WorldWideScience

Sample records for psychological refractory period

  1. Determinants of central processing order in psychological refractory period paradigms: central arrival times, detection times, or preparation?

    Science.gov (United States)

    Leonhard, Tanja

    2011-10-01

    Three psychological refractory period (PRP) experiments were conducted to assess the effect of central arrival times at the bottleneck on task order scheduling. In Experiment 1, a visual first task (plus-minus symbol discrimination) was combined with an auditory second task (left-right tone judgement) in a standard PRP paradigm with constant task order. In Experiment 2, the order of the tasks varied unpredictably. In Experiment 3, visual-auditory dual-task trials were randomly mixed with single-task trials. To dissociate central arrival times from stimulus detection times, the perceptual stage of the visual task was extended using stimulus degradation. Most importantly, no evidence for a first-come, first-served principle at the central bottleneck was found with the employed paradigms. Instead, the results indicated that preparation (Experiment 1) and the detection times of the stimuli (Experiments 2 and 3) were the main determinants of central processing order in the present study. In the light of previous research, the results indicate that central processing order can be influenced by various factors. The interplay between these factors seems to depend highly on the conditions and requirements of the employed experimental paradigm.

  2. When underadditivity of factor effects in the Psychological Refractory Period paradigm implies a bottleneck: evidence from psycholinguistics.

    Science.gov (United States)

    Besner, Derek; Reynolds, Mike; O'Malley, Shannon

    2009-11-01

    The Psychological Refractory Period (PRP) paradigm is a dual-task procedure that can be used to examine the resource demands of specific cognitive processes. Inferences about the underlying processes are typically based on performance in the second of two speeded tasks. If the effect of a factor manipulated in Task 2 decreases as the stimulus onset asynchrony (SOA) between tasks decreases (underadditivity), the normative inference is that the effect of this factor occurs prior to a limited-capacity central processing mechanism. In contrast, if the effect of a factor is additive with SOA then the inference is that this indexes a process that either uses a limited-capacity central processing mechanism or occurs after some process that uses this mechanism. A heretofore unidentified exception to this logic arises when Task 2 involves two separate processes that operate in parallel, but compete. Interference with one process in Task 2 because of work on Task 1 will eliminate or reduce competition within Task 2 and is hence manifest as an underadditive interaction with decreasing SOA. This is illustrated here by reference to a PRP experiment in which the ubiquitous effect of spelling-to-sound regularity on reading aloud time is eliminated at a short SOA and by consideration of three converging lines of investigation in the PRP paradigm when Task 2 involves reading aloud.

  3. Bypassing the central bottleneck after single-task practice in the psychological refractory period paradigm: evidence for task automatization and greedy resource recruitment.

    Science.gov (United States)

    Maquestiaux, François; Laguë-Beauvais, Maude; Ruthruff, Eric; Bherer, Louis

    2008-10-01

    In this research, the controversial issue of whether the central bottleneck can be bypassed through task automatization was investigated. To examine this issue, participants received six single-task practice sessions with an auditory-vocal task (low vs. high pitch). We then assessed dual-task performance using the analytically tractable psychological refractory period (PRP) paradigm, in which the highly practiced auditory-vocal task was presented as Task 2, along with an unpracticed visual-manual Task 1. The results provide evidence of bottleneck bypass for virtually all the participants (17 out of 20). Several converging tests suggest that the bottleneck reemerged, however, in a follow-up experiment with tasks presented in the opposite order (auditory-vocal Task 1 and visual-manual Task 2). One possible explanation is that tasks greedily recruit central resources when available, even though they can operate without central resources when unavailable.

  4. A comparison of the psychological refractory period and prioritized processing paradigms: Can the response-selection bottleneck model explain them both?

    Science.gov (United States)

    Miller, Jeff; Durst, Moritz

    2015-10-01

    Four experiments examined whether well-established phenomena from the psychological refractory period (PRP) paradigm are also observed in the prioritized processing paradigm, as would be expected from a common description of the 2 paradigms with the response selection bottleneck (RSB) model. Consistent with a generalization of the RSB model to the prioritized processing paradigm, Experiments 1 and 2 showed that this paradigm yields effects of SOA and stimulus discriminability analogous to those observed in the PRP paradigm. In Experiments 3 and 4, however, overall RTs and effect sizes differed between the PRP and prioritized processing paradigms in ways that are difficult to explain within the RSB model. Understanding the differences between these 2 paradigms offers considerable promise as a way to extend the RSB model beyond the domain of the PRP paradigm and to generalize our understanding of multitasking interference. (c) 2015 APA, all rights reserved).

  5. A mechanical refractory period of chondrocytes after dynamic hydrostatic pressure.

    Science.gov (United States)

    Cao, Xu; Xia, Hansong; Li, Na; Xiong, Kun; Wang, Zili; Wu, Song

    2015-06-01

    Mechanical stimulation, a crucial factor for maintaining the cartilaginous phenotype and promoting the chondrogenesis, has been widely used in autologous chondrocyte transplantation. This study was designed to investigate a novel concept of mechanical refractory period of chondrocytes after dynamic hydrostatic pressure (dHP). dHP protocols (0.1 Hz, 2 MPa) were applied. The variation in type II collagen (Col II) expression induced by each dHP unit was measured. The dynamic remodeling of F-actin during the mechanical protocols was observed morphologically and mechanically by laser confocal microscopy and optical magnetic twisting cytometry (OMTC), respectively. About 20 ng/ml VEGF was used to stabilize the F-actin and restrain the mechanical refractory period. Compared with the remarkable increase of Col II (16-fold) induced by the initial dHP unit, the chondrocytes entered a mechanical refractory period and the second unit hardly elevated Col II expression (only 2.9-fold). This refractory period recovered partially within 2 h. The uniform, parallel, and coarse fibers of F-actin before dHP became thin, sparse, and disordered, and the cell stiffness decreased concomitantly. The variations in both the morphology and the mechanical property of F-actin were highly synchronous to the mechanical refractory period and recovered in a time-dependent manner. VEGF postponed the appearance of this refractory period and maintained the high expression of Col II by VEGF/p38/MAPKAPK-2/LIMK/cofilin pathway. A mechanical refractory period of chondrocytes has been discovered and defined in this study. The F-actin depolymerization is the putative mechanism, and this refractory period can be postponed by VEGF-induced F-actin stabilization.

  6. Effect of acute subendocardial ischemia on ventricular refractory periods.

    Science.gov (United States)

    Ma, Longle; Wang, Lexin

    2007-01-01

    To investigate the impact of acute subendocardial ischemia on the dispersion of ventricular refractory periods. Acute subendocardial ischemia was induced in sheep by partial ligation of the left circumflex coronary artery and rapid pacing of the left atrium. The ventricular effective refractory period (ERP) was measured in five areas of the left ventricle by a programmed premature stimulation technique. The average ERP and ERP dispersion remained unchanged in the control group (n=5, P>0.05). In the study group (n=5), the ERP was shortened following subendocardial ischemia. ERP dispersion decreased significantly from 48+/-9 ms to 36+/-13 ms 30 min after the ischemia (P=0.02). There was neither spontaneous nor stimulation-induced ventricular arrhythmia after ischemia. Acute subendocardial ischemia leads to a homogenous reduction of ventricular ERP. This may partially explain why subendocardial ischemia is associated with a low incidence of ventricular arrhythmia.

  7. Asynchronous presynaptic glutamate release enhances neuronal excitability during the post-spike refractory period.

    Science.gov (United States)

    Iremonger, Karl J; Bains, Jaideep S

    2016-02-15

    Many excitatory synapses in the brain release glutamate with both synchronous and asynchronous components. Immediately following an action potential, neurons display a reduced excitability due to the post-spike afterhyperpolarization (AHP). This gives rise to a relative refractory period. When an action potential is evoked by glutamate synaptic input possessing asynchronous release, the delayed glutamate release events act to depolarize the neuron during the AHP and overcome the relative refractory period. These results demonstrate a new role for asynchronous release in regulating post-spike excitability and the relative refractory period in central neurons. Post-spike afterhyperpolarizations (AHPs) functionally inhibit neuronal excitability for tens to hundreds of milliseconds following each action potential. This imposes a relative refractory period during which synaptic excitation is less effective at evoking spikes. Here we asked whether some synapses have mechanisms in place that allow them to overcome the AHP and drive spiking in target cells during this period of reduced excitability. We examined glutamate synapses onto oxytocin and vasopressin neurons in the paraventricular nucleus of the hypothalamus. These synapses can display pronounced asynchronous glutamate release following a single presynaptic spike, with the time course of release being similar to that of the post-spike AHP. To test whether asynchronous release is more effective at overcoming the relative refractory period, we evoked a single action potential with either a brief synchronous depolarization or an asynchronous potential and then assessed excitability at multiple time points following the spike. Neurons receiving asynchronous depolarizing synaptic inputs had a shorter relative refractory period than those receiving synchronous depolarizations. Our data demonstrate that synapses releasing glutamate in an asynchronous and delayed manner are ideally adapted to counter the AHP. By

  8. Role of refractory period in homoclinic models of neural synchronization.

    Science.gov (United States)

    Montina, A; Mendoza, C; Arecchi, F T

    2007-04-01

    We study the properties of a homoclinic model of neuron by introducing a suitable one-dimensional map. We show that the system is characterized by a response time to external signals which is a decreasing function of the signal strength, in contrast to excitable models whose response time is signal-independent. In a one-dimensional array of these systems with bidirectional coupling, we observe a sudden transition to a synchronized state at a certain value of the coupling strength. The transition occurs when the response time of a site to the signals of the adjacent sites is of the order of refractory time. Near the transition, we find an intermittent behavior due to the competition between a turbulent and a synchronized state. The observed behavior distinguishes homoclinic systems from excitable systems.

  9. Postrepolarization refractoriness in acute ischemia and after antiarrhythmic drug administration: Action potential duration is not always an index of the refractory period

    NARCIS (Netherlands)

    Coronel, Ruben; Janse, Michiel J.; Opthof, Tobias; Wilde, Arthur A.; Taggart, Peter

    2012-01-01

    Action potential duration is widely used as a measure of refractory period in ischemia. Although the end of repolarization closely corresponds to the end of refractoriness in the well-perfused, well-oxygenated myocardium, it is no longer true for the ischemic myocardium, in which the recovery of

  10. Neuropsychological and psychological rehabilitation interventions in refractory sport-related post-concussive syndrome.

    Science.gov (United States)

    Conder, Robert; Conder, Alanna Adler

    2015-01-01

    The neuropsychological, physical, vestibular and oculomotor sequelae of sports-related concussion are extremely well documented. However, there is a paucity of interventions for these symptoms in refractory sports-related concussions. The intent of this article is to review the known and emerging neuropsychological and psychological rehabilitation interventions for reducing morbidity in refractory sports-related concussions (SRCs). The authors openly acknowledge the limited amount of empirical data available for review, as did the Zurich consensus papers, but posit a mindful and ethical approach towards rehabilitation interventions in the absence of evidence-based guidelines. Further, rehabilitation interventions proven useful with similar injuries or illnesses, particularly non-sports-related mild TBI, will be reviewed for applicability. Such interventions include Cognitive-Behavioural psychotherapy, biofeedback, cranial electrical stimulation, neurofeedback and cognitive rehabilitation. Modified approaches for rehabilitation with young children within family and school systems are provided. Recommendations for further research are offered.

  11. Auditory and visual refractory period effects in children and adults: an ERP study.

    Science.gov (United States)

    Coch, Donna; Skendzel, Wendy; Neville, Helen J

    2005-09-01

    This developmental study was designed to investigate event-related potential (ERP) refractory period effects in the auditory and visual modalities in children and adults and to correlate these electrophysiological measures with standard behavioral measures. ERPs, accuracy, and reaction time were recorded as school-age children and adults monitored a stream of repetitive standard stimuli and detected occasional targets. Standards were presented at various interstimulus intervals (ISIs) in order to measure refractory period effects on early sensory components. As has been reported previously in adults, larger components for standards with longer ISIs were observed for an auditory N1 and the visual occipital P1 and P2 in adults. Remarkably similar effects were observed in children. However, only children showed refractory effects on the amplitude of the visual N1 and P2 measured at anterior sites. Across groups, behavioral accuracy and reaction time were correlated with latencies of auditory N1 and visual P2 across ISI conditions. The results establish a normal course of development for auditory and visual ERP refractory period effects across the 6- to 8-year-old age range and indicate similar refractoriness in the neural systems indexed by ERPs in these paradigms in typically developing children and adults. Further, the results suggest that electrophysiological measures and standard behavioral measures may at least in part index similar processing in the present paradigms. These findings provide a foundation for further investigation into atypical development, particularly in those populations for which processing time deficits have been implicated such as children with specific language impairment or dyslexia.

  12. Incorporating Refractory Period in Mechanical Stimulation Mitigates Obesity-Induced Adipose Tissue Dysfunction in Adult Mice.

    Science.gov (United States)

    Patel, Vihitaben S; Chan, M Ete; Pagnotti, Gabriel M; Frechette, Danielle M; Rubin, Janet; Rubin, Clinton T

    2017-10-01

    The aim of this study was to determine whether inclusion of a refractory period between bouts of low-magnitude mechanical stimulation (LMMS) can curb obesity-induced adipose tissue dysfunction and sequelae in adult mice. A diet-induced obesity model that included a diet with 45% of kilocalories from fat was employed with intention to treat. C57BL/6J mice were weight matched into four groups: low-fat diet (LFD, n = 8), high-fat diet (HFD, n = 8), HFD with one bout of 30-minute LMMS (HFDv, n = 9), and HFD with two bouts of 15-minute LMMS with a 5-hour separation (refractory period, RHFDv, n = 9). Two weeks of diet was followed by 6 weeks of diet plus LMMS. HFD and HFDv mice continued gaining body weight and visceral adiposity throughout the experiment, which was mitigated in RHFDv mice. Compared with LFD mice, HFD and HFDv mice had increased rates of adipocyte hypertrophy, increased immune cell infiltration (B cells, T cells, and macrophages) into adipose tissue, increased adipose tissue inflammation (tumor necrosis factor alpha gene expression), and a decreased proportion of mesenchymal stem cells in adipose tissue, all of which were rescued in RHFDv mice. Glucose intolerance and insulin resistance were elevated in HFD and HFDv mice, but not in RHFDv mice, as compared with LFD mice. Incorporating a 5-hour refractory period between bouts of LMMS attenuates obesity-induced adipose tissue dysfunction and improves glucose metabolism. © 2017 The Obesity Society.

  13. Five Alzheimer's disease cases with refractory behavioural psychological symptoms of dementia treated with blonanserin.

    Science.gov (United States)

    Hamuro, Atsushi; Saito, Satona

    2010-12-01

    The aim of the present study was to determine the efficacy, side-effects and tolerability of blonanserin for treating refractory behavioural psychological symptoms of dementia (BPSD). The present study was a 12-week, prospective, structured clinical trial of blonanserin for the treatment of BPSD. The degree of cognitive function, activities of daily living score, and the degree of BPSD were determined using the Mini-Mental State Examination (MMSE), Disability Assessment for Dementia (DAD), Neuropsychiatric Inventory (NPI) and the Rating Scale for Aggressive Behaviour in the Elderly (RAGE). The severity of extrapyramidal symptoms was assessed using the Drug-Induced Extrapyramidal Symptoms scale (DIEEPS). Five patients were enrolled. These patients met the NINCDS-ADRDA criteria. The patients were prescribed more than two kinds of existing antipsychotic drugs and were considered refractory cases; the drugs were discontinued because they were ineffectual and side-effects appeared. Each drug was prescribed independently for at least 2 weeks. The mean changes (at baseline and at the last week, respectively) in the MMSE (12.25, 9.25), in the DAD (6.5, 6.75), in the RAGE (5.5, 5.3) and in the DIEEPS (0.5, 1.5) were minimal. The mean changes in the NPI were two or fewer points. Some side-effects (one gait abnormality and one pneumonia) were observed. The results of this preliminary study show that blonanserin does not have adequate efficacy for the treatment of refractory BPSD. © 2010 The Authors. Psychogeriatrics © 2010 Japanese Psychogeriatric Society.

  14. [Efficacy observation of periodic fecal microbiota transplantation in the treatment of refractory constipation].

    Science.gov (United States)

    Zhang, Xuelei; Tian, Hongliang; Ma, Chunlian; Yang, Bo; Hua, Yue; Zhu, Yifan; Gu, Lili; Li, Ning

    2017-12-25

    To evaluate the efficacy of periodic fecal microbiota transplantation (FMT) for refractory constipation. Clinical data of 49 patients with refractory constipation undergoing FMT through standard transplantation path of nasojejunal tube between April 2015 and April 2016 in Intestinal Microenvironment Treatment Centre of Nanjing General Hospital were analyzed retrospectively. Of 49 patients, 25 received single FMT for only 6 days (single group), and 24 received periodic FMT with another 6 days FMT 1 month after the first 6 days FMT (periodic group). The follow up was at 12 weeks after treatment. Autonomous defecation frequency, Wexner constipation score, gastrointestinal quality of life index and related adverse reaction were evaluated and compared at 4-, 8- and 12-week after treatment. Statistical analysis was performed on the difference after treatment at each time point, and the greater difference indicated the better improvement. There were no statistically significant differences in general characteristics between the two groups (all P0.05). Compared with before FMT treatment, the autonomous defecation frequency, Wexner constipation score, gastrointestinal quality of life index were obviously improved at the 4-, 8-, 12-week (all P=0.000). At the 4-week after FMT treatment, the improvement degree of autonomous defecation frequency, Wexner constipation score, gastrointestinal quality of life index was compared between two groups, and no statistically significant differences were found (all P>0.05). While at 8-week and 12-week after FMT treatment, as compared to single group, periodic group had greater Wexner constipation score (at 8-week: 7.29±2.05 vs. 5.96±2.30, t=2.135, P=0.038; at 12-week: 7.21±1.98 vs. 5.80±2.43, t=2.218, P=0.031), greater gastrointestinal quality of life index (at 8-week: 25.71±8.91 vs. 20.20±8.53, t=2.211, P=0.032; at 12-week: 24.16±8.99 vs. 18.92±8.28, t=2.127, P=0.039) and better autonomous defecation frequency [at 8-week: (2.42±0

  15. Beyond blow-up in excitatory integrate and fire neuronal networks: Refractory period and spontaneous activity.

    Science.gov (United States)

    Cáceres, María J; Perthame, Benoît

    2014-06-07

    The Network Noisy Leaky Integrate and Fire equation is among the simplest model allowing for a self-consistent description of neural networks and gives a rule to determine the probability to find a neuron at the potential v. However, its mathematical structure is still poorly understood and, concerning its solutions, very few results are available. In the midst of them, a recent result shows blow-up in finite time for fully excitatory networks. The intuitive explanation is that each firing neuron induces a discharge of the others; thus increases the activity and consequently the discharge rate of the full network. In order to better understand the details of the phenomena and show that the equation is more complex and fruitful than expected, we analyze further the model. We extend the finite time blow-up result to the case when neurons, after firing, enter a refractory state for a given period of time. We also show that spontaneous activity may occur when, additionally, randomness is included on the firing potential VF in regimes where blow-up occurs for a fixed value of VF. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. A Periodization of Psychological Development to Adulthood with an Emphasis on Psychoanalysis

    OpenAIRE

    Nogolová, Kateřina

    2007-01-01

    Author's name: Kateřina Nogolová (roz. Brožová) Institution: Charles University in Prague Psychology dept. Myslíkova 7, 110 00 Praha 1 Major: Psychology and Special education Program: Psychology Title: PERIODIZATION OF MENTAL/PSYCHOLOGICAL DEVELOPMENT TILL ADULTHOOD WITH PSYCHOANALYTICAL IMPACT Consultant: Doc. PhDr. Miloš Kučera, CSc. Year: 2007 Number of pages: 198 pg.(Incl. Attachement); 161 (without att.) Number of attachments: 15 Key words: Psychological development, periodisation, menta...

  17. [Psychological support for socially vulnerable people in the context of a periodic health examination].

    Science.gov (United States)

    Jobeir, Houssine; Peton, Gabrielle; Brigand, Alain; Chatain, Carine; Sass, Catherine; Moulin, Jean-Jacques

    2009-01-01

    Social vulnerability often leads to the expression of psychological distress. The Health Examination Center of Côtes d'Armor, in Quimper, experimented with the development and implementation of psychological counseling for a highly socio-economically vulnerable population. As part of a periodic health examination, the center offers psychological counseling to patients with pathological sleep disorders and who lack sufficient psychological support. The Health Examination Center's framework and the context of the periodic health examination have facilitated the establishment of a tailored non-stigmatizing intervention well-embedded within the institutional environment. Marginalized people in situations of psychological distress are offered an opportunity to be listened to, and to receive counseling, appropriate prevention services and access to care.

  18. [The medical and psychological support for the child athletes during different periods of the training cycle].

    Science.gov (United States)

    Stepanenko, N P; Levitskaia, T E; Matveeva, E A; Zaĭtsev, A A; Konovalov, A B; Tren'kaeva, N A; Akimova, K K; Kremeno, S V; Dostovalova, O V; Merzliakova, N V

    2014-01-01

    To study dynamics of the indicators of the hormonal and psychological status as well as psychological features of significance for the sportive performance under conditions of rehabilitative treatment during training and post-training periods in the child athlete engaged in rhythmic gymnastics. The study included 42 child athletes at the age from 8 to 15 years engaged in rhythmic gymnastics. The children of the study group (group 1, n=17) received the combined restorative treatment under conditions of regular training while those comprising group 2 group (n=25) were given a similar treatment in the absence of the training load. All athletes underwent clinical and laboratory examination before and after the treatment for the assessment of their psychological status. The study has demonstrated that additional physical activities were responsible for the development of negative changes in the hormonal and psychological spheres of the child athletes. As a result, they experienced the impairment of certain qualities significant for their sportive performance. The rehabilitative measures during different periods of the training cycle promote normalization of all parameters of the hormonal, psychological, and physical status of the child athletes; moreover, they improve the adaptive capacity of the children.

  19. Women Health and Psychological Functioning in Different Periods of Life: Evaluation of Nursing Approach

    Directory of Open Access Journals (Sweden)

    Fusun Terzioglu

    2011-03-01

    Full Text Available World Health Organization describes health as the state of being completely fine corporally, socially and psychologically. The state of being completely fine which is indicated in this description of health has been criticised by many scientists and with the idea that noone shall ever realise tha state of being completely fine corporally and psychologically, it was emphasized that individuals could be evaluated to be “healthy” as long as they are productive. Starting from the intrauterine period, woman passes through different periods such as childhood, adolescence, adulthood, elderliness and she experiences some physical, psychological and social differences in each of these periods within the frame of life cycle. While these differences influence productivities and life qualities of women negatively, they also make them more inclined to psychiatric illnesses. Therefore, psychological problems are more common among women and they last longer. Considering the fact that among the medical personnel, it is the nurses who spend time with patients during the phases of diagnosis, treatment and rehabilitation the most, it could be said that nurses have a significant role in intervening in problems that affect the psychological health of woman. The nurse has responsibilities such as determining the problem the woman goes through, providing protective care, getting an early diagnosis, making the convenient remedial intervention and consigning, when necessary. In this article, significant woman health problems that could be experienced starting from the intrauterine life until the end of life by woman, the effects of this problem to the psychological health of the woman and nursing approaches in view of these problems are discussed.

  20. Of mothers and experts: the psychology of post war period and the disciplining of maternal care

    Directory of Open Access Journals (Sweden)

    Claudia Calquín Donoso

    2013-07-01

    Full Text Available The article reflects on the discursive construction of maternal care in psychology. We discuss the emergence of this knowledge and its connections to the political and economic transformations occurred during the postwar period and the beginning of the cold War. From a Foucauldian perspective, the general hypothesis guiding this reflection states that motherly care practices, rather than having an individual and spontaneous character, represent a product of power relationships and knowledge relationships both historically situated and a social practice through which, psychology emerged as science and device of normality and subjectivity.

  1. A systematic review of psychological treatments for clinical anxiety during the perinatal period.

    Science.gov (United States)

    Loughnan, Siobhan A; Wallace, Matthew; Joubert, Amy E; Haskelberg, Hila; Andrews, Gavin; Newby, Jill M

    2018-01-24

    Maternal anxiety is common during the perinatal period, and despite the negative outcomes of anxiety on the mother and infant, its treatment has received limited attention. This paper describes the first review of psychological interventions for clinical anxiety during the perinatal period. A systematic search was carried out of six electronic databases. Five studies which evaluated psychological interventions for clinical anxiety in perinatal women were identified. Of the five studies included, four were open trials and one was a randomised controlled trial. Three studies evaluated group-based interventions; one study evaluated an online-delivered intervention; and one study a combined pharmacologic-psychological intervention. All participants demonstrated significant reductions in anxiety symptom severity from pre- to post-treatment. However, this review was limited to published literature evaluating treatments for clinical anxiety in perinatal women, which may have excluded important intervention studies and prevention programs, and unpublished literature. This review identifies an area of research that needs urgent attention, as very few studies have evaluated psychological treatments for perinatal anxiety. The studies included in this review demonstrate that symptoms of anxiety during the perinatal period appear to improve during treatment. Future research is needed to establish the efficacy of perinatal anxiety interventions in randomised controlled trials, whether reductions persist long term and whether benefits extend to other outcomes for the mother, infant and family.

  2. Changes in the psychological characteristics of oral cancer patients in the perioperative period: a quantitative evaluation.

    Science.gov (United States)

    Koizumi, Aya; Matsushima, Eisuke; Mochizuki, Yumi; Omura, Ken; Amagasa, Teruo

    2013-03-01

    We examined the changes in psychological distress and quality of life (QOL) during the perioperative period in oral cancer patients undergoing surgery and investigated the relationship between patient's psychological distress and QOL. Methods. Fifty patients participated. The Hospital Anxiety and Depression Scale (HADS; Japanese version), as a psychological test and the Functional Assessment of Cancer Therapy General (FACT-G); and Head and Neck (FACT-H&N), as quality of life (QOL) surveys were administered preoperatively, after surgery, and 1 month after leaving the hospital. Results. Anxiety was highest pre-operation and depression was highest post-operation, but improvements in both were seen post-discharge. At the pre-operation time point, anxiety and depression low-score groups had significantly high scores on Emotional well-being and Functional well-being. At the post-operation time point, anxiety and depression low-score groups had significantly high scores on all QOL subscales. Conclusion. Providing psychological support while considering anxiety might be particularly useful preoperatively whereas providing psychological support while considering depression might be particularly useful postoperatively.

  3. Impact of alternate fuels on industrial refractories and refractory insulation applications. An Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Wei, G.C.; Tennery, V.J.

    1976-09-01

    The effects of use of alternate fuels such as distillate oils, residual oils, coal, producer gas, and electricity on refractory insulation are evaluated. Sections are included on alternate fuels for 1976 to 1980, assessment by industry of fuel conversion impact on industrial refractories in the period 1976 to 1980, interactions of alternate fuel combustion products with refractories and refractory insulation, and analysis of degradation mechanisms in refractories and refractory materials. (JRD)

  4. Interaction of sequential stimuli applied during the relative refractory period in relation to determination of fibrillation threshold in the canine ventricle.

    Science.gov (United States)

    Tamargo, J; Moe, B; Moe, G K

    1975-11-01

    An ineffective stimulus applied to cardiac tissue within the relative refractory period can alter the response to an immediately subsequent stimulus. We observed three response patterns that can coexist at different sites of stimulation in the same heart. In the first pattern, a stimulus of two to ten times diastolic threshold, applied too early to elicit a propagated response, becomes effective when a stimulus of equal strength is delivered 10 msec earlier. In the second pattern, a stimulus applied just late enough to evoke a response fails to do so when a stimulus of equal strenght precedes it by as much as 30 msec. Finally, in the third pattern, two stimuli, separated by 10 msec, both of which are late enough to be effective when they are given alone, fail to yield a propagated response when they are applied together. These results have a bearing on the use of trains of stimuli to assess the ventricular fibrillation threshold. Possible interpretations are based on the temporal dispersion of recovery from the refractory state.

  5. FORMATION OF THE PRECONDITIONS FOR THE EMERGENCE OF GENDER PSYCHOLOGY IN MIDDLE AGES PERIOD

    Directory of Open Access Journals (Sweden)

    Veronika Olegovna Mokhova

    2013-10-01

    Full Text Available The main purpose of this article is to analyze the main ideas of the Medieval Period authors in Europe and in Russia, in terms of identifying the most important theses of this historical period for the formation and development of the ideas of gender psychology. It is being considered the role of Christianity and the emergence of the women's education issue in the formation of gender stereotypes. In this article the Middle Ages period is being considered as a separate historical phase for the basic ideas formation in the gender psychology, which is a new approach to the history of gender science. To estimate medieval texts - European and Russian, the method of qualitative content analysis is used, by means of which the most relevant to the period ideas associated with the sexes are identified. For Europe, it inter-sexual features, for Russia - different behavioral requirements of the society associated with sexes. Conclusions contain ideas of the Middle Ages in Europe and in Russia that are relevant to the development and establishment of gender psychology. In Europe: the continuation of the ancient thesis of the initial androgyny of a human being; impact of the woman's education on her ability for development; consideration of sexuality as sinful; the issue of women's emancipation, the declining value of the large numerous families despite of a ban on interference in the reproductive cycle in the middle of the Medieval period. In Russia: the perception of inter-sexual characteristics as defined by the God; unconditional obedience of a woman to her husband; androgyny in the distribution of the farmers’ responsibilities.Objective: To analyze the main ideas of the authors of the Middle Ages in Europe and in Russia, in terms of identifying the significant theses of this historical period for the formation and development of the ideas of the gender psychology.Method of the research work: A qualitative content analysis of the texts by the authors

  6. Periodic and chaotic psychological stress variations as predicted by a social support buffered response model

    Science.gov (United States)

    Field, Richard J.; Gallas, Jason A. C.; Schuldberg, David

    2017-08-01

    Recent work has introduced social dynamic models of people's stress-related processes, some including amelioration of stress symptoms by support from others. The effects of support may be ;direct;, depending only on the level of support, or ;buffering;, depending on the product of the level of support and level of stress. We focus here on the nonlinear buffering term and use a model involving three variables (and 12 control parameters), including stress as perceived by the individual, physical and psychological symptoms, and currently active social support. This model is quantified by a set of three nonlinear differential equations governing its stationary-state stability, temporal evolution (sometimes oscillatory), and how each variable affects the others. Chaos may appear with periodic forcing of an environmental stress parameter. Here we explore this model carefully as the strength and amplitude of this forcing, and an important psychological parameter relating to self-kindling in the stress response, are varied. Three significant observations are made: 1. There exist many complex but orderly regions of periodicity and chaos, 2. there are nested regions of increasing number of peaks per cycle that may cascade to chaos, and 3. there are areas where more than one state, e.g., a period-2 oscillation and chaos, coexist for the same parameters; which one is reached depends on initial conditions.

  7. Refractory vasculitis

    NARCIS (Netherlands)

    Rutgers, Bram; Kallenberg, Cees G. M.

    Refractory vasculitis occurs in 4-5% of patients with anti-neutrophil cytoplasmic antibody associated vasculitis (AAV). Differences between therapies used for refractory disease are mostly reflected in the percentages of complete and partial remissions, but also in the number of serious side

  8. Factors associated with trajectories of psychological distress for Australian fathers across the early parenting period.

    Science.gov (United States)

    Giallo, Rebecca; D'Esposito, Fabrizio; Cooklin, Amanda; Christensen, Daniel; Nicholson, Jan M

    2014-12-01

    Little is known about the course of fathers' psychological distress and associated risk factors beyond the postnatal period. Therefore, the current study aimed to: (a) assess the course of distress over 7 years postnatally; (b) identify classes of fathers defined by their symptom trajectories; and (c) identify early postnatal factors associated with persistent symptoms. Data from 2,470 fathers in the Longitudinal Study of Australian Children were analysed using latent growth modelling. Fathers' psychological distress was assessed using the Kessler-6 (Kessler et al. in Arch Psychiatry 60:184-189, 2003) when their children were aged 0-1, 2-3, 4-5 and 6-7 years. Overall, distress was highest in the first postnatal year and then decreased over time. Two distinct trajectories were identified. The majority of fathers (92%) were identified as having minimal distress in the first postnatal year which decreased over time, whilst 8% had moderate distress which increased over time. Low parental self-efficacy, poor relationship and job quality were associated with 'persistent and increasing distress'. Early postnatal factors associated with fathers' persistent distress were identified, providing opportunities for early identification and targeted early intervention.

  9. Refractoriness of on extended movement to directional change.

    Science.gov (United States)

    Williams, L R

    1971-12-01

    An extended movement was used to compare the memory-drum and single-channel definitions of psychological refractoriness. The basic movement In response to the first signal (S1) was a forward lunge and a concurrent arm swing through a target string. The response to the second signal (S2) was a reversal of the original movement The interstimulus Interval (ISI) ranged from .10 - .70 sec. in .10-sec. steps. The hypothesis that refractoriness of the reversal movement would decrease as ISI shortened was confirmed by the fact that error frequencies decreased significantly and substantially with decreasing IS I. The availability of some residual capacity to deal with S2 during the refractory period was also indicated by an examination of the relationship between RT2 and the interval between S2 and RT1. This departure from the classical single-channel model shows some agreement with the neuromotor-programming theory.

  10. Effects of Na+ channel blockers on the restitution of refractory period, conduction time, and excitation wavelength in perfused guinea-pig heart.

    Directory of Open Access Journals (Sweden)

    Oleg E Osadchii

    Full Text Available Na+ channel blockers flecainide and quinidine can increase propensity to ventricular tachyarrhythmia, whereas lidocaine and mexiletine are recognized as safe antiarrhythmics. Clinically, ventricular fibrillation is often precipitated by transient tachycardia that reduces action potential duration, suggesting that a critical shortening of the excitation wavelength (EW may contribute to the arrhythmic substrate. This study examined whether different INa blockers can produce contrasting effects on the rate adaptation of the EW, which would explain the difference in their safety profile. In perfused guinea-pig hearts, effective refractory periods (ERP, conduction times, and EW values were determined over a wide range of cardiac pacing intervals. All INa blockers tested were found to flatten the slope of ERP restitution, indicating antiarrhythmic tendency. However, with flecainide and quinidine, the beneficial changes in ERP were reversed owing to the use-dependent conduction slowing, thereby leading to significantly steepened restitution of the EW. In contrast, lidocaine and mexiletine had no effect on ventricular conduction, and therefore reduced the slope of the EW restitution, as expected from their effect on ERP. These findings suggest that the slope of the EW restitution is an important electrophysiological determinant which can discriminate INa blockers with proarrhythmic and antiarrhythmic profile.

  11. Effects of Na+ channel blockers on the restitution of refractory period, conduction time, and excitation wavelength in perfused guinea-pig heart.

    Science.gov (United States)

    Osadchii, Oleg E

    2017-01-01

    Na+ channel blockers flecainide and quinidine can increase propensity to ventricular tachyarrhythmia, whereas lidocaine and mexiletine are recognized as safe antiarrhythmics. Clinically, ventricular fibrillation is often precipitated by transient tachycardia that reduces action potential duration, suggesting that a critical shortening of the excitation wavelength (EW) may contribute to the arrhythmic substrate. This study examined whether different INa blockers can produce contrasting effects on the rate adaptation of the EW, which would explain the difference in their safety profile. In perfused guinea-pig hearts, effective refractory periods (ERP), conduction times, and EW values were determined over a wide range of cardiac pacing intervals. All INa blockers tested were found to flatten the slope of ERP restitution, indicating antiarrhythmic tendency. However, with flecainide and quinidine, the beneficial changes in ERP were reversed owing to the use-dependent conduction slowing, thereby leading to significantly steepened restitution of the EW. In contrast, lidocaine and mexiletine had no effect on ventricular conduction, and therefore reduced the slope of the EW restitution, as expected from their effect on ERP. These findings suggest that the slope of the EW restitution is an important electrophysiological determinant which can discriminate INa blockers with proarrhythmic and antiarrhythmic profile.

  12. -C Refractories

    Science.gov (United States)

    Xu, Yibiao; Sang, Shaobai; Li, Yawei; Ren, Bo; Zhao, Lei; Li, Yuanbing; Li, Shujing

    2014-06-01

    Al2O3-C refractories were first fabricated in a coke bed at 1673 K (1400 °C) using tabular corundum, reactive alumina, carbon black, silicon, and microsilica as the starting materials and phenol resin as the binder. Then the alkali attack resistance of those materials was conducted in the powder mixture of carbon black and potassium carbonate (1:1 wt pct) in a graphite crucible at 1273 K (1000 °C) for 10 hours. The correlation between pore size, permeability of Al2O3-C refractories, and their alkali (K2CO3) attack was investigated by means of mercury intrusion porosimetry, X-ray diffraction (XRD), and scanning electron microscopy (SEM). The results showed that the pore structure of Al2O3-C refractories was controlled by the addition of silicon, ultrafine reactive alumina, and microsilica to in-situ form SiC whiskers and mullite in the preparation process. The mean pore size of Al2O3-C refractories was strongly associated with permeability. With the decrease of the mean pore size, the permeability of the Al2O3-C refractories reduced constantly. The alkali attack test also verified that the Al2O3-C refractories with lower permeability had better alkali corrosion resistance, because the penetration of K vapor into the materials could be restricted effectively. The corrosion mechanism of Al2O3-C refractories supposes that (1) K2CO3 was reduced to K vapor and penetrated into the specimen through the open pores and (2) K vapor reacted with SiC, SiO2, and alumina to form KAlSi2O6 and KAlSiO4, which is in agreement with the thermodynamic prediction.

  13. Feedback effect of human physical and psychological adaption on time period of thermal adaption in naturally ventilated building

    DEFF Research Database (Denmark)

    liu, weiwei; Huangfu, Hao; Xiong, Jing

    2014-01-01

    This study proposed a method to determine time period of thermal adaption for occupants in naturally ventilated building, and analyzed the synergistic and separate feedback effect of the physical and psychological adaption modes on the time period of thermal adaption. Using the method, the values...... indicated that the psychological adaption mode can speed up the process of thermal adaption to the variation in the outdoor climate condition. This study presented a new insight into the feedback from the thermal adaption modes to occupant thermal comfort.......This study proposed a method to determine time period of thermal adaption for occupants in naturally ventilated building, and analyzed the synergistic and separate feedback effect of the physical and psychological adaption modes on the time period of thermal adaption. Using the method, the values......, under the synergistic feedback effect of the physical and psychological adaption modes. The time period of thermal adaption increased to 13 days, if only the feedback effect of the physical adaption mode was accounted for. The difference between the two values of the time period of thermal adaption...

  14. Mode of birth and women’s psychological and physical wellbeing in the postnatal period

    Directory of Open Access Journals (Sweden)

    Rowlands Ingrid J

    2012-11-01

    Full Text Available Abstract Background Physical and psychological problems after childbirth are common, and may have a significant negative and long-term impact on women’s wellbeing and daily functioning. The method of birth may be a particularly important factor influencing women’s health and wellbeing following birth, however, population-wide evidence is limited. This study uses data from 5,332 women who responded to a national survey of women’s experiences of maternity care in England. We examined women’s postnatal wellbeing in the first three months after birth, and whether these varied by mode of birth. Methods This is a secondary analysis of survey data using a random sample of women selected from birth registration. We used multinomial logistic regression models to examine the association between women’s self-reported psychological symptoms, health problems and mode of birth. Results Women who had forceps-assisted vaginal births and unplanned caesarean section births reported the poorest health and wellbeing, while those of women who had unassisted vaginal births and planned caesarean section births were less affected by the birth process. Most women’s physical and emotional health appeared to improve with time, however, those who had a forceps-assisted vaginal birth were more likely to report ongoing posttraumatic-type symptoms several months after the birth. Conclusions Mode of birth was associated with differences in outcomes at three months. By comparison to women who had unassisted vaginal births, the risk of reduced postnatal health and wellbeing was higher amongst the women who had forceps-assisted vaginal births but not amongst women who had ventouse-assisted vaginal births. This would suggest that it is important to differentiate the different types of instrumental birth in outcome studies. Of concern was the higher rate of posttraumatic-type symptoms among women who had forceps-assisted vaginal births relative to the other modes of

  15. The Effectiveness of Psychological Services of Rehabilitation Period on Addictions’ Negative Self Concept, Anxiety, Depression and Self Esteem

    Directory of Open Access Journals (Sweden)

    Sasan Bavi

    2010-02-01

    Full Text Available Objective: The purpose of this study was to investigate the effectiveness of Psychological services of rehabilitation period on negative self concept, anxiety, depression and self esteem of T.C. addicts of Ahwaz city in 1386-1387. Method: The research design was semi experimental namely: pretest-posttest with one group. Population was all self reported addicts that accepted in Ahwaz T.C. center for 4 months period. The sample was 50 addicts who were selected by available sampling. Before psychological services pre test was administered. The questionnaires were administered in this research were Rogers's self concept, Cattle’s anxiety, Beck's depression and Copper Smith's self esteem questionnaire. Results: the results showed that the psychological services were effective on reduction of addicts’ negative self concept, depression, and anxiety also, on increasing of their self esteem. Conclusion: The results showed that participation of T.C. and using of psychological services can be affected on reduction of negative self concept, depression, and anxiety also, on increasing of self esteem.

  16. Quality of Life in Physical and Psychological Health and Social Environment at Posthospitalization Period in Patients with Stroke.

    Science.gov (United States)

    Karube, Narumi; Sasaki, Aya; Hondoh, Fumika; Odagiri, Chiyo; Hagii, Joji; Seino, Satoshi; Yasujima, Minoru; Osanai, Tomohiro

    2016-10-01

    Interaction of quality of life (QOL) in physical and psychological health and social environment has not been tested in stroke during a posthospitalization period, and a better understanding of the components of QOL would lead to a more integrated and person-centered approach to health management and outcome optimization. We investigated how QOL emerges from the sequelae of stroke and interacts with each other during the posthospitalization period. We performed a cross-sectional study in 53 outpatients of stroke survivors (39 men and 14 women with a mean age of 66 years, 46 infarctions, and 7 hemorrhages). Eight QOL domains of psychological health were scored by interview, and 2 of them ("desire to distend what they can do" or "desire to do rehabilitation") were associated with the improvement of physical health during the posthospitalization period (P health improvement, to go home, to go back to work, and to see grandchildren" as goals to achieve their desire (P health and social environment, another psychological domain "to gain satisfaction from the experience" was closely related to the presence of hobby or work before stroke attack (P health may support that of physical health, being associated with the presence of hobby or work before stroke attack. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  17. Study of specificities of arm wrestlers’ psychological status in competition period

    Directory of Open Access Journals (Sweden)

    Podrigalo L. V.

    2015-06-01

    Full Text Available Purpose: researching and analysis of psychological status dynamic of different qualification arm-wrestlers in competitions’ condition. Material: in the research 21 students-sportsmen of 17-24 years’ age participated. Results: before the beginning of competition experienced sportsmen are characterized by higher workability in comparison with beginners - (56.61±8.31 % against (23.23±11.93 %. After competitions among experienced sportsmen 57.14% had reduced anxiety; 71.43% - reduced activity and self-feeling; 50% - had worse mood. After competitions among sportsmen-beginners 73.73% demonstrated reduction of workability; 54.54% had weakened activity, mood and self-feeling. We established significant prevalence of statistically confident correlations among experienced sportsmen: 65.15% against 46.97%. Contribution of psychological components in system of sportsmen-beginners is significantly lower than of experienced sportsmen. Conclusions: we determined certain changes of psychological status of arm-wrestlers of different qualification under influence of competitions. For experienced sportsmen we confirmed more optimal status and favorable dynamic, illustrating high reliability of functioning.

  18. The relationships between physical violence, verbal abuse and women’s psychological distress during the postpartum period

    Science.gov (United States)

    ROMITO, PATRIZIA; POMICINO, LAURA; LUCCHETTA, CHIARA; SCRIMIN, FEDERICA; TURAN, JANET MOLZAN

    2009-01-01

    Objective To analyse the relationship between violence in the post-partum period and mothers’ psychological distress. Method Three hundred and fifty two women responded to a questionnaire after the birth, at the Trieste Hospital (Italy), and 292 of them responded to a telephone interview 8 months later. Psychological distress was evaluated with the General Health Questionnaire (GHQ); partner and family violence were evaluated with a 28-item scale. Results Eight months post-partum, 10% of women were experiencing violence either from the partner or from another family member; 5% showed high psychological distress. Multivariate analyses show that, after adjustment for covariates, the OR for depressive symptoms was 19.17 for women experiencing partner or family violence. Being dissatisfied with their working situation, hospitalisation of the baby and pre-pregnancy mental health were also significantly associated with high GHQ scores Conclusion These results stress the relationship between violence in post-partum and maternal psychological distress. Measures aimed to identify and end violence against women around pregnancy could contribute to the improvement of women’s mental health post-partum. PMID:19533491

  19. Changes in Social Exclusion Indicators and Psychological Distress Among Homeless People Over a 2.5-Year Period.

    Science.gov (United States)

    Van Straaten, Barbara; Rodenburg, Gerda; Van der Laan, Jorien; Boersma, Sandra N; Wolf, Judith R L M; Van de Mheen, Dike

    2018-01-01

    Although homelessness is inherently associated with social exclusion, homeless individuals are rarely included in conventional studies on social exclusion. Use of longitudinal survey data from a cohort study on homeless people in four major Dutch cities ( n  = 378) allowed to examine: changes in indicators of social exclusion among homeless people over a 2.5-year period after reporting to the social relief system, and associations between changes in indicators of social exclusion and changes in psychological distress. Multinomial logistic regression analysis was applied to investigate the associations between changes in indicators of social exclusion and changes in psychological distress. Improvements were found in various indicators of social exclusion, whereas financial debts showed no significant improvement. Changes in unmet care needs, health insurance, social support from family and relatedness to others were related to changes in psychological distress. This study demonstrated improvements in various indicators of social exclusion among homeless people over a period of 2.5 years, and sheds light on the concept of social exclusion in relation to homelessness.

  20. PSYCHOLOGICAL DETERMINANTS OF PRONENESS TO CONFLICT BEHAVIOR IN THE PERIOD OF STUDENTSHIP

    Directory of Open Access Journals (Sweden)

    N. A. Bunjak

    2013-03-01

    Full Text Available The University student is claimed to be one of the most important ?gure today whо deter mines the future of the society and its progressive development and democratic transformations. In the dif?cult conditions of life, characterizing the situation in the country nowadays contemporary students are often uncertain about their future and in connection with this, experience negative emotional states which might cause intrapersonal con?icts. The contemporary youth is characterized nowadays by numerous con?icts in which the development of the age speci?c achievements  takes  place,  namely:  self-actualization,  self-expression,  competition,  defending one’s own values, attitudes and passions. The paper presents the results of an anonymous survey in testing of Ternopil National university students aimed at de?ning the relationships between the frequency of the intrapersonal con?icts experienced by the young people and psychological factors causing them. The proneness to the con?ict behavior of the personality has been shown to be caused by such psychological characteristics of the individual as the level of self-esteem, the level of aggression, anxiety, frustration, rigidity and locus of control. It is postulated in the paper that high proneness of the personality to the con?ict behavior can be adequately described with reference to a set of personality properties which jointly de?ne and enhance the levels of con?ict. This set of characteristics act as psychological determinants of con?icts. The analysis of the survey designed to de?ne the sources of the students’ proneness to the con?ict behavior shows that the problem requires further theoretical research and empirical studies to obtain a more comprehensive picture of the possible causes of proneness to this type of behavior.

  1. Depression in Men in the Postnatal Period and Later Child Psychology: A Population Cohort Study

    Science.gov (United States)

    Ramchandani, Paul G.; Stein, Alan; O'Connor, Thomas G.; Heron, Jon; Murray, Lynne; Evans, Jonathan

    2008-01-01

    The factors responsible for depression in men following childbirth and the association between their depression in the postnatal period and later psychiatric disorders in their children are assessed. Findings show that depression in fathers in their postnatal period is associated with later psychiatric disorders in their children, independent of…

  2. Research of level of psychological preparedness of 30–40 years old tourists skiers in the preparation period

    Directory of Open Access Journals (Sweden)

    Alexander Toporkov

    2015-04-01

    Full Text Available Purpose: сompare the results of research of the psychological state of 30–40 years old tourists skiers at various stages of preparation period. Material and Methods: 14 people aged 30 to 40 years old who have a different experience in water, hiking and mountain as well as ski-sport hiking took part in research. Analysis of scientific and methodical literature, pedagogical observations, pedagogical experiment, methods of mathematical statistics is used. Results: the test results of 30–40 years old tourists skiers which are the participants in the experimental group received at different stages of preparation period and the results. Their comparative analysis is held. Conclusions: it was found that, at the stages of preparation period indicators of personal qualities and concentration had always risen, reaching the highest degree at the end of the experiment.

  3. Approaches to refractory epilepsy

    Directory of Open Access Journals (Sweden)

    Jerome Engel

    2014-01-01

    Full Text Available Epilepsy is one of the most common serious neurological conditions, and 30 to 40% of people with epilepsy have seizures that are not controlled by medication. Patients are considered to have refractory epilepsy if disabling seizures continue despite appropriate trials of two antiseizure drugs, either alone or in combination. At this point, patients should be referred to multidisciplinary epilepsy centers that perform specialized diagnostic testing to first determine whether they are, in fact, pharmacoresistant, and then, if so, offer alternative treatments. Apparent pharmacoresistance can result from a variety of situations, including noncompliance, seizures that are not epileptic, misdiagnosis of the seizure type or epilepsy syndrome, inappropriate use of medication, and lifestyle issues. For patients who are pharmacoresistant, surgical treatment offers the best opportunity for complete freedom from seizures. Surgically remediable epilepsy syndromes have been identified, but patients with more complicated epilepsy can also benefit from surgical treatment and require more specialized evaluation, including intracranial EEG monitoring. For patients who are not surgical candidates, or who are unwilling to consider surgery, a variety of other alternative treatments can be considered, including peripheral or central neurostimulation, ketogenic diet, and complementary and alternative approaches. When such alternative treatments are not appropriate or effective, quality of life can still be greatly improved by the psychological and social support services offered by multidisciplinary epilepsy centers. A major obstacle remains the fact that only a small proportion of patients with refractory epilepsy are referred for expert evaluation and treatment.

  4. Psychological Distress in Healthy Low-Risk First-Time Mothers during the Postpartum Period: An Exploratory Study

    Directory of Open Access Journals (Sweden)

    Christina Murphey

    2017-01-01

    Full Text Available Psychological distress, defined as depression, anxiety, and insomnia in this study, can occur following the birth of a baby as new mothers, in addition to marked physiological changes, are faced with adapting to new roles and responsibilities. We investigated the cooccurrence of stress, depression, anxiety, and insomnia in mothers during the postpartum period; tested the feasibility of study methods and procedures for use in this population; and identified new mothers interest in using cranial electrotherapy stimulation (CES as an intervention for reducing psychological distress. We recruited healthy, low-risk, English speaking first-time mothers, ages 18–32 years, with healthy babies (N=33, within 12 months of an uncomplicated birth. Participants completed the PSS, HAM-D14, HAM-A17, and PSQI19. No problems were encountered with study procedures. Mothers reported a high interest (4.9 in the potential use of CES to treat or prevent the occurrence of psychological distress. All participants (N=33 reported moderate levels of depression and anxiety, while 75.8% (n=25 reported insomnia. PSS scores were within the norms for healthy women. Further research is recommended to investigate if our findings can be replicated or if different patterns of associations emerge. Implications for clinical practice are addressed.

  5. [Changes in psychological features in patients for anesthesia and operation during perioperative period].

    Science.gov (United States)

    Kunihiro, M; Somura, H; Matsumoto, M; Sakabe, T

    1998-09-01

    The purpose of this study was to assess perioperative changes in psychological features of patients receiving anesthesia and operation. Anxiety level and desire for obtaining information were evaluated in 37 patients using the Amsterdam preoperative anxiety and information scale (APAIS) at three points: before and after the preanesthetic examination, and 3 to 5 days after the operation. Anxiety scale (4-20) and information scale (2-10) scores decreased postoperatively from 9.8 +/- 3.8 to 7.3 +/- 3.4 and from 6.1 +/- 2.1 to 4.1 +/- 1.9, respectively. There was a significant but weak correlation (rs = 0.35) between the anxiety scale and information scale before the preanesthetic examination. The postoperative information scale score correlated well with preoperative anxiety scale score (rs = 0.61), and this correlation was higher than with preoperative information scale score (rs = 0.37). When patients were divided into two subgroups, namely patients with (U, n = 12) or without (non-U, n = 25) an increase in postoperative information scale score, anxiety scale score before the preanesthetic examination tended to be higher and the postoperative anxiety scale score was significantly higher in the U group than in the non-U group. We conclude that we should provide more information to the patients who have higher anxiety scale score before the preanesthetic examination regardless of their degree of desire for information.

  6. Trajectories of fathers' psychological distress across the early parenting period: Implications for parenting.

    Science.gov (United States)

    Giallo, Rebecca; Cooklin, Amanda; Brown, Stephanie; Christensen, Daniel; Kingston, Dawn; Liu, Cindy H; Wade, Catherine; Nicholson, Jan M

    2015-10-01

    Fathers' parenting behavior is a likely key mechanism underlying the consistent associations between paternal mental health difficulties and poor emotional-behavioral outcomes for children. This study investigates the association between fathers' mental health trajectories and key parenting behaviors (warmth, hostility, consistency) spanning the first 8-9 years postpartum. Secondary analyses of 5 waves of data from 2,662 fathers participating in the Longitudinal Study of Australian Children were conducted. Latent growth class analysis was used to identify distinct trajectories of fathers' distress (Kessler-6; Kessler et al., 2003), and latent growth models estimated parenting warmth, hostility, and consistency. Multiple group analyses were conducted to describe and compare the course of parenting behaviors for fathers assigned to the distress trajectories identified. Two distinct classes of fathers were identified based on the trajectories of distress: minimal distress (92%) and persistent and increasing distress (8%). The latter group reported significantly lower parenting warmth when their children were 8-9 years and lower consistency and higher hostility across all study intervals. The postnatal and early parenting period is a critical time for the development of parenting behaviors that are important for children's development. Engagement and support for fathers around well-being and parenting is vital for promoting optimal family and child developmental outcomes. (c) 2015 APA, all rights reserved).

  7. Carbon Based Refractories

    National Research Council Canada - National Science Library

    EWAIS, Emad Mohamed M

    2004-01-01

    .... They are classified into two groups; carbon/bricks/blocks and carbon containing materials. Carbon containing materials are further classified into carbon containing basic refractories and non-basic refractories...

  8. Training Load, Physical Performance, Biochemical Markers, and Psychological Stress During A Short Preparatory Period in Brazilian Elite Male Volleyball Players.

    Science.gov (United States)

    Horta, Thiago A G; Bara Filho, Maurício G; Coimbra, Danilo R; Miranda, R; Werneck, Francisco Z

    2017-12-11

    The aim of this study was to assess the relationship between training load (TL) and physical performance, biochemical markers, and psychological stress during a short preparatory period (PP) in Brazilian elite male volleyball players. Twelve volleyball players from a team competing in the Brazilian Men's Volleyball Super League were enrolled (26.9 ± 4.6 years). Countermovement Jump (CMJ), Creatine Kinase (CK), Testosterone (T), Cortisol (Cr), T/Cr ratio, and Recovery and Stress Questionnaire for Athletes (RESTQ-Sport) were collected at baseline, after 2, 4, and 6 week. TL was quantified daily using the Rating of Perceived Exertion (RPE). Differences were noted between Total Weekly TL (TWTL) (F3,33 = 50.907; p = 0.0001), CK (F3,33 = 16.157; p = 0.0001), and T (F3,33 = 3.283; p = 0.03). No differences were seen in CMJ (F3,33 = 1.821; p = 0.16), Cr (F3,33 = 2.409; p = 0.08), or T/Cr ratio (F3,33 = 1.527; p = 0.23). The RESTQ-Sport demonstrated differences between moments in Social Stress (F3,33 = 2.297; p = 0.04; Eta = 0.25), Success (F3,33 = 4.350; p = 0.01; Eta = 0.19), General Well-being (F3,33 = 4.465; p = 0.01; Eta = 0.36), and Injury (F3,33 = 2.792; p = 0.05; Eta = 0.62). The results showed a significant correlations of small to moderate magnitude between TWTL and CK (r = 0.32; p = 0.05). In conclusion, a short PP in volleyball leads to increased TL, CK level, and psychological stress. TL was related with the increase of CK, suggesting muscle damage without increased of physical performance.

  9. Dexmedetomidine for Refractory Intracranial Hypertension.

    Science.gov (United States)

    Schomer, Kendra J; Sebat, Christian M; Adams, Jason Y; Duby, Jeremiah J; Shahlaie, Kiarash; Louie, Erin L

    2017-01-01

    Dexmedetomidine (DEX) is a selective α2 adrenergic agonist that is commonly used for sedation in the intensive care unit (ICU). The role of DEX for adjunctive treatment of refractory intracranial hypertension is poorly defined. The primary objective of this study was to determine the effect of DEX on the need for rescue therapy (ie, hyperosmolar boluses, extraventricular drain [EVD] drainages) for refractory intracranial hypertension. Secondary objectives included the number of intracranial pressure (ICP) excursions, bradycardic, hypotensive, and compromised cerebral perfusion pressure episodes. This retrospective cohort study evaluated patients admitted to the neurosurgical ICU from August 1, 2009, to July 29, 2015, and who received DEX for refractory intracranial hypertension. The objectives were compared between the 2 time periods-before (pre-DEX) and during therapy (DEX). Twenty-three patients with 26 episodes of refractory intracranial hypertension met the inclusion criteria. The number of hyperosmolar boluses was decreased after DEX therapy was initiated. Mannitol boluses required were statistically reduced (1 vs 0.5, P = .03); however, reduction in hypertonic boluses was not statistically significant (1.3 vs 0.9, P = .2). The mean number of EVD drainages per 24 hours was not significantly different between the time periods (15.7 vs 14.0, P = .35). The rate of ICP excursions did not differ between the 2 groups (24.3 vs 22.5, P = .62). When compared to pre-DEX data, there was no difference in the median number of hypotensive (0 vs 0), bradycardic (0 vs 0), or compromised cerebral perfusion pressure episodes (0.5 vs 1.0). Dexmedetomidine may avoid increases in the need for rescue therapy when used as an adjunctive treatment of refractory intracranial hypertension without compromising hemodynamics.

  10. Scientific networks and research groups development. Educational psychology case in Spain during the five-year periods 2004-2008 and 2009-2013

    OpenAIRE

    Osca-Lluch, Julia; González-Sala, Francisco

    2017-01-01

    [EN]: The aim of this study was to identify and understand the changes experienced in the scientific community groups of authors working in Spanish institutions and publishing articles in scientific journals included in the "Educational Psychology" in the Web of Science during the period 2004 till 2013 and its membership and permanence in different research groups. A comparative study of groups and their composition over the five year periods 2004-2008 and 2009-2013 was performed. The results...

  11. Application of Behavioral Analysis Phase of PRECEDE Model on Women’s Psychological Well-being in the Menopausal Period

    Directory of Open Access Journals (Sweden)

    Mahdi Moshki

    2015-08-01

    Full Text Available Background and Aims Positive psychology introduce mental health as a positive psychological functioning and represent it as wellbeing psychology and having positive characteristics such as self-esteem, positive social relationships, and life satisfaction. The purpose of this study was to investigate the psychological wellbeing of postmenopausal women based on the behavioral analysis phase of PRECEDE model. Materials and Methods This study is a cross-sectional survey and carried out through random sampling in the case of 110 postmenopausal women at Ferdows city, Iran in 2014. The psychological wellbeing variable was studied by Ryff test, including 84 questions and six components containing autonomy, purposeful in life, dominance on environment, personal development, positive relationships with others, and self-acceptance. The collected data were analyzed by SPSS v.20 using descriptive statistics and analytic statistics through correlation and ANOVA. Results The mean age of participants and the average number of their children were 51.62 ± 4.26 and 3.42 ± 1.38, respectively. 61.80 percent of participants had primary education. Pearson correlation test indicated a positive and significant relationship between psychological wellbeing and predisposing factors (knowledge, attitude toward menopause, environmentalbehavioral factors, enabling factors and reinforcing factors (P < 0.01. Conclusion The results indicated that increasing awareness, creating positive attitude and promoting healthy behaviors are the effective steps to improve the psychological wellbeing in postmenopausal women. * Corresponding Author: Gonabad University of Medical Sciences, Faculty of Public Health. Email: Fpf357@gmail.com

  12. Development of improved refractories

    Energy Technology Data Exchange (ETDEWEB)

    Wereszczak, A.A.; Ferber, M.K.; Liu, K.C. [Oak Ridge National Lab., TN (United States); Moore, R.E. [Univ. of Missouri, Rolla, MO (United States)

    1997-04-01

    The goal of the proposed project is to provide expertise and facilities for the high temperature mechanical properties characterization of refractory materials which are of interest to the US DOE`s Office of Industrial Technologies Advanced Industrial Materials Project. Initially the project would establish dedicated refractory testing facilities which would be capable of generating representative engineering creep and high temperature modulus of elasticity (MOE) data to a temperature of 3300{degrees}F (1815{degrees}C) in ambient air. The generated engineering creep and MOE data would serve R&D requirements of refractories-manufacturers and its glass-manufacturer end-users and designers. The relevance of this effort to the refractory and glass-making industries would be ensured by coordinating the research activities through a membership with Alfred University`s Center for Glass Research (CGR) Satellite Center at the University of Missouri-Rolla (UMR), an NSF Center. Valid engineering creep and high temperature MOE data currently do not exist for almost all commercial refractories. Refractory end-users such as glass-manufacturers require such data for efficient and economical design of their various glass-melting furnace superstructures (e.g., furnace crowns). Refractories in glass production furnaces may be subjected to extreme temperatures as high as 3200{degrees}F (1760{degrees}C). With the simultaneous imposition of mechanical and thermal stresses, creep deformation of the refractory material will assuredly occur as a consequence. Designers must ensure that the structural integrity is maintained, so these high temperature deformations must be considered for successful glass furnace superstructure design. These criteria can only be satisfied with the utilization of representative engineering creep and high temperature MOE data for the refractory materials that are chosen for the design of the refractory superstructures.

  13. A longitudinal study of relationships between previous academic achievement, emotional intelligence and personality traits with psychological health of medical students during stressful periods.

