively impaired subjects also exhibited higher fasting insulin compared to ND subjects, (CI: 8.7 [7.8] vs. ND: 4.2 [3.8] μU/mL; p = 0.023) and higher fasting amylin (CI: 24.1 [39.1] vs. 8.37 [14.2]; p = 0.050) with no difference in fasting glucose. Insulin infusion elicited a detrimental effect on one test of verbal episodic memory (Free and Cued Selective Reminding Test) in both groups (p insulin resistance was observed in cognitively impaired subjects compared to ND controls, insulin infusion did not improve memory. Furthermore, a significant correlation between HOMA-IR and glucose disposal rate was present only in ND (p = 0.0002) but not in cognitively impaired (p = 0.884) subjects, indicating potentially important

Influence of heating rates on in situ resistance measurements of a bronze route Nb-Sn-Cu-Ta multifilamentary conductor

International Nuclear Information System (INIS)

Tan, K.S.; Hopkins, S.C.; Glowacki, B.A.

2004-01-01

The superconducting properties of a bronze process multifilamentary conductor are controlled by the structure, dimensions and composition of the intermetallic layers, which are strongly influenced by the details of the heat treatments applied to the conductor. It has previously been reported that the electrical resistivity of a Vacuumschmelze bronze process conductor varies during heat treatment, and that analysis of the conductor as a set of parallel resistors allows the features of the resistivity variation to be assigned to the progress of Nb 3 Sn intermetallic phase formation. The behaviour of NSP2 Nb-Sn-Cu-Ta bronze process multifilamentary conductors (Imperial Metal Industries) is now reported as a function of the heating rate, in preparation for more complex non-isothermal heat treatment procedures. It is shown that the resistance of the wire measured in situ by an alternating current (AC) technique can be used to observe the progress of the formation of Nb 3 Sn, and that the comparison of resistometric measurements at different heating rates can give an indication of other processes (such as recovery and recrystallisation) occurring at lower temperatures during the heating up process prior to isothermal annealing. In addition, this wire containing only about 1% of copper was carefully chosen because of the broken tantalum barriers around individual copper filaments. Therefore, the resistometric measurements were used to attempt to detect the diffusion of tin from the bronze matrix into the copper filaments at lower temperatures without noticeable influence on Nb 3 Sn phase formation. Treating the NSP2 wire as a set of parallel resistors also permits estimates to be made of the intermetallic layer thicknesses from resistometric measurements, and these are shown to be in good agreement with estimates from scanning electron microscopy. The difference in critical temperature, T c , between wires heated at different rates, with the presence of the bronze matrix

Emerging antimicrobial resistance pattern of Helicobacter pylori in central Gujarat

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H B Pandya

2014-01-01

Full Text Available Background: Antimicrobial resistance is a growing problem in H. pylori treatment. The study was intended to evaluate the prevalence of resistance amongst 80 H.pylori isolates cultured from biopsy taken during routine endoscopies in 2008-2011. Materials and Methods: 855 gastro duodenal biopsies were collected and cultured on H.pylori selective medium (containing Brucella agar and Columbia agar (Hi media, with Skirrow′s supplement (antibiotic supplement and 7% human blood cells. H.pylori was isolated from 80 specimens. The antimicrobial susceptibility of H.pylori isolates was carried out by the Kirby Bauer technique against metronidazole (5 µg, clarithromycin (15 µg, ciprofloxacin (5 µg, amoxicillin (10 µg, tetracycline (30 µg, erythromycin (15 µg, levofloxacin (5 µg, and furazolidone (50 µg (Sigma- Aldrich, MO. Results: 83.8% isolates were resistant to metronidazole, 58.8% were resistant to Clarithromycin 72.5% were resistant to Amoxicillin, 50% to Ciprofloxacin and 53.8% to tetracycline. furazolidone, erythromycin and Levofloxacin showed only 13.8% resistance to H.pylori. Multi drug resistance with metronidazole+ clarithromycin+ tetracycline was 85%. For all the drugs Antimicrobial resistance rate was found higher in males compare to females. Metronidazole and amoxicillin resistance was found noteworthy in patients with duodenal ulcer (p = 0.018, gastritis (P = 0.00, and in reflux esophagitis (P = 0.00. clarithromycin and tetracycline resistance was suggestively linked with duodenitis (P = 0.018, while furazolidone, erythromycin and levofloxacin showed excellent sensitivity in patients with duodenitis (P value- 0.018, gastritis (P= 0.00 and reflux esophagitis (P = 0.00. Resistance with metronidazole (P = 0.481, clarithromycin (P= 0.261, amoxicillin (P = 0.276, tetracycline (P = 0.356, ciprofloxacin (P = 0.164 was not correlated well with Age-group and Gender of the patients. Conclusion: A very high percentage of patients were infected

Effects of vildagliptin versus sitagliptin, on cardiac function, heart rate variability and mitochondrial function in obese insulin-resistant rats

Science.gov (United States)

Apaijai, Nattayaporn; Pintana, Hiranya; Chattipakorn, Siriporn C; Chattipakorn, Nipon

2013-01-01

Background and Purpose Long-term high-fat diet (HFD) consumption has been shown to cause insulin resistance, which is characterized by hyperinsulinaemia with metabolic inflexibility. Insulin resistance is associated with cardiac sympathovagal imbalance, cardiac dysfunction and cardiac mitochondrial dysfunction. Dipeptidyl peptidase-4 (DPP-4) inhibitors, vildagliptin and sitagliptin, are oral anti-diabetic drugs often prescribed in patients with cardiovascular disease. Therefore, in this study, we sought to determine the effects of vildagliptin and sitagliptin in a murine model of insulin resistance. Experimental Approach Male Wistar rats weighing 180–200 g, were fed either a normal diet (20% energy from fat) or a HFD (59% energy from fat) for 12 weeks. These rats were then divided into three subgroups to receive vildagliptin (3 mg·kg−1·day−1), sitagliptin (30 mg·kg−1·day−1) or vehicle for another 21 days. Metabolic parameters, oxidative stress, heart rate variability (HRV), cardiac function and cardiac mitochondrial function were determined. Key Results Rats that received HFD developed insulin resistance characterized by increased body weight, plasma insulin, total cholesterol and oxidative stress levels along with a decreased high-density lipoprotein (HDL) level. Moreover, cardiac dysfunction, depressed HRV, cardiac mitochondrial dysfunction and cardiac mitochondrial morphology changes were observed in HFD rats. Both vildagliptin and sitagliptin decreased plasma insulin, total cholesterol and oxidative stress as well as increased HDL level. Furthermore, vildagliptin and sitagliptin attenuated cardiac dysfunction, prevented cardiac mitochondrial dysfunction and completely restored HRV. Conclusions and Implications Both vildagliptin and sitagliptin share similar efficacy in cardioprotection in obese insulin-resistant rats. PMID:23488656

Inflammation and insulin resistance induced by trans-10, cis-12 conjugated linoleic acid depend on intracellular calcium levels in primary cultures of human adipocytes

DEFF Research Database (Denmark)

Kennedy, Arion; Martinez, Kristina; Chung, Soonkyu

2010-01-01

We previously demonstrated that trans-10, cis-12 (10,12) conjugated linoleic acid (CLA) induced inflammation and insulin resistance in primary human adipocytes by activating nuclear factor kappaB (NFkappaB) and extracellular signal-related kinase (ERK) signaling. In this study, we demonstrated...... that the initial increase in intracellular calcium ([Ca2+]i) mediated by 10,12 CLA was attenuated by TMB-8, an inhibitor of calcium release from the endoplasmic reticulum (ER), by BAPTA, an intracellular calcium chelator, and by D609, a phospholipase C (PLC) inhibitor. Moreover, BAPTA, TMB-8, and D609 attenuated......, and suppression of peroxisome proliferator activated receptor gamma protein levels and insulin-stimulated glucose uptake. These data suggest that 10,12 CLA increases inflammation and insulin resistance in human adipocytes, in part by increasing [Ca2+]i levels, particularly calcium from the ER....

Knockdown resistance, Rdl alleles, and the annual entomological Inoculation rate of wild mosquito populations from Lower Moshi, Northern Tanzania

Directory of Open Access Journals (Sweden)

Aneth M Mahande

2012-01-01

Full Text Available Aim: Understanding vector behavioral response due to ecological factors is important in the control of disease vectors. This study was conducted to determine the knockdown resistance (kdr alleles, dieldrin resistance alleles, and entomological inoculation rates (EIRs of malaria vectors in lower Moshi irrigation schemes for the mitigation of disease transmission. Materials and Methods: The study was longitudinal design conducted for 14 months. Mosquitoes were collected fortnightly by using a CDC miniature light trap in 20 houses. Mosquitoes were identified morphologically in the field, of which 10% of this population was identified to species level by using molecular techniques. Samples from this study population were taken for kdr and resistance to dieldrin (rdl genes detection. Results: A total of 6220 mosquitoes were collected by using a light trap, of which 86.0% (n=5350 were Anopheles gambiae sensu lato and 14.0% (n=870 were Culex quinquefasciatus. Ten percent of the An. gambiae s.l. (n=535 collected were taken for species identification, of which 99.8% (n=534 were identified as An. arabiensis while 0.2% (n=1 were An. gambiae sensu stricto. Of the selected mosquitoes, 3.5% (n=19 were sporozoite positive. None of the mosquitoes tested had the kdr gene. The rdl resistant allele was detected at a frequency of 0.48 throughout the year. EIR was determined to be 0.54 ib/trap/year. Conclusion: The findings of this study suggest that the homozygous and the heterozygous resistance present in rdl genes demonstrated the effect of pesticide residues on resistance selection pressure in mosquitoes. A better insecticide usage protocol needs to be developed for farmers to use in order to avoid excessive use of pesticides. Key words: An. arabiensis, EIR, Knockdown mutation, Moshi, rdl locus, Tanzania

Having your cake and eating it - Staphylococcus aureus small colony variants can evolve faster growth rate without losing their antibiotic resistance

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Gerrit Brandis

2017-08-01

Full Text Available Staphylococcus aureus can produce small colony variants (SCVs during infections. These cause significant clinical problems because they are difficult to detect in standard microbiological screening and are associated with persistent infections. The major causes of the SCV phenotype are mutations that inhibit respiration by inactivation of genes of the menadione or hemin biosynthesis pathways. This reduces the production of ATP required to support fast growth. Importantly, it also decreases cross-membrane potential in SCVs, resulting in decreased uptake of cationic compounds, with reduced susceptibility to aminoglycoside antibiotics as a consequence. Because SCVs are slow-growing (mutations in men genes are associated with growth rates in rich medium ~30% of the wild-type growth rate bacterial cultures are very susceptible to rapid takeover by faster-growing mutants (revertants or suppressors. In the case of reversion, the resulting fast growth is obviously associated with the loss of antibiotic resistance. However, direct reversion is relatively rare due to the very small genetic target size for such mutations. We explored the phenotypic consequences of SCVs evolving faster growth by routes other than direct reversion, and in particular whether any of those routes allowed for the maintenance of antibiotic resistance. In a recent paper (mBio 8: e00358-17 we demonstrated the existence of several different routes of SCV evolution to faster growth, one of which maintained the antibiotic resistance phenotype. This discovery suggests that SCVs might be more adaptable and problematic that previously thought. They are capable of surviving as a slow-growing persistent form, before evolving into a significantly faster-growing form without sacrificing their antibiotic resistance phenotype.

Surveillance of Levofloxacin Resistance in Helicobacter pylori Isolates in Bogotá-Colombia (2009-2014.

Directory of Open Access Journals (Sweden)

Alba A Trespalacios-Rangél

Full Text Available Increased resistance of Helicobacter pylori to clarithromycin and metronidazole has resulted in recommendation to substitute fluoroquinolones for eradication therapy. The aims of the study were to determine the prevalence and changes in primary levofloxacin resistance related to H. pylori gyrA sequences. The study utilized H. pylori strains isolated from patients undergoing gastroscopy in Bogotá, Colombia from 2009 to 2014. Levofloxacin susceptibility was assessed by agar dilution. Mutations in gyrA sequences affecting the quinolone resistance-determining region (QRDR were evaluated by direct sequencing. Overall, the mean prevalence of primary levofloxacin resistance was 18.2% (80 of 439 samples. Resistance increased from 11.8% (12/102 in 2009 to 27.3% (21/77 in 2014 (p = 0.001. gyrA mutations in levofloxacin resistant strains were present in QRDR positions 87 and 91. The most common mutation was N87I (43.8%, 35/80 followed by D91N (28.8%, 23/80 and N87K (11.3%, 9/80. Levofloxacin resistance increased markedly in Colombia during the six-year study period. Primary levofloxacin resistance was most often mediated by point mutations in gyrA, with N87I being the most common QRDR mutation related to levofloxacin resistance.

Resistance versus Balance Training to Improve Postural Control in Parkinson's Disease: A Randomized Rater Blinded Controlled Study.

Science.gov (United States)

Schlenstedt, Christian; Paschen, Steffen; Kruse, Annika; Raethjen, Jan; Weisser, Burkhard; Deuschl, Günther

2015-01-01

Reduced muscle strength is an independent risk factor for falls and related to postural instability in individuals with Parkinson's disease. The ability of resistance training to improve postural control still remains unclear. To compare resistance training with balance training to improve postural control in people with Parkinson's disease. 40 patients with idiopathic Parkinson's disease (Hoehn&Yahr: 2.5-3.0) were randomly assigned into resistance or balance training (2x/week for 7 weeks). Assessments were performed at baseline, 8- and 12-weeks follow-up: primary outcome: Fullerton Advanced Balance (FAB) scale; secondary outcomes: center of mass analysis during surface perturbations, Timed-up-and-go-test, Unified Parkinson's Disease Rating Scale, Clinical Global Impression, gait analysis, maximal isometric leg strength, PDQ-39, Beck Depression Inventory. Clinical tests were videotaped and analysed by a second rater, blind to group allocation and assessment time. 32 participants (resistance training: n = 17, balance training: n = 15; 8 drop-outs) were analyzed at 8-weeks follow-up. No significant difference was found in the FAB scale when comparing the effects of the two training types (p = 0.14; effect size (Cohen's d) = -0.59). Participants from the resistance training group, but not from the balance training group significantly improved on the FAB scale (resistance training: +2.4 points, Cohen's d = -0.46; balance training: +0.3 points, Cohen's d = -0.08). Within the resistance training group, improvements of the FAB scale were significantly correlated with improvements of rate of force development and stride time variability. No significant differences were found in the secondary outcome measures when comparing the training effects of both training types. The difference between resistance and balance training to improve postural control in people with Parkinson's disease was small and not significant with this sample size. There was weak evidence that freely

Resistance versus Balance Training to Improve Postural Control in Parkinson's Disease: A Randomized Rater Blinded Controlled Study.