    Science.gov (United States)

    Yusoff, Muhamad Saiful Bahri; Esa, Ab Rahman; Mat Pa, Mohamad Najib; Mey, See Ching; Aziz, Rosniza Abdul; Abdul Rahim, Ahmad Fuad

    2013-01-01

    There is considerable evidence that emotional intelligence, previous academic achievement (i.e. cumulative grade point average (GPA)) and personality are associated with success in various occupational settings. This study evaluated the relationships of these variables with psychological health of first year medical students during stressful periods. A 1-year prospective study was done with students accepted into the School of Medical Sciences, Universiti Sains Malaysia. Information on emotional intelligence, GPA and personality traits were obtained prior to admission. The validated Universiti Sains Malaysia Emotional Quotient Inventory and Universiti Sains Malaysia Personality Inventory were used to measure emotional intelligence and personality traits, respectively. Stress, anxiety and depression were measured by the 21-item Depression Anxiety Stress Scale during the end-of-course (time 1) and final (time 2) examinations. At the less stressful period (time 1), stress level was associated with agreeableness and the final GPA, anxiety level was associated with emotional control and emotional conscientiousness and depression level was associated with the final GPA and extraversion. At the more stressful period (time 2), neuroticism associated with stress level, anxiety level was associated with neuroticism and emotional expression, and depression level was associated with neuroticism. This study found that neuroticism was the strongest associated factor of psychological health of medical students during their most stressful testing period. Various personality traits, emotional intelligence and previous academic performance were associated factors of psychological health during a less stressful period. These data suggest that early identification of medical students who are vulnerable to the stressful environment of medical schools might help them maintain psychological well-being during medical training.

  14. Cross-sectional associations between daily rest periods during weekdays and psychological distress, non-restorative sleep, fatigue, and work performance among information technology workers.

    Science.gov (United States)

    Tsuchiya, Masao; Takahashi, Masaya; Miki, Keiichi; Kubo, Tomohide; Izawa, Shuhei

    2017-04-07

    A daily rest period (DRP; rest taken from daily work during a 24 h period), is essential to work recovery. This study examined DRPs' distribution and association with health outcomes among information technology workers recruited from an internet panel (N=1,811). Participants completed a web questionnaire examining psychological distress as a primary outcome, along with non-restorative sleep, fatigue (stress reaction), and work performance. Logistic regression analysis showed elevated psychological distress when DRP was working and commuting hours. After the above adjustment, similar associations were found with non-restorative sleep and fatigue, but not work performance, when DRP was <12 h. These findings constitute the first analysis of a dose-response relationship between DRP and subjective health outcomes among white-collar workers.

  15. Colectomy for refractory constipation

    DEFF Research Database (Denmark)

    Raahave, Dennis; Loud, Franck Bjørn; Christensen, Elsebeth

    2010-01-01

    OBJECTIVE: This study evaluated the type of colectomy, postoperative complications, functional results, and satisfaction in patients with constipation refractory to conservative therapy. Further, colonic transit time (CTT), faecal load (coprostasis), and colon length (redundancies) were compared...

  16. Prevalence of psychiatric morbidity and psychological adaptation of the nurses in a structured SARS caring unit during outbreak: a prospective and periodic assessment study in Taiwan.

    Science.gov (United States)

    Su, Tung-Ping; Lien, Te-Cheng; Yang, Chih-Yi; Su, Yiet Ling; Wang, Jia-Horng; Tsai, Sing-Ling; Yin, Jeo-Chen

    2007-01-01

    To assess the rapidly changing psychological status of nurses during the acute phase of the 2003 SARS outbreak, we conducted a prospective and periodic evaluation of psychiatric morbidity and psychological adaptation among nurses in SARS units and non-SARS units. Nurse participants were from two SARS units (regular SARS [N=44] and SARS ICU [N=26]) and two non-SARS units (Neurology [N=15] and CCU [N=17]). Participants periodically self-evaluated their depression, anxiety, post-traumatic stress symptoms, sleep disturbance, attitude towards SARS and family support. Results showed that depression (38.5% vs. 3.1%) and insomnia (37% vs. 9.7%) were, respectively, greater in the SARS unit nurses than the non-SARS unit nurses. No difference between these two groups was found in the prevalence of post-traumatic stress symptoms (33% vs. 18.7%), yet, three unit subjects (SARS ICU, SARS regular and Neurology) had significantly higher rate than those in CCU (29.7% vs. 11.8%, respectively) (pregular SARS unit. Occurrence of psychiatric symptoms was linked to direct exposure to SARS patient care, previous mood disorder history, younger age and perceived negative feelings. Positive coping attitude and strong social and family support may have protected against acute stress. In conclusion, the psychological impact on the caring staffs facing future bio-disaster will be minimized with lowered risk factors and a safer and more structured work environment.

  17. Management of refractory epilepsy.

    Science.gov (United States)

    Muñana, Karen R

    2013-05-01

    The term refractory epilepsy is utilized in veterinary medicine to describe a condition in which an animal with epilepsy fails to attain satisfactory seizure control or suffers intolerable side effects despite appropriate therapy with conventional antiepileptic drugs. Refractory epilepsy is an important problem in small animal practice as it occurs in approximately one-third of dogs with epilepsy. Consequently, there is much interest in identifying ways to more effectively treat this population of animals. More than a dozen new antiepileptic drugs have been approved for humans over the last 2 decades, and several of these drugs, including gabapentin, zonisamide, levetiracetam, and pregabalin, have been evaluated for the treatment of refractory seizures in veterinary patients. Nonmedical methods to treat poorly controlled epilepsy are also being explored. The 2 alternative forms of therapy that have shown the most promise in humans with epilepsy are electrical stimulation of the brain and dietary modification, both of which have also been evaluated in dogs. This overview summarizes the available data on pharmacologic as well as nonmedical treatment options for dogs and cats with refractory epilepsy. Although many forms of therapy are currently being utilized in clinical practice, our knowledge of the safety and efficacy of these treatments is limited. Additional randomized controlled trials are needed to better evaluate these novel therapies for refractory epilepsy in dogs and cats. © 2013 Elsevier Inc. All rights reserved.

  18. Refractory gastroesophageal reflux disease

    Directory of Open Access Journals (Sweden)

    Joaquim Prado P. Moraes-Filho

    2012-12-01

    Full Text Available CONTEXT: Gastroesophageal reflux disease (GERD is a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Its pathophysiology, diagnosis and treatment have frequently been analyzed but it is interesting to review some aspects of the GERD refractory patients to the proton pump inhibitors treatment. The treatment encompasses behavioral measures and pharmacological therapy. The majority of the patients respond well to proton pump inhibitors treatment but 20%-42% of them may not do so well. Patients who are unresponsible to 4-8 weeks' treatment with proton pump inhibitors (omeprazole, pantoprazole, rabeprazole, lansoprazole, esomeprazole, pantoprazole-Mg might have so-called refractory GERD. RESULTS: In some cases the patients are not real refractory because either they do not have GERD or the disease was not correctly treated, but the term refractory is still employed. Although debatable, the Brazilian GERD Consensus based upon evidences recommends as first step in the diagnosis, the upper digestive endoscopy to exclude the diagnosis of peptic ulcer and cancer and in some cases identify the presence of esophageal mucosa erosions. CONCLUSIONS: The main causes of the so-called refractory GERD are: (1 functional heartburn; (2 low levels of adherence to proton pump inhibitors treatment; (3 inadequate proton pump inhibitors dosage; (4 wrong diagnosis; (5 co-morbidities and pill-induced esophagitis; (6 genotypic differences; (7 nonacid gastroesophageal reflux; (8 autoimmune skin diseases; (9 eosinophilic esophagitis.

  19. [Treatment of refractory ascites].

    Science.gov (United States)

    Martínez, Javier; Albillos, Agustín

    2014-07-01

    Ascites is a common complication of hepatic cirrhosis and portal hypertension. Patients present systemic and splanchnic circulation disorders, which cause central hypovolemia and arterial hypotension, with the subsequent activation of vasoconstrictor systems and increased renal reabsorption of sodium and water. Approximately 5%-10% of patients present refractory ascites. Refractory ascites is considered when it is not controllable with standard dietary (sodium restriction) and diuretic (furosemide up to 160 mg a day and spironolactone up to 400mg a day) treatment or when patients present adverse effects due to diuretics that impede their administration at optimum dosages. The current therapeutic options for these patients are repeated evacuative paracentesis and the percutaneous intrahepatic portosystemic shunt. Despite these treatments, refractory ascites has a poor prognosis; patients should therefore be assessed for liver transplantation. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  20. Iron refractory iron deficiency anemia

    Science.gov (United States)

    De Falco, Luigia; Sanchez, Mayka; Silvestri, Laura; Kannengiesser, Caroline; Muckenthaler, Martina U.; Iolascon, Achille; Gouya, Laurent; Camaschella, Clara; Beaumont, Carole

    2013-01-01

    Iron refractory iron deficiency anemia is a hereditary recessive anemia due to a defect in the TMPRSS6 gene encoding Matriptase-2. This protein is a transmembrane serine protease that plays an essential role in down-regulating hepcidin, the key regulator of iron homeostasis. Hallmarks of this disease are microcytic hypochromic anemia, low transferrin saturation and normal/high serum hepcidin values. The anemia appears in the post-natal period, although in some cases it is only diagnosed in adulthood. The disease is refractory to oral iron treatment but shows a slow response to intravenous iron injections and partial correction of the anemia. To date, 40 different Matriptase-2 mutations have been reported, affecting all the functional domains of the large ectodomain of the protein. In vitro experiments on transfected cells suggest that Matriptase-2 cleaves Hemojuvelin, a major regulator of hepcidin expression and that this function is altered in this genetic form of anemia. In contrast to the low/undetectable hepcidin levels observed in acquired iron deficiency, in patients with Matriptase-2 deficiency, serum hepcidin is inappropriately high for the low iron status and accounts for the absent/delayed response to oral iron treatment. A challenge for the clinicians and pediatricians is the recognition of the disorder among iron deficiency and other microcytic anemias commonly found in pediatric patients. The current treatment of iron refractory iron deficiency anemia is based on parenteral iron administration; in the future, manipulation of the hepcidin pathway with the aim of suppressing it might become an alternative therapeutic approach. PMID:23729726

  1. Dynamic Testing of Gasifier Refractory

    Energy Technology Data Exchange (ETDEWEB)

    Michael D. Mann; Wayne S. Seames; Devdutt Shukla; Xi Hong; John P. Hurley

    2005-12-01

    The University of North Dakota (UND) Chemical Engineering Department in conjunction with the UND Energy & Environmental Research Center (EERC) have initiated a program to examine the combined chemical (reaction and phase change) and physical (erosion) effects experienced by refractory materials under slagging coal gasification conditions. The goal of this work is to devise a mechanism of refractory loss under these conditions. The controlled-atmospheric dynamic corrodent application furnace (CADCAF) was utilized to simulate refractory/slag interactions under dynamic conditions that more realistically simulate the environment in a slagging coal gasifier than any of the static tests used previously by refractory manufacturers and researchers. High-alumina and high-chromia refractory bricks were tested using slags obtained from two solid fuel gasifiers. Testing was performed at 1475 C in a reducing atmosphere (2% H{sub 2} in N{sub 2}) The CADCAF tests show that high-chrome refractories have greater corrosion resistance than high-aluminum refractories; coal slag readily diffuses into the refractory through its grain boundaries; the refractory grains are more stable than the matrix in the tests, and the grains are the first line of defense against corrosion; calcium and alkali in the slag are more corrosive than iron; and silicon and calcium penetrate the deepest into the refractory. The results obtained from this study are preliminary and should be combined with result from other research programs. In particular, the refractory corrosion results from this study should be compared with refractories removed from commercial gasifiers.

  2. Refractory chronic migraine

    DEFF Research Database (Denmark)

    Martelletti, Paolo; Katsarava, Zaza; Lampl, Christian

    2014-01-01

    The debate on the clinical definition of refractory Chronic Migraine (rCM) is still far to be concluded. The importance to create a clinical framing of these rCM patients resides in the complete disability they show, in the high risk of serious adverse events from acute and preventative drugs...

  3. Status epilepticus: Refractory and super-refractory.

    Science.gov (United States)

    Dubey, Deepanshu; Kalita, Jayantee; Misra, Usha K

    2017-01-01

    Status epilepticus (SE) is an important neurological emergency. It is defined as seizures lasting for 5 minutes or more or recurrent seizures without recovery of consciousness to baseline between the attacks. Refractory SE (RSE) is defined as SE persisting despite sufficient dose of benzodiazepines and at least one antiepileptic drug (AED), irrespective of time. Super refractory SE (SRSE) is defined as SE that continues for 24 hours or more after the use of anesthetic therapy, including cases that recur on weaning of the anesthestic agent. RSE occurs in 23%-48% of the patients and SRSE in approximately 22% of the patients with SE. In general, RSE occurs in patients with new-onset seizures rather than in patients with chronic epilepsy. The etiology of RSE in developing countries is dominated by central nervous system (CNS) infections and head injury compared to stroke and drug withdrawal in the developed countries. The treatment of RSE and SRSE is not evidence based. Following benzodiazepines, the second line antiepileptic drugs include sodium valproate, phenytoin, levetiracetam, and anesthetic drugs such as midazolam, phenobarbital, and propofol. Most intravenous anesthetic drugs produce hypotension and respiratory suppression; therefore, patients with RSE are managed in intensive care units (ICUs). In RSE patients, electroencephalogram (EEG) burst suppression with interburst interval of 2-20 s or even flat EEG has been tried. Recently, concerns have been raised on the safety of burst suppression in RSE and SRSE. The paucity of ICUs in developing countries limits the use of these management protocols. There is a need to explore intravenous AEDs with safer cardiovascular and respiratory profile for the management of SE.

  4. Refractory rheumatoid vasculitis.

    Science.gov (United States)

    Kumar, Ashok; Goel, Anshul; Lapsiwala, Mehul; Singhal, Suman

    2016-11-01

    Systemic rheumatoid vasculitis (SRV) can develop in rheumatoid arthritis of long duration and high disease activity. It most commonly manifests as cutaneous vasculitis and mononeuritis multiplex. This can involve any organ of the body and carries very high mortality. We report a case of a young male who had rheumatoid arthritis for the past 15 years and became refractory to standard drugs and anti-TNF agents. He subsequently developed SRV, which started as mononeuritis multiplex. Disease progressed to result in gangrene of hands and feet despite receiving intravenous cyclophosphamide. Intravenous immunoglobulin and rituximab also could not provide any response. Prolonged ICU stay resulted in critical care neuromyopathy. Central nervous system vasculitis developed even after repeated infusions of intravenous immunoglobulins and at last he died of complications. In this case report, we have presented rare and chronic protracted presentation of rheumatoid vasculitis involving skin, nerves, brain and testis, which was refractory to the recommended therapies.

  5. Refractoriness in human atria

    DEFF Research Database (Denmark)

    Skibsbye, Lasse; Jespersen, Thomas; Christ, Torsten

    2016-01-01

    rhythm and chronic atrial fibrillation tissues and was neither affected by changes in frequency (1 vs. 3Hz). CONCLUSIONS: Our results suggest a preferentially voltage-dependent, rather than time-dependent, effect with respect to refractoriness at physiologically relevant rates in human atria. However...... drugs. Cardiomyocyte excitability depends on availability of sodium channels, which involves both time- and voltage-dependent recovery from inactivation. This study therefore aims to characterise how sodium channel inactivation affects refractoriness in human atria. METHODS AND RESULTS: Steady......-state activation and inactivation parameters of sodium channels measured in vitro in isolated human atrial cardiomyocytes were used to parameterise a mathematical human atrial cell model. Action potential data were acquired from human atrial trabeculae of patients in either sinus rhythm or chronic atrial...

  6. Refractory status epilepticus

    Directory of Open Access Journals (Sweden)

    Sanjay P Singh

    2014-01-01

    Full Text Available Refractory status epilepticus is a potentially life-threatening medical emergency. It requires early diagnosis and treatment. There is a lack of consensus upon its semantic definition of whether it is status epilepticus that continues despite treatment with benzodiazepine and one antiepileptic medication (AED, i.e., Lorazepam + phenytoin. Others regard refractory status epilepticus as failure of benzodiazepine and 2 antiepileptic medications, i.e., Lorazepam + phenytoin + phenobarb. Up to 30% patients in SE fail to respond to two antiepileptic drugs (AEDs and 15% continue to have seizure activity despite use of three drugs. Mechanisms that have made the treatment even more challenging are GABA-R that is internalized during status epilepticus and upregulation of multidrug transporter proteins. All patients of refractory status epilepticus require continuous EEG monitoring. There are three main agents used in the treatment of RSE. These include pentobarbital or thiopental, midazolam and propofol. RSE was shown to result in mortality in 35% cases, 39.13% of patients were left with severe neurological deficits, while another 13% had mild neurological deficits.

  7. Features of Physical and Neuro-Psychological Development of Children with Low, Very Low and Extremely Low Birth Weight in Different Age Periods of Life

    Directory of Open Access Journals (Sweden)

    I. A. Deev

    2016-01-01

    Full Text Available Analysis of features of physical and neuro-psychological development of children with low, very low and extremely low birth weight in different age periods is carried out according to cohort studies of newborns with different gestational age and birth weight, presented in electronic databases PubMed and Medscape. It is revealed that the overwhelming number of children with low, very low and extremely low birth weight, gain physical and neuro- psychological development impairments, hearing and vision disorders of varying severity, violation of motor function, intelligence and cognitive skills infringement in an older age. In this regard, it is actual not only to develop new neonatal reanimation and intensive care technologies, but also to ensure adequate prevention of preterm birth in the group of women with a high degree of perinatal risk. All this will further allow preventing increase in children with disabling conditions number among premature infants.

  8. Long-term improvement in refractory headache following ozone therapy.

    Science.gov (United States)

    Clavo, Bernardino; Santana-Rodriguez, Norberto; Gutierrez, Dominga; Lopez, Juan C; Suarez, Gerardo; Lopez, Laura; Robaina, Francisco; Bocci, Velio

    2013-05-01

    Headache afflicts approximately 10%-15% of the general population. Mixed results are obtained from various therapies, usually drugs, but also oxygen inhalation, behavioral psychology, physical therapy, and peripheral or central neurostimulation. When refractory to treatment, it has severe impact on quality of life. OBJECTIVES/SUBJECTS: Five (5) patients are presented who had suffered from severe/persistent headache refractory to standard management (including 5-HT1 agonist triptan drugs) and were treated with ozone therapy. Ozone administration was by major autohemotherapy. The procedure involved venous blood drawn into a sterile single-use glass bottle containing anticoagulant, gently mixed with an equal volume of O3/O2 gas mixture (prefiltered through a sterile 0.20-μm filter) and slowly reinfused back into the donor patient via the antecubital vein. The analyzed parameters were analgesia requirements, days of sick leave due to headache, number of headache events, and pain intensity according to the visual analogue scale (VAS); these recorded at three time points: pre-ozone therapy, post-ozone therapy, and before the last follow-up (mean: 64.6±36.8 months). The number of headache episodes pretreatment (n=80; range 5-200) was significantly decreased during the first 6 months post-treatment (n=0, range 0-1; p=0.042) and over the 6 months before the last follow-up visit (n=1, range 0-2; p=0.043). The corresponding VAS scores were 8.7±0.8 pretreatment versus 1.1±2.5 the 6 months post-treatment (p=0.003) and versus 3.1±3.3 the 6 months before last follow-up visit (p=0.036). Ozone therapy decreased headache episodes and pain severity over a protracted period. This novel approach is effective and merits further research.

  9. Refractory chronic cluster headache

    DEFF Research Database (Denmark)

    Mitsikostas, Dimos D; Edvinsson, Lars; Jensen, Rigmor H

    2014-01-01

    Chronic cluster headache (CCH) often resists to prophylactic pharmaceutical treatments resulting in patients' life damage. In this rare but pragmatic situation escalation to invasive management is needed but framing criteria are lacking. We aimed to reach a consensus for refractory CCH definition...... for clinical and research use. The preparation of the final consensus followed three stages. Internal between authors, a larger between all European Headache Federation members and finally an international one among all investigators that have published clinical studies on cluster headache the last five years...

  10. Highly Refractory Porous Ceramics,

    Science.gov (United States)

    1979-03-14

    also highly refractory porous materials based on co- rundum and magnesite were released in a limited amount.(1,6). The technology of manufacturing...there is an effect of slags and 4and other molten substances ( glasses , metals, etc.), under conditions where there is an effect of gas flows at high...slags, metal, glass , ashes, etc. (Table 53). Table 53 Ta6.,Hua 53 A Upeue~mbuas TenepaTypa npNveneas aA$MocANAEnaTNX n AunacoMux aerolecubM

  11. Phenomenon of the inner psychological migration as the factor of the national identity preservation in a period of social crises, anomia and repressions in case of the Polish settlement Marchlewsk (Dovbysh

    Directory of Open Access Journals (Sweden)

    Staniszewska Żanna

    2016-04-01

    Full Text Available The article gives a review of the population history of the Polish National Region named after Julian Marchlewski (settlement of Dovbysh, Zhitomir province, Ukraine. The author explores the psychological factors affecting the preservation of culture, religion and identity of the Polish community in the period of the repressions 1920-30 years. The article researches and analyses the phenomenon of internal psychological migration as a factor in preservation of national and personal self-identity.

  12. Relational development in children with cleft lip and palate: influence of the waiting period prior to the first surgical intervention and parental psychological perceptions of the abnormality.

    Science.gov (United States)

    Grollemund, Bruno; Guedeney, Antoine; Vazquez, Marie-Paule; Picard, Arnaud; Soupre, Véronique; Pellerin, Philippe; Simon, Etienne; Velten, Michel; Dissaux, Caroline; Kauffmann, Isabelle; Bruant-Rodier, Catherine; Danion-Grilliat, Anne

    2012-06-08

    The birth of a child with a cleft lip, whether or not in association with a cleft palate, is a traumatic event for parents. This prospective, multidisciplinary and multi-centre study aims to explore the perceptions and feelings of parents in the year following the birth of their child, and to analyse parent-child relationships. Four inclusion centres have been selected, differing as to the date of the first surgical intervention, between birth and six months. The aim is to compare results, also distinguishing the subgroups of parents who were given the diagnosis in utero and those who were not. The main hypothesis is that the longer the time-lapse before the first surgical intervention, the more likely are the psychological perceptions of the parents to affect the harmonious development of their child. Parents and children are seen twice, when the child is 4 months (T0) and when the child is one year old (T1). At these two times, the psychological state of the child and his/her relational abilities are assessed by a specially trained professional, and self-administered questionnaires measuring factors liable to affect child-parent relationships are issued to the parents. The Alarme Détresse BéBé score for the child and the Parenting Stress Index score for the parents, measured when the child reaches one year, will be used as the main criteria to compare children with early surgery to children with late surgery, and those where the diagnosis was obtained prior to birth with those receiving it at birth. The mental and psychological dimensions relating to the abnormality and its correction will be analysed for the parents (the importance of prenatal diagnosis, relational development with the child, self-image, quality of life) and also, for the first time, for the child (distress, withdrawal). In an ethical perspective, the different time lapses until surgery in the different protocols and their effects will be analysed, so as to serve as a reference for improving

  13. Relational development in children with cleft lip and palate: influence of the waiting period prior to the first surgical intervention and parental psychological perceptions of the abnormality

    Directory of Open Access Journals (Sweden)

    Grollemund Bruno

    2012-06-01

    Full Text Available Abstract Background The birth of a child with a cleft lip, whether or not in association with a cleft palate, is a traumatic event for parents. This prospective, multidisciplinary and multi-centre study aims to explore the perceptions and feelings of parents in the year following the birth of their child, and to analyse parent–child relationships. Four inclusion centres have been selected, differing as to the date of the first surgical intervention, between birth and six months. The aim is to compare results, also distinguishing the subgroups of parents who were given the diagnosis in utero and those who were not. Methods/Design The main hypothesis is that the longer the time-lapse before the first surgical intervention, the more likely are the psychological perceptions of the parents to affect the harmonious development of their child. Parents and children are seen twice, when the child is 4 months (T0 and when the child is one year old (T1. At these two times, the psychological state of the child and his/her relational abilities are assessed by a specially trained professional, and self-administered questionnaires measuring factors liable to affect child–parent relationships are issued to the parents. The Alarme Détresse BéBé score for the child and the Parenting Stress Index score for the parents, measured when the child reaches one year, will be used as the main criteria to compare children with early surgery to children with late surgery, and those where the diagnosis was obtained prior to birth with those receiving it at birth. Discussion The mental and psychological dimensions relating to the abnormality and its correction will be analysed for the parents (the importance of prenatal diagnosis, relational development with the child, self-image, quality of life and also, for the first time, for the child (distress, withdrawal. In an ethical perspective, the different time lapses until surgery in the different protocols and their

  14. Refractory Celiac Disease

    Directory of Open Access Journals (Sweden)

    K Khatami

    2014-04-01

    Full Text Available Refractory celiac disease (RCD is when malabsorption symptoms and villous atrophy persist despite strict adherence to a gluten free diet (GFD for more than 12 months and other causes of villous atrophy have been ruled out.  RCD is considered a rare disease and almost exclusively occurs in adults. Persistent diarrhea, abdominal pain, weight loss are the most common symptoms in RCD. Also, anemia, fatigue, malaise, thromboembolic events and coexisting autoimmune disorders are frequent. Diagnosis of RCD is based on other causes of unresponsiveness to the GFD, particularly collagenous sprue, ulcerative jejunitis, and enteropathy-associated T-cell lymphoma. Many disorders such as autoimmune enteropathy, tropical sprue, common variable immunodeficiency, and intolerance to non-gluten dietary proteins may have similar histological findings but not necessarily identical with CD and therefore should be excluded. Repeat intestinal biopsy may help to differentiate causes of non-responsive CD associated with ongoing villous atrophy (e.g., gluten contamination, small-bowel bacterial overgrowth, RCD. There are 2 subtypes of RCD according to absence (type I or presence (type II of an abnormal intraepithelial lymphocyte population. RCD type 1 usually becomes better with a combination of aggressive nutritional support, adherence to GFD, and pharmacologic therapies such as prednisone, budesonide and azathioprine. For RCD type 2, more aggressive therapeutic approach is needed since clinical response to therapies is less certain and may evolve into aggressive enteropathy associated T-cell lymphoma and the prognosis is poor.   Key words: Celiac Disease, Refractory.  

  15. [Lamotrigine in refractory epilepsy].

    Science.gov (United States)

    García-Escrivà, A; López-Hernández, N; Alvarez-Saúco, M; Pampliega-Pérez, A; Oliver-Navarrete, C; Asensio-Asensio, M; Moltó-Jordá, J M; Palao-Sánchez, A

    Lamotrigine (LTG) is a new antiepileptic drug indicated in all kinds of partial and generalised clonic-tonic seizures, both in monotherapy and polytherapy. Between 20 and 30% of epileptic patients have poor control over their seizures despite adequate treatment. We report on our experience regarding the long-term efficacy and tolerability of LTG in refractory seizures. We conducted a consecutive 10-year study of patients who began LTG therapy following poor control of their seizures, in spite of being treated with two or more antiepileptic drugs in monotherapy or in combination. Both their epidemiological and clinical data were collected for study. We studied the efficacy of the treatment, differentiating between remission (absence of seizures), improvement (reduction>50% of the seizures), inefficacy (reductionepilepsy, in 28.5% it was symptomatic and in the remaining 28.5% it was idiopathic. EEG readings and neuroimaging scans were pathological in 53.8% and 43.6%, respectively. After beginning therapy with LTG, 33% remained free of seizures, 43.6% improved, in 18.3% it was seen to be ineffective and 5.1% got worse. Dropout rate was 56.4%:23.1% due to insufficient control over the seizures, 17.9% owing to side effects and 15.4% because of non-compliance. Treatment with LTG offers a high degree of efficacy in the control of seizures in patients with refractory epilepsy, although it is limited by a high dropout rate.

  16. REFRACTORY COATING FOR GRAPHITE MOLDS

    Science.gov (United States)

    Stoddard, S.D.

    1958-06-24

    Refractory coating for graphite molds used in the casting of uranium is described. The coating is an alumino-silicate refractory composition which may be used as a mold surface in solid form or as a coating applied to the graphite mold. The composition consists of a mixture of ball clay, kaolin, alumina cement, alumina, water, sodium silicate, and sodium carbonate.

  17. Therapeutic laryngoscopy during exercise: A novel non-surgical therapy for refractory EILO.

    Science.gov (United States)

    Olin, J Tod; Deardorff, Emily H; Fan, Elizabeth M; Johnston, Kristina L; Keever, Valerie L; Moore, Camille M; Bender, Bruce G

    2017-06-01

    Exercise-induced laryngeal obstruction (EILO) may affect as many as 6% of the adolescent population, with some patients experiencing symptoms refractory to conservative interventions. This report describes therapeutic laryngoscopy during exercise, a novel, non-surgical intervention that harnesses real-time laryngoscopy video as biofeedback to control laryngeal aperture during high-intensity exercise. Additionally, we quantitate patient-reported perceptions of procedure safety, tolerability, learning value, and effectiveness. Clinical EILO patients with symptoms refractory to conventional respiratory retraining and other therapies were referred for the procedure which features laryngoscopy video as biofeedback during serial physician-guided 1-min exercise sprints. We quantify perceptions of procedure safety, tolerability, learning value, and effectiveness through questionnaires offered to all patients as well as observers of the procedure. Forty-one patients and 37 parent observers were approached for feedback; 88% of patients and 95% of observers consented to participation. Patients and observers reported perceptions of safety and tolerability (81% and 86%, respectively), learning value (78% and 91%, respectively), and effectiveness (58% and 80%, respectively) with patient age predicting some responses. Seventy-five percent of patients noted that "Since the procedure, my breathing during exercise has improved," and 85% of this group noted that therapeutic laryngoscopy during exercise was "the most important therapy leading to my breathing improvement." The procedure also provided insight into the psychological experience of patients, a domain not clinically apparent prior to the procedure. Our data support further study of therapeutic laryngoscopy during exercise as a possible intervention for patients with refractory EILO. Pediatr Pulmonol. 2017;52:813-819. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  18. Ciclosporin and refractory colitis.

    Science.gov (United States)

    Hawthorne, A Barney

    2003-03-01

    Intravenous ciclosporin 4 mg/kg daily is rapidly effective as a salvage therapy for patients with refractory colitis, who would otherwise face colectomy, but its use is controversial because of risk of toxicity, and long-term failure rate. Opportunistic infections remain a serious concern, with a number of reports of death related to ciclosporin. Renal and neurotoxicity are also well-recognized. The drug should not be continued for more than 3-6 months and its main role is as a bridge to azathioprine or 6-mercaptopurine. Risks of toxicity can be reduced by using lower doses (2 mg/kg/day intravenously), by oral microemulsion ciclosporin, or by monotherapy without corticosteroids. Preliminary evidence shows good response rates, but further studies are needed to confirm optimal use of this potent, but hazardous, therapy.

  19. Management of Refractory Vasodilatory Shock.

    Science.gov (United States)

    Jentzer, Jacob C; Vallabhajosyula, Saraschandra; Khanna, Ashish K; Chawla, Lakhmir S; Busse, Laurence W; Kashani, Kianoush B

    2018-01-09

    Refractory shock is a lethal manifestation of cardiovascular failure defined by an inadequate hemodynamic response to high doses of vasopressor medications. Approximately 7% of critically ill patients will develop refractory shock, with short-term mortality exceeding 50%. Refractory vasodilatory shock develops from uncontrolled vasodilation and vascular hyporesponsiveness to endogenous vasoconstrictors, causing failure of physiologic vasoregulatory mechanisms. Standard approaches to the initial management of shock include fluid resuscitation and initiation of norepinephrine. When these measures are inadequate to restore BP, vasopressin or epinephrine can be added. Few randomized studies exist to guide clinical management and hemodynamic stabilization in patients who do not respond to this standard approach. Adjunctive therapies, such as hydrocortisone, thiamine, and ascorbic acid, may increase BP in severe shock and should be considered when combination vasopressor therapy is needed. Novel vasopressor agents, such as synthetic human angiotensin II, can increase BP and reduce the need for high doses of catecholamine vasopressors in severe or refractory vasodilatory shock. Few effective rescue therapies exist for established refractory shock, which emphasizes the importance of aggressive intervention before refractory shock develops, including the earlier initiation of rational combination vasopressor therapy. The present review discusses the diagnosis and management of refractory shock to offer guidance for management of this important clinical problem and to provide a framework for future research. Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  20. Examining Psychological Well-Being and Self-Esteem Levels of Turkish Students in Gaining Identity against Role during Conflict Periods

    Science.gov (United States)

    Isiklar, Abdullah

    2012-01-01

    In this research, university students' psychological well being and self-esteem levels are investigated in terms of a number of variables. The sample in this study is composed of 382 university students. To gather the data for this study, the Subjective Information Form, Psychological Well-Being Scale and Self-Esteem Scale are used. T tests and…

  1. IMPROVED CORROSION RESISTANCE OF ALUMINA REFRACTORIES

    Energy Technology Data Exchange (ETDEWEB)

    John P. Hurley; Patty L. Kleven

    2001-09-30

    The initial objective of this project was to do a literature search to define the problems of refractory selection in the metals and glass industries. The problems fall into three categories: Economic--What do the major problems cost the industries financially? Operational--How do the major problems affect production efficiency and impact the environment? and Scientific--What are the chemical and physical mechanisms that cause the problems to occur? This report presents a summary of these problems. It was used to determine the areas in which the EERC can provide the most assistance through bench-scale and laboratory testing. The final objective of this project was to design and build a bench-scale high-temperature controlled atmosphere dynamic corrosion application furnace (CADCAF). The furnace will be used to evaluate refractory test samples in the presence of flowing corrodents for extended periods, to temperatures of 1600 C under controlled atmospheres. Corrodents will include molten slag, steel, and glass. This test should prove useful for the glass and steel industries when faced with the decision of choosing the best refractory for flowing corrodent conditions.

  2. Can Local Citation Analysis of Master's and Doctoral Theses Help Decision-Making about the Management of the Collection of Periodicals? A Case Study in Psychology and Education Sciences

    Science.gov (United States)

    Feyereisen, Pierre; Spoiden, Anne

    2009-01-01

    This study analyzed reference lists in a large number of master's and doctoral theses in a university library of psychology and education sciences. It compared citation counts to other indicators of the use of periodicals. The usefulness and limitations of these statistics are discussed in relation to decision-making in subscriptions' management.…

  3. Intrathecal ziconotide for refractory pain.

    Science.gov (United States)

    Doggrell, Sheila A

    2004-07-01

    For cancer and AIDS patients, 10-30% of pain is refractory to strong opioids, requiring intraspinal administration for pain management. Ziconotide is a selective N-type calcium channel blocker, which inhibits neurotransmitter release, and following intrathecal administration will affect primary nociceptive afferents. In 108 patients with previously unmanaged refractory pain despite the use of systemic or intrathecal opioids, in the initial titration phase, the mean Visual Analogue Scale of Pain Intensity scores improved more in the ziconotide group (53%) than the placebo group (18%). Serious adverse effects were more common in the ziconotide group (31%) than placebo group (10%) in the initial titration phase. In the 48 patients receiving ziconotide, who proceeded to the maintenance phase, the benefit of ziconotide was continued. Until a new approach with a better effectiveness/adverse effects profile than ziconotide for refractory pain emerges, further optimisation of ziconotide for use in the treatment of refractory pain should be undertaken.

  4. Psychological and Linguistic Means of Forming “A Soviet Person” in the Journal Periodicals of the Ukrainian Soviet Socialist Republic

    Directory of Open Access Journals (Sweden)

    Kolisnyk Yurij

    2017-08-01

    Full Text Available The article deals with the psychological and linguistic methods of establishing a social life and the impact of the magazines on the public consciousness in the Ukrainian Soviet Socialist Republic. Press provided concealed manipulation programming of the citizens′ behaviour. The whole society was imposed with the regulated values, moral imperatives and ideals via indoctrination, pressure and attack. Mass zombing was considerably played by “the new language” which implemented the basic notions of the totalitarian ideology. Transforming of citizens′ consciousness was possible by manipulating with their interests and desires. In this way the run of social processes was regulated. Russification, denationalization and destroying of national memory took place. Having no alternative a person was transformed into a system cog. Thus the aim of the article is to specify the influence of the journal periodicals in 1950- 1980s by psycho-linguistic means on forming the necessary concept of “a Soviet person”. The following methods were used: concrete historical and sociological press analysis, systematic and comparative analysis as well as generalization of contents and subjects of the magazines, analysis of political impact factors on magazines transformation as the mean of forming public consciousness, content analysis for stating the level of ideological partiality in the magazines and the frequency of usage of the ideological words in magazine texts and peculiarity of their combinability. Content analysis indicators are received by calculation on the sectional observation material. The basis of the empirical research is four public-political magazines “Ukrayina” (“Ukraine”, “Vitchyzna” (“Motherland”, “Zhovten’” (“October”, “Radyans’ka Zhinka” (“Soviet Woman” and two children’s magazines “Barvinok” (“Periwinkle” and “Malyatko”2 (“Baby” of the 1950-1980s.

  5. Testing Requirements for Refractory Materials

    Science.gov (United States)

    Calle, Luz Marina; Hintze, Paul E.; Parlier, Christopher R.; Curran, Jerome P.; Kolody, Mark R.; Sampson, Jeffrey W,; Montgomery, Eliza M.

    2012-01-01

    Launch Pads 39A and 39B currently use refractory material (Fondu Fyre) in the flame trenches. This material was initially approved for the Saturn program. This material had a lifetime of 10years according to the manufacturer, and it has been used for over 40 years. As a consequence, the Fondu Fyre at Launch Complex 39 requires repair subsequent to almost every launch. A review of the literature indicates that the gunned Fondu Fyre refractory product (WA-1 G) was never tested prior to use. With the recent severe damage to the flame trenches, a new refractory material is sought to replace Fondu Fyre. In order to replace Fondu Fyre, a methodology to test and evaluate refractory products was developed. This paper outlines this methodology and discusses current testing requirements, as well as the laboratory testing that might be required. Furthermore, this report points out the necessity for subscale testing, the locations where this testing can be performed, and the parameters that will be necessary to qualify a product. The goal is to identify a more durable refractory material that has physical, chemical, and thermal properties suitable to withstand the harsh environment of the launch pads at KSC.

  6. Oral tranexamic acid lightens refractory melasma.

    Science.gov (United States)

    Tan, Aaron Wei Min; Sen, Priya; Chua, Sze Hon; Goh, Boon Kee

    2017-08-01

    Melasma is a common acquired hyperpigmentary disorder, particularly among Asians and Hispanics, but its exact pathomechanism is poorly understood. Tranexamic acid has been found to lighten melasma by interfering with the interaction of melanocytes and keratinocytes by inhibiting the plasminogen/plasmin system. The aim was to evaluate the therapeutic effects of oral tranexamic acid in the treatment of melasma refractory to topical skin-lightening agents. This retrospective study analyses patients with melasma recruited from a tertiary dermatological centre in Singapore between 1 August 2009 and 31 March 2011. The patients chosen had refractory melasma treated with oral tranexamic acid 250 mg twice daily in addition to pre-existing combination topical therapy. Objective assessment using the physician's global assessment and melasma area and severity index (MASI) scores were performed based on a post-hoc analysis of photographic records by three independent physicians. A paired t-test was used to evaluate the changes in the MASI scores pre-therapy and post-treatment. Statistical significance was defined as P tranexamic acid for a mean period of 3.7 ± 0.33 months, in addition to combination topical therapy. Their mean age was 47.2 ± 1.61 years. The mean MASI scores after tranexamic acid treatment (2.7 ± 1.6) were significantly lower (P tranexamic acid can serve as a safe and useful adjunct in the treatment of refractory melasma. © 2016 The Australasian College of Dermatologists.

  7. Infliximab for refractory oral ulcers.

    Science.gov (United States)

    Ryu, Hee Jung; Seo, Mi Ryoung; Choi, Hyo Jin; Baek, Han Joo

    2014-01-01

    Recurrent oral ulcer (ROU) is a common condition that significantly impacts quality of life. It is often related to systemic diseases, such as Behçet's disease (BD), Crohn's disease, and ulcerative colitis. Treatment of ROU depends on its severity: from topical agents for mild cases to systemic agents, such as corticosteroids, azathioprine, or other immunosuppressants for severe cases. Recently, good results have been reported with infliximab in refractory ROU. However, the optimal dosage and treatment duration have not been determined and the cost and potential side effects should be considered. We report on four patients who received a single-dose infliximab for refractory ROU. Two patients had refractory ROU with no underlying disease; one of them had soft palate perforation accompanied by severe oral ulcers. The two other patients had ROU of BD without major organ involvement. All patients received a single infusion of infliximab and an additional infusion was given on demand in one patient. Infliximab showed a rapid, good response in three patients and was also effective in improving the acute inflammation in the perforation of the soft palate, which had been resistant to conventional therapies. These effects diminished over a few weeks, but the ROU were tolerable and it was not necessary to increase steroids or add another medicine for about 1 year. We suggest that a single infusion of infliximab can be considered for refractory ROU. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. AVIATION PSYCHOLOGY,

    Science.gov (United States)

    PSYCHOLOGY , AERONAUTICS, FLIGHT, PILOTS, PERCEPTION, ATTENTION, READING, MEMORY( PSYCHOLOGY ), PERSONALITY, EMOTIONS, FATIGUE(PHYSIOLOGY), AVIATION SAFETY, AVIATION ACCIDENTS, PSYCHOMOTOR TESTS, PSYCHOLOGICAL TESTS, TRAINING.

  9. Vigabatrin and lamotrigine in refractory epilepsy.

    Science.gov (United States)

    Stolarek, I; Blacklaw, J; Forrest, G; Brodie, M J

    1994-08-01

    Epilepsy arises from an imbalance of inhibitory and excitatory influences in the brain. Vigabatrin (VIG) decreases the breakdown of the inhibitory neurotransmitter gamma-aminobutyric acid, whereas lamotrigine (LTG) reduces presynaptic excitatory amino acid release. 22 patients with refractory epilepsy, treated with an anticonvulsant regimen containing VIG, entered a balanced, double blind, placebo controlled, crossover trial of additional LTG. Treatment periods of 12 weeks (25 mg, 50 mg, 100 mg LTG twice daily for four weeks at each dose, and matched placebo) were followed by wash out intervals of four weeks. 14 of the 20 patients completing the study improved, resulting in a significant fall in seizure days and numbers. Analysis of seizure type confirmed a beneficial effect on partial and secondary generalised tonic-clonic seizures. At the highest LTG dose (200 mg daily) there was a median fall of 37% in seizure count with nine (45%) patients reporting > 50% reduction. Three of these patients were seizure free during this month of treatment. Side effects were minimal throughout the study. Concentrations of other antiepileptic drugs, including those of carbamazepine 10,11-epoxide, were not modified by LTG. This study suggests a substantial efficacy for a regimen containing VIG and LTG. Combinations of drugs with complementary modes of action may provide a rational pharmacological approach to the management of refractory epilepsy.

  10. Chromia refractory brick with carbon treatment

    Science.gov (United States)

    Bennett, James P.; Kwong, Kyei-Sing

    2017-03-21

    The disclosure provides a refractory brick system comprising a chromia refractory brick for operation in the slagging environment of an air-cooled gasifier. The chromia refractory brick comprises a ceramically-bonded porous chromia refractory having a porosity greater than 9% and having carbon deposits residing within the pores. The brick may be further comprised of Al.sub.2O.sub.3. The air-cooled gasifier generates a liquefied slag in contact with the refractory brick and generally operates at temperatures between 1250.degree. C. and 1575.degree. C. and pressures between 300 psi to 1000 psi, with oxygen partial pressures generally between 10.sup.-4 and 10.sup.-10 atm. The refractory brick performs without substantial chromium carbide or chromium metal formation in the low oxygen partial pressure environment. The inclusion of carbon without chromium carbide formation provides for significant mitigation of slag penetration and significantly reduced refractory wear.

  11. REFRACTORY DIE FOR EXTRUDING URANIUM

    Science.gov (United States)

    Creutz, E.C.

    1959-08-11

    A die is presented for the extrusion of metals, said die being formed of a refractory complex oxide having the composition M/sub n/O/sub m/R/sub x/O/sub y/ where M is magnesium, zinc, manganese, or iron, R is aluminum, chromic chromium, ferric iron, or manganic manganese, and m, n, x, and y are whole numbers. Specific examples are spinel, magnesium aluminate, magnetite, magnesioferrite, chromite, and franklinite.

  12. [Adolescent psychology].

    Science.gov (United States)

    Lemerle, Sophie

    2005-05-31

    Adolescence is a transitional period dominated by puberty modifications. These modifications must come with a psychological work leading towards increased self containing from parents and also towards the choice of an own life orientation. In order to do so, adolescent must satisfy his needs to be able to change. This process will not run smoothly. The troubled adolescent will express himself with groans or acting out more than with words. This modus operandi is typical of that age. The general practitioner will be in the front line in being attentive to the adolescent and his parents needs.

  13. Psychology in Japan.

    Science.gov (United States)

    Imada, Hiroshi; Tanaka-Matsumi, Junko

    2016-06-01

    The purpose of this article is to provide information about Japan and its psychology in advance of the 31st International Congress of Psychology (ICP), to be held in Yokohama, Japan, in 2016. The article begins with the introduction of the Japanese Psychological Association (JPA), the hosting organization of the ICP 2016, and the Japanese Union of Psychological Associations consisting of 51 associations/societies, of which the JPA is a member. This is followed by a brief description of a history of psychology of Japan, with emphasis on the variation in our approach to psychology in three different periods, that is, the pre- and post-Pacific War periods, and the post-1960 period. Next, the international contributions of Japanese psychology/psychologists are discussed from the point of view of their visibility. Education and training in psychology in Japanese universities is discussed with a final positive remark about the long-awaited enactment of the Accredited Psychologist Law in September, 2015. © 2016 International Union of Psychological Science.

  14. Wettability between molten slag and dolomitic refractory

    OpenAIRE

    Shen, Ping; Zhang, Lifeng; Wang, Yi; Sridhar, Seetharaman; Wang, Qiangqiang

    2016-01-01

    In the current study, the wettability between molten slag and dolomitic refractory materials used in the ladle during steel refining was investigated. The contact angle between molten slag and dolomitic substrate decreased with increasing temperature. The slag with lower basicity spread on the substrate more easily and penetrated deeper into the substrate. The penetration depth of slag into the refractory increased with the extension of holding time. The CaO in the refractory dissolved into s...

  15. New psychological therapies for irritable bowel syndrome: mindfulness, acceptance and commitment therapy (ACT).

    Science.gov (United States)

    Sebastián Sánchez, Beatriz; Gil Roales-Nieto, Jesús; Ferreira, Nuno Bravo; Gil Luciano, Bárbara; Sebastián Domingo, Juan José

    2017-09-01

    The current goal of treatment in irritable bowel syndrome (IBS) focuses primarily on symptom management and attempts to improve quality of life. Several treatments are at the disposal of physicians; lifestyle and dietary management, pharmacological treatments and psychological interventions are the most used and recommended. Psychological treatments have been proposed as viable alternatives or compliments to existing care models. Most forms of psychological therapies studied have been shown to be helpful in reducing symptoms and in improving the psychological component of anxiety/depression and health-related quality of life. According to current NICE/NHS guidelines, physicians should consider referral for psychological treatment in patients who do not respond to pharmacotherapy for a period of 12 months and develop a continuing symptom profile (described as refractory irritable bowel syndrome). Cognitive behavioral therapy (CBT) is the best studied treatment and seems to be the most promising therapeutic approach. However, some studies have challenged the effectiveness of this therapy for irritable bowel syndrome. One study concluded that cognitive behavioral therapy is no more effective than placebo attention control condition and another study showed that the beneficial effects wane after six months of follow-up. A review of mind/body approaches to irritable bowel syndrome has therefore suggested that alternate strategies targeting mechanisms other than thought content change might be helpful, specifically mindfulness and acceptance-based approaches. In this article we review these new psychological treatment approaches in an attempt to raise awareness of alternative treatments to gastroenterologists that treat this clinical syndrome.

  16. Refractory, Abrasive and Other Industrial Mineral Operations

    Data.gov (United States)

    Department of Homeland Security — This map layer includes refractory, abrasive, and other industrial minerals operations in the United States. The data represent commodities covered by the Minerals...

  17. Refractory organic substances in the environment

    National Research Council Canada - National Science Library

    Frimmel, F. H

    2002-01-01

    ... and its Quality Control in Fractions of Refractory Organic Substances and the Corresponding Original Water Samples 39 Introduction 39 Description of Analytical Methods 41 Sample Treatment 41 Fl...

  18. The improvement of slagging gasifier refractories

    Energy Technology Data Exchange (ETDEWEB)

    Kwong, K.-S.; Bennett, J.P.; Powell, C.A.; Krabbe, R.A.

    2006-03-01

    Refractories play a vital role in slagging gasifier on-line availability and profitability for the next clean power generation system. A recent survey of gasifier users by USDOE indicated that a longer service life of refractories is the highest need among gasifier operators. Currently, Cr2O3 based refractories, the best of commercially available materials for use in slagging gasifiers, last between 3 and 24 months. Researchers at Albany Research Center (ARC) have identified structural spalling, caused by slag penetration, as one of the major failure mechanisms of Cr2O3 refractories through postmortem analysis. New Cr2O3 refractories with phosphate additives have been developed by ARC to decrease slag penetration and thus structural spalling. Laboratory physical property tests indicated that ARC developed refractories are superior to other commercial bricks. One of the ARC developed phosphate containing refractories has been installed in a slagging gasifier. Preliminary results of the performance of this refractory in the gasifier will be reported along with research to develop non-chromia refractories.

  19. Tacrolimus in Corticosteroid-Refractory Vernal Keratoconjunctivitis.

    Science.gov (United States)

    Chatterjee, Samrat; Agrawal, Deepshikha

    2016-11-01

    To evaluate the efficacy of 0.03% tacrolimus in the treatment of corticosteroid-refractory vernal keratoconjunctivitis (VKC). This open-label study enrolled 30 patients with VKC who were not responding to topical corticosteroid treatment for at least 4 weeks. All patients were treated with 0.03% tacrolimus eye ointment 3 times daily, 0.05% ketotifen eye drops twice daily, and preservative-free artificial tears. Symptoms (itching, redness, watering, discharge, burning, and photophobia) and signs (conjunctival injection, papillae, cobblestone papillae, limbal inflammation, or hypertrophy and corneal epithelial staining) were graded on a 4-point scale at enrolment, after 4 weeks, and at the end of treatment period, which was at 12 weeks. Composite scores for symptoms and signs were computed by summing individual scores. Treatment failure was denoted if additional treatment with corticosteroids were required. The composite scores for symptoms (10.8, 3.8, 3.4) and signs (8.7, 4.7, 4.0) in 23 patients showed a statistically significant (P < 0.05) improvement from baseline to the 4- and 12-week visits. Among the signs, upper tarsal papilla showed improvement only at 12 weeks, but the scores for giant cobblestone papillae did not reach statistically significant reduction even at 12 weeks. There was improvement in visual acuity at 12 weeks, although it was not statistically significant (P = 0.05). Treatment failure was recorded in 17% patients. The only adverse effect reported was transient stinging sensation lasting for a few days. Tacrolimus 0.03% was apparently safe and effective in treating patients with steroid-refractory VKC. A small subset of patients may still require supplemental topical corticosteroids for resolution of their symptoms.

  20. ENGINEERING PSYCHOLOGY,

    Science.gov (United States)

    MAN MACHINE SYSTEMS, APPLIED PSYCHOLOGY ), INFORMATION THEORY, ELECTROPHYSIOLOGY, HUMAN FACTORS ENGINEERING, PERCEPTION( PSYCHOLOGY ...PSYCHOPHYSIOLOGY, AUTOMATION, BRAIN, AUDITORY PERCEPTION, VISUAL PERCEPTION, MEMORY( PSYCHOLOGY ), MOTOR REACTIONS, NOISE, PERFORMANCE(HUMAN), USSR

  1. Military Psychology.

    Science.gov (United States)

    MILITARY FORCES(FOREIGN), *MILITARY PSYCHOLOGY , *TEXTBOOKS, USSR, ORGANIZATIONS, COMBAT READINESS, PSYCHOMOTOR FUNCTION, REASONING, SURVEYS...TRANSLATIONS, MILITARY TRAINING, OFFICER PERSONNEL, PERCEPTION( PSYCHOLOGY ), PERSONALITY, COMMUNISM, INTERPERSONAL RELATIONS, EMOTIONS.

  2. Genetics Home Reference: iron-refractory iron deficiency anemia

    Science.gov (United States)

    ... refractory iron deficiency anemia Iron-refractory iron deficiency anemia Printable PDF Open All Close All Enable Javascript ... expand/collapse boxes. Description Iron-refractory iron deficiency anemia is one of many types of anemia , which ...

  3. Multimodal intrathecal analgesia in refractory cancer pain.

    Science.gov (United States)

    Mastenbroek, Thierry C; Kramp-Hendriks, Bianca J; Kallewaard, Jan Willem; Vonk, Johanna M

    2017-01-01

    Cancer pain treatment has improved over the last decades. The majority of this population can be treated effectively with analgesics following the Guidelines of the original World Health Organisation (WHO). Unfortunately 10-15% of these patients still suffer from severe and refractory cancer pain, especially in the terminal phases of disease and require additional pain management modalities. Therefore, end-stage clinical interventions are particularly needed to minimize the perception of pain. With intrathecal therapy (ITT), drugs are delivered close to their site of action in the central nervous system avoiding first-pass metabolism and blood-brain barrier. It may improve analgesia with a smaller dose and possibly achieve a reduction in systemic or cerebral side effects compared to oral supplied medication alone. Multimodal analgesia enables further dose reduction with improved analgesia and fewer side effects. In this retrospective research we investigated the effectiveness and side-effect profile of intrathecal morphine, bupivacaine and clonidine. Patients were followed until death occurred. Pain scores and side effects were recorded before initiating ITT (T0), just after initiating ITT (T1), at hospital discharge (T2), in the ambulant setting (T3) and the last obtained scores before death occurred (T4). Nine patients were included who suffered from severe and refractory cancer pain, not reacting to conventional pain management or had intolerable side effects. Primary tumour location was pancreatic (4), urothelial (3) and prostate (2). Primary pain was considered neuropathic or mixed neuropathic-nociceptive. The treatment team consisted of an anaesthetist, specialized nurse in coordination with primary physician, treating oncologist and specialized home care. All patients were free of pain after initiation of the intrathecal therapy. The average follow-up period was 11 weeks in which there was a slight increase in NRS-score. In the last days before death

  4. Neuroimaging evaluation in refractory epilepsy.

    Science.gov (United States)

    Granados, Ana M; Orejuela, Juan F; Rodriguez-Takeuchi, Sara Y

    2015-10-01

    To describe the application of neuroimaging analysis, compared to neuropsychological tests and video-electroencephalogram, for the evaluation of refractory epilepsy in a reference centre in Cali, Colombia. Between March 2013 and November 2014, 29 patients, 19 men and 10 women, aged 9-65 years and with refractory epilepsy, were assessed by structural and functional magnetic resonance imaging while performing tasks related to language, verbal and non-verbal memory. Also, volumetric evaluation was performed. A 1.5 Tesla magnetic resonance imaging scanner was used in all cases. Neuroimaging evaluation identified 13 patients with mesial temporal sclerosis. The remaining patients were classified as: 10 patients with neoplastic masses, two patients with cortical atrophy, two patients with scarring lesions and two patients with non-structural aetiology. Among patients with mesial temporal sclerosis, comparison between techniques for lateralising the epileptogenic foci was made; the κ index between functional magnetic resonance imaging and hippocampi volumetry was κ=1.00, agreement between neuroimaging and video-electroencephalogram was good (κ=0.78) and comparison with a neuropsychological test was mild (κ=0.24). Neuroimaging studies allow the assessment of functional and structural damage related to epileptogenic lesions and foci, and are helpful to select surgical treatment, conduct intraoperative neuronavigation techniques, predict surgical deficits and evaluate patient recovery. © The Author(s) 2015.

  5. Pulsed radiofrequency of brachial plexus under ultrasound guidance for refractory stump pain: a case report

    Directory of Open Access Journals (Sweden)

    Zheng B

    2017-11-01

    Full Text Available Bixin Zheng, Li Song, Hui Liu Department of Pain Management, West China Hospital of Sichuan University, Chengdu, China Abstract: The post-amputation (pain syndrome, including stump pain, phantom limb sensation, and phantom limb pain is common but difficult to treat. Refractory stump pain in the syndrome is an extremely challenging and troublesome clinical condition. Patients respond poorly to drugs, nerve blocks, and other effective treatments like spinal cord stimulation and surgery. Pulsed radiofrequency (PRF technique has been shown to be effective in reducing neuropathic pain. This report describes a patient with persistent and refractory upper limb stump pain being successfully relieved with PRF of brachial plexus under ultrasound guidance after a 6-month follow-up period, suggesting that PRF may be considered as an alternative treatment for refractory stump-neuroma pain. Keywords: ultrasound guidance, pulsed radiofrequency, brachial plexus, refractory stump pain 

  6. Present situation of refractories in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Bittencourt, P. (Magnesita S.A., (Brazil))

    1992-11-10

    This paper outlines the present situation of refractories in Brazil, particularly the use of refractories in the steel industry which is one of the major industries in this country. Brazil is the 8th largest steel producer in the world, and about 64% of all the production is exported. Because of increasing competitions in the world market, high-level production techniques are required, and active improvements of refractories are also being carried out. The specific consumption of refractories in 1 ton of steel has gradually decreased to produce high-quality refractories. In Brazil, 95% of all demand except for special items such as submerged nozzles and blast furnace carbon blocks can be provided domestically. It is characteristic that raw materials for refractories, such as magnesite, bauxite, and graphite can also be self-supporting. Compositions and physical properties of typical refractories used for various purposes in iron and steel manufactures including blast furnaces, torpedo cars, BOF converters, electric are furnaces, and electric arc ladles are described, and the direction toward their conversion into new materials is shown. Moreover, the trends of refractories for the cement industry and for nonferrous metals such as aluminum are introduced. 6 figs., 15 tabs.

  7. Relationship between "extension of refractoriness" and probability of successful defibrillation.

    Science.gov (United States)

    Tovar, O H; Jones, J L

    1997-02-01

    The "extension of refractoriness" hypothesis, which suggests that the shock halts fibrillation by extending the refractory period, has not been directly tested. Defibrillation (5 isolated rabbit hearts; 111 episodes) was attempted by 8-ms pulses (65% tilt) delivered through epicardial patches. Monophasic action potentials were recorded in a low current density region (6.3 V/cm at 90% success). Fifty shocks failed to convert; 61 shocks successfully defibrillated. Postshock response duration (from shock to repolarization) was significantly longer for successful type A (with no postshock activations) defibrillation (102.3 +/- 7.5 ms) than for unsuccessful defibrillation (47.6 +/- 4.3 ms; P defibrillation were significantly longer than those for unsuccessful defibrillation. A minimum prolongation of 75 ms was associated with type A defibrillation. These results suggest that shock-induced response duration correlates with successful defibrillation and that a response of 75 ms is required to completely block fibrillation wavefronts.

  8. Refractory metal particles in refractory inclusions in the Allende meteorite

    Energy Technology Data Exchange (ETDEWEB)

    Fuchs, L. H.; Blander, M.

    1980-01-01

    An examination of refractory metal particles in five calcium-aluminum-rich inclusions in the Allende meteorite indicates a complex variety of compositions and large departures from equilibrium. These particles appear to have been primordial condensates which were isolated from the nebula and from each other at different times by cocondensing oxides. Selective diffusion and/or oxidation of the more oxidizable metals (Mo, W, Fe and Ni), phase segregations into different alloy phases (fcc, bcc, hcp and perhaps ordered phases) and the formation of metastable condensates appears to have been involved in the modification of these materials to their present state. Only a small fraction of our observations cannot be reconciled with this picture because of a lack of knowledge of some of the phase equilibria which might have bee involved.

  9. Features of the psychological States of a person residing in the area of armed conflict, in the context of the transformation of life strategies in the post-conflict period

    Directory of Open Access Journals (Sweden)

    Ryadinskaya E.N.

    2017-01-01

    Full Text Available The article is a theoretical study of the psychological characteristics of the effects of armed conflict. In this article the author considers issues of importance to modern psychology, such as mental and emotional state of people in the period of occurrence of the armed conflict, the impact of immediate residence in the area of armed conflict on the mental state of the person, the stressors that affect the mental state of a person in an armed conflict. The author focuses on the fact that the current socio-political situation in the regions where there was armed conflict, seriously affect the population, its relation to reality, setting goals, and vision of prospects in life. In conclusion, the article notes that the experience of life crisis in a situation of armed conflict may manifest in the loss of a sense of integrity and inner balance, the loss of the ability to control and manage their own lives. The study was supported by the grant SFU № 213.01-11/2016-2НМ (job Minobrnauki No. 28.125.2016/NM.

  10. Refractory for Black Liquor Gasifiers

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Musa Karakus; Xiaoting Laing

    2005-10-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  11. REFRACTORY FOR BLACK LIQUOR GASIFIERS

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Musa Karakus; Jun Wei

    2005-03-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  12. Acute metabolic, hormonal, and psychological responses to strength training with superimposed EMS at the beginning and the end of a 6 week training period.

    Science.gov (United States)

    Wirtz, N; Wahl, P; Kleinöder, H; Wechsler, K; Achtzehn, S; Mester, J

    2015-12-01

    The aim was to determine metabolic and hormonal responses to strength training with or without superimposed electromyostimulation (EMS) at the beginning and the end of a 6 week training period. 20 strength trained subjects were randomly assigned to two groups. The first group (S) performed 4 sets of back squats with a constantly adjusted additional load of their individual 10 repetition maximum (10 RM) twice a week over 6 weeks. The second group (S+E) did the same training program with superimposed EMS on leg and trunk muscles. Physiological responses were determined before and after the first (TS 1) and the last training session (TS 12). No significant differences of hormonal responses could be observed between groups and TSs. However, small to large effects on metabolism occurred between groups and TSs. Delayed onset muscle soreness (DOMS) was significantly higher 48h after TS 1 for S+E. Despite a higher DOMS after S+E, there is no acute effect of superimposed EMS on hormonal response to exhaustive resistance exercise. We suggest that, because of the high resistance during 10 RM bouts, most of the muscle fibers are already activated and superimposed EMS only activates few additional muscle fibers.

  13. Acute metabolic, hormonal, and psychological responses to strength training with superimposed EMS at the beginning and the end of a 6 week training period

    Science.gov (United States)

    Wirtz, N.; Wahl, P.; Kleinöder, H.; Wechsler, K.; Achtzehn, S.; Mester, J.

    2015-01-01

    Objectives: The aim was to determine metabolic and hormonal responses to strength training with or without superimposed electromyostimulation (EMS) at the beginning and the end of a 6 week training period. Methods: 20 strength trained subjects were randomly assigned to two groups. The first group (S) performed 4 sets of back squats with a constantly adjusted additional load of their individual 10 repetition maximum (10 RM) twice a week over 6 weeks. The second group (S+E) did the same training program with superimposed EMS on leg and trunk muscles. Physiological responses were determined before and after the first (TS 1) and the last training session (TS 12). Results: No significant differences of hormonal responses could be observed between groups and TSs. However, small to large effects on metabolism occurred between groups and TSs. Delayed onset muscle soreness (DOMS) was significantly higher 48h after TS 1 for S+E. Conclusions: Despite a higher DOMS after S+E, there is no acute effect of superimposed EMS on hormonal response to exhaustive resistance exercise. We suggest that, because of the high resistance during 10 RM bouts, most of the muscle fibers are already activated and superimposed EMS only activates few additional muscle fibers. PMID:26636278

  14. NASA research on refractory compounds.

    Science.gov (United States)

    Gangler, J. J.

    1971-01-01

    The behavior and properties of the refractory carbides, nitrides, and borides are being investigated by NASA as part of its research aimed at developing superior heat resistant materials for aerospace applications. Fundamental studies on the electronic and defect structures of the carbides indicate that there is promise for improving the strength and ductility of these materials. Studies of the zirconium-carbon-oxygen system show that zirconium oxycarbides of different compositions and lattice parameters can be formed between 1500 and 1900 C and are stable below 1500 C. More applied studies show that hot working generally improves the microstructure and therefore the strength of TiC and NbC. Sintering studies on UN indicate that very high densities can be achieved. Hot pressing of cermets of HfN and HfC produces good mechanical properties for high temperature bearing applications.

  15. REFRACTORY FOR BLACK LIQUOR GASIFIERS

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Musa Karakus; Xiaoting Liang; Alireza Rezaie

    2004-07-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  16. REFRACTORY FOR BLACK LIQUOR GASIFIERS

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Musa Karakus; Xiaoting Liang; Alireza Rezaie

    2004-10-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  17. Refractory for Black Liquor Gasifiers

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Musa Karakus; Xiaoting Liang

    2005-10-01

    The University of Missouri-Rolla identified materials that permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project was to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study attempted to define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials were selected/developed that either react with the gasifier environment to form protective surfaces in

  18. REFRACTORY FOR BLACK LIQUOR GASIFIERS

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Musa Karakus; Xiaoting Liang

    2005-07-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  19. REFRACTORY FOR BLACK LIQUOR GASIFIERS

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Musa Karakus; Xiaoting Liang; Jun Wei

    2005-01-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  20. Refractory for Black Liquor Gasifiers

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Alireza Rezaie; Xiaoting Liang; Musa Karakus; Jun Wei

    2005-12-01

    The University of Missouri-Rolla identified materials that permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project was to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study attempted to define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials were selected or developed that reacted with the gasifier environment to form protective surfaces in

  1. REFRACTORY FOR BLACK LIQUOR GASIFIERS

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Musa Karakus; Xiaoting Liang; Jun Wei

    2005-04-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  2. REFRACTORY FOR BLACK LIQUOR GASIFIERS

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr.; Alireza Rezaie

    2003-12-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the materials problems encountered during the operation of low-pressure high-temperature (LFHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  3. Refractory for Black Liquor Gasifiers

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Alireza Rezaie

    2003-08-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the materials problems encountered during the operation of low-pressure high-temperature (LFHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  4. Refractory for Black Liquor Gasifiers

    Energy Technology Data Exchange (ETDEWEB)

    William L. Headrick Jr; Alireza Rezaie

    2003-12-01

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the materials problems encountered during the operation of low-pressure high-temperature (LFHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  5. Refractory for Black Liquor Gasifiers

    Energy Technology Data Exchange (ETDEWEB)

    Robert E. Moore; William L. Headrick; Alireza Rezaie

    2003-03-31

    The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the materials problems encountered during the operation of low-pressure high-temperature (LFHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

  6. Primordial Compositions of Refractory Inclusions

    Energy Technology Data Exchange (ETDEWEB)

    Grossman, L; Simon, S B; Rai, V K; Thiemens, M H; Hutcheon, I D; Williams, R W; Galy, A; Ding, T; Fedkin, A V; Clayton, R N; Mayeda, T K

    2008-02-20

    Bulk chemical and oxygen, magnesium and silicon isotopic compositions were measured for each of 17 Types A and B refractory inclusions from CV3 chondrites. After bulk chemical compositions were corrected for non-representative sampling in the laboratory, the Mg and Si isotopic compositions of each inclusion were used to calculate its original chemical composition assuming that the heavy-isotope enrichments of these elements are due to Rayleigh fractionation that accompanied their evaporation from CMAS liquids. The resulting pre-evaporation chemical compositions are consistent with those predicted by equilibrium thermodynamic calculations for high-temperature nebular condensates but only if different inclusions condensed from nebular regions that ranged in total pressure from 10{sup -6} to 10{sup -1} bar, regardless of whether they formed in a system of solar composition or in one enriched in OC dust relative to gas by a factor of ten relative to solar composition. This is similar to the range of total pressures predicted by dynamic models of the solar nebula for regions whose temperatures are in the range of silicate condensation temperatures. Alternatively, if departure from equilibrium condensation and/or non-representative sampling of condensates in the nebula occurred, the inferred range of total pressure could be smaller. Simple kinetic modeling of evaporation successfully reproduces observed chemical compositions of most inclusions from their inferred pre-evaporation compositions, suggesting that closed-system isotopic exchange processes did not have a significant effect on their isotopic compositions. Comparison of pre-evaporation compositions with observed ones indicates that 80% of the enrichment in refractory CaO + Al{sub 2}O{sub 3} relative to more volatile MgO + SiO{sub 2} is due to initial condensation and 20% due to subsequent evaporation for both Type A and Type B inclusions.

  7. Nonequilibrium dynamics of stochastic point processes with refractoriness.

    Science.gov (United States)

    Deger, Moritz; Helias, Moritz; Cardanobile, Stefano; Atay, Fatihcan M; Rotter, Stefan

    2010-08-01

    Stochastic point processes with refractoriness appear frequently in the quantitative analysis of physical and biological systems, such as the generation of action potentials by nerve cells, the release and reuptake of vesicles at a synapse, and the counting of particles by detector devices. Here we present an extension of renewal theory to describe ensembles of point processes with time varying input. This is made possible by a representation in terms of occupation numbers of two states: active and refractory. The dynamics of these occupation numbers follows a distributed delay differential equation. In particular, our theory enables us to uncover the effect of refractoriness on the time-dependent rate of an ensemble of encoding point processes in response to modulation of the input. We present exact solutions that demonstrate generic features, such as stochastic transients and oscillations in the step response as well as resonances, phase jumps and frequency doubling in the transfer of periodic signals. We show that a large class of renewal processes can indeed be regarded as special cases of the model we analyze. Hence our approach represents a widely applicable framework to define and analyze nonstationary renewal processes.

  8. Posterior quadrant disconnection for refractory epilepsy: A case series

    Directory of Open Access Journals (Sweden)

    Javeria Nooraine

    2014-01-01

    Full Text Available Objective: To analyze the surgical outcome and safety of posterior quadrant disconnection in medically refractory epilepsy arising from the posterior head region from a level IV tertiary care center over a period of three years. Materials and Methods: Seven consecutive patients who underwent posterior quadrant disconnection for refractory epilepsy were analyzed. Results: We analyzed the data of seven (n = 7 consecutive posterior quadrant epilepsy patients who underwent posterior quadrant disconnection with a mean age of 8.5 years over the last three years of which 4 were male and 3 females. All patients underwent extensive pre-surgical evaluation including detailed history, examination, prolonged video EEG recordings, neuropsychological testing, MRI brain, DTI, PET scan (n = 6, fMRI (n = 4, WADA test (n = 1 and invasive recording (n = 1, Of seven patients four had left sided pathology and three had right sided pathology. All patients except one underwent pure disconnection and one underwent partial resection. Conclusion: Posterior quadrant disconnection is effective surgical procedure for medically refractory epilepsy arising from the posterior quadrant in carefully selected patients without morbidity or functional disability across various age groups especially in children. In our series, all seven patient had good seizure outcome and none had functional disabilities.

  9. Fecal Microbiota Transplantation for Refractory and Recurrent Clostridium difficile Infection: A Case Series of Nine Patients.

    Science.gov (United States)

    Bang, Byoung Wook; Park, Jin Seok; Kim, Hyung Kil; Shin, Yong Woon; Kwon, Kye Sook; Kwon, Hea Yoon; Baek, Ji Hyeon; Lee, Jin Soo

    2017-04-25

    Fecal microbiota transplantation (FMT) is a highly effective therapy for refractory and recurrent Clostridium difficile infection (CDI). Despite its excellent efficacy and recent widespread use, FMT has not been widely used in South Korea thus far. We describe our experience with FMT to treat refractory/recurrent CDI. We conducted a chart review of patients who underwent FMT for refractory/recurrent CDI at Inha University Hospital, between March 2014 and June 2016. The demographic information, treatment data, and adverse events were reviewed. FMT was administered via colonoscopy and/or duodenoscopy. All stool donors were rigorously screened to prevent infectious disease transmission. FMT was performed in nine patients with refractory/recurrent CDI. All patients were dramatically cured. Bowel movement was normalized within one week after FMT. There were no procedure-related adverse events, except aspiration pneumonia in one patient. During the follow-up period (mean 11.4 months), recurrence of CDI was observed in one patient at one month after FMT due to antibiotics. FMT is a safe, well-tolerated and highly effective treatment for refractory/recurrent CDI. Although there are many barriers to using FMT, we expect that FMT will be widely used to treat refractory/recurrent CDI in South Korea.

  10. Refractories for Industrial Processing. Opportunities for Improved Energy Efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Hemrick, James G. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hayden, H. Wayne [Metals Manufacture Process and Controls Technology, Inc., Oak Ridge, TN (United States); Angelini, Peter [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Moore, Robert E. [R.E. Moore Associates, Maricopa, AZ (United States); Headrick, William L. [R.E. Moore Associates, Maricopa, AZ (United States)

    2005-01-01

    Refractories are a class of materials of critical importance to manufacturing industries with high-temperature unit processes. This study describes industrial refractory applications and identifies refractory performance barriers to energy efficiency for processing. The report provides recommendations for R&D pathways leading to improved refractories for energy-efficient manufacturing and processing.

  11. Prognostic Factors for Refractory Status Epilepticus

    Directory of Open Access Journals (Sweden)

    J. Gordon Millichap

    2013-03-01

    Full Text Available Researchers at the Mayo Clinic, Rochester, MN studied the outcome and identified prognostic factors for refractory status epilepticus (RSE in 54 adult patients, median age 52 years [range 18-93].

  12. Testing Consent Order on Refractory Ceramic Fibers

    Science.gov (United States)

    This notice announces that EPA has signed signed an enforceable testing consent order under the Toxic Substances Control Act (TSCA), 15 U.S.C. section 2601 at seq., with three of the primary producers of refractory ceramic fibers (RCF).

  13. Ultra High Temperature Refractory Materials Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Legacy refractory materials that have origins dating to the original Saturn program are commonly used in current launch facilities. Although they failure to meet the...

  14. Ultra High Temperature Refractory Materials Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Legacy refractory materials that have origins dating to the original Saturn program are commonly used in current launch facilities. Although they fail to meet the...

  15. Emergency coronary angioplasty in refractory unstable angina

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); P.W.J.C. Serruys (Patrick); M.J.B.M. van den Brand (Marcel); K. Balakumaran (Kulasekaram); A.L. Soward; P.G. Hugenholtz (Paul); A.E.R. Arnold (Alfred); B. Mochtar (Bas)

    1985-01-01

    textabstractWe performed percutaneous transluminal coronary angioplasty as an emergency procedure in 60 patients with unstable angina pectoris that was refractory to treatment with maximally tolerated doses of beta-blockers, calcium antagonists, and intravenous nitroglycerin. The initial success

  16. Psychological Treatment

    Science.gov (United States)

    ... Low FODMAP Diet Complementary or Alternative Treatments Medications Psychological Treatments Online Studies News You Can Use Living ... Low FODMAP Diet Complementary or Alternative Treatments Medications Psychological Treatments Online Studies News You Can Use Living ...

  17. Investigative psychology

    OpenAIRE

    Canter, David V.

    2010-01-01

    The domain of Investigative Psychology covers all aspects of psychology that are relevant to the conduct of criminal or civil investigations. Its focus is on the ways in which criminal activities may be examined and understood in order for the detection of crime to be effective and legal proceedings to be appropriate. As such Investigative Psychology is concerned with psychological input to the full range of issues that relate to the management, investigation and prosecution of crime

  18. Functional outcome of prolonged refractory status epilepticus

    OpenAIRE

    Lai, Alexandre; Outin, Hervé D.; Jabot, Julien; Mégarbane, Bruno; Gaudry, Stéphane; Coudroy, Rémi; Louis, Guillaume; Schneider, Francis; Barbarot, Nicolas; Roch, Antoine; Lerolle, Nicolas; Luis, David; Fourrier, François; Renault, Anne; Argaud, Laurent

    2015-01-01

    International audience; Introduction:To characterize etiology, clinical course and outcomes of patients in prolonged refractory status epilepticus (PRSE) and looking for prognostic factors.Methods:Retrospective study conducted in patients hospitalized from January 1, 2001 to December 31, 2011 in 19 polyvalent intensive care units in French university and general hospitals. Patients were adults with a generalized convulsive refractory status epilepticus that lasted more than seven days, despit...

  19. Molecular Determinants of Hormone Refractory Prostate Cancer

    Science.gov (United States)

    2017-07-01

    Award Number: W81XWH-12-1-0062 TITLE: Molecular Determinants of Hormone Refractory Prostate Cancer PRINCIPAL INVESTIGATOR: Atish Choudhury...CONTRACTING ORGANIZATION: Dana-Farber Cancer Institute Boston, MA 02215 REPORT DATE: July 2017 TYPE OF REPORT: Annual PREPARED FOR: U.S. Army...Determinants of Hormone Refractory Prostate Cancer 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-12-1-0062 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Atish

  20. The Modified Atkins Diet in Refractory Epilepsy

    Directory of Open Access Journals (Sweden)

    Suvasini Sharma

    2014-01-01

    Full Text Available The modified Atkins diet is a less restrictive variation of the ketogenic diet. This diet is started on an outpatient basis without a fast, allows unlimited protein and fat, and does not restrict calories or fluids. Recent studies have shown good efficacy and tolerability of this diet in refractory epilepsy. In this review, we discuss the use of the modified Atkins diet in refractory epilepsy.

  1. Positive Psychology

    Science.gov (United States)

    Peterson, Christopher

    2009-01-01

    Positive psychology is a deliberate correction to the focus of psychology on problems. Positive psychology does not deny the difficulties that people may experience but does suggest that sole attention to disorder leads to an incomplete view of the human condition. Positive psychologists concern themselves with four major topics: (1) positive…

  2. The history of psychological categories.

    Science.gov (United States)

    Smith, Roger

    2005-03-01

    Psychological terms, such as 'mind', 'memory', 'emotion' and indeed 'psychology' itself, have a history. This history, I argue, supports the view that basic psychological categories refer to historical and social entities, and not to 'natural kinds'. The case is argued through a wide ranging review of the historiography of western psychology, first, in connection with the field's extreme modern diversity; second, in relation to the possible antecedents of the field in the early modern period; and lastly, through a brief introduction to usage of the words 'soul', 'mind', 'memory' and 'emotion'. The discussion situates the history of psychology within a large historical context, questions assumptions about the continuity of meaning, and draws out implications for the philosophical and social constitution of 'psychology' and 'the psychological' from the existing literature. The historical evidence, this paper concludes, does not support the conventional presumption that modern psychological terms describe 'natural kinds'.

  3. REFRACTORY THROMBOCYTOPENIA AND NEUTROPENIA: A DIAGNOSTIC CHALLENGE

    Directory of Open Access Journals (Sweden)

    Emmanuel Gyan

    2015-02-01

    Full Text Available Background. The 2008 WHO classification identified refractory cytopenia with unilineage dysplasia (RCUD as a composite entity encompassing refractory anemia, refractory thrombocytopenia (RT, and refractory neutropenia (RN, characterized by 10% or more dysplastic cells in the bone marrow respective lineage. The diagnosis of RT and RN is complicated by several factors.  Diagnosing RT first requires exclusion of familial thrombocytopenia, chronic auto-immune thrombocytopenia, concomitant medications, viral infections, or hypersplenism. Diagnosis of RN should also be made after ruling out differential diagnoses such as ethnic or familial neutropenia, as well as acquired, drug-induced, infection-related or malignancy-related neutropenia. An accurate quantification of dysplasia should be performed in order to distinguish RT or RN from the provisional entity named idiopathic cytopenia of unknown significance (ICUS. Cytogenetic analysis, and possibly in the future somatic mutation analysis (of genes most frequently mutated in MDS, and flow cytometry analysis aberrant antigen expression on myeloid cells may help in this differential diagnosis. Importantly, we and others found that, while isolated neutropenia and thrombocytopenia are not rare in MDS, those patients can generally be classified (according to WHO 2008 classification as refractory cytopenia with multilineage dysplasia or refractory anemia with excess blasts, while RT and RN (according to WHO 2008 are quite rare.These results suggest in particular that identification of RT and RN as distinct entities could be reconsidered in future WHO classification updates.

  4. Refractory Materials for Flame Deflector Protection System Corrosion Control: Refractory Ceramics Literature Survey

    Science.gov (United States)

    Calle, Luz Marina; Hintze, Paul E.; Parlier, Christopher R.; Curran, Jerome P.; Kolody, Mark; Perusich, Stephen; Whitten, Mary C.; Trejo, David; Zidek, Jason; Sampson, Jeffrey W.; hide

    2009-01-01

    Ceramics can be defmed as a material consisting of hard brittle properties produced from inorganic and nonmetallic minerals made by firing at high temperatures. These materials are compounds between metallic and nonmetallic elements and are either totally ionic, or predominately ionic but having some covalent character. This definition allows for a large range of materials, not all applicable to refractory applications. As this report is focused on potential ceramic materials for high temperature, aggressive exposure applications, the ceramics reviewed as part of this report will focus on refractory ceramics specifically designed and used for these applications. Ceramic materials consist of a wide variety of products. Callister (2000) 1 characterized ceramic materials into six classifications: glasses, clay products, refractories, cements, abrasives, and advanced ceramics. Figure 1 shows this classification system. This review will focus mainly on refractory ceramics and cements as in general, the other classifications are neither applicable nor economical for use in large structures such as the flame trench. Although much work has been done in advanced ceramics over the past decade or so, these materials are likely cost prohibitive and would have to be fabricated off-site, transported to the NASA facilities, and installed, which make these even less feasible. Although the authors reviewed the literature on advanced ceramic refractories 2 center dot 3 center dot 4 center dot 5 center dot 6 center dot 7 center dot 8 center dot 9 center dot 10 center dot 11 center dot 12 after the review it was concluded that these materials should not be ' the focus of this report. A review is in progress on materials and systems for prefabricated refractory ceramic panels, but this review is focusing more on typical refractory materials for prefabricated systems, which could make the system more economically feasible. Refractory ceramics are used for a wide variety of applications

  5. Effectiveness of peripheral neurectomy in refractory cases of trigeminal neuralgia

    Directory of Open Access Journals (Sweden)

    Narayan Sharma Lamichhane

    2016-01-01

    Full Text Available Context: Trigeminal neuralgia (TN is a commonly diagnosed neurosensory disease of orofacial region involving the fifth cranial nerve. Patient refractory to pharmacotherapy or with clinical and/or laboratory side effects sufficient to demand drug cessation is subjected to surgical technique. Aims: The aim of this study is to investigate the efficacy of peripheral neurectomy in the management of refractory TN. Settings and Design: This retrospective study on forty patients refractory to carbamazepine was conducted in the department of oral and maxillofacial surgery in the Northeast part of China from September 2011 to September 2014. Patients and Methods: Patients treated with neurectomy were followed up at regular intervals to assess the duration of pain-free period, and the pain was assessed using visual analog scale and the success of the surgery was defined accordingly. Statistical Analysis Used: Descriptive statistical analysis was carried out using IBM SPSS-20. Results: The mean age of the patients was 67.92 years (46–86 years, with higher incidence in females (F:M = 1.6:1. The 3rd division of trigeminal nerve was most commonly affected by the disease. The right side was more common than the left side. Duration of postsurgical pain-free period varied from 12 to 36 months with mean pain-free duration of 23.25 months. Recurrent cases were treated with low dose of carbamazepine, and majority of them were relieved of symptoms. Conclusions: Peripheral neurectomy is a minimal invasive surgery; safe and effective for elderly patients, especially in rural areas where advanced neurosurgical facilities are not available and for those who are reluctant to major neurosurgical procedures.

  6. Efficacy of ω-3 polyunsaturated fatty acids for the treatment of refractory hydroa vacciniforme.

    Science.gov (United States)

    Durbec, Frédérique; Reguiaï, Ziad; Léonard, Fabienne; Pluot, Michel; Bernard, Philippe

    2012-01-01

    Hydroa vacciniforme (HV) is a rare photodermatosis. Several therapies, with sometimes severe side effects, have been used in isolated cases. We report a case of refractory HV successfully treated with dietary fish oil rich in ω-3 polyunsaturated fatty acids. © 2011 Wiley Periodicals, Inc.

  7. Effect of microcracks on thermal shock resistance of magnesite-chrome refractories. Magu-kuro renga no tainetsu shogeki sei ni oyobosu bikiretsu no koka

    Energy Technology Data Exchange (ETDEWEB)

    Uzaki, N.; Ishii, H.; Aratani, K.; Oguchi, Y.; Kawakami, T. (Kawasaki Refractories Co. Ltd., Hyogo (Japan)); Sakai, M. (Toyohashi Univ. of Technology, Aichi (Japan))

    1991-08-10

    Direct-bonded refractories are mainly used in the secondary refining furnace. Thermal shock damage of refractories is one of the most crucial types of damage to the refractories because it may results in spalling of the surface. To improve the thermal shock resistance of magnesite-chrome refractories, microcracks are induced in the refractories by addition of an additive having a different expansion coefficient, and material with expected quality is obtained. Stress fracture toughness, energy fracture toughness of the obtained high thermal shock resisting refractories are obtained, and the effect of microcracks on the crack propagation resistance is investigated. The improved refractories with the special additive show rising R-curve behavior, and the rate of rising R-curve of the refractories with the additive of 3% is found to be large. The refractory with 3% additive shows a large energy fracture toughness value even in the latter period of crack propagation. However, too much addition of the special additive results in a reverse effect, decreasing the crack propagation suppression effect. 11 refs., 15 figs., 2 tabs.

  8. Intrathecal ziconotide for refractory chronic pain.

    Science.gov (United States)

    Lynch, Shalini S; Cheng, Christine M; Yee, Jennie L

    2006-01-01

    To describe the pharmacology, efficacy, and safety of ziconotide for treatment of severe chronic pain in patients who are candidates for intrathecal therapy. A PubMed/MEDLINE search (1966-June 2006) was conducted using the terms ziconotide, Prialt, and SNX-111. Manufacturer-provided data, the Food and Drug Administration medical review of ziconotide, and abstracts presented at American Pain Society meetings (2001-2006) were also reviewed. Human studies evaluating the efficacy and safety of ziconotide for the treatment of chronic pain were considered. Animal data were excluded. Ziconotide is the first and only neuronal-type (N-type) calcium-channel blocker. Ziconotide must be administered intrathecally via continuous infusion. A programmable implanted variable-rate microinfusion device, or an external microinfusion device and catheter must be utilized. In double-blind, placebo-controlled studies, ziconotide significantly improved patient perception of pain from baseline to the end of the study periods, which ranged from 11 to 21 days. Patients enrolled in clinical trials were intolerant of or refractory to other treatment modalities. There have been no studies that directly compared ziconotide with other intrathecal or systemic analgesics. Key ziconotide-related adverse events are neuropsychiatric, including depression, cognitive impairment, and hallucinations; depressed levels of consciousness; and elevation of creatine kinase levels. Ziconotide is also associated with a risk of meningitis due to possible contamination of the microinfusion device. Ziconotide is a therapeutic option for treatment of severe chronic pain in patients who have exhausted all other agents, including intrathecal morphine, and for whom the potential benefit outweighs the risks of serious neuropsychiatric adverse effects and of having an implanted device. Further studies are needed to determine the comparative efficacy of ziconotide and other pain therapies.

  9. Refractory of Furnaces to Reduce Environmental Impact

    Energy Technology Data Exchange (ETDEWEB)

    Hanzawa, Shigeru, E-mail: hanzawa@ngk.co.jp [NGK Insulators, LTD., Mizuho, Nagoya (Japan)

    2011-10-29

    The energy load of furnaces used in the manufacturing process of ceramics is quite large. Most of the environmental impact of ceramics manufacturing is due to the CO{sub 2} produced from this high energy load. To improve this situation, R and D has focused on furnace systems and techniques of control in order to reduce energy load. Since furnaces are comprised of refractory, consideration of their mechanical and thermal characteristics is important. Herein are described several refractory types which were chosen through comparison of the characteristics which contribute to heat capacity reduction, heat insulating reinforcement and high emissivity, thereby improving thermal radiation heat transfer efficiency to the ceramic articles. One selected refractory material which will reduce the environmental impact of a furnace, chosen considering low heat capacity and high emissivity characteristics, is SiC. In this study, thermal radiation heat transfer efficiency improvement and its effect on ceramic articles in the furnace and oxidation behaviour were investigated at 1700K. A high density SiC refractory, built into the furnace at construction, has relatively high oxidation durability and has the ability to reduce environmental impact-CO{sub 2} by 10 percent by decreasing the furnace's energy load. However, new oxidation prevention techniques for SiC will be necessary for long-term use in industrial furnaces, because passive to active oxidation transition behaviour of commercial SiC refractory is coming to close ideal.

  10. Rational use of refractories in regenerator checkers

    Energy Technology Data Exchange (ETDEWEB)

    Popov, O.N.; Borovkova, L.B.; Izosenkova, A.V.; Shatova, N.P.

    1985-09-01

    The thermal efficiency of regenerators in glass furnaces depends on the rational choice of the checker system and the refractory materials used in their construction. In order to develop practical recommendations for the rational use of refractories in checkers for sheet glass, container, and medical-glass furnaces, the authors carried out an all-around investigation of the resistance of aluminosilicate and magnesia refractories in laboratory conditions, modelling the actual service conditions of the material in the checkers. Magnesite, ordinary MO-89, compressed magnesite MU-91, magnesitechromite ordinary, MKhSO, periclase-spinel ordinary, PShSO, forsterite F, unfired magnesite-chromite BMKh, chamotte ShN-38, and highalumina DV-12 were selected as refractories. The use in checkers of magnesia refractories, bearing in mind their corrosion resistance, and with the elimination of the factors in the damaging action, will enable one to ensure prolonged service for the checkers without carrying out hot repairs during the campaign of furnaces producing sheet, container, and medical glasses.

  11. Clinical Use of the Interferon Inducer IIBI in Patients with Refractory Hodgkin’s Lymphoma

    Directory of Open Access Journals (Sweden)

    Daniar R. Aspetov

    2015-12-01

    Full Text Available This study evaluated the effects of the immunobiological preparation "Interferon inducer bacterial liquid" (IIBI combined with chemoradiotherapy (CRT in patients with refractory Hodgkin’s lymphoma (HL are presented. The clinical application of IIBI increases the efficacy of treatment. IIBI in combination with CRT induces the production of highly active endogenous IFN-α/β, provides a marked regression of the affected lymph nodes in a short period (within 7 to 10 days of treatment, relieves B symptoms, and increases by 2 times the length of remission in patients with refractory HL.

  12. Psychology's Renaissance.

    Science.gov (United States)

    Nelson, Leif D; Simmons, Joseph; Simonsohn, Uri

    2018-01-04

    In 2010-2012, a few largely coincidental events led experimental psychologists to realize that their approach to collecting, analyzing, and reporting data made it too easy to publish false-positive findings. This sparked a period of methodological reflection that we review here and call Psychology's Renaissance. We begin by describing how psychologists' concerns with publication bias shifted from worrying about file-drawered studies to worrying about p-hacked analyses. We then review the methodological changes that psychologists have proposed and, in some cases, embraced. In describing how the renaissance has unfolded, we attempt to describe different points of view fairly but not neutrally, so as to identify the most promising paths forward. In so doing, we champion disclosure and preregistration, express skepticism about most statistical solutions to publication bias, take positions on the analysis and interpretation of replication failures, and contend that meta-analytical thinking increases the prevalence of false positives. Our general thesis is that the scientific practices of experimental psychologists have improved dramatically.

  13. [Political psychology].

    Science.gov (United States)

    Resch, Mária; Bella, Tamás

    2013-04-21

    In Hungary one can mostly find references to the psychological processes of politics in the writings of publicists, public opinion pollsters, philosophers, social psychologists, and political analysts. It would be still important if not only legal scientists focusing on political institutions or sociologist-politologists concentrating on social structures could analyse the psychological aspects of political processes; but one could also do so through the application of the methods of political psychology. The authors review the history of political psychology, its position vis-à-vis other fields of science and the essential interfaces through which this field of science, which is still to be discovered in Hungary, connects to other social sciences. As far as its methodology comprising psycho-biographical analyses, questionnaire-based queries, cognitive mapping of interviews and statements are concerned, it is identical with the psychiatric tools of medical sciences. In the next part of this paper, the focus is shifted to the essence and contents of political psychology. Group dynamics properties, voters' attitudes, leaders' personalities and the behavioural patterns demonstrated by them in different political situations, authoritativeness, games, and charisma are all essential components of political psychology, which mostly analyses psychological-psychiatric processes and also involves medical sciences by relying on cognitive and behavioural sciences. This paper describes political psychology, which is basically part of social sciences, still, being an interdisciplinary science, has several ties to medical sciences through psychological and psychiatric aspects.

  14. Vagus nerve stimulation for the treatment of refractory epilepsy

    Directory of Open Access Journals (Sweden)

    Gorgan M.R.

    2015-06-01

    Full Text Available Vagus nerve stimulation (VNS represents one of the main surgical options for the treatment of the refractory epilepsy in pediatric and adult patients. There are several mechanism involved in vagal nerve stimulation which could influence the pathophysiology of seizures like neuromodulation of the thalamic and subthalamic nuclei involved in seizure initiation and the modulation of the neurotransmitters pattern norepinefrin, GABA, and serotonin. The VNS system is composed of the implanted components (the generator, the lead with the electrodes attached and the programming system components (programming wand and handheld computer. The authors present their experience with 81 patients diagnosed with refractory epilepsy, investigated, selected and implanted with vagal neurostimulators between December 2012 and January 2015 in Neurosurgery Clinic, "Bagdasar-Arseni" Emergency Hospital. The surgical technique and the potential pitfalls are described in detail. There were 20 children (24,7% and 61 (75,3% adults in this series. There was no death in this series and no intraoperative incidence. One patient presented dysphagia postoperatively which completely remitted after two months of follow-up. The outcome in term of seizure frequency and severity was better for patients under 30 years compared with patients older than 30 years. VNS represents now a safe, quick and efficient surgical procedure with a minimum period of hospitalization and a short recovery period. The good results on long term improve the quality of life of the patients and facilitate the social and professional reinsertion

  15. Dramatic response to infliximab in refractory neurosarcoidosis

    Directory of Open Access Journals (Sweden)

    Chintamaneni Sreekanth

    2010-01-01

    Full Text Available Sarcoidosis is a systemic disease characterized by noncaseating granulomas in the involved organs. Neurologic manifestations involving the central and/or peripheral nervous system occur in about 5% of patients. Neurosarcoidosis is often refractory to conventional treatment and therefore more effective treatment options are needed. While the etiology of the disease is still unknown, there is now a better understanding of its pathogenesis on a molecular level. It is clear that tumor necrosis factor-α (TNFα plays a pivotal role in the development of the granulomas and it is believed to be a key cytokine involved in the pathogenesis of the disease. Taking advantage of this better understanding of disease pathogenesis, anti-TNFα agents are being increasingly used to treat refractory sarcoidosis. We report a patient with refractory neurosarcoidosis who showed dramatic improvement in the clinical and radiological manifestations following treatment with infliximab; he suffered a relapse upon discontinuation of the medication.

  16. Treatment of refractory neonatal seizures with topiramate.

    Science.gov (United States)

    Riesgo, Rudimar; Winckler, Maria Isabel; Ohlweiler, Lygia; Ranzan, Josiane; Becker, Michele; Salvador, Socrates; Magalhaes, Luiza; Ribeiro, Ricardo

    2012-12-01

    The objective of this study is to describe the usefulness of topiramate in refractory neonatal seizures. We reported the clinical off-label use of topiramate in three cases of refractory neonatal seizures of unclear origin with no response to conventional antiepileptic drugs. In all cases, the seizures were completely controlled with adding topiramate. All patients became seizure free during hospitalization and were followed by approximately 1 year after hospital discharge, with monotherapy with topiramate. The clinical off-label use of topiramate in neonatal seizures is still incipient. When searching publications in this matter, only one report was identified. Because of its efficacy for both seizures and neuroprotection, topiramate could be a useful choice in refractory neonatal seizures. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  17. Refractory Behaviors of Magnetite-Kaolin Bricks

    Science.gov (United States)

    Adeosun, S. O.; Akpan, E. I.; Gbenebor, O. P.; Taiwo, O. O.; Eke, I. J.

    2016-11-01

    In this work, the suitability of using kaolin-magnetite-plastic clay to produce refractory bricks has been experimentally explored. Thirty bricks of different compositions were produced and fired at 1200°C. The density, shrinkage moisture content, loss on ignition, porosity and permeability of the bricks were examined. Results show that the bricks remained stable during firing and thus possess good insulating characteristics. The highest (2.23 g/cm3) and lowest (2.00 g/cm3) bulk densities obtained in this study are higher than the highest bulk density reported for Al dross-filled refractories (1.23 g/cm3). The bricks also possessed very low effective moisture content (10-23%) and very high compression modulus (16-100 MPa) desirable in insulating refractory bricks with high resistance to abrasion.

  18. Monitoring of Refractory Wall recession using high temperature impact echo instrumentation

    Energy Technology Data Exchange (ETDEWEB)

    University of Dayton

    2004-04-30

    Regression of refractory linings of furnaces occurs due to a variety of mechanisms. The specific mechanism selected for investigation during this program is the regression of refractories which are in direct contact with a liquid corrodant. Examples include the melting of glass, the production of pig iron and steel, and the melting of aluminum. The rates of regression to a wall thickness which requires reline or extensive reconstruction vary widely, from less than a year to over ten years depending on the specific service environment. This program investigated the feasibility of measuring refractory wall thickness with an impact-echo method while at operating temperature (wall temperatures exceeding 500 C). The impact-echo method uses the impact of a small sphere with the surface of the test object to send a stress wave into the object. In a plate-like structure, the stress wave reflects back to the front surface, reverberating in the structure and causing a periodic surface displacement whose frequency is inversely proportional to the thickness of the test object. Impact-echo testing was chosen because it requires access to only one side of the test object and could be performed during the operation of a refractory structure. Commercially-available impact-echo instrumentation is available for room temperature use for a variety of tests on concrete. The enabling technology for this work was to use a high-temperature piezoelectric material, aluminum nitride, as the receiving sensor for the stress waves, allowing its use on refractories during furnace operation.

  19. The efficacy of topical interferon alpha 2b treatment in refractory vernal keratoconjunctivitis.

    Science.gov (United States)

    Turan-Vural, Ece; Acar, Banu Torun; Acar, Suphi

    2012-04-01

    This study aimed to investigate the efficacy and safety of a 2-month topical interferon alpha 2b treatment in patients with refractory vernal keratoconjunctivitis. Twelve (10 male, 2 female) patients with refractory vernal keratoconjunctivitis received topical treatment with one million IU/mL interferon alpha 2b 4 times a day for 2 months. Symptom and ophthalmological examination scores were assessed at baseline and during follow-up. No significant complications or side effects associated with the use of topical interferon alpha 2b were observed. Symptom scores for itching, tearing, photophobia, and total symptom score, and objective scores for corneal lesion, hyperemia, chemosis, papillary hypertrophy, secretion, and total examination score significantly improved during the 2-month treatment. Improvements were maintained after discontinuation of the treatment for most parameters. Topical interferon alpha 2b treatment seems to offer a safe and effective alternative for the treatment of refractory vernal keratoconjunctivitis for a brief period.

  20. HIGH TEMPERATURE REFRACTORY COATING FOR GRAPHITE MOLDS

    Science.gov (United States)

    Stoddard, S.D.

    1958-10-21

    An improved foundry mold coating for use with graphite molds used in the casting of uranium is presented. The refractory mold coating serves to keep the molten uranium from contact with graphite of the mold and thus prevents carbon pickup by the molten metal. The refractory coating is made by dry mixing certain specific amounts of aluminum oxide, bentonite, Tennessee ball clay, and a soluble silicate salt. Water is then added to the mixture and the suspension thus formed is applied by spraying onto the mold.

  1. Office Procedures in Refractory Chronic Rhinosinusitis.

    Science.gov (United States)

    Thamboo, Andrew; Patel, Zara M

    2017-02-01

    Office procedures in chronic rhinosinusitis (CRS) can be considered before and after medical management, as well as before and after surgical management. This article focuses specifically on refractory CRS, meaning those patients who have failed medical and surgical management already. The options available in the management of refractory CRS depend on the personnel, equipment, and instrumentation available in the office setting; surgeon experience; and patient suitability and tolerability. This article provides readers with possible procedural options that can be done in their clinics with indications, patient selection, potential complications, and postoperative considerations. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Magnesite and chromium-magnesite refractories

    Energy Technology Data Exchange (ETDEWEB)

    Campos Loriz, D.

    1981-01-01

    The fifth part of the series, is concerned with a study on magnesite refractories, essential to the basic steelplant and starts with both traditional (natural carbonates and hydroxides) and recently-used (sea-water hydroxide) raw materials. Following a discussion on the fundamental system MgO-CaO-Si/sub 2/ consideration is given, among others, to baked, tarred and chemically-bonded refractories; their properties and use, ending with a brief examination of conventional and direct-bond chromium-magnesite materials.

  3. Double sequential defibrillation for refractory ventricular fibrillation.

    Science.gov (United States)

    El Tawil, Chady; Mrad, Sandra; Khishfe, Basem F

    2017-12-01

    A 54-year-old suffered from an out-of-hospital cardiac arrest. Compressions were started within minutes and the patient was in refractory ventricular fibrillation despite multiple asynchronized shocks and maximal doses of antiarrhythmic agents. Double sequential defibrillation was attempted with successful Return Of Spontaneous Circulation (ROSC) after a total of 61min of cardiac arrest. The patient was discharged home neurologically intact. Double sequential defibrillation could be a simple effective approach to patients with refractory ventricular fibrillation. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Psychology in Spain: Its Historical and Cultural Roots, Instruction, Research and Future Prospects

    Science.gov (United States)

    Montes-Berges, Beatriz; Aranda, Maria; Castillo-Mayen, Maria del Rosario

    2011-01-01

    Roots in Spanish Psychology dated back to Huarte de San Juan (1575). From this period to nowadays, Psychology has notably developed, branching in different areas such as psychology and sports and physical exercise, clinical and health psychology, educational psychology, psychology of social intervention, legal psychology, work and organisational…

  5. Psychological behaviorism and behaviorizing psychology

    Science.gov (United States)

    Staats, Arthur W.

    1994-01-01

    Paradigmatic or psychological behaviorism (PB), in a four-decade history of development, has been shaped by its goal, the establishment of a behaviorism that can also serve as the approach in psychology (Watson's original goal). In the process, PB has become a new generation of behaviorism with abundant heuristic avenues for development in theory, philosophy, methodology, and research. Psychology has resources, purview and problem areas, and nascent developments of many kinds, gathered in chaotic diversity, needing unification (and other things) that cognitivism cannot provide. Behaviorism can, within PB's multilevel framework for connecting and advancing both psychology and behaviorism. PMID:22478175

  6. Psychological behaviorism and behaviorizing psychology.

    Science.gov (United States)

    Staats, A W

    1994-01-01

    Paradigmatic or psychological behaviorism (PB), in a four-decade history of development, has been shaped by its goal, the establishment of a behaviorism that can also serve as the approach in psychology (Watson's original goal). In the process, PB has become a new generation of behaviorism with abundant heuristic avenues for development in theory, philosophy, methodology, and research. Psychology has resources, purview and problem areas, and nascent developments of many kinds, gathered in chaotic diversity, needing unification (and other things) that cognitivism cannot provide. Behaviorism can, within PB's multilevel framework for connecting and advancing both psychology and behaviorism.

  7. Mozart K.448 acts as a potential add-on therapy in children with refractory epilepsy.

    Science.gov (United States)

    Lin, Lung-Chang; Lee, Wei-Te; Wang, Chien-Hua; Chen, Hsiu-Lin; Wu, Hui-Chuan; Tsai, Chin-Lin; Wei, Ruey-Chang; Mok, Hin-Kiu; Weng, Chia-Fen; Lee, Mei-Wen; Yang, Rei-Cheng

    2011-03-01

    Mozart's Sonata for two pianos in D major, K.448 (Mozart K.448), has been shown to improve mental function, leading to what is known as the Mozart effect. Our previous work revealed that epileptiform discharges in children with epilepsy decreased during and immediately after listening to Mozart K.448. In this study, we evaluated the long-term effects of Mozart K.448 on children with refractory epilepsy. Eleven children with refractory epilepsy were enrolled. All of the patients were diagnosed as having had refractory epilepsy for more than 1 year (range =1 year to 6 years 4 months, mean =3 years 11 months) and had been receiving at least two antiepileptic drugs (AED). During the study period, they listened to Mozart K.448 once a day before bedtime for 6 months. Seizure frequencies were recorded 6 months before they started listening to this music and monthly during the study period. All of the patients remained on the same AEDs during the 6-month study period. Frequencies of seizures were compared before and after listening to Mozart K.448. Eight of eleven patients were seizure free (N=2) or had very good responses (N=6) after 6 months of listening to Mozart K.448. The remaining three (27.3%) showed minimal or no effect (effectiveness Mozart K.448 should be further studied as a potential add-on therapy in the treatment of children with refractory epilepsy. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. Refractory disease in antineutrophil cytoplasmic antibodies associated vasculitis

    NARCIS (Netherlands)

    Rutgers, Abraham; Kallenberg, Cornelis

    Purpose of review Induction treatment of antineutrophil cytoplasmic antibodies (ANCA) associated vasculitis (AAV) is not always successful and nonresponding patients are considered refractory. Recent findings Refractory disease should be subdefined to the treatment that was received.

  9. German Military Psychology 1973.

    Science.gov (United States)

    SCIENTIFIC RESEARCH, *WEST GERMANY, MILITARY PSYCHOLOGY , PSYCHOLOGICAL TESTS, APTITUDE TESTS, SOCIAL PSYCHOLOGY , PSYCHIATRY, MILITARY PROCUREMENT, CLASSIFICATION, SELECTION, PILOTS, AVIATION MEDICINE.

  10. Staging operation in the treatment of refractory glaucoma

    Directory of Open Access Journals (Sweden)

    Yu-Wei Gao

    2016-02-01

    Full Text Available AIM:To analyze the clinical results of cyclophotocoagulation followed by other anti-glaucoma surgeries in the treatment of refractory glaucoma.METHODS:The clinical data of 30 patients(30 eyeswith refractory glaucoma were retrospectively analyzed from January 2013 to July 2014 in Beijing Huade Hospital, including 12 females and 18 males, with an average age of 56 years. Among the 30 eyes, there were 2 eyes with acute angle-closure glaucoma, 4 eyes with over mature cataract, 6 eye with intumescent cataract, 5 eyes with neovascular glaucoma,9 eyes with hard-to-controlled glaucoma even after surgeries,4 eyes with secondary glaucoma after vitrectomy. Diode laser transscleral cyclophotocoagulation was applied to all patients as the primary choice. If the intraocular pressure(IOPwas not well controlled, a secondary anti-glaucoma surgery was applied. RESULTS:During the follow-up period, all of the 30 eyes had satisfactory results, with no complications during or after the operations. The average pre-operative IOP was 62.79±5.59mmHg, which dropped to 32.84±8.16mmHg at 1wk after cyclophotocoagulation. Six of 30 eyes had totally normal IOP, the rest 24 cases underwent another anti-glaucoma operation, after which the IOP decreased to a normal range and in which no complication occurred.CONCLUSION:In the treatment of refractory glaucoma, applying cyclophotocoagulation first to control the IOP can greatly reduce risk of complications during the secondary surgeries. According to their original categories, further anti-glaucoma surgery can reduce the IOP to a safe and effective range.

  11. Maintenance plasma exchange therapy for steroid-refractory neuromyelitis optica.

    Science.gov (United States)

    Khatri, Bhupendra O; Kramer, John; Dukic, Mary; Palencia, Mauricio; Verre, William

    2012-01-01

    Neuromyelitis optica (NMO) is a severe inflammatory demyelinating disease of the central nervous system with exacerbations involving the optic nerves, spinal cord, or both. This study explores the utility of maintenance plasma exchange (mTPE) as a therapy in patients with relapsing, corticosteroid-refractory, NMO. This retrospective case series presents data on patients who were diagnosed with NMO using currently accepted criteria. These patients were refractory to high-dose corticosteroids and received mTPE. Seven patients met the criteria for NMO diagnosis and all were positive for antibodies against aquaporin-4. Over a mean of 7.1 years (range, 2-16), these patients received between 21 and 154 TPE treatments (mean, 76). Although treated with mTPE, five out of the seven patients improved by more than one point on the Expanded Disability Status Scale. Interruption in mTPE in five patients resulted in clinical worsening. When mTPE was restarted in three out of the five patients who experienced a cessation of mTPE, these patients either stabilized or improved. The two patients who did not restart the mTPE protocol died. Patients treated with mTPE also experienced a reduction in the number of NMO exacerbations. Finally, stabilization of the retinal nerve fiber layer thickness was observed while on mTPE. In this preliminary study, mTPE appeared safe and may bring about improvement in disability and sustained stabilization of the clinical course in patients with steroid-refractory relapsing forms of NMO. Copyright © 2012 Wiley Periodicals, Inc.

  12. Characterization and testing of refractories for glass tank melters

    OpenAIRE

    Velez,M.; Karakus,M.; Reidmeyer,M. R.; Headrick,W. D.; Moore,R. E.

    2001-01-01

    Current and future research goals in our laboratories include the study of the attack of glass-contact refractories and of crown refractories in glass tank melters, under either air-gas or oxyfuel conditions. There is an emphasis on evaluation and characterization of critical parameters of commercial refractories such as microstructure, porosity and mechanical properties. A second focus is the evaluation of the performance of refractory alternatives to traditional crown and superstructure ref...

  13. Recent advances in silica-alumina refractory: A review

    OpenAIRE

    Sadik, Chaouki; El Amrani, Iz-Eddine; Albizane, Abderrahman

    2014-01-01

    In this article, the elaboration and the characterization of silica-alumina refractory have been reviewed. Refractory oxides encompass a broad range of unary, binary, and ternary ceramic compounds that can be used in structural, insulating, and other applications. This paper provides a historical perspective on the elaboration and the use of silica-alumina refractory, reviews applications for refractory oxides, describes typical processing routes, overviews fundamental structure–property rela...

  14. Recent advances in silica-alumina refractory: A review

    Directory of Open Access Journals (Sweden)

    Chaouki Sadik

    2014-06-01

    Full Text Available In this article, the elaboration and the characterization of silica-alumina refractory have been reviewed. Refractory oxides encompass a broad range of unary, binary, and ternary ceramic compounds that can be used in structural, insulating, and other applications. This paper provides a historical perspective on the elaboration and the use of silica-alumina refractory, reviews applications for refractory oxides, describes typical processing routes, overviews fundamental structure–property relations, and summarizes the properties of these materials.

  15. NOVEL REFRACTORY MATERIALS FOR HIGH ALKALI, HIGH TEMPERATURE ENVIRONMENTS

    Energy Technology Data Exchange (ETDEWEB)

    Hemrick, James Gordon [ORNL; Smith, Jeffrey D [ORNL; O' Hara, Kelley [University of Missouri, Rolla; Rodrigues-Schroer, Angela [Minteq International, Inc.; Colavito, [Minteq International, Inc.

    2012-08-01

    A project was led by Oak Ridge National Laboratory (ORNL) in collaboration with a research team comprised of the academic institution Missouri University of Science and Technology (MS&T), and the industrial company MINTEQ International, Inc. (MINTEQ), along with representatives from the aluminum, chemical, glass, and forest products industries. The project was to address the need for new innovative refractory compositions by developing a family of novel MgO-Al 2O3, MgAl2O4, or other similar spinel structured or alumina-based unshaped refractory compositions (castables, gunnables, shotcretes, etc.) utilizing new aggregate materials, bond systems, protective coatings, and phase formation techniques (in-situ phase formation, altered conversion temperatures, accelerated reactions, etc). This family of refractory compositions would then be tailored for use in high-temperature, high-alkaline industrial environments like those found in the aluminum, chemical, forest products, glass, and steel industries. Both practical refractory development experience and computer modeling techniques were used to aid in the design of this new family of materials. The newly developed materials were expected to offer alternative material choices for high-temperature, high-alkali environments that were capable of operating at higher temperatures (goal of increasing operating temperature by 100-200oC depending on process) or for longer periods of time (goal of twice the life span of current materials or next process determined service increment). This would lead to less process down time, greater energy efficiency for associated manufacturing processes (more heat kept in process), and materials that could be installed/repaired in a more efficient manner. The overall project goal was a 5% improvement in energy efficiency (brought about through a 20% improvement in thermal efficiency) resulting in a savings of 3.7 TBtu/yr (7.2 billion ft3 natural gas) by the year 2030. Additionally, new

  16. [Mediation model in adolescent psychology].

    Science.gov (United States)

    Deguitre, Marie; Pascal-Verdelhan, Chantal; Saez, Catherine; Calmels, Marie-Jeanne; Nesensohn, Jessica; Legras, Stéphanie; Paradis, Martine

    2014-01-01

    Body mediation is today used as a tool for establishing a relationship with a young person experiencing psychological suffering. It is particularly useful in adolescence, a period marked by the destabilisation of emotional and relational fields.

  17. Iatrogenic colorectal Kaposi sarcoma complicating a refractory ...

    African Journals Online (AJOL)

    Kaposi sarcoma is a mesenchymal tumor associated to a human herpes virus-8. It often occurs in human immunodeficiency virus-positive subjects. Colorectal localization is rare. We report the case of a colorectal Kaposi sarcoma complicating a refractory ulcerative colitis treated with surgery after the failure of ...

  18. Emerging therapeutics in refractory renal cell carcinoma.

    Science.gov (United States)

    Koshkin, Vadim S; Rini, Brian I

    2016-06-01

    Metastatic renal cell carcinoma (mRCC) has seen the introduction of numerous new treatments over the past decade. However, the efficacy of these therapies has plateaued, and new treatment options are needed for the majority of patients with mRCC whose disease inevitably progresses through one or more standard therapies ('refractory' mRCC). Recently approved agents in this space have shown great promise. This article reviews the evidence behind current management strategies for mRCC. After reviewing clinical trials that established current first-line therapies and agents used in the refractory setting, we address new ideas for the treatment of refractory disease including combination therapies and novel targeted agents. In particular, we focus on targeted immunotherapy in refractory mRCC. We conclude by considering future directions in combination treatments utilizing these novel agents. Numerous approaches have produced tangible benefits for the treatment of patients with mRCC. These include development of next generation VEGFR/TKIs, targeted immunotherapy agents, and the development of combined regimens. In particular, immunotherapy agents targeting the PD1/PD-L1 pathway have shown great promise with a robust survival advantage seen in patients treated with nivolumab. A tolerable side effect profile of immunotherapy agents makes them amenable for use in combination therapies and ongoing trials are addressing this question.

  19. Binary alloys for refractory-metal brazing

    Science.gov (United States)

    Morris, J. F.

    1974-01-01

    Data on binary-metal eutectics and melting-point minimums have been assembled for use in selecting brazing filler compositions for refractory metals. Data are presented in four tables for ready reference. Brief discussion of problems and potentials of metallides is included in appendix.

  20. Introducing the Action Potential to Psychology Students

    Science.gov (United States)

    Simon-Dack, Stephanie L.

    2014-01-01

    For this simple active learning technique for teaching, students are assigned "roles" and act out the process of the action potential (AP), including the firing threshold, ion-specific channels for ions to enter and leave the cell, diffusion, and the refractory period. Pre-post test results indicated that students demonstrated increased…

  1. Iron refractory iron deficiency anemia: a heterogeneous disease that is not always iron refractory.

    Science.gov (United States)

    Donker, Albertine E; Schaap, Charlotte C M; Novotny, Vera M J; Smeets, Roel; Peters, Tessa M A; van den Heuvel, Bert L P; Raphael, Martine F; Rijneveld, Anita W; Appel, Inge M; Vlot, Andre J; Versluijs, A Birgitta; van Gelder, Michel; Granzen, Bernd; Janssen, Mirian C H; Rennings, Alexander J M; van de Veerdonk, Frank L; Brons, Paul P T; Bakkeren, Dirk L; Nijziel, Marten R; Vlasveld, L Thom; Swinkels, Dorine W

    2016-12-01

    TMPRSS6 variants that affect protein function result in impaired matriptase-2 function and consequently uninhibited hepcidin production, leading to iron refractory iron deficiency anemia (IRIDA). This disease is characterized by microcytic, hypochromic anemia and serum hepcidin values that are inappropriately high for body iron levels. Much is still unknown about its pathophysiology, genotype-phenotype correlation, and optimal clinical management. We describe 14 different TMPRSS6 variants, of which 9 are novel, in 21 phenotypically affected IRIDA patients from 20 families living in the Netherlands; 16 out of 21 patients were female. In 7 out of 21 cases DNA sequencing and multiplex ligation dependent probe amplification demonstrated only heterozygous TMPRSS6 variants. The age at presentation, disease severity, and response to iron supplementation were highly variable, even for patients and relatives with similar TMPRSS6 genotypes. Mono-allelic IRIDA patients had a milder phenotype with respect to hemoglobin and MCV and presented significantly later in life with anemia than bi-allelic patients. Transferrin saturation (TSAT)/hepcidin ratios were lower in IRIDA probands than in healthy relatives. Most patients required parenteral iron. Genotype alone was not predictive for the response to oral iron. We conclude that IRIDA is a genotypically and phenotypically heterogeneous disease. The high proportion of female patients and the discrepancy between phenotypes of probands and relatives with the same genotype, suggest a complex interplay between genetic and acquired factors in the pathogenesis of IRIDA. In the absence of inflammation, the TSAT/hepcidin ratio is a promising diagnostic tool, even after iron supplementation has been given. Am. J. Hematol. 91:E482-E490, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  2. Barbiturate-refractory epilepsy: safe schedule for therapeutic substitution

    Directory of Open Access Journals (Sweden)

    Ana Maria Gorz

    1986-09-01

    Full Text Available Barbiturates are considered first line antiepileptic drugs in third world countries due to traditional and economic reasons. This prospective uncontrolled study of 52 patients aged 15 to 64 years (mean 24 demonstrates that patients who become refractory to barbiturates are mainly those with partial seizures with or without generalization or with a focal EEG abnormality (71%. Seizures tend to become refractory approximately 6 years after barbiturates were started. Progressive barbiturate withdrawal over a period of two to 8 months (mean 5 with institution of treatment with carbamazepine, phenytoin or sodium valproate allowed complete barbiturate withdrawal in 42 of the 52 patients (81%. Furthermore monthly seizure frequency in those in whom barbiturates were withdrawn decreased from 7.1 to 1.7 per patient. An improvement in mental status was observed but not measured. These results show that barbiturates should not be first-choice drugs in patients who have a chronic disease such as epilepsy, and indicate a schedule for barbiturate withdrawal Which is safe and independent of hospitalization or monitoring of antiepileptic drug serum concentrations.

  3. Hyperbaric oxygen therapy for refractory radiation-induced hemorrhagic cystitis.

    Science.gov (United States)

    Ribeiro de Oliveira, Tiago M; Carmelo Romão, António J; Gamito Guerreiro, Francisco M; Matos Lopes, Tomé M

    2015-10-01

    To analyze the efficacy of hyperbaric oxygen for the treatment of radiation-induced hemorrhagic cystitis and to identify factors associated with successful treatment. Clinical records from 176 patients with refractory radiation-induced hemorrhagic cystitis treated at the Portuguese Navy Center for Underwater and Hyperbaric Medicine, during a 15-year period, were retrospectively analyzed. Evolution of macroscopic hematuria was used to analyze treatment efficacy and correlated with other external variables. From a total of 176 treated patients, 23.9% evidenced other radiation-induced soft tissue lesions. After an average on 37 sessions, 89.8% of patients showed resolution of hematuria, with only 1.7% of adverse events. In our sample, hematuria resolution after treatment with hyperbaric oxygen was statistically associated to the need for transfusion therapy (P = 0.026) and the number of sessions of hyperbaric oxygen (P = 0.042). No relationship was found with the remaining variables. Refractory radiation-induced hemorrhagic cystitis can be successfully and safely treated with hyperbaric oxygen. Treatment effectiveness seems to be correlated with the need for transfusion therapy and the number of sessions performed. © 2015 The Japanese Urological Association.

  4. Clinical Features of Refractory Ascites in Outpatients

    Directory of Open Access Journals (Sweden)

    Wanda Regina Caly

    Full Text Available OBJECTIVES: To present the clinical features and outcomes of outpatients who suffer from refractory ascites. METHODS: This prospective observational study consecutively enrolled patients with cirrhotic ascites who submitted to a clinical evaluation, a sodium restriction diet, biochemical blood tests, 24 hour urine tests and an ascitic fluid analysis. All patients received a multidisciplinary evaluation and diuretic treatment. Patients who did not respond to the diuretic treatment were controlled by therapeutic serial paracentesis, and a transjugular intrahepatic portosystemic shunt was indicated for patients who required therapeutic serial paracentesis up to twice a month. RESULTS: The most common etiology of cirrhosis in both groups was alcoholism [49 refractory (R and 11 non-refractory ascites (NR]. The majority of patients in the refractory group had Child-Pugh class B cirrhosis (p=0.034. The nutritional assessment showed protein-energy malnutrition in 81.6% of the patients in the R group and 35.5% of the patients in the NR group, while hepatic encephalopathy, hernia, spontaneous bacterial peritonitis, upper digestive hemorrhage and type 2 hepatorenal syndrome were present in 51%, 44.9%, 38.8%, 38.8% and 26.5% of the patients in the R group and 9.1%, 18.2%, 0%, 0% and 0% of the patients in the NR group, respectively (p=0.016, p=0.173, p=0.012, p=0.012, and p=0.100, respectively. Mortality occurred in 28.6% of the patients in the R group and in 9.1% of the patients in the NR group (p=0.262. CONCLUSION: Patients with refractory ascites were malnourished, suffered from hernias, had a high prevalence of complications and had a high postoperative death frequency, which was mostly due to infectious processes.

  5. Sport Psychology.

    Science.gov (United States)

    Krotee, March L.

    1980-01-01

    Sport psychology is defined in terms of human behavior in athletic situations. The psychosocial cross-cultural setting provides a model for studying trait and state psychosocial attributes and suggests issues and concerns for further study. (JMF)

  6. Characterization and testing of refractories for glass tank melters

    Directory of Open Access Journals (Sweden)

    Velez M.

    2001-01-01

    Full Text Available Current and future research goals in our laboratories include the study of the attack of glass-contact refractories and of crown refractories in glass tank melters, under either air-gas or oxyfuel conditions. There is an emphasis on evaluation and characterization of critical parameters of commercial refractories such as microstructure, porosity and mechanical properties. A second focus is the evaluation of the performance of refractory alternatives to traditional crown and superstructure refractories including their physical aspects, crown design, and joint quality.

  7. Whither Psychology.

    Science.gov (United States)

    Halpern, Diane F

    2017-07-01

    Contemporary psychology is experiencing tremendous growth in neuroscience, and there is every indication that it will continue to gain in popularity notwithstanding the scarcity of academic positions for newly minted Ph.Ds. Despite the general perception that brain correlates "explain" or "cause" the mind and behavior, these correlates have not yet proven useful in understanding psychological processes, although they offer the possibility of early identification of some disorders. Other recent developments in psychology include increased emphasis on applications and more global representation among researchers and participants. In thinking about the way we want psychology to evolve, psychologists need to pay more than lip service to the idea that complex questions in psychology require multiple levels of analysis with contributions from biological (brain, hormones, and genetics), individual differences and social and cultural perspectives. Early career psychologists who can attain a breadth of knowledge will be well-positioned for a team approach to psychological inquiry. Finally, I offer the belief that an emphasis on enhancing critical thinking skills at all levels of education offers the best hope for the future.

  8. Pharmacotherapy for Refractory and Super-Refractory Status Epilepticus in Adults.

    Science.gov (United States)

    Holtkamp, Martin

    2018-01-24

    Patients with prolonged seizures that do not respond to intravenous benzodiazepines and a second-line anticonvulsant suffer from refractory status epilepticus and those with seizures that do not respond to continuous intravenous anesthetic anticonvulsants suffer from super-refractory status epilepticus. Both conditions are associated with significant morbidity and mortality. A strict pharmacological treatment regimen is urgently required, but the level of evidence for the available drugs is very low. Refractory complex focal status epilepticus generally does not require anesthetics, but all intravenous non-anesthetizing anticonvulsants may be used. Most descriptive data are available for levetiracetam, phenytoin and valproate. Refractory generalized convulsive status epilepticus is a life-threatening emergency, and long-term clinical consequences are eminent. Administration of intravenous anesthetics is mandatory, and drugs acting at the inhibitory gamma-aminobutyric acid (GABA) A receptor such as midazolam, propofol and thiopental/pentobarbital are recommended without preference for one of those. One in five patients with anesthetic treatment does not respond and has super-refractory status epilepticus. With sustained seizure activity, excitatory N-methyl-d-aspartate (NMDA) receptors are increasingly expressed post-synaptically. Ketamine is an antagonist at this receptor and may prove efficient in some patients at later stages. Neurosteroids such as allopregnanolone increase sensitivity at GABA A receptors; a Phase 1/2 trial demonstrated safety and tolerability, but randomized controlled data failed to demonstrate efficacy. Adjunct ketogenic diet may contribute to termination of difficult-to-treat status epilepticus. Randomized controlled trials are needed to increase evidence for treatment of refractory and super-refractory status epilepticus, but there are multiple obstacles for realization. Hitherto, prospective multicenter registries for pharmacological

  9. Estudo prospectivo das repercussões de baixas doses de remifentanil na função sinoatrial e na condução e refratariedade cardíaca Estudio prospectivo de las repercusiones de bajas dosis de remifentanil en la función sinoatrial en la conducción y refractariedad cardiaca Prospective study on the repercussions of low doses of remifentanil on sinoatrial function and in cardiac conduction and refractory period

    Directory of Open Access Journals (Sweden)

    Simone Soares Leite

    2007-10-01

    recuperación del nódulo sino-atrial (p = 0,0004, del período refractario del atrio derecho (p = 0,001 y del período refractario del nódulo atrio ventricular (p = 0,0001, pero no hubo disminución de la frecuencia cardíaca basal entre M0 e M1. CONCLUSIONES: El remifentanil altero las variables electrofisiológicas cardíacas, lo que en dosis mayores que las estudiadas podría causar bradicardia sinusal, asistolia y disturbios de conducción.BACKGROUND AND OBJECTIVES: Remifentanil is an opiod with fast onset of action and short acting, and its use in short-duration procedures has increased in the last few years. Bradycardia and asystole are among the side effects reported. The objective of this study was to evaluate the effects of this drug in cardiac conduction and refractory period in human beings. METHODS: A prospective study with 16 patients, ages 18 to 65, both genders, ASA I to III, undergoing elective intracardiac electrophysiological study, was undertaken. Patients with disorders of the sinoatrial node and those with severe cardiac blocks were excluded. In the laboratory of electrophysiology, patients were sedated with midazolam (0.03 mg.kg-1 after 5 minutes the degree of sedation and degree of pain, systolic and diastolic blood pressure, heart rate and respiratory rate, and oxygen saturation were evaluated. The electrophysiologist evaluated cardiac conduction (duration of the QRS complex, and AA, AH, HV, and PA intervals, duration of sinoatrial node recovery, and cardiac refractory period (refractory period of the right atrium, right ventricle, and atrioventricular node. After the initial measurements, remifentanil was administered (bolus of 0.5 µg.kg-1 + infusion of 0.05 µg.kg-1.min-1 and, after 20 minutes, the same parameters were evaluated. RESULTS: There was a reduction in systolic and diastolic blood pressure (p = 0.0001 between M0 and M1, and significant differences in respiratory rate and oxygen saturation, which were not statistically significant. The

  10. Acupuncture for refractory epilepsy: role of thalamus.

    Science.gov (United States)

    Chen, Shuping; Wang, Shubin; Rong, Peijing; Liu, Junling; Zhang, Hongqi; Zhang, Jianliang

    2014-01-01

    Neurostimulation procedures like vagus nerve stimulation (VNS) and deep brain stimulation have been used to treat refractory epilepsy and other neurological disorders. While holding promise, they are invasive interventions with serious complications and adverse effects. Moreover, their efficacies are modest with less seizure free. Acupuncture is a simple, safe, and effective traditional healing modality for a wide range of diseases including pain and epilepsy. Thalamus takes critical role in sensory transmission and is highly involved in epilepsy genesis particularly the absence epilepsy. Considering thalamus serves as a convergent structure for both acupuncture and VNS and the thalamic neuronal activities can be modulated by acupuncture, we propose that acupuncture could be a promising therapy or at least a screening tool to select suitable candidates for those invasive modalities in the management of refractory epilepsy.