Directory of Open Access Journals (Sweden)

Christian Schlenstedt

Full Text Available Reduced muscle strength is an independent risk factor for falls and related to postural instability in individuals with Parkinson's disease. The ability of resistance training to improve postural control still remains unclear.To compare resistance training with balance training to improve postural control in people with Parkinson's disease.40 patients with idiopathic Parkinson's disease (Hoehn&Yahr: 2.5-3.0 were randomly assigned into resistance or balance training (2x/week for 7 weeks. Assessments were performed at baseline, 8- and 12-weeks follow-up: primary outcome: Fullerton Advanced Balance (FAB scale; secondary outcomes: center of mass analysis during surface perturbations, Timed-up-and-go-test, Unified Parkinson's Disease Rating Scale, Clinical Global Impression, gait analysis, maximal isometric leg strength, PDQ-39, Beck Depression Inventory. Clinical tests were videotaped and analysed by a second rater, blind to group allocation and assessment time.32 participants (resistance training: n = 17, balance training: n = 15; 8 drop-outs were analyzed at 8-weeks follow-up. No significant difference was found in the FAB scale when comparing the effects of the two training types (p = 0.14; effect size (Cohen's d = -0.59. Participants from the resistance training group, but not from the balance training group significantly improved on the FAB scale (resistance training: +2.4 points, Cohen's d = -0.46; balance training: +0.3 points, Cohen's d = -0.08. Within the resistance training group, improvements of the FAB scale were significantly correlated with improvements of rate of force development and stride time variability. No significant differences were found in the secondary outcome measures when comparing the training effects of both training types.The difference between resistance and balance training to improve postural control in people with Parkinson's disease was small and not significant with this sample size. There was weak evidence that

Antimicrobial resistant Salmonella enterica and Escherichia coli recovered from dairy operations

Science.gov (United States)

Antimicrobial resistance has become a major public health concern and animal agriculture is often implicated as a source of resistant bacteria. The primary objective of this study was to determine prevalence of antimicrobial resistance in Salmonella and E. coli from healthy animals on dairy farms i...

Effect of pedal rate on primary and slow-component oxygen uptake responses during heavy-cycle exercise.

Science.gov (United States)

Pringle, Jamie S M; Doust, Jonathan H; Carter, Helen; Tolfrey, Keith; Jones, Andrew M

2003-04-01

We hypothesized that a higher pedal rate (assumed to result in a greater proportional contribution of type II motor units) would be associated with an increased amplitude of the O(2) uptake (Vo(2)) slow component during heavy-cycle exercise. Ten subjects (mean +/- SD, age 26 +/- 4 yr, body mass 71.5 +/- 7.9 kg) completed a series of square-wave transitions to heavy exercise at pedal rates of 35, 75, and 115 rpm. The exercise power output was set at 50% of the difference between the pedal rate-specific ventilatory threshold and peak Vo(2), and the baseline power output was adjusted to account for differences in the O(2) cost of unloaded pedaling. The gain of the Vo(2) primary component was significantly higher at 35 rpm compared with 75 and 115 rpm (mean +/- SE, 10.6 +/- 0.3, 9.5 +/- 0.2, and 8.9 +/- 0.4 ml. min(-1). W(-1), respectively; P exercise at the same relative intensity, presumably by altering motor unit recruitment patterns.

Strain rate and temperature effects on the stress corrosion cracking of Inconel 600 steam generator tubing in the primary water conditions

International Nuclear Information System (INIS)

Kim, U.C.; van Rooyen, D.

1985-01-01

A single heat of Inconel Alloy 600 was examined in this work, using slow strain rate tests (SSRT) in simulated primary water at temperatures of 325 0 -345 0 -365 0 C. The best measure of stress corrosion cracking (SCC) was percent SCC present on the fracture surface. Strain rate did not seem to affect crack growth rate significantly, but there is some question about the accuracy of calculating these values in the absence of a direct indication of when a crack initiates. Demarcation was determined between domains of temperature/strain rate where SCC either did, or did not, occur. Slower extension rates were needed to produce SCC as the temperature was lowered. 10 figs

The Outcome of Health Anxiety in Primary Care. A Two-Year Follow-up Study on Health Care Costs and Self-Rated Health

OpenAIRE

Fink, Per; ?rnb?l, Eva; Christensen, Kaj Sparle

2010-01-01

BACKGROUND: Hypochondriasis is prevalent in primary care, but the diagnosis is hampered by its stigmatizing label and lack of valid diagnostic criteria. Recently, new empirically established criteria for Health anxiety were introduced. Little is known about Health anxiety's impact on longitudinal outcome, and this study aimed to examine impact on self-rated health and health care costs. METHODOLOGY/PRINCIPAL FINDINGS: 1785 consecutive primary care patients aged 18-65 consulting their family p...

Development of Resistive Micromegas for Sampling Calorimetry

Science.gov (United States)

Geralis, T.; Fanourakis, G.; Kalamaris, A.; Nikas, D.; Psallidas, A.; Chefdeville, M.; Karyotakis, I.; Koletsou, I.; Titov, M.

2018-02-01

Resistive micromegas is proposed as an active element for sampling calorimetry. Future linear collider experiments or the HL-LHC experiments can profit from those developments for Particle Flow Calorimetry. Micromegas possesses remarkable properties concerning gain stability, reduced ion feedback, response linearity, adaptable sensitive element granularity, fast response and high rate capability. Recent developments on Micromegas with a protective resistive layer present excellent results, resolving the problem of discharges caused by local high charge deposition, thanks to its RC-slowed charge evacuation. Higher resistivity though, may cause loss of the response linearity at high rates. We have scanned a wide range of resistivities and performed laboratory tests with X-rays that demonstrate excellent response linearity up to rates of (a few) times 10MHz/cm2, with simultaneous mitigation of discharges. Beam test studies at SPS/CERN with hadrons have also shown a remarkable stability of the resistive Micromegas and low currents for rates up to 15MHz/cm2. We present results from the aforementioned studies confronted with MC simulation

Fate of antibiotic resistance genes in mesophilic and thermophilic anaerobic digestion of chemically enhanced primary treatment (CEPT) sludge.

Science.gov (United States)

Jang, Hyun Min; Shin, Jingyeong; Choi, Sangki; Shin, Seung Gu; Park, Ki Young; Cho, Jinwoo; Kim, Young Mo

2017-11-01

Anaerobic digestion (AD) of chemically enhanced primary treatment (CEPT) sludge and non-CEPT (conventional sedimentation) sludge were comparatively operated under mesophilic and thermophilic conditions. The highest methane yield (692.46±0.46mL CH 4 /g VS removed in CEPT sludge) was observed in mesophilic AD of CEPT sludge. Meanwhile, thermophilic conditions were more favorable for the removal of total antibiotic resistance genes (ARGs). In this study, no measurable difference in the fates and removal of ARGs and class 1 integrin-integrase gene (intI1) was observed between treated non-CEPT and CEPT sludge. However, redundancy analysis indicated that shifts in bacterial community were primarily accountable for the variations in ARGs and intI1. Network analysis further revealed potential host bacteria for ARGs and intI1. Copyright © 2017 Elsevier Ltd. All rights reserved.

Biologically resistant contaminants, primary treatment with ozone

Energy Technology Data Exchange (ETDEWEB)

Echegaray, Diego F [White Martins Gases Industriais do Nordeste S.A., Salvador, BA (Brazil); Olivieri, Nadja F [White Martins Gases Industriais S.A., Cordovil, RJ (Brazil)

1994-12-31

Organic effluent oxidation tests were conducted in petrochemical companies, in Camacari Petrochemical Complex (Northeast Brazil), to reduce treatment costs and improve the primary treatment efficiency in each industrial process. Ozone achieved 99.96 percent benzene reduction and 100 percent ethyl benzene and toluene reduction. Process efficiency is strongly dependent on the wastewater chemical composition and concentration. For this reason it is necessary to run pilot trials for each specific case. Ozone was obtained feeding commercial oxygen through a corona discharge generator and dissolved in the effluent with a bubble column. Commercial oxygen was used instead of air to increase 250 percent the ozone production, using the same ozone generator. (author). 4 figs., 2 tabs.

Biologically resistant contaminants, primary treatment with ozone

Energy Technology Data Exchange (ETDEWEB)

Echegaray, Diego F. [White Martins Gases Industriais do Nordeste S.A., Salvador, BA (Brazil); Olivieri, Nadja F. [White Martins Gases Industriais S.A., Cordovil, RJ (Brazil)

1993-12-31

Organic effluent oxidation tests were conducted in petrochemical companies, in Camacari Petrochemical Complex (Northeast Brazil), to reduce treatment costs and improve the primary treatment efficiency in each industrial process. Ozone achieved 99.96 percent benzene reduction and 100 percent ethyl benzene and toluene reduction. Process efficiency is strongly dependent on the wastewater chemical composition and concentration. For this reason it is necessary to run pilot trials for each specific case. Ozone was obtained feeding commercial oxygen through a corona discharge generator and dissolved in the effluent with a bubble column. Commercial oxygen was used instead of air to increase 250 percent the ozone production, using the same ozone generator. (author). 4 figs., 2 tabs.

Initial drug resistance in India

Indian Academy of Sciences (India)

First page Back Continue Last page Overview Graphics. Initial drug resistance in India. There is gradual increase in primary MDR all over India : Pondi= Pondicherry 1985; Bangalore =1986; Jaipur = 1991; Jaipur =2000. Overall the MDR is less than 3% (TRC studies).

Test for bacterial resistance build-up against plasma treatment

International Nuclear Information System (INIS)

Zimmermann, J L; Shimizu, T; Li, Y-F; Morfill, G E; Schmidt, H-U; Isbary, G

2012-01-01

It is well known that the evolution of resistance of microorganisms to a range of different antibiotics presents a major problem in the control of infectious diseases. Accordingly, new bactericidal ‘agents’ are in great demand. Using a cold atmospheric pressure (CAP) plasma dispenser operated with ambient air, a more than five orders of magnitude inactivation or reduction of Methicillin-resistant Staphylococcus aureus (MRSA; resistant against a large number of the tested antibiotics) was obtained in less than 10 s. This makes CAP the most promising candidate for combating nosocomial (hospital-induced) infections. To test for the occurrence and development of bacterial resistance against such plasmas, experiments with Gram-negative bacteria (Escherichia coli) and Gram-positive bacteria (Enterococcus mundtii) were performed. The aim was to determine quantitative limits for primary (naturally) or secondary (acquired) resistance against the plasma treatment. Our results show that E. coli and E. mundtii possess no primary resistance against the plasma treatment. By generating four generations of bacteria for every strain, where the survivors of the plasma treatment were used for the production of the next generation, a lower limit to secondary resistance was obtained. Our results indicate that CAP technology could contribute to the control of infections in hospitals, in outpatient care and in disaster situations, providing a new, fast and efficient broad-band disinfection technology that is not constrained by bacterial resistance mechanisms. (paper)

Bimodal effect on pancreatic β-cells of secretory products from normal or insulin-resistant human skeletal muscle

DEFF Research Database (Denmark)

Bouzakri, Karim; Plomgaard, Peter; Berney, Thierry

2011-01-01

Type 2 diabetes is characterized by insulin resistance with a relative deficiency in insulin secretion. This study explored the potential communication between insulin-resistant human skeletal muscle and primary (human and rat) β-cells.......Type 2 diabetes is characterized by insulin resistance with a relative deficiency in insulin secretion. This study explored the potential communication between insulin-resistant human skeletal muscle and primary (human and rat) β-cells....

Calculation of activity concentration and dose rates from online radioactivity measurement in primary coolant channel of TAPS-III and IV

International Nuclear Information System (INIS)

Chaudhury, Sanhita; Agarwal, Chhavi; Goswami, A.; Mhatre, Amol; Chaturvedi, T.P.; Tawde, N.; Gathibandhe, Manohar; Dash, S.C.

2011-05-01

Radioactivity measurement using CdZnTe detector and dose measurement using teletector were done at several locations of primary heat transport (PHT) system of the Tarapur Atomic Power Station-III and IV reactor during shut down as well as operating condition of the reactors. The detector efficiency for the required counting geometry was simulated using MCNP code. Using this simulated efficiency and the experimental count rate (cps), the activity concentrations (Bq/mL) of different radionuclides in coolant water were calculated. The dose rates for the counted locations were also simulated using Monte Carlo code and it matched well with the experimentally obtained dose rate. (author)

System level analysis of cacao seed ripening reveals a sequential interplay of primary and secondary metabolism leading to polyphenol accumulation and preparation of stress resistance.