  11. Acupuncture for Refractory Epilepsy: Role of Thalamus

    Directory of Open Access Journals (Sweden)

    Shuping Chen

    2014-01-01

    Full Text Available Neurostimulation procedures like vagus nerve stimulation (VNS and deep brain stimulation have been used to treat refractory epilepsy and other neurological disorders. While holding promise, they are invasive interventions with serious complications and adverse effects. Moreover, their efficacies are modest with less seizure free. Acupuncture is a simple, safe, and effective traditional healing modality for a wide range of diseases including pain and epilepsy. Thalamus takes critical role in sensory transmission and is highly involved in epilepsy genesis particularly the absence epilepsy. Considering thalamus serves as a convergent structure for both acupuncture and VNS and the thalamic neuronal activities can be modulated by acupuncture, we propose that acupuncture could be a promising therapy or at least a screening tool to select suitable candidates for those invasive modalities in the management of refractory epilepsy.

  12. Deoxyspergualin in relapsing and refractory Wegener's granulomatosis

    DEFF Research Database (Denmark)

    Flossmann, O; Baslund, B; Bruchfeld, A

    2008-01-01

    OBJECTIVES: Conventional therapy of Wegener's granulomatosis with cyclophosphamide and corticosteroids is limited by incomplete remissions and a high relapse rate. The efficacy and safety of an alternative immunosuppressive drug, deoxyspergualin, was evaluated in patients with relapsing...... or refractory disease. METHODS: A prospective, international, multicentre, single-limb, open-label study. Entry required active Wegener's granulomatosis with a Birmingham vasculitis activity score (BVAS) > or =4 and previous therapy with cyclophosphamide or methotrexate. Immunosuppressive drugs were withdrawn......-threatening (> or = grade 3) treatment-related adverse events occurred in 24 (53%) patients mostly due to leucopaenias. CONCLUSIONS: Deoxyspergualin achieved a high rate of disease remission and permitted prednisolone reduction in refractory or relapsing Wegener's granulomatosis. Adverse events were common but rarely led...

  13. Periclase-chromite refractories from fused materials

    Energy Technology Data Exchange (ETDEWEB)

    Slovikovskii, V.V.; Eroshkina, V.I.; Kononenko, G.V.; Nechistykh, G.A.; Simonov, K.V.

    1985-11-01

    Experiments were carried out to obtain high-grade fused chromitepericlase. It is shown that during the melting of batch consisting of raw magnesite and chromite ore the process of reducing the chromite ore to metallic ferrochromium is eliminated, which adversely affects both the content of Cr/sub 2/O/sub 3/ in the fused material, and also the commercial appearance of the resulting refractories. The authors developed a technology for preparing periclase-chromite refractories with chrommite-periclase constituents. The goods obtained possess good physicoceramic properties and a low content of silicites. The articles thus prepared were used to make the linings of the most critical parts of the converters which allowed an increase to be made in the duration of campaigns for the Kivset units of 1.5-2 times.

  14. Plasmonic properties of refractory titanium nitride

    Science.gov (United States)

    Catellani, Alessandra; Calzolari, Arrigo

    2017-03-01

    The development of plasmonic and metamaterial devices requires the research of high-performance materials alternative to standard noble metals. Renewed as a refractory stable compound for durable coatings, titanium nitride has recently been proposed as an efficient plasmonic material. Here, by using a first-principles approach, we investigate the plasmon dispersion relations of TiN bulk and we predict the effect of pressure on its optoelectronic properties. Our results explain the main features of TiN in the visible range and prove a universal scaling law which relates its mechanical and plasmonic properties as a function of pressure. Finally, we address the formation and stability of surface-plasmon polaritons at different TiN-dielectric interfaces proposed by recent experiments. The unusual combination of plasmonics and refractory features paves the way for the realization of plasmonic devices able to work at conditions not sustainable by the usual noble metals.

  15. Intravenous immunoglobulin therapy for refractory recurrent pericarditis.

    Science.gov (United States)

    del Fresno, M Rosa; Peralta, Julio E; Granados, Miguel Ángel; Enríquez, Eugenia; Domínguez-Pinilla, Nerea; de Inocencio, Jaime

    2014-11-01

    Recurrent pericarditis is a troublesome complication of idiopathic acute pericarditis and occurs more frequently in pediatric patients after cardiac surgery (postpericardiotomy syndrome). Conventional treatment with nonsteroidal antiinflammatory drugs, corticosteroids, and colchicine is not always effective or may cause serious adverse effects. There is no consensus, however, on how to proceed in those patients whose disease is refractory to conventional therapy. In such cases, human intravenous immunoglobulin, immunosuppressive drugs, and biological agents have been used. In this report we describe 2 patients with refractory recurrent pericarditis after cardiac surgery who were successfully treated with 3 and 5 monthly high-dose (2 g/kg) intravenous immunoglobulin until resolution of the effusion. Our experience supports the effectiveness and safety of this therapy. Copyright © 2014 by the American Academy of Pediatrics.

  16. Psychological Spacetime

    Directory of Open Access Journals (Sweden)

    Lucian Gideon Conway

    2016-11-01

    Full Text Available It has been an accepted scientific fact in physics for almost 100 years that time speeds up and slows down for an observer based on factors—such as motion and gravity—that affect space. Yet this fact, drawn from the theory of relativity, has not been widely integrated into the study of the psychology of time. The present article helps to fill in this gap between physics and psychology by reviewing evidence concerning what a psychological spacetime processor—one that accounted for the theory of relativity’s empirically validated predictions of the compensatory relationship between time and space—would look like. This model of the spacetime processor suggests that humans should have a psychological mechanism for slowing time down as motion speeds up, a prediction that already has widespread research support. We also discuss several novel hypotheses directly suggested by the spacetime model and a set of related speculations that emerge when considering spacetime (some of which have already received empirical support. Finally, we compare and contrast three very different potential reasons why we might have developed a spacetime processor in the first place. We conclude that the spacetime model shows promise for organizing existing data on time perception and generating novel hypotheses for researchers to pursue. Considering how humans might process spacetime helps reduce the existing gap between our understanding of physics and our understanding of human psychology.

  17. Political psychology.

    Science.gov (United States)

    Stone, Susanna; Johnson, Kate M; Beall, Erica; Meindl, Peter; Smith, Benjamin; Graham, Jesse

    2014-07-01

    Political psychology is a dynamic field of research that offers a unique blend of approaches and methods in the social and cognitive sciences. Political psychologists explore the interactions between macrolevel political structures and microlevel factors such as decision-making processes, motivations, and perceptions. In this article, we provide a broad overview of the field, beginning with a brief history of political psychology research and a summary of the primary methodological approaches in the field. We then give a more detailed account of research on ideology and social justice, two topics experiencing a resurgence of interest in current political psychology. Finally, we cover research on political persuasion and voting behavior. By summarizing these major areas of political psychology research, we hope to highlight the wide variety of theoretical and methodological approaches of cognitive scientists working at the intersection of psychology and political science. WIREs Cogn Sci 2014, 5:373-385. doi: 10.1002/wcs.1293 For further resources related to this article, please visit the WIREs website. The authors have declared no conflicts of interest for this article. © 2014 John Wiley & Sons, Ltd.

  18. Management of refractory ischemic priapism: current perspectives

    Directory of Open Access Journals (Sweden)

    Capece M

    2017-08-01

    Full Text Available Marco Capece,1 Arianna Gillo,2 Andrea Cocci,3 Giulio Garaffa,1 Massimiliano Timpano,4 Marco Falcone4 1The Institute of Urology, University College of London Hospital (UCLH, London, UK; 2Department of Urology, “Umberto Parini” Hospital, Aosta, 3Department of Urology, Careggi Hospital, Firenze, 4Department of Urology, University of Turin, Città della Salute e della Scienza, Turin, Italy Objectives: The aim of the present manuscript is to review the current literature on priapism, focusing on the state-of-the-art knowledge of both the diagnosis and the treatment of the refractory ischemic priapism (IP.Methods: Pubmed and EMBASE search engines were used to search for words “priapism”, “refractory priapism”, “penile prosthesis”, “diagnosis priapism”, “priapism treatment”, “penile fibrosis”, “priapism therapy”. All the studies were carefully examined by the authors and then included in the review.Results: First-line treatment involves ejaculation, physical exercise and cold shower followed by corporal blood aspiration and injection of α-adrenoceptor agonists. Subsequently, a distal or proximal shunt may be considered. If none of the treatment is effective or the priapism episode lasts >48 hours penile prosthesis implantation could be the only option to solve the priapism and treat the ongoing erectile dysfunction.Conclusion: The management of IP is to achieve detumescence of persistent penile erection and to preserve erectile function after resolution of the priapic episode. On the other hand, penile fibrosis and following shortening should be prevented. Early penile prosthesis implantation in patients with refractory IP is able to solve both the priapic episode and prevent the otherwise certain penile shortening. Penile prosthesis implantation is the actual gold standard of care in cases of refractory IP. Keywords: priapism, ischemic priapism, penile fibrosis, penile prosthesis, shunt 

  19. Acupuncture for Refractory Epilepsy: Role of Thalamus

    OpenAIRE

    Chen, Shuping; Wang, Shubin; Rong, Peijing; Liu, Junling; Zhang, Hongqi; Zhang, Jianliang

    2014-01-01

    Neurostimulation procedures like vagus nerve stimulation (VNS) and deep brain stimulation have been used to treat refractory epilepsy and other neurological disorders. While holding promise, they are invasive interventions with serious complications and adverse effects. Moreover, their efficacies are modest with less seizure free. Acupuncture is a simple, safe, and effective traditional healing modality for a wide range of diseases including pain and epilepsy. Thalamus takes critical role in ...

  20. Processes for preparing novel baddeleyite refractory articles

    Energy Technology Data Exchange (ETDEWEB)

    McGarry, Ch.N.; Stunis, J.; Wehrenberg, Th.M.

    1984-07-24

    A novel process for fabricating novel high zirconia content refractory articles directly from novel sinterable compositions including as the major ingredient thereof baddeleyite ore concentrates thereby reducing costs. Appropriate additives, particularly zircon, further provide enhanced resistance to thermal shock damage. Plasticizers, binders and other processing aids are identified for press forming exemplary compositions into continuous casting nozzles, shrouds and other ceramic products typically used in the processing of molten steel, specialty metals and glass.

  1. Medical image of the week: refractory dyspnea

    OpenAIRE

    Malo J; Reyes N; Rischard F

    2012-01-01

    A 61 year old man with an extensive smoking history and emphysema was referred for evaluation of dyspnea refractory to standard therapy. He was diagnosed with a pulmonary embolism 5 months prior to presentation and has been on warfarin since that time. Review of the patient’s CT scan performed prior to the visit demonstrated dilated main; right; and left pulmonary arteries (Figure 1). Also visualized was an eccentrically located thrombus with areas of calcification and central recanalization...

  2. How I treat refractory thrombotic thrombocytopenic purpura

    Science.gov (United States)

    Sayani, Farzana A.

    2015-01-01

    Acquired thrombotic thrombocytopenic purpura (TTP) is characterized by thrombocytopenia and microangiopathic hemolytic anemia (MAHA) without an obvious cause, and may include fever, mild renal failure, and neurologic deficits. It is characterized by a deficiency of the von Willebrand factor (VWF) cleaving enzyme, ADAMTS13 (a disintegrin and metalloproteinase, with a thrombospondin type 1 motif, member 13), resulting in formation of microthrombi in the high sheer environment of the microvasculature. This causes microvascular occlusion, MAHA, and organ ischemia. Diagnosis is based on the presence of clinical symptoms, laboratory aberrations consistent with MAHA, decreased ADAMTS13 activity, and possibly presence of anti-ADAMTS13 autoantibodies. Upfront treatment of acute TTP includes plasma exchange and corticosteroids. A significant number of patients are refractory to this treatment and will require further interventions. There are limited data and consensus on the management of the refractory TTP patient. Management involves simultaneously ruling out other causes of thrombocytopenia and MAHA, while also considering other treatments. In this article, we describe our management of the patient with refractory TTP, and discuss use of rituximab, increased plasma exchange, splenectomy, and immunosuppressive options, including cyclophosphamide, vincristine, and cyclosporine. We also review recent evidence for the potential roles of bortezomib and N-acetylcysteine, and explore new therapeutic approaches, including recombinant ADAMTS13 and anti-VWF therapy. PMID:25784681

  3. Refractory hematemesis caused by haemoductal pancreatitis

    Directory of Open Access Journals (Sweden)

    Chandrasekharan Rajasekharan

    2012-04-01

    Full Text Available We report a case of a 48-year-old female, who presented with refractory haemetemesis. Her oesophago-gastroduodenoscopy showed only a healing ulcer but profuse bleeding was seen from duodenum. In spite of a negative oesophago-gastroduodenoscopy she was bleeding profusely with haemodynamic decompensation. Doppler coeliac trunk showed a suprapancreatic cystic lesion with yin-yang pattern of blood flow confirming a pseudo aneurysm involving the superior and inferior pancreatioduodenal arterial arcade using digital subtraction angiography. The conversion of a pancreatic pseudo cyst into a pseudo aneurysm is a potential lethal complication because, when rupture occurs, mortality rises up to 40%.She was diagnosed to have pancreatic pseudocyst, psedoaneurysm and haemosuccus pancreaticus with wirsungorrhagia and was offered arterial embolization following which she improved. Patients with chronic calcificpancratitis (CCP could remain silent and can present with normal amylase and lipase. Complications such as pseudocysts or pseudoaneurysms can be asymptomatic. The pancreas should be considered a possible site of hemorrhage in CCP in cases of refractory upper gasrtrointestinal haemorrhage. We highlight the importance of looking for causes other than bleeding duodenal/gastic ulcer/oesophageal varices in case of a refractory hametemeis giving the patient option of a nonsurgical modality of treatment and it’s reduced risks.The effectiveness of embolistion for bleeding psuedoaneurysms is emphasized.

  4. Angiotensin II in Refractory Septic Shock.

    Science.gov (United States)

    Antonucci, Elio; Gleeson, Patrick J; Annoni, Filippo; Agosta, Sara; Orlando, Sergio; Taccone, Fabio Silvio; Velissaris, Dimitrios; Scolletta, Sabino

    2017-05-01

    Refractory septic shock is defined as persistently low mean arterial blood pressure despite volume resuscitation and titrated vasopressors/inotropes in patients with a proven or suspected infection and concomitant organ dysfunction. Its management typically requires high doses of catecholamines, which can induce significant adverse effects such as ischemia and arrhythmias. Angiotensin II (Ang II), a key product of the renin-angiotensin-aldosterone system, is a vasopressor agent that could be used in conjunction with other vasopressors to stabilize critically ill patients during refractory septic shock, and reduce catecholamine requirements. However, very few clinical data are available to support Ang II administration in this setting. Here, we review the current literature on this topic to better understand the role of Ang II administration during refractory septic shock, differentiating experimental from clinical studies. We also consider the potential role of exogenous Ang II administration in specific organ dysfunction and possible pitfalls with Ang II in sepsis. Various issues remain unresolved and future studies should investigate important topics such as: the optimal dose and timing of Ang II administration, a comparison between Ang II and the other vasopressors (epinephrine; vasopressin), and Ang II effects on microcirculation.

  5. Barrier Coatings for Refractory Metals and Superalloys

    Energy Technology Data Exchange (ETDEWEB)

    SM Sabol; BT Randall; JD Edington; CJ Larkin; BJ Close

    2006-02-23

    In the closed working fluid loop of the proposed Prometheus space nuclear power plant (SNPP), there is the potential for reaction of core and plant structural materials with gas phase impurities and gas phase transport of interstitial elements between superalloy and refractory metal alloy components during service. Primary concerns are surface oxidation, interstitial embrittlement of refractory metals and decarburization of superalloys. In parallel with kinetic investigations, this letter evaluates the ability of potential coatings to prevent or impede communication between reactor and plant components. Key coating requirements are identified and current technology coating materials are reviewed relative to these requirements. Candidate coatings are identified for future evaluation based on current knowledge of design parameters and anticipated environment. Coatings were identified for superalloys and refractory metals to provide diffusion barriers to interstitial transport and act as reactive barriers to potential oxidation. Due to their high stability at low oxygen potential, alumina formers are most promising for oxidation protection given the anticipated coolant gas chemistry. A sublayer of iridium is recommended to provide inherent diffusion resistance to interstitials. Based on specific base metal selection, a thin film substrate--coating interdiffusion barrier layer may be necessary to meet mission life.

  6. Psychological IVF

    DEFF Research Database (Denmark)

    Adrian, Stine Willum

    2015-01-01

    During ethnographic fieldwork at a fertility clinic in Denmark, I became intrigued by emotions. In particular, I found an incidence labelled ‘psychological IVF’ theoretically provocative as it challenged my views on materializations, which I was preparing to study. This paper centres on the story...... of psychological IVF, and I use this narrative to consider emotions and materialization methodologically. I also ask how emotions at fertility clinics can be conceptualized to enable analysis of their materialization, change, and effects. In order to do so, I develop the term ‘emotional choreography......’. This theoretical work has three aims. First, it seeks to illustrate how the story of psychological IVF offers a rich range of materializations of emotions. Secondly, this work proposes a feminist materialist conceptualization of emotions that is both non-representational and posthuman. This conceptualization draws...

  7. Trabeculetomy combined with implantation of silicon rubber slice for refractory glaucoma

    Directory of Open Access Journals (Sweden)

    Ming-Hai Shen

    2013-10-01

    Full Text Available AIM: To evaluate the effect of trabecular filtration surgery combined with scleral interlayer filled with silicon rubber for refractory glaucoma and its complications.METHODS: A total of 32 cases(32 eyesof refractory glaucoma underwent trabecular filtration surgery combined with sclera interlayer filled silicone piece, namely trabeculectomy combined silicon rubber filled in sclera between layers was as experimental group. Twenty-one cases(21 eyestreated by simple trabecular filtration surgery were as control group. Reducing effect of intraocular pressure(IOPand complications of two groups were observed after operation.RESULTS: Postoperative follow-up was 6-24 months. The mean IOP was 14.36±5.2mmHg(1mmHg=0.133kPain experimental group and 23.36±9.3mmHg in control group after operation. IOP of three eyes(9.4%in experimental group and 5 eyes(23.8%in control group was over 30mmHg. There was no serious complications and rejection correlated with silicone piece during the follow-up period.CONCLUSION:Silicone piece filled between sclera layer is an effective method for refractory glaucoma, and can effectively reduce IOP. Due to its economic, convenient, especially can replace expensive imported drainage plant figure treatment of refractory glaucoma in our country the grass-roots hospital, it should be widely applied.

  8. Comprehensive Creep and Thermophysical Performance of Refractory Materials

    Energy Technology Data Exchange (ETDEWEB)

    Ferber, M.K.; Wereszczak, A.; Hemrick, J.A.

    2006-06-29

    Furnace designers and refractory engineers recognize that optimized furnace superstructure design and refractory selection are needed as glass production furnaces are continually striving toward greater output and efficiencies. Harsher operating conditions test refractories to the limit, while changing production technology (such as the conversion to oxy-fuel from traditional air-fuel firing) can alter the way the materials perform [1-3]. Refractories for both oxy- and air-fuel fired furnace superstructures (see Fig. 1) are subjected to high temperatures that may cause them to creep excessively or subside during service if the refractory material is not creep resistant, or if it is subjected to high stress, or both. Furnace designers can ensure that superstructure structural integrity is maintained if the creep behavior of the refractory material is well understood and well represented by appropriate engineering creep models. Several issues limit the abilities of furnace designers to (1) choose the optimum refractory for their applications, (2) optimize the engineering design, or (3) predict the service mechanical integrity of their furnace superstructures. Published engineering creep data are essentially nonexistent for almost all commercially available refractories used for glass furnace superstructures. The limited data that do exist are supplied by the various refractory suppliers. Unfortunately, the suppliers generally have different ways of conducting their mechanical testing, and they interpret and report their data differently. This inconsistency makes it hard for furnace designers to draw fair comparisons between competing grades of candidate refractories. Furthermore, the refractory suppliers' data are often not available in a form that can be readily used for furnace design or for the prediction and design of long-term structural integrity of furnace superstructures. As a consequence, the U.S. Department of Energy (DOE) Industrial Technology Program

  9. Space psychology

    Science.gov (United States)

    Parin, V. V.; Gorbov, F. D.; Kosmolinskiy, F. P.

    1974-01-01

    Psychological selection of astronauts considers mental responses and adaptation to the following space flight stress factors: (1) confinement in a small space; (2) changes in three dimensional orientation; (3) effects of altered gravity and weightlessness; (4) decrease in afferent nerve pulses; (5) a sensation of novelty and danger; and (6) a sense of separation from earth.

  10. Deployment psychology

    African Journals Online (AJOL)

    abel

    breaking fashion, brings into a single compendium the growing body of literatures, since Yerkes's work, which point to the ... [they] reflect on how they have changed”.3 From the outset of this text, there is a very real and palpable sense .... embedded and enmeshed. At times, Deployment psychology appears to ignore the.

  11. Diagnosis and management of refractory celiac disease: a systematic review.

    Science.gov (United States)

    Labidi, Asma; Serghini, Meriem; Karoui, Sami; Boubaker, Jalel; Filali, Azza

    2013-01-01

    Refractory celiac disease is defined by persisting malabsorptive symptoms in spite of a strict gluten free diet for at least 6 to 12 months. Alternatives to gluten free diet seem to be still controversial. To describe the clinical and epidemiologic aspects of refractory celiac disease, and to identify therapeutic options in this condition. Systematic review and critical analysis of observational studies, clinical trials and case reports that focused on diagnosis and management of refractory celiac disease. Refractory celiac disease can be classified as type 1 or type 2 according to the phenotype of intraepithelial lymphocytes. Great complications such as enteropathy-associated T-cell lymphoma may occur in a subgroup of these patients mainly in refractory celiac disease type 2. Curative therapies are still lacking. Refractory celiac disease remains a diagnosis of exclusion. Its prognosis remains still dismal by the absence yet of curative therapies. However, some new treatments seem to hold promise during few cohort-studies.

  12. Current Management of Refractory Germ Cell Tumors and Future Directions.

    Science.gov (United States)

    Allen, J Clayton; Kirschner, Austin; Scarpato, Kristen R; Morgans, Alicia K

    2017-02-01

    We review current management strategies for patients with relapsed and refractory germ cell tumors (GCTs), defined as relapsed or persistent disease following at least one line of cisplatin-based chemotherapy. Additionally, we discuss future directions in the management of these patients. Recent studies involving targeted therapies have been disappointing. Nevertheless, studies of the management of refractory germ cell cancer are ongoing, with a focus on optimal utilization of high-dose chemotherapy and autologous stem cell transplant, as well as the role of immune checkpoint inhibitors in refractory germ cell tumors. Studies aiming to identify those patients who may benefit from more intensive treatment up front to prevent the development of refractory disease are also in progress. Testicular germ cell tumors are among the most curable of all solid tumor malignancies, with cure being possible even in the refractory, metastatic setting. Treatment of refractory disease remains a challenging clinical scenario, but potentially practice changing studies are ongoing.

  13. SENSOR-BASED SORTING OF SPENT REFRACTORY BRICKS

    OpenAIRE

    Knapp, Henning; Horckmans, Liesbeth; Bouillot, Frédérique; Fricke-Begemann, Cord; Connemann, Sven; Makowe, Joachim; Ducastel, Antoine; Stark, Alexander

    2016-01-01

    Refractory materials are essential for all high-temperature applications in industry. Depending on the position in the furnace and specific process requirements, refractories are produced from several raw materials, such as dolomite, magnesite, bauxite, graphite or chromite. Most of these raw materials are not rare but strict quality requirements limit the producers of refractories to only a few deposits in the world. Thus, raw material supply is a critical factor for the production of refrac...

  14. Sensor-based identification of spent Refractory Bricks

    OpenAIRE

    Knapp, Henning; Horckmans, L.; Fricke-Begemann, Cord; Makowe, Joachim; Ducastel, A.; Stark, Alexander; Bouillot, F.

    2015-01-01

    Refractory bricks are essential for high-temperature applications in various industries. The fabrication of most of our daily life products consumes a certain amount of refractories. Although essential, they are often not perceived so by the public. Depending on their specific application and the position in the furnace, different types of refractories are necessary. The different types consist of a small number of naturally occurring high quality raw materials, such as dolomite, magnesite, b...

  15. Properties of Refractory Concrete in Tension and Compression

    Science.gov (United States)

    Sampson, Jeffrey

    2009-01-01

    Refractory concrete on the LC-39A Flame Deflector has been damaged during multiple Space Shuttle launches (e.g. STS-124, STS-126, STS-119, and STS-125, STS-127). These events have prompted a better understanding of the system via an analytical model of the Flame Deflector assembly to include the Fondu Fyre refractory concrete. This model requires test data inputs of the refractory concrete's mechanical properties, which include stress versus strain curves in tension and compression, modulus of elasticity, and Poisson's ratio. Sections of Fondu Fyre refractory concrete removed from the LC-39A Flame Deflector were provided for this testing.

  16. Refractory Coated/Lined Low Density Structures Project

    Data.gov (United States)

    National Aeronautics and Space Administration — This project addresses the development of refractory coated or lined low density structures applicable for advanced future propulsion system technologies. The...

  17. Ketogenic diet therapy is effective in encephalitis with refractory seizures.

    Science.gov (United States)

    Matsuzono, Kosuke; Kurata, Tomoko; Deguchi, Shoko; Yamashita, Toru; Deguchi, Kentaro; Abe, Koji

    2014-10-01

    Although ketogenic diet therapy is effective in refractory seizures in childhood, its effect on adult encephalitis with similar refractory seizures and prolonged encephalopathy has not been well reported. We report here a case of a 22-year-old man with acute encephalitis with refractory repetitive partial seizures (AERRPS). Partial seizures of the face developed to repeated generalized convulsions, which were refractory against anti-epileptic drugs and a high dose of propofol. After struggling for 9 months, he dramatically recovered after ketogenic diet therapy. Ketogenic diet therapy may be an important tool to help cure AERRPS.

  18. Handbook of industrial refractories technology principles, types, properties and applications

    CERN Document Server

    Caniglia, Stephen

    1989-01-01

    Encompasses the entire range of industrial refractory materials and forms: properties and their measurement, applications, manufacturing, installation and maintenance techniques, quality assurance, and statistical process control.

  19. LEARNING THEORY AND CLINICAL PSYCHOLOGY,

    Science.gov (United States)

    ABNORMAL PSYCHOLOGY , *ADJUSTMENT( PSYCHOLOGY ), LEARNING, LEARNING, BEHAVIOR, PERSONALITY, ANXIETY, ATTITUDES( PSYCHOLOGY ), NEUROSES, MENTAL DISORDERS...PERCEPTION( PSYCHOLOGY ), VERBAL BEHAVIOR, SOCIAL PSYCHOLOGY , DIAGNOSIS(MEDICINE), THERAPY.

  20. Controlled trial of lamotrigine (Lamictal) for refractory partial seizures.

    Science.gov (United States)

    Jawad, S; Richens, A; Goodwin, G; Yuen, W C

    1989-01-01

    The antiepileptic effect of lamotrigine (LTG) was assessed in a double-blind, placebo-controlled crossover trial in 24 adult patients with refractory partial seizures. LTG or placebo was added to existing antiepileptic drugs (AEDs). The dose of LTG varied from 75 to 400 mg daily. Three patients did not complete the trial. One was withdrawn from the trial with ataxia, tiredness, dyspnea, and diplopia while receiving LTG and died 18 days later of invasive carcinoma involving the liver. A second patient was withdrawn during baseline for contravening admission criteria, and a third received LTG in error during both treatment periods. Twenty-one patients (12 men and 9 women) completed the trial. An analysis of seizure counts in the 12-week treatment period with LTG showed a statistically significant reduction in seizures as compared with placebo for total seizures (p less than 0.002), partial seizures (p less than 0.002), and secondarily generalized seizures (p less than 0.05). The analysis of total seizure days showed a significant reduction during LTG treatment (p less than 0.002). There were no statistically significant changes in plasma concentrations of phenytoin (PHT), carbamazepine (CBZ), primidone (PRM), or phenobarbital (PB) between the two treatment periods. The most common adverse events reported during the trial were diplopia, drowsiness, tiredness, ataxia, and headache, but although these were more frequent during LTG treatment, the differences from placebo were not statistically significant. No hematological or biochemical changes were noted.

  1. Stereotactic radiosurgery for medically refractory multiple sclerosis-related tremor.

    Science.gov (United States)

    Raju, Sudesh S; Niranjan, Ajay; Monaco, Edward A; Flickinger, John C; Lunsford, L Dade

    2017-06-30

    OBJECTIVE Multiple sclerosis (MS) is a neurodegenerative disease that can lead to severe intention tremor in some patients. In several case reports, conventional radiotherapy has been reported to possibly exacerbate MS. Radiosurgery dramatically limits normal tissue irradiation to potentially avoid such a problem. Gamma Knife thalamotomy (GKT) has been established as a minimally invasive technique that is effective in treating essential tremor and Parkinson's disease-related tremor. The goal in this study was to analyze the outcomes of GKT in patients suffering from medically refractory MS-related tremor. METHODS The authors retrospectively studied the outcomes of 15 patients (mean age 46.5 years) who had undergone GKT over a 15-year period (1998-2012). Fourteen patients underwent GKT at a median maximum dose of 140 Gy (range 130-150 Gy) using a single 4-mm isocenter. One patient underwent GKT at a dose of 140 Gy delivered via two 4-mm isocenters (3 mm apart). The posteroinferior region of the nucleus ventralis intermedius (VIM) was the target for all GKTs. The Fahn-Tolosa-Marin clinical tremor rating scale was used to evaluate tremor, handwriting, drawing, and drinking. The median time to the last follow-up was 39 months. RESULTS After GKT, 13 patients experienced tremor improvement on the side contralateral to surgery. Four patients noted tremor arrest at a median of 4.5 months post-GKT. Seven patients had excellent tremor improvement and 6 had good tremor improvement. Four patients noted excellent functional improvement, 8 noted good functional improvement, and 1 noted satisfactory functional improvement. Three patients experienced diminished tremor relief at a median of 18 months after radiosurgery. Two patients experienced temporary adverse radiation effects. Another patient developed a large thalamic cyst 60 months after GKT, which was successfully managed with Ommaya reservoir placement. CONCLUSIONS Gamma Knife thalamotomy was found to be a minimally

  2. Arthroscopic treatment of refractory adhesive capsulitis of the shoulder

    Directory of Open Access Journals (Sweden)

    Marcos Rassi Fernandes

    Full Text Available OBJECTIVE: to evaluate the results of arthroscopic treatment of refractory adhesive capsulitis of the shoulder associated as for improved range of motion after a minimum follow up of six years. METHODS: from August 2002 to December 2004, ten patients with adhesive capsulitis of the shoulder resistant to conservative treatment underwent arthroscopic surgery. One interscalene catheter was placed for postoperative analgesia before the procedure. All were in Phase II, with a minimum follow up of two years. The mean age was 52.9 years (39-66, predominantly female (90%, six on the left shoulder. The time between onset of symptoms and surgical treatment ranged from six to 20 months. Four adhesive capsulitis were found to be primary (40% and six secondary (60%. RESULTS: the preoperative mean of active anterior elevation was 92°, of external rotation was 10.5° of the L5 level internal rotation; the postoperative ones were 149°, 40° and T12 level, respectively. Therefore, the average gain was 57° for the anterior elevation, 29.5° for external rotation in six spinous processes. There was a significant difference in movements' gains between the pre and post-operative periods (p<0.001. By the Constant Score (range of motion, there was an increase of 13.8 (average pre to 32 points (average post. CONCLUSION: the arthroscopic treatment proved effective in refractory adhesive capsulitis of the shoulder resistant to conservative treatment, improving the range of joint movements of patients evaluated after a minimum follow up of six years.

  3. Minimal model for calcium alternans due to SR release refractoriness

    Science.gov (United States)

    Cantalapiedra, Inma R.; Alvarez-Lacalle, Enrique; Peñaranda, Angelina; Echebarria, Blas

    2017-09-01

    In the heart, rapid pacing rates may induce alternations in the strength of cardiac contraction, termed pulsus alternans. Often, this is due to an instability in the dynamics of the intracellular calcium concentration, whose transients become larger and smaller at consecutive beats. This alternation has been linked experimentally and theoretically to two different mechanisms: an instability due to (1) a strong dependence of calcium release on sarcoplasmic reticulum (SR) load, together with a slow calcium reuptake into the SR or (2) to SR release refractoriness, due to a slow recovery of the ryanodine receptors (RyR2) from inactivation. The relationship between calcium alternans and refractoriness of the RyR2 has been more elusive than the corresponding SR Ca load mechanism. To study the former, we reduce a general calcium model, which mimics the deterministic evolution of a calcium release unit, to its most basic elements. We show that calcium alternans can be understood using a simple nonlinear equation for calcium concentration at the dyadic space, coupled to a relaxation equation for the number of recovered RyR2s. Depending on the number of RyR2s that are recovered at the beginning of a stimulation, the increase in calcium concentration may pass, or not, over an excitability threshold that limits the occurrence of a large calcium transient. When the recovery of the RyR2 is slow, this produces naturally a period doubling bifurcation, resulting in calcium alternans. We then study the effects of inactivation, calcium diffusion, and release conductance for the onset of alternans. We find that the development of alternans requires a well-defined value of diffusion while it is less sensitive to the values of inactivation or release conductance.

  4. Effectiveness and Safety of Anakinra for Management of Refractory Pericarditis.

    Science.gov (United States)

    Jain, Sonia; Thongprayoon, Charat; Espinosa, Raul E; Hayes, Sharonne N; Klarich, Kyle W; Cooper, Leslie T; Moder, Kevin G; Anavekar, Nandan S; Oh, Jae K; Matteson, Eric L

    2015-10-15

    Recurrent pericarditis is a debilitating condition that can be recalcitrant to conventional therapy with nonsteroidal anti-inflammatory agents, colchicine, and glucocorticoids. The aim of this study was to evaluate the therapeutic role of the recombinant interleukin-1 receptor antagonist anakinra in a series of adult patients with recurrent pericarditis refractory to conventional therapy. We retrospectively reviewed the medical records of 13 consecutive patients with treatment-refractory recurrent pericarditis who received anakinra for management of their disease. None of the patients had an identified systemic inflammatory rheumatic disease. The primary end points were symptom resolution and glucocorticoid discontinuation. Thirteen patients (10 women) treated with anakinra were followed for a median (range) of 16.8 months (1.3 to 24). All patients had chest pain. Total duration of symptoms before initiation of anakinra was 3 years (1.1 to 6.0). Pericardial thickening was detected by echocardiography in 9 patients (69%). All 13 patients (100%) experienced at least a partial and, most, a complete resolution of symptoms. Response to therapy was rapid, within 2 to 5 days. At last follow-up, 11 patients (84%) had successfully discontinued concomitant nonsteroidal anti-inflammatory agent, colchicine, and glucocorticoid therapy; 11 patients remained on anakinra at the end of the follow-up period. The only side effect was transient injection site reaction in 4 patients (31%). In conclusion, anakinra may be an effective alternative agent for the management of glucocorticoid-dependent recurrent pericarditis. Side effects were minor. A formal clinical trial to evaluate the usefulness of this agent should be considered. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Feasibility and Safety of Repeat Instant Endovascular Interventions in Patients with Refractory Cerebral Vasospasms.

    Science.gov (United States)

    Andereggen, L; Beck, J; Z'Graggen, W J; Schroth, G; Andres, R H; Murek, M; Haenggi, M; Reinert, M; Raabe, A; Gralla, J

    2017-03-01

    For patients with cerebral vasospasm refractory to medical and hemodynamic therapies, endovascular therapies often remain the last resort. Data from studies in large cohorts on the efficacy and safety of multiple immediate endovascular interventions are sparse. Our aim was to assess the feasibility and safety of multiple repeat instant endovascular interventions in patients with cerebral vasospasm refractory to medical, hemodynamic, and initial endovascular interventions. This was a single-center retrospective study of prospectively collected data on patients with cerebral vasospasm refractory to therapies requiring ≥3 endovascular interventions during the course of treatment following aneurysmal subarachnoid hemorrhage. The primary end point was functional outcome at last follow-up (mRS ≤2). The secondary end point was angiographic response to endovascular therapies and the appearance of cerebral infarctions. During a 4-year period, 365 patients with aneurysmal subarachnoid hemorrhage were treated at our institution. Thirty-one (8.5%) met the inclusion criteria. In 52 (14%) patients, ≤2 endovascular interventions were performed as rescue therapy for refractory cerebral vasospasm. At last follow-up, a good outcome was noted in 18 (58%) patients with ≥3 interventions compared with 31 (61%) of those with ≤2 interventions (P = .82). The initial Hunt and Hess score of ≤2 was a significant independent predictor of good outcome (OR, 4.7; 95% CI, 1.2-18.5; P = .03), whereas infarcts in eloquent brain areas were significantly associated with a poor outcome (mRS 3-6; OR, 13.5; 95% CI, 2.3-81.2; P = .004). Repeat instant endovascular intervention is an aggressive but feasible last resort treatment strategy with a favorable outcome in two-thirds of patients with refractory cerebral vasospasm and in whom endovascular treatment has already been initiated. © 2017 by American Journal of Neuroradiology.

  6. The mortality and response rate after FLANG regimen in patients with refractory/relapsed acute leukemia

    Directory of Open Access Journals (Sweden)

    Vali A Mehrzad

    2012-01-01

    Full Text Available Background: Oncologists today are greatly concerned about the treatment of relapsed/refractory acute leukemia. FLANG regimen, combination of novantron, cytarabine, fludarabine, and granulocyte-colony stimulating factor, has been used in treatment of refractory/relapsed acute leukemia since 1990s. The present study has evaluated mortality and response rate of this regimen. Materials and Methods: In this study, 25 patients with refractory/relapsed acute leukemia aged 15-55 years underwent FLANG regimen at Seyed-Al-Shohada Hospital, Isfahan, Iran during 2008-2009. One month later, bone marrow samples were taken to evaluate the responsiveness to treatment. Participants were followed for a year. The data was analyzed by student-t and chi-square tests, logistic, and Cox regression analysis, and Kaplan-Meier curves in SPSS 19. Results: Out of the 25 patients, 8 patients (32% had acute lymphoblastic leukemia (5 refractory and 3 relapsed cases and 17 subjects had acute myeloid leukemia (7 refractory and 10 relapsed cases. According to the bone marrow biopsies taken one month after FLANG regimen, 10 patients (40% had responded to treatment. Five patients of the 10 responders underwent successful bone marrow transplantation (BMT. On the other hand, 13 patients (52%, who had not entered the CR period, died during the follow-up. Logistic regression analysis did not reveal any significant associations between disease type and responsiveness to treatment. Conclusion: This study indicated higher rates of unresponsiveness to treatment while its mortality rate was comparable with other studies. Overall, according to limitations for BMT (as the only chance for cure in Iran, it seems that FLANG therapy is an acceptable choice for these patients.

  7. Outcomes of Ahmed valve surgery for refractory glaucoma in Dhahran, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Tariq Alasbali

    2015-06-01

    Full Text Available AIM:To evaluate the outcomes of Ahmed glaucoma valve (AGV implantation surgery for refractory glaucoma.METHODS:This one-armed historical cohort study was conducted in 2011. Refractory glaucoma was defined as eyes with an intraocular pressure (IOP greater than 21 mm Hg with maximally tolerated glaucoma medications, failed surgeries, or both. For all eyes with refractory glaucoma that underwent AGV implantation, data were collected on IOP, the best corrected visual acuity (BCVA and glaucoma medications preoperatively and 4, 6, 12, 24 and 56wk postoperatively. Logarithm values of IOP were calculated and compared.RESULTS: The study group was comprised of 30 patients (30 eyes, 16 males and 14 females with refractory glaucoma. Mean preoperative IOP was 39.3±13.8 mm Hg. Postoperative mean IOP was 15.7±7.1 mm Hg, 19.6±12.8 mm Hg and 13.9±14.2 mm Hg at 12, 24 and 56wk respectively. BCVA was ≥ 6/60 in 11 eyes preoperatively, and five eyes had BCVA≥6/60 at 56wk postoperatively. Preoperatively, more than four medications were used to treat glaucoma in 21 eyes. At 12wk postoperatively, no medications were required to control IOP in 20 eyes. At 56wk postoperatively, at least one medication was required to control IOP in 10 eyes. Over the entire follow up period, four eyes were treated with yttrium aluminium garnet (YAG laser and 14 eyes required a second surgery. The AGV was removed in four eyes.CONCLUSION: AGV implantation reduced IOP and the number of medications required to control refractory glaucoma. However, there was a higher risk of decreased vision. Long-term follow up and prompt intervention are recommended.

  8. Outcomes of Ahmed valve surgery for refractory glaucoma in Dhahran, Saudi Arabia.

    Science.gov (United States)

    Alasbali, Tariq; Alghamdi, Abdullah Ali; Khandekar, Rajiv

    2015-01-01

    To evaluate the outcomes of Ahmed glaucoma valve (AGV) implantation surgery for refractory glaucoma. This one-armed historical cohort study was conducted in 2011. Refractory glaucoma was defined as eyes with an intraocular pressure (IOP) greater than 21 mm Hg with maximally tolerated glaucoma medications, failed surgeries, or both. For all eyes with refractory glaucoma that underwent AGV implantation, data were collected on IOP, the best corrected visual acuity (BCVA) and glaucoma medications preoperatively and 4, 6, 12, 24 and 56wk postoperatively. Logarithm values of IOP were calculated and compared. The study group was comprised of 30 patients (30 eyes, 16 males and 14 females) with refractory glaucoma. Mean preoperative IOP was 39.3±13.8 mm Hg. Postoperative mean IOP was 15.7±7.1 mm Hg, 19.6±12.8 mm Hg and 13.9±14.2 mm Hg at 12, 24 and 56wk respectively. BCVA was ≥ 6/60 in 11 eyes preoperatively, and five eyes had BCVA≥6/60 at 56wk postoperatively. Preoperatively, more than four medications were used to treat glaucoma in 21 eyes. At 12wk postoperatively, no medications were required to control IOP in 20 eyes. At 56wk postoperatively, at least one medication was required to control IOP in 10 eyes. Over the entire follow up period, four eyes were treated with yttrium aluminium garnet (YAG) laser and 14 eyes required a second surgery. The AGV was removed in four eyes. AGV implantation reduced IOP and the number of medications required to control refractory glaucoma. However, there was a higher risk of decreased vision. Long-term follow up and prompt intervention are recommended.

  9. [Effectiveness and safety of the FLAG-IDA regimen in acute refractory or recurrent leukaemia].

    Science.gov (United States)

    Domínguez Senín, L; Rodríguez Rodríguez, J N; Garrido Martínez, M T; Sánchez Argáiz, M; Martín Chacón, E

    2012-01-01

    To evaluate the effectiveness and safety of the FLAG-IDA regimen in patients with acute refractory and/or recurrent leukaemia. Descriptive, retrospective, observational study of the clinical histories of patients with the FLAG-IDA regimen during the period of 2005-2010. Effectiveness was measured using objective response, progression-free interval, and global survival. Safety was measured using the NCI classification system of common toxicity criteria for adverse events. We registered 12 patients (52.17±8.26 years in women, and 54.83±7.22 years in men), 11 cases were acute myeloid leukaemia (5 refractory, 3 in recurrence, 1 secondary to chronic refractory myeloid leukaemia (CML) and 2 secondary to myelodysplastic syndrome (MDS), one of which was refractory and the other had not been previously treated) and one case was acute refractory lymphoblastic leukaemia (ALL). Six patients (50%) reached a complete response (CR). One patient reached a partial response (PR), which was followed by another protocol that produced a CR, two died due to disease progression, and three due to secondary complications from treatment. The progression-free interval for patients that reached a CR was 24.38 weeks (6 months). Median global survival was 8.4 weeks. Mean time needed for the recovery of neutropenia was 23 and 37 days in the first and second cycle, respectively. The mean time required for recuperation of thrombocytopenia was 24 and 35 days in each cycle. The FLAG-IDA induction regimen for the treatment of high-risk leukaemia patients is an established protocol, with good tolerance and acceptable toxicity levels that offers an opportunity for facilitating the transplantation of haematopoietic progenitors. Copyright © 2010 SEFH. Published by Elsevier Espana. All rights reserved.

  10. Tolvaptan is effective in treating patients with refractory ascites due to cirrhosis.

    Science.gov (United States)

    Tahara, Toshiyuki; Mori, Kiyoto; Mochizuki, Mari; Ishiyama, Ryoko; Noda, Marin; Hoshi, Hitomi; Lefor, Alan Kawarai; Shinozaki, Satoshi

    2017-12-01

    The treatment of refractory ascites due to cirrhosis is a clinical challenge for hepatologists. Tolvaptan, a novel aquaporin modulator, was made available in Japan in 2013 for the treatment of patients with refractory ascites due to cirrhosis. Despite the potential of this drug, few reports are available regarding its clinical use. The aim of the present study was to clarify the efficacy of tolvaptan in patients with refractory ascites due to cirrhosis and to review the clinical outcomes of treatment. Medical records were retrospectively reviewed for 65 patients with refractory ascites due to cirrhosis who were treated daily with 7.5 mg tolvaptan. The median follow-up time, defined as the period between starting tolvaptan and the last clinic visit or date of mortality, was 175 days (interquartile range 56-406). After one week of tolvaptan treatment, the mean weight reduction was 3.4 kg, with a response rate of 69% (45/65). Subsequently, factors associated with the response to tolvaptan were analyzed. On univariate analysis, maintaining serum sodium (Na) ≥140 mEq/l and an estimated glomerular filtration rate (eGFR) ≥55 ml/min were significant predictors of response (Ptolvaptan was a predictor of long-term survival (P=0.002), and hyperbilirubinemia was associated with short-term survival (P=0.028). Additionally, Kaplan-Meier analysis with a log-rank test indicated longer survival times in tolvaptan responders than non-responders (P=0.011). In conclusion, tolvaptan was effective in treating patients with refractory ascites due to cirrhosis. In particular, tolvaptan treatment was highly effective for patients with hepatitis C virus etiology and normal serum Na and renal function. Furthermore, response to tolvaptan was associated with longer survival time while hyperbilirubinemia was associated with shorter survival time.

  11. Launch Pad Flame Trench Refractory Materials

    Science.gov (United States)

    Calle, Luz M.; Hintze, Paul E.; Parlier, Christopher R.; Bucherl, Cori; Sampson, Jeffrey W.; Curran, Jerome P.; Kolody, Mark; Perusich, Steve; Whitten, Mary

    2010-01-01

    The launch complexes at NASA's John F. Kennedy Space Center (KSC) are critical support facilities for the successful launch of space-based vehicles. These facilities include a flame trench that bisects the pad at ground level. This trench includes a flame deflector system that consists of an inverted, V-shaped steel structure covered with a high temperature concrete material five inches thick that extends across the center of the flame trench. One side of the "V11 receives and deflects the flames from the orbiter main engines; the opposite side deflects the flames from the solid rocket boosters. There are also two movable deflectors at the top of the trench to provide additional protection to shuttle hardware from the solid rocket booster flames. These facilities are over 40 years old and are experiencing constant deterioration from launch heat/blast effects and environmental exposure. The refractory material currently used in launch pad flame deflectors has become susceptible to failure, resulting in large sections of the material breaking away from the steel base structure and creating high-speed projectiles during launch. These projectiles jeopardize the safety of the launch complex, crew, and vehicle. Post launch inspections have revealed that the number and frequency of repairs, as well as the area and size of the damage, is increasing with the number of launches. The Space Shuttle Program has accepted the extensive ground processing costs for post launch repair of damaged areas and investigations of future launch related failures for the remainder of the program. There currently are no long term solutions available for Constellation Program ground operations to address the poor performance and subsequent failures of the refractory materials. Over the last three years, significant liberation of refractory material in the flame trench and fire bricks along the adjacent trench walls following Space Shuttle launches have resulted in extensive investigations of

  12. Bulk Vitrification Castable Refractory Block Protection Study

    Energy Technology Data Exchange (ETDEWEB)

    Hrma, Pavel R.; Bagaasen, Larry M.; Beck, Andrew E.; Brouns, Thomas M.; Caldwell, Dustin D.; Elliott, Michael L.; Matyas, Josef; Minister, Kevin BC; Schweiger, Michael J.; Strachan, Denis M.; Tinsley, Bronnie P.; Hollenberg, Glenn W.

    2005-05-01

    Bulk vitrification (BV) was selected for a pilot-scale test and demonstration facility for supplemental treatment to accelerate the cleanup of low-activity waste (LAW) at the Hanford U.S. DOE Site. During engineering-scale (ES) tests, a small fraction of radioactive Tc (and Re, its nonradioactive surrogate) were transferred out of the LAW glass feed and molten LAW glass, and deposited on the surface and within the pores of the castable refractory block (CRB). Laboratory experiments were undertaken to understand the mechanisms of the transport Tc/Re into the CRB during vitrification and to evaluate various means of CRB protection against the deposition of leachable Tc/Re. The tests used Re as a chemical surrogate for Tc. The tests with the baseline CRB showed that the molten LAW penetrates into CRB pores before it converts to glass, leaving deposits of sulfates and chlorides when the nitrate components decompose. Na2O from the LAW reacts with the CRB to create a durable glass phase that may contain Tc/Re. Limited data from a single CRB sample taken from an ES experiment indicate that, while a fraction of Tc/Re is present in the CRB in a readily leachable form, most of the Tc/Re deposited in the refractory is retained in the form of a durable glass phase. In addition, the molten salts from the LAW, mainly sulfates, chlorides, and nitrates, begin to evaporate from BV feeds at temperatures below 800 C and condense on solid surfaces at temperatures below 530 C. Three approaches aimed at reducing or preventing the deposition of soluble Tc/Re within the CRB were proposed: metal lining, sealing the CRB surface with a glaze, and lining the CRB with ceramic tiles. Metal liners were deemed unsuitable because evaluations showed that they can cause unacceptable distortions of the electric field in the BV system. Sodium silicate and a low-alkali borosilicate glaze were selected for testing. The glazes slowed down molten salt condensate penetration, but did little to reduce the

  13. Efficacy and safety of autologous hematopoietic stem cell therapy for refractory Crohn's disease: A systematic review and meta-analysis.

    Science.gov (United States)

    Qiu, Xiao; Feng, Jue-Rong; Chen, Li-Ping; Liu, Shi; Zhang, Meng; Zhou, Zhou; Liu, Jing; Zhao, Qiu

    2017-06-01

    Autologous hematopoietic stem cell transplantation (HSCT) has been proposed for patients with refractory Crohn's disease (CD), but it is associated with mortality and adverse events; the balance between risks and benefits becomes significantly important in the therapy. The aim of the study was to assess the efficacy and safety of autologous HSCT therapy for refractory CD. We conducted a comprehensive search of PubMed, Embase, the Cochrane library, and Web of Science from inception to February 2017. The pooled estimate rates for efficacy and safety of refractory CD was performed by meta-analysis and reported according to the standard Cochrane guidelines and the PRISMA statement. Four prospective uncontrolled cohort studies, 4 prospective case series, and 1 randomized controlled trial (RCT) were included. Autologous HSCT had a high rate of clinical and endoscopic remission in refractory CD [79.4%, 95% confidence interval (95% CI): 0.550-0.924; 81.9%, 95% CI: 0.603-0.931, respectively]. In the case of safety, it had a relatively high incidence rate of transplant-related mortality (6.4%, 95% CI: 0.028-0.140). A significant association was observed between autologous HSCT and the incidence of febrile neutropenia (83.2%, 95% CI: 0.632-0.934). About 18.5% (95% CI: 0.061-0.442) of patients with refractory CD reached clinical remission at mobilization phase. Besides, 82.1% (95% CI: 0.692-0.903) and 54.1% (95% CI: 0.261-0.797) patients with refractory CD could achieve immunosuppressive-free and steroid-free remission for at least 12 months after the therapy. Autologous HSCT could be a complicated treatment with relatively high mortality and significantly high efficacy for refractory CD, which should be used with caution. However, more RCTs of larger samples using refined and standardized protocols and longer period of follow-up time are needed to further assess the outcomes of autologous HSCT therapy.

  14. Design of Refractory Linings for Balanced Energy Efficiency, Uptime, and Capacity in Lime Kilns

    Energy Technology Data Exchange (ETDEWEB)

    Gorog, John Peter [ORNL; Hemrick, James Gordon [ORNL; Walker, Harold [Refratechnik North America, Inc.; Leary, William R [ORNL; Ellis, Murray [Australian Paper, Co.

    2014-01-01

    The rotary kilns used by the pulp and paper industry to regenerate lime in the Kraft process are very energy intensive. Throughout the 90 s, in response to increasing fuel prices, the industry used back up insulation in conjunction with the high alumina brick used to line the burning zones of their kilns. While this improved energy efficiency, the practice of installing insulating brick behind the working lining increased the inner wall temperatures. In the worst case, due to the increased temperatures, rapid brick failures occurred causing unscheduled outages and expensive repairs. Despite these issues, for the most part, the industry continued to use insulating refractory linings in that the energy savings were large enough to offset any increase in the cost of maintaining the refractory lining. Due to the dramatic decline in the price of natural gas in some areas combined with mounting pressures to increasing production of existing assets, over the last decade, many mills are focusing more on increasing the uptime of their kilns as opposed to energy savings. To this end, a growing number of mills are using basic (magnesia based) brick instead of high alumina brick to line the burning zone of the kiln since the lime mud does not react with these bricks at the operating temperatures of the burning zone of the kiln. In the extreme case, a few mills have chosen to install basic brick in the front end of the kiln running a length equivalent to 10 diameters. While the use of basic brick can increase the uptime of the kiln and reduce the cost to maintain the refractory lining, it does dramatically increase the heat losses resulting from the increased operating temperatures of the shell. Also, over long periods of time operating at these high temperatures, damage can occur in the shell. There are tradeoffs between energy efficiency, capacity and uptime. When fuel prices are very high, it makes sense to insulate the lining. When fuel prices are lower, trading some

  15. Refractory reverse amblyopia with atropine penalization

    Directory of Open Access Journals (Sweden)

    Preeti Ajit Patil

    2010-01-01

    Full Text Available Pharmacological penalization with atropine has been shown to be equally effective as conventional occlusion therapy in the treatment of amblyopia in children. Reverse amblyopia of the sound eye with atropine penalization has been reported before, but is more common in cases where the effect is augmented with optical penalization and is mostly reversible. We report a case of reverse amblyopia with atropine penalization, in a 4-year-old girl, which was refractory to treatment. This report highlights the need for strict monitoring of the vision in the sound eye and regular follow-up in children undergoing amblyopia treatment.

  16. Medical image of the week: refractory dyspnea

    Directory of Open Access Journals (Sweden)

    Malo J

    2012-12-01

    Full Text Available A 61 year old man with an extensive smoking history and emphysema was referred for evaluation of dyspnea refractory to standard therapy. He was diagnosed with a pulmonary embolism 5 months prior to presentation and has been on warfarin since that time. Review of the patient’s CT scan performed prior to the visit demonstrated dilated main; right; and left pulmonary arteries (Figure 1. Also visualized was an eccentrically located thrombus with areas of calcification and central recanalization. Echocardiography confirmed the presence of elevated pulmonary pressures consistent with a diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH. Medical therapy and a referral for pulmonary artery endarterectomy are being considered.

  17. Logotherapy and positive psychology

    Directory of Open Access Journals (Sweden)

    Oscar R. Oro

    2015-09-01

    Full Text Available Psychology omitted to approach, during almost a century, the positive aspects from persons, like creativity, humor, optimism, hope, forgiveness, life meaning, and happiness. These themes are approached by Positive Psychology, with Seligman like the principal exponent. Psychology was dedicated to explore the negative aspects from human beings improving human health. Nevertheless, this pathogenic model could not prevent mental disease. Concepts of Positive Psychology have a solid antecedent in Víktor Frankl ́s studies, which is the Logotherapy founder. This allows incorporating another perspective to approach positive aspects, from a philosophical and anthropological focus. Although the ways adopted by Frank and Seligman are different, both considered main aspects of human existence. Nevertheless, they investigated in different countries (from Europe and EE.UU.; in different circumstances (concentration camps, deaths, tortures; vs. academic context; in different historical periods and different social contexts (a country that lost the war and other that gave freedom to Europeans. In this work is used the concept life sense as the focus in professional formation and psychotherapy approach. 

  18. Beyond Positive Psychology?

    Science.gov (United States)

    McNulty, James K.; Fincham, Frank D.

    2014-01-01

    The field of positive psychology rests on the assumption that certain psychological traits and processes are inherently beneficial for well-being. We review evidence that challenges this assumption. First, we review data from 4 independent longitudinal studies of marriage revealing that 4 ostensibly positive processes—forgiveness, optimistic expectations, positive thoughts, and kindness—can either benefit or harm well-being depending on the context in which they operate. Although all 4 processes predicted better relationship well-being among spouses in healthy marriages, they predicted worse relationship well-being in more troubled marriages. Then, we review evidence from other research that reveals that whether ostensibly positive psychological traits and processes benefit or harm well-being depends on the context of various noninterpersonal domains as well. Finally, we conclude by arguing that any movement to promote well-being may be most successful to the extent that it (a) examines the conditions under which the same traits and processes may promote versus threaten well-being, (b) examines both healthy and unhealthy people, (c) examines well-being over substantial periods of time, and (d) avoids labeling psychological traits and processes as positive or negative. PMID:21787036

  19. Psychological barriers

    DEFF Research Database (Denmark)

    Skinner, T. C.

    2004-01-01

    of lifestyle changes and pharmacological therapy in preventing future complications. Negative emotions and preconceptions about treatment can also discourage adherence to treatment plans. 'Psychological Insulin resistance' caused by fear and concerns about insulin and daily insulin injections can discourage...... many patients from starting insulin therapy, even if oral agents have failed. Depression, stress and anxiety represent further obstacles to optimum self-care and the attainment of glucose goals. Healthcare professionals should endeavour to understand and accommodate these issues when setting personal...

  20. Psychological Theories of Acculturation

    DEFF Research Database (Denmark)

    Ozer, Simon

    2018-01-01

    of acculturation also include cognate disciplines such as cultural psychology, social psychology, sociology, and anthropology.The expansion of psychological theories of acculturation has led to advancements in the field of research as well as the bifurcation of epistemological and methodological approaches...... advancements, together with greater mobility. Acculturation psychology aims to comprehend the dynamic psychological processes and outcomes emanating from intercultural contact. Acculturation psychology has been a growing field of research within cross-cultural psychology. Today, psychological theories...

  1. Historiske perioder

    DEFF Research Database (Denmark)

    2017-01-01

    For at forstå fortiden og fortællingerne om den, må vi skabe en form for orden og systematik. Her spiller inddelingen af fortiden i historiske perioder en afgørende rolle – og historiske perioder er da også et kompetencemål efter 6. klasse. Videoen diskuterer forskellige principper...... for periodisering. Kronologi og sammenhænge hænger naturligt sammen med historiske perioder. Videoen handler også om forståelser og brug af synkrone og diakrone sammenhænge i faget....

  2. Refractory Materials for Flame Deflector Protection

    Science.gov (United States)

    Calle, Luz M.; Hintze, Paul E.; Parlier, Christopher R.; Sampson, Jeffrey W.; Curran, Jerome P.; Kolody, Mark R.; Peruisich, Stephen A.

    2010-01-01

    Fondu Fyre (FF) is currently the only refractory material qualified for use in the flame trench at KSC's Shuttle Launch Pads 39A and 3913. However, the material is not used as it was qualified and has undergone increasingly frequent and severe degradation due to the launch blasts. This degradation is costly as well as dangerous for launch infrastructure, crew and vehicle. The launch environment at KSC is unique. The refractory material is subject to the normal seacoast environment, is completely saturated with water before launch, and is subjected to vibrations and aggressive heat/blast conditions during launch. This report presents results comparing two alternate materials, Ultra-Tek FS gun mix and Kruzite GR Plus, with Fondu Fyre. The materials were subjected to bulk density, porosity, compression strength, modulus of rupture and thermal shock tests. In addition, test specimens were exposed to conditions meant to simulate the launch environment at KSC to help better understand how the materials will perform once installed.

  3. Ziconotide: a new option for refractory pain.

    Science.gov (United States)

    Prommer, Eric

    2006-06-01

    Ziconotide has been introduced as a new nonopioid treatment for chronic pain. Structurally, it is a peptide, the synthetic analog of the omega-conotoxin, derived from the marine snail, Conus magus. N-type voltage-sensitive calcium channels play a role in the transmission of nociceptive stimuli and also are involved in the release of neurotransmitters important in pain transmission. Ziconotide's therapeutic benefit derives from its potent and selective blockade of neuronal-type voltage-sensitive calcium channels. Blockade of the channels results in suppression of abnormal ectopic discharges from the injury site or the dorsal root ganglia, possibly resulting in decreased neuroplasticity, and decreased synaptic transmission that leads to the generation of chronic pain syndromes. The advantage of ziconotide is that tolerance does not occur, while disadvantages associated with ziconotide are the need for intrathecal administration and significant neurotoxicites associated with its use. When tested in clinical trials, ziconotide has been shown to have synergistic or additive value to the effect of morphine. Ziconotide, formerly known also as SNX- 111, represents a new class of agents, the N-type calcium channel blockers. These may represent another option for patients with refractory pain and refractory pain syndromes.

  4. Intravesical silver nitrate for refractory hemorrhagic cystitis.

    Science.gov (United States)

    Montgomery, Brian D; Boorjian, Stephen A; Ziegelmann, Matthew J; Joyce, Daniel D; Linder, Brian J

    2016-09-01

    Hemorrhagic cystitis is a challenging clinical entity with limited evidence available to guide treatment. The use of intravesical silver nitrate has been reported, though supporting literature is sparse. Here, we sought to assess outcomes of patients treated with intravesical silver nitrate for refractory hemorrhagic cystitis. We identified nine patients with refractory hemorrhagic cystitis treated at our institution with intravesical silver nitrate between 2000-2015. All patients had failed previous continuous bladder irrigation with normal saline and clot evacuation. Treatment success was defined as requiring no additional therapy beyond normal saline irrigation after silver nitrate instillation prior to hospital discharge. Median patient age was 80 years (IQR 73, 82). Radiation was the most common etiology for hemorrhagic cystitis 89% (8/9). Two patients underwent high dose (0.1%-0.4%) silver nitrate under anesthesia, while the remaining seven were treated with doses from 0.01% to 0.1% via continuous bladder irrigation for a median of 3 days (range 2-4). All nine patients (100%) had persistent hematuria despite intravesical silver nitrate therapy, requiring additional interventions and red blood cell transfusion during the hospitalization. There were no identified complications related to intravesical silver nitrate instillation. Although well tolerated, we found that intravesical silver nitrate was ineffective for bleeding control, suggesting a limited role for this agent in the management of patients with hemorrhagic cystitis.

  5. Extracorporeal membrane oxygenation for refractory cardiac arrest

    Directory of Open Access Journals (Sweden)

    Steven A Conrad

    2017-01-01

    Full Text Available Extracorporeal cardiopulmonary resuscitation (ECPR is the use of rapid deployment venoarterial (VA extracorporeal membrane oxygenation to support systemic circulation and vital organ perfusion in patients in refractory cardiac arrest not responding to conventional cardiopulmonary resuscitation (CPR. Although prospective controlled studies are lacking, observational studies suggest improved outcomes compared with conventional CPR when ECPR is instituted within 30-60 min following cardiac arrest. Adult and pediatric patients with witnessed in-hospital and out-of-hospital cardiac arrest and good quality CPR, failure of at least 15 min of conventional resuscitation, and a potentially reversible cause for arrest are candidates. Percutaneous cannulation where feasible is rapid and can be performed by nonsurgeons (emergency physicians, intensivists, cardiologists, and interventional radiologists. Modern extracorporeal systems are easy to prime and manage and are technically easy to manage with proper training and experience. ECPR can be deployed in the emergency department for out-of-hospital arrest or in various inpatient units for in-hospital arrest. ECPR should be considered for patients with refractory cardiac arrest in hospitals with an existing extracorporeal life support program, able to provide rapid deployment of support, and with resources to provide postresuscitation evaluation and management.

  6. Treatment of relapsed and refractory Hodgkin Lymphoma

    Science.gov (United States)

    von Tresckow, Bastian

    2017-01-01

    Despite the high first line cure rates in patients with Hodgkin Lymphoma (HL) still 10–20% of patients suffer from relapsed or refractory disease. High dose chemotherapy (HDCT) followed by autologous stem cell transplant (ASCT) is standard of care for suitable patients with relapsed or refractory HL and allows for cure in approximately 50%. Due to the poor prognosis of high risk patients even with HDCT and ASCT, consolidation strategies have been evaluated to improve the cure rates. For patients with recurrence after HDCT and ASCT, treatment is palliative in most cases. The anti CD30 antibody-drug conjugate brentuximab vedotin (BV) has been shown to induce high response rates in these patients; however, durable responses were reported in a small percentage of patients only. For carefully selected patients with multiple relapses, dose-reduced allogeneic transplant (RICallo) is a potentially curative option. The role of RICallo will have to be reevaluated in the era of anti-programmed death-1 (PD1) antibodies. PMID:27496309

  7. INFLIXIMAB IN TREATMENT OF REFRACTORY JUVENILE ARTHRITIS

    Directory of Open Access Journals (Sweden)

    I.P. Nikishina

    2010-01-01

    Full Text Available Inclusion to the clinical practice of genetically engineered biological medications opens new opportunities in treatment of juvenile arthritis. The article summarizes an experience of treatment of juvenile arthritis with infliximab in children’s department of Scientific Center of Rheumatology, Russian Academy of Medical Sciences. The analysis included 55 patients (16 children had systemic type, 23 — polyarticular type of juvenile arthritis, and 16 patients had juvenile spondylarthritis, treated with infliximab in 2002–2009 years. Infliximab was administrated in patients with high activity of the disease refractory to the modern basic therapy. Patients received intravenous infliximab 3–5 mg/kg daily according to the standard scheme (on 0, 2, 6 weeks and further every 8 weeks. Therapy with this drug was estimated as effective (improvement on 30% and more according ACRpedi in 80% of patients: 16% achieved ACR30, 29% — ACR50, 26% — ACR70, and 9% — ACR90. Unfavorable effects (infusion reactions were detected in 16% of cases. Infections, including one case of disseminated tuberculosis, developed in 20% of patients. Thus, treatment with infliximab is effective and has good «risk–benefit» ratio in treatment of patients with refractory juvenile arthritis. Key words: children, juvenile arthritis, infliximab, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1:142-149

  8. [Lenvatinib in radioiodine refractory thyroid carcinomas].

    Science.gov (United States)

    de la Fouchardiere, Christelle

    2016-11-01

    Differentiated thyroid cancers are usually cured by an appropriate surgery and a radioiodine remnant ablation. If metastases occur, successive radioiodine administrations and/or local treatments can be provided. Nevertheless, some patients will be, or become refractory to radioiodine. In case of significant and rapid progression of metastatic lesions, they will be candidate to kinase inhibitor treatments. Two agents are now approved in this situation: sorafenib and lenvatinib. Lenvatinib (Lenvima®) is a tyrosine kinase inhibitor (TKI) targeting the VEGFR1-3, FGFR 1-4, PDGFR-α, RET and c-kit. It received an FDA and EMA approval in February and March 2015 for the treatment of radioiodine refractory thyroid cancers following the SELECT study's results. In this study, patients treated with lenvatinib had a significant increase in progression-free survival (18.3 months vs. 3.6 months; HR=0.21; CI=0.14-0.31, P Cancer. Published by Elsevier Masson SAS. All rights reserved.

  9. Evaluation of olivine refractories for TES

    Science.gov (United States)

    Gay, B. M.; Cochrane, R. L.; Palmour, H., III; Paisley, M. J.

    1982-02-01

    The principal objectives of this program are to (1) experimentally determine the degree of improvement in thermal and mechanical performance that can be obtained with an olivine thermal storage brick made of domestic materials using advanced processing techniques compared with state-of-the-art as represented by commercial European bricks, (2) conduct an assessment of existing German ceramic process technology and determine its adaptability to domestic raw materials and manufacturing practices, and (3) investigate, on a limited basis, method for further improvement of domestic-olivine brick. To date, accomplishments include (1) installation of improved, computer-based instrumentation, (2) the use of this system to determine performance characteristics of a set of heat storage refractories under cyclic use conditions, (3) acquisition of the services of a knowledgeable European consultant, (4) continued lab-scale process/property optimization studies, and (5) comparative testing of olivine-based and magnesite-based heat storage refractories in the calorimetric test facility at Purdue University.

  10. The Ahmed Glaucoma Valve in Refractory Glaucoma: Experiences ...

    African Journals Online (AJOL)

    BACKGROUND: The management of refractory glaucoma is a challenging task for any glaucoma surgeon. This study is aimed to evaluate the efficacy of Ahmed Glaucoma Valve implantation in refractory glaucomas in South-West Ethiopia. METHODS: A retrospective review was conducted on the charts of consecutive ...

  11. Refractory gastro-oesophageal reflux disease: a major management ...

    African Journals Online (AJOL)

    2009-05-12

    May 12, 2009 ... Refractory oesophagitis (non-healing of erosions) is rare since the advent of potent gastric acid inhibition with proton pump inhibitors (PPIs). However, refractory gastro-oesophageal reflux disease (GORD) symptoms, both typical and atypical (cough, chronic hoarseness, asthma and atypical chest pain), ...

  12. Quasi-coherent thermal emitter based on refractory plasmonic materials

    DEFF Research Database (Denmark)

    Liu, Jingjing; Guler, Urcan; Lagutchev, Alexei

    2015-01-01

    The thermal emission of refractory plasmonic metamaterial - a titanium nitride 1D grating - is studied at high operating temperature (540 degrees C). By choosing a refractory material, we fabricate thermal gratings with high brightness that are emitting mid-infrared radiation centered around 3 mu m...

  13. Dermatitis Herpetiformis Refractory to Gluten-free Dietary Treatment.

    Science.gov (United States)

    Hervonen, Kaisa; Salmi, Teea T; Ilus, Tuire; Paasikivi, Kaija; Vornanen, Martine; Laurila, Kaija; Lindfors, Katri; Viiri, Keijo; Saavalainen, Päivi; Collin, Pekka; Kaukinen, Katri; Reunala, Timo

    2016-01-01

    Dermatitis herpetiformis (DH) is a blistering skin disease, which is regarded as an extra-intestinal manifestation of coeliac disease. Refractory cases of coeliac disease, that do not respond to a gluten-free diet and which carry an increased risk of lymphoma, are well-known in coeliac disease. To determine whether refractory cases of DH with active rash and persistent small bowel atrophy occur we analysed our series of 403 patients with DH. Seven (1.7%) patients, who had been on a gluten-free diet for a mean of 16 years, but who still required dapsone to treat the symptoms of DH, were identified. Of these, one patient died from mucinous adenocarcinoma before re-examination. At re-examination skin immunoglobulin A (IgA) deposits were found in 5/6 refractory and 3/16 control DH patients with good dietary response. Small bowel mucosa was studied at re-examination from 5 refractory and 8 control DH patients and was normal in all 5 refractory and 7/8 control DH patients. One refractory DH patient died from adenocarcinoma, but no lymphoma developed in any of the patients. This study documents for the first time refractory DH, in which the rash is non-responsive to a gluten-free diet, but the small bowel mucosa heals. This differs from refractory coeliac disease, in which the small bowel mucosa does not heal on a gluten-free diet.

  14. Intraepithelial lymphocytes in refractory celiac disease : lost in transition

    NARCIS (Netherlands)

    Schmitz, Frederike

    2014-01-01

    Refractory coeliac disease type II (RCDII) is a severe complication of coeliac disease. Whereas celiac disease can successfully be treated by the strict avoidance of gluten, refractory celiac patients show no remission despite a gluten-free diet. The pathology of RCDII is only partially understood,

  15. Lightweight cordierite–mullite refractories with low coefficients of ...

    Indian Academy of Sciences (India)

    Lightweight cordierite–mullite refractories with low coefficients of thermal conductivity (CTCs), high strengths and high thermal-shock resistances were prepared using porous cordierite ceramics as aggregates. Phase compositions and microstructures of lightweight refractories were measured by X-ray diffraction (XRD), ...

  16. Ketogenic diet in 3 cases of childhood refractory status epilepticus

    DEFF Research Database (Denmark)

    Sort, Rune; Born, Alfred P; Pedersen, Karen N.

    2013-01-01

    Refractory status epilepticus (RSE) in children is associated with a significant risk of death or neurological morbidity. Recently attention has been drawn to the ketogenic diet (KD) as an acute treatment, as it has shown promise in controlling seizures in otherwise refractory status epilepticus...

  17. Development of alumino-silicate refractories in Ghana | Kisiedu ...

    African Journals Online (AJOL)

    The clay and kaolin minerals could be used to produce fireclay refractories for construction of incinerators operating at maxi-mum temperatures of about 1000 oC. The performance of the refractories was demonstrated by producing bric-ks to construct kilns and incinerators for the ceramic industries and hospitals. Journal of ...

  18. Psychology Faculty Perceptions of Abnormal Psychology Textbooks

    Science.gov (United States)

    Rapport, Zachary

    2011-01-01

    The problem. The purpose of the current study was to investigate the perceptions and opinions of psychology professors regarding the accuracy and inclusiveness of abnormal psychology textbooks. It sought answers from psychology professors to the following questions: (1) What are the expectations of the psychology faculty at a private university of…

  19. Psychology of religion: perspectives from cultural psychology

    NARCIS (Netherlands)

    Belzen, J.A.

    2010-01-01

    After a brief introduction, this paper tries to establish what type of psychology the psychology of religion is. Having introduced cultural psychology in general, some theories applicable in research on religion are presented, and some examples of cultural psychological research of religious

  20. Management of refractory Leber miliary aneurysms with macular edema: a case report.

    Science.gov (United States)

    Tiroumal, Sambath; Lotery, Andrew

    2014-01-01

    To report a case study of a patient with Leber miliary aneurysms with macular edema refractory to various treatment modalities. This is a retrospective study of a 35-year-old man who had multiple Leber miliary aneurysms with exudation and edema involving the macula. The patient's data were collected from case notes over a 3-year period of management of the condition. The patient's Leber miliary aneurysm with exudation and macular edema was refractory to various treatment modalities, including laser photocoagulation, anti-vascular endothelial growth factor injections, photodynamic therapy, and cryotherapy. However, recently, the patient showed a good response to treatment with intravitreal dexamethasone implants. His macular edema and vision have improved with these injections. Intravitreal dexamethasone implants should be considered along with other treatment options when planning treatment of Leber miliary aneurysms. However, the long-term stability of the disease with these injections is not known.

  1. Diagnosis and Treatment of Refractory Gastroesophageal Reflux Disease (GERD

    Directory of Open Access Journals (Sweden)

    Selfie

    2015-12-01

    Full Text Available Gastroesophageal reflux disease (GERD was a damage in mucosal layer caused by gastric acid reflux. GERD was found about 10-20% in Western Countries and less in Asia, about 2,6-6,7%. Among different type of GERD, refractory GERD was a problem found in daily clinical practice. This terminology was used in patients with regurgitation and heartburn symptoms which is not responsive to 8 weeks proton pump inhibitor (PPI therapy. There were several mechanisms underlying the etiology and pathophysiology of refractory GERD. In general, refractory GERD diagnosis was based on clinical findings, objective endoscopic examination, ambulatory reflux monitoring, and response to antiacid-secretion therapy. Reevaluation of patients compliance should be the first step in refractory GERD management. A further treatment strategies could be started, consist of medical and surgical therapies. A basic clinical knowledge of refractory GERD would help clinician in deciding the best approach for diagnosis and therapy.

  2. Refractory alloy technology for space nuclear power applications

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, R.H. Jr.; Hoffman, E.E. (eds.)

    1984-01-01

    Purpose of this symposium is twofold: (1) to review and document the status of refractory alloy technology for structural and fuel-cladding applications in space nuclear power systems, and (2) to identify and document the refractory alloy research and development needs for the SP-100 Program in both the short and the long term. In this symposium, an effort was made to recapture the space reactor refractory alloy technology that was cut off in midstream around 1973 when the national space nuclear reactor program began in the early 1960s, was terminated. The six technical areas covered in the program are compatibility, processing and production, welding and component fabrication, mechanical and physical properties, effects of irradiation, and machinability. The refractory alloys considered are niobium, molybdenum, tantalum, and tungsten. Thirteen of the 14 pages have been abstracted separately. The remaining paper summarizes key needs for further R and D on refractory alloys. (DLC)

  3. NOvel Refractory Materials for High Alkali, High Temperature Environments

    Energy Technology Data Exchange (ETDEWEB)

    Hemrick, J.G.; Griffin, R. (MINTEQ International, Inc.)

    2011-08-30

    Refractory materials can be limited in their application by many factors including chemical reactions between the service environment and the refractory material, mechanical degradation of the refractory material by the service environment, temperature limitations on the use of a particular refractory material, and the inability to install or repair the refractory material in a cost effective manner or while the vessel was in service. The objective of this project was to address the need for new innovative refractory compositions by developing a family of novel MgO-Al2O3 spinel or other similar magnesia/alumina containing unshaped refractory composition (castables, gunnables, shotcretes, etc) utilizing new aggregate materials, bond systems, protective coatings, and phase formation techniques (in-situ phase formation, altered conversion temperatures, accelerated reactions, etc). This family of refractory compositions would then be tailored for use in high-temperature, highalkaline industrial environments like those found in the aluminum, chemical, forest products, glass, and steel industries. A research team was formed to carry out the proposed work led by Oak Ridge National Laboratory (ORNL) and was comprised of the academic institution Missouri University of Science and Technology (MS&T), and the industrial company MINTEQ International, Inc. (MINTEQ), along with representatives from the aluminum, chemical, glass, and forest products industries. The two goals of this project were to produce novel refractory compositions which will allow for improved energy efficiency and to develop new refractory application techniques which would improve the speed of installation. Also methods of hot installation were sought which would allow for hot repairs and on-line maintenance leading to reduced process downtimes and eliminating the need to cool and reheat process vessels.

  4. [Ibn Sina--psychology and psychological disorders].

    Science.gov (United States)

    Cerić, I; Mehić-Basara, N

    1997-01-01

    Ebu Ali Husein Ibn Ali Ibn Sina (or Avicenna) was primarily a philosopher with amusing knowledge, who dealt in all aspects of art of medicine, astronomer, poet, musician and psychologist. This giant with an encyclopedic knowledge has dealt in almost all scientific branches or praxis with the great success. Numerous statements of his have been cornerstone of many sciences for centuries; and some of them are (in the era of computers and Internet) still current. The best known treatise on medicine of his is El-Kanun, consisting of five volumes, wherein all medical achievements (including psychology, psychiatry and neurology) of that period were described clearly. In his psychology, Ibn Sina (Avicenna) analyses the essence of human soul, mind, psychical streams, intellectum, dreams and prophecy, man's desires etc. in details. It is unnecessary to point out how much these items are actual in the contemporary psychology. Ibn al-Nefis has described systematically the symptoms and recovery of "head sick" (including headaches, cerebral sick like cranitis, letargy, coma, demency, melancholy, insomnia, nightmares, epilepsy, appoplexy, paralysis, spasm and many others) in his Mujez al-Kanun, that is synopsis of Ibn Sina Kanun. We need much time to see magnificance of this philosopher, that is best known as the great one among the physicians. His writings could be found in whole Bosnia, but there were many few that would study him and his works. It is out task to enable the future generations not only to know those works exist, but, also, to realize the essence of this marvelous genius; because there are very few people that can be compared to him.

  5. One-year infliximab administration for the treatment of chronic refractory pouchitis

    Science.gov (United States)

    Viazis, Nikos; Giakoumis, Marios; Koukouratos, Theodoros; Saprikis, Efstathios; Anastasopoulos, Elias; Al-Odat, Mousa; Kechagias, Georgios; Zacharakis, Georgios; Markoglou, Konstantinos; Gouma, Paraskevi; Karamanolis, Demetrios G.

    2011-01-01

    Aim To determine the efficacy of infliximab in the treatment of chronic refractory pouchitis, following ileo-pouch anal anastomosis (IPAA) for ulcerative colitis (UC). Methods Seven patients (4 females, 3 males) with chronic refractory pouchitis were included in an open study. Pouchitis was diagnosed by clinical plus endoscopic and histological criteria. Three patients also had fistulae (pouch-bladder in 1 and perianal in 2). Extraintestinal manifestations were also present in 4 patients (erythema nodosum in 2, arthralgiae in 2). All patients were refractory to standard therapy. Crohn’s disease was carefully excluded in all patients after re-evaluation of the history and examination of the small bowel with enteroclysis or small bowel capsule endoscopy. Patients received Infliximab 5 mg/kg at 0, 2 and 6 weeks and thereafter every 2 months for 1 year. Clinical response was classified as complete, partial, and no response. Fistulae closure was classified as complete, partial, and no closure. The pouchitis disease activity index (PDAI) was also used as an outcome measure. Results Clinically, all patients improved. After 1 year of follow-up, 5 of the 7 patients had a complete clinical response, and 2 of the 3 patients with a fistula had complete fistulae closure. At the end of the follow-up period the median PDAI dropped from 11 (baseline) (range, 10-14) to 5 (range, 3-8). Extraintestinal manifestations were in complete remission at the end of the followup period as well. Conclusions Our results indicate that infliximab may be recommended for the treatment of chronic refractory pouchitis complicated or not by fistulae following IPAA for UC. PMID:24713783

  6. Pregabalin, the lidocaine plaster and duloxetine in patients with refractory neuropathic pain: a systematic review

    Directory of Open Access Journals (Sweden)

    Budhia Sangeeta

    2010-11-01

    Full Text Available Abstract Background Patients frequently fail to receive adequate pain relief from, or are intolerant of, first-line therapies prescribed for neuropathic pain (NeP. This refractory chronic pain causes psychological distress and impacts patient quality of life. Published literature for treatment in refractory patients is sparse and often published as conference abstracts only. The aim of this study was to identify published data for three pharmacological treatments: pregabalin, lidocaine plaster, and duloxetine, which are typically used at 2nd line or later in UK patients with neuropathic pain. Methods A systematic review of the literature databases MEDLINE, EMBASE and CCTR was carried out and supplemented with extensive conference and grey literature searching. Studies of any design (except single patient case studies that enrolled adult patients with refractory NeP were included in the review and qualitatively assessed. Results Seventeen studies were included in the review: nine of pregabalin, seven of the lidocaine plaster, and one of duloxetine. No head-to-head studies of these treatments were identified. Only six studies included treatments within UK licensed indications and dose ranges. Reported efficacy outcomes were not consistent between studies. Pain scores were most commonly assessed in studies including pregabalin; trials of pregabalin and the lidocaine plaster reported the proportion of responders. Significant improvements in the total, sensory and affective scores of the Short-form McGill Pain Questionnaire, and in function interference, sleep interference and pain associated distress, were associated with pregabalin treatment; limited or no quality of life data were available for the other two interventions. Limitations to the review are the small number of included studies, which are generally small, of poor quality and heterogeneous in patient population and study design. Conclusions Little evidence is available relevant to the

  7. Talimogene Laherparepvec and Nivolumab in Treating Patients With Refractory Lymphomas or Advanced or Refractory Non-melanoma Skin Cancers

    Science.gov (United States)

    2017-10-09

    Adenoid Cystic Carcinoma; Adnexal Carcinoma; Apocrine Carcinoma; Eccrine Porocarcinoma; Extraocular Cutaneous Sebaceous Carcinoma; Hidradenocarcinoma; Keratoacanthoma; Malignant Sweat Gland Neoplasm; Merkel Cell Carcinoma; Microcystic Adnexal Carcinoma; NK-Cell Lymphoma, Unclassifiable; Non-Melanomatous Lesion; Paget Disease; Papillary Adenocarcinoma; Primary Cutaneous Mucinous Carcinoma; Refractory Anaplastic Large Cell Lymphoma; Refractory Mature T-Cell and NK-Cell Non-Hodgkin Lymphoma; Refractory Mycosis Fungoides; Refractory Primary Cutaneous T-Cell Non-Hodgkin Lymphoma; Refractory T-Cell Non-Hodgkin Lymphoma; Sezary Syndrome; Signet Ring Cell Carcinoma; Skin Basal Cell Carcinoma; Skin Basosquamous Cell Carcinoma; Skin Squamous Cell Carcinoma; Spiradenocarcinoma; Squamous Cell Carcinoma of Unknown Primary Origin; Stage III Skin Cancer; Stage IV Skin Cancer; Sweat Gland Carcinoma; Trichilemmocarcinoma; Vulvar Squamous Cell Carcinoma

  8. Development of learning science after learning psychology

    OpenAIRE

    森, 敏昭

    2015-01-01

    Learning psychology began as a branch of psychology in the last couple of decades of the nineteenth century, and its history is therefore as long as that of psychology itself. However, learning science is a relatively young discipline: its development may be traced to 1991, when the first international conference was held and Journal of the Learning Sciences was first published. In the short subsequent period, learning science has grown rapidly as an interdisciplinary approach to learning and...

  9. Ancient asteroids enriched in refractory inclusions.

    Science.gov (United States)

    Sunshine, J M; Connolly, H C; McCoy, T J; Bus, S J; La Croix, L M

    2008-04-25

    Calcium- and aluminum-rich inclusions (CAIs) occur in all classes of chondritic meteorites and contain refractory minerals predicted to be the first condensates from the solar nebula. Near-infrared spectra of CAIs have strong 2-micrometer absorptions, attributed to iron oxide-bearing aluminous spinel. Similar absorptions are present in the telescopic spectra of several asteroids; modeling indicates that these contain approximately 30 +/- 10% CAIs (two to three times that of any meteorite). Survival of these undifferentiated, large (50- to 100-kilometer diameter) CAI-rich bodies suggests that they may have formed before the injection of radiogenic 26Al into the solar system. They have also experienced only modest post-accretionary alteration. Thus, these asteroids have higher concentrations of CAI material, appear less altered, and are more ancient than any known sample in our meteorite collection, making them prime candidates for sample return.

  10. Refractory pruritus in primary biliary cirrhosis

    Science.gov (United States)

    Pinheiro, Nuno Cercas; Marinho, Rui Tato; Ramalho, Fernando; Velosa, José

    2013-01-01

    Pruritus is a major symptom of primary biliary cirrhosis, cholestatic autoimmune disease which affects mostly middle-age women. Often, it can be severe and refractory to multiple treatments, and mostly affecting the patient’s health-related quality of life. Intense pruritus can be itself an indication to liver transplantation, in extreme cases leading to suicide. Its physiopathology has not yet been fully elucidated, but recent studies added the elevation of autotaxin and lysophosphatidic acid to the group of classic mechanisms already linked to cholestatic pruritus. In this case report we illustrate how ultraviolet B phototherapy appears to successfully control severe pruritus and contribute to the healing of pruritic skin lesions caused by intense scratching. There is limited medical literature concerning this therapeutic approach on cholestatic pruritus, but we hope that further randomised controlled trials will successfully establish it as an effective treatment in the near future. PMID:24234429

  11. PERIODIC BEHAVIORS

    NARCIS (Netherlands)

    Napp, Diego; Put, Marius van der; Shankar, Shiva

    2010-01-01

    This paper studies behaviors that are defined on a torus, or equivalently, behaviors defined in spaces of periodic functions, and establishes their basic properties analogous to classical results of Malgrange, Palamodov, Oberst et al. for behaviors on R(n). These properties-in particular the

  12. Esquizofrenia refratária Refractory schizophrenia

    Directory of Open Access Journals (Sweden)

    Helio Elkis

    2007-10-01

    Full Text Available OBJETIVO: O propósito deste artigo é o de revisar vários aspectos da esquizofrenia refratária levando em conta questões relacionadas à definição, aspectos clínicos, correlatos psicobiológicos, tratamentos farmacológicos e não farmacológicos, assim como preditores de resposta terapêutica. MÉTODO: Pesquisa no Medline, assim como artigos dos autores. RESULTADOS E CONCLUSÕES: Pelo menos um terço dos pacientes com esquizofrenia são refratários a tratamento com antipsicóticos e as evidências apontam a clozapina em monoterapia como a principal opção nesses casos. A politerapia com antipsicóticos não tem apoio em evidências. Ensaios clínicos recentes mostraram que a potencialização da clozapina com outros antipsicóticos não é superior ao placebo.OBJECTIVE: The aim of the present paper is to review the various aspects of refractory schizophrenia regarding issues such as definitions, clinical aspects, psychobiological correlates, pharmacological and non-pharmacological treatment options and predictors of treatment response. METHOD: Medline search as well as articles of the authors. RESULTS AND CONCLUSIONS: Refractory schizophrenia affects at least one third of patients with schizophrenia and the best evidence shows that is monotherapy with clozapine remains the mainstay for the treatment of such condition. Antipsychotic polipharmacy is not supported by current evidence and recent clinical trials have shown that clozapine augmentation with antipsychotics has no benefit over placebo.

  13. Pegloticase: in treatment-refractory chronic gout.

    Science.gov (United States)

    Lyseng-Williamson, Katherine A

    2011-11-12

    Intravenous pegloticase offers a novel approach to treating chronic gout refractory to conventional therapy. Pegloticase is a recombinant polyethylene glycol-conjugated form of uricase (a uric acid-specific enzyme lacking in humans) that catalyses the oxidation of uric acid to allantoin. In randomized, placebo-controlled, double-blind, 6-month, phase III trials, intravenous pegloticase 8 mg every 2 or 4 weeks provided sustained reductions in plasma uric acid levels to less than the therapeutic target of 6 mg/dL in a substantial proportion of patients with chronic gout who were refractory to, or intolerant of, conventional urate-lowering therapy. Pegloticase 8 mg every 2 weeks was associated with disease-modifying benefits relative to placebo, as shown by significant improvements from baseline in tophi resolution, frequency of gout flares and tender joint count, and clinically relevant and statistically significant improvements from baseline in health-related quality-of-life parameters related to disability, pain and physical function. Pegloticase 8 mg every 4 weeks was also significantly more effective than placebo with regard to most, but not all, of these endpoints. Preliminary data from an open-label extension of the phase III trials indicate that long-term treatment with pegloticase 8 mg every 2 or 4 weeks may maintain plasma uric acid normalization in patients who experienced a sustained uric acid response during the phase III trials. The most common serious adverse events associated with pegloticase are gout flares, infusion reactions and anaphylaxis. In addition, exacerbation of pre-existing congestive heart failure was reported in 2% of patients receiving pegloticase 8 mg every 2 weeks in the phase III trials.

  14. Polycultural psychology.

    Science.gov (United States)

    Morris, Michael W; Chiu, Chi-yue; Liu, Zhi

    2015-01-03

    We review limitations of the traditional paradigm for cultural research and propose an alternative framework, polyculturalism. Polyculturalism assumes that individuals' relationships to cultures are not categorical but rather are partial and plural; it also assumes that cultural traditions are not independent, sui generis lineages but rather are interacting systems. Individuals take influences from multiple cultures and thereby become conduits through which cultures can affect each other. Past literatures on the influence of multiple cultural identities and cultural knowledge legacies can be better understood within a polyculturalist rubric. Likewise, the concept elucidates how cultures are changed by contact with other cultures, enabling richer psychological theories of intercultural influence. Different scientific paradigms about culture imply different ideologies and policies; polyculturalism's implied policy of interculturalism provides a valuable complement to the traditional policy frames of multiculturalism and colorblindness.

  15. Nitroimidazole-refractory giardiasis: a growing problem requiring rational solutions.

    Science.gov (United States)

    Carter, E R; Nabarro, L E; Hedley, L; Chiodini, P L

    2018-01-01

    Giardia intestinalis is microaerophilic diarrhoea-causing protozoan common in countries with suboptimal sanitation. Standard treatment is with nitroimidazoles, but a growing number of refractory cases is being reported. Treatment failure has become increasingly prevalent in travellers who contract giardiasis in Asia. Clinicians are increasingly falling back on second-line and less well-known drugs to treat giardiasis. To review nitroimidazole-refractory G. intestinalis infection, examine the current efficacy of standard therapeutic agents, consider potential resistance mechanisms which could cause treatment failure and describe the practical aspects of managing this emerging clinical problem. A PubMed search was conducted using combinations of the following terms: refractory, Giardia, giardiasis, resistance and treatment. Articles on the pharmacotherapy, drug resistance mechanisms and use of alternative agents in nitroimidazole-refractory giardiasis were reviewed. We review the standard drugs for giardiasis, including their efficacy in initial treatment, mode of action and documented in vitro and in vivo drug resistance. We assess the efficacy of alternative drugs in nitroimidazole-refractory disease. Existing data suggest a potential advantage of combination treatment. An optimal treatment strategy for refractory giardiasis has still to be determined, so there is no standard treatment regimen for nitroimidazole-refractory giardiasis. Further work on drug resistance mechanisms and the use of drug combinations in this condition is a priority. Copyright © 2017. Published by Elsevier Ltd.

  16. High-Density Infrared Surface Treatments of Refractories

    Energy Technology Data Exchange (ETDEWEB)

    Tiegs, T.N.

    2005-03-31

    Refractory materials play a crucial role in all energy-intensive industries and are truly a crosscutting technology for the Industries of the Future (IOF). One of the major mechanisms for the degradation of refractories and a general decrease in their performance has been the penetration and corrosion by molten metals or glass. Methods and materials that would reduce the penetration, wetting, and corrosive chemistry would significantly improve refractory performance and also maintain the quality of the processed liquid, be it metal or glass. This report presents the results of an R&D project aimed at investigating the use of high-density infrared (HDI) heating to surface treat refractories to improve their performance. The project was a joint effort between Oak Ridge National Laboratory (ORNL) and the University of Missouri-Rolla (UMR). HDI is capable of heating the near-surface region of materials to very high temperatures where sintering, diffusion, and melting can occur. The intended benefits of HDI processing of refractories were to (1) reduce surface porosity (by essentially sealing the surface to prevent liquid penetration), (2) allow surface chemistry changes to be performed by bonding an adherent coating onto the underlying refractory (in order to inhibit wetting and/or improve corrosion resistance), and (3) produce noncontact refractories with high-emissivity surface coatings.

  17. Evolutionary developmental psychology.

    Science.gov (United States)

    King, Ashley C; Bjorklund, David F

    2010-02-01

    The field of evolutionary developmental psychology can potentially broaden the horizons of mainstream evolutionary psychology by combining the principles of Darwinian evolution by natural selection with the study of human development, focusing on the epigenetic effects that occur between humans and their environment in a way that attempts to explain how evolved psychological mechanisms become expressed in the phenotypes of adults. An evolutionary developmental perspective includes an appreciation of comparative research and we, among others, argue that contrasting the cognition of humans with that of nonhuman primates can provide a framework with which to understand how human cognitive abilities and intelligence evolved. Furthermore, we argue that several aspects of childhood (e.g., play and immature cognition) serve both as deferred adaptations as well as imparting immediate benefits. Intense selection pressure was surely exerted on childhood over human evolutionary history and, as a result, neglecting to consider the early developmental period of children when studying their later adulthood produces an incomplete picture of the evolved adaptations expressed through human behavior and cognition.

  18. Refractory myasthenia gravis - clinical profile, comorbidities and response to rituximab.

    Science.gov (United States)

    Sudulagunta, Sreenivasa Rao; Sepehrar, Mona; Sodalagunta, Mahesh Babu; Settikere Nataraju, Aravinda; Bangalore Raja, Shiva Kumar; Sathyanarayana, Deepak; Gummadi, Siddharth; Burra, Hemanth Kumar

    2016-01-01

    Introduction: Myasthenia gravis (MG) is an antibody mediated autoimmune neuromuscular disorder characterized by fatigable muscle weakness. A proportion of myasthenia gravis patients are classified as refractory due to non responsiveness to conventional treatment. This retrospective study was done to evaluate clinical profile, epidemiological, laboratory, and features of patients with MG and mode of management using rituximab and complications. Methods: Data of myasthenia gravis patients admitted or presented to outpatient department (previous medical records) with MG between January 2008 and January 2016 were included. A total of 512 patients fulfilled the clinical and diagnostic criteria of myasthenia gravis of which 76 patients met the diagnostic certainty for refractory myasthenia gravis and were evaluated. Results: Out of 76 refractory MG patients, 53 (69.73%) patients fulfilled all the three defined criteria. The median age of onset of the refractory MG group was 36 years with a range of 27-53 years. In our study 25 patients (32.89%) belonged to the age group of 21-30 years. Anti-MuSK antibodies were positive in 8 non-refractory MG patients (2.06%) and 36 refractory MG patients (47.36%). Mean HbA 1C was found to be 8.6±2.33. The dose of administered prednisone decreased by a mean of 59.7% ( p =3.3x10 -8 ) to 94.6% ( p =2.2x10 -14 ) after the third cycle of rituximab treatment. Conclusion: The refractory MG patients are most commonly female with an early age of onset, anti-MuSK antibodies, and thymomas. Refractory MG patients have higher prevalence and poor control (HbA 1C >8%) of diabetes mellitus and dyslipidemia probably due to increased steroid usage. Rituximab is very efficient in treatment of refractory MG with adverse effects being low.

  19. Risk of recurrent or refractory strictures and outcome of endoscopic dilation for radiation-induced esophageal strictures.

    Science.gov (United States)

    Agarwalla, Anant; Small, Aaron J; Mendelson, Aaron H; Scott, Frank I; Kochman, Michael L

    2015-07-01

    Radiation therapy for head, neck, and esophageal cancer can result in esophageal strictures that may be difficult to manage. Radiation-induced esophageal strictures often require repeat dilation to obtain relief of dysphagia. This study aimed to determine the long-term clinical success and rates of recurrent and refractory stenosis in patients with radiation-induced strictures undergoing dilation. Retrospective cohort study of patients with radiation-induced strictures who underwent endoscopic dilation by a single provider from October 2007-October 2012. Outcomes measured included long-term clinical efficacy, interval between sessions, number of dilations, and proportion of radiation strictures that were recurrent or refractory. Risk factors for refractory strictures were assessed. 63 patients underwent 303 dilations. All presented with a stricture >30 days after last radiation session. Clinical success to target diameter was achieved in 52 patients (83%). A mean of 3.3 (±2.6) dilations over a median period of 4 weeks was needed to achieve initial patency. Recurrence occurred in 17 (33%) at a median of 22 weeks. Twenty-seven strictures (43%) were refractory to dilation therapy. Fluoroscopy during dilation (OR 22.88; 95% CI 3.19-164.07), severe esophageal stenosis (lumen 30 days) from time of radiation injury. (2) Endoscopic dilation can achieve medium-term luminal remediation but the strictures have a high long-term recurrence rate of up to 33%. (3) Remediation of radiation strictures following laryngectomy can be achieved but require frequent dilations. (4) Clinical and procedural predictors may identify patients at high risk of refractory strictures. (5) The optimal strategy in highly selected refractory patients is not clear.

  20. The prevalence and efficacy of ganciclovir on steroid-refractory ulcerative colitis with cytomegalovirus infection: a prospective multicenter study.

    Science.gov (United States)

    Kim, You Sun; Kim, Young-Ho; Kim, Joo Sung; Cheon, Jae Hee; Ye, Byong Duk; Jung, Sung-Ae; Park, Young Sook; Choi, Chang Hwan; Jang, Byung Ik; Han, Dong Soo; Yang, Suk-Kyun; Kim, Won Ho

    2012-01-01

    It remains controversial whether or not cytomegalovirus infection in patients with active ulcerative colitis reflects a nonpathogenic colonization or a pathogenic disease warranting antiviral therapy. The aim of this study was to determine the prevalence of cytomegalovirus infection in patients with active ulcerative colitis and the therapeutic efficacy of ganciclovir against cytomegalovirus infection in patients with steroid-refractory ulcerative colitis. A prospective, multicenter study was conducted in 72 patients with moderate-to-severe ulcerative colitis who were treated with intravenous steroids. The presence of cytomegalovirus was evaluated serologically and histopathologic examination, including immunohistochemical staining. In patients with steroid-refractory ulcerative colitis, cytomegalovirus infections were treated with intravenous ganciclovir. In patients with steroid-responsive ulcerative colitis, steroid therapy was continued irrespective of cytomegalovirus infection. The evidence of cytomegalovirus infection was found in 31 patients (43%) with moderate-to-severe active ulcerative colitis. In patients with steroid-refractory ulcerative colitis, the cytomegalovirus infection rate increased to 67% (14 of 21). No significant clinical and endoscopic differences existed between patients with and without a cytomegalovirus infection; however, the amount of steroids used during the flare-up period was significantly higher in patients with a cytomegalovirus infection (P = 0.013). Eleven of 14 patients (79%) with steroid-refractory ulcerative colitis and a cytomegalovirus infection improved with ganciclovir treatment. Cytomegalovirus infections in the steroid-responsive group (17 of 31) did not require ganciclovir therapy. Cytomegalovirus infections are frequently observed in patients with moderate-to-severe ulcerative colitis, especially steroid-refractory ulcerative colitis. Ganciclovir was effective in patients with steroid-refractory ulcerative colitis who

  1. Composition and process for making an insulating refractory material

    Science.gov (United States)

    Pearson, A.; Swansiger, T.G.

    1998-04-28

    A composition and process are disclosed for making an insulating refractory material. The composition includes calcined alumina powder, flash activated alumina powder, an organic polymeric binder and a liquid vehicle which is preferably water. Starch or modified starch may also be added. A preferred insulating refractory material made with the composition has a density of about 2.4--2.6 g/cm{sup 3} with reduced thermal conductivity, compared with tabular alumina. Of importance, the formulation has good abrasion resistance and crush strength during intermediate processing (commercial sintering) to attain full strength and refractoriness.

  2. Outcomes in Transplant Recipients Treated With Foscarnet for Ganciclovir-Resistant or Refractory Cytomegalovirus Infection.

    Science.gov (United States)

    Avery, Robin K; Arav-Boger, Ravit; Marr, Kieren A; Kraus, Edward; Shoham, Shmuel; Lees, Laura; Trollinger, Brandon; Shah, Pali; Ambinder, Rich; Neofytos, Dionysios; Ostrander, Darin; Forman, Michael; Valsamakis, Alexandra

    2016-10-01

    Antiviral-resistant or refractory cytomegalovirus (CMV) infection is challenging, and salvage therapies, foscarnet, and cidofovir, have significant toxicities. Several investigational anti-CMV agents are under development, but more information is needed on outcomes of current treatments to facilitate clinical trial design for new drugs. Records of solid organ transplant (SOT) and hematopoietic cell transplant (HCT) recipients at a single center over a 10-year period were reviewed retrospectively to characterize those who had received foscarnet treatment for ganciclovir-resistant or refractory CMV infection. Data were collected on virologic responses, mortality, and nephrotoxicity. Of 39 patients (22 SOT, 17 HCT), 15 had documented ganciclovir resistance mutations and 11 (28%) of 39 had tissue-invasive CMV. Median duration of foscarnet was 32 days. Virologic failure occurred in 13 (33%) of 39 and relapses of viremia occurred in 31%. Mortality was 12 (31%) of 39 and was higher in HCT than SOT (P = 0.001), although ganciclovir resistance was more common in SOT (P = 0.003). Doses of ganciclovir or valganciclovir were low in 10 (26%) of 39 at some time before switching to foscarnet. Renal dysfunction occurred in 20 (51%) of 39 by end of treatment and in 7 (28%) of 25 after 6 months. Outcomes of existing treatment for ganciclovir-resistant or refractory CMV are suboptimal, in terms of virologic clearance, renal dysfunction, and mortality. These data should provide background information for future clinical trials of newer antiviral agents.

  3. PSYCHOLOGICAL ASPECTS OF ANTARCTIC LIVING,

    Science.gov (United States)

    POLAR REGIONS, ECOLOGY), (*ADJUSTMENT( PSYCHOLOGY ), POLAR REGIONS), (*NAVAL PERSONNEL, ADJUSTMENT( PSYCHOLOGY )), LEADERSHIP, SOCIAL PSYCHOLOGY , EMOTIONS , PERFORMANCE(ENGINEERING), ACCLIMATIZATION, STRESS( PSYCHOLOGY )

  4. Usefulness of high-dose intravenous human immunoglobulins treatment for refractory recurrent pericarditis.

    Science.gov (United States)

    Moretti, Michele; Buiatti, Alessandra; Merlo, Marco; Massa, Laura; Fabris, Enrico; Pinamonti, Bruno; Sinagra, Gianfranco

    2013-11-01

    The management of refractory recurrent pericarditis is challenging. Previous clinical reports have noted a beneficial effect of high-dose intravenous human immunoglobulins (IvIgs) in isolated and systemic inflammatory disease-related forms. In this article, we analyzed retrospectively our clinical experience with IvIg therapy in a series of clinical cases of pericarditis refractory to conventional treatment. We retrospectively analyzed 9 patients (1994 to 2010) with refractory recurrent pericarditis, who received high-dose IvIg as a part of their medical treatment. Nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, or colchicine treatment was not discontinued during IvIg treatment. No patients had a history of autoimmune or connective tissue diseases. During an average period of 11 months from the first recurrence, patients had experienced a mean of 5 relapses before the first IvIg treatment. In 4 cases, patients showed complete clinical remission with no further relapse after the first IvIg cycle. Two patients experienced a single minor relapse, responsive to short-term nonsteroidal anti-inflammatory drugs. In 2 patients, we performed a second cycle of IvIg after a recurrence of pericarditis, with subsequent complete remission. One patient did not respond to 3 cycles of IvIg and subsequently underwent pericardial window and long-term immunosuppressive treatment. No major adverse effect was observed in consequence of IvIg administration in all the cases. In conclusion, although IvIg mode of action is still poorly understood in this setting, this treatment can be considered as an option in patients with recurrent pericarditis refractory to conventional medical treatment and, in our small series, has proved to be effective in 8 of 9 cases. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Double-blind placebo-controlled trial of dapsone in antihistamine refractory chronic idiopathic urticaria.

    Science.gov (United States)

    Morgan, Matt; Cooke, Andrew; Rogers, Laura; Adams-Huet, Beverley; Khan, David A

    2014-01-01

    Management of antihistamine refractory chronic idiopathic urticaria (CIU) has poorly defined therapeutic options. To evaluate the efficacy of dapsone (4,4'-diaminodiphenylsulfone) in antihistamine refractory CIU compared with placebo. Twenty-two patients with antihistamine refractory CIU were randomly assigned to 100 mg of dapsone daily or placebo for 6 weeks in a 14-week double-blind, placebo-controlled crossover trial. End points were measured from a daily diary that reflected the weekly hive score, the weekly itch score, and a visual analog scale (VAS) score. Secondary to a carryover effect, the first period results were analyzed as a parallel design that compared placebo with dapsone directly by using repeated-measures analysis. After 6 weeks, the patients in the dapsone arm showed mean improvement over baseline in VAS (2.3 [95% CI, 0.6-4.1], P = .01), urticaria score (-3.5 [95% CI, -6.2 to -0.9], P = .01), and itch score (-4.8 [95% CI, -7.6 to -2.1], P = .001), whereas the placebo arm showed no improvement over baseline for VAS, urticaria, or itch scores. Dapsone showed greater improvement compared with placebo for itch (P = .047) and VAS (P = .04). Of the 22 patients, 3 showed complete resolution of hives and itch with dapsone, whereas 31% and 41% had ≥ 50% resolution of hives and itch, respectively. No serious adverse effects were observed with dapsone. To our knowledge, this is the first double-blind, placebo controlled study of dapsone in CIU and indicates that dapsone has efficacy in patients with antihistamine refractory CIU. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  6. Double-Blind Placebo Controlled Trial of Dapsone in Antihistamine Refractory Chronic Idiopathic Urticaria

    Science.gov (United States)

    Morgan, Matt; Cooke, Andrew; Rogers, Laura; Adams-Huet, Beverley; Khan, David A.

    2014-01-01

    Background Management of antihistamine refractory CIU has poorly defined therapeutic options. Objective To evaluate the efficacy of dapsone in antihistamine refractory CIU compared to placebo. Methods Twenty-two patients with antihistamine refractory CIU were randomly assigned to 100 mg of dapsone daily or placebo for 6 weeks in a 14 week double-blind, placebo-controlled crossover trial. Endpoints were measured from a daily diary reflecting weekly hive score (WHS) and weekly itch score (WIS) and a visual analog score. Secondary to a carryover effect, the first period results were analyzed as a parallel design comparing placebo to dapsone directly using repeated measures analysis. Results After 6 weeks patients in the dapsone arm showed mean improvement over baseline in VAS (+2.3 [0.6,4.1], p=0.01), urticaria score (-3.5 [-6.2, -0.9], p=0.01), and itch score (-4.8 [-7.6, -2.1], p=0.001), whereas the placebo arm showed no improvement over baseline for VAS, urticaria or itch scores. Dapsone showed greater improvement compared to placebo for itch (p=0.047) and VAS (p=0.04). Of the 22 patients, 3 showed complete resolution of hives and itch with dapsone, while 31% and 41% had ≥ 50% resolution of hives and itch respectively. No serious adverse effects were observed from dapsone. Conclusion To our knowledge, this is the first DBPC study of dapsone in CIU and suggests dapsone has efficacy in antihistamine refractory CIU patients. PMID:25213055

  7. CLINICAL EVALUATION OF EFFECTIVENESS OF ITRACONAZOLE IN PREOPERATIVE AND REFRACTORY POSTOPERATIVE PATIENTS OF ALLERGIC FUNGAL SINUSITIS

    Directory of Open Access Journals (Sweden)

    Ch. Venkatasubbaiah

    2016-07-01

    Full Text Available BACKGROUND Allergic Fungal Sinusitis (AFS is a noninvasive type of fungal sinusitis, clinically and pathologically a unique entity of chronic rhinosinusitis. The aetiology, pathogenesis, and treatment of AFS are subject to controversy. In spite of aggressive endoscopic surgery, pre- and postoperative steroids and immunotherapy recurrence rates are high. Many additions are made to its original description and management since its early description in 1980. The aim of the present paper was to evaluate clinically. The response to high-dose itraconazole before endoscopic sinus surgery and in refractory postoperative patients. Related literature was reviewed in the light of the present study. MATERIALS AND METHODS A 2 year prospective study conducted on 68 AFS patients divided into two groups to clinically evaluate the results after using oral itraconazole preoperatively in one group and in refractory postoperative period in another. RESULTS The mean age of patients with typical AFS was 36±3.9 years. Patients with AFS with an average follow up of 21 months were included. Recurrence was 6/34 (17.64% in itraconazole group and revision FESS done in 3/34 (08.82%. Recurrence in patients without itraconazole was 16/34 (47.05% and refractory to conventional treatment, but responded to itraconazole in 14/16 (87.50%. Revision surgery required in 2/16 (12.50% after starting oral itraconazole. No side effects or reactions were observed in a total of 7920 doses administered. CONCLUSION Itraconazole is well tolerated by patients and effective in shrinking the polyposis preoperatively with low recurrence. Postoperative refractory AFS is amenable in (87.50% of patients avoiding repeat FESS. Overall, low recurrence rate and minimizing revision surgery when compared to patients treated without itraconazole was evident in the study.

  8. Distributed Fiber Optic Sensor for On-Line Monitoring of Coal Gasifier Refractory Health

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Anbo [Center for Photonics Technology, Blacksburgh, VA (United States); Yu, Zhihao [Center for Photonics Technology, Blacksburgh, VA (United States)

    2015-11-30

    This report summarizes technical progress on the program “Distributed Fiber Optic Sensor for On-Line Monitoring of Coal Gasifier Refractory Health,” funded by the National Energy Technology Laboratory of the U.S. Department of Energy, and performed by the Center for Photonics Technology of the Bradley Department of Electrical and Computer Engineering at Virginia Tech. The scope of work entails analyses of traveling grating generation technologies in an optical fiber, as well as the interrogation of the gratings to infer a distributed temperature along the fiber, for the purpose of developing a real-time refractory health condition monitoring technology for coal gasifiers. During the project period, which is from 2011-2015, three different sensing principles were studied, including four-wave mixing (FWM), coherent optical time-domain reflectometer (C-OTDR) and Brillouin optical time-domain analysis (BOTDA). By comparing the three methods, the BOTDA was selected for further development into a complete bench-top sensing system for the proposed high-temperature sensing application. Based on the input from Eastman Chemical, the industrial collaborator on this project, a cylindrical furnace was designed and constructed to simulate typical gasifier refractory temperature conditions in the laboratory, and verify the sensor’s capability to fully monitor refractory conditions on the back-side at temperatures up to 1000°C. In the later stages of the project, the sensing system was tested in the simulated environment for its sensing performance and high-temperature survivability. Through theoretical analyses and experimental research on the different factors affecting the sensor performance, a sensor field deployment strategy was proposed for possible future sensor field implementations.

  9. Approach to seizures in the neonatal period: a European perspective

    DEFF Research Database (Denmark)

    Vento, M; de Vries, Lisbeth Elvira; Alberola, A

    2010-01-01

    approach among different doctors and institutions. Hence, although phenobarbital is still considered the initial drug of choice, the protocols reported in the literature show a great variability in the approach to treatment of refractory seizures. We used a questionnaire to gain information regarding...... the treatment of seizures in the neonatal period in different European institutions. Conclusion: We conclude that phenobarbital is still the initial drug of choice followed by benzodiazepines, except in preterm infants with a birth weight below 1800 g. In refractory seizures, the use of continuous lidocaine...

  10. The Dialectic Psychology perspectives

    OpenAIRE

    Oliveros M., Ricardo; Facultad de Psicología, Universidad Nacional Mayor de San Marcos, Lima, Perú

    2014-01-01

    The present paper exposes the dialectic psychology perspectives in the twentieth first century Peru. We ponder about the dialectics psychology denomination, connecting them to other denominations used in the materialist psychology trend. We analyze the relations between dialectics psychology and social neuroscience, delimiting both the psychological sciences field and the neuroscience field. We develop issues from the emancipator project of dialectics psychology, precising personal developmen...

  11. Prospective study of zonisamide therapy for refractory idiopathic epilepsy in dogs.

    Science.gov (United States)

    von Klopmann, T; Rambeck, B; Tipold, A

    2007-03-01

    Investigation of the efficacy of zonisamide as an add-on therapy in dogs with refractory epilepsy. Thirteen dogs fulfilled the inclusion criteria of poor seizure control despite adequate serum levels of phenobarbital, potassium bromide or both. One further dog was treated with zonisamide as monotherapy because of severe blood dyscrasia due to phenobarbital treatment. Various seizure parameters were evaluated retrospectively for a four month period without zonisamide and prospectively for the same time period under zonisamide add-on therapy. The study time period was extended by up to 17 months to evaluate long-term outcome. Data of 11 dogs could be evaluated: nine of them were responders. The median reduction of seizure frequency of all dogs on zonisamide add-on therapy was 70 per cent (range 14 to 100 per cent). Only transient central nervous system side effects were reported. No further increase of liver enzymes occurred. In three of the responder dogs, seizure control subsided after individual time periods (between 69 days and seven months). In dogs with refractory epilepsy, zonisamide may have a beneficial effect on seizure control. In three responder dogs, seizure activity relapsed possibly because of an induction of tolerance. Limiting factors are the high costs.

  12. Sport psychology: training the mind for competition.

    Science.gov (United States)

    Hammermeister, Jon; VonGuenthner, Shannon

    2005-06-01

    An optimal psychologic state for peak athletic performance is strongly documented in the sport psychology literature. A wealth of peer-reviewed studies also strongly supports the role that mental skills training (MST) plays in the development of this state. However, some disagreement exists in the sport psychology community over how best to deliver the MST tools and skills necessary for optimal sport performance. Mental training consultants and intervention researchers have recently suggested that periodization of mental training may be the next major leap forward in applied sport psychology program delivery. This new method of "training the mind" is presented and discussed.

  13. Refractory Depression, Fatigue, Irritable Bowel Syndrome, and Chronic Pain: A Functional Medicine Case Report.

    Science.gov (United States)

    Plotnikoff, Gregory; Barber, Melissa

    2016-01-01

    Single-disorder or single-organ-system clinical practice guidelines are often of limited usefulness in guiding effective management of patients with chronic multidimensional signs and symptoms. The presence of multiple long-standing medical problems in a given patient despite intensive medical effort suggests that addressing systemic core imbalances could complement more narrowly focused approaches. A 72-year-old man experiencing longstanding depression, fatigue, irritable bowel syndrome, and chronic pain in the context of additional refractory illnesses was assessed and treated, guided by a system-oriented approach to underlying core imbalances termed functional medicine. This patient was referred from a team of clinicians representing primary care, cardiology, gastroenterology, hematology, and psychology. Prior treatment had been unsuccessful in managing multiple chronic comorbidities. Diagnostic assessment included comprehensive stool and nutritional/metabolic laboratory testing. The blood-, urine-, or stool-based measurements of relevant markers for multiple systemic issues, including digestion/absorption, inflammation, oxidative stress, and methylation, identified previously unrecognized root causes of his constellation of symptoms. These functional measurements guided rational recommendations for dietary choices and supplementation. The patient experienced steady and significant improvement in his mental health, fatigue, chronic pain, and irritable bowel syndrome-as well as the unexpected resolution of his chronic idiopathic pancytopenia. The success in this case suggests that other patients with chronic, complex, and treatment-refractory illness may benefit from a system-oriented assessment of core imbalances guided by specialized nutritional/metabolic and digestive laboratory testing.

  14. Psychology Ethics in Introductory Psychology Textbooks

    Science.gov (United States)

    Zucchero, Renee' A.

    2011-01-01

    Previous research revealed that introductory psychology textbooks included limited information about psychology ethics. This study reviewed 48 current introductory psychology textbooks for research and other APA ethics content. These textbooks included slightly more total ethics content and were more thorough in their review of research ethics…

  15. Evolutionary developmental psychology

    National Research Council Canada - National Science Library

    King, Ashley C; Bjorklund, David F

    2010-01-01

    The field of evolutionary developmental psychology can potentially broaden the horizons of mainstream evolutionary psychology by combining the principles of Darwinian evolution by natural selection...

  16. Prospective, multicenter, controlled study of quality of life, psychological adjustment process and medical outcomes of patients receiving a preemptive kidney transplant compared to a similar population of recipients after a dialysis period of less than three years--The PreKit-QoL study protocol.

    Science.gov (United States)

    Sébille, Véronique; Hardouin, Jean-Benoit; Giral, Magali; Bonnaud-Antignac, Angélique; Tessier, Philippe; Papuchon, Emmanuelle; Jobert, Alexandra; Faurel-Paul, Elodie; Gentile, Stéphanie; Cassuto, Elisabeth; Morélon, Emmanuel; Rostaing, Lionel; Glotz, Denis; Sberro-Soussan, Rebecca; Foucher, Yohann; Meurette, Aurélie

    2016-01-19

    Treatment of end stage renal disease has an impact on patients' physical and psychological health, including quality of life (QoL). Nowadays, it is known that reducing the dialysis period has many advantages regarding QoL and medical outcomes. Although preemptive transplantation is the preferred strategy to prevent patients undergoing dialysis, its psychological impact is unknown. Moreover, transplantation can be experienced in a completely different manner among patients who were on dialysis and those who still had a functioning kidney at the time of surgery. Longitudinal data are often collected to allow analyzing the evolution of patients' QoL over time using questionnaires. Such data are often difficult to interpret due to the patients' changing standards, values, or conceptualization of what the questionnaire is intended to measure (e.g. QoL). This phenomenon is referred to as response shift and is often linked to the way the patients might adapt or cope with their disease experience. Whether response shift is experienced in a different way among patients who were on dialysis and those who still had a functioning kidney at time of surgery is unknown and will be studied in the PreKit-QoL study (trial registration number: NCT02154815). Understanding the psychological impact of pre-emptive transplantation is an important issue since it can be associated with long-term patient and graft survival. Adult patients with a pre-emptive transplantation (n = 130) will be prospectively included along with a control group of patients with a pre-transplant dialysis period < 36 months (n = 260). Only first and single kidney transplantation will be considered. Endpoints include: comparison of change between groups in QoL, anxiety and depressive disorders, perceived stress, taking into account response shift. These criteria will be evaluated every 6 months prior to surgery, at hospital discharge, at three and six months, one and two years after transplantation

  17. Refractory primary immune thrombocytopenia with subsequent del(5q) MDS

    DEFF Research Database (Denmark)

    Bech Mortensen, Thomas; Frederiksen, Henrik; Marcher, Claus Werenberg

    2017-01-01

    A patient with refractory primary immune thrombocytopenia (ITP) characterised by severe skin and mucosal bleedings was treated with several ITP-directed therapies including cyclophosphamide. He later developed therapy-related del(5q) myelodysplastic syndrome with no dysplastic morphological...

  18. Beta-blockers in cirrhosis and refractory ascites

    DEFF Research Database (Denmark)

    Kimer, Nina; Feineis, Martin; Møller, Søren

    2015-01-01

    OBJECTIVE: It is currently discussed if beta-blockers exert harmful effects and increase mortality in patients with cirrhosis and refractory ascites. In this study, we provide an overview of the available literature in this field in combination with a retrospective analysis of 61 patients...... with cirrhosis and refractory ascites in a tertiary unit. MATERIAL AND METHODS: We performed a systematic search of literature in May 2014. In addition, 61 patients with cirrhosis and ascites were identified and followed from development of refractory ascites until death or end of follow-up. RESULTS: Fourteen...... trials (9 trials on propranolol, 1 case-control study and 4 retrospective analyses) were identified. One trial suggested an increased mortality in patients treated with beta-blockers and refractory ascites. The results of the remaining trials were inconclusive. No increase in mortality among beta...

  19. Refractory Coated/Lined Low Density Structures Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The innovation in this proposed effort is the development of refractory coated or lined low density structures. Lightweight structures are desirable for space...

  20. Recycling MgO-C refractory in electric arc furnaces

    Energy Technology Data Exchange (ETDEWEB)

    Conejo, A.N. [Metallurgy Department, Morelia Technological Institute, Morelia (Mexico); Lule, R.G.; Lopez, F. [Process Engineering Department-Steelmaking Shop, Lazaro Cardenas City (Mexico); Rodriguez, R. [Refractories Department, Lazaro Cardenas City (Mexico)

    2006-11-15

    MgO-C refractory recycling from electric arc furnaces and ladle furnaces has been carried out during the melting of direct reduced iron (DRI). Metallurgical trials to define the effects of refractory recycling on energy consumption, melting time, flux consumption and refractory consumption are reported in this work. The method of preparation as well as the method of injection is also included in this study. Based on current results, the practice of recycling spent refractory is highly recommended. Visual inspection indicates the potential benefits in slag foaming which starts to form at the beginning of the heat thus allowing the use of full power transformer and in turn results in faster melting rates. (author)

  1. Ketogenic Diet in Super-Refractory Status Epilepticus

    OpenAIRE

    Smith, Garnett; Press, Craig A.

    2017-01-01

    Researchers from the Children’s National Health System in Washington, D.C. studied the feasibility, rate of complications, and effect on seizures of initiating the Ketogenic Diet (KD) in pediatric patients with Super-Refractory Status Epilepticus (SRSE).

  2. Silica crown refractory corrosion in glass melting furnaces

    National Research Council Canada - National Science Library

    Balandis A; Nizeviciene D

    2011-01-01

    ... of glass furnaces, when the rate of corrosion of crowns were about 2 times greater. The change of these parameters, the chemical composition and formation of the microcracks in the used silica refractories material were studied...

  3. Refractory, Abrasive, and Other Industrial Minerals Operations - Direct Download

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This map layer includes refractory, abrasive, and other industrial minerals operations in the United States. The data represent commodities covered by the Minerals...