Science.gov (United States)

Wang, Lei; Nägele, Thomas; Doerfler, Hannes; Fragner, Lena; Chaturvedi, Palak; Nukarinen, Ella; Bellaire, Anke; Huber, Werner; Weiszmann, Jakob; Engelmeier, Doris; Ramsak, Ziva; Gruden, Kristina; Weckwerth, Wolfram

2016-08-01

Theobroma cacao and its popular product, chocolate, are attracting attention due to potential health benefits including antioxidative effects by polyphenols, anti-depressant effects by high serotonin levels, inhibition of platelet aggregation and prevention of obesity-dependent insulin resistance. The development of cacao seeds during fruit ripening is the most crucial process for the accumulation of these compounds. In this study, we analyzed the primary and the secondary metabolome as well as the proteome during Theobroma cacao cv. Forastero seed development by applying an integrative extraction protocol. The combination of multivariate statistics and mathematical modelling revealed a complex consecutive coordination of primary and secondary metabolism and corresponding pathways. Tricarboxylic acid (TCA) cycle and aromatic amino acid metabolism dominated during the early developmental stages (stages 1 and 2; cell division and expansion phase). This was accompanied with a significant shift of proteins from phenylpropanoid metabolism to flavonoid biosynthesis. At stage 3 (reserve accumulation phase), metabolism of sucrose switched from hydrolysis into raffinose synthesis. Lipids as well as proteins involved in lipid metabolism increased whereas amino acids and N-phenylpropenoyl amino acids decreased. Purine alkaloids, polyphenols, and raffinose as well as proteins involved in abiotic and biotic stress accumulated at stage 4 (maturation phase) endowing cacao seeds the characteristic astringent taste and resistance to stress. In summary, metabolic key points of cacao seed development comprise the sequential coordination of primary metabolites, phenylpropanoid, N-phenylpropenoyl amino acid, serotonin, lipid and polyphenol metabolism thereby covering the major compound classes involved in cacao aroma and health benefits. © 2016 The Authors The Plant Journal © 2016 John Wiley & Sons Ltd.

Analysis of Survival Rates Following Primary Surgery of 178 Consecutive Patients with Oral Cancer in a Large District General Hospital.

Science.gov (United States)

Stathopoulos, Panagiotis; Smith, William P

2017-06-01

The aim of this study is to present the survival rates in patients treated for oral cancer with primary surgery in a large district general hospital. We discuss the influence of the most significant prognostic factors on survival and compare our results with larger centres specializing in the management of oral cancer. All patients diagnosed with oral cancer from 1995 to 2006 and were treated in the Department had their details entered prospectively onto a computerized database. Demographic details of patients, type of treatment, pathological stage of tumor (TNM), local and regional recurrence rate, overall survival, disease specific survival and incidence of involved margins were recorded and calculated. Of the 178 patients, 96 (54 %) were alive and free of oral cancer 5 years after surgery. Forty-four patients died of oral cancer (24.7 %) but 38 (21.3 %) died of other causes. The overall survival rate after primary surgery in relation to stage was: I 84 %, II 71 %, III 36 % and IV 28 %. As almost half of our patients presented with advanced cancer and had discouraging survival rates, we emphasize the need for early recognition of the disease. Advanced disease signifies difficulty in obtaining clear margins which actually indicates a higher recurrence rate. 25 % of our patients died of oral cancer within 5 years of surgery which highlights the poor prognosis that recurrence carries after treatment. Effective educational campaign with purpose to raise oral cancer awareness and earlier referral may result in improvement of survival.

Control system of power supply for resistance welding machine

Directory of Open Access Journals (Sweden)

Світлана Костянтинівна Поднебенна

2017-06-01

Full Text Available This article describes the existing methods of heat energy stabilizing, which are realized in thyristor power supplies for resistance welding machines. The advantages and features of thyristor power supplies have been described. A control system of power supply for resistance welding machine with stabilization of heat energy in a welding spot has been developed. Measurements are performed in primary winding of a welding transformer. Weld spot heating energy is calculated as the difference between the energy, consumed from the mains, and the energy losses in the primary and secondary circuits of the welding transformer as well as the energy losses in the transformer core. Algorithms of digital signal processing of the developed control system are described in the article. All measurements and calculations are preformed automatically in real-time. Input signals to the control system are: transformer primary voltage and current, temperature of the welding circuit. The designed control system ensures control of the welding heat energy and is not influenced by the supply voltage and impedance changes caused by insertion of the ferromagnetic mass in the welding circuit, the temperature change during the welding process. The developed control system for resistance welding machine makes it possible to improve the quality of welded joints, increase the efficiency of the resistance welding machine

Panitumumab and pegylated liposomal doxorubicin to platinum-resistant epithelial ovarian cancer with KRAS wild-type: An ongoing, nonrandomized, multicenter, phase II trial

DEFF Research Database (Denmark)

Dahl Steffensen, Karina; Waldstrøm, Marianne; Lund, B

2010-01-01

, and head and neck cancer. No previous studies have evaluated the effect of panitumumab in OC based on KRAS mutation status. Methods: Eligibility criteria are confirmed stage I-IV primary epithelial ovarian/fallopian/peritoneal cancer patients with progression either during or within 6 months after end...... to a total of 33 patients. At present, 15 patients have been enrolled. The primary endpoint is to investigate the response rate in platinum-resistant, KRAS wild- type OC patients treated with PLD supplemented with panitumumab. Translational research is included as a secondary endpoint and tumor tissue...

Insulin Resistance and Mitochondrial Dysfunction.

Science.gov (United States)

Gonzalez-Franquesa, Alba; Patti, Mary-Elizabeth

2017-01-01

Insulin resistance precedes and predicts the onset of type 2 diabetes (T2D) in susceptible humans, underscoring its important role in the complex pathogenesis of this disease. Insulin resistance contributes to multiple tissue defects characteristic of T2D, including reduced insulin-stimulated glucose uptake in insulin-sensitive tissues, increased hepatic glucose production, increased lipolysis in adipose tissue, and altered insulin secretion. Studies of individuals with insulin resistance, both with established T2D and high-risk individuals, have consistently demonstrated a diverse array of defects in mitochondrial function (i.e., bioenergetics, biogenesis and dynamics). However, it remains uncertain whether mitochondrial dysfunction is primary (critical initiating defect) or secondary to the subtle derangements in glucose metabolism, insulin resistance, and defective insulin secretion present early in the course of disease development. In this chapter, we will present the evidence linking mitochondrial dysfunction and insulin resistance, and review the potential for mitochondrial targets as a therapeutic approach for T2D.

Effect of the rate of heating on the quality of the primary tar in low-temperature coal-carbonization process

Energy Technology Data Exchange (ETDEWEB)

Turskii, Y I

1956-01-01

Two stages are observed. The first stage yields products of the primary and partial decomposition of coal, mainly water, CO/sub 2/, and CO as decomposition products of functional groups (-COOH, > CO, - OH, and so forth). No tar is formed in this stage. The structural decomposition and tar formation occur in the second stage. The rate of heating is important for the quality of the tar obtained. The slow rate of heating with both stages following each other yields a good-quality tar, richer in C and H, with lower O content. In case of high rate of heating both stages overlap. The tar is of poorer quality with higher specific gravity, and contains more O and asphaltenes. The complete experimental data are given in detail.

Antimicrobial Resistance status and prevalence rates of Extended Spectrum Beta-Lactamase (ESBL producers isolated from a mixed human population.

Directory of Open Access Journals (Sweden)

Ruth A. Afunwa

2011-05-01

Full Text Available Owing to the increasing epidemiological and therapeutic challenges associated with infections due to ESBL producers, ESBL prevalence rate among some bacteria isolates from healthy and non-healthy human population in a metropolitan Nigerian setting was evaluated.A total of one hundred and forty-five (145 bacteria strains were isolated from a total of four hundred and sixty (460 samples collected from urine, wound, throat and anal swabs of 220 healthy volunteers in the community and from 240 patients in 2 secondary and 2 tertiary hospitals (altogether, 4 in Enugu metropolis. The presumptive confirmatory test used for ESBL detection was the Double Disc Synergy Test (DDST method. Conjugation and plasmid curing studies were also done for resistance factor determination.Of the 145 isolates, 20 were ESBL producers with 35% of these ESBL producers being of community origin and 65% from hospitals. This translates to 4.8% and 9% incidences (comparably higher than established prevalence of 4.4% and 7.5 respectively for community and hospital infections respectively. The ESBL isolates showed high resistance to tetracycline, gentamicin, pefloxacin, ceftriaxone, cefuroxime, ciprofloxacin and Augmentin® (Amoxicilin and clavulanic acid combination. Conjugation studies for Resistance plasmid transfer showed non-transference of resistance determinants between the ESBL transconjugants and recipient strains. Correspondingly, the plasmid curing studies revealed that the acridine orange could not effect a cure on the isolates as they still retained high resistance to the antibiotics after the treatment.This study confirms the growing incidences/pool of ESBL strains in Nigeria and call for widespread and continuous monitoring towards an effective management of the potential therapeutic hurdle posed by this trend.

Antimicrobial susceptibilities and molecular typing of neisseria gonorrhoeae isolates at a medical centre in Taiwan, 2001-2013 with an emphasis on high rate of azithromycin resistance among the isolates.

Science.gov (United States)

Liu, Yen-Hung; Huang, Yu-Tsung; Liao, Chun-Hsing; Hsueh, Po-Ren

2018-05-01

A high prevalence of gonococcal resistance to various antimicrobials and Neisseria gonorrhoeae isolates exhibiting resistance to extended-spectrum cephalosporins have been reported in the past few decades. A total of 226 N. gonorrhoeae isolates obtained from the National Taiwan University Hospital from 2001 to 2013 were evaluated. The minimum inhibitory concentrations (MICs) of the isolates to antimicrobials were determined by the agar dilution method and interpreted using the 2017 clinical breakpoints or epidemiological cut-off values recommended by the Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST). The genetic relatedness of these isolates was determined by multilocus sequence typing. None of the isolates was resistant to ceftriaxone and cefotaxime, and the resistance rates to cefixime, spectinomycin, cefpodoxime, ciprofloxacin, and penicillin were 0.4%, 0.4%, 13.3%, 91.6%, and 87.6%, respectively. The rate of isolates resistant to azithromycin was 14.6% (EUCAST criteria), which is higher than in previous surveillance studies. A total of 57 sequence types (ST) were identified, and ST1901, ST7365, and ST1927 prevailed. Isolates of ST8143 emerged after 2011. ST1901 isolates had relatively higher MIC values for ceftriaxone and azithromycin than those of the other STs. In conclusion, ceftriaxone remains an effective drug of choice for gonorrhoeal management in Taiwan. High rates of azithromycin resistance among N. gonorrhoeae isolates were found. The circulating ST1901 strains with high MIC values for ceftriaxone and azithromycin and the emerging ST8143 strains were alarming. Copyright © 2018 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

The resistive tearing instability for generalized resistivity models: Applications

International Nuclear Information System (INIS)

Birk, G.T.; Otto, A.

1991-01-01

The dispersion relation for the resistive tearing mode is investigated with a general form of the resistivity that allows for evaluating the dependence of the mode on the anomalous dissipation caused by the lower-hybrid-drift turbulence and the ion-acoustic turbulence. The coupling of the plasma dynamic and radiative processes due to a temperature-dependent Spitzer resistivity are also discussed. The dispersion relation is solved numerically for two-dimensional equilibrium configurations with applications to the Earth's magnetosphere and the solar corona. In the case of the parameter regimes of the magnetopause and the solar corona, growth rates that result in realistic time scales for the respective dynamic processes as flux transfer events and solar flares were found. Moreover, the influence of a nonvanishing component of the magnetic field normal to the current sheet on the dispersion relation is examined. The normal field component leads to overstable modes and the growth rate of the pure tearing mode is not altered, whereas the radiative tearing mode is damped effectively

Echocardiographic dimensions and function in adults with primary growth hormone resistance (Laron syndrome).

Science.gov (United States)

Feinberg, M S; Scheinowitz, M; Laron, Z

2000-01-15

Patients with primary growth hormone (GH) resistance-Laron Syndrome (LS)-have no GH signal transmission, and thus, no generation of circulating insulin-like growth factor-I (IGF-I), and should serve as a unique model to explore the controversies concerning the longterm effect of GH/IGF-I deficiency on cardiac dimension and function. We assessed 8 patients with LS (4 men, 4 women) with a mean (+/- SD) age of 38+/-7 years (range 22 to 45), and 8 aged-matched controls (4 men, 4 women) with a mean age of 38+/-9 years (range 18 to 47) by echocardiography at rest, following exercise, and during dobutamine administration. Left ventricular (LV) septum, posterior wall, and end-diastolic diameter were significantly reduced in untreated patients with LS compared with the control group (p<0.05 for all). Systolic Doppler-derived parameters, including LV stroke volume, stroke index, cardiac output, and cardiac index, were significantly lower (p<0.05 for all) than in the control subjects, whereas LV diastolic Doppler parameters, including mitral valve waves E, A, E/A ratio, and E deceleration time, were similar in both groups. LV ejection fraction at rest as well as the stress-induced increment of the LV ejection fraction were similar in both groups. Our results show that untreated patients with long-term IGF-I deficiency have reduced cardiac dimensions and output but normal LV ejection fraction at rest and LV contractile reserve following stress.

Novel resistance functions uncovered using functional metagenomic investigations of resistance reservoirs

Directory of Open Access Journals (Sweden)

Erica C. Pehrsson

2013-06-01

Full Text Available Rates of infection with antibiotic-resistant bacteria have increased precipitously over the past several decades, with far-reaching healthcare and societal costs. Recent evidence has established a link between antibiotic resistance genes in human pathogens and those found in non-pathogenic, commensal, and environmental organisms, prompting deeper investigation of natural and human-associated reservoirs of antibiotic resistance. Functional metagenomic selections, in which shotgun-cloned DNA fragments are selected for their ability to confer survival to an indicator host, have been increasingly applied to the characterization of many antibiotic resistance reservoirs. These experiments have demonstrated that antibiotic resistance genes are highly diverse and widely distributed, many times bearing little to no similarity to known sequences. Through unbiased selections for survival to antibiotic exposure, functional metagenomics can improve annotations by reducing the discovery of false-positive resistance and by allowing for the identification of previously unrecognizable resistance genes. In this review, we summarize the novel resistance functions uncovered using functional metagenomic investigations of natural and human-impacted resistance reservoirs. Examples of novel antibiotic resistance genes include those highly divergent from known sequences, those for which sequence is entirely unable to predict resistance function, bifunctional resistance genes, and those with unconventional, atypical resistance mechanisms. Overcoming antibiotic resistance in the clinic will require a better understanding of existing resistance reservoirs and the dissemination networks that govern horizontal gene exchange, informing best practices to limit the spread of resistance-conferring genes to human pathogens.

Through-vial impedance spectroscopy of the mechanisms of annealing in the freeze-drying of maltodextrin: the impact of annealing hold time and temperature on the primary drying rate.

Science.gov (United States)

Smith, Geoff; Arshad, Muhammad Sohail; Polygalov, Eugene; Ermolina, Irina

2014-06-01

The study aims to investigate the impact of annealing hold time and temperature on the primary drying rate/duration of a 10% (w/v) solution of maltodextrin with an emphasis on how the mechanisms of annealing might be understood from the in-vial measurements of the ice crystal growth and the glass transition. The electrical impedance of the solution within a modified glass vial was recorded between 10 and 10(6) Hz during freeze-drying cycles with varying annealing hold times (1-5 h) and temperatures. Primary drying times decreased by 7%, 27% and 34% (1.1, 4.3 and 5.5 h) with the inclusion of an annealing step at temperatures of -15°C, -10°C and -5°C, respectively. The glass transition was recorded at approximately -16°C during the re-heating and re-cooling steps, which is close to the glass transition (Tg ') reported for 10% (w/v) maltodextrin and therefore indicates that a maximum freeze concentration (∼86%, w/w, from the Gordon-Taylor equation) was achieved during first freezing, with no further ice being formed on annealing. This observation, coupled to the decrease in electrical resistance that was observed during the annealing hold time, suggests that the reduction in the drying time was because of improved connectivity of ice crystals because of Ostwald ripening rather than devitrification. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

Self-rated health of primary care house officers and its relationship to psychological and spiritual well-being

Directory of Open Access Journals (Sweden)

Mueller Caroline V

2007-05-01

Full Text Available Background The stress associated with residency training may place house officers at risk for poorer health. We sought to determine the level of self-reported health among resident physicians and to ascertain factors that are associated with their reported health. Methods A questionnaire was administered to house officers in 4 residency programs at a large Midwestern medical center. Self-rated health was determined by using a health rating scale (ranging from 0 = death to 100 = perfect health and a Likert scale (ranging from "poor" health to "excellent" health. Independent variables included demographics, residency program type, post-graduate year level, current rotation, depressive symptoms, religious affiliation, religiosity, religious coping, and spirituality. Results We collected data from 227 subjects (92% response rate. The overall mean (SD health rating score was 87 (10; range, 40–100, with only 4 (2% subjects reporting a score of 100; on the Likert scale, only 88 (39% reported excellent health. Lower health rating scores were significantly associated (P Conclusion Residents' self-rated health was poorer than might be expected in a cohort of relatively young physicians and was related to program type, depressive symptoms, and spiritual well-being. Future studies should examine whether treating depressive symptoms and attending to spiritual needs can improve the overall health and well-being of primary care house officers.

Improved Survival and Cure Rates With Concurrent Treatment for Multidrug-Resistant Tuberculosis-Human Immunodeficiency Virus Coinfection in South Africa.

Science.gov (United States)

Brust, James C M; Shah, N Sarita; Mlisana, Koleka; Moodley, Pravi; Allana, Salim; Campbell, Angela; Johnson, Brent A; Master, Iqbal; Mthiyane, Thuli; Lachman, Simlatha; Larkan, Lee-Megan; Ning, Yuming; Malik, Amyn; Smith, Jonathan P; Gandhi, Neel R

2018-04-03

Mortality in multidrug-resistant (MDR) tuberculosis-human immunodeficiency virus (HIV) coinfection has historically been high, but most studies predated the availability of antiretroviral therapy (ART). We prospectively compared survival and treatment outcomes in MDR tuberculosis-HIV-coinfected patients on ART to those in patients with MDR tuberculosis alone. This observational study enrolled culture-confirmed MDR tuberculosis patients with and without HIV in South Africa between 2011 and 2013. Participants received standardized MDR tuberculosis and HIV regimens and were followed monthly for treatment response, adverse events, and adherence. The primary outcome was survival. Among 206 participants, 150 were HIV infected, 131 (64%) were female, and the median age was 33 years (interquartile range [IQR], 26-41). Of the 191 participants with a final MDR tuberculosis outcome, 130 (73%) were cured or completed treatment, which did not differ by HIV status (P = .50). After 2 years, CD4 count increased a median of 140 cells/mm3 (P = .005), and 64% had an undetectable HIV viral load. HIV-infected and HIV-uninfected participants had high rates of survival (86% and 94%, respectively; P = .34). The strongest risk factor for mortality was having a CD4 count ≤100 cells/mm3 (adjusted hazards ratio, 15.6; 95% confidence interval, 4.4-55.6). Survival and treatment outcomes among MDR tuberculosis-HIV individuals receiving concurrent ART approached those of HIV-uninfected patients. The greatest risk of death was among HIV-infected individuals with CD4 counts ≤100 cells/mm3. These findings provide critical evidence to support concurrent treatment of MDR tuberculosis and HIV.

[Naturally occurring oseltamivir resistance in influenza A.

DEFF Research Database (Denmark)

Madsen, Laura; Nielsen, Alex; Lundgren, Jens

2010-01-01

in the development of resistance. The best prevention strategy remains vaccination of the general population to avoid immunity. Future antiviral treatment calls for knowledge about resistance to existing types of influenza and the availability of all three types of antiviral medication. Udgivelsesdato: 2010-Aug......During the last two influenza seasons, one of the predominant influenza A types (H1N1) has developed complete resistance to oseltamivir, the primary treatment option. The virus does, however, remain sensitive to zanamavir and amantadine. There is no unequivocal explanation for this slide...

[Naturally occurring oseltamivir resistance in influenza A.

DEFF Research Database (Denmark)

Madsen, Laura; Nielsen, Alex; Lundgren, Jens

2010-01-01

During the last two influenza seasons, one of the predominant influenza A types (H1N1) has developed complete resistance to oseltamivir, the primary treatment option. The virus does, however, remain sensitive to zanamavir and amantadine. There is no unequivocal explanation for this slide...... in the development of resistance. The best prevention strategy remains vaccination of the general population to avoid immunity. Future antiviral treatment calls for knowledge about resistance to existing types of influenza and the availability of all three types of antiviral medication. Udgivelsesdato: 2010-Aug...

Power allocation and achievable data rate in spectrum-sharing channels under adaptive primary service outage constraints

KAUST Repository

Yang, Yuli

2012-09-01

In this paper, we focus on a cognitive radio network where adaptive modulation is adopted in primary links. The gap between the primary user (PU)\\'s received signal-to-noise ratio (SNR) and the lower SNR boundary of the modulation mode that is being used, provides an interference-tolerable zone. Based on this gap, a secondary user (SU) has an increased opportunity to access the licensed spectrum and to determine the transmit power it should use to keep the PU\\'s quality-of-service (QoS) unaffected. However, since the SU cannot obtain perfect information on the PU\\'s received SNR, it has to choose an SNR point between the lower and upper boundaries of the PU\\'s current modulation mode as if this point were the real SNR received by the PU. Considering this issue, in order to quantify the effect of the SU\\'s transmissions on the PU\\'s QoS, we define the PU\\'s service outage probability and obtain its closed-form expressions by taking into account whether the peak transmit power constraint is imposed on the secondary\\'s transmission or not. Subsequently, we derive the SU\\'s achievable data rate in closed form for counterpart scenarios. Numerical results provided here quantify the relation between the PU\\'s service outage probability and the SU\\'s achievable data rate, which further demonstrate that the higher the peak transmit power a secondary transmitter can support, the better performance the cognitive radio network can achieve. © 2012 IEEE.

Atovaquone/proguanil resistance in Africa: a case report

DEFF Research Database (Denmark)

David, Kim P; Alifrangis, Michael; Salanti, Ali

2003-01-01

The Atovaquone/proguanil combination has quickly been established as an effective chemoprophylaxis for travellers to areas with chloroquineresistant Plasmodium falciparum malaria. We describe the molecular cause of the first reported case of primary Atovaquone/proguanil resistance observed in our...... department in a Plasmodium falciparum infected traveller returning from West Africa, and link our findings to other reports of resistance....

Ipsilateral Breast Tumor Relapse: Local Recurrence Versus New Primary Tumor and the Effect of Whole-Breast Radiotherapy on the Rate of New Primaries

International Nuclear Information System (INIS)

Gujral, Dorothy M.; Sumo, Georges; Owen, John R.; Ashton, Anita; Bliss, Judith M.; Haviland, Joanne; Yarnold, John R.

2011-01-01

Purpose: The justification for partial breast radiotherapy after breast conservation surgery assumes that ipsilateral breast tumor relapses (IBTR) outside the index quadrant are mostly new primary (NP) tumors that develop despite radiotherapy. We tested the hypothesis that whole-breast radiotherapy (WBRT) is ineffective in preventing NP by comparing development rates in irradiated and contralateral breasts after tumor excision and WBRT. Methods and Materials: We retrospectively reviewed 1,410 women with breast cancer who were entered into a prospective randomized trial of radiotherapy fractionation and monitored annually for ipsilateral breast tumor relapses (IBTR) and contralateral breast cancer (CLBC). Cases of IBTR were classified into local recurrence (LR) or NP tumors based on location and histology and were subdivided as definite or likely depending on clinical data. Rates of ipsilateral NP and CLBC were compared over a 15-year period of follow-up. Results: At a median follow-up of 10.1 years, there were 150 documented cases of IBTR: 118 (79%) cases were definite or likely LR; 27 (18%) cases were definite or likely NP; and 5 (3%) cases could not be classified. There were 71 cases of CLBC. The crude proportion of definite-plus-likely NP was 1.9% (27/1,410) patients compared with 5% (71/1,410) CLBC patients. Cumulative incidence rates at 5, 10, and 15 years were 0.8%, 2.0%, and 3.5%, respectively, for definite-plus-likely NP and 2.4%, 5.8%, and 7.9%, respectively for CLBC, suggesting a difference in the rates of NP and CLBC. Conclusions: This analysis suggests that WBRT reduces the rate of ipsilateral NP tumors. The late presentation of NP has implications for the reporting of trials that are testing partial breast radiotherapy.

HIV-1 drug resistance mutations among antiretroviral-naive HIV-1-infected patients in Asia: results from the TREAT Asia Studies to Evaluate Resistance-Monitoring Study.

Science.gov (United States)

Sungkanuparph, Somnuek; Oyomopito, Rebecca; Sirivichayakul, Sunee; Sirisanthana, Thira; Li, Patrick C K; Kantipong, Pacharee; Lee, Christopher K C; Kamarulzaman, Adeeba; Messerschmidt, Liesl; Law, Matthew G; Phanuphak, Praphan

2011-04-15

Of 682 antiretroviral-naïve patients initiating antiretroviral therapy in a prospective, multicenter human immunodeficiency virus type 1 (HIV-1) drug resistance monitoring study involving 8 sites in Hong Kong, Malaysia, and Thailand, the prevalence of patients with ≥1 drug resistance mutation was 13.8%. Primary HIV drug resistance is emerging after rapid scaling-up of antiretroviral therapy use in Asia.

Anatomy of the bacitracin resistance network in Bacillus subtilis.

Science.gov (United States)

Radeck, Jara; Gebhard, Susanne; Orchard, Peter Shevlin; Kirchner, Marion; Bauer, Stephanie; Mascher, Thorsten; Fritz, Georg

2016-05-01

Protection against antimicrobial peptides (AMPs) often involves the parallel production of multiple, well-characterized resistance determinants. So far, little is known about how these resistance modules interact and how they jointly protect the cell. Here, we studied the interdependence between different layers of the envelope stress response of Bacillus subtilis when challenged with the lipid II cycle-inhibiting AMP bacitracin. The underlying regulatory network orchestrates the production of the ABC transporter BceAB, the UPP phosphatase BcrC and the phage-shock proteins LiaIH. Our systems-level analysis reveals a clear hierarchy, allowing us to discriminate between primary (BceAB) and secondary (BcrC and LiaIH) layers of bacitracin resistance. Deleting the primary layer provokes an enhanced induction of the secondary layer to partially compensate for this loss. This study reveals a direct role of LiaIH in bacitracin resistance, provides novel insights into the feedback regulation of the Lia system, and demonstrates a pivotal role of BcrC in maintaining cell wall homeostasis. The compensatory regulation within the bacitracin network can also explain how gene expression noise propagates between resistance layers. We suggest that this active redundancy in the bacitracin resistance network of B. subtilis is a general principle to be found in many bacterial antibiotic resistance networks. © 2016 John Wiley & Sons Ltd.

Targeting chemotherapy-resistant leukemia by combining DNT cellular therapy with conventional chemotherapy.

Science.gov (United States)

Chen, Branson; Lee, Jong Bok; Kang, Hyeonjeong; Minden, Mark D; Zhang, Li

2018-04-24

While conventional chemotherapy is effective at eliminating the bulk of leukemic cells, chemotherapy resistance in acute myeloid leukemia (AML) is a prevalent problem that hinders conventional therapies and contributes to disease relapse, and ultimately patient death. We have recently shown that allogeneic double negative T cells (DNTs) are able to target the majority of primary AML blasts in vitro and in patient-derived xenograft models. However, some primary AML blast samples are resistant to DNT cell therapy. Given the differences in the modes of action of DNTs and chemotherapy, we hypothesize that DNT therapy can be used in combination with conventional chemotherapy to further improve their anti-leukemic effects and to target chemotherapy-resistant disease. Drug titration assays and flow-based cytotoxicity assays using ex vivo expanded allogeneic DNTs were performed on multiple AML cell lines to identify therapy-resistance. Primary AML samples were also tested to validate our in vitro findings. Further, a xenograft model was employed to demonstrate the feasibility of combining conventional chemotherapy and adoptive DNT therapy to target therapy-resistant AML. Lastly, blocking assays with neutralizing antibodies were employed to determine the mechanism by which chemotherapy increases the susceptibility of AML to DNT-mediated cytotoxicity. Here, we demonstrate that KG1a, a stem-like AML cell line that is resistant to DNTs and chemotherapy, and chemotherapy-resistant primary AML samples both became more susceptible to DNT-mediated cytotoxicity in vitro following pre-treatment with daunorubicin. Moreover, chemotherapy treatment followed by adoptive DNT cell therapy significantly decreased bone marrow engraftment of KG1a in a xenograft model. Mechanistically, daunorubicin increased the expression of NKG2D and DNAM-1 ligands on KG1a; blocking of these pathways attenuated DNT-mediated cytotoxicity. Our results demonstrate the feasibility and benefit of using DNTs as

Influence of hydrazine primary water chemistry on corrosion of fuel cladding and primary circuit components

International Nuclear Information System (INIS)

Iourmanov, V.; Pashevich, V.; Bogancs, J.; Tilky, P.; Schunk, J.; Pinter, T.