  4. Atom Probe Tomography and Its Application to Refractory Metal Nuggets

    Science.gov (United States)

    Daly, L.; Bland, P. A.; Forman, L. V.; Reddy, S. M.; Rickard, W. D. A.; Saxey, D. W.; La Fontaine, A.; Yang, L.; Trimby, P. W.; Cairney, J.; Ringer, S.; Schaefer, B. F.

    2016-08-01

    Atom probe tomography is capable of achieving atomic resolution. This allows us to accurately measure the chemistry of refractory metal nuggets in situ, revealing nanometre scale variations in their chemistry and the presence of sulphur in the alloy.

  5. Compressive Creep and Thermophysical Performance of Mullite Refractories

    Energy Technology Data Exchange (ETDEWEB)

    Hemrick, JG

    2002-04-01

    Compressive creep testing of ten commercially available mullite refractories was performed at 1300-1450 C and at static stresses between 0.2-0.6 MPa. These refractories were examined because they are used in borosilicate glass furnace crowns and superstructures along with in sidewall applications. Additionally, despite their high cost ({approx}$500/ft{sup 3}) they are cheaper than other refractories such as chrome alumina ({approx}$3000/ft{sup 3}) or fusion-cast alumina ({approx}900/ft{sup 3}) which are used as replacements for traditional silica refractories in harsh oxy-fuel environments. The corrosion resistances of these ten materials were also evaluated. In addition, measurements were made that tracked their dimensional stability, phase content, microstructure, and composition as a function of temperature and time. The techniques used for these characterizations and their respective analyses are described. An intent of this study was to provide objective and factual results whose interpretations were left to the reader.

  6. Refractory absence epilepsy associated with GLUT-1 deficiency syndrome.

    LENUS (Irish Health Repository)

    Byrne, Susan

    2011-05-01

    GLUT-1 deficiency syndrome (GLUT-1 DS) is a disorder of cerebral glucose transport associated with early infantile epilepsy and microcephaly. We report two boys who presented with refractory absence epilepsy associated with hypoglycorrhachia, both of whom have genetically confirmed GLUT-1 DS. We propose that these children serve to expand the phenotype of GLUT-1 DS and suggest that this condition should be considered as a cause of refractory absence seizures in childhood.

  7. Barbiturate-refractory epilepsy: safe schedule for therapeutic substitution

    OpenAIRE

    Gorz, Ana Maria; Silvado, Carlos E. S.; Bittencourt, Paulo Rogério M.

    1986-01-01

    Barbiturates are considered first line antiepileptic drugs in third world countries due to traditional and economic reasons. This prospective uncontrolled study of 52 patients aged 15 to 64 years (mean 24) demonstrates that patients who become refractory to barbiturates are mainly those with partial seizures with or without generalization or with a focal EEG abnormality (71%). Seizures tend to become refractory approximately 6 years after barbiturates were started. Progressive barbiturate wit...

  8. Silica crown refractory corrosion in glass melting furnaces

    OpenAIRE

    Balandis A.; Nizeviciene D.

    2011-01-01

    The critical parameters of silica refractories, such as compressive strength, bulk, density, quantity of silica, microstructure and porosity were evaluated of unused and used bricks to line the crowns of glass furnaces, when the rate of corrosion of crowns were about 2 times greater. The change of these parameters, the chemical composition and formation of the microcracks in the used silica refractories material were studied. It was established that the short time at service of containe...

  9. The Use Of Phosphates To Reduce Slag Penetration In Cr203-Based Refractories

    Science.gov (United States)

    Kwong, Kyei-Sing; Dogan, Cynthia P.; Bennett, James P.; Chinn, Richard E.; Petty, Arthur V.

    2004-11-09

    A high-chromium refractory material that provides improved resistance to coal slag penetration is presented. The refractory mixture comprises a blend of chromium oxide, aluminum oxide and phosphates. The refractory mixture may be blended with an aggregate and cured. In addition a phosphorous oxide may be blended with chromium oxide and aluminum oxide and additionally an aggregate. The refractory mixture reduces the rate of coal slag penetration into the surface of the cured refractory.

  10. Use of phosphates to reduce slag penetration in Cr2O3-based refractories

    Energy Technology Data Exchange (ETDEWEB)

    Kwong, Kyei-Sing; Dogan, Cynthia P.; Bennett, James P.; Chinn, Richard E.; Petty, Arthur V.

    2004-11-09

    A high-chromium refractory material that provides improved resistance to coal slag penetration is presented. The refractory mixture comprises a blend of chromium oxide, aluminum oxide and phosphates. The refractory mixture may be blended with an aggregate and cured. In addition a phosphorous oxide may be blended with chromium oxide and aluminum oxide and additionally an aggregate. The refractory mixture reduces the rate of coal slag penetration into the surface of the cured refractory.

  11. Use of Phosphates to Reduce Slag Penetration in CR203-Based Refractories

    Energy Technology Data Exchange (ETDEWEB)

    Kwong, Kyei-Sing; Dogan, Cynthia P.; Bennett, James P.; Chinn, Richard E.; Petty, Arthur V.

    2004-11-09

    A high-chromium refractory material that provides improved resistance to coal slag penetration is presented. The refractory mixture comprises a blend of chromium oxide, aluminum oxide and phosphates. The refractory mixture may be blended with an aggregate and cured. In addition a phosphorus oxide may be blended with chromium oxide and aluminum oxide and additionally an aggregate. The refractory mixture reduces the rate of coal slag penetration into the surface of the cured refractory.

  12. Duloxetine in the treatment of burning mouth syndrome refractory to conventional treatment: A case report.

    Science.gov (United States)

    Kim, Yeon-Dong; Lee, Ji-Hye; Shim, Jee-Hoon

    2014-06-01

    Patients with burning mouth syndrome (BMS) report burning sensation and pain involving the tongue and oral mucosa without any apparent medical or dental cause. The pathogenesis of this syndrome remains unclear and there is currently no standard treatment. BMS is, therefore, often misdiagnosed and its management is complex. This lack of clinical expertise may result in decreased health-related quality of life and increased psychological distress among patients with BMS. The present case report involves a 77-year-old female patient with BMS refractory to conventional treatment with nerve block and medication, who was successfully treated with duloxetine. Duloxetine may become a new therapeutic option in the management of BMS. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  13. Sexual HIV risk behaviors in a treatment-refractory opioid-dependent sample.

    Science.gov (United States)

    McHugh, R Kathryn; Weitzman, Meara; Safren, Steven A; Murray, Heather W; Pollack, Mark H; Otto, Michael W

    2012-01-01

    The propensity to engage in risk behaviors confers an elevated risk of HIV and other infectious disease transmission in opioid-dependent populations. Although drug abuse treatment may decrease drug-related risk behaviors such as needle-sharing, additional intervention may be needed to reduce HIV risk behavior. In this investigation, we assessed sexual HIV risk behaviors in opioid-dependent patients who were engaging in regular drug use despite ongoing counseling and methadone maintenance therapy. Potential risk and protective factors for engaging in sexual HIV risk behavior were examined. Taking into account demographic, psychiatric, substance use, and psychological variables, the only significant predictor of risk behavior was age. Specifically, younger patients were more likely to engage in sexual HIV risk behavior. The implications of these results for reducing sexual HIV risk behavior and for HIV prevention in methadone-maintained, treatment-refractory opioid-dependent patients are discussed.

  14. Aflibercept in exudative age related macular degeneration refractory to ranibizumab.

    Science.gov (United States)

    Ruiz Ramos, J; Pascual-Camps, I; Cuéllar-Monreal, M J; Dolz-Marco, R; Fenoll, M A; Font-Noguera, I; Poveda-Andrés, J L; Gallego-Pinazo, R

    2015-12-01

    The aim of this study is to determine the effectiveness, safety and cost of aflibercept in the treatment of wet age-related macular degeneration (ARMD) refractory to ranibizumab. Retrospective observational study was conducted on patients diagnosed with wet ARMD, and previously treated with ranibizumab. Efficacy variables assessed were changes in visual acuity (BCVA) and anatomical improvements in the most affected eye. Factors associated with improvement of BCVA with aflibercept were also studied. Adverse events related to the aflibercept administration were recorded. Cost analysis data were collected from the hospital perspective, and only taking the direct medical costs into account. Cost-effectiveness analysis was calculated using the aflibercept treatment cost, and effectiveness calculated as BCVA gained. A total of 50 eyes corresponding to 46 patients were included. The median follow-up period was 4.6 months (range: 1.0-6.0). Improvement in visual acuity after the first 2 doses and at the end of the follow-up period was observed in 32.0 and 28.0% of treated eyes, respectively. None of the variables studied was associated with an improvement in the BCVA after treatment. No significant differences were found in the average monthly cost between treatments. Aflibercept is shown to be an effective treatment in a significant number of patients resistant to treatment with ranibizumab, presenting a cost similar to that generated during the final stages of treatment with ranibizumab. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  15. Chronic lymphocytic leukemia: treatment options for patients with refractory disease.

    Science.gov (United States)

    Motta, Marina; Wierda, William G; Ferrajoli, Alessandra

    2009-09-01

    Patients with purine analogue-refractory chronic lymphocytic leukemia (CLL) have short survival and limited treatment options. Defining the best salvage strategies for this population is challenging, because limited data are available from clinical trials, and because studies have enrolled mixed populations (patients with recurrent and refractory disease or patients with refractory disease and Richter transformation). Moreover, patients with refractory CLL have a high incidence of unfavorable molecular and clinical features, such as high-risk genomic profiles, unmutated immunoglobulin heavy-chain genes, expression of zeta-chain-associated protein kinase 70, and bulky lymphadenopathies. These patients are also severely immunosuppressed because of the underlying disease and the treatments received, and experience a high rate of infectious complications that pose an additional difficulty in selecting treatment. Despite these challenges, in parallel with better characterizations of the biologic features of refractory CLL, the number of available treatment modalities for this population has increased. Several chemoimmunotherapy combinations have been developed, and novel agents with a different mechanism of action are being investigated in clinical trials. Furthermore, allogeneic stem cell transplantation with nonmyeloablative conditioning regimens is a therapeutic strategy that is increasingly offered to patients with refractory CLL.

  16. Recent advances in refractories for steelmaking. Seikoyo taikabutsu no shinpo

    Energy Technology Data Exchange (ETDEWEB)

    Kasai, K. (Nippon Steel Corp., Tokyo (Japan))

    1994-05-07

    Advances and problems of refractories for steelmaking are explained. With the division of refining functions in the steel manufacturing process, and the development of new processes, functions which comply to them are being demanded for refractories. Progress related to the main refractories is summarized. Long-life refractories such as magnesite-carbon bricks, alumina-carbon silicate-carbon bricks, magnesite-chrome bricks were developed, and the unit requirement of furnace materials was reduced by 25% in 10 years. Labor-saving in furnace construction work also advanced by the development of the wall construction methods based on execution of casting process. For realization of high quality steel, ladles made of neutral alumina-spinel which does not contaminate the steel are used. For the preliminary treatment process of hot metal, ASC bricks and glass-added ASC bricks were developed as refractories, and the unit requirement was reduced. For converters, MgO-C bricks which have anticorrosion properties as well as antispalling properties are being broadly used. As for RH of secondary refining facility, magnesite-chrome type basic bricks which cope with the very severe conditions are used. For the ladle, alumina-spinel type casting material is used in order to save labor and to improve the quality of the steel. However, in the case of continuous casting, various types of refractories having special functions are used. 35 refs., 16 figs.

  17. Recycling practices of spent MgO-C refractories

    Energy Technology Data Exchange (ETDEWEB)

    Kwong, Kyei-Sing; Bennett, James P.

    2002-10-01

    The recycling options of spent MgO-C refractories from an electrical arc furnace (EAF) have been evaluated. The economic, quality of spent refractories and products made from it, the ease of implementation of a recycling practice and the interest of steel melt shops were considered. It was decided that the best option of most EAF shops would be to recycle spent MgO-C refractory as a foaming slag conditioner because of their MgO content. Crushed MgO-C spent refractories can be reused directly back into an EAF without complex and costly beneficiation. Even though this practice is simple, it is critical to know the optimum amount of MgO in the slag to achieve the best foaming quality. A computer model was designed to find the optimum MgO amount. This modeling also helps the melt shop extend refractory service life, increase the energy efficiency, increase productivity, and decrease the amount of slag. Issues related to the refractory recycling will be discussed.

  18. Electron microscopy study of refractory ceramic fibers.

    Science.gov (United States)

    MacKinnon, P A; Lentz, T J; Rice, C H; Lockey, J E; Lemasters, G K; Gartside, P S

    2001-10-01

    In epidemiological studies designed to identify potential health risks of exposures to synthetic vitreous fibers, the characterization of airborne fiber dimensions may be essential for assessing mechanisms of fiber toxicity. Toward this end, air sampling was conducted as part of an industry-wide study of workers potentially exposed to airborne fibrous dusts during the manufacture of refractory ceramic fibers (RCF) and RCF products. Analyses of a subset of samples obtained on the sample filter as well as on the conductive sampling cowl were performed using both scanning electron microscopy (SEM) and transmission electron microscopy (TEM) to characterize dimensions of airborne fibers. Comparison was made of bivariate fiber size distributions (length and diameter) from air samples analyzed by SEM and by TEM techniques. Results of the analyses indicate that RCF size distributions include fibers small enough in diameter (fibers (> 60 microm) may go undetected by TEM, as evidenced by the proportion of fibers in this category for TEM and SEM analyses (1% and 5%, respectively). Limitations of the microscopic techniques and differences in fiber-sizing rules for each method are believed to have contributed to the variation among fiber-sizing results. It was concluded from these data that further attempts to characterize RCF exposure in manufacturing and related operations should include analysis by TEM and SEM, since the smallest diameter fibers are not resolved with SEM and the fibers of longer length are not sized by TEM.

  19. [Clinical features of atypical refractory anemia (RA)].

    Science.gov (United States)

    Matsuda, A; Jinnai, I; Kusumoto, S; Shiramatsu, F; Bessho, M; Saito, M; Hirashima, K

    1991-08-01

    Twenty-three patients with bicytopenia or pancytopenia were retrospectively studied. The patients with underlying disorders, blast count of more than 5% on bone marrow (BM) aspirate, blast count of more than 1% on peripheral blood or ringed sideroblast count of more than 15% on BM aspirate were excluded. According to Yoshida's criteria, 23 patients were classified into 6 subtypes [AA (aplastic anemia)1: typical AA, AA2: atypical AA, MDS (myelodysplastic syndrome)3: typical RA (refractory anemia, MDS4-6: atypical RA], and AA1 7 cases; AA2 2 cases; MDS3 5 cases; MDS4 1 case; MDS5 2 cases; MDS6 6 cases. To clarify the clinical features of atypical RA group (MDS4-6), we investigated ferrokinetics, RBC life span, karyotype, serum Epo (erythropoietin) concentration, response to therapy and prognosis. Results were as follows: 1) all three RA patients who were younger than 30 years old were included in atypical RA group, 2) in ferrokinetics study PID (plasma iron disappearance time) values of MDS4 and MDS6 patients ranged between those of AA1 and those of MDS3 patients (5 of 7 patients), 3) two cases who developed leukemia belonged to typical RA group, 4) patients with atypical RA showed response to therapy and their prognosis were better than those with typical RA. These observations suggest that atypical RA have different clinical features from typical RA.

  20. Efficacy of levetiracetam in refractory childhood epilepsy

    Directory of Open Access Journals (Sweden)

    Keon Su Lee

    2010-04-01

    Full Text Available Purpose : To evaluate the efficacy and safety of levetiracetam adjunctive therapy for reducing the rate of seizure frequency in children with intractable pediatric epilepsy. Methods : We reviewed the medical records of 86 patients with intractable pediatric epilepsy who visited our hospital between March 1989 and February 2009. Levetiracetam was included in the previous anticonvulsant regimen for at least 6 months and the reduction in the rate of seizure frequency was determined in follow-up examinations. We analyzed demographic data, seizure types, antiepileptic drug history, levetiracetam dose, adverse effects of levetiracetam therapy, treatment outcome, electroencephalogram findings, etc. Results : More than 50% reduction in the seizure frequency was observed in 62 of the 86 (72.1% patients; 44 patients (51.1% became seizure free, while the seizure frequency increased in 5.8% patients. The associations between seizure reduction rate and age, associated diseases, seizure types, and seizure frequency before treatment were not significant. However, the duration of disease, dose of levetiracetam, duration and frequency of anticonvulsant administration before levetiracetam therapy were significantly correlated. Electroencephalogram findings and the cause of epilepsy showed partial correlation. Forty (46% patients showed adverse symptoms; the symptoms in the order of their frequency were somnolence, hyperactivity, irritability, aggressiveness, tiredness, etc. Conclusion : The findings of our study provide the evidence that levetiracetam adjunctive therapy is efficacious and well tolerated in various refractory childhood epilepsy cases.

  1. Flavopiridol and Vorinostat in Treating Patients With Relapsed or Refractory Acute Leukemia or Chronic Myelogenous Leukemia or Refractory Anemia

    Science.gov (United States)

    2013-04-01

    Blastic Phase Chronic Myelogenous Leukemia; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Refractory Anemia With Excess Blasts; Relapsing Chronic Myelogenous Leukemia; Untreated Adult Acute Lymphoblastic Leukemia; Untreated Adult Acute Myeloid Leukemia

  2. The State of the Psychology Health Service Provider Workforce

    Science.gov (United States)

    Michalski, Daniel S.; Kohout, Jessica L.

    2011-01-01

    Numerous efforts to describe the health service provider or clinical workforce in psychology have been conducted during the past 30 years. The American Psychological Association (APA) has studied trends in the doctoral education pathway and the resultant effects on the broader psychology workforce. During this period, the creation and growth of…

  3. Successful treatment of refractory listeria meningitis and bacteremia with trimethoprim-sulfamethoxazole in an immunocompetent child.

    Science.gov (United States)

    Polat, Meltem; Kara, Soner Sertan; Tapısız, Anıl; Derinöz, Okşan; Çağlar, Kayhan; Tezer, Hasan

    2016-01-01

    Listeria monocytogenes is an important cause of life-threatening bacteremia and meningoencephalitis in neonates, pregnant women, the elderly, and immunocompromised individuals. However, it is an uncommon cause of illness in immunocompetent children beyond the neonatal period. Ampicillin with or without an aminoglycoside remains the best treatment for listeriosis. Here, we report a rare case of Listeria meningitis and bacteremia in a 7-month-old immunocompetent girl, which was refractory to ampicillin plus gentamicin treatment and successfully treated by the addition of TMP/SMX.

  4. Quantifying hemodynamic refractory bold effects in normal subjects at the single-subject level using an inverse logit fitting procedure.

    Science.gov (United States)

    Descamps, Benedicte; Vandemaele, Pieter; Reyngoudt, Harmen; Deblaere, Karel; Leybaert, Luc; Paemeleire, Koen; Achten, Eric

    2012-03-01

    To evaluate whether hemodynamic refractory effects provoked by repeated visual stimulation can be detected and quantified at the single-subject level using a recently described hemodynamic response function (HRF) fitting algorithm. Hemodynamic refractory effects were induced with an easily applicable functional MRI (fMRI) paradigm. A fitting method with inverse logit (IL) functions was applied to quantify net HRFs at the single-subject level with three interstimulus intervals (ISI; 1, 2, and 6 s). The model yielded amplitude, latencies, and width for each HRF. HRF fitting was possible in 44 of 51 healthy volunteers, with excellent goodness-of-fit (R(2) = 0.9745 ± 0.0241). Refractory effects were most pronounced for the 1-s ISI (P < 0.001) and had nearly disappeared for the 6-s ISI. Quantifying refractory effects in individuals was possible in 86.3% of normal subjects using the IL fitting algorithm. This setup may be suitable to explore such effects in individual patients. Copyright © 2011 Wiley Periodicals, Inc.

  5. Psychology of psychology? A theoretization of psychological science through historical and socio-anthropological analysis of Psychology as institution

    OpenAIRE

    Martin Žužek-Kres

    2008-01-01

    The article presents a "new" history of psychology, which is also termed as "psychology of psychology". In some academic communities this unconventional history of psychology represents today an accepted approach to epistemological questions about psychological concepts and it enables an insight into social contextualization of Psychology as an institution. The conclusion presents a referential and institutional context where this psychology of psychology is realized.

  6. Introduction to Psychology.

    Science.gov (United States)

    Edwards, Lesley

    Designed for community students interested in learning about psychology as a field of study, this module offers group and individual activities to involve the beginning student in research, experimentation and discussion. Unit 1, "What Is Psychology?," includes the use of animals in psychology, ethics, the history of psychology, an…

  7. Mainstreaming Culture in Psychology

    Science.gov (United States)

    Cheung, Fanny M.

    2012-01-01

    Despite the "awakening" to the importance of culture in psychology in America, international psychology has remained on the sidelines of psychological science. The author recounts her personal and professional experience in tandem with the stages of development in international/cross-cultural psychology. Based on her research in cross-cultural…

  8. Directed light fabrication of refractory metals and alloys

    Energy Technology Data Exchange (ETDEWEB)

    Fonseca, J.C.; Lewis, G.K.; Dickerson, P.G.; Nemec, R.B.

    1999-05-30

    This report covers deposition of refractory pure metals and alloys using the Directed Light Fabrication (DLF) process and represents progress in depositing these materials through September 1998. In extending the DLF process technology to refractory metals for producing fully dense, structurally sound deposits, several problems have become evident. (1) Control of porosity in DLF-deposited refractory metal is difficult because of gases, apparently present in commercially purchased refractory metal powder starting materials. (2) The radiant heat from the molten pool during deposition melts the DLF powder feed nozzle. (3) The high reflectivity of molten refractory metals, at the Nd-YAG laser wavelength (1.06{micro}m), produces damaging back reflections to the optical train and fiber optic delivery system that can terminate DLF processing. (4) The current limits on the maximum available laser power to prevent back reflection damage limit the parameter range available for densification of refractory metals. The work to date concentrated on niobium, W-25Re, and spherodized tungsten. Niobium samples, made from hydride-dehydride powder, had minimal gas porosity and the deposition parameters were optimized; however, test plates were not made at this time. W-25Re samples, containing sodium and potassium from a precipitation process, were made and porosity was a problem for all samples although minimized with some process parameters. Deposits made from potassium reduced tungsten that was plasma spherodized were made with minimized porosity. Results of this work indicate that further gas analysis of starting powders and de-gassing of starting powders and/or gas removal during deposition of refractory metals is required.

  9. Directed Light Fabrication of Refractory Metals and Alloys

    Energy Technology Data Exchange (ETDEWEB)

    Fonseca, J.C.; Lewis, G.K.; Dickerson, P.G.; Nemec, R.B.

    1999-05-14

    This report covers work performed under Order No. FA0000020 AN Contract DE-AC12-76SN00052 for deposition of refractory pure metals and alloys using the Directed Light Fabrication (DLF) process and represents the progress in depositing these materials through September 1998. In extending the DLF process technology to refractory metals for producing fully dense, structurally sound deposits, several problems have become evident. 1. Control of porosity in DLF-deposited refractory metal is difficult because of gases, apparently present in commercially purchased refractory metal powder starting materials. 2. The radiant heat from the molten pool during deposition melts the DLF powder feed nozzle. 3. The high reflectivity of molten refractory metals, at the Nd-YAG laser wavelength (1.06{micro}m), produces damaging back reflections to the optical train and fiber optic delivery system that can terminate DLF processing. 4. The current limits on the maximum available laser power to prevent back reflection damage limit the parameter range available for densification of refractory metals. The work to date concentrated on niobium, W-25Re, and spherodized tungsten. Niobium samples, made from hydride-dehydride powder, had minimal gas porosity and the deposition parameters were optimized; however, test plates were not made at this time. W-25Re samples, containing sodium and potassium from a precipitation process, were made and porosity was a problem for all samples although minimized with some process parameters. Deposits made from potassium reduced tungsten that was plasma spherodized were made with minimized porosity. Results of this work indicate that further gas analysis of starting powders and de-gassing of starting powders and/or gas removal during deposition of refractory metals is required.

  10. Probiotics and refractory chronic spontaneous urticaria.

    Science.gov (United States)

    Nettis, E; Di Leo, E; Pastore, A; Distaso, M; Zaza, I; Vacca, M; Macchia, L; Vacca, A

    2016-09-01

    Background. In chronic spontaneous urticaria (CSU) first-line therapy with an antihistamine-based regimen may not achieve satisfactory control in patients. Thus, a continuing need exists for effective and safe treatments for refractory CSU. Aim. To evaluate the clinical efficacy and safety of an intake of a combination of 2 probiotics (Lactobacillus salivarius LS01 and Bifidobacterium breve BR03) in patients with CSU who remain symptomatic despite concomitant H1-antihistamine therapy. Methods. This report analyzes the effects of therapy with two probiotic strains on the clinical progress of 52 unselected patients with difficulty to treat CSU underwent to medical examination in two Italian specialist urticaria Clinics between September 2013 and September 2014. A mixture of Lactobacillus LS01 and Bifidobacterium BR03 were administered in each patient twice daily for 8 weeks. To evaluate patients' improvement with probiotics, urticaria activity score over 7 days (UAS7) was used at baseline and at week 8 in addition to a 5-question urticaria quality of life questionnaire. Results. Fifty-two patients with CSU were included in this study (10 male and 42 female, age range 19-72 years). Mean disease duration was 1.5 years. Fourteen patients discontinued treatment, so evaluable population consisted of 38 patients. Nine of the 38 patients experienced mild clinical improvement during probiotic treatment (23.7%); one patient reported significant clinical improvement (2.6%) and one patient had complete remission of urticaria (2.6%). Twenty-seven patients did not have improvement in symptoms (71.1%). No side effects during the course of therapy were reported. Conclusions. A combination of Lactobacillus salivarius LS01 and Bifidobacterium breve BR03 administered twice daily for 8 weeks might reduce the symptoms scores and improve quality of life scores in a part of patients with CSU who remained symptomatic despite treatment with H1 antihistamine mostly in subjects with allergic

  11. Organically bound sulfur in refractory organic substances.

    Science.gov (United States)

    Abbt-Braun, G; Jahnel, J B

    2001-11-01

    The sulfur compounds of refractory organic substances (ROS) of different origin have been characterized. Total organic sulfur was determined by elemental analysis. Sulfur-containing amino acids methionine and cystine were analyzed chromatographically after hydrolysis with HCl or by proteolytic digestion using enzymes. The results obtained from elemental analysis show that the total amount of sulfur is strongly dependent on the origin of the samples, because of different environmental factors during the formation of ROS. For naturally occurring samples isolated from soil seepage water, bog lake water and ground water the carbon-to-sulfur atomic ratios (C/S) decrease with the stage of humification, because of preferential loss of carbon. In humic acids (HA) isolated from secondary effluent the high value of the nitrogen-to-sulfur ratio (N/S) was indicative of a large amount of protein-derived nitrogen and sulfur compounds. In the solutions from acid hydrolysis the total amount of amino acid carbon related to the dissolved organic carbon (DOC) was generally less than 5%. Percentages of cystine related to all the amino acids detected were in the range 4 to 16%; methionine was below the detection limit for most samples. The results show that cystine is very important among the amino acids released. Enzymatic release generally resulted in smaller amounts of amino acids, indicating that these molecules are not only present in bioavailable protein-like structures. The data were compared with those from other approaches reported in the literature for the speciation of sulfur forms in ROS, including potentiometric titration, differential reduction methods, and spectroscopic investigations.

  12. Dexamethasone intravitreal implants for diabetic macular edema refractory to ranibizumab monotherapy or combination therapy.

    Science.gov (United States)

    Gutiérrez-Benítez, L; Millan, E; Arias, L; Garcia, P; Cobos, E; Caminal, M

    2015-10-01

    To determine the effectiveness and local safety of dexamethasone intravitreal implants as a treatment in diabetic macular edema (DME) refractory to intravitreal injections of ranibizumab monotherapy or combination therapy. A retrospective study conducted on patients with DME refractory to ranibizumab monotherapy or combined with other treatments treated with dexamethasone intravitreal implants. The parameters analyzed were visual acuity (VA) by ETDRS (Early Treatment Diabetic Retinopathy Study) charts and foveal thickness by spectral-domain optical coherence tomography (SD-OCT) before the treatment, 2 months after treatment, and at the end of the follow-up. A total of 14 eyes of 14 patients were included, with a mean age of 64 years (SD: 9.5; range 41-78) and a mean follow-up of 7.6 months. The mean VA improved from 53 letters to 59 letters at 2 months (P=.03), and 57 at the end of the follow-up period (P=.3). The mean foveal thickness decreased from 502 μ to 304 μ at 2 months (P=.001), and 376 μ at the end of the follow-up period (P=.009). Further treatment with intravitreal dexamethasone was required in 43% of the patients, and 21% had increased intraocular pressure, which was controlled with topical medication. Intravitreal dexamethasone implant is an effective and locally safe treatment for the management of DME refractory to ranibizumab monotherapy or combined with other treatments. Copyright © 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  13. Cultural Psychology and Deconstructing Developmental Psychology

    OpenAIRE

    Crafter, Sarah

    2015-01-01

    This paper looks at points of convergence and divergence between the different branches of cultural psychology and Burman's ideas in Deconstructing Developmental Psychology (DDP). The paper discusses the relationship between the developing ideas in cultural psychology over time and some of the shared theoretical and conceptual criticisms put forward in DDP. This takes into account some of the differences between symbolic approach, activity theory and an individualistic approach to cultural ps...

  14. Sport psychology: psychologic issues and applications.

    Science.gov (United States)

    Carr, Christopher M

    2006-08-01

    This article has briefly highlighted the area of sport psychology as it relates to performance psychology skills (mental training), including a historical overview and current topics overview. The use of mental training skills may be of interest to the practicing physical medicine and rehabilitation professional in the treatment of his or her patients. It is important that the physical medicine professional recognize what sport or performance psychology represents within the paradigm of psychologic interventions. Referring to an individual based on his or her training (licensed psychologist versus mental training consultant) is essential for the appropriate management of psychologic issues related to performance. The issues related to the psychologic rehabilitation of the injured athlete are of importance to the medical staff; the overview of affective responses can assist in understanding the normal and adaptive responses of the injured athlete. Finally, a brief description of a psychologist's role within a sports medicine and rehabilitation practice is presented. The psychologic issues that are present in the world of sport and elite performance are numerous, and not all are mentioned in this article. Issues of eating disorders, substance abuse, and psychologic health with athletes should be further explored within the physical medicine and rehabilitation discipline as well as in the sports medicine discipline. The ever-evolving psychologic dynamics of individuals involved in sport and elite performance are intriguing and unique. A specialized knowledge base, training, and experience in providing psychologic services are required to treat this unique population. Counseling and clinical issues of the athlete and elite performer require further attention in the realm of psychologic interventions, including further exploration of the efficacy of interventions for performance enhancement. The field of applied sport psychology may offer the physical medicine

  15. Identity of psychology, identity and psychology

    OpenAIRE

    Mirjana Nastran Ule

    2003-01-01

    The article deals with epistemic issues of modern psychology with the starting hypothesis being that scientific psychology must satisfy three main interests: scientific, practical and emancipatory interest. Particularly important is the emancipatory interest, which is based on the social reflection of scientific work and conclusions. Psychological knowledge involves not only neutral descriptions of facts, but also implicit rules, expectations regarding values or norms, and criticism of undesi...

  16. Time-dependent change in fast pathway refractoriness after slow pathway ablation in atrioventricular node reentrant tachycardia. Mansfield Polaris Investigators.

    Science.gov (United States)

    Krahn, A D; Klein, G J; Yee, R

    1997-06-01

    To determine the time course of change in fast pathway refractoriness after slow pathway ablation. Antegrade fast pathway refractoriness has been observed to shorten in patients undergoing slow pathway ablation for atrioventricular (AV) node reentrant tachycardia. The time course and mechanism of this observation have not been explained. Twenty-eight patients with AV node reentrant tachycardia and dual AV node pathways undergoing slow pathway ablation had the fast pathway effective refractory period (ERP) assessed immediately before, and at 0, 15, 30 and 45 mins after slow pathway ablation (Group 1). Twenty-five additional patients with AV node reentry and dual pathways involved in a multicentre protocol evaluating the Mansfield Polaris LE catheter underwent assessment of fast pathway refractoriness before and after slow pathway ablation, and at a routine three-month follow-up electrophysiology study (Group 2). In Group 1, antegrade fast pathway ERP fell from 394 ms before ablation to 334 ms immediately after slow pathway ablation, increased to 348 ms within 15 mins and was 353 ms at 45 mins (ANOVA P < 0.001). Retrograde fast pathway ERP fell from 325 ms before ablation to 294 ms at 45 mins (P = 0.02). In Group 2, antegrade fast pathway ERP fell from 390 ms before ablation to 337 ms after ablation, and rose to 362 ms at three months (P = 0.01). Retrograde fast pathway ERP also fell from 347 ms to 319 ms after ablation (P = 0.01), and remained unchanged at three months. Slow pathway ablation results in an immediate and sustained change in antegrade and retrograde first pathway refractoriness. There are immediate reversible and long term nonreversible components to this phenomenon. The latter finding may be related to loss of electrotonic inhibition of the fast pathway by the slow pathway.

  17. Targeted prodrug approaches for hormone refractory prostate cancer.

    Science.gov (United States)

    Aloysius, Herve; Hu, Longqin

    2015-05-01

    Due to the propensity of relapse and resistance with prolonged androgen deprivation therapy (ADT), there is a growing interest in developing non-hormonal therapeutic approaches as alternative treatment modalities for hormone refractory prostate cancer (HRPC). Although the standard treatment for HRPC consists of a combination of ADT with taxanes and anthracyclines, the clinical use of chemotherapeutics is limited by systemic toxicity stemming from nondiscriminatory drug exposure to normal tissues. In order to improve the tumor selectivity of chemotherapeutics, various targeted prodrug approaches have been explored. Antibody-directed enzyme prodrug therapy (ADEPT) and gene-directed enzyme prodrug therapy (GDEPT) strategies leverage tumor-specific antigens and transcription factors for the specific delivery of cytotoxic anticancer agents using various prodrug-activating enzymes. In prostate cancer, overexpression of tumor-specific proteases such as prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA) is being exploited for selective activation of anticancer prodrugs designed to be activated through proteolysis by these prostate cancer-specific enzymes. PSMA- and PSA-activated prodrugs typically comprise an engineered high-specificity protease peptide substrate coupled to a potent cytotoxic agent via a linker for rapid release of cytotoxic species in the vicinity of prostate cancer cells following proteolytic cleavage. Over the past two decades, various such prodrugs have been developed and they were effective at inhibiting prostate tumor growth in rodent models; several of these prodrug approaches have been advanced to clinical trials and may be developed into effective therapies for HRPC. © 2014 Wiley Periodicals, Inc.

  18. [Early identification of refractory Mycoplasma pneumoniae pneumonia in children].

    Science.gov (United States)

    Wang, Zhen; Li, Ya-Chun; Chen, Lu

    2015-11-01

    To investigate the clinical indicators for early identification of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children. The clinical data of 142 children with Mycoplasma pneumoniae pneumonia (MPP) between January 2014 and June 2015 were retrospectively studied. Among the 142 children, there were 32 cases of RMPP and 110 cases of non-refractory MPP. The clinical data were compared between the RMPP and non-refractory MPP groups. The percentage of school-age children in the RMPP group was higher than in the non-refractory MPP group (Prefractory MPP group (Prefractory MPP children (Prefractory MPP children (Prefractory MPP group (P40 mg/L and ESR>30 mm/h+LDH>300 IU/L than the non-refractory MPP group (P<0.05). RMPP is common in school-age children. Consolidation of lung on chest X-Ray, pleural effusion and increased levels of CRP and ESR+LDH may be helpful to early identification of RMPP in children.

  19. Historizing epistemology in psychology.

    Science.gov (United States)

    Jovanović, Gordana

    2010-12-01

    The conflict between the psychometric methodological framework and the particularities of human experiences reported in psychotherapeutic context led Michael Schwarz to raise the question whether psychology is based on a methodological error. I take this conflict as a heuristic tool for the reconstruction of the early history of psychology, which bears witness to similar epistemological conflicts, though the dominant historiography of psychology has largely forgotten alternative conceptions and their valuable insights into complexities of psychic phenomena. In order to work against the historical amnesia in psychology I suggest to look at cultural-historical contexts which decisively shaped epistemological choices in psychology. Instead of keeping epistemology and history of psychology separate, which nurtures individualism and naturalism in psychology, I argue for historizing epistemology and for historical psychology. From such a historically reflected perspective psychology in contemporary world can be approached more critically.

  20. Preoperative Psychological Preparation of Children

    OpenAIRE

    Güleç, Ersel; Özcengiz, Dilek

    2015-01-01

    Surgery and anaesthesia are significant sources of anxiety for children. In the preoperative period, reducing anxiety helps in preventing the negative consequences that may occur after surgery. The predetermined high-risk children in terms of the development of anxiety play an important role in reducing the negative consequences. Recently featured approaches are modelling and coping techniques, although many techniques are used in the preoperative psychological preparation. The use of compute...

  1. Investigation of Appropriate Refractory Material for Laboratory Electritic Resistrance Furnance

    Directory of Open Access Journals (Sweden)

    J.B Agboola

    2009-07-01

    Full Text Available There have been numerous efforts to increase the local content of furnaces; hence the choice of appropriate refractory material for lining of locally manufactured furnaces has remained a major concern. This research work investigates the choice of appropriate local refractory material for the lining of laboratory electric resistance furnace.Electric resistance furnaces are extensively used in the laboratory for heat treatment of metals and alloys. Refractory binders such as silicon carbide were experimented upon for strength and resistance to high temperature.The results obtained showed that Kankara fireclay containing 15% SiC ( 5.70 % linear shrinkage , 46.2% apparent porosity, 1.77gkm³ Bulk density, 18 cycles of spalling tests at 1300°C, 5.253KN/m² of cold strength has appropriate properties for producing grooved bricks for lining of laboratory electric resistance Furnace.

  2. Decompressive laparotomy for refractory intracranial hypertension after traumatic brain injury.

    Science.gov (United States)

    Dorfman, Jon D; Burns, Joseph D; Green, Deborah M; DeFusco, Christina; Agarwal, Suresh

    2011-12-01

    Intracranial hypertension is a crucial modifiable risk factor for poor outcome after traumatic brain injury (TBI). Limited evidence suggests that decompressive laparotomy may be an effective treatment for refractory ICH in patients who have elevated intra-abdominal pressure. Case report. We present a multi-trauma patient who sustained severe TBI in a motor vehicle collision. Intracranial pressure (ICP) was initially medically managed but became refractory to standard therapies. Emergent decompressive laparotomy performed in the surgical intensive care unit for abdominal compartment syndrome concomitantly improved the patient's ICP. Elevated intra-abdominal pressure can exacerbate intracranial hypertension in patients with TBI. Recognition of this condition and treatment with decompressive laparotomy may be useful in patients with intracranial hypertension refractory to optimal medical therapy.

  3. Neuroimaging in refractory epilepsy. Current practice and evolving trends

    Energy Technology Data Exchange (ETDEWEB)

    Ramli, N. [Department of Biomedical Imaging, University Malaya Research Imaging Centre (Malaysia); Rahmat, K., E-mail: katt_xr2000@yahoo.com [Department of Biomedical Imaging, University Malaya Research Imaging Centre (Malaysia); Lim, K.S.; Tan, C.T. [Neurology Unit, Department of Medicine, University Malaya, Kuala Lumpur (Malaysia)

    2015-09-15

    Highlights: • Neuroimaging is imperative in diagnostic work up and therapeutic assessment of refractory epilepsy. • Identification of epileptogenic zone on EEG, MRI and functional imaging improves the success of surgery. • High performance MRI greatly enhanced metabolic information and elucidate brain functions. • Optimisation of epilepsy protocols in structural and functional MRI are presented in this article. - Abstract: Identification of the epileptogenic zone is of paramount importance in refractory epilepsy as the success of surgical treatment depends on complete resection of the epileptogenic zone. Imaging plays an important role in the locating and defining anatomic epileptogenic abnormalities in patients with medically refractory epilepsy. The aim of this article is to present an overview of the current MRI sequences used in epilepsy imaging with special emphasis of lesion seen in our practices. Optimisation of epilepsy imaging protocols are addressed and current trends in functional MRI sequences including MR spectroscopy, diffusion tensor imaging and fusion MR with PET and SPECT are discussed.

  4. Felbamate in an adult population with severe refractory epilepsy.

    LENUS (Irish Health Repository)

    Kearney, H

    2011-04-05

    Felbamate (FBM) is efficacious in treating patients with refractory epilepsy but was withdrawn due to cases of aplastic anaemia, hepatic failure and five reported deaths. FBM is currently used in specialist centres and is only being used in one Irish centre to date. This papers aim is to review the efficacy and safety experience of FBM in Irish adult patients with refractory epilepsy. A retrospective chart review was done on patients\\' medical records. Patients were subdivided into responders and non responders based on change in seizure frequency and side effects were recorded for all. Of the 13 patients on FBM nine patients responded to FBM, four patients did not. FBM is a safe and efficacious alternative in an Irish adult population with refractory epilepsy. However close monitoring is still required given the potential fatal side effects that are possible with this anticonvulsant.

  5. Using low porosity refractory materials in coke ovens

    Energy Technology Data Exchange (ETDEWEB)

    Narita, Y.; Sudzuki, T.

    1982-02-19

    Refractory bricks with porosity (KP) of less than or equal to 17 percent, which contain less than 1 percent iron oxide and are resiliant at temperatures of more than 1,000/sup 0/C, are made through caking or electrosmelting of materials with a high aluminum content (chamotte, sillimanite, cordierite, pagodite) and silicon content (magnesial chromite, alumina, magnesite, calcite and zircon). In a refractory material with a seeming porosity of less than or equal to 17 percent the deposition of carbon in the pores is reduced which promotes a constant heat conductivity and strength of the refractory material in the operation of coke ovens. Normally the carbon is formed with the reduction of CO under the catalytic action of iron oxide.

  6. An unusual cause of refractory hypoxemia in cirrhosis.

    Science.gov (United States)

    Patidar, Yashwant; Kumar, Sachin

    2015-03-01

    Pulmonary gas exchange abnormalities and refractory hypoxemia cause myriad difficulties in patients with chronic liver disease. In addition to intrinsic cardiopulmonary diseases and hepatopulmonary syndrome, some unusual pathophysiological mechanisms in patients with portosystemic collaterals might contribute to hypoxemia. We report the clinical presentation of an unusual portosystemic anatomic shunt that permits venous admixture with oxygenated blood, causing hypoxemia that is refractory to the administration of supplemental oxygen, and recurrent hepatic encephalopathy. There has been no such report in the published literature. This case highlights the importance of keeping direct portopulmonary venous anastomosis in the differential diagnosis of oxygen-refractory hypoxemia and recurrent hepatic encephalopathy in patients with cirrhosis in the appropriate clinical context. Copyright © 2015 by Daedalus Enterprises.

  7. Compatibility of refractory materials for nuclear reactor poison control systems

    Science.gov (United States)

    Sinclair, J. H.

    1974-01-01

    Metal-clad poison rods have been considered for the control system of an advanced space power reactor concept studied at the NASA Lewis Research Center. Such control rods may be required to operate at temperatures of about 140O C. Selected poison materials (including boron carbide and the diborides of zirconium, hafnium, and tantalum) were subjected to 1000-hour screening tests in contact with candidate refractory metal cladding materials (including tungsten and alloys of tantalum, niobium, and molybdenum) to assess the compatibility of these materials combinations at the temperatures of interest. Zirconium and hafnium diborides were compatible with refractory metals at 1400 C, but boron carbide and tantalum diboride reacted with the refractory metals at this temperature. Zirconium diboride also showed promise as a reaction barrier between boron carbide and tungsten.

  8. Propofol in the treatment of refractory migraine headaches.

    Science.gov (United States)

    Dhir, Ashish

    2016-09-01

    Refractory/intractable migraine headaches are associated with chronic pain that does not respond to standard care of treatment. Propofol(2,6-diisopropylphenol) in sub-anesthetic doses has been reported to be beneficial in such patients. The present article describes the complete drug profile of propofol in the management of these super-refractory migraine headaches. The article covers different preclinical and clinical studies available in the literature. Expert commentary: Propofol is useful as an off-label drug molecule in an emergency situation of refractory migraines where it has been found to reduce the pain intensity. The molecule with a narrow therapeutic index and high abuse potential is prescribed only when conventional drugs fail to deliver any relief. There are not adequate double-blind crossover studies that substantiate the effectiveness of propofol in the treatment of migraine headaches. Furthermore, long-term outcomes for the use of propofol in migraine headaches requires an extensive investigation.

  9. Salvage use of activated recombinant factor VII in the management of refractory bleeding following cardiac surgery

    Directory of Open Access Journals (Sweden)

    Barua A

    2011-09-01

    Full Text Available Anupama Barua1, Vinay P Rao1, BC Ramesh2, Biplab Barua3, Hussain El-Shafei21Cardiothoracic Department, Nottingham City Hospital, Nottingham, UK; 2Cardiothoracic Department, Aberdeen Royal Infirmary, Aberdeen, UK; 3General Surgery Department, Glenfield Hospital, Glenfield, Leicester, UKBackground: Refractory post cardiopulmonary bypass (CPB bleeding continues to cause concern for cardiac surgeons and intensivists. Massive postoperative hemorrhage following CPB is multifactorial and not fully understood, and it is also associated with increased mortality and morbidity. Activated recombinant factor VII (rFVIIa has emerged as possible salvage medication in refractory post cardiac surgical bleeding. This observational study sought to identify the pattern of use of rFVIIa in cardiac surgery, its effectiveness, and risk.Methods: This study involved a retrospective case review of medical records of ten patients undergoing a variety of cardiac surgery procedures and who developed life-threatening bleeding during surgery or after surgery despite conventional medical therapy, including transfusion of blood and blood products, and received rFVIIa at a regional center between August 2007 and April 2009.Results: All ten patients received two consecutive doses of rFVIIa (average dose 65 µg/kg at a 2-hour interval. Eight patients were re-explored due to massive postoperative bleeding or cardiac tamponade before receiving rFVIIa. Surgical sources of bleeding were not identified in any cases. A second re-exploration was carried out in two cases. Two patients (20% died in ITU from problems not related to bleeding and thromboembolism. Blood loss was significantly reduced after administration of rFVIIa. Blood loss 6 hours prior to treatment was 1758.5 ± 163.9 mL and blood loss in the 6-hour period post treatment was 405.6 ± 50.5 mL (P < 0.05. Blood and blood products used in the 6-hour period before and after administration of rFVIIa were 19.6 ± 1.5U and 4.4

  10. Proposed consensus definitions for new-onset refractory status epilepticus (NORSE), febrile infection-related epilepsy syndrome (FIRES), and related conditions.

    Science.gov (United States)

    Hirsch, Lawrence J; Gaspard, Nicolas; van Baalen, Andreas; Nabbout, Rima; Demeret, Sophie; Loddenkemper, Tobias; Navarro, Vincent; Specchio, Nicola; Lagae, Lieven; Rossetti, Andrea O; Hocker, Sara; Gofton, Teneille E; Abend, Nicholas S; Gilmore, Emily J; Hahn, Cecil; Khosravani, Houman; Rosenow, Felix; Trinka, Eugen

    2018-02-05

    We convened an international group of experts to standardize definitions of New-Onset Refractory Status Epilepticus (NORSE), Febrile Infection-Related Epilepsy Syndrome (FIRES), and related conditions. This was done to enable improved communication for investigators, physicians, families, patients, and other caregivers. Consensus definitions were achieved via email messages, phone calls, an in-person consensus conference, and collaborative manuscript preparation. Panel members were from 8 countries and included adult and pediatric experts in epilepsy, electroencephalography (EEG), and neurocritical care. The proposed consensus definitions are as follows: NORSE is a clinical presentation, not a specific diagnosis, in a patient without active epilepsy or other preexisting relevant neurological disorder, with new onset of refractory status epilepticus without a clear acute or active structural, toxic or metabolic cause. FIRES is a subcategory of NORSE, applicable for all ages, that requires a prior febrile infection starting between 2 weeks and 24 hours prior to onset of refractory status epilepticus, with or without fever at onset of status epilepticus. Proposed consensus definitions are also provided for Infantile Hemiconvulsion-Hemiplegia and Epilepsy syndrome (IHHE) and for prolonged, refractory and super-refractory status epilepticus. This document has been endorsed by the Critical Care EEG Monitoring Research Consortium. We hope these consensus definitions will promote improved communication, permit multicenter research, and ultimately improve understanding and treatment of these conditions. Wiley Periodicals, Inc. © 2018 International League Against Epilepsy.

  11. Comparison of long-term outcomes between children with aplastic anemia and refractory cytopenia of childhood who received immunosuppressive therapy with antithymocyte globulin and cyclosporine.

    Science.gov (United States)

    Hama, Asahito; Takahashi, Yoshiyuki; Muramatsu, Hideki; Ito, Masafumi; Narita, Atsushi; Kosaka, Yoshiyuki; Tsuchida, Masahiro; Kobayashi, Ryoji; Ito, Etsuro; Yabe, Hiromasa; Ohga, Shouichi; Ohara, Akira; Kojima, Seiji

    2015-11-01

    The 2008 World Health Organization classification proposed a new entity in childhood myelodysplastic syndrome, refractory cytopenia of childhood. However, it is unclear whether this morphological classification reflects clinical outcomes. We retrospectively reviewed bone marrow morphology in 186 children (median age 8 years; range 1-16 years) who were enrolled in the prospective study and received horse antithymocyte globulin and cyclosporine between July 1999 and November 2008. The median follow-up period was 87 months (range 1-146 months). Out of 186 patients, 62 (33%) were classified with aplastic anemia, 94 (49%) with refractory cytopenia of childhood, and 34 (18%) with refractory cytopenia with multilineage dysplasia. Aplastic anemia patients received granulocyte colony-stimulating factor more frequently and for longer durations than other patients (Panemia, 4 patients with refractory cytopenia of childhood, and 3 patients with refractory cytopenia with multilineage dysplasia. Although the cumulative incidence of total clonal evolution at ten years was not significantly different among the 3 groups, the cumulative incidence of monosomy 7 development was significantly higher in aplastic anemia than in the other groups (P=0.02). Multivariate analysis revealed that only granulocyte colony-stimulating factor administration duration of 40 days or more was a significant risk factor for monosomy 7 development (P=0.02). These findings suggest that even the introduction of a strict morphological distinction from hypoplastic myelodysplastic syndrome cannot eradicate clonal evolution in children with aplastic anemia. Copyright© Ferrata Storti Foundation.

  12. Development of Hemolytic Anemia in a Nivolumab-Treated Patient with Refractory Metastatic Squamous Cell Skin Cancer and Chronic Lymphatic Leukemia.

    Science.gov (United States)

    Schwab, K S; Heine, A; Weimann, T; Kristiansen, G; Brossart, P

    2016-01-01

    Management of patients with metastatic squamous cell skin cancer, refractory to initial therapy with standard chemotherapy and radiation protocols, remains difficult with poor overall prognosis and limited therapeutic options. Recently, promising response rates with nivolumab, a programmed death receptor-1-blocking antibody, in squamous cancer of the head and neck have been demonstrated. Considering the similar histological patterns of squamous cell cancer of the skin and squamous cell cancer of the head and neck, we assumed that nivolumab could also be effective in our patients with refractory metastatic squamous cell cancer of the skin. So far, there have been no clinical data on the therapeutic efficacy of nivolumab in squamous cell skin cancer. We here present a case of a patient with metastatic squamous cell skin cancer refractory to previous therapies, who showed a good response to nivolumab over a period of 5 months, but developed a serious hemolytic crisis under nivolumab treatment after eight applications.

  13. Development of Hemolytic Anemia in a Nivolumab-Treated Patient with Refractory Metastatic Squamous Cell Skin Cancer and Chronic Lymphatic Leukemia

    Directory of Open Access Journals (Sweden)

    K.S. Schwab

    2016-06-01

    Full Text Available Management of patients with metastatic squamous cell skin cancer, refractory to initial therapy with standard chemotherapy and radiation protocols, remains difficult with poor overall prognosis and limited therapeutic options. Recently, promising response rates with nivolumab, a programmed death receptor-1-blocking antibody, in squamous cancer of the head and neck have been demonstrated. Considering the similar histological patterns of squamous cell cancer of the skin and squamous cell cancer of the head and neck, we assumed that nivolumab could also be effective in our patients with refractory metastatic squamous cell cancer of the skin. So far, there have been no clinical data on the therapeutic efficacy of nivolumab in squamous cell skin cancer. We here present a case of a patient with metastatic squamous cell skin cancer refractory to previous therapies, who showed a good response to nivolumab over a period of 5 months, but developed a serious hemolytic crisis under nivolumab treatment after eight applications.

  14. Ketogenic diet treatment for pediatric super-refractory status epilepticus.

    Science.gov (United States)

    Appavu, Brian; Vanatta, Lisa; Condie, John; Kerrigan, John F; Jarrar, Randa

    2016-10-01

    We aimed to study whether ketogenic diet (KD) therapy leads to resolution of super-refractory status epilepticus in pediatric patients without significant harm. A retrospective review was performed at Phoenix Children's Hospital on patients with super-refractory status epilepticus undergoing ketogenic diet therapy from 2011 to 2015. Ten children with super-refractory status epilepticus, ages 2-16 years, were identified. 4/10 patients had immune mediated encephalitis, including Rasmussen encephalitis, anti-N-methyl-d-aspartate receptor encephalitis, and post-infectious mycoplasma encephalitis. Other etiologies included Lennox Gastaut Syndrome, non-ketotic hyperglycinemia, PCDH19 and GABRG2 genetic epilepsy, New Onset Refractory Status Epilepticus, and Febrile Infection-Related Epilepsy Syndrome. 4/10 patients' EEG features suggested focal with status epilepticus, and 6/10 suggested generalized with status epilepticus. Median hospital length was 61days and median ICU length was 27days. The median number of antiepileptic medications prior to diet initiation was 3.0 drugs, and the median after ketogenic diet treatment was 3.5 drugs. Median duration of status epilepticus prior to KD was 18days. 9/10 patients had resolution of super-refractory status epilepticus in a median of 7days after diet initiation. 8/9 patients were weaned off anesthesia within 15days of diet initiation, and within 1day of achieving ketonuria. 1/10 patients experienced side effects on the diet requiring supplementation. Most patients achieved resolution of status epilepticus on KD therapy, suggesting it could be an effective therapy that can be utilized early in the treatment of children with super refractory status epilepticus. Copyright © 2016. Published by Elsevier Ltd.

  15. Specific attitudes which predict psychology students' intentions to seek help for psychological distress.

    Science.gov (United States)

    Thomas, Susan J; Caputi, Peter; Wilson, Coralie J

    2014-03-01

    Although many postgraduate psychology programs address students' mental health, there are compelling indications that earlier, undergraduate, interventions may be optimal. We investigated specific attitudes that predict students' intentions to seek treatment for psychological distress to inform targeted interventions. Psychology students (N = 289; mean age = 19.75 years) were surveyed about attitudes and intentions to seek treatment for stress, anxiety, or depression. Less than one quarter of students reported that they would be likely to seek treatment should they develop psychological distress. Attitudes that predicted help-seeking intentions related to recognition of symptoms and the benefits of professional help, and openness to treatment for emotional problems. The current study identified specific attitudes which predict help-seeking intentions in psychology students. These attitudes could be strengthened in undergraduate educational interventions promoting well-being and appropriate treatment uptake among psychology students. © 2013 Wiley Periodicals, Inc.

  16. The Utility of Cannabidiol in the Treatment of Refractory Epilepsy.

    Science.gov (United States)

    Reddy, D S

    2017-02-01

    Cannabis-derived cannabinoids such as cannabidiol (CBD) have anticonvulsant properties. Recently, there has been an emerging interest in the use of CBD-enriched products for treatment of drug-resistant epilepsy. Some pilot trials of CBD have proved beneficial for refractory epilepsy, but its efficacy is yet to be confirmed by standard placebo-controlled trials. However, the mechanisms underlying the seizure protection efficacy claims of CBD remain unclear. This review briefly describes the clinical utility of CBD in the treatment of refractory epilepsy. © 2016 American Society for Clinical Pharmacology and Therapeutics.

  17. Refractory experience in circulating fluidized bed combustors, Task 7

    Energy Technology Data Exchange (ETDEWEB)

    Vincent, R.Q.

    1989-11-01

    This report describes the results of an investigation into the status of the design and selection of refractory materials for coal-fueled circulating fluidized-bed combustors. The survey concentrated on operating units in the United States manufactured by six different boiler vendors: Babcock and Wilcox, Combustion Engineering, Foster Wheeler, Keeler Dorr-Oliver, Pyropower, and Riley Stoker. Information was obtained from the boiler vendors, refractory suppliers and installers, and the owners/operators of over forty units. This work is in support of DOE's Clean Coal Technology program, which includes circulating fluidized-bed technology as one of the selected concepts being evaluated.

  18. Amantadine for the treatment of refractory absence seizures in children.

    Science.gov (United States)

    Perry, M Scott; Bailey, Laurie J; Kotecha, Amy C; Malik, Saleem I; Hernandez, Angel W

    2012-04-01

    Amantadine has demonstrated efficacy in small series for absence and myoclonic type seizures. We examined the efficacy of amantadine for treating refractory absence seizures in a cohort of pediatric patients. We retrospectively reviewed medical records for patients with absence seizures treated with amantadine at Cook Children's Medical Center after January 2007. Abstracted data included sex, age at initiation, concomitant antiepileptic drugs, amantadine dosing, and seizure frequency. Outcomes at 3, 6, and 12 months after initiation were categorized as >90%, ≥50%, or 90% reduction in seizure frequency. Amantadine may constitute an efficacious alternative treatment for refractory absence seizures. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Influence of the phase composition of refractory materials on creep

    Directory of Open Access Journals (Sweden)

    Terzić A.

    2006-01-01

    Full Text Available In this paper, the relationship between the creeping effect and mineralogical characteristics of the applied binding phase for various refractory materials (high-alumina materials, with high or low impurity content, tar bonded either magnesite or dolomite materials and silicate bonded chrom-magnesite materials is presented. The mechanism of creeping is analyzed and the activation energy for creep for each investigated material is obtained and discussed. All investigated materials are creep sensitive under investigated conditions and have similar activation energies for creep except high-alumina refractories with a low impurity content.

  20. A questão da periodização do desenvolvimento psicológico em Wallon e em Vigotski: alguns aspectos de duas teorias The issue of the periodization of psychological development in Wallon and in Vygotsky: aspects of two theories

    Directory of Open Access Journals (Sweden)

    Edival Sebastião Teixeira

    2003-12-01

    psychological development within rigid schemes following a linear logic; the idea that human psyche has been and continues to be historically produced by men themselves inside relations they establish with each other and with nature; the defense they promote of the constitutive, and therefore positive, nature of conflicts and oscillation between critical and stable periods that characterize psychological development; and, particularly, the fact that both authors emphasize that an adequate understanding of development requires the analysis of this process in its internal essence, that is, an analysis of the conditionings of the external symptoms of psychological development. Regarding the Wallonian theory, the article draws attention to the idea that development is characterized by the alternation between cognition and affection, reason and emotion; as to the Vygotskyan conception, the text emphasizes that the investigation of psychological development must start from the analysis of a child's activities inside the concrete conditions of his/her life.

  1. Psychology of family business

    OpenAIRE

    Taylyakova, Feruzahon

    2014-01-01

    This article analyzes the basic psychological characteristics of family businesses. The author describes the psychological properties that contribute to improve individual and family businesses. The article also discusses mental properties adversely affect the development of a family business.

  2. Professional psychology in Portugal.

    Science.gov (United States)

    Fagulha, T; Dana, R H

    1997-12-01

    This paper describes the history and current status of professional psychology in Portugal where a unique perspective combines training, research, and practical contributions from Europe and the Americas with their own history of psychological tradition and expertise. Training in professional psychology includes Social Psychology and Educational and Vocational Guidance specializations in addition to Clinical Psychology and Psychotherapy and Counseling for the professional degree, Licenciatura. Advanced degrees are offered in Environmental Psychology, Career Development, Social Cognition, and other areas, primarily for academic positions. Research in all of these areas is expected to have applied outcomes that contribute to individual well being and an improved quality of life for the entire population. The result has been a rapid development of an indigenous professional psychology to address mental health, social, and environmental concerns that compel psychological attention and resources worldwide as well as those problems of local and national origins.

  3. Psychological Stress and Cancer

    Science.gov (United States)

    ... learn to cope with psychological stress? Emotional and social support can help patients learn to cope with psychological stress. Such support can reduce levels of depression, anxiety, and disease- and treatment-related symptoms among patients. Approaches can include the ...

  4. Long-term effects of electrical neurostimulation in patients with unstable angina : Refractory to conventional therapies

    NARCIS (Netherlands)

    de Vries, Jessica; DeJongste, Mike J. L.; Zijlstra, Felix; Staal, Michiel

    2007-01-01

    Background. Patients with unstable angina pectoris may become refractory to conventional therapies. Electrical neurostimulation with transcutaneous electrical stimulation and/or spinal cord stimulation has been shown to be effective for patients with refractory unstable angina pectoris in hospital

  5. Ascorbic Acid and Combination Chemotherapy in Treating Patients With Relapsed or Refractory Lymphoma

    Science.gov (United States)

    2018-01-25

    High Grade B-Cell Lymphoma With MYC and BCL2 or BCL6 Rearrangements; Recurrent Diffuse Large B-Cell Lymphoma; Recurrent Hodgkin Lymphoma; Recurrent Lymphoma; Refractory Diffuse Large B-Cell Lymphoma; Refractory Lymphoma

  6. Efficacy and Safety of Rituximab in Children with Refractory Nephrotic Syndrome; A Multicenter Clinical Trial

    Directory of Open Access Journals (Sweden)

    Yo Han Ahn

    2014-06-01

    Conclusions: In this interim analysis of clinical trial to evaluate the efficacy and safety of RTX in children with refractory NS, RTX treatment for refractory NS was safe and effective, especially in patients with DNS.

  7. Reactions Between MgO-C Refractory, Molten Slag and Metal

    National Research Council Canada - National Science Library

    Li, Zushu; Mukai, Kusuhiro; Tao, Zainan

    2000-01-01

    The behavior of MgO-C refractory-slag-metal system, which is caused by the reactions such as the dissolution of MgO and graphite in the refractory into slag and metal respectively and the generation...

  8. Psychology in its Place

    OpenAIRE

    Radford, John

    2008-01-01

    In 1996 Graham Richards published Putting Psychology in its Place: An introduction from a critical historical perspective. Here, I seek to consider what is or should be the ‘place’ of Psychology in education, more particularly Higher Education, and not just from a historical perspective. This raises issues about several contexts in which Psychology finds itself. In the Higher Education context itself, Psychology continues to be in demand. But what is offered in first degrees is largely dictat...