1999-01-01

Earlier at Paks 1-4 NPP standard ammonia chemistry was in use. The following station performance indicators were improved when hydrazine primary water chemistry was introduced: occupational radiation exposures of personnel; gamma-radiation dose rates near primary system components during refuelling and maintenance outages. The reduction of radiation exposures and radiation fields were achieved without significant expenses. Recent results of experimental studies allowed to explain the mechanism of hydrazine dosing influence on: corrosion rate of structure materials in primary coolant; behaviour of soluble and insoluble corrosion products including long-life corrosion-induced radionuclides in primary system during steady-state and transient operation modes; radiolytic generation of oxidising radiolytic products in core and its corrosion activity in primary system; radiation situation during refuelling and maintenance outages; foreign material degradation and removal (including corrosion active oxidant species) from primary system during abnormal events. Operational experience and experimental data have shown that hydrazine primary water chemistry allows to reduce corrosion wear and thereby makes it possible to extend the life-time of plant components in primary system. (author)

Anti-Epidermal Growth Factor Receptor Therapy in Head and Neck Squamous Cell Carcinoma: Focus on Potential Molecular Mechanisms of Drug Resistance

Science.gov (United States)

Baay, Marc; Wouters, An; Specenier, Pol; Vermorken, Jan B.; Peeters, Marc; Lardon, Filip

2013-01-01

Targeted therapy against the epidermal growth factor receptor (EGFR) is one of the most promising molecular therapeutics for head and neck squamous cell carcinoma (HNSCC). EGFR is overexpressed in a wide range of malignancies, including HNSCC, and initiates important signal transduction pathways in HNSCC carcinogenesis. However, primary and acquired resistance are serious problems and are responsible for low single-agent response rate and tumor recurrence. Therefore, an improved understanding of the molecular mechanisms of resistance to EGFR inhibitors may provide valuable indications to identify biomarkers that can be used clinically to predict response to EGFR blockade and to establish new treatment options to overcome resistance. To date, no predictive biomarker for HNSCC is available in the clinic. Therapeutic resistance to anti-EGFR therapy may arise from mechanisms that can compensate for reduced EGFR signaling and/or mechanisms that can modulate EGFR-dependent signaling. In this review, we will summarize some of these molecular mechanisms and describe strategies to overcome that resistance. PMID:23821327

Corrosion Behavior and Oxide Properties of Zr-Nb-Cu and Zr-Nb-Sn Alloy in High Dissolved Hydrogen Primary Water Chemistry

Energy Technology Data Exchange (ETDEWEB)

Lee, Yun Ju; Kim, Tae Ho; Kim, Ji Hyun [UNIST, Ulsan (Korea, Republic of)

2016-05-15

The water-metal interface is regarded as rate-controlling site governing the rapid oxidation transition in high burn-up fuel. And the zirconium oxide is made in water-metal interface and its structure and phase do an important role in terms of oxide properties. During oxidation process, the protective tetragonal oxide layer develops at the interface due to accumulated high stress during oxide growth, and it turns into non-protective monoclinic oxide with increasing oxide thickness, thus decreasing the stress. It has been reported that Nb addition was proven to be very beneficial for increasing the corrosion resistance of the zirconium alloys. From a more recent study, Cu addition in Nb containing Zirconium alloy was reported to be effective for increasing corrosion resistance in water containing B and Li. According to the previous research conducted, Zr-Nb-Cu shows better corrosion resistance than Zircaloy-4. The dissolved hydrogen (DH) concentration is the key issue of primary water chemistry, and the effect of DH concentration on the corrosion rate of nickel based alloy has been researched. However, the effect of DH on the zirconium alloy corrosion mechanism was not fully investigated. In this study, the weight gain measurement, FIB-SEM analysis, and Raman spectroscopic measurement were conducted to investigate the effects of dissolved hydrogen concentration and the chemical composition on the corrosion resistance and oxide phase of Zr-Nb-Cu alloy and Zr-Nb-Sn alloy after oxidizing in a primary water environment for 20 d. The corrosion rate of Zr-Nb-Cu alloy is slow, when it is compared to Zr-Nb-Sn alloy. In SEM images, the oxide thickness of Zr-Nb-Cu alloy is measured to be around 1.06 μm it of Zr-Nb-Sn alloy is measured to be 1.15 μm. It is because of the Segregation made by Sn solute element when Sn solute element oxidized. And according to ex situ Raman spectra, Zr-Nb-Cu alloy oxide has more tetragonal zirconium oxide fraction than Zr-Nb-Sn alloy oxide.

Antimicrobial resistance and prevalence of resistance genes of obligate anaerobes isolated from periodontal abscesses.

Science.gov (United States)

Xie, Yi; Chen, Jiazhen; He, Junlin; Miao, Xinyu; Xu, Meng; Wu, Xingwen; Xu, Beiyun; Yu, Liying; Zhang, Wenhong

2014-02-01

This study attempts to determine the antimicrobial resistance profiles of obligate anaerobic bacteria that were isolated from a periodontal abscess and to evaluate the prevalence of resistance genes in these bacteria. Forty-one periodontal abscess samples were cultivated on selective and non-selective culture media to isolate the oral anaerobes. Their antibiotic susceptibilities to clindamycin, doxycycline, amoxicillin, imipenem, cefradine, cefixime, roxithromycin, and metronidazole were determined using the agar dilution method, and polymerase chain reaction assays were performed to detect the presence of the ermF, tetQ, nim, and cfxA drug resistance genes. A total of 60 different bacterial colonies was isolated and identified. All of the isolates were sensitive to imipenem. Of the strains, 6.7%, 13.3%, 16.7%, and 25% were resistant to doxycycline, metronidazole, cefixime, and amoxicillin, respectively. The resistance rate for both clindamycin and roxithromycin was 31.7%. Approximately 60.7% of the strains had the ermF gene, and 53.3% of the amoxicillin-resistant strains were found to have the cfxA gene. Two nim genes that were found in eight metronidazole-resistant strains were identified as nimB. In the present study, the Prevotella species are the most frequently isolated obligate anaerobes from periodontal abscesses. The current results show their alarmingly high resistance rate against clindamycin and roxithromycin; thus, the use of these antibiotics is unacceptable for the empirical therapy of periodontal abscesses. A brief prevalence of four resistance genes in the anaerobic bacteria that were isolated was also demonstrated.

Insulin resistance and bone: a biological partnership.

Science.gov (United States)

Conte, Caterina; Epstein, Solomon; Napoli, Nicola

2018-04-01

Despite a clear association between type 2 diabetes (T2D) and fracture risk, the pathogenesis of bone fragility in T2D has not been clearly elucidated. Insulin resistance is the primary defect in T2D. Insulin signalling regulates both bone formation and bone resorption, but whether insulin resistance can affect bone has not been established. On the other hand, evidence exists that bone might play a role in the regulation of glucose metabolism. This article reviews the available experimental and clinical evidence on the interplay between bone and insulin resistance. Interestingly, a bilateral relationship between bone and insulin resistance seems to exist that unites them in a biological partnership.

Effects of Creatine and Resistance Training on Bone Health in Postmenopausal Women.

Science.gov (United States)

Chilibeck, Philip D; Candow, Darren G; Landeryou, Tim; Kaviani, Mojtaba; Paus-Jenssen, Lisa

2015-08-01

Our primary purpose was to determine the effect of 12 months of creatine (Cr) supplementation during a supervised resistance training program on properties of bone in postmenopausal women. Participants were randomized (double-blind) into two groups: resistance training (3 d·wk) and Cr supplementation (0.1 g·kg·d) or resistance training and placebo (Pl). Our primary outcome measures were lumbar spine and femoral neck bone mineral density (BMD). Secondary outcome measures were total hip and whole-body BMD, bone geometric properties at the hip, speed of sound at the distal radius and tibia, whole-body lean tissue mass, muscle thickness, and bench press and hack squat strength. Forty-seven women (57 (SD, 6) yr; Cr, n = 23; Pl, n = 24) were randomized, with 33 analyzed after 12 months (Cr, n = 15; Pl, n = 18). Cr attenuated the rate of femoral neck BMD loss (-1.2%; absolute change (95% confidence interval), -0.01 (-0.025 to 0.005) g·cm) compared with Pl (-3.9%; -0.03 (-0.044 to -0.017) g·cm; P < 0.05) and also increased femoral shaft subperiosteal width, a predictor of bone bending strength (Cr, 0.04 (-0.09 to 0.16) cm); Pl, -0.12 (-0.23 to -0.01) cm; P < 0.05). Cr increased relative bench press strength more than Pl (64% vs 34%; P < 0.05). There were no differences between groups for other outcome measures. There were no differences between groups for reports of serum liver enzyme abnormalities, and creatinine clearance was normal for Cr participants throughout the intervention. Twelve months of Cr supplementation during a resistance training program preserves femoral neck BMD and increases femoral shaft superiosteal width, a predictor of bone bending strength, in postmenopausal women.

Entropy resistance minimization: An alternative method for heat exchanger analyses

International Nuclear Information System (INIS)

Cheng, XueTao

2013-01-01

In this paper, the concept of entropy resistance is proposed based on the entropy generation analyses of heat transfer processes. It is shown that smaller entropy resistance leads to larger heat transfer rate with fixed thermodynamic force difference and smaller thermodynamic force difference with fixed heat transfer rate, respectively. For the discussed two-stream heat exchangers in which the heat transfer rates are not given and the three-stream heat exchanger with prescribed heat capacity flow rates and inlet temperatures of the streams, smaller entropy resistance leads to larger heat transfer rate. For the two-stream heat exchangers with fixed heat transfer rate, smaller entropy resistance leads to larger effectiveness. Furthermore, it is shown that smaller values of the concepts of entropy generation numbers and modified entropy generation number do not always correspond to better performance of the discussed heat exchangers. - Highlights: • The concept of entropy resistance is defined for heat exchangers. • The concepts based on entropy generation are used to analyze heat exchangers. • Smaller entropy resistance leads to better performance of heat exchangers. • The applicability of entropy generation minimization is conditional

Distribution of antibiotic resistance in urban watershed in Japan

International Nuclear Information System (INIS)

Ham, Young-Sik; Kobori, Hiromi; Kang, Joo-Hyon; Matsuzaki, Takayuki; Iino, Michiyo; Nomura, Hayashi

2012-01-01

Antibiotic-resistant E. coli concentrations showed large spatial and temporal variations, with greater concentrations observed in tributaries and downstream than in the upstream and midstream. Twenty percent of the geometric mean concentrations of antibiotic-resistant E. coli in the Tama River basin (Japan) exceeded the maximum acceptable concentration of indicator E. coli established by the USEPA. The indicator E. coli concentrations were positively correlated with those of antibiotic-resistant E. coli and multiple-antibiotic-resistant E. coli (resistance to more than two kinds of antibiotics), respectively, but not the detection rate of antibiotic-resistant E. coli, implying that use of antibiotic-resistant E. coli concentration rather than the detection rate can be a better approach for water quality assessment. Multiple-antibiotic-resistant E. coli is a useful indicator for estimating the resistance diffusion, water quality degradation and public health risk potential. This assessment provides beneficial information for setting national regulatory or environmental standards and managing integrated watershed areas. - Highlights: ► We extensively observed antibiotic-resistant E. coli (AREc) in Tama River (Japan). ► AREc count rather than the detection rate is better approach for water quality test. ► Multiple-AREc is resistant to the antibiotic to which single-AREc has no resistance. ► Multiple-AREc increase will accelerate the diffusion of antibiotic resistance. - Multiple-antibiotic-resistant E. coli in the watershed can cause the diffusion of conventionally rare antibiotic resistance.

Stress corrosion cracking of iron-nickel-chromium alloys in primary circuit environment of PWR-type reactors

International Nuclear Information System (INIS)

Boursier, Jean-Marie

1993-01-01

Stress corrosion cracking of Alloy 600 steam generator tubing is a great concern for pressurized water reactors. The mechanism that controls intergranular stress corrosion cracking of Alloy 600 in primary water (lithiated-borated water) has yet to be clearly identified. A study of stress corrosion cracking behaviour, which can identify the main parameters that control the cracking phenomenon, was so necessary to understand the stress corrosion cracking process. Constant extension rate tests, and constant load tests have evidenced that Alloy 600 stress corrosion cracking involves firstly an initiation period, then a slow propagation stage with crack less than 50 to 80 micrometers, and finally a rapid propagation stage leading to failure. The influence of mechanical parameters have shown the next points: - superficial strain hardening and cold work have a strong effect of stress corrosion cracking resistance (decrease of initiation time and increase of crack growth rate), - strain rate was the most suitable parameter for describing the different stage of propagation. The creep behaviour of alloy 600 has shown an increase of creep rate in primary water compared to air, which implies a local interaction plasticity/corrosion. An assessment of the durations of the initiation and the propagation stages was attempted for the whole uniaxial tensile tests, using the macroscopic strain rate: - the initiation time is less than 100 hours and seems to be an electrochemical process, - the durations of the propagation stage are strongly dependent on the strain rate. The behaviour in high primary water temperature of Alloys 690 and 800, which replace Alloy 600, was studied to appraise their margin, and validate their choice. Then the last chapter has to objective to evaluate the crack tip strain rate, in order to better describe the evolution of the different stages of cracking. (author) [fr

Surgery for Drug-Resistant Epilepsy in Children.

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Dwivedi, Rekha; Ramanujam, Bhargavi; Chandra, P Sarat; Sapra, Savita; Gulati, Sheffali; Kalaivani, Mani; Garg, Ajay; Bal, Chandra S; Tripathi, Madhavi; Dwivedi, Sada N; Sagar, Rajesh; Sarkar, Chitra; Tripathi, Manjari

2017-10-26

Neurosurgical treatment may improve seizures in children and adolescents with drug-resistant epilepsy, but additional data are needed from randomized trials. In this single-center trial, we randomly assigned 116 patients who were 18 years of age or younger with drug-resistant epilepsy to undergo brain surgery appropriate to the underlying cause of epilepsy along with appropriate medical therapy (surgery group, 57 patients) or to receive medical therapy alone (medical-therapy group, 59 patients). The patients in the medical-therapy group were assigned to a waiting list for surgery. The primary outcome was freedom from seizures at 12 months. Secondary outcomes were the score on the Hague Seizure Severity scale, the Binet-Kamat intelligence quotient, the social quotient on the Vineland Social Maturity Scale, and scores on the Child Behavior Checklist and the Pediatric Quality of Life Inventory. At 12 months, freedom from seizures occurred in 44 patients (77%) in the surgery group and in 4 (7%) in the medical-therapy group (Pchildren and adolescents with drug-resistant epilepsy who had undergone epilepsy surgery had a significantly higher rate of freedom from seizures and better scores with respect to behavior and quality of life than did those who continued medical therapy alone at 12 months. Surgery resulted in anticipated neurologic deficits related to the region of brain resection. (Funded by the Indian Council of Medical Research and others; Clinical Trial Registry-India number, CTRI/2010/091/000525 .).

Strategies to Minimize Antibiotic Resistance

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Sang Hee Lee

2013-09-01

Full Text Available Antibiotic resistance can be reduced by using antibiotics prudently based on guidelines of antimicrobial stewardship programs (ASPs and various data such as pharmacokinetic (PK and pharmacodynamic (PD properties of antibiotics, diagnostic testing, antimicrobial susceptibility testing (AST, clinical response, and effects on the microbiota, as well as by new antibiotic developments. The controlled use of antibiotics in food animals is another cornerstone among efforts to reduce antibiotic resistance. All major resistance-control strategies recommend education for patients, children (e.g., through schools and day care, the public, and relevant healthcare professionals (e.g., primary-care physicians, pharmacists, and medical students regarding unique features of bacterial infections and antibiotics, prudent antibiotic prescribing as a positive construct, and personal hygiene (e.g., handwashing. The problem of antibiotic resistance can be minimized only by concerted efforts of all members of society for ensuring the continued efficiency of antibiotics.

Body mass and weight thresholds for increased prosthetic joint infection rates after primary total joint arthroplasty.

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Lübbeke, Anne; Zingg, Matthieu; Vu, Diemlan; Miozzari, Hermes H; Christofilopoulos, Panayiotis; Uçkay, Ilker; Harbarth, Stephan; Hoffmeyer, Pierre

2016-01-01

Obesity increases the risk of deep infection after total joint arthroplasty (TJA). Our objective was to determine whether there may be body mass index (BMI) and weight thresholds indicating a higher prosthetic joint infection rate. We included all 9,061 primary hip and knee arthroplasties (mean age 70 years, 61% women) performed between March 1996 and December 2013 where the patient had received intravenous cefuroxime (1.5 g) perioperatively. The main exposures of interest were BMI (5 categories: prosthetic joint infection. The mean follow-up time was 6.5 years (0.5-18 years). 111 prosthetic joint infections were observed: 68 postoperative, 16 hematogenous, and 27 of undetermined cause. Incidence rates were similar in the first 3 BMI categories (infection from the early postoperative period onward (adjusted HR = 2.1, 95% CI: 1.3-3.6). BMI ≥ 35 or weight ≥ 100 kg may serve as a cutoff for higher perioperative dosage of antibiotics.

Where antibiotic resistance mutations meet quorum-sensing

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Rok Krašovec

2014-06-01

Full Text Available We do not need to rehearse the grim story of the global rise of antibiotic resistant microbes. But what if it were possible to control the rate with which antibiotic resistance evolves by de novo mutation? It seems that some bacteria may already do exactly that: they modify the rate at which they mutate to antibiotic resistance dependent on their biological environment. In our recent study [Krašovec, et al. Nat. Commun. (2014, 5, 3742] we find that this modification depends on the density of the bacterial population and cell-cell interactions (rather than, for instance, the level of stress. Specifically, the wild-type strains of Escherichia coli we used will, in minimal glucose media, modify their rate of mutation to rifampicin resistance according to the density of wild-type cells. Intriguingly, the higher the density, the lower the mutation rate (Figure 1. Why this novel density-dependent ‘mutation rate plasticity’ (DD-MRP occurs is a question at several levels. Answers are currently fragmentary, but involve the quorum-sensing gene luxS and its role in the activated methyl cycle.

Lodging Resistance of Japonica Rice (Oryza Sativa L.): Morphological and Anatomical Traits due to top-Dressing Nitrogen Application Rates.

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Zhang, Wujun; Wu, Longmei; Wu, Xiaoran; Ding, Yanfeng; Li, Ganghua; Li, Jingyong; Weng, Fei; Liu, Zhenghui; Tang, She; Ding, Chengqiang; Wang, Shaohua

2016-12-01

Lodging in rice production often limits grain yield and quality by breaking or bending stems. Excessive nitrogen (N) fertilizer rates are the cause of poor lodging resistance in rice, but little is known about the effect of top-dressing N application rates on the mechanical strength of japonica rice plants, especially how the anatomical structure in culms is affected by N. In this study, field experiments on two japonica rice varieties with three top-dressing N application rates, 0 kg N ha(-1) (LN), 135 kg N ha(-1) (MN), and 270 kg N ha(-1) (HN) as urea, were conducted. Wuyunjing23, a lodging-resistant japonica rice cultivar and W3668, a lodging-susceptible japonica rice cultivar were used. The lodging index, breaking strength, morphological and anatomical traits in culms were measured in this study. The visual lodging rate in japonica rice differed remarkably between genotypes and top-dressing N treatments. The higher lodging index of rice plants was primarily attributed to the weak breaking strength of the lower internodes. The longer elongated basal internodes were responsible for higher plant height and a higher lodging index. Correlation analysis showed that breaking strength was significantly and positively correlated with the thickness of the mechanical tissue but was significantly and negatively correlated with the inner diameter of the major axis (b2). With increasing top-dressing N rates, the sclerenchyma cells of the mechanical tissues and the vascular bundles of the Wuyunjing23 cultivar varied little. The plant height, inner diameter of the minor axis (a2) and b2 increased significantly, but the area of the large vascular bundle (ALVB) and the area of the small vascular bundle (ASVB) decreased significantly and resulted in lower stem strength and a higher lodging index under higher top-dressing N conditions. The culm diameter of the W3668 cultivar increased slightly with no significant difference, and the sclerenchyma cells in the mechanical

Emergence of resistant pathogens against colistin

OpenAIRE

Rakesh Kumar; Baljit Jassal; Bhupinder Kumar

2015-01-01

Emergence of resistant strain to antimicrobials is a growing problem worldwide. Here, we report a case of multidrug-resistant Klebsiella pneumoniae and Acinectobacter baumannii, Gram-negative bacilli, which was only intermediate sensitive to colistin; a polymyxin E. Colistin has attracted more interest recently because of its significant activity against multi-resistant Pseudomonas aeruginosa, A. baumannii and K. pneumoniae, and the low resistance rates to it. The decrease in sensitivity of c...

Recent amendments of the KTA 2101.2 fire barrier resistance rating method for German NPP and comparison to the Eurocode t-equivalent method

Energy Technology Data Exchange (ETDEWEB)

Forell, Burkhard [Gesellschaft fuer Anlagen- und Reaktorsicherheit (GRS) gGmbH, Koeln (Germany)

2015-12-15

The German nuclear standard KTA2101 on ''Fire Protection in Nuclear Power Plants'', Part 2: ''Fire Protection of Structural Plant Components'' includes a simplified method for the fire resistance rating of fire barrier elements based on the t-equivalent approach. The method covers the specific features of compartments in nuclear power plant buildings in terms of the boundary conditions which have to be expected in the event of fire. The method has proven to be relatively simple and straightforward to apply. The paper gives an overview of amendments with respect to the rating method made within the regular review of the KTA 2101.2. A comparison to the method of the non-nuclear Eurocode 1 is also provided. The Eurocode method is closely connected to the German standard DIN 18230 on structural fire protection in industrial buildings. Special emphasis of the comparison is given to the ventilation factor, which has a large impact on the required fire resistance.

Changes in transpiration rate of SO/sub 2/-resistant and -sensitive plants with SO/sub 2/ fumigation and the participation of abscisic acid

Energy Technology Data Exchange (ETDEWEB)

Kondo, N.; Sugahara, K.

1978-01-01

Peanut and tomato plants were resistant to 2.0 ppm SO/sub 2/, while radish, perilla and spinach plants were sensitive. The amounts of SO/sub 2/ absorbed by peanut and tomato were obviously less than those absorbed by radish, perilla and spinach. Transpiration rates of peanut and tomato began to decrease within 5 min after the commencement of SO/sub 2/ fumigation and reached minimum levels, i.e., 10 and 50% for the initial levels, respectively, after initiation of fumigation, then declined. Those of radish and spinach did not change for about 20 and 30 min, then decreased gradually. The content of abscisic acid (ABA) was highest in peanut. The content in tomato was also high, but low in radish, perilla and spinach. Radish supplied with exogenous ABA began to decrease its transpiration rate immediately after SO/sub 2/ fumigation and was markedly resistant to SO/sub 2/. ABA in leaves may control the rapid stomatal closure following SO/sub 2/ fumigation. 26 references.

Arterial Stiffness and Autonomic Modulation After Free-Weight Resistance Exercises in Resistance Trained Individuals.

Science.gov (United States)

Kingsley, J Derek; Mayo, Xián; Tai, Yu Lun; Fennell, Curtis

2016-12-01

Kingsley, JD, Mayo, X, Tai, YL, and Fennell, C. Arterial stiffness and autonomic modulation after free-weight resistance exercises in resistance trained individuals. J Strength Cond Res 30(12): 3373-3380, 2016-We investigated the effects of an acute bout of free-weight, whole-body resistance exercise consisting of the squat, bench press, and deadlift on arterial stiffness and cardiac autonomic modulation in 16 (aged 23 ± 3 years; mean ± SD) resistance-trained individuals. Arterial stiffness, autonomic modulation, and baroreflex sensitivity (BRS) were assessed at rest and after 3 sets of 10 repetitions at 75% 1-repetition maximum on each exercise with 2 minutes of rest between sets and exercises. Arterial stiffness was analyzed using carotid-femoral pulse wave velocity (cf-PWV). Linear heart rate variability (log transformed [ln] absolute and normalized units [nu] of low-frequency [LF] and high-frequency [HF] power) and nonlinear heart rate complexity (Sample Entropy [SampEn], Lempel-Ziv Entropy [LZEn]) were measured to determine autonomic modulation. BRS was measured by the sequence method. A 2 × 2 repeated measures analysis of variance (ANOVA) was used to analyze time (rest, recovery) across condition (acute resistance exercise, control). There were significant increases in cf-PWV (p = 0.05), heart rate (p = 0.0001), normalized LF (LFnu; p = 0.001), and the LF/HF ratio (p = 0.0001). Interactions were also noted for ln HF (p = 0.006), HFnu (p = 0.0001), SampEn (p = 0.001), LZEn (p = 0.005), and BRS (p = 0.0001) such that they significantly decreased during recovery from the resistance exercise compared with rest and the control. There was no effect on ln total power, or ln LF. These data suggest that a bout of resistance exercise using free-weights increases arterial stiffness and reduces vagal activity and BRS in comparison with a control session. Vagal tone may not be fully recovered up to 30 minutes after a resistance exercise bout.

Multidrug-resistant tuberculosis in Europe, 2010-2011

DEFF Research Database (Denmark)

Günther, Gunar; van Leth, Frank; Alexandru, Sofia

2015-01-01

Drug-resistant Mycobacterium tuberculosis is challenging elimination of tuberculosis (TB). We evaluated risk factors for TB and levels of second-line drug resistance in M. tuberculosis in patients in Europe with multidrug-resistant (MDR) TB. A total of 380 patients with MDR TB and 376 patients...... with non-MDR TB were enrolled at 23 centers in 16 countries in Europe during 2010-2011. A total of 52.4% of MDR TB patients had never been treated for TB, which suggests primary transmission of MDR M. tuberculosis. At initiation of treatment for MDR TB, 59.7% of M. tuberculosis strains tested were...

Ablation of the mitochondrial complex IV assembly protein Surf1 leads to increased expression of the UPRMT and increased resistance to oxidative stress in primary cultures of fibroblasts

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Gavin Pharaoh

2016-08-01

Full Text Available Mice deficient in the electron transport chain (ETC complex IV assembly protein SURF1 have reduced assembly and activity of cytochrome c oxidase that is associated with an upregulation of components of the mitochondrial unfolded protein response (UPRMT and increased mitochondrial number. We hypothesized that the upregulation of proteins associated with the UPRMT in response to reduced cytochrome c oxidase activity in Surf1−/− mice might contribute to increased stress resistance. To test this hypothesis we asked whether primary cultures of fibroblasts from Surf1−/− mice exhibit enhanced resistance to stressors compared to wild-type fibroblasts. Here we show that primary dermal fibroblasts isolated from Surf1−/− mice have increased expression of UPRMT components ClpP and Hsp60, and increased expression of Lon protease. Fibroblasts from Surf1−/− mice are significantly more resistant to cell death caused by oxidative stress induced by paraquat or tert-Butyl hydroperoxide compared to cells from wild-type mice. In contrast, Surf1−/− fibroblasts show no difference in sensitivity to hydrogen peroxide stress. The enhanced cell survival in response to paraquat or tert-Butyl hydroperoxide in Surf1−/− fibroblasts compared to wild-type fibroblasts is associated with induced expression of Lon, ClpP, and Hsp60, increased maximal respiration, and increased reserve capacity as measured using the Seahorse Extracellular Flux Analyzer. Overall these data support a protective role for the activation of the UPRMT in cell survival.

Elucidating the Interdependence of Drug Resistance from Combinations of Mutations.