  9. Phase I study of perifosine monotherapy in patients with recurrent or refractory neuroblastoma.

    Science.gov (United States)

    Matsumoto, Kimikazu; Shichino, Hiroyuki; Kawamoto, Hiroshi; Kosaka, Yoshiyuki; Chin, Motoaki; Kato, Koji; Mugishima, Hideo

    2017-11-01

    Perifosine is an alkylphospholipid analog that inhibits or modulates signaling through signal transduction pathways such as Akt, which is enhanced in neuroblastoma (NB) by activation of tyrosine kinase receptors. We conducted a phase I study of perifosine in Japanese patients with recurrent or refractory NB. All patients enrolled were over 2 years of age; all had refractory or relapsed NB and a performance status of greater than 50%. Perifosine was orally administered at a loading dose (100-300 mg) on day 1 and at a maintenance dose (50-150 mg) from day 2 onward. Dose-limiting toxicity (DLT) and pharmacokinetics were assessed in Step 1 and safety and efficacy in Step 2. Nineteen patients were recruited. No DLT was observed. Adverse reactions occurring in more than 30% of the patients were vomiting (63%), nausea (53%), and diarrhea (37%). The mean plasma concentration of perifosine was 27.5 ± 9.8 μM on day 15 and 27.3 ± 11.5 μM on day 29. The response rate (RR) in 18 patients evaluable according to modified International Neuroblastoma Response Criteria was 0%; the disease control rate (DCR) was 56%. Median progression-free survival (PFS) was 122 days. In 11 patients evaluable according to the Response Evaluation Criteria in Solid Tumors, the RR and DCR were 9% and 55%, respectively. The median PFS was not reached. Perifosine monotherapy was well tolerated in Japanese patients with recurrent/refractory NB. Further investigations in combination with other anticancer or molecular targeted agents are warranted. © 2017 Wiley Periodicals, Inc.

  10. Refractory spasm of coronary arteries and grafted conduits after isolated coronary artery bypass surgery.

    Science.gov (United States)

    Lorusso, Roberto; Crudeli, Elena; Lucà, Fabiana; De Cicco, Giuseppe; Vizzardi, Enrico; D'Aloia, Antonio; Gelsomino, Sandro

    2012-02-01

    Refractory vascular spasm (RVS) concomitantly involving the entire coronary artery system and grafted conduits after coronary artery bypass grafting (CABG) surgery is a rare, but dreadful event. No consensus exists in terms of appropriate management. Between 1986 and 2009, 5,762 patients underwent isolated CABG at our institution, and 7 patients experienced RVS involving the coronary arteries and implanted conduits. Mean age was 65.6 years and 3 were female. All patients received from 3 to 5 distal anastomoses, including use of the left internal mammary artery. During the same time period, 18 patients experienced perioperative vasospasm of a single coronary artery or of a grafted conduit. All diffuse RVS events occurred between 3 and 8 hours after surgery. All patients had diffuse ischemic-like electrocardiographic changes, and 5 patients rapidly developed cardiogenic shock in the intensive care unit. Angiography was quickly performed in all patients and showed diffuse RVS involving either the native coronary arteries or the anastomosed arterial and venous conduits. The first 5 patients of this series died in the catheterization lab due to rapidly evolving refractory cardiogenic shock and unresponsive cardiac arrest, despite intraaortic counterpulsation and aggressive pharmacologic interventions (selective vasodilators and systemic inotropes). In the last 2 patients, extracorporeal membrane oxygenation was quickly instituted (1 in the catheterization lab, 1 in the operating room) and RVS could be successfully managed with complete resolution of ongoing vasospasm. In the single vascular spasm, there was only 1 death for refractory cardiac arrest, whereas all the other patients were successfully treated with direct infusion of vasodilators. Diffuse RVS after CABG is a rare but lethal condition. Our experience, although limited, indicates that in such cases an aggressive treatment, that is, prompt extracorporeal membrane oxygenation institution and controlled

  11. Outcome based definition of the anterior thalamic deep brain stimulation target in refractory epilepsy.

    Science.gov (United States)

    Lehtimäki, K; Möttönen, T; Järventausta, K; Katisko, J; Tähtinen, T; Haapasalo, J; Niskakangas, T; Kiekara, T; Öhman, J; Peltola, J

    2016-01-01

    Deep brain stimulation of the anterior nucleus of the thalamus (ANT) is an emerging therapy for refractory focal epilepsy. However, the most optimal target for stimulation has not been unambiguously described. In the present study, we investigated the correlation between the stimulation site and outcome in order to define the optimal target for deep brain stimulation in refractory epilepsy. The locations of 62 contacts used in 30 treatment attempts in 15 prospectively followed patients during a 5 year period were assessed. Treatment attempts were classified into responding and non-responding trials using seizure reduction and side effect profile as criteria. The locations of active contacts were calculated with respect to mid-commissural point and visible borders of ANT in 3T MRI (ANT-normalized coordinate system) aiming to minimize the confounding effect of individual variation in the location and size of the ANT. Contacts in successful treatment trials were located significantly more anterior and superior both in AC-PC and ANT-normalized coordinate systems. Favourable outcome was observed at 3T MRI based location of ANT but not at location predicted by Schaltenbrandt atlas sagittal data. Contacts used in successful trials were at anterior aspect of the ANT complex evidenced by the ANT-normalized coordinate system. The anti-epileptic effect of anterior thalamic DBS may be dependent on stimulation site especially in the anterior to posterior axis. Extensive anatomical variation confounds severely the targeting of ANT. Therefore, direct visualization of the desired target for stimulation is essential for favourable outcome in refractory epilepsy. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  12. Deep brain stimulation of the nucleus accumbens for treatment-refractory obsessive-compulsive disorder.

    Science.gov (United States)

    Denys, Damiaan; Mantione, Mariska; Figee, Martijn; van den Munckhof, Pepijn; Koerselman, Frank; Westenberg, Herman; Bosch, Andries; Schuurman, Rick

    2010-10-01

    Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder that affects 2% of the general population. Even when the best available treatments are applied, approximately 10% of patients remain severely afflicted and run a long-term deteriorating course of OCD. To determine whether bilateral deep brain stimulation of the nucleus accumbens is an effective and safe treatment for treatment-refractory OCD. The study consisted of an open 8-month treatment phase, followed by a double-blind crossover phase with randomly assigned 2-week periods of active or sham stimulation, ending with an open 12-month maintenance phase. Academic research. Patients Sixteen patients (age range, 18-65 years) with OCD according to DSM-IV criteria meeting stringent criteria for refractoriness to treatment were included in the study. Treatment with bilateral deep brain stimulation of the nucleus accumbens. Primary efficacy was assessed by score change from baseline on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Responders were defined by a score decrease of at least 35% on the Y-BOCS. In the open phase, the mean (SD) Y-BOCS score decreased by 46%, from 33.7 (3.6) at baseline to 18.0 (11.4) after 8 months (P stimulation was 8.3 (2.3), or 25% (P = .004). Depression and anxiety decreased significantly. Except for mild forgetfulness and word-finding problems, no permanent adverse events were reported. Bilateral deep brain stimulation of the nucleus accumbens may be an effective and safe treatment for treatment-refractory OCD. isrctn.org Identifier: ISRCTN23255677.

  13. A study of cognitive function in treatment-refractory obsessive-compulsive disorder treated with capsulotomy.

    Science.gov (United States)

    Gong, Feilong; Li, Peng; Li, Bin; Zhang, Shizhen; Zhang, Xinjie; Yang, Sen; Liu, Hongbin; Wang, Wei

    2018-02-01

    OBJECTIVE Anterior capsulotomy (AC) is sometimes used as a last resort for treatment-refractory obsessive-compulsive disorder (OCD). Previous studies assessing neuropsychological outcomes in patients with OCD have identified several forms of cognitive dysfunction that are associated with the disease, but few have focused on changes in cognitive function in OCD patients who have undergone surgery. In the present study, the authors investigated the effects of AC on the cognitive function of patients with treatment-refractory OCD. METHODS The authors selected 14 patients with treatment-refractory OCD who had undergone bilateral AC between 2007 and 2013, 14 nonsurgically treated OCD patients, and 14 healthy control subjects for this study. The 3 groups were matched for sex, age, and education. Several neuropsychological tests, including Similarities and Block Design, which are subsets of the Wechsler Abbreviated Scale of Intelligence; Immediate and Delayed Logical Memory and Immediate and Delayed Visual Reproduction, which are subsets of the Wechsler Memory Scale-Revised; and Corrects, Categories, Perseverative Errors, Nonperseverative Errors, and Errors, subtests of the Wisconsin Card Sorting Test, were conducted in all 42 subjects at baseline and after AC, after nonsurgical treatment, or at 6-month intervals, as appropriate. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to measure OCD symptoms in all 28 OCD patients. RESULTS The Y-BOCS scores decreased significantly in both OCD groups during the 12-month follow-up period. Surgical patients showed higher levels of improvement in verbal memory, visual memory, visuospatial skills, and executive function than the nonsurgically treated OCD patients. CONCLUSIONS The findings of this study suggest that AC not only reduces OCD symptoms but also attenuates moderate cognitive deficits.

  14. PSYCHOLOGICAL EMPOWERMENT AND DEVELOPMENT

    African Journals Online (AJOL)

    Elizabeth

    PSYCHOLOGICAL EMPOWERMENT AND. DEVELOPMENT. Oladipo, S.E. PhD. Dept. of Counselling Psychology, Tai Solarin University of Education,. Ijagun, Ogun State. Abstract. Using the archival method of investigation, this paper explores the subject of psychological empowerment (particularly in relation to youths) ...

  15. What is Political Psychology?

    Science.gov (United States)

    Deutsch, Morton

    1983-01-01

    Political psychology is the study of the bidirectional interaction of political and psychological processes. This academic discipline was founded after the First World War by Harold D. Lasswell. The content of political psychology is discussed and illustrative studies of the field are briefly summarized. (CS)

  16. School Psychology in Denmark.

    Science.gov (United States)

    Poulsen, Anders

    1987-01-01

    Describes education system of Denmark and reviews background and development of school psychology in that country. Discusses organization of school psychology work and practice. Explains qualifications and training of school psychologists and describes professional organizations, wages, and problems in school psychology. (NB)

  17. Intro through Internet Psychology.

    Science.gov (United States)

    Webster, Sandra K.; Kelliher, Thomas P.

    Psychology and computer science were clustered into a course in "Internet Psychology" with the goal of enabling students to use electronic networks responsibly and creatively and to understand the principles of psychology as they operate in the electronic context. Fourteen students from a variety of majors registered for the class.…

  18. Psychology in India

    Science.gov (United States)

    Sushma, B.; Padmaja, G.

    2011-01-01

    Psychology forms the basis of every human activity. The scope of psychology is increasingly widening in various economic, political, social, cultural and technological aspects. Though the application of psychology is extending to various aspects of life, it needs to be indigenised to address the dynamic needs in the various socio-economic contexts…

  19. Psychology in Mexico

    Science.gov (United States)

    Ruiz, Eleonora Rubio

    2011-01-01

    The first formal psychology course taught in Mexico was in 1896 at Mexico's National University; today, National Autonomous University of Mexico (UNAM in Spanish). The modern psychology from Europe and the US in the late 19th century were the primary influences of Mexican psychology, as well as psychoanalysis and both clinical and experimental…

  20. Refractory nonconvulsive status epilepticus in coma: analysis of the evolution of ictal patterns

    Directory of Open Access Journals (Sweden)

    Paulo Breno Noronha Liberalesso

    2012-07-01

    Full Text Available OBJECTIVE: Nonconvulsive status epilepticus (NCSE is currently considered as one of the most frequent types of status epilepticus (SE. The objective of the present study was to identify the natural history of the electrographical evolution of refractory NCSE and to establish the relationship between ictal patterns and prognosis. METHODS: We analyzed, retrospectively, 14 patients with loss of consciousness and NCSE. The ictal patterns were classified as discrete seizures (DS, merging seizures (MS, continuous ictal discharges (CID, continuous ictal discharges with flat periods (CID-F, and periodic lateralized epileptiform discharges (PLEDs. RESULTS: The ictal patterns were DS (n=7; 50.0%, PLEDs (n=3; 1.4%, CID (n=2; 14.3%, MS (n=1; 7.1%, and CID-F (n=1; 7.1%. CONCLUSIONS: NCSE electrographic findings are heterogeneous and do not follow a stereotyped sequence. PLEDs were related to a higher probability of neurological morbidity and mortality.

  1. Intensive sleep deprivation and cognitive behavioral therapy for pharmacotherapy refractory insomnia in a hospitalized patient.

    Science.gov (United States)

    Breitstein, Joshua; Penix, Brandon; Roth, Bernard J; Baxter, Tristin; Mysliwiec, Vincent

    2014-06-15

    The case of a 59-year-old woman psychiatrically hospitalized with comorbid insomnia, suicidal ideation, and generalized anxiety disorder is presented. Pharmacologic therapies were unsuccessful for treating insomnia prior to and during hospitalization. Intensive sleep deprivation was initiated for 40 consecutive hours followed by a recovery sleep period of 8 hours. Traditional components of cognitive behavioral therapy for insomnia (CBTi), sleep restriction, and stimulus control therapies, were initiated on the ward. After two consecutive nights with improved sleep, anxiety, and absence of suicidal ideation, the patient was discharged. She was followed in the sleep clinic for two months engaging in CBTi. Treatment resulted in substantial improvement in her insomnia, daytime sleepiness, and anxiety about sleep. Sleep deprivation regimens followed by a restricted sleep recovery period have shown antidepressant effects in depressed patients. Similar treatment protocols have not been investigated in patients with pharmacotherapy refractory insomnia and generalized anxiety disorder.

  2. Iron-Refractory Iron Deficiency Anemia

    Directory of Open Access Journals (Sweden)

    Ebru Yılmaz Keskin

    2015-03-01

    Full Text Available Demir, oksijenin taşınması, DNA sentezi ve hücre çoğalması gibi çeşitli biyolojik reaksiyonlar için vazgeçilmez olduğundan, yaşam için zorunludur. Demir metabolizması ve bu elementin düzenlenmesiyle ilgili bilgilerimiz, son yıllarda belirgin şekilde değişmiştir. Demir metabolizması ile ilgili yeni bozukluklar tanımlanmış ve demirin başka bozuklukların kofaktörü olduğu anlaşılmaya başlamıştır. Hemokromatozis ve demir tedavisine dirençli demir eksikliği anemisi (IRIDA; “iron-refractory iron deficiency anemia” gibi genetik durumlar üzerinde yapılan çalışmalar, vücuttaki demir dengesini kontrol eden moleküler mekanizmalar ile ilgili önemli ipuçları sunmuştur. Bu ilerlemeler, gelecekte, hem genetik hem de kazanılmış demir bozukluklarının daha etkili şekilde tedavi edilmesi amacıyla kullanılabilir. IRIDA, demir eksikliği ile giden durumlarda, hepsidin üretimini baskılayan matriptaz-2’yi kodlayan TMPRSS6 genindeki mutasyonlardan kaynaklanmaktadır. Hastalığın tipik özellikleri, hipokrom, mikrositer anemi, çok düşük ortalama eritrosit hacmi, oral demir tedavisine yanıtsızlık (veya yetersiz yanıt ve parenteral demire kısmi yanıttır. Klasik demir eksikliği anemisinin aksine, serum ferritin değeri genellikle hafif düşük ya da normal aralıkta; serum ve idrar hepsidin değerleri ise, aneminin derecesi ile orantısız şekilde yüksek bulunur. Şimdiye kadar literatürde bildirilmiş olguların sayısı 100’ü geçmediği halde, IRIDA’nın, “atipik” mikrositik anemilerin en sık nedeni olduğu düşünülmektedir. Bu derlemenin amacı, IRIDA hakkındaki güncel bilgileri araştırıcılar ile paylaşmak ve bu alandaki farkındalıklarını arttırmaktır.

  3. Corrosion Resistances of Cr-Free Refractories to Copper Smelting Slags

    Science.gov (United States)

    Chen, Mao; Chen, Junhong; Zhao, Baojun

    Appropriate selection of refractories for high temperature processes is vital to the production. Magnesia-chromite refractory has been widely used in copper making industry. However, the risk of generating high poisonous Cr6+ drives the researchers to find Cr-free refractories for copper industry.

  4. Aborted and refractory status epilepticus in children : A comparative analysis

    NARCIS (Netherlands)

    Lambrechtsen, Florise A. C. P.; Buchhalter, Jeffrey R.

    Purpose: The aims of this retrospective study were: (1) to compare the demographics, clinical characteristics, etiology, and EEG findings of status epilepticus aborted with medication (ASE) and refractory status epilepticus (RSE), (2) to describe the treatment response of status epilepticus (SE),

  5. Role of rectal myomectomy in refractory chronic constipation ...

    African Journals Online (AJOL)

    Background: To assess the role of diagnostic and therapeutic value of anorectal myectomy in cases of chronic refractory constipation. Materials and Methods: Twenty-eight patients 11 months to 9 years of age presenting with chronic constipation, with contrast enema showing dilated rectum and sigmoid colon were included ...

  6. Reserpine for the treatment of refractory mania | Eloff | South African ...

    African Journals Online (AJOL)

    We report a case of refractory mania treated successfully with reserpine. The patient was a 26-year-old man with bipolar I disorder, who had recurrent hospital admissions for manic episodes that failed to respond to multiple mood stabilisers and antipsychotics. The patient also suffered from hypertension. His manic ...

  7. A case of incomplete and refractory Kawasaki disease: Diagnostic ...

    African Journals Online (AJOL)

    The diagnosis of incomplete Kawasaki disease (KD) – i.e. cases that do not full all the diagnostic criteria – requires a high index of suspicion. We report a case of incomplete KD that was refractory to treatment with intravenous immunoglobulin and subsequently responded to treatment with intravenous methylprednisolone.

  8. Long-term outcomes of thalidomide in refractory Crohn's disease.

    Science.gov (United States)

    Gerich, M E; Yoon, J L; Targan, S R; Ippoliti, A F; Vasiliauskas, E A

    2015-03-01

    Several open-label and retrospective studies have indicated that thalidomide may be beneficial in patients with refractory Crohn's disease (CD). To report our long-term experience with the use of thalidomide for adults with refractory Crohn's disease. We conducted a retrospective study of long-term clinical and safety outcomes among adults treated with thalidomide for refractory Crohn's disease. Response was defined as a clinician's assessment of improvement after at least 7 days treatment of one or more of the following: bowel movement frequency, fistula output, rectal bleeding, abdominal pain, extraintestinal manifestations, or well-being. Remission required all of the following: thalidomide for a median of 4.4 months and followed up for a median of 58 months. Clinical response and remission rates were 54% and 19%, respectively. About 40% of patients were able to stop steroids. Response rates were higher for those treated with more than 50 mg/day (85%) than for those treated with a maximum of 50 mg/day (40%; P = 0.01). An adverse event occurred in 68% of patients. Approximately one-third of patients (38%) experienced neuropathy. Thalidomide appears to be safe and effective in some patients with refractory Crohn's disease. Although side effects may limit long-term use, thalidomide has potential to induce significant clinical responses. © 2014 John Wiley & Sons Ltd.

  9. Therapy of the refractory ascites: Total paracentesis vs. TIPS.

    Science.gov (United States)

    La Mura, Vincenzo; Salerno, Francesco

    2016-01-01

    This revision was aimed to report the evidences on the treatment of patients with cirrhosis and refractory ascites. Mainly, we wished to explore which of the predicting variables could be used to prefer large-volume paracentesis or TIPS. Copyright © 2015 Elsevier España, S.L.U. y AEEH y AEG. All rights reserved.

  10. Productivity costs in patients with refractory chronic rhinosinusitis.

    Science.gov (United States)

    Rudmik, Luke; Smith, Timothy L; Schlosser, Rodney J; Hwang, Peter H; Mace, Jess C; Soler, Zachary M

    2014-09-01

    Disease-specific reductions in patient productivity can lead to substantial economic losses to society. The purpose of this study was to: 1) define the annual productivity cost for a patient with refractory chronic rhinosinusitis (CRS) and 2) evaluate the relationship between degree of productivity cost and CRS-specific characteristics. Prospective, multi-institutional, observational cohort study. The human capital approach was used to define productivity costs. Annual absenteeism, presenteeism, and lost leisure time was quantified to define annual lost productive time (LPT). LPT was monetized using the annual daily wage rates obtained from the 2012 U.S. National Census and the 2013 U.S. Department of Labor statistics. A total of 55 patients with refractory CRS were enrolled. The mean work days lost related to absenteeism and presenteeism were 24.6 and 38.8 days per year, respectively. A total of 21.2 household days were lost per year related to daily sinus care requirements. The overall annual productivity cost was $10,077.07 per patient with refractory CRS. Productivity costs increased with worsening disease-specific QoL (r = 0.440; p = 0.001). Results from this study have demonstrated that the annual productivity cost associated with refractory CRS is $10,077.07 per patient. This substantial cost to society provides a strong incentive to optimize current treatment protocols and continue evaluating novel clinical interventions to reduce this cost. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  11. Refractory metal nuggets in different types of cosmic spherules.

    Digital Repository Service at National Institute of Oceanography (India)

    Rudraswami, N.G.; ShyamPrasad, M.; Plane, J.M.C.; Berg, T.; Feng, W.; Balgar, S.

    Out of the three basic cosmic spherule types collected from the seafloor, RMNs (refractory metal nuggets) have been reported from I-type spherules commonly, rarely from S-type spherules and never from the G-type spherules. Nuggets in the I-type...

  12. Performance Evaluation of Refractory Bricks produced from locally ...

    African Journals Online (AJOL)

    The performance evaluation of refractory bricks produced from some local clay deposits in Delta State, Nigeria was investigated. Four major sites in Delta State renowned for abundant clay deposits were selected, namely; Oghara, Ekpan, Ubeji and Jeddo. The clay samples were crushed, milled (pulverised) and sieved to ...

  13. Super Refractory Status Epilepticus: A Case Report from Livingstone ...

    African Journals Online (AJOL)

    Background: Status Epilepticus (SE) is defined as more than five minutes of persistent seizure activity without full recovery of consciousness in between the seizures. If SE fails to respond to two antiepileptic drugs, it is called refractory status epilepticus (RSE) and if it continues or recurs 24 hours after anesthesia, it is called ...

  14. [Refractory cardiac arrest patients in prehospital care, potential organ donors].

    Science.gov (United States)

    Le Jan, Arnaud; Dupin, Aurélie; Garrigue, Bruno; Sapir, David

    2016-09-01

    Under the authority of the French Biomedicine Agency, a new care pathway integrates refractory cardiac arrest patients into a process of organ donation. It is a medical, logistical and ethical challenge for the staff of the mobile emergency services. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  15. Thermochemical Considerations in Self-Sustaining Synthesis of Refractory Compounds,

    Science.gov (United States)

    1982-08-01

    REPORT DATE Defense Advanced Research Projects Agency August 1982 1400 Wilson Boulevard 13. NUMBER OF PAGES Arlington, Virginia 22209 14. MONITORING...TEMPERATURES FOR SOME REFRACTORY AND OTHER MATERIALS Material Temperature (*F) Hafnium carbide 7520 Tantalum carbide 7025 Graphite 6870 Zirconium carbide...4892 Zirconia 4850 Molybdenum 4748 Beryllia 4660 Zircon 4530 Boron carbide 4430 Silicon carbide (volatilizes) 4160 Spinel 3860 Alumina 3720 Magnesium

  16. A case of incomplete and refractory Kawasaki disease : diagnostic ...

    African Journals Online (AJOL)

    disease.[4,5] Not all cases ful l all the diagnostic criteria, and these are termed incomplete KD.[6,7] We report a case of incomplete KD that was refractory to the recommended standard treatment with intravenous immunoglobulin (IVIG), but responded to treatment with intravenous methylprednisolone. e case highlights the.

  17. Effectiveness of infliximab in refractory FDG PET-positive sarcoidosis

    NARCIS (Netherlands)

    Vorselaars, Adriane D M; Crommelin, Heleen A; Deneer, Vera H M; Meek, Bob; Claessen, Anke M E; Keijsers, Ruth G M; van Moorsel, Coline H M; Grutters, JC

    Inconclusive evidence for the efficacy of infliximab in sarcoidosis hinders the global use of this potentially beneficial drug. To study infliximab efficacy in a clinical setting, we performed a prospective open-label trial in patients refractory to conventional treatment. Patients (n=56) received

  18. Epidural blood patch for refractory low CSF pressure headache

    DEFF Research Database (Denmark)

    Madsen, Søren Aalbæk; Fomsgaard, Jonna Storm; Jensen, Rigmor

    2011-01-01

    reduction in frequency. An increase in days with use of medication was found. Increased awareness of low CSF pressure headache is emphasized and a controlled larger randomized study is needed to confirm the results. However the present results, allows us to conclude that EBP in treatment-refractory low CSF...

  19. Microscopic colitis: A review of etiology, treatment and refractory disease.

    Science.gov (United States)

    Park, Tina; Cave, David; Marshall, Christopher

    2015-08-07

    Microscopic colitis is a common cause of chronic, nonbloody diarrhea. Microscopic colitis is more common in women than men and usually affects patients in their sixth and seventh decade. This article reviews the etiology and medical management of microscopic colitis. The etiology of microscopic colitis is unknown, but it is associated with autoimmune disorders, such as celiac disease, polyarthritis, and thyroid disorders. Smoking has been identified as a risk factor of microscopic colitis. Exposure to medications, such as non-steroidal anti-inflammatory drugs, proton pump inhibitors, and selective serotonin reuptake inhibitors, is suspected to play a role in microscopic colitis, although their direct causal relationship has not been proven. Multiple medications, including corticosteroids, anti-diarrheals, cholestyramine, bismuth, 5-aminosalicylates, and immunomodulators, have been used to treat microscopic colitis with variable response rates. Budesonide is effective in inducing and maintaining clinical remission but relapse rate is as high as 82% when budesonide is discontinued. There is limited data on management of steroid-dependent microscopic colitis or refractory microscopic colitis. Immunomodulators seem to have low response rate 0%-56% for patients with refractory microscopic colitis. Response rate 66%-100% was observed for use of anti-tumor necrosis factor (TNF) therapy for refractory microscopic colitis. Anti-TNF and diverting ileostomy may be an option in severe or refractory microscopic colitis.

  20. Association of interleukin 17 / angiotensin II with refractory ...

    African Journals Online (AJOL)

    Abstract. Objective: The study was performed to investigate the association of interleukin 17 (IL 17) or angiotensin II (Ang II) with refractory hypertension risk in hemodialysis patients. Methods: Ninety hemodialysis patients were enrolled into this study, and those with hypertension were divided into two groups.

  1. Penetration and Effectiveness of Micronized Copper in Refractory Wood Species.

    Directory of Open Access Journals (Sweden)

    Chiara Civardi

    Full Text Available The North American wood decking market mostly relies on easily treatable Southern yellow pine (SYP, which is being impregnated with micronized copper (MC wood preservatives since 2006. These formulations are composed of copper (Cu carbonate particles (CuCO3·Cu(OH2, with sizes ranging from 1 nm to 250 μm, according to manufacturers. MC-treated SYP wood is protected against decay by solubilized Cu2+ ions and unreacted CuCO3·Cu(OH2 particles that successively release Cu2+ ions (reservoir effect. The wood species used for the European wood decking market differ from the North American SYP. One of the most common species is Norway spruce wood, which is poorly treatable i.e. refractory due to the anatomical properties, like pore size and structure, and chemical composition, like pit membrane components or presence of wood extractives. Therefore, MC formulations may not suitable for refractory wood species common in the European market, despite their good performance in SYP. We evaluated the penetration effectiveness of MC azole (MCA in easily treatable Scots pine and in refractory Norway spruce wood. We assessed the effectiveness against the Cu-tolerant wood-destroying fungus Rhodonia placenta. Our findings show that MCA cannot easily penetrate refractory wood species and could not confirm the presence of a reservoir effect.

  2. Issues Impacting Refractory Service Life in Biomass/Waste Gasification

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, J.P.; Kwong, K.-S.; Powell, C.A.

    2007-03-01

    Different carbon sources are used, or are being considered, as feedstock for gasifiers; including natural gas, coal, petroleum coke, and biomass. Biomass has been used with limited success because of issues such as ash impurity interactions with the refractory liner, which will be discussed in this paper.

  3. Evaluation of nutritional status in children with refractory epilepsy

    Directory of Open Access Journals (Sweden)

    Testolin G

    2006-04-01

    Full Text Available Abstract Background children affected by refractory epilepsy could be at risk of malnutrition because of feeding difficulties (anorexia, chewing, swallowing difficulties or vomiting and chronic use of anticonvulsants, which may affect food intake and energy metabolism. Moreover, their energy requirement may be changed as their disabilities would impede normal daily activities. The aim of the present study was to evaluate nutritional status, energy metabolism and food intake in children with refractory epilepsy. Methods 17 children with refractory epilepsy (13 boys and 4 girls; mean age 9 ± 3,2 years; Body Mass Index 15,7 ± 3,6 underwent an anthropometric assessment, body composition evaluation by dual-energy X-ray absorptiometry, detailed dietetic survey and measurement of resting energy expenditure by indirect calorimetry. Weight-for-age, height-for-age (stunting and weight-for-height (wasting were estimated compared to those of a reference population of the same age. Results 40% of children were malnourished and 24% were wasted. The nutritional status was worse in the more disabled children. Dietary intake resulted unbalanced (18%, 39%, 43% of total daily energy intake derived respectively from protein, lipid and carbohydrate. Adequacy index [nutrient daily intake/recommended allowance (RDA × 100] was Conclusion many children with refractory epilepsy would benefit from individual nutritional assessment and management as part of their overall care.

  4. Anaesthesia for left thoracoscopic sympathectomy for refractory long ...

    African Journals Online (AJOL)

    Left thoracoscopic sympathectomy is an effective treatment for patients who are refractory to medical therapy or who need frequent epicardial internal cardio defibrillator intervention. The authors report three cases, one adult and two children, who underwent successful left thoracoscopic sympathectomy. All three patients ...

  5. Immunomodulatory therapy in refractory/recurrent ovarian cancer

    Directory of Open Access Journals (Sweden)

    Chao-Yu Chen

    2015-04-01

    Conclusion: IMT alone or add-on to palliative/salvage chemotherapy for refractory/recurrent EOC achieves a substantial disease stabilizing rate without severe toxicity, which might be a potential option in selected patients. The ALC 1 month after IMT could be an early indicator to disease stabilization.

  6. Treatment-refractory, juvenile-onset bipolar affective disorder

    OpenAIRE

    Vijay Sagar, K. John

    2005-01-01

    A case of juvenile-onset bipolar affective disorder with a childhood history of attention-deficit hyperactivity disorder (ADHD) is presented. As the patient was refractory to treatment with mood stabilizers, clozapine was given, which succeeded in achieving remission. The disorder's natural history needs further study. Data also need to be collected for optimal pharmacotherapeutic guidance.

  7. Refractory generalised convulsive status epilepticus : a guide to treatment.

    Science.gov (United States)

    Kälviäinen, Reetta; Eriksson, Kai; Parviainen, Ilkka

    2005-01-01

    The patient with status epilepticus has continuous or rapidly repeating seizures. Generalised convulsive status epilepticus (GCSE) is the most common form of the disorder and is a life-threatening condition that requires prompt medical management. Status epilepticus that does not respond to first-line benzodiazepines (lorazepam or diazepam) or to second-line antiepileptic drugs (phenytoin/fosphenytoin, phenobarbital or valproate) is usually considered refractory and requires more aggressive treatment. The optimal treatment of refractory GCSE has not been defined, but patients should be treated in an intensive care unit, as artificial ventilation and haemodynamic support are required. Invasive haemodynamic monitoring is often necessary and EEG monitoring is essential. The drug treatment of refractory GCSE involves general anaesthesia with continuous intravenous anaesthetics given in doses that abolish all clinical and electrographic epileptic activity, often requiring sedation to the point of burst suppression on the EEG. Barbiturate anaesthetics, pentobarbital in the US and thiopental sodium in Europe and Australia, are the most frequently used agents and are highly effective for refractory GCSE both in children and adults. Indeed, they remain the only way to stop seizure activity with certainty in severely refractory cases. Other options are midazolam for adults and children and propofol for adults only.Regardless of the drug selected, intravenous fluids and vasopressors are usually required to treat hypotension. Once seizures have been controlled for 12-24 hours, continuous intravenous therapy should be gradually tapered off if the drug being administered is midazolam or propofol. Gradual tapering is probably not necessary with pentobarbital or thiopental sodium. Continuous EEG monitoring is required during high-dose treatment and while therapy is gradually withdrawn. During withdrawal of anaesthetic therapy, intravenous phenytoin/fosphenytoin or valproate should

  8. Assédio moral no trabalho e suas representações na mídia jornalística Acoso moral en el trabajo y sus representaciones en el medio periodístico Representations of workplace psychological harassment in print news media

    Directory of Open Access Journals (Sweden)

    Andréia De Conto Garbin

    2012-06-01

    fueron analizadas las materias periodísticas transmitidas en tres periódicos de gran circulación del Estado de Sao Paulo, en el período de 1990 a 2008. A partir de la metodología de análisis del discurso se reconocieron las prácticas discursivas que constituyen el fenómeno de acoso moral en la sociedad actual, las explicaciones para su ocurrencia y la repercusión para la salud de los trabajadores. ANÁLISIS DE LOS RESULTADOS: El surgimiento del tema en los medios de comunicación se logró por medio de la divulgación de libros, de producciones académicas y de legislaciones. Ocurrió en editoriales que manejan asuntos generales y posteriormente, migró para las editoriales de empleo y/o de carácter económico-financiero. Los discursos de naturaleza indemnizatoria, de precaución empresarial y las estrategias de enfrentamiento son ampliamente difundidos. La promoción de la salud se disipa por la lógica patrimonial. Hay un espacio permisivo en las organizaciones para práctica del acoso moral potencializando los conflictos para alcanzar las metas y resultados. Indiferencia, cohibiciones, descalificaciones y burlas fueron comunes en las materias. CONCLUSIONES: Las explicaciones sobre el acoso tienden a una interpretación psicológica del fenómeno, acentuando el carácter individualista y minimizando un abordaje colectivo. Los discursos trivializan el acoso al crear caricaturas para los actores participantes. El contenido psicológico y la estigmatización producen sentido en la sociedad contribuyendo para naturalizar el acoso moral en el trabajo y trivializar la violencia en el trabajo.OBJECTIVE: To analyze discourses on workplace psychological harassment in print media. METHODOLOGICAL PROCEDURES: Documental study on workplace psychological harassment that analyzed news stories published in three major newspapers of the State of São Paulo (southeastern Brazil between 1990 and 2008. Discourse analysis was performed to identify discursive practices that

  9. Physical activity and psychological health in breast cancer survivors: an application of basic psychological needs theory.

    Science.gov (United States)

    Mack, Diane E; Meldrum, Lindsay S; Wilson, Philip M; Sabiston, Catherine M

    2013-11-01

    The role of psychological need satisfaction in terms of understanding the mechanisms through which leisure-time physical activity (LTPA) is associated with psychological health in breast cancer survivors who have recently completed treatment was examined. Adopting a longitudinal two-wave design, female breast cancer survivors (N = 144) completed self-report instruments of LTPA, psychological need satisfaction, and psychological health at two points separated by 3 months. The first test administration period was 6 months following the completion of primary treatment. Change score analyses demonstrated that greater LTPA across the 3-month period was associated with greater perceptions of well-being (rs ranged from .17 to .20) and lower ill-being (rs ranged from -.06 to -.21). Results of multiple mediation analyses demonstrated that psychological need fulfillment underpinned the LTPA-well-being relationship only. Collectively these findings indicate that increased engagement in LTPA represents one factor associated with greater psychological health in breast cancer survivors, with fulfilling the psychological need for relatedness most salient in understanding this relationship. Continued investigation into the mechanisms associated with reductions in ill-being in breast cancer survivors appear justified. © 2013 The International Association of Applied Psychology.

  10. The modified ketogenic diet for adults with refractory epilepsy: An evaluation of a set up service.

    Science.gov (United States)

    Martin-McGill, Kirsty J; Jenkinson, Michael D; Tudur Smith, Catrin; Marson, Anthony G

    2017-11-01

    The ketogenic diet (KD) has been proven to be effective in children with refractory epilepsy and is recommended by the National Institute of Health and Care Excellence (NICE). There is no randomised control trial (RCT) evidence for the clinical or cost effectiveness of KD in adults, for whom the KD is not currently recommended. We assessed the feasibility of the modified ketogenic diet (MKD) in adults with refractory epilepsy along with the willingness of patients to participate in a future RCT. The service evaluation was undertaken in two parts; questionnaire and diet evaluation. 102 patients completed a questionnaire, of which 51 patients were willing to try the MKD for 3 months to assess effect on seizures. Forty three patients were willing to participate in a clinical trial to investigate deliverability, efficacy and tolerability. Thirty seven of which would still be willing to participate if the trial were randomised. Of the 17 patients who commenced the diet, 9 completed the 12 week period, 7 of which stayed on the diet for the longer term. Constipation (n=6) and loose stools (n=3) were the only reported adverse effects. Our results indicate that there is demand for a ketogenic diet service in adults. The MKD is well tolerated, feasible and financially viable to deliver to adults with epilepsy in the NHS. There is also interest in and willingness to participate in a UK based RCT that would ultimately inform decisions about commissioning appropriate services. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  11. Pulsed intravenous immunoglobulin therapy in refractory ulcerated livedoid vasculopathy: seven cases and a literature review.

    Science.gov (United States)

    Kim, Eun Jee; Yoon, So Young; Park, Hyun Sun; Yoon, Hyun-Sun; Cho, Soyun

    2015-01-01

    Livedoid vasculopathy (LV) is a thrombotic vasculopathy of the skin of unknown origin. No treatment has been validated in this indication, but case reports demonstrated successful use of intravenous immunoglobulins (IVIg) in LV. We assessed the efficacy and tolerability of 2 g/kg IVIg therapy every month for 2∼3 cycles in patients with refractory LV. We analyzed the efficacy, side effects and recurrence after long-term follow-up (51.9 ± 14.0 months) in seven patients with LV treated with 2 g/kg of IVIg. Mean clinical score of sum of erythema, ulceration and pain index (each: 0-3) was 5.7 ± 0.9 before the therapy and significantly lower after therapy (1.1 ± 0.5) (p = 0.001). Even after just one cycle of IVIg, the score decreased significantly from 5.7 ± 0.9 to 3.7 ± 0.9 (p = 0.002), especially the pain score. In one patient, LV has not recurred for over 7 years; six patients experienced recurrence after a mean of 12.7 ± 2.8 months. Out of the six patients, two patients were re-administered IVIg whereas the others were well controlled by conventional therapy. We propose that IVIg is a rapid, effective, and safe therapeutic option in LV refractory to other treatment modalities. © 2015 Wiley Periodicals, Inc.

  12. "Solid Red Line": An Observational Study on Death from Refractory Intracranial Hypertension.

    Science.gov (United States)

    Czosnyka, M; Aries, M; Weersink, C; Wolf, S; Budohoski, K; Dias, C; Lewis, P; Smielewski, P; Kordasti, S

    2016-01-01

    The index of cerebrovascular pressure reactivity (PRx) correlates independently with outcome after traumatic brain injury (TBI). However, as an index plotted in the time domain, PRx is rather noisy. To "organise" PRx and make its interpretation easier, the colour coding of values, with green when PRx 0.3, has been introduced as a horizontal colour bar on the ICM+ screen. In rare cases of death from refractory intracranial hypertension, an increase in intracranial pressure (ICP) is commonly preceded by values of PRx >0.3, showing a "solid red line".Twenty patients after TBI and one after traumatic subarachnoid haemorrhage (SAH) from six centres in Europe and Australia have been studied. All of them died in a scenario of refractory intracranial hypertension. In the majority of cases the initial ICP was below 20 mmHg and finally increased to values well above 60 mmHg, resulting in cerebral perfusion pressure less than 20 mmHg. In three cases initial ICP was elevated at the start of monitoring. A solid red line was observed in all cases preceding an increase in ICP above 25 mmHg by minutes to hours and in two cases by 2 and 3 days, respectively. If a solid red line is observed over a prolonged period, it should be considered as an indicator of deep cerebrovascular deterioration.

  13. Use of propofol infusion in alcohol withdrawal-induced refractory delirium tremens.

    Science.gov (United States)

    Lorentzen, Kristian; Lauritsen, Anne Øberg; Bendtsen, Asger Ole

    2014-05-01

    Delirium tremens is a potentially fatal complication of alcohol withdrawal. In severe delirium, very large dosages of benzodiazepines can be required and in refractory cases, sedation with propofol can be used. Treatment of refractory delirium tremens with propofol is mainly described in case reports. We aimed to evaluate the treatment of delirium tremens with propofol infusion for 48 h. This study was a single-centre retrospective cohort analysis of 15 patient journals covering the period from May 2012 to September 2013. Five women and ten men were included. Their mean age was 50.9 years. Prior to propofol treatment, conventional treatment with up to 1,500 mg of benzodiazepines, 2,000 mg of chlordiazepoxide or 1,200 mg of phenobarbital was attempted in the medical or psychiatric ward, without effect (sleep). Patients were sedated, intubated and mechanically ventilated in the intensive care unit. The mean propofol infusion rate was 4.22 mg/kg/h. Thirteen patients received supplemental infusion of opioids, whereas seven required concomitant vasopressor infusion. Once propofol infusion was discontinued after 48 h, 12 patients had a long awakening, displaying symptoms of prolonged sedation. Twelve of the 15 patients treated for delirium tremens with propofol for 48 h were successfully treated. Three patients needed further treatment. Our study suggests that treatment with propofol is viable. Establishing indication, dose, duration, and long-term effects of propofol treatment of delirium tremens requires further investigation. not relevant. not relevant.

  14. Case Series Report of 66 Refractory Maintenance Patients Evaluating the Effectiveness of Topical Oxidizing Agents.

    Science.gov (United States)

    Cochrane, R Bruce; Sindelar, Betty

    2015-01-01

    To evaluate the clinical effects of a prescription tray application of hydrogen peroxide gel as an adjunct to frequent maintenance appointments for refractory periodontal patients. Case series data were analyzed from 66 failing periodontal maintenance patients who had exhausted treatment options before using prescription trays with a 1.7% hydrogen peroxide gel once or twice daily for two-and-a-half to five years. Data included pocket probing depths (PPD), bleeding on probing (BOP), smoking status, and compliance with tray usage. Data were collected prior to tray usage and after tray delivery at six months, one year, and annual intervals. A clinical and statistical reduction in BOP was maintained over the length of the study (p ≤ 0.01). No differences were seen in patients who used trays two times or one time a day or in patients who smoked or did not smoke. The 1.7% peroxide delivered via a prescription tray was most effective in shallow pockets. Aggregate PPD distribution did not change significantly. Of clinical relevance, only one tooth out of 1,745 teeth studied was lost due to periodontal disease during the study period. Prescription tray application of peroxide gel, as an adjunct to frequent periodontal maintenance appointments for refractory patients, demonstrated significant reductions in BOP'for smokers and non-smokers who used tray delivery once or twice a day.

  15. Illness identity in young adults with refractory epilepsy.

    Science.gov (United States)

    Luyckx, Koen; Oris, Leen; Raymaekers, Koen; Rassart, Jessica; Moons, Philip; Verdyck, Ludo; Mijnster, Teus; Mark, Ruth E

    2018-02-01

    Refractory epilepsy is an intrusive condition with important implications for daily functioning in emerging and young adulthood. The present study examined the degree to which refractory epilepsy is integrated in one's identity, and examined how such a sense of illness identity was related to health-related quality of life (HRQOL). A total of 121 18- to 40-year-old patients with refractory epilepsy (56.2% women) completed self-report questionnaires assessing the four illness identity states of acceptance, enrichment, engulfment, and rejection (Illness Identity Questionnaire (IIQ)); HRQOL (Quality of Life in Epilepsy Inventory - 31); and seizure frequency and severity (Liverpool Seizure Severity Scale (LSSS)). Illness identity scores were compared with a sample of 191 patients with a nonneurological chronic disease (congenital heart disease). Hierarchical regression analyses were conducted to assess the predictive value of illness identity for HRQOL when simultaneously controlling for demographic and clinical features. Patients with refractory epilepsy scored higher on rejection and engulfment and lower on acceptance when compared with patients with congenital heart disease. Further, seizure severity and number of medication side-effects were positively related to engulfment and negatively to acceptance. Finally, when simultaneously controlling for various demographic and clinical variables, illness identity significantly predicted HRQOL (with engulfment being the strongest and most consistent predictor). The extent to which patients with refractory epilepsy succeed in integrating their illness into their identity may have important implications for HRQOL. Clinicians should be especially attentive for signs that patients feel engulfed by their epilepsy. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. Ixabepilone: a new chemotherapeutic option for refractory metastatic breast cancer

    Directory of Open Access Journals (Sweden)

    Shannon Puhalla

    2008-09-01

    Full Text Available Shannon Puhalla, Adam BrufskyUPMC Magee-Womens Cancer Program, University of Pittsburgh, Pittsburgh, Pennsylvania, USAAbstract: Taxane therapy is commonly used in the treatment of metastatic breast cancer. However, most patients will eventually become refractory to these agents. Ixabepilone is a newly approved chemotherapeutic agent for the treatment of metastatic breast cancer. Although it targets microtubules similarly to docetaxel and paclitaxel, ixabepilone has activity in patients that are refractory to taxanes. This review summarizes the pharmacology of ixapebilone and clinical trials with the drug both as a single agent and in combination. Data were obtained using searches of PubMed and abstracts of the annual meetings of the American Society of Clinical Oncology and the San Antonio Breast Cancer Symposium from 1995 to 2008. Ixapebilone is a semi-synthetic analog of epothilone B that acts to induce apoptosis of cancer cells via the stabilization of microtubules. Phase I clinical trials have employed various dosing schedules ranging from daily to weekly to 3-weekly. Dose-limiting toxicites included neuropathy and neutropenia. Responses were seen in a variety of tumor types. Phase II studies verified activity in taxane-refractory metastatic breast cancer. The FDA has approved ixabepilone for use as monotherapy and in combination with capecitabine for the treatment of metastatic breast cancer. Ixabepilone is an efficacious option for patients with refractory metastatic breast cancer. The safety profile is similar to that of taxanes, with neuropathy and neutropenia being dose-limiting. Studies are ongoing with the use of both iv and oral formulations and in combination with other chemotherapeutic and biologic agents.Keywords: ixabepilone, epothilone, metastatic breast cancer, taxane-refractory

  17. Total cost comparison in relapsed/refractory multiple myeloma.

    Science.gov (United States)

    Durie, Brian; Binder, Gary; Pashos, Chris; Khan, Zeba; Hussein, Mohamad; Borrello, Ivan

    2013-01-01

    Advances in survival in multiple myeloma have focused payer attention on the cost of care. An assessment was conducted to compare the costs of two recent treatments for relapsed/refractory multiple myeloma (rrMM), from the perspective of a US payer. An economic model estimated the total costs of care for two guideline-recommended therapies in rrMM patients: bortezomib (BORT) and lenalidomide plus dexamethasone (LEN/DEX). To evaluate total treatment costs, the costs associated with drug treatment, medical resource utilization, and adverse event (AE) management were determined for each regimen over a common 1-year period. Medical costs and grade 3/4 AE costs were based on rates from published literature, package inserts, and fee schedules (US dollars). To evaluate cost per outcome, assessments determined the monthly costs without disease progression based on pivotal clinical trials (APEX [BORT] and MM-009/MM-010 [LEN/DEX]). Univariate sensitivity analyses and alternative scenarios were also conducted. Drug costs for the treatments were very similar, differing by under $10 per day. Medical and AE management costs for BORT were higher by more than $40 per day. Treatment with BORT had annual excess total costs of >$17,000 compared with LEN/DEX. A cost advantage for LEN/DEX was maintained across a variety of sensitivity analyses. Total cost per month without progression was 11% lower with LEN/DEX. This analysis relied on separate studies having similar comparators, populations, and end-points. Actual treatment patterns and costs pre- and post-relapse may vary from the base scenario and sensitivities modeled. The 12-month time frame captures the preponderance of costs for a relapse line of therapy, yet may not reflect the entirety of costs. There is insufficient evidence to determine whether, or how, a difference in the lifetime costs of the two regimens would vary from the 1-year cost difference. While rrMM treatment with BORT and LEN/DEX had comparable drug costs, total

  18. Accelerated Total Lymphoid Irradiation-containing Salvage Regimen for Patients With Refractory and Relapsed Hodgkin Lymphoma: 20 Years of Experience

    Energy Technology Data Exchange (ETDEWEB)

    Rimner, Andreas; Lovie, Shona [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Hsu, Meier [Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Chelius, Monica [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Zhang, Zhigang [Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Chau, Karen [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Moskowitz, Alison J.; Matasar, Matthew; Moskowitz, Craig H. [Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Yahalom, Joachim, E-mail: yahalomj@mskcc.org [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States)

    2017-04-01

    Purpose: We report the long-term results of integrated accelerated involved field radiation therapy (IFRT) followed by total lymphoid irradiation (TLI) as part of the high-dose salvage regimen followed by autologous bone marrow transplantation or autologous stem cell transplantation in patients with relapsed or refractory Hodgkin lymphoma (HL). Methods and Materials: From November 1985 to July 2008, 186 previously unirradiated patients with relapsed or refractory HL underwent salvage therapy on 4 consecutive institutional review board–approved protocols. All patients had biopsy-proven primary refractory or relapsed HL. After standard-dose salvage chemotherapy (SC), accelerated IFRT (18-20 Gy) was given to relapsed or refractory sites, followed by TLI (15-18 Gy) and high-dose chemotherapy. Overall survival (OS) and event-free survival (EFS) were analyzed by Cox analysis and disease-specific survival (DSS) by competing-risk regression. Results: With a median follow-up period of 57 months among survivors, 5- and 10-year OS rates were 68% and 56%, respectively; 5- and 10-year EFS rates were 62% and 56%, respectively; and 5- and 10-year cumulative incidences of HL-related deaths were 21% and 29%, respectively. On multivariate analysis, complete response to SC was independently associated with improved OS and EFS. Primary refractory disease and extranodal disease were independently associated with poor DSS. Eight patients had grade 3 or higher cardiac toxicity, with 3 deaths. Second malignancies developed in 10 patients, 5 of whom died. Conclusions: Accelerated IFRT followed by TLI and high-dose chemotherapy is an effective, feasible, and safe salvage strategy for patients with relapsed or refractory HL with excellent long-term OS, EFS, and DSS. Complete response to SC is the most important prognostic factor.

  19. Mainstreaming culture in psychology.

    Science.gov (United States)

    Cheung, Fanny M

    2012-11-01

    Despite the "awakening" to the importance of culture in psychology in America, international psychology has remained on the sidelines of psychological science. The author recounts her personal and professional experience in tandem with the stages of development in international/cross-cultural psychology. Based on her research in cross-cultural personality assessment, the author discusses the inadequacies of sole reliance on either the etic or the emic approach and points out the advantages of a combined emic-etic approach in bridging global and local human experiences in psychological science and practice. With the blurring of the boundaries between North American-European psychologies and psychology in the rest of the world, there is a need to mainstream culture in psychology's epistemological paradigm. Borrowing from the concept of gender mainstreaming that embraces both similarities and differences in promoting equal opportunities, the author discusses the parallel needs of acknowledging universals and specifics when mainstreaming culture in psychology. She calls for building a culturally informed universal knowledge base that should be incorporated in the psychology curriculum and textbooks. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  20. The relationship between Counseling Psychology and Positive Psychology

    OpenAIRE

    Vossler, Andreas; Steffen , Edith; Joseph, Stephen

    2015-01-01

    The aim of this chapter is to explore the relation between the professional specialty of counseling psychology and positive psychology. Following a brief historical overview of counseling psychology, we explore its theoretical convergence with positive psychology and examine how the ideas from positive psychology have been received by counseling psychologists. We argue that although counseling psychology has its roots in ideas that are consistent with positive psychology, the profession has d...

  1. Outcome of autologous stem-cell transplantation in relapsed or refractory Hodgkin lymphoma patients in a centre from Turkey.

    Science.gov (United States)

    Sucak, Gülsan Türköz; Çakar, Merih Kızıl; Suyanı, Elif; Akı, Zeynep; Altındal, Şermin; Acar, Kadir

    2013-09-01

    The aim of this study is to assess the predictors of outcome in patients with relapsed or refractory Hodgkin's lymphoma (HL) receiving autologous stem-cell transplantation (ASCT) MATERIALS AND METHODS: Fifty-two consecutive patients who received ASCT at the Stem Cell Transplantation Unit of Gazi University Hospital from February 2005 through June 2011 for relapsed or refractory HL were analysed retrospectively Fifty-one patients could be evaluated after transplantation, as one of the patients died in the early post-transplantation period. Complete remission was obtained in 36 (71%), partial remission in 9 (18%), stable disease in 4 (8%), and progressive disease in 2 (3%) patients. After a median follow-up of 22 (range, 0.5-75) months, 46 (88%) patients were alive. The probability of overall survival (OS), progression free survival (PFS) and transplantation related mortality at 5 years were 87, 53, and 2%, respectively. Chemosensitive relapse had a positive impact on both OS and PFS CONCLUSION: ASCT remains to be the standard treatment of relapsed or refractory HL patients. Chemosensitive relapse is the most important prognostic factor determining the outcome of the ASCT.

  2. Identity of psychology, identity and psychology

    Directory of Open Access Journals (Sweden)

    Mirjana Nastran Ule

    2003-09-01

    Full Text Available The article deals with epistemic issues of modern psychology with the starting hypothesis being that scientific psychology must satisfy three main interests: scientific, practical and emancipatory interest. Particularly important is the emancipatory interest, which is based on the social reflection of scientific work and conclusions. Psychological knowledge involves not only neutral descriptions of facts, but also implicit rules, expectations regarding values or norms, and criticism of undesirable behavior. The traditional psychological model attempts to satisfy the scientific interest and partly practical interest, while avoiding emancipatory interest. But I believe modern socio-historical models of psychology to be significant precisely owing to the inclusion of emancipatory interest. The difference between these two models of psychology is most obvious in their perception of identity i.e. individuality. Conventional perceptions follow the logic of "possessive individualism" in which the individual is seen as an autonomous bearer and owner of his/her psychological states and processes. The conventional model of identity supports the modernist concept of the individual as being focused on his/her self or personal identity. Socio-historical models, on the other hand, see the individual as a being embedded in social relations and social interactions, and one who builds and expresses his/her individuality through the reflection on social interactions, discursive practices, and response to the hierarchy of power and social mechanisms of control. According to this model, identity evolves through a series of social constructions which are embodied in the individual and represent him/her in society. Identity thus becomes a notion that combines individuality and social context, subjectivation and objectivation of the individual, and historical and biographical time.

  3. Felbamate as an add-on therapy for refractory partial epilepsy.

    Science.gov (United States)

    Shi, Li Li; Dong, JianCheng; Ni, HengJian; Geng, JinSong; Wu, Taixiang

    2017-07-18

    This review is an update of a previously published review in the Cochrane Database of Systematic Reviews (Issue 7, 2014) on 'Felbamate as an add-on therapy for refractory epilepsy'. Epilepsy is a chronic and disabling neurologic disorder, affecting approximately 1% of the population. Up to 30% of people with epilepsy have seizures that are resistant to currently available drugs. Felbamate is one of the second-generation antiepileptic drugs and we have assessed its effects as an add-on therapy to standard drugs in this review. To evaluate the efficacy and tolerability of felbamate versus placebo when used as an add-on treatment for people with refractory partial-onset epilepsy. For the latest update we searched the Cochrane Epilepsy Specialized Register, CENTRAL, MEDLINE, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform, up to 20 October 2016. There were no language and time restrictions. We reviewed the reference lists of retrieved studies to search for additional reports of relevant studies. We also contacted the manufacturers of felbamate and experts in the field for information about any unpublished or ongoing studies. Randomised placebo-controlled add-on studies of people of any age with refractory partial-onset seizures. The studies could be double-blind, single-blind or unblinded and could be of parallel or cross-over design. Two review authors independently selected studies for inclusion and extracted information. We resolved disagreements by discussion. If disagreements persisted, the third review author arbitrated. We assessed the following outcomes: 50% or greater reduction in seizure frequency; absolute or percentage reduction in seizure frequency; treatment withdrawal; adverse effects; quality of life. We included four randomised controlled trials with a total of 236 participants. Two trials were parallel design, the third had a two-period cross-over design, and the fourth had a three-period cross-over design. Two studies

  4. Effects of low-dose morphine on perceived sleep quality in patients with refractory breathlessness: A hypothesis generating study.

    Science.gov (United States)

    Martins, Rodrigo T; Currow, David C; Abernethy, Amy P; Johnson, Miriam J; Toson, Barbara; Eckert, Danny J

    2016-02-01

    The management of chronic refractory breathlessness is one of the indications for regular low-dose (≤30 mg/24 h) oral sustained release morphine. Morphine may disrupt sleep in some conditions and improve sleep quality in others. This study aimed to determine any signal of regular, low-dose morphine on perceived sleep disruption due to breathlessness and perceived sleep quality. This is a secondary analysis of data from 38 participants with refractory breathlessness (30 male; 33 with COPD) aged 76 ± 0.9 years who completed a double-blind, randomized, placebo-controlled, cross-over study in which they received 20 mg oral sustained release morphine daily and placebo for 4 days each. Participant ratings of sleep disruption due to breathlessness and perceived sleep quality were obtained daily throughout the 8-day trial. Perceived sleep disruption due to breathlessness over the 4-day period ranged between 13% and 32% of participants for placebo and 13% and 26% for morphine, decreasing by each day of the study during the morphine arm. Most participants reported 'very good' or 'quite good' sleep throughout the trial and were less likely to perceive poor sleep quality during the morphine arm (odds ratio = 0.55, 95% confidence interval: 0.34-0.88, P = 0.01). Participants who reported decreased breathlessness during the 4 days on morphine were also likely to report improved sleep quality with morphine (P = 0.039). Four days of low-dose morphine improved perceived sleep quality in elderly participants with refractory breathlessness. Regular low-dose morphine targeted to reduce refractory breathlessness may yield associated benefits by reducing sleep disruption and improving sleep quality. © 2015 Asian Pacific Society of Respirology.

  5. SPORT AND EXERCISE PSYCHOLOGY

    OpenAIRE

    Andy Lane

    2008-01-01

    DESCRIPTION The book introduces the undergraduate psychology student to both academic and professional aspects of Sport and Exercise Psychology. It uses up to date research evidence, established theory and a variety of activities that help the student consider and understand academic and professional aspects of this particular academic discipline. PURPOSE The book aims to provide the undergraduate psychology student with a structured introduction to the subject area and an insight into the th...

  6. Ethnographic Fieldwork in psychology

    DEFF Research Database (Denmark)

    Tanggaard, Lene

    2014-01-01

    It is argued in the present article that ethnographic fieldwork can serve useful methodological ends within psychology and open the discipline to the cultural landscape of psychological phenomena in everyday life in social practices. Furthermore, a positive case is made for the soundness...... of ethnographic fieldwork. That is, rather than disputing the claim that qualitative methods can serve scientific ends, it is argued that ethnographic fieldwork is suitable for studying the constitution of psychological phenomena in social practices across time....

  7. Psychological Intervention of Murophobia

    National Research Council Canada - National Science Library

    Yihun, A; Anand, P; Abebe, F

    2011-01-01

    .... Especially in a country like Ethiopia, where awareness, orientation to mental health and its psychological treatment is undergoing its infancy on account of several reasons, the neurotic disorders...

  8. Center for Deployment Psychology

    Data.gov (United States)

    Federal Laboratory Consortium — The Center for Deployment Psychology was developed to promote the education of psychologists and other behavioral health specialists about issues pertaining to the...

  9. Nonlinear dynamics in psychology

    Directory of Open Access Journals (Sweden)

    Stephen J. Guastello

    2001-01-01

    Full Text Available This article provides a survey of the applications of nonlinear dynamical systems theory to substantive problems encountered in the full scope of psychological science. Applications are organized into three topical areas – cognitive science, social and organizational psychology, and personality and clinical psychology. Both theoretical and empirical studies are considered with an emphasis on works that capture the broadest scope of issues that are of substantive interest to psychological theory. A budding literature on the implications of NDS principles in professional practice is reported also.

  10. Psychological profile of individuals presenting with chronic cough

    Directory of Open Access Journals (Sweden)

    Katrin Hulme

    2017-03-01

    Full Text Available Chronic refractory cough (CRC is a common problem in respiratory clinics. Adverse effects on quality of life are documented in the literature, but relatively little is known about the underlying psychological factors in this patient population. We aimed to investigate the association of psychological factors with chronic cough, comparing CRC to explained cough and non-cough groups. 67 patients attending a specialist cough clinic (CRC, n=25; explained cough, n=42 and 22 non-cough individuals participated. All participants completed the Hospital Anxiety & Depression Scale, Big Five Inventory (Personality, Chalder Fatigue Scale and Patient Health Questionnaire-15. Cough patients also completed the Illness Perception Questionnaire-Revised. Appropriate statistical analyses were used to compare participant groups. Chronic refractory coughers displayed significantly higher levels of anxiety, depression, fatigue and somatic physical symptoms than non-cough participants. Compared to explained coughers, there were higher depression and fatigue scores and significantly more negative illness representations (specifically, strong beliefs regarding negative consequences, lower illness coherence and higher emotional representations. “Explained” coughers reported significantly increased fatigue and somatic symptoms in comparison to non-coughers. The prevalence of fatigue, low mood, negative illness beliefs and increased physical symptom reporting should be considered in consultations and in developing novel interventions for CRC patients.

  11. Public Image of Counseling Psychology: What Introductory Psychology Textbooks Say.

    Science.gov (United States)

    Dixon, David N.; Vrochopoulos, Sam; Burton, Jennifer

    1997-01-01

    Examines the adequacy of descriptions of counseling psychology and its professionals in introductory psychology textbooks compared to the descriptions of other applied areas of psychology. Results indicate that counseling psychology is less represented than industrial or organizational and clinical psychology and more represented than school…

  12. Positive Psychology: Considerations and Implications for Counseling Psychology

    Science.gov (United States)

    Mollen, Debra; Ethington, Lanaya L.; Ridley, Charles R.

    2006-01-01

    Why has the specialty of counseling psychology been overlooked in the larger conversation about positive psychology? Is it reasonable that counseling psychology claims positive psychology as its own? What are some of the problems in defining "positive psychology," and how does the lack of consensus around operationalization thwart discourse on…

  13. The impact of a sport psychology education intervention on physiotherapists

    OpenAIRE

    Heaney, Caroline A.; Walker, Natalie C.; Green, Alison J.K.; Rostron, Claire L

    2017-01-01

    The purpose of this study was to measure the impact of an online sport psychology education module on the attitudes and behaviours of qualified sports physiotherapists in the UK. Ninety-five sport physiotherapists studied either a sport psychology module or a control module, and their attitudes and behaviours towards sport psychology were measured prior to studying the module and at three points over a six-month period following its completion. It was found that those who had studied the spor...