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Ragland, Debra A; Whitfield, Troy W; Lee, Sook-Kyung; Swanstrom, Ronald; Zeldovich, Konstantin B; Kurt-Yilmaz, Nese; Schiffer, Celia A

2017-11-14

HIV-1 protease is responsible for the cleavage of 12 nonhomologous sites within the Gag and Gag-Pro-Pol polyproteins in the viral genome. Under the selective pressure of protease inhibition, the virus evolves mutations within (primary) and outside of (secondary) the active site, allowing the protease to process substrates while simultaneously countering inhibition. The primary protease mutations impede inhibitor binding directly, while the secondary mutations are considered accessory mutations that compensate for a loss in fitness. However, the role of secondary mutations in conferring drug resistance remains a largely unresolved topic. We have shown previously that mutations distal to the active site are able to perturb binding of darunavir (DRV) via the protein's internal hydrogen-bonding network. In this study, we show that mutations distal to the active site, regardless of context, can play an interdependent role in drug resistance. Applying eigenvalue decomposition to collections of hydrogen bonding and van der Waals interactions from a series of molecular dynamics simulations of 15 diverse HIV-1 protease variants, we identify sites in the protease where amino acid substitutions lead to perturbations in nonbonded interactions with DRV and/or the hydrogen-bonding network of the protease itself. While primary mutations are known to drive resistance in HIV-1 protease, these findings delineate the significant contributions of accessory mutations to resistance. Identifying the variable positions in the protease that have the greatest impact on drug resistance may aid in future structure-based design of inhibitors.

Solid-Liquid Interface Thermal Resistance Affects the Evaporation Rate of Droplets from a Surface: A Study of Perfluorohexane on Chromium Using Molecular Dynamics and Continuum Theory.

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Han, Haoxue; Schlawitschek, Christiane; Katyal, Naman; Stephan, Peter; Gambaryan-Roisman, Tatiana; Leroy, Frédéric; Müller-Plathe, Florian

2017-05-30

We study the role of solid-liquid interface thermal resistance (Kapitza resistance) on the evaporation rate of droplets on a heated surface by using a multiscale combination of molecular dynamics (MD) simulations and analytical continuum theory. We parametrize the nonbonded interaction potential between perfluorohexane (C 6 F 14 ) and a face-centered-cubic solid surface to reproduce the experimental wetting behavior of C 6 F 14 on black chromium through the solid-liquid work of adhesion (quantity directly related to the wetting angle). The thermal conductances between C 6 F 14 and (100) and (111) solid substrates are evaluated by a nonequilibrium molecular dynamics approach for a liquid pressure lower than 2 MPa. Finally, we examine the influence of the Kapitza resistance on evaporation of droplets in the vicinity of a three-phase contact line with continuum theory, where the thermal resistance of liquid layer is comparable with the Kapitza resistance. We determine the thermodynamic conditions under which the Kapitza resistance plays an important role in correctly predicting the evaporation heat flux.

Exercise order affects the total training volume and the ratings of perceived exertion in response to a super-set resistance training session

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Balsamo S

2012-02-01

Full Text Available Sandor Balsamo1–3, Ramires Alsamir Tibana1,2,4, Dahan da Cunha Nascimento1,2, Gleyverton Landim de Farias1,2, Zeno Petruccelli1,2, Frederico dos Santos de Santana1,2, Otávio Vanni Martins1,2, Fernando de Aguiar1,2, Guilherme Borges Pereira4, Jéssica Cardoso de Souza4, Jonato Prestes41Department of Physical Education, Centro Universitário UNIEURO, Brasília, 2GEPEEFS (Resistance training and Health Research Group, Brasília/DF, 3Graduate Program in Medical Sciences, School of Medicine, Universidade de Brasília (UnB, Brasília, 4Graduation Program in Physical Education, Catholic University of Brasilia (UCB, Brasília/DF, BrazilAbstract: The super-set is a widely used resistance training method consisting of exercises for agonist and antagonist muscles with limited or no rest interval between them – for example, bench press followed by bent-over rows. In this sense, the aim of the present study was to compare the effects of different super-set exercise sequences on the total training volume. A secondary aim was to evaluate the ratings of perceived exertion and fatigue index in response to different exercise order. On separate testing days, twelve resistance-trained men, aged 23.0 ± 4.3 years, height 174.8 ± 6.75 cm, body mass 77.8 ± 13.27 kg, body fat 12.0% ± 4.7%, were submitted to a super-set method by using two different exercise orders: quadriceps (leg extension + hamstrings (leg curl (QH or hamstrings (leg curl + quadriceps (leg extension (HQ. Sessions consisted of three sets with a ten-repetition maximum load with 90 seconds rest between sets. Results revealed that the total training volume was higher for the HQ exercise order (P = 0.02 with lower perceived exertion than the inverse order (P = 0.04. These results suggest that HQ exercise order involving lower limbs may benefit practitioners interested in reaching a higher total training volume with lower ratings of perceived exertion compared with the leg extension plus leg curl

Adding Postal Follow-Up to a Web-Based Survey of Primary Care and Gastroenterology Clinic Physician Chiefs Improved Response Rates but not Response Quality or Representativeness.

Science.gov (United States)

Partin, Melissa R; Powell, Adam A; Burgess, Diana J; Haggstrom, David A; Gravely, Amy A; Halek, Krysten; Bangerter, Ann; Shaukat, Aasma; Nelson, David B

2015-09-01

This study assessed whether postal follow-up to a web-based physician survey improves response rates, response quality, and representativeness. We recruited primary care and gastroenterology chiefs at 125 Veterans Affairs medical facilities to complete a 10-min web-based survey on colorectal cancer screening and diagnostic practices in 2010. We compared response rates, response errors, and representativeness in the primary care and gastroenterology samples before and after adding postal follow-up. Adding postal follow-up increased response rates by 20-25 percentage points; markedly greater increases than predicted from a third e-mail reminder. In the gastroenterology sample, the mean number of response errors made by web responders (0.25) was significantly smaller than the mean number made by postal responders (2.18), and web responders provided significantly longer responses to open-ended questions. There were no significant differences in these outcomes in the primary care sample. Adequate representativeness was achieved before postal follow-up in both samples, as indicated by the lack of significant differences between web responders and the recruitment population on facility characteristics. We conclude adding postal follow-up to this web-based physician leader survey improved response rates but not response quality or representativeness. © The Author(s) 2013.

The radiological spectrum of pulmonary multidrug-resistant tuberculosis: in HIV-Negative patients

International Nuclear Information System (INIS)

Zahirifard, S.; Amiri, M.V.; Bakhshayesh Karam, M.; Mirsaeidi, S.M.; Ehsanpour, A.; Masjedi, M.R.

2003-01-01

Background: Multidrug-resistant tuberculosis is a major worldwide health problem. In countries where tuberculosis is of moderate to high prevalence, the issue of Multidrug-resistant tuberculosis carries significant importance. Multidrug-resistant tuberculosis, similar to drug-sensitive tuberculosis, is contagious. Meanwhile its treatment is not only more difficult but also more expensive with lower success rates. Regarding clinical findings, there is no significant difference between Multidrug-resistant tuberculosis and drug-sensitive tuberculosis. Therefore determination of characteristic radiological findings in cases of Multidrug-resistant tuberculosis might be of help in early detection, and hence appropriate management of this disease condition. Objective: To explain the radiological spectrum of pulmonary Multidrug-resistant tuberculosis. Patients and methods: We retrospectively evaluated the radiographic images of 35 patients with clinically-and microbiologically- proven Multidrug-resistant tuberculosis admitted to our tertiary-care tuberculosis unit over a period of 13 months. The latest chest x-ray of all patients and the conventional chest CT scan without contrast of 15 patients were reviewed by three expert radiologists who rendered consensus opinion. Results: Of the 35 patients with imaging studies, 23 (66%) were male and 12 (34%) were female. The mean±SD age of participants was 38.2±17.3 (range: 16-20) years. 33 patients were known as secondary and only 2 had primary Multidrug-resistant tuberculosis. Chest radiography revealed cavitary lesion in 80% pulmonary infiltration in 89% and nodules in 80% of the cases. Pleurisy was the rarest finding observed in only 5 (14%) patients. All of 15 chest CT scans revealed cavitation, 93% of which were bilateral and multiple. Pleural involvement was seen in 93% of patients. Conclusion: Presence of multiple cavities, especially in both lungs, nodular and infiltrative lesions, and pleural effusion are main features

Resistance of Four Canola Genotypes Against Cabbage Aphid Brevicoryne brassicae (L.

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S.H. MousaviAnzabi

2017-12-01

Full Text Available Introduction: Canola (Brassica napus L. is one of the prominent oil seed plants in Iran. This plant has good agricultural and food nourishment properties, such as resistant to drought, cold and salinity stresses and low level of cholesterol. Cabbage waxy aphid Brevicorynebrassicae (L. is the most important and cosmopolitan pest of cruciferous crops. This aphid is reduced 9 to 77% grain yields and up to 11% oil content. Developing environmental-friendly methods, such as deploying insect-resistant varieties to pest control was advised by scientists. Resistant varieties decrease production costs and can be integrated with other pest control policies in IPM programs. In a greenhouse experiment plants of cabbage, cauliflower wassusceptible host plant and broccoli, turnip, rapeseed, showed resistance to cabbage aphid. With the aim of identifying the existence of resistance resources, a laboratory study was conducted to evaluate the effects of seven canola genotypes on biological parameters of cabbage aphid. Detected resistant variety could be used as a resistance source. Material and Methods: In order to resistancy evaluation of canola, genotypes contain “RGS”,“Hyola-308”,“Hyola-401” and “Sarigol” to cabbage aphid, two experiments was conducted under field and greenhouse conditions in Kahriz region of West Azerbaijan province in 2010.In this study infestation index and tolerance in Field conditions and antibiosis study in greenhouse conditions was evaluated.To study antibiosis, genotypes were planted in pots with 10 replications based on completely random design and cabbage aphid population intrinsic rate of increase (rm was calculated. As followed: (Lotka 1924: 1= other population parameters computed by Carey (1993 method. Field experiment contains10 replications wereperformed based on complete randomized blocks experimental designs that five of them were under natural infestation and five others, free of infestation (control. To

Assessing primary care in Austria: room for improvement.

Science.gov (United States)

Stigler, Florian L; Starfield, Barbara; Sprenger, Martin; Salzer, Helmut J F; Campbell, Stephen M

2013-04-01

There is emerging evidence that strong primary care achieves better health at lower costs. Although primary care can be measured, in many countries, including Austria, there is little understanding of primary care development. Assessing the primary care development in Austria. A primary care assessment tool developed by Barbara Starfield in 1998 was implemented in Austria. This tool defines 15 primary care characteristics and distinguishes between system and practice characteristics. Each characteristic was evaluated by six Austrian primary care experts and rated as 2 (high), 1 (intermediate) or 0 (low) points, respectively, to their primary care strength (maximum score: n = 30). Austria received 7 out of 30 points; no characteristic was rated as '2' but 8 were rated as '0'. Compared with the 13 previously assessed countries, Austria ranks 10th of 14 countries and is classified as a 'low primary care' country. This study provides the first evidence concerning primary care in Austria, benchmarking it as weak and in need of development. The practicable application of an existing assessment tool can be encouraging for other countries to generate evidence about their primary care system as well.

Measuring Resistance to Change at the Within-Session Level

Science.gov (United States)

Tonneau, Francois; Rios, Americo; Cabrera, Felipe

2006-01-01

Resistance to change is often studied by measuring response rate in various components of a multiple schedule. Response rate in each component is normalized (that is, divided by its baseline level) and then log-transformed. Differential resistance to change is demonstrated if the normalized, log-transformed response rate in one component decreases…

Does the volume of supplemental intraligamentary injections affect the anaesthetic success rate after a failed primary inferior alveolar nerve block? A randomized-double blind clinical trial.

Science.gov (United States)

Aggarwal, V; Singla, M; Miglani, S; Kohli, S; Sharma, V; Bhasin, S S

2018-01-01

To investigate the efficacy of 0.2 mL vs. 0.6 mL of 2% lidocaine when given as a supplementary intraligamentary injection after a failed inferior alveolar nerve block (IANB). Ninety-seven adult patients with symptomatic irreversible pulpits received an IANB and root canal treatment was initiated. Pain during treatment was recorded using a visual analogue scale (Heft-Parker VAS). Patients with unsuccessful anaesthesia (n = 78) randomly received intraligamentary injection of either 0.2 mL or 0.6 mL of 2% lidocaine with 1 : 80 000 epinephrine. Root canal treatment was reinitiated. Success after primary injection or supplementary injection was defined as no or mild pain (HP VAS score ≤54 mm) during access preparation and root canal instrumentation. Heart rate was monitored using a finger pulse oximeter. The anaesthetic success rates were analysed with Pearson chi-square test at 5% significance levels. The heart rate changes were analysed using t-tests. The intraligamentary injections with 0.2 mL solution gave an anaesthetic success rate of 64%, whilst the 0.6 mL was successful in 84% of cases with failed primary IANB. (χ 2  = 4.3, P = 0.03). There was no significant effect of the volume of intraligamentary injection on the change in heart rate. Increasing the volume of intraligamentary injection improved the success rates after a failed primary anaesthetic injection. © 2017 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Evolutionary ARMS Race: Antimalarial Resistance Molecular Surveillance.

Science.gov (United States)

Prosser, Christiane; Meyer, Wieland; Ellis, John; Lee, Rogan

2018-04-01

Molecular surveillance of antimalarial drug resistance markers has become an important part of resistance detection and containment. In the current climate of multidrug resistance, including resistance to the global front-line drug artemisinin, there is a consensus to upscale molecular surveillance. The most salient limitation to current surveillance efforts is that skill and infrastructure requirements preclude many regions. This includes sub-Saharan Africa, where Plasmodium falciparum is responsible for most of the global malaria disease burden. New molecular and data technologies have emerged with an emphasis on accessibility. These may allow surveillance to be conducted in broad settings where it is most needed, including at the primary healthcare level in endemic countries, and extending to the village health worker. Copyright © 2018 Elsevier Ltd. All rights reserved.

High dose rate intraoperative radiation therapy (HDR-IORT) as part of the management strategy for locally advanced primary and recurrent rectal cancer

International Nuclear Information System (INIS)

Harrison, Louis B.; Minsky, Bruce D.; Enker, Warren E.; Mychalczak, Borys; Guillem, Jose; Paty, Philip B.; Anderson, Lowell; White, Carol; Cohen, Alfred M.

1998-01-01

Purpose: Primary unresectable and locally advanced recurrent rectal cancer presents a significant clinical challenge. Local failure rates are high in both situations. Under such circumstances, there is a significant need to safely deliver tumoricidal doses of radiation in an attempt to improve local control. For this reason, we have incorporated a new approach utilizing high dose rate intraoperative radiation therapy (HDR-IORT). Methods and Materials: Between 11/92-12/96, a total of 112 patients were explored, of which 68 patients were treated with HDR-IORT, and 66 are evaluable. The majority of the 44 patients were excluded for unresectable disease or for distant metastases which eluded preoperative imaging. There were 22 patients with primary unresectable disease, and 46 patients who presented with recurrent disease. The histology was adenocarcinoma in 64 patients, and squamous cell carcinoma in four patients. In general, the patients with primary unresectable disease received preoperative chemotherapy with 5-fluorouracil (5-FU) and leucovorin, and external beam irradiation to 4500-5040 cGy, followed by surgical resection and HDR-IORT (1000-2000 cGy). In general , the patients with recurrent disease were treated with surgical resection and HDR-IORT (1000-2000 cGy) alone. All surgical procedures were done in a dedicated operating room in the brachytherapy suite, so that HDR-IORT could be delivered using the Harrison-Anderson-Mick (HAM) applicator. The median follow-up is 17.5 months (1-48 mo). Results: In primary cases, the actuarial 2-year local control is 81%. For patients with negative margins, the local control was 92% vs. 38% for those with positive margins (p = 0.002). The 2-year actuarial disease-free survival was 69%; 77% for patients with negative margins vs. 38% for patients with positive margins (p = 0.03). For patients with recurrent disease, the 2-year actuarial local control rate was 63%. For patients with negative margins, it was 82%, while it was

Functional cooperation between HIF-1α and c-Jun in mediating primary and acquired resistance to gefitinib in NSCLC cells with activating mutation of EGFR.

Science.gov (United States)

Meng, Shuyan; Wang, Guorui; Lu, Yang; Fan, Zhen

2018-07-01

Hypoxia-inducible factor 1 (HIF-1) and activator protein 1 (AP-1) are important transcription factors regulating expression of genes involved in cell survival. HIF-1α and c-Jun are key components of HIF-1 and AP-1, respectively, and are regulated by epidermal growth factor receptor (EGFR)-mediated cell signaling and tumor microenvironmental cues. The roles of HIF-1α and c-Jun in development of resistance to EGFR tyrosine kinase inhibitor (TKI) in non-small cell lung cancer (NSCLC) with activating mutation of EGFR have not been explored. In this study, we investigated the roles of HIF-1α and c-Jun in mediating primary and acquired resistance to gefitinib in NSCLC cells with activating mutation of EGFR. Changes in HIF-1α protein and in total and phosphorylated c-Jun levels in relation to changes in total and phosphorylated EGFR levels before and after gefitinib treatment were measured using Western blot analysis in NSCLC cells sensitive or resistant to gefitinib. The impact of overexpression of a constitutively expressed HIF-1α (HIF-1α/ΔODD) or a constitutively active c-Jun upstream regulator (SEK1 S220E/T224D mutant) on cell response to gefitinib was also examined. The effect of pharmacological inhibition of SEK1-JNK-c-Jun pathway on cell response to gefitinib was evaluated. Downregulation of HIF-1α and total and phosphorylated c-Jun levels correlated with cell inhibitory response to gefitinib better than decrease in phosphorylated EGFR did in NSCLC cells with intrinsic or acquired resistance to gefitinib. Overexpression of HIF-1α/ΔODD or SEK1 S220E/T224D mutant conferred resistance to gefitinib. There exists a positive feed-forward regulation loop between HIF-1 and c-Jun. The JNK inhibitor SP600125 sensitized gefitinib-resistant NSCLC cells to gefitinib. HIF-1α and c-Jun functionally cooperate in development of resistance to gefitinib in NSCLC cells. The translational value of inhibiting HIF-1α/c-Jun cooperation in overcoming resistance to EGFR TKI

Materials Reliability Program Resistance to Primary Water Stress Corrosion Cracking of Alloys 690, 52, and 152 in Pressurized Water Reactors (MRP-111)

Energy Technology Data Exchange (ETDEWEB)

Xu, H. [Framatome ANP, Inc., Lynchburg, VA (United States); Fyfitch, S. [Framatome ANP, Inc., Lynchburg, VA (United States); Scott, P. [Framatome ANP, SAS, Paris (France); Foucault, M. [Framatome ANP, SAS, Le Creusot (France); Kilian, R. [Framatome ANP, GmbH, Erlangen (Germany); Winters, M. [Framatome ANP, GmbH, Erlangen (Germany)

2004-03-01

Over the last thirty years, stress corrosion cracking in PWR primary water (PWSCC) has been observed in numerous Alloy 600 component items and associated welds, sometimes after relatively long incubation times. Repairs and replacements have generally utilized wrought Alloy 690 material and its compatible weld metals (Alloy 152 and Alloy 52), which have been shown to be very highly resistant to PWSCC in laboratory experiments and have been free from cracking in operating reactors over periods already up to nearly 15 years. It is nevertheless prudent for the PWR industry to attempt to quantify the longevity of these materials with respect to aging degradation by corrosion in order to provide a sound technical basis for the development of future inspection requirements for repaired or replaced component items. This document first reviews numerous laboratory tests, conducted over the last two decades, that were performed with wrought Alloy 690 and Alloy 52 or Alloy 152 weld materials under various test conditions pertinent to corrosion resistance in PWR environments. The main focus of the present review is on PWSCC, but secondary-side conditions are also briefly considered.

Materials Reliability Program Resistance to Primary Water Stress Corrosion Cracking of Alloys 690, 52, and 152 in Pressurized Water Reactors (MRP-111)

International Nuclear Information System (INIS)

Xu, H.; Fyfitch, S.; Scott, P.; Foucault, M.; Kilian, R.; Winters, M.

2004-01-01

Over the last thirty years, stress corrosion cracking in PWR primary water (PWSCC) has been observed in numerous Alloy 600 component items and associated welds, sometimes after relatively long incubation times. Repairs and replacements have generally utilized wrought Alloy 690 material and its compatible weld metals (Alloy 152 and Alloy 52), which have been shown to be very highly resistant to PWSCC in laboratory experiments and have been free from cracking in operating reactors over periods already up to nearly 15 years. It is nevertheless prudent for the PWR industry to attempt to quantify the longevity of these materials with respect to aging degradation by corrosion in order to provide a sound technical basis for the development of future inspection requirements for repaired or replaced component items. This document first reviews numerous laboratory tests, conducted over the last two decades, that were performed with wrought Alloy 690 and Alloy 52 or Alloy 152 weld materials under various test conditions pertinent to corrosion resistance in PWR environments. The main focus of the present review is on PWSCC, but secondary-side conditions are also briefly considered

Lytic phages obscure the cost of antibiotic resistance in Escherichia coli.

Science.gov (United States)

Tazzyman, Samuel J; Hall, Alex R

2015-03-17

The long-term persistence of antibiotic-resistant bacteria depends on their fitness relative to other genotypes in the absence of drugs. Outside the laboratory, viruses that parasitize bacteria (phages) are ubiquitous, but costs of antibiotic resistance are typically studied in phage-free experimental conditions. We used a mathematical model and experiments with Escherichia coli to show that lytic phages strongly affect the incidence of antibiotic resistance in drug-free conditions. Under phage parasitism, the likelihood that antibiotic-resistant genetic backgrounds spread depends on their initial frequency, mutation rate and intrinsic growth rate relative to drug-susceptible genotypes, because these parameters determine relative rates of phage-resistance evolution on different genetic backgrounds. Moreover, the average cost of antibiotic resistance in terms of intrinsic growth in the antibiotic-free experimental environment was small relative to the benefits of an increased mutation rate in the presence of phages. This is consistent with our theoretical work indicating that, under phage selection, typical costs of antibiotic resistance can be outweighed by realistic increases in mutability if drug resistance and hypermutability are genetically linked, as is frequently observed in clinical isolates. This suggests the long-term distribution of antibiotic resistance depends on the relative rates at which different lineages adapt to other types of selection, which in the case of phage parasitism is probably extremely common, as well as costs of resistance inferred by classical in vitro methods.

Standard practice for slow strain rate testing to evaluate the susceptibility of metallic materials to environmentally assisted cracking

CERN Document Server

American Society for Testing and Materials. Philadelphia

2000-01-01

1.1 This practice covers procedures for the design, preparation, and use of axially loaded, tension test specimens and fatigue pre-cracked (fracture mechanics) specimens for use in slow strain rate (SSR) tests to investigate the resistance of metallic materials to environmentally assisted cracking (EAC). While some investigators utilize SSR test techniques in combination with cyclic or fatigue loading, no attempt has been made to incorporate such techniques into this practice. 1.2 Slow strain rate testing is applicable to the evaluation of a wide variety of metallic materials in test environments which simulate aqueous, nonaqueous, and gaseous service environments over a wide range of temperatures and pressures that may cause EAC of susceptible materials. 1.3 The primary use of this practice is to furnish accepted procedures for the accelerated testing of the resistance of metallic materials to EAC under various environmental conditions. In many cases, the initiation of EAC is accelerated through the applic...

Carbon Costs of Constitutive and Expressed Resistance to a Non-Native Pathogen in Limber Pine.

Directory of Open Access Journals (Sweden)

Patrick J Vogan

Full Text Available Increasing the frequency of resistance to the non-native fungus Cronartium ribicola (causative agent of white pine blister rust, WPBR in limber pine populations is a primary management objective to sustain high-elevation forest communities. However, it is not known to what extent genetic disease resistance is costly to plant growth or carbon economy. In this study, we measured growth and leaf-level physiology in (1 seedling families from seed trees that have previously been inferred to carry or not carry Cr4, the dominant R gene allele conferring complete, gene-for-gene resistance to WPBR in limber pine, and (2 populations that were and were not infected with C. ribicola. We found that, in the absence of C. ribicola exposure, there was no significant difference in carbon relations between families born from seed trees that harbor the resistance allele compared to those that lack it, either to plant growth and phenology or leaf-level photosynthetic traits. However, post-infection with C. ribicola, growth was significantly reduced in inoculation survivors expressing complete resistance compared to uninoculated seedlings. Furthermore, inoculation survivors exhibited significant increases in a suite of traits including photosynthetic rate, respiration rate, leaf N, and stomatal conductance and a decrease in photosynthetic water-use efficiency. The lack of constitutive carbon costs associated with Cr4 resistance in non-stressed limber pine is consistent with a previous report that the R gene allele is not under selection in the absence of C. ribicola and suggests that host resistance may not bear a constitutive cost in pathosystems that have not coevolved. However, under challenge by C. ribicola, complete resistance to WPBR in limber pine has a significant cost to plant growth, though enhanced carbon acquisition post-infection may offset this somewhat. These costs and effects on performance further complicate predictions of this species' response in

Heterogeneity in induced thermal resistance of rat tumor cell clones

International Nuclear Information System (INIS)

Tomasovic, S.P.; Rosenblatt, P.L.; Heitzman, D.

1983-01-01

Four 13762NF rat mammary adenocarcinoma clones were examined for their survival response to heating under conditions that induced transient thermal resistance (thermotolerance). Clones MTC and MTF7 were isolated from the subcutaneous locally growing tumor, whereas clones MTLn2 and MTLn3 were derived from spontaneous lung metastases. There was heterogeneity among these clones in thermotolerance induced by either fractionated 45 0 C or continuous 42 0 C heating, but the order of sensitivity was not necessarily the same. The clones developed thermal resistance at different rates and to different degrees within the same time intervals. There was heterogeneity between clones isolated from within either the primary site or metastatic lesions. However, clones derived from metastatic foci did not intrinsically acquire more or less thermotolerance to fractionated 45 0 C or continuous 42 0 C heating than did clones from the primary tumor. Further, there was no apparent relationship between any phenotypic properties that conferred more or less thermotolerance in vitro and any phenotypic properties that conferred enhanced metastatic success of these same clones by spontaneous (subcutaneous) or experimental (intravenous) routes in vivo. These tumor clones also differ in their karyotype, metastatic potential, cell surface features, sensitivity to x-irradiation and drugs, and ability to repair sublethal radiation damage. These results provide further credence to the concept that inherent heterogeneity within tumors may be as important in therapeutic success as other known modifiers of outcome such as site and treatment heterogeneity

Calcineurin Inhibitors in the Treatment of Primary Focal Segmental Glomerulosclerosis

Directory of Open Access Journals (Sweden)

Louis-Philippe Laurin

2017-02-01

Full Text Available Purpose of review: Primary focal segmental glomerulosclerosis (FSGS is the most common cause of nephrotic syndrome in adults. Glucocorticoids have been evaluated in the treatment of primary FSGS in numerous retrospective studies. Evidence suggesting a role for including calcineurin inhibitors (CNIs in early therapy remains limited. The aim of this study was to systematically review the literature examining the efficacy of CNIs in the treatment of primary FSGS both as first-line therapy and as an adjunctive agent in steroid-resistant patients, with respect to remission in proteinuria and renal survival. Sources of information: PubMed and EMBASE were searched from inception to August 2014 for prospective controlled trials, and case-control and cohort studies. Findings: After systematically applying our inclusion criteria, a total of 152 titles and abstracts were identified. Six randomized controlled trials and 2 cohort studies were reviewed. Three randomized controlled trials compared CNIs with placebo or supportive therapy. The pooled relative “risk” of proteinuria remission associated with cyclosporine was 7.0 (95% confidence interval, 2.9-16.8 compared with placebo/supportive therapy. There was very low heterogeneity among these studies with an I -squared of 0%. Three studies compared CNIs with another immunosuppressive agent. All prospective trials were conducted in patients with primary FSGS deemed steroid-resistant. Limitations: The relatively small number of included studies and their heterogeneity with respect to treatment protocols, and possible publication bias, limit conclusions drawn from this systematic review. Implications: The efficacy of CNIs has been evaluated in steroid-resistant primary FSGS patients. There is no evidence supporting their role as first-line therapy. Further studies are needed to determine this role.