  14. Clomiphene treatment may be effective in refractory episodic and chronic cluster headache.

    Science.gov (United States)

    Nobre, Maria Eduarda; Peres, Mario Fernando Prieto; Moreira, Pedro Ferreira; Leal, Antonio José

    2017-09-01

    To describe the evolution of 15 patients who were treated for difficult-to-control episodic and chronic cluster headaches with clomiphene. Clomiphene treatment was used for seven chronic and eight episodic cluster headache patients. The chronic patients were refractory to the medication being used, and the episodic patients, in addition to being resistant to conventional medication, had longer cluster headache periods, exceeding the average time of previous cluster cycles. Our main analysis was of the time to pain-free, complete remission, and the length of pain-free time and complete remission. Clomiphene was used for 45-180 days. The average time to being pain-free was 15 days and cluster remission was up to 60 days. The average time between being pain-free until cluster remission was 26 days. Clomiphene treatment was significantly efficient. It interrupted chronicity in all patients, suggesting the capability of changing the pattern of attacks. It proved to be safe and well tolerated.

  15. Omeprazole for Refractory Gastroesophageal Reflux Disease during Pregnancy and Lactation

    Directory of Open Access Journals (Sweden)

    John K Marshall

    1998-01-01

    Full Text Available Symptomatic gastroesophageal reflux is a common complication of pregnancy and lactation. However, the safety of many effective medical therapies, including oral proton pump inhibitors, has not been well defined. The administration of oral omeprazole to a 41-year-old female during the third trimester of pregnancy, after ranitidine and cisapride failed to control her refractory gastroesophageal reflux, is reported. No adverse fetal effects were apparent, and the patient elected to continue omeprazole therapy (20 mg/day while breastfeeding. Peak omeprazole concentrations in breast milk (58 nM, 3 h after ingestion were less than 7% of the peak serum concentration (950 nM at 4 h, indicating minimal secretion. Although omeprazole is a potentially useful therapy for refractory gastroesophageal reflux during pregnancy and lactation, further data are needed to define better its safety and efficacy.

  16. Gamma radiography of refractory-lined vessels and components

    Energy Technology Data Exchange (ETDEWEB)

    Lapinski, N. P.

    1978-08-01

    Materials used in coal-conversion systems are exposed to high pressure, high temperature, corrosive and erosive gases, and liquids containing particulate matter. These severe environments necessitate an assessment of the integrity of components to prevent premature failures. Gamma radiography was evaluated as a viable technique for testing such components in the laboratory or after operation in situ. Penetrameters (image-quality indicators) were developed for refractory-lined vessels and transfer lines, and exposure times for various combinations of refractory-steel thicknesses were determined. Radiography with /sup 60/Co was performed on gasifier vessels, combustor vessels, and critical transfer lines in existing pilot plants using the experience gained through laboratory experiments. The results show that gamma radiography is a practical and effective method to detect critical conditions in coal-conversion system components. 18 figures, 3 tables.

  17. Treatment of pediatric refractory Crohn’s disease with thalidomide

    Science.gov (United States)

    Zheng, Cui-Fang; Xu, Jia-Hua; Huang, Ying; Leung, Ying-Kit

    2011-01-01

    AIM: To assess the efficacy and tolerability of thalidomide in pediatric Crohn’s disease (CD). METHODS: Six patients with refractory CD received thalidomide at an initial dose of 2 mg/kg per day for one month, then increased to 3 mg/kg per day or decreased to 1 mg/kg per day, and again further reduced to 0.5 mg/kg per day, according to the individual patient’s response to the drug. RESULTS: Remission was achieved within three months. Dramatic clinical improvement was demonstrated after thalidomide treatment. Endoscopic and pathological improvements were also observed after thalidomide treatment, which was well tolerated by all patients. CONCLUSION: Thalidomide is a useful drug for pediatric refractory CD. PMID:21455327

  18. Etanercept in refractory lupus arthritis: An observational study.

    Science.gov (United States)

    Cortés-Hernández, Josefina; Egri, Natalia; Vilardell-Tarrés, Miquel; Ordi-Ros, Josep

    2015-06-01

    To investigate the long-term safety and preliminary efficacy of etanercept in patients with refractory lupus arthritis. We evaluated 43 patients in this observational cohort study. All received etanercept (50mg/week) in addition to concomitant immunosuppressive agents. Patient and disease characteristics were collected. Incidence of adverse events and the effect on autoantibody levels were evaluated. Clinical efficacy was measured by the 28-joint count and the SLEDAI-2K scores. Remission of lupus arthritis was defined by a 28-joint score = 0. Clinically inactive systemic disease was defined by a SLEDAI-2K score etanercept reduction. A total of 24 patients discontinued treatment, 12 of them due to clinical remission. Long-term therapy with etanercept was relatively safe and had remarkable long-term efficacy for refractory lupus arthritis. In view of these results, further controlled trials are warranted. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Omeprazole for refractory gastroesophageal reflux disease during pregnancy and lactation.

    Science.gov (United States)

    Marshall, J K; Thompson, A B; Armstrong, D

    1998-04-01

    Symptomatic gastroesophageal reflux is a common complication of pregnancy and lactation. However, the safety of many effective medical therapies, including oral proton pump inhibitors, has not been well defined. The administration of oral omeprazole to a 41-year-old female during the third trimester of pregnancy, after ranitidine and cisapride failed to control her refractory gastroesophageal reflux, is reported. No adverse fetal effects were apparent, and the patient elected to continue omeprazole therapy (20 mg/day) while breastfeeding. Peak omeprazole concentrations in breast milk (58 nM, 3 h after ingestion) were less than 7% of the peak serum concentration (950 nM at 4 h), indicating minimal secretion. Although omeprazole is a potentially useful therapy for refractory gastroesophageal reflux during pregnancy and lactation, further data are needed to define better its safety and efficacy.

  20. Plasma exchange in cryptogenic new onset refractory status epilepticus.

    Science.gov (United States)

    Li, Judy; Saldivar, Christina; Maganti, Rama K

    2013-01-01

    New onset refractory status epilepticus (NORSE) is a recently described entity and has been difficult to treat because the etiology is often cryptogenic. Our aim in each case was to stop status epilepticus while simultaneously searching for the etiology. We describe three patients who presented with NORSE, who were refractory to multiple anticonvulsants and general anesthetics for at least 5 days. All patients had an extensive evaluation including MRI brain, CSF studies, radiologic scans for malignancy and serological autoimmune and infectious investigations. Each patient responded dramatically to the use of plasma exchange therapy with cessation of status epilepticus by the fourth day of treatment. Although an etiology was sought after, no appropriate cause for NORSE could be found. We propose early use of plasma exchange therapy (Class IV evidence) in hopes to prevent the complications of status epilepticus and prolonged hospitalization. Copyright © 2012 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  1. Combination of interferon and dexamethasone in refractory multiple myeloma.

    Science.gov (United States)

    San Miguel, J F; Moro, M; Bladé, J; Guerras, L; Hernandez, J; Jimenez-Galindo, R; Ortega, F; Gonzalez, M

    1990-01-01

    The present pilot study was designed to analyse the efficacy and toxicity of the association of interferon (IFN) and dexamethasone (Dx) in 32 resistant and relapsed myeloma patients. Among the evaluable cases, 15 (68 per cent) responded to treatment (32 per cent achieved an objective response--OR--and 36 per cent a partial response--PR--), the 'remission' status lasting for more than one year in six of them. Moreover, four out of the seven OR patients showed a reduction in B.M. plasma cells to less than 5 per cent. Five out of 11 patients that were previously refractory to VBAD, that includes high dose dexamethasone (Dx), responded to IFN-Dx. The protocol was generally well tolerated with only four patients discontinuing therapy due to adverse effects. The present results show that the combination IFN + Dx is a promising therapeutic approach for patients with refractory myeloma.

  2. Target therapies for radioiodine refractory advanced thyroid tumors.

    Science.gov (United States)

    Schlumberger, M

    2012-01-01

    A small but not irrelevant percentage of differentiated thyroid cancers become refractory to radioiodine treatment either because they lose the ability of taking up iodine over the time or because, despite a persistent uptaking ability, the effect of the radioiodine is lost in terms of tumor burden reduction. These patients receive only few and transient benefits from other conventional therapies and particularly from chemotherapy. In the last decade, several new drugs have been discovered as potentially useful and tested in clinical trials. They are mainly represented by protein kinase inhibitor molecules that should be proposed to advanced and progressive 131I refractory thyroid cancer patients by enrolling them in clinical trials or by the "off label" use of the drug.

  3. Brentuximab vedotin for relapsed or refractory Hodgkin’s lymphoma

    Directory of Open Access Journals (Sweden)

    Chen R

    2015-03-01

    Full Text Available Runzhe Chen, Baoan Chen Department of Hematology and Oncology (Key Department of Jiangsu Medicine, Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu Province, People’s Republic of China Abstract: Brentuximab vedotin is a promising antibody–drug conjugate (ADC targeting CD30 of tumor cells. It selectively delivers monomethyl auristatin E (MMAE into CD30-expressing cells and induces tumor cell apoptosis. Various clinical trials have provided evidence that it is effective in relapsed or refractory Hodgkin’s lymphoma (HL, and it has also shown its advantages in other CD30-positive lymphomas. In this review, we focus on the structure, mechanisms, and pharmacokinetics of brentuximab vedotin. We also summarize clinical trials with brentuximab vedotin and make recommendations for brentuximab vedotin in the treatment of relapsed or refractory HL. Keywords: lymphoma, CD30-positive, clinical trials, tumor cells, antitumor effects, monoclonal antibody

  4. Chronic, refractory CRPS involving 3 limbs: a case report.

    Science.gov (United States)

    Zyluk, A

    2013-06-01

    We report the case of a 26-year-old woman with CRPS involving consecutively 3 extremities during 8 years. None of the treatments used was effective and each CRPS episode resulted in persistence and chronification of the disease. We suggest that this patient presents a specific subtype of the disease, called "chronic, refractory CRPS" which is extremely severe, disabling and resistant to treatment. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Oral cyclosporine therapy for refractory severe vernal keratoconjunctivitis

    Directory of Open Access Journals (Sweden)

    Nikhil S Gokhale

    2012-01-01

    Full Text Available We report the success of oral cyclosporine therapy in a patient with severe vision-threatening vernal keratoconjunctivitis. A child presented with severe allergy which was not controlled with topical steroids, cyclosporine and mast cell stabilizers. Oral steroids were required repeatedly to suppress inflammation. Child showed a dramatic improvement and stabilization with oral cyclosporine therapy. Oral cyclosporine therapy can be tried in severe vision-threatening allergy refractory to conventional therapy.

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

    OpenAIRE

    Roy-Byrne, Peter

    2015-01-01

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

  7. Refractory plasmonics with titanium nitride: broadband metamaterial absorber.

    Science.gov (United States)

    Li, Wei; Guler, Urcan; Kinsey, Nathaniel; Naik, Gururaj V; Boltasseva, Alexandra; Guan, Jianguo; Shalaev, Vladimir M; Kildishev, Alexander V

    2014-12-17

    A high-temperature stable broadband plasmonic absorber is designed, fabricated, and optically characterized. A broadband absorber with an average high absorption of 95% and a total thickness of 240 nm is fabricated, using a refractory plasmonic material, titanium nitride. This absorber integrates both the plasmonic resonances and the dielectric-like loss. It opens a path for the interesting applications such as solar thermophotovoltaics and optical circuits. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  8. Oral cyclosporine therapy for refractory severe vernal keratoconjunctivitis

    Science.gov (United States)

    Gokhale, Nikhil S; Samant, Rohini; Sharma, Vishnu

    2012-01-01

    We report the success of oral cyclosporine therapy in a patient with severe vision-threatening vernal keratoconjunctivitis. A child presented with severe allergy which was not controlled with topical steroids, cyclosporine and mast cell stabilizers. Oral steroids were required repeatedly to suppress inflammation. Child showed a dramatic improvement and stabilization with oral cyclosporine therapy. Oral cyclosporine therapy can be tried in severe vision-threatening allergy refractory to conventional therapy. PMID:22569387

  9. Low-Chrome/Chrome Free Refractories for Slagging Gasifiers

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, J.P.; Kwong, K.-S.; Powell, C.P.; Thomas, H.; Petty, A.V., Jr.

    2007-01-01

    Gasifiers are containment vessels used to react carbon-containing materials with oxygen and water, producing syngas (CO and H2) that is used in chemical and power production. It is also a potential source of H2 in a future hydrogen economy. Air cooled slagging gasifiers are one type of gasifier, operating at temperatures from 1275-1575º C and at pressures of 400 psi or higher. They typically use coal or petroleum coke as the carbon source, materials which contain ash impurities that liquefy at the gasification temperatures, producing liquid slag in quantities of 100 or more tons/day, depending on the carbon fed rate and the percent ash present in the feedstock. The molten slag is corrosive to refractory linings, causing chemical dissolution and spalling. The refractory lining is composed of chrome oxide, alumina, and zirconia; and is replaced every 3-24 months. Gasifier users would like greater on-line availability and reliability of gasifier liners, something that has impacted gasifier acceptance by industry. Research is underway at NETL to improve refractory service life and to develop a no-chrome or low-chrome oxide alternative refractory liner. Over 250 samples of no- or low-chrome oxide compositions have been evaluated for slag interactions by cup testing; with potential candidates for further studies including those with ZrO2, Al2O3, and MgO materials. The development of improved liner materials is necessary if technologies such as IGCC and DOE’s Near Zero Emissions Advanced Fossil Fuel Power Plant are to be successful and move forward in the marketplace.

  10. Omeprazole for Refractory Gastroesophageal Reflux Disease during Pregnancy and Lactation

    OpenAIRE

    Marshall, John K; Thomson, Alan BR; Armstrong, David

    1998-01-01

    Symptomatic gastroesophageal reflux is a common complication of pregnancy and lactation. However, the safety of many effective medical therapies, including oral proton pump inhibitors, has not been well defined. The administration of oral omeprazole to a 41-year-old female during the third trimester of pregnancy, after ranitidine and cisapride failed to control her refractory gastroesophageal reflux, is reported. No adverse fetal effects were apparent, and the patient elected to continue omep...

  11. Plasmapheresis in a Patient With "Refractory" Urticarial Vasculitis

    OpenAIRE

    Kartal, Ozgur; Gulec, Mustafa; Caliskaner, Zafer; Nevruz, Oral; Cetin, Turker; Sener, Osman

    2012-01-01

    Immune complexes are found in the circulation of 30%-75% of patients with urticarial vasculitis and much evidence supports the role of these immune complexes in the pathogenesis of urticarial vasculitis. Plasmapheresis is effective for removing these immune complexes; however, there are few reports on the use of plasmapheresis in the treatment of urticarial vasculitis. We describe a case of "refractory" urticarial vasculitis in which the symptoms improved after plasmapheresis treatment. We su...

  12. ROSA DAMASCENA OIL: AN ADJUNCTIVE THERAPY FOR PEDIATRIC REFRACTORY SEIZURES

    OpenAIRE

    F. Ashrafzadeh MD; H. Rakhshandeh MD; E. Mahmodi MD

    2009-01-01

    ObjectiveSeveral investigations have demonstrated that Rosa damascena has an inhibitory effect on the hypothalamus and on pituitary system reactivity in the rat; it has also been shown that the essential oil of Rosa damascena has significant antiepileptic effects on pentylentetrazole (PTZ) induced seizures in rats. We aimed at assessing the effects of the essential oil of Rosa damascena when used as an adjunct treatment to treat children with refractory seizuresMaterials and MethodsIn this do...

  13. Influence of the phase composition of refractory materials on creep

    OpenAIRE

    Terzić A.; Pavlović Lj.; Milutinović-Nikolić A.

    2006-01-01

    In this paper, the relationship between the creeping effect and mineralogical characteristics of the applied binding phase for various refractory materials (high-alumina materials, with high or low impurity content, tar bonded either magnesite or dolomite materials and silicate bonded chrom-magnesite materials) is presented. The mechanism of creeping is analyzed and the activation energy for creep for each investigated material is obtained and discussed. All investigated materials are creep s...

  14. Preoperative Psychological Preparation of Children.

    Science.gov (United States)

    Güleç, Ersel; Özcengiz, Dilek

    2015-10-01

    Surgery and anaesthesia are significant sources of anxiety for children. In the preoperative period, reducing anxiety helps in preventing the negative consequences that may occur after surgery. The predetermined high-risk children in terms of the development of anxiety play an important role in reducing the negative consequences. Recently featured approaches are modelling and coping techniques, although many techniques are used in the preoperative psychological preparation. The use of computer programs in this area may facilitate important achievements, and it needs to support new studies to be performed.

  15. Convulsiones neonatales refractarias Neonatal refractory seizures

    Directory of Open Access Journals (Sweden)

    Jaume Campistol

    2009-01-01

    Full Text Available Las convulsiones del período neonatal y del primer año de vida pueden tener un origen, un tratamiento y un pronóstico muy distintos y serán el neonatólogo y el neuropediatra quienes mejor las conozcan y manejen con mayor experiencia. Existen formas graves de encefalopatía epiléptica del período neonatal como el Sídrome Ohtahara o la encefalopatía mioclónica de Aicardi, con un pronóstico muy reservado y una elevada morbimortalidad. Además existen algunas formas de convulsiones y epilepsias del período neonatal y del lactante joven que no responden al empleo de fármacos antiepilépticos (FAEs. En esta situación el iniciar precozmente otro tipo de terapia puede evitar el deterioro neurológico que, sin duda debido a las crisis convulsivas, se producirá y podrá permitir al paciente llevar una vida normal con la única obligación de tomar de por vida una medicación distinta de los FAEs. Revisamos el grupo de defectos metabólicos que dan lugar a convulsiones y epilepsias y cuyo tratamiento es muy distinto al de una epilepsia. Incluimos en esta revisión algunas formas de convulsiones y epilepsias del lactante joven que tienen en la actualidad tratamiento efectivo mediante sustancias totalmente distintas de los FAEs.Convulsions appearing in the neonatal or first year of life can have a very different origin, treatment or prognosis and it shall be up to the neonatologist or neuropediatrician to resolve the problem since they are the ones who know their patients best. There are severe forms of epileptic encephalopathy in the neonatal period such as Ohtahara syndrome or Aicardi myoclonic encephalopathy with poor prognosis and high morbimortality. Furthermore, there are forms of convulsions and epilepsies during the neonatal and infant period which do not respond to AED. In such cases, it is important to initiate as soon as possible another type of treatment to prevent a neurological deterioration due to repeated convulsion crises and

  16. Neurocysticercosis: An uncommon cause of drug-refractory epilepsy in North Indian population.

    Science.gov (United States)

    Goyal, Manoj; Chand, Partap; Modi, Manish; Khandelwal, Niranjan; Kharbanda, Parampreet Singh; Lal, Vivek; Singla, Veenu; Sehgal, Rakesh

    2015-11-01

    Being a common cause of epilepsy in endemic areas, neurocysticercosis (NCC) is expected to account for a sizable proportion of patients with drug-refractory epilepsy (DRE) as well. However, data regarding prevalence of DRE in NCC are sparse. This study aimed to determine the prevalence of DRE as well as identification of clinical and radiologic factors that lead to DRE in patients with NCC. This study was conducted in a tertiary-care postgraduate teaching institute in Northern India from July 2011 to July 2013. Two hundred patients with epilepsy due to NCC (definite [n = 59, 29.5%] or probable [n = 141, 70.5%]) based on diagnostic criteria by Del Brutto et al. were enrolled in the study in both a prospective (n = 51 [25.5%]) and a retrospective manner (n = 149 [74.5%]), and were followed for a minimum period of 1 year. Thirteen patients with NCC were found to be refractory to drug therapy. Prevalence of DRE was found to be 65 of 1,000 NCC patients with epilepsy in the present study. The risk factors associated with high risk of DRE were male sex (p = 0.035), older age (p = 0.016), pig-raising practices (p = 0.003), pork eating (p = 0.04), and presence of multiple (>2) (p = 0.0001) or mixed stage lesions (p = 0.007) on neuroimaging. On multivariate analysis, it was found that residing in an area where pig raising is prevalent (p = 0.01) and presence of multiple (>2) (p = 0.004) lesions on neuroimaging are associated with increased risk of DRE. NCC is only rarely associated with the development of DRE. The common risk factors associated with increased chance of DRE include pig-rearing practices and presence of multiple (>2) lesions on neuroimaging. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

  17. Performance Evaluation of Refractory Composite Coatings in Potassium Rich Environment

    Directory of Open Access Journals (Sweden)

    Kristina BRINKIENĖ

    2016-09-01

    Full Text Available A laboratory scale method was used to study the performance of reinforced cement composites in potassium rich environment of biomass combustion. Buckwheat husk (BH was used as potential source of unexploited biomass product applicable as biomass derived fuel. In order to enhance the alkali effect on the properties of the investigated materials, the solution of potassium carbonate (K2CO3 was selected as potassium rich aggressive environment. Two reinforced cement composites as potential repair coatings for restoration of damaged refractory surfaces with different composition of aggregate were used in corrosion tests. Performance of refractory coatings was evaluated by analysing the microstructure of the treated composites as well as mechanical properties. Energy-dispersive X-ray spectroscopy (SEM/EDS and optical microscopy were used to study the microstructure in the corroded region of the refractory coatings. Long term studies in the solution of 1M K2CO3 for 56 months have demonstrated that composite with the additive of fluid cracking catalyst of oil refinery and petrochemical industries is more durable in the potassium rich environment.DOI: http://dx.doi.org/10.5755/j01.ms.22.3.8348

  18. Evaluation of nutritional status in children with refractory epilepsy

    Science.gov (United States)

    Bertoli, S; Cardinali, S; Veggiotti, P; Trentani, C; Testolin, G; Tagliabue, A

    2006-01-01

    Background children affected by refractory epilepsy could be at risk of malnutrition because of feeding difficulties (anorexia, chewing, swallowing difficulties or vomiting) and chronic use of anticonvulsants, which may affect food intake and energy metabolism. Moreover, their energy requirement may be changed as their disabilities would impede normal daily activities. The aim of the present study was to evaluate nutritional status, energy metabolism and food intake in children with refractory epilepsy. Methods 17 children with refractory epilepsy (13 boys and 4 girls; mean age 9 ± 3,2 years; Body Mass Index 15,7 ± 3,6) underwent an anthropometric assessment, body composition evaluation by dual-energy X-ray absorptiometry, detailed dietetic survey and measurement of resting energy expenditure by indirect calorimetry. Weight-for-age, height-for-age (stunting) and weight-for-height (wasting) were estimated compared to those of a reference population of the same age. Results 40% of children were malnourished and 24% were wasted. The nutritional status was worse in the more disabled children. Dietary intake resulted unbalanced (18%, 39%, 43% of total daily energy intake derived respectively from protein, lipid and carbohydrate). Adequacy index [nutrient daily intake/recommended allowance (RDA) × 100] was nutritional assessment and management as part of their overall care. PMID:16640779

  19. Advances in multidisciplinary individualized treatment of refractory hepatic alveolar echinococcosis

    Directory of Open Access Journals (Sweden)

    ABUDUAINI Abulizi

    2015-04-01

    Full Text Available Hepatic alveolar echinococcosis (HAE is a zoonotic parasitic disease that seriously threatens the population in western China and compromises patients′ quality of life. With the continuous improvement in radical resection rate in recent years, late-stage HAE patients that were incurable in the past now have the opportunity for radical resection. However, patients who are not suitable candidates for radical resection still suffer from various complications and poor quality of life. Therefore, HAE is still considered a refractory and complex disease. The simple empirical treatment model provided by traditional professional discussion is unable to satisfy the treatment of advanced refractory HAE as it is unable to integrate specialized, standardized clinical skills for diagnosis and treatment. Multidisciplinary individualized treatment (MDT organically integrates the advantages of the available treatment into a reasonable individualized comprehensive treatment regimen. This review summarizes the advances in MDT for HAE as the best option to increase long-term survival, and suggests MDT as the first-line treatment for late-stage refractory hepatic alveolar echinococcosis.

  20. Super Refractory Status Epilepticus in Hashimoto’s Encephalopathy

    Directory of Open Access Journals (Sweden)

    Mujahid Al-Busaidi

    2017-05-01

    Full Text Available We present a case of a 38-year-old woman who was at eight weeks of gestation and was admitted to Sultan Qaboos University Hospital with refractory status epilepticus (SE. She presented with a two-day history of fever and a depressed level of consciousness that was followed with generalized tonic-clonic seizures. She progressed to refractory SE that required intubation and mechanical ventilation. Autoimmune workup was suggestive of Hashimoto’s encephalopathy (HE as suggested by the high levels of thyroid antibodies. Her magnetic resonance imaging showed bilateral hippocampal and basal ganglia hyperintensities, and electroencephalogram showed bilateral frontal epileptiform discharges. Other autoimmune workup was negative. Intravenous anesthetics were started including propofol, midazolam, ketamine, and thiopentone. She was started on multiple immunosuppressive therapies. Multiple antiepileptics were used including phenytoin, lamotrigine, levetiracetam, sodium valproate, clobazam, phenobarbital, and lacosamide. The outcome was unusual in terms of refractoriness to immunotherapy treatment despite a confirmed diagnosis. We did a literature review of all cases with HE presenting with SE with their clinical characteristics and outcome.

  1. Refractory metal alloys and composites for space nuclear power systems

    Science.gov (United States)

    Titran, Robert H.; Stephens, Joseph R.; Petrasek, Donald W.

    1988-01-01

    Space power requirements for future NASA and other U.S. missions will range from a few kilowatts to megawatts of electricity. Maximum efficiency is a key goal of any power system in order to minimize weight and size so that the Space Shuttle may be used a minimum number of times to put the power supply into orbit. Nuclear power has been identified as the primary power source to meet these high levels of electrical demand. One method to achieve maximum efficiency is to operate the power supply, energy conservation system, and related components at relatively high temperatures. For systems now in the planning stages, design temperatures range from 1300 K for the immediate future to as high as 1700 K for the advanced systems. NASA Lewis Research Center has undertaken a research program on advanced technology of refractory metal alloys and composites that will provide baseline information for space power systems in the 1900's and the 21st century. Special emphasis is focused on the refractory metal alloys of niobium and on the refractory metal composites which utilize tungsten alloy wires for reinforcement. Basic research on the creep and creep-rupture properties of wires, matrices, and composites are discussed.

  2. Obinutuzumab for relapsed or refractory indolent non-Hodgkin's lymphomas.

    Science.gov (United States)

    Gabellier, Ludovic; Cartron, Guillaume

    2016-04-01

    The use of anti-CD20 monoclonal antibodies (mAbs), such as rituximab, in CD20-positive B-cell malignancies has dramatically improved the outcome of chronic lymphoid leukemia and non-Hodgkin's lymphomas (NHL). However, the occurrence of relapse and development of rituximab-refractory disease highlight the need to develop novel anti-CD20 mAbs, with improved mechanisms of action. Obinutuzumab is the first humanized type II glycoengineered anti-CD20 mAb. In vitro and in vivo data suggested several differences compared with rituximab, including a low level of complement-dependent cytotoxicity and an increased direct nonapoptotic cell death. Moreover, the glycoengineered Fc-linked nonfucosylated oligosaccharide enhanced the Fc-Fcγ receptor (FcγR) IIIa interaction, resulting in improved antibody-dependent cellular cytotoxicity and phagocytosis. Preclinical models suggested that these differences translate into superior survival in murine lymphoma models. Phase I/II trials in monotherapy in relapsed or refractory B-cell NHL demonstrated that obinutuzumab has an acceptable safety profile, infusion-related reactions being the most common adverse event. In rituximab-refractory indolent NHL, the recent randomized phase III GADOLIN study demonstrated an improved median progression-free survival for patients treated with obinutuzumab plus bendamustine rather than bendamustine alone. Further trials are ongoing to determine the role of obinutuzumab as a first-line agent in the treatment of follicular lymphoma.

  3. Refractory gastric antral vascular ectasia: a new endoscopic approach.

    Science.gov (United States)

    Zulli, C; Del Prete, A; Romano, M; Esposito, F; Amato, M R; Esposito, P

    2015-11-01

    Gastric antral vascular ectasia (GAVE) is an uncommon disorder observed in patients with liver cirrhosis, causing upper gastro-intestinal haemorrhage. GAVE is diagnosed through esophagogastroduodenoscopy and is characterized by the presence of visible columns of red tortuous enlarged vessels along the longitudinal folds of the antrum (i.e., so-called watermelon stomach). Pharmacological, endoscopic and surgical approaches have been proposed for the treatment of GAVE. Endoscopy represents the gold standard for GAVE treatment. The most widely used endoscopic approach is represented by Neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. Argon plasma coagulation (APC) has been proven to be more efficient in terms of costs and complication rates than and equally effective as Nd:YAG. Other endoscopic procedures proposed for this treatment are banding ligature (EBL) and sclerotherapy with Polidocanol. Refractory GAVE represents a therapeutic challenge because it may cause persistent anemia, often leading to repeated blood transfusions due to the inefficacy of pharmacological and endoscopic therapeutic approaches. Endoscopic band ligation (EBL) has been shown to be superior to APC in the treatment of refractory GAVE. Surgical antrectomy by Billroth I anastomosis can be considered in selected cases. In this study, we report a successful endoscopic treatment of refractory GAVE by using a combination of submucosal injection of 1% Polidocanol at the four antral quadrants and subsequent application of APC on the visible antral lesions in two patients.

  4. Adalimumab for the treatment of refractory noninfectious paediatric uveitis.

    Science.gov (United States)

    Muñoz-Gallego, Alicia; Barral, Estefanía; Enríquez, Eugenia; Tejada, Pilar; Barceló, Ana; de Inocencio, Jaime

    2017-06-01

    To report the experience of our center with the use of adalimumab (ADA) for the treatment of severe refractory noninfectious paediatric uveitis. The study is a retrospective case series of all paediatric patients with refractory uveitis who were treated with ADA at the Paediatric Uveitis Unit of our center from 2008 to 2015. We present 12 patients (6 Juvenile idiopathic arthritis-associated uveitis, 4 idiopathic panuveitis, 1 early-onset sarcoidosis-associated panuveitis, and 1 intermediate uveitis), with uveitis in 19/24 eyes. Once ADA therapy was started, all the patients presented improved activity according to Standardization of Uveitis Nomenclature (SUN) criteria. Nine out of the 12 patients had structural damage before ADA could be started: cataract (n = 4), glaucoma (n = 2), cystic macular edema (n = 1), exudative retinal detachment (n = 1), and optic disk edema (n = 5). Visual acuity improved or maintained stable in 17/19 affected eyes, and only 2 eyes decreased its visual acuity because of structural damage, which was already present before ADA therapy. In our experience, ADA presents a good safety profile and is efficacious in the treatment of paediatric patients with different forms of refractory noninfectious uveitis.

  5. Efficacy and tolerability of levetiracetam for pediatric refractory epilepsy.

    Science.gov (United States)

    Muramatsu, Kazuhiro; Sawaura, Noriko; Ogata, Tomomi; Makioka, Nishiki; Tomita, Keiko; Motojima, Toshino; Ida, Kuniko; Hazama, Kyoko; Arakawa, Hirokazu

    2017-03-01

    Levetiracetam has a high tolerability and is effective against various seizure types and epilepsy syndromes. However, no study has specifically evaluated the efficacy of levetiracetam in children with refractory epilepsy based on magnetic resonance imaging (MRI) findings and the presence of intellectual disability (ID). We retrospectively evaluated levetiracetam efficacy and safety in 49 pediatric patients who met the following inclusion criteria: (1) diagnosis of refractory epilepsy with first-line antiepileptic (AED) treatment ⩾2years, (2) younger than 20years old, and (3) received oral levetiracetam treatment for ⩾6months. We assessed the relationships of these outcomes with MRI findings and ID status. Eighteen (37%) patients achieved a ⩾50% reduction in seizure frequency, and the majority (78%) had no remarkable side effects. Twenty-two (45%) patients had previously been treated with more than seven antiepileptic drugs prior to levetiracetam. Among 18 patients who achieved a ⩾50% reduction in seizure frequency, 13 and 5 had negative and positive MRI findings, and 9 and 9 had and did not have ID, respectively. Our findings suggest that even for intractable pediatric cases with symptomatic etiology (i.e., MRI lesion and ID), levetiracetam has favorable efficacy for refractory epilepsy with tolerable adverse effects. Copyright © 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  6. Role of rectal myomectomy in refractory chronic constipation

    Directory of Open Access Journals (Sweden)

    Rajeev G Redkar

    2012-01-01

    Full Text Available Background: To assess the role of diagnostic and therapeutic value of anorectal myectomy in cases of chronic refractory constipation. Materials and Methods: Twenty-eight patients 11 months to 9 years of age presenting with chronic constipation, with contrast enema showing dilated rectum and sigmoid colon were included in the study. Anorectal myectomy under general anaesthesia was carried out in these selected patients and were followed-up for up to 6 months to 5 years. Clinical improvement was measured by post-operative bowel habits and relief of symptoms. Results: Twenty-two patients improved clinically; partial response in 4 patients, no response in 2 patients. Two patient required further pull through surgery and was found to have transition zone at the recto-sigmoid level. Ten patients had aganglionosis (of which 5 had ganglion cells present in the proximal part of speciment, 7 had normal histology, 7 had hypoganglionosis, 2 had intestinal neuronal dysplasia, one had nerve hypertrophy and one had immature ganglia. Conclusion: Anorectal myectomy is an effective and technically simple procedure in selected patients with chronic refractory constipation, for both diagnostic and therapeutic purpose. Because apart from confirming Hirschsprung′s disease, it also therapeutically relieves symptoms in 93% of patients with chronic refractory constipation.

  7. Absent menstrual periods - primary

    Science.gov (United States)

    Primary amenorrhea; No periods - primary; Absent periods - primary; Absent menses - primary; Absence of periods - primary ... nutrition Tumors In many cases, the cause of primary amenorrhea is not known.

  8. The psychology of thinking, animal psychology, and the young Karl Popper.

    Science.gov (United States)

    Ter Hark, Michel

    2004-01-01

    In the 1920s, Karl Popper wrote two large manuscripts on psychology that he never published. In his autobiography, Unended Quest, he attempts to reduce the importance of his work in psychology as much as possible, and in his philosophical work he is an antipsychologist. However, in this article, it is argued that Popper's early psychology has been pivotally important for the development of his philosophy. In particular, it is shown that Popper's views on psychology underwent a radical shift, one that paved the way for his characteristic deductive stance in philosophy. Popper's views shifted from an inductive and associationistic psychology toward a noninductive psychology of problem solving. Tracing the historical background of Popper's early work reveals how he integrated various parts of the psychology of Karl Groos into his analysis of the childish phenomenon of dogmatic thinking and how he shortly after appropriated various elements of the animal psychology of Hans Volkelt and Herbert Jennings in his biological approach to (dogmatic) thinking. In the monumental works of Otto Selz, however, Popper finally found the roots of a noninductive and biological approach to the growth of individual and scientific knowledge. Copyright 2004 Wiley Periodicals, Inc.

  9. Interaction mechanism between refractory and melts in iron bath smelting reduction process

    Directory of Open Access Journals (Sweden)

    Qiu G.B.

    2010-01-01

    Full Text Available The corrosion behavior of three sorts of refractories based on alumina-graphite were studied by immersion tests. The melts included smelting reduction molten slag and corresponding carbon saturated molten iron. The influence of test temperature, FeO content in slag and specimen rotative velocity on the corrosion rate of refractories was examined. By means of SEM and EDS, the microstructure change of the refractories after immersion test in kinds of melts was studied. The morphology of the deteriorated layer showed the corrosion extent of refractories. With the addition of zirconia and titania into the refractories, the corrosion rate changed to some extent. The corrosion rate of three sorts of refractories increased dramatically with the increasing FeO content in smelting reduction slag. Compared with alumina-graphite refractory and alumina-graphite-zirconia refractory, alumina-graphite-titania refractory had stronger corrosion resistance in the smelting reduction conditions. By the results of SEM and EDS, the corrosion mechanism of refractories was developed.

  10. Refractory Trichophyton rubrum infection in lamellar ichthyosis.

    Science.gov (United States)

    Scheers, Christel; Andre, Josette; Thompson, Curtis; Rebuffat, Elisabeth; Harag, Saadia; Kolivras, Athanassios

    2013-01-01

    A 10-month-old boy with congenital lamellar ichthyosis presented with a chronic Trichophyton rubrum infection. There was no history of atopy or immunosuppression, and examination revealed high total immunoglobulin E (IgE) with a positive specific IgE for T. rubrum. Multiple treatments with fluconazole were necessary to control the infection. T. rubrum is present worldwide and is responsible for the vast majority of chronic dermatophytosis. Lamellar ichthyosis is a risk factor for chronic dermatophytosis because of excessive keratin and the barrier defect. A delayed-type hypersensitivity reaction to T. rubrum is associated with cure, whereas immediate hypersensitivity and IgE are not protective and may lead to chronic infection. Atopy and the Th2 profile therefore seem to be associated with chronic dermatophytosis. The association between ichthyosis and atopy is well documented. T. rubrum also has an interesting ability to evade immunity, which helps explain the chronic infection. Finally, in ichthyosis, it is likely that fluconazole has difficulty penetrating the acanthotic stratum corneum, which explains treatment failure. We report this case to alert clinicians to the possible association between lamellar ichthyosis and chronic dermatophytosis and to report the difficulties of management. © 2013 Wiley Periodicals, Inc.

  11. Discursive social psychology now.

    Science.gov (United States)

    Parker, Ian

    2012-09-01

    This paper reviews the progress of discourse-analytic approaches in social psychology from the late 1980s to the present day, with a particular focus on the way conceptual and methodological contributions from within the Discourse and Rhetoric Group at Loughborough University have negotiated a positive role for innovative studies of language in the discipline of psychology. Social psychology has become a key site for the accumulation of a series of empirical studies that have seen the flourishing of a distinctive form of 'discursive social psychology' that has succeeded in moving from the margins of the discipline to a more accepted position. The paper traces this trajectory of discourse analysis from the limits to the centre of social psychology attending to five features that now characterise its contribution to psychology; an emphasis on everyday conversation, a concern with interpersonal interaction, explication of formal sequences; an insistence on empirical claims; and fidelity to the ethos of its host discipline. The paper concludes with some comments on the wider context of this new approach inside psychology today. ©2011 The British Psychological Society.

  12. Psychologism and Instructional Technology

    Science.gov (United States)

    Gur, Bekir S.; Wiley, David A.

    2009-01-01

    Little of the work in critical and hermeneutical psychology has been linked to instructional technology (IT). This article provides a discussion in order to fill the gap in this direction. The article presents a brief genealogy of American IT in relation to the influence of psychology. It also provides a critical and hermeneutical framework for…

  13. Simulation and psychology

    DEFF Research Database (Denmark)

    Dieckmann, Peter; Krage, Ralf

    2013-01-01

    Psychology is relevant for improving the use of simulation in anesthesiology, as it allows us to describe, explain and optimize the interactions of learners and instructors as well as the design of simulation scenarios and debriefings. Much psychological expertise is not used for simulation...

  14. European Psychology Map

    Directory of Open Access Journals (Sweden)

    DANA SCHÖN

    2009-06-01

    Full Text Available The Institute for Psychology Information (ZPID compiled an extensive list of European psycho-logical organizations, comprised of university departments, research institutions, professional associa-tions and publishing houses. The list is available on the ZPID website, together with a web mapping applet that indicates the exact geographical location of the organizations.

  15. Alchemical crossings in Psychology

    Directory of Open Access Journals (Sweden)

    Helton Marculino de Souza

    2014-12-01

    Full Text Available The objective of this article is to discuss the contributions of Alchemy to the field of Psychology, especially for Analytical Psychology as a proposal of an Alchemical Psychology, whose representatives highlighted here are Carl Gustav Jung and James Hillman. It is understood that the knowledge of Alchemy have been applied in various areas such as metallurgy, chemistry, philosophy, and it has a possible application in the field of Psychology. In this sense, it is observed that if to Jung the concepts of Alchemy interlace connections with the knowledge proposed by Analytical Psychology, on the other hand Hillman adopts this knowledge to develop a strategy for use in the field of psychotherapy, proposing to think alchemically. Thus, for this second author in the exercise of Psychology, the meetings with the patient go beyond the application of theories, constituting as a “do-soul” in the office. This is, more than translating symbols, it is proposed to “stay with the image”, with an attention from both the patient and the psychologist for that the words expressed in this dialogue does not become “wordthings” or be reduced to a unique meaning that tends to discard the image. It is hoped, through this work, to promote knowledge of the professionals about the Analytical Psychology and Alchemy Psychology in their connections with Alchemy and its reverberations in the field of psychotherapy in these approaches.

  16. Industrial Psychology in France

    Science.gov (United States)

    de Montmollin, Maurice

    1977-01-01

    The current status of French industrial psychology is evaluated. Within the social and economic context of contemporary France, varying ideologies and scarce resources have created a gap between applied and academic industrial psychology. Personnel practices and systems and organizational research are noted. (Editor)

  17. Virtual Reality in Psychology

    Science.gov (United States)

    Foreman, Nigel

    2009-01-01

    The benefits of using virtual environments (VEs) in psychology arise from the fact that movements in virtual space, and accompanying perceptual changes, are treated by the brain in much the same way as those in equivalent real space. The research benefits of using VEs, in areas of psychology such as spatial learning and cognition, include…

  18. Editorial overview: Evolutionary psychology

    NARCIS (Netherlands)

    Gangestad, S.W.; Tybur, J.M.

    2016-01-01

    Functional approaches in psychology - which ask what behavior is good for - are almost as old as scientific psychology itself. Yet sophisticated, generative functional theories were not possible until developments in evolutionary biology in the mid-20th century. Arising in the last three decades,

  19. Genetics and Developmental Psychology

    Science.gov (United States)

    Plomin, Robert

    2004-01-01

    One of the major changes in developmental psychology during the past 50 years has been the acceptance of the important role of nature (genetics) as well as nurture (environment). Past research consisting of twin and adoption studies has shown that genetic influence is substantial for most domains of developmental psychology. Present research…

  20. Discursive and scientific psychology.

    Science.gov (United States)

    Edwards, Derek

    2012-09-01

    I begin with the origins of Loughborough University's Discourse and Rhetoric Group (DARG), and in particular discursive psychology (DP). Rather than attempting to summarize DP, versions of which are plentiful, the article attempts to clarify various relationships and tensions between DP and other kinds of social psychology, particularly experimental. Common sense psychology is defined as DP's topic rather than rival; the aim is to study how people deploy everyday psychological notions and manage psychological business within talk and text, and what they accomplish by such deployments, rather than trying, as experimental psychology is often characterized as doing, to replace it all with something purportedly better. Claims for DP being particularly interpretative rather than scientific are rejected, by appeal to an 'interpretative gap' between phenomena, data, analysis, and conclusions that all research must manage, that gap being often much larger in quantitative and experimental work. The importance of pursuing causal explanations of psychological phenomena is questioned, and the importance asserted, of discovering, through rigorous empirical and conceptual analysis, the normative bases of human conduct and accountability. ©2012 The British Psychological Society.

  1. Who's Who in Introductory Psychology Textbooks: A Citation Analysis Redux

    Science.gov (United States)

    Griggs, Richard A.; Christopher, Andrew N.

    2016-01-01

    It is important to assess periodically how introductory textbooks portray our discipline because introductory psychology is the most popular psychology course, almost all teachers use textbooks for it, and textbooks play a major role in defining the course for students. To do so, past studies have used textbook citation analyses. We analyzed…

  2. The Status of Cognitive Psychology Journals: An Impact Factor Approach

    Science.gov (United States)

    Togia, Aspasia

    2013-01-01

    The purpose of this study was to examine the impact factor of cognitive psychology journals indexed in the Science and Social Sciences edition of "Journal Citation Reports" ("JCR") database over a period of 10 consecutive years. Cognitive psychology journals were indexed in 11 different subject categories of the database. Their mean impact factor…

  3. Reflections on Educational Psychology in an Emerging Democracy

    Science.gov (United States)

    Eloff, Irma

    2015-01-01

    This paper reflects on the changes in Educational Psychology in South Africa in a ten year period (2005-2015) after the first democratic elections. It shows how Educational Psychology as a scientific discipline, and as a helping profession, has responded to the changing landscape and how the post-democracy years inspired a complete departure from…

  4. School Psychology Review: Looking Back on 2006-2010

    Science.gov (United States)

    Power, Thomas J.; Mautone, Jennifer A.

    2010-01-01

    Information pertaining to outcomes of "School Psychology Review" in relation to goals established by the journal editor for the period of 2006-2010 (Power, 2006) are reviewed. In particular, outcomes with regard to publishing research articles that address the goals of the School Psychology Futures Conference are described. In addition,…

  5. Theorising context in psychology

    DEFF Research Database (Denmark)

    Glaveanu, Vlad Petre

    2014-01-01

    This article aims to address the issue of what context is and how it can be incorporated in psychological theory by using the case study of creativity research. It starts from a basic definition of context as the spatiotemporal continuum that, together with psychological phenomena, constitutes...... a totality and should be considered a single, integrated whole. As such, contexts are neither subjective, existing only in perception, nor are they a set of variables external to the person, but participate directly in the processes under study in psychology. We can therefore distinguish between “flat......” theorising, one-dimensional and overconcerned with intra-psychological factors, and “3-D” models trying to articulate the psychological, the spatial (sociomaterial), and the temporal. These categories are illustrated by different theoretical approaches to creativity. It is argued here that a cultural...

  6. PSYCHOLOGY. Estimating the reproducibility of psychological science

    NARCIS (Netherlands)

    Krause, Robert Wilhelm; Scholz, Sabine; van Rijn, Hedderik; Wagenmakers, Eric-Jan

    2015-01-01

    Reproducibility is a defining feature of science, but the extent to which it characterizes current research is unknown. We conducted replications of 100 experimental and correlational studies published in three psychology journals using high-powered designs and original materials when available.

  7. Four Social Psychological Lenses for Developmental Psychology

    Science.gov (United States)

    Zittoun, Tania; Perret-Clermont, Anne-Nelly

    2009-01-01

    How can the advances of social and developmental psychology be integrated? This conceptual paper proposes to examine four basic theoretical models of social situations through which learning and development have been observed in the post-piagetian tradition: the psychosocial triangle, the frame, models of transfer and transitions, and models…

  8. Features of Adult Autoimmune Enteropathy Compared With Refractory Celiac Disease.

    Science.gov (United States)

    Sharma, Ayush; Choung, Rok Seon; Wang, Xiao Jing; Russo, Pierre A; Wu, Tsung-Teh; Nehra, Vandana; Murray, Joseph A

    2018-01-04

    Little is known about the features of immune-mediated non-celiac villous atrophies, such as autoimmune enteropathy (AIE). We investigated the demographic, clinical, and histologic features of adults with AIE compared to adults with refractory celiac disease type 1. We also report outcomes of treatment with open-label budesonide. We performed a retrospective case-control of patients with AIE (n=30) seen at the Mayo Clinic (in Rochester, Minnesota) from 2000 through 2015. Patients with refractory celiac disease type 1 who were treated with open-label budesonide served as controls (n=42). Biopsy specimens were reviewed for all patients. We collected demographic, clinical, biochemical and histologic data from patients. We also collected data on responses to open-capsule budesonide from patients with AIE (available from 22 patients) and controls (available from 42 patients); the median duration of follow up was 28 months (range, 0-1421 months). Patients with AIE had a higher proportion of men (60%) and were younger (mean, 44±18 years) than patients with refractory celiac disease type 1 (29% men; P=.002 and mean age, 57±16 years; P=.007). A higher proportion of patients with AIE presented with chronic diarrhea (100%) and weight loss (90%) than patients with refractory celiac disease type 1 (71%; P40 per 100 epithelial cells in 100%) compared with patients with AIE (in 50%) (P=.003). Conventional therapy (systemic steroids) had failed in most patients with AIE (a complete clinical response was reported in only 7 patients) before treatment with open-capsule budesonide was initiated. A clinical response to open-capsule budesonide was reported for 85% of patients with AIE (50% complete response, 35% partial response) compared to 92% of controls (68% complete response, 24% partial response). In a retrospective study of 30 patients with AIE, followed for a median 28 months, we found this disease to have has distinct demographic, clinical, and histologic characteristics

  9. Sub-micrometer refractory carbonaceous particles in the polar stratosphere

    Science.gov (United States)

    Schütze, Katharina; Wilson, James Charles; Weinbruch, Stephan; Benker, Nathalie; Ebert, Martin; Günther, Gebhard; Weigel, Ralf; Borrmann, Stephan

    2017-10-01

    Eleven particle samples collected in the polar stratosphere during SOLVE (SAGE III Ozone loss and validation experiment) from January until March 2000 were characterized in detail by high-resolution transmission and scanning electron microscopy (TEM/SEM) combined with energy-dispersive X-ray microanalysis. A total of 4202 particles (TEM = 3872; SEM = 330) were analyzed from these samples, which were collected mostly inside the polar vortex in the altitude range between 17.3 and 19.9 km. Particles that were volatile in the microscope beams contained ammonium sulfates and hydrogen sulfates and dominated the samples. Some particles with diameters ranging from 20 to 830 nm were refractory in the electron beams. Carbonaceous particles containing additional elements to C and O comprised from 72 to 100 % of the refractory particles. The rest were internal mixtures of these materials with sulfates. The median number mixing ratio of the refractory particles, expressed in units of particles per milligram of air, was 1.1 (mg air)-1 and varied between 0.65 and 2.3 (mg air)-1. Most of the refractory carbonaceous particles are completely amorphous, a few of the particles are partly ordered with a graphene sheet separation distance of 0.37 ± 0.06 nm (mean value ± standard deviation). Carbon and oxygen are the only detected major elements with an atomic O/C ratio of 0.11 ± 0.07. Minor elements observed include Si, S, Fe, Cr and Ni with the following atomic ratios relative to C: Si/C: 0.010 ± 0.011; S/C: 0.0007 ± 0.0015; Fe/C: 0.0052 ± 0.0074; Cr/C: 0.0012 ± 0.0017; Ni/C: 0.0006 ± 0.0011 (all mean values ± standard deviation).High-resolution element distribution images reveal that the minor elements are distributed within the carbonaceous matrix; i.e., heterogeneous inclusions are not observed. No difference in size, nanostructure and elemental composition was found between particles collected inside and outside the polar vortex. Based on chemistry and nanostructure

  10. Psychological distress: concept analysis.

    Science.gov (United States)

    Ridner, Sheila H

    2004-03-01

    The term 'distress' is frequently used in nursing literature to describe patient discomfort related to signs and symptoms of acute or chronic illness, pre- or post-treatment anxiety or compromised status of fetuses or the respiratory system. 'Psychological distress' may more accurately describe the patient condition to which nurses respond than does the term 'distress'. Psychological distress is seldom defined as a distinct concept and is often embedded in the context of strain, stress and distress. This creates confusion for nurses attempting to manage the care of people experiencing psychological distress. This paper is a concept analysis of psychological distress based on Walker and Avant's (1995) criteria that identifies the attributes, antecedents, and consequences of psychological distress based upon the findings of the literature review. In addition, empirical references are identified and constructed cases presented. A literature search was conducted using MEDLINE, CINAHL, Ovid, PsychINFO, and Cancer Lit databases over the last 50 years. The purposes of this concept analysis were: (1) to establish the concept of psychological distress as a clear and distinct concept, separate from strain, stress and distress, and (2) to provide nurses with a base of knowledge from which to plan effective clinical interventions. Content analysis of the literature revealed that, although used frequently in health care literature, the origin of the concept of psychological distress has not been clearly articulated and is ill-defined. Psychological distress is a serious problem faced by many of the people whom nurses encounter on a daily basis. An understanding of the concept of psychological distress will help nurses ameliorate this problem in patients. Nursing research related to the exploration of psychological distress is also needed.

  11. Approach to seizures in the neonatal period: a European perspective

    DEFF Research Database (Denmark)

    Vento, M; de Vries, Lisbeth Elvira; Alberola, A

    2010-01-01

    In the neonatal period, seizures rank among the most common neurological symptoms, often indicating an underlying serious neurological condition. It is remarkable that although new tools have been incorporated into the diagnosis of neonatal seizures, there is no consensus about the therapeutic...... the treatment of seizures in the neonatal period in different European institutions. Conclusion: We conclude that phenobarbital is still the initial drug of choice followed by benzodiazepines, except in preterm infants with a birth weight below 1800 g. In refractory seizures, the use of continuous lidocaine...

  12. Evolution of periodicity in periodical cicadas.

    Science.gov (United States)

    Ito, Hiromu; Kakishima, Satoshi; Uehara, Takashi; Morita, Satoru; Koyama, Takuya; Sota, Teiji; Cooley, John R; Yoshimura, Jin

    2015-09-14

    Periodical cicadas (Magicicada spp.) in the USA are famous for their unique prime-numbered life cycles of 13 and 17 years and their nearly perfectly synchronized mass emergences. Because almost all known species of cicada are non-periodical, periodicity is assumed to be a derived state. A leading hypothesis for the evolution of periodicity in Magicicada implicates the decline in average temperature during glacial periods. During the evolution of periodicity, the determinant of maturation in ancestral cicadas is hypothesized to have switched from size dependence to time (period) dependence. The selection for the prime-numbered cycles should have taken place only after the fixation of periodicity. Here, we build an individual-based model of cicadas under conditions of climatic cooling to explore the fixation of periodicity. In our model, under cold environments, extremely long juvenile stages lead to extremely low adult densities, limiting mating opportunities and favouring the evolution of synchronized emergence. Our results indicate that these changes, which were triggered by glacial cooling, could have led to the fixation of periodicity in the non-periodical ancestors.

  13. Advancing further the history of Soviet psychology: moving forward from dominant representations in Western and Soviet psychology.

    Science.gov (United States)

    González Rey, Fernando L

    2014-02-01

    This article discusses the works of some Soviet scholars of psychology, their theoretical positions, and the times within which their works were developed. Dominant representations of Soviet psychology and some of the main Soviet authors are revisited in the light of a blending of facts actively associated with their emergence in both Soviet and Western psychology. From the beginning, Soviet psychology was founded upon Marxism. However, the ways by which that psychology pretended to become Marxist in its philosophical basis were diverse and often contradictory. Other philosophical and theoretical positions also influenced Soviet psychologists. Different moments of that contradictory process are discussed in this article, and through this, I bring to light their interrelations and the consequences for the development of Soviet psychology. This article reinterprets several myths found within Soviet psychology, in which different theoretical representations have become institutionalized for long periods in both Soviet and Western psychology. Particular attention is given to identifying the conditions that presented Vygotsky, Luria, and Leontiev as part of the same paradigm, and which paved the way for a perception of Leontiev and his group as paralleling Vygotsky's importance among American psychologists. Many of the sources that are used in this article were published in Soviet psychology only after the 1970s. Unlike the different and interesting works that began to appear on diverse trends in Soviet psychology, this article details in depth the articulation of topics and questions that still now are presented as different chapters in the analysis of Soviet psychology.

  14. Psychological distress and in vitro fertilization outcome

    Science.gov (United States)

    Pasch, Lauri A.; Gregorich, Steven E.; Katz, Patricia K.; Millstein, Susan G.; Nachtigall, Robert D.; Bleil, Maria E.; Adler, Nancy E.

    2016-01-01

    Objective To examine whether psychological distress predicts IVF treatment outcome as well as whether IVF treatment outcome predicts subsequent psychological distress. Design Prospective cohort study over an 18-month period. Setting Five community and academic fertility practices. Patients Two hundred and two women who initiated their first IVF cycle. Interventions Women completed interviews and questionnaires at baseline and at 4, 10, and 18 months follow-up. Main Outcome Measures IVF cycle outcome and psychological distress. Results Using a binary logistic model including covariates (woman’s age, ethnicity, income, education, parity, duration of infertility, and time interval), pre-treatment depression and anxiety were not significant predictors of the outcome of the first IVF cycle. Using linear regression models including covariates (woman’s age, income, education, parity, duration of infertility, assessment point, time since last treatment cycle, and pre-IVF depression or anxiety), experiencing failed IVF was associated with higher post-IVF depression and anxiety. Conclusions IVF failure predicts subsequent psychological distress, but pre-IVF psychological distress does not predict IVF failure. Instead of focusing efforts on psychological interventions specifically aimed at improving the chance of pregnancy, these findings suggest that attention be paid to helping patients prepare for and cope with treatment and treatment failure. PMID:22698636

  15. Unity within psychology, and unity between science and practice.

    Science.gov (United States)

    Kihlstrom, John F

    2004-12-01

    The unity of psychology as a science is to be found in its definition as the science of mental life, and its explanation of individual behavior in terms of mental states. This disciplinary focus will help negotiate psychology's relations with other disciplines, such as neuroscience and cognitive science. The unity within psychology between science and practice is to be found in a focus on scientific evidence as the source of the status, autonomy, and privileges of professional practitioners. Psychology should avoid the temptations of reductionism, and assert (and enjoy) its twin status as both a biological science and a social science. 2004 Wiley Periodicals, Inc.

  16. Perampanel in patients with refractory and super-refractory status epilepticus in a neurological intensive care unit.

    Science.gov (United States)

    Rohracher, A; Höfler, J; Kalss, G; Leitinger, M; Kuchukhidze, G; Deak, I; Dobesberger, J; Novak, H; Pilz, G; Zerbs, A; Trinka, E

    2015-08-01

    In refractory status epilepticus (SE), because of subcellular maladaptive changes, GABAergic drugs are no longer effective, and the excitatory neurotransmitter glutamate (Glu) plays a major role in seizure perpetuation. Perampanel (PER, licensed since 09/2012) is the first orally active noncompetitive AMPA receptor antagonist for adjunctive treatment of refractory focal epilepsy. We analyzed treatment response, seizure outcome, and adverse effects of add-on treatment with perampanel in patients with refractory status epilepticus in the Neurological Intensive Care Unit (NICU), Salzburg, Austria between 09/2012 and 11/2014 by retrospective chart review. Twelve patients (75% women) with refractory status epilepticus were treated with PER administered per nasogastric tube between 09/2012 and 11/2014. Median age was 75 years [range: 60-91]. The most frequent SE type was nonconvulsive SE (NCSE) with (5/12, 42%) and without coma (6/12, 50%). In seven patients (58%), SE arose de novo, with an acute symptomatic cause in five patients (42%). Cerebrovascular diseases (4/12, 33%) and cerebral tumors (4/12, 33%) were the most common etiologies. Perampanel was given after a median number of four antiepileptic drugs [range: 2-7] and a median time of 1.5 days [range: 0.8-18.3]. In one patient (8%), clinical improvement was observed within 24h and EEG improvement within 60 h after administration of PER, while in another patient (8%), clinical and EEG improvement was observed more than 48 h after administration. Median initial dose was 4 mg [range: 2-12; SD: 4.11], titrated up to a median of 12 mg [range: 4-12] in steps of 2 to 4 mg per day. No adverse effects were reported regarding cardiorespiratory changes or laboratory parameters. Outcomes after SE were moderate disability in five patients (42%), death in three patients (25%), and persistent vegetative state in two patients (17%). Though glutamate plays a major role in seizure perpetuation, the noncompetitive AMPA receptor

  17. Francis Bacon's behavioral psychology.

    Science.gov (United States)

    MacDonald, Paul S

    2007-01-01

    Francis Bacon offers two accounts of the nature and function of the human mind: one is a medical-physical account of the composition and operation of spirits specific to human beings, the other is a behavioral account of the character and activities of individual persons. The medical-physical account is a run-of-the-mill version of the late Renaissance model of elemental constituents and humoral temperaments. The other, less well-known, behavioral account represents an unusual position in early modern philosophy. This theory espouses a form of behavioral psychology according to which (a) supposed mental properties are "hidden forms" best described in dispositional terms, (b) the true character of an individual can be discovered in his observable behavior, and (c) an "informed" understanding of these properties permits the prediction and control of human behavior. Both of Bacon's theories of human nature fall under his general notion of systematic science: his medical-physical theory of vital spirits is theoretical natural philosophy and his behavioral theory of disposition and expression is operative natural philosophy. Because natural philosophy as a whole is "the inquiry of causes and the production of effects," knowledge of human nature falls under the same two-part definition. It is an inquisition of forms that pertains to the patterns of minute motions in the vital spirits and the production of effects that pertains both to the way these hidden motions produce behavioral effects and to the way in which a skillful agent is able to produce desired effects in other persons' behavior. (c) 2007 Wiley Periodicals, Inc.

  18. The effect of various sintering temperature on used refractory towards its physical properties

    Science.gov (United States)

    Sudibyo; Wulandari, Y. R.; Amin, M.; Azhar

    2018-01-01

    The used magnesia refractory from the kiln of cement industry was successfully recycled to new refractory using Kaolin as an adhesive. In this work, the temperatures of sintering were varied from 1000°C to 1500°C. The result shows that the increment temperature effects in sintering process will enhance refractory physical properties such as bulk density, cold crushing strength or pressure strength and thermal conductivity. Meanwhile, the porosity was decreased as the increase of the sintering temperature.

  19. RESULTS OF OUTPATIENT PROGRAM ON EFFECTIVE THERAPY OF REFRACTORY ARTERIAL HYPERTENSION

    OpenAIRE

    M. M. Batyushin; I. V. Derevyankina; M. Z. Gasanov; O. V. Akopova; K. I. Babiyan; Y. N. Boychenko; N. V. Vasilchenko; T. A. Gabysyan; S. Ch. Gayboryan; I. S. Golovatenko; N. M. Demkova; D. O. Dmitriev; E. V. Kirtava; O. L. Kotyankova; G. V. Ludanova

    2015-01-01

    Aim. To increase in efficacy of antihypertensive therapy in patients with refractory arterial hypertension (HT).Material and methods. Patients with refractory HT were revealed during first month of program. The causes of refractory HT were analyzed. Combined antihypertensive therapy was prescribed to reach target level of blood pressure (BP). This therapy lasted 24 weeks and included angiotensin converting enzyme (ACE) inhibitor, thiazid diuretic (indapamide) and dihydropyridine calcium antag...

  20. RESULTS OF OUTPATIENT PROGRAM ON EFFECTIVE THERAPY OF REFRACTORY ARTERIAL HYPERTENSION

    OpenAIRE

    M. M. Batyushin; I. V. Derevyankina; M. Z. Gasanov; O. V. Akopova; K. I. Babiyan; Y. N. Boychenko; N. V. Vasilchenko; T. A. Gabysyan; S. Ch. Gayboryan; I. S. Golovatenko; N. M. Demkova; D. O. Dmitriev; E. V. Kirtava; O. L. Kotyankova; G. V. Ludanova

    2007-01-01

    Aim. To increase in efficacy of antihypertensive therapy in patients with refractory arterial hypertension (HT).Material and methods. Patients with refractory HT were revealed during first month of program. The causes of refractory HT were analyzed. Combined antihypertensive therapy was prescribed to reach target level of blood pressure (BP). This therapy lasted 24 weeks and included angiotensin converting enzyme (ACE) inhibitor, thiazid diuretic (indapamide) and dihydropyridine calcium antag